Mississippi Today
New Health Department program puts nurses in the homes of high-risk moms, babies in Mississippi
Through a partnership between the state Health Department and the state Division of Medicaid, Healthy Moms, Healthy Babies program places registered nurse case managers in the homes of pregnant mothers undergoing high-risk pregnancies.
Since launching, it has expanded to 23 full-time nurses and 17 part-time nurses providing services to about 640 patients around the state.
State Health Officer Dr. Daniel Edney said the program is “plugging the gap” by bringing resources to small rural communities that aren’t there.
“With limited resources for mothers and babies, a lot of our efforts are going to be directed to our highest impacted areas to help the folks in the most desperate need the fastest,” Edney said.
The way resources are distributed across the state – sparsely in rural and remote areas but plentiful in certain others – means the program must take a targeted approach.
“We can not look at Mississippi as one organism. We are really six different regions when it comes to public health in terms of populations, demographics, resources available and challenges,” Edney explained. “I have to have different strategies for different areas. The one-size fits all strategy won’t work.”
Dr. Justin Turner, chief medical officer at the state Health Department, witnessed personally how important access to quality health care for mothers is.
Turner’s wife made 23 total visits to five different hospitals or emergency rooms during her last two pregnancies.
Seven out of 23 of those visits came during her pregnancy five years ago, and the remainder of the visits came during their second pregnancy in August 2022. During her last pregnancy, she experienced “uncharacteristic pain” around month five, requiring her to be supervised by her family 24 hours a day until she gave birth.
The pain would spiral out of control resulting in psychogenic nonepileptic seizures (PNES), previously known as pseudoseizures – emotional and stress-related episodes similar to epileptic seizures but not of neurological origin.
As the number of trips increased, Turner said he had a tough time reassuring his family and himself.
“I was thinking, 'how do I continue to do what I’m supposed to do as the chief medical officer and help assist the state as a whole, when I can’t even help my wife at home?'” Turner told Mississippi Today.
For Black women in Mississippi, the pregnancy-related mortality rate increased from 51.9 to 65.1 deaths per 100,000 live births, quadruple the rate of white women (16.2). With this data in mind, fears of the worst outcome flooded both Turner and his wife’s minds.
“It was natural for me to think that my wife was going to be another statistic,” Turner explained. “She would ask me things like, ‘Baby, am I going to die?’”
The pregnancy remained a challenge until the day that she delivered their child by cesarean section. Every day prior to her being pregnant was “a day of misery,” Turner said. After delivery, his wife never experienced another pseudoseizure episode.
Turner said fortunately for his wife, she had a husband who is a doctor, an OB-GYN, support from family and friends, and a great health care team.
However, he couldn't help but think of how many mothers in Mississippi lack support. Turner said the Healthy Moms, Healthy Babies program aims to add emotional support for mothers who may be in need of it.
“For a lot of women, they benefit from the nurturing and feeling like someone is listening,” Turner continued. “The more people that’s on their team, the better it helps them to endure the process of pregnancy itself.”
As services are being provided to participants, Turner said the health department, stakeholders, policy makers and community members must collaborate to improve outcomes for mothers and their babies.
“We need to find common ground in the areas that we can improve and make sure that we are providing our moms and babies a decent chance at having a healthy pregnancy and coming into this world,” Turner said.
As a Medicaid-reimbursed program, Healthy Moms, Healthy Babies allows mothers to receive monthly targeted case management, health education, and assessments by nurses, social workers and nutritionists at no direct cost to them.
For moms with Medicaid, the services are reimbursed. Edney said the program works with uninsured moms to help them enroll in Medicaid or, if they are not eligible, will provide the services for free.
The Mississippi State Health Department declined Mississippi Today's request to interview a mother who has participated in the program.
After making contact with a mom in need, the nurse consults with the mother’s doctor, who shares why she may be considered high-risk. Common high-risk conditions include preterm labor, diabetes, multiple pregnancy losses and starting prenatal care late.
