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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

On this day in 1965

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mississippitoday.org – Jerry Mitchell – 2025-01-25 07:00:00

Jan. 25, 1965

Oprah Winfrey portrays Annie Lee Cooper in “Selma.” Credit: Atsushi Nishijima, courtesy of Paramount Pictures, Pathé and Harpo Films

Annie Lee Cooper — portrayed by Oprah Winfrey in the film “Selma” — had been standing in line for hours outside the Dallas County courthouse in Selma, Alabama, once again attempting to register to vote. 

Sheriff Jim Clark and his deputies appeared. The 6-foot Clark had a reputation for racism and violence, carrying a billy club and cattle prod and telling others that the only problem with his job was “all this n—– fuss here of late. … You just have to know how to handle them.” He ordered the activists to leave, despite the fact they were legally entitled to register. 

Cooper recalled, “I was just standing there when his deputies told a man with us to move, and when he didn’t, they tried to kick him. That’s when (Clark), and I got into it. I try to be nonviolent, but I just can’t say I wouldn’t do the same thing all over again if they treat me brutish like they did this time.” 

Clark began poking her over and over in the neck with his billy club. She finally struck back, knocking him down. Deputies attacked her, beating her with a billy club. They threw her into jail, where she began to sing spirituals. 

Cooper had returned to Selma to care for her sick mother three years earlier. She had registered to vote where she lived in Kentucky and Ohio, but when she tried to register, the clerk told her she failed the test. She kept trying and joined SNCC’s first Freedom Day, where she waited with 400 others to register to vote in fall 1963. She was fired from her job and struck with a cattle prod. And after she was jailed in 1965, she never gave up. 

The Voting Rights Act passed Congress, and she was able to vote. She lived to be 100, and the city of Selma named a street after her. Winfrey said she decided to portray Cooper because of “what her courage meant to an entire movement. Having people look at you and not see you as a human being — she just got tired of it.”

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

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Will new state-appointed Jackson court have city-based jurists? Yes, chief justice decides

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mississippitoday.org – Mina Corpuz – 2025-01-24 14:04:00

In 2023 as lawmakers were passing the bill that would establish a state-appointed court within Jackson, there was talk about appointing “the best and the brightest” judges from around the state to serve – a comment some Black legislators said implied they couldn’t be found within a majority Black Hinds County. 

Over a year later, the Capitol Complex Improvement District Court is set to open next week, and three judges with roots in Jackson and live in the capital have been appointed to serve. 

The judges who were sworn in during a Friday ceremony said they were interested in the positions because they wanted to serve the community where many of them grew up and live. 

“This is a very serious undertaking to citizens who live in this city,” said Judge Christopher Collins, who will serve on a part-time basis. He moved to Jackson for the role. 

Judge Stanley Alexander and James Holland will be the full-time judges.

Supreme Court Chief Justice Mike Randolph swears in Stanley Alexander during the opening of the Capitol Complex Improvement District Court (CCID), Friday, Jan. 24, 2025 in Jackson. Credit: Vickie D. King/Mississippi Today

Alexander is a former assistant district attorney in multiple judicial districts and he worked in the attorney general’s office, including as director of the Division of Public Integrity. Holland has practiced law for over 40 years and has trial experience, including defense in state and federal courts. He ran an unsuccessful race for Hinds County district attorney in 2015.

Collins has been a prosecutor and public defender. His judicial experience includes work as a circuit and municipal judge, intervention court judge and a judge for the Mississippi Band of Choctaw Indians. 

Dr. Bryana Smith McDougal, is sworn in as Clerk of the Capitol Complex Improvement District Court by Supreme Court Chief Justice Mike Randolph, during the opening of the Capitol Complex Improvement District Court (CCID), Friday, Jan. 24, 2025 in Jackson. Credit: Vickie D. King/Mississippi Today

Bryana Smith McDougal was appointed as the court’s clerk. She previously was judicial assistant to former Supreme Court Justice Jim Kitchens and an assistant deputy clerk for the Supreme Court. She grew up in Jackson and lives in Madison.

Supreme Court Chief Justice Mike Randolph, who appointed the judges and clerk, said he considered many from across the state and took recommendations. It was through letters of recommendation and conversations with the three judges that showed that they were the best for the position. 

“These judges have proven themselves,” Randolph said. 

House Bill 1020, passed in 2023, created the court. The CCID court was supposed to be operating last year, but it waited on a building to operate. Now business will begin operation Monday at 8 a.m. at its renovated facility at 201 S. Jefferson St., a former bus terminal in downtown. 

A graph showing the workings of the criminal justice system displayed at the Capitol Complex Improvement District Court (CCID), Friday, Jan. 24, 2025 in Jackson. Credit: Vickie D. King/Mississippi Today

The CCID court will hear misdemeanor cases and initial appearances for felonies investigated by Capitol Police. Those cases have been handled in the existing Hinds County court system during the interim.

“We want to stay current (with cases.) Our goal is to support and supplement the current court system,” Holland said. 

At the Friday ceremony, Gov. Tate Reeves said the court and the ongoing work of Capitol Police will help make Jackson safer. 

“Make no mistake. Jackson’s best days are ahead of us,” he said. 

