TOPEKA, Kan. (AP) — A preliminary report says a small plane that crashed in suburban Chicago was nearly vertical to the ground when it went down, killing three Kansas physicians.

The National Transportation Safety Board report does not detail a cause of the Oct. 12 accident in the Chicago suburb of Palos Hills, Illinois. The crash killed Tausif Rehman and Ali Kanchwala, both physicians at Stormont-Vail HealthCare of Topeka, and Maria Javaid, a cardiologist at Providence Medical Center in Kansas City, Kansas.

The Topeka Capital-Journal reports the preliminary report says Rehman was piloting the twin-engine Beechcraft Baron when it took off from Midway Airport in Chicago bound for Lawrence, Kansas.

Weather conditions at the time included mist and overcast skies but the preliminary report doesn’t say whether that contributed to the crash.

 

TOPEKA, Kan. (AP) -€” Kansas Gov. Sam Brownback says he and top officials in his administration are asking the federal government to withdraw a new rule asserting regulatory authority over many of the nation’s streams and wetlands.

Brownback had a Statehouse news conference Thursday to announce that he and five members of his Cabinet are sending a letter to the U.S. Environmental Protection Agency’s administrator.

The Republican governor has made his opposition to the rule part of his re-election campaign ahead of the Nov. 4 election. He’s in a tough race with Democratic challenger Paul Davis.

The EPA contends the rule clarifies which waters are shielded from development under federal law.

But farm-state officials contend the rule would allow the federal government to dictate what farmers and others can do on their land.

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TOPEKA, Kan. (AP) — Gov. Sam Brownback is preparing to announce new efforts by Kansas to protest a new federal rule asserting regulatory authority over many of the nation’s streams and wetlands.

Brownback was having a Statehouse news conference Thursday to discuss the rule proposed by the U.S. Environmental Protection Agency.

The Republican governor has made his opposition to the rule part of his re-election campaign in rural areas ahead of the Nov. 4 election. He’s in a tough race with Democratic challenger Paul Davis.

The EPA contends the rule clarifies which waters are shielded from development under federal law.

But agriculture groups and farm-state officials like Brownback call the proposed rule a power grab that would allow the government to dictate what farmers can do on their own land.

TOM KRISHER, AP Auto Writer

DETROIT (AP) — Two U.S. senators are calling on U.S. auto safety regulators to immediately issue a nationwide recall for cars with faulty air bags made by Takata Corp.

WICHITA, Kan. (AP) — A survey finds that many Kansas contractors are having trouble filling skilled jobs in the construction industry.

The survey is by the Associated General Contractors and was released Wednesday. Ninety percent of the 20 Kansas firms that participated in the survey say they’re having a hard time finding project managers, engineers, welders, plumbers and carpenters.

An Associated General Contractors economist says Kansas isn’t the only state experiencing a shortage of people applying for construction jobs. He notes that other states like Texas and Louisiana are seeing fewer job applications too.

The Wichita Eagle reports the construction industry is seeing its skilled workforce age and retire. Many construction workers also have left the industry after being laid off in 2008 and 2009.

 

By Mike Sherry
Hale Center for Journalism
KANSAS CITY, Mo. — The disorder is so powerful that, even though the body is wasting away, patients in intensive care sometimes rip out feeding lines or hide the peanut butter provided by staff in their armpits.

Known as anorexia nervosa, the condition is a process of self-starvation – and, researchers say, the deadliest of all psychiatric disorders. Some estimates put the mortality rate at 20 percent.

Approximately 30 million Americans – two-thirds of them women – battle a clinically significant eating disorder during their lifetime, and hundreds of thousands of these people live in Missouri or Kansas, according to the National Association of Anorexia Nervosa and Associated Disorders.
In the most severe cases, a patient might drop to half of his or her optimal body weight.

Kansas City once had an inpatient clinic that handled the delicate re-feeding process for patients from both here and across the country. The clinic was unique among eating disorder clinics nationwide in accepting low-income individuals on Medicaid and people with disabilities on Medicare, according to former staff members.

In business for more than two decades, the 16-bed treatment center’s last home was a wing at Research Medical Center. It operated for many years under the name VITA, from the Latin word for “life.”

When it closed two years ago, clinic personnel turned to one of their co-workers, Mary Beth Blackwell, hoping she could convince another local hospital to reconstitute the clinic.

“This has been my pilgrimage since 2012,” Blackwell said.

