IOWA CITY, Iowa (AP) — Prosecutors have dropped trespassing charges against an activist who helped secretly record&nbsp;<a href="https://www.usnews.com/news/best-states/iowa">Iowa</a>’s largest pork producer using heat to kill thousands of hogs last year as the pandemic devastated the industry.

Matt Johnson, an activist with <a href="https://www.facebook.com/directactioneverywhere/">the group Direct Action Everywhere,</a> had been scheduled to stand trial in Grundy County, Iowa, on Monday on two counts of trespassing at Iowa Select Farms properties in May.

County prosecutors moved to dismiss the charges Thursday at the request of Iowa Select, whose personnel had been subpoenaed but said they didn't wish to testify, court documents show.

“We cannot be distracted by individuals who choose to break the law and grandstand,” Iowa Select spokeswoman Jen Sorenson said Friday.

Johnson was planning a necessity defense, arguing that his actions were lawful because they were the only way to expose the inhumane treatment of animals. He was hoping to draw more attention to the company's use of a method known as ventilation shutdown to cut the size of its herd in May.

Johnson had acknowledged, however, that his defense was likely to fail and that he could face fines or jail time if convicted.

Iowa Select's animals are raised and sent to be slaughtered by Tyson Foods and other meatpackers, and they end up in grocery stores as bacon and pork under several brand names. The company is an influential backer of Republican Gov. Kim Reynolds.

Last spring, some producers said they had no choice but to euthanize hogs after coronavirus outbreaks at meatpacking plants led to closures and production slowdowns. They said they had no markets to sell them and ran out of space to house them.

One of the methods they used to trim herds was ventilation shutdown, which involves stopping airflow inside a facility to raise the temperature high enough to kill animals inside.

American Veterinary Medical Association guidelines say the method should be a last resort after others are ruled out, that it should be done quickly enough to kill 95% of the animals within an hour, and that all must be eventually killed.

Acting on a tip from a whistleblower, a team of activists that included Johnson placed equipment inside an Iowa Select barn and recorded audio of pigs shrieking, some for hours, as the temperature rose and killed many of them.

They also captured video showing workers hours later walking through the pile of animals and shooting those showing signs of life with a bolt gun. Then, they used heavy machinery to remove the carcasses.

Johnson said that his investigation has found some of Iowa Select’s own employees dissented from the practice, a claim he wanted to explore at trial.

“This company knows that the public ... is horrified to learn what ISF is willing to do in the name of profit,” he said. “They’re desperate to conceal their abhorrent and criminal conduct.”

Johnson said that activists snuck in and placed a wireless home security camera in the barn that they could control remotely as well as an audio recorder that they were able to retrieve the next day.

Johnson, an Iowa native who now lives in Berkeley,&nbsp;<a href="https://www.usnews.com/news/best-states/california">California</a>, was charged with trespassing after returning to the farm and confronting Iowa Select chief operations officer Noel Williams about the practice. He faced a second trespassing charge related to an incident days later on a different property.

Iowa Select blasted Johnson and other activists at the time, saying they were trying to exploit the coronavirus crisis to advance their agenda. In June, after The Intercept published some of the material captured by activists, the company announced that it had discontinued the practice as the industry rebounded.

“We are cautiously optimistic that we will never again have to face a difficult decision like we had to face last month,” the company said then.

Johnson said that before the practice was exposed, a whistleblower alleged the company had been planning to kill more hogs through ventilation shutdown.

Johnson still faces more serious charges in Wright County, where he is charged with placing recording equipment inside another Iowa Select barn and taking a piglet that he says he rescued from slaughter. He is charged with electronic eavesdropping and third-degree burglary, which are both felonies, and is awaiting trial.

<figure>
 <img src="https://media.eaglewebservices.com/public/2021/1/1611941435232.png" alt="Matt Johnson photo courtesy <a href="https://www.facebook.com/directactioneverywhere/">Direct Action Everywhere</a>" />
 <figcaption>Matt Johnson photo courtesy <a href="https://www.facebook.com/directactioneverywhere/">Direct Action Everywhere</a></figcaption>
 </figure>IOWA CITY, Iowa (AP) — Prosecutors have dropped trespassing charges against an activist who helped secretly record&nbsp;<a href="https://www.usnews.com/news/best-states/iowa">Iowa</a>’s largest pork producer using heat to kill thousands of hogs last year as the pandemic devastated the industry.Matt Johnson, an activist with <a href="https://www.facebook.com/directactioneverywhere/">the group Direct Action Everywhere,</a> had been scheduled to stand trial in Grundy County, Iowa, on Monday on two counts of trespassing at Iowa Select Farms properties in May.County prosecutors moved to dismiss the charges Thursday at the request of Iowa Select, whose personnel had been subpoenaed but said they didn't wish to testify, court documents show.“We cannot be distracted by individuals who choose to break the law and grandstand,” Iowa Select spokeswoman Jen Sorenson said Friday.Johnson was planning a necessity defense, arguing that his actions were lawful because they were the only way to expose the inhumane treatment of animals. He was hoping to draw more attention to the company's use of a method known as ventilation shutdown to cut the size of its herd in May.Johnson had acknowledged, however, that his defense was likely to fail and that he could face fines or jail time if convicted.Iowa Select's animals are raised and sent to be slaughtered by Tyson Foods and other meatpackers, and they end up in grocery stores as bacon and pork under several brand names. The company is an influential backer of Republican Gov. Kim Reynolds.Last spring, some producers said they had no choice but to euthanize hogs after coronavirus outbreaks at meatpacking plants led to closures and production slowdowns. They said they had no markets to sell them and ran out of space to house them.One of the methods they used to trim herds was ventilation shutdown, which involves stopping airflow inside a facility to raise the temperature high enough to kill animals inside.American Veterinary Medical Association guidelines say the method should be a last resort after others are ruled out, that it should be done quickly enough to kill 95% of the animals within an hour, and that all must be eventually killed.Acting on a tip from a whistleblower, a team of activists that included Johnson placed equipment inside an Iowa Select barn and recorded audio of pigs shrieking, some for hours, as the temperature rose and killed many of them.They also captured video showing workers hours later walking through the pile of animals and shooting those showing signs of life with a bolt gun. Then, they used heavy machinery to remove the carcasses.Johnson said that his investigation has found some of Iowa Select’s own employees dissented from the practice, a claim he wanted to explore at trial.“This company knows that the public ... is horrified to learn what ISF is willing to do in the name of profit,” he said. “They’re desperate to conceal their abhorrent and criminal conduct.”Johnson said that activists snuck in and placed a wireless home security camera in the barn that they could control remotely as well as an audio recorder that they were able to retrieve the next day.Johnson, an Iowa native who now lives in Berkeley,&nbsp;<a href="https://www.usnews.com/news/best-states/california">California</a>, was charged with trespassing after returning to the farm and confronting Iowa Select chief operations officer Noel Williams about the practice. He faced a second trespassing charge related to an incident days later on a different property.Iowa Select blasted Johnson and other activists at the time, saying they were trying to exploit the coronavirus crisis to advance their agenda. In June, after The Intercept published some of the material captured by activists, the company announced that it had discontinued the practice as the industry rebounded.“We are cautiously optimistic that we will never again have to face a difficult decision like we had to face last month,” the company said then.Johnson said that before the practice was exposed, a whistleblower alleged the company had been planning to kill more hogs through ventilation shutdown.Johnson still faces more serious charges in Wright County, where he is charged with placing recording equipment inside another Iowa Select barn and taking a piglet that he says he rescued from slaughter. He is charged with electronic eavesdropping and third-degree burglary, which are both felonies, and is awaiting trial.

Charges dropped against activist who secretly recorded pork producer

By GREG ECHLIN <a href="https://www.kcur.org/sports/2021-01-27/study-suggests-kansas-city-teachers-and-students-need-a-lesson-plan-for-super-bowl-lv">Kansas News Service</a>

Kansas City Chiefs fans of all ages will watch Super Bowl LV on 
February 7, and in some cases, it may mean postponing some academic 
obligations. 

Before Super Bowl LIV last year when the Chiefs 
defeated the San Francisco 49ers, the results of a study by Brainly—an 
online study group for kids K through 12—showed that Missouri and Kansas
 ranked No. 1 and 2, respectively, in the U.S. where parents let their 
kids skip their homework on the night of the Super Bowl.

“A lot of
 schools were asking for a study sort of like this because they want to 
know: Should they be assigning big homework assignments around these 
major social events that are happening?” says Patrick Quinn, an Austin, 
Texas, based parenting expert for Brainly.

But Quinn recalls from first-hand experience that students aren’t the only ones potentially slacking on Super Bowl night.

“I
 can tell you 100 percent from a teacher’s perspective, because I was a 
teacher in New York City for a number of years, teachers are maybe more 
so ready to not do anything on Super Bowl Sunday and the Monday 
afterward,” says Quinn.

It happened six years ago when the Kansas City Royals were on their way to a World Series championship.

Shawnee
 Mission North High School teacher Katie (Melcher) Moorehead caught some
 flak when she slipped out of town with her father to follow the Royals 
on the road in the fall of 2015. “Big, big memories and a 
once-in-a-lifetime opportunity for sure,” she said at the time.

But
 her trip was exposed when her poster board with the written words 
““Skipping school for the Royals. Don’t tell my students!!” made a 
splash on social media.

When Rockhurst University chose to keep classes in session last year 
on the day of the Chiefs parade, its school president, Father Thomas 
Curran, wasn’t surprised to see lighter attendance that day, not only 
among the students, but with RU staffers and faculty.

“We made no 
judgement on that and that’s the way we operate because we don’t force a
 professor to hold or not hold their classes,” says Father Curran.

As
 steadfast as Father Curran is about not cancelling classes, he’s still 
in the esprit de corps about what the Chief are accomplishing.

“I’m
 happy for the Chiefs, the Chiefs fans, for our community,” said Father 
Curran. “It’s certainly exciting at this time. It helps us build 
community at a time when we do need one another.”

On top of all 
that, he has the satisfaction of winning a friendly wager. John Hurley, 
Father Curran’s counterpart at Canisius University in Buffalo, has been 
wearing a face mask with a Chiefs logo after the Chiefs beat the Buffalo
 Bills in the AFC Championship game on Sunday.

