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First HBCU to offer prison education in Mississippi

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Valley State first HBCU to offer prison college program in Mississippi

Incarcerated people at two prisons in the Delta will be able to start earning four-year degrees from Mississippi Valley State University this fall for the first time in more than two decades.  

Valley State’s Prison Educational Partnership Program (PEPP) is part of a growing number of colleges providing classes in prison with Second Chance Pell, a federal program that is restoring access to income-based financial aid for incarcerated people. 

Seven colleges and nonprofits currently offer for-credit college classes and vocational courses in prisons in Mississippi, but PEPP will be the first program run by a Historically Black college in the state. 

Provost Kathie Stromile Golden said that’s significant because while people of any race can participate in the program, in Mississippi, incarcerated people are disproportionately Black. PEPP will be a way for them to form a connection with an institution of the Black community on the outside. 

Stromile Golden said she views prison education as ensuring incarcerated students know their communities haven’t forgotten about them. 

“Many of the people who are incarcerated are parents and relatives of our students,” Stromile Golden said. “It’s in our best interest to do something like this, because these are the very same people who will come back to our community.” 

The university has accepted about 50 incarcerated students for the first semester of classes at Bolivar County Correctional Facility and the Delta Correctional Facility, a prison in Greenwood for people who violated parole. The Second Chance Pell program is limited to incarcerated students with a high school degree or GED diploma who will eventually be released. 

Rochelle McGee-Cobbs, an associate professor of criminal justice who will be the director of PEPP, worked with faculty and administration over the course of last year to set up the prison education program. She made multiple trips to the prisons to meet with potential students, bringing paper applications because they didn’t have access to computers to apply online. 

The students expressed interest in business administration, computer science and engineering technology courses, so those are the majors that Valley State is planning to offer, McGee-Cobbs said. 

She doesn’t know yet what courses PEPP will offer in the fall, because that will depend on the students’ transcripts, which she drove to Bolivar County on a Thursday in June to collect. 

“Here at Mississippi Valley State University, regardless of where a student is at when they come in, we try to make sure that we nourish them,” McGee-Cobbs said. “We try to make sure that we cater to the needs of each student.” 

Stromile Golden said Valley won’t know until the fall how many faculty are going to teach in the program. Instructors will be paid for travel to the prisons, but the university is working out whether instructors will reach courses as part of their regular load or as an additional class. 

Faculty who elect to participate in the program will receive training from Jamii Sisterhood, a nonprofit that works to increase the number of Black people teaching in prisons. Stromile Golden said the training, which is supported by a grant from Project Freedom, will emphasize culturally competent approaches to teaching incarcerated students without adopting a “savior” mindset, which can be demeaning. 

“Teaching inside is not the same as teaching outside,” she said.

Valley State’s incarcerated students will have access to the university’s counseling and financial aid offices. Stromile Golden and McGee-Cobbs are also working to partner with re-entry programs to assist students when they are released 

College prisons like PEPP, supported by federal financial aid that incarcerated people need to afford classes, were the norm for decades. That changed when President Bill Clinton revoked access to Pell Grants in the 1994 bill as a way to look “tough on crime.” Hundreds of college prison programs shut down, cut off from the public funding that made them viable. 

Over the last 15 years, as incarceration has become more expensive due to the growing population, lawmakers have started revisiting prison education programs, which studies repeatedly have shown reduce recidivism. 

Second Chance Pell, the program Valley State is participating in, was started in 2015 as an “experiment” by President Barack Obama’s administration to give incarcerated people access to Pell Grants. In December 2020, Congress passed a law restoring full access, regardless of a person’s sentence, to Pell Grants. 

In Mississippi, Burl Cain, the Department of Corrections commissioner, has supported prison education programs and restoring access to Pell Grants for incarcerated people as “a huge opportunity to cut costs.” Cain has met with Holmes Community College and Mississippi Gulf Coast Community College, which also participate in the Second Chance Pell program. 

“We need this training and skills in the prison to cut costs because not only do classes keep prisoners focused and calm, we need the training so they can train other prisoners to help us run the prison,” he said in an MDOC press release. 

The emphasis on prison education as a way to reduce recidivism can also be seen in the guidelines for Second Chance Pell. According to a USDOE fact sheet, participating schools should “only enroll students in postsecondary education and training programs that prepare them for high-demand occupations from which they are not legally barred from entering due to restrictions on formerly incarcerated individuals obtaining any necessary licenses or certifications for those occupations.” 

Stromile Golden said that Valley State’s prison education program is also a form of “restorative justice,” an approach to criminal justice that involves addressing how an act of harm has affected a whole community, not just the perpetrator and the victim. 