It has been an arduous quest.

A spiral

For Sarah Wilcher of Kansas City, Mo., the road to eating disorder activism began a decade ago. It was then that her teenage daughter, Piper, confided to Sarah and her husband, Todd, that she could not stop the disorder’s characteristic cycle of binging and purging.

It was 1 o’clock in the morning and Piper was sobbing. The couple embraced their daughter, Sarah recalled, and they promised they would do whatever it took to help her.
But that was easier said than done. Her parents went from confidantes to combatants, clashing with Piper about her eating habits.

It was frightening, Sarah said, to feel just skin and bones when she rubbed her daughter’s shoulders.

Ever defiant, Piper moved out on her own at age 18. Beaten down by their experience, the Wilchers surrendered to the realization that the disease would likely claim their daughter’s life.

Piper has survived. But it took the suicide of an acquaintance to jolt her into recovery. That included overcoming alcoholism, which helped mask the anxiety and depression that contributed to her disorder.

Piper remains unsure about the cause of a disease that emerged as early as the fourth grade and later convinced her that eating a bowl of cereal would kill her.

“We didn’t realize how terrifying it was for our daughter to eat,” Sarah said.

Survey results released last year by the National Eating Disorder Association (NEDA) showed that:

• Approximately a third of the respondents who reported having eating disorders had been in treatment more than five years.

• Relapse rates among those with eating disorders were nearly 90 percent.

• Two-thirds of the respondents with an eating disorder reported other psychiatric conditions that concerned them, the most common being anxiety and depression.

Hard to solve

Like the Wilchers, Patty and Jim Fitzpatrick of Kansas City, Mo., have lived these grim statistics with their 26-year-old daughter Brooks, who has had an eating disorder since graduating from college.

Brooks, like Piper, has cycled in and out of various levels and types of treatment. She has tried programs in the Kansas City area and undergone extended stays at facilities in Denver and St. Louis. She also has made four treks to the Timberline Knolls Residential Treatment Center, just outside Chicago.
Back at home now with her parents, she’s working hard to stay on the path toward recovery that began with her treatment in St. Louis, which ended in August.

She says her eating disorder first emerged when she was in her late teens. She was able to cope with it through her early years in college, she said, but it became progressively worse and got especially bad as she faced the uncertainties of life after college.

Filled with anxiety and self-loathing, she said the disorder wormed its way into her psyche.

“It just takes over, and this shadow moves in,” she said, “and all of a sudden, you are in the dark.”

Beating the disorder, she said, requires constant vigilance.

“It’s not like you have healed from a surgery. It’s more like doing physical therapy every day,” Brooks said. “You have to stay on top of it because that voice in your head – it is pervasive. And the more my voice gets louder, like my own self comes out, the more muted the eating disorder is, but it still echoes sometimes. It’s a process. I mean, I still fight it every day.”

A lost battle

In May 2011, Emily Heim took her own life after battling anorexia and bulimia for seven years. She was 21 years old.

Emily’s mother, Suzi, remembers seeing Piper and Sarah Wilcher through the crowd at the visitation. They were clutching each other and weeping.

For Sarah, the experience was surreal. “It was like going to Piper’s funeral with Piper sitting right next to me,” she said. “It was like going to ‘This is Your Life,’ literally. It was horrible.”

Piper and Emily had known one another at Lee’s Summit High School, each aware of the other’s eating struggles, and Sarah had become friendly with Emily through a church support group.

Not long after the funeral, Piper entered the eating disorder clinic at Research Medical Center for a second time. She improved enough to take a second stab at Timberline Knolls, the facility outside Chicago.

Now 25, she lives with her fiancé and their 14-month-old son, Phineas, in Virginia, where her fiancé is attending law school. But she hasn’t forgotten what frightening condition she was in around the time of Emily Heim’s suicide.

“I just thought I was pretty much doomed if things didn’t change,” she said. “Things got really dark.”

Not perfect

Patty Fitzpatrick said she and her husband did not seek treatment for Brooks at VITA because the family didn’t hear much good about it.

Sarah Wilcher remembers being appalled at a presentation when Piper was in the Research clinic. She said the speaker, presented to the patients as someone who was recovering from an eating disorder, acknowledged to the group that she wasn’t doing well and perhaps should be admitted herself.

