Mississippi Today

Mississippi ambulance providers anticipate downfall of services amid hospital crisis

Published

10 months ago

September 20, 2023

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.

Clyde Deschamp, emergency medical service director for Mississippi Health Care Alliance Credit: Courtesy of Clyde Deschamp

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.

Gregory M. Cole, EMS advisory committee member to the board of health and former chief compliance officer at Covington County Hospital Credit: Courtesy of Gregory Cole

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.

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Mississippi Today

Mississippi Today staffers win top investigative prize, other awards

Published

13 hours ago

July 1, 2024

Staff Editor

Mississippi Today (Social Sharing Image)

Mississippi Today's Isabelle Taft, Kate Royals and Will Stribling won the 2023 Bill Minor Prize for Investigative Reporting, and several of the newsroom's journalists won other honors during the 2023 Mississippi Press Association awards.

The prizes, awarded annually by the state's print news association, recognize the best journalism of Mississippi's newspapers and digital newsrooms. The 2023 prizes were announced at a Saturday luncheon in Biloxi.

Kate Royals, Mississippi Today health team editor

Taft, Royals and Stribling won the state's top 2023 investigative prize for their impactful “Shaky Science, Fractured Families” series that revealed how Dr. Scott Benton, the state's only board-certified child abuse pediatrician, has broad power and limited oversight to accuse Mississippi parents of child abuse and testify for prosecutors in related cases.

“What a great read about a doctor who may be the only person that can declare that a child has been abused no matter what other officials are saying,” the MPA judges wrote of the investigation. “Wonderful quotes throughout and well thought-out. Outstanding research and the time needed to put this story together.”

Several other Mississippi Today reporters took home 2023 MPA awards. Below is a complete list of the winners and the awards they won:

Sports News Story, first place: Rick Cleveland for “Rolling Fork tornado rebuild”
Feature Story, first place: Molly Minta for “In the Mississippi Bible Belt, a family wrestles with raising trans kids in the Mormon church”
Community Service Award, second place: Mississippi Today for series on state lawmakers' deliberation of postpartum Medicaid extension
News Package, second place: Taylor Vance for “Tate Reeves state plane usage”
Breaking News Reporting, second place: Bobby Harrison and Adam Ganucheau for “White-appointed court system for Blackest city in America”
Photo Series, third place: Eric J. Shelton for “Ocean Springs resident concerns”
Sports Feature, third place: Rick Cleveland for “IBC winner”
Feature Story, third place: Molly Minta for “Issaquena County college degrees”
Planned Series, honorable mention: Molly Minta for “Turmoil inside a public university's music department”
Commentary Column, honorable mention: Adam Ganucheau
Feature Photo, honorable mention: Eric J. Shelton for “The Dotsons' dangerous water”
News Package, honorable mention: Adam Ganucheau for “Bob Hickingbottom”

In addition to the MPA annual awards, the association inducted Mississippi Today sports columnist Rick Cleveland into its Hall of Fame in a Friday evening program.

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

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Mississippi Today

Freedom Summer’s lasting impact: ‘They never forgot their mission’

Published

13 hours ago

July 1, 2024

Staff Editor

mississippitoday.org – Jerry Mitchell – 2024-07-01 11:29:24

Freedom Summer did more than change Mississippi. It changed America.

“So many of those volunteers went back to school with a new mission,” said Davis Houck, Florida State University's Fannie Lou Hamer professor of rhetorical studies. “They never forgot that mission.”

The seeds of the summer of 1964 changed voting in America. Changed political parties. Changed the nation.

That metamorphosis came not through some dramatic event captured on television, but through person-to-person relationships, said Dave Tell, the University of Kansas professor and author of “Remembering Emmett Till.” “It was a slower paced change, but in the end, it was a more powerful change.”

In 1964, civil rights leaders made public their plans to let student volunteers join them in working in the civil rights movement in Mississippi.

Upon hearing the news, Sam Bowers, imperial wizard for the White Knights of the Ku Klux Klan, told his fellow Klansmen to prepare for this “communist invasion.” “When the first waves of blacks hit our streets this summer,” they must avoid fighting them on the streets and attack them and their white collaborators at night, he said.

