In this shrinking Mississippi Delta county, getting a college degree means leaving home behind

In this shrinking Mississippi Delta county, getting a college degree means leaving home behind

ISSAQUENA COUNTY — The kings and queens of the South Delta School District tossed candy and waved at their families as the mid-October parade wound through a small town several miles north of this rural county.

“There’s no place like homecoming,” read a sign on a colorful “Wizard of Oz” themed float with a picture of Emerald City on the back.

Homecoming in Issaquena County, the least populated county in Mississippi — and one of the smallest in the country — is so popular that locals call it “South Delta University.”

But there is no college here, not for miles and miles; in fact, there is no public school of any kind. Students from Issaquena County attend school in neighboring counties — and it’s a big reason why many of these kids will have no choice when they grow up but to move away.

There are virtually no jobs for college graduates in this rural county blanketed in farm fields of soybeans, cotton and corn. There are no factories and no hospitals in Issaquena County. There are no public schools – haven’t been for decades. The median household income is roughly $24,000, a little more than half of the statewide average.

A single statistic underscores all these factors. Here, out of the county’s 1,111 residents, just an estimated 42 people aged 25 and older have a bachelor’s degree — meaning Issaquena County’s population has one of the lowest rates of educational attainment in America.

That’s not because people from this county aren’t going to college. Many of their families want them to get a degree — and then leave.

There’s little appetite or means in Issaquena to change this reality, a product of generations of decisions that favored powerful, largely white land interests over education and jobs.

“All my grandkids, they’re going to college,” said Norah Fuller, a Black farm manager, as he watched the football game that Friday night. “I’m going to make sure they’re going to college. Do we want the kids to stay? No. What they gonna stay here for?”

Farmland in the Mississippi Delta is pictured here on Wednesday, Nov. 29, 2023. Credit: Eric J. Shelton/Mississippi Today

Unless his grandchildren want to work on a farm, it’s hard to say. Outside of local government and a prison, the primary source of jobs are the farms that have existed since before the Civil War. But these days, the white families who own much of the land in a county that’s 63% Black are hiring less, and they have little incentive to make room for industries or jobs that could bring college-educated people back.

Fuller himself left the area, dropping out of school in the early 1960s. He didn’t come back until he felt mentally ready to do the same kind of labor enslaved people in this area did.

“I had to get away,” he said. “I stayed away until I could handle it.”

So the cycle continues in Issaquena: Year after year, more and more people move away, leaving behind fewer reasons for anyone else to stay, for any change to happen, and more reasons for young, educated people to go.

“Around here, that’s really the only way you’re gonna make money,” said Amber Warren, a 29-year-old mom who has an associate’s degree and has tried to get a job in Issaquena that will support her three kids. After years of applying, she finally landed one as a caseworker aid last year making $11-an-hour. 

Now she’s searching for a better-paying job, up the hills and out of the Delta, away from all her family.

Issaquena County is flat, desolate and strikingly more rural than anywhere else in Mississippi. The famous “blues highway” largely skirts this southwestern corner of the Delta, where much of the traffic consists of pickups, tractors and trailers. Along the river looms a grassy levee that’s rivaled in height only by large silver grain bins and silos.

The county has been in a state of economic depression for decades. But that didn’t happen overnight.

The story of this fertile land starts in 1820, when it was ceded by the Choctaw, whose words for “deer river” form “Issaquena.” Wealthy settlers — cotton farmers from the east — swooped in and set up plantations. By the eve of the Civil War, a vast majority of the nearly 100 farm operators in Issaquena owned enslaved people, who made up 93% of the county’s population, the highest percentage in Mississippi.

Reconstruction did little to change this imbalance of power. Agriculture continued to dominate the local economy. The “wild lands” were cheap, and Mayersville, the county seat, became something of a boom town, replete with hotels and saloons as the area grew to more than 10,000 people.

The water tower is the only structure taller than the levee in Mayersville. Credit: Eric J. Shelton/Mississippi Today

Soon politicians, businessmen and planters all over the Delta were vying for a railroad to come through their town, eager for alternatives to the crumbling, unpaved roads.

Issaquena’s landowners resisted, believing their land could get a higher price from the railroad companies. That wasn’t the case. The county was circumvented, and Issaquena, as one newspaper in 1902 put it, had “repented” ever since. A few logging rails run through the county today.

Thus began Issaquena’s first major population decline. Mayersville was soon considered the last undeveloped place in the Delta. By the 1930s, the county’s population had shrunk to less than 6,000. Nearly all of the farms were operated by sharecroppers.

Around this time, Stan Delaney’s grandfather crossed the river from Arkansas to Mayersville and, with money he’d saved from managing a farm, bought land. Delaney grew up on it. He learned to drive a tractor when he was 7, and he dropped out of the newly formed, private Sharkey-Issaquena Academy in his senior year to farm, working alongside a Black family, the Wallaces, that his dad employed.