“For African Americans, this is part of our legacy, and we are all steeped in the Baptist church code that says, ‘forgive, forgive, forgive.’ But for the grace of God, easily any of us could be on the other side of it,” she said. “From my perspective, it’s the right thing to do. It’s needed. It’s a win-win for our community.” 

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

Maximus call center workers continue striking

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Maximus call center workers in Mississippi continue striking for better wages and benefits

Frances Poole says she is still rationing medication from 2019 after doctors raced to save her life by removing her colon. 

Last time she attempted to have the pills refilled at the pharmacy, she said the bill was $70. She should also be having regular checkups with a specialist. 

“I just cannot afford that,” said Poole, 55. 

Poole has spent the last seven years at Maximus Federal in Hattiesburg, a call center contracted by the federal government. All workday, she answers questions about the Obamacare marketplace. Often, she says, the health benefits she’s helping callers with are better than what she has through Maximus. 

That’s why she’s become one of the call center’s most vocal employees, working alongside the Communications Workers of America and its local Hattiesburg chapter to organize Maximus workers. She attended their first strike in March and was back on the picket line for a two-day strike on Monday and Tuesday.

In addition to offering assistance with the Affordable Care Act marketplace, call center workers also handle Medicare inquiries. There are about 10,000 Maximus workers across 11 call centers. Workers in a Louisiana call center also went on strike this week.

Workers say they’ve seen no response from Maximus – the nation’s largest federal contractor – since their first strike in March. Their biggest complaints continue to be benefits and wages. The changes the company made earlier this year to improve pay and aren’t enough, according to workers.

Maximus lowered the health care deductibles from $4,500 to $2,500 after employee pressure began in 2021. 

“But who has $2,500?” Poole said. 

Call center workers make about $15 an hour, leaving most of the Hattiesburg workers with wages between $31,000 to $35,000 a year before taxes. That latest hike came just ahead of a presidential order in January that all federal contract workers be paid $15 an hour. 

Most of the Hattiesburg workers were making between $9 and $11 before the pandemic. 

On Tuesday morning – while dozens of workers, activists and CWA members marched to deliver the second-day strike notice – Maximus leaders held a virtual investors call. 

Maximus CEO Bruce Caswell called the company’s “people its advantage.” 

“Our commitment to make Maximus an employer of choice is not a new goal,” Caswell told investors, as he touted flexibility the company offers with work-from-home options and the recent cuts to health care costs. 

In its second quarter report that came out earlier this month, Maximus reported a revenue increase of 22.7% to $1.18 billion to last year. The company expects revenue for the latest fiscal year to range between $4.5 to $4.7 billion. 

With the costs of essentials like gas and food on the rise, Poole and her coworkers say it has been all the more difficult to stretch each paycheck enough. Their wages, workers say, have never kept up with inflation making it near impossible to build up any sort of meaningful savings. 

“What man or woman or family can survive at $9.05 an hour?” Jaimie Brown, 49, said, referring to his long-held former wage as a Maximus worker. “Seven years I’d been doing this. What makes me not a professional? Why can’t you pay me as a professional?”

Brown said he was regularly assisting insurance brokers do their jobs.

He is a single parent of a 7-year-old son. Many of his former coworkers are single mothers; most are Black. 

Brown’s employment ended with Maximus in March. He filed a complaint against the National Labor Relations Review Board with the help of the CWA, the union Maximus employees are working with. The CWA said in a statement that they’re holding Maxiums accountable for discouraging workers from forming a union. 

Brown declined to comment on the specifics of the complaint and his separation from the company. Maximus said it doesn’t comment on pending litigation, but that it respects workers rights to organize. 

Brown has lived in Mississippi for almost two decades. He was raised in New York, where unions are more common. Organizers and experts across Mississippi have said one of the biggest hurdles organizers face in the South is educating workers on their rights. 

READ MORE: Starbucks employees and others trying to unionize in Mississippi face decades-old hardships

“There’s going to be some ups and downs,” Brown said. “You got to take the bumps with it in order for improvement. It takes a fight … but there will be no benefits unless we all stand up to do this.” 

In a statement, Maximus said it “routinely meets with its employees to address various concerns and issues.” It also says it has an employee hotline where workers can submit issues anonymously. 

CWA said nearly 100 workers went on strike this week in Mississippi. 

“It can all go around,” Brown said, referring to forming a union. “Everyone could win.”

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

Judge Carlton Reeves nominated to become first Black chair of National Sentencing Commission

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Judge Carlton Reeves nominated to become first Black chair of National Sentencing Commission

U.S. District Judge Carlton Reeves, is shown in this photograph taken June 11, 2021, in Greenville, Miss. (AP Photo/Rogelio V. Solis)

U.S. District Judge Carlton Reeves of the Southern District of Mississippi has been nominated by to serve as chair of the U.S. Sentencing Commission.

