As Marquise Tillman led deputies on a high-speed chase through rural Mississippi in March 2019, Sheriff Todd Kemp issued a blunt order over the radio: “Shut him down and beat his ass.”

When the Clarke County deputies caught Mr. Tillman, they did just that, he later alleged in a lawsuit. He said they pummeled and stomped on him while he was handcuffed, leaving him with a fractured eye socket and broken bones in his face and chest.

The sheriff denied giving the order. But it was captured on tape and described under oath by four of his deputies.

Such an explosive revelation might have roiled a community elsewhere in the country and led state or federal officials to investigate. But in Mississippi, it was largely ignored, even after the county paid Mr. Tillman an undisclosed amount to settle his claim.

There was no news coverage and no state investigation. In an interview, Sheriff Kemp said he had turned the case over to the state’s police agency. But the agency could find no record of having pursued it.

That is not unusual in Mississippi, where allegations like those leveled against Sheriff Kemp often go nowhere, an investigation by The New York Times and the Mississippi Center for Investigative Reporting at Mississippi Today has found.

State authorities are responsible for investigating shootings and in-custody deaths involving sheriffs and deputies. But they are not obligated to investigate other potential wrongdoing by sheriffs’ offices, and may not even know about it: The sheriffs’ offices are also not obligated to report incidents to them.

The Times and Mississippi Today examined dozens of publicly available federal lawsuits that described severe brutality and other abuses of power, reviewing thousands of pages of court records and interviewing people involved in cases across the state.

At least 27 claims do not appear to have led to a state investigation, including accusations of rape, brutal assault and retaliation against sheriffs’ enemies.

Many of the lawsuits depicted incidents that had eyewitnesses or significant physical evidence. Some included transcripts of deputies admitting under oath to troubling conduct. All but five of the cases were settled, according to court files that do not disclose the financial terms.

Mississippi has a long history of powerful rural sheriffs breaking the law with little consequence. This year, The Times and Mississippi Today revealed how sheriffs and deputies dodged accountability after allegations that they had sexually abused women in their custody, tortured people for information or misused subpoena power to spy on others.

The lawsuits underscored how many similar allegations have been leveled in the state over the past decade, especially in small-town jails. A man in Itawamba County said that in 2020 his jailers tied him to a chair, choked him and squeezed his genitals until he vomited. A woman in Bolivar County said that in 2016 a deputy held her arms behind her back and raped her in her cell. A man in Simpson County said that the sheriff in 2012, Kenneth Lewis, choked him and slammed his head against a cell wall until he passed out.

All of their lawsuits were settled. Attempts to reach former Sheriff Lewis for comment were unsuccessful.

Officials with the Mississippi Bureau of Investigation and Attorney General Lynn Fitch’s office said they could find no records indicating that either office had investigated any of the 27 allegations. Jim Hood, who was attorney general during most of these cases, did not respond to requests for comment.

Reporters also reached people familiar with 12 of the claims, including plaintiffs, their family members and their lawyers. All said they were not aware of state investigators asking about the cases.

In a statement responding to The Times and Mississippi Today’s findings, the state’s public safety commissioner, Sean Tindell, said he was working toward more oversight. He said he would ask the legislature to empower Mississippi’s law enforcement licensing board, which he oversees along with the bureau of investigation, to investigate abuse allegations and consider revoking law enforcement officers’ licenses, an approach some states use aggressively.

Sheriffs are elected and not required to hold licenses, however. And it would not change how cases are investigated criminally.

The lack of investigations troubled experts who reviewed some of the cases.

James Tierney, a former Maine attorney general who now lectures at Harvard Law School, said the lawsuits described “corrupt” and “criminal” behavior that should have been investigated by the attorney general.

“This wasn’t one renegade cop or a renegade D.A. There is a systemic problem here,” he said.

In Mr. Tillman’s case, the accused deputies all denied beating him. They do not appear to have faced any consequences. “I don’t think there was any wrongdoing,” Sheriff Kemp said in an interview.

“Everybody kept their job,” recalled Mr. Tillman’s aunt, Kristy Tillman.

Mr. Tillman is serving 12 years in prison for crashing into deputies during the high-speed chase. Sheriff Kemp is retiring at the end of this month after 24 years in office. His elected successor, Anthony Chancelor, is one of the deputies accused in the beating.

Trails of Evidence

Across Mississippi’s 82 counties, candidates for sheriff are not required to have law enforcement experience or police training. Once in office, sheriffs can launch investigations, direct the use of force and put people in jail, where they control virtually every aspect of an inmate’s life.

