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Lawmakers weigh possible changes to certificate of need law

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mississippitoday.org – Gwen Dilworth – 2024-08-20 15:40:00

Lawmakers weigh possible changes to certificate of need law

A new committee convened this week at the Capitol to discuss changes to the state’s law requiring medical facilities to seek state approval before offering new or expanded services.  

Health leaders said there is room to strengthen the law with reforms but cautioned against doing away with it entirely.

The law, which requires medical facilities to apply for a โ€œcertificate of need,โ€ aims to lower costs and increase the accessibility and quality of health care in the state by avoiding duplication of services. 

Critics argue that the law stifles competition in the state’s already sparse health care ecosystem and does little to decrease costs. Advocates say it ensures that communities have access to a range of services, not just those that are profitable for providers.ย 

Nationwide, the laws have not accomplished much of what they were intended to, like increase quality or reduce costs, State Health Officer Dr. Daniel Edney told committee members on Monday. 

But the law has been โ€œextremelyโ€ successful at preventing health care companies from choosing only to offer only the most profitable services to , he said. 

โ€œWhen we’re looking at a very fragile health care framework, especially in rural of the state, cherry-picking can be disastrous,โ€ he said. โ€œIt can be catastrophic.โ€ 

When health centers choose to offer only services with a high-profit margin, he explained, it can draw business away from hospitals that services at a loss, like inpatient and emergency care. He said this applies in both rural and urban areas. 

Rural hospitals in Mississippi are struggling to stay afloat. Over half are at risk of closing, and 64% are operating with losses on services. More than half of Mississippi residents in a rural area.ย 

Richard Roberson, the incoming president and CEO of the Mississippi Hospital Association, said he believes it is unlikely that removing certificate of need requirements will incentivize investment in areas of the state with the highest need for new health care services.

โ€œWhat I suspect is you’re going to see an overproliferation of services in more commercially insured areas,โ€ he said. โ€œAnd if you’re talking about folks coming in and investing money, that’s where they’re going to put it, where they can make their money back.โ€ 

Gov. Tate Reeves has advocated for abolishing certificate of need laws in the state, arguing that it will allow more competition and innovative health care services to flourish.

Last session, a bill sponsored by Sen. Angela Burks Hill, R-, sought to repeal the state’s certificate of need law, but it died in committee.ย 

Bills seeking to repeal or reform the law have become -of-the-mill in the statehouse. Last year, over two dozen bills sought to modify the state’s certificate of need law.ย 

Legislators in 2016 made several changes to the law, including shortening application review timelines and increasing capital expenditure thresholds.

States were first required to implement certificate of need laws in 1974 in order to receive for certain federal programs. Today, 35 states operate certificate of need programs, and 12 have repealed their laws entirely, according to the National Conference of State Legislatures.ย 

Laurin St. Pรฉ, CEO of the nonprofit Health System, said that without the certificate of need law, private equity-backed companies could open health centers near existing hospitals, drawing away patients with insurance. 

Hospitals with emergency departments are required to provide emergency care to patients regardless of insurance status under the Emergency Medical Treatment and Labor Act. These hospitals depend on providing services to patients with insurance to offset losses from uncompensated care.

โ€œIf they siphon (insured patients) off, we’re not going to be able to take care of those with the most need,โ€ he said. 

Over 10 percent of Mississippians do not have health insurance, according to data from KFF.ย 

Edney said that Medicaid expansion could offset risks associated with repealing the certificate of need law by lowering the rate of people in the state without insurance in response to a question from House Medicaid Chair Missy McGee, R-Hattiesburg. 

McGee authored the Medicaid expansion bill that died earlier this year.ย Mississippi remains one of 10 states in the country not to have expanded Medicaid.

Rep. Hank Zuber, R-Ocean Springs, is the co-chair of the committee on the certificate of need law. Credit: Mississippi House

โ€œAs we close the coverage gap, that does create more revenue into the system that flows to the hospitals,โ€ Edney said. 

Keith Norman, vice president and chief government affairs officer for Baptist Memorial Health Care, agreed. 

โ€œI believe expansion goes hand in hand with this conversation,โ€ he said. 

Though Edney and Roberson cautioned lawmakers of the impacts of repealing certificate of need law, they agreed that reforms could improve the program. 

Roberson suggested that allowing hospitals to offer dialysis services without a certificate of need would reduce patient transfers to other hospitals. Many small hospitals do not have their own dialysis centers. 

