Mississippi Today
Mississippi ambulance providers anticipate downfall of services amid hospital crisis
Mississippi ambulance providers fear a collapse of emergency medical services is on the horizon, partly as a result of hospitals discontinuing services and, in some cases, closing.
The crisis has caused a decline in worker availability for ambulance providers and an increase in emergency service wait times, those in the field say. And with the rise of medical costs and stagnant reimbursement rates, finances are also a challenge.
“Everything is working together and is causing this downward spiral of the whole system,” Clyde Deschamp, emergency medical service director for Mississippi Health Care Alliance, an organization aimed at coordinating medical activities within the state's EMS districts, said. “It's one big cycle.”
Hospital closures across the state are not only jeopardizing residents' access to medical care but increasing interfacility transports – the transport of patients between two health care facilities.
Emergency services personnel are transporting patients longer distances due to rural hospitals no longer offering as many services. Patients now have to travel farther to get the care they need.
He said to make matters worse, once the ambulance arrives at the receiving hospital, the crew may be required to wait up to six hours in the emergency room due to bed shortages before transferring care to the hospital.
This “wall time” – the length of time emergency medical technicians and paramedics are waiting with patients before admission – prevents ambulance crews from responding to additional 911 calls, sometimes leaving a county area undercovered and residents with no assistance.
“Some of the more complicated transports won't take just one paramedic but two. So, the problem with being stuck on the wall now is you have two people stuck waiting instead of one,” Deschamp said.
Despite the demand for workers, fewer people are pursuing this career.
According to a recent National Association of Emergency Medical Technicians report, most agencies nationwide reported increasing turnover rates on average from 8% in 2019 to 11% in 2022.
In addition, the report found from 2019 to 2022, nearly 66% of agencies experienced a decrease in job applications.
Deschamp said existing paramedics have stepped up as much as they can to fill staffing gaps, making it common for paramedics to work 80-plus hours per week.
“Unfortunately, resource management – no matter how good – simply cannot compensate for a lack of paramedics to staff ambulances and a growing demand for interfacility transports,” Deschamp told Mississippi Today. “Regrettably, the situation may get worse before it gets better.”
Gregory M. Cole, EMS advisory committee member to the Mississippi Board of Health and former chief compliance officer at Covington County Hospital, said working with limited resources to provide service in an adverse environment “is killing the morale of EMS workers.”
Cole said paramedics are burning out.
“They are exhausted,” Cole explained. “If you take a man or woman that has worked a 16-hour shift after running 12 calls, then at midnight have them take a patient six hours away. That is not safe for the patient nor is it healthy for the crew.”
At Covington County Ambulance Service, there are currently 70 employed medics and nine ambulances covering Covington, Simpson and Magee County, a roughly 1,010-square-mile area.
The ambulance service received a total of 10,000 calls last year – 90% were non-emergency and less than 10% were emergency calls. Non-emergencies included sprains and noise complaints, while emergencies included falls, motor vehicle accidents and respiratory disorders.
The number of hospital-to-hospital transfers this year for Covington County Ambulance Service as of Sept. 7 was 1,214, an increase from 714 in 2021 and 1,261 in 2022.
The rate of patient transfers spiked for two reasons, said Todd Jones, director of EMS at Covington County Hospital. The first is staff shortages at the hospitals it serves; the second is the service added Magee General Hospital and Simpson General Hospital.
In addition, the reimbursement model for EMS services is a problem, Cole said.
Cole told Mississippi Today that EMS is reimbursed at a bundled rate – it is paid an overall sum for treating a patient instead of an individualized amount for different patients.
He explained that even if he spends 12 hours taking care of a patient and $1,300 worth of medication to treat them, he is still provided one amount by the Centers for Medicare & Medicaid Services (CMS). And it usually doesn't cover the expenses to provide emergency medical services, he said.
Cole said the uninsured, underinsured and private insurances cover only a portion of cost.
“This is equivalent to someone going into Walmart, getting $100 worth of groceries, deciding to only pay for $25 of it but still walking out with the rest of the groceries,” Cole explained. “Walmart wouldn't allow you to do that, but somehow it's okay to do that in ambulance services.”
Cole said without adequate reimbursement, EMS providers cannot stay response ready, attract the amount of workers they want and retain employees.
David Grayson, president of Mississippians for Emergency Medical Services, the state's largest trade organization for ambulance personnel in Mississippi, said health insurers reimbursement rates vary by insurance type.
Nationwide, almost half of EMS patients are covered by Medicare, according to a 2008 American Ambulance Association study. The study found Medicare reimbursement rates for ambulance services are six percent less than the national average cost per ambulance transport.
In addition, uninsured patients make up an average of 14 percent of ambulance transports. Ambulance services experience almost double the uncompensated care burden as US hospitals and physicians, the study said.
Twenty to 40 percent of EMS patients are covered by Medicaid, which pays “universally low” rates.
