Limited Government Archives - Page 15 of 34 - Mississippi Center for Public Policy

Mississippi is projected to have the medical resources needed when the state hits its peak medical equipment usage from the coronavirus pandemic on Thursday.

That projection is according to the Institute for Health Metrics and Evaluation at the University of Washington.

The state will need 100 ICU beds, while 340 are available. The state will need 410 hospital beds, with 5,733 available. Eighty-nine ventilators are needed.

Louisiana is the only neighboring state to have insufficient resources. It hit its peak on April 14, with 648 ICU beds needed and 477 available.

Most shortages were in the Northeast, which has been the national hotspot for coronavirus. Connecticut, New Jersey, and New York all had deficits of hospital beds and ICU beds. Massachusetts did not have enough ICU beds.

For the most part though, beds have not been an issue.

State	Hosp. beds available	Hosp. beds needed	ICU beds available	ICU beds needed
Alabama	5,743	329	474	95
Arkansas	5,005	129	394	32
Louisiana	7,204	2,619	477	648
Mississippi	5,733	410	340	100
Tennessee	7,812	282	629	68

Underlying conditions are one of the reasons why the death rate in Mississippi is so high from the coronavirus pandemic.

Mississippi is ranked 17th in the death rate for COVID-19. One of the main reasons the state is ranked so high is that it has some of the highest incidences nationally of these underlying conditions that can lead to increased morbidity from the virus.

They include:

Hypertension (high blood pressure). Mississippi has the nation’s highest death rate in this category during normal times.
Obesity. Mississippi is the nation’s fattest state, with 39.5 percent of its citizens considered obese according to the U.S. Centers for Disease Control.
Diabetes. The Magnolia State has the second highest death rate nationally from this disease.
Cardiovascular disease. Mississippi has the nation’s highest death rate from this syndrome and this is the number one cause of death statewide.
Renal (kidney) disease, which Mississippi leads the nation in the death rate.
Lung disease. Mississippi has the third highest death rate nationwide for lung disease
Compromised immune system. Jackson is the fourth-highest city nationally for HIV infection rates.

There are 2,003 cases of COVID-19 statewide, with 67 deaths, according to data from the state Department of Health as of April 9.

Four of the COVID-19 deaths statewide have been from those without any of these conditions, with the rest having one or more of these issues.

Forty deaths statewide have come from those with cardiovascular disease, while 34 with diabetes have passed away after catching the virus. Twenty six of the COVID-19 victims in the state also had hypertension.

The latest models at the Institutes for Health Metrics and Evaluation predict that there will be 301 deaths from COVID-19 in Mississippi. The models also predict that April 19 is the projected peak in daily deaths, which would be 11 deaths.

The models also predict that there won’t be a bed shortage (5,733 available) by the disease’s peak in Mississippi, same for intensive care unit beds (111 needed, 340 available).

To implement lessons learned from the unprecedented emergency caused by the spread of the coronavirus, there are numerous long-term strategies we encourage Mississippi legislators and leaders to tackle to ensure a prosperous future for all.

These aren’t different than what Mississippi Center for Public Policy has long advocated. But as the current pandemic crystalized, we witnessed how government regulations often got in the way and stymied the help they are designed to provide. This was true in the past, it is true today, and will be true in the future.

Healthcare:

1. Repeal CON laws

Certificate of Need laws require would-be medical providers to prove — essentially to their competitors — that their community needs a new facility or service. And they are one of the reasons we see a shortage of hospital beds during a time of crisis. The Mississippi Department of Health is the central planner tasked with administering the state’s CON program. The Department’s CON Review program applies to “the establishment of new healthcare facilities, the offering of defined new institutional health services, and the acquisition of major medical equipment.” In some cases, new CONs have not been issued for decades because of government mandated prohibitions. Healthcare facilities shouldn’t have to ask the state for permission to open or expand a facility.

2. Expand scope of practice

Current regulations prevent nurse practitioners from practicing up to their full practice authority. Rather, they are required to enter into a “collaborative agreement” with a physician if an APRN wishes to open their own clinic. APRNs should be allowed to practice without this agreement.

Licensing and regulations:

5. Require a full regulatory audit of every agency to provide regulatory relief

Pending legislation would require a regulatory audit of four agencies in the state. That should be expanded to every agency in the state to provide a full picture of our regulatory burden. As we have seen, numerous regulations hinder access to healthcare and our ability to use technology for services, ranging from medical supply delivery via drones to alcohol delivery. Additionally, going forward, for every new regulation an agency adopts, two should be removed as we work to scale down the 117,000 regulations in the state.