After darkness fell June 16, 1964, Klansmen heard that civil rights activists had gathered at Mount Zion Methodist Church in Neshoba County. They sped in their cars to the historically Black church and grabbed members, demanding to know where the activists were.

On June 29, 1964, the FBI began distributing these pictures of civil rights workers, from left, Michael Schwerner, 24, of New York, James Chaney, 21, from Mississippi, and Andrew Goodman, 20, of New York, who disappeared near Philadelphia, Miss., June 21, 1964. Credit: Associated Press / FBI

When members said they didn't know, Klansmen began to beat and pistol-whip members. Before Klansmen left, they torched the church.

“My mother had blood on her,” recalled member Jewel McDonald. “My brother had blood on him.”

Five days later, three young activists — James Chaney, Andrew Goodman and Michael Schwerner — came to investigate the Klan attack. Chaney and Schwerner had long been involved in the movement. Goodman had come as a Freedom Summer volunteer.

After spotting the trio, a deputy jailed them and released them that night into the hands of his fellow Klansmen, who killed the trio and buried their bodies 15 feet down in an earthen dam.

James Chaney never got to see his daughter, Angela Lewis, born 10 days before his death.

That's because he was on his way to Ohio to help train volunteers for Freedom Summer.

In the years that followed his killing, she didn't share the identity of her father, whose mother and family had been terrorized afterward.

During Black History Week in junior high, she followed other students into the library, where there were pictures on the wall of Martin Luther King Jr. and other civil rights activists. Then she saw it. A picture of her father.

“I never said a word,” she recalled. “I never told anyone.”

But each birthday carried a solemn reminder of the death of the father she never knew.

On the 40th anniversary of his death, she finally shared with others that her father was the civil rights icon, James Chaney.

“I love my dad and am so appreciative that he knew his purpose and assignment in life was to help others,” she said. “I am just like my dad.”

A year later in 2005, she wept as she watched a jury convict the Klan leader who helped orchestrate his killing, Edgar Ray Killen.

Young people need to be educated so that they can display the same passion and courage as her father's generation, she said. “Even with my dad, Andy and Mickey being killed, those students still got on the bus [for Freedom Summer in Mississippi].”

Buttons are in place during an unveiling ceremony for a freedom marker that honors civil rights workers James Chaney, Michael Schwerner and Andrew Goodman in Philadelphia, Miss., on Friday, June 14, 2024. Credit: Eric Shelton/Mississippi Today

In June 1964, nearly 1,000 Freedom Summer volunteers, mostly white college students, arrived in Oxford, Ohio, for training.

They learned how to respond nonviolently to attacks from mobs and police. They learned how to run Freedom Schools to help educate children. They learned how to go door to door to encourage Black Mississippians to register to vote.

These white volunteers stayed with Black families, went to church with them and followed their house rules, Houck said. “It was a deeply immersive experience.”

Through that summer, volunteers came to understand what life was like for these Black families in Mississippi, he said. In turn, these families, who had never had white people under their roofs, now felt the burden of protecting them, he said.

Freedom Summer altered the trajectories of all of their lives, he said. “The movement changed them.”

Schwerner's widow, Rita Bender, said Freedom Summer's overarching lesson is that “if people organize themselves, they can collectively effect significant change in society.”

In that summer of 1964, the civil rights movement shone a light on Mississippi, which had done its best to keep Black voters from the polls after the Civil War ended, first with violence and then with laws and a new state constitution.

“There is no use to equivocate or lie about the matter,” future Gov. James K. Vardaman declared, “Mississippi's constitutional convention of 1890 was held for no other purpose than to eliminate the n—– from politics.”

Two years later, lawmakers purged all names from the voting rolls and barred Black voters from re-registering through poll taxes and constitutional quizzes.

The changes worked. Within a decade, the number of Black registered voters fell from more than 130,000 to less than 1,300.

Even after the passage of more than 70 years, that number remained miniscule. By 1964, less than 7% of Black Mississippians could vote.

That began to change with the passage of the Voting Rights Act of 1965, which Congress adopted in part because of the trio's murders and similar violence.

“Today, the hard-fought right to vote is under sustained attack,” Bender said. “Tragically, the gains of the past are not being utilized by many.”

Since 2023, at least 20 states, including Mississippi, have passed laws that make voting more difficult, according to the Brennan Center for Justice.

