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A program is putting more doctors in rural Mississippi. The auditor says it needs improvements.

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A program aimed at increasing doctors in rural Mississippi communities isn’t effective enough, a new report from the state auditor’s office says. 

As health care worker shortages continue, the program’s success could be crucial to improving the state’s persistent health care crisis.

The Mississippi Rural Physicians Scholarship Program, established in 2007 by the Legislature and administered by the University of Mississippi Medical Center, awards money to medical school students for tuition or student loans. In exchange, recipients must spend one year practicing in Mississippi for every year they accept the money. A similar program focused on incentivizing dentists to practice in rural Mississippi followed in 2013.

Ideally, the programs would help close the state’s health care gap — half of all Mississippians live in medically underserved counties, according to a 2021 assessment from the state Health Department. Eighty of Mississippi’s 82 counties are federally classified as Health Professional Shortage Areas in either primary or dental care.

State Auditor Shad White speaking at the Neshoba County Fair, Thursday, July 28, 2022. Credit: Vickie D. King/Mississippi Today

But according to State Auditor Shad White, the programs aren’t producing doctors and dentists fast enough. A former participant of the program, however, says it was never intended to solve the shortage entirely – the problem is too big and complex.

Data in the report show that the percent of need met for primary and dental care in Mississippi’s neediest communities has decreased over the past decade, despite more money being infused into the programs.

Fletcher Freeman, a spokesperson for the State Auditor’s office, said the programs, as they stand, are too small to be effective.

But participants like Dr. Jonathan Buchanan who moved home to Carthage in 2017 to practice family medicine said the programs are making significant changes in the communities they serve, despite the fact they are not solving the entire problem.

“I was the first physician to come back to this area in 26 years — that’s a generation’s worth of time,” he said. “Our program is currently somewhere in the 70 range of people graduated from the program and practicing, and if you asked each of those physicians, they’d say they’re making a tremendous impact on the quality of health care that rural Mississippians are receiving.”

The report takes issue with several things in particular: the programs’ definition of “rural” is too broad, and the commissions running the programs should maintain better oversight of them.

“We just don’t have the definition of ‘rural’ down,” Freeman said. “We’re using definitions when it’s convenient to potentially place doctors in Flowood.”

Though no participants have been placed in Flowood, the rules for the program allow for the Jackson suburb to be considered “rural” because of its small population. Currently, 10% of scholarship recipients practice in areas that the federal government doesn’t consider “rural.”

The report recommends adopting the federal definition of “rural” to ensure participants are placed where they’re most needed.

However, when the Legislature created the programs, they established commissions to oversee them. Those commissions decide how the programs work, including the definitions under which they operate.

Natalie Gaughf, assistance vice chancellor of academic affairs at the University of Mississippi Medical Center Credit: Courtesy of UMMC

Dr. Natalie Gaughf, the University of Mississippi Medical Center’s assistant vice chancellor for academic affairs, said “it has been determined that the federal designation of ‘rural’ is not adequate” to meet the state’s needs, and what’s currently used is based on an “understanding of Mississippi’s current and historic health care landscape.”

Mississippi towns that have a population of less than 15,000 and are located more than 20 miles from a “medically served” metropolitan area are eligible for graduates to be placed for work, she said, and every practice location request is reviewed individually.

Students who aren’t from rural areas are also eligible to receive a scholarship, though Gauphf said that all of the program’s recipients have “substantial ties” to rural communities.

Additionally, the report found that a quarter of rural physician scholarship recipients and 14% of dental scholarship participants have breached their contracts.

That can mean students did not complete their commitment requirements, or they chose a non-primary care field of medicine or chose to practice in a non-rural part of Mississippi or out of the state entirely.

Breaching the contract should result in the scholarship being converted into a loan with interest. However, the report found that the scholarship programs’ offices do not accurately monitor this data. Gauphf did not expand on the challenges associated with tracking these numbers.

According to Gaughf, 49 medical school graduates have breached their contract from the time the program was created to the fall of last year.

