Mississippi Today
Lawmakers plan challenge to jail as ‘default place’ for people awaiting psychiatric treatment
For years, Mississippians have been jailed without criminal charges while they await mental health treatment.
This session, lawmakers will propose bills aiming to significantly curtail that practice, legislators said in interviews last week. And in the House, the measures will be sponsored by the chair and vice chair of the Public Health and Human Services Committee, to which at least some of the proposals may be referred.
“We can’t send people with mental illness to jail because the county doesn’t want to pay” for an alternative, said Rep. Kevin Felsher, R-Biloxi, vice chair of that committee.
No legislation has been filed so far. But Felsher and Rep. Sam Creekmore, R-New Albany, the new public health chairman, said they plan to introduce a slate of bills that together would address multiple aspects of the civil commitment process and impose new limits on the jailing of people without criminal charges.
The Department of Mental Health supports those efforts, Director Wendy Bailey said in an email.
Last year, Mississippi Today and ProPublica reported that hundreds of Mississippians are jailed every year without criminal charges while they await mental health treatment through the civil commitment process. At least 14 Mississippians have died following incarceration during commitment proceedings since 2006, and no other state routinely jails people for days or weeks without charges during the commitment process.
Currently, the state’s commitment code says people detained before their commitment hearings “shall not be held in jail unless the court finds that there is no reasonable alternative.”
Felsher said one of his bills will impose stricter limits on the use of jail.
“You have to look for every other alternative before jail would become an option,” he said.
In some counties, Creekmore said, jail is “the default place to put them.”
Bailey told Mississippi Today that her agency had reviewed commitment statutes in states including Minnesota, Tennessee, Alabama, South Dakota, and Virginia. Alabama, Tennessee and Virginia prohibit jailing people without criminal charges during the process. Statues in Minnesota and South Dakota strictly limit it.
“Limits that could be considered include requirements such as a chancellor must issue a specific order for someone to be held in jail, that the person cannot be held in jail unless actively violent, the local mental health authority would offer to provide services while someone is held in jail and limiting the amount of time the person is held in jail,” Bailey wrote.
Bailey has emphasized that she opposes jailing people without criminal charges while they await treatment.
Last year, Creekmore sponsored HB 1222, which became law and requires more mental health training for law enforcement and expanded a court liaison program that aims to help families find treatment options other than civil commitment, if appropriate.
Jailed for lack of health insurance?
Felsher also plans to reintroduce legislation that failed last year, establishing that a person being committed can’t be held in jail just because they are indigent and lack health insurance to pay for treatment. That bill would have required counties to pay for a person’s treatment after their hearing if a publicly funded state hospital or crisis stabilization unit bed is unavailable, capping costs at the Medicaid reimbursement rate.
Harrison County, part of which Felsher represents, and some other counties in the state, such as Neshoba, already pay for private treatment if a public bed is unavailable.
The measures could trigger a fight with counties, many of which are reluctant to spend money to treat people instead of jailing them while they wait for a state-funded bed.
For example, Lee County Chancery Clerk Bill Benson said in an interview that it costs about $40 per day to jail someone in his county. When a county sends a resident to a private hospital, it pays more than $500 a day, according to contracts Mississippi Today reviewed.
At a hearing in November 2022, Felsher asked Benson whether he would support his county paying hospitals to treat county residents as an alternative to jail.
“My supervisors would hang me … if I said yes,” Benson said.
On Thursday, Benson said cost is still an issue. He thinks county leaders would want some assurance that they won’t have to pay for long hospitalizations of a week or more.
“And who is going to be responsible for finding that place to house them?” he said.
According to data from the Department of Mental Health, Lee County jailed 25 people before their admission to a state hospital in fiscal year 2023, detaining them for more than five days on average (a figure that doesn’t include the days they likely spent in jail before their hearings).
Felsher said he thinks county supervisors support keeping people out of jail without criminal charges but could be concerned about costs. He said he hopes to improve access to public treatment so that counties aren’t on the hook.
A pilot project and more
Creekmore said he plans to sponsor a measure requiring an evaluation before commitment paperwork can be filed—a change that would mean someone can’t be detained unless at least one mental health provider has recommended it. Currently, a person can be detained on the basis of a sworn affidavit by anyone alleging that the individual is dangerous to themselves or others because of a mental illness.
Creekmore said he also plans to propose a pilot project that would eliminate jail detentions in participating counties by designating the local crisis stabilization units as the only place deputies can take someone they pick up after an affidavit has been filed. If the person was violent, a deputy would remain with them at the facility for some time period instead of taking them to jail, as sometimes happens now.
“If that can be successful, then maybe that can simplify it for all regions,” Creekmore said.