If confirmed by the U.S. Senate, Reeves will be the first African American to serve as chair of the group that was created in the 1980s to reduce sentencing disparities and promote transparency in criminal sentencing.

Reeves, who has presided over several monumental cases at the federal level, previously served as a clerk, as chief of the civil division in the U.S. Attorney’s Office for the Southern District of Mississippi and in private practice for multiple years.

U.S. Rep. Bennie Thompson, Mississippi’s sole African American and Democratic member of Congress, praised the appointment this week on social media.

“I support the appointment of Judge Carlton Reeves on being named head of the United States Sentencing Commission,” Thompson said. “It is a pleasure to witness the first Black judge to be appointed chair of the commission.”

Reeves is the second African American appointed as a judge in the Southern District of Mississippi. He was nominated in 2010 by then-President Barack Obama.

The Sentencing Commission consists of seven members, but has not had enough members since 2019 to function. That inability to function has caused concern among members of the judiciary since federal judges across the nation rely on the commission’s work to set sentencing guidelines.

The membership of the commission must include three federal judges. No more than four members can be of the same political party.

As a federal judge, Reeves has handled some of the most high-profile cases in Mississippi, including the trial and ultimate conviction of three young white men for brutally murdering a Black man in 2011. He also issued the ruling that legalized gay marriage in Mississippi, has heard numerous cases seeking to limit access in the state, and has been overseeing a challenge to the constitutionality of the state’s mental health system.

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

Delta Council calls for Medicaid expansion

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Influential Delta business group calls for Medicaid expansion

A major economic development organization that represents the 19 Mississippi Delta counties on Monday called for lawmakers to expand

The Delta Council, long a powerful lobby that has the ear of top Republican leaders, is among the state’s first major, non- related organizations to recommend Medicaid expansion. Major medical groups in the state like the Mississippi Hospital Association have supported expansion for years.

The resolution was passed unanimously by Delta Council’s health and education committee. There are around 150 council members on the committee, though not all of them were in attendance.

“While Medicaid expansion is not a complete panacea for individuals, the community’s , health care providers, and employers, it is a critical first step that will benefit all of them in the short and long term,” the resolution reads. 

The resolution was presented to the committee after a special subcommittee studied different options for helping struggling health care facilities in the Delta.

“After we talked to the experts and people in the industry, it became obvious that the best way to do that is to expand Medicaid,” said Wade Litton, chairman of Delta Council’s Economic Development Committee and the leader of the subcommittee. 

Mississippi is one of just 12 states not to expand Medicaid despite an increased federal matching rate under the of 2021 that would provide the state with an extra $600 million per year. 

Gov. Tate Reeves and Speaker of the House Philip Gunn, two of Mississippi’s top elected officials, fiercely oppose Medicaid expansion. Reeves derisively calls it “Obamacare expansion” and has promised to never support it. Both Reeves and Gunn maintain that the state cannot afford it, despite years of legitimate research and economic studies that indicate otherwise.

At least eight expansion bills were filed during the 2022 legislative session, but none were debated or considered before dying in committee. 

If state leaders were to expand Medicaid, at least 225,000 Mississippians would qualify for health care coverage.

READ MORE: ‘It makes it hard to work’: The real cost of not expanding Medicaid in Mississippi

The Delta Council resolution repeatedly refers to the findings of a report from State Economist Corey Miller that showed expanding Medicaid would pay for itself and offer a litany of economic benefits.

According to the report, Medicaid expansion would: 

  • Reduce the uncompensated care costs incurred by hospitals statewide. While these costs hurt each hospital’s bottom line, they have devastated small, rural hospitals Mississippi, particularly in the Delta.
  • Create nearly 11,300 jobs a year between 2022 to 2027. Most of these jobs would be added in the health care and social assistance sector.
  • Increase the state’s gross domestic product by between $719 million and $783 million each year.
  • Increase the state’s population by about 3,300 to 11,500 new residents per year between 2022 and 2027. Mississippi was one of just three states in the U.S. to lose population between 2010 to 2020.

Expanding Medicaid would also help decrease the costs incurred by small businesses across the state in paying health insurance premiums for their employees, according to Litton. High amounts of uncompensated care contribute to hospitals raising the price of care, which then leads insurers to raise premiums. 

The result is a negative feedback loop that ultimately harms those paying for insurance, Litton said. 

Litton also said that Mississippi taxpayers are already helping pay for Medicaid expansion through their federal income taxes, but aren’t seeing any of the benefits from it. 

