BY:&nbsp;TIM CARPENTER <a href="https://kansasreflector.com/">Kansas Reflector</a>

Review of KanCare applicants plagued by mail delays, call center backlog

TOPEKA — Lengthy delays in mail delivery, unprecedented call center volume and a surge in unsigned applications contributed to the Kansas Department of Health and Environment’s tribulations in processing Medicaid renewal applications that led to suspension of benefits on procedural grounds for more than 60,000 Kansans.

KDHE’s extension of application deadlines, deployment of additional staff and collaboration with organizations working on behalf of Medicaid clients reduced obstacles to determining who could remain in Kansas’ Medicaid program, a KDHE official said. The federal government triggered the wave of eligibility reviews after ending a three-year ban imposed during the COVID-19 pandemic.

Participation in KanCare, the Medicaid program in Kansas, surged during the pandemic from 410,000 to 540,000. The nationwide process of evaluating Medicaid rolls to identify people no longer eligible, known as unwinding, began in March and must be completed in early 2024.

“Obviously, we’ve never done an unwinding before in the state of Kansas or anywhere in the nation,” said KDHE deputy secretary Christine Osterlund. “In these first four months, we’ve learned a lot. We’ve made some missteps. We’ve corrected some things.”

Rep. Brenda Landwehr, a Wichita Republican on the Legislature’s Medicaid committee, said individuals no longer eligible for KanCare should be urged to seek health insurance under provisions of the Affordable Care Act signed by President Barack Obama.

“I had some people call me that got canceled,” Landwehr said. “Four of those individuals … got Obamacare insurance. You know, one was a zero premium, one was $10 dollars and one was $15. Are we making sure that they have information so that they know that’s an option?”

Child advocacy groups have been alarmed children made up two-thirds of Kansans declared ineligible for KanCare due to procedural issues with applications, including missed deadlines and missing signatures. Those concerns were raised Wednesday and Thursday at the Capitol during meetings of the joint House and Senate committee responsible for Medicaid oversight.

“We suspect that because nearly 72% of KanCare enrollees are children, thousands of Kansas kids have already had their coverage discontinued and thousands more will in the future,” said Heather Braum, health policy director of Kansas Action for Children. “A lack of health coverage means these kids will be less likely to get medical treatments on time, will fall behind in therapies and could have the long-term trajectory of their lives negatively impacted.”

Sean Gatewood, of KanCare Advocates Network, said continuous coverage was important for children and for adults with chronic health conditions.

“We recognize the challenges that come with restarting eligibility reviews after three years of continuous coverage during the pandemic,” Gatewood said. “Our partners report that KanCare members continue to be either unaware or confused about process. Ongoing confusion among members and problems associated with paperwork issues seem to indicate the need for additional communication and outreach.”

He urged KDHE to allow the three managed-care organizations under contract with the state to operate the privatized KanCare program to work with applicants subject to renewal.

“KanCare members need a simple renewal process that is easy to complete to continue their health care, their medications and therapies,” Gatewood said.

Osterlund said KDHE decided to conduct KanCare renewals in a chronological order rather than subjectively prioritize children, people with serious medical challenges, individuals in long-term care or other populations. So far, KDHE has sent notices to individuals or families with renewal dates in April, May, June and July.

KDHE said renewal applications submitted by the deadline allowed members to retain eligibility while the renewal was processed, but the state has been instructed to sever eligibility for people who didn’t submit renewals on time. Families or persons losing KanCare eligibility for procedural issues have been given an additional 30 days to complete the application and, if approved, would have benefits backdated to address the coverage gap.

“I know there’s a gap in coverage and that’s stressful for the families,” Osterlund said. “I’m not minimizing that, but we do kind of provide this second chance, if you will, to go ahead and get that review in and be able to have their eligibility backdated.”

Osterlund said the volume of calls received by KDHE’s help line exceeded the agency’s projections by about 2,000 calls per day. She said the number of calls climbed from 19,000 in April to more than 37,000 in May and June. The response time at outset of unwinding in April was 43 minutes and more than half of callers chose to hang up.