Freeman couldn’t say what provoked the first-time review of the programs, aside from gauging their general effectiveness and ensuring that taxpayer dollars are being put to good use.

Since the program’s inception, more than $33.5 million in state dollars have gone toward it.

“This report was meant to highlight basically efficiencies and inefficiencies in the program to maximize every dollar they receive,” he said.

Freeman said if the offices use the report to address the programs’ deficiencies, perhaps they’ll receive more money and be able to make more of an impact. According to Gauphf, changes based on the report have already been made, including at least one new form used to track individuals who breach their contracts.

The Legislature has recently expanded both programs, putting $2.17 million into the rural physician scholarship program and $420,000 into the dentists’ program in fiscal years 2023 and 2024, according to the report.

“It’s a good program that’s effective at producing doctors,” Freeman said. “Just not at the rate we need them.”

Still, it’ll be hard for the program to keep up with the rate physicians and dentists are choosing to leave the state or retire, which Gauphf said is “faster than the programs can produce graduates.”

Buchanan, the scholarship program alumnus practicing in Carthage, sees the state’s health care worker crisis as multifactorial and not something that can be solved through a single program.

“We just don’t have enough physicians, period,” he said. “But I think this is definitely a step in the right direction.”

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

Mississippi Today

Early voting proposal killed on last day of Mississippi legislative session

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mississippitoday.org – @MSTODAYnews – 2025-04-03 13:02:00

Mississippi will remain one of only three states without no-excuse early voting or no-excuse absentee voting. 

Senate leaders, on the last day of their regular 2025 session, decided not to send a bill to Gov. Tate Reeves that would have expanded pre-Election Day voting options. The governor has been vocally opposed to early voting in Mississippi, and would likely have vetoed the measure.

The House and Senate this week overwhelmingly voted for legislation that established a watered-down version of early voting. The proposal would have required voters to go to a circuit clerk’s office and verify their identity with a photo ID. 

The proposal also listed broad excuses that would have allowed many voters an opportunity to cast early ballots. 

The measure passed the House unanimously and the Senate approved it 42-7. However, Sen. Jeff Tate, a Republican from Meridian who strongly opposes early voting, held the bill on a procedural motion. 

Senate Elections Chairman Jeremy England chose not to dispose of Tate’s motion on Thursday morning, the last day the Senate was in session. This killed the bill and prevented it from going to the governor. 

England, a Republican from Vancleave, told reporters he decided to kill the legislation because he believed some of its language needed tweaking. 

The other reality is that Republican Gov. Tate Reeves strongly opposes early voting proposals and even attacked England on social media for advancing the proposal out of the Senate chamber. 

England said he received word “through some sources” that Reeves would veto the measure.

“I’m not done working on it, though,” England said. 

Although Mississippi does not have no-excuse early voting or no-excuse absentee voting, it does have absentee voting. 

To vote by absentee, a voter must meet one of around a dozen legal excuses, such as temporarily living outside of their county or being over 65. Mississippi law doesn’t allow people to vote by absentee purely out of convenience or choice. 

Several conservative states, such as Texas, Louisiana, Arkansas and Florida, have an in-person early voting system. The Republican National Committee in 2023 urged Republican voters to cast an early ballot in states that have early voting procedures. 

Yet some Republican leaders in Mississippi have ardently opposed early voting legislation over concerns that it undermines election security. 

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

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Mississippi Legislature approves DEI ban after heated debate

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mississippitoday.org – @MSTODAYnews – 2025-04-02 16:34:00

Mississippi lawmakers have reached an agreement to ban diversity, equity and inclusion programs and a list of “divisive concepts” from public schools across the state education system, following the lead of numerous other Republican-controlled states and President Donald Trump’s administration.  

House and Senate lawmakers approved a compromise bill in votes on Tuesday and Wednesday. It will likely head to Republican Gov. Tate Reeves for his signature after it clears a procedural motion.

