David Caulfield, State Department of Health Central Regional Administrator, in an examination room at the newly re-opened Yazoo County Health Department in Yazoo City, Monday, June 5, 2023. Credit: Vickie D. King/Mississippi Today

The Lauderdale County Board of Supervisors decided this year not to award over $200,000 to the state health agency for the operation of the county health department as it had done the previous year.

But Lauderdale officials say that’s not because they don’t care about public health — in fact, they’re spending more than $2 million of their pandemic relief funds upgrading the facility’s air-conditioning system. 

They say it’s because the Mississippi State Department of Health couldn’t adequately answer what that money was going toward. 

County health departments are funded by a mixture of state and county money. Usually, the county provides a building, while the Health Department provides staffing, according to State Health Officer Dr. Daniel Edney. The facilities provide essential public health services such as vaccinations, STI testing, diabetes and hypertension care, pap smears, pregnancy testing and more. 

And as hospitals struggle amid a statewide health care crisis and more of the state’s wellbeing may fall on publicly funded health care, Edney has stressed the importance of these local clinics. 

The state Department of Health has been tasked with mounting responsibilities over the years, but their state funding has remained relatively stable. Health officials are still reeling from the pandemic, and 40% of positions at the agency were unfilled as of May.  

Daniel Edney, M.D., is the State Health Officer. Credit: Vickie D. King/Mississippi Today

Edney acknowledged at last month’s state Board of Health meeting that his agency had dropped the ball with Lauderdale, and it may not be an isolated incident. 

“We did not do a good enough job with that board,” he said. “Fires break out — I personally have been going and putting those fires out — but we’re already talking internally about doing a better job on our regional level of our folks being at board of supervisors meetings, just going and saying, ‘Hello.’”

Chris Lafferty, administrator of Lauderdale County, isn’t aware of any changes at the county health department, so he didn’t realize there was a “fire.” His conversations with Mississippi Today this week was the first time he had heard of any issues, he said.

“The question of need comes up — was the money really needed? If it was, why didn’t they articulate that?” Lafferty said. “None of the local leadership has contacted us. Now they’re all over it. They’ve had a year.”

In 2022, Lafferty sent a letter to Susan Rigdon, a division director at the agency, informing her that the Board of Supervisors didn’t approve any funding for the agency. The previous year, the board had allocated $242,100 in its $65 million budget to the Department of Health.

Lafferty said he hadn’t heard back from the agency, nor did he hear any complaints, until Mississippi Today recounted a quote from Edney at a state Board of Health meeting on July 12, more than nine months later. 

“It was a $200,000-a-year appropriation that (Lauderdale County) defunded,” Edney said at the meeting. “They took us out of their budget totally.”

According to Lafferty, it wasn’t an easy decision. More than a year ago, the Board of Supervisors was determined to avoid a tax increase in Lauderdale, and Lafferty started looking at how to save dollars. 

So, he called David Caulfield, the Health Department’s regional administrator for the Central Public Health Region which includes Lauderdale and 27 other counties. Lafferty wanted him to explain where the nearly quarter of a million dollars was going – whether it was staying in Lauderdale County and what services it was funding. Caulfield couldn’t tell him, Lafferty said.

“I think those are reasonable questions,” he said. “I cannot in good conscience … ask the Board of Supervisors to give money to an organization that could not answer simple questions.”

Lafferty recommended to the Board of Supervisors, then, that the funding be cut, and Lauderdale County did not have a tax hike last year, he said.

Chris Lafferty has been Lauderdale’s County Administrator since 2016. Credit: Lauderdale County

According to Lafferty, no services have been cut or reduced at the county health department as a result – which begged the question, what did the Department of Health do with the $242,100 last year?

Mississippi Today reached out to the Health Department on July 31 with questions about Lauderdale County’s funding to their agency.

The agency replied with an emailed statement that said it provided the same information to Lauderdale County last year as it had in prior years, but it’s unclear what specific information that included. 

“Each year, information is provided to each county board of supervisors that includes overall budget information of each county health department and the services these funds support,” the emailed statement from spokesperson Liz Sharlot reads. “Our local administrators also meet with county officials, as needed, to answer any questions and provide additional information. This information was provided to Lauderdale last year as it had been provided in years past.”

The statement goes on to say that the money from Lauderdale was funding county health department personnel as well as equipment and supplies. 

Mississippi Today reached out to the state Health Department again on Tuesday with follow-up questions, including whether the Health Department provided the county officials with the information they sought regarding how the money was spent and how the supervisors’ decision not to award the agency any money impacted the county health department’s operations. 

Spokesperson Elizabeth Grey did not answer any specific questions, including if and how the Lauderdale County Health Department was impacted. She said on Thursday that Edney and Caulfield were working to schedule a meeting with the Lauderdale County Board of Supervisors to rectify the situation — after that meeting, the agency would respond to Mississippi Today’s questions, she said.  

Mississippi state law mandates that county supervisors “shall be authorized” to make necessary appropriations to the Department of Health to pay the salary of the employees of the county health department, as well as supplies. It goes on to say more clearly that the board “shall provide” an office, or building, for the health department. 

It’s not clear if most counties are providing additional funding beyond building costs for their health departments — the state Health Department did not respond to that question from Mississippi Today.

Jonathan Wells, president of the Lauderdale County Board of Supervisors, says the county provides a building — and more. 

“So, the Legislature says — and I would call it an unfunded mandate — that we supply the Department of Health a building,” he said. “Not only are we doing that, but we’re putting $2.5 million in ARPA (American Rescue Plan Act) money into a new HVAC system for that building.”

The county continues to pay for utilities in that building, security services as well as other general upkeep, Wells said. 

That won’t change next year, according to Lafferty — but neither will their zero-dollar allocation toward the State Health Department. 

On Wednesday, Caulfield visited Lafferty in his office, holding a budget request for the upcoming year in his hands, he said. Lafferty says he is still unclear what the county’s funding responsibilities are and will recommend that the Board of Supervisors continue to withhold funding to the state Department of Health.

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Devna Bose, a Neshoba County native, covers community health. She is a 2019 graduate of the University of Mississippi, where she studied print journalism and was a member of the Sally McDonnell Barksdale Honors College. Before joining Mississippi Today, Devna reported on education at Chalkbeat Newark and at the Post and Courier’s Education Lab, and on race and social justice at the Charlotte Observer. Her work has appeared in the Hechinger Report, the Star-Ledger and the Associated Press, and she has appeared on WNYC to discuss her reporting. Devna has been awarded for her coverage of K-12 education in the Carolinas.