KDHE’s call center contractor gradually reduced the call-waiting time to 12 minutes and the level of call abandonment to 16% in July by adding staff, changing work schedules and allowing for overtime.

KDHE was surprised by the slow pace at which the agency’s Medicaid renewal notices were moved by the U.S. Postal Service to Kansans and how much time it took for applications to be returned once placed in the postal system. In the past, KDHE said, it might take two or three days for a KanCare client’s letter to reach Topeka.

KDHE discovered it was taking up to 10 days for mail to reach an applicant and another 10 days for mailed responses to reach clearinghouse staff in Topeka, which left applicants only 10 days during the original window to submit paperwork.

KDHE responded by pausing Medicaid discontinuances and expanded the period allotted for applicants to receive and return necessary documents, Osterlund said.

She said KDHE also encountered an increase in the proportion of applicants who didn’t sign paperwork in compliance with federal regulations. Unsigned applications must be sent back by KDHE to the family.

Given the escalation in mail sent to KDHE, officials said, agency staff were reassigned to the mailroom and eight additional scanners were obtained to address backlogs in the mail department.

Osterlund said KDHE’s computer system in place since 2016 wasn’t constructed to accommodate a national health emergency nor a three-year suspension of eligibility reviews for Medicaid. She said the agency had received many requests for detailed data about the unwinding that the current IT system wasn’t programmed to handle.

“It’s not even an option. We would have to do massive system changes,” she said. “Again, no one anticipated wanting the level of detail we are being asked for.”

KDHE was able in mid-July to release information on KanCare renewals by county and by age of applicants. That prompted alarm among KanCare activists who concluded two-thirds of rejections in Kansas involved children.

Osterlund cautioned unwinding information released by the U.S. Centers for Medicare and Medicaid Services showing Kansas had a 70% disenrollment rate could be misinterpreted. She said point-in-time data submitted by KDHE to CMS each month could be outdated within a single day. She said state-by-state comparisons of data from CMS weren’t typically valid given variation in how the review process was conducted.

KanCare Advocates Network and Kansas Action for Children continued to press KDHE for greater statistical insight into why people were losing Medicaid benefits. KDHE’s initial breakdown by age and county was helpful, they said, but more robust data and targeted communication could assist KanCare members in retention of coverage.

“Without aggregated demographic data,” Gatewood said, “stakeholders don’t know where to target outreach. The stakes are high for people who depend on Medicaid for their health care needs.”

