Gov. Laura Kelly’s decision to merge the Department of Children and Families into a new larger bureaucracy is nothing more than the government equivalent of rearranging the deck chairs on the Titanic, at the expense of Kansas’ most vulnerable.&nbsp;

The issues facing Kansas’ child welfare system are massive. These issues need dedicated leadership from a cabinet level official. They should not be placed into a larger agency that will encompass the entire scope of human services, and allow for less accountability. Rather than addressing the management issues facing DCF, Governor Kelly has chosen to participate in a rebranding exercise in the hopes of a “one stop shop.”&nbsp;

Governor, our vulnerable children need dedicated leadership and accountability, not the chance to wait to take a number to talk to someone at the “one-stop human services shop.”

We have seen too many reports of the failures of child welfare in our state. Lost children in foster care, children sleeping in offices, rising caseloads that are leading to burnout among social workers. These issues need dedicated leadership and management that will make the tough decisions and be accountable. Our Legislature is taking steps to address the child welfare crisis. Sadly, the Governor and her administration could not even consult lawmakers about this ill-advised plan, and even announced it days before legislators return to Topeka.

DCF should be a stand-alone agency. By being a stand-alone agency, the secretary and top leadership will be focused on one issue and one issue only, cleaning up our child welfare system. An independent DCF will provide more accountability, with the public and the Legislature being able to see the massive problems in child welfare and address them, not worry that they are hidden in the maze of a massive bureaucracy. If we are to ever truly help our most vulnerable children, we need to make sure there is accountability and sunshine.&nbsp;

Other states and cities that have had issues with child welfare have created stand-alone children’s agencies, in order to prevent the issues from being lost in the bureaucracy. These bipartisan leaders knew that our children need help and that we need to make sure that foster care is the pathway to a better life.

A new human services bureaucracy does not address the rising caseloads for social workers and the burnout for social workers statewide. In fact, a larger agency could even increase caseloads and burnout if we now have social workers addressing issues across the “one stop shop.”

Children’s issues are personal for me. My father was in the Wichita Children’s Home as a child. He was lucky, he grew up to lead a full and productive life. Every child in Kansas foster care deserves the same chance he had.

Whitney Houston once sang that the “children are our future” and that we should “give them a sense of pride to make it easier.” This is the spirit that should be guiding us. Our children are our future and they deserve no less than to not be treated as pieces on a bureaucratic chess board.&nbsp;

Wink Hartman is the CEO of the Hartman Group of Companies in Wichita and the 2018 Republican nominee for lieutenant governor.&nbsp;

<figure>
 <img src="https://media.eaglewebservices.com/public/2019/12/1576860566850.jpeg" alt="Wink Hartman is the CEO of the Hartman Group of Companies in Wichita and the 2018 Republican nominee for lieutenant governor.&nbsp;" />
 <figcaption>Wink Hartman is the CEO of the Hartman Group of Companies in Wichita and the 2018 Republican nominee for lieutenant governor.&nbsp;</figcaption>
 </figure>By WINK HARTMANGov. Laura Kelly’s decision to merge the Department of Children and Families into a new larger bureaucracy is nothing more than the government equivalent of rearranging the deck chairs on the Titanic, at the expense of Kansas’ most vulnerable.&nbsp;The issues facing Kansas’ child welfare system are massive. These issues need dedicated leadership from a cabinet level official. They should not be placed into a larger agency that will encompass the entire scope of human services, and allow for less accountability. Rather than addressing the management issues facing DCF, Governor Kelly has chosen to participate in a rebranding exercise in the hopes of a “one stop shop.”&nbsp;Governor, our vulnerable children need dedicated leadership and accountability, not the chance to wait to take a number to talk to someone at the “one-stop human services shop.”We have seen too many reports of the failures of child welfare in our state. Lost children in foster care, children sleeping in offices, rising caseloads that are leading to burnout among social workers. These issues need dedicated leadership and management that will make the tough decisions and be accountable. Our Legislature is taking steps to address the child welfare crisis. Sadly, the Governor and her administration could not even consult lawmakers about this ill-advised plan, and even announced it days before legislators return to Topeka.DCF should be a stand-alone agency. By being a stand-alone agency, the secretary and top leadership will be focused on one issue and one issue only, cleaning up our child welfare system. An independent DCF will provide more accountability, with the public and the Legislature being able to see the massive problems in child welfare and address them, not worry that they are hidden in the maze of a massive bureaucracy. If we are to ever truly help our most vulnerable children, we need to make sure there is accountability and sunshine.&nbsp;Other states and cities that have had issues with child welfare have created stand-alone children’s agencies, in order to prevent the issues from being lost in the bureaucracy. These bipartisan leaders knew that our children need help and that we need to make sure that foster care is the pathway to a better life.A new human services bureaucracy does not address the rising caseloads for social workers and the burnout for social workers statewide. In fact, a larger agency could even increase caseloads and burnout if we now have social workers addressing issues across the “one stop shop.”Children’s issues are personal for me. My father was in the Wichita Children’s Home as a child. He was lucky, he grew up to lead a full and productive life. Every child in Kansas foster care deserves the same chance he had.Whitney Houston once sang that the “children are our future” and that we should “give them a sense of pride to make it easier.” This is the spirit that should be guiding us. Our children are our future and they deserve no less than to not be treated as pieces on a bureaucratic chess board.&nbsp;Wink Hartman is the CEO of the Hartman Group of Companies in Wichita and the 2018 Republican nominee for lieutenant governor.&nbsp;

HARTMAN: Expanding bureaucracy in Kansas is not the answer

RAWLINS COUNTY —Two people were&nbsp; injured in an accident just after 3p.m. Sunday in Rawlins County.

The Kansas Highway Patrol reported a 2002 Chevy Cavalier driven by Timberly R. Solko, 14, Culbertson, NE., was&nbsp;turning left from County Road X onto County Road 34. 

The driver lost control of the vehicle. It traveled&nbsp; into the east ditch and rolled one time.

EMS transported Solko and a passenger Teather Solko, 14, Culbertson, NE., to the hospital in Atwood. The KHP did not have information on seat belt usage.

RAWLINS COUNTY —Two people were&nbsp; injured in an accident just after 3p.m. Sunday in Rawlins County.The Kansas Highway Patrol reported a 2002 Chevy Cavalier driven by Timberly R. Solko, 14, Culbertson, NE., was&nbsp;turning left from County Road X onto County Road 34. The driver lost control of the vehicle. It traveled&nbsp; into the east ditch and rolled one time.EMS transported Solko and a passenger Teather Solko, 14, Culbertson, NE., to the hospital in Atwood. The KHP did not have information on seat belt usage.

Two 14-year-olds hospitalized after car rolls in NW Kansas



Open to all USD 412 students, grades 7-12

Want to be your own boss now or in the future? Do you have an idea for a new product or service? Come learn about an exciting, educational competition -- Youth Entrepreneurship Challenge -- being offered this semester.

Find out more Monday, Jan. 13, 2:30 p.m.-2:45 p.m. in the Hoxie High School auditorium 1625 Queen Ave., Hoxie.

Plus, participate for your chance to win a cash award and be eligible to compete at the state competition in Manhattan!

Sponsored by the Sheridan County Community Foundation, USD 412 and NetWork Kansas.

Questions, contact Mr. Karl Pratt, Board Liaison with the Sheridan County Community Foundation at karlpratt.sccf@gmail.com or 785-675-1240.



<figure>
 <img src="https://media.eaglewebservices.com/public/2020/1/1578499226986.jpeg" alt="" />
 <figcaption></figcaption>
 </figure>

Open to all USD 412 students, grades 7-12Want to be your own boss now or in the future? Do you have an idea for a new product or service? Come learn about an exciting, educational competition -- Youth Entrepreneurship Challenge -- being offered this semester.Find out more Monday, Jan. 13, 2:30 p.m.-2:45 p.m. in the Hoxie High School auditorium 1625 Queen Ave., Hoxie.Plus, participate for your chance to win a cash award and be eligible to compete at the state competition in Manhattan!LOCAL EVENT CASH AWARDS1st Place: $5002nd Place: $3003rd Place: $100Sponsored by the Sheridan County Community Foundation, USD 412 and NetWork Kansas.Questions, contact Mr. Karl Pratt, Board Liaison with the Sheridan County Community Foundation at karlpratt.sccf@gmail.com or 785-675-1240.

- SUBMITTED -&nbsp;

Sheridan Co. students to compete in Youth Entrepreneurship Challenge

BUNKER HILL&nbsp;– The Jewell County Community Foundation has awarded Smoky Hills PBS with a grant for $500.

The foundation’s grant will provide books in the Winter, Spring, and Fall to those children enrolled in preschool at Rock Hills Elementary in Mankato, KS.&nbsp; The grant will also support children’s programming in Jewell County.

Larry Calvery, General Manager of Smoky Hills PBS stated, “At Smoky Hills PBS we are dedicated to educating the youth within our viewing area and we want to thank the Jewell County Community Foundation for partnering with us in this mission!&nbsp; The foundation makes it possible for the children of Jewell county to receive the tools they need for a great education!”

Since 2018, the <a href="http://jewellcountykansas.com/jewell-county-community-foundation-apply/">Jewell County Community Foundation</a> has built stronger communities and helped donors make a difference through charitable giving in Jewell County.&nbsp; Each year, the foundation distributes thousands of dollars back to our region through community grants.

