Only minutes after leaving the three-hour Legislative Black Caucus hearing on health emergencies in rural Mississippi Monday afternoon, this reporter had a chance encounter with House Speaker Phillip Gunn just outside the entrance to the Capitol building.
“Mr. Speaker, why are you letting over half the hospitals in Mississippi close down?” the reporter blurted out, not having time to think over the question due to the surprise encounter.
“I’m not aware of any such situation,” Gunn said. “Where is this happening?”
“I have a number of reliable reports that say that over half the state’s rural hospitals are facing closure. The number is 38 altogether, I believe.”
“I only know of one hospital closing,” said Gunn. “And that’s the hospital in Greenwood. I have to go to a meeting now.”
Gunn simply ignored the facts and swept past this reporter and entered the Capitol leaving behind him a confused picture of health care and medical services for Mississippi’s future.
The medical statistics came from the state’s chief medical officer, Dr. Daniel Edney, during his appearance last November 22 at a State Senate hearing. Edney said that 54 percent of the state’s rural hospitals — 38 total — could close. The potential closures threaten to exacerbate poor health outcomes in one of the nation’s poorest states, he said.
“That is a situation that is intolerable from an economic standpoint — to lose 54 percent of our hospitals in the state,” Edney said.
Black doctors and nurses from Claiborne County, Mound Bayou, Canton and other rural communities had convened Monday morning while envisionng a picture of a failing health care system in their rural areas, and they had stressed the need for training more Black doctors and nurses to replace those who have been leaving the state in droves, due to low pay and maltreatment in many cases.
Featured among the medical experts discussing the shortage of Black doctors in Mississippi were Dr. Loretta Jackson-Williams, the vice-dean of UMC’s School of Medicine, Dr. Selika Sweet of Jackson and Dr. William Truly of Canton, who is also that city’s mayor.
Mississippi Nurses Association Executive Director Teresa Malone reported a nursing shortage in the state of more than 3,000. Many of those nurses left Mississippi as travel nurses during the COVID pandemic. Travel nurse agents are recruiting some potential graduates from the state’s schools of nursing, Malone said.
Nurse practitioner Marvel Spears of Claiborne County joined Drs. Sweet and Truly in discussing the worsening of an already bad situation in Emergency Room care. Sen. Barbara Blackmon of Canton chaired the hearing.
“What’s going on is that the state leadership is not directing enough money to these rural hospitals or to help alleviate the nursing shortage,” Blackmon said. “On the senate side, they’ve already decided how much money will go to the hospitals. In our opinion, that’s not nearly enough to address the problems that the hospitals are having, because this is going to be one-time money, and it’s going to be based on the number of beds or whether it’s for the Emergency Room. These community hospitals have needs that are ongoing and have been ongoing for years. These hospitals are the first line of defense for most of the citizens in those areas. We maintain that there should be a concentration of funds going into the rural hospitals instead of trying to address every need the state has.”
SENATE ACTION
For most of January, Gunn’s counterpart in the State Senate, Lt. Governor Delbert Hosemann, has been highlighting four health-care bills that address the rural hospital crisis along with emergency care funding.
Senate Bill 2372, if passed, will establish the Mississippi Hospital Sustainability Grant program. This bill explicitly states that its purpose is “to measure, improve and preserve access to Mississippi hospital care for all Mississippians.” It targets rural hospitals with less than 100 beds that are not classified as critical access hospitals. Funding would also be allocated to other Mississippi hospitals that have more than 100 beds for emergency services.
SB 2373 is titled “The Hospital Nurses Retention Loan Repayment Program,” and awards $6,000 a year up to three years for new nurses employed at a Mississippi hospital or health care facility.
SB 2371 is an ARPA (American Rescue Plan Act) related bill that focuses on the training and retention of nurses and allied health workers. It is entitled the “American Rescue Plan Act Nurse/Allied Health Workforce Development and Retention Act.” A special fund in the state treasurer’s office will be used to seek out and recruit “citizens seeking employment in nursing, allied health, and other health care fields.” Grants would go mostly to hospitals and other institutions that provide health education training programs, including programs at community and junior colleges.
SB 2323 grants immunity from federal and state antitrust law to community hospital boards of trustees that seek to expand their services through consolidation or collaboration with other hospitals and health care facilities. Suggested in this legislation is the possibility that two or more small community hospitals might seek to combine their operations rather than close down individually.
“Mississippians should have access to affordable, quality healthcare, and our hospitals across the state are a critical part of this network,” Hosemann said. “The proposed funding is short-term, but these bills also are the beginning of a thoughtful, candid conversation about the delivery of healthcare in our state.”
FAILED LEADERSHIP
Sen. Hillman Frazier of Jackson attributes the growing crises of rural hospitals and the failure to deliver medical services to people who need them to a self-centered Republican ruling majority, more interested in scoring points with the ultra-conservative national GOP than in doing what’s best for Mississippians.
“Everyone in this state of Mississippi is entitled to quality health care,” Frazier says. “Once the rural hospitals are closed, the people from those areas will be forced to come to Jackson, if they can find transportation. Many of our people in the rural areas can’t afford the transportation costs. Even UMMC is short staffed. That puts an additional burden on UMMC.”