This year, Kansas 
City Mayor Quentin Lucas has already put the word out there that there 
likely won’t be a parade of last year’s magnitude. That means schools, 
which have been struggling to return to pre-pandemic conditions, will 
remain in session.

But there’s still time to figure out a lesson plan for the night of the Super Bowl.

In
 the midst of the pandemic, the word is already out that there won’t be a
 parade celebration like last year if the Chiefs win Super Bowl 55. 
Which means schools are likely to be in session.

But teachers and students might want to thing twice about not completing school work on Super Bowl weekend.

<figure>
 <img src="https://media.eaglewebservices.com/public/2021/1/1611844275199.png" alt="Kansas News Service" />
 <figcaption>Kansas News Service</figcaption>
 </figure>By GREG ECHLIN <a href="https://www.kcur.org/sports/2021-01-27/study-suggests-kansas-city-teachers-and-students-need-a-lesson-plan-for-super-bowl-lv">Kansas News Service</a>Kansas City Chiefs fans of all ages will watch Super Bowl LV on 
February 7, and in some cases, it may mean postponing some academic 
obligations. Before Super Bowl LIV last year when the Chiefs 
defeated the San Francisco 49ers, the results of a study by Brainly—an 
online study group for kids K through 12—showed that Missouri and Kansas
 ranked No. 1 and 2, respectively, in the U.S. where parents let their 
kids skip their homework on the night of the Super Bowl.“A lot of
 schools were asking for a study sort of like this because they want to 
know: Should they be assigning big homework assignments around these 
major social events that are happening?” says Patrick Quinn, an Austin, 
Texas, based parenting expert for Brainly.But Quinn recalls from first-hand experience that students aren’t the only ones potentially slacking on Super Bowl night.“I
 can tell you 100 percent from a teacher’s perspective, because I was a 
teacher in New York City for a number of years, teachers are maybe more 
so ready to not do anything on Super Bowl Sunday and the Monday 
afterward,” says Quinn.It happened six years ago when the Kansas City Royals were on their way to a World Series championship.Shawnee
 Mission North High School teacher Katie (Melcher) Moorehead caught some
 flak when she slipped out of town with her father to follow the Royals 
on the road in the fall of 2015. “Big, big memories and a 
once-in-a-lifetime opportunity for sure,” she said at the time.But
 her trip was exposed when her poster board with the written words 
““Skipping school for the Royals. Don’t tell my students!!” made a 
splash on social media.<figure>
 <img src="https://media.eaglewebservices.com/public/2021/1/1611844359588.png" alt="Canisius president John Hurley, as part of a friendly Jesuit institutional wager between the Buffalo-based school and Rockhurst University in Kansas City, is wearing a face mask with a Chiefs logo this week since the Bills lost the AFC Championship game in Kansas City. Rockhurst University" />
 <figcaption>Canisius president John Hurley, as part of a friendly Jesuit institutional wager between the Buffalo-based school and Rockhurst University in Kansas City, is wearing a face mask with a Chiefs logo this week since the Bills lost the AFC Championship game in Kansas City. Rockhurst University</figcaption>
 </figure>When Rockhurst University chose to keep classes in session last year 
on the day of the Chiefs parade, its school president, Father Thomas 
Curran, wasn’t surprised to see lighter attendance that day, not only 
among the students, but with RU staffers and faculty.“We made no 
judgement on that and that’s the way we operate because we don’t force a
 professor to hold or not hold their classes,” says Father Curran.As
 steadfast as Father Curran is about not cancelling classes, he’s still 
in the esprit de corps about what the Chief are accomplishing.“I’m
 happy for the Chiefs, the Chiefs fans, for our community,” said Father 
Curran. “It’s certainly exciting at this time. It helps us build 
community at a time when we do need one another.”On top of all 
that, he has the satisfaction of winning a friendly wager. John Hurley, 
Father Curran’s counterpart at Canisius University in Buffalo, has been 
wearing a face mask with a Chiefs logo after the Chiefs beat the Buffalo
 Bills in the AFC Championship game on Sunday.This year, Kansas 
City Mayor Quentin Lucas has already put the word out there that there 
likely won’t be a parade of last year’s magnitude. That means schools, 
which have been struggling to return to pre-pandemic conditions, will 
remain in session.But there’s still time to figure out a lesson plan for the night of the Super Bowl.In
 the midst of the pandemic, the word is already out that there won’t be a
 parade celebration like last year if the Chiefs win Super Bowl 55. 
Which means schools are likely to be in session.But teachers and students might want to thing twice about not completing school work on Super Bowl weekend.

Study: Teachers, students need a lesson plan for Super Bowl LV

MONTGOMERY COUNTY—Law enforcement authorities are investigating a accident that landed a driver in jail.

Just after 10a.m. Friday sheriff's deputies responded to U.S. 169 and U.S. 160 Junction for a report of a two-vehicle motor vehicle accident, according Sheriff Ron Wade.

&nbsp;Jeffery Dean Davison Jr, 33, Ottawa&nbsp; lost control of a Chevy Cruze while driving onto the on ramp of U.S. 160.

The Chevy rear-ended a 2015 Dodge Durango driven by Mandy Ann Smith, 45,&nbsp; Cherryvale,&nbsp; while she was stopped at the stop sign. 

After further investigation, it was determined Davison was driving under the influence of alcohol.

Deputies transported Davison to the Montgomery County Department of Corrections and booked into jail on requested charges of; Felony DUI, Criminal use of weapon; Device attachment used to silence firearm and Operating a car without a required ignition interlock devise, according to Sheriff Wade.

<figure>
 <img src="https://media.eaglewebservices.com/public/2021/1/1612031761827.png" alt="Davison photo Montgomery Co." />
 <figcaption>Davison photo Montgomery Co.</figcaption>
 </figure>MONTGOMERY COUNTY—Law enforcement authorities are investigating a accident that landed a driver in jail.Just after 10a.m. Friday sheriff's deputies responded to U.S. 169 and U.S. 160 Junction for a report of a two-vehicle motor vehicle accident, according Sheriff Ron Wade.&nbsp;Jeffery Dean Davison Jr, 33, Ottawa&nbsp; lost control of a Chevy Cruze while driving onto the on ramp of U.S. 160.The Chevy rear-ended a 2015 Dodge Durango driven by Mandy Ann Smith, 45,&nbsp; Cherryvale,&nbsp; while she was stopped at the stop sign. After further investigation, it was determined Davison was driving under the influence of alcohol.Deputies transported Davison to the Montgomery County Department of Corrections and booked into jail on requested charges of; Felony DUI, Criminal use of weapon; Device attachment used to silence firearm and Operating a car without a required ignition interlock devise, according to Sheriff Wade.

Kansas man jailed for alleged DUI after rear-end crash

By CARA ANTHONY <a href="https://www.kcur.org/health/2021-01-28/birthday-rule-blindsides-first-time-olathe-parents-with-a-mammoth-medical-bill">Kaiser Health News</a>

In the nine months leading up to her due date, Kayla Kjelshus and her
 husband, Mikkel, meticulously planned for their daughter's arrival.

Their
 long to-do list included mapping out their family's health insurance 
plan and registering for baby gear and supplies. They even nailed down 
child care ahead of her birth.

"We put a deposit down to hold a spot at a local day care following our first ultrasound," says Kayla Kjelshus, of Olathe, Kan.

The
 first-time parents felt ready for their daughter's debut on Feb. 15, 
2019. But one of the happiest days of their lives turned out to be one 
of the scariest. Their daughter, Charlie, had a complication during 
delivery that caused her oxygen levels to drop and put her at risk for 
brain damage.

"We had a waiting room filled with family and 
friends," Mikkel recalls. "To come out and say things aren't well ... it
 was really hard."

Charlie was transferred from Saint Luke's 
Community Hospital to HCA Overland Park Regional Medical Center, where 
she received treatment in the neonatal intensive care unit, known as the
 NICU, for the next seven days.

Doctors sent Charlie home with a 
positive prognosis. The couple had decided that Kayla, a nurse 
practitioner, would carry Charlie on her insurance plan through Blue 
Cross and Blue Shield of Kansas City. Her plan offered better rates than
 Mikkel's, and his plan was based in another state and carried a higher 
deductible. So when the hospital asked for insurance information, Kayla 
provided her policy number — Mikkel did not.

They expected things to work out fine between the insurance company and the hospitals.

The Patient: Charlie Kjelshus, an infant covered by her 
mother's plan through Blue Cross and Blue Shield of Kansas City and, 
eventually, her father's plan, CommunityCare of Oklahoma

Medical Service: <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3743149/" target="_blank">Whole body cooling</a> and other treatment in the NICU to prevent brain injury that may result from oxygen deprivation during birth

Service Provider: HCA Overland Park Regional Medical Center in Overland Park, Kan.

Total Bill: Multiple charges totaling $270,951, according to Mikkel Kjelshus, including a charge of $207,455 for the NICU stay

What Gives:
 Kayla Kjelshus filed a claim with Blue KC, and the insurer started 
paying for baby Charlie's care. But then it canceled payments to the HCA
 Overland Park hospital, St. Luke's Community Hospital and Charlie's 
neurologist, pediatrician and other physicians.

"We thought, 'This is crazy,'" Mikkel says. "'We have insurance.'"

The
 Kjelshus family had slammed into something well known among insurance 
experts but little understood by the general public. "Coordination of 
benefits" and "the birthday rule" are the jargon terms for the red tape 
that snared them.

When a child is born into a family in which both
 parents have insurance through their jobs, the parents are supposed to 
"coordinate benefits'' — meaning they must tell both insurers that their
 child is eligible for coverage under two plans. The parents might be 
forgiven for thinking they have some say in how their child will be 
insured. In most cases, they don't.

Instead, a child with double 
health insurance eligibility must take as primary coverage the plan of 
the parent whose birthday comes first in the calendar year; the other 
parent's insurance is considered secondary. This model regulation was 
set by the National Association of Insurance Commissioners and adopted 
by most states, including Kansas, says Lee Modesitt, director of 
government affairs with the Kansas Insurance Department.

For 
Charlie Kjelshus, the birthday rule meant her dad's plan — with a 
$12,000 deductible, high coinsurance obligation and a network focused in
 a different state — was primary. Her mom's more generous plan was 
secondary.