The Wallaces have since moved away, Delaney said. Today, Delaney’s wife and son help him work the family’s roughly 1,150 acres, which are worth about $1 million. One of the county’s 189 farm producers who are white, Delaney rents the land from his mother.

His daughter, Whitney Delaney, went to college because she didn’t now want to farm. Now she figures she makes less working in a local community college’s student services than her brother does in farming.

Stan Delaney and his daughter, Whitney, talk about their family’s connection to the land in Issaquena County, Miss. Credit: Eric J. Shelton/Mississippi Today

Delaney wants to see more young people in Issaquena — especially so his 28-year-old son can meet someone. He knows industry could bring that. But he’d never dream of selling the land to make way for something different. If his kids didn’t feel the same, he’d set up a trust so it could never be sold.

“My dad worked so hard, and my grandfather worked so hard and sacrificed,” he said. “That’s your tradition, that’s just your Southern tradition.”

Like everything else here, the brick building four minutes from Mayersville on Highway 1 is surrounded by fields. Bales of cotton bound in bright yellow plastic greet visitors driving down the gravel road to the Head Start. The school, which opened in 1964, is Issaquena’s sole educational institution.

LaSonya Coleman logs attendance on her sherbert-green office’s desktop computer around 10 a.m. As the center manager, she oversees the development of 41 students. Just seven, she said, are from Issaquena.

The only educational institution in Issaquena County, Miss., the Head Start serves 41 children from the surrounding area, but only seven are from Issaquena. Credit: Eric J. Shelton/Mississippi Today

Today, many residents, Black and white, aren’t troubled by Issaquena’s lack of public schools because the population is so small. In rural school districts across the country, consolidation is a common cost-saving measure.

But the reason why there are no public schools in Issaquena has nothing to do with population.

In 1952, the U.S. Supreme Court took up five cases that signaled it was going to rule on school segregation. Fearing the end of separate-but-equal, white lawmakers in Mississippi scrambled. In a special session, they passed a plan to finally “equalize” the white and Black schools, believing the ruling could be stopped if the state proved it actually funded separate-but-equal facilities equally.

It was a futile attempt. Instead, the plan threw into relief how unequal school funding really was: Black students received just 13% of education funding around that time, despite making up 57% of the school-age population.

In Issaquena, which had no white schools, the plan resulted in the shuttering of the school district, making it the first county in the state to not have one of its own. There was little reporting on the local fallout, but according to a 1988 article, Isssaquena’s 13 public schools closed too.

Yet Issaquena County has continued to pay taxes to support public schools that, aside from educating its residents, provide scant economic benefit to the county itself. South Delta is based in Sharkey County; the Western Line School District is in Washington County. Mississippi Delta Community College is 60 miles away in Moorhead.

Last year, Issaquena paid more than $937,000 in taxes to support all three institutions, the bulk going to South Delta, according to the county auditor.

“Having a school district does require college-educated people earning not great salaries, but still college-educated salaries, which helps in terms of property taxes, income taxes, all of the above,” said Toren Ballard, an analyst at Mississippi First, an education policy nonprofit.

LaSonya Coleman is the center manager of the Head Start, the only educational institution in Issaquena County. Credit: Courtesy of LaSonya Coleman

Coleman, the Head Start director, had grown up just south of Issaquena in a tenant house her father designed and built on a plantation farm. A “country kid,” Coleman and her 14 siblings would play in a nearby creek while her dad worked the land and her mom, a housekeeper, cared for the farm owners’ kids.

In 1991, Coleman, wanting to explore after she got her associate’s degree at Hinds Community College, moved to Chicago. She worked at her sister’s daycare center. Four years later, she came back to the area after her dad was diagnosed with prostate cancer. He could no longer work on the farm, so he had to move out of the house.

By 2016, Coleman returned for good to find the area’s population even smaller than when she’d left. She said she would always tell her sister that local politicians should be working to bring more to the county, like a museum, something that isn’t seasonal like farming or school.

“I mostly stay to myself, but I do a lot of observing of what goes on in the community,” she said. “And I feel that they should bring the jobs in.”

If anyone wanted to bring more jobs to Issaquena County, it’d be tough to do it without talking to George Mahalitc first.

George Mahalitc, the largest landowner and one of the major employers in Issaquena County, Miss., said he doesn’t want a “big population” in the area. Credit: Eric J. Shelton/Mississippi Today

With more than 9,200 acres, Mahalitc is one of the largest private landowners in the county. His properties flank Mayersville to the north and south. In a classic tale of American success, his family moved to the area from Texas in 1961. Now, he may be the only farmer in Issaquena rich enough to grow cotton, an expensive crop. If a field is marked by bales of cotton wrapped in yellow, some locals say that probably means it’s Mahalitc’s land.

Mahalitc is also one of the county’s major employers. He hires tractor drivers and mechanics and workers for the cotton gin he owns with his brothers just over the county line in Washington County.