Some detractors also questioned the my-way-or-the-highway approach of a physician who once served as the medical director of the clinic and chronicled what they considered to be serious lapses of care among nursing staff.

For others, though, the clinic was a literal lifesaver.

Suzi Heim, for one, found it comforting to have an eating disorder clinic nearby when the family began seeking treatment for Emily. “We were scared to death,” she said, “and we didn’t have a clue.”

Whether Kansas City should reconstitute the clinic remains a matter of some debate.

Steven Sehr, the medical director for New Directions Behavioral Health in Kansas City, said the city could use more services, including partial hospitalization, which allows a patient to stay in a unit during the day but go home at night.

More programs here, he said, would make it easier on patients and families who now have to travel elsewhere.

But, he added, additional local resources might not be preferable to referring a patient to any of the nationally renowned facilities across the country. “I wouldn’t substitute the quality for the vicinity,” he said.

When one door closes

Research Medical Center is part of HCA Midwest Health, the region’s largest health care network, which includes 10 hospitals, outpatient centers, physician clinics and ambulatory surgery centers.

Asked about their decision to close the clinic at Research, system officials issued a statement saying that Research has “a 128-year commitment of providing high-quality, compassionate healthcare to patients in the Kansas City metropolitan area.”

The officials said the hospital regularly assesses the effectiveness of its programs and services, and it was one of those assessments that led to the decision to close the clinic.

“Although the program was once very robust,” the statement said, “patient volumes dropped and the inpatient program was no longer sustainable.”

The statement attributed the drop to the growth of outpatient options. It said the hospital would “continue to evaluate and assess healthcare services.”

Former staff members blame the drop in patient volume on hospital administrators’ decision to change the name of the clinic to the Midwest Center for Eating Disorders, causing confusion about whether the facility – prominently known as VITA – was still operating.

The former staffers also say intake suffered when administrators shifted management of the unit to Research’s psychiatric hospital, where they said staff was unprepared to handle inquiries.

Making the case

Blackwell, the woman who has been trying to get the clinic reopened, worked there as a part-time therapist in addition to her role as the director of the Eating Disorder Resource Center at Jewish Family Services of Greater Kansas City.

Former clinic personnel hoped that Blackwell could resurrect the clinic and perhaps become its program director.

With the assistance of her co-workers, she developed a business plan that included a chronology tracing the clinic’s founding to 1986 at Menorah Hospital.

According to the business plan, the unit served approximately 1,250 patients between 2005 and 2011. The average age of the patients was 27, and females made up more than 95 percent of the admissions.

The data from 2011 showed that the average body weight change for the sickest patients increased by 25 percent. The average discharge weight was 106 pounds.

About half the patients were from outside a 50-mile radius of the Kansas City area, according to data from 2004 to 2010, and about 94 percent had some type of insurance coverage. The average length of stay was 19.9 days.

Blackwell and her supporters project that, if re-established at another hospital, a 12-bed eating disorder clinic could generate approximately $7.7 million in annual revenue through insurance reimbursements and private payments. The estimate is based on full occupancy throughout the year and assumes all start-up costs have been paid.

They estimate staffing expenses would be about $1 million a year.

The potential net profit or loss is unclear, supporters said, because it would depend on other expenses – such as utilities and patient-care costs – that are unavailable to them and would vary by hospital.

A separate analysis based on setting up the clinic at Truman Medical Centers projects it would operate in the black, with an 11.1 percent net operating profit in the first year.

Blackwell said discussions about finding a new home for the clinic went the furthest with Truman, but the hospital said in a statement that it did not have the money to pay for the up-front capital costs.

“We plan to continue to pursue this idea,” the statement said, “but at this point, we do not have a funding source available to get it going.”

For Blackwell, it’s been an uphill battle. By this summer, she was forced to concede that, short of someone stepping forward with funding, her pursuit had all but petered out.

More dispiriting news followed: Two former patients, women in their 20s, died within weeks of each other in July.

Blackwell doesn’t know the cause of death in either case, though she heard both women were underweight and struggling with their eating disorders.

Their deaths led her to wonder what might have been.

“They were actually willing to ask for help. They came into our program multiple times to receive treatment,” she said. “And because that was taken away, was that a contributing factor in their deaths? That is what the frustration is more than anything: Were they were senseless deaths and could they have been avoided?”

 

Mike Sherry is a reporter for Heartland Health Monitor, a news collaboration focusing on health issues and their impact in Missouri and Kansas.