Smoky Hills PBS serves 71 counties in central and western Kansas and has been named Kansas Association of Broadcasters Non-Metro Station of the Year.&nbsp; More information on Smoky Hills PBS and its programs and projects are available at&nbsp;<a href="http://www.smokyhillstv.org/" target="_blank">www.SmokyHillsPBS.org</a>&nbsp;or by calling&nbsp;800-337-4788.&nbsp;&nbsp;

SHPBSBUNKER HILL&nbsp;– The Jewell County Community Foundation has awarded Smoky Hills PBS with a grant for $500.The foundation’s grant will provide books in the Winter, Spring, and Fall to those children enrolled in preschool at Rock Hills Elementary in Mankato, KS.&nbsp; The grant will also support children’s programming in Jewell County.Larry Calvery, General Manager of Smoky Hills PBS stated, “At Smoky Hills PBS we are dedicated to educating the youth within our viewing area and we want to thank the Jewell County Community Foundation for partnering with us in this mission!&nbsp; The foundation makes it possible for the children of Jewell county to receive the tools they need for a great education!”Since 2018, the <a href="http://jewellcountykansas.com/jewell-county-community-foundation-apply/">Jewell County Community Foundation</a> has built stronger communities and helped donors make a difference through charitable giving in Jewell County.&nbsp; Each year, the foundation distributes thousands of dollars back to our region through community grants.Smoky Hills PBS serves 71 counties in central and western Kansas and has been named Kansas Association of Broadcasters Non-Metro Station of the Year.&nbsp; More information on Smoky Hills PBS and its programs and projects are available at&nbsp;<a href="http://www.smokyhillstv.org/" target="_blank">www.SmokyHillsPBS.org</a>&nbsp;or by calling&nbsp;800-337-4788.&nbsp;&nbsp;

Smoky Hills PBS receives grant from  Jewell County Community Foundation 

The
 Hays Police Department Special Situation Response Team will be 
conducting training between 3 and 7 p.m. Monday at 2701 Augusta Lane.

Police officers will be training with special tactical equipment. This training is being done with great care and safety.

As
 a home or business owner, you may see law enforcement officers move 
through your area. There is no need to be alarmed. The officers are 
merely conducting a realistic training exercise and there is no danger 
to the community.

If you have any questions or concerns, contact the on-site supervisor (Team Commander Tim Greenwood, or Chief&nbsp; Don Scheibler at 785-625-1030.

Hays PDThe
 Hays Police Department Special Situation Response Team will be 
conducting training between 3 and 7 p.m. Monday at 2701 Augusta Lane.Police officers will be training with special tactical equipment. This training is being done with great care and safety.As
 a home or business owner, you may see law enforcement officers move 
through your area. There is no need to be alarmed. The officers are 
merely conducting a realistic training exercise and there is no danger 
to the community.If you have any questions or concerns, contact the on-site supervisor (Team Commander Tim Greenwood, or Chief&nbsp; Don Scheibler at 785-625-1030.

Hays PD will have tactical training Monday

By CRISTINA JANNEY Hays Post

The United Way of Ellis County is only 77 percent to goal, and officials are concerned this will mean cuts for its partner agencies in 2020.

The agency has raised $309,ooo of its $400,000 goal.

Erica Berges, executive director, said the agency is close to where it was at this time last year. The agency raised about $350,000 and was propelled to its goal by a late donation by the Robert E. Schmidt Foundation.

The campaign is still waiting on donations from a few businesses, but a majority of businesses have made their pledges for the year, Berges said.

"We are making a final push with donors in the past who have not given this year," she said.&nbsp;

"We really want to get the word out that we are still in need. Our campaign is not done by any means. We still have some time left. We just need those last donations to help reach our goal."

The United Way hopes to wrap up donations by the end of January. This will enable its Care Council to have distributions to partner agencies by March.

The United Way supports 22 programs at 17 partner agencies:

"Obviously, the amount we give to agencies will have to be decreased," Berges said. "We try to keep that at a minimal amount. We try to cut every way possible from the United Way budget before we want to make that cut to the agencies.

"We know when donors give, they want the money to go to the agencies."

If United Way has to make cuts to partner agency funding, it will affect the people those agencies serve, Berges said.

"The people in need, unfortunately, that number does not decrease," she said. "It always seems to increase."

Berges said nationwide trends are resulting in the United Way seeing&nbsp; declines in donations. The baby boomer generation is retiring, and the workers who are replacing them are not donating at the same levels.

"I think the general landscape of how people give and why people give has changed," she said.

She said the style of giving has changed. More people are giving to nonprofits directly online or through GoFundMe campaigns. This is a change from older workers who gave through payroll contributions through their work, which has been a staple for United Way for years.

More young people are also volunteering and giving of their time instead of making monetary donations.

Berges said United Way is continuing to spread its message.

"That is something that we are continuing to explore," she said. "Are we not reaching people enough? Do they not know enough about what we do? We try each year to do more to get the word out, but we can still do more."

Berges said the economy is another contributor to the declines in donations. Members of the younger generation might not have as much to give.

"Not hitting this goal doesn't hurt the United Way," she said. "It hurts the agencies we help fund. ... That trickles on down. 

"The agency doesn't have the funds to help the people. It is the people who are losing out on whatever need they have — whether it's a child who needs a mentor or someone who needs help with utilities, someone with disabilities not able to get the services they need. It hits every area of the population."

You can contribute with a credit card online at&nbsp;<a href="https://www.liveunited.us/">www.liveunited.us</a>. You can establish a monthly ACH withdrawal from your checking account. You can also donate directly by cash or check at the United Way office at&nbsp;&nbsp;205 E. Seventh (Hadley Center, Suite 111, Hays. Checks can also be mailed to&nbsp;PO Box 367, Hays, KS 67601.

If you have questions, you may call the United Way at&nbsp;785-628-8281 or email them at&nbsp;<a href="mailto:unitedway@media-net.net">unitedway@media-net.net</a>.

<figure>
 <img src="https://media.eaglewebservices.com/public/2020/1/1578603284899.png" alt="" />
 <figcaption></figcaption>
 </figure>By CRISTINA JANNEY Hays PostThe United Way of Ellis County is only 77 percent to goal, and officials are concerned this will mean cuts for its partner agencies in 2020.The agency has raised $309,ooo of its $400,000 goal.Erica Berges, executive director, said the agency is close to where it was at this time last year. The agency raised about $350,000 and was propelled to its goal by a late donation by the Robert E. Schmidt Foundation.The campaign is still waiting on donations from a few businesses, but a majority of businesses have made their pledges for the year, Berges said."We are making a final push with donors in the past who have not given this year," she said.&nbsp;"We really want to get the word out that we are still in need. Our campaign is not done by any means. We still have some time left. We just need those last donations to help reach our goal."The United Way hopes to wrap up donations by the end of January. This will enable its Care Council to have distributions to partner agencies by March.The United Way supports 22 programs at 17 partner agencies:<ul>
 <li>Arc of the Central Plains</li>
 </ul><ul>
 <li>American Red Cross</li>
 </ul><ul>
 <li>Big Brothers/Big Sisters</li>
 </ul><ul>
 <li>Cancer Council</li>
 </ul><ul>
 <li>Catholic Charities</li>
 </ul><ul>
 <li>Center for Life Experiences</li>
 </ul><ul>
 <li>Cerebral Palsy Research Foundation</li>
 </ul><ul>
 <li>Court Appointed Special Advocates</li>
 </ul><ul>
 <li>Developmental Services of Northwest Kansas</li>
 </ul><ul>
 <li>Early Childhood Connections</li>
 </ul><ul>
 <li>First Call for Help</li>
 </ul><ul>
 <li>Hays Area Children's Center</li>
 </ul><ul>
 <li>KVC Wheatland Hospital</li>
 </ul><ul>
 <li>Options Domestic and Sexual Violence Services</li>
 </ul><ul>
 <li>Parents and Children Together</li>
 </ul><ul>
 <li>Western Kansas Association for the Concerns of the Disabled</li>
 </ul><ul>
 <li>Western Kansas Child Advocacy Center</li>
 </ul>"Obviously, the amount we give to agencies will have to be decreased," Berges said. "We try to keep that at a minimal amount. We try to cut every way possible from the United Way budget before we want to make that cut to the agencies."We know when donors give, they want the money to go to the agencies."If United Way has to make cuts to partner agency funding, it will affect the people those agencies serve, Berges said."The people in need, unfortunately, that number does not decrease," she said. "It always seems to increase."Berges said nationwide trends are resulting in the United Way seeing&nbsp; declines in donations. The baby boomer generation is retiring, and the workers who are replacing them are not donating at the same levels."I think the general landscape of how people give and why people give has changed," she said.She said the style of giving has changed. More people are giving to nonprofits directly online or through GoFundMe campaigns. This is a change from older workers who gave through payroll contributions through their work, which has been a staple for United Way for years.More young people are also volunteering and giving of their time instead of making monetary donations.Berges said United Way is continuing to spread its message."That is something that we are continuing to explore," she said. "Are we not reaching people enough? Do they not know enough about what we do? We try each year to do more to get the word out, but we can still do more."Berges said the economy is another contributor to the declines in donations. Members of the younger generation might not have as much to give."Not hitting this goal doesn't hurt the United Way," she said. "It hurts the agencies we help fund. ... That trickles on down. "The agency doesn't have the funds to help the people. It is the people who are losing out on whatever need they have — whether it's a child who needs a mentor or someone who needs help with utilities, someone with disabilities not able to get the services they need. It hits every area of the population."You can contribute with a credit card online at&nbsp;<a href="https://www.liveunited.us/">www.liveunited.us</a>. You can establish a monthly ACH withdrawal from your checking account. You can also donate directly by cash or check at the United Way office at&nbsp;&nbsp;205 E. Seventh (Hadley Center, Suite 111, Hays. Checks can also be mailed to&nbsp;PO Box 367, Hays, KS 67601.All donations are tax-deductible.If you have questions, you may call the United Way at&nbsp;785-628-8281 or email them at&nbsp;<a href="mailto:unitedway@media-net.net">unitedway@media-net.net</a>.

United Way of Ellis Co. just 77% to goal as campaign deadline looms

HaysMed recently recognized Dr. Shari Claude, pediatrician, as its Wellness Champion Award winner.&nbsp; The Wellness Champion Award celebrates and recognizes a HaysMed Associate who promotes healthy lifestyle choices and engages others in wellness activities.