All told, Mahalitc employs about 30 people — something, he said, that’s getting harder to do.

Workers get ready to pack processed cotton to be shipped on Nov. 1, 2023 from Mahalitc’s Issaquena-South Washington Gin Inc. in Glen Allan, Miss. Credit: Eric J. Shelton/Mississippi Today

He believes that Issaquena has no jobs for college graduates, and few jobs for anyone else, because its people don’t want to work. His point of view is not uncommon among farmers and landowners.

“What needs to happen is people need to get off their lazy tails and wanna go to work,” Mahalitc said. “Our government is subsidizing paying these people to sit at home. That’s the problem.”

But it doesn’t take long for Mahalitc to admit that farmers, by and large, want Issaquena to stay this way.

“Us farmers, we like it like that,” he said. “We don’t want the big population.”

As farmers have historically provided most of the jobs in Issaquena, they’ve also resisted efforts to develop the land that could bring other industries to the county, even as mechanization means they’re hiring less. And because just 26 farm producers in Issaquena are Black, most of the people protesting development in Issaquena are white.

Some farmers want more development. For Mahalitc, it depends on the project; he was interested in selling his land to a solar panel company that recently approached him but, he said, the company backed out.

Waye Windham, another white farmer and the county’s sheriff, said a decade ago, he would hire seven to eight workers for his farm of soybeans and corn. Now he hires two.

“We can’t stop looking for industry to come here,” he said. “If we do, we won’t ever find anybody.”

Harvested cotton is seen at George Mahalitc’s Issaquena-South Washington Gin Inc. in Glen Allan, Miss., on Nov. 1, 2023. Credit: Eric J. Shelton/Mississippi Today

Yet in 1990, farmers across the tri-county area foiled the county board of supervisors’ efforts to get a $75 million hazardous waste incinerator. It would have created 79 permanent jobs and increased local tax revenues by an estimated $2.5 million at a time when cities and towns across the southern United States were competing to process each other’s trash.

And it was a rare opportunity: Issaquena is prone to backwater flooding that can destroy roads, homes and farmland, another factor that has limited the county’s economic opportunities.

Fearing the damage the waste could cause to local crops, a pair of farmers fiercely opposed it, writing op-eds and sending mailers to every registered voter in the county, which ultimately voted 413-315 against the plant.

Mahalitc was one of the 413. The plant would have been across his property line, and he was worried about his crops. Plus, he didn’t think anyone in Issaquena would be qualified to work at the plant.

“Where would they have qualified people to help run something like that?” Mahalitc said. “They’re not here.”

Those who wanted to develop Issaquena didn’t pin their whole hope for the future on the incinerator. The county also voted to legalize gambling (but the riverboat casino went to Vicksburg). Then came along the prison.

When the Issaquena County Regional Correctional Facility opened in the late 1990s, it promised to bring $1 million in revenue to the county tax rolls, but some locals are skeptical the prison has kept its word. Credit: Eric J. Shelton/Mississippi Today

When the 376-bed Issaquena County Correctional Facility opened in 1997, it brought $1 million to the county tax rolls. Today it is the largest employer in the county — more than 50 people work there, but many are not from Issaquena — and it sits across Highway 1 from Mayersville. It, too, borders Mahalitc’s land.

Stallard Williams, a board supervisor who represents Mayersville, is skeptical the prison has kept its promise to Issaquena County. So is Willie Peterson, an alderman who has worked in local government for decades.

“We ain’t got no benefit from it, make sure you put that down,” Peterson said.

The prison recently has been at risk of shuttering. In 2019, the board of supervisors voted to do just that, believing the prison had lost more than $760,000 that year. But Williams thought there was more to the story. He’d been getting calls from people concerned the prison would be privatized, so he audited the numbers and determined the shortfall had simply been a mathematical error.

“I feel like, if something is not right, if it’s something that especially an interest group or anybody else have over the people, over the community, then I speak up,” Williams said.

With what money the county does have, Williams would much rather be spending his time on ambitious projects to finally develop Issaquena. In his nearly eight years as a supervisor,  he has led the board to build a park and secured funding for a walking trail outside the county courthouse, right next to the street that could one day be Mayersville’s center of business activity.

Issaquena County Supervisor Stallard Williams , center, received an award in June 2023 from the institute for Excellence in County Government. With him are his brother Robert, right, and fellow Supervisor Eddie Holcomb. Credit: Courtesy of Stallard Williams

But Williams wants to do more. He has a long list. To attract tourism, he wants to preserve the home of former Mayersville Mayor Unita Blackwell, the first Black woman to be elected mayor in the United States.

The Mississippi River, he says, is Mayersville’s “golden opportunity for economic development,” but the town doesn’t even have a port. He’d like to raise salaries at the prison, which pays just a few dollars above minimum wage. Issaquena, with its quiet swathes of land, attracts hundreds of recreational hunters and fishers — but there’s no place for them to buy gas locally.