The proposed pilot would include Region 8 and Region 10, the community mental health centers serving a total of 14 counties around Jackson and east central Mississippi
“The involuntary commitment process is a heart wrenching experience and we, as a society, have a moral and ethical responsibility to put forth our best effort to help these hurting families identify and access the most humane and appropriate environment in our communities,” said Dave Van, the executive director of Region 8, in a text message to Mississippi Today.
A summary of mental health proposals lawmakers are discussing:
Proposals addressing civil commitment:
- Stricter limits on jail detentions
- Requiring counties to pay for private treatment if a public bed is unavailable after a judge has ordered someone to receive psychiatric treatment, and capping county costs at the Medicaid rate
- Prohibiting jailing someone during the commitment process because they can’t pay for treatment
- Requiring a pre-evaluation before someone can be detained
- A pilot project to designate the crisis stabilization units in two regions as a “single point of entry” where deputies take people after picking them up and stay with them if necessary, aiming to eliminate jail detentions
Other mental health proposals
- Expanding Medicaid coverage for people with serious mental illness to pay for supportive housing, aiming to bring new facilities to Mississippi
- Establishing a mental health peer support program to address suicides among teenagers
- Requiring the 988 suicide and crisis lifeline to be printed on all state IDs, including student IDs
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Mississippi Today
Health Department cuts clinical services at some county clinics following insufficient funding from Legislature
After the Legislature failed to give the state health department the funding it needed to fully staff county health departments, some no longer offer clinical services and the agency may close others.
County health departments now offer one of three levels of care as a part of a plan to ensure their sustainability in the face of limited and unpredictable funding.
Eight county health departments no longer offer the clinical services they have traditionally provided, like immunizations, preventive screening and reproductive health services. Instead, they serve as a connection point to other health departments with higher levels of care.
The reorganization is the county health departments’ “pathway for survival,” State Health Officer Dr. Daniel Edney told Mississippi Today.
Previously, clinicians rotated between county health departments, he said. The new system establishes consistent levels of care.
“That didn’t work,” he said. “But this is working.”
Health departments are now classified into three levels:
- Level 3 clinics, or “super clinics,” have a doctor or nurse practitioner on staff. They offer a full range of services, including family planning, immunizations, disease screenings and programming for mothers and children.
- Level 2 clinics have a nurse on staff and offer limited family planning services, immunization, disease screenings, programming for mothers and children and telehealth appointments.
- Level 1 clinics do not have a clinician on staff, and offer referrals, record services, federal programming for women and children and help people schedule rides to higher level clinics.
Some clinics offer Level 2 services on some days of the week and Level 3 services on others.
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The new system aims to concentrate resources and ensure that every region of Mississippi has access to needed health services, said Dr. Renia Dotson, Mississippi’s state epidemiologist and the director of the recently created Center for Public Health Transformation, the health department division responsible for overseeing the changes.
It utilizes telehealth and transportation services – like the department’s partnership with Uber – to ensure that patients can access a doctor or nurse practitioner even in health department locations without one on staff.
In just over one year, the health department doubled the number of nurse practitioners it employs to over 30 and increased the number of Level 3 clinics to 15, said Dotson. She said the health department aims to continue expanding the number of Level 3 clinics.
Drastic budget cuts in 2017 forced the agency to shutter county health departments and lay off staff. The agency has spent the last eight years rebounding from the cuts.
In 2023, the Legislature denied the health department’s $9 million budget request to hire the nurses needed to fully staff county health departments and a program that puts nurses in the homes of low-income pregnant women with high-risk pregnancies.
The Mississippi State Department of Health began implementing a tiered approach to county health departments’ level of care not long afterwards. The agency has been making the changes for the past 18 months, said Edney.
No county health departments have yet been closed as a result of the changes, said Dotson, but there may be some areas where it is not possible to continue operating a county health department. The agency is currently in the process of evaluating the level of care that is needed and that the department is able to support in each county, and considering other health services offered in an area when making determinations on need.
“We’ll make an effort to maintain a presence in every county if that is feasible,” she said.
The agency’s website does not currently include information about the reorganization or provide information about which level of care each county health department provides.
The Department of Health made a meager budget request this year of just $4.8 million to train early-career doctors and help Mississippians enroll in health insurance. It did not include any specific requests for county health department funding or funding positions for doctors or nurses.
The agency is working to create margins in a tight budget by reducing its overhead, Edney told Mississippi Today.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Mississippi Today
On this day in 1994
Feb. 5, 1994
A jury convicted Byron De La Beckwith for the 1963 murder of Medgar Evers after seeing evidence that included Beckwith’s fingerprint on the murder weapon and hearing six witnesses share how he had bragged about killing Evers. The judge sentenced Beckwith to life in prison.