Criteria for the award includes commitment to healthy lifestyle choices and motivating others to do the same, displaying an energetic passion for promoting health and wellness and striving to build a culture of wellness at HaysMed.

In the nominations, fellow Associates noted that Dr. Claude is someone everyone can look up to in the health and fitness world.&nbsp; She works out at home and is always eating healthy at work.

Dr. Claude is always doing something healthy whether it is eating healthy, working out at the gym and she is always doing a step challenge with someone on her fit bit. She is an advocate for helping her patients and their families how to incorporate healthy foods into their daily routine. She is always talking about her gym classes that she goes to and encourages us to join her. She's always up moving and getting her steps in every hour. She is a true role model for others. &nbsp;

<figure>
 <img src="https://media.eaglewebservices.com/public/2020/1/1578326113396.png" alt="" />
 <figcaption></figcaption>
 </figure>HaysMed recently recognized Dr. Shari Claude, pediatrician, as its Wellness Champion Award winner.&nbsp; The Wellness Champion Award celebrates and recognizes a HaysMed Associate who promotes healthy lifestyle choices and engages others in wellness activities.Criteria for the award includes commitment to healthy lifestyle choices and motivating others to do the same, displaying an energetic passion for promoting health and wellness and striving to build a culture of wellness at HaysMed.In the nominations, fellow Associates noted that Dr. Claude is someone everyone can look up to in the health and fitness world.&nbsp; She works out at home and is always eating healthy at work.Dr. Claude is always doing something healthy whether it is eating healthy, working out at the gym and she is always doing a step challenge with someone on her fit bit. She is an advocate for helping her patients and their families how to incorporate healthy foods into their daily routine. She is always talking about her gym classes that she goes to and encourages us to join her. She's always up moving and getting her steps in every hour. She is a true role model for others. &nbsp;— HaysMed

HaysMed pediatrician earns Wellness Champion honors

By NOMIN UJIYEDIIN <a href="https://www.kcur.org/post/kansas-sees-shortage-psychiatrists-and-other-mental-health-providers#stream/0">Kansas News Service</a>

TOPEKA — It typically took Walt Hill more than a year to recruit a psychiatrist to northwest Kansas. Now he doesn’t even bother.

Instead, the executive director of the <a href="http://hpmhc.com/" target="_blank">High Plains Mental Health Center</a> relies on out-of-state doctors willing to work remotely, treating patients through video conference.

For
 years, the center has used remote appointments with local psychiatrists
 to reach patients in far-flung corners of its coverage area, which 
spans 20 largely rural counties.

But recently, Hill said, it’s 
been almost impossible to find psychiatrists and psychiatric nurses to 
do even that. He’s had to turn to providers who conference in from 
Kansas City, Texas and Tennessee.

Like the <a href="https://www.npr.org/2018/03/09/592333771/severe-shortage-of-psychiatrists-exacerbated-by-lack-of-federal-funding" target="_blank">rest of the United States</a>,
 Kansas is seeing an increase in patients seeking mental health 
treatment. But the state can’t find enough doctors, nurses and 
therapists to treat them. Providers say the problem is worse in the 
state’s least-populated rural areas, where clinic jobs can stay open for
 years at a time.&nbsp;

“Fewer and fewer individuals are going into 
these professions,” Hill said. “We’re seeing a demographic challenge, a 
crisis coming.”

One <a href="https://data.hrsa.gov/tools/shortage-area/hpsa-find" target="_blank">measure from the federal government</a>
 suggests only nine of the counties in Kansas have enough psychiatrists,
 and they’re mostly in urban areas: Johnson, Wyandotte, Shawnee, 
Douglas, Harvey, Sedgwick, Marion, McPherson and Miami counties.

There are 431 psychiatrists actively licensed to practice in Kansas, according to the state’s Board of Healing Arts. <a href="https://www.kff.org/other/state-indicator/mental-health-care-health-professional-shortage-areas-hpsas/?currentTimeframe=0&amp;selectedRows=%7B%22states%22:%7B%22kansas%22:%7B%7D%7D%7D&amp;sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D" target="_blank">One calculation</a> by the Kaiser Family Foundation estimates the state needs 53 more to meet its needs.

The
 state’s community mental health centers, like the one Hill manages, 
face a particular challenge. The centers treat people regardless of 
their ability to pay. Some say they’ve had to absorb more patients since
 the state-run mental health hospital in Osawatomie reduced its 
admissions drastically.

Hill said High Plains Mental Health 
Center hasn’t experienced that so much. But as reimbursement rates from 
insurance companies have stagnated, the center has had to raise its base
 fees to cover costs.

The center sees 6,000 patients a year, 
about half of whom need medication. Some have to wait as long as six 
weeks for an initial appointment with a provider.

“It’s 
stretched. Some people do have to take on a lot more cases,” he said. 
“That is just way too long for people to have to wait.”

In some ways, telemedicine has helped, said Greg Hennen, executive director of the<a href="https://www.fourcounty.com/" target="_blank"> Four County Mental Health Center</a> in Independence. But it’s also made it worse.

“It’s
 a very nice resource, but it’s also hampered our capacity to recruit 
because people can work from their living room instead,” he said. 
“People don’t have to relocate to deliver services.”

Hennen’s 
center has been trying to recruit a psychiatrist to serve as medical 
director for two years. Only two people have applied for the job. One 
couldn’t get his license and the other decided he didn’t want to live in
 southeast Kansas.

The location is a hard sell for many candidates.

“We
 do have some people that are not interested because it’s an hour and a 
half to drive to Tulsa or Joplin or two hours to Kansas City,” he said. 
“They just want to be a little closer to the cultural offerings of a big
 city.”

Pay is an issue, too. Neighboring states like Nebraska 
and Colorado can afford to pay medical staff and therapists partly 
because they expanded Medicaid coverage. That can mean more of their 
patients have health insurance. Oklahoma and Missouri have federal 
funding from another source: the Excellence in Mental Health Act, a 
program Kansas never applied for.

The result is that other states
 have hired providers away from Kansas. Hennen said one experienced 
therapist left his center to work across the border in Oklahoma for a 
$20,000 raise.

Meanwhile, he has three openings for therapists. 
And he hears regularly from schools and other community organizations 
that they’re hiring, too.

“If I was actually going to answer the demand,” Hennen said, “ I could hire another five on top of those three.”

For Lisa Southern, executive director of <a href="http://compassbh.org/" target="_blank">Compass Behavioral Health</a> in Garden City, hiring nurses is the challenge.

She has hired nurse practitioners on a temporary basis through the <a href="https://nhsc.hrsa.gov/" target="_blank">National Health Service Corps</a>,
 which repays student loans in exchange for a few years of work. But 
it’s hard to get people to stay in southwestern Kansas. Many qualified 
nurses just end up going back home, she said.

The center paid a 
recruiter $20,000 to find a qualified nurse. But in 18 months, they only
 had two applicants. Even those nurses decided not to take the job 
because they didn’t want to move.

“It’s not about the agency. 
It’s not about the population we serve,” Southern said. “It is simply 
about people wanting to live in a different area than where we are.”

The
 Garden City center hasn’t had any trouble recruiting therapists. That’s
 because aspiring social workers in the area can earn a master’s degree 
at the University of Kansas or Washburn University.

“That is our 
saving grace for therapy staff,” Southern said. Her center has also 
offered scholarships for staff to get their master’s degrees.

The
 centers that Hennen and Hill run have also paid for master’s degrees 
for nurses who agree to come back and work at their centers.

In 
an effort to recruit and retain more staff, Gov. Laura Kelly raised 
salaries for employees at Larned State Hospital, a state-run mental 
health facility, in early December. The vacancy rate at the hospital is 
57% for RNs and 73% for LPNs, said a spokeswoman for the Kansas 
Department for Aging and Disability Services. The hospital does not 
track vacancies for psychiatrists or therapists. The state’s other 
mental health hospital in Osawatomie has 14 vacancies for RNs and none 
for psychiatrists or therapists.

In 2017, to attract more psychiatrists to rural areas, Kansas passed <a href="http://www.kslegislature.org/li_2018/b2017_18/measures/SB32/" target="_blank">a law</a> that added psychiatry to the state’s <a href="http://www.kumc.edu/student-affairs/student-financial-aid/loan-information/loan-programs/kansas-medical-student-loan.html" target="_blank">medical student loan program</a>.
 The program helps pay for tuition and other expenses in exchange for 
the student practicing primary medicine in the state’s less populated 
counties after graduation.

It’s too early to tell whether that’s 
encouraged more medical students to choose psychiatry and practice in 
Kansas, said Dr. William Gabrielli, head of psychiatry at the University
 of Kansas School of Medicine, the only medical school in the state.

But
 as attitudes toward mental health treatment change, Gabrielli is 
optimistic more students will feel encouraged to do psychiatry 
residencies in rural areas.

“It’s really where they do their 
residency training that helps them put down roots and that keeps them in
 those locations,” Gabrielli said.

Typically, doctors are reluctant to go to rural areas because they prefer not to practice alone, Gabrielli said.

“If
 you go out and be a lone practitioner in a rural part of the state, you
 have no partner,” he said. “You have nobody to help cover for you. You 
have nobody to bounce cases off of.”

Plus, psychiatry is one of 
the lower-paying medical specialties, which means it’s a hard draw for 
medical students, who can rack up hundreds of thousands of dollars in 
loans. The problem is exacerbated by an aging population of 
psychiatrists who are retiring, Gabrielli said.

Ultimately, he said, doctors go into the field because of intrinsic motivations.

“Most
 of the people that pursue psychiatry as their medical specialty are not
 focused on maximizing their incomes,” he said. “They’re focused on 
taking care of the people.”