Mom Kayla says Blue KC dispatched an investigator to 
discover that dad Mikkel had insurance through his job. The family had 
not been trying to hide Mikkel's coverage; they merely weren't aware of 
the birthday rule and that they may be subject to state laws that ensure
 babies are covered <a href="http://www.kslegislature.org/li_2016/b2015_16/statute/040_000_0000_chapter/040_002_0000_article/040_002_0102_section/040_002_0102_k/" target="_blank">for the first 31 days of life</a>.

"If
 these are the rules of engagement, you need to tell people upfront that
 these are the rules," says Dr. Linda Burke, OB-GYN and author of The Smart Mother's Guide to a Better Pregnancy. "It's a communication problem."

After
 Blue KC informed Mikkel that his insurance had to serve as primary 
coverage, CommunityCare of Oklahoma did pay Charlie's bills to the 
hospitals and other providers. It paid HCA Overland Park $16,605 on the 
$207,455 NICU charge. The insurer said its negotiated rate on the bill 
was $35,721. With Mikkel's deductible and coinsurance, that left the 
family on the hook for more than $19,116, it seemed.

"When an 
insurance company finds out that a baby is in the NICU, then it's a red 
flag," Burke says. "They are going to look for ways to cut their 
losses."

Resolution: The couple turned to the Kansas 
Department of Insurance to file a complaint about the bill, but the 
department declined to help because Kayla's policy is self-funded by her
 employer, which means the company is subject to federal rather than 
state regulations.

After close to a year and a half of going back 
and forth with their insurance companies and the hospitals, Blue KC paid
 $19,116 of the Kjelshuses' bill as a secondary insurer and said the 
Kjelshuses should not be responsible for what HCA Overland Park said was
 a remaining balance of $7,504.51. But the family kept getting bills.

And, beginning in summer 2020, collections calls from the hospital rolled in daily, leaving the couple frustrated and confused.

Eventually,
 after a human resources officer at Kayla's job stepped in to help, they
 received a statement with a zero balance. Their own calls to HCA 
Overland Park hospital billing department didn't get them anywhere.

"We always got a different answer," Kayla says. "It was so frustrating."

A spokesperson for the hospital apologized for the deluge of calls from collections.

"We
 made an administrative error and an automated billing call system for 
payment occurred, causing the family undue frustration during an already
 stressful time, and we apologize," the hospital wrote in a statement. 
"Once the issue was identified and resolved, the insurance companies 
processed the claim and we informed the family that there is a zero 
balance on the account. Again, we are sorry for the stress and 
inconvenience, and wish them well."

In a statement, Blue KC 
acknowledged that coordination of benefits can be confusing for members 
and that the company follows rules of state and federal regulators, 
modeled on standards set by the NAIC. It said that the Kjelshuses' 
future claims would continue to be paid and that a "dedicated service 
consultant" would continue to work with Kayla Kjelshus.

In the 
end, the insurers and hospitals settled Charlie's bill as they were 
supposed to: The primary insurer paid first, and the secondary paid what
 had not been covered by the first. But it took more than a year of 
phone calls, appeals and complaints before the Kjelshus family had the 
matter settled. Charlie turns 2 next month.

The Takeaway: In theory, "the birthday rule" would be a fair, 
if random, way to figure out which insurance should be primary and which
 secondary for families with insurance from two employers. The 
presumption is that the premiums, deductibles and networks are roughly 
similar in both parents' insurance plans — but that's simply not the 
case for many families.

The Kjelshuses found out the hard way they
 didn't have a choice about which parent's insurance was primary. They 
might have avoided their quagmire if Mikkel had dropped his own coverage
 and gotten onto Kayla's plan before Charlie was born.

It's not 
clear whose responsibility it is to help families navigate these rules 
before a baby is born. It's even more complicated for parents <a href="https://selecthealth.org/-/media/selecthealth82/pdf-documents/fehb-plan-documents/2017-naic-and-coordination-of-benefits.ashx" target="_blank">who are divorced or never married</a>. Insurance companies don't always offer the critical information families need about the coordination of benefits.

"Expecting
 parents should try to get in touch with their health plan before the 
baby is born to find out about the coverage rules," says Karen Pollitz, a
 senior fellow at KFF, the Kaiser Family Foundation. (KHN is an 
editorially independent program of KFF.)

New parents should "also figure out if they want to switch the entire family onto one plan once the baby is born."

It's
 also a good idea to speak to human resources representatives at both 
parents' jobs. The birth of a baby is considered "a qualifying event" 
for insurance coverage in all group health plans, so families can make 
decisions about changing coverage at that time. Otherwise, families 
might have to wait for open enrollment to make coverage changes.

"It
 is ridiculous to me my wife and I faced so many issues since both 
parents have health insurance," Mikkel Kjelshus says. His daughter, 
Charlie, now is covered only by his wife's plan.

Bill of the 
Month is a crowdsourced investigation by KHN and NPR that dissects and 
explains medical bills. Do you have an interesting medical bill you want
 to share with us? Tell us about it!

