Year: 2022

By Anthony Whisenant, policy intern –

The Mississippi Rural Health Association is pleased to report a successful legislative session this year. We have been supporting and tracking multiple bills throughout the year, working with lawmakers and supplying information to assist with successful passage. The following is a description of legislation that passed this year that the MRHA has been watching and supporting:

Mississippi House Bill 365 (top supported bill by the MRHA)

House bill 365 establishes the Mississippi Rural Hospital Loan Program in the state department of health to assist rural hospitals in providing needed direct healthcare services.  This increased funding will allow rural hospitals to offer additional services in their community that are not currently available there now, maintain or increase their staffing levels, and keep up with necessary facility maintenance.  For rural hospitals to be eligible for loans they must submit a financial audit proving they are in a good financial position.  The loan they receive may not be less than twenty-five thousand dollars or more than one-hundred thousand dollars.  The department will determine terms, conditions, and requirements for loans.  This loan program will be funded through a state appropriated $2.5 million in support. Note: the MRHA would love to have seen the loan amount increase to a cap of $1 million per facility, but this is a great start. A big thank you to Rep. Sam Mims for his sponsorship of this bill.

Mississippi House Bill 732

House bill 732 provides legislative intent to assure all Mississippians receive a consistent level of 9-8-8 and crisis behavioral service no matter where they live.  The purpose for the signing of this bill is to save lives of Mississippi residents by providing them better access to services pertaining to the behavioral health crisis.  This bill authorizes the state department of mental health to use technology that is interoperable across emergency response systems in Mississippi and to deploy crisis and outgoing services. 

Mississippi House Bill 1421

House bill 1421 establishes a grant program known as the Arpa Rural Water Infrastructure Grant Program in order to assist rural water associations in the construction of eligible drinking water infrastructure projects.  Upon approval, the department will enter into a project grant agreement with each guarantee to establish the terms of the grant for the project, including the amount of the grant.  In the first fiscal year after the effective date of this act, twenty percent of the funds appropriated to the department for the program will be obligated to projects that have completed plans and specifications, acquired all necessary land and/or easements, and are ready to proceed to construction. 

Mississippi House Bill 1538

House bill 1538 provides additional appropriation to the state department of health for the purpose of funding the Arpa Rural Water Associations Infrastructure Grant Program establishes under house bill 1421.  As a condition of receiving and expending the funds appropriated to the department under this act, the department shall certify to the Department of Finance and Administration that each expenditure of the funds appropriated to the department under this act complies with the guidelines, guidance, rules, regulations and/or other criteria.  It states that the money appropriated by the act will be paid by the State Treasurer out of any money in the Coronavirus State Fiscal Recovery Fund. 

Mississippi House Bill 1613

House bill 1613 makes appropriation to the Governor’s Office-Division of Medicaid for the purpose of providing medical assistance under the Mississippi Medicaid Law and defraying the expense of that law for the fiscal year 2023.  With this bill, the Governor’s Office – Division of Medicaid will provide statistical and financial reports monthly to the Legislative Budget Office and the PEER Committee.  These reports include an accounting of all funds spent in the medical program, the CHIP program, the Dialysis Transportation program, and each of the Home and Community Based Waiver programs.  The reports will also include an accounting of all funds spent in the administrative program, participant statistics, and any other information requested by the Legislative Budget Office and the PEER Committee. 

Mississippi Senate Bill 2738 (top supported bill by the MRHA)

The purpose of senate bill 2738 is to revise the definition of telemedicine as it is used in the statute requiring health insurance plans to provide coverage for telemedicine services.  It requires health insurance and employee benefit plans to reimburse providers for telemedicine services using the proper medical codes.  It provides that all health insurance and employee benefit plans in Mississippi must provide coverage for telemedicine services to the same extent that the services would be covered if they were provided through in-person consultation.  All health insurance and employee benefit plans in this state must reimburse providers who are out-of-network for telemedicine services under the same reimbursement policies applicable to other out-of-network providers of healthcare services.  A big thank you to Senators Boyd and Michel for their sponsorship of this bill.

Mississippi Senate Bill 2739

Senate bill 2739 requires nonemergency medical transportation (NEMT) providers to have a permit from the state department of health before they may provide NEMT transportation services in Mississippi.  It requires the department to adopt rules providing for applications of permits, issuance of permits, renewal of permits, and revocation of permits.  The bill authorizes the department to provide for the payment of fees for the issuance and renewal of permits.  It requires the department to adopt standards for the operation of vehicles used to provide NEMT transportation services.  The bill also authorizes the department to revoke the permit of or impose fines on any NEMT provider who is found to not follow the requirements and standards set by the department. 

Mississippi Senate Bill 2865           

Senate bill 2865 makes appropriation from the Coronavirus State Fiscal Recovery Fund to the Department of Mental Health for the purpose of assisting with behavioral and mental health needs.  The legislation intends that no funds under this act should be used to pay employee premium payments.  The bill states that as a condition of receiving the funds appropriated in this act, the Department of Mental Health shall obtain advice from the Office of the Coordinator of Mental Health Accessibility when determining the utilization of funds. 

Unfortunately one bill that did not pass this year was a bill sponsored by both the House and Senate to remove the Medicaid rate freeze, which was originally established in the Medicaid Technical Bill in 2021. This bill made it to conference, but unfortunately was not able to pass out of conference. We are hopeful that this rate freeze will be removed soon.

Note: The Mississippi Rural Health Association would like to thank its policy intern Anthony Whisenant for his work tracking this legislation and providing summaries to the MRHA membership.

