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Poll: 80% of Mississippians favor Medicaid expansion

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Poll: 80% of Mississippians favor Medicaid expansion

A wide majority of across partisan and demographic lines support expanding Medicaid to provide health coverage for the working poor, according to a newly released Mississippi Today/Siena College poll.

The poll showed 80% of respondents — including 70% of — either strongly agree or somewhat agree the should “accept federal funds to expand Medicaid.”

The numbers appear to show a continued shift of voter sentiment in what has long been a partisan battle. Mississippi's elected Republican governors and other leaders for the last decade have blocked Medicaid expansion via the Affordable Care Act and the billions in federal dollars that would have come with it. This resistance continues even as struggling hospitals and more citizens in the poorest, unhealthiest state cry for .

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“Yes, I support it,” said Joy Cevera, 60, a Republican voter from Oxford who said she generally supports Gov. Tate Reeves but disagrees with him on Medicaid expansion. Several poll respondents agreed to with Mississippi Today about their responses.

For Cevera, a disability-retired cook, the issue is personal.

“I used to be one of the working poor,” she said. “I watched my son suffer because I couldn't afford medical care for him … He's now 35, and I'm still watching him suffer because he's one of the working poor. There's got to be something done. If other states can do it, why can't we?”

Graphic: Bethany Atkinson

The poll showed large majorities across partisan and demographic lines strongly support the state's hospitals, large and small, being adequately funded and a majority believe state has a responsibility to help poor, working people pay for basic . Vast majorities, including 91% of Republican voters, agree every Mississippian should have access to good health care.

“I think we do have a responsibility as a society to help folks, and sometimes the folks you're helping aren't your favorite folks, but too bad,” said Brad Dickey, 58, an engineer from Southaven who said he votes Republican at least 90% of the time. “The right to live is a basic right … They should expand it. We are an unhealthy state … I tell my friends who say they don't want to give money to people who don't work or can't afford insurance, ‘Yes, but they have children.'

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“They have got to have something, otherwise what they do is go to the emergency room,” Dickey continued. “It would be much more affordable care if done another way. It stresses the hospitals, and yes, we end up paying for it anyway.”

Editor's note: Poll methodology and crosstabs can be found at the bottom of this story. Click here to read more about our partnership with Siena College Research Institute.

Mississippi is one of 11 states to refuse expansion. The decision means the state is refusing about $1 a year in federal funding meant to help poor states provide healthcare, and leaving up to 300,000 working Mississippians without coverage.

Meanwhile, health officials say 38 rural hospitals are in danger of closure, in large part due to eating the cost of providing care to indigent . Some of those hospitals are larger regional care centers, such as Greenwood Leflore Hospital, and even larger metro area hospitals are struggling financially because of uncompensated care costs.

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But 14% of voters, including 23% of Republicans, according to the poll, remain opposed to Medicaid expansion. Some of those, such as small business owner Joseph Allen, 42, of Brandon, see it as an issue of fairness and too much of their tax dollars going to social or entitlement programs.

“I pay for my own insurance myself, and it's a lot of money,” Allen said. “… To me it's like the same old broken record in America. The more you put in, the more you're penalized. The harder you work, the more they take.”

Independent voter Michelle Dukes, 52, a homemaker and caregiver in Edwards, said previously working 15 years in the mental health services field showed Medicaid is a flawed program and “the system needs to be fixed before they expand it.”

For some voters, support of Medicaid expansion comes with caveats and limits.

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“I support it, but in a very specific way,” said Robby Raymond, 47, a heavy equipment operator who supports Gov. Reeves and is friends with him from their hometown in Florence.

“I do believe we need to do more to help the working poor, or the retired,” Raymond said. “… But for the people who are able to work that don't and think they need assistance — what they need is a job. That's our big downfall in this whole country, that we don't do enough to help the people that need help, and do too much for the people who don't need it … I've been fortunate and always had a good job, made good money and had insurance. But there's lots of people I know that struggle.