Education:

10. Enable online learning in Mississippi

Mississippi has a very limited public virtual school, but no full-time options for students wishing to pursue that course, emergency or not. Yet, as the education future continues to develop, we will continue to see a demand for online learning. With online learning options, students literally have the world at their fingertips. Whether it’s a unique subject with hard-to-find instructors, a class they need more help with, or one that they are wishing to dive deeper into, the ability to use technology to transform education is very real. Mississippi should work to expand the current Virtual Public School to make it full-time and remove the prohibition on virtual charter schools to provide parents with more options.

The REAL ID deadline of October 1, 2020 has been delayed a year because of the spread of the coronavirus in the United States. Now, Americans won’t need to update their ID until October 1, 2021 to travel domestically or visit federal facilities.

The delay was announced on March 23 by President Donald Trump and the Department of Homeland Security.

“We are postponing the deadline for compliance with REAL ID requirement at a time when we are asking Americans to maintain social distancing,” Trump said.

Many DMVs nationwide, include those in Mississippi, are currently closed.

What is REAL ID?

Passed by Congress in 2005, the REAL ID Act enacted the 9/11 Commission's recommendation that the Federal Government “set standards for the issuance of sources of identification, such as driver's licenses.” The Act established minimum security standards for state-issued driver's licenses and identification cards and prohibits Federal agencies from accepting for official purposes licenses and identification cards from states that do not meet these standards. These purposes are:

Accessing Federal facilities
Boarding federally regulated commercial aircraft
Entering nuclear power plants

What happens when REAL ID enforcement begins?

Federal agencies, including DHS and TSA, may only accept state-issued driver’s licenses and identification cards as identification for purposes of accessing federal facilities - including TSA airport security checkpoints - if the license or card was issued by a REAL ID compliant state in accordance with the REAL ID security standards (meaning the license or card must include the REAL ID compliant star marking). Most EDLs do not contain the star marking and this is acceptable.

How do I know if my license is REAL ID compliant?

In Mississippi, the REAL ID card has a gold star on it.

The legislature will not reconvene on April 1 as initially planned when the session was suspended last Wednesday.

HCR 65 halted the session and allowed legislative leaders to further delay the return, as they have chosen to do.

“Lt. Gov. Delbert Hosemann, Speaker Philip Gunn, and members of the legislature continue to analyze the impact of COVID-19 and the new federal stimulus legislation on the state’s emergency response efforts, healthcare facilities, and the wider state budget. Budget analysts and agencies have advised legislative leadership that all agencies currently have the funds needed to meet the needs of our citizens,” the release said.

An official return date has not been announced, but public schools in the state are closed through at least April 17.

An analysis of coronavirus cases nationwide shows that rural states with much smaller population densities and less international travel also have much fewer cases of the virus at this time.

According to federal data, New York has the highest number of confirmed cases at more than 10,000, while Washington and California both have more than 1,000. West Virginia, South Dakota, Alaska, Montana, and Wyoming are the least impacted at this time.

As testing continues to ramp up, Mississippi continues sees the number of positive cases increase. There are now 140 positive cases in the state as of Saturday morning, with one death. There have now been 775 individuals tested from the Department of Health’s Public Health laboratory.

There is also the toll that the coronavirus is having on the economic wellbeing of the country, and individual states.

As for which states will bear the brunt of the financial impact, those with the most employment in leisure and hospitality and manufacturing will be hit the hardest. Mississippi is a big player in both employment sectors, according to data from the U.S. Bureau of Labor Statistics.

The leisure and hospitality sector includes lodging, food and beverage, recreation, and other travel-related fields.

All casinos in Mississippi are closed and restaurants are switching to a takeout or delivery only, or are closing entirely. This has an outsized effect on the state’s economy as Mississippi has the 11th largest leisure and hospitality sector nationally, with 11.6 percent of its workforce in the industry.

Nevada (nearly 25 percent of their workforce), Hawaii (19.52 percent), Florida (13.92 percent) and Montana (13.38 percent) have the highest employment in the hospitality sector.

Another employment sector heavily affected by COVID-19 is manufacturing. Major automakers are shutting down their factories, including the Nissan plant in Canton and the Toyota plant in Blue Springs. These shutdowns will also affect suppliers as well.