Medicaid currently covers around 780,000 Mississippians. Those include the disabled, poor pregnant women, poor children and a segment of the elderly population. Medicaid expansion would provide coverage to those making up to 138% of the federal poverty level, or $17,774 annually for an individual.

Tom Gresham, a member of the health and education committee who has previously served as chairman and president of Delta Council, said the passing of the resolution supporting Medicaid expansion shows that the leadership of the business and agriculture communities in the Delta understand the health care needs in their communities. 

“You have to have a healthy workforce and quality medical care for communities to thrive and to grow,” Gresham said.

More people left the Mississippi Delta between 2010 and 2020 than any other area of the state. Gresham said that the much-needed economic boon Medicaid expansion would provide the Delta would help encourage people to stay. 

Getting people insured would also improve access to health screenings and preventative care, resulting in huge savings for individuals, health systems and taxpayers, Gresham said. 

“If we keep somebody from having a stroke, think of the money we save versus if they have a stroke and they have to get on disability,” Gresham said. “That’s how we keep people in the workforce.”

READ MORE: Medicaid expansion would boost economy significantly more than legislative income tax cut, studies show

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

Despite objection from every Black lawmaker, anti-CRT bill passes

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Despite objection from every Black Mississippi lawmaker, anti-critical race theory bill passed to governor

After more than six hours of debate and filibuster with 17 attempted amendments and many passionate floor speeches from Black lawmakers, the Republican and white-majority state House of Representatives passed a bill Thursday entitled, “: prohibit.”

The bill was passed even though the academic theory is not being taught in Mississippi K-12 schools and proponents of the measure assured Black lawmakers it really wouldn’t do anything — other than check a Republican political box.

But the bill has ripped the Band-Aid off the issue of race in the Mississippi Capitol less than two years after the historic vote legislators made to remove the state with a battle emblem in its canton. For hours Thursday, Black lawmakers spoke on the floor about their or their families’ experience with racism, segregation and Jim Crow in Mississippi and urged their white Republican colleagues to vote against the bill.

“If Mississippi wants to go forward in this world’s and be a leader like we say we want to do, then we’ve got to stop this,” said Rep. Chris Bell, D-Jackson. “This is not going to bring a single business to Mississippi. It’s not going to bring a single tourist here.”

The bill passed 75-43 with three white members — two Democrats and an independent — joining all Black lawmakers in against it. The bill now goes to Gov. Tate Reeves, who has said preventing teaching of critical race theory is a top priority for him.

READ MORE: Every Black Mississippi senator walked out as white colleagues voted to ban critical race theory

After hours of debate and questions, it still is not clear what the results of the three-page bill will be if it signed into law by the governor. While the bill’s title says it prohibits the teaching of critical race theory, that phrase is nowhere in the legislation.

When asked by Rep. Zakiya Summers, D-Jackson, whether the bill would prevent the teaching of critical race theory, Rep. Joey Hood, R-Ackerman, responded, “If this piece of legislation is affirmed by this body today, then the tenets … that where any person is considered inferior and superior would not be allowed.”

Hood, who handled the bill on the House floor, repeatedly said all the bill would do is say no university, community college or public school “shall direct of compel students to affirm that any sex, race, ethnicity, religion or national origin is inherently superior or that individuals should be adversely treated based on such characteristics.”

Hood, under constant questioning, conceded he had not studied the origins of critical race theory.

“A lot of people have a lot of different definitions of what critical race is,” said Hood.

Critical race theory has been taught for years, primarily in university settings, as an examination of the impact of systemic racism on the nation. In recent years critical race theory has become a hot-button issue in conservative circles. Both House Speaker Philip Gunn and Reeves, possible opponents in the 2023 Republican gubernatorial primary, have spoken against critical race theory. Reeves has advocated state funds be spent on the teaching of “patriotic” history.

“This bill is only before us so that some of you can go back home and have something to campaign on,” said Rep. Willie Bailey, D-Greenville.

READ MORE: Critical race theory in Mississippi, explained

But opponents said they feared that even if the language of the bill is innocuous, it will have a chilling effect on teaching history — particularly Mississippi’s dark history — and lead to censorship in the state’s classrooms.

“The language means something to me,” Summers said. “… You cannot pass a bill like this and continue the rhetoric that we can all work together.”

While Hood consistently said the bill was meant to prevent anyone from being made to feel superior or inferior, Bailey asked if his white House colleagues should be concerned that all Black members of the House voted against the proposal, just as all Black senators did earlier this session.