“The concern I have is, if our reimbursements continue to stay flat or have a slow increase while our costs are obviously going up at a steeper level, then there's going to come a time where ambulances are not going to be available,” Grayson told Mississippi Today.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Mississippi Today
Mississippi judge blocks Biden attempt to ensure LGBTQ+ medical treatment
A federal judge in Mississippi has blocked enactment of a Biden administration rule designed to prevent medical care from being denied to those seeking treatment related to gender identity or sexual orientation.
The lawsuit U.S. Southern District Judge Louis Guirola Jr. ruled on Wednesday was filed by 15 states, including Mississippi. But he said his injunction preventing the Biden administration from enforcing its rule would apply nationwide. His ruling is likely to be appealed.
On social media, the Human Rights Campaign proclaimed, “This is not over. All LGBTQ+ people should receive the health care we deserve and be able to make informed decisions about our own bodies.”
The Biden administration rule enacted earlier this year is designed to ensure those seeking medical care on the basis of gender identity or sexual orientation are not subject to discrimination. The rule is supposed to cover entities receiving federal funds for the delivery of health care.
The states argued against being forced to provide gender-affirming care through Medicaid programs or through health plans for state employees. In addition, the states argued against private insurance companies being required to provide such care.
“Injecting gender identity into our state's medical system is a dangerous pursuit of a political agenda from the Biden Administration,” Mississippi Attorney Lynn Fitch said in a statement. “Medical professionals should not be forced to provide gender transition surgeries or drugs against their judgment and hospitals should not be prohibited from providing women-only spaces for patients. I am proud to lead the multistate effort with Tennessee Attorney General Jonathan Skrmetti to stop the Biden Administration and push back on this reckless rule.”
The lawsuit is one of many filed by attorneys general and others objecting to the Biden administration interpreting Title IX to apply to banning discrimination based on sexual orientation and sexual identity. Congress passed, and President Richard Nixon signed into law, Title IX in 1972 to ban sexual discrimination.
In response to one of the similar lawsuits ruled on earlier in Louisiana, Kelley Robinson, president of the Human Rights Campaign, said, “Every student … deserves to be safe. Every young person deserves protection from bullying, misgendering and abuse.”
Robinson added, referring to the earlier court ruling, “This is MAGA theatrics with the dangerous goal of weaving discrimination into state law.”
Mississippi has passed a state law prohibiting minors from receiving gender-affirming care even if it is recommended by physicians.
On social media, Gov. Tate Reeves said, “The Biden Administration attempted to undermine Title IX by dramatically reinterpreting its meaning to now apply to gender identity. Thankfully, a federal court judge has sided with Mississippi and other states who chose to stand up for women and defend Title IX as it currently exists.”
The lawsuit filed by Fitch and other attorneys general argued that their states could be penalized by the loss of federal Medicaid funds, for example, if they did not adhere to the rule.
In blocking the rule. Guirola cited the Chevron case where the U.S. Supreme Court recently said that federal agencies should not be given deference in their rules-making.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Mississippi Today
State GOP plans to endorse judicial candidates, while Democratic Party does not
The leaders of the Mississippi's two major political parties recently offered two opposing plans for how much they plan to interact with candidates competing for one the state's three contested races for the state Court of Appeals and the state Supreme Court.
Mississippi Republican Party Chairman Mike Hurst told Mississippi Today on the June 24 edition of Mississippi Today's “The Other Side” podcast that the GOP will likely endorse certain candidates in the race, while Mississippi Democratic Party Chairman Cheikh Taylor said on the July 1 episode of the podcast that judicial endorsements are not on the party's radar.
Judicial elections tend to be low-interest races, but the elections this year will take place on the same ballot as the presidential and congressional elections. If a major political party endorses a candidate, it could give them more name recognition at the ballot box.
“I know it's a nonpartisan race, and I think there should be a clear dividing line between the campaigns for nonpartisan races and the partisan entities like the Republican Party,” Hurst said. “But at the same time, we all know that there are differences that judicial candidates hold in their opinions on how to interpret the constitution and how to interpret statutes.”
Candidates for the Mississippi Court of Appeals and the Mississippi Supreme Court are required to run as nonpartisan, meaning they do not run in a party primary. However, political parties can still endorse candidates running for those offices.
For a few years, state law banned parties from endorsing or donating money to nonpartisan judicial candidates. But the state GOP in 2002 filed a federal lawsuit challenging the ban. U.S. District Judge Henry T. Wingate struck down the ban as unconstitutional, saying it was a violation of the U.S. Constitution's First Amendment.
Taylor, who just won election to a full term as Democratic Party chairman, said the party is still in a “rebuilding phase” and has to carefully decide which races it should get involved with.
“There are so many races to get involved in and so many ways that funding is limited,” Taylor said. “We are structuring now to broaden our base to make sure that fundraising is not an issue moving forward.”