The county’s future, Williams said, should be about “give and take” between landowners and workers.

“I benefit from the farmers,” said Williams, who started with his dad a local lawn business mowing farmers’ yards. “But as far as the people that just want a job here, they’re more likely gonna have to work on a farm or go 50 or 60 miles to get a job.”

Yet so many of his ideas require land to generate taxes and to build on. In recent years, some of the county’s land was bought by the state to create hunting grounds named after former governor Phil Bryant.

Change also requires political will. Some supervisors, like Eddie Hatcher, who runs a trucking company and privately owned hunting grounds, believe jobs are available in Issaquena if people want to work.

Barges on the Mississippi River sit on the other side of the levee from Mayersville, Miss., which lacks a port despite locals’ desire to develop one. Credit: Eric J. Shelton/Mississippi Today

“When the government is giving able-bodies money for nothing,” he said, “why would you go to work?”

And sometimes even small improvements can be hard to do in an under-resourced place like Issaquena.

In late October, the Mayersville board of aldermen met at the town’s multipurpose complex. The mayor, Linda Williams Short, led the meeting. She has been mayor since she unseated Blackwell by 11 votes in 2001. Like most people in Issaquena, Williams Short doesn’t have a college degree.

Just two community members attended the meeting. The Yazoo City-bound Warren, whose mom is an alderman, and a man who Warren said always comes for “moral support.”

A heated discussion concerned some of the aging infrastructure in Mayersville, and the local construction company that was struggling to keep up. A few pipes were leaking across town. The water tower needed a new pump, and its gate, which had just been fixed, was falling down.

One alderman suggested getting “the whole system redone.” Williams Short insisted there was nothing she could do to speed up the work.

“We all know it’s been too long,” she said. “And all we can do is ask.”

This reporting is part of a collaboration with the Institute for Nonprofit NewsRural News Network, and the Cardinal News, KOSU, Mississippi Today, Shasta Scout and The Texas Tribune. Support from Ascendium made the project possible.

The post In this shrinking Mississippi Delta county, getting a college degree means leaving home behind appeared first on Mississippi Today.

Mississippi jailed more than 800 people awaiting psychiatric treatment in a year. Just one jail meets state standards.

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

In Mississippi, many people awaiting court-ordered treatment for mental illness or substance abuse are jailed, even though they haven’t been charged with a crime. Read our full series here.

Fourteen years ago, Mississippi legislators passed a law requiring county jails to be certified by the state if they held people awaiting court-ordered psychiatric treatment.

Today, just one jail in the state is certified.

And yet, from July 2022 to June 2023, more than 800 people awaiting treatment were jailed throughout the state, almost all in uncertified facilities, according to state data.

Mississippi Today and ProPublica have been reporting on county officials’ practice of jailing people with mental illness, most of whom haven’t been charged with a crime, as they await treatment under the state’s civil commitment law. After the news organizations started asking about the 2009 law earlier this year, the state attorney general’s office concluded that it is a “mandatory requirement” that the Mississippi Department of Mental Health certify the facilities where people are held after judges have ordered them into treatment.

The Department of Mental Health, which oversees the state’s behavioral health system and has no other responsibility for jails, responded by sending letters to county officials across the state encouraging them to stop holding people in uncertified jails. But the law provides no funding to help counties comply and no penalties if they don’t.

Wendy Bailey, executive director of the Mississippi Department of Mental Health, sent a letter in October to officials in all 82 counties encouraging them to stop holding people awaiting mental health treatment in uncertified jails. According to the department’s data, more than 800 people were held in jail before being admitted to a state hospital through the civil commitment process in the 12 months ending in June. (Obtained by Mississippi Today and ProPublica, highlighting by ProPublica)

Under state law, counties are responsible for housing people going through the commitment process until they are admitted to a state hospital. Counties are allowed to put them in jail before their court hearings if there’s “no reasonable alternative.”

The last time the Department of Mental Health tried to ensure those jails met state standards,  more than a decade ago, it had little success. After the law passed, the agency got to work to inform counties about the new rules. Some didn’t respond. Others expressed interest but didn’t follow through. By 2013, just two jails had been certified. (One of them no longer is.) After that, the effort apparently petered out, according to a review of state documents.

To be certified, a jail must offer on-call crisis care by a physician or psychiatric nurse practitioner and must have a supply of medications. Staff must be trained in crisis intervention and suicide prevention. People detained during the commitment process must be housed separately from people charged with crimes, in rooms free of fixtures or structures that could be used for self-harm, according to Department of Mental Health standards that took effect in 2011.

“If they’re going to be held in jail, they have to receive some kind of treatment in a semi-safe environment,” a department attorney told The Clarion-Ledger at the time.

