House Bill 613, sponsored by Rep. Donnie Scoggin, will allow nurse practitioners to expand their scope of practice.
Currently, nurse practitioners are required to practice in a collaboration with a physician. This would exempt them from this requirement after working for 3,600 hours.
Mississippi limits the ability of nurse practitioners to practice up to their full training — what is called “full practice authority.” In particular, nurse practitioners who wish to open their own practice, or a free-standing clinic, must enter into a collaborative agreement with a physician. This agreement requires the supervising physician to be within a 75-mile radius of the nurse’s practice location. The supervising physician is then required to randomly review up to 20 of the nurse practitioner’s patient charts and meet with the nurse practitioner once every quarter. The typical charge for this minimal (not real time) standard of review is $74 a day or $2,250 a month.
Numerous studies demonstrate that nurse practitioners provide care that is at least as good as physicians, with some studies showing even better outcomes. In part, this may be because nurse practitioners are both less expensive and more accessible, especially for rural and low-income patients. Other evidence suggests that nurse practitioners tend to follow recommended guidelines more frequently and, also, spend more time with patients — practices associated with better patient outcomes.
That is why 24 states and the District of Columbia extend full practice authority to nurse practitioners, which means nurse practitioners can independently evaluate and treat patients.
Just as Certificate of Need laws are being used to protect hospital monopolies, professional licensing and scope-of-practice regulations are being used to protect individual provider monopolies.
MCPP has reviewed this legislation and finds that it is aligned with our principles and therefore should be supported.
Read HB 613.
Track the status of this and all bills in our legislative tracker.
House Bill 526, sponsored by Rep. Steve Hopkins, and House Bill 628, sponsored by Rep. Randy Boyd, will prohibit municipalities from restricting free speech activities within the vicinity of a medical facility.
This is a response to the city of Jackson’s ordinance that was adopted last year and is designed to prevent individuals from engaging in free speech outside of the state’s only abortion facility.
That ordinance bans individuals who are near health facilities from approaching within eight feet of any person without consent, for the purpose of engaging in various forms of speech such as counseling, education, or distributing leaflets; bans people from congregating or demonstrating within 15 feet of the abortion facility, and bans any amplified sound. Violations of the ordinance could result in fines of up to $1,000 and 90 days in jail.
Shortly after the city adopted the ordinance, the Mississippi Justice Institute filed suit against the city, arguing that the prohibition violates free speech rights.
While the issue of abortion clouds the judgment of many on this issue, free speech – whether you agree with the issue or not – is something that should be encouraged, and protected.
MCPP has reviewed this legislation and finds that it is aligned with our principles and therefore should be supported.
Track the status of this and all bills in our legislative tracker.
Two bills that would’ve possibly allowed state and local retirees to receive pay for their service in the Mississippi legislature while also collecting their retirement benefits died in the Appropriations Committee Wednesday afternoon on party line votes.
House Bill 601 was sponsored by state Rep. Earl Banks (D-Jackson) and would’ve allowed future legislators who were retirees to continue to receive their Public Employees’ Retirement System of Mississippi benefits while also collecting partial legislative pay (50 percent).
It was defeated after 25 out of 33 members of the committee voted against it on a roll call vote.
House Bill 604 would’ve allowed members to waive all or a portion of their salary. It was sponsored by state Rep. Billy Andrews (R-Purvis), who is one of three remaining PERS retirees elected this cycle who are still in the legislature. Ramona Blackledge resigned her seat in the House last week.
Like HB 601, it also died after 24 members of the committee voted against it on another roll call vote.
Andrews also sponsored HB 603, which would allow PERS retirees to serve in the legislature in the same manner as elected county or municipal offices. It was not taken up by the committee on Tuesday.
House Speaker Philip Gunn has said that having PERS retirees receive both their benefits and a legislative salary is double-dipping and refuses to reduce the pay of legislators who are also retirees.
According to state law that governs legislative pay ($10,000 per year plus per diem and mileage), the language used for legislative pay is shall, which means something must be done.
In 2018, then-Attorney General Jim Hood released an opinion that said that a PERS retiree doesn’t forfeit their benefits if they were elected to the legislature and could receive both salary and pension benefits simultaneously. The opinion overrode a long-time rule of PERS that prohibited state elected officials from receiving salaries and pension benefits.
An opinion issued in January 2019 by Hood clarified the issue and said that any retiree serving as an state elected official could do the same thing as those who go back to work for state agencies, where they could receive only one half of the salary and only be employed on a part-time basis.