Nomin Ujiyediin reports on criminal justice and social welfare for the Kansas News Service.&nbsp; Follow her on Twitter <a href="https://twitter.com/nominuj?lang=en" target="_blank">@NominUJ</a> or email nomin@kcur.org.&nbsp;

<figure>
 <img src="https://media.eaglewebservices.com/public/2020/1/1578414748992.jpeg" alt="Kansas community mental health centers say job vacancies for doctors and therapists sometimes stay open for years.&nbsp; Celia Llopis-Jepsen / Kansas News Service " />
 <figcaption>Kansas community mental health centers say job vacancies for doctors and therapists sometimes stay open for years.&nbsp; Celia Llopis-Jepsen / Kansas News Service </figcaption>
 </figure>By NOMIN UJIYEDIIN <a href="https://www.kcur.org/post/kansas-sees-shortage-psychiatrists-and-other-mental-health-providers#stream/0">Kansas News Service</a>TOPEKA — It typically took Walt Hill more than a year to recruit a psychiatrist to northwest Kansas. Now he doesn’t even bother.Instead, the executive director of the <a href="http://hpmhc.com/" target="_blank">High Plains Mental Health Center</a> relies on out-of-state doctors willing to work remotely, treating patients through video conference.For
 years, the center has used remote appointments with local psychiatrists
 to reach patients in far-flung corners of its coverage area, which 
spans 20 largely rural counties.But recently, Hill said, it’s 
been almost impossible to find psychiatrists and psychiatric nurses to 
do even that. He’s had to turn to providers who conference in from 
Kansas City, Texas and Tennessee.Like the <a href="https://www.npr.org/2018/03/09/592333771/severe-shortage-of-psychiatrists-exacerbated-by-lack-of-federal-funding" target="_blank">rest of the United States</a>,
 Kansas is seeing an increase in patients seeking mental health 
treatment. But the state can’t find enough doctors, nurses and 
therapists to treat them. Providers say the problem is worse in the 
state’s least-populated rural areas, where clinic jobs can stay open for
 years at a time.&nbsp;“Fewer and fewer individuals are going into 
these professions,” Hill said. “We’re seeing a demographic challenge, a 
crisis coming.”One <a href="https://data.hrsa.gov/tools/shortage-area/hpsa-find" target="_blank">measure from the federal government</a>
 suggests only nine of the counties in Kansas have enough psychiatrists,
 and they’re mostly in urban areas: Johnson, Wyandotte, Shawnee, 
Douglas, Harvey, Sedgwick, Marion, McPherson and Miami counties.There are 431 psychiatrists actively licensed to practice in Kansas, according to the state’s Board of Healing Arts. <a href="https://www.kff.org/other/state-indicator/mental-health-care-health-professional-shortage-areas-hpsas/?currentTimeframe=0&amp;selectedRows=%7B%22states%22:%7B%22kansas%22:%7B%7D%7D%7D&amp;sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D" target="_blank">One calculation</a> by the Kaiser Family Foundation estimates the state needs 53 more to meet its needs.The
 state’s community mental health centers, like the one Hill manages, 
face a particular challenge. The centers treat people regardless of 
their ability to pay. Some say they’ve had to absorb more patients since
 the state-run mental health hospital in Osawatomie reduced its 
admissions drastically.Hill said High Plains Mental Health 
Center hasn’t experienced that so much. But as reimbursement rates from 
insurance companies have stagnated, the center has had to raise its base
 fees to cover costs.The center sees 6,000 patients a year, 
about half of whom need medication. Some have to wait as long as six 
weeks for an initial appointment with a provider.“It’s 
stretched. Some people do have to take on a lot more cases,” he said. 
“That is just way too long for people to have to wait.”<h2>Hiring issues</h2>In some ways, telemedicine has helped, said Greg Hennen, executive director of the<a href="https://www.fourcounty.com/" target="_blank"> Four County Mental Health Center</a> in Independence. But it’s also made it worse.“It’s
 a very nice resource, but it’s also hampered our capacity to recruit 
because people can work from their living room instead,” he said. 
“People don’t have to relocate to deliver services.”Hennen’s 
center has been trying to recruit a psychiatrist to serve as medical 
director for two years. Only two people have applied for the job. One 
couldn’t get his license and the other decided he didn’t want to live in
 southeast Kansas.The location is a hard sell for many candidates.“We
 do have some people that are not interested because it’s an hour and a 
half to drive to Tulsa or Joplin or two hours to Kansas City,” he said. 
“They just want to be a little closer to the cultural offerings of a big
 city.”Pay is an issue, too. Neighboring states like Nebraska 
and Colorado can afford to pay medical staff and therapists partly 
because they expanded Medicaid coverage. That can mean more of their 
patients have health insurance. Oklahoma and Missouri have federal 
funding from another source: the Excellence in Mental Health Act, a 
program Kansas never applied for.The result is that other states
 have hired providers away from Kansas. Hennen said one experienced 
therapist left his center to work across the border in Oklahoma for a 
$20,000 raise.Meanwhile, he has three openings for therapists. 
And he hears regularly from schools and other community organizations 
that they’re hiring, too.“If I was actually going to answer the demand,” Hennen said, “ I could hire another five on top of those three.”For Lisa Southern, executive director of <a href="http://compassbh.org/" target="_blank">Compass Behavioral Health</a> in Garden City, hiring nurses is the challenge.She has hired nurse practitioners on a temporary basis through the <a href="https://nhsc.hrsa.gov/" target="_blank">National Health Service Corps</a>,
 which repays student loans in exchange for a few years of work. But 
it’s hard to get people to stay in southwestern Kansas. Many qualified 
nurses just end up going back home, she said.The center paid a 
recruiter $20,000 to find a qualified nurse. But in 18 months, they only
 had two applicants. Even those nurses decided not to take the job 
because they didn’t want to move.“It’s not about the agency. 
It’s not about the population we serve,” Southern said. “It is simply 
about people wanting to live in a different area than where we are.”<h2>Solutions</h2>The
 Garden City center hasn’t had any trouble recruiting therapists. That’s
 because aspiring social workers in the area can earn a master’s degree 
at the University of Kansas or Washburn University.“That is our 
saving grace for therapy staff,” Southern said. Her center has also 
offered scholarships for staff to get their master’s degrees.The
 centers that Hennen and Hill run have also paid for master’s degrees 
for nurses who agree to come back and work at their centers.In 
an effort to recruit and retain more staff, Gov. Laura Kelly raised 
salaries for employees at Larned State Hospital, a state-run mental 
health facility, in early December. The vacancy rate at the hospital is 
57% for RNs and 73% for LPNs, said a spokeswoman for the Kansas 
Department for Aging and Disability Services. The hospital does not 
track vacancies for psychiatrists or therapists. The state’s other 
mental health hospital in Osawatomie has 14 vacancies for RNs and none 
for psychiatrists or therapists.In 2017, to attract more psychiatrists to rural areas, Kansas passed <a href="http://www.kslegislature.org/li_2018/b2017_18/measures/SB32/" target="_blank">a law</a> that added psychiatry to the state’s <a href="http://www.kumc.edu/student-affairs/student-financial-aid/loan-information/loan-programs/kansas-medical-student-loan.html" target="_blank">medical student loan program</a>.
 The program helps pay for tuition and other expenses in exchange for 
the student practicing primary medicine in the state’s less populated 
counties after graduation.It’s too early to tell whether that’s 
encouraged more medical students to choose psychiatry and practice in 
Kansas, said Dr. William Gabrielli, head of psychiatry at the University
 of Kansas School of Medicine, the only medical school in the state.But
 as attitudes toward mental health treatment change, Gabrielli is 
optimistic more students will feel encouraged to do psychiatry 
residencies in rural areas.“It’s really where they do their 
residency training that helps them put down roots and that keeps them in
 those locations,” Gabrielli said.Typically, doctors are reluctant to go to rural areas because they prefer not to practice alone, Gabrielli said.“If
 you go out and be a lone practitioner in a rural part of the state, you
 have no partner,” he said. “You have nobody to help cover for you. You 
have nobody to bounce cases off of.”Plus, psychiatry is one of 
the lower-paying medical specialties, which means it’s a hard draw for 
medical students, who can rack up hundreds of thousands of dollars in 
loans. The problem is exacerbated by an aging population of 
psychiatrists who are retiring, Gabrielli said.Ultimately, he said, doctors go into the field because of intrinsic motivations.“Most
 of the people that pursue psychiatry as their medical specialty are not
 focused on maximizing their incomes,” he said. “They’re focused on 
taking care of the people.”Nomin Ujiyediin reports on criminal justice and social welfare for the Kansas News Service.&nbsp; Follow her on Twitter <a href="https://twitter.com/nominuj?lang=en" target="_blank">@NominUJ</a> or email nomin@kcur.org.&nbsp;

Kan. sees shortage of psychiatrists, other mental health providers 

This year I was preparing my Christmas card list. As I went through the list from last year, there were so many changes because of friends, family members and clients passing away. It reminded me of an article I wrote over three years ago that I would like to share with you today.&nbsp;

My best friends have been two Labrador retrievers—Star, the mother, and Maggie, her daughter.&nbsp; This year, they turned 14 and 12 years of age.&nbsp; Both are famous for their friendliness and vigorous tail wagging—greeting family and guests with a nudge and their whole bodies shaking back and forth from the wag of their heavy tails. Most mornings, my alarm clock was Maggie’s tail striking the wall as she waited for me to get out of bed.&nbsp; &nbsp;

Both Star and Maggie fell ill the end of July.&nbsp; Star had two stays in the veterinary clinic.&nbsp; During Star’s second stay, Maggie died.&nbsp; When my son picked up Star from her second stay at the veterinarian, she was so excited to go home.&nbsp; Though she was quite weak, she managed to wag her tail.&nbsp; After she walked through the house and could not find Maggie, she climbed onto the couch with help.&nbsp; She never wagged her tail again.