<figure>
 <img src="https://media.eaglewebservices.com/public/2023/8/1691181866636.png" alt="Rep. Brenda Landwehr, R-Wichita, said Kansans determined to be ineligible for the state’s Medicaid program should be urged to seek health insurance under provisions of the Affordable Care Act. Kansas has resumed KanCare eligibility reviews after pausing for three years due to COVID-19. (Sam Bailey/Kansas Reflector)" />
 <figcaption>Rep. Brenda Landwehr, R-Wichita, said Kansans determined to be ineligible for the state’s Medicaid program should be urged to seek health insurance under provisions of the Affordable Care Act. Kansas has resumed KanCare eligibility reviews after pausing for three years due to COVID-19. (Sam Bailey/Kansas Reflector)</figcaption>
 </figure>BY:&nbsp;TIM CARPENTER <a href="https://kansasreflector.com/">Kansas Reflector</a><h2>Review of KanCare applicants plagued by mail delays, call center backlog</h2>TOPEKA — Lengthy delays in mail delivery, unprecedented call center volume and a surge in unsigned applications contributed to the Kansas Department of Health and Environment’s tribulations in processing Medicaid renewal applications that led to suspension of benefits on procedural grounds for more than 60,000 Kansans.KDHE’s extension of application deadlines, deployment of additional staff and collaboration with organizations working on behalf of Medicaid clients reduced obstacles to determining who could remain in Kansas’ Medicaid program, a KDHE official said. The federal government triggered the wave of eligibility reviews after ending a three-year ban imposed during the COVID-19 pandemic.Participation in KanCare, the Medicaid program in Kansas, surged during the pandemic from 410,000 to 540,000. The nationwide process of evaluating Medicaid rolls to identify people no longer eligible, known as unwinding, began in March and must be completed in early 2024.“Obviously, we’ve never done an unwinding before in the state of Kansas or anywhere in the nation,” said KDHE deputy secretary Christine Osterlund. “In these first four months, we’ve learned a lot. We’ve made some missteps. We’ve corrected some things.”Rep. Brenda Landwehr, a Wichita Republican on the Legislature’s Medicaid committee, said individuals no longer eligible for KanCare should be urged to seek health insurance under provisions of the Affordable Care Act signed by President Barack Obama.“I had some people call me that got canceled,” Landwehr said. “Four of those individuals … got Obamacare insurance. You know, one was a zero premium, one was $10 dollars and one was $15. Are we making sure that they have information so that they know that’s an option?”<h2>Concerns expressed</h2>Child advocacy groups have been alarmed children made up two-thirds of Kansans declared ineligible for KanCare due to procedural issues with applications, including missed deadlines and missing signatures. Those concerns were raised Wednesday and Thursday at the Capitol during meetings of the joint House and Senate committee responsible for Medicaid oversight.“We suspect that because nearly 72% of KanCare enrollees are children, thousands of Kansas kids have already had their coverage discontinued and thousands more will in the future,” said Heather Braum, health policy director of Kansas Action for Children. “A lack of health coverage means these kids will be less likely to get medical treatments on time, will fall behind in therapies and could have the long-term trajectory of their lives negatively impacted.”Sean Gatewood, of KanCare Advocates Network, said continuous coverage was important for children and for adults with chronic health conditions.“We recognize the challenges that come with restarting eligibility reviews after three years of continuous coverage during the pandemic,” Gatewood said. “Our partners report that KanCare members continue to be either unaware or confused about process. Ongoing confusion among members and problems associated with paperwork issues seem to indicate the need for additional communication and outreach.”He urged KDHE to allow the three managed-care organizations under contract with the state to operate the privatized KanCare program to work with applicants subject to renewal.“KanCare members need a simple renewal process that is easy to complete to continue their health care, their medications and therapies,” Gatewood said.<h2>Call center avalanche</h2>Osterlund said KDHE decided to conduct KanCare renewals in a chronological order rather than subjectively prioritize children, people with serious medical challenges, individuals in long-term care or other populations. So far, KDHE has sent notices to individuals or families with renewal dates in April, May, June and July.KDHE said renewal applications submitted by the deadline allowed members to retain eligibility while the renewal was processed, but the state has been instructed to sever eligibility for people who didn’t submit renewals on time. Families or persons losing KanCare eligibility for procedural issues have been given an additional 30 days to complete the application and, if approved, would have benefits backdated to address the coverage gap.“I know there’s a gap in coverage and that’s stressful for the families,” Osterlund said. “I’m not minimizing that, but we do kind of provide this second chance, if you will, to go ahead and get that review in and be able to have their eligibility backdated.”Osterlund said the volume of calls received by KDHE’s help line exceeded the agency’s projections by about 2,000 calls per day. She said the number of calls climbed from 19,000 in April to more than 37,000 in May and June. The response time at outset of unwinding in April was 43 minutes and more than half of callers chose to hang up.KDHE’s call center contractor gradually reduced the call-waiting time to 12 minutes and the level of call abandonment to 16% in July by adding staff, changing work schedules and allowing for overtime.<h2>Postal delivery</h2>KDHE was surprised by the slow pace at which the agency’s Medicaid renewal notices were moved by the U.S. Postal Service to Kansans and how much time it took for applications to be returned once placed in the postal system. In the past, KDHE said, it might take two or three days for a KanCare client’s letter to reach Topeka.KDHE discovered it was taking up to 10 days for mail to reach an applicant and another 10 days for mailed responses to reach clearinghouse staff in Topeka, which left applicants only 10 days during the original window to submit paperwork.KDHE responded by pausing Medicaid discontinuances and expanded the period allotted for applicants to receive and return necessary documents, Osterlund said.She said KDHE also encountered an increase in the proportion of applicants who didn’t sign paperwork in compliance with federal regulations. Unsigned applications must be sent back by KDHE to the family.Given the escalation in mail sent to KDHE, officials said, agency staff were reassigned to the mailroom and eight additional scanners were obtained to address backlogs in the mail department.<h2>Availability of data</h2>Osterlund said KDHE’s computer system in place since 2016 wasn’t constructed to accommodate a national health emergency nor a three-year suspension of eligibility reviews for Medicaid. She said the agency had received many requests for detailed data about the unwinding that the current IT system wasn’t programmed to handle.“It’s not even an option. We would have to do massive system changes,” she said. “Again, no one anticipated wanting the level of detail we are being asked for.”KDHE was able in mid-July to release information on KanCare renewals by county and by age of applicants. That prompted alarm among KanCare activists who concluded two-thirds of rejections in Kansas involved children.Osterlund cautioned unwinding information released by the U.S. Centers for Medicare and Medicaid Services showing Kansas had a 70% disenrollment rate could be misinterpreted. She said point-in-time data submitted by KDHE to CMS each month could be outdated within a single day. She said state-by-state comparisons of data from CMS weren’t typically valid given variation in how the review process was conducted.KanCare Advocates Network and Kansas Action for Children continued to press KDHE for greater statistical insight into why people were losing Medicaid benefits. KDHE’s initial breakdown by age and county was helpful, they said, but more robust data and targeted communication could assist KanCare members in retention of coverage.“Without aggregated demographic data,” Gatewood said, “stakeholders don’t know where to target outreach. The stakes are high for people who depend on Medicaid for their health care needs.”

