Before the legislature suspended the session to combat the spread of the coronavirus in the state, both chambers opted against considering legislation that would have allowed those holding an occupational license in another state to receive one in Mississippi without jumping through the traditional hoops.
Senate Bill 2415 was sponsored by Sen. Kevin Blackwell. The bill died in Accountability, Efficiency, Transparency without a vote. House Bill 261 was sponsored by Rep. Becky Currie. It died in Judiciary A without a vote.
As of now, a new state resident who is part of a licensed occupation often has to go through the same process as someone receiving their license for the first time with the subsequent fees and tests.
Mississippi does have limited reciprocity agreements with some states with some occupations to honor their licenses, but new legislation would have ended this practice and allow most new residents to trade in their former state’s license with a new Mississippi one with little hassle.
But as the state copes with COVID-19 and the strain on the healthcare system, we have seen emergency actions to allow out-of-state medical professionals to work in Mississippi. Out-of-state nurses – both RNs and LPNs – are allowed to apply for a temporary license. Additionally, out-of-state doctors and nurse practitioners are allowed to provide telemedicine services courtesy of an order from the Mississippi State Board of Medical Licensure.
This is similar to what many other states are doing. One state that didn't need to issue orders for out-of-state medical professionals to provide care was Arizona. That is because they were the first state in the nation to pass universal recognition of licensing in 2019.
Recognizing occupational licenses from another state is good policy any day of the week. It shouldn’t take a pandemic for us to see it. And it shouldn’t take an emergency declaration to make it occur. That is true regardless of the occupation.
The overarching plan used by the state Department of Health to allocate health care resources under the state’s certificate of need program has a goal to reduce surplus, unused bed capacity at hospitals statewide. Yet as the coronavirus pandemic spreads, the number of available hospital beds is expected to become an issue.
The part of the state’s most recent health plan released in 2018 that dealt with hospital bed capacity said there was an importance to reducing excess bed capacity and that it is not likely to result in problematic consequences. It’s been the policy of the department since 2009.
The same document also said there was a glut of licensed hospital beds statewide despite a decreasing trend nationally since 1999. The state Department of Health urges each hospital to voluntarily reduce the licensed bed capacity.
According to the Henry Kaiser Family Foundation, the state (as of 2018) has four beds per 1,000 population, considerably higher than the U.S. average of 2.4 beds per 1,000 population. In 1999, Mississippi had 4.8 hospital beds per each 1,000 of population (the national average was three).
The plan also says that the “carrying cost” of maintaining unused beds could raise operating costs for hospitals and that such surpluses could retard the introduction of more cost-effective practices and services. The document also said continuing surpluses could create an environment that could invite policy intervention by the legislature and others.
The MSDH determines hospital need under the certificate of need program by multiplying the state’s average annual occupied beds per 1,000 population by the estimated county population to determine the number of beds required.
The state health plan provides guidance for the decisions made by the board when considering certificate of need applications. Mississippi law requires CON approval for all projects that increase the bed complement or a capital expenditure of at least $2 million. CON approval is also required for major medical equipment purchases of more than $1.5 million and is not a replacement for existing equipment. Mississippi is one of 35 states that requires a certificate of need.
Most of those applications for a CON are approved, at least in the last decade. From 2009 to 2018, 91.45 percent of the applications passed the first hurdle of a health department staff review.
During the 2009 to 2018 timeframe, there were 234 analyses performed by department staff for CON applications. The Department of Health recommended authorization on 214 without conditions, two received conditional approval and one received a partial approval.
Only 17 applications were recommended for disapproval (7.26 percent) and most of these were for new providers, largely from out of state, seeking to provide services in the state.
CONs originated from the National Health Planning and Resources Development Act of 1974 that was signed into law by then-President Gerald Ford. This act was intended to reduce annual increases in federal health care spending and one of the cost control measures was to require states to institute CON laws to regulate health care facilities.
Congress later eliminated this requirement, but CONs in some form persist in 35 states.
The Desoto county cities of Southaven and Olive Branch became two of the latest cities in the state to require restaurants to close their dining facilities and move to take-out or delivery services only in an effort to combat the spread of coronavirus transmission.
The city's held emergency meetings on Sunday, according to the Desoto Times-Tribune. The county also issued a proclamation, but it is just a recommendation to close bars and restaurants, similar to the recommendation from the state.
Along with Olive Branch and Southaven, the following local governments have enacted similar restaurant bans: Oxford, Jackson, Tupelo, Moss Point, Biloxi, Gulfport, Ocean Springs, Houston, Forrest county, Hattiesburg, Columbus, Starkville, Hancock county, Bay St. Louis, Diamondhead, Waveland, and Vicksburg.
So far, Tupelo is the only city in the state with a 'shelter-in-place' ordinance requiring all non-essential businesses and all non-essential residents to stay at home. Residents would still be able to travel to the grocery store, medical facilities, restaurants, hardware stores, daycares, and gas stations.
Similar orders cover the states of California, Connecticut, Delaware, Illinois, Kentucky, Louisiana, New Jersey, New York, Ohio, and Oregon, as well as a number of large cities nationwide.
