close

As the coronavirus pandemic sweeps across the nation, it was revealed that we were critically short on certain medical necessities including hand sanitizer, masks, and ventilators. 

Many feared for what would be a soon to come shortfall on these items that are medically critical to prevent further spread of the virus and effectively treat those who have it. Thankfully, private enterprise has stepped up to the plate in a historic way. Businesses are transitioning to fill the existing gaps and provide the supplies that the country needs. In Mississippi, we have seen local business leaders bravely take risks in order to fill critical medical needs. 

A few days ago, I had the chance to speak with David Rich of Rich Grain Distilling Company in Canton. He has shifted his entire company from making bourbon to producing hand sanitizer en masse.

When it comes to sanitizer, it has proven a vital and yet over-purchased resource, leaving many fire departments, police units, hospices, hospitals and more in serious need. Hand sanitizer is an incredibly important tool for countering this virus and deterring its spread.

Unfortunately, many folks are finding their local providers’ shelves to be empty. While in a local drug store a few weeks ago, David noticed that the store was running out of hand sanitizer, so he offered to try making some.

What began as a hobby years ago, led to a distillery, and now is the reason that thousands in Canton, including many emergency service providers still have access to hand sanitizer today. A Madison County native, David was working in mechanical engineering for a defense contractor while researching bourbon and its production in his free time. Ultimately, he decided to pursue his dream and opened the doors of Rich Grain Distilling in 2016.

In a normal situation, burdensome regulations would have prohibited distilleries such as Rich Grain Distilling from being able to make this transition. Luckily, as David noted, the “federal government decided to lift certain regulations,” allowing for specific companies such as distilleries to move their operations into the production of much-needed resources like hand sanitizer.

The Alcohol and Tobacco Tax and Trade Bureau waived requirements to obtain permits to legally manufacture hand sanitizer and removed the excise tax for alcohol-based hand sanitizer products. That wasn’t all. The Food and Drug Administration then had to issue guidance saying they do not “intend to take action against manufacturing firms that prepare alcohol‐​based hand sanitizers for consumer use and for use as health care personnel hand rubs during this ongoing public health emergency.”

The difficult element of the transition was processing ingredients and working with suppliers to secure necessary bottles and other resources. High proof alcohol is then mixed with other products in the necessary process to create sanitizer.

While he’s making less per unit, demand has been high, and this has allowed him to retain his staff and even bring on a few new employees. Thus, he is not only fulfilling the critical needs of his community by helping local providers but is also able to continue offering a steady paycheck in a time of dire economic need for many.

I asked David if he had any plans for continued sanitizer production once the coronavirus crisis is over and he noted to me that, he doesn’t “want to be in the hand sanitizer business.” Naturally, he’d greatly prefer to be making the bourbon that first inspired his distillery to open. But, for now he’s happy that he’s been able to help people in his community. Indeed, I think while some are currently missing the taste of Rich Grain Distilling bourbon, it will be appreciated all the more in the future, especially knowing how David Rich took business risks to help his community when it was most in need.

David is currently operating at capacity, and so unless you are a representative of an emergency service or essential business, please do not attempt to place any current additional orders of sanitizer.

These businesses that are stepping up deserve to be highlighted, and so the Mississippi Center for Public Policy is launching a series dedicated to doing just that. Over the coming weeks, we aim to continue showcasing the stories of these local businesses, including Blue Delta Jeans in Oxford and now Rich Grain Distilling Company, who have willingly given up their normal operating procedures to help as many people as they possibly can.

If you know of a local Mississippi business that is helping those in need during this critical time, we’d love to highlight the work that they’re doing. Please email Hunter Estes via [email protected] to discuss further.

Healthcare is complicated. But during the current coronavirus outbreak, healthcare policy goals are very simple: How do we increase the supply of healthcare for those who need it most? And how do we increase access to healthcare to those who need it most?

Right now, the real challenge is prioritizing very limited healthcare resources. The people who need care the most are, obviously, patients who are suffering life-threatening complications from the coronavirus. Care must also be prioritized for those who have other life-threatening events, such as a heart attack, a stroke or an auto accident.

Seen in this light, it becomes clear that calls to expand Medicaid to able-bodied adults are, not only a sorry example of political opportunism, but an immoral and wasteful redistribution of healthcare resources that need to be safeguarded for more vulnerable populations.

