‘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.
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.”
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.
To fight teacher shortages, schools turn to custodians, bus drivers and aides
MORGAN CITY, La. — Jenna Gros jangles as she walks the halls of Wyandotte Elementary School in St Mary’s Parish, Louisiana. The dozens of keys she carries while she sweeps, sprays, shelves and sorts make a loud sound, and when children hear her coming, they call out, “Miss Jenna!”
Gros is head custodian at Wyandotte, in this small town in southern Louisiana. She’s also a teacher-in-training.
In August 2020, she signed up for a new program designed to provide people working in school settings the chance to turn their job into an undergraduate degree in education, at a low cost. There’s untapped potential among people who work in schools right now, as classroom aides, lunchroom workers, afterschool staff and more, the thinking goes, and helping them become teachers could ease the shortage that’s dire in some districts around the country, particularly in rural areas like this one.
In two and a half years, the teacher training program, run by nonprofit Reach University, has grown from 50 applicants to about 1,000, with most coming from rural areas of Louisiana, Arkansas, Alabama and California. The “apprenticeship degree” model costs students $75 dollars a month. The rest of the funding comes from Pell Grants and philanthropic donations. The classes, which are online, are taught by award-winning teachers, and districts must agree to have students work in the classroom for 15 hours a week as part of their training.
“We have overlooked a talent pool to our detriment,” said Joe Ross, president of Reach University. “These people have heart and they have the grit and they have the intelligence. There’s a piece of paper standing in the way.”
Efforts to recruit teacher candidates from the local community date back to the 1990s, but programs have “exploded” in number over the past five years, said Danielle Edwards, assistant professor of educational leadership, policy and workforce development at Old Dominion University in Virginia. Some of these “grow your own” programs, like Reach’s, recruit school employees who don’t have college degrees or degrees in education, while others focus on retired professionals, military veterans, college students, and even K12 students, with some starting as young as middle school.
“‘Grow your own’ has really caught on fire,” said Edwards, in part because of research showing that about 85 percent of teachers teach within 40 miles of where they grew up. But while these programs are increasingly popular, she says it isn’t clear what the teacher outcomes are in terms of effectiveness or retention.
Nationwide, there are at least 36,500 teacher vacancies, along with approximately 163,000 positions held by underqualified teachers, according to estimates by Tuan Nguyen, anassociate professor of education at Kansas State University. At Wyandotte, Principal Celeste Pipes has three uncertified teachers out of 26.
“We are pulling people literally off the streets to fill spots in a classroom,” she said. Surrounding parishes in this part of Louisiana, 85 miles west of New Orleans, pay more than the starting salary of $46,000 she can offer; some even cover the full cost of health insurance.
Data suggests not having qualified teachers can worsen student achievement and increase costs for districts. An unstable workforce also affects the school culture, said Pipes: “Once we have people here that are years and years and years in, we know how things are run.”
As Gros walks the hallways, she stops to swat a fly for a scared child, ties a first grader’s shoelaces and asks a third about their math homework. Her colleagues had long noticed her calm, encouraging manner, and so, when a teacher’s aide at Wyandotte heard about Reach, she urged Gros to sign up with her.
Gros grew up in this town — her father worked as a mechanic in the oil rigs — and always wanted to be a teacher. But with three children and a salary of $22,000 a year, she couldn’t afford to do so. The low cost and logistics of Reach’s program suddenly made it possible: Her district agreed to her spending 15 hours of her work week in the classroom, mentoring or tutoring students. She takes her online classes at night or on weekends.
Current employees are also in the retirement system, meaning the years they’ve already worked count toward their pension. For Gros, who has worked for 18 years in her school system, that was an important consideration, she said.
Pipes said people like Gros understand the vibe of this rural community — the importance of family, the focus on church, the love of hunting. And people with community roots are also less likely to leave, said Chandler Smith, the superintendent in West Baton Rouge Parish School System, a few hours’ drive away.
His district is the second-highest paying in the state but still struggles to attract and retain teachers: It saw a 15 percent teacher turnover rate last year. Now, it has 29 teacher candidates through Reach.
