Mississippi
Mississippi’s maternity program is extremely insufficient
Since January 2011, the state of Mississippi has contracted a NY based company, ActiveHealthⓇ Management, a former subsidiary of Aetna and currently owned by CVS Health.
ActiveHealth Management purportedly provides comprehensive health and wellness management services to the State and School Employees Health Insurance Plan to improve health among more than 197,000 active employees, dependents, spouses and retirees.
The company has received four consecutive contracts valued at a nearly $64,000,000. Yet, it has not produced one evaluation report on its efficacy because the Department of Finance Administration does not require it to assess employees’ health outcomes.
According to Cindy Bradshaw, former State Insurance Administrator, DFA administers patient satisfaction surveys about their experiences within the ActiveHealth Management program. Patient satisfaction surveys are designed to determine how a person feels about or perceives her/his experience with something or someone; it does not determine whether the experience was effective and to what degree.
This is particularly concerning for pregnant state employees who are at risk for pre-term births and Cesarean deliveries, the No. 1 surgery in the state of MS and the nation.
Annually, Mississippi pays for over 90% of prenatal care and births in the state through Mississippi Medicaid and Blue Cross Blue Shield of Mississippi plans. In 2022, members in both plans experienced comparable Cesarean delivery rates. About 39% of BCBS of MS members experienced a Cesarean delivery and 37% Medicaid members, according to data from the Mississippi State Department of Health. Also, 20% of BCBS members and 21% of Medicaid members, whose labor was induced, subsequently delivered via a Cesarean. The State paid an estimated average of $27.4 million for Medicaid-members and $30.6 million for BCBS-members who had Cesarean deliveries.
Furthermore, those members who had a first-time Cesarean delivery have a 90% probability of experiencing a repeat procedure because only a handful of providers in Mississippi will attempt to deliver a vaginal birth after a Cesarean delivery.
Liz Welch, DFA’s executive director, said she wasn’t aware of the birth outcomes of state employees and would request a report from BCBS of MS, the state’s plan administrator. I am almost certain she did not.
Since 2019, I have administered a community health worker program that provides preventive based services to pregnant residents, including state employees. I have found ActiveHealth Management’s maternity program to be extremely insufficient and ineffective as it does not address the complex underlying risk factors influencing common negative birth outcomes in Mississippi.
Underlying preventable risk factors affecting most pregnant women in Mississippi are maternal obesity and smoking that can lead to gestational hypertension, preeclampsia, gestational diabetes, Cesarean deliveries, preterm babies, low birth weight babies, NICU babies, and maternal and infant mortality. Annually Mississippi residents experience the highest rates of maternal obesity (37.6%), fetal deaths (9.5), Cesarean deliveries (39%), preterm births (15), low birth weight (13), maternal mortality (43) and infant mortality (9.2) in the nation.
ActiveHealth Management’s maternity intervention involves nurses making three phone calls to pregnant state employees and one call after the baby is born.
The nurse asks a list of general questions such as, “how’s your overall health,” “how’s your pregnancy going so far,” “any medical concerns,” “are you taking prenatal vitamins,” “what you know about pre-eclampsia,” etc.
There is no face-to-face engagement between the employee and nurse, including no home visits and no birth support. The nurse doesn’t assist the employee with developing a prenatal dietary and exercise plan, a birth plan, healthy birth practices to prevent medically unnecessary labor inductions, and Cesarean deliveries. She does not provide crucial childbirth education and breastfeeding and postpartum support, which is needed in the home.
Providing exclusive phone support during pregnancy has been shown to reduce risk for depression, but it does not improve risky health behaviors, e.g. smoking, sedentary, unhealthy foods or birth outcomes. Data show that neither phone nor short message support are effective at reducing prenatal smoking, improving prenatal body mass index, reducing preterm births, and Cesarean deliveries.
In contrast, there is considerable evidence showing that community health worker programs, which provide in-personal maternal health education and birth assistance, are significantly effective at changing risky behaviors and improving healthcare decisions that lead to better prenatal health and birth outcomes.
Community health workers can provide a supportive social network, motivate and drive pregnant patients at risk to make healthy lifestyle changes that reduce maternal obesity, stress and anxiety and improve physical health, which subsequently reduces maternal morbidities associated with pre-eclampsia, preterm births, and Cesarean deliveries.
In 2021, I initiated a dialogue with ActiveHealth Management’s medical leadership about enhancing its program through the integration of community health workers. My suggestion was met with resentment and rejection. They stated they would do no more than their contract requires.
The State will issue a new RFP in 2025 and likely renew ActiveHealth Management’s contract. It should seriously consider reducing the value of the contract and redirecting a substantial amount of funding to the Mississippi Department of Health’s Community Health Worker Program.