“I do disagree with Tate Reeves (on Medicaid expansion), but I still talk with him a couple of times a year, and I know that he also shares my viewpoint that we should do more to help our retired and our working poor,” Raymond said.

Tim Moore, president of the Mississippi Hospital Association and advocate for Medicaid expansion, said he was not surprised to see widespread support for expansion, but the numbers were a little higher than he would have expected.

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“I have for a long time thought it's at least 65%-70%, simply because of the high numbers we got on our last poll just with Republican voters,” Moore said. “An overwhelming majority of Mississippians support it. I don't know how our leadership ignores that.”

Moore said MHA participated in polling in 2019, gearing up for a ballot initiative drive for voters to force Medicaid expansion over legislative reluctance. But the state Supreme Court, in a ruling on medical marijuana, invalidated the state's ballot initiative system and lawmakers have yet to restore that right to voters.

Moore noted that South Dakota, like Mississippi, was long a hold out on Medicaid expansion because of partisan politics. South Dakota voted 56% to 44% last year to expand Medicaid.

“South Dakota is also a very red state,” Moore said. “Their governor made a public statement that she didn't support it, but if that's what South Dakotans wanted, she would put it in place.

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“I am very encouraged by the numbers this new poll is reflecting,” Moore said. “Mississippi is seeing the need for change.”

State Rep. Tracy Arnold, a conservative Republican from Booneville, said he's not surprised at the support the poll showed for Medicaid expansion. He recently did some informal polling of his constituents on Facebook, and said he estimates support was 90% to 95%, “As long as you're talking about the working poor.”

“I'm not surprised, because that's the only portion of our society that is left out of everything — working people and small business owners,” Arnold said. Arnold said he's interested in “some sort of hybrid,” expansion, perhaps similar to that enacted by Arkansas.

“Maybe have some buy in, like normal insurance with copay for visits and medicines, or even a voucher to let them buy insurance on the private market,” Arnold said. He said he might also support helping seniors who struggle to pay for supplemental insurance for Medicare.

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Arnold said that although the leadership has thwarted voting or debate on Medicaid expansion in recent years, he suspects it will be at least debated when other issues are brought up, such as the Senate's push to expand postpartum coverage for mothers.

“I think people are a little more open minded about it than they were,” Arnold said. “We have a substantial amount of revenue now. We have to help save our struggling hospitals, and this would not only be giving hospitals more funding, it would hep the struggling taxpaying citizen.

“There's only a few states left that haven done this, and it appears to be providing some benefit and services where they have,” Arnold said. “… My position is, I will listen to the people I represent.”

The Mississippi Today/Siena College Research Institute poll of 821 registered voters was conducted Jan. 8-12 and has an overall margin of error of +/- 4.6 percentage points. Siena has an A rating in FiveThirtyEight's analysis of pollsters.

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Click here for complete methodology and crosstabs relevant to this story.

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

Mississippi Today

Thanks to the Super Six, there’s now a shiny, gold ball in Blue Mountain

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Blue Mountain coach Regina Chills (left) and Keyauna Foote hoist the Class 1A Championship trophy. Credit: Keith Warren/MHSAA

For most of this made-for-Hollywood season, the remarkable Blue Mountain girls basketball team has been known as the Super Six. That's because for most of the season there were only six players, three with the last name of Foote.

Rick Cleveland

That explains the Six. The Super? The Blue Mountain Cougars brought a 28-1 record into Thursday night's Class 1A State Championship at Mississippi Coliseum, known as the Big House throughout Mississippi high school basketball. Rarely, if ever, has there been a smaller team in the Big House.

The opponent this night was 26-6 Lumberton, and nothing came easy for Blue Mountain. Nothing ever has for the Cougars, who represent the fourth smallest public school in Mississippi. The three smaller: The Mississippi School for the Deaf, the Mississippi School for the Blind and Piney Woods.

But basketball is big in small schools across northeast Mississippi's Hill Country, and that's especially true in Blue Mountain where there aren't enough to field a football team. The school also recently has dropped and softball due to the lack of players.

Keyauna Foote (right) with her proud daddy, Dominique Foote.