PERS then released a regulation that was approved by the fund’s governing board in April 2019 that allowed legislators to collect their retirement and partial legislative pay.
The defined benefit pension system is still awaiting U.S. Internal Revenue Service approval for the new regulation. According to a release, the IRS still has some questions and a call with federal officials is anticipated for later this month. If PERS doesn’t receive approval, the regulation that prohibited retirees from collecting their benefits while serving in the legislature will be re-instated.
The opinion also said that a retiree would require a 90-day break in service between when they retired from their state or local position and were elected to the legislature, unless an exception was allowed.
State law says that retirees can return to work at a state agency after a 90-day break in service on a part-time basis for half pay.
The legislature is considered a part-time position.
State Auditor Shad White and his investigators arrested the former head of the state’s largest welfare agency, the director of several non-profits, her son, and a former professional wrestler on Tuesday for defrauding a government program that provides assistance to the poor.
Former director of the Department of Human Services John Davis; executive director of the Mississippi Community Education Center Nancy New; her son Zach New, who is the assistant executive director of the same 501 (c)(3) non-profit, and former wrestler Brett DiBiase are accused of obtaining millions from the Temporary Aid to Needy Families program via a variety of business entities and accounting tricks.
Agents from the auditor office also arrested a former Department of Human Services employee Latimer Smith and Anne McGrew, an accountant for the Mississippi Community Education Center.
It was the culmination of an eight-month investigation that White said is still ongoing. The accused were indicted by a grand jury empaneled by Hinds County District Attorney Jody Owens, whose office will prosecute the case.
The auditor’s office said the amount lost in the scam hasn’t been determined, but the loss already exceeds any embezzlement scheme in the office’s records.
According to a scan of the Mississippi Community Education Center’s filings with the IRS, the organization received $26.7 million in government grants in 2017 and $12.9 million in 2016 after receiving nearly $2.4 million from government sources in 2015.
The IRS filings for the Mississippi Community Education Center said the organization’s purpose is for the promotion, improvement, and expansion of community education through training seminars, consulting services, and technical assistance.
Davis and Smith are accused of creating false invoices to pay DiBiase from TANF funds for teaching classes about drug abuse when the former professional wrestler was in a drug rehabilitation center in California at the time and didn’t teach the classes. The invoices were created and payment was rendered despite both knowing that DiBiase was not performing the work.
The News allegedly used the Mississippi Community Education Center to pay for DiBiase’s rehab at the luxury rehab facility called the Rise in Malibu from TANF funds received by the non-profit. Documentation submitted by the News said the funds were used to pay DiBiase for the training sessions that he never conducted.
The News are also accused of transferring millions in TANF funds to their private businesses and then converted funds to their personal use via fund transfers, fraudulent documents, at least one forged signature, and deceptive accounting measures.
The pair allegedly used TANF funds to invest in a pair of medical device companies — Prevacus and PreSolMD — based in Florida.
Imagine if Mississippi had a government agency that regulated the building of restaurants according to a centralized plan hatched by bureaucrats on the needs of the state’s foodies.
Want to open a new restaurant in (insert any city here)? This fictitious body would analyze whether there was another similar eatery in the city and whether the city’s economy could support another with the same cuisine. The fictitious agency would issue a recommendation and a hearing officer would hold a hearing and make the ultimate decision on whether to allow the restaurant to be built.
This scenario sounds ridiculous, but this is no different than the regulation of healthcare providers in the state under what is called a “Certificate Of Need.” It stifles innovation and is a protectionist racket that puts a moat around the state’s healthcare industry to prevent entry by potential competitors.
Mississippi is one of 35 states with a CON program that requires healthcare providers to seek approval from the state Department of Health to build a new facility, add beds or diagnostic equipment to an existing facility, or any other capital-related project. Want to add more beds to your hospital or nursing home? You have to ask permission. Want to bring a new piece of diagnostic equipment to your facility? Permission is needed as well. Even building a medical office building or any other capital project requires approval. Even hospital repairs after a tornado and the addition of hurricane-resistant windows to a hospital on the Gulf Coast require health department approval. This is ridiculous.
Applying for a CON starts a 90-day process that begins with a staff evaluation using a Soviet-style central planning document, the state health plan. They make a recommendation and an independent hearing officer makes a ruling that can be appealed in local court. If you’re a local provider with an existing CON, you’re good to go as more than 91 percent of these applications were approved in the last decade. The rejects are most likely new providers seeking a CON in the state.