“There is no transparency for what happens inside these local jails, and we know that abuse thrives in dark places,” said Michele Deitch, the director of a center at the University of Texas at Austin that studies jail oversight and operations. She said the allegations of brutality described in the lawsuits were a window into a world that sheriffs have been allowed to conceal.

Many of the lawsuits examined by The Times and Mississippi Today included trails of evidence — video footage, medical records, eyewitness accounts — ready for an investigator to follow.

In 2020, deputies at the Itawamba County jail beat Christopher Evan Easter relentlessly, he said in court filings and an interview.

He said one jailer put him in a chokehold until he passed out; he awoke to deputies doing chest compressions on him. They tied him to a chair, squeezed his genitals and punched his head until he lost consciousness again, he said. “When I come to, my ears are ringing. I’m covered in puke and blood,” he recalled.

Mr. Easter was taken to a hospital, he said, but when he returned to jail, he was stripped naked and thrown in a dark, maggot-infested room the deputies called “the hole,” where the plumbing did not work and the toilet was full of feces.

Mr. Easter’s father, Christopher Lewis Easter, said the jail’s administrator told him that his son had fallen and hit his head on a filing cabinet. The family filed a lawsuit, detailing the violence inflicted on Mr. Easter, which the county settled for $15,000, he said.

Some claims revealed patterns of similar allegations. In a three-year span, two men held in the jail used by Humphreys County filed lawsuits saying deputies had taken them to the chapel before beating them out of view of security cameras. The lawsuits said that members of each family had confronted then-Sheriff J.D. Roseman, who acknowledged one of the assaults happened. Both cases were settled. Sheriff Roseman remained in office until his death in 2020.

In other cases, deputies’ testimony supported some of the plaintiffs’ claims.

The county administrator of Tunica County, population 10,000, accused Sheriff Calvin Hamp of conspiring to have him arrested in 2014 in retaliation for trying to cut the department’s budget.

Two days after the men argued over a purchase order, a captain in the department pulled over an S.U.V. carrying the administrator, Michael Thompson. The captain instructed Mr. Thompson to get behind the wheel and watched him drive away, then pulled him over and charged him with driving with a suspended license. The sheriff’s office issued a press release announcing the arrest.

In a sworn deposition, the captain conceded that he had known Mr. Thompson’s license was suspended — because of an unpaid traffic ticket in another county — when he told him to drive.

Sheriff Hamp did not respond to questions from The Times and Mississippi Today. Mr. Thompson declined to comment.

On appeal, a judge dismissed the charge against Mr. Thompson, and a jury later awarded him $50,000 in damages.

Deflecting Responsibility

In 2022, state lawmakers formally gave the attorney general and the Mississippi Bureau of Investigation responsibility for investigating police shootings and prosecuting those that involve criminal misconduct.

When a sheriff or a deputy is accused of other types of crimes, however, it remains less clear what is supposed to happen.

The F.B.I. and the Justice Department handle some law enforcement cases, but generally look into only the most serious allegations.

District attorneys can investigate and bring charges. But those local prosecutors can have “politically incestuous” relationships with sheriffs, creating pressure to overlook allegations, said Chris Toth, the former executive director of the National Association of Attorneys General.

To avoid conflicts of interest, sheriffs or local prosecutors can ask the attorney general or the Mississippi Bureau of Investigation to step in. But the system only works if local officials contact the state for help, and that often does not happen, The Times and Mississippi Today found.

Mississippi’s Board on Law Enforcement Officer Standards and Training also conducts background checks and decides whether law enforcement officers who have been fired for cause or charged with a crime should be allowed to serve in other counties. But it does not perform its own investigations into officers’ conduct. Mr. Tindell, the public safety commissioner, argues that it should.

Some states, including Florida and Arizona, have long taken an approach like the one Mr. Tindell is proposing, with powerful licensing boards that require police agencies to report misconduct and then can hold hearings and potentially revoke officers’ certification.

More recently, other states have given their attorneys general additional authority. New York’s can now investigate any officer or deputy, and Illinois’s and Colorado’s can conduct wide-ranging civil investigations into patterns of illegal conduct.

In Mississippi, the lack of process has allowed some sheriffs and district attorneys to disregard reports of abuse within their jurisdictions.

In Clarke County, accounts that Sheriff Kemp had gotten on the radio and ordered his deputies to beat a fleeing man were widely known.

District Attorney Kassie Coleman said in a statement that she had heard about the accusation and that it was “general knowledge” that both the Mississippi Bureau of Investigation and the F.B.I. had been contacted about the case.

