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Mississippi mothers are now guaranteed coverage for a year after giving birth. But they may not get the prenatal care they need.

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Mississippi cleared a big hurdle after lawmakers extended postpartum Medicaid coverage this session, guaranteeing low-income women a year of health care coverage after having a baby.

Now experts say that Mississippi needs to turn its attention to what happens before these women give birth. Early prenatal care is vital to healthy moms, babies and pregnancies, but because of the state Division of Medicaid’s policies, it’s unknown if the majority of pregnant Mississippians are getting that care.

The division, which funds more than two-thirds of births in Mississippi, doesn’t monitor when people go to their first prenatal visit. And the absence of presumptive eligibility in Mississippi creates major delays for people seeking prenatal care.

Pregnancy presumptive eligibility allows people to receive care when they’re pregnant, even if they’re not on Medicaid. It’s presumed that they qualify, so their providers enroll them and start billing Medicaid, which reimburses providers immediately.

That means fewer delays when it comes to receiving care. They’re able to go to doctor’s offices and get the care they need quickly, without having to pay out of pocket.

The agency is hoping to eventually track when recipients go to prenatal visits, but Communications Officer Matt Westerfield could not provide a timeline for when that data might be available. And Medicaid Executive Director Drew Snyder has said he won’t take steps to make it easier for expecting mothers to get on Medicaid without legislative action.

Mississippi is one of the most dangerous states in the country to give birth in, and early intervention is key to successful pregnancies, according to Dr. Anita Henderson, former president of the Mississippi Chapter of the American Academy of Pediatrics.

The state’s dismal maternal mortality rate is getting worse, especially for Black people, and Mississippi has the highest infant mortality, preterm birth and low birthweight rates in the nation.

But as rural health care collapses and hospital closures loom, it’s getting harder to access health care for expecting Mississippians. Neonatal ICUs and labor and delivery units are closing, and county health departments stopped enrolling new maternity patients in 2016.

It’s a dangerous mix following the U.S. Supreme Court’s decision last summer to overturn abortion rights, which means the state is expecting thousands more pregnancies.

Care during the first trimester is crucial to a healthy pregnancy and healthy babies, especially for people with conditions that need to be managed like high blood pressure or diabetes.

“I think given the level of health concerns in our population that exists before pregnancy, we know too many people are going to start prenatal care with medical conditions that make that pregnancy high risk,” said Dr. Charlene Collier, an OB-GYN based in Mississippi. “The consequences are always snowballing when a person enters pregnancy with an untreated or complicated medical history.”

When people who are expecting can’t make it to a prenatal visit in a timely manner, the consequences can be deadly — and, often, preventable.

Collier cited the prevalence of congenital syphilis in Mississippi, which is at an all time high, to stress the importance of early care. She said there’s a limited time frame to prevent complications from syphilis.

Last month, the state health department implemented an emergency order requiring doctors to test pregnant patients for syphilis. Previously, Mississippi was one of six states in the country not to require the testing.

“Now that we’re seeing a rise in congenital syphilis, it’s even more important that people are in prenatal care, getting their blood work done and getting treatment so that infections like syphilis, which is easily treatable with penicillin, can be identified and treated early,” she said. “Any delays increase the chance of a really detrimental infection in a pregnancy.”

Another barrier to timely prenatal care is that it’s complicated to get pregnancy Medicaid coverage.

According to the Kaiser Family Foundation, Mississippi is one of 21 states as of January 2020 that doesn’t offer presumptive eligibility for pregnant people, which has significant benefits.

According to a study commissioned with the University of Mississippi Center for Population Studies by the Center for Mississippi Health Policy, preterm births are less likely for low-income people when they live in a state with presumptive eligibility and expanded Medicaid.

Mississippi is one of only three states in the country that has neither expanded Medicaid nor provides pregnancy presumptive eligibility.

And it takes the Mississippi Division of Medicaid about 24 days to approve pregnancy applications, Westerfield said in November. Until then, uninsured people who are expecting must foot the bills themselves, if a doctor sees them at all.

It’s a tedious process that even top officials in Mississippi are confused by.

At a recent press conference about Mississippi’s commitment to its “culture of life” following the overturning of abortion rights, Republican Gov. Tate Reeves said that the state has presumptive eligibility. But he was referring to hospital presumptive eligibility, which allows hospitals to assume patients’ Medicaid eligibility to provide care. It is not the same thing as presumptive eligibility for pregnant people, which allows them to get care at doctor’s offices just as they would if they were insured.