<figure>
 <img src="https://media.eaglewebservices.com/public/2021/1/1611856961625.png" alt="Mikkel and Kayla Kjelshus' daughter, Charlie, had a complication during delivery that caused her oxygen levels to drop and put her at risk for brain damage. Charlie needed seven days of neonatal intensive care, which resulted in a huge bill — $207,455 for the NICU alone — and confusion over which parent's insurer would cover the little girl's health costs. Christopher Smith / Kaiser Health News " />
 <figcaption>Mikkel and Kayla Kjelshus' daughter, Charlie, had a complication during delivery that caused her oxygen levels to drop and put her at risk for brain damage. Charlie needed seven days of neonatal intensive care, which resulted in a huge bill — $207,455 for the NICU alone — and confusion over which parent's insurer would cover the little girl's health costs. Christopher Smith / Kaiser Health News </figcaption>
 </figure>By CARA ANTHONY <a href="https://www.kcur.org/health/2021-01-28/birthday-rule-blindsides-first-time-olathe-parents-with-a-mammoth-medical-bill">Kaiser Health News</a>In the nine months leading up to her due date, Kayla Kjelshus and her
 husband, Mikkel, meticulously planned for their daughter's arrival.Their
 long to-do list included mapping out their family's health insurance 
plan and registering for baby gear and supplies. They even nailed down 
child care ahead of her birth."We put a deposit down to hold a spot at a local day care following our first ultrasound," says Kayla Kjelshus, of Olathe, Kan.The
 first-time parents felt ready for their daughter's debut on Feb. 15, 
2019. But one of the happiest days of their lives turned out to be one 
of the scariest. Their daughter, Charlie, had a complication during 
delivery that caused her oxygen levels to drop and put her at risk for 
brain damage."We had a waiting room filled with family and 
friends," Mikkel recalls. "To come out and say things aren't well ... it
 was really hard."Charlie was transferred from Saint Luke's 
Community Hospital to HCA Overland Park Regional Medical Center, where 
she received treatment in the neonatal intensive care unit, known as the
 NICU, for the next seven days.Doctors sent Charlie home with a 
positive prognosis. The couple had decided that Kayla, a nurse 
practitioner, would carry Charlie on her insurance plan through Blue 
Cross and Blue Shield of Kansas City. Her plan offered better rates than
 Mikkel's, and his plan was based in another state and carried a higher 
deductible. So when the hospital asked for insurance information, Kayla 
provided her policy number — Mikkel did not.They expected things to work out fine between the insurance company and the hospitals.Then the bills came.<figure>
 <img src="https://media.eaglewebservices.com/public/2021/1/1611857026650.png" alt="For Charlie Kjelshus, “the birthday rule” meant that dad Mikkel’s plan ― with a $12,000 deductible, a high coinsurance obligation and a network focused in another state ― was deemed her primary coverage after her NICU stay as a newborn. Mom Kayla’s more generous plan was considered secondary coverage." />
 <figcaption>For Charlie Kjelshus, “the birthday rule” meant that dad Mikkel’s plan ― with a $12,000 deductible, a high coinsurance obligation and a network focused in another state ― was deemed her primary coverage after her NICU stay as a newborn. Mom Kayla’s more generous plan was considered secondary coverage.</figcaption>
 </figure>The Patient: Charlie Kjelshus, an infant covered by her 
mother's plan through Blue Cross and Blue Shield of Kansas City and, 
eventually, her father's plan, CommunityCare of OklahomaMedical Service: <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3743149/" target="_blank">Whole body cooling</a> and other treatment in the NICU to prevent brain injury that may result from oxygen deprivation during birthService Provider: HCA Overland Park Regional Medical Center in Overland Park, Kan.Total Bill: Multiple charges totaling $270,951, according to Mikkel Kjelshus, including a charge of $207,455 for the NICU stayWhat Gives:
 Kayla Kjelshus filed a claim with Blue KC, and the insurer started 
paying for baby Charlie's care. But then it canceled payments to the HCA
 Overland Park hospital, St. Luke's Community Hospital and Charlie's 
neurologist, pediatrician and other physicians."We thought, 'This is crazy,'" Mikkel says. "'We have insurance.'"What was going on?The
 Kjelshus family had slammed into something well known among insurance 
experts but little understood by the general public. "Coordination of 
benefits" and "the birthday rule" are the jargon terms for the red tape 
that snared them.When a child is born into a family in which both
 parents have insurance through their jobs, the parents are supposed to 
"coordinate benefits'' — meaning they must tell both insurers that their
 child is eligible for coverage under two plans. The parents might be 
forgiven for thinking they have some say in how their child will be 
insured. In most cases, they don't.Instead, a child with double 
health insurance eligibility must take as primary coverage the plan of 
the parent whose birthday comes first in the calendar year; the other 
parent's insurance is considered secondary. This model regulation was 
set by the National Association of Insurance Commissioners and adopted 
by most states, including Kansas, says Lee Modesitt, director of 
government affairs with the Kansas Insurance Department.For 
Charlie Kjelshus, the birthday rule meant her dad's plan — with a 
$12,000 deductible, high coinsurance obligation and a network focused in
 a different state — was primary. Her mom's more generous plan was 
secondary.Mom Kayla says Blue KC dispatched an investigator to 
discover that dad Mikkel had insurance through his job. The family had 
not been trying to hide Mikkel's coverage; they merely weren't aware of 
the birthday rule and that they may be subject to state laws that ensure
 babies are covered <a href="http://www.kslegislature.org/li_2016/b2015_16/statute/040_000_0000_chapter/040_002_0000_article/040_002_0102_section/040_002_0102_k/" target="_blank">for the first 31 days of life</a>."If
 these are the rules of engagement, you need to tell people upfront that
 these are the rules," says Dr. Linda Burke, OB-GYN and author of The Smart Mother's Guide to a Better Pregnancy. "It's a communication problem."After
 Blue KC informed Mikkel that his insurance had to serve as primary 
coverage, CommunityCare of Oklahoma did pay Charlie's bills to the 
hospitals and other providers. It paid HCA Overland Park $16,605 on the 
$207,455 NICU charge. The insurer said its negotiated rate on the bill 
was $35,721. With Mikkel's deductible and coinsurance, that left the 
family on the hook for more than $19,116, it seemed."When an 
insurance company finds out that a baby is in the NICU, then it's a red 
flag," Burke says. "They are going to look for ways to cut their 
losses."Resolution: The couple turned to the Kansas 
Department of Insurance to file a complaint about the bill, but the 
department declined to help because Kayla's policy is self-funded by her
 employer, which means the company is subject to federal rather than 
state regulations.After close to a year and a half of going back 
and forth with their insurance companies and the hospitals, Blue KC paid
 $19,116 of the Kjelshuses' bill as a secondary insurer and said the 
Kjelshuses should not be responsible for what HCA Overland Park said was
 a remaining balance of $7,504.51. But the family kept getting bills.And, beginning in summer 2020, collections calls from the hospital rolled in daily, leaving the couple frustrated and confused.Eventually,
 after a human resources officer at Kayla's job stepped in to help, they
 received a statement with a zero balance. Their own calls to HCA 
Overland Park hospital billing department didn't get them anywhere."We always got a different answer," Kayla says. "It was so frustrating."A spokesperson for the hospital apologized for the deluge of calls from collections."We
 made an administrative error and an automated billing call system for 
payment occurred, causing the family undue frustration during an already
 stressful time, and we apologize," the hospital wrote in a statement. 
"Once the issue was identified and resolved, the insurance companies 
processed the claim and we informed the family that there is a zero 
balance on the account. Again, we are sorry for the stress and 
inconvenience, and wish them well."In a statement, Blue KC 
acknowledged that coordination of benefits can be confusing for members 
and that the company follows rules of state and federal regulators, 
modeled on standards set by the NAIC. It said that the Kjelshuses' 
future claims would continue to be paid and that a "dedicated service 
consultant" would continue to work with Kayla Kjelshus.In the 
end, the insurers and hospitals settled Charlie's bill as they were 
supposed to: The primary insurer paid first, and the secondary paid what
 had not been covered by the first. But it took more than a year of 
phone calls, appeals and complaints before the Kjelshus family had the 
matter settled. Charlie turns 2 next month.<figure>
 <img src="https://media.eaglewebservices.com/public/2021/1/1611857078503.png" alt="First-time parents Mikkel and Kayla Kjelshus felt ready for their daughter’s debut on Feb. 15, 2019, but they weren’t ready for a scary complication that landed daughter Charlie in the NICU for her first seven days of life ― nor were they ready for the red tape surrounding “the birthday rule,” designating which parent’s insurance would cover the hefty bill." />
 <figcaption>First-time parents Mikkel and Kayla Kjelshus felt ready for their daughter’s debut on Feb. 15, 2019, but they weren’t ready for a scary complication that landed daughter Charlie in the NICU for her first seven days of life ― nor were they ready for the red tape surrounding “the birthday rule,” designating which parent’s insurance would cover the hefty bill.</figcaption>
 </figure>The Takeaway: In theory, "the birthday rule" would be a fair, 
if random, way to figure out which insurance should be primary and which
 secondary for families with insurance from two employers. The 
presumption is that the premiums, deductibles and networks are roughly 
similar in both parents' insurance plans — but that's simply not the 
case for many families.The Kjelshuses found out the hard way they
 didn't have a choice about which parent's insurance was primary. They 
might have avoided their quagmire if Mikkel had dropped his own coverage
 and gotten onto Kayla's plan before Charlie was born.It's not 
clear whose responsibility it is to help families navigate these rules 
before a baby is born. It's even more complicated for parents <a href="https://selecthealth.org/-/media/selecthealth82/pdf-documents/fehb-plan-documents/2017-naic-and-coordination-of-benefits.ashx" target="_blank">who are divorced or never married</a>. Insurance companies don't always offer the critical information families need about the coordination of benefits."Expecting
 parents should try to get in touch with their health plan before the 
baby is born to find out about the coverage rules," says Karen Pollitz, a
 senior fellow at KFF, the Kaiser Family Foundation. (KHN is an 
editorially independent program of KFF.)New parents should "also figure out if they want to switch the entire family onto one plan once the baby is born."It's
 also a good idea to speak to human resources representatives at both 
parents' jobs. The birth of a baby is considered "a qualifying event" 
for insurance coverage in all group health plans, so families can make 
decisions about changing coverage at that time. Otherwise, families 
might have to wait for open enrollment to make coverage changes."It
 is ridiculous to me my wife and I faced so many issues since both 
parents have health insurance," Mikkel Kjelshus says. His daughter, 
Charlie, now is covered only by his wife's plan.Bill of the 
Month is a crowdsourced investigation by KHN and NPR that dissects and 
explains medical bills. Do you have an interesting medical bill you want
 to share with us? Tell us about it!

'Birthday rule' blindsides Kan. parents with mammoth medical bill

MISSION, Kan. (AP) — A long line of seniors, some clutching walkers, waited in the cold this week when Kansas’ largest county began vaccinating its oldest residents against the coronavirus.

Johnson County, which blamed the long-wait mishap in part on people showing up without appointments, isn’t alone in struggling with demand as the state moved beyond vaccinating health care workers and long-term residents. Health officials and hospitals are being deluged with calls, and appointment slots are filling up in minutes.

“We are pleased to see the enthusiasm and the interest in vaccines,” County Manager Penny Ferguson said in apologizing for the logistical problems that occurred Tuesday. The situation improved later in the week.

The challenge is that the second phase is massive, including about one-third of the state’s 2.9 million residents. It prioritizes those 65 and older, essential workers including teachers and police officers, and those living in communal settings such as prisons and homeless shelters.

Health officials say there isn’t enough vaccine to immunize everyone in the second phase quickly. And messaging is tricky because the state is allowing individual counties to decide who goes first within that phase.

As of Friday, just 5.8% of the state’s population, or nearly 168,341 people, had been vaccinated, state health officials said.

“I think one of the things that has happened is it is so confusing to people about where to go to get vaccination because of probably a lack of transparency and good communication,” Dr. Steve Stites, the chief medical officer at the University of Kansas Health System, said during a webcast. “People are so frustrated because they want the vaccine right now.”

He said his own health system found itself with leftover doses after vaccinating its employees because some of them didn’t want to be immunized yet. The health system then provided some of the unused vaccines to nearby health departments but still had 2,000 or 3,000 doses left. It turned to its own patients who were 65 and older and prioritized them based on a random number generator.

“But what that did is it made 2,000 or 3,000 people super happy and like 100,000 people really mad,” he said. “And it’s not that it’s a bad attempt. The problem isn’t that we don’t want to give it. The problem is we do not have it to give it.”

As vaccine supply runs low, the state on Friday reported its smallest increase since Oct. 23, adding 2,168 cases over two days to increase its pandemic total to 274,685. In November, state health officials were routinely reporting about three times that number of cases in a two-day span. The state also reported 61 more COVID-19 deaths since Wednesday, pushing the state’s death toll to 3,779.

In the Lawrence area, health officials sent out text alerts to 1,300 randomly selected people who were 65 and older, inviting them to a drive-thru clinic. Issues surfaced when more than 300 additional people showed up at Lawrence Memorial hospital, many of them spouses and elderly parents of the people who received the invitations.

The hospital, which offered the drive-thru clinic service from Tuesday through Friday this week, worked with the county to obtain more doses so it wouldn’t have to turn away anyone who was qualified.

Hospital spokeswoman Rebecca Smith said the situation illustrates the demand, noting that she receives hundreds of phone calls and emails daily from people inquiring about how they can get vaccinated.

“When you look at the community, there is an incredible and intense desire to be vaccinated as soon as possible, and that is amazing. That is a community that knows and understands the importance of the public health initiative,” Smith said. “And our goal is to ensure that as soon as vaccines are available that we can get them into arms as quickly as possible because that’s what our patients want. That’s what our community wants.”

But she added: “It depends entirely on our ability to get vaccine. We can vaccinate 750 people a day or zero. It depends. Do we have vaccines in hand?”