One of the most regrettable things about the Obamacare Medicaid expansion is that it provides a 90 percent federal match to states that expand Medicaid insurance to low-income, able-bodied, working-age adults. That’s right – the expansion only applies to adults who either can work or are working and who are not disabled, not elderly and who do not have children. Given that we have disabled children and elderly people on a Medicaid services waiting list, one would have thought that D.C. would have provided a 90 percent match to cover these patients. 

No doubt, able-bodied adults without insurance are at-risk of catching the coronavirus. But they are not, by definition, a high-risk category. Moreover, these individuals already have access to a vast array of other government welfare programs, such as SNAP (food stamps), Obamacare health insurance exchange coverage, and the federal earned income tax credit (EITC). The federal government fully funds each of these three programs.

Consider also that subsidized health insurance exchange coverage is already available to people who earn between 100 percent and 400 percent of the federal poverty level. If Mississippi were to expand Medicaid, this subsidized coverage would disappear for anyone earning between 100 percent and 138 percent of the federal poverty level. Again, this coverage is fully funded by the federal government. In addition, Mississippi has one of the highest EITC participation rates in the country. As of December 2019, more than 350,000 Mississippi individuals and families received $1 billion in ETIC subsidies. This number will only increase as 2020 wears on.  

Likewise, able-bodied, working-age adults will be benefitting in numerous ways from generous waivers and payments being offered by federal and state governments in response to the coronavirus, including a massive increase in unemployment benefits as well as direct cash payments to every American. The federal government is also waiving all current SNAP work requirements, providing supplemental SNAP benefits, expanding school meal and other food service programs, providing hundreds of millions more for the WIC food program, and sending tens of billions more to states to help pay for higher Medicaid costs. The Trump administration even withdrew a proposed rule aimed at reducing improper Medicaid enrollment and fraud. 

Already, the second coronavirus relief package, passed by Congress on March 18, increased the federal share of Mississippi Medicaid payments by 6.2 percent. This means that the current federal match for Medicaid has increased from a highest-in-the-nation 76.98 percent to a still highest-in-the-nation 83.18 percent. Medicaid, Medicare and private insurers are also being reimbursed to offer free COVID-19 testing and related services. Uninsured patients can get tested at no-cost, thanks to an additional $1 billion set aside. 

These payouts are dwarfed by the third $2 trillion relief package which includes more than $100 billion for hospitals. The American Hospital Association is demanding billions more and is likely to get it.

Time will tell whether these investments will stimulate the economy or bankrupt the country. What is clear is that states, like Mississippi, will be experiencing budget shortfalls. What is also clear, as demonstrated in state after state that has expanded Medicaid, is that the cost will be far more than projected. These costs, however, are only monetary. We have to acknowledge the human cost of expanding Medicaid.

Gold-standard research shows that expanding Medicaid increases the demand for healthcare services while delivering no improved physical health outcomes. Expanding Medicaid won’t make people healthier. And it won’t get better care to people who have the coronavirus. Let’s save the debate over Medicaid expansion for after this crisis passes and instead focus on solutions we know will work.  

This column appeared in the Clarion Ledger on April 5, 2020.

In this episode of Unlicensed, we talk with Josh Archambault of FGA about how many states are responding to the coronavirus pandemic by expanding telemedicine options. Meanwhile, Mississippi is making it more difficult for patients to access the doctor of their choice via telemedicine. 

Follow: Spotify / Apple

The Department of Revenue announced today that they are allowing patrons in a Leisure and Recreation District (LRD) to leave with a mixed drink from their to go order.

This means if you live in one of the 19 LRDs in the state, you can order a mixed drink with your curbside order and take it home.

"Due to the emergency situation all Mississippians are facing, ABC is now allowing drinks in the "to go" orders made by patrons for curbside pick-up if the restaurant is located in an LRD," the order reads.  

The following cities are designated LRDs: Bay St. Louis, Tupelo, Ridgeland, Jackson, Gulfport, Biloxi, Ocean Springs, Brandon, Clinton, Diamondhead, D’Iberville, Hattiesburg, Laurel, Long Beach, Moss Point, Natchez, Pascagoula, Pass Christian, and Vicksburg.