The MS Department of Health could train, certify, and strategically deploy community health workers across the State to deliver evidence based, maternity services, which would be more feasible and effective than ActiveHealth Management’s telephonic/virtual program.
— Getty Israel, MPH, is a population health specialist in the Jackson area.
Mississippi
Mississippi State vs. UMass: Bulldogs Defense Faces Dual-Threat QB Test Again
STARKVILLE, Miss. – Mississippi State didn’t have much success stopping a dual-threat quarterback last week against Arkansas.
Razorbacks’ quarterback Taylen Green led his offense to a 58-25 win with nearly 400 yards of total offense (314 passing yards, 79 rushing yards), six total touchdowns (five passing, one rushing) and just one interception.
If the Bulldogs (1-7, 0-5 SEC) want to avoid another shocking upset, they’ll have to stop another dual-threat quarterback.
“We’ve got to get this guy on the ground when we have opportunities,” Mississippi State coach Jeff Lebby said this week. “It’s about us making sure that we know who’s got the QB, who’s got the back, and all of the quarterback run game. Then, from a scramble standpoint, the contain-rusher cannot get outside and understanding those things right there. When you’re playing QB-run guys, you’re playing guys that have the ability to go extend the play.”
Here are three UMass players to watch on offense, starting with the Minutemen’s dual-threat quarterback.
UMass Brings Bottom-10 Ranking to Starkville: 5 Key Stats About the Minutemen
Mississippi
Buses, notaries and strolls to the polls: How Mississippi college students are overcoming the nation’s toughest barriers to the ballot box
In 2016, Jarrius Adams’ absentee ballot never arrived at his apartment in Oxford, so the then-19-year-old at the University of Mississippi was left with one option to vote: Skip all his classes and drive four hours home to his polling place in Hattiesburg.
Faced with a similar situation, the reality is most college students would decide not to vote, said Adams, who now works with the nonprofit Mississippi Votes.
“For some students, it’s just as simple as eating three times a day now that you have no supervision,” he said. “To add voting for the first time?”
It can be hard to cast a ballot in Mississippi, where state voting laws consistently rank as among the strictest in the nation.
But for the state’s tens of thousands of college students — many of whom are voting for the first time while also trying to stay on top of homework, classes, chores and having a social life — the barriers to the ballot box faced by all Mississippi voters pose an even greater challenge.
Mississippi is one of just three states without early voting. This means college students who choose to vote in person most likely have just one day to get to the polls, which are not always on campus. According to a list provided by the Secretary of State’s office, three of the eight public universities in Mississippi lack an on-campus polling location for this election.
When college students turn 18 in Mississippi, they are not automatically registered to vote if they have a driver’s license, a law on the books in 23 other states. There’s no same-day voter registration, which voting experts say can pose an issue for college students whose addresses, and therefore precincts, change more often than other voters. And Mississippi doesn’t have online voter registration for new applicants.
Mississippi “pretty much has all the things that make it hard to vote,” said Jennifer McAndrew, the senior director of strategic communications for Tisch College at Tufts University, which houses the National Study of Learning, Voting and Engagement.
Nevertheless, colleges and students who have been working all semester long to encourage their peers to vote say that young Mississippians pursuing higher education are motivated to turn out this Election Day.
“Our young Mississippians are the future of our state,” Secretary of State Michael Watson, who has visited colleges across the state to talk to students about voting, said in a statement. “It is important for them to educate themselves not just on the voting process, but also the policies and issues affecting the state and nation..”
At Ole Miss this semester, the Center for Community Engagement has registered more students to vote before the deadline in an election year than it ever has before: About 350 students, according to William Teer, the program director for student leadership programs and financial well-being.
Now, it’s just a matter of getting these students to the polls.
“Everyone hears about how young people and college students in particular don’t vote in huge numbers for whatever reason,” said Marshall Pendes, a senior math and economics major who serves as a voting ambassador at Ole Miss. “I get a chance as a student to try and change that.”
Pendes cited a study that Tufts’ National Study of Learning, Voting and Engagement conducted of student voting at Ole Miss, which found that about 15,000 students — more than 75% of campus — were registered to vote during the last presidential election.
That’s in part because of the efforts of voting ambassadors like Pendes. In his four years at the university, Pendes estimated he’s helped register more than 600 students. He’s helped students complete the Mississippi Secretary of State’s paper registration application all across campus, at fraternities and sororities, before and after class, during student government meetings, in the Circle and at meetings for all kinds of political clubs.
But not so much on in the Grove.
“During games, people aren’t really interested in doing paperwork,” Pendes said.