He also proposed allowing hospitals to operate home health services, which would reduce rates of readmission to the hospital. The Centers for Medicare and Medicaid Services penalizes hospitals when readmissions top the national average. Hospitals in the Delta have in the past high penalty rates for readmissions.ย 

Edney added psychiatric and perinatal care to the list of services he believed should not have to undergo the review due to the state’s dearth of such care. 

The application itself should also be reformed to prevent long, costly appeals, said Edney. 

Last year, an applicant vying to provide โ€œmuch-neededโ€ ambulatory care in the Delta โ€“ a region of the state with limited health care services โ€“ withdrew its application after its certificate of need approval was contested. He said the hospital did not have the resources to sustain a potentially years-long legal struggle. 

โ€œWe go through these long battles that are very costly, just to get to the same ruling,โ€ Edney said.

The State Department of Health approves 95% of certificate of need applications, he said. 

Edney also suggested that lawmakers consider more vigorous enforcement of existing certificates of need, noting that some health care facilities do not follow through on the commitments made in their applications. 

โ€œWe’re lacking accountability and transparency in the CON world,โ€ he said.

Rep. Henry Zuber III, R-Ocean Springs, co-chair of the committee, said the group will explore a range of possibilities for certificate of need reform before drafting any legislation. The group will meet again on Sep.10.

โ€œEverything, everything is on the table,โ€ Zuber said.

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

Mississippi Today

On this day in 1875

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mississippitoday.org – Jerry Mitchell – 2024-11-02 07:00:00

Nov. 2, 1875

Pictured here are U.S. Sen. Hiram Revels of Mississippi, left, with six Black members of the U.S. House, Ben J.S. Turner of Alabama, Josiah T. Walls of Florida, Jefferson H. Long of Georgia, and Robert C. De Large, Joseph H. Rainy and R. Brown Elliot, all of South Carolina. Credit: Library of

The first Mississippi Plan, which included violence against Black Americans to keep them from , resulted in huge victories for white Democrats across the

A year earlier, the Republican Party had carried a majority of the votes, and many Black had been elected to office. In the wake of those victories, white leagues arose to Republican rule and began to use widespread violence and fraud to recapture control of the state. 

Over several days in September 1875, about 50 Black Mississippians were killed along with white supporters, a school teacher who worked with the Black community in Clinton. 

The governor asked President Ulysses Grant to intervene, but he decided against intervening, and the violence and fraud continued. Other Southern states soon copied the Mississippi plan. 

John R. Lynch, the last Black congressman for Mississippi until the 1986 election of Mike Espy, wrote: โ€œIt was a well-known fact that in 1875 nearly every Democratic club in the State was converted into an armed military company.โ€ 

A federal grand jury concluded: โ€œFraud, intimidation, and violence perpetrated at the last election is without a parallel in the annals of history.โ€

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

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Mississippi Todayโ€™s NewsMatch Campaign is Here: Support Journalism that Strengthens Mississippi

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mississippitoday.org – Mary Margaret White – 2024-11-01 12:34:00

High-quality journalism like ours depends on reader support; without it, we simply couldn’t exist. That’s why we’re proud to join the NewsMatch movement, a national initiative aimed at raising $50 million for nonprofit newsrooms that serve communities like ours here in Mississippi, where access to reliable information has often been limited.

In a time when trusted journalists and sources are disappearing, we believe the stakes couldn’t be higher. Without on-the-ground, trustworthy reporting, civic engagement suffers, accountability falters and corruption often goes unaddressed. But it doesn’t have to be this way.

Here at we act as watchdogs, holding those in power accountable, and as storytellers, giving a platform to voices that have been ignored for too long. And we’re committed to keeping our stories free for everyone because information should be accessible when it’s needed most.

Why NewsMatch and Why Now?

This year’s NewsMatch campaign runs from November 1 through December 31, giving us a special opportunity to make each dollar you give go even further. Through matching funds provided by local foundations like the Maddox Foundation, and national funders like the MacArthur Foundation, the Rural Partner Fund and the Hewlett Foundation, your gift will be dollar for dollar up to $1,000. Plus, if 100 new donors join us, we’ll unlock an additional $2,000 in , bringing us even closer to our goal. Boiled down: your donation goes four times as far.