Reeves’ spokesperson Shelby Wilcher responded that pregnant women in Mississippi have presumptive eligibility at hospitals. After Mississippi Today clarified hospital presumptive eligibility was not the same thing as presumptive eligibility for pregnant women, Wilcher suggested further questions be directed to the Division of Medicaid.

She did not respond to a question asking if the governor would support establishing presumptive eligibility for pregnant women.

“Presumptive eligibility is, intentionally, a very loosely used umbrella term,” said John Dillon Harris, a health care systems and policy consultant at the Center for Mississippi Health Policy. “The question is who is presumed eligible and for what?”

At the last Medical Care Advisory Committee Meeting on Feb 24, Snyder said that the Division of Medicaid wouldn’t utilize pregnancy presumptive eligibility unless directed to by the Legislature.

Westerfield said in an email that position is to prevent the DOM from paying “providers for services for women who subsequently would not qualify for Medicaid.”

Rep. Missy McGee, R-Hattiesburg, introduced a bill this past session to establish presumptive eligibility for pregnant women, but it died after being referred to the Medicaid committee, which met just once last legislative session and only advanced two bills out of committee.

Collier said she recently had a patient who applied for Medicaid but hadn’t yet been approved. The patient delayed getting ultrasounds and other labs out of fear of running up a higher bill even though all her bills would be back-paid once she got on Medicaid.

“I do think the lack of insurance preceding pregnancy is a major barrier to initiating early prenatal care, particularly getting bloodwork done in a timely manner,” Collier said.

It’s a paradox — a confirmatory pregnancy test is required to qualify for Medicaid, but many doctor’s offices don’t provide care to people who are uninsured.

County health departments still offer these confirmatory tests for free, said Liz Sharlot, communications director at the Mississippi Department of Health.

“In fact, that is the most common reason women come in for the pregnancy tests is to confirm that pregnancy test and receive the confirmation letter to bring to the Regional Medicaid Offices in order to apply for Medicaid benefits during pregnancy,” she said.

Clinics that specifically serve uninsured and underserved populations such as the Hinds Comprehensive Health Center, where Dr. Jaleen Sims works as an OB-GYN, also provide these confirmatory pregnancy tests at low cost.

It’s not clear how many people are aware these services are offered at low or no cost at places other than primary care doctor’s offices. And if they are aware, transportation can be another issue.

“The patients who live in these areas need a ride or they have to take off work for a full day to drive to Jackson or their closest areas, spend time in the waiting room, have their visit and then drive back,” she said. “By the time you finish with that you’ve missed … a full day of work for the most part.”

According to a report from the March of Dimes, more than half the counties in Mississippi are considered maternity care deserts, with no OB-GYNs, certified midwives or hospitals providing obstetric care.

It also continues to be a challenge to recruit doctors, especially OB-GYNs, to Mississippi and keep them here. Of the five people who graduated from UMMC’s OB-GYN program in 2019, Sims was the only one to stay in Mississippi.

For the doctors who stay, their patient waitlists are long.

One of the nurses Sims works with had to use her health care connections to get into a doctor’s office. She had just missed her period and called to schedule an appointment, only to be told she had to wait four months.

“I’ll never judge a person again on coming late to prenatal care,” Sims said the nurse told her.

It’s hard work being pregnant in Mississippi, Sims said.

“It’s almost like you have this feeling of being defeated,” she said. “It’s like, ‘I’m trying everything that I can to take care of me and to take care of my baby. But I have all these barriers and hoops that I have to jump through just to get to that point.’”

Reporter Isabelle Taft contributed to this story.

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

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Mississippi Today

On this day in 1867

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14 hours ago

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November 23, 2024

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mississippitoday.org – Jerry Mitchell – 2024-11-23 07:00:00

Nov. 23, 1867

Extract from the Reconstructed Constitution of the State of Louisiana, 1868. Credit: Library of Congress

The Louisiana Constitutional Convention, composed of 49 White delegates and 49 Black delegates, met in New Orleans. The new constitution became the first in the state’s history to include a bill of rights. 

The document gave property rights to married women, funded public education without segregated schools, provided full citizenship for Black Americans, and eliminated the Black Codes of 1865 and property qualifications for officeholders. 

The voters ratified the constitution months later. Despite the document, prejudice and corruption continued to reign in Louisiana, and when Reconstruction ended, the constitution was replaced with one that helped restore the rule of white supremacy.

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

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Mississippi Today

Crystal Springs commercial painter says police damaged his eyesight

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1 day ago

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November 22, 2024

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mississippitoday.org – Mina Corpuz – 2024-11-22 12:21:00

CRYSTAL SPRINGS – Roger Horton has worked decades as a commercial painter, a skill he’s kept up with even with the challenge of having what his wife has called “one good eye.” 