There are three contested judicial races this year: an open seat on the Mississippi Court of Appeals and two Mississippi Supreme Court races where incumbents face challengers.
In the Central District race for the Supreme Court, longtime incumbent Justice Jim Kitchens, a senior member of the Court, faces a challenge from four candidates: Abby Robinson, Ceola James, Byron Carter and Jenifer Branning. In the Southern District race, incumbent Justice Dawn Beam faces a challenge from David Sullivan.
Three people are competing for an open Court of Appeals seat: Jennifer Schloegel, Amy Lassiter St. Pe and Ian Baker.
All candidates will appear on the Nov. 5 general election ballot. If a candidate does not receive a majority of the votes cast, the two candidates who received the most votes will advance to a runoff election on Nov. 26.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Mississippi Today
Federal judges order Mississippi Legislature to create more Black districts, may prompt 2024 elections
The Mississippi Legislature has been ordered to create more Black-majority House and Senate Districts by a federal three-judge panel.
“The court rightly held that the Mississippi Legislature used the redistricting process to dilute the power of Black voters. Those legislative districts denied Black Mississippians an equal voice in state government,” said Jarvis Dortch, executive director of the ACLU of Mississippi.
The judges ruled in a lawsuit filed on behalf of the Mississippi Conference of the NAACP and Black voters from across the state that the districts that were drawn in 2022 by the state Legislature diluted Black voting strength. Legislative redistricting occurs every 10 yeas after the federal census.
In the ruling, released late Tuesday, the federal panel said it would give the Legislature the opportunity to redraw the districts, but added, “It is the desire of this court to have new legislators elected before the 2025 legislative session convenes, but the parties can make whatever arguments about timing they conclude are valid.”
The state, which opposed the lawsuit, can argue for more time to redraw the districts. Or the state could appeal the ruling to the U.S. Supreme Court.
MaryAsa Lee, a spokesperson for Republican Attorney General Lynn Fitch's office, said the agency is currently reviewing the court's opinion. She did not say whether Fitch wanted to appeal the order.
The federal panel did not accept all of the arguments of the NAACP and other plaintiffs. But the panel ruled that Black-majority Senate districts should be drawn at least in the DeSoto County area in north Mississippi and in the Hattiesburg area in south Mississippi. In addition, a new Black majority House district should be drawn in the Chickasaw County area in northeast Mississippi.
The state has a Black population of about 38%. Currently there are 42-Black majority districts in the 122-member House and 15 Black majority districts in the 52-seat Senate.
Multiple groups represented the NAACP and other plaintiffs in the case.
The three judges serving on the panel were all appointed by Republican President George W. Bush.
Charles Taylor, executive director of the Mississippi State Conference of the NAACP, said he was pleased with the decision “although we wish the court had gone further.”
The NAACP and others argued the totality of the 2022 redistricting by the Legislature diluted Black voting strength. Groups argued by “packing” a large percentage of Black voters in a concentrated number of districts it deprived them from having an impact in other districts. The three judge panel did not accept the total argument of the plaintiffs.
But still, the people who brought the lawsuit maintained the decision of the federal panel was a victory for Black Mississippians.
“This ruling brings us much closer to the goal of ensuring that Mississippi has a fair number of majority-Black legislative districts to go along with the majority-white ones,” said Rob McDuff, an attorney with the Mississippi Center for Justice.
READ MORE: Lawsuit claiming Mississippi Supreme Court districts are discriminatory is set for August
The Lawyers' Committee for Civil Rights Under Law, the American Civil Liberties Union, ACLU of Mississippi, the law firm of Morgan, Lewis & Bockius, Mississippi Center for Justice and civil rights attorney Carroll Rhodes all participated in the case.
“This ruling affirms that the voices of Black Mississippians matter and should be reflected in the state Legislature,” said Jennifer Nwachukwu, of the Lawyers' Committee for Civil Rights Under Law Voting Rights Project.
The next step will be for either the state to appeal or present arguments to the federal panel on why the new districts should not be drawn and filled via election before the 2025 legislative session.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
-
Mississippi News6 days ago
Pearl under boil water notice due to E. coli
-
Mississippi News7 days ago
Tropical wave has a 70 percent chance of developing, National Hurricane Center says
-
Mississippi Business7 days ago
Communities qualify for Welcome Home Mississippi recertification
-
Our Mississippi Home7 days ago
Mississippi State’s UTC Staff Win Seven Emmy Awards
-
SuperTalk FM6 days ago
Move over 662, a new area code is coming to north Mississippi
-
Our Mississippi Home7 days ago
Celebrating the 15th Season of Festival South
-
Kaiser Health News7 days ago
Supreme Court Upends Purdue Pharma Opioid Settlement
-
Mississippi News6 days ago
Youth Court Judge says there is a dire need for foster homes – Home – WCBI TV