Tupelo Mayor Jason Shelton is looking to enact an order that would close all non-essential businesses and require all non-essential residents to ‘shelter in place’ in response to the spread of coronavirus. He did this while criticizing Gov. Tate Reeves for not taking similar action.
Similar orders cover the states of California, Connecticut, Illinois, New Jersey, New York, and Oregon, as well as a number of large cities nationwide.
According to the Daily Journal, Shelton “will issue an executive order requiring all residents comply with the coronavirus guidelines from the Centers for Disease Control and Prevention, closing all non-essential businesses, requiring all non-essential business employees to “shelter in place” and suspending all utility disconnections, evictions and foreclosures.” Residents would still be able to travel to the grocery store, medical facilities, restaurants, hardware stores, daycares, and gas stations.
At least one Tupelo city councilman, Buddy Palmer, said he thought a shelter in place order was 'ridiculous' at this time.
Multiple cities throughout the state have issued orders closing bars and restaurants, though they haven't been as far reaching as what Shelton is proposing. Tupelo took similar action last week.
Meanwhile, Shelton continues to blast Gov. Tate Reeves and other state leaders for not issuing statewide orders to keep residents at home.
“I mistakenly waited for the state to act,” Shelton said. “I understand that the state is not going to issue any orders to assist the city. So local governments, cities and counties, are going to be on their own….It’s just an abdication of leadership at the highest level of the state of Mississippi, and we’re just not going to wait any longer in the city of Tupelo.”
Yesterday Shelton ordered the Tupelo Police Department and Tupelo Fire Department to break up a large gathering of people at an auction at the Tupelo Furniture Market.
Following a recommendation from the Department of Health, the Gulf Coast cities of Biloxi, Gulfport, Ocean Springs, and D'Iberville all moved to close bars and restaurants Friday.
Under a new recommendation from the department, restaurants should close dining facilities and move to take out and delivery only in an effort to ease the spread of coronavirus. Last night, the cities of Biloxi, Gulfport, Ocean Springs, and D'Iberville joined Jackson, Tupelo, Oxford, and Moss Point in making such a move.
Even without an official statewide ban, most restaurants had already made this move. Thanks to the innovation of food delivery apps, the ability to get food without having to leave your house is a reality. Many of the apps have responded to the crisis by waiving delivery fees. And as the demand has increased, so has the opportunity for gig work delivering food.
The department is also recommending gatherings should be 10 people or less, which is in line with the CDC guidance. Residents are advised not to attend weddings, funerals, or church services, for example. Many churches have moved to live-streaming services, if they had not already done so.
Three states – California, New York, and Illinois – have moved forward with “shelter in place” orders that require all residents to stay home, except for essential workers who must go to work and those purchasing essential supplies, such as groceries.
As of Friday, Mississippi had 80 positive cases of COVID-19 and one death.
The Mississippi Department of Health is now recommending that all restaurants and bars close their dining facilities in an effort to combat the spread of the coronavirus.
Currently, four cities in Mississippi – Jackson, Oxford, Tupelo, and Moss Point – have enacted ordinances or orders requiring restaurants to close and move to take out or delivery orders only. But the nationwide movement is toward closing restaurants, or any facility where large groups gather.
Even without an official statewide ban, most restaurants had already made this move. Thanks to the innovation of food delivery apps, the ability to get food without having to leave your house is a reality. Many of the apps have responded to the crisis by waiving delivery fees. And as the demand has increased, so has the opportunity for gig work delivering food.
The department is also recommending gatherings should be 10 people or less, which is in line with the CDC guidance. Residents are advised not to attend weddings, funerals, or church services, for example. Many churches have moved to live-streaming services, if they had not already done so.
Three states – California, New York, and Illinois – have moved forward with “shelter in place” orders that require all residents to stay home, except for essential workers who must go to work and those purchasing essential supplies, such as groceries.
As of Friday, Mississippi had 80 positive cases of COVID-19 and one death.
The Department of Revenue has updated multiple regulations to make it easier for consumers to purchase alcohol as residents deal with the impact of the COVID-19 pandemic, and the related self-quarantine.
Earlier in the week, DOR began allowing liquor stores to take orders online or over the phone, while providing curbside delivery rather than having to enter the retail establishment. This was previously illegal.
Now, as many restaurants are shutting down dining halls either voluntarily or via local ordinance or order, DOR will allow customers to purchase a sealed bottle of wine with their to-go order. To-go sales of mixed drinks remain prohibited. As does the delivery of alcoholic beverages.
Many states have begun to ease off similar alcohol prohibitions, but some have moved further. In Texas, an order from Gov. Greg Abbot allows restaurants to deliver alcoholic beverages with your meal delivery.
For years, supporters have pushed for direct shipment of wine to their house. The proposal was loudly defeated in the Senate last week, killing its chances for another year.