It hasn’t stopped him from being able to complete detailed paint jobs and create straight lines without the help of tape. But last year following a head injury, he and others said people have been pointing out a change in his work. Horton says the sight in his right eye is clouded, like he is looking underwater.

Affected vision, short term memory and periods of irritability – potential symptoms of concussion – followed after he was arrested last September. During an encounter with several police officers, Horton alleges more than one slammed his head into a cruiser and placed handcuffs on so tight that he started to bleed. 

“(The officer) was kind of rough with me and all, and he takes my head and I said, ‘What’d I do?’” he recalled recently. 

Horton ended up being convicted of two misdemeanor charges and has paid off the fines, but a year later he still has questions about the arrest and treatment by the police. 

To date, he has not seen a doctor to evaluate his eye and check for vision or cognitive issues. Horton and his wife Rhonda don’t have a car, and transportation to doctor’s appointments in the Jackson area remains a challenge. 

The Hortons have lived in Crystal Springs all their lives, and they have lived in the home the past five years that belonged to Rhonda’s mother. 

More than a quarter of all people in Crystal Springs live below the poverty line, and that includes the couple. Rhonda Horton said it’s hard to make a living because there aren’t a lot of jobs, but they support themselves as painters. 

That’s how they met Yvonne Florczak-Seeman, who lived in Illinois and purchased her first historical property in Crystal Springs in 2019. She splits her time between the two states. 

“We painted that porch bar and the rest is history,” Rhonda Horton said, adding that they went on to complete detailed work on mantles, kitchen cabinets and a cigar room at Florczak-Seeman’s North Jackson Street residence. 

Over the years, the couple built a relationship with Florczak-Seeman, who is seeking to open a women’s empowerment center called the Butterfly Garden, in the building next to city hall. 

Yvonne Florczak-Seeman poses for a portrait at her business, The Butterfly Garden, in Crystal Springs, Miss., Tuesday, Oct. 1, 2024. Credit: Eric Shelton/Mississippi Today

Florczak-Seeman has supported the couple numerous times, including helping them pay a late water bill and offering them work. She called them talented painters and hired them again to paint the interior of the future center, located at East Railroad Avenue. 

In pieces, Rhonda Horton told Florczak-Seeman about her husband’s arrest and later the injuries she said he sustained from it. Florczak-Seeman had questions about the encounter and other potential injustices at play, so she offered to help. 

“I just want them to pay for what they’ve done not just to him, but everybody,” Rhonda Horton said. “That’s what I want, justice.” 

The Arrest

On Sept. 24, 2023, Horton was walking home from a friend’s house when officers approached him. One grabbed his arms to handcuff him, and he remembers them cutting his wrist and causing it to bleed.

Then, he said, a second officer slammed his head into the top of the police car, followed by another officer who slammed his head again. During the encounter, a bag of marijuana that Horton said he found fell out of his pocket onto the ground. 

An officer put Horton in the back of the cruiser and took him to the station where Horton asked to speak to the police chief and call his wife. He said the police took his phone and clothes.

Afterward, he was taken to the Copiah County Detention Center in Gallman. 

Police Chief Tony Hemphill disputed Horton’s allegation of mistreatment, saying he did not sustain any injuries that required hospitalization. He said Horton’s wrist was cut while he resisted arrest. 

“He was not brutalized and targeted,” Hemphill said. “If he had just complied, he wouldn’t have had to come up there (to jail) that night.”

Two police reports from the night of the September 2023 arrest detail how officers had responded to a possible assault and were given the description of a white man. While in the area, they encountered Horton — the only person who fit that description. 

Hemphill said a mother called police after her daughter told her she was assaulted. He said officers approached Horton on the street and tried to talk with him to rule him out as a suspect. 

That’s when Horton began “fighting, pulling away, and kicking against (the officer’s) patrol vehicle, trying to run,” according to a police report from the night and Hemphill. Horton denies doing any of that. 

The next day police took Horton from the county jail to the Crystal Springs police station. There, police informed him a teenage girl reported being assaulted. After learning about the assault allegation, Horton remembered feeling shocked and saying it couldn’t be true because he was not on the street where the alleged incident took place. 

Hemphill confirmed the police investigated the assault allegation and found it not credible, meaning Horton wouldn’t face any related charges. He said he communicated this to Horton and his wife early on and since then, which the couple disputes. 

As Horton was being arrested and detained, his wife grew worried because she had just spoken with him on the phone and expected him to arrive home shortly. Rhonda Horton and her adult son started calling Roger’s phone, each not getting an answer. 