Kansas official points to mistakes, improvements in processing Medicaid eligibility renewals

MORRIS COUNTY—A Kansas teen died in an accident just before 11a.m. Sunday in Morris County.

According to the sheriff's department, the&nbsp;Life Alert 360 mobile phone app, notified the sheriff's office of a possible car crash near 1800 Road and Z Ave. in Morris County.

A Sheriff’s Deputy responded to the accident location and found a 2003 Chevy S10 pickup driven by Kolter L. Litke, 15, of Council Grove had been involved in an accident.

The Deputy immediately started CPR. EMS transported Kolter to the Morris County Hospital with life threatening injuries. He was later pronounced deceased.

&nbsp;The preliminary investigation indicated the truck was traveling eastbound on Z Avenue near 1800 Road when it left the roadway and struck a concrete bridge rail.

MORRIS COUNTY—A Kansas teen died in an accident just before 11a.m. Sunday in Morris County.According to the sheriff's department, the&nbsp;Life Alert 360 mobile phone app, notified the sheriff's office of a possible car crash near 1800 Road and Z Ave. in Morris County.A Sheriff’s Deputy responded to the accident location and found a 2003 Chevy S10 pickup driven by Kolter L. Litke, 15, of Council Grove had been involved in an accident.The Deputy immediately started CPR. EMS transported Kolter to the Morris County Hospital with life threatening injuries. He was later pronounced deceased.&nbsp;The preliminary investigation indicated the truck was traveling eastbound on Z Avenue near 1800 Road when it left the roadway and struck a concrete bridge rail.

Sheriff: 15-year-old Kan. boy dies after crash into bridge rail

JOHNSON COUNTY — A shooting early Sunday at a convenience store left a suspect dead and a Kansas police officer hospitalized after an exchange of gunfire, according to Lenexa police.

Just after 7:30 a.m., police responded to a stolen vehicle call at the QuikTrip at 95th Street and Interstate 35, according to a media release.

 Officers located that car and the suspect in the stolen vehicle struck one of Lenexa police department's patrol vehicles and drove away.