Reeves stood alongside various government officials, law enforcement and lawmakers, including House Ways and Means Chairman Trey Lamar, who authored HB 1020, and Public Safety Commissioner Sean Tindell, whose agency includes Capitol Police. 

Lamar said the court will be for the regular people of Jackson who want to have their kids play safely in their yards, people who want an efficient and blind justice system and families who will be supported by future jobs that come to the city. 

HB 1020 also expanded the jurisdiction of the Capitol Police from within the district to Jackson. The district covers downtown, the area around Jackson State University, Belhaven, the hospitals, Fondren and up to Northside Drive. A bill has been proposed this session to expand the district even further. 

In recent years, Capitol Police has been built up from a former security force for government buildings into a law enforcement agency. 

The court and police expansion were touted as solutions to crime and a backlogged Hinds County court system. Pushback came from Jackson lawmakers, advocacy groups and community members and two lawsuits were filed, but they have since been resolved. 

Prosecutors from the attorney general office’s Public Integrity Unit were also appointed to work in the CCID court, but they were not announced Friday. A spokesperson said their identities will be known once the court opens. 

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

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UMMC refuses to answer questions about shuttered diversity office

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mississippitoday.org – Molly Minta – 2025-01-24 10:51:00

Until a few years ago, the University of Mississippi Medical Center’s press releases and social media posts regularly touted the accomplishments of faculty and staff who worked to promote diversity, equity and inclusion at the public hospital. 

In one example from 2021, the vice chancellor for health affairs, LouAnn Woodward, affirmed the hospitals’ commitment to a range of administrative efforts, centered around the Office of Diversity and Inclusion, to comply with civil rights law and increase minority enrollment.

“Diversity among our workforce and student populations and an inclusive environment are, and must always be, core considerations at the Medical Center,” Woodward said. 

Then sometime before the start of this fiscal year, UMMC closed its diversity office. 

The public hospital is now refusing to answer questions about when or why that decision was made, if any employees were let go as a result, or what happened to the more than $1 million in funding that once supported the office. 

It is unclear if UMMC announced the decision internally; the hospital did not say if it had. Partially redacted faculty senate meeting minutes from 2024, obtained through a public records request, contain no mention of the move, even though the faculty have a committee dedicated to diversity and inclusion. 

A March 2024 announcement lists the now-defunct office’s chief diversity officer among new hires at the School of Population Health, indicating UMMC may have shuttered the office around that time. 

That’s also when UMMC appears to have scrubbed the office from its website, according to the Internet Archive. The URL for the office now redirects to a web page titled “Diversity and Inclusion at UMMC” which states “throughout UMMC’s three mission areas – education, research and health care – a climate of diversity and inclusion is present.” 

Missing from the webpage are the many initiatives the diversity office oversaw, including a professional development certificate. 

While UMMC is not the only institution of higher learning in Mississippi to shutter or reimagine its efforts to foster DEI on campus, the public hospital appears unique in its reticence about the decision. 

Other institutions in Mississippi have made their plans to revamp DEI offices more accessible. Last fall, the University of Mississippi announced its decision to reinvent its diversity division in a campus-wide email from the chancellor. Earlier in the year, Mississippi State University’s vice president for access, opportunity and success appeared before faculty to discuss the reasons behind the diversity division’s new focus.

In response to questions from Mississippi Today, UMMC’s director of communications provided a written statement with the preface that the hospital would have no further comments. 

“While we no longer have that office, our commitment to access and opportunity for all students, faculty and staff remains,” Patrice Guilfoyle wrote in an email. “If we are to effectively address Mississippi’s persistent and daunting health challenges, it will take everyone working together to fulfill our tripartite mission of education, research and patient care.”

Though funding fluctuated, the office was allocated $1,029,143 during the 2023-2024 fiscal year, according to budget documents obtained through a public records request. About a third of the office’s funding came from state appropriations. 

Until its closure, it appears the office was led by a member of Woodward’s executive cabinet, a role Woodward created shortly after she was appointed in 2015, according to a press release announcing the hire. The chief diversity officer was charged with creating a strategic diversity and inclusion plan for the hospital. 

“Not only did I want this work to be represented and visible at the highest level of leadership, this new institutional role would cover all three of our missions as well as coordinate diversity and inclusion efforts between them,” Woodward said

The chief diversity officer also oversaw three employees as of fiscal year 2023, according to information UMMC reported to the state auditor that year, including a cultural competency and education manager who ran workshops on topics like health disparities and a program coordinator who worked on the office’s annual award ceremony. 

Beyond that, the office also hosted a professional development program and held monthly conversations to foster “dialogue among members of the UMMC community on stimulating topics in pursuit of sharing and understanding experiences, emotions, and different perspectives,” according to a newsletter

This legislative session, lawmakers have filed multiple bills to ban DEI at state-supported institutions of higher learning, as well as one directed at public and charter schools. Mississippi has not passed such a ban, but lawmakers may be primed to do so on the heels of President Donald Trump’s executive orders targeting DEI in the federal government. 

UMMC has in the past curtailed programs after receiving pushback from lawmakers. 

In 2023, the hospital shuttered an LGBTQ+ focused clinic months after cutting gender-affirming care for trans minors because lawmakers complained.

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

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