Until recently, many county officials weren’t even aware of those requirements, according to interviews across the state — even though they were routinely jailing people solely because they might need mental health treatment. Mississippi appears to be the only state in the country where people awaiting treatment are commonly jailed without charges for days or weeks at a time.

Mississippi jails are subject to no statewide health and safety standards. Many jails treat people going through the civil commitment process virtually the same as those who have been charged with crimes, Mississippi Today and ProPublica found. They’re shackled and given jail uniforms. They’re often held in the same cells as criminal defendants. They receive minimal medical care. Some said they couldn’t access prescribed psychiatric medications. Since 1987, at least 18 people going through the commitment process for mental illness and substance abuse have died after being jailed, most of them by suicide.

Colett Boston, left, and Everlean Boston hold a photograph of their mother, Mae Evelyn Boston, in Oxford, Mississippi. In 1987, when Colett was a newborn and Everlean was 12 years old, their mother died in the Lafayette County jail as she waited for a mental health evaluation. (Eric J. Shelton/Mississippi Today) Credit: Eric Shelton/Mississippi Today

Some local officials say getting certified could be expensive. Sheriffs worry it could codify their role as their county’s de facto mental health care provider.

“It looks like the state wants the sheriff to be the chief mental health officer,” said Will Allen, attorney for the Mississippi Sheriffs’ Association. “This is coming down to the state stuffing the cost of this down to the counties, and frankly I just think that’s wrong.”

‘Are you going to shut the jail down? No.’

The genesis of the 2009 law was a conversation state Sen. Joey Fillingane had with his girlfriend at the time, a social worker who worked with troubled youth. She told him that Mississippians going through the commitment process in some counties were locked in jail cells like criminals, while in other counties they were held in hospitals like patients, according to a 2011 news story in The Clarion-Ledger.

Fillingane’s bill addressed that. “Shouldn’t there be some kind of minimum standard where you’re holding people who haven’t committed a crime?” the Republican from Sumrall, near Hattiesburg, said in that story about his legislation.

His bill passed with little fanfare. It made it “illegal for individuals committed to a DMH behavioral health program to be held in jail unless it had been certified” as a holding facility, an agency staffer wrote in a timeline of the law’s implementation obtained by Mississippi Today and ProPublica.

The board overseeing the Department of Mental Health set detailed standards for those facilities. Department staff surveyed counties to see whether they could meet them.

Ed LeGrand was head of the department when the law passed. He said he viewed it as a progressive effort that could spur counties to stop holding mentally ill people in jail. And even if that didn’t happen, the law would improve jail conditions — at least somewhat.

“I didn’t think that everybody would be able to meet those standards. I thought they would give it a try,” he said in a recent interview. “A lot of them did, but some of them didn’t.”

Department staff met with county officials and toured jails to offer assistance. Those visits, which records show mostly took place in 2011 and 2012, were the first time the Department of Mental Health had tried to get a comprehensive look at the local facilities where Mississippians awaited psychiatric treatment in state hospitals, LeGrand said.

Many jails were poorly equipped to care for these people, according to notes by agency staff.

“Toured the current jail (scary),” reads a status update written after staff visited Tishomingo County, in the northeast corner of the state, shortly before the county opened a new jail. In Jones County in south Mississippi, where the jail had 180 inmates and only four staff: “The holding cells are not safe for violent behavior. Too much cement.”

Jones County Sheriff Joe Berlin said the cells have not changed since then, though now detainees are monitored with cameras.

In early 2011, LeGrand told county officials who hadn’t already begun the certification process that they had six months to find a certified provider to house people awaiting treatment.

Sheriffs were frustrated. Some objected to being told they had to upgrade their jails and train guards so they could care for mentally ill people they didn’t think they should be responsible for in the first place.

“What do they expect of me?” one sheriff was quoted as saying in the 2011 news story. “What they need to do is turn around and certify some places that are under Mental Health’s control so they can be responsible for it, not me.”

In 2011, The Clarion-Ledger reported that sheriffs were frustrated by a law requiring the Department of Mental Health to certify their jails if people were detained there as they awaited admission to a state psychiatric hospital. Sheriffs worried that the law would force them to spend time and resources on a job they didn’t sign up for. (Hattiesburg American via Blurred by ProPublica for emphasis.)

Some county officials concluded there was little the state could do if they didn’t comply. Mike Harlin, the jail administrator in Lamar County, discussed the standards with a Department of Mental Health staffer in 2012, according to an agency memo. In an interview this year, Harlin said he remembered thinking, “What are you going to do? Are you going to shut the jail down? No.”

By June 2013, jails in just two of the state’s 82 counties had been certified, according to the department’s tally. (A hospital was certified in another county, and a different type of facility was certified in a fourth.)

Six counties said they couldn’t meet the standards. Another 23 had received guidance from the department on how to meet them. Thirty, including a few of the counties that had received advice, eventually said they didn’t jail people, some because they had contracts with providers. Twenty-one never responded.