“In Mississippi certain things should be off limits,” said Rep. Bryant Clark, D-Pickens, whose father was the first African American elected to the Mississippi Legislature in the 20th Century. “Certain things are hitting below the belt. Certain things should not be brought up. We don’t have to dip water from this well, not in Mississippi … This bill turns my stomach. I know it turns some of y’all’s stomachs as well. We are debating an issue that does not exist in Mississippi … I think it is an insult to the citizens of the state to tell them we have to throw this issue out to you in order to galvanize you — in order to win elections.”

“History in Mississippi can be taught under this legislation,” Hood repeatedly said from the well of the chamber. But overall, Hood had few answers to the dozens of questions he was asked.

And when Black legislators offered amendments designed to try to ensure that history could be taught without any fear of a school losing state funding under the mandates of the bill, the Republican majority voted down those proposals. Other amendments — including ones to honor famous Black musicians, athletes, former President Barack Obama and others — were used more for filibuster and to prove points.

VIDEO: What you need to know about critical race theory in Mississippi

Rep. Shanda Yates, I-Jackson, told Hood that the only critical race theory class being taught in the state was at the University of Mississippi School of Law. When she asked if the class could still be taught if the bill becomes law, Hood responded, “That will be up to .”

Yates offered an amendment, which was voted down by Republicans, that would have added disabilities and sexual orientation to the protected class in the bill.

“If that is the true intent of this bill, that no one is discriminated against or made to feel inferior, then you should vote for this,” Yates said.

When the bill was debated in the Senate earlier this session, all Black members walked out of the chamber before the final vote. On Thursday in the House, Black members voted in unanimity against the bill.

READ MORE: Inside Mississippi’s only class on critical race theory

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

Medicaid expansion opponent proposes federal coverage for sick inmates

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Republican legislators oppose Medicaid expansion, but want federal dollars to pay for prisoner healthcare

State Republicans have balked at expanding Medicaid, but are embracing legislation that would take advantage of the federal program to pay for healthcare for very sick incarcerated people — and likely create a money-making opportunity for nursing homes. 

Senate Bill 2448, which passed the Senate with little opposition and is now with the House Committee, would allow “medically frail” inmates to be paroled to “special care facilities.” These would be specially licensed nursing homes where Medicaid could help pay for their care. 

Sponsor Sen. Brice Wiggins, R-, says his bill would reduce costs for the Mississippi Department of Corrections, which spends about $77 million annually on healthcare for people in its custody. Medicaid won’t pay for healthcare provided inside jails and prisons, so the state pays the full cost of care for very sick and elderly incarcerated people. Currently, only a small number of Mississippians are granted medical parole every year, according to the Department of Corrections — just three were released in 2021.

When Mississippi Today asked for an estimate of the savings, Wiggins said he didn’t have the number offhand but could get it later. He did not respond to subsequent phone calls and text messages.  

Wiggins said he continues to oppose Medicaid expansion, which would save Mississippi an estimated net $200 million by 2027. He declined to explain why.

“I answered your question on the legislation, which is fair,” he said. “And then you jumped into Medicaid. I’m not discussing that.”

Last year, a similar bill passed the Senate and died in the House. 

House Medicaid Committee Chair Rep. Joey Hood, R-Ackerman, did not respond to a request for comment. 

Some prominent proponents of Medicaid expansion in Mississippi are skeptical of the bill.

“If what we’re doing is offloading and giving parole to inmates so they can then get off the state’s dime, and putting them on Medicaid, when we’re not allowing working Mississippians who pay taxes to have the same benefit of healthcare coverage as these inmates who have committed crimes against society, who haven’t paid taxes in years, that’s just wrong,” said Richard Roberson, vice president of state policy for the Mississippi Hospital Association. 

To Roberson, the politics around SB 2448 are puzzling.

“Any time you see something unusual from the Capitol that seems a little out of sorts like this one does, where you have Republicans passing a bill to expand Medicaid to inmates, that seems inconsistent with the ‘no to Obamacare,’ ‘no to Medicaid expansion,’” he said. “That typically tells me that there’s something under the surface somewhere.” 

Senate Bill 2448 defines “medically frail” inmates as those who are “a minimal threat to society” because of their medical condition, who can’t perform daily living activities on their own, and who may have limited mobility because of their condition. Sex offenders and people on row would not be eligible. 

MDOC does not currently use the term “medically frail” to categorize incarcerated people, so the Department could not immediately say how many people might be eligible for parole if SB 2448 became law. 

If the bill were to pass, people could be paroled to “special care facilities” that offer services like other nursing homes, including recreation and spiritual activities as well as medical care. 

“It reduces the cost to the state,” Wiggins said. “It places these inmates in a place to receive medical treatment. And it’s a win-win all around.”

One additional potential winner of the legislation: nursing facilities. By getting licensed as “special care facilities,” they could welcome new patients with guaranteed funding. 