“We're a little school in a little bitty town,” said Dominique Foote, a former Blue Mountain Cougar and proud father of Keyauna Foote, the team's star player and Miss Basketball for Class 1A.

About 800 folks live in Blue Mountain. There are 66 – boys and girls, combined – in grades 7 through 12. The Cougars play their home games on a gym floor that is roughly about three-quarters the size of a regulation basketball court. Put it this way: A player with big feet can't shoot a three-pointer from the corner because the three-point line extends just six inches short of out of bounds.

And even that's not all that's small about the Tippah County town about 34 miles northwest of Tupelo about six miles southwest of Ripley, the county seat.

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“Nope, we don't have any traffic lights in Blue Mountain,” said Regina Chills, the team's coach.

But the town without a traffic light now has one gleaming, gold state championship trophy. Despite many scary moments – and a dogged effort from Lumberton – Blue Mountain prevailed 38-36 in a defensive struggle that turned into an offensive barn-burner in the fourth quarter.

As usual, only the original Super Six played for Blue Mountain, while two more youngsters, promoted from the junior high team late in the season, watched and cheered from the bench. The three Footes, Keyauna and her first cousins A'rare and Beiga, made play after play after play, especially in the fourth quarter.

Keyauna scored 14 points, grabbed seven rounds, blocked two shots and passed out two assists. A'rare scored 11 points and made two steals. Beiga scored seven points and stole the ball three times. So, the three Footes provided 32 of the team's 39 points.

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The bench is a lonely place for the Blue Mountain girls basketball team. Credit: Keith Warren/MHSAA

There were some tense and anxious moments, like when Beiga Foote went down hard after a collision midway through the first quarter and had to the . The Super Six was suddenly down to five. Thankfully, Beiga returned after a short rest to recuperate. Another starter and key player, Ahkeeah Lipsey, drew her fourth foul in the last minute of the third quarter and sat for much of the fourth. But the Cougars kept hustling, kept answering every Lumberton – and there were plenty of those.

“We've done that all season,” Coach Chills said afterward. “Plus this was a championship game. No matter what happens, you have to stay in the game and keep playing.”

Mission accomplished. Baskets were cherished like rare gems through the first three quarters. Blue Mountain led 21-19 into the fourth quarter when both teams started scoring almost at will. Keyauna Foote scored three straight baskets to give the Cougars a five-point midway through, but Lumberton fired back and kept firing back until Keyauna scored what proved to be the winning basket on an in-bounds play with 20 seconds left.

As is always the case in the Big House this time of the year, a wild celebration ensued. If 866 folks live in Blue Mountain, nearly all were present and dancing in the stands.

Hard to say what next for Blue Mountain basketball. Four of the Super Six are seniors and won't be around next year. This year's junior high team was winless.

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“What are you going to do?” someone asked Coach Childs.

She held up her hands as if to dismiss the question. “Right now,” she said, “I'm going to go celebrate.”

No doubt, all of Blue Mountain, bursting with pride, will celebrate with her.

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

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Jackson lawmakers ‘shocked’ after Henifin backs bill depleting local power

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Just over a year into his uniquely powerful role reviving Jackson's water , third-party Ted Henifin is supporting an effort to leave the city without any future control of its water and sewer assets.

Sen. David Parker, R-Olive Branch, authored Senate Bill 2628, a renewed attempt to place the capital city's water and sewer infrastructure under the control of a “Capitol Region Utility Authority.” The measure passed out of its Senate committee last week.

Parker in last year's filed a similar bill, which Henifin, along with Jackson's legislative delegation and city officials, criticized as a power grab by the state. That bill failed in the House.

But in a Feb. 23 press release, Henifin seemingly flipped his narrative on the state's efforts by giving his for SB 2628.

“After reviewing SB 2628, I believe this is a great foundation,” Henifin said in a Feb. 23 press release. “It appears that many of the comments I provided during the last session regarding the bill introduced in 2023 were taken to heart and this bill now includes many of the suggestions I made at that time.”