A couple of weeks later, I was speaking out of town.&nbsp; Throughout the day, I would get reports on Star.&nbsp; Late that night, I got home and Star was on the couch.&nbsp; I sat on the couch beside her, putting her head in my lap.&nbsp; There was little recognition.&nbsp; I started reading my own article reprinted in The Hays Daily News about letting an old dog (Star) hunt for as long as possible and about enjoying life, even as you grow old.&nbsp; I realized at that point, sitting on the couch, Star and I would never hunt together again—that she had stopped enjoying life.

The most emotional part of my practice as an elder law attorney is working with families facing end-of-life decisions.&nbsp; As prepared as families think they are, it is the most difficult of times.

Unfortunately, it can be much more difficult if there has not been “the talk.”&nbsp; What quality of life is important to them?&nbsp; Do they want feeding tubes or other life support?&nbsp; Do they want to donate organs?&nbsp; Who will be the decision maker if they cannot speak for themselves?&nbsp; What happens if they lose cognitive abilities on a permanent basis?&nbsp; What type of health services do they want or not want?

Many of these decisions need and must be conveyed in legal documents—a living will, powers of attorney for financial and health care decisions, and perhaps a do-not-resuscitate order. &nbsp;

But more important (or at least as important) is that these wishes need to be communicated to your family.&nbsp; You need to have “the talk.”&nbsp; Let them know what you want or do not want. &nbsp;

Please understand that the journey is not yours alone.&nbsp; Dying is not just the journey of the ill person; it is the journey of many who love and care for that person.

When I assumed the care of my grandmother, she had three to six months to live.&nbsp; That went on for ten years. I smile at that because we had ten great years together.&nbsp; Through the years, we had several discussions about end of life.&nbsp; When Mam-Maw did die, I knew what she wanted and that she was ready. I knew what health services she wanted and did not want. I knew she was ready to go.

As my sister and I stood at the gravesite of my grandmother, we were able to make the transition ourselves—transition to a world without Mam-Maw—a world we had never experienced.&nbsp; It was an important transition for my sister and I, as it was for my grandmother.

So, that night with Star’s head on my lap, I knew it was time for the transition.&nbsp; The next day, my wife, my son Josh and his wife Andrea, and my son Ben all accompanied Star to the veterinary clinic.&nbsp; As she laid there, we all held her.&nbsp; She was able to muster a final raise of her head, looking to all of us with those great, kind eyes – eyes that trusted and loved us. She closed those eyes and then passed with her family leading her through the transition.&nbsp; Part of all of us went with her.

I cannot overemphasize how dying is a transition for the dying, but also for family members and friends.&nbsp; It is hard to let go—darn hard—the hardest.&nbsp; Having “the talk” allows for the transition. But when the wagging stops, it is time to let your loved one pass. Hopefully you can be there, in person or in spirit.

Somewhere, I know Star and Maggie are wagging their tails, waiting for me to come home, so that we can continue our journey.

Randy Clinkscales of Clinkscales Elder Law Practice, PA, Hays, Kansas, is an elder care attorney, practicing in western Kansas. To contact him, please send an email to randy@clinkscaleslaw.com. Disclaimer: The information in the column is for general information purposes and does not constitute legal advice. Each case is different and outcomes depend on the fact of each case and the then applicable law. For specific questions, you should contact a qualified attorney.

This year I was preparing my Christmas card list. As I went through the list from last year, there were so many changes because of friends, family members and clients passing away. It reminded me of an article I wrote over three years ago that I would like to share with you today.&nbsp;<figure>
 <img src="https://media.eaglewebservices.com/public/2019/11/1573141343378.png" alt="Randy Clinkscales" />
 <figcaption>Randy Clinkscales</figcaption>
 </figure>My best friends have been two Labrador retrievers—Star, the mother, and Maggie, her daughter.&nbsp; This year, they turned 14 and 12 years of age.&nbsp; Both are famous for their friendliness and vigorous tail wagging—greeting family and guests with a nudge and their whole bodies shaking back and forth from the wag of their heavy tails. Most mornings, my alarm clock was Maggie’s tail striking the wall as she waited for me to get out of bed.&nbsp; &nbsp;Both Star and Maggie fell ill the end of July.&nbsp; Star had two stays in the veterinary clinic.&nbsp; During Star’s second stay, Maggie died.&nbsp; When my son picked up Star from her second stay at the veterinarian, she was so excited to go home.&nbsp; Though she was quite weak, she managed to wag her tail.&nbsp; After she walked through the house and could not find Maggie, she climbed onto the couch with help.&nbsp; She never wagged her tail again.A couple of weeks later, I was speaking out of town.&nbsp; Throughout the day, I would get reports on Star.&nbsp; Late that night, I got home and Star was on the couch.&nbsp; I sat on the couch beside her, putting her head in my lap.&nbsp; There was little recognition.&nbsp; I started reading my own article reprinted in The Hays Daily News about letting an old dog (Star) hunt for as long as possible and about enjoying life, even as you grow old.&nbsp; I realized at that point, sitting on the couch, Star and I would never hunt together again—that she had stopped enjoying life.The most emotional part of my practice as an elder law attorney is working with families facing end-of-life decisions.&nbsp; As prepared as families think they are, it is the most difficult of times.Unfortunately, it can be much more difficult if there has not been “the talk.”&nbsp; What quality of life is important to them?&nbsp; Do they want feeding tubes or other life support?&nbsp; Do they want to donate organs?&nbsp; Who will be the decision maker if they cannot speak for themselves?&nbsp; What happens if they lose cognitive abilities on a permanent basis?&nbsp; What type of health services do they want or not want?Many of these decisions need and must be conveyed in legal documents—a living will, powers of attorney for financial and health care decisions, and perhaps a do-not-resuscitate order. &nbsp;But more important (or at least as important) is that these wishes need to be communicated to your family.&nbsp; You need to have “the talk.”&nbsp; Let them know what you want or do not want. &nbsp;Please understand that the journey is not yours alone.&nbsp; Dying is not just the journey of the ill person; it is the journey of many who love and care for that person.When I assumed the care of my grandmother, she had three to six months to live.&nbsp; That went on for ten years. I smile at that because we had ten great years together.&nbsp; Through the years, we had several discussions about end of life.&nbsp; When Mam-Maw did die, I knew what she wanted and that she was ready. I knew what health services she wanted and did not want. I knew she was ready to go.As my sister and I stood at the gravesite of my grandmother, we were able to make the transition ourselves—transition to a world without Mam-Maw—a world we had never experienced.&nbsp; It was an important transition for my sister and I, as it was for my grandmother.So, that night with Star’s head on my lap, I knew it was time for the transition.&nbsp; The next day, my wife, my son Josh and his wife Andrea, and my son Ben all accompanied Star to the veterinary clinic.&nbsp; As she laid there, we all held her.&nbsp; She was able to muster a final raise of her head, looking to all of us with those great, kind eyes – eyes that trusted and loved us. She closed those eyes and then passed with her family leading her through the transition.&nbsp; Part of all of us went with her.I cannot overemphasize how dying is a transition for the dying, but also for family members and friends.&nbsp; It is hard to let go—darn hard—the hardest.&nbsp; Having “the talk” allows for the transition. But when the wagging stops, it is time to let your loved one pass. Hopefully you can be there, in person or in spirit.Somewhere, I know Star and Maggie are wagging their tails, waiting for me to come home, so that we can continue our journey.Randy Clinkscales of Clinkscales Elder Law Practice, PA, Hays, Kansas, is an elder care attorney, practicing in western Kansas. To contact him, please send an email to randy@clinkscaleslaw.com. Disclaimer: The information in the column is for general information purposes and does not constitute legal advice. Each case is different and outcomes depend on the fact of each case and the then applicable law. For specific questions, you should contact a qualified attorney.

CLINKSCALES: When the wagging stops

<a href="https://hayspost.com/state-farm-weather-window/">For a full look at weather visit the State Farm Weather Window by clicking here.&nbsp;</a>

<figure>
 <img src="https://media.eaglewebservices.com/public/2019/12/1575929617735.png" alt="" />
 <figcaption></figcaption>
 </figure><a href="https://hayspost.com/state-farm-weather-window/">For a full look at weather visit the State Farm Weather Window by clicking here.&nbsp;</a><figure>
 <img src="https://media.eaglewebservices.com/public/2020/1/1578688641415.jpeg" alt="" />
 <figcaption></figcaption>
 </figure>

Three-day weather outlook

WICHITA -- U.S. Citizenship and Immigration Services (USCIS) welcomed 153 new United States citizens during a naturalization ceremony Friday.

The ceremony was held at Wichita State’s Eugene M. Hughes Metropolitan Complex. U.S. District Court Judge J. Thomas Marten presided.

The citizenship candidates originated from 36 countries: Afghanistan, Bangladesh, Brazil, Burma, Cambodia, Canada, Congo (Kinshasa, Cuba, Egypt, El Salvador, Eritrea, Ethiopia, Guatemala, Haiti, Honduras, Hong Kong, India, Iraq, Ireland, Jordan, Kazakhstan, Kenya, Lebanon, Mexico, New Zealand, Nicaragua, Nigeria, Pakistan, Philippines, Senegal, Somalia, South Africa, Sudan, Tanzania, United Kingdom, and Vietnam.

The new U.S. citizens live in Andover, Augusta, Bel Aire, Coffeyville, Colby, Derby, Dodge City, Garden City, Great Bend, Hays, Hesston, Hugoton, Independence, Kinsley, Liberal, Macksville, Newton, Plains, Quinter, Salina, Satanta, Syracuse, Ulysses, and Wichita.

During fiscal year 2019, 834,000 people were naturalized at ceremonies throughout the country and around the world, an 11-year high.

