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
As heat rises, inmates and staff swelter in Mississippi’s prisons
As of Friday, five of the six locations where Mississippi's prisons are located are under a National Weather Service heat advisory.
And the Mississippi Department of Corrections has no clear timeline as to when it will install air conditioning to bring relief to inmates and staff.
“We are continuing to explore our options to provide air conditioning where possible; however, there is no timetable for that installation at this time,” MDOC spokesperson Kate Head wrote in an email.
One woman incarcerated at the women's prison at the Central Mississippi Correctional Facility in Pearl said relief from the heat is hard to come by and the temperatures inside are worse than outside without any shade or trees. The woman asked not to be named for fear of retaliation.
“It's actually worse (in) here,” she said Tuesday. “The heat just hits you in the face.”
The heat index, also known as what temperature feels like on the body, takes into account humidity and air temperature. Friday's advisory was said to expect index temperatures up to 110.
According to the Centers for Disease Control and Prevention, people who are at an increased risk of heat-related illnesses include those without access to air conditioning, those over the age of 65 and people with chronic conditions – populations that include incarcerated people.
Last year was the incarcerated woman's first summer at the prison, and she witnessed people pass out or experience seizures because of the heat.
Head, the MDOC spokesperson, wrote in an email that the department is taking steps to mitigate the heat by providing incarcerated people with water, ice and fans.
This is similar to what has been done in previous years, but some incarcerated people have said that distribution of ice isn't always regular or enough to support hundreds of people and that fans move hot air around. MDOC did not respond to these concerns Friday.
Air conditioning installation has been completed at the women's prison at CMCF in the church, school and dining areas, the incarcerated woman said. Several weeks ago it was completed in her housing zone, she said, but the AC there has not been turned on.
Tuesday evening, the prison superintendent visited the building where the incarcerated woman lives and told residents the air conditioning would not be turned on for the foreseeable future because it requires a part that is on backorder, the woman said.
The woman has also seen how three emotional support dogs trained by seminary students are moved to air conditioned areas and provided pools of water to stay cool. She doesn't understand how the animals get access to the relief but she and the other women don't.
“We get the short end of the stick on everything,” she said, in reference to how the men at CMCF already have AC and the dogs in the women's prison get access to it.
MDOC did not respond to questions about the air conditioning and the dogs' access to it.
Last year as air conditioning was installed at three-fourths of the Mississippi State Penitentiary at Parchman, Commissioner Burl Cain estimated that by sometime in 2025, AC would be coming Parchman's Unit 29, South Mississippi Correctional Institute in Leakesville and other facilities, so long as funding was available to support those upgrades.
“It just takes a good while to get it all done,” he said in an April 2023 interview with Missisisppi Today. “That's just the way the funding is.”
At Parchman, the heat index was above 130 degrees – within the extreme danger category where a person's risk of heat-related illness is likely – for 25 of the past 72 hours, according to the National Weather Service records.
On four separate instances Wednesday afternoon, the heat index reached 185 at Parchman, according to weather data.
Pictures from Parchman's Unit 29, which doesn't have air conditioning, shows how men have secured 8-inch fans purchased from the commissary to the bars of their cells and placed their mattress on the floor beneath the fan, which some have told advocates is how they get relief from the heat.
The majority of Parchman has had air conditioning since last summer, but Unit 29 is part of the group of prisons that are expected to get AC sometime in the future.
At all prisons, an 8-inch fan is available to buy from the commissary for $29.95, which is among one of the most expensive on the prison's commissary list compiled by The Appeal.
Even if an incarcerated person has a job, Mississippi prison industry jobs can pay between 20 cents and $1.30 an hour, which falls within an estimated national average calculated by the Prison Policy Initiative. The group also estimated regular prison jobs nationwide have an estimated range of 14 cents and 63 cents an hour.
Privately operated Eastern Mississippi Correctional Facility has AC including in its housing units, but family members told advocates that since the end of May, the air conditioning has not been functional.
The maximum daily temperatures in Meridian, where the prison is located, have been above 90 degrees since the end of May, according to the National Weather Service.
Meridian is also under a heat advisory, and within the past three days, the highest heat index was 107 degrees – 95 degrees at 75% humidity, which is in the danger category for heat-related illnesses.
Management and Training Corp. spokesperson Emily Lawhead said technicians have diagnosed problems with air conditioning units and will install new units when they arrive.
“We're working hard to get all AC units back online as soon as possible,” she wrote in an email.
In the meantime, Lawson said cold water and fans are available, and Gatorade is provided to staff and incarcerated people for them to stay hydrated. Swamp coolers are cooling the air in areas where AC units are waiting to be repaired, she said Friday.
Heat in prison is a national issue that Families Against Mandatory Minimums, which represents incarcerated people and their families, and One Voice United, a group representing corrections staff, have teamed up to address.
The Safer Prisons, Safer Communities campaign is highlighting a nationwide crisis through overcrowding, understaffing and deteriorating conditions that make prisons unconducive to rehabilitation and create poor conditions for incarcerated people, prison staff, families and communities.
Andy Potter, executive director of One Voice United and a former Michigan corrections officer, recognizes prison infrastructure can be old and it can be expensive to install air conditioning.
But he said it's not enough for incarcerated people and the corrections staff to rely on fans, water bottles and Gatorade to stay cool. The incarcerated and staff do not have the freedom or ability to seek relief in a similar way as those not in a prison system can do, Potter said.