The nurse then works to mitigate her symptoms by going to the mother's home and pairing her with a multidisciplinary team of resources, such as social workers and nutritionists.
The team of health care workers educate her on the importance of prenatal care, diet plans and how to limit her chances of becoming high-risk in the future. Edney said the program is “working aggressively” to support affected Medicaid moms.
“In our last reporting from the maternal mortality review committee, 87% of deaths were Medicaid moms, and out of all of our maternal deaths, 80% were preventable,” Edney told Mississippi Today. “That is unacceptable.”
Currently, 86% of the participating mothers are Medicaid beneficiaries.
Healthy Moms, Healthy Babies monitors not only high-risk mothers but also high-risk babies up to one year of age.
A baby is considered high risk if they are born prior to 37 weeks of gestation, weigh less than 5 pounds 8 ounces at birth, have genetic disorders, experience nutritional deficiencies, infections, or live in unsafe conditions among other factors as well.
The average age of infants enrolled in the program is less than one month old.
The goal of the program is to increase the infant's chances of survival, Edney said. Mississippi leads the nation in its rate of infant mortality.
“I know that if we continue doing what we are doing, nothing is going to change. So, if we all agree we have a problem, which I think everybody does, then this has got to change,” Edney stated. “I don’t have to convince anybody that being 50th in the nation for dead babies is a good thing, because it isn’t.”
The Health Department plans to expand the program so that more women and babies in rural communities have access to necessary care.
Around 35% of babies were born to women living in rural counties of the state, but only a quarter of maternity care providers practice there, according to the latest March of Dimes’ report.
Jillian Harper-Peavy, the state program director for Healthy Moms, Healthy Babies, said partnerships with different individuals and organizations are critical for the program to expand.
Those organizations include community health centers; hospitals; OB-GYN offices; pediatricians; managed care organizations; and other maternal and child health programs.
“We are prioritizing outreach and engagement of patients continually, as we do want to see the program serve more pregnant women and infants,” Harper-Peavy continued. “As additional patients are enrolled, we will continue to assess our staffing capacity and plan accordingly.”
However, financial constraints have hindered its expansion.
Earlier this year, Edney asked lawmakers to fund $9 million to hire nurses needed to fully staff county health departments and Healthy Moms, Healthy Babies. The request was denied.
Now, Edney said he is seeking to redirect the funding he has and cut back in every department possible to hire the 100 or so nurses he’s identified as potential job candidates.
“I’m trying to provide core public health services around this state with a battered workforce,” Edney explained. “I try to get people to understand that while everybody else may be over COVID-19, the health department is not. We were beaten to pieces, and we’re working hard to rebuild our workforce with the resources that we have.”
Susan Bates, nurse team lead in the northeastern region of the state, manages a team of nurses who serve patients in 11 counties, seven of which are maternal health deserts: Marshall, Benton, Tippah, Pontotoc, Prentiss, Tishomingo and Itawamba.
These counties have no hospitals or birthing centers that provide obstetric care, and no practicing OB-GYNs or certified nurse midwives.
Across the state, 51.2% of counties are defined as maternity care deserts, compared to 32.6% nationally.
Bates, who cares for an average of six to 10 mothers and babies each day, has encountered women experiencing preterm labor, preterm delivery, preeclampsia, anxiety and depression. She’s also cared for premature and low-birthweight babies.
With more than 26 years of nursing experience, Bates said she aims to make every patient feel respected, valued and heard. Her approach is to listen, understand and “not just focus on checking a box.”
“I feel that it is important to establish a relationship of trust between the mother and her doctors that way we can promote and foster communication. This allows us to provide a more comprehensive care and therefore improve our patients’ outcomes,” Bates continued. “So, when we meet our patients' needs, consistently and correctly, they develop trust in us as their caregiver.”
The Corinth native previously worked for the Mississippi State Health Department for 11 years as a public health nurse, promoting and protecting the health of populations using knowledge from nursing, social and public health science.