<figure>
 <img src="https://media.eaglewebservices.com/public/2020/1/1578764825432.jpeg" alt="Students from&nbsp;Hamilton Middle School in Wichita present the colors at the naturalization ceremony Friday. Photos by&nbsp; the&nbsp;Wichita metro Daughters of the American Revolution&nbsp;" />
 <figcaption>Students from&nbsp;Hamilton Middle School in Wichita present the colors at the naturalization ceremony Friday. Photos by&nbsp; the&nbsp;Wichita metro Daughters of the American Revolution&nbsp;</figcaption>
 </figure>WICHITA -- U.S. Citizenship and Immigration Services (USCIS) welcomed 153 new United States citizens during a naturalization ceremony Friday.The ceremony was held at Wichita State’s Eugene M. Hughes Metropolitan Complex. U.S. District Court Judge J. Thomas Marten presided.<figure>
 <img src="https://media.eaglewebservices.com/public/2020/1/1578765184301.jpeg" alt="Some of the new U.S. citizens." />
 <figcaption>Some of the new U.S. citizens.</figcaption>
 </figure>The citizenship candidates originated from 36 countries: Afghanistan, Bangladesh, Brazil, Burma, Cambodia, Canada, Congo (Kinshasa, Cuba, Egypt, El Salvador, Eritrea, Ethiopia, Guatemala, Haiti, Honduras, Hong Kong, India, Iraq, Ireland, Jordan, Kazakhstan, Kenya, Lebanon, Mexico, New Zealand, Nicaragua, Nigeria, Pakistan, Philippines, Senegal, Somalia, South Africa, Sudan, Tanzania, United Kingdom, and Vietnam.The new U.S. citizens live in Andover, Augusta, Bel Aire, Coffeyville, Colby, Derby, Dodge City, Garden City, Great Bend, Hays, Hesston, Hugoton, Independence, Kinsley, Liberal, Macksville, Newton, Plains, Quinter, Salina, Satanta, Syracuse, Ulysses, and Wichita.<figure>
 <img src="https://media.eaglewebservices.com/public/2020/1/1578765314795.jpeg" alt="Celebrating after the naturalization ceremony." />
 <figcaption>Celebrating after the naturalization ceremony.</figcaption>
 </figure>During fiscal year 2019, 834,000 people were naturalized at ceremonies throughout the country and around the world, an 11-year high.

153 new US citizens take oath Friday in Wichita



The 13th-ranked Fort Hays State women's basketball team continues its swing through the Sooner State on Saturday) when the Tigers take on Rogers State. Tipoff is set for 2 p.m. inside the Claremore Expo Center. You can hear the game on KJLS (103.3-FM).

<a href="https://streamdb7web.securenetsystems.net/cirrusencore/index.cfm?stationCallSign=KJLS">LISTEN LIVE</a>

This is the first time Tigers have met up with the Hillcats&nbsp;in program history. After facing off with Minnesota Duluth, Harding and Saint Anselm for the first time ever earlier this season, the Tigers have played 130 different schools in their 51-year history. FHSU is 81-49 when facing off with a program for the first time. Head coach&nbsp;<a href="https://fhsuathletics.com/coaches.aspx?rc=884">Tony Hobson</a>&nbsp;is 16-3 in games against schools FHSU had never previously played.

Fort Hays State (12-2, 3-2 MIAA) heads into the contest riding a six-game winning streak. The Tigers have been very balanced on offense over that stretch, with six different players averaging at least 10 points per game.

The Tigers rank in the top 10 in the country in six statistical categories, including assist/turnover ratio (first, 1.68, fewest turnovers (third, 142, personal fouls per game (sixth, 13.1, scoring margin (fourth, 25.4, turnover margin (third, 10.36) and turnovers per game (first, 10.1).

The Tigers are now 11-5 in the Sooner State under Hobson after Thursday's 77-66 win over Northeastern State (6-2 @ NSU, 3-3 @ UCO, 1-0 @ OPSU, 1-0 @ NWOSU).

Rogers State is looking to shake off a 10-game losing streak, heading into the weekend 2-13 overall, 0-6 in conference play. Both of Rogers State's victories have come at home. The Hillcats rank 14th in the conference in both scoring (61.0 ppg) and scoring defense (76.4 ppg). Opposing teams are shooting 46.6 percent from the floor against RSU, ranking 303rd out of 304 NCAA DII programs. Alicia Brown leads the team with 8.9 points per contest, with Darian Jackson (8.6 ppg) and Vanessa Gajdosova (8.5 ppg) close behind. Gajdosova leads the team and ranks 13th in the MIAA with 2.8 assists per game. Jackson grabs a team-high 5.5 rebounds per contest.



<figure>
 <img src="https://media.eaglewebservices.com/public/2020/1/1578711189446.jpeg" alt="Allie Schweizer photo" />
 <figcaption>Allie Schweizer photo</figcaption>
 </figure>FHSU Sports Information

The 13th-ranked Fort Hays State women's basketball team continues its swing through the Sooner State on Saturday) when the Tigers take on Rogers State. Tipoff is set for 2 p.m. inside the Claremore Expo Center. You can hear the game on KJLS (103.3-FM).<a href="https://streamdb7web.securenetsystems.net/cirrusencore/index.cfm?stationCallSign=KJLS">LISTEN LIVE</a>This is the first time Tigers have met up with the Hillcats&nbsp;in program history. After facing off with Minnesota Duluth, Harding and Saint Anselm for the first time ever earlier this season, the Tigers have played 130 different schools in their 51-year history. FHSU is 81-49 when facing off with a program for the first time. Head coach&nbsp;<a href="https://fhsuathletics.com/coaches.aspx?rc=884">Tony Hobson</a>&nbsp;is 16-3 in games against schools FHSU had never previously played.Fort Hays State (12-2, 3-2 MIAA) heads into the contest riding a six-game winning streak. The Tigers have been very balanced on offense over that stretch, with six different players averaging at least 10 points per game.The Tigers rank in the top 10 in the country in six statistical categories, including assist/turnover ratio (first, 1.68, fewest turnovers (third, 142, personal fouls per game (sixth, 13.1, scoring margin (fourth, 25.4, turnover margin (third, 10.36) and turnovers per game (first, 10.1).The Tigers are now 11-5 in the Sooner State under Hobson after Thursday's 77-66 win over Northeastern State (6-2 @ NSU, 3-3 @ UCO, 1-0 @ OPSU, 1-0 @ NWOSU).Rogers State is looking to shake off a 10-game losing streak, heading into the weekend 2-13 overall, 0-6 in conference play. Both of Rogers State's victories have come at home. The Hillcats rank 14th in the conference in both scoring (61.0 ppg) and scoring defense (76.4 ppg). Opposing teams are shooting 46.6 percent from the floor against RSU, ranking 303rd out of 304 NCAA DII programs. Alicia Brown leads the team with 8.9 points per contest, with Darian Jackson (8.6 ppg) and Vanessa Gajdosova (8.5 ppg) close behind. Gajdosova leads the team and ranks 13th in the MIAA with 2.8 assists per game. Jackson grabs a team-high 5.5 rebounds per contest.

No. 13 FHSU women's basketball wraps up road trip at Rogers State

As the 2020 legislative session rapidly approaches, local legislators say health care and mental health will be two of the top issues.

State Sen. Rick Billinger, R-Goodland, said one of his top priorities is getting acute care juvenile psychiatric beds reinstated at the KVC Hospital in Hays.

KVC announced in fall of last year it was closing its acute care beds in Hays because of Centers for Medicaid and Medicare regulations and issues with the space it rents at the Hadley Center.

This means the nearest acute care&nbsp;psychiatric treatment for youth is in Wichita or Kansas City, and even Wichita has been full, Billinger said.

"Some of the folks from western Kansas have chosen not to get their youth any help because it is not a good option for them to go to Kansas City," Billinger said. "Consequently some of them are just taking these kids home."

<a href="https://archive.hayspost.com/2019/11/04/closure-of-kvc-beds-leaves-kids-with-psychiatric-needs-hundreds-of-miles-from-treatment/">RELATED: Closure of KVC beds leaves kids with psychiatric needs hundreds of miles from treatment</a>

Billinger said he has not been satisfied with KVC's explanation for the closure, saying similar rules were in place when KVC was awarded the state contract for the acute care beds 10 years ago.

"For many folks in the western part of Kansas, traveling to Wichita or Kansas City is not an option," Billinger said. "These parents need to be involved in the therapy sessions. Most of them are working and have jobs. It's just a crisis for those folks."

Officials at KVC said they planned to convert the acute-care beds to residential treatment beds.

Both Sen. Billinger and state Rep. Barb Wasinger, R-Hays, said they expect Medicaid expansion to be debated again this year.

Gov. Kelly has said she is behind Medicaid expansion. Both houses of the Legislature passed bills to expand Medicaid while Gov. Brownback was in office. Brownback vetoed the bill, and the Legislature was unable to override the veto.

Billinger was one of the legislators who has been a past supporter of the Medicaid expansion. He said he thought expansion is important to Kansas' rural hospitals.

"I hope we can put some policy in there that will make it better for the people on the expansion of Medicaid, but also the taxpayers," he said.

Rep. Wasinger said she also supports Medicaid expansion.

"I believe with what they are proposing, I need to support Medicaid expansion because it is important to my constituents in Ellis County along with HaysMed," she said.&nbsp; "I am concerned about the cost. I know we need to take great care with that and not bankrupt the state."

Wasinger also said the issue of autonomy for Advanced Registered Nurse Practitioners will likely be a topic of debate. ARNPs must work under the supervision of physicians, who often take a portion of their fees. ARNPs wish to be able to practice without this supervision.

Wasinger said she supports ARNP autonomy and hoped this would be a means to expand health care options for northwest Kansas.

She said she would also support a constitutional amendment that would reinstate abortion regulations.

" I am very interested in it because there are no regulations," Wasinger said. "I think it is a safety issue for women. It think we should protect the women of our state no matter what they decide to do."