As COVID-19 has shown, good health is not universal. Some communities face challenges that leave them more vulnerable to health risks than other groups. Each year on April 7, the World Health Organization, along with other related organizations, observes World Health Day to raise awareness of global health inequities, such as COVID-19’s disproportionate impact on minority communities.

According to data from the Centers for Disease Control and Prevention (CDC), people of color experience significantly higher rates of COVID-19 infection, hospitalization, and death, with Black and Hispanic people being hospitalized for COVID-19 at over double the rate of non-Hispanic white people. Various social, geographic, economic, and environmental factors – such as lack of health care access and increased exposure due to occupational settings –  have contributed to increased health risks in these communities.

Some of the same factors that are related to health disparities also affect COVID-19 vaccine equity. Across the U.S. vaccination rates are lower in the Black population when compared to rates in the white population. Many communities mistrust the health care system due to mistreatment by the medical community. Because they haven’t always been included in the research used to create treatment and prevention strategies, it can be difficult to trust those in the health care system even in moments when help is offered.

But the All of Us Research Program is looking to change that. If you are also looking for ways to help our community fight COVID-19, one way you can do your part is by participating in research. The All of Us Research Program is gathering health information from one million or more people across the U.S. from all different backgrounds to help build one of the most diverse health databases in history. Researchers can then use this information for important health studies.   COVID-19’s disproportionate impact on communities of color, those with disabilities, and others make the All of Us Research Program’s contributions especially important to efforts to learn more about the virus and related health disparities. While the health data contributed to the program may help with future treatment, All of Us implemented several initiatives to provide immediate insights into the impacts of the pandemic. The COVID-19 Participant Experience (COPE) Survey helps researchers understand how the pandemic has affected all aspects of people’s lives, like mental and physical health, housing, and job security. The Minute Survey can help researchers understand barriers to people receiving the COVID-19 vaccine by finding out who, when, and why people do or don’t get vaccinated. Sharing your story can help researchers learn more about COVID-19 and other diseases, which could lead to better treatment and disease prevention for all of us.

Make sure your community is included in health research and join All of Us at bit.ly/togetherAoU.

11 Steps that will Help You Sleep at Night!

As a firm who has a demonstrated record of success in hospital tax elections and won $180 million for clients, we have a unique perspective on how to begin the process. These steps are work that you do before you start the real work of public information and outreach. Hospitals who prepare well in the beginning are more successful.

First, research your messaging in the last election and see what promises you made and collect data on the promises you kept.

This step provides you with information that you can use to show that the hospital is trustworthy of another investment by the community. Use photos and descriptions of these completed projects. Get a testimonial from a popular physician on how this progress has helped deliver quality care in your hospital.  

Second, research how other public entities like school boards, city or county or fire departments have succeeded or failed in their recent tax elections. 

This information gives you an idea of the willingness of the voters to support public entities. Look for organized opposition in these past elections because those same folks may oppose your proposition. If this is your first election, this step is critical because you do not have a hospital track record to review. 

Third, determine the capital needs of the hospital that the funds will address. 

Perhaps, technology upgrades, lab expansion, a new clinic, new services like infusion or outpatient surgery are needed. Maybe you actually need a new hospital facility. Even if you are using other funding for your new facility, supplementing it with a community investment is important. Compile a list of your needs and most importantly prioritize them.  

If your funds will be to build a new hospital, you will need to demonstrate why this is necessary and how the community investment fits with the overall funding. 

Fourth, quantify the capital required to meet the needs that you have identified.

You need more than one global number. Today’s voters want to see an itemized list. Make sure that you know the schedule on which you will address the needs and account for any escalation in price. Currently construction costs are considerably higher than they were two years ago. 

Fifth, determine the amount and term of the property or sales tax that is realistic to attain the capital required.  

Get the input of the hospital’s bond counsel. The amount and term of the tax must meet bond obligations. 

Sixth, learn the required schedule of legal events that need to happen in relationship to the various election date options.  

Your bond counsel can provide the schedule. This action begins your decision sequence on which date would be best for your election. It also helps you to plan the public outreach information schedule.  

Seventh, determine what other items or candidates may be on the ballot on your most likely date of the election.  

Voters are influenced by other propositions and candidate elections.  For example – If the school system is unpopular and they have a proposition on the same ballot it may increase your unfavorable votes. 

Eighth, test the favorability of your proposed use of funds and other variables with the voters.   In the preparation phase, you can modify your proposal to ensure your success. Once decisions are made and there is information in the public domain, changes are impossible.  An accurate public opinion survey guides many key decisions in an election effort. 

Ninth, bring key physicians into the decision making process when you feel It’s appropriate.

You need “buy-in” from physicians to be successful. Having a discussion with physicians and getting their input is ensuring that your use of funds is aligned with the needs that they believe are important. It also makes them part of the team rather than part of the spectators to the process. 

Tenth, as you work through this preparatory process, look for allies. 

Some members of your leadership and hospital team have deep roots in the community.  Quietly make a list of those people. As you proceed through the entire community education and outreach process at a later time you will need these allies. 

Eleventh, develop a board strategy to persuade board members to approve your proposition.  

Board members are fearful of losing tax elections and raising taxes in general. If this is a renewal it is easier for board members to approve.  In all cases, board members need information and data to help them make ballot decisions. Survey results are very helpful. Major points must stand on as much data as possible. Preparing your messaging and timing your presentation to your board is extremely important. Questions must be anticipated and nothing must be left to chance.

After you have completed these 11 steps successfully, you are ready to prepare for the next phase, which is gaining the approval of your county board, state bond commission and educating the many stakeholders of the hospital and the public.   TCI can guide the leadership team through this preparation process and provide the research and messaging that you need. We want you to be successful in your next election!