Restaurants will still be prohibited from selling you a mixed drink if they are located outside one of the allowable cities because it it prohibited by state law.

Over the past few weeks, DOR has made updated multiple regulations to make it easier to purchase alcohol. Along with the most recent change, liquor stores can now take orders online or over the phone, while providing curbside delivery rather than having to enter the retail establishment. You are also allowed to purchase a sealed bottle of wine with their to-go order.

These actions were previously illegal.

America finds itself facing an unprecedented adversary at the moment. This invisible enemy of coronavirus has challenged us deeply, but has also brought out the best in people as we come together in community.

Indeed, the best of America has been showcased during this crisis as we continue to fight though this. 

For over 220 years now, Mississippi has been a part of this American community, united by the common values we share. On this day, April 7th, in 1798, Mississippi first became an official territory of the United States, setting it on a historic path.

In so doing, we recognized our belief in a fundamental set of principles founded on liberty, freedom, and personal responsibility. We joined a society governed by the Constitution, a document that empowered the people instead of a king and wrote into law an unprecedented form of republican governance.

In 1795, through an agreement with Spain, most commonly referred to as Pinckney’s Treaty, in honor of the American diplomat who negotiated it, the United States settled territorial disputes and Spain released its claims over swaths of land in what is now Mississippi and Alabama, paving the way for American control and formal governance in the region.

Mississippi was the product of a famed migration that occurred among American colonists following the victory in the Revolutionary War. Population dramatically jumped and Mississippi quickly went from a territory to a state by 1820. So quickly was migration to the Mississippi territory growing that some in the old Southern colonial states worried over this population flight, even referring to it as the “Mississippi Fever.”

Poor agricultural practices and expanded farms left the older agricultural states with little land left available. So, hundreds of thousands of Americans pushed west in search of new land and opportunity. In Mississippi, they found a vast untamed wilderness, but also fertile soil. It wasn’t long before the agricultural economy quickly developed, and with it came slavery, a continued stain on the promise of freedom.

With the imperfection of man comes the inability to ever achieve perfection in regards to the ideals towards which we strive: freedom, liberty, personal responsibility. And yet, there is something remarkable about having the ability to trace one’s beliefs through generations to those who laid the foundations for our current governance structure.

On this day, in 1798, Mississippi took a major step forward. In joining the United States, we were partnered to a fundamentally revolutionary idea. Through self-government and republican rule, our nation was making history. As we look back on this story, well over 200 years down the line, it is remarkable to understand the challenges that were faced, the hurdles that were overcome, and the incessant march, to which we are still committed, which centers around constantly seeking to better uphold the freedoms that we committed to in 1798.

On Friday evening, businesses deemed non-essential closed their doors in Mississippi as they have been doing over the past couple weeks to combat the coronavirus pandemic that has spread across the country. 

Was this the right call? Was it too much or too little and too late? Regardless of what the blue checkmarks say, I will defer to the experts who are making those decisions and guiding the governor through these unthinkable times.

My family is doing the best we can to stay safe, and that’s really all we can control. Just like your family is all you can control.

But as we went for a ride on Saturday around lunchtime, we got a weird feeling going through the empty parking lots of the normally bustling Dogwood Festival Market off of Lakeland Drive in Flowood. Of course, as you drive near the Target, Kroger, or Lowe's you probably see more traffic than normal. 

But across the street near Belk, Old Navy, HomeGoods, Bath and Body Works, etc., you see a sprawling empty parking lot. For those who are fans of dead malls, it was as if that is what you entered. Except the signage was intact and the landscaping was freshly manicured. 

Yet tucked in between large national chains are numerous small businesses, such as Time 4 Toys, a rare independent toy store that competes every day with the likes of Walmart and Amazon. That was already enough of a challenge. Not being able to open their doors is just the latest obstacle.

But they, like many others, are getting creative. They’re offering free delivery within a 10 miles radius of the Flowood store. They are also offering curbside pickup from 11-2 during the week for those who place orders online. If you’re struggling to find something, send them a Facebook or Instagram message or call the store. They will be there to help you. 

And that’s just one of the many, many retailers who are trying to survive financially. Because as has been said, this is not just a health crisis. It’s also a financial crisis. The 30,000 Mississippians who filed for unemployment last week can attest to that. 