Mississippi Today and ProPublica requested all Department of Mental Health records since 2010 related to enforcement of the certification law and correspondence with counties. Documents through 2013 included standards, correspondence, memos describing visits to county facilities and a log summarizing contact with each county. After that, the records released show no statewide outreach.

The final entry in the department’s timeline of the law’s implementation reads: “June 2013 was the last attempt to update the information about DMH Designated Mental Health Holding Facilities due to lack of additional responses from the counties.” That timeline is undated, but a department spokesperson said data in the file shows that it was created in January 2015 by a staffer who held positions in the certification and behavioral health divisions.

LeGrand, who served until 2014, said he doesn’t recall any decision to stop contacting counties about the law.

Katie Storr, the current chief of staff at the Department of Mental Health, told Mississippi Today and ProPublica it’s possible staff did communicate with counties beyond what the records indicate. “After more than a decade, a lack of correspondence, email, or other documentation is not indicative that communication and follow-ups did not take place,” she wrote in an email. However, she said the department had no additional records that would show this.

During this time, Storr wrote, the department was focused on trying to get counties to hold people going through the commitment process in short-term crisis stabilization units rather than jail.

Department can’t ‘boss counties around’

The recent effort to implement the certification law stems from inquiries by Mississippi Today and ProPublica.

In January, the news organizations asked the head of the Department of Mental Health, Wendy Bailey, if the department certifies jails where people are held as they await admission to a state hospital. Bailey, who handled communications for the department when the certification law passed, initially said it didn’t apply to jails. In March, after reviewing documents showing prior efforts to certify jails, she said she didn’t believe the law was intended to apply to them.

After our inquiries, Bailey sought an opinion from the attorney general. (Such opinions are not binding, but officials who request and abide by them are protected from liability.)

Around the same time, the Department of Mental Health contacted the four facilities it had previously certified to schedule inspections. The department’s standards say such inspections will happen annually, but this was the first year in which staff had sought to visit all of them since 2017. (Storr said the inspection effort was planned before inquiries by Mississippi Today and ProPublica.)

In March, staffers inspecting the Chickasaw County jail in rural northeastern Mississippi found serious violations. Inmates and people awaiting mental health treatment were housed together in the same cells, where beds were anchored with long bolts that “could be used by a person to harm themselves,” the reviewers recorded.

The department suspended the jail’s certification in August, but reinstated it after the county submitted a compliance plan that included shortening the bolts and providing mental health training for staff.

Lafayette County told the state it didn’t want its jail to be certified anymore. The certification for a holding facility in Warren County, home to Vicksburg, was suspended. A hospital in Alcorn County in northeast Mississippi maintained its certification.

In 2021 and again early this year, Lafayette County Sheriff’s Department staff told the state Department of Mental Health that they no longer wanted their jail to be certified. In an interview conducted before the department notified counties about the certification law this fall, Sheriff Joey East, pictured here, said he believes people in his jail waited longer to be admitted to a state hospital because the state prioritizes those waiting in uncertified jails. “There was not a lot of benefit” to being certified, he said. DMH director Wendy Bailey said people held in any jail get priority for psychiatric treatment. (Eric J. Shelton/Mississippi Today) Credit: Eric Shelton/Mississippi Today

In August, the attorney general’s office confirmed that the department must “ensure that each county holding facility, including but not limited to county jails,” meets its standards. If they don’t, an assistant attorney general wrote, the law allows the department to require counties to contract with a county that does have a certified facility.

When Bailey informed county officials about the opinion in her October letter, she instructed that if a county holds someone in an uncertified facility, including a jail, officials should contact the department to seek certification or work with local community mental health centers. These are publicly funded, independent providers set up to ensure that poor, uninsured people can access mental health care.

Several counties, including Lamar, have taken up the matter in public meetings or have contacted the department to begin the certification process.

Storr told Mississippi Today and ProPublica that the department asked counties to initiate the certification process because the law says it’s up to counties to determine which facility they use.

But the Department of Mental Health already knows which counties have held people in uncertified jails. Starting in July 2021, in response to a federal lawsuit over the state’s mental health system, department staff have tracked how many people come to state hospitals directly from jails for psychiatric treatment.

The tally for the year ending in June breaks down all 71 jails, only one of which is certified, where a total of 812 people who had been civilly committed were held before being admitted to a state hospital. (The tally doesn’t include anyone who was jailed and released without being admitted to a state hospital.)

For the past two years, the Mississippi Department of Mental Health has gathered data on how many people are admitted to a state hospital directly from jail and how long they wait in jail after commitment hearings. (Obtained by Mississippi Today and ProPublica)

In Lauderdale County, on the Alabama line: 83. Across the state in DeSoto County: 76. A couple hundred miles down the Mississippi River in Adams County: 33.

Storr and Bailey have emphasized that they have limited authority over counties and no way to force them to do anything. The department’s only means of enforcement, Storr wrote, is to put a jail on probation, then revoke certification — if the jail in question even was certified in the first place — and require the county to contract with another provider.

