Experts tracking how states are spending billions of federal dollars to improve rural healthcare told a panel of lawmakers on Thursday what many of them already knew: Mississippi is uniquely opaque about how it will spend this money.
Jamila McLean, the director of health equity for the State Health and Value Strategies consortium, told legislators at a joint meeting of House and Senate Public Health committees that nearly every other state in the nation has held public meetings to gather input on how to spend this money.
“I do think that Mississippi is an outlier in terms of the availability of the information,” McLean said.
Some state lawmakers have expressed frustration at the limited role they have played in the application and appropriation of the money and criticized what they see as Gov. Tate Reeves’ lack of transparency in administering the program.
Rep. Donnie Scoggins, a Republican from Ellisville, homed in on that comment and asked McLean to repeat herself to make sure he understood her.
“To put it bluntly, yes, we have not seen any public information,” McLean said. “All of our tracking is based off of what we are able to find publicly. And there is very little that we are able to find.”
“I appreciate very much you saying that because out of all the 50 states, we probably need the money the most, and it appears we’re the least transparent in using that money,” Scoggins responded.
Mississippi ranks near the bottom of most health outcome reports and the state’s rural hospitals have for years struggled to remain solvent.
Thursday’s hearing stems from the federal government awarding Mississippi nearly $206 million in December as part of the federal Rural Health Transformation Program. States will receive payments over five years as part of a national, $50-billion program.
Congress created the last-minute fund as a part of the One Big Beautiful Bill Act, passed last July, to sweeten the deal for Republican lawmakers concerned about the disproportionate impact that rural hospitals are expected to face as a result of the legislation.
Reeves’ office led the state’s application for the federal money last fall and is overseeing distribution of it. Mississippi’s plan includes a statewide rural health assessment and other initiatives that focus on coordinating care, strengthening the workforce, creating a statewide health information exchange, expanding telehealth opportunities and improving infrastructure.
Gov. Tate Reeves talks about Mississippi’s Rural Health Transformation Program plan during a press conference at the Walter Sillers Building in Jackson on Tuesday, Oct. 4, 2025. Credit: Eric Shelton/Mississippi TodayMississippi and New Hampshire are the only two states where the governor’s office directly oversees the distribution of the money. McLean told lawmakers, though, that New Hampshire is being more transparent in how it’s using the funds.
McLean said Mississippi did solicit input from the public via an online survey. Examples of how other states have solicited more public input include having in-person health summits, establishing advisory councils and conducting workshops to advise groups on how to apply for the federal money.
Reeves announced April 29 that Richard Grimes, a certified public accountant, will serve as project director for the Mississippi Rural Health Transformation Office.
Grimes did not attend Thursday’s hearing, but House Public Health Chairman Sam Creekmore said lawmakers have arranged for Grimes to testify at a June 4 hearing.
“This is for rural health, and it is to be transformational,” Creekmore said. I think the Legislature has shown that we are serious about transparency, holding people accountable and making sure that these funds are making a difference in our rural communities, which is most of our state.”
The Centers for Medicare and Medicaid Services approved Mississippi’s program budget on April 20.
“What’s going on in Mississippi is not what other states are doing,” Senate Public Health Chairman Hob Bryan said Thursday. “It’s not typical, and what’s going on in Mississippi is not based on some requirement from CMS. It’s an intentional decision to proceed this way in Mississippi.”
Lawmakers passed oversight and transparency legislation in March requiring the program’s funding to be directed toward rural communities and spending to be reported to the Legislature. Reeves vetoed the bill, arguing it could jeopardize the state’s access to the money by slowing down its distribution and potentially result in a loss of up to $1 billion over five years. Lawmakers failed to override his veto.
The vetoed legislation would have:
Mandated quarterly reports on how funds were spent be provided to the Legislature. Required a competitive procurement for establishing a statewide health information exchange to support real-time data sharing between providers. 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.Bryan, a Democrat from Amory, and several other lawmakers have said it’s unthinkable that legislators, who are constitutionally tasked with appropriating money, have largely abdicated their spending authority over these funds to the governor.
Sen. Hob Bryan, D-Amory, speaks during a Public Health and Human Services Joint Committee hearing Thursday, Nov. 6, 2025, at the state Capitol in Jackson. Credit: Vickie D. King/Mississippi TodayAs part of their reasons for siding with the governor, some lawmakers have said their local hospitals asked them not to override the veto because the hospitals were promised a portion of the federal money.
“It raises the question how do these people know that they’re going to get money out of this program?” Bryan asked. “We keep hearing there’s information being shared with some individuals, but not publicly.”
Reeves did not respond to Mississippi Today’s questions about the transparency elements the office plans to implement. He also did not respond to a request for an interview with Grimes.
The governor’s office in January entered into a seven-year, $10.2-million contract with BDO Government Services, formerly HORNE, for consulting and accounting services to administer the program.
The program’s website currently lists one funding opportunity, for a vendor to assist with the Mississippi Comprehensive State Health Plan. The plan will be used to identify health care gaps and workforce needs to support long-term policy.
Mississippi must obligate all of its first-year funds by October and spend them by September 2027.
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