We don’t know when the health issues will pass or when we will all be safe to go about our daily lives. The stay at home order is in effect until April 20, but it could certainly be extended. Beyond not knowing when we’ll return to normal, we don’t even know what normal will look like. 

Will we be ready to go into restaurants or will we stick with the convenience of food delivery apps? Will we maintain our virtual approach to business with more people working from home or attending conferences in another state without having to leave town? Will you feel safe being within five feet of another person?

Maybe. Like most everything going on right now, we don’t know is the only answer we can be sure of. 

But for those who have kids who enjoy going into a toy store – and those whose livelihood depends on it – we can just hope that our small businesses make it. 

Thanks to a policy of ensuring the state’s rainy day fund is filled each year to the legal limit, Mississippi is better off than half of states when it comes to a fiscal cushion from the coronavirus pandemic and the associated downturn in tax revenues. 

According to a study by the non-partisan Tax Foundation, Mississippi ranks 25th nationally in the amount of money in its rainy day fund. The study used figures from the start of fiscal 2020 to calculate how much states had in their rainy day funds.

According to the study by the Tax Foundation’s Director of State Tax Policy Jared Walczak, Mississippi lawmakers have 8.1 percent of the state’s general fund expenditures in the state’s savings account. Mississippi had $465 million at the start of fiscal 2020 in its rainy day fund, but that figure is up to $678 million now. The total amount that Mississippi lawmakers have in unallocated funds adds up to a $1.2 billion.

The Magnolia State’s savings account balance is better than all but one of its neighbors.

Alabama’s rainy day fund represents 10.1 percent of its general fund expenditures, ranking it 18th nationally.

Arkansas is the worst (2.7 percent cushion, 45th ranking) and Louisiana is second worst at 4.4 percent of its general fund expenditures in reserve(42nd worst). Tennessee has seven percent reserves (ranked 31st).

Wyoming was the best nationally, with 109 percent of its general fund expenditures in reserve. Alaska was second, with 52.6 percent of its expenditures in its rainy day fund. Illinois and Kansas were the worst, with both states having little (Illinois has a reserve of $4 million) or no money left in reserve. 

The study recommended that states consider spending cuts, drawing down reserves, accounting adjustments and possible revenue enhancements to get their balance sheets in order. The study also said that delaying spending cuts until the next budget might force harsher cuts down the road.

Walczak said in the study that income taxes are more volatile than sales taxes and fall more sharply during a recession since layoffs and reduced wages result in less taxable income. The demand on government services, such as unemployment benefits and SNAP (Supplemental Nutrition Aid Program) will also increase during the COVID-19 recession.

Walzak recommended that states take care in drawing down their rainy day funds and save some for the fiscal 2021 budget. He also said in the study that there isn’t enough time left in the fiscal year in most states to generate revenue from new or increased taxes.

Every state, except Vermont, have a requirement to have a balanced budget. 

According to analysis by the Mississippi Center for Public Policy, Mississippi’s budget hole for this fiscal year (which ends June 30) could be between $414 million and $1.1 billion. 

The unallocated funds for Mississippi that could be used to shore up the state’s budget crisis include:

A growing number of expectant moms are considering home births as the coronavirus pandemic continues to spread and to overwhelm hospitals. This is true even in Mississippi, a state with few midwives and among the lowest percentage of home births each year. 

“I’ve seen a considerable uptick in the number of women who are now interested in home births,” said Kristina Harper, a midwife in Olive Branch who serves women in Arkansas, Tennessee, and Mississippi. 

“We are fielding an extra five-to-ten emails each day, an extra five-to-ten phone calls each day from women who want to deliver at home,” Harper added. “In the last two weeks, I’ve gone from one or two patients to four or five.”

Dr. Delta Stark, a prenatal chiropractor in Madison county and the Board President of Better Birth Mississippi, said this is true statewide.

“We specifically have been receiving an influx of questions and requests to join our consumer discussion page from pregnant women who even into their late third trimester are looking for out-of-hospital birthing options due to fear and concerns with COVID-19,” Stark said. 

That's one of the reasons for the newfound interest in midwives, who delivered virtually every baby in the mother’s house at the turn of the 20th century. 