The goal is to educate students on how, where and why it’s important to vote, Pendes said, whether that’s in-person in the county where they attend school or at home through an absentee ballot.
“One of the great things about voting as a college student is you have so many choices,” he said. “Every person’s situation is different.”
Even though college students qualify for an absentee ballot in Mississippi, students say it’s far more common for their peers to register to vote in their college’s county.
“It’s more common for students to register on campus,” said Avantavis TyMon, an elementary education major at Alcorn State University who is also a Mississippi Votes’ Democracy in Action fellow. “It’s easier, and it’s more accessible … especially for the out-of-state students who don’t have cars.”
Alcorn State University is one of five public universities that will host on-campus precincts this year, along with Mississippi Valley State University, Mississippi State University, the University of Southern Mississippi and Jackson State University.
Though Delta State University does not have an on-campus voting location, there is a precinct across the street.
On Election Day, TyMon said he and other student leaders plan to canvass the dorms and ask students if they want to join a “stroll to the polls” event, which will involve a short walk to the on-campus precinct.
“It’s a little bit of a walk from where students live,” TyMon said, adding that in previous years, “we would meet up and all walk together.”
Mississippi’s absentee ballot process, which experts describe as onerous, may be another reason college students register to vote in-person in greater numbers.
“It is an unbelievable barrier for college students who don’t live in Mississippi or are voting absentee in Mississippi,” McAndrews said.
First, a voter must request an absentee ballot application from their circuit clerk’s office, according to a step-by-step guide from the Mississippi Secretary of State’s office. Once they receive the application in the mail, the voter must have it witnessed by a notary, unless they are disabled. When a voter gets a ballot, the next step is finding another notary to watch the voter fill it out.
“You can do your taxes in one day,” Adams said. In Mississippi, “you cannot vote by mail in one day.”
Even some notaries think Mississippi’s absentee ballot law could be eased.
Bill Anderson, the vice president of government affairs at the National Notary Association, said that, of the handful of states that involve notaries in the process, Mississippi’s law is the strictest.
“You’d expect us to be supportive of states that allow or create a role for notaries in absentee ballots,” Anderson said. “We think this is a good idea. … These states, including Mississippi, want there to be a layer of security that is absent for voters voting absentee.”
Nonetheless, Anderson said he is hoping to work with Mississippi lawmakers next year on some issues he sees with what he called the “non-notarial functions” required by the state’s law.
For instance, Mississippi’s law requires notaries to sign the back of the envelope containing the voters’ ballot, something Anderson said is not expressly permitted by the notary laws of his home state in California. And Mississippi doesn’t oblige notaries to affix their seal to the envelope, which Anderson said other states require notaries to do.
“You can just imagine the poor voter,” Anderson said. “They’re out here, and the California notary is trying to find their state law and doesn’t want to get in trouble with the Secretary of State of California and says look … I’d love to do this for you, but I can’t.”
For his part, Pendes said he thinks students who want to vote absentee are motivated to find notaries, which can be relatively easy to do on a college campus.
“In my experience, people usually aren’t defeated by the notarization part,” he said.
At Mississippi State, the student government association and the Division of Student Affairs held an event called “Notary Day” last week. More than 70 students had their absentee ballots notarized, said Carson McFatridge, the student association president.
“When I think of a notary, I think of someone at the bank,” she said. “That can be a challenge just not knowing who has the capability to do that … so it was really, really cool to be able to see people like our dean of students volunteer an hour of his time to sit out there and help people.”
McAndrew said it’s important for colleges to make voting as a student as simple as possible, because even the perception that voting is complicated is itself a barrier.
“There’s so much out there about strict voter ID laws, it becomes this ghost barrier on top of the actual barrier,” McAndrew said.
“Anything we can do not only to reduce the complexity but to reduce the intimidation and anxiety factor is really important,” she added.
To that end, many professors have canceled classes to give students the day off to vote, and universities across the state are offering rides to the polls. At Ole Miss, buses will leave from the Walk of Champions and behind Ole Miss Bike Shop from 7 a.m. to 7 p.m. on Election Day.
This does more than help students without cars, Pendes said.
“The other thing to consider is that parking spaces on our campus are extremely hard to come by,” he said. “Do you want to move your car and lose your parking space to try to go vote? Because that isn’t necessarily something that’s always guaranteed to you, especially in commuter spaces.”
This semester, the Center for Community Engagement was also successful in finding a solution to an issue that has troubled student voters for years at Ole Miss, which is that residence halls and Greek Life houses are not considered acceptable mailing addresses at which to register.
Teer, the program director, said he worked with the Lafayette County Circuit Clerk’s office to establish the center as a mailing address for students who live on campus.