Bates, who is certified in pediatric advanced life support and neonatal advanced life support, said caring for high-risk mothers and babies requires a calm demeanor to help the family through what can be a scary time.
“If you look at the big picture, then it may seem overwhelming, but we can’t be stopped by that. We have to know that what we are doing makes a difference to each patient,” Bates explained. “One life at a time, we’re making a difference.”
Edney said that scoring poorly in maternal and infant mortality is a “heavy burden” that requires a “heavy lift” to flip the negative trend to a positive one.
“It’ll take years, but with the work that we’re going to do with the agency, I’m convinced that we will not only get off the bottom with infant mortality,” Edney stated, “we will get off the radar.”
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Mississippi Today
All eyes on Mississippi’s Rep. Guest as his committee considers releasing Gaetz report
President-elect Donald Trump’s announcement to nominate former U.S. Rep. Matt Gaetz as attorney general has, again, thrust Mississippi Congressman Michael Guest, chairman of the House Ethics Committee, into the national spotlight.
Guest’s committee will potentially vote at its Wednesday meeting whether to release an ethics report on Gaetz. The committee, which was investigating Florida’s Gaetz over allegations of sexual misconduct and illicit drug use, was set to release the report before Gaetz abruptly resigned from Congress.
Guest is a Republican who represents Mississippi’s 3rd Congressional District and has chaired the bipartisan House committee that investigates whether House members have committed ethics violations since January 2023.
Gaetz resigned last week shortly after Trump announced he planned to nominate him to lead the Department of Justice, despite having been previously investigated by the department for alleged sex trafficking crimes. The department declined to pursue criminal charges against Gaetz.
After the resignation, House Speaker Mike Johnson announced that he does not want the House to make the committee’s report public because Gaetz is no longer in office.
Guest declined to comment to Mississippi Today about recent developments with the committee’s investigation into Gaetz. But the Mississippi Republican told Politico that the panel will make its own decision about releasing the report, regardless of Johnson’s opinion that it should be kept under wraps. Lawmakers on both sides of the aisle have called for the report to be provided to senators before a confirmation vote on Gaetz and-or to the public.
Guest is the former district attorney of Rankin and Madison counties. He also gained national attention when he introduced a resolution last year to expel New York Congressman George Santos from the House.
Some U.S. senators such as Republican John Cornyn of Texas have publicly called for the Ethics Committee to hand over its report of the Gaetz investigation. Neither of Mississippi’s two U.S. senators, Roger Wicker and Cindy Hyde-Smith, sit on the Senate Judiciary Committee, but they will get to vote on the nomination if it reaches the full Senate.
Wicker, a Republican from Tupelo, told Mississippi Today that the Senate has the constitutional obligation to “provide the president with advice and consent on executive and judicial branch nominations” and he takes that responsibility seriously. He did not comment on Gaetz.
“I think that we are in a position to give President-elect Trump good advice on what is likely to work,” Wicker said. We are going to fulfill our constitutional role, and we are going to do so as friends of the president-elect and as members of a team who want him to be as successful as possible.”
Hyde-Smith, a Republican from Brookhaven, did not respond to a request for comment.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Mississippi Today
Exploring all the many facets of Mississippi College’s decision to end football
Monday’s news that Mississippi College – soon to be Mississippi Christian University – will no longer field a football team seemed to come out of nowhere. “Shocking” is the word many have used to describe the news.
“I feel like I just lost a family member,” said Mississippi Sports Hall of Famer Fred “Fast Freddie” McAfee, one of the two most famous football players in Mississippi College history. “I remember playing my last regular season game against Delta State before an overflow crowd. I remember winning a national championship. I just can’t believe it has come to this.”
Many readers might wonder who the other most famous Mississippi College player was. That would have been the remarkable Edwin “Goat” Hale, a College Football Hall of Famer who in 1916 led the Choctaws to a 74-6 victory over Ole Miss. You read that correctly. Mississippi College 74, Ole Miss 6. MC also defeated Mississippi State, Southern Miss, Tulane and many other southern football powers early in the 20th century.