Senate Bill 2534, authored by Sen. Walter Michel (R-Ridgeland) and carried by Sen. Josh Harkins (R-Flowood) on the floor, would have made Mississippi the 44th state in the country to allow consumers to purchase wine and have it shipped directly to their house. Currently in Mississippi, a control state, you are limited to what the state has in stock, limiting your freedom to choose the wine you prefer. If ABC doesn’t have it available, you don’t have the option.
On deadline day, the bill came to the floor and was defeated 32-13. Thirteen Republicans voted for the bill, and two others that would have supported the bill paired their votes with opponents. Every other Republican voted no, as did the entire Democratic caucus.
This is the latest defeat this session, though we don’t usually see floor votes showcasing the opposition from legislators. Earlier this session, bills to allow wine in grocery stores died in committee without a vote considered in either chamber.
House Bill 981, sponsored by Rep. Brent Powell (R-Flowood), and Senate Bill 2531, sponsored by Michel, would have allowed wine to be sold in grocery stores, while providing up to six permits. You are currently limited to one permit. Wine sales in grocery stores are legal in 39 states, including Alabama, Louisiana, and Tennessee. But it will remain illegal in Mississippi, at least in 2020.
Some new establishments, including Costco in Ridgeland, Whole Foods in Jackson, and Sam’s Club in Madison, have separate establishments that sell alcohol – essentially their own liquor store attached to their main store, but not a place you can access without leaving the main grocery store. Most grocery stores can’t or won’t take on what is an unnecessary burden.
The opposition to alcohol freedom is very loud, and obviously influential with legislators.
And they don’t even hide what they are trying to do. It is liquor stores who don’t want competition, and everyone in Jackson knows that. But it shouldn’t be the job of the legislature to pick winners and losers. Coupled with the Department of Revenue who says we can’t handle the capacity of the wine needed to stock Kroger and Walmart (maybe we should remove the state from the alcohol distribution business), you have a pretty dangerous one-two punch that has outgunned citizens who overwhelmingly favor these ideas.
It is abundantly clear that most Mississippians who don’t have a vested interest in the status quo want change. They are tired of having the government make life decisions for them and would prefer that they have the ability to decide if, when, and where they purchase wine, and how it is delivered.
But for now, Mississippi will have these small regulatory changes. For at least a couple months.
In this episode of Unlicensed, Brett and Hunter talk about what the coronavirus has meant for Mississippi and the country, how technology has benefited us all, and what states are doing to lift licenses and regulations that make it harder to access healthcare.
Occupational licensing laws have long stood as a barrier to entry for many, while limiting consumer choices for all. As the COVID-19 virus spreads, both the federal government and various states have moved to ease overburdensome regulations.
The Mississippi Board of Medical Licensure lifted telemedicine regulations that previously prevented out-of-state physicians and nurse practioners from utilizing telemedicine in Mississippi without securing a license to practice medicine in the state. Our emergency orders also allow out-of-state nurses to work in Mississippi.
A similar story is being told nationwide.
In Massachusetts, an order was issued to grant temporary licenses, within one day, to nurses holding out-of-state licenses who wish to come to Massachusetts to staff healthcare facilities. North Carolina, South Carolina, Texas, and Maryland followed, allowing out-of-state doctors and nurses to receive temporary licenses.
One state that won’t be issuing such an order is Arizona. Last year, they became the first state to grant universal recognition to out-of-state license holders in all licensed professions and occupations. Including doctors and nurses. Pennsylvania and Montana enacted similar reforms.
Bills were introduced in the state legislature this year to do the same thing. If you received a license in another state, you could work in Mississippi without jumping through red tape. That was the thought at least. The universal bills died without consideration earlier in the session, but a bill specifically for military families passed the House and Senate.
Today, about 19 percent of Mississippians are in an occupation that requires a license. And this is particularly troubling in low and middle-income occupations. Mississippi currently licenses 66 of 102 lower-income occupations, as identified by Institute for Justice.
On average, licensing for low and middle-income occupations in Mississippi requires an individual to complete 160 days of training, to pass two exams, and to pay $330 in fees. Those numbers will vary depending on the industry. For example, a shampooer must receive 1,500 clock hours of education. A fire alarm installer must pay over $1,000 in fees.
The net result is a decrease in the number of people who can work. A study from the National Bureau of Economic Research found that occupational licensing reduces labor supply by 17 to 27 percent.
In Mississippi, the Institute for Justice estimates that licensing has cost the state 13,000 jobs. That represents two Nissan plants that could be created by reducing our licensing burden, and it wouldn’t require a dime in taxpayer incentives.
We are making it easier for doctors and, at least in other states, nurses, to practice because it is a good thing for all. We should take that mindset and expand to all occupations that the state currently licenses. Because when we emerge from the current crisis, our economy, and the jobs many of us occupy, will probably look different than they did prior to the virus.
Now would be a good time to take a deep dive into those various licenses we require in Mississippi and determine if there are voluntary or non-regulatory options that would accomplish the same goals, while opening the doors to those who want to work.
Pre-Coronavirus spread, Mississippi's unemployment was among the highest in the country and our labor participation rate was among the lowest. We should be making it easier to work.