TOPEKA (AP) — A study has found that Kansas saves more money, on average, than any other state that uses federal grants to mitigate natural disasters.

The Pew Charitable Trusts recently released its data analysis showing that for every $1 of federal funds spent on protecting against flood and tornado damage, Kansas avoided $6.81 in potential recovery costs. Researchers drew from a previous study of federal disaster mitigation grants between 1993 and 2016.

The data shows Missouri trailed close behind, with each federal dollar saving $6.72, the Kansas News Service reported.

The findings come after Kansas saw heavy rain and flooding this spring, delaying wheat harvests. A May tornado near Pittsburg damaged buildings and toppled power lines and trees.

The mitigation programs in Kansas and Missouri only addressed threats of wind and flooding, but the projects had a large payback in the two states.

Federal programs typically have a match — typically 25% — that must be paid by the state or local government receiving the grant. Researchers found Kansas and the federal government spent roughly $220 million on wind and flood mitigation, which netted about $1.5 billion in savings.

“The mitigation projects that the Kansas Division of Emergency Management are able to support or implement are largely reliant on the federal grants,” said Bryan Murdie, director of the Planning and Mitigation Branch at the Kansas Division of Emergency Management.

California, which is prone to earthquakes and fires, ranked near the bottom of the list, with every dollar of mitigation saving $3.26.

Colin Foard, one of the study’s authors, said governments should find ways to fit mitigation costs into their budgets.

“The takeaway for policymakers really should be that investing in mitigation saves,” Foard said.

TOPEKA (AP) — A former Kansas legislator who also served on a federal parole board will represent the U.S. in meetings of a group that promotes peace in Ireland and Northern Ireland.

Former state Sen. Ed Reilly says he expects to attend meetings of the board of the International Fund for Ireland in November. He was appointed as a U.S. observer last month by President Donald Trump’s administration.

The 82-year-old Reilly is a Leavenworth native who now lives in the Washington area after serving as a member and chairman of the U.S. Parole Commission.

He served 29 years in the Kansas Legislature as a Republican. He was appointed to fill a vacancy in the House in 1964, won a Senate seat that year and served there until 1992.

Topeka zoo director Brenden Wiley told KSNT-TV that Kristyn Hayden-Ortega returned to work Tuesday.

She was seriously injured in the April 20 attack by a 7-year-old Sumatran tiger named Sanjiv.

The zoo released a lengthy report last month that said “multiple” protocols and procedures concerning spaces occupied by tigers had prevented any similar attack at the zoo for decades. Its report says protocol was not followed when the keeper entered the tiger’s outdoor habitat without ensuring that the animal was locked inside.

Other zoo employees lured the animal away with meat so emergency responders could treat Hayden-Ortega.

Cyanobacteria is toxic to livestock and other animals, says K-State veterinarian

MANHATTAN – The extreme heat that hailed the end of June in Kansas combined with the heavy runoff from rains earlier in the month put many of the state’s waterways at risk to a waterborne toxin that could impact livestock and other animals around the farm.

Kansas State University veterinary toxicologist Steve Ensley said that the incidence of blue-green algae in farm ponds “has become more frequent in the last 15-20 years,” creating headaches for farmers who rely on those ponds to keep livestock hydrated during the hot, summer months.

When blue-green algae blooms, it creates a toxin that can affect the liver or the nervous system of animals that drink affected water. Animals may recover from toxins that affect the liver, but when they ingest toxins affecting the nervous system, those animals often die – sometimes within hours of exposure.

“There is no antidote for this toxin,” Ensley said. “If we have animals that look sick, we’ll try to do supportive care. If the damage is to the liver, there are things we can do to treat animals to get them over the initial damage they may have.”

But, he adds, “neurotoxins are very acute, so typically they lead to sudden death. In the last two years in Kansas, I have had grazing animals that have died…horses, cattle, sheep, goats and even dogs that swim in the water and drink as they’re swimming through the pond.”

Blue-green algae can form in a pond or other waterway from runoff that carries nitrogen or phosphorus into the body of water. The algae grow and bloom as temperatures reach 75 degrees or higher.

Farmers and others should be on the lookout for a blue, green or even orange color in the water. The bacteria will often give the impression of paint in the water, or a growth mat, according to Ensley. Blue-green algae is a threat to surface water only; it does not affect ground water. Well water typically is not affected.