Wiggins said a number of facilities around the state are interested in becoming licensed for the purpose, though he did not say which ones. 

In 2013, Connecticut became the first state to contract with a nursing facility to house people paroled from prisons with serious medical needs. The facility, 60 West, now houses about 40 people paroled from prison, out of a total of about 85 residents. Other residents are considered “hard to place” for other reasons, such as prior criminal history or registered sex offender status. 

David Skoczulek, vice president of business development at iCare Health Network, which operates 60 West, said the facility is “a financially viable model” — that is, profitable for the operator. 

Skoczulek said he was vaguely familiar with the Mississippi proposal because a year or two ago, his company was contacted by someone in Mississippi who wanted to pursue a similar project. He didn’t remember the specifics, but said the Mississippian had an existing property in mind and wanted advice from iCare on turning it into a facility that could care for paroled prisoners, or possibly to pursue a joint venture.

“They were interested in getting it pushed along in the legislature,” Skoczulek said. 

Other states have also followed Connecticut’s example in expanding medical parole to send inmates to nursing homes. That’s the model Wiggins’ bill would emulate. 

Skoczulek said iCare frequently provides information and advice to people in other states seeking to replicate the success of 60 West. The company also operates a similar facility in Massachusetts. 

The Mississippi Association, the state’s largest organization of nursing homes, has not taken a position on the bill. The organization declined to comment for the story. 

The , which would be responsible for licensing the special care facilities, said it had not been contacted by any interested facilities. The agency also said it had not seen an analysis of the bill’s costs and savings. 

After the 1970s, tough-on- policies and harsh mandatory minimum sentencing laws led to an explosion in the number of incarcerated Americans. Now, those policies mean more people are growing old in prison. 

According to a 2012 ACLU report, the number of incarcerated Americans over age 55 quadrupled from 1995 to 2010. By 2030, they could comprise a third of all prisoners. Providing healthcare for an older, sicker prisoner is expensive: In North Carolina, officials estimated the average cost of caring for someone over age 55 was four times that of someone under 55. 

Mississippi currently incarcerates 507 people aged 65 or older, according to MDOC.

To save money, some states have expanded compassionate release policies to send people home, where Medicaid and Medicare can help pay for all of their care.

Mississippi also has a compassionate release policy. People who are 60 years or older or have a severe medical condition with no chance of recovery– a condition that is “incapacitating, totally disabling, and/or terminal in nature”– can qualify for early release. 

But as in many states, Mississippi’s policy is little used. According to MDOC, 10 people were granted parole under the policy in 2019, followed by seven in 2020 and only three last year.

If saving money for the state’s prison system is the goal, there’s another measure that experts say would be even more effective: expanding Medicaid eligibility for all Mississippians. 

In states that have expanded Medicaid coverage, incarcerated people are nearly always eligible because of their limited incomes. Medicaid won’t pay for healthcare provided inside jails and prisons, but it can reimburse states for care that takes place off-site and requires at least a 24-hour stay in a hospital or nursing facility. 

If a healthy 35-year-old incarcerated in Kentucky gets appendicitis and requires a two-day hospital stay, for example, Medicaid can help pay for his care. That saved the state $16.4 million in 2014 and 2015, according to the Pew Charitable Trust. 

In Mississippi, the state picks up the entire tab. MDOC spent $24 million on off-site care in fiscal year 2020.

Dan Mistak, acting president and director of Health Care Initiatives for Justice-Involved Populations at the non-profit Community Oriented Correctional Health Services, said SB 2448 would likely affect only a small number of incarcerated people, limiting the potential savings for Mississippi. 

Not only would broader Medicaid expansion allow MDOC to get reimbursed by for a greater share of medical expenses, it could also help reduce the number of people who wind up in the criminal justice system, Mistak said. Expanding access to mental and behavioral health care and substance use treatment programs could mean fewer people sent to jails and prisons. 

“What this legislator seems to be trying to do is patch this up at the very end of this, at the most expensive side, rather than go upstream and say how do we improve people’s health, and keep them out of prisons,” Mistak said. 

Some states have found that paroling incarcerated people to nursing homes is not as simple as passing a law.  In Colorado, officials have struggled to find nursing homes willing to accept medical parolees because of their criminal records. 

And initially, Medicaid refused to reimburse Connecticut for parolees’ care at 60 West, citing the fact that some residents lived in a secure unit with no medical justification. But the federal government later certified 60 West for reimbursement. 

If a facility resembles a prison, Medicaid won’t pay for a person’s care there.

“If I had you tour both nursing homes right now and didn’t tell you what the mission was, you would have no idea you were in anything other than a standard nursing home,” Skoczulek said. “There are no guards, no gates, no shackles, no lights out, no any of that stuff… We have to preserve resident rights.”