Part of the issue is new constraints on hospitals that have become swamped because of coronavirus. Though policies tend to change daily, some hospitals have begun to restrict all visitors, even the father of the baby. And then there is the fear that new moms will contract COVID-19 while at the same hospital as so many patients who have the virus.  

“Some are looking specifically for midwives and home birth options,” Stark added. “But some are more concerned with the fear of not having support persons allowed into their birth setting (including family members, doulas, partners, etc.). These are very uncertain times to be birthing due to ever-changing hospital rules and regulations.”

Harper has been a midwife since 2004. She is a Certified Professional Midwife (CPM), which is a private national certification for midwives to establish knowledge, skills, and abilities. It includes training, education, supervised experience, and the successful competition of a skills assessment and written exam. Most CPM’s like Harper practice in homes or birth centers. 

The Certified Professional Midwife credential, issued by the North American Registry of Midwives, is accredited by the National Commission for Certifying Agencies, the accrediting body of the Institute for Credentialing Excellence.

For those who don’t plan on working in the hospital setting, this is the gold-standard certification. 

“Midwives, who receive extensive education and training, are qualified to attend to low risk women who desire a home birth,” Harper says on her website. “Midwives have proven over and over again, that they can and do safely attend to women who are low risk for complications during pregnancy and childbirth. Midwives aren’t there for when everything is going perfectly smoothly. Midwives are there because they are knowledgeable in normal, monitor for normal and are with the laboring mother for the majority of their labors.”

As Harper says, a home birth isn’t for everyone, only low-risk pregnancies. 

Harper is licensed in Tennessee and collaborates with a physician in the Volunteer State. 

She doesn’t in Mississippi because the state doesn’t license midwives. While a lack of license would generally be a positive, it also contributes to Mississippi having among the fewest home births in the country and no true birthing centers. Part of that is because the low number of midwives in the state. According to Stark, they generally have 10 practicing midwives at a time.

“In Tennessee it is easier to find physicians to work with and to get doctors to call in prescriptions,” Harper said.

But not in Mississippi. 

“In my personal experience caring for pregnant moms in central Mississippi for the last three years as a prenatal chiropractor, very few OBs or hospitals are willing to collaborate care with midwives serving clients choosing home births in the area,” Stark said. “There are a few exceptions, but generally speaking there is a lot of push back for families seeking support and backup birth plans in a hospital setting. Again, I feel like this could strongly discourage some moms that may have a positive relationship with their OBs from seeing home births as even an option. The way this system currently works, it is not providing supportive care that honors a mom’s wishes to give birth the way she desires, and I truly think this negatively impacts your home birth rates as a whole.”  

In this case, a license based on a private certification such as the CPM would likely lead to an increase in the number of clients using the service. This would make it easier for midwives to consult with physicians, to carry medications, and even for patients to have insurance cover the birth. This, in turn, would benefit insurance companies as the cost of a home birth is generally half to one-third the cost of a birth in a hospital. 

But higher number of home births is something that could benefit the state even after the virus passes. In a rural state where many hospitals don’t deliver babies and there is a shortage of OB-GYNs, midwives could serve and expand their role.

“With continued limited access to care in rural areas of Mississippi, families are losing access to quality providers locally,” Stark said. “Due to current travel restrictions they are also being pushed towards an increased amount of birth interventions such as scheduled inductions and C-sections versus allowing labor to begin naturally, and thus increasing unnecessary risk for both moms and babies. By utilizing certified midwifery care to fill in the gaps in these rural areas for low risk births, along with collaboration from other birth professionals for high risk births, we can aim to provide safer, quality care for all Mississippi families.”

For Harper, she is going to continue her work caring for mothers and their babies. As she has always done. 

“It’s a calling.”

Mississippi’s shelter in place order begins at 5 p.m. today and runs for two weeks. 

But that doesn’t mean you can’t leave your house. Nor will it close all businesses. Under the order, individuals will be allowed to leave their house for health-related reasons, to obtain food and common household supplies, to engage in individual outdoor activity, and to work in an essential business.

“If there’s a pond, creek, or private lake near you where you can safely drop a line while staying away from other anglers I strongly encourage you to do so,” Gov. Tate Reeves recently tweeted.

In a recent news conference, Reeves talked about closing the Barnett Reservoir and other public waterways that people like to congregate. Large crowds – of at least more than 10 – have been gathering at such locations prompting the shut down.