“If you see something different about your pond or surface water, you need to investigate it,” Ensley said. “You need to get a sample taken and send it in to be tested.”

The Kansas State University Veterinary Diagnostic Lab can test water samples for blue-green algae, but Ensley said farmers can also work through their local veterinarian or extension agent.

Until water is confirmed safe, Ensley said farmers should keep animals away from the pond, and look for other ways to provide water to the herd.

“It takes about two weeks from when we see a bloom for it to get rid of the toxin,” Ensley said. “That’s kind of the guideline. Get them off that water for two weeks and then we can re-evaluate.”

For the future, Ensley noted that farmers can lessen the risk of toxins forming in their ponds by installing “as much grass and buffer strips between crop fields and surface water as possible so that we can slow down the movement of nitrogen and phosphorus into that water.”

Some short-term solutions to prevent algae blooms include installing solar-powered aerators to keep water moving; or adding water-soluble dyes to the water, which block the amount of sunlight that can get to the pond.

For more information, talk with your local veterinarian or extension agent, or visit the K-State Veterinary Diagnostic Lab at www.ksvdl.org.

By SARAh JANE TRIBBLE
Kaiser Health News

One Monday in February, 65-year-old Karen Endicott-Coyan gripped the wheel of her black 2014 Ford Taurus with both hands as she made the hour-long drive from her farm near Fort Scott to Chanute. With a rare form of multiple myeloma, she requires weekly chemotherapy injections to keep the cancer at bay.

She made the trip in pain, having skipped her morphine for the day to be able to drive safely. Since she sometimes “gets the pukes” after treatment, she had her neighbor and friend Shirley Palmer, 76, come along to drive her back.

Continuity of care is crucial for cancer patients in the midst of treatment, which often requires frequent repeated outpatient visits. So when Mercy Hospital Fort Scott, the rural hospital in Endicott-Coyan’s hometown, was slated to close its doors at the end of 2018, hospital officials had arranged for its cancer clinic — called the “Unit of Hope” — to remain open.

Then “I got the email on Jan. 15,” said Reta Baker, the hospital’s CEO. It informed her that Cancer Center of Kansas, the contractor that operated and staffed the unit, had decided to shut it down too, just two weeks later.

“There are too many changes in that town” to keep the cancer center open, Yoosaf “Abe” Abraham, chief operating officer of the Cancer Center of Kansas, later told KHN. He added that patients would be “OK” because they could get treated at the center’s offices in Chanute and Parsons.

From Fort Scott, those facilities are 50 and 63 miles away, respectively.

For Endicott-Coyan and dozens of other cancer patients, the distance meant new challenges getting lifesaving treatment. “You have a flat tire, and there is nothing out here,” Endicott-Coyan said, waving her arm toward the open sky and the pastures dotted with black Angus and white-faced Hereford cattle on either side of the shoulderless, narrow highway she now must drive to get to her chemo appointment.

Nationwide, more than 100 rural hospitals have closed since 2010. In each case, a unique but familiar loss occurs. Residents, of course, lose health care services as wards are shut and doctors and nurses begin to move away.

But the ripple effect can be equally devastating. The economic vitality of a community takes a blow without the hospital’s high-paying jobs and it becomes more difficult for other industries to attract workers who want to live in a town with a hospital. Whatever remains is at risk of withering without the support of the stabilizing institution.

The 7,800 residents of Fort Scott are reeling from the loss of their 132-year-old community hospital that was closed at the end of December by Mercy, a St. Louis-based nonprofit health system. Founded on the frontier in the 19th century and rebuilt into a 69-bed modern facility in 2002, the hospital had outlived its use, with largely empty inpatient beds, the parent company said. For the next year, Kaiser Health News and NPR will track how its citizens fare after the closure in the hopes of answering pressing national questions: Do citizens in small communities like Fort Scott need a traditional hospital for their health needs? If not a hospital, what then?

When Wichita-based Cancer Center for Kansas closed its Fort Scott location, patients were told to travel to Parsons or Chanute to continue seeing their oncologist and receiving treatment. This map provides a look at what that meant in miles. 