“I was not provided an investigative case regarding any potential criminal acts that resulted from the investigation into the allegations,” Ms. Coleman wrote, “nor was I provided a copy of the federal lawsuit.”

But the state bureau of investigation said it had no file on the case, Mr. Tillman’s family said he was never contacted by the F.B.I. or anyone else, and the lawsuit is available in an online courts database.

People who have complained directly to Mississippi sheriffs’ offices have often found themselves speaking to someone close to the sheriff.

A man accused deputies in Forrest County of shackling him in a holding cell, beating him unconscious and breaking his ribs in 2016. He noted in his lawsuit that he filed complaints with the F.B.I. and Nick Calico, a chief investigator for then-Sheriff Billy McGee, giving him medical records and photos that could have served as evidence.

In an interview, Mr. Calico said he had investigated the allegations and found that nothing improper happened. After the lawsuit was filed, he said, he was contacted by the F.B.I., sent them a copy of his investigative file and never heard about it again.

Seven months after the alleged beating, he would marry Sheriff McGee’s daughter.

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This article was co-reported by The New York Times and the Mississippi Center for Investigative Reporting at Mississippi Today.

Joel Engelhardt contributed reporting. Kitty Bennett contributed research.

The post Who Investigates the Sheriff? In Mississippi, Often No One. appeared first on Mississippi Today.

In 2013, at 54 years old, Jones had two toes on his right foot removed and would later lose the big toe on his left foot. He didn’t know it then, but he had peripheral artery disease, or PAD, a condition where plaque builds up in peripheral arteries – those that do not supply blood to the heart or brain – and restricts circulation. Without treatment, a patient will continue to need further amputations and will die young.

One doctor told Jones he would likely need to amputate his entire foot – but Jones, whose condition made him retire early from his job at Baxter Pharmaceuticals, was resolved not to let that happen.

“I thought ‘I don’t want that,’ and me and the doctor were through,” Jones said. “It would have changed my life. I already can’t drive my truck no more.”

But many diabetics in rural Mississippi don’t have access to the care Jones went on to receive to avoid further amputations. Diabetes and the cardiovascular problems it causes are often asymptomatic at first, or symptoms are obscure. A lack of specialists coupled with some of the lowest social determinants in the country leave regions like the Delta prone to late detection of diabetes and a high rate of amputations.

Now, Jones goes to cardiologist Dr. Foluso Fakorede’s Cleveland clinic, Cardiovascular Solutions of Central Mississippi, for regular wound care from a nurse practitioner who travels to the clinic every Thursday from Oxford.

His life is different now, but he’s thankful he can still move around and hasn’t had to undergo a major amputation, which, for legs, is characterized as any cut above the ankle joint.

Mississippi is the only state with every county represented in what is called the “diabetes belt” of the U.S., which spans an upward arc from the deep South to Appalachian states, according to the Centers for Disease Control and Prevention.

Fakorede said academic institutions should be investing in the region through medical research, but it’s not an attractive market.

“I’ll make the argument that it should be,” he said. “Because these people were never given the chance to catch up. And now we’ve left them to suffer in isolation and in pain.”

With 14.8% of its adults diagnosed with the disease, Mississippi is second only to West Virginia in prevalence.

Uncontrolled diabetes, which runs rampant in rural and underserved areas, can lead to blindness, kidney failure, high blood pressure, high cholesterol, heart attacks, strokes and gangrene.

Mississippi, one of 10 states that has not expanded Medicaid, is the fifth highest uninsured state. In Bolivar County and several other Delta counties, at least one in five residents have medical debt in collections.

About one in three diabetics over the age of 50 will develop PAD, which often goes undiagnosed and untreated in medical care deserts like the Delta.

When it is caught, doctors often have an “amputation-first” mentality, which results in the loss of limbs and early mortality – despite the fact that a procedure exists to clean out the arteries of a PAD patient and restore blood flow to extremities.

Within five years of an amputation, diabetics stand a good chance of being dead. Nationally, Black patients are four times more likely to suffer diabetes-related amputations than white patients.

“It’s a death sentence,” Fakorede said, “and it’s very often preventable.”

Jones received five angiograms and revascularization procedures in both his legs over the course of the last two years.

The number of angiograms a diabetic patient with PAD will need depends on a number of risk factors such as age, race, hypertension, heart conditions and habits such as diet and tobacco use.

In the U.S., more than half of patients never receive an angiogram or revascularization procedure before a major amputation.