<figure>
 <img src="https://media.eaglewebservices.com/public/2021/1/1611962954922.png" alt="Traffic backed up in Lawrence Friday as residents wait for vaccinations-photo Douglas Co. Sheriff" />
 <figcaption>Traffic backed up in Lawrence Friday as residents wait for vaccinations-photo Douglas Co. Sheriff</figcaption>
 </figure>MISSION, Kan. (AP) — A long line of seniors, some clutching walkers, waited in the cold this week when Kansas’ largest county began vaccinating its oldest residents against the coronavirus.Johnson County, which blamed the long-wait mishap in part on people showing up without appointments, isn’t alone in struggling with demand as the state moved beyond vaccinating health care workers and long-term residents. Health officials and hospitals are being deluged with calls, and appointment slots are filling up in minutes.“We are pleased to see the enthusiasm and the interest in vaccines,” County Manager Penny Ferguson said in apologizing for the logistical problems that occurred Tuesday. The situation improved later in the week.The challenge is that the second phase is massive, including about one-third of the state’s 2.9 million residents. It prioritizes those 65 and older, essential workers including teachers and police officers, and those living in communal settings such as prisons and homeless shelters.Health officials say there isn’t enough vaccine to immunize everyone in the second phase quickly. And messaging is tricky because the state is allowing individual counties to decide who goes first within that phase.As of Friday, just 5.8% of the state’s population, or nearly 168,341 people, had been vaccinated, state health officials said.“I think one of the things that has happened is it is so confusing to people about where to go to get vaccination because of probably a lack of transparency and good communication,” Dr. Steve Stites, the chief medical officer at the University of Kansas Health System, said during a webcast. “People are so frustrated because they want the vaccine right now.”He said his own health system found itself with leftover doses after vaccinating its employees because some of them didn’t want to be immunized yet. The health system then provided some of the unused vaccines to nearby health departments but still had 2,000 or 3,000 doses left. It turned to its own patients who were 65 and older and prioritized them based on a random number generator.“But what that did is it made 2,000 or 3,000 people super happy and like 100,000 people really mad,” he said. “And it’s not that it’s a bad attempt. The problem isn’t that we don’t want to give it. The problem is we do not have it to give it.”As vaccine supply runs low, the state on Friday reported its smallest increase since Oct. 23, adding 2,168 cases over two days to increase its pandemic total to 274,685. In November, state health officials were routinely reporting about three times that number of cases in a two-day span. The state also reported 61 more COVID-19 deaths since Wednesday, pushing the state’s death toll to 3,779.In the Lawrence area, health officials sent out text alerts to 1,300 randomly selected people who were 65 and older, inviting them to a drive-thru clinic. Issues surfaced when more than 300 additional people showed up at Lawrence Memorial hospital, many of them spouses and elderly parents of the people who received the invitations.The hospital, which offered the drive-thru clinic service from Tuesday through Friday this week, worked with the county to obtain more doses so it wouldn’t have to turn away anyone who was qualified.Hospital spokeswoman Rebecca Smith said the situation illustrates the demand, noting that she receives hundreds of phone calls and emails daily from people inquiring about how they can get vaccinated.“When you look at the community, there is an incredible and intense desire to be vaccinated as soon as possible, and that is amazing. That is a community that knows and understands the importance of the public health initiative,” Smith said. “And our goal is to ensure that as soon as vaccines are available that we can get them into arms as quickly as possible because that’s what our patients want. That’s what our community wants.”But she added: “It depends entirely on our ability to get vaccine. We can vaccinate 750 people a day or zero. It depends. Do we have vaccines in hand?”

Frustration, lines common as Kan. expands vaccine rollout

KANSAS CITY (AP) —Irritated by the sweeping use of executive orders during the COVID-19 crisis, state lawmakers around the U.S. are moving to curb the authority of governors and top health officials to impose emergency restrictions such as mask rules and business shutdowns.

The push is underway in such states as Kansas, Arizona, Michigan, Ohio, Maryland, Kentucky, Indiana and Pennsylvania, where legislators are seeking a constitutional amendment to strip the governor of many of his emergency powers.

Pennsylvania Republican Sen. Wayne Langerholc said the amendment would "make it unequivocally clear that our General Assembly is a co-equal branch ... that we are not a monarchy and that our voices matter.”

Democratic Gov. Tom Wolf and some of his counterparts around the country have argued that they need authority to act quickly and decisively against the fast-changing threat.

The coronavirus has killed an estimated 430,000 Americans and is going through its most lethal phase yet, despite the rollout of vaccines, with new and more contagious variants from abroad turning up in the U.S.

State legislatures generally took on lesser roles after the pandemic hit, with many suspending work or adjourning. It has been governors or their top health officials who have set many of the policies — imposing mask mandates, limiting public gatherings and shutting down dine-in restaurants, gyms, hair salons and other businesses.

Lawmakers in more than half the states have filed bills this year to limit gubernatorial powers during the pandemic and other emergencies, according to the National Conference of State Legislatures. Most legislatures began their sessions this month.

Kentucky’s Republican-led Legislature could consider as soon as next week whether to override Democratic Gov. Andy Beshear’s vetoes of several bills that would rein in his emergency powers.

Wisconsin’s GOP-controlled Assembly was expected to vote Thursday on a measure repealing Democratic Gov. Tony Evers’ statewide mask mandate.

Wisconsin Republicans have argued that Evers exceeded his authority by issuing multiple emergency declarations during the pandemic, which enabled him to extend the mask mandate beyond the 60 days allowed under the law without getting the Legislature’s approval.

Evers contends that the changing nature of the pandemic warranted new emergency declarations.

The amendment Pennsylvania Republicans are seeking to place on the May ballot also would put a cap on the governor's disaster declarations — 21 days, unless lawmakers vote to extend them. The Legislature also could halt them at any time with a two-thirds vote.

Wolf has said that prematurely ending his disaster declaration would itself be “disastrous” for the state and that requiring repeated legislative approval “could slow down or halt emergency response when aid is most needed.”

In Michigan, House Republicans have threatened to withhold billions of dollars for schools unless Democratic Gov. Gretchen Whitmer cedes her administration’s power to prohibit in-person instruction and sports to local health departments. Whitmer was the target of an alleged kidnapping plot last fall by anti-government extremists upset over her coronavirus restrictions.

Though legislative resistance to executive coronavirus orders has fallen largely along partisan lines in some states, lawmakers elsewhere are pushing back against governors of their own parties.

Republicans in the Arizona Senate want to end the broad emergency powers that GOP Gov. Doug Ducey has used to limit large gatherings and business capacities.

Ohio Sen. Rob McColley introduced a bill this week that could rescind emergency health orders issued by Gov. Mike DeWine, a fellow Republican. It would create a committee to retroactively review them. DeWine vetoed a similar bill last year.

McColley said the Legislature needs to take action “when the relatively unfettered power of the executive branch during a time of emergency has lasted as long as it has.”

In Indiana, Republican Gov. Eric Holcomb’s executive orders have also stirred opposition from his own party. GOP-sponsored legislation would require lawmakers to be called into session to extend a governor’s emergency order beyond 60 days.

South Carolina Gov. Henry McMaster is supporting legislation that would give lawmakers greater opportunity to pass judgment on his emergency declarations.

Under current law, McMaster can issue a declaration for just 15 days before the General Assembly has to weigh in. The Republican governor has skirted that by issuing 22 different declarations, with incremental changes, every two weeks or so.

McMaster has said his goal wasn’t to avoid legislative oversight; he said he couldn’t wait for lawmakers to meet when they were trying to stay apart during the pandemic.

Democrats who control the Maryland General Assembly are pressing for more transparency from Republican Gov. Larry Hogan’s administration. One idea would require him to go through a state board or alert a legislative panel before making emergency coronavirus purchases.

Hogan spent millions of dollars last year on a confidential deal to acquire COVID-19 testing supplies from South Korea that didn’t initially meet federal requirements.

A separate GOP-sponsored bill seeks to limit Hogan’s power by capping the number of times he could extend a state of emergency without legislative input. Hogan has denounced it as “about probably the dumbest thing I’ve ever heard in my life.”

Lawmakers are also seeking to rein in the emergency powers of local officials, especially in states such as Missouri, where the Republican governor has deferred most decisions on shutdowns and masks to cities and counties.

St. Louis County, the state's biggest jurisdiction, has imposed a variety of restrictions, including periodic prohibitions and capacity limits on indoor dining at restaurants.

Jeff Fitter, the owner of Super Smokers BBQ, said his profits were cut in half last year. He is supporting a bill that would limit local emergency health orders to 14 days unless authorized for longer by the Legislature. It also would give tax breaks to businesses affected by occupancy limits imposed by cities and counties.

“One person, one pen, shouldn’t be the difference between my business surviving or its demise," Fitter said. "That should be something that is ran through a legislative body.”

KANSAS CITY (AP) —Irritated by the sweeping use of executive orders during the COVID-19 crisis, state lawmakers around the U.S. are moving to curb the authority of governors and top health officials to impose emergency restrictions such as mask rules and business shutdowns.The push is underway in such states as Kansas, Arizona, Michigan, Ohio, Maryland, Kentucky, Indiana and Pennsylvania, where legislators are seeking a constitutional amendment to strip the governor of many of his emergency powers.Pennsylvania Republican Sen. Wayne Langerholc said the amendment would "make it unequivocally clear that our General Assembly is a co-equal branch ... that we are not a monarchy and that our voices matter.”Democratic Gov. Tom Wolf and some of his counterparts around the country have argued that they need authority to act quickly and decisively against the fast-changing threat.The coronavirus has killed an estimated 430,000 Americans and is going through its most lethal phase yet, despite the rollout of vaccines, with new and more contagious variants from abroad turning up in the U.S.State legislatures generally took on lesser roles after the pandemic hit, with many suspending work or adjourning. It has been governors or their top health officials who have set many of the policies — imposing mask mandates, limiting public gatherings and shutting down dine-in restaurants, gyms, hair salons and other businesses.Lawmakers in more than half the states have filed bills this year to limit gubernatorial powers during the pandemic and other emergencies, according to the National Conference of State Legislatures. Most legislatures began their sessions this month.Kentucky’s Republican-led Legislature could consider as soon as next week whether to override Democratic Gov. Andy Beshear’s vetoes of several bills that would rein in his emergency powers.Wisconsin’s GOP-controlled Assembly was expected to vote Thursday on a measure repealing Democratic Gov. Tony Evers’ statewide mask mandate.Wisconsin Republicans have argued that Evers exceeded his authority by issuing multiple emergency declarations during the pandemic, which enabled him to extend the mask mandate beyond the 60 days allowed under the law without getting the Legislature’s approval.Evers contends that the changing nature of the pandemic warranted new emergency declarations.The amendment Pennsylvania Republicans are seeking to place on the May ballot also would put a cap on the governor's disaster declarations — 21 days, unless lawmakers vote to extend them. The Legislature also could halt them at any time with a two-thirds vote.Wolf has said that prematurely ending his disaster declaration would itself be “disastrous” for the state and that requiring repeated legislative approval “could slow down or halt emergency response when aid is most needed.”In Michigan, House Republicans have threatened to withhold billions of dollars for schools unless Democratic Gov. Gretchen Whitmer cedes her administration’s power to prohibit in-person instruction and sports to local health departments. Whitmer was the target of an alleged kidnapping plot last fall by anti-government extremists upset over her coronavirus restrictions.Though legislative resistance to executive coronavirus orders has fallen largely along partisan lines in some states, lawmakers elsewhere are pushing back against governors of their own parties.Republicans in the Arizona Senate want to end the broad emergency powers that GOP Gov. Doug Ducey has used to limit large gatherings and business capacities.Ohio Sen. Rob McColley introduced a bill this week that could rescind emergency health orders issued by Gov. Mike DeWine, a fellow Republican. It would create a committee to retroactively review them. DeWine vetoed a similar bill last year.McColley said the Legislature needs to take action “when the relatively unfettered power of the executive branch during a time of emergency has lasted as long as it has.”In Indiana, Republican Gov. Eric Holcomb’s executive orders have also stirred opposition from his own party. GOP-sponsored legislation would require lawmakers to be called into session to extend a governor’s emergency order beyond 60 days.South Carolina Gov. Henry McMaster is supporting legislation that would give lawmakers greater opportunity to pass judgment on his emergency declarations.Under current law, McMaster can issue a declaration for just 15 days before the General Assembly has to weigh in. The Republican governor has skirted that by issuing 22 different declarations, with incremental changes, every two weeks or so.McMaster has said his goal wasn’t to avoid legislative oversight; he said he couldn’t wait for lawmakers to meet when they were trying to stay apart during the pandemic.Democrats who control the Maryland General Assembly are pressing for more transparency from Republican Gov. Larry Hogan’s administration. One idea would require him to go through a state board or alert a legislative panel before making emergency coronavirus purchases.Hogan spent millions of dollars last year on a confidential deal to acquire COVID-19 testing supplies from South Korea that didn’t initially meet federal requirements.A separate GOP-sponsored bill seeks to limit Hogan’s power by capping the number of times he could extend a state of emergency without legislative input. Hogan has denounced it as “about probably the dumbest thing I’ve ever heard in my life.”Lawmakers are also seeking to rein in the emergency powers of local officials, especially in states such as Missouri, where the Republican governor has deferred most decisions on shutdowns and masks to cities and counties.St. Louis County, the state's biggest jurisdiction, has imposed a variety of restrictions, including periodic prohibitions and capacity limits on indoor dining at restaurants.Jeff Fitter, the owner of Super Smokers BBQ, said his profits were cut in half last year. He is supporting a bill that would limit local emergency health orders to 14 days unless authorized for longer by the Legislature. It also would give tax breaks to businesses affected by occupancy limits imposed by cities and counties.“One person, one pen, shouldn’t be the difference between my business surviving or its demise," Fitter said. "That should be something that is ran through a legislative body.”___

