The chairmen of two major health agencies are slamming legislative proposals to consolidate the departments and put them under the governor’s control, saying the effects would be disastrous for the health of Mississippians.
“This could be the most tragic bill in the history of public health in Mississippi,” Dr. Luke Lampton, chairman of the state Board of Health, told Mississippi Today in a phone interview.
Lampton’s comments came after the proposal moved closer to reality Thursday when it passed the Senate Appropriations Committee on 12-8 split vote; four senators voted present.
He went on to say the move would destabilize an already pared-down department, ultimately costing the state millions in longterm health-care costs.
“I’m not sure the average Mississippian and average legislator really understands the significant work that the department performs to keep the lives of Mississippians healthy,” Lampton said. “And we need the department that does this to have stability and oversight. We need one that is scientifically competent and not swayed by the whims of the politics of the day.”
The bill proposes to give the governor the reins to the Departments of Health, Mental Health and Rehabilitation Services. Advocates of the legislation argue it will streamline the agencies, opening the door for them to share some services down the road. But some Senate Democrats are uneasy, saying the legislation could pollute agency business with unnecessary political influence.
Lampton’s concerns are echoed by his counterpart, Richard Barry, chairman of the Board of Mental Health, in a letter obtained by Mississippi Today.
Barry’s letter, addressed “To Concerned Mississippians” and dated Jan. 25, said the reorganization would jeopardize a system that currently “allows policies and goals to be developed in a neutral manner based on data and current needs while reducing political conflicts.”
Barry urged people to contact their representative to oppose this bill and its mirror legislation, House Bill 886, which has not yet been considered in committee.
“The current structure of the Mississippi Department of Mental Health provides for a Board-appointed agency director and a management structure that is less affected by changes in the political leadership. This ensures great management stability within the Department to offer leadership in the direction and fulfillment of the agency’s goals,” Barry wrote in his letter.
Despite the alarm, the bill proposes few major changes to day-to-day operations of the agencies.
The bill would, however, allow the governor to replace the head of each agency with his own appointee. Currently the boards of each department appoint the directors. The bill would also exempt the employees of these agencies from the regulations of the state Personnel Board, a move that makes these positions easier to eliminate.
But the biggest concern, according to Lampton and Barry, is that this bill would severely limit the power of all three agencies’ boards, demoting them to “advisory” roles.
The ‘very essence’ of the boards
In Thursday’s Appropriations committee meeting, Sen. Buck Clarke, R-Hollandale, who authored the legislation, tried to drill home the idea that this bill was primarily about efficiency. The boards of each department, he said, would not change.
“(This legislation) changes how the executive director is chosen; it doesn’t change the board. The board is still there in its advisory role,” Clarke said.
However, the text of both the Senate and House bills states that the names of the boards would change if the bills become law.
The State Board of Mental Health would become the State Advisory Board on Mental Health; the State Board of Health would become the State Board of Health Advisors; and the State Board of Rehabilitation Services would become the State Advisory Board for Rehabilitation Services.
In addition to the name change, the bill would severely limit each board’s duties, moving it from the governing body of its agency to a consulting role with no authority.
Lampton called Clarke’s assertion that the boards would remain unchanged “a very misleading statement.”
“The very essence of the board would be changed,” Lampton said.
Clarke did not immediately respond to Mississippi Today’s request for a response Friday morning.
In recent years, the relationship between legislators and the Departments of Health and Mental Health has been laced with tension, as the agency heads have repeatedly sought funding for services and defended their work while Republican leaders have questioned how many of the services are necessary.
Two rounds of mid-year budget cuts and fallout over legislation passed in 2016, which swept some special funds into the state’s general fund, have drawn protests from many agencies, including Health and Mental Health.
State leaders, however, have argued that these cuts have helped streamline a bloated budget.
Rep. John Read, R-Gautier, who authored the House (consolidation) legislation, said any disagreements with the Departments of Health, Mental Health and Rehabilitation had no bearing on which agencies were selected for potential oversight by the governor.
“The question is, can they use each other’s administrative staffs, can they share space?” Read said.
Already at a breaking point
Lampton said he believes the Department of Health has already been stretched to its breaking point.
“As far as saving money, the current Department of Health, which the Board oversees, is the least funded per capita in the United States, and we’re generally recognized as the best run department in the United States. So what this would tell me is for the average Mississippian, is that per dollar the Department of Health is a great investment,” Lampton said.
Mississippi’s Department of Health ranked 47th in funding nationally for 2014, the most recent year available, according to data from nonprofit Trust for America’s Health. State funding that year was $36.7 million or $12.28 per person. In comparison, the average of Mississippi’s four neighboring states (Alabama, Arkansas, Louisiana and Tennessee) was $30.65 per person.
Although Clarke told the Senate committee on Thursday that money was not a motive in the proposed agency reorganization, when asked what he would change about how the departments are run, he was direct: “I think at every level you can probably save the state money. We always talk about back office positions, like even accounting type stuff.”
Lampton argues that eliminating or consolidating these positions is more likely to cost the department money.
“If we’re one of the last funded per capita, there are no other positions to eliminate,” Lampton said. “I don’t see how we’re going to save by putting together different agencies that have different missions.”
State funding amounts to only a fraction of the department of health’s total operating budget. The rest is filled in with federal matching funds and grants. Lampton said errors here could cost the department “millions, if there are mistakes done with the grants.”
Lampton is passionate about the current Board of Health and its members. And he praised the Legislature, which completely reorganized the Board in 2007.
“The Legislature has done an incredible job in creating the current board of health,” Lampton said. “And here we are trying to change it.”
Currently the members of all three boards are appointed by the governor, a move that would not change under the proposed legislation.
“So as far as having significant influence over what happens in the department – the governor already approves every single member there,” Lampton said.
But a department run by the governor’s appointees is very different from a department run by the governor, Lampton stressed.