If that continues, would we start to see people being arrested? Probably not. At least at first.

“What I would hope would happen is local or state law enforcement breaks up that group and tells them to go home,” Reeves said. “I don’t think we’re going to see significant arrests initially unless you ignore what you’re supposed to do.”

Essentially, the police aren’t going to pull people over in their car asking for proof that they are traveling to or a from an essential business or activity. And if they do see you violating the order, you’ll likely just be asked to disperse.

Nationwide, we have seen some high-profile arrests for people who are clearing ignoring orders. Preachers in Louisiana and Florida have been arrested for holding church services with upwards of 1,000 people. 

But, by and large, that has not been the case to this point. Arrests have generally come after multiple warnings from law enforcement or if the person was engaged in another illegal activity.

What are essential businesses?

Government: Public safety, first responders, law enforcement, fire prevention and response, courts and court personnel, military, emergency management personnel, correction, probation and parole, child protection, child welfare, EMTs, 911 call center employees, all workers and vendors that support law enforcement and emergency management operations and services.

Healthcare: Hospitals, clinics, research and laboratory operations, nursing homes, residential healthcare facilities, congregate care facilities, assisted living facilities, elder care, medical wholesale and distribution, home health workers and aides, medical supply and equipment manufacturers and providers, medical waste disposal, hazardous waste disposal, other ancillary healthcare services. 

Infrastructure: Utilities including power generation, nuclear facilities, utility poles and components, fuel and transmission, petroleum producers, suppliers and distributors, supply chain companies, telecommunications, electronic security and life safety services, wireless communication, communications sales and customer support, telecommunications and data centers, cybersecurity operations, flood control, operations of dams, aviation, airports, ports, roads and highways, mass transit, automotive sales and repair, vehicle rental services, taxi and network providers such as Uber and Lyft, freight and passenger rail, pipelines, transportation infrastructure, public water and waste water, hazardous waste disposal, hotels and commercial lodging services. 

Manufacturing: Food processing and production, pharmaceuticals, food additives, medical equipment, medical devices and supplies, technology, biotechnology, chemical products, telecommunications products, automotive production and supplies, healthcare, energy, steel and steel products, fuel and petroleum exploration and production, lubricants, greases and engine oils, mining, national defense, sanitary and cleaning products, household products, personal care products, products used by other essential businesses or operations.

Agriculture: Food cultivation, livestock, cattle, poultry and seafood operations, livestock auctions, feedlots, dealers and brokers of livestock, livestock transporters, farmer’s markets, feed stores, repair of agricultural equipment, gas, diesel and petroleum suppliers, aquaculture, horticulture, chemicals including pesticides, herbicides and fertilizers, producers and distributors, forest products businesses, including those involved in forestry operations, logging, manufacture of lumber and paper products, meat processing facilities, rendering facilities and transporters, feed processing facilities, veterinary services.

Retail: Supermarkets, food and beverage stores, food providers, convenience stores, pharmacies, hardware and building materials, gas station, restaurants or bars (must comply with limit of 10 people).

Services: Trash collection, mail and shipping services, home repair, automotive sales and repair, warehouse, distribution and fulfilment centers, laundromats/ laundry services.

Media: Newspaper, digital news sites, television, radio, other media services.

Finance: Banks and related institutions, insurance, payroll, accounting, processing financial transactions, services related to financial markets. 

Professional: Legal, accounting, insurance, real estate (including appraisal and title) services.

Construction: Building and construction, lumber, building materials and hardware, electricians, plumbers, exterminators, cleaning and janitorial, HVAC and water heating industry, painting, moving and relocating services, other skilled trades and other related construction firms and professionals to maintain essential infrastructure. 

Safety, sanitation, and operations of residences and businesses: Law enforcement, fire prevention and response, firearm and ammunition manufacturers and retailers, building code enforcement, security, emergency management and response, building cleaning including disinfection, automotive sales and repair, mortuaries and cemeteries. 

This also includes organizations that provide basic necessities to economically disadvantaged populations, defense industrial bases employers and personnel, vendors that provide essential services or products, and religious entities (that adhere to gathering size limitations). 

magnifiercross linkedin facebook pinterest youtube rss twitter instagram facebook-blank rss-blank linkedin-blank pinterest youtube twitter instagram