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State Health Officer Dr. Ed Thompson may have some explaining to do before the Mississippi Legislature grants his wish for more people and a new building.

Helming the Jan. 23 meeting of the Mississippi State Board of Health (MSBH), Thompson said the Mississippi State Department of Health’s staff, especially its frontline nurses and disease investigators, has continued declining to an unhealthy number since 2003 and has jeopardized its response availability to the public.

“The biggest problem is the fact we’ve allowed our field staff to decline,” he said, citing the department’s fiscal year 2008 budget of $300.7 million, of which the state contributes $37 million. Thompson is seeking a $16.4 million increase for FY09 to help fund salaries for more public health nurses and disease investigators.

In 2003, the department had 312 nurses; now the number is 283, Thompson pointed out, adding the personnel shortage hampers the department’s ability to appropriately monitor chronic health problems such as cardiovascular disease and obesity rates.

Thompson has legislative support, particularly from the Senate Public Health Committee, for the increased funding, though probably not for the full amount requested.

However, public health advocates are questioning the level of pay for central office managers. They want to see reports on the department’s staffing levels, salaries and contract pay for central office, district and county management jobs before the state lawmakers approve a spike in funding. Under his tenure from 2003 to 2007, ousted state health officer Dr. Brian Amy moved $1.5 million of salary funds from the districts to central office pay for top-level positions. Thompson has emphatically denied overstaffing at the central office level.

At the January board meeting, two new central office staffers were announced. Sherwin L. Stewart, who previously served as director of Allied Health Programs for Virginia College in Jackson, Miss., was named director of the new Office of Tobacco Control. Hope Ladner, former public information officer for the Mississippi Senate, joined the department as the new health policy analyst and legislative liaison. Thompson has reportedly contracted to bring several retirees back, at least two nurses in high-level central office positions.

Board member Carl Nicholson said the search for an internal audit director has hit a stumbling block, noting there is an insufficient talent pool for the “low” salary the position pays. Thompson said the department “has a staff still functioning; we just need a director.”

Thompson is also asking for a new $25 million public health laboratory that he says is long overdue. The current lab in Jackson is more than a half-century old, which he describes as “physically too small” with a limited electrical system that prevents adding more and higher tech equipment. The department’s recommendation calls for the facility to be funded by general obligation bond money, a move some public health advocates say would need to be closely monitored if approved. Two years ago, the lab received bond authorization, which had a faulty funding mechanism, Thompson explained.

Other meeting notes:

• Thompson and board chairman Luke Lampton led discussion about a strategic planning retreat, which will be held after the legislative session ends and will not be considered a board meeting. No public health policy decision will be made and the meeting will not be open to the public.
• Board members approved changes to the EMS law, rules and regulations, based on a recommendation from the EMS Advisory Committee.
• Board members reviewed a Trauma Care Task Force report, with Charles Stokes of North Mississippi Medical Center in Tupelo, who chairs the task force, discussing access, Bill Oliver of Forrest General Hospital in Hattiesburg discussing funding concerns, and Dr. Hugh Gamble of Greenville reporting on the lack of physician availability.
• To avoid even the appearance of a conflict of interest concerning voting on Health Facilities Licensure changes, board members recused and returned themselves for votes.
• Concerning individual on-site wastewater disposal systems, Thompson told the board that “on-site wastewater disposal” will remain one of their biggest headaches. “The department thinks (a pending bill concerning mandatory maintenance) is a good idea … will be easier, clear to homeowners, and offers more specifics in relation to required maintenance,” said Thompson. Without maintenance, any system will eventually cease to work and could discharge pathogens from raw sewage. The board approved endorsing the legislation.
• Board member Dr. Edward Hill asked for an update from an internal group of public health workers who primarily scrutinize infant deaths, a request Thompson said the group was already working on. Mississippi ranks first in infant mortality.

Only Dr. Kelly S. Segars, Sr., of Iuka was absent from the January board meeting; the next board meeting is slated for April 9.



March 2008

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