Police pursued the suspect northbound on Interstate 35 until the suspects left the vehicle and ran to a QuikTrip in the 4700 Block of Lamar Avenue in Mission.

Police from multiple agencies were trying to arrest the suspects when gunfire broke out. A suspect later identified as 40-year-old&nbsp;Shannon Wayne Marshall of Ashland City, Tennessee was shot and killed and a Fairway Kansas police officer was shot and hospitalized. 

The other suspect was arrested and later identified as 32-year-old Andrea Cothran of Portland Tennesee.

Cothran, a registered sex offender, is being held in Johnson County on&nbsp; requested charges of aggravated assault of a law enforcement officer, according to online jail records.

She is listed on the Tennessee sex offender registry for a July 2019 conviction for solicitation to commit sexual exploitation of a minor.  She has three previous convictions for child abuse and a probation violation for drugs, according to the Tennessee offender registry. She is scheduled for a court appearance in the case at 1:30p.m. Monday, according to online jail records.

Police have identified the officer who was wounded. A Johnson County law enforcement team is investigating the officer-involved shooting.

<figure>
 <img src="https://media.eaglewebservices.com/public/2023/8/1691373333169.png" alt="Cothran is listed on the Tennessee sex offender registry for a July 2019 conviction for solicitation to commit sexual exploitation of a minor.&nbsp; She has three previous convictions for child abuse and a probation violation for drugs, according to the Tennessee offender registry." />
 <figcaption>Cothran is listed on the Tennessee sex offender registry for a July 2019 conviction for solicitation to commit sexual exploitation of a minor.&nbsp; She has three previous convictions for child abuse and a probation violation for drugs, according to the Tennessee offender registry.</figcaption>
 </figure>JOHNSON COUNTY — A shooting early Sunday at a convenience store left a suspect dead and a Kansas police officer hospitalized after an exchange of gunfire, according to Lenexa police.Just after 7:30 a.m., police responded to a stolen vehicle call at the QuikTrip at 95th Street and Interstate 35, according to a media release. Officers located that car and the suspect in the stolen vehicle struck one of Lenexa police department's patrol vehicles and drove away.Police pursued the suspect northbound on Interstate 35 until the suspects left the vehicle and ran to a QuikTrip in the 4700 Block of Lamar Avenue in Mission.Police from multiple agencies were trying to arrest the suspects when gunfire broke out. A suspect later identified as 40-year-old&nbsp;Shannon Wayne Marshall of Ashland City, Tennessee was shot and killed and a Fairway Kansas police officer was shot and hospitalized. The other suspect was arrested and later identified as 32-year-old Andrea Cothran of Portland Tennesee.Cothran, a registered sex offender, is being held in Johnson County on&nbsp; requested charges of aggravated assault of a law enforcement officer, according to online jail records.She is listed on the Tennessee sex offender registry for a July 2019 conviction for solicitation to commit sexual exploitation of a minor. She has three previous convictions for child abuse and a probation violation for drugs, according to the Tennessee offender registry. She is scheduled for a court appearance in the case at 1:30p.m. Monday, according to online jail records.Police have identified the officer who was wounded. A Johnson County law enforcement team is investigating the officer-involved shooting.

Sex offender jailed after chase, fatal gunfight that injured Kan. officer

WASHINGTON (AP) —Two conservative groups are asking a federal court to block the Biden administration's plan to cancel $39 billion in student loans for more than 800,000 borrowers.

In a lawsuit filed Friday in Michigan, the groups argue that the administration overstepped its power when it announced the forgiveness in July, just weeks after the Supreme Court&nbsp;<a href="https://apnews.com/article/student-loan-forgiveness-supreme-court-653c2e9c085863bdbf81f125f87669fa">struck down a broader cancellation plan</a>&nbsp;pushed by President Joe Biden.

It asks a judge to rule the cancellation illegal and stop the Education Department from carrying it out while the case is decided. The suit was filed by the New Civil Liberties Alliance on behalf of the Mackinac Center for Public Policy and the Cato Institute.