Mississippi College competed in football for 117 years. There’s a lot of history there, both good and bad, including that 1989 NCAA Division II National Championship, later vacated for scholarship violations. McAfee, a star player on that team, says he never was on more than a half scholarship in his four years at MC.
And McAfee, who later made All-Pro in the NFL, surely didn’t receive any NIL (name, image and likeness) money, which is one stated reason why Mississippi College made its decision to drop the sport. We will get to that.
First, this: There are many losers with this decision: the coaches, who no longer have a job; long-time Mississippi College football fans who no longer have a favorite team; and even Delta State, which loses its arch-rival. Delta State football coach Todd Cooley, whose Statesman defeated MC 20-14 on Nov. 16 in what apparently is the last football game MC will ever play, called the MC decision “very disappointing” and added, “I just hate it for the players and the coaches.”
But make no mistake: The biggest losers are the MC football players, who really do play for the love of the game. They must decide if they love it enough to play it somewhere else and, if so, then find a school that will take them.
Dr. Blake Thompson, the Mississippi College president in his seventh year at the helm, says he hurts for those players but at the same time strongly believes that the decision to drop football – along with the name change – are in the best, long-term interest of the school. One primary reason is economics.
“I don’t have the exact numbers in front of me, but we’re looking at close to $2 million that we can save to put into our other sports programs, upgrade our facilities, and also put into other areas, including, of course, academics,” Thompson said. “We have a long standing tradition of academic excellence. We have the highest incoming ACT scores of any school in the state. We’re proud of that.”
Thompson continued, “We also have bold aspirations for the future. I like the model of schools like Belmont University (Nashville), which doesn’t play football but has become quite competitive at the Division I level in baseball and basketball and other sports. Dallas Baptist, like us a faith-based school, has become a Division I baseball power.”
Thompson, who formerly worked at Ohio State, is in the middle of a seven-year term on the powerful NCAA Division II Presidents Council, and, consequently, is familiar with all aspects of of college athletics. “We’ve tried to look at the overall landscape of college athletics and determine where we stand and where we want to stand in that landscape,” he said. “We want to excel in everything we do. Sometimes, that requires tough decisions.”
One firm decision, Thompson says, “We are not in a place where we are going to be paying players. We are not going to play in that space.”
Over its last 10 full seasons, MC has won just 28 games, lost 74. Since the 1989 “championship” season MC has won 144, lost 200 and tied four. Those numbers will never be confused with Thompson’s goal of “excellence” in all MC does. None of that changes the fact, Thompson says, that this has been a gut-wrenching, quite emotional decision.
“My commitment since I got here seven years ago has been to care for these students,” he said. “All scholarship arrangements will be the same through the end of this school year. For those players who want to remain in school here, we will work with them, find scholarship money where we can from other sources. For those who want to continue playing football, we will help them every way we can with the transfer portal.”
The rest of the Gulf South Conference, including Delta State, faces a different and difficult situation. MC’s decision now leaves the league with only four football playing members: Delta State, No. 1 ranked Valdosta State, West Alabama and West Florida. The GSC was once known as the SEC of Division II football conferences. And, indeed, the four remaining football members all play the sport at a high level and all have won at least one national championship. But can four teams really be called a conference?
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Mississippi Today
Bill to provide prenatal care to low-income women still inaccessible as 2025 legislative session looms
Nearly five months after a new law to make prenatal care more accessible to low-income women was supposed to go into effect, its fate remains unclear.
The state is still in negotiations with the Centers for Medicare and Medicaid Services – the federal agency responsible for approving the state plan – according to Matt Westerfield, spokesperson for the Mississippi Division of Medicaid. CMS is supposed to take no more than 90 days to approve or reject a plan, but that 90-day clock has been suspended indefinitely since issues have been raised with legislation Mississippi lawmakers wrote last session.
Presumptive eligibility for pregnant women allows temporary and immediate Medicaid coverage for low-income expectant mothers while they wait for their official Medicaid application to be approved – a process that can take months.