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Empowered by U.S. District Judge Henry Wingate, Henifin's primary role is to use about $800 million in federal funding to stabilize Jackson's water and, as of last fall, sewer . But the 2022 court order that hired Henifin also asked him to suggest a future governance structure for the water system after his time in charge ends.

While Henifin has yet to make an official recommendation to the court, he last year brought up an idea of creating a corporate nonprofit, similar to what's proposed in SB 2628, but also keeping ownership of the water assets with the city.

While the two versions of the Parker bill are largely similar, the 2024 version strips all power from Jackson city officials to have any say in how their water and sewer systems are run. In the 2023 measure, the newly created utility authority would be governed by a nine-person board. Five appointees would have came from the governor and lieutenant governor, outnumbering the four that would have came from the mayor of Jackson.

While that version left the city with a minority of the board appointments, the 2024 measure goes even further: SB 2628 would give five appointees to the governor, and the remaining four to the lieutenant governor. That would leave who controls a city service in a majority Black, largely Democratic city in the hands of two white Republicans.

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Mississippi reached out to Henifin asking whether he had any concern with the lack of local power being proposed in the Parker bill. The third-party manager responded via e-mail that he has “no dog in the appointment fight.”

“I am agnostic as to who appoints the board,” Henifin said. “The important thing to me is the board seats remain as defined along with the various requirements of all board members — connected to the system, no elected officials, etc.”

But state officials representing Jackson were far from pleased with his support of the bill.

Sen. John Horhn, D-Jackson, told Mississippi Today that no one from the Jackson delegation even knew about Parker's bill until it was introduced at last week's Senate committee meeting. Horhn also said he met with Henifin earlier this week.

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“We met with Mr. Henifin this week to express our dismay with the position that we've been put into by his comments,” Horhn said, explaining that Henifin's support of the bill gives its proponents extra ammunition to argue for it.

On top of the city having no elected officials in charge of the proposed authority, the bill would also allow the authority to purchase the physical assets from Jackson at a “fair market value,” as determined by the federal court.

“It's disrespectful,” Rep. Chris Bell, D-Jackson, said of the bill. “I'm going to do everything I can to try to kill the bill on (the House's) side if it gets here.”

Bell explained that the bill would “dilute” the power of Jackson residents in governing their own utilities. The position from Henifin, who has emphasized building trust with residents as a key to his , left Bell shocked, he added.

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“I was shocked, dismayed, and really left speechless,” the lawmaker said. “That's what I'm more disappointed about than anything, is before he made those statements he should have talked to the (Jackson) delegation first.”

Horhn added that the repeated attempts by the state to power from Jackson officials begs the question: Why have a city government in the first place?

“We saw it with the airport, we saw it with the 1% sales tax, we saw it with the Capitol Complex Improvement District, we saw it with the Capitol Police, and we're seeing it now with the water and wastewater,” Horhn said. “At some point, the city of Jackson won't have any governing it'll be doing at all.”

Under SB 2628, the city's water, wastewater and storm water systems would be governed by the nine-person board, which would consult with the federal court to pick a president that would handle administrative tasks, such as hiring personnel, dealing with the infrastructure. The president would work “at the will and pleasure of the board.”

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The governor's five board appointees would have to include:

  • one employee of a large nonhealthcare business with at least 200 employees working within the service area.
  • an owner of a restaurant in the service area.
  • an employee of a nonprofit within the service area.
  • a member of the clergy leading a place of worship within the service area.
  • and an at-large appointee who lives or works in the service area.

The lieutenant governor's four appointees must include:

  • a small business owner whose primary location is in the service area.
  • an employee of a large facility in the service area.
  • an employee of a post-secondary institution in the service area.
  • and an at-large appointee who lives or works in the service area.

Henifin said there were a few changes to Parker's proposal that earned his support this session: requiring the president to serve as the third-party manager's deputy until Wingate relieves Henifin of his duties; maintaining Henifin and the court's control of federal money received so far; adding specifications as to who can be on the board; and defining the authority's customers as those connected to the Jackson systems as of July 1, 2024.