LeGrand said a law without teeth is effectively optional. “The department’s not really in a good position to boss counties around,” he said.

James Tucker, an attorney and the director of the Alabama Disabilities Advocacy Program, which has sued that state over its civil commitment process, said the agency has a responsibility to make sure counties are treating people properly. “You don’t discharge that duty by sitting on your hands and waiting for every local sheriff to report in,” he said.

Bailey’s department encourages counties to connect families with outpatient services in order to avoid the commitment process. If someone does need to be committed, the department said, counties should hold people in crisis stabilization units operated by community mental health centers.

“I do not believe jails are an appropriate location to hold someone who is not charged with a crime and is awaiting admission to a treatment bed,” Bailey told Mississippi Today and ProPublica in an email. “The person should be in a safe location, receiving treatment.”

Adams County Sheriff Travis Patten said he doesn’t think the county jail, pictured here, could meet state standards. Due to deteriorating conditions, most people facing charges — but not those awaiting court-ordered mental health treatment — are now sent to another jail. Lacey Robinette Handjis died in another part of the jail in August while she was awaiting mental health treatment. (Eric J. Shelton/Mississippi Today) Credit: Eric Shelton/Mississippi Today

But there are only 180 crisis beds in the state, and crisis stabilization units frequently turn people away because they are full, can’t provide the needed care, or deem a patient too violent. Storr said the agency is working to reduce denials and plans to use one-time federal pandemic funding to expand capacity.

Allen, the sheriffs’ association attorney, said the state will need more crisis beds if officials want to keep people out of jail as they await mental health care. He said he’s been meeting with sheriffs and county officials since the guidance was issued.

“This has catalyzed the county governments and law enforcement to do something,” he said. Sheriffs agree on the need for “certified centers, just not in the county jail.”

Mollie Simon of ProPublica contributed research to this story.

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Mississippi Today joins national collaboration focusing on rural workforce development

Mississippi Today joins four U.S. newsrooms in exploring changes in rural workforce development as part of an editorial collaboration from the Institute for Nonprofit News’ Rural News Network (RNN).

As one of 75 newsrooms reporting on rural issues in 47 states, Mississippi Today is part of a national initiative to uncover the most critical needs in these communities. Collaborative reporting reaches more people to make meaningful change possible.

“We are delighted to have Mississippi Today join this reporting project to share how Mississippians can bridge gaps in the work-to-jobs pipeline for rural communities,” said Alana Rocha, Rural News Network editor. “This crucial reporting will be shared across the country to surface solutions for other communities fighting for a better future for rural workers.”

For the next six months, Mississippi Today will work with Cardinal News in Virginia, KOSU in Oklahoma, Shasta Scout in Northern California and The Texas Tribune in covering the issue for regional, statewide and national audiences. The journalists will explore how changing demographics, politics and economic needs are reshaping rural workforce development programs.

Mississippi Today’s higher education reporter Molly Minta will focus her reporting on one Mississippi Delta county, Issaquena, where less than 1% of adult residents have a bachelor’s degree, the lowest in Mississippi and the second lowest in the nation. Her research is showing that nearly a quarter of adults aged 25 or older in this sparsely populated county on the edge of the Mississippi River have attempted college but didn’t graduate. Her project will look at the barriers to higher education there but also focus on efforts underway to increase the county’s college-going rate.

“Working with this collaborative has enabled us to see how some of the same issues affecting Mississippi’s Issaquena County are at play in other parts of the country and to see how other communities are attempting to tackle the problem,” said Debbie Skipper, Mississippi Today’s Justice Team and Special Projects Editor. “We are also gaining insight and advice from the leadership at the Rural News Network as we move forward in the reporting and editing process.”

This series is made possible with support from the Walton Family Foundation. Financial supporters have zero say in the editorial process.

The first round of the series publishes in early December, with follow-up stories set for early 2024.

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Medicaid drops another 13,000 Mississippians as agency’s backlog snowballs

Nearly 13,000 Mississippians were kicked from Medicaid’s rolls in September during the most recent batch of disenrollments, while the agency’s backlog grows.

The latest numbers bring the state’s total disenrollments to 81,454 people, most of whom were dropped for paperwork issues, not because they were found to be ineligible.

Medicaid divisions all over the country are reviewing their rolls for the first time in three years after the end of federal regulations that prevented state Medicaid agencies from disenrolling beneficiaries during the pandemic. Prior to this process, referred to as “unwinding,” Mississippi Medicaid enrollment exceeded 900,000 people for the first time in the agency’s history.

June numbers showed that 29,460 Mississippians were dropped in the first wave of disenrollments. Another 22,507 people followed in July, and 16,659 people were disenrolled in August.