“We’ve had students coming in daily because they’ve received an email from us that their voter information cards had arrived,” Teer said.
Every Thursday, students at Alcorn State held a voter registration event at the campus chapel. TyMon also helped organize a voter registration block party that featured food trucks. These efforts resulted in more than 400 students registering to vote.
TyMon said he thinks student leaders have an important role to play in setting an example for their peers.
“When they see that we’re serious, they get serious,” he said.
That’s why A’Davion Bush, a sophomore political science major at Ole Miss, is going to drive home to Indianola not just to vote, but to volunteer at the polls. The Mississippi Votes’ Democracy in Action fellow said he’s going to post about his plan on social media so his friends who are still in high school will be inspired to vote when they turn 18.
“The older population is not doing anything to influence young people in my county,” he said.
McFatridge, the student body president at Mississippi State, said she recently registered a student to vote who had just become a U.S. citizen, which reminded her that while voting is a right, it’s also a privilege not had by everyone around the world.
Not voting in the U.S. is “kind of like looking a gift horse in the mouth,” McFatridge said.
“It’s a silly phrase,” she added, “but I truly believe that when given the opportunity to share your own thoughts and beliefs, I don’t know why you wouldn’t.”
An Arkansan, McFatridge had intended to vote early in her hometown of Searcy during fall break, but a family emergency prevented that.
It’s too late for her to order an absentee ballot, so now she’s driving home to vote before Election Day, 4.5 hours away.
Mississippi
Trump will campaign in Wisconsin with Brett Favre, who's linked to a Mississippi welfare scandal
Donald Trump and Kamala Harris will crisscross several swing states on Wednesday, passing each other in Wisconsin, where the former president is scheduled to appear in Green Bay with a onetime local icon, retired NFL quarterback Brett Favre.
A longtime supporter of Trump and other Republicans, Favre spent most of his career with the Green Bay Packers, winning the NFL’s Most Valuable Player award three times and a Super Bowl. But the Pro Football Hall of Famer has been in the news lately for a welfare scandal in his home state of Mississippi.
Favre, 55, is not facing any criminal charges, but he is among more than three dozen people or groups being sued as the state tries to recover misspent money. Favre has repaid just over $1 million he received in speaking fees funded by the Temporary Assistance for Needy Families Program. Mississippi Auditor Shad White, a Republican, has said Favre never showed up for the speaking engagements. White also said Favre still owes nearly $730,000 in interest.
Favre has posted and reposted social media messages supporting Trump and criticizing Harris, the Democratic presidential nominee.
“In all the elections I’ve seen over my lifetime, I’ve never seen one where there was so much hate,” Favre posted Monday on X. “It’s certainly sad to see.”
With six days until Election Day, Harris will travel from Harrisburg, Pennsylvania, to Wisconsin’s capital, Madison, and then back south to Raleigh, North Carolina. Trump will be moving in the opposite direction, heading to Green Bay after an event in Rocky Mount, North Carolina.
The focus on Wisconsin is no surprise. The Badger State is a perennial presidential battleground, often decided by only a few thousand votes. Trump won it in 2016 by 23,000 votes and lost it in 2020 to Democrat Joe Biden by 20,000 votes.
In relying on Favre, Trump is tapping into the state’s deep and loyal support for the Packers and the team’s onetime star quarterback. But Favre also comes with increased baggage after becoming enmeshed in Mississippi’s welfare spending scandal.
Mississippi has ranked among the poorest states for decades, but only a fraction of its federal welfare money has been going to families. Instead, the Mississippi Department of Human Services allowed well-connected people to waste tens of millions of welfare dollars from 2016 to 2019, according to White and state and federal prosecutors.
A nonprofit group called the Mississippi Community Education Center made two payments of welfare money to Favre Enterprises, the athlete’s business: $500,000 in December 2017 and $600,000 in June 2018. The TANF money was to go toward a volleyball arena at the University of Southern Mississippi. Favre agreed to lead fundraising efforts for the facility at his alma mater, where his daughter started playing on the volleyball team in 2017.
The Mississippi Community Education Center director, Nancy New, pleaded guilty in April 2022 to charges of misspending welfare money, as did her son Zachary New, who helped run the nonprofit. They await sentencing and have agreed to testify against others.
Favre appeared in September before a Republican-led congressional committee that was examining how states are falling short on using welfare to help families in need. U.S. House Republicans have said a Mississippi welfare misspending scandal involving Favre and others points to the need for “serious reform” in the TANF program.
Favre told the congressional committee that he was diagnosed with Parkinson’s disease in January.
____
Wagster Pettus reported from Jackson, Mississippi.
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