State lawmakers push to curb governors' virus powers

KANSAS CITY, Mo. (AP) — The operator of a Kansas drug treatment clinic has been indicted in Kansas City, Missouri, on federal charges of drug trafficking.

Trevor Robinson, 44, was indicted Tuesday on one count each of possessing methamphetamine, cocaine, heroin, fentanyl and ecstasy, with the intent to distribute the drugs, federal prosecutors for western Missouri said in a news release Thursday.

Authorities said in the release that Robinson was the owner of Nuvista, an an opioid addiction clinic in Olathe. Robinson remained listed Friday as the manager on the clinic’s website. Neither he nor others at the clinic immediately returned a phone message left Friday seeking comment.

Prosecutors said the case got its start in October when Kansas City police stopped a 2014 Maserati driven by Robinson. During the stop, officers found 1.5 kilograms of methamphetamine, pills, plastic bags containing cocaine and heroin, a digital scale, more than $12,500 in cash and a leather-bound ledger notebook, prosecutors said.

<figure>
 <img src="https://media.eaglewebservices.com/public/2021/1/1611938886946.png" alt="Trevor Robinson photo Johnson Co." />
 <figcaption>Trevor Robinson photo Johnson Co.</figcaption>
 </figure>KANSAS CITY, Mo. (AP) — The operator of a Kansas drug treatment clinic has been indicted in Kansas City, Missouri, on federal charges of drug trafficking.Trevor Robinson, 44, was indicted Tuesday on one count each of possessing methamphetamine, cocaine, heroin, fentanyl and ecstasy, with the intent to distribute the drugs, federal prosecutors for western Missouri said in a news release Thursday.Authorities said in the release that Robinson was the owner of Nuvista, an an opioid addiction clinic in Olathe. Robinson remained listed Friday as the manager on the clinic’s website. Neither he nor others at the clinic immediately returned a phone message left Friday seeking comment.Prosecutors said the case got its start in October when Kansas City police stopped a 2014 Maserati driven by Robinson. During the stop, officers found 1.5 kilograms of methamphetamine, pills, plastic bags containing cocaine and heroin, a digital scale, more than $12,500 in cash and a leather-bound ledger notebook, prosecutors said.

Kansas treatment clinic owner accused of trafficking drugs

WASHINGTON (AP) — Security screeners confiscated guns at airport checkpoints at a record pace last year although the total number of guns dropped along with the steep plunge in travelers because of the pandemic.

The Transportation Security Administration said this week that screeners found 3,257 firearms on passengers or in their carry-on bags in 2020, or about 10 for every million travelers. About 83% of the guns were loaded.

The rate was double that in 2019, when screeners found 5 guns for every million passengers. However, with 500 million more travelers screened in 2019, TSA officers found a record 4,432 guns that year.

Screeners found 220 guns at Hartsfield-Jackson Atlanta International Airport, followed by 176 at Dallas/Fort Worth International Airport, 126 at George Bush Intercontinental Airport in Houston, 126 at Phoenix’s Sky Harbor International Airport, and 104 at Denver International Airport.

Federal law prohibits passengers other than certain law enforcement officers from bringing guns or ammunition into the cabin. Federal law allows passengers to put guns in checked bags that go into the cargo hold if they are unloaded and in a locked case.

Airlines don’t have to permit guns even in checked bags. All leading U.S. carriers temporarily banned guns in checked bags on flights to Washington, D.C.-area airports for a week after the Jan. 6 riot at the U.S. Capitol by supporters of former President Donald Trump. Those bans lapsed last weekend, three days after the inauguration of President Joe Biden.

&nbsp;Visit the TSA website for details on&nbsp;<a href="https://www.tsa.gov/travel/transporting-firearms-and-ammunition">how to properly travel with a firearm</a>.

WASHINGTON (AP) — Security screeners confiscated guns at airport checkpoints at a record pace last year although the total number of guns dropped along with the steep plunge in travelers because of the pandemic.<div><blockquote class="twitter-tweet"><a href="https://twitter.com/hashtag/TSAofficer?src=hash&amp;ref_src=twsrc%5Etfw">#TSAofficer</a> vigilance never stops. Despite reduced passenger volume, travelers continue to be stopped with firearms in their carry-on bag, like this one <a href="https://twitter.com/Reagan_Airport?ref_src=twsrc%5Etfw">@reagan_airport</a>. Remember, firearms are a <a href="https://twitter.com/hashtag/prohibiteditem?src=hash&amp;ref_src=twsrc%5Etfw">#prohibiteditem</a>. Learn more: <a href="https://t.co/s6SDKT4iO1">https://t.co/s6SDKT4iO1</a>. <a href="https://twitter.com/hashtag/NotOnOurWatch?src=hash&amp;ref_src=twsrc%5Etfw">#NotOnOurWatch</a> <a href="https://t.co/WuhKICseIL">pic.twitter.com/WuhKICseIL</a>&mdash; TSA (@TSA) <a href="https://twitter.com/TSA/status/1346489131942068224?ref_src=twsrc%5Etfw">January 5, 2021</a></blockquote> <script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script></div>The Transportation Security Administration said this week that screeners found 3,257 firearms on passengers or in their carry-on bags in 2020, or about 10 for every million travelers. About 83% of the guns were loaded.<figure>
 <img src="https://www.tsa.gov/sites/default/files/firearms-pr_0.png" alt="Firearms discovered at TSA checkpoints in 2020 (TSA Photo)​​​ " />
 <figcaption>Firearms discovered at TSA checkpoints in 2020 (TSA Photo)​​​ </figcaption>
 </figure>The rate was double that in 2019, when screeners found 5 guns for every million passengers. However, with 500 million more travelers screened in 2019, TSA officers found a record 4,432 guns that year.Screeners found 220 guns at Hartsfield-Jackson Atlanta International Airport, followed by 176 at Dallas/Fort Worth International Airport, 126 at George Bush Intercontinental Airport in Houston, 126 at Phoenix’s Sky Harbor International Airport, and 104 at Denver International Airport.Federal law prohibits passengers other than certain law enforcement officers from bringing guns or ammunition into the cabin. Federal law allows passengers to put guns in checked bags that go into the cargo hold if they are unloaded and in a locked case.Airlines don’t have to permit guns even in checked bags. All leading U.S. carriers temporarily banned guns in checked bags on flights to Washington, D.C.-area airports for a week after the Jan. 6 riot at the U.S. Capitol by supporters of former President Donald Trump. Those bans lapsed last weekend, three days after the inauguration of President Joe Biden.&nbsp;Visit the TSA website for details on&nbsp;<a href="https://www.tsa.gov/travel/transporting-firearms-and-ammunition">how to properly travel with a firearm</a>.

Report: Rate of guns seized at US airports doubled 

SHAWNEE COUNTY–Law enforcement authorities are investigating a Kansas woman on multiple charges after traffic accident in northeast Kansas.

Just after 3a.m. Friday,&nbsp;deputies were dispatched to the 8000 block of SW Topeka Boulevard on a report of an accident involving one vehicle, according to Deputy Abigail Christian.

Deputies located a maroon 2002 Hyundai Elantra in the west ditch. 

Following an investigation, deputies arrested the driver identified as Elise N. Shea, 30, of Prairie Village, and booked her into the Shawnee County Department of Corrections on requested charges of possession of methamphetamine, possession of drug paraphernalia, driving under the influence, interference with law enforcement, trafficking in contraband in a correctional institution, improper driving on laned roadway and transporting an open container, according to Christian.

<figure>
 <img src="https://media.eaglewebservices.com/public/2021/1/1611954311286.png" alt="Shea photo Shawnee County" />
 <figcaption>Shea photo Shawnee County</figcaption>
 </figure>SHAWNEE COUNTY–Law enforcement authorities are investigating a Kansas woman on multiple charges after traffic accident in northeast Kansas.Just after 3a.m. Friday,&nbsp;deputies were dispatched to the 8000 block of SW Topeka Boulevard on a report of an accident involving one vehicle, according to Deputy Abigail Christian.Deputies located a maroon 2002 Hyundai Elantra in the west ditch. Following an investigation, deputies arrested the driver identified as Elise N. Shea, 30, of Prairie Village, and booked her into the Shawnee County Department of Corrections on requested charges of possession of methamphetamine, possession of drug paraphernalia, driving under the influence, interference with law enforcement, trafficking in contraband in a correctional institution, improper driving on laned roadway and transporting an open container, according to Christian.