At his Delta clinic, Fakorede, the only cardiologist in Bolivar County, estimates that the number of amputees who never had an angiogram is close to 90%.

Fakorede, who was born in Nigeria and spent his teenage and young adult life in New Jersey, struggled to justify moving to Mississippi and opening his own clinic. He knew nothing about the place and had never operated his own business.  But when he saw how great the need was in the Delta for a procedure he was skilled at, he knew his mind was made up.

“You walk through Walmart or Kroger here,” Fakorede said, “and I promise you you’ll see someone who has had a limb taken off or a dialysis catheter around their neck.”

In the end, Fakorede said the Delta proved to be far more similar to his hometown in Nigeria than he thought. They are regions that, for the majority of residents, reflect nothing of their country’s wealth – despite the rich resources they provide that contribute to that wealth.

“That is actually what made me stay – that similarity,” he said.

In the Delta, Fakorede explained, there are a number of socioeconomic factors that contribute to what he calls “the perfect storm” and leave people at a greater risk of chronic and life-threatening conditions.

Studies have shown that the body’s inflammatory response to chronic stressors like poverty, food deserts and unemployment – all of which pervade the Delta – can accelerate diseases like PAD.

Fakorede believes that a large part of the problem is inadequate screening measures. The United States Preventive Services Taskforce, or USPSTF, is the governing body that doctors look to for recommendations on who to screen for which conditions.

The USPSTF has not endorsed a screening for PAD, despite the fact that the five-year mortality for undiagnosed or untreated PAD patients is higher than that of breast cancer and prostate cancer, and studies have shown minorities are disproportionately affected.

“That is atrocious,” Fakorede said. “These patients have existed for decades. We know that this disease is destroying them because it’s taking them out of the workforce. It’s taking them out of their homes. They’re ending up in caskets early on.”

In Mississippi, nurse practitioner KC Arnold, director of the Ocean Springs Diabetes Center, witnesses the shortage daily.

“Every single day I’m getting a call: ‘hey, my pharmacy can’t get this,’” Arnold said. “In all my years of helping people with diabetes, this has been the biggest challenge for me to help people get what they need.”

Arnold’s facility is nurse practitioner owned and run – a rarity in Mississippi, where restrictive and expensive collaboration agreements limit the freedom with which nurse practitioners can operate.

Ozempic has a weight-loss version called Wegovy, but it isn’t covered by Medicare, so doctors will sometimes prescribe Ozempic in its place. The Mississippi Board of Nursing has guidelines that prohibit nurse practitioners from prescribing the weight loss drugs off label. But that rule doesn’t apply to doctors.

Arnold says she supports insurance companies covering a drug that addresses obesity. But until that happens, doctors shouldn’t be prescribing Ozempic to patients for weight loss.

“I can’t get the medicine for my patients with Type 2 diabetes,” she said. “Insurance needs to change to help people with weight –  I’m all for that – but right now my patients with diabetes need medicine they’re not getting.”

And the drug isn’t just prescribed to people with diagnosed obesity. Chelsea Handler, a comedian and host of the 2023 Critics Choice Awards, joked that “everyone’s on Ozempic” in Hollywood.

Many insurance companies don’t cover drugs prescribed off label, but those who can afford it are paying premiums out of pocket.

“You know who ain’t getting it?” Fakorede said. “We ain’t getting it here in the Delta. There are people who are not even diabetic who are getting it in the Upper East Side in New York. Socioeconomic status matters.”

Pregnancy tends to highlight the socioeconomic disparities of diabetes since some women receive Medicaid coverage for the first time during pregnancy, according to maternal-fetal specialist Dr. Sarah Novotny.

“Often, pregnancy is the first time women have access to health care insurance,” Novotny, who serves as division director of maternal-fetal medicine at University of Mississippi Medical Center, said. “So, a lot of times patients are coming into pregnancy with very poorly controlled diabetes because they didn’t have access to pre-pregnancy care.”

In pregnancy, diabetes can be separated into two categories: women who already had diabetes, whether it be Type 1 or Type 2, and then became pregnant, versus those who developed gestational diabetes during pregnancy.

Women who have preexisting diabetes and become pregnant are at risk of developing vascular problems, high blood pressure, renal problems and retinopathy. Gestational diabetes doesn’t carry the same risks for the mother. Both conditions carry increased risks such as abnormal growth and birth defects for babies.

Women who develop gestational diabetes carry a 50% risk of developing Type 2 diabetes later in life.

