Reeves vetoes bill aimed at increasing oversight of his spending federal rural health funds
By Gwen Dilworth | Originally published by Mississippi Today
Gov. Tate Reeves vetoed a bill on Thursday that was meant to increase oversight of and impose priorities on his spending of hundreds of millions of federal dollars for rural health care.
Reeves said the bill could jeopardize the state’s access to the money and potentially result in a loss of up to $1 billion over five years.
“The imposition of additional priorities, preferences and state procurement requirements will create an unnecessary layer of bureaucracy that will have the effect of slowing down the process of awarding grant funds and puts such funds at risk,” Reeves wrote in his veto message.
The vetoed bill, which would have taken effect immediately if Reeves had signed it into law, would have increased the Legislature’s oversight over the spending by requiring each agency awarding grants or funding to provide quarterly reports to the Legislature and requiring a competitive procurement process for establishing a statewide health information exchange to support real-time data sharing between providers.
It also called for priority for the funding to be given to rural areas, the Delta, programs that provide direct assistance to Mississippi providers and patients and entities that have not received state or federal assistance for facility improvements or medical equipment in the past three years.
The bill was a weaker version of oversight legislation passed by the state House and Senate earlier this year, which would have required a competitive bidding process to distribute the money.
In December, Mississippi was awarded nearly $206 million as a part of the Rural Health Transformation Program. States will receive payments over five years as a part of the $50 billion program, which was designed to support rural health care and offset the disproportionate impact already-struggling rural hospitals are expected to face as a result of federal spending cuts Congress passed into law last summer. States must spend the money within two years.
Some stakeholders have expressed concerns that the funding will not make up for funding losses to hospitals and could be directed to urban communities, rather than rural ones.
Reeves said Centers for Medicare and Medicaid Services Director Dr. Mehmet Oz encouraged him to block legislation that could make it difficult for Mississippi to meet the program’s tight deadlines for spending the money.
“Any legislation that attempts to impede or restrict the procurement process will put Mississippi at serious risk of failing to obligate its funding on time,” Oz wrote in an excerpted message included in Reeves’ veto message.
Reeves also said portions of the legislation are redundant, noting that executed contracts are already subject to Mississippi’s Public Records Act and a health information system would already be required to go through a competitive procurement process.
Reeves’ office led the state’s application for the federal funds last fall and is overseeing distribution of the money.
State legislators have expressed frustration at the limited role they have played in the application and appropriation of the funds. Lawmakers typically hold the authority to appropriate money through the “power of the purse.”
In the past, lawmakers have moved to exert control over large sums of federal funding set to be administered by Reeves. During the COVID-19 pandemic, Mississippi lawmakers voted to strip Reeves of his sole spending authority over more than $1 billion dollars in federal stimulus funds.
House Speaker Jason White seemed to indicate in September that a similar battle could play out during this year’s legislative session, but lawmakers did not make efforts to take control of the funds.
During a Senate Public Health Committee meeting March 3, lawmakers expressed confusion over who should be tasked with overseeing the funds.
Three weeks later, Senate Appropriations Chairman Briggs Hopson told Mississippi Today he still did not have “total clarity” on how the funds should be spent, but noted that they are different from pandemic stimulus programs because those funds were delivered directly to the state, while the Rural Health Transformation Program funding was allocated to the state as a part of an application process.
And, he noted, states risk losing federal funding if they change plans approved during the application process. Reeves echoed this concern in his veto message.
“At the same time, I think the Legislature typically almost always would have the control of the funds because that’s the way that the law is in Mississippi,” Hopson said. “And I wish we’d had more clarity from the federal government when they sent the rural funds down.”
There are few decisive rules for how states should spend or administer the money, creating a “patchwork of policy” across the U.S., said Brock Slabach, chief operations officer for the National Rural Health Association.
“Each state has their own design and their own systems that they have to work through in order to spend money,” said Slabach, who said he expects additional guidance from the federal government to be released in coming weeks.
Nationwide, states’ programs are being led by a range of state agencies. Most programs are being led by state health departments or Medicaid divisions, according to a report from Princeton University’s State Health & Value Strategies program. Mississippi and New Hampshire are the only states where the governor is leading implementation.
How or if any of the funds have been spent so far in Mississippi has largely remained a mystery, even to lawmakers.
“I’m extremely concerned that so much apparently is taking place in secret behind closed doors, and I think it needs to be a more open process,” said Senate Public Health and Welfare Chairman Hob Bryan, a Democrat from Amory and author of the vetoed legislation.
The state’s application for the funding proposed that a number of tasks be performed between January and March — during the months of the legislative session — including the selection of a vendor to perform a statewide assessment of rural health needs that will inform funding decisions for the program. The state will conduct procurement for the company that will perform these services, according to the application.
The Department of Finance and Administration, on behalf of the governor’s office, entered into a seven-year contract for accounting, auditing, administration and consulting services for the funds in January, according to a copy of the contract obtained by Mississippi Today.
Lawmakers are set to return to the Capitol on Friday to address minor procedural issues, but they are expected to adjourn the legislative session early, leaving little time to try to override the governor’s veto.
This article was originally published by Mississippi Today and is republished here under a Creative Commons license.
Source: Original Article