The Education Department called the suit “a desperate attempt from right wing special interests to keep hundreds of thousands of borrowers in debt.”

“We are not going to back down or give an inch when it comes to defending working families,” the department said in a statement.

It’s part of a wave of legal challenges Republicans have leveled at the Biden administration’s efforts to reduce or eliminate student debt for millions of Americans. Biden has said he will pursue a different cancellation plan after the Supreme Court decision, and his administration is separately unrolling a&nbsp;<a href="https://apnews.com/article/student-loans-debt-college-cancellation-forgiveness-34152bb5000128a413efd2287887a37a">more generous repayment plan</a>&nbsp;that opponents call a “backdoor attempt” at cancellation.

The Biden administration announced July 14 that it would soon forgive loans for 804,000 borrowers enrolled in income-driven repayment plans. The plans have long offered cancellation after borrowers make 20 or 25 years of payments, but “past administrative failures” resulted in inaccurate payments counts that set borrowers back on their progress toward forgiveness, the department said.

The new action was announced as a “one-time adjustment” that would count certain periods of past nonpayment as if borrowers had been making payments during that time. It moved 804,000 borrowers across the 20- or 25-year mark needed for cancellation, and it moved millions of others closer to that threshold.

It’s meant to address a practice known as forbearance steering, in which student loan servicers hired by the government wrongly pushed borrowers to go into forbearance — a temporary pause on payments because of hardship — even if they would have been better served by enrolling in one of the income-driven repayment plans.

Under the one-time fix, past periods in forbearance were also counted as progress toward&nbsp;<a href="https://apnews.com/article/pslf-public-service-loan-forgiveness-program-student-loans-e840af29f8879512199ed6fce226c722">Public Service Loan Forgiveness</a>, a program that offers cancellation after 10 years of payments while working in a government or nonprofit job.

Biden's action was illegal, the lawsuit says, because it wasn’t authorized by Congress and didn’t go through a federal rulemaking process that invites public feedback.

“No authority allows the Department to count non-payments as payments,” the lawsuit says. It adds that the action came in “a press release that neither identified the policy’s legal authority nor considered its exorbitant price tag.”

The conservative groups say Biden’s plan undercuts Public Service Loan Forgiveness. The Mackinac Center and Cato Institute say they employ borrowers who are working toward student loan cancellation through the program. They say Biden’s action illegally accelerates progress toward relief, diminishing the benefit for nonprofit employers.

“This unlawful reduction in the PSLF service requirement injures public service employers that rely on PSLF to recruit and retain college-educated employees,” the suit alleges.

The Cato Institute previously sued the administration over the cancellation plan that was struck down by the Supreme Court. The Mackinac Center is separately challenging Biden’s pause on student loan payments, which is scheduled to end this fall with payments resuming Oct. 1.