Daniel Landsman, vice president of policy for FAMM, said air conditioning can help decrease incidents of violence and fatalities, which research has found increases with heat.
“Heat is just going to make all the things we are experiencing in our prison system worse,” he said.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Mississippi Today
On this day in 1827
JULY 5, 1827
![](https://i0.wp.com/mississippitoday.org/wp-content/uploads/2023/06/July5-Illustration-of-Black-Americans.jpg?resize=780%2C781%7CTAXOPRESSENTITY038TAXOPRESSENTITY%7Cssl=1)
A day after those enslaved were freed in the state of New York, 4,000 Black Americans marched along Broadway through downtown streets with a grand marshal carrying a drawn sword. They arrived at the African Zion Church, where abolitionist leader William Hamilton said, “This day we stand redeemed from a bitter thralldom.”
Celebrations took place as far away as Boston and Philadelphia. In New York's capital, Nathaniel Paul, pastor of the First African Baptist Society, declared, “We look forward … (to) when this foul stain will be entirely erased, and this, the worst of evils, will be forever done away … God who has made of one blood all nations of men, and who is said to be no respecter of persons, has so decreed; I therefore have no hesitation in declaring this sacred place, that not only throughout the United States of America, but throughout every part of the habitable world where slavery exists, it will be abolished.”
Among those freed by this act? Sojourner Truth, who was born into slavery and had escaped to freedom just a year earlier. The Fifth of July is still recognized and celebrated in New York City.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
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Mississippi Today
Salaries for two public university presidents creep toward $1 million a year
Two public university presidents in Mississippi now make almost $1 million a year each while pay for faculty and staff at the state's eight universities remains stagnant.
The hefty salaries are largely, but not entirely, due to the private foundations for the University of Mississippi and Mississippi State University supplementing the state salaries for Glenn Boyce and Mark Keenum, respectively.
Both presidents now pull $950,000 a year, with taxpayers supporting $500,000 of their salaries and the foundations making up the rest, according to IHL board meeting minutes.
That constitutes a $100,000 raise, which Keenum and Boyce received after the Institutions of Higher Learning Board of Trustees conducted performance reviews for the two presidents at the end of last year, John Sewell, a spokesperson, wrote in an email.
“University presidents play a critical role not only at their respective institutions but across the state,” Sewell wrote, “as Mississippi's public university system is poised to have an $8 billion impact on Mississippi's economy over the next six years.”
The board also reviewed Nora Miller, the president of Mississippi University for Women, but Miller did not receive a raise, and it's unclear if she requested one. Miller will continue to make $300,000, plus a $5,000 foundation supplement, in her new four-year contract.
When Miller was hired in 2018, the state paid her $215,000, and she received a $30,000 foundation supplement, according to IHL board records. In 2022, the board gave every college president a raise and reduced the foundation supplements to $5,000 for every university but Ole Miss and Mississippi State.
Last month, the board also approved significant “retention” plans for Boyce and Keenum, a kind of bonus paid for by the university foundations that no other college president in Mississippi receives. Keenum has an opportunity to get up to $1.4 million from the MSU foundation if he stays at Mississippi State through the end of his contract in 2028, and Boyce can receive up to $800,000 from the one at Ole Miss.
It is unclear if either president is planning to retire or leave their universities. While Mississippi taxpayers pay the university presidents significant sums of money, the board considers its salary decisions confidential.
Sewell declined to answer further questions about the purpose of the plans, writing that “information about specific evaluations and salary decisions are personnel matters and are considered confidential.”
A document obtained by Mississippi Today last year shows the criteria the board used to evaluate the eight college presidents as of January 2023, including “provides effective leadership in enrollment management,” “supports initiatives and programs that promote student retention” and “provides effective leadership in acquiring and sustaining regional and professional accreditations.”
Under Keenum, the National Science Foundation has ranked Mississippi State as a top research institution. Boyce's “Now and Ever” campaign has raised more than $1.5 billion in private support for Ole Miss.
“I am most grateful to the IHL trustees, Commissioner Rankins, and our university foundation board members for their vote of confidence in my leadership,” Boyce said in a statement. “More importantly, I am mindful that our university is thriving because of the unending commitment of our faculty and staff to deliver on our mission of education, research, service and healthcare each and every day.”
The IHL board first approved retention pay for Boyce in 2022. When the board granted Keenum that opportunity in 2021, he asked the Mississippi State University Foundation to “use a majority—if not all—of this incentive for scholarships.”
Sid Salter, an MSU spokesperson, declined to answer questions about whether the foundation used Keenum's retention pay for scholarships.
“The portions of those compensation packages that may rely on private MSU Foundation funds are not required to be disclosed beyond what the College Board has already provided,” Salter wrote. “The university has no additional comment.”
The IHL board also released its legislative priorities for the next year, including increasing pay for faculty and staff who make less than average compared to their peers at other Southern universities.
Since 2016, the average faculty member in Mississippi has actually seen a nearly $11,000 pay cut due to inflation, according to an analysis of federal data. In fall 2022, the average faculty salary in Mississippi was $68,676.
Though IHL has obtained nominal wage increases for faculty and staff, inflation and health insurance premium increases have put meaningful raises out of reach, the board has said.
READ MORE: ‘USM's new president making $650,000; all public college presidents saw raises this year'
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
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