Under current Mississippi law, if voters fail to respond to a “confirmation notice” of their address, they are purged from the voting rolls.

In 2023, U.S. District Judge Henry T. Wingate blocked a law that he concluded might criminalize assistance to disabled Mississippians that might need help with absentee voting. This year, the state Legislature passed a measure to correct the law.

Mississippi also has the nation's strictest felony disenfranchisement law, barring more than 10% of the state's population from ever voting again because they've been convicted of certain felonies outlined in the constitution.

While some states, including Florida, have enabled those convicted of felonies to regain the right to vote, Mississippi has balked at such reform. That means more than 130,000 Black Mississippians, or 16% of the Black adult population, can't cast a ballot.

The Hill concluded that the second most difficult state in the nation to vote in was Mississippi.

Those in power “don't want ‘certain people' to vote,” said state Sen. John Horhn, a Democrat from Jackson. “It's a part of a bigger plan to maintain control, even as the white majority loses its numbers.”

Bender said a new movement — of the people, by the people and for the people — is needed to ensure that voting and other constitutional rights are protected.

As the nation diversifies, “there needs to be coalition building around extremely important common interests,” she said. “There is increasing resistance among some to this new reality as they feel threatened by these inevitable demographic changes.”

Goodman's brother, David, said that, for centuries, the notion was that authorities could do no wrong and must be obeyed, he said. “Back in King Henry's day, if you didn't accept the authority, you had your head chopped off.”

Those enslaved had to accept such authority or face possible death, he said. Afterward, they faced the horrors of Jim Crow, he said.

In 2014, President Barack Obama presented the Presidential Medal of Freedom posthumously to civil rights activists James Chaney, Andrew Goodman and Michael Schwerner during a ceremony in the East Room of the White House. Schwerner's widow, Rita Bender, accepted the award from Obama. Chaney's daughter, Angela Lewis, and Goodman's brother, David, can be seen standing between Bender and Obama. Credit: Courtesy: White House photograph

“My brother was murdered by people who viewed the imperial wizard as an authoritarian who should be listened to,” he said. “None of them were convicted of murder.”

Now, 60 years since Freedom Summer, “we're going back to the future,” he said. “We're dignifying the notion that an authoritarian can do no wrong.”

Throughout history, he said some of those in power have tried to deny or impede equal access to the ballot. For instance, student volunteers for the Andrew Goodman Foundation discovered a statewide ban on early in-person voting on Florida campuses.

“This ban of denying polling sites where young people lived, worked and studied had a negative impact on turnout,” Goodman said.

The foundation and the Florida League of Women Voters sued the state, and this in-person voting was restored.

On the 60th anniversary of the burning of Mount Zion Methodist Church, the church honored the slain trio in a service titled, “Rise From the Ashes.”

The Rev. Eddie Hinton, who serves as pastor for the church, said he sees people of different races coming together now.

“We have come a long way, but we still have a long way to go,” he said. “Black and white can work together.”

Mount Zion also honored McDonald and her family for their courage.

She told Mississippi Today that she has forgiven the Klansmen who attacked her family.

“Why should I hate someone?” she asked. “I don't believe in holding grudges. Why should I carry that when I can just forgive them and go on and live my life?”

Jewel McDonald at the 60th anniversary service of Mount Zion Methodist Church, which the Ku Klux Klan burned in 1964. Credit: Jerry Mitchell/Mississippi Today

Some people may think she's crazy for saying that, she said, “but I do believe in order for us to go to heaven, we need to love each other and, if we see someone who needs help, then help them out.”

She called on Mississippians to start healthy conversations across racial lines. “There's too much hatred,” she said. “We need to get rid of that hatred and love each other.”

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

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Mississippi Today

Mississippi Today launches collaboration with JPMorganChase

Published

15 hours ago

July 1, 2024

Staff Editor

The American Journalism Project today announced it is teaming up with JPMorganChase to support local news organizations throughout the country. In addition to providing funding for the American Journalism Project's national efforts to rebuild local news, JPMorganChase is sponsoring eight nonprofit newsrooms nationwide, sharing ongoing financial health content, organizing local events, and providing expertise tailored to their unique challenges to help meet their business and operational goals. This work with JPMorganChase marks the first time the American Journalism Project is collaborating with a financial services firm.

