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
On this day in 1960
Feb. 1, 1960
Four Black freshmen students from North Carolina A&T — Franklin McCain, Joseph A. McNeil, David L. Richmond and Ezell A. Blair Jr. — began to ask themselves what they were going to do about discrimination.
“At what point does a moral man act against injustice?” McCain recalled.
McNeil spoke up. “We have a definite purpose and goal in mind,” he said, “and with God on our side, then we ask, ‘Who can be against us?’”
That afternoon, they entered Woolworth’s in downtown Greensboro. After buying toothpaste and other items inside the store, they walked to the lunch counter and sat down.
They ordered coffee, but those in charge refused to serve them. The students stood their ground by keeping their seats.
The next day, they returned with dozens of students. This time, white customers shouted racial epithets and insults at them. The students stayed put. By the next day, the number of protesting students had doubled, and by the day after, about 300 students packed not just Woolworth’s, but the S.H. Kress Store as well.
A number of the protesting students were female students from Bennett College, where students had already been gathering for NAACP Youth Council meetings and had discussed possible sit-ins.
By the end of the month, 31 sit-ins had been held in nine other Southern states, resulting in hundreds of arrests. The International Civil Rights Center & Museum has preserved this famous lunch counter and the stories of courage of those who took part in the sit-ins.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Mississippi Today
At least 96 Mississippians died from domestic violence. Bills seek to answer why
At least 96 Mississippians died from domestic violence. Bills seek to answer why
Nearly 100 Mississippians, some of them children, some of them law enforcement, died last year in domestic violence-related events, according to data Mississippi Today collected from multiple sources.
Information was pulled from local news stories, the Gun Violence Archive and Gun Violence Memorial and law enforcement to track locations of incidents, demographics of victims and perpetrators and any available information about court cases tied to the fatalities.
But domestic violence advocates say Mississippi needs more than numbers to save lives.
They are backing a refiled bill to create a statewide board that reviews domestic violence deaths and reveals trends, in hopes of taking preventative steps and making informed policy recommendations to lawmakers.
A pair of bills, House Bill 1551 and Senate Bill 2886, ask the state to establish a Domestic Violence Fatality Review Board. The House bill would place the board in the State Department of Public Health, which oversees similar existing boards that review child and maternal deaths, and the Senate version proposes putting the board under the Department of Public Safety.
“We have to keep people alive, but to do that, we have to have the infrastructure as a system to appropriately respond to these things,” said Stacey Riley, executive director of the Gulf Coast Center for Nonviolence and a board member of the Mississippi Coalition Against Domestic Violence.
“It’s not necessarily just law enforcement, just medical, just this,” she said. “It’s a collaborative response to this to make sure that the system has everything it needs.”
Mississippi is one of several states that do not have a domestic violence fatality review board, according to the National Domestic Violence Fatality Review Initiative.
Without one, advocates say it is impossible to know how many domestic fatalities and injuries there are in the state in any year.
Riley said data can tell the story of each person affected by domestic violence and how dangerous it can be. Her hope is that a fatality review board can lead to systemic change in how the system helps victims and survivors.
Last year, Mississippi Today began to track domestic violence fatalities similar to the way the board would be tasked to do. It found over 80 incidents in 2024 that resulted in at least 100 deaths.
Most of the victims were women killed by current and former partners, including Shaterica Bell, a mother of four allegedly shot by Donald Demario Patrick, the father of her child, in the Delta at the beginning of that year. She was found dead at the home with her infant. One of her older children went to a neighbor, who called 911.
Just before Thanksgiving on the Coast, Christopher Antoine Davis allegedly shot and killed his wife, Elena Davis, who had recently filed a protection order against him. She faced threats from him and was staying at another residence, where her husband allegedly killed her and Koritnik Graves.
The proposed fatality review board would have access to information that can help them see where interventions could have been made and opportunities for prevention, Riley said.
The board could look at whether a victim had any domestic abuse protection orders, law enforcement calls to a location, medical and mental health records, court documents and prison records on parole and probation.