Wiggins, a former prosecutor, told Mississippi Today paroling “convicted felons” to medical facilities was better than paroling them to their homes to be with their families. 

“They gotta serve their time,” he said. “And they would be considered an inmate.”

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

Hosemann wants to shun the term ‘Medicaid expansion.’ Is he appealing to Gunn, Reeves?

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Hosemann wants to shun the term ‘Medicaid expansion.’ Is he appealing to Gunn, Reeves?

Lt. Gov. Delbert Hosemann believes a plea to Mississippians’ better angels ultimately will lead to expansion.

Granted, Hosemann does not utter the phrase “better angels,” but listen closely and it is obvious that he is appealing to them. He also does not want to use the term “Medicaid expansion.” Instead, he would rather discuss everyday scenarios of working Mississippians who suffer, who die because they don’t have access to health insurance.

Hosemann said legislation to provide that access will pass “when we start focusing on real life Mississippians… who are really suffering who don’t have to be, who are dying leaving their children motherless. I think we have a sense of values in Mississippi, and I think that will be energized by that discussion.”

Hosemann recently was asked by a reporter about the possibility of expanding Medicaid.

“What is expansion of Medicaid? That is a lazy question,” Hosemann retorted. “What you need to be thinking about is how are we going to cover people who are working in Mississippi who have catastrophic illnesses? That is the real question.”

Hosemann told media members they need to focus on real life consequences instead of “some nomenclature that is three presidents ago.”

Granted, Medicaid expansion was enacted during the first term of former President Barack Obama in 2009. But in fairness to the media, the original Medicaid program was enacted during the 1960s and Social Security was created in the 1930s, yet their names have not changed.

But in fairness to the lieutenant governor, he understands the value of providing health care access and because of the political rhetoric in the state he cannot state the obvious: that the most cost-efficient way to provide health care is by expanding Medicaid as is allowed under the Affordable Care Act, better known as Obamacare.

Under Medicaid expansion, estimates show, between 100,000 to 300,000 primarily working Mississippians, who currently have no insurance, can gain health care with the federal government paying the bulk of the cost. Multiple studies have found that Medicaid expansion will save the state money because of the influx of federal funds.

The two politicians who make it nearly impossible to expand Medicaid in Mississippi are Gov. Tate Reeves and House Speaker Philip Gunn who often, boldly proclaim their opposition to Obamacare.

Perhaps Hosemann, ignoring the political rhetoric and turning focus to helping Mississippians, is also appealing to the better angels of Reeves and Gunn, who often speak of the importance of their Christian faith.

It complicates matters because it is possible — some say likely — that Gunn will square off against Reeves in the 2023 Republican primary for governor, and because of the staunch Mississippi Republicans who will vote in that primary, neither candidate wants to be seen as supporting Obamacare.

Recent polling indicates that Mississippi politicians’ fear of being linked to Obamacare might be exaggerated. A January 2022 poll by AARP found that 68% of Mississippians over the age of 50, including 57% of Republicans polled, favor expanding Medicaid. Other polls, such as those conducted by Chism Research and Millsaps College, have shown similar results.

But polls have not moved Gunn and Reeves.

“I just don’t think that Medicaid expansion is realistic,” Gunn said last week. “Personally, I’m not for it. I’ve been very clear that I’m against it. I don’t see that as a way forward in Mississippi. We need to be looking for ways to get people off Medicaid, not put them on Medicaid. But the bottom line is it’s all an academic discussion until you’ve got the votes (in the supermajority Republican Legislature), and I don’t think the votes exist.”

The cold hard truth that Hosemann knows is that as long as Gunn and Reeves are opposed, the votes won’t exist.

So instead of talking about expanding Medicaid, Hosemann would rather tell the story of a mother of two in Greenwood who worked as a store clerk and was married to a mechanic. Like most people working in similar jobs, she did not have health insurance. Her employer did not provide it, and she could not afford to purchase private coverage.

She developed breast cancer but delayed seeing a doctor because of the lack of insurance.

“By the time she got to the hospital, they could just give her palliative care and she died,” Hosemann said. “And that is happening in Mississippi to working people… Rather than get into some easy question like that (about expanding Medicaid), I think we ought to start focusing on how we provide health care to working Mississippians.

“I think when we do that it takes down a lot of the barriers that may have been built on political discourse.”

Then, Hosemann believes, Mississippians will hear and listen to their better angels.

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

Experts say Medicaid expansion is still Mississippi’s best option as Build Back Better vote looms

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Experts say Medicaid expansion is still Mississippi’s best option as Build Back Better vote looms

The state would be better off expanding even if the federal Build Back Better bill that would provide coverage for poor Mississippians becomes law, a diverse group of health care advocates claim.