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

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Lawmakers could limit when county officials in Mississippi can jail people awaiting psychiatric treatment

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This article was produced for ProPublica's Local Network in partnership with Mississippi Today. Sign up for Dispatches to get stories like this one as soon as they are published.

Key Mississippi lawmakers have introduced several bills that would drastically limit when people can be jailed without criminal charges as they await court-ordered psychiatric treatment.

The proposals follow an investigation by Mississippi and ProPublica finding that hundreds of people in the are jailed without charges every year as they go through the civil commitment , in which a judge can force people to undergo treatment if they're deemed dangerous to themselves or others. People who were jailed said they were treated like criminal defendants and received no mental care. Since 2006, at least 17 people have died after being jailed during the commitment process, raising questions about whether jails can protect people in the midst of a mental health crisis.

Civil rights lawyers contend Mississippi's practice is unconstitutional because it amounts to punishing people for mental illness, but the state's civil commitment law allows it. That law spells out the process by which people suffering from severe mental illness can be detained, evaluated and ordered into treatment. Under the law, those people can be held in jail until they're admitted to a state psychiatric hospital or another mental health facility if there is “no reasonable alternative.” If there isn't room at a publicly funded facility or open beds are too far away, local officials often conclude that they have no other option besides jail.

“Putting a person in jail because they're hearing voices and you don't know what to do with them — that's not right,” said state Rep. Kevin Felsher, R-, one of the lawmakers behind legislation to curtail the practice. The news stories, he said, showed that people are jailed for longer than he thought and that Mississippi is unique in doing so.

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The proposals represent the biggest effort to change the state's civil commitment process since at least 2010, according to a review of legislation and interviews with mental health advocates. That year, lawmakers standardized the commitment process across the state and gave county officials the option to call on crisis teams before initiating the commitment process. A measure that would have prohibited jail detentions altogether ultimately failed.

A bill proposed by Felsher would allow jail detentions during the commitment process only for “protective custody purposes and only while awaiting transportation” to a medical facility. It would restrict such detentions to 72 hours. 

A bill authored by House Public Health Chairman Sam Creekmore, R-New Albany, chair of the House Public Health and Human Services Committee, would clamp down on the practice even more, allowing counties to jail people without criminal charges only if they are “actively violent” and for no longer than 24 hours. 

The vast majority of the 2,000 jail detentions in 19 counties analyzed by Mississippi Today and ProPublica lasted longer than 24 hours. About 1,200 lasted longer than 72 hours. (Those figures include detentions between 2019 and 2022 for both mental illness and substance abuse; the legislation would address only the commitment process for mental illness.)

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Rep. Sam Creekmore, R-New Albany, has proposed a bill that would prohibit jail detentions for people going through the civil commitment process unless they are “actively violent” and would limit such detentions to 24 hours. The vast majority of detentions in 19 counties over four years lasted longer than that, according to an analysis by Mississippi Today and ProPublica. (Eric J. Shelton/Mississippi Today) Credit: Eric J. Shelton/Mississippi Today

Creekmore's bill, which passed out of committee without opposition Thursday, aims to reduce unnecessary commitments by generally requiring people to be screened for mental illness before paperwork can be filed to have them committed. Those screenings would be conducted in most cases by community mental health centers — independent organizations, partly funded by state grants, that are supposed to provide mental health care close to home. That bill also would require those organizations to treat people while they're in jail.

A bill authored by Sen. Nicole Boyd, R-Oxford, to increase state oversight of community mental health centers contains language similar to Creekmore's proposal restricting jail detentions. Her bill has been referred to the Judiciary A committee, which is chaired by one of its co-authors, Sen. Brice Wiggins, R-Pascagoula.

The bills would bring Mississippi more in line with other states that allow people going through the civil commitment process to be jailed in limited circumstances. South Dakota permits jail detentions without criminal charges but limits them to 24 hours. Wyoming permits them in an “extreme emergency” and only for 72 hours before a hearing. 

The Mississippi Department of Mental Health says reforming the commitment process is a priority this legislative session. “We don't want someone to have to wait in jail simply because they need mental health treatment,” said Wendy Bailey, director of the agency, at a January conference attended by county officials from all over the state.