There will likely be the usual battles over the budget. A group of Kansas judges sued the Legislature claiming their courts are being underfunded.

Pay for Kansas judges ranks 49 out of 50 states, with West Virginia the only state below Kansas.

Billinger said the Legislature has been trying to put more money into courts, but filing a lawsuit was the wrong way to address the issue.

"We only have so much money to spend, and we are trying to address all of the challenges, including the courts. I'm not saying the courts don't need the additional funding, especially for some of the staff. ...

"We have a lot of challenges," Billinger said of the budget. "We still have foster kids who sleep on the floors. We need to look at and repair a lot of these things."

Wasinger said she did not wish to comment on the court lawsuit.

She did say she was also concerned about the state of Kansas' foster care system.

"We have incredible foster care parents in Hays, and the fact they have not gotten calls and we still have children sleeping in offices is a sin," she said. "It is so scary."

Neither legislator supported Gov. Kelly's plan to reamortize KPERS in 2020 to stretch the budget. An attempt to delay payments to KPERS last session was not supported by the Legislature. The proposed reamortization last year would have cost the state $7 billion.

Last year was the first time in 25 years the state has made the full required contribution to KPERS.

"She has decided she wants to fund the state government on the backs of our KPERS folks — our school teachers and our state workers," Billinger said. "I don't believe that is going to fly."

Wasinger said, "I think a stable budget is a much wiser policy than adding interest to our debt."

Billinger said he would like to see the state decouple state income taxes from federal income taxes. When the federal government increased the standard deduction on income taxes, it meant some Kansans could no longer itemize on their state taxes.

The governor vetoed two attempts to decouple during the last session.

"Part of the argument will be 'Here you are trying to cut taxes for the rich,' " he said. "Well, no, these folks are not what I call the rich. Folks that have a lot — they already have more than $24,000 in deductions. They have always itemized and they will continue to itemize."

Wasinger said she did not want to increase taxes.

"I think we need to get our budget under control," she said.

Billinger and Wasigner&nbsp; both said they thought there might be another attempt to decrease sales tax on food. Both legislators said they would support legislation to that end.

Kansas has one of the highest food sales taxes in the country. Colorado and Nebraska both have no food sales tax, which makes it difficult for grocery stores near the borders to compete, Billinger said.

Billinger is co-sponsoring legislation to increase funding to the University of Kansas Cancer Center. The hope is the increased funding would put KU on par with cancer centers like the Mayo Clinic and MD Anderson in Texas.

Billinger also serves on the Financial Institutions and Insurance Committee. During a meeting of the committee this summer, concerns were expressed about the removal by the courts of the economic cap on lawsuits. The concern is this will cause insurance rates for doctors and professionals to increase.

The Legislature is set to be back in session Monday. Gov. Kelly will deliver her State of the State Address at 6:30 p.m. Wednesday, Jan. 15.

<figure>
 <img src="https://media.eaglewebservices.com/public/2020/1/1578519879551.png" alt="" />
 <figcaption></figcaption>
 </figure>By CRISTINA JANNEY Hays PostAs the 2020 legislative session rapidly approaches, local legislators say health care and mental health will be two of the top issues.State Sen. Rick Billinger, R-Goodland, said one of his top priorities is getting acute care juvenile psychiatric beds reinstated at the KVC Hospital in Hays.KVC announced in fall of last year it was closing its acute care beds in Hays because of Centers for Medicaid and Medicare regulations and issues with the space it rents at the Hadley Center.This means the nearest acute care&nbsp;psychiatric treatment for youth is in Wichita or Kansas City, and even Wichita has been full, Billinger said.<figure>
 <img src="https://media.eaglewebservices.com/public/2019/12/1576518852593.jpeg" alt="Sen. Rick Billinger, R-Goodland" />
 <figcaption>Sen. Rick Billinger, R-Goodland</figcaption>
 </figure>"Some of the folks from western Kansas have chosen not to get their youth any help because it is not a good option for them to go to Kansas City," Billinger said. "Consequently some of them are just taking these kids home."<a href="https://archive.hayspost.com/2019/11/04/closure-of-kvc-beds-leaves-kids-with-psychiatric-needs-hundreds-of-miles-from-treatment/">RELATED: Closure of KVC beds leaves kids with psychiatric needs hundreds of miles from treatment</a>Billinger said he has not been satisfied with KVC's explanation for the closure, saying similar rules were in place when KVC was awarded the state contract for the acute care beds 10 years ago."For many folks in the western part of Kansas, traveling to Wichita or Kansas City is not an option," Billinger said. "These parents need to be involved in the therapy sessions. Most of them are working and have jobs. It's just a crisis for those folks."Officials at KVC said they planned to convert the acute-care beds to residential treatment beds.<h2>Medicaid expansion</h2>Both Sen. Billinger and state Rep. Barb Wasinger, R-Hays, said they expect Medicaid expansion to be debated again this year.Gov. Kelly has said she is behind Medicaid expansion. Both houses of the Legislature passed bills to expand Medicaid while Gov. Brownback was in office. Brownback vetoed the bill, and the Legislature was unable to override the veto.Billinger was one of the legislators who has been a past supporter of the Medicaid expansion. He said he thought expansion is important to Kansas' rural hospitals."I hope we can put some policy in there that will make it better for the people on the expansion of Medicaid, but also the taxpayers," he said.<figure>
 <img src="https://media.eaglewebservices.com/public/2020/1/1578522379850.jpeg" alt="Rep. Barb Wasinger, R-Hays" />
 <figcaption>Rep. Barb Wasinger, R-Hays</figcaption>
 </figure>Rep. Wasinger said she also supports Medicaid expansion."I believe with what they are proposing, I need to support Medicaid expansion because it is important to my constituents in Ellis County along with HaysMed," she said.&nbsp; "I am concerned about the cost. I know we need to take great care with that and not bankrupt the state."<h2>ARNPs</h2>Wasinger also said the issue of autonomy for Advanced Registered Nurse Practitioners will likely be a topic of debate. ARNPs must work under the supervision of physicians, who often take a portion of their fees. ARNPs wish to be able to practice without this supervision.Wasinger said she supports ARNP autonomy and hoped this would be a means to expand health care options for northwest Kansas.She said she would also support a constitutional amendment that would reinstate abortion regulations." I am very interested in it because there are no regulations," Wasinger said. "I think it is a safety issue for women. It think we should protect the women of our state no matter what they decide to do."<h2>Court funding</h2>There will likely be the usual battles over the budget. A group of Kansas judges sued the Legislature claiming their courts are being underfunded.Pay for Kansas judges ranks 49 out of 50 states, with West Virginia the only state below Kansas.Billinger said the Legislature has been trying to put more money into courts, but filing a lawsuit was the wrong way to address the issue."We only have so much money to spend, and we are trying to address all of the challenges, including the courts. I'm not saying the courts don't need the additional funding, especially for some of the staff. ..."We have a lot of challenges," Billinger said of the budget. "We still have foster kids who sleep on the floors. We need to look at and repair a lot of these things."Wasinger said she did not wish to comment on the court lawsuit.She did say she was also concerned about the state of Kansas' foster care system."We have incredible foster care parents in Hays, and the fact they have not gotten calls and we still have children sleeping in offices is a sin," she said. "It is so scary."<h2>Budget and KPERS</h2>Neither legislator supported Gov. Kelly's plan to reamortize KPERS in 2020 to stretch the budget. An attempt to delay payments to KPERS last session was not supported by the Legislature. The proposed reamortization last year would have cost the state $7 billion.Last year was the first time in 25 years the state has made the full required contribution to KPERS."She has decided she wants to fund the state government on the backs of our KPERS folks — our school teachers and our state workers," Billinger said. "I don't believe that is going to fly."Wasinger said, "I think a stable budget is a much wiser policy than adding interest to our debt."<h2>Taxes</h2>Billinger said he would like to see the state decouple state income taxes from federal income taxes. When the federal government increased the standard deduction on income taxes, it meant some Kansans could no longer itemize on their state taxes.The governor vetoed two attempts to decouple during the last session."Part of the argument will be 'Here you are trying to cut taxes for the rich,' " he said. "Well, no, these folks are not what I call the rich. Folks that have a lot — they already have more than $24,000 in deductions. They have always itemized and they will continue to itemize."Wasinger said she did not want to increase taxes."I think we need to get our budget under control," she said.Billinger and Wasigner&nbsp; both said they thought there might be another attempt to decrease sales tax on food. Both legislators said they would support legislation to that end.Kansas has one of the highest food sales taxes in the country. Colorado and Nebraska both have no food sales tax, which makes it difficult for grocery stores near the borders to compete, Billinger said.Billinger is co-sponsoring legislation to increase funding to the University of Kansas Cancer Center. The hope is the increased funding would put KU on par with cancer centers like the Mayo Clinic and MD Anderson in Texas.Billinger also serves on the Financial Institutions and Insurance Committee. During a meeting of the committee this summer, concerns were expressed about the removal by the courts of the economic cap on lawsuits. The concern is this will cause insurance rates for doctors and professionals to increase.The Legislature is set to be back in session Monday. Gov. Kelly will deliver her State of the State Address at 6:30 p.m. Wednesday, Jan. 15.

Local senator wants KVC beds back; Medicaid expansion back on table in 2020

By CELIA LLOPIS-JEPSEN, <a href="https://www.kcur.org/post/getting-health-care-kansas-your-odds-may-be-worse-here-youll-get-surprise-bill#stream/0">Kansas News Service</a>

KANSAS CITY, Mo. — Chris Costantini lay in a cold sweat, his shoulder dislocated after slipping on a porch in Kansas City, Kansas.

He’d
 been out alone, knocking on doors and rustling up voters for the 
upcoming midterms in October 2018. Now he waited for an ambulance, full 
of anxiety about how the injury could hinder his next performance at the
 Kansas City Ballet.