Strict Medicaid eligibility requirements in Mississippi mean that a majority of low-income women are only eligible for Medicaid once they become pregnant. If a woman applies when she finds out she’s pregnant, that means a lengthy application process could cut well into her pregnancy and delay her seeking prenatal care, which is proven to lead to poor outcomes such as preterm birth – in which Mississippi leads the nation.
Nicole Boyd, R-Oxford, who leads the Senate Study Group for Women, Children and Families, has been checking in weekly with Medicaid about the status of the policy. In a committee hearing Monday, Boyd followed up twice with newly appointed Medicaid Executive Director Cindy Bradshaw at the beginning and end of the meeting to try to gain clarity on the status of the policy.
Boyd asked Bradshaw whether the 2024 legislation could be salvaged or whether lawmakers would need to redo legislation to enact the policy in 2025. Bradshaw said both that she hopes the state and federal agencies can come to an agreement, and also that she’d feel better with new legislation.
“Well, I think we can come to a reasonable place that we will be able to get it,” Bradshaw said. “Am I 100% comfortable with that? No. I would prefer that we have legislation to shore up the concessions that we’ve had to make.”
It’s not clear what concessions the Mississippi Division of Medicaid has had to make, but it’s likely that CMS is requiring Medicaid to take out a proof of income and proof of requirement lawmakers included in the original bill.
Federal guidelines state that while the agency may require proof of citizenship or residency, it should not “require verification of the conditions for presumptive eligibility.”
CMS will not comment on ongoing negotiations with individual states.
If 2024 legislation can’t be salvaged, lawmakers would have two options for rewriting the law next session. They could take out the requirements with which CMS has an issue, or they could take their chances hoping a Trump administration would grant a waiver allowing them to keep requirements at odds with federal guidelines – something lawmakers will likely bank on with a Medicaid expansion bill next session, as well.
Insisting on the proof of pregnancy requirement doesn’t serve much of a purpose, since it wouldn’t be possible for a woman to fake a pregnancy and receive prenatal care, such as ultrasounds. As for the proof of income requirement, it can be cumbersome on low-income women already facing socioeconomic hurdles, explained Tricia Brooks, a research professor at the Center for Children and Families at Georgetown University and the lead author on the KFF Annual Survey on Medicaid and CHIP Eligibility, Enrollment and Renewal Policies.
“I remember when I first got pregnant, I thought I had the flu because I was nauseous for days on end,” Brooks said. “If I go to the doctor and find out that lo and behold maybe I am pregnant, and you want me to get enrolled, but now you’re asking me for paystubs … So now I have to come back in or somehow communicate or transmit proof of income to the provider. That just gives everybody pause of, ‘Oh my god, is this even worth it?’”
In the meantime, the Division of Medicaid is continuing to accept providers who wish to participate in the program and conduct eligibility determination trainings, according to Westerfield. Until CMS approves the state plan, none of the providers that have been approved will be able to provide care under the policy to eligible women.
Below is a list of the 13 providers that have been approved to participate as of Oct. 18:
- Physicians & Surgeons Clinic – Amory
- Mississippi Department of Health, Dr. Renia Dotson – County Health Department (Family Planning Clinic)
- Family Health Center – Laurel
- Delta Health Center Inc (Dr. H. Jack Geiger Medical Center) – Mound Bayou
- G.A. Carmichael Family Health Center Providers – Belzoni, Canton, Yazoo City
- Coastal Family Health Center Inc. – Biloxi
- Delta Health System – Greenville
- Delta Medical Group – Women’s Specialty Clinic – Greenville
- Southeast MS Rural Health Initiative Inc. – Women’s Health Center – Hattiesburg
- University of Mississippi Medical Center – Jackson
- Jackson Hinds Comprehensive Health Center – Jackson
- Central MS Health Service – Jackson
- Northwest MS Regional Medical Center – Clarksdale
An expectant mother would need to fall under the following income levels to qualify for presumptive eligibility:
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
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