<figure>
 <img src="https://media.eaglewebservices.com/public/2022/8/1661367707782.png" alt="The Biden administration announced July 14 that it would soon forgive loans for 804,000 borrowers enrolled in income-driven repayment plans.-file photo White House" />
 <figcaption>The Biden administration announced July 14 that it would soon forgive loans for 804,000 borrowers enrolled in income-driven repayment plans.-file photo White House</figcaption>
 </figure>WASHINGTON (AP) —Two conservative groups are asking a federal court to block the Biden administration's plan to cancel $39 billion in student loans for more than 800,000 borrowers.In a lawsuit filed Friday in Michigan, the groups argue that the administration overstepped its power when it announced the forgiveness in July, just weeks after the Supreme Court&nbsp;<a href="https://apnews.com/article/student-loan-forgiveness-supreme-court-653c2e9c085863bdbf81f125f87669fa">struck down a broader cancellation plan</a>&nbsp;pushed by President Joe Biden.It asks a judge to rule the cancellation illegal and stop the Education Department from carrying it out while the case is decided. The suit was filed by the New Civil Liberties Alliance on behalf of the Mackinac Center for Public Policy and the Cato Institute.The Education Department called the suit “a desperate attempt from right wing special interests to keep hundreds of thousands of borrowers in debt.”“We are not going to back down or give an inch when it comes to defending working families,” the department said in a statement.It’s part of a wave of legal challenges Republicans have leveled at the Biden administration’s efforts to reduce or eliminate student debt for millions of Americans. Biden has said he will pursue a different cancellation plan after the Supreme Court decision, and his administration is separately unrolling a&nbsp;<a href="https://apnews.com/article/student-loans-debt-college-cancellation-forgiveness-34152bb5000128a413efd2287887a37a">more generous repayment plan</a>&nbsp;that opponents call a “backdoor attempt” at cancellation.<figure>
 <img src="https://media.eaglewebservices.com/public/2023/7/1689354752515.png" alt="" />
 <figcaption></figcaption>
 </figure>The Biden administration announced July 14 that it would soon forgive loans for 804,000 borrowers enrolled in income-driven repayment plans. The plans have long offered cancellation after borrowers make 20 or 25 years of payments, but “past administrative failures” resulted in inaccurate payments counts that set borrowers back on their progress toward forgiveness, the department said.The new action was announced as a “one-time adjustment” that would count certain periods of past nonpayment as if borrowers had been making payments during that time. It moved 804,000 borrowers across the 20- or 25-year mark needed for cancellation, and it moved millions of others closer to that threshold.It’s meant to address a practice known as forbearance steering, in which student loan servicers hired by the government wrongly pushed borrowers to go into forbearance — a temporary pause on payments because of hardship — even if they would have been better served by enrolling in one of the income-driven repayment plans.Under the one-time fix, past periods in forbearance were also counted as progress toward&nbsp;<a href="https://apnews.com/article/pslf-public-service-loan-forgiveness-program-student-loans-e840af29f8879512199ed6fce226c722">Public Service Loan Forgiveness</a>, a program that offers cancellation after 10 years of payments while working in a government or nonprofit job.Biden's action was illegal, the lawsuit says, because it wasn’t authorized by Congress and didn’t go through a federal rulemaking process that invites public feedback.“No authority allows the Department to count non-payments as payments,” the lawsuit says. It adds that the action came in “a press release that neither identified the policy’s legal authority nor considered its exorbitant price tag.”The conservative groups say Biden’s plan undercuts Public Service Loan Forgiveness. The Mackinac Center and Cato Institute say they employ borrowers who are working toward student loan cancellation through the program. They say Biden’s action illegally accelerates progress toward relief, diminishing the benefit for nonprofit employers.“This unlawful reduction in the PSLF service requirement injures public service employers that rely on PSLF to recruit and retain college-educated employees,” the suit alleges.The Cato Institute previously sued the administration over the cancellation plan that was struck down by the Supreme Court. The Mackinac Center is separately challenging Biden’s pause on student loan payments, which is scheduled to end this fall with payments resuming Oct. 1.___

Two groups sue to block Biden plan canceling $39 billion in student loans

WYANDOTTE COUNTY —Law enforcement authorities are investigating a shooting that has left one person dead and another injured

Just after 5p.m. Saturday, police were dispatched to report of a shooting in the 1500 block of N. 5th Street in Kansas City, according to a&nbsp; media release. 

First responders discovered a man and a juvenile who had both been struck by gunfire. Both victims were transported to an area hospital for treatment. Once at the hospital, the man was pronounced deceased. The juvenile was in stable condition.

This incident is under investigation by the KCKPD Major Case Unit. Police reported no additional details including suspect information.

WYANDOTTE COUNTY —Law enforcement authorities are investigating a shooting that has left one person dead and another injuredJust after 5p.m. Saturday, police were dispatched to report of a shooting in the 1500 block of N. 5th Street in Kansas City, according to a&nbsp; media release. First responders discovered a man and a juvenile who had both been struck by gunfire. Both victims were transported to an area hospital for treatment. Once at the hospital, the man was pronounced deceased. The juvenile was in stable condition.This incident is under investigation by the KCKPD Major Case Unit. Police reported no additional details including suspect information.