Many of them have been children, according to the agency’s monthly enrollment reports. Federal research predicts that kids are most at risk of losing benefits during unwinding, and it’s not clear how many are being dropped despite being eligible. Before the terminations began, children in low-income families made up more than half of the state’s Medicaid rolls.

Almost 45,000 kids in Mississippi have been dropped from Medicaid since the start of unwinding.

Though Medicaid’s spokesperson Matt Westerfield previously told Mississippi Today that the agency hopes to increase its ex-parte rate, or automatic renewal rate, the state continues to disproportionately drop beneficiaries for procedural reasons, which means their paperwork was either not turned in on time or it was incomplete.

Of the 12,828 people dropped in September, around 75% were procedural disenrollments. Overall, Mississippi reports a 78% procedural disenrollment rate thus far. According to KFF, 72% of all people disenrolled were terminated for procedural reasons across all states with available data.

And though it appears in recent data that Mississippi’s disenrollments are decreasing, that’s because the agency’s backlog is growing.

During the first round of disenrollments completed in June, Mississippi Medicaid didn’t get around to checking the eligibility of 5,892 people that were due for the review. However, that backlog has significantly increased — to 19,402 in July; 29,788 in August and now 45,989 in September.

Westerfield did not reply to questions by press time.

As Republican Gov. Tate Reeves continues to voice his opposition to Medicaid expansion, which would insure thousands more working Mississippians, unwinding is set to continue for months. Thousands more Mississippians are poised to lose Medicaid coverage amid a statewide health care crisis — nearly half of the state’s rural hospitals are at risk of closure, according to one report.

KFF says at least 8,696,000 people nationally have been dropped from Medicaid as of Oct. 11.

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Speaking out

‘These are not good numbers’: Thousands more Mississippians, kids dropped from Medicaid

More than 16,000 Mississippians were dropped from Medicaid in August during the latest round of the agency’s disenrollments.

The pandemic-era federal regulations that prevented state Medicaid agencies from disenrolling beneficiaries ended in May. Since then, Medicaid divisions all over the country are reviewing their rolls for the first time in three years.

In June, 29,460 Mississippians were dropped. Another 22,507 people were disenrolled in July.

August’s numbers bring the agency’s total number of disenrollments thus far to 68,626 people. Before unwinding began, the agency’s enrollment exceeded 900,000 people for the first time in the agency’s history.

Most concerningly, most of those who were disenrolled — 54,366 people or 79% — have not been kicked off because they’re ineligible. Instead, there were issues with their paperwork – it was either not turned in on time or was incomplete. That could mean some people have been kicked off Medicaid even though they’re still eligible.

It’s unknown how many of the procedural disenrollments have been children. Children are most at risk of losing benefits during the unwinding process, federal research predicts, and many of them may still be eligible. Kids in low-income families comprise more than half of Mississippi’s overall Medicaid beneficiaries.

“These are not good numbers,” said Joan Alker, executive director of Georgetown University’s Center for Children and Families. “It’s very concerning to see … people, likely children and parents by and large, losing Medicaid for red tape or procedural reasons.”

According to the Kaiser Family Foundation, 13 states have higher procedural disenrollment rates than Mississippi.

From June to July, 18,710 kids were unenrolled from Medicaid, when the first wave of disenrollments took place.

Mississippi Today has requested to interview an agency official about the unwinding data, but the requests were not granted.

New enrollment numbers show that from July to August, another 12,882 children were dropped, bringing the agency’s total of children dropped since unwinding began to 31,592.

Mississippi Medicaid’s monthly unwinding reports do not say what number of terminations were children, but Mississippi Medicaid spokesperson Matt Westerfield confirmed that most of these disenrollments are due to unwinding.

The agency’s ex-parte rate, or automatic renewal rate, remains low. Westerfield previously told Mississippi Today that the agency wants to increase those rates, but August numbers show that of the 70,069 people up for renewal, only 10,817 were renewed on an ex-parte basis.

That’s on par with the previous data release, which shows that of the 75,110 people up for renewal in July, 12,188 were renewed ex-parte.

The agency in August requested permission from the Centers for Medicare and Medicaid Services for “four additional flexibilities that would reduce procedural disenrollments while increasing ex-parte renewals.” According to Westerfield, some were approved, while discussions continue about the others.

The agency’s backlog of beneficiaries to review also keeps growing. In June, about 5,000 renewals were not reviewed. About 15,000 additional reviews went uncompleted in July and another 10,000 in August.

As unwinding continues for the next several months, the burden on the state’s already crumbling health care infrastructure grows. One report puts nearly a half of the state’s rural hospitals at risk of closure.

State Republican leaders have adamantly opposed expanding Medicaid to the working poor, which research shows would bring in billions, though presumptive incoming House Speaker Jason White recently indicated he would consider expansion. His predecessor Philip Gunn largely led the effort to oppose the policy change.

The Kaiser Family Foundation says at least 6,438,000 people nationally have been disenrolled from Medicaid as of Sept. 13.

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