This isn’t a free process, since attorneys are required to draft the paperwork and charge the applicants for expensive billable hours for their work. These funds could go to patient care instead. Since 15.3 percent of the CON applications over the last decade were for cost overruns on capital projects by providers, this unnecessary need to seek a rubber stamp only added to the bottom line.
Advocates for the CON say that restricting healthcare options via regulation is a cost-cutting exercise. They also say that a CON ensures that rural patients have access to providers because they would cluster centrally in metropolitan areas to be closer to the majority of their patients. Research indicates otherwise.
According to several studies by the non-profit Mercatus Center at George Mason University, states with certificate of need regulations have 99 fewer hospital beds per 100,000 than states that don’t have a CON and have fewer diagnostic machines.
These same scholars also found that patients in states with a certificate of need were more likely to have to travel outside their county to access care. The ultimate kicker in the Mercatus research is the rural hospital issue; states with CONs actually have 30 percent fewer rural hospitals per 100,000 residents.
The best way to save Mississippi’s rural hospitals and improve the quality and access to care while lowering costs is to inject competitive market forces into the state’s healthcare industry. Scrapping the state’s certificate of need program would do exactly that.
This column appeared in the Meridian Star on February 1, 2020.
House Bill 550, sponsored by Rep. Charles Young, would increase the hours of training for nail technicians from 350 to 600.
At the beginning of the session, the Board of Cosmetology said they would push for this bill. Mississippi’s 350-hour requirement is in line with the national average of 368. But a bump to 600 hours would be the second highest burden in the nation, which is shared by eight states. Only Alabama’s 750 hours would be greater.
One of the chief arguments for the additional hours was for sanitation purposes. To address that, this bill would require one hour of continuing education on sanitation from the board. If sanitation is the biggest issue, one hour hardly seems sufficient. And this is the only mention of sanitation in the law.
We should focus on decreasing the burdens to work in Mississippi and figuring out a way to teach sanitary practices within the already allotted 350 hours.
Occupational licensing leads to a decrease in the number of people working and an increase in costs to everyone. That should not be our goal. Rather, we should move toward voluntary or non-regulatory options that help entrepreneurs start and run businesses while providing the maximum options for consumers, as outlined in the High Road to Freedom.
MCPP has reviewed this legislation and finds that it violates our principles and therefore must be opposed.
Read HB 550.
Track the status of this and all bills in our legislative tracker.
The Mississippi Senate has already introduced at least two measures seeking to lower the mandatory age for kindergarten from the current standard of age six to age five.
Only nine states force five-year-old children to attend kindergarten.
Senate Bill 2062 has been introduced by state Sen. Briggs Hopson, the new chairman of the Appropriations Committee. It is one of the few bills this session that has not been double referred by leadership to two committees, meaning it might enjoy an easier road to passage. The other senate bill is SB 2022, sponsored by state Sen. David Jordan. It has been double referred.
Lt. Gov. Delbert Hosemann said that one of his first priorities will be to fully fund prekindergarten, even suggesting that we need a universal program to capture an estimated 9,000 children not participating in a program. Today, the Senate held hearings on taxpayer funded prekindergarten.
Insofar as there is no difference between state-sponsored pre-K for five-year-olds and a compulsory attendance law for five-year-olds, we treat pre-K expansion and kindergarten expansion as two sides of the same policy. It is worth noting that pre-K expansion being promoted by some in the Mississippi Senate is intended to cover four-year-olds as well.
Current state policy regarding mandatory kindergarten attendance is that if a parent has already enrolled a five-year-old in a full-day public school program, that child’s continued attendance is mandatory. In other words, attendance for five-year-olds is essentially optional. Hopson’s bill would eliminate this option and require kindergarten for all five-year-olds, even those enrolled in a private school or a home school; or at least those “which promote services that address the cognitive, social and emotional needs of five-year-old children.”
It is worth asking whether these needs are better met by forming close bonds with caregivers, like a stay-at-home parent or grandparent. In any event, educational and psychological experts agree that the best thing a five-year-old can do is play.
Here are a few facts about mandatory kindergarten/pre-K that show that it is not a common policy because the costs – fiscal, personal and social – outweigh any possible benefits:
No state requires mandatory pre-K for four-year-olds
Florida, Georgia, and Oklahoma offer universal pre-K. Participation in these programs is voluntary and is available to anyone desiring to participate. The programs are open to ages 4 through 5.
No state has close to 100 percent pre-K participation
The percentage of pre-K aged children attending a state-subsidized pre-K program vary, even within the states that offer it universally such as Florida 77 percent, Georgia 60 percent and Oklahoma 74 percent.