“As the largest bank in the country, this commitment from JPMorganChase sends a powerful signal that corporations can play an integral role in rebuilding local news,” said Sarabeth Berman, CEO of the American Journalism Project. “The investment and scale will infuse resources in a thrilling new generation of news outlets that are working to ensure local news is available to all, strengthening and informing communities.”

“The evidence is clear that a thriving local news ecosystem is key to more civic engagement and a healthy democracy. JPMorganChase believes supporting sustainable models for local news is essential to meeting information needs, strengthening communities and fostering inclusive economic growth,” said Andrew Gray, Managing Director of Regional Communications for JPMorganChase. “The American Journalism Project is playing a key role in supporting the sector by growing local news from the ground up so outlets can independently thrive. We're proud to be a part of this effort, and engage locally to identify the best opportunities where we can make an impact.”

JPMorganChase will work directly with eight local nonprofit news organizations in the American Journalism Project's portfolio, including:

THE CITY (New York City), a nonpartisan news outlet that serves the people of New York through independent journalism that holds the powerful to account, deepens democratic participation, and makes sense of complex issues.
Block Club Chicago, a newsroom dedicated to delivering reliable, relevant, and nonpartisan coverage of Chicago's diverse neighborhoods.
Mississippi Today, which as part of the Deep South Today nonprofit news network is providing free nonpartisan news to inform communities statewide and ensure accountability from public officials.
Cityside (San Francisco Bay Area), a nonpartisan digital news organization building community through local journalism with three local news sites, Berkeleyside, The Oaklandside and Richmondside.
Montana Free Press, a nonpartisan, public-powered news organization dedicated to reaching and serving the information needs of all Montanans by producing in-depth news, information, and analysis.
Signal Ohio, a statewide news organizations with newsrooms in Cleveland and Akron, committed to producing high-quality accountability journalism while working directly with residents to produce and distribute community reporting that is free to access for all
Fort Worth Report, producing independent, factual news coverage that aims to find solutions for community issues and strengthen a diverse and rapidly growing city and home county.
Spotlight Delaware, a community-powered, collaborative newsroom covering the impact of public policy, increasing access to information and civic engagement in historically underserved communities, and strengthening existing newsrooms throughout the state.

“Deep South Today is grateful for this opportunity to partner with JPMorganChase to further build the capacity of Mississippi Today to deliver essential local news to the communities it serves,” said Warwick Sabin, President and CEO of Deep South Today. “We look forward to working closely with them over the long term to achieve a healthier democracy and civil society through journalism that informs, engages, and inspires more Mississippians.”

AJP is the leading venture philanthropy working to address the market failure in local news. It is establishing and advancing a new generation of nonprofit local news organizations across the country. Founded in 2019, AJP is built on the evidence that robust journalism is an essential component of a healthy democracy. To date, AJP has raised $175M from local and national funders to address the local news crisis and has backed 44 news operations across 33 states.

JPMorganChase is a leading financial services firm and one of the oldest financial institutions in the U.S. It serves millions of customers, clients, and communities in 100+ global markets. This collaboration with AJP is part of the bank's overarching efforts to support local journalism.

About the American Journalism Project

The American Journalism Project is a venture philanthropy dedicated to local news. We believe in civic journalism as a public good and are reimagining its future by building a model to finance and sustain the local news our democracy requires. We make grants to local nonprofit news organizations to build their revenue and business operations, partner with communities to launch new organizations, and meteor leaders as they grow and sustain their newsrooms. To learn more about the American Journalism Project, visit our website.

About JPMorganChase

JPMorgan Chase & Co. (NYSE: JPM) is a leading financial services firm based in the United States of America (“U.S.”), with operations worldwide. JPMorgan Chase had $4.1 trillion in assets and $337 billion in stockholders' equity as of March 31, 2024. The Firm is a leader in investment banking, financial services for consumers and small businesses, commercial banking, financial transaction processing and asset management. Under the J.P. Morgan and Chase brands, the Firm serves millions of customers in the U.S., and many of the world's most prominent corporate, institutional and government clients globally. Information about JPMorgan Chase & Co. is available at www.jpmorganchase.com.

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

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