In West Baton Rouge Parish, Jackie Noble is walking back into the Brusly Elementary school building at 6:45 p.m. She’d finished her workday as a special education teacher’s aide around 3:30 p.m., then babysat her granddaughter for a few hours, spent time with her husband, and picked up a McDonald’s order of chicken nuggets, a large coffee and a Coke to get her through her evening classes. Some Reach classes go until 11 p.m.
Noble was a bus driver in this area for five years, but she longed to be a teacher. When she mustered the courage to research options for joining the profession, she learned it would cost somewhere between $5,000 to $15,000 a year over at least four years. “I wasn’t even financially able to pay for my transcript because it was going to cost me almost $100,” she said.
When Noble heard about Reach and the monthly tuition of $75 a month, she said, “My mouth hit the floor.”
Ross, of Reach University, said he often hears some variation of: “I had to choose between a job and a degree.”
“What if we eliminate the question?” he said. “Let’s turn jobs into degrees.”
Brusly Elementary is quiet as Noble settles down in a classroom. She moves her food strategically off camera and ensures she has multiple devices logged in: her phone, laptop and desktop. Sometimes the internet here is spotty, and she doesn’t want to take any chances.
It’s the night of the final class of her course, “Children with Special Needs: History and Practice.” Her 24 classmates smile and wave as they log on from different states. They’ve been taking turns presenting on disabilities such as dyslexia, brain injuries and deafness; Noble gave hers, on assistive technologies for children with physical disabilities, last week.
Reach began in 2006 as a certification program for entry-level teachers who had a degree but still needed a credential. It then expanded to offer credentials to teachers who wanted to move into administration as well as graduate degrees in teaching and leadership. In 2020, Reach University started the program focused on school employees without a degree.
Kim Eckert, a former Louisiana teacher of the year and Reach’s dean, says she was drawn to the program because, as a high school special education teacher, she saw how little opportunity there was for classroom aides in her school to boost their skills. She started monthly workshops specifically for them.
In growing the Reach program, Eckert drew from her teacher-of-the-year class, hiring people who understood the realities of classroom management and could model what it’s like to be a great teacher. She shied away from those who haven’t proven themselves in the classroom, even if they have degrees from top universities. “Everybody thinks they can be a teacher because they’ve had a teacher,” she said, but that’s not true.
The 15 hours a week of “in-class training,” which can include observing a teacher, tutoring students or helping write lessons, is designed to allow students to test out what they’re learning almost immediately, without having to wait months or years to put their studies into practice. Michelle Cottrell Williams, a Reach administrator and Virginia’s 2018 teacher of the year, recalls discussing an exercise in class about Disney’s portrayal of historical events versus the reality. One of her students, a classroom aide, shared it with the fifth graders she was working with the next day.
Noble says she’ll carry lessons about managing students from the bus to her classroom. She was responsible for up to 70 students while driving 45 miles an hour — so 20 in a classroom seems doable, she said.
She can’t wait to have her own classroom where she is responsible for everything. “Being with the students approximately eight hours a day, you make a very, very larger impression on their lives,” she said.
In May, Reach graduated its first class of teachers, a group of 13 students from Louisiana who had prior credits. The organization’s first full cohort will walk across the stage in spring 2024.
There are promising signs. Nationwide, about half of teacher candidates pass their state’s teaching licensure exam; more than 60 percent of the 13 Reach graduates did. All of them had a job waiting for them, not only in their local community, but in the building where they’d been working.
But Roddy Theobald, deputy director of the National Center for Analysis of Longitudinal Data in Education Research and researcher at the American Institutes for Research, says far more research is needed on “grow your own” programs. “There’s very, very little empirical evidence about the effectiveness of these pathways,” he said.
One of the challenges is that the programs rarely target the specific needs of schools, he said. Some states have staffing shortages only in specific areas, like special education, STEM or elementary ed. “Sometimes they result in even more teachers with the right credentials to teach courses that the state doesn’t actually need,” he said.