Mississippi has the seventh largest manufacturing sector nationwide as a percentage of its total workforce at just under 13 percent. Indiana (17.06 percent), Wisconsin (16.34 percent), Iowa (14.37 percent), Michigan (14.27 percent and Kentucky (13.13 percent) are the nation’s leaders in this category.

One area that likely won’t be as affected by the economic shutdown, government. This is especially true at the state and local level. State lawmakers have already adopted legislation to ensure they will receive paid leave during the shutdown of the state. Mississippi has the ninth largest public sector employment as a percentage of its population at nearly 21 percent.

Alaska (more than 25 percent), Wyoming (24.1 percent), New Mexico (22 percent) have the largest public sectors as a percentage of their total employment.

The Mississippi legislature is suspending operations for a couple weeks or possibly longer in reaction to the COVID-19 virus pandemic.

Mississippi is just the latest state to pause legislative work. Accord to a Pew tweet this morning, 11 other states had put the brakes on their session. Those numbers have only increased in the past eight or 10 hours.

House Concurrent Resolution 65 would extend the session to June 9 and adjust the deadlines for legislation. Previously, the session was supposed to end, known as sine die (which means with no appointed date for resumption), on May 3. Under the resolution, the legislature could reconvene on or before April 1. The resolution passed 82-38 vote on a mostly party line vote and will be taken up in the Senate tomorrow morning,

If the legislature hasn’t returned, completed its business, and adjourned sine die by June 9, the final day of the session could be pushed back to July 9, which would be after the start of the fiscal year.

House Democrats tried to add an amendment that would’ve provided paid leave to those with a case of COVID-19 or their employer suspended or discontinued their business, but it was defeated on a party-line vote. State Rep. John Hines (D-Greenville) said on the floor that failure to pass the amendment would be a “Custer moment” for the legislature.

The House also passed House Bill 1647 that would authorize local and county governments, along with school districts, to grant administrative leave with pay for their employees. State employees are already able to receive pay while on administrative leave.

The only legal requirement that must be fulfilled by the legislature every session is putting together a balanced budget for fiscal year 2021, which begins on July 1. The legislature saves the task of putting together the budget (composed of separate appropriation bills for each agency) for the final weeks of the session. None of those bills are in the system since the appropriation and finance deadlines are so much later than those for general bills.

Having the session end early could lead some to wonder why it meets every year. Several state legislatures, most notably Texas, convene every other year.

If state Rep. Hank Zuber (R-Ocean Springs) has his way, the legislature would convene every year to put together a budget and would handle general bills and constitutional amendments to even years. House Resolution 7 would do that. Zuber’s plan wouldn’t require a two-year budget as Texas and Indiana’s legislatures must pass before sine die.

Following last week’s state of emergency declaration from Gov. Tate Reeves, the Mississippi State Board of Medical Licensure has issued a proclamation easing off regulations around telemedicine.

The Board has temporarily lifted multiple regulations concerning access to telemedicine, a move that could provide relief to both patients and healthcare workers as reports of COVID-19 cases continue to add up in Mississippi.

The Board is encouraging “all physicians to utilize telemedicine so as to avoid unnecessary patient travel both in-state and out of state.”

With that, the Board has said they will not enforce “any statute, rule, or regulation” that requires physicians to personally examine a patient prior to the issuance of a prescription. This includes controlled substances, and every physician will have access to the Prescription Monitoring Program when a controlled substance is issued and urine drug tests will not be required.

Out-of-state physicians may also utilize telemedicine in treating patients in Mississippi without securing a license to practice medicine in the state.

This proclamation was ordered and approved Sunday.

With a deadline looming to get legislation out of the originating chamber, both houses of the Mississippi legislature passed a raft of legislation and let others die.

Among the good bills that survived the deadline day included some regulatory and licensing reform, a bill that would stop the practice of abortions carried out because of a child’s race, sex, disability, or genetic makeup, and another that would help protect free speech on the campuses of the state’s universities and community colleges.

Unfortunately, a bill that would’ve allowed direct shipment of wine died in the Senate, while a controversial bill that deals with campus sexual assault passed in the House. Also, the Senate passed a resolution that supporters of the medical marijuana ballot initiative say is designed to kill the initiative.

