The U.S. Department of Justice sued Mississippi in 2016. It claimed that Mississippi had unlawfully held people looking for help in its state-run institutions and hospitals, and violated the federal standard of community-oriented healthcare. Hood quickly reacted and criticized lawmakers for cutting mental healthcare funding. Hood stated, “The truth is…it’s all about money” to a group of mental health advocates in 2017, criticizing the state Legislature. Hood said, “And you need to spend a bit of money in order to save money. You can’t get them to understand that because they are only focused on next election.” Hood is considered the front-runner for the Democratic nomination for governor. The lawsuit could be used against Hood’s likely opponent in November, Lt. Governor. Tate Reeves is a Republican who controls the purse strings of the state Legislature. He was sent the first letter by the federal government in 2012 to Mississippi advising it that the state was not complying with federal standards. Hood has slowed down his rhetoric ahead of the trial which starts June 4th and will last until July. Hood refused to comment when asked about the merits of the Department of Justice case and whether the state had sufficiently improved since 2016. Instead, his office sent Mississippi Today a 2016 statement by Hood’s office. It states that the lawsuit is “a clarion cry to all of you in state leadership to think about how we care for those least among us” and requests the Legislature to increase spending on mental healthcare. He also noted that litigation could be expensive. The attorney general’s office claims that the state has spent more than $1.4 million so far on expert witnesses and outside counsel. In a brief, outside lawyers argued that the state is moving to community-based care in a responsible manner and that “a mental healthcare system that has no “gaps” and no “unmet needs” is a system that “no State can deliver.” The Department of Mental Health declined to comment on the improvements made over the past three years due to the ongoing litigation. The agency did provide a document in which Adam Moore, spokesman for the department, stated that it “highlights some ways community services have expanded in Mississippi” over the past year. This document includes $13.3million that was transferred from the department’s institutional budget to community programmes in 2019. These are the positive steps taken by mental health advocates, but they maintain that the Mississippi mental health system is still largely unchanged. “We are so far behind. “We have a lot to make up,” stated Polly Tribble (executive director of Disability Rights Mississippi). “We still have a lot of work to do before it becomes acceptable for people who use these services,” said Polly Tribble, executive director of Disability Rights Mississippi. The basis of Mississippi’s lawsuit was Olmstead v. L.C. 1999 Supreme Court decision. The Olmstead v. L.C. 1999 Supreme Court decision found that Georgia violated the Americans with Disabilities Act when it locked people with mental illnesses in institutions. Therapists determined that these patients would be better off living in their own communities. The Olmstead ruling states that all states must provide community-based services whenever appropriate. Mississippi twice pointed out the inefficiency of its dependence on institutions. A 2008 legislative watchdog report found that Mississippi was behind other states in moving towards community-based services, even though it had previously recommended that the agency create a system to track patients and implement services. In a 2016 Department of Justice complaint, Hood outlines the allegations. It describes a system where “individuals with persistent need cycle through the state hospital over and over again, not to mention admissions to local emergency room, private psychiatric, and jails.” Hood blames funding for the problem. The Department of Justice sued Mississippi in 2016. In 2017, lawmakers cut nearly $28 million from $600 million budget of the Department of Mental Health. This move resulted in the loss of more than 500 state hospital jobs. Hood used the lawsuit in 2017 and 2018 to paint the issue as a political issue. He linked the Department of Mental Health budget cuts to Reeves’ 2016 package of corporate tax cuts. They gave away all their money and ran out of money. Hood said that they gave it to tax cuts for the wealthy. Hood also stated that Mississippi Today should pay more attention to mental health. Governor. Phil Bryant attacked the Department of Mental Health’s reliance on its hospitals. “They are reinforcing the old mental health care continuums. The federal government is suing us. The federal government is suing us. The lawsuit does not include the Department of Mental Health, which certifies or provides the majority of state’s mental healthcare services. The Division of Medicaid, which provides many of these services and the Department of Rehabilitation Services are not parties to the lawsuit. They also do not provide job training or other services for people who have left care. Instead, the Department of Justice sued Mississippi, claiming that the state has repeatedly allowed residents seeking mental health care to fall through the cracks. This is something many mental health advocates claim hasn’t changed despite the fact that the Department of Mental Health has increased its resources at its community mental hospitals. Joy Hogge, Executive Director of Families as Allies, stated that she is unsure how to fund the system and how it should be funded. “Until we get it focused and on the services and support that people need most — and, more importantly how the system should structure to provide those supports — I don’t think we know how much money that will be required to fund that and where it might need to go,” Joy Hogge said. The lack of planning across the state is evident in excerpts taken from dozens of depositions by the Department of Justice. One of the depositions was conducted last summer almost two years after the Department of Justice sued. An attorney for the Department of Justice asked Steve Allen, deputy executivedirector for the Department of Mental Health, what an Olmstead plan is. It would be a plan for how to make a system that allows people to
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Allen stated that they can live, work and play in the communities of their choice. Allen was asked if Mississippi had an Olmstead Plan. Allen replied, “I have never seen one.” This lack of coordination is also evident when trying to determine how Mississippi’s spending on mental healthcare services has changed since 2016, when the Department of Justice sued Mississippi. Mississippi does not have a central repository of information on mental health. For each agency contributing — the Department of Mental Health Division of Medicaid and the Department of Rehab Services — funds must be requested individually. If numbers are available, they will arrive with an asterisk. Medicaid receives a three for one federal match for every dollar spent in mental health. Matt Westerfield (director of communications) said that Medicaid tracks spending on community mental services. However, it was unable to provide immediate numbers due to multiple programs that offer these services. These include reimbursements for community mental health centers and waiver programs. According to the Department of Mental Health, it expects that it will spend $23million less on institutional care in fiscal 2019, and $10 million more for services at its community mental hospitals than it did three year ago. Adam Moore, spokesperson for the agency, clarified that these figures don’t represent all Service Budget allocations and are limited to adult mental health services at those centers as well as in the community. That’s the problem. Hogge stated that there is no way to see the whole picture of mental health services across the state. “So how can we coordinate all these incredibly disparate parts of our mental healthcare system to make them work together to track the outcomes people get?” The impact of new money going towards community care has been positive. The state spent $13.3 million on its total service budget last year, which allowed it to add 42 crisis stabilization rooms across the state. One of the community mental hospitals was also able to open a Simpson County women’s transition home and expedite restoration and evaluation in the Mississippi State Hospital’s Forensics unit. These additions do not eliminate discrepancies. Although emergency stabilization beds were added to the 14 community mental hospitals, they are not yet available. Tribble said that whether people receive the services they require, including beds, depends on what is available in their local area. Tribble stated that no matter where you live, the services should be identical. Editor’s Note: An earlier version incorrectly stated that the 2014 closing of Mississippi State Hospital was due to legislative budget cuts. The hospital was closed, but not just its community services division.