Edwards, one of the first researchers to study “grow your own” programs, is investigating whether teachers who complete them are effective in the classroom and stay employed in the field long term, as well as how diverse these educators are and whether they actually end up in hard-to-staff schools.
“States are investing millions of dollars into this strategy, and we don’t know anything about its effectiveness,” she said. “We could be putting all this money into something that may or may not work.”
Ross, of Reach University, says his group plans to research whether its new teachers are effective and stay in their jobs. In terms of meeting schools’ specific labor needs, Reach has agreements with other organizations such as TNTP (formerly The New Teacher Project) and the University of West Alabama to help people take higher-level courses in hard-to-fill specialties such as high school math. But while Reach staff look at information on teacher vacancies before partnering with a school district, they don’t focus on matching the district’s exact staffing needs said Ross: “Our hope is the numbers work themselves out.”
In Louisiana, Ross said he believes the organization could put a serious dent in the teacher vacancy numbers statewide. Some 84 percent of all parishes have signed on for Reach trainees, he said, and 650 teachers-in-training are enrolled. That amounts to more than a quarter of the teacher vacancy numbers statewide, 2,500.
“We’re getting pretty close to being a material contribution to the solution in that state,” he said.
His group is also looking to partner with states, including Louisiana, to use Department of Labor money for teacher apprenticeships. At least 16 states have such programs. Under a Labor Department rule last year, teacher apprenticeships can now access millions in federal job-training funds. Reach is in talks to use some of that money, which Ross says would allow it to make the programs free to students and rely less on philanthropy.
A straight-A student since her first semester, head custodian Jenna Gros expects to graduate without any debt in May 2024. She expects to teach at this same elementary school. At that point, her salary will almost double.
She said she loves how a teacher can shape a child’s future for the better. “That’s what a teacher is — a nurturer trying to provide them with the resources that they are going to need for later on in life.
I think I can be that person,” she said. She pauses. “I know I can.”
This story about grow your own programs was produced by The Hechinger Report, a nonprofit, independent news organization focused on inequality and innovation in education. Sign up for the Hechinger newsletter.
Hundreds lose Wyoming Medicaid and Kid Care coverage
More than 450 people have so far lost health coverage through Wyoming Medicaid or Kid Care CHIP as the state moves away from pandemic-era measures, the state health department reported at the end of June. Thousands more are expected to lose coverage over the next nine months.
The largest factors in losing eligibility were age, residency and income, according to Wyoming Department of Health spokesperson Kim Deti.
The health department has estimated that between 10,000 and 15,000 residents could lose access to Medicaid programs this year as it conducts a yearlong renewal process. Some free medical clinics expect the increase in uninsured residents to further strain resources.
That annual process was put on hold during the pandemic to ensure coverage for more people in exchange for a temporary increase in federal funding. Starting in April, Wyoming health officials began removing people who no longer qualify, but a more complete picture of these “procedural removals” is expected to come out next month.
Early reports from Montana show more than 70% of those at risk of losing coverage simply didn’t provide requested information to health officials.
Wyoming’s health department started updating people’s contact details back in March, the agency stated, to make sure those who are still eligible get the renewal notice.
“Because of the pause, our clients have not received these notices by mail over the last three years,” Lee Grossman, state Medicaid agent and senior WDH administrator, said in a March press release. “We know living situations may have changed during that time for many people.”
Income has been one of the largest factors in losing eligibility so far, but thousands of Wyomingites already fall into a “gap” where they make too much to qualify for Medicaid in the state but too little to afford private insurance. To shore up this gap, 41 states have expanded Medicaid, but Wyoming lawmakers have yet to do so, often citing concerns that the federal government won’t hold up its end of the bargain to help pay for it.
The state estimates Medicaid expansion would insure about 19,000 people over two years.
To ensure they get a renewal notice, Wyoming Medicaid enrollees can update their contact information at www.wesystem.wyo.gov or by calling 1-855-294-2127.
Youth Soccer returns to Breckenridge after three-year hiatus
Food pantries see usage soar after government cuts pandemic-era emergency benefits
On Friday afternoon, the Charlottesville Emergency Food Network’s small distribution center was packed with dozens of food orders and families lined up out the door.