Here are some of the bills and their fates on deadline:

The Good

House Bill 1422 would create a pilot program to reduce state regulations at four agencies: Mississippi Departments of Health, Transportation, Agriculture and Commerce, and Information Technology Services. It passed on a largely party-line vote.

Senate Bill 2790 and HB 1104 would give the Occupational Licensing Review Commission the ability to do a review of an existing regulation to determine whether it increases economic opportunities for citizens by promoting competition and uses the least restrictive regulation to protect consumers. Right now, the OLRC, which is comprised of the governor, attorney general and secretary of state, is limited to review of only new regulations.

SB 2351 is a bill that requires the state-chartered Mississippi High School Activities Association — which governs public school athletics and activities in the state — to comply with the state’s Open Meetings Act. Sen. Angela Hill (R-Picayune), along with Sens. Chris McDaniel (R-Ellisville) and Melanie Sojourner (R-Natchez) attached an amendment that would prohibit public school districts from having to join and pay membership dues to the MHSAA or any other sanctioning body that allowed biological males to compete against biological females in sports. The bill was passed on a party-line vote, but held on a motion to reconsider, which was cleared on Friday.

HB 1295, also known as The Life Equality Act, would prohibit abortion for the reasons of race, sex or genetic abnormality except in the case of a medical emergency. Physicians would also have to report the reason for an abortion. It passed the House and is now in the hands of the Senate.

HB 1200, known as the Forming Open and Robust University Minds (FORUM) Act, would permit all forms of peaceful assembly, protests, speeches, guest speakers, distribution of literature, carrying signs, and circulating petitions on campuses of the state’s universities and community colleges. It passed in the House despite large-scale resistance from the state’s universities on a largely party-line vote.

HB 1398 is a civil asset forfeiture bill that would end a practice where law enforcement or prosecutors could request a property owner to waive their rights to their property, often in exchange for charges to be dropped. The new language in the bill will also change the burden of proof for forfeiture to clear and convincing evidence.

HB 1510 would require the state to recognize an occupational license from another state for military families who move to Mississippi. It passed the House unanimously.

HB 4 would increase the number of package store permits one could own under present law from one to three. It is now in the hands of the Senate after a very narrow passage in the House.

SB 2552 would remove the prohibition on the amount of beer that can be sold directly to consumers at craft breweries. Right now, brewers are limited to selling either 10 percent of the beer produced there or 1,500 barrels, whichever is the lesser amount and this bill would eliminate this provision. The Senate approved the bill and sent it to the House.

SB 2725 and HB 1208, both known as the Hemp Cultivation Act, would allow the cultivation, processing, transportation and handling of hemp under strict guidelines. The Senate version passed with a 35-16 margin and is now in the hands of the House, which passed its version by an overwhelming 104-10 margin.

The Bad

SB 2857 builds upon the existing direct care model by expanding it to more providers. It would also ensure that paying cash for health care services as an insurance product wouldn’t be regulated by the state Department of Insurance. It died without a vote on deadline.

HB 989 would make several changes to the way school districts report their financial information to the Mississippi Department of Education and prohibit some districts from automatically increasing taxes. The House didn’t vote on the bill before the deadline.

The Ugly

The Senate approved House Concurrent Resolution 39, which its defenders say would create a much needed tightly regulated medical marijuana program. The vote means it will appear on the ballot alongside Initiative 65, which would create a more free market-oriented medical marijuana program. HCR 39 detractors say putting an alternative on the ballot is designed to kill the original initiative, which was approved by more than 230,000 voters.

HB 1212 would increase the license requirements for real estate brokers from 12 months to 36 months. A similar bill was adopted by the legislature in 2018, only to be vetoed by then-Gov. Phil Bryant. As Bryant said, this is an overburdensome barrier to market entry that does not use the least restrictive means necessary, as state law requires.

HB 158, the Sexual Assault Response for College Students Act, passed the House with only four nay votes. Like the other iterations of the bill, it has some due process problems for the accused in campus sexual assault cases that need to be addressed and would codify into state law some of the federal regulations from a superseded Obama administration “Dear Colleague” guidance letter. The Trump administration has issued different guidance on this issue that preserves the rights of the accused.

SB 2847 would extend the deadline to 2024 for the Mississippi Development Authority to approve projects under the Tourism Project Incentive Program, which allows a portion of the sales tax collected at a tourism attraction to be rebated to the developer to cover construction costs. It passed unanimously in the Senate.