Among the provisions in the $1.75 trillion Build Back Better legislation, which passed the U.S. House last week and faces a close Senate vote in coming days, is “workaround” language to provide health care coverage to primarily the working poor in the 12 states, including Mississippi, that have not expanded Medicaid.

But groups like the Mississippi Hospital Association and the still maintain that it would be to the state’s financial advantage to expand Medicaid. A provision of the Build Back Better bill increases the federal match from 90% to 92% for the existing Medicaid program, meaning Mississippi could stand to gain hundreds of millions more in federal funds if the state’s leaders chose to expand.

“Build Back Better is not a panacea,” said Vangela M. Wade, president and CEO of the Mississippi Center for Justice. “The provisions that close the coverage gap are only temporary. Yes, it is a victory for working Mississippians, but it is a fleeting one. Mississippi’s legislators must enact Medicaid expansion at the state level.”

Wade continued: “For hold-out states like Mississippi, the financial incentives to expand Medicaid are enormous… We are in a position to greatly benefit both the overall health and economic well-being of our state. Medicaid expansion is a no-brainer.”

READ MORE: State economist refutes politicians’ claim that Mississippi cannot afford Medicaid expansion

In an attempt to close the health care coverage gap, Build Back Better allows people earning up to 138% of the federal poverty level — which equates to up to $17,774 per year for an individual or $24,040 for a couple — to obtain health insurance at no cost to them through the health insurance exchanges that were established through the Patient Protection and Affordable Care Act, better known as Obamacare.

The federal government would pay all the costs for the health care coverage offered to the poor in the Build Back Better legislation.

Mississippi is one of 12 primarily Southern states that have refused to expand Medicaid. It is estimated that expansion would provide coverage for between 150,000 and 300,000 Mississippians, primarily the working poor. The federal government, in recent months, has upped the financial incentives for the 12 states.

While state leaders, led by Gov. Tate Reeves and House Speaker Philip Gunn, maintain the state cannot afford the expansion despite studies, several studies by leading economic experts show that Medicaid expansion would effectively pay for itself while significantly aiding both the Mississippi and treasury.

Tim Moore, chief executive officer with the Mississippi Hospital Association, said while he applauds provisions of the Build Back Better legislation providing more health care coverage to Mississippians, the state still will be penalized if Medicaid is not expanded.

Under the legislation as it is currently written, Mississippi hospitals would lose about $300 million in federal funds that are designed to help them pay for uncompensated care or care for those with no insurance and no ability to pay for the care. The loss of the funds for uncompensated care could be viewed as “a hammer” to try to convince the final 12 states to expand Medicaid.

“While we are very supportive of increasing access to coverage for all Mississippians, it should not come at the expense of hospitals across our communities that continue to care for large numbers of children, the poor, the disabled and the elderly,” Moore said.

There is language in the Build Back Better legislation that increases the matching rate paid by the federal government for the costs of treating people covered through Medicaid expansion from 90% to 92%, resulting in additional savings for the state.

“We can implement a plan (through Medicaid expansion) that is more descriptive of the needs of Mississippians or our tax dollars can fund the federal plan. For true conservative Mississippians, I think the choice is clear,” Moore said.

The Build Back Better legislation also includes a provision that requires 12 months of postpartum coverage for poor mothers on the Medicaid program. Temporarily, the federal government is requiring all state Medicaid programs to provide 12 months of coverage. Build Back Better would extend that federal mandate. Before the federal mandate, Mississippi Medicaid provided 60 days of coverage after childbirth.

Mississippi has the highest infant mortality rate in the nation with 9.07 deaths per 1,000 births, according to the U.S. Centers for Disease Control and Prevention. Mississippi also has the 19th-highest maternal mortality rate at 20.8 deaths per 100,000 births, according to a study released by USA Today in 2019.

Build Back Better also would enhance federal funding for people who have health coverage through the ACA exchanges.

U.S. Rep. Bennie Thompson, a Democrat and only member of the Mississippi congressional delegation to vote for Build Back Better, said, “The Biden Administration has once again delivered for Mississippi. It was my honor to vote for legislation that presents such tremendous opportunities for our state. Now the Senate has the opportunity to support the Build Back Better Act, and it is my hope that they do so. Not just for the benefit or our state, but for the entire country.”

The bill also includes an extension of the child tax credit, expanded access for home and community-based care for needy seniors, tax cuts for low wage earners, expanded access to childcare, paid leave for medical and family emergencies, universal pre-kindergarten and funds to combat climate change.

Editor’s note: Vangela M. Wade is a member of Mississippi Today’s board of directors.

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

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