“‘I’m not afraid to admit it was the most 
pain I’ve ever been in,” Costantini recalled. “The shoulder was probably
 out of the socket for about 45 minutes.”

A different anxiety 
only began later, when the bills rolled in. That ambulance, it turned 
out, didn’t fall in his insurance network. So Costantini found himself 
on the hook for a $900 bill.

Americans frequently get slapped 
with costs for out-of-network services in situations where they never 
had the chance to shop for an in-network option. But research suggests 
Kansans may be especially vulnerable.

A <a href="https://www.healthsystemtracker.org/brief/an-examination-of-surprise-medical-bills-and-proposals-to-protect-consumers-from-them/" target="_blank">Kaiser Family Foundation study</a>
 put Kansas in the five worst states for how often patients ran into 
out-of-network providers in 2017 during emergencies or during inpatient 
care at their in-network hospitals.

The extra bills that land in their mailboxes often come as a 
surprise, and pile onto in-network medical costs that already have 
patients’ heads spinning.

Costantini’s emergency led to more than
 $6,000 in in-network charges alone, for the hospital and doctor. His 
insurance company’s pre-negotiated rates knocked those charges down to 
less than $2,000.

<figure>
 <img src="https://media.eaglewebservices.com/public/2020/1/1578415041999.jpeg" alt="A student practices surgery techniques at Washburn Tech in Topeka. Chris Neal / For the Kansas News Service " />
 <figcaption>A student practices surgery techniques at Washburn Tech in Topeka. Chris Neal / For the Kansas News Service </figcaption>
 </figure>By CELIA LLOPIS-JEPSEN, <a href="https://www.kcur.org/post/getting-health-care-kansas-your-odds-may-be-worse-here-youll-get-surprise-bill#stream/0">Kansas News Service</a>KANSAS CITY, Mo. — Chris Costantini lay in a cold sweat, his shoulder dislocated after slipping on a porch in Kansas City, Kansas.He’d
 been out alone, knocking on doors and rustling up voters for the 
upcoming midterms in October 2018. Now he waited for an ambulance, full 
of anxiety about how the injury could hinder his next performance at the
 Kansas City Ballet.“‘I’m not afraid to admit it was the most 
pain I’ve ever been in,” Costantini recalled. “The shoulder was probably
 out of the socket for about 45 minutes.”A different anxiety 
only began later, when the bills rolled in. That ambulance, it turned 
out, didn’t fall in his insurance network. So Costantini found himself 
on the hook for a $900 bill.Americans frequently get slapped 
with costs for out-of-network services in situations where they never 
had the chance to shop for an in-network option. But research suggests 
Kansans may be especially vulnerable.A <a href="https://www.healthsystemtracker.org/brief/an-examination-of-surprise-medical-bills-and-proposals-to-protect-consumers-from-them/" target="_blank">Kaiser Family Foundation study</a>
 put Kansas in the five worst states for how often patients ran into 
out-of-network providers in 2017 during emergencies or during inpatient 
care at their in-network hospitals.The extra bills that land in their mailboxes often come as a 
surprise, and pile onto in-network medical costs that already have 
patients’ heads spinning.Costantini’s emergency led to more than
 $6,000 in in-network charges alone, for the hospital and doctor. His 
insurance company’s pre-negotiated rates knocked those charges down to 
less than $2,000.He tackled that and the ambulance in more manageable monthly increments, counting his blessings that he could afford it.“Perversely, I feel lucky,” Costantini said. “You would think that we wouldn’t have to feel lucky.”<h2>The ‘black box’</h2>Kaiser
 tapped a database with claims for 19 million people nationwide who got 
their health insurance through large-employer plans.Nearly one 
in five emergency care visits meant running into a doctor or someone 
else outside a patient’s network. The situation was only slightly better
 for inpatient care at in-network hospitals.But those figures 
mask a more complex picture: The situation varies widely by state. While
 Kansas fell at the bottom of the pack, neighboring Nebraska rose to the
 top.What explains higher out-of-network rates in Kansas? Experts aren’t sure.Hospitals and billing are “very much a black box,” said Karen Pollitz, the study’s co-author.That
 complicates research. And patients wonder whether they’ll make it out 
the hospital door without bumping into an out-of-network assistant 
surgeon or radiologist.“It just feels like a minefield, you know,” Pollitz said.Nationally,
 experts know some hospitals are far worse than others, though it’s 
difficult to pinpoint the culprits behind wide regional and even local 
disparities. And situations can vary year by year, as insurance networks
 change, as hospitals buy up physician groups, or as new staffing 
companies land on the scene with business models built around aggressive
 billing.The Kansas Insurance Department doesn’t oversee the nitty-gritty 
details of insurer-provider contracts that might shed light on Kaiser’s 
analysis of Kansas claims. The kind of private insurance studied by 
Kaiser overwhelmingly falls under federal, not state, law.<h2>Where logic fails</h2>Patients
 often don’t realize they’ve received out-of-network services until an 
extra bill arrives from a provider they never chose.“The 
anesthesiologist is who’s on call when you show up,” Pollitz said. “If 
you’re having cancer surgery, you’ll never meet the pathologist who 
looks at your slides.”Laura Burton made the common assumption 
that the doctors walking the halls of her in-network hospital in Topeka 
work for that hospital and fall in the same network.“Absolutely,” she said. “One hundred percent, that’s what I believed.”Then
 came a letter from a Michigan mailing address demanding $400 for a 
pediatrician employed by an external staffing firm who checked on baby 
Amelia soon after her 2014 birth.“It was not something we could 
pay off off-hand,” Burton recalled. “Who would ever anticipate that a 
random physician would come in who wouldn’t be covered?”After a 
pregnancy full of complications, her bills surpassed her deductible and 
out-of-pocket maximum well before labor. She and her husband went into 
the final stretch thinking delivery wouldn’t cost more. They paid off 
the unpleasant surprise gradually.A <a href="https://www.federalreserve.gov/publications/2018-economic-well-being-of-us-households-in-2017-dealing-with-unexpected-expenses.htm" target="_blank">Federal Reserve</a>
 survey found an unexpected $400 bill would cause problems for 40% of 
U.S. adults, making them borrow money, sell property or fall behind on 
credit card debt. And surprise bills are, by definition, impossible to 
plan for.“It’s a really frustrating, powerless feeling for 
patients,” said Chris Garmon, an economist at the University of 
Missouri-Kansas City who previously worked on antitrust investigations 
at the Federal Trade Commission. “The more things that are done to you 
in the hospital, the more likely you are to encounter an out-of-network 
provider.”<figure>
 <img src="https://media.eaglewebservices.com/public/2020/1/1578414966600.jpeg" alt="Credit Chris Neal / For the Kansas News Service" />
 <figcaption>Credit Chris Neal / For the Kansas News Service</figcaption>
 </figure>Even a brief drop-in to someone’s room can lead to a hefty surprise bill.“That’s called drive-by doctoring,” he said. “That’s a real source of this.”<h2>In search of a solution</h2>People
 like Burton in Topeka have done things right, said Jack Hoadley, a 
health policy researcher and professor emeritus at Georgetown 
University. They got insurance and went to an in-network hospital.Yet none of that helps if the pediatrician who pops by has no deal with your insurer.“You run into a situation that — how do you control?” he said.Experts warn that some providers — such as hospital staffing companies <a href="https://khn.org/news/investors-deep-pocket-push-to-defend-surprise-medical-bills/" target="_blank">backed by private equity funds</a>
 — avoid joining networks to cash in on the lucrative world of surprise 
billing. That lets them charge more than the rates negotiated by 
insurance companies.A Stanford University analysis of millions of insurance claims found <a href="https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2740802?guestAccessKey=9fba6e0c-f029-401a-9675-737db3e67b5d&amp;utm_source=For_The_Media&amp;utm_medium=referral&amp;utm_campaign=ftm_links&amp;utm_content=tfl&amp;utm_term=081219" target="_blank">more than 80%</a>
 of ambulance rides fell outside patients’ insurance networks. New 
research from Yale University, meanwhile, estimates that reining in 
out-of-network billing by anesthetists and others could cut health care 
spending by <a href="https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2019.00507?utm_campaign=MEDIA+ADVISORY%3A+Cooper+AOP+12-16-19&amp;utm_medium=email&amp;utm_content=From+Health+Affairs%3A++The+Cost+Of+Out-of-Network+Billing+For+In-Network+Hospital+Care&amp;utm_source=Newsletter" target="_blank">tens of billions of dollars</a> annually.“It’s
 (a problem) that jumps up and bites people for a significant amount of 
money that they can’t afford,” Hoadley said, “And it’s one that that is 
fixable.”<a href="https://khn.org/news/congress-compromise-legislation-on-surprise-medical-bills/" target="_blank">A recent push in Congress</a>
 has advocates hopeful that 2020 could finally bring a federal solution,
 though details remain up in the air. Surprise billers have pressed 
Congress not to curb charges too much.Meanwhile, half of states —
 red and blue alike — didn’t wait for a federal fix. They’ve passed some
 level of consumer protections against surprise bills.Kansas hasn’t. And though it might be especially useful in a state where the ACA health exchange <a href="https://www.kcur.org/post/kansans-have-more-options-ever-2020-aca-marketplace-read-fine-print#stream/0" target="_blank">offers only plans that are particularly unhelpful</a> for out-of-network care, advocates say action in Washington, D.C., is the ideal.State laws can’t help most people with private insurance through work, for example. Only changes to federal law can.Celia
 Llopis-Jepsen reports on consumer health and education for the Kansas 
News Service. You can follow her on Twitter @Celia_LJ or email her at 
celia@kcur.org. The Kansas News Service is a collaboration of
 KCUR, Kansas Public Radio, KMUW and High Plains Public Radio focused on
 the health and well-being of Kansans, their communities and civic life.