Reta Baker, the hospital’s president who grew up on a farm south of Fort Scott, understood that the hospital’s closure was unavoidable. She scrambled to make sure basic health care needs would be met. Mercy agreed to keep the building open and lights on until 2021. And Baker recruited a federally qualified health center to take over four outpatient clinics, including one inside the hospital; former employees were bought out and continue to operate a rehabilitation center; and the nonprofit Ascension Via Christi Hospital in Pittsburg reopened the emergency department in February.

But cancer care in rural areas, which requires specialists and the purchase and storage of a range of oncology drugs, presents unique challenges.

Rural cancer patients typically spend 66% more time traveling each way to treatment than those who live in more urban areas, according to a recent national survey by ASCO, the American Society of Clinical Oncology. Dr. Monica Bertagnolli, a cattle rancher’s daughter who is now chair of ASCO’s board, called this a “tremendous burden.” Cancer care, she explained, is “not just one visit and you’re done.”

ASCO used federal data to find that while about 19% of Americans live in rural areas, only 7% of oncologists practice there.

People in rural America are more likely to die from cancer than those in the country’s metropolitan counties, according to a Centers for Disease Control and Prevention report in 2017. It found 180 cancer deaths per 100,000 people a year in rural counties, compared with 158 deaths per 100,000 in populous metropolitan counties.

The discrepancy is partly because habits like smoking are more common among rural residents, but the risk of dying goes beyond that, said Jane Henley, a CDC epidemiologist and lead author of the report. “We know geography can affect your risk factors, but we don’t expect it to affect mortality.”

From an office inside a former Mercy outpatient clinic, Fort Scott’s cancer support group, Care to Share, continues its efforts to meet some of the community’s needs — which in some ways have increased since the Unit of Hope closed. It provides Ensure nutritional supplements, gas vouchers and emotional support to cancer patients.

Lavetta Simmons, one of the support group’s founders, said she will have to raise more money to help people pay for gas so they can drive farther to treatments. Last year, in this impoverished corner of southeastern Kansas, Care to Share spent more than $17,000 providing gas money to area residents who had to travel to the Mercy hospital or farther away for care.

The group expects to spend more on gas this year, having spent nearly $6,000 during the first four months of 2019.

And the reserves of donated Ensure from Mercy are running out, so Simmons is reaching out to hospitals in nearby counties for help.

With Mercy Hospital Fort Scott closed, the likelihood of residents here dying from their cancer will grow, experts worry, because it’s that much harder to access specialists and treatments.

Krista Postai, who took over the Fort Scott hospital’s four primary care clinics, said it’s not unusual for her staff to “see someone walk in [with] end-stage cancer that they put off because they didn’t have money, they didn’t have insurance, or it’s just the way you are. … We wait too long here.”

‘If they can’t cure me, I’m done’

Art Terry, 71, a farmer and Vietnam veteran, was one of them. Doctors discovered Terry’s cancer after he broke a rib while baling hay. When they found a mass below his armpit, it was already late-stage breast cancer that had metastasized to his bones.

With his twice-weekly chemotherapy treatment available in the “Unit of Hope,” Terry spent hours there with his son and grandchildren telling stories and jokes as if they were in their own living room. The nurses began to feel like family, and Terry brought them fresh eggs from his farm.

“Dad couldn’t have better or more personalized care anywhere,” said his son, Dwight, bleary-eyed after a factory shift.

Terry knew it was difficult to find trustworthy cancer care. The shortage of cancer specialists in southeastern Kansas meant that many, including Mercy Hospital Fort Scott’s patients, counted on traveling oncologists to visit their communities once or twice a week.

Wichita-based Cancer Center of Kansas has nearly two dozen locations statewide. It began leasing space in Fort Scott’s hospital basement in the mid-2000s, the center’s Abraham said. The hospital provided the staff while the Cancer Center of Kansas paid rent and sent roving oncologists to drop in and treat patients.

At its closing, the Unit of Hope served nearly 200 patients, with about 40% of them on chemotherapy treatment.

When Art Terry was diagnosed, his son tried to talk to him about seeking treatment at the bigger hospitals and academic centers in Joplin, Mo., or the Kansas City area. The elder Terry wasn’t interested. “He’s like, ‘Nope,’” Dwight Terry recalled. “I’m going right there to Fort Scott. If they can’t cure me, I’m done. I’m not driving.’”