Pre-K and kindergarten expansion is expensive
Some states, such as Georgia, Florida and New York, have had large plans for universal pre-K without having consistent funding to implement these plans. While funding may be allocated to pre-K for a time, this often changes in times of economic downturn when states are required by to cut costs or raise taxes.
Pre-K and kindergarten expansion increases prices for working families
Universal pre-K provided by the government encourages child care providers to increase the amount they charge for their services. When children ages 3 and 4 are mostly in government pre-K programs, the higher overhead costs associated with the care of younger children (due to requirements of more staff, regulatory expenses, etc.) are no longer counterbalanced by the higher profits earned by child care providers when caring for those ages 3 and 4. In light of these factors, childcare providers are forced to increase their prices for younger children, thus amplifying calls to expand pre-K to even younger children. This same crowd out effect will occur if five-year-olds are forced to attend kindergarten.
Few states force five-year-olds to attend kindergarten
Only nine states: Arkansas, Connecticut, Delaware, Hawaii, Maryland, New Mexico, Oklahoma, South Carolina, and Virginia, as well as the District of Columbia, require compulsory attendance for 5-year-olds. These states rank anywhere from fifth (Connecticut) to 50th (New Mexico) in their K-12 educational performance ranking, undermining claims that there is even a correlation between mandatory kindergarten attendance and academic performance.
Few countries mandate pre-K for four-year-olds
Eight countries require compulsory education for four-year-olds. These are: France, Israel, Argentina, Brazil, Hungary, Greece, England, and Luxembourg. Again, these countries rank anywhere from fifth (France) to 30th (Brazil) in educational performance.
Not many countries mandate kindergarten for five-year-olds either
These countries are Cyprus, Latvia, Scotland, Netherlands and are equally as varied in their educational rankings, from ninth (Netherlands) to 50th (Latvia).
Fade out is real
A great deal of uncertainty exists regarding the actual effectiveness of pre-K in giving children an educational advantage because of the varying results and dynamics brought about by the effects of “fade out.” Fade out is the phenomena when children who attend pre-K do not later demonstrate that their time spent in a program gave them an advantage in later grades.
Not a good use of taxpayer funds
The uncertainty regarding the effectiveness of pre-K calls into question whether it merits further government funding. For instance, a landmark study of Tennessee’s pre-K program found that academic gains achieved by students in Tennessee pre-K classrooms began to fade out by first grade and vanished by third grade.
Mississippi’s pre-K program remains unproven
The Mississippi PEER Committee found in a recently released report that the Mississippi Department of Education needs a better evaluation criteria for program participants and uses a curriculum that isn’t evidence-based because it hasn’t been tested at multiple, random sites across heterogeneous populations.
Experts on the Left question pre-K
Policy groups as varied as the Brookings Institution and the National Conference of State Legislators have noted that since the actual effectiveness of pre-K in preparing children for primary school has not been verified, policies regarding pre-K should be viewed with a great degree of caution.
Experts on the Right question pre-K
The Heritage Foundation argues that since universal pre-K has not been scientifically verified to bring about its promised results, it cannot be justified enough to institute the higher taxes and further government control that it would necessitate. In short, “universal preschool may do more harm than good.” Likewise, the Cato Institute has noted that although a great deal of political rhetoric has been put forth to promote the concept of universal preschool, the empirical evidence necessary to make soundly grounded policy decisions does not support the efforts necessary to make universal pre-K a reality.
The city of Vicksburg is ready to welcome electric scooters to their town.
According to WLBT, the city is working with scooter company Blue Duck, and has designated a certain area where scooters can be located and a time they can run.
“This is just another tool to make Vicksburg different because we will be the first in the state of Mississippi to have them and this is only a trial, a pilot program for one year,” Vicksburg Mayor George Flaggs said.
Electric scooters are just the latest technological development that has been made available to citizens, only to be stymied by local governments. With Vicksburg being an exception.
For some, micromobility is a touristy gimmick. For others, it has helped to solve the first-mile and last-mile gaps.
In the past few years, dozens of scooter and bike companies have sprung up to meet the needs of consumers expanding to many major and midsized communities, along with college towns.
Yet at the same time, scooters have hit some roadblocks with city governments opting to ban the service, often describing it as a nuisance. Essentially, the same treatment ridesharing services received from Mississippi governments not too long ago.
Though scooters are generally designed for urban areas, of which Mississippi has few, residents of midsized communities, particularly college towns, could stand to benefit greatly from local deregulation.
Oxford and Starkville stand out as the most logical destination for scooters.