Then during one of the calls by her son, someone who did not identify himself answered Roger’s phone and said, ‘Your daddy’s dead’ and then hung up, Rhonda Horton said. 

She was starting to assume the worst had happened. Rhonda Horton wouldn’t have confirmation her husband was alive until he called from the county jail in the early morning. 

The next morning as she talked with the police chief, Rhonda Horton asked the chief about who answered the phone and told her son that Roger was dead. The chief told her the person who answered must have been from the county. 

Hemphill later told Mississippi Today that he did not know about the call and that type of behavior by his staff “is not going to be tolerated.” Similarly, Copiah County Sheriff Byron Swilley said he had not heard about it and could not say whether a member of his department made the comment to Rhonda and Roger Horton’s son. 

A Sept. 25, 2023, citation signed by Hemphill, shared with Mississippi Today, summoned Roger Horton to municipal court for the misdemeanor charges of possession of marijuana and resisting arrest and directed him not to have contact with the alleged victim in the assault case. No contact orders are typically for cases such as domestic violence and sexual assault and they are set by a judge.

LaKiedra Kangar, who works in municipal court services, said the no contact order was put in place because of the assault allegation. She confirmed Horton was not charged with the offense following the police department’s investigation of the allegation. 

Weeks passed. Roger Horton went to court for the misdemeanor charges, to which he pleaded guilty.  Felony assault charges were not part of the hearing. Municipal Court Judge Matthew Kitchens ordered Roger to pay over $900 in fines for the misdemeanors. 

Horton was able to pay for some of the fine through at least 10 hours worth of court-ordered community service, which he said involved painting buildings for the city. 

Months later after learning about Horton’s arrest and how he said the police treated him, Florczak-Seeman said she wanted to know more. Horton didn’t have access to his arrest documents, so she accompanied him and his wife to the police department to ask for them. 

The first visit, Horton asked but did not receive the arrest report. Florczak-Seeman asked if he had a fine for any of the charges, which police said Horton did even after completing some community service hours. Florczak-Seeman paid for the remaining balance and had him work for her for two days to pay that off. 

This year, they went to the police department a second time so Horton could ask for his arrest paperwork. An officer told him he didn’t need it and that the rape allegation had been investigated and found not to be credible, Horton told Mississippi Today. 

Florczak-Seeman asked why Horton couldn’t receive the report. She said Hemphill asked if she was Horton’s attorney, and Florczak-Seeman clarified she was his representative. 

The chief left for a few minutes and returned with two pieces of paper and handed them to Horton. Hemphill told Mississippi Today he did not recall whether he was the one who handed the report to Horton. 

Florczak-Seeman took the document from Horton and began to read it as they stood in the lobby. She said she was horrified to see the name of the alleged, underage victim and her address in the report.

Hemphill said the victim’s personal information should have been restricted and not doing so was an oversight. 

After reading the report, Florczak-Seeman went down the street to the mayor’s office at city hall to explain what happened, and how she believed the mayor had grounds to fire the police chief because he provided that document to Roger with the alleged victim’s information. 

Crystal Springs Mayor Sally Garland Credit: Crystal Springs website

Mayor Sally Garland confirmed she had a conversation with Florczak-Seeman about the police chief’s employment. 

She said she reviews all complaints about city officials, and Garland said she goes to the department head to get a better understanding of the situation. If she determines there are potential grounds for termination, a hearing would be scheduled with the Board of Aldermen, and the group would vote on that decision.   

Garland did not find grounds for termination, and Hemphill remains police chief. 

A Strange Visit

The Hortons and Florczak-Seeman hadn’t given much thought about the 2023 arrest, until weeks ago when a teenaged girl suddenly showed up in Florczak-Seeman’s yard. 

At the end of September at the North Jackson Street home, Florczak-Seeman heard screaming and found the teenage girl who came onto her property. She asked what was wrong, and the teenager said she was chased by a dog, which Florczak-Seeman and Rhonda Horton did not see. 

The teenager asked for a soda, and Rhonda Horton went inside to get one. Florczak-Seeman asked where the teenager lived, and she gave an answer that Florczak-Seeman said conflicted with what two girls who were standing nearby on the public sidewalk said she told them. 

Then Florczak-Seeman asked the teenager’s name and recognized it as the name of the alleged victim on Horton’s arrest record. Immediately, Florczak-Seeman said she turned to Horton and told him to stay back, and she told the teenager to get off her property, which she did. 

At the moment, they were not able to verify whether the teenager was the alleged victim from the report. Neither the Hortons nor Florczak-Seeman had seen her before, and they only knew her name from the arrest report.