Deputies arrest Kan. woman after car lands in ditch

WASHINGTON — The Internal Revenue Service today posted updated FAQs about recent legislation that extended and amended tax relief to certain small- and mid-sized employers under the Families First Coronavirus Response Act (FFCRA). The FAQs are available at&nbsp;<a href="https://www.irs.gov/newsroom/covid-19-related-tax-credits-for-required-paid-leave-provided-by-small-and-midsize-businesses-faqs">COVID-19-Related Tax Credits for Required Paid Leave Provided by Small and Midsize Businesses FAQs</a>.

The updates to the FAQs cover how the COVID-related Tax Relief Act of 2020, enacted December 27, 2020, extends the availability of the tax credits created by the FFCRA to eligible employers for paid sick and family leave provided through March 31, 2021, as well as other amendments to the credits.

The paid sick and family leave credits, which previously were available only until the end of 2020, have been extended for periods of leave taken through March 31, 2021.

The paid sick leave credit is designed to allow qualified businesses – those with fewer than 500 employees and who pay "qualified sick leave wages" – to get a credit for wages or compensation paid to an employee who is unable to work (including telework) because of coronavirus quarantine or self-quarantine or has coronavirus symptoms and is seeking a medical diagnosis. Eligible employers may claim credit for paid sick leave provided to an employee for up to two weeks (up to 80 hours) at the employee's regular rate of pay up to $511 per day and $5,110 in total.

In addition, an eligible employer can receive the paid sick leave credit for employees who are unable to work due to caring for someone with coronavirus or caring for a child because the child's school or place of care is closed, or the paid childcare provider is unavailable due to the coronavirus. Eligible employers may claim the credit for paid sick leave provided to an employee for up to two weeks (up to 80 hours) at 2/3 the employee's regular rate of pay, or up to $200 per day and $2,000 in total.

Employers are also entitled to a paid family leave credit for paid family leave provided to an employee equal to 2/3 of the employee's regular pay, up to $200 per day and $10,000 in total. Up to 10 weeks of qualifying leave can be counted towards the family leave credit.

Eligible employers are entitled to immediately receive a credit in the full amount of the paid sick leave and family leave plus related health plan expenses and the employer's share of Medicare tax on the leave provided through March 31, 2021. The refundable credit is applied against certain employment taxes on wages paid to all employees.

Eligible employers may claim the credits on their federal employment tax returns (e.g., Form 941, Employer's Quarterly Federal Tax Return), but they can benefit more quickly from the credits by reducing their federal employment tax deposits. If there are insufficient federal employment taxes to cover the amount of the credits, an eligible employer may request an advance payment of the credits from the IRS by submitting a Form 7200, Advance Payment of Employer Credits Due to COVID-19.

IRSWASHINGTON — The Internal Revenue Service today posted updated FAQs about recent legislation that extended and amended tax relief to certain small- and mid-sized employers under the Families First Coronavirus Response Act (FFCRA). The FAQs are available at&nbsp;<a href="https://www.irs.gov/newsroom/covid-19-related-tax-credits-for-required-paid-leave-provided-by-small-and-midsize-businesses-faqs">COVID-19-Related Tax Credits for Required Paid Leave Provided by Small and Midsize Businesses FAQs</a>.The updates to the FAQs cover how the COVID-related Tax Relief Act of 2020, enacted December 27, 2020, extends the availability of the tax credits created by the FFCRA to eligible employers for paid sick and family leave provided through March 31, 2021, as well as other amendments to the credits.The paid sick and family leave credits, which previously were available only until the end of 2020, have been extended for periods of leave taken through March 31, 2021.The paid sick leave credit is designed to allow qualified businesses – those with fewer than 500 employees and who pay "qualified sick leave wages" – to get a credit for wages or compensation paid to an employee who is unable to work (including telework) because of coronavirus quarantine or self-quarantine or has coronavirus symptoms and is seeking a medical diagnosis. Eligible employers may claim credit for paid sick leave provided to an employee for up to two weeks (up to 80 hours) at the employee's regular rate of pay up to $511 per day and $5,110 in total.In addition, an eligible employer can receive the paid sick leave credit for employees who are unable to work due to caring for someone with coronavirus or caring for a child because the child's school or place of care is closed, or the paid childcare provider is unavailable due to the coronavirus. Eligible employers may claim the credit for paid sick leave provided to an employee for up to two weeks (up to 80 hours) at 2/3 the employee's regular rate of pay, or up to $200 per day and $2,000 in total.Employers are also entitled to a paid family leave credit for paid family leave provided to an employee equal to 2/3 of the employee's regular pay, up to $200 per day and $10,000 in total. Up to 10 weeks of qualifying leave can be counted towards the family leave credit.Eligible employers are entitled to immediately receive a credit in the full amount of the paid sick leave and family leave plus related health plan expenses and the employer's share of Medicare tax on the leave provided through March 31, 2021. The refundable credit is applied against certain employment taxes on wages paid to all employees.Eligible employers may claim the credits on their federal employment tax returns (e.g., Form 941, Employer's Quarterly Federal Tax Return), but they can benefit more quickly from the credits by reducing their federal employment tax deposits. If there are insufficient federal employment taxes to cover the amount of the credits, an eligible employer may request an advance payment of the credits from the IRS by submitting a Form 7200, Advance Payment of Employer Credits Due to COVID-19.

IRS updates FAQs on paid sick leave credit, family leave credit

OMAHA, Neb. (AP) — Nebraska has agreed to pay millions more to a&nbsp;<a href="https://apnews.com/article/salina-kansas-topeka-1b3b0e420e470e18a7dec207441ad8f7">troubled</a>&nbsp;Kansas-based foster care contractor that was rapidly&nbsp;<a href="https://apnews.com/article/kansas-omaha-nebraska-4081f394b3b66965af10a148643c188a">running out of money&nbsp;</a>after significantly underbidding the company that used to provide child welfare services in the Omaha area.

The total cost of the new 25-month contract with St. Francis Ministries totals more than $147 million.

St. Francis won the Nebraska job in 2019 by offering to do it for less than 60% of the bid from PromiseShip, the Omaha-based agency that held the previous contract.

At the time, PromiseShip executives and some state lawmakers questioned how St. Francis could provide care in Douglas and Sarpy Counties for that much less money. As it turned out, they couldn’t.

St. Francis said it was in the hole by nearly $35 million over the time it took over services from PromiseShip. State officials say it needs to continue working with St. Francis to ensure continuity of services for the children, families and caseworkers involved in the two counties’ foster care and child welfare system.

The yearly cost for services from St. Francis will now exceed what it would have cost if PromiseShip had been given a renewed contract.

<figure>
 <img src="https://media.eaglewebservices.com/public/2021/1/1611946908688.jpeg" alt="Photo by Sherman Smith/Kansas Reflector" />
 <figcaption>Photo by Sherman Smith/Kansas Reflector</figcaption>
 </figure>OMAHA, Neb. (AP) — Nebraska has agreed to pay millions more to a&nbsp;<a href="https://apnews.com/article/salina-kansas-topeka-1b3b0e420e470e18a7dec207441ad8f7">troubled</a>&nbsp;Kansas-based foster care contractor that was rapidly&nbsp;<a href="https://apnews.com/article/kansas-omaha-nebraska-4081f394b3b66965af10a148643c188a">running out of money&nbsp;</a>after significantly underbidding the company that used to provide child welfare services in the Omaha area.The total cost of the new 25-month contract with St. Francis Ministries totals more than $147 million.St. Francis won the Nebraska job in 2019 by offering to do it for less than 60% of the bid from PromiseShip, the Omaha-based agency that held the previous contract.At the time, PromiseShip executives and some state lawmakers questioned how St. Francis could provide care in Douglas and Sarpy Counties for that much less money. As it turned out, they couldn’t.St. Francis said it was in the hole by nearly $35 million over the time it took over services from PromiseShip. State officials say it needs to continue working with St. Francis to ensure continuity of services for the children, families and caseworkers involved in the two counties’ foster care and child welfare system.The yearly cost for services from St. Francis will now exceed what it would have cost if PromiseShip had been given a renewed contract.

Troubled Kansas foster care agency gets big boost from Nebraska

KANSAS CITY (AP) — A 29-year-old Kansas City man has been charged in the stabbing deaths of his aunt and uncle in Raytown, Jackson County Prosecutor Jean Peters Baker announced Friday.

Desmond C. Richardson, was charged with two counts each of first-degree murder and armed criminal action.

Raytown police were called to the home of Kenneth and Etta McKenzie on Jan. 13. Officers found a naked man inside suffering from several gunshot wounds and covered in blood.

Officers then found the McKenzies' bodies. Blood and multiple knives were found throughout the house. The victims several stab wounds, investigators said.

On Jan. 12, Richardson committed a carjacking in Kansas City, prosecutors said, and drove that car to his aunt's and uncle's home.

Prosecutors requested a bond of $500,000 cash.

<figure>
 <img src="https://media.eaglewebservices.com/public/2021/1/1611974206726.png" alt="Richardson-photo Jackson County" />
 <figcaption>Richardson-photo Jackson County</figcaption>
 </figure>KANSAS CITY (AP) — A 29-year-old Kansas City man has been charged in the stabbing deaths of his aunt and uncle in Raytown, Jackson County Prosecutor Jean Peters Baker announced Friday.Desmond C. Richardson, was charged with two counts each of first-degree murder and armed criminal action.Raytown police were called to the home of Kenneth and Etta McKenzie on Jan. 13. Officers found a naked man inside suffering from several gunshot wounds and covered in blood.Officers then found the McKenzies' bodies. Blood and multiple knives were found throughout the house. The victims several stab wounds, investigators said.On Jan. 12, Richardson committed a carjacking in Kansas City, prosecutors said, and drove that car to his aunt's and uncle's home.Prosecutors requested a bond of $500,000 cash.

Kansas City man charged in murder of his aunt and uncle

By NOMIN UJIYEDIIN <a href="https://www.kcur.org/news/2021-01-26/the-emotional-strain-of-the-pandemic-is-taking-its-toll-on-kansas-health-care-workers">Kansas News Service</a>

Sometimes, Becky Angell doesn’t even realize she’s started crying.

