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Justin Sellers/The Clarion-Ledger
During Mississippi’s mental health task force’s third meeting since Attorney General Jim Hood created it last summer, a security guard stood by the elevators at the Walter Sillers State Office Building in downtown Jackson, asking folks attempting to enter if they were “on the task force.”
That’s because members of the public and press have been barred from attending the gatherings, which take place on the 13th floor — in the press room. The meetings, in which attendees are split into several subcommittees, are designed to address issues within the state’s multi-pronged mental health system.
They met Wednesday for nearly four hours.
MS Pulse: Mississippi has a transparency problem and it could be hurting health
Hood’s office is defending the state in a lawsuit U.S. Department of Justice filed against Mississippi in 2016 for its delivery of mental health services. The state is accused of having too great a reliance on institutional versus community-based care.
Building officials said the public cannot visit the public, taxpayer-funded offices in the Sillers building — including the governor’s office and Medicaid — unless they have an appointment.
The task force is made up of representatives from more than 30 agencies, many that already serve folks with mental illnesses. The group includes health care professionals, judges, law enforcement officers, academics and advocates, as well as lawmakers Rep. Chris Bell, D-Jackson, Rep. Becky Currie, R-Brookhaven, Sen. Hob Bryan, R-Amory, and Rep. Bryant Clark, D-Pickens.
The attorney general’s office claims the group is not subject to the Open Meetings Act because it is not drafting legislation or policy, only recommendations.
A press release on the task force says it “will also review current legislation as well as needs for additional legislation.”
A similar task force created by Gov. Phil Bryant to study the state’s opioid crisis, an issue that overlaps greatly with mental health, also wrote recommendations. It held meetings open to the public.
The membership of the mental health task force, the only folks authorized to attend meetings, is in flux, said Hood’s spokesperson Margaret Morgan. Morgan said Hood extended an invitation to participate to many groups, which either accepted, declined, or even invited others in the field to join.
Hood, a likely candidate for governor in 2019, asked task force members to decide whether other members of the public or press should be allowed to attend. A majority of respondents said they preferred the meetings be closed, making it impossible for outside review to determine the group’s productivity.
Morgan has provided the Clarion Ledger the contact information for at least three members of the task force who said they’d be willing to talk to reporters.
One of those members, Biloxi Police Chief Chris De Back, said his involvement on the task force focuses mainly with coordinating efforts between mental health professionals and law enforcement to identify folks in crisis and provide “the necessary services they need before it ends up in a law enforcement capacity.”
In general, De Back said the task force is good for bringing folks of all disciplines together from across the state to learn how each person plays a role — something advocates have pleaded for over the years.
“There are all kinds of services out there. The problem is the services aren’t working together or they don’t know about each other,” De Back said. “By becoming a team, bringing everything together, we can be more efficient and, in the long run, more effective.”
Sen. Bryan said Wednesday he doesn’t understand why the meetings are closed and was willing to discuss what his subcommittee addressed: improvements to the state’s commitment process.
Bryan said the state has made progress with commitments, a process “based on a law that existed a hundred years ago, passed when there wasn’t the knowledge there is now.” His subcommittee is discussing ways to continue moving away from commitments being the default way to get services for someone with a mental illness.
Questions for veteran health reporter Deb Pressey? Click here and she’ll chase down an answer.
Q: Is it advisable to get the shingles shot now if you haven’t had that, or wait for the new, more effective vaccine that’s going to be available? And are the clinics in this area saying how soon they’ll have the new one?
A: To address availability first, GlaxoSmithKline said it expected its shingles vaccine, Shingrix, to be available “shortly” following its approval by the Food and Drug Administration late last month.
How soon health providers such as Carle and Christie Clinic will have it is hard to say.
A Christie Clinic spokeswoman said Christie doesn’t have an expected delivery date for the Shingrix vaccine.
Carle plans to learn more about it in the coming weeks and then decide about potentially making the vaccine available here in 2018, according to spokeswoman Laura Mabry.
Health Alliance Medical Plans has checked with the manufacturer, and was given the impression that the vaccine will be available mid-to-later November or early December, according to the insurer’s Director of Pharmacy Brian Smolich.
Both Carle and Health Alliance go through their own review processes for newly-approved drugs, and for Health Alliance that won’t start for Shingrix until after it’s available, Smolich said.
Health Alliance already covers Zostavax, the other shingles vaccine made by Merck, as a wellness benefit for people 60 and older, he said. The company will need to decide about coverage for Shingrix based on a study of the data, guidelines and comparisons with what’s been available, he said.
The review process for a new drug can take as long as six months, Smolich said, but Health Alliance is aware people want Shingrix as soon as it’s available and will likely expedite the review for that vaccine.
For patients who haven’t yet been vaccinated for shingles and are on the fence about which one to get — Zostavax now or Shingrix later — that’s a good conversation to have with their doctors, Smolich advised.
One thing to consider for people considering getting vaccinated now is they may be advised to get re-vaccinated with Shingrix when it’s available, he said.
About one in three U.S. adults are expected to get shingles, with people over 50 at the highest risk. It causes a painful, itchy rash and blisters and sometimes comes with more serious complications — among them postherpetic neuralgia, a burning pain that lingers after the rash and blisters clear.
Anyone who’s ever had chickenpox — and that’s most people over 40 — can get shingles, because the varicella zoster virus that causes chickenpox can remain dormant in the body and manifest later in life as shingles.
There are a few differences to consider between Zostavax and Shingrix.
Zostavax is a live, attenuated (weakened) virus vaccine administered in one dose, while Shingrix is a non-live virus vaccine that requires two doses.
Shingrix has been shown to be greater than 90 percent effective at preventing shingles across all age groups, with the effectiveness sustained over a 4-year follow-up.
Zostavax reduced shingles overall in people over age 60 by 51 percent after three years of follow-up. It was more effective — 64 percent — in the 60-69 age group, but its effectiveness dropped to 41 percent for those ages 70-79 and 18 percent for those 80 and older, according to the Food and Drug Administration
Both Zostavax and Shingrix are approved for people age 50 and older, but federal health authorities have advised shingles vaccination only for those 60 and older.
Age guidelines could change, though. The Center for Disease Control and Prevention’s Advisory Committee on Immunization Practices voted Oct. 25 to recommend Shingrix both for healthy adults 50 and older and for adults who previously received Zostavax. The committee further backed Shingrix as the preferred vaccine for helping prevent shingles and related complications.