Managing diabetes before conception would go a long way in mitigating the state’s maternal and fetal mortality and morbidity rates, according to Novotny. But at the very least, recognizing and diagnosing diabetes during pregnancy can serve as an opportunity for previously uninsured or underinsured women to improve their quality of life.

In the last three decades, despite all the technological and medical advancements that have been made, diabetics in minority populations have seen worse outcomes.

Turning those statistics around would mean prioritizing tackling inequities in health care and recognizing places like the Delta as meccas for research, according to Fakorede.

“We need to be collaborators,” he said. “We need to be hope dealers. We need to be disruptive in terms of using our positive thinking to address some of the systemic inequities that have plagued these people and this region for decades.”

The post ‘These people were never given the chance to catch up’: Inside the diabetes belt of rural Mississippi appeared first on Mississippi Today.

When she heard her great grandmother calling for her aunt from the bedroom, Simmons strode into the room, hopped up on the hospital bed and helped to turn and change the 84-year-old the way she had seen the women in her family do many times.

Forty-seven years later, that’s still the way she operates as a certified nursing assistant in the Mississippi nursing home she serves.

“When you walk in that door, every resident is your patient,” Simmons said.

Despite her dedication and more than 30 years of experience, she is only making $17 an hour at the nursing home where she currently works. In order to make ends meet, she works two jobs between 6 a.m. and 5 p.m., sometimes working overtime until 10 at night. She says some nights she gets out of work and sits in her car for an hour and a half because she’s too drained to move.

“I feel helpless. I feel exhausted,” she said. “But I know I got to keep going because who else is going to do it? If the people with the hearts give up, there’s going to be no one left for the people in there who are just forgotten about.”

Simmons never considered going back to school to become a registered nurse. What she loves about her job is being a familiar and reliable face for her residents. A CNA is responsible for providing the majority of hands-on resident care, and is often the person a nursing home resident sees the most on any given day.

“I don’t just want to be pushing pills,” Simmons said. “I want to let them talk to me. A lot of the residents tell me things that their families don’t even know about them.”

Poor pay and high turnover are among the reasons Simmons believes new federal staffing requirements in nursing homes will be, in effect, meaningless.

“Where are they going to get the staff from?” Simmons asked. “People are not doing it because they’re underpaid, and they can’t feed their families on that kind of money.”

That’s in line with the national trend: Over the first quarter of 2023 – from January to March – less than 1% of skilled nursing facilities in the U.S. met the draft rule’s two core standards of provider care.

After signing the executive order in September, Biden accepted public comment through Nov. 6. The Centers for Medicare and Medicaid Services is the agency responsible for reviewing the more than 40,000 comments and writing the final rule – which hasn’t happened yet and can take anywhere from months to years. Sixty days after the final rule is published in the Federal Registrar, the first phase in a staggered implementation process will begin.

The proposal, which comes at the heels of a years-long battle nursing home lobbyists waged against reform, outlines minimal standards. For example, the draft rule mandates 2.45 hours of CNA care and .55 hours of RN care per resident per day. That’s less than the 2.8 hours and .75 hours recommended by a CMS landmark 2001 study – even though residents’ needs have gotten more complex over the last two decades with more people living longer.

The proposal also mandates having an RN on duty 24-7. Current regulations mandate having 24-7 care, but allow the position to be filled by licensed practical nurses, who are used more frequently because their salaries are lower than those of RNs. The proposal does not have a requirement for LPN care, leaving experts worried nursing homes will simply replace LPNs with other staff.

“The 24-hour staffing requirement is good, as long as they make that in addition to the administrative nurses,” explained gerontologist and national nursing home expert Charlene Harrington. “But the other requirements they propose are just shockingly low. And that’s partly because the nursing homes have been lobbying against these standards for over a year and a half. So, all these advocates and the experts are very upset about it.”

The only two skilled nursing homes in Mississippi already meeting the not-yet imposed standards are Reginald P. White and James T. Champion nursing facilities – sister organizations of East Mississippi State Hospital, one of the state’s two psychiatric hospitals. The two Meridian nursing homes met the staffing minimums every day of the 91-day second quarter of 2023.

These homes receive about 20% of their funding from the state, according to Mississippi Department of Mental Health Planning and Communications Director Adam Moore. That’s in addition to the funding they receive from Medicaid and Medicare, as well as personal insurance and private pay.

Kevin Walker, administrator of Reginald P. White Facility, and Judd Nance, administrator of James T. Champion Facility, were surprised to learn they met the new requirements every day between April and June.