In 2024, perpetrators were mostly men, which is in line with national statistics and trends about intimate partner violence.
Over a dozen perpetrators took their own lives, and at least two children – a toddler and a teenager – were killed during domestic incidents in 2024, according to Mississippi Today’s review.
Some of the fatalities were family violence, with victims dying after domestic interactions with children, parents, grandparents, siblings, uncles or cousins.
Most of the compiled deaths involved a firearm. Research has shown that more than half of all intimate partner homicides involve a firearm.
A fatality review board is meant to be multidisciplinary with members appointed by the state health officer, including members who are survivors of domestic violence and a representative from a domestic violence shelter program, according to the House bill.
Other members would include: a health and mental health professionals, a social worker, law enforcement and members of the criminal justice system – from prosecutors and judges to appointees from the Department of Public Safety and the attorney general’s office.
The House bill did not make it out of the Judiciary B Committee last year. This session’s House bill was filed by the original author, Rep. Fabian Nelson, D-Byram, and the Senate version was filed by Sen. Brice Wiggins, R-Pascagoula.
The Senate bill was approved by the Judiciary A Committee Thursday and will proceed to the full chamber. The House bill needs approval by the Public Health and Human Services Committee by Feb. 4.
“The idea behind this is to get at the root cause or at least to study, to look at what is leading to our domestic violence situation in the state,” Wiggins said during the Judiciary A meeting.
Luis Montgomery, a public policy and compliance specialist with the Mississippi Coalition Against Domestic Violence, has been part of drafting the House bill and is working with lawmakers as both bills go through the legislative process.
He said having state-specific, centralized data can help uncover trends that could lead to opportunities to pass policies to help victims and survivors, obtain resources from the state, educate the public and see impacts on how the judicial system handles domestic violence cases.
“It’s going to force people to have conversations they should have been having,” Montgomery said.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Mississippi Today
Emergency hospital to open in Smith County
A new emergency-care hospital is set to open in Smith County early this year. It will house the rural county’s first emergency room in two decades.
Smith County Emergency Hospital in Raleigh will provide 24-hour emergency services, observation care and outpatient radiology and lab work services. Raleigh is currently a 35-minute drive from the nearest emergency room.
The hospital will operate as a division of Covington County Hospital. The Collins hospital is a part of South Central Regional Medical Center’s partnership with rural community hospitals Simpson General Hospital in Mendenhall and Magee General Hospital, all helmed by CEO Greg Gibbes.
The hospital’s opening reflects Covington County Hospital’s “deeply held mission of helping others, serving patients and trying to do it in a way that would create sustainability,” not just for its own county, but also for surrounding communities, said Gibbes at a ribbon-cutting ceremony Friday.
Renovations of the building – which previously housed Patients’ Choice Medical Center of Smith County, an acute-care facility that closed in 2023 – are complete. The facility now awaits the Mississippi Department of Health’s final inspection, which could come as soon as next week, according to Gibbes.
The hospital hopes to then be approved as a “rural emergency hospital” by the Centers for Medicare and Medicaid Services.
A rural emergency hospital status allows hospitals to receive $3.3 million from the federal government each year in exchange for closing their inpatient units and transferring patients requiring stays over 24 hours to a nearby facility.
The program was created to serve as a lifeline for struggling rural hospitals at risk of closing. Six hospitals have closed in Mississippi since 2005, and 33% are at immediate risk of closure, according to the Center for Healthcare Quality and Payment Reform.
Receiving a rural emergency hospital designation will make the hospital more financially sustainable, said Gibbes. He said he has “no concerns” about the hospital being awarded the federal designation.
Mississippi has more rural emergency hospitals than any other state besides Arkansas, which also operates five. Nationwide, 34 hospitals have received the designation, according to Centers for Medicare & Medicaid Services enrollment data. Over half of them are located in the Southeast.
The hospital will have a “significant economic impact” of tens of millions of dollars and has already created about 60 jobs in Smith County, Gibbes said.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
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