Volunteers say the demand for the small pantry’s services has nearly doubled since early March, after the federal government ended the emergency increases it had been giving to Supplemental Nutrition Assistance Program (formerly food stamp) recipients during the COVID-19 pandemic.
“We’re getting a lot more people,” said Dana Eastman, a volunteer food distributor. “We went from about 12 to 15 — we have 26 today.”
And the folks arriving appear ever more desperate, said Diane, another volunteer who did not give her last name. People have started showing up early for pickup, concerned that there will not be enough food — even though all customers register in advance and are guaranteed a bag with a three-day food supply.
Other area food pantries are experiencing a similar need.
It’s a sign, pantry workers say, that the emergency COVID-19 funding was addressing a need that has not gone away.
But the SNAP emergency allotments were only meant to be temporary. The increase was part of the Families First Coronavirus Response Act of 2020, which directed the U.S. Department of Agriculture to max out every SNAP receipt’s benefits “due to pandemic related economic conditions.”
During that time, businesses and schools were closing for the country-wide lockdown, causing many people to lose hours or jobs entirely.
That was certainly the case in central Virginia. Data from local SNAP offices show the number of people in Albemarle County receiving food assistance increased nearly 60% from pre-COVID February 2020 to February 2023. That’s 4,175 to 6,561 people. In Charlottesville, the number of recipients increased by about 30% during that same time period: 3,898 to 5,117.
The reasons people cited were pandemic-related job losses, reduced hours and illness. Basically more people applied due to lack of income, jobs, and/or illness, said Blair Smith, a training supervisor with the Charlottesville Department of Social Services, which distributes SNAP benefits to city residents.
While those issues are no longer as pressing, they’ve been replaced by stubbornly high inflation that brings with it higher food, housing and electricity costs.
“We needed the SNAP [emergency allotments] so badly,” said a woman waiting to pick up a three-day food supply for her family of five from the Emergency Food Network. “We are stretching our dollars for everything, not just food: rent, gas and all the other necessities. We wish [the government] can come up with something more for us. It is hard and we are struggling to make ends meet.”
The allotments also brought to light the number of people who do not qualify for enough food assistance under the normal guidelines to feed their families — and never did.
Loaves and Fishes, a large pantry near Albemarle High School, is seeing the return of people who have not visited during the last two years, said its executive director, Jane Colony Mills. She said it’s a sign that people receiving the COVID-19 allotments were able to purchase all the food they needed. And, without the allotments, they can’t.
The allotments did not affect every SNAP recipient the same. Because the program temporarily gave each recipient the maximum amount of money possible for their household size, the increases varied widely.
William Marshall, an Albemarle County resident, said his benefits dropped by about $25 per month when the allotments stopped. A Charlottesville woman waiting at the Emergency Food Network said her benefits dropped from $200 to $77. Another said her benefits went from $300 to $23.
“When I’ve asked people if they get SNAP, many times I’ve heard, ‘Yeah, $16 a month,’ which means they hardly feel it’s worth the effort to apply,” Colony Mills said.
Broadly, Colony Mills said she’s now seeing more families with small children. Smith, with the Charlottesville Department of Social Services, said households with elderly, blind and disabled recipients seemed to have larger increases in food assistance during the pandemic.
The woman whose benefits dropped to $77 is disabled and caring for another disabled adult and three children.
“I have nothing in my house right now,” she said, while waiting at the Emergency Food Network. “I am eating beans out of a can right now, trying to piece together a meal each evening using whatever we can find.”
It is impossible to predict whether the continually improving job market will enable families to become more food secure, but pantries like Loaves and Fishes and the Emergency Food Network are settling in for a long time with more people needing their help.
And they say they’re prepared to handle the new demand.
“We have a clear message: No one needs to go without food,” said Zachary Nissen, director of programs for the Blue Ridge Area Food Bank, which provides food to the pantries. “We are well stocked and prepared to provide food to anyone who needs it.”