“We probably try to staff a little heavier than most nursing homes do, but we think we’re short all the time,” Nance said.

Any nursing facility participating in Medicaid or Medicare reimbursement is required by law to provide services that “attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident,” as dictated by the Nursing Home Reform Act of 1987.

Richard Mollot, the executive director of Long Term Care Community Coalition – a national nonprofit dedicated to advocating for residents of nursing homes and their families – says that when it comes to laws, the Nursing Home Reform Act is unique because it focuses on the customer – in this case, the resident.

“Most laws focus on the industry itself,” Mollot said. “For instance, all car manufacturers are expected to meet specific miles-per-gallon efficiency or have certain safety features. Nursing homes, on the other hand, are required to provide the staffing, supplies, and services to assure that every resident is able to attain and maintain their highest practicable well-being as an individual, based upon a comprehensive assessment of the person and a care plan that includes not only clinical needs, but the resident’s cultural background, goals, and personal preferences, too.”

Currently, states are in charge of regulating staffing in nursing homes. Some states have no staffing minimums, while the ones that do keep the requirements very low. In Mississippi, regulations require there to be at least a ratio of one CNA for every 15 residents during the day, and 25 residents at night – despite the fact that studies have shown one CNA for every six to eight residents during the day and 11 to 13 at night is optimal.

Even these suboptimal regulations are rarely enforced, according to Harrington, due in part to a national shortage of inspectors. States are required by the U.S. Department of Health and Human Services to conduct annual surveys and certifications of nursing homes receiving Medicaid and Medicare. In Mississippi, 54% of nursing home state surveyor positions were vacant in 2022, and 44% of the working surveyors had less than two years of experience.

“Enforcement is very weak, especially on staffing,” said Harrington. “We’d like to see CMS really crack down on the nursing homes that don’t have enough staff, and maybe put a hold on admissions until they have enough staff. If they’re not actually able to hire staff they shouldn’t be able to admit patients.”

In previous nursing homes, Simmons says she witnessed bathroom requests going unanswered and continent residents being diapered out of convenience.

The results can be devastating. Residents who are confined to bed and unable to go to the bathroom not only suffer low morale, but can also develop concurrent urinary tract infections. In the elderly, these infections can cause delirium and exacerbate dementia. Those who try to get up on their own may suffer falls, broken bones and concussions as a result.

“You see residents with UTIs and falls and stuff because they’re crying out for help to go to the bathroom in the middle of the night and they fall because they have to go to the bathroom and they’re told to go to the bathroom in their briefs,” Simmons said. “Who wants to be sitting somewhere with a wet brief on? It’s humiliating. And it’s unacceptable.”

According to Mollot, it’s a violation of the Nursing Home Reform Act, and one that could be resolved with adequate staffing.

“Nursing homes claim that diapering residents is necessary because they don’t have enough staff to respond to call bells or implement resident-centered toileting practices,” Mollot said. “But if you think about it, that is pretty outrageous. In effect, facilities are admitting that they are taking in and retaining vulnerable human beings for whom they have neither the ability nor intention of providing decent care. Why do we accept the warehousing of millions of vulnerable Americans every year?”

Simmons says she has been let go twice, in two different states, shortly after filing incident reports to Occupational Safety and Health Administration and to the staffing agency she was contracted with.

But Simmons is resolved to continue advocating for the residents she serves and hopes that in time, higher pay and more stringent regulations will lead to better working environments for staff and quality of life for residents in nursing homes.

“I don’t care if they fire me from every job,” she said. “When I know something is not right, I’m going to stand up for it. And can’t nobody stop me from doing that.”

The post Falling short: 99% of Mississippi nursing homes don’t meet new staffing regs appeared first on Mississippi Today.

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?”

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.

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.

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.

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.”

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.

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.

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.”

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.

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.”

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.”

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.

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.

“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 News‘ Rural 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.

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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.

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.

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.”

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 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.)

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.”

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.

The post Mississippi jailed more than 800 people awaiting psychiatric treatment in a year. Just one jail meets state standards. appeared first on Mississippi Today.

The University of Mississippi intends to begin offering a Master of Science in dietary supplements and medical cannabis in the fall of 2024.

The post A Medical Marijuana Graduate Degree Coming to University of Mississippi in Fall 2024  appeared first on Mississippi Free Press.

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.

The post Mississippi Today joins national collaboration focusing on rural workforce development appeared first on Mississippi Today.

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.

The post Medicaid drops another 13,000 Mississippians as agency’s backlog snowballs appeared first on Mississippi Today.