In the end, as the elder Terry struggled to stay alive, Dwight Terry said he would have driven his father the hour to Chanute for treatment. Gas — already a mounting expense as they traveled the 20 miles from the farm near tiny Prescott, Kan., to Fort Scott — would be even more costly. And the journey would be taxing for his father, who traveled so little over the course of his life that he had visited Kansas City only twice in the past 25 years.

As it turned out, the family never had to make a choice. Art Terry’s cancer advanced to his brain and killed him days before the hospital’s cancer unit closed.

What happens next?

As Endicott-Coyan and her friend Palmer drove to Chanute for treatment, they passed the time chatting about how the hospital’s closure is changing Fort Scott. “People started putting their houses up for sale,” Palmer said.

Like many in Fort Scott, they had both spent their days at the Fort Scott hospital. Endicott-Coyan worked in administration for more than 23 years; Palmer volunteered with the auxiliary for six years.

The hospital grew with the community. But as the town’s fortunes fell, it’s perhaps no surprise that the hospital couldn’t survive. But the intertwined history of Mercy and Fort Scott is also why its loss hit so many residents so hard.

Fort Scott began in 1842 when the U.S. government built a military fort to help with the nation’s westward expansion. Historians say Fort Scott was a boomtown in the years just after the Civil War, with its recorded population rising to more than 10,000 as the town competed with Kansas City to become the largest railroad center west of the Mississippi. The hospital was an integral part of the community after Sisters of Mercy nuns opened a 10-bed hospital in 1886 with a mission to serve the needy and poor. Baker, Mercy Hospital Fort Scott’s president, said the cancer center was an extension of that mission.

The Unit of Hope began operating out of the newest hospital building’s basement, which was “pretty cramped,” Baker said. As cancer treatments improved, it grew so rapidly that Mercy executives moved it to a spacious first-floor location that had previously been the business offices.

“Our whole purpose when we designed it was for it to be a place where somebody who was coming to have something unpleasant done could actually feel pampered and be in a nice environment,” Baker said.

The center, with its muted natural grays and browns, had windows overlooking the front parking lot and forested land beyond. Every patient could look out the windows or watch their personal television terminal, and each treatment chair had plenty of space for family members to pull up chairs.

When Endicott-Coyan and Palmer arrived at the Cancer Center of Kansas clinic in Chanute in February, things looked starkly different. Patients entered a small room through a rusted back door. Three brown infusion chairs sat on either side of the entry door and two television monitors were mounted high on the walls. A nurse checked Endicott-Coyan’s blood pressure and ushered her back to a private room to get a shot in her stomach. She was ready to leave about 15 minutes later.

The center’s Abraham said the Chanute facility is “good for patients for the time being” and not a “Taj Mahal” like Mercy’s Fort Scott hospital building, which he said was too expensive to maintain. Cancer Center of Kansas plans to open a clinic at a hospital in Girard, which is about 30 miles from Fort Scott, he said.

Some oncology doctors would say driving is not necessary. Indeed, a few health care systems across the country, such as Sanford Health in South Dakota and Thomas Jefferson University Hospitals in Pennsylvania, are administering some chemotherapy in patients’ homes. Oncologist Adam Binder, who practices at Thomas Jefferson in Philadelphia, said “over 50% of chemotherapy would be safe to administer in the home setting if the right infrastructure existed.”

But the infrastructure — that is, the nurses who would travel to treat patients and a reimbursement model to pay for such care within our complex health care system — is not yet in place.

Back in the car, Palmer took the wheel and Endicott-Coyan began planning for future cancer treatments in the void left by Mercy Hospital Fort Scott’s closure. “I put a note on Facebook today and said, ‘OK, I have drivers for the rest of February; I need drivers for March!’”

This is the first installment in KHN’s year-long series, No Mercy, which follows how the closure of one beloved rural hospital disrupts a community’s health care, economy and equilibrium.

Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation which is not affiliated with Kaiser Permanente.

The body of 56-year-old Floyd Wood’s body was discovered Monday night in the Kansas City suburb of Claycomo. Police haven’t said how he died.

He was a key witness in the first-degree murder case against 30-year-old Colton Stock. Court documents in that case say Wood fled in May after Stock assaulted and shot at him. The gunfire led police to Stock’s house, where officers saw a fire.

After firefighters extinguished the flames, police found the remains of Matthew Calkins of Gardner, Kansas.
Stock is jailed on $1 million bond. He’s entered a not guilty plea.