The agreement between the Republican-dominated chambers followed hours of heated debate in which Democrats, almost all of whom are Black, excoriated the legislation as a setback in the long struggle to make Mississippi a fairer place for minorities. They also said the bill could bog universities down with costly legal fights and erode academic freedom.

Democratic Rep. Bryant Clark, who seldom addresses the entire House chamber from the podium during debates, rose to speak out against the bill on Tuesday. He is the son of the late Robert Clark, the first Black Mississippian elected to the state Legislature since the 1800s and the first Black Mississippian to serve as speaker pro tempore and preside over the House chamber since Reconstruction.

“We are better than this, and all of you know that we don’t need this with Mississippi history,” Clark said. “We should be the ones that say, ‘listen, we may be from Mississippi, we may have a dark past, but you know what, we’re going to be the first to stand up this time and say there is nothing wrong with DEI.'”

Legislative Republicans argued that the measure — which will apply to all public schools from the K-12 level through universities — will elevate merit in education and remove a list of so-called “divisive concepts” from academic settings. More broadly, conservative critics of DEI say the programs divide people into categories of victims and oppressors and infuse left-wing ideology into campus life.

“We are a diverse state. Nowhere in here are we trying to wipe that out,” said Republican Sen. Tyler McCaughn, one of the bill’s authors. “We’re just trying to change the focus back to that of excellence.”

The House and Senate initially passed proposals that differed in who they would impact, what activities they would regulate and how they aim to reshape the inner workings of the state’s education system. Some House leaders wanted the bill to be “semi-vague” in its language and wanted to create a process for withholding state funds based on complaints that almost anyone could lodge. The Senate wanted to pair a DEI ban with a task force to study inefficiencies in the higher education system, a provision the upper chamber later agreed to scrap.

The concepts that will be rooted out from curricula include the idea that gender identity can be a “subjective sense of self, disconnected from biological reality.” The move reflects another effort to align with the Trump administration, which has declared via executive order that there are only two sexes.

The House and Senate disagreed on how to enforce the measure but ultimately settled on an agreement that would empower students, parents of minor students, faculty members and contractors to sue schools for violating the law.

People could only sue after they go through an internal campus review process and a 25-day period when schools could fix the alleged violation. Republican Rep. Joey Hood, one of the House negotiators, said that was a compromise between the chambers. The House wanted to make it possible for almost anyone to file lawsuits over the DEI ban, while Senate negotiators initially bristled at the idea of fast-tracking internal campus disputes to the legal system.   

The House ultimately held firm in its position to create a private cause of action, or the right to sue, but it agreed to give schools the ability to conduct an investigative process and potentially resolve the alleged violation before letting people sue in chancery courts.

“You have to go through the administrative process,” said Republican Sen. Nicole Boyd, one of the bill’s lead authors. “Because the whole idea is that, if there is a violation, the school needs to cure the violation. That’s what the purpose is. It’s not to create litigation, it’s to cure violations.” 

If people disagree with the findings from that process, they could also ask the attorney general’s office to sue on their behalf.

Under the new law, Mississippi could withhold state funds from schools that don’t comply. Schools would be required to compile reports on all complaints filed in response to the new law.

Trump promised in his 2024 campaign to eliminate DEI in the federal government. One of the first executive orders he signed did that. Some Mississippi lawmakers introduced bills in the 2024 session to restrict DEI, but the proposals never made it out of committee. With the national headwinds at their backs and several other laws in Republican-led states to use as models, Mississippi lawmakers made plans to introduce anti-DEI legislation.

The policy debate also unfolded amid the early stages of a potential Republican primary matchup in the 2027 governor’s race between State Auditor Shad White and Lt. Gov. Delbert Hosemann. White, who has been one of the state’s loudest advocates for banning DEI, had branded Hosemann in the months before the 2025 session “DEI Delbert,” claiming the Senate leader has stood in the way of DEI restrictions passing the Legislature. 

During the first Senate floor debate over the chamber’s DEI legislation during this year’s legislative session, Hosemann seemed to be conscious of these political attacks. He walked over to staff members and asked how many people were watching the debate live on YouTube. 