She’s
 been a nurse for seven years, and worked in an intensive care unit in 
Olathe for the past two. She loves her job and is used to seeing people 
die.

But the past months of caring for one desperately ill 
COVID-19 patient after another have left her overwhelmed and in tears at
 the dinner table and on the drive home from work.

“It’s this 
helpless, worthless feeling that you’re doing everything you can do and 
this patient is still not thriving,” Angell said. “It’s like endlessly 
treading water with no land in sight.”

As the <a href="https://www.kcur.org/news/2020-11-18/with-hospitals-reeling-kansas-gov-kelly-makes-second-push-to-tame-coronavirus-with-masks" target="_blank">pandemic’s worst months</a>
 have stretched on in Kansas, many people who treat coronavirus patients
 have continued to feel the strain. The stress of watching so many 
people die, the fear of bringing the virus home to loved ones and the 
frustration of seeing people without masks have left health care 
workers, a group that already struggles with mental health, frazzled and
 emotionally drained.

Angell has trouble sleeping and sometimes 
loses her train of thought during conversations. She’s considering 
asking her doctor for antidepressants. She used to relieve stress by 
hanging out with her friends and coworkers. Lately, they’ve talked on 
social media and through group chats, but it’s not the same.

Usually,
 patients in an ICU get better and move on to other units. But the 
coronavirus has changed that. Now, when Angell sees elderly, 
COVID-positive people enter her unit, she assumes they won’t leave 
alive.

She went through a two-day stretch where only one of
 her patients survived. Meanwhile, she still comes across people who 
don’t wear masks or believe in science, including one couple she treated
 who tested positive for COVID but still didn’t believe in the virus.

“You’re
 kind of like, ‘What am I busting my buns at work for to keep people 
alive, if they’re just going to keep going out and making silly choices 
that put everybody in danger?’” she said. “You just kind of feel like 
you’re screaming into the wind.”

The stress of seeing patients die
 is getting to Dr. Hazen Short, too. He’s a family medicine physician 
who works in Kansas City, Kansas, and moonlights as an emergency room 
doctor in south-central and southeastern Kansas. Usually, small, rural 
ER shifts are calmer than those in larger hospitals. But not during the 
pandemic. Short has seen a few patients die as soon as they come into 
the ER. He’s noticed fewer people in rural parts of Kansas wear masks, 
even though some of those areas have been hit hard by the virus. And 
he’s worried about bringing the virus home to his wife and child.

“The
 hardest thing is the days before the shift. Because I know I have to go
 and I don’t know what I’m going to see,” he said. “I get very anxious 
before my shifts start and then I have trouble unwinding after.”

Short has tried relaxation techniques, and is thinking of going to 
therapy for the first time. His anxiety feels like a buzzing in his 
chest and head that sometimes he can’t get rid of. It can be hard to 
stop thinking about the family members who are told about their loved 
ones’ deaths over the phone. Or thinking: what he could have done 
differently to save someone’s life?

“You think about the patients 
that were really sick, and then, ‘Well, maybe I could have started this 
antibiotic or done this test instead of that,’” he said. “It’s 
impossible to be perfect, and I understand that. But it’s something that
 most physicians go through.”

<figure>
 <img src="https://media.eaglewebservices.com/public/2021/1/1611758677381.png" alt="Months of constant patient deaths and people refusing to believe in the virus have worn out health care workers. Nomin Ujiyediin / Kansas News Service" />
 <figcaption>Months of constant patient deaths and people refusing to believe in the virus have worn out health care workers. Nomin Ujiyediin / Kansas News Service</figcaption>
 </figure>By NOMIN UJIYEDIIN <a href="https://www.kcur.org/news/2021-01-26/the-emotional-strain-of-the-pandemic-is-taking-its-toll-on-kansas-health-care-workers">Kansas News Service</a>Sometimes, Becky Angell doesn’t even realize she’s started crying.She’s
 been a nurse for seven years, and worked in an intensive care unit in 
Olathe for the past two. She loves her job and is used to seeing people 
die.But the past months of caring for one desperately ill 
COVID-19 patient after another have left her overwhelmed and in tears at
 the dinner table and on the drive home from work.“It’s this 
helpless, worthless feeling that you’re doing everything you can do and 
this patient is still not thriving,” Angell said. “It’s like endlessly 
treading water with no land in sight.”<figure>
 <img src="https://media.eaglewebservices.com/public/2021/1/1611758747763.png" alt="Olathe ICU nurse Becky Angell says she's had trouble sleeping during the pandemic. Courtesy photo" />
 <figcaption>Olathe ICU nurse Becky Angell says she's had trouble sleeping during the pandemic. Courtesy photo</figcaption>
 </figure>As the <a href="https://www.kcur.org/news/2020-11-18/with-hospitals-reeling-kansas-gov-kelly-makes-second-push-to-tame-coronavirus-with-masks" target="_blank">pandemic’s worst months</a>
 have stretched on in Kansas, many people who treat coronavirus patients
 have continued to feel the strain. The stress of watching so many 
people die, the fear of bringing the virus home to loved ones and the 
frustration of seeing people without masks have left health care 
workers, a group that already struggles with mental health, frazzled and
 emotionally drained.Angell has trouble sleeping and sometimes 
loses her train of thought during conversations. She’s considering 
asking her doctor for antidepressants. She used to relieve stress by 
hanging out with her friends and coworkers. Lately, they’ve talked on 
social media and through group chats, but it’s not the same.Usually,
 patients in an ICU get better and move on to other units. But the 
coronavirus has changed that. Now, when Angell sees elderly, 
COVID-positive people enter her unit, she assumes they won’t leave 
alive.She went through a two-day stretch where only one of
 her patients survived. Meanwhile, she still comes across people who 
don’t wear masks or believe in science, including one couple she treated
 who tested positive for COVID but still didn’t believe in the virus.“You’re
 kind of like, ‘What am I busting my buns at work for to keep people 
alive, if they’re just going to keep going out and making silly choices 
that put everybody in danger?’” she said. “You just kind of feel like 
you’re screaming into the wind.”The stress of seeing patients die
 is getting to Dr. Hazen Short, too. He’s a family medicine physician 
who works in Kansas City, Kansas, and moonlights as an emergency room 
doctor in south-central and southeastern Kansas. Usually, small, rural 
ER shifts are calmer than those in larger hospitals. But not during the 
pandemic. Short has seen a few patients die as soon as they come into 
the ER. He’s noticed fewer people in rural parts of Kansas wear masks, 
even though some of those areas have been hit hard by the virus. And 
he’s worried about bringing the virus home to his wife and child.“The
 hardest thing is the days before the shift. Because I know I have to go
 and I don’t know what I’m going to see,” he said. “I get very anxious 
before my shifts start and then I have trouble unwinding after.”<figure>
 <img src="https://media.eaglewebservices.com/public/2021/1/1611758783538.png" alt="Dr. Hazen Short works in emergency rooms in rural parts of Kansas, where he sees many people not wearing masks. Courtesy photo" />
 <figcaption>Dr. Hazen Short works in emergency rooms in rural parts of Kansas, where he sees many people not wearing masks. Courtesy photo</figcaption>
 </figure>Short has tried relaxation techniques, and is thinking of going to 
therapy for the first time. His anxiety feels like a buzzing in his 
chest and head that sometimes he can’t get rid of. It can be hard to 
stop thinking about the family members who are told about their loved 
ones’ deaths over the phone. Or thinking: what he could have done 
differently to save someone’s life?“You think about the patients 
that were really sick, and then, ‘Well, maybe I could have started this 
antibiotic or done this test instead of that,’” he said. “It’s 
impossible to be perfect, and I understand that. But it’s something that
 most physicians go through.”Physicians have long had <a href="https://psychiatryonline.org/doi/full/10.1176/appi.ajp-rj.2018.131101" target="_blank">worse mental health</a>
 than the general public, said Dr. Srijan Sen, a professor at the 
University of Michigan. High-pressure training, long hours and an 
increasing administrative workload have contributed to higher rates of 
depression, anxiety and suicide among doctors, even before the pandemic.<a href="https://1329574c-75a7-ab97-2a46-2b33890df3e6.filesusr.com/ugd/3fdf20_20ac720c01474568a62a9724ada86876.pdf" target="_blank">Research suggests</a> the pandemic has taken its toll, Sen said, especially now that early efforts to praise health care workers have faded.“Fatigue has set in,” Sen said. “We’re seeing probably worse mental health among physicians than we’ve ever seen before.”Health care workers often worry about a <a href="https://www.bmj.com/content/369/bmj.m1815.long" target="_blank">stigma</a> about getting mental health treatment, both feelings that they internalize and that they feel colleagues might harbor.“We
 care for others much more than we care for ourselves,” said Dr. Jessi 
Gold, a psychiatrist at Washington University in St. Louis who 
specializes in treating health care workers. “We don’t go get care 
because asking for help for that is a weakness.”Gold thinks that 
hospitals and other employers could combat that perception by 
automatically signing up all employees for counseling, and letting 
people cancel if they don’t need it. Employers could also offer grants 
to cover the costs of mental health treatment, she said. Custodians, 
social workers, respiratory therapists, administrative staff and others 
are exposed to COVID at work, but aren’t paid as highly as doctors and 
nurses. There’s also not as much research about those groups.“Health care workers come from a spectrum of financial backgrounds,” she said.The
 Midwest saw its surge in cases later than some other parts of the 
country, meaning that many health care workers in the region experienced
 the anxiety of anticipation before COVID hit, Gold said.Now that
 the virus has become so widespread, she’s worried the mental health 
system won’t be able to handle the flood of traumatized people likely to
 seek help after the pandemic is over.“It’s like, if there was a 
storm and everybody walked outside and surveyed the damage, and then 
after surveying the damage, they took a deep breath and looked at 
themselves — that’s what's going to happen,” she said. “And then we’re 
going to see a huge influx of people.”Nomin Ujiyediin reports 
on criminal justice and social welfare for the Kansas News Service. You 
can email her at nomin@kcur.org and follow her on Twitter <a href="https://twitter.com/nominuj" target="_blank">@NominUJ</a>.