“That didn’t make sense at all,” Rhonda Horton told Mississippi Today. 

Florczak-Seeman called 911 to report the situation and ask for police to come, which they did not. Hemphill told Mississippi Today a dispatcher informed him about the call with Florczak-Seeman, including details with the teenage girl and how she wanted to report the girl for trespassing. 

Florczak-Seeman is one of the people who have noticed a difference in Horton’s vision. It’s clear when comparing the detailed and clean paint job Roger completed at her Jackson Street property in 2019 and the center where he painted last year.

During an interview at the center in October, Florczak-Seeman pointed to the ceiling and noted spots that Horton did not paint. She remembers telling him about them and realized that he couldn’t see them. 

“The spots on my ceiling are still not painted, and they’re not painted as a reminder of the injustices that happened in this situation and why I got involved,” Florczak-Seeman said. 

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

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Job opening: Jackson Reporter

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1 day ago

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November 22, 2024

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mississippitoday.org – Mississippi Today – 2024-11-22 15:00:00

Mississippi Today, a Pulitzer Prize-winning newsroom focused on investigative and accountability journalism, is building a dedicated team of reporters to provide in-depth coverage of Jackson, Mississippi.

As the state’s largest and capital city, Jackson matters greatly to us and all Mississippians. Launched in 2016 as the state’s flagship nonprofit newsroom focused on Mississippi government and policy, Mississippi Today is focusing our lens beyond the statehouse and to the city of Jackson, serving our readers with the watchdog reporting they’ve come to expect from Mississippi Today. Our newsroom, with a proven record of providing impactful government accountability, aims to serve the city more directly with this team.

Our Jackson team will focus on sharp investigative reporting, watchdog accountability journalism and meaningful cultural storytelling. We aim to both elevate the voices of those working for positive change in the community while offering a balanced perspective on the city’s obstacles and triumphs. Our goal is to deliver impactful, honest journalism that will inform, inspire and empower Jackson’s citizens.

The team will be led by Pulitzer Prize winner Anna Wolfe, an investigative reporter with a decade of experience covering Jackson.

Roles and Responsibilities:

  • We are purposefully casting a wide net, hoping to connect with journalists of many different backgrounds who may be uniquely qualified to help us launch this team. If you’re a reporter with any of the following experience or attributes, this team may be for you.
  • Investigative reporting focused on uncovering systemic issues within government and politics. The bigger the impact of your reporting on government leaders or systems, the better.
  • Political reporting covering not only high-profile candidates for offices, but experience delving into issues and ideas that affect a community. We hope to delve deeply into a deep distrust in the city’s institutions.
  • Cultural reporting that highlights the often-overlooked success stories of citizens who are making a positive impact on their communities.
  • Strong understanding of Jackson (or similar large urban centers) and the unique challenges facing the city and its residents.
  • Commitment to the mission of balanced, impactful journalism that centers and respects the voice of the community.
  • Collaborative mindset and ability to work within a team-oriented newsroom.

The starting salary for this position is $58,000. Compensation is commensurate with experience level.

Expectations:

  • Work with a small team of journalists who are focused on social inequities and racial equality in our area.
  • Willingness to collaborate closely with a small team of like-minded journalists.
  • Get people to talk, find willing sources and protect them while telling sensitive and timely stories.
  • Build trust: Many people who have been impacted by inequities in Mississippi have been victims of predatory practices and forces. This will require empathy, patience and savvy.
  • Work with our Audience Team and data and visual journalists to create compelling story presentations.

Qualified candidates should have:

  • Experience working as a reporter in a newsroom.
  • Ability to work quickly, with accuracy and good news judgment.
  • Comfortability in digital or multimedia journalism spaces.
  • Ability to independently develop and cultivate sources.
  • Ability to use social media for research and to engage readers.

What you’ll get:

  • The opportunity to work alongside award-winning journalists and make significant contributions to Mississippi’s top nonprofit, nonpartisan digital news and information sources.
  • Highly competitive salary with medical insurance, and options for vision and dental insurance.
  • Use of appropriate technology and equipment. 
  • 29 days paid time off.
  • Up to 12 weeks of parental family leave, with return-to-work flexibility.
  • Simple IRA with 3 percent company matching. Group-term life insurance provided to employees ($15,000 policy).
  • Support for professional training and attending industry conferences.

How to Apply:

We’re committed to building an inclusive newsroom that represents the people and communities we serve. We especially encourage members of traditionally underrepresented communities to apply for this position, including women, people of color, LGBTQ people and people who are differently abled. Please apply here.

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

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