As the DEI debate cleared one of its final hurdles Wednesday afternoon, the House and Senate remained at loggerheads over the state budget amid Republican infighting. It appeared likely the Legislature would end its session Wednesday or Thursday without passing a $7 billion budget to fund state agencies, potentially threatening a government shutdown.

“It is my understanding that we don’t have a budget and will likely leave here without a budget. But this piece of legislation …which I don’t think remedies any of Mississippi’s issues, this has become one of the top priorities that we had to get done,” said Democratic Sen. Rod Hickman. “I just want to say, if we put that much work into everything else we did, Mississippi might be a much better place.”

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

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House gives Senate 5 p.m. deadline to come to table, or legislative session ends with no state budget

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mississippitoday.org – @MSTODAYnews – 2025-04-02 16:13:00

The House on Wednesday attempted one final time to revive negotiations between it and the Senate over passing a state budget.

Otherwise, the two Republican-led chambers will likely end their session without funding government services for the next fiscal year and potentially jeopardize state agencies.

The House on Wednesday unanimously passed a measure to extend the legislative session and revive budget bills that had died on legislative deadlines last weekend. 

House Speaker Jason White said he did not have any prior commitment that the Senate would agree to the proposal, but he wanted to extend one last offer to pass the budget. White, a Republican from West, said if he did not hear from the Senate by 5 p.m. on Wednesday, his chamber would end its regular session. 

“The ball is in their court,” White said of the Senate. “Every indication has been that they would not agree to extend the deadlines for purposes of doing the budget. I don’t know why that is. We did it last year, and we’ve done it most years.” 

But it did not appear likely Wednesday afternoon that the Senate would comply.

The Mississippi Legislature has not left Jackson without setting at least most of the state budget since 2009, when then Gov. Haley Barbour had to force them back to set one to avoid a government shutdown.

The House measure to extend the session is now before the Senate for consideration. To pass, it would require a two-thirds majority vote of senators. But that might prove impossible. Numerous senators on both sides of the aisle vowed to vote against extending the current session, and Lt. Gov. Delbert Hosemann who oversees the chamber said such an extension likely couldn’t pass. 

Senate leadership seemed surprised at the news that the House passed the resolution to negotiate a budget, and several senators earlier on Wednesday made passing references to ending the session without passing a budget. 

“We’ll look at it after it passes the full House,” Senate President Pro Tempore Dean Kirby said. 

The House and Senate, each having a Republican supermajority, have fought over many issues since the legislative session began early January.

But the battle over a tax overhaul plan, including elimination of the state individual income tax, appeared to cause a major rift. Lawmakers did pass a tax overhaul, which the governor has signed into law, but Senate leaders cried foul over how it passed, with the House seizing on typos in the Senate’s proposal that accidentally resembled the House’s more aggressive elimination plan.

The Senate had urged caution in eliminating the income tax, and had economic growth triggers that would have likely phased in the elimination over many years. But the typos essentially negated the triggers, and the House and governor ran with it.

The two chambers have also recently fought over the budget. White said he communicated directly with Senate leaders that the House would stand firm on not passing a budget late in the session. 

But Senate leaders said they had trouble getting the House to meet with them to haggle out the final budget. 

On the normally scheduled “conference weekend” with a deadline to agree to a budget last Saturday, the House did not show, taking the weekend off. This angered Hosemann and the Senate. All the budget bills died, requiring a vote to extend the session, or the governor forcing them into a special session.

If the Legislature ends its regular session without adopting a budget, the only option to fund state agencies before their budgets expire on June 30 is for Gov. Tate Reeves to call lawmakers back into a special session later. 

“There really isn’t any other option (than the governor calling a special session),” Lt. Gov. Delbert Hosemann previously said. 

If Reeves calls a special session, he gets to set the Legislature’s agenda. A special session call gives an otherwise constitutionally weak Mississippi governor more power over the Legislature. 

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

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