Students would no longer have to worry about parking or missing a bus to class as scooters or electric bikes could supplement their transportation needs. While scooters have never made it to Oxford, they lasted less than a month in Starkville.
The city brought scooters in on a trial basis, while Mississippi State had a ban in place. Naturally, the confusing laws led many students, the biggest user of scooters, to bring the scooters on to campus, drawing the ire of university officials. Lime, the scooter operator, decided to leave the city as a result. And students were again left without this option.
In larger cities like Jackson or tourist towns along the Coast, the introduction of scooters could radically transform how transportation is thought about. That is what Vicksburg is taking advantage of.
The dangers of scooters are not different than the dangers of any other mode of transportation. There are people who are reckless, whether it’s on a scooter or behind the wheel. We can control bad behavior without punishing everyone else. The government just needs to err on the side of individual liberty and personal responsibility.
While Mississippi has been a leader since 2014 in its efforts to reform the criminal justice system and reduce the state’s prison population, a spate of recent deaths in the state’s prisons have led to calls for more reforms and more spending on corrections.
The Senate Judiciary B Committee held a hearing Tuesday to talk about issues with criminal justice reform and address issues with the state’s prison system, where 15 inmates have died since December 29.
“We didn’t get here overnight and it’s not going to be fixed in one session,” said Sen. Brice Wiggins (R-Pascagoula), the chairman of the Senate Judiciary B Committee.
Wiggins cited a report from the Joint Legislative Committee on Performance Evaluation and Expenditure Review or PEER committee released last fall that detailed how revocations (those on parole being sent back to prison for violations of the conditions of their release) have increased the inmate population after the enactment of the reforms.
According to the same PEER report, an increase in offenders sentenced for drug possession also added to the inmate population.
In January 2014, before the passage of House Bill 585, the state’s inmate population was 22,008. Violent offenders made up 34.7 percent (7,632 inmates) of the prison population.
As of January 2020, the state’s prison population is 19,057 and violent offenders (9,410) represent 49.38 percent of it.
While that’s a big improvement, the numbers have rebounded from 2015, when the prison population dropped 11 percent. Still, Chief Justice Mike Randolph told the Joint Legislative Budget Committee that criminal justice reform has saved taxpayers an estimated $452 million in incarceration costs, primarily due to the drug intervention courts created by HB 585. This bill also created mental health and veteran courts as well.
The passage of HB 387 in 2018 clarified the use of technical violation centers to deal with parolees and the supervised population dealt with by TVCs increased from a low of 190 parolees in January 2018 to nearly 500 by November 2018, according to state data.
Circuit Judge Prentiss Harrell of Hattiesburg is the chairman of the Corrections and Criminal Justice Oversight Task Force. He briefed the Senate Judiciary B Committee on possible problems with the reforms.
One of the main reforms with HB 585 were revisions to the monetary thresholds for certain property crimes that changed many from felonies to misdemeanors and reduced the applicable penalties.
Harrell told the committee that has resulted in the burden for incarceration on these offenders being passed to local communities. He also said the legislature needs to enact new re-entry courts to supervise and help ex-offenders adjust to life outside bars. He said this would reduce the amount of workloads for the state’s probation officers, who often are forced to supervise 300 former offenders.
He’d also like more vocational and technical education opportunities for ex-offenders to reduce recidivism.
State Sen. Angela Hill has sponsored a bill, Senate Bill 2080, that would reduce the workload for probation officers to 100 cases or fewer.
Mississippi Association of Gang Investigators Northern Region vice president and Panola County Sheriff’s Department investigator Jimmy Anthony told the committee that there are unconfirmed rumors of gangs not only infiltrating the state’s prisons, but bribing guards and even having gang members or sympathizers outside the walls hired by the DOC.
He said 41 gangs have been identified operating in the state, including eight outlaw motorcycle clubs.
Anthony told the committee that several national gangs have had thousands of confirmed members behind bars in Mississippi since 2011 (when MAGI data began began), including the Vice Lords (5,542 members in DOC custody), Simon City Royals (2,896), Latin Kings (1,029), Aryan Brotherhood (1,026).
Wiggins authored Senate Bill 2728 last session that would’ve expanded the definition of a gang member and prescribed stiffer penalties for related crimes. It died in committee, as did a similar bill in the House.
He said he wants to bring back similar legislation.
Mississippi already has legislation on the books concerning gangs. The Mississippi Street Gang Act was passed in 1997 and allows the attorney general, district attorneys, or a county attorney to bring a civil case against any gang (defined as three or more persons with an established hierarchy that engages in felonious criminal activity).