Frazier saw a direct link between the alleged stealing of millions of dollars in welfare funds by some of the wealthiest whites in the state at the behest of both Governors Phil Bryant and Tate Reeves and the failing health services.
“TANF funds that were designed to help the poor—the Temporary Assistance to Needy Families— were stolen by these people in high places. You have some new welfare queens as a result of that, such as Nancy New and Brett Favre, the new King of Welfare,” he said.
“We have a failed political leadership at the very top here in Mississippi. They’d rather help their well-off friends and buddies in business than to honestly distribute the money to the poor that the federal government sent explicitly to help them.”
FOLLOW A PLAN
Sen. Juan Barnett of Heidelberg, a member of the Public Health and Welfare Committee, says the entire state suffers when a rural hospital is closed.
“Regardless to whether you have a hospital in your area, you have a relative or friend that’s directly affected when a hospital closes,” Barnett said. “We should do everything we can to prevent a closure. I’m just so happy right now there is a plan out there so we can address this. Any plan is better than no plan in an attempt to save what we can among our threatened hospitals.
“My whole concern is to make sure, if there’s any way possible, that we won’t lose another hospital, regardless of the size or geographical location, because they’re important in all our communities. My position is to look at the plan and observe what’s out there and make the best decision going forward.”
Representative Bryant Clark of Holmes County says the political leadership has failed the people of Mississippi by continuing to restrict the Medicaid program.
“The house has passed some bills out of committees, but they won’t come anywhere near solving the problems that we have in public health and our rural hospitals, specifically,” he said. “They have one bill that will create a fund for a one-time grant, and the bill has no amount of money in it. They’re talking about some $80 million, but our hospital directors told us they need at least $200 million. And that will be only a band-aid, a temporary fix. Twelve to 18 months down the road, our hospitals will be back in the same condition. We need a long-term solution, and the long-term solution is the expansion of Medicaid.
“There’s no way that Mississippi state government will be willing to fund these hospitals on a permanent basis. The federal government is willing to come in and put up as high as $2 billion a year, and we only have to put up about $600 million a year under the Medicaid expansion. That will save the majority of these hospitals that are threatened with closure right now. It will create more jobs than Toyota and Nissan put together. That’s about 15,000 jobs.
Holmes County has a hospital branch that is under the arm of UMMC, Clark said. If it didn’t have that UMMC connection, the county would not have a medical care facility,” he added.
“When you see these major hospitals in these rural areas about to close, you can tell that we’re about to see our entire health care system crumble down around us,” Clark said. “It’s a cancer and it’s spreading quickly.”
State Rep. Omeria Scott of Laurel says that by not adopting the Affordable Care Act when it was first made available in 2010, Mississippi has suffered from self-inflicted wounds to its economy since.
“The other thing Mississippi has failed to do is to look at the role of hospitals in the state and ask how we can maximize what hospitals actually do,” she said. “I introduced many bills over the years that would take some of the wings of these hospitals and make them into crisis wings. That would create revenue for the hospitals outside of the people just being admitted in their emergency room care. We have a drug problem, and we have a mental health crisis that has been exacerbated by this COVID-19 pandemic. We need these crisis centers.”
Despite the obvious faults and failings of the Republican leadership, Scott says, Democrats are not stepping up to challenge them for the leadership and control of state government as they should.
“We don’t have any Democrats running for these seats all over the state of Mississippi,” she said. “We have just as many organizations right here in the state of Mississippi as the Republicans have. We should have one voice that would include the Democratic caucuses, the Black supervisors, the people in municipal government going out into counties like Tishomingo, Union, Itawamba and Clark counties and down on the Gulf Coast to win elections against Republicans. Otherwise, we’ve ceded all that territory to them.
“You’ve got to run to get elected. We’ve got to have people running up and down the tickets, for all positions. If we want to make changes in this state, the advocacy groups should be emphasizing one thing, ‘Run!’ They should not leave one Republican seat uncontested. Whether its coroner, justice court, constable, state representative and so on, they should all be challenged.”
If people are not engaged in the political fight to support hospitals and other medical facilities in their areas, they will eventually die because of a lack of care once the hospitals are shut down, Scott says.
“If you don’t believe that will happen, go and talk to some of the people who were here when we had South Mississippi State Charity Hospital in Jones. In the interim of five or six years before the new hospital came, people were just dying. They told them to get a Medicaid card, but the doctors said they were not going to accept Medicaid. Now, it’s advised to get a Medicaid card, but we don’t have enough people with cards to sustain the program.”
The Federal Reserve Bank of Richmond, VA reported on the impact of hospital closings nationwide in its Oct. 2, 2018 news brief.
“The high rate of rural hospital closures is not expected to slow anytime soon — instead, some analysis suggests that they may close at an even higher rate in coming years,” the report said. “Some 430 hospitals across 43 states are at a high financial risk of closing based on an assessment of their current financial viability. Together, these hospitals are major economic contributors to their communities, representing 21,547 staffed beds, 150,000 jobs, and $21.2 billion total patient revenue.”