Evers’ widow, Myrlie Evers, had prayed for this day, and now that it had come, she could hardly believe it. “All I want to say is, ‘Yay, Medgar, yay!’”
She wiped away tears. “My God, I don’t have to say accused assassin anymore. I can say convicted assassin, who laughed and said, ‘He’s dead, isn’t he? That’s one n—– who isn’t going to come back.’ But what he failed to realize was that Medgar was still alive in spirit and through each and every one of us who wanted to see justice done.”
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Mississippi Today
Sending taxpayer money to private schools advances in Mississippi House
A House committee advanced a bill Tuesday that would send taxpayer money from public to private schools,
The move keeps alive a yearslong push from private school advocates and prompted concern among Democrats that the legislation could undermine public schools serving some of the state’s neediest students.
House Education Chairman Rob Roberson’s bill passed after an hour of debate. Roberson advanced the bill by voice vote and denied Democrats’ request for a roll call where each member’s vote could be recorded. Roberson acknowledged the bill faces a tough road ahead in the Legislature before it would have a chance of becoming law. But he said lawmakers needed to discuss solutions for students in disadvantaged areas who aren’t getting a quality education.
“The purpose of this is for us to continue having a conversation about how we help the poorest of the poor (students),” Roberon said. “I do realize that you all are getting a lot of pressure to push back on this, but we’ve got to keep talking about these things. Even if it makes you uncomfortable, even if you’re getting a million phone calls, these kids deserve to have us talking about this.”
Roberson’s bill would allow students who have been enrolled in a district rated D or F within the past five years to use the state portion of their base student cost — money that would normally go to their local public school — and use it to pay for private school tuition.
Students could only use the money at a private school if there is not an A- or B-rated district willing to accept them within 30 miles of their home. The legislation does not cover transportation costs for students, an omission that Democrats on the committee said would exacerbate the economic strain on poor families.
The money from each child’s base student cost would be placed in an education savings account, a provision designed to protect the legislation from a legal challenge.
The constitutionality of education savings accounts in Mississippi remains a subject of debate. Skeptics say ESAs are unconstitutional because they allow public money to be used to support private schools. Supporters say the accounts do not directly fund private schools, but instead allow families to make their own decisions about where to educate their children.
The legislation creates an initial appropriation of $5 million in public money. The Legislature would then need to appropriate funds for the program based on the state Department of Education’s estimation of students attending private schools that are currently receiving public money and the projected number of eligible students who opt to attend a private school.
Students in families that make less than 138% of the federal poverty level would have first access to the money. After that, funds would be disbursed on a first-come, first-served basis.
Students would need to obtain approval from the receiving district in order to transfer to another public school. The district could decline to accept the student if school officials say they don’t have enough room.
Proponents of such “school choice” measures argue that parents should have greater autonomy to customize their children’s education and that students shouldn’t be trapped in low-performing schools. Opponents argue these measures starve already under-resourced public schools of funds they would otherwise receive.
Rep. Cheikh Taylor, D-Starkville, said the bill and similar measures sending taxpayer funds to private schools would widen the “separation of school systems” between rich and poor areas. He also said the bill would be struck down by either a state or federal court if it became law.
“There will be an educational gap that will be furthered by this bill and the constitutionality has not been vetted,” Taylor said. “The intent has always been to divert money to charter schools and private schools. For years we’ve pushed back against it. Now we’re seeing again that this ugly head of the separation of education, those who are afforded more access and those who are not.”
Roberson said that divide already exists in Mississippi and that wealthy families find ways to send their children to the schools of their choosing, either public or private.
“Frankly it comes down to, the rich people can take kids can take their kids and go anywhere they want to. The poor kids, whether transportation is attached or not, end up going to what’s left over,” Roberson said. “If you’re a wealthy person, you have school choice.”
The school choice debate has been intertwined with debates over race and class in education. Those against school choice say the policies could effectively re-segregate schools. School choice supporters say some high-performing school districts fight school choice measures to avoid accepting students from poor and minority backgrounds.
Roberson said he did not believe the Legislature was ready to support “full-blown school choice.” Lt. Gov. Delbert Hosemann and senators with sway over education policy have not said they support sending public money to private schools. Senate Education Chairman Dennis DeBar, R-Leakesville, said this week that he is skeptical that even a measure to ease transfers between public schools could pass.
The bill has already drawn fierce opposition from public education groups, who said the measure could lay the groundwork for an unconstitutional voucher program impacting all public schools in the state
“Just because it is being passed through the parents’ hands before it goes to the private school, doesn’t make the action any less unconstitutional, in our opinion,” said Erica Jones, Executive Director of the Mississippi Association of Educators.
The proposal now awaits a vote on the House floor.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
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