Every dollar raised strengthens our ability to serve you with fact-based journalism on issues that impact your everyday lifeโ€”whether it’s covering local election issues or reporting on decisions affecting schools, safety and economic growth in Mississippi. Your support makes it possible for us to stay rooted in the community, offering nuanced perspectives that Mississippians understand and engage with what’s around them.

Special Event: โ€œFreedom of the Press: Southern Challenges, National Impactโ€

As part of the campaign, we’re excited to host a special virtual event, โ€œFreedom of the Press: Southern Challenges, National Impact.โ€ Join Deep South Today newsrooms Mississippi Today and Verite News, along with national experts on press freedom, for an in-depth discussion on the unique challenges facing journalists in the Deep South. This one-hour will explore the critical role local newsrooms play in holding power accountable, highlighting recent restrictions on press freedom such as Louisiana’s โ€œ25- ,โ€ which affects journalists’ ability to vital news.

We’ll examine what’s at stake if local newsrooms lose press freedoms and will discuss how you, as members of the public, can help protect it. This event is open to Mississippi Today and Verite News members as a special thank-you for supporting local journalism and standing with us in this mission. Donate today to RSVP!

How You Can Help

Make Your Gift Today

Together, let’s ensure Mississippi has the robust, independent journalism it needs to thrive. Your support fuels our ability to expose the truth, elevate marginalized stories and build a more informed Mississippi.

Thank you for believing in the power of journalism to strengthen the communities we loveโ€”not only during election season but year-round. With your help, we’ll keep Mississippi informed, engaged and connected for generations to come.

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

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Hinds County loses fight over control of jail

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mississippitoday.org – Mina Corpuz – 2024-11-01 12:57:00

The sheriff and Board of Supervisors have lost an appeal to prevent control of its jail by a court-appointed receiver and an injunction that orders the county to address unconstitutional conditions in the facility.   

Two members from a three-judge panel of the 5th U.S. Circuit Court of Appeals agreed with decisions by U.S. District Judge Carlton Reeves to appoint a receiver to oversee day-to-day jail operations and keep parts of a previous consent decree in place to fix constitutional violations, a failure to protect detainees from harm. 

However, the appeals court called the new injunction โ€œoverly broadโ€ in one area and is asking Reeves to reevaluate the scope of the receivership.

The injunction retained provisions relating to sexual assault, but the appeals court found the provisions were tied to general risk of violence at the jail, rather than specific concerns about the Prison Rape Elimination Act. The court reversed those points of the injunction and remanded them to the district court so the provisions can be

The court also found that the receiver should not have authority over budgeting and staff salaries for the Raymond Detention Center, which could be seen as โ€œfederal intrusion into RDC’s budgetโ€ โ€“ especially if the receivership has no end date. 

Hinds County Board of Supervisors President Robert Graham was not immediately available for comment Friday. Sheriff Tyree Jones declined to comment because he has not yet read the entire court opinion.ย 

In 2016, the Department of Justice sued Hinds County alleging a pattern or practice of unconstitutional conditions in four of its detention facilities. The county and DOJ entered a consent decree with stipulated changes to make for the jail system, which people facing trial. 

โ€œBut the decree did not resolve the dispute; to the contrary, a yearslong battle ensued in the district court as to whether and to what extent the County was complying with the consent decree,โ€ the appeals court wrote.  

This prompted Reeves to hold the county in contempt of court twice in 2022. 

The county argued it was doing its best to comply with the consent decree and spending millions to fix the jail. One of the they offered was building a new jail, which is now under construction in

The county had a to further prove itself during three weeks of hearings held in February 2022. Focuses included the of seven detainees in 2021 from assaults and suicide and issues with staffing, contraband, old and use of force. 

Seeing partial compliance by the county, in April 2022 Reeves dismissed the consent decree and issued a new, shorter injunction focused on the jail and removed some provisions from the decree.

But Reeves didn’t see improvement from there. In July 2022, he ordered receivership and wrote that it was needed because of an ongoing risk of unconstitutional harm to jail detainees and staff. 

The county pushed back against federal oversight and filed an appeal, arguing that there isn’t sufficient evidence to show that there are current and ongoing constitutional violations at the jail and that the county has acted with deliberate indifference. 

Days before the appointed receiver was set to take control of the jail at the beginning of 2023, the 5th Circuit Court ordered a stay to halt that receiver’s work. The new injunction ordered by Reeves was also stayed, and a three-person jail monitoring team that had been in place for years also was ordered to stop work. 

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

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