But the Mississippi Association of Supervisors, which represents county governments, has raised questions about whether the bills would force county officials to spend more money. Under state law, counties are responsible for housing going through the commitment process until they are admitted to a state hospital. Some local officials contend they don't have any place other than jail to put people.

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“I think you'll find all 82 clerks, all 82 sheriffs, all 400 supervisors understand that the jail is not the place they need to be,” said Bill Benson, who as Lee County's chancery clerk coordinates the commitment process there. “But there has to be a place. If it's not the jail, there has to be a place available.”

Derrick Surrette, executive director of the Mississippi Association of Supervisors, said county leaders are “all for” keeping people out of jail while they wait for mental health care. But, he said, they're concerned that they'll be forced to pay for treatment in private facilities because there aren't enough publicly funded beds. None of the proposals would expand publicly funded treatment beds, nor would they provide funding to counties. The association hasn't taken a position on the bills to limit jail detentions.

“It's a whole lot of legislation being proposed telling the county and a regional mental facility what to do,” Surrette said. “Is there very much in there telling what the state shall do?”

The Department of Mental Health advises local officials to direct people who need help to outpatient mental health care when appropriate and to rely on the civil commitment process only when needed. If the commitment process can't be avoided, the department says officials should work with their local community mental health centers to seek alternatives to jail.

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A padded cell used to hold people awaiting psychiatric evaluation and court-ordered treatment at the Adams County jail in Natchez, Mississippi. Lacey Robinette Handjis, a 37-year-old hospice care consultant and mother of two, was found dead in one of the jail's two padded cells in late August, less than 24 hours after she was booked with no criminal charges to await mental health treatment. Credit: Eric Shelton/Mississippi Today

The state has expanded the number of beds in crisis stabilization units, which are designed to provide short-term treatment in a less restrictive setting than state hospitals. Chancery clerks and sheriff's deputies complain that those facilities frequently refuse to accept people they deem to be violent or in need of additional medical care, though state data shows those refusals are declining. 

An additional bill filed by Felsher would require counties to pay for care at a medical facility if a judge has ordered someone into treatment, no publicly funded bed is available and the person can't pay for treatment. Although the Mississippi Association of Supervisors hasn't taken a position on that bill, either, it opposed a similar provision last year because the measure didn't provide any funding.

At a hearing in November 2022, Felsher asked Benson, the chancery clerk in Lee County, whether he would support his county paying hospitals to treat residents as an alternative to jail. Benson responded that if he did, “My supervisors would hang me.”

Benson said in an interview that it costs just $40 a day on average to jail someone in Lee County. By contrast, Neshoba County, which is among those that contract with private providers, pays between $625 and $675 a day to Alliance Health Center to treat county residents when no public bed is available.

Felsher said he hopes to expand the availability of public treatment facilities so counties aren't on the hook except in rare circumstances. But he also said he believes the cost of alternatives can't justify jailing people who haven't been charged with crimes.

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“We can't send people with mental illness to jail because the county doesn't want to pay for it,” he said. “If it is a fight, it's a fight that I will have. We may not win it, but we'll have it.”

Staffers with Disability Rights Mississippi say the bills don't go far enough because they don't ban jail detentions outright. At least a dozen states, including neighboring Alabama, and Tennessee, have done so.

Without such a ban, Disability Rights Mississippi staff say they're planning to sue the state and some counties, alleging the practice is unconstitutional. A federal lawsuit in Alabama led to a ruling in 1984 prohibiting the practice there.

“Mississippi Today's reporting has revealed the horrifying scope of this problem, including those who have met an untimely and data to back it up,” said Polly Tribble, the organization's director. “I hope that, in light of these dire situations, the will be motivated to address these issues.”

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Bailey, head of the state Department of Mental Health, said she was not aware of the possibility of litigation until Mississippi Today asked about it. She said her agency is working to find ways to make sure people get mental health treatment without going through the civil commitment process, and to restrict the use of jail when they do.

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

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