Man dead, juvenile wounded in Kansas shooting

SEDGWICK COUNTY—A law enforcement officer is recovering from injuries in accident that occurred just after 12:30p.m. Saturday in Wichita.

The Kansas Highway Patrol reported a 2020 Ford Explorer driven by Officer Christopher Ruhlen, 34,Wichita, was southbound on Main Street passing through the intersection of Main and Kellogg Drive with emergency lights activated.

An eastbound 2018 Ford F150 driven by Ernest Ramirez, 60, Hutchinson,&nbsp; struck the SUV on the passenger side door and quarter panel.

EMS transported both drivers to a local hospital for treatment. Two juveniles were present in the vehicle; juvenile record protected data, according to the KHP.

Wichita police released no additional details on the incident or why Ruhlen had emergency lights activated.

<figure>
 <img src="https://media.eaglewebservices.com/public/2023/8/1691332520774.png" alt="View of the crash scene -photo courtesy KWCH" />
 <figcaption>View of the crash scene -photo courtesy KWCH</figcaption>
 </figure>SEDGWICK COUNTY—A law enforcement officer is recovering from injuries in accident that occurred just after 12:30p.m. Saturday in Wichita.The Kansas Highway Patrol reported a 2020 Ford Explorer driven by Officer Christopher Ruhlen, 34,Wichita, was southbound on Main Street passing through the intersection of Main and Kellogg Drive with emergency lights activated.An eastbound 2018 Ford F150 driven by Ernest Ramirez, 60, Hutchinson,&nbsp; struck the SUV on the passenger side door and quarter panel.EMS transported both drivers to a local hospital for treatment. Two juveniles were present in the vehicle; juvenile record protected data, according to the KHP.Wichita police released no additional details on the incident or why Ruhlen had emergency lights activated.

Kan. officer recovering after 2-vehicle crash during pursuit

JACKSON COUNTY—Law enforcement authorities are investigating a suspect for alleged child sex crimes.

On August 2,&nbsp;&nbsp;Jackson County Sheriff Detectives and Deputies served a search warrant on a residence located at 110 S. Pennsylvania Avenue in Holton, according to Sheriff Tim Morse.

Deputies arrested 30-year-old Taylor Bryant Day of Holton for the alleged sexual solicitation of a small child.

He is being held in the Jackson County Jail on requested charges of criminal solicitation indecent liberties of a child, child endangerment, possession of a hallucinogenic drug and possession of drug paraphernalia, according to Morse.

<figure>
 <img src="https://media.eaglewebservices.com/public/2023/8/1691160957916.png" alt="Day-photo Jackson County" />
 <figcaption>Day-photo Jackson County</figcaption>
 </figure>JACKSON COUNTY—Law enforcement authorities are investigating a suspect for alleged child sex crimes.On August 2,&nbsp;&nbsp;Jackson County Sheriff Detectives and Deputies served a search warrant on a residence located at 110 S. Pennsylvania Avenue in Holton, according to Sheriff Tim Morse.Deputies arrested 30-year-old Taylor Bryant Day of Holton for the alleged sexual solicitation of a small child.He is being held in the Jackson County Jail on requested charges of criminal solicitation indecent liberties of a child, child endangerment, possession of a hallucinogenic drug and possession of drug paraphernalia, according to Morse.

Kansas man accused of sexual solicitation of a small child

SHAWNEE COUNTY —Law enforcement authorities are investigating two suspect on drug allegations after a traffic stop.

Just after&nbsp;11p.m. August 3, a deputy with the Shawnee County Sheriff’s Office conducted a traffic stop on a red 2003 Dodge Dakota&nbsp;with an expired license plate near SW Topeka Boulevard and SE 45th Street with an expired license plate, according to Deputy Abigail Christian.

During the investigation, the deputy located illegal narcotics.

The driver, Crystle T. Moten, 37, of Topeka, had a misdemeanor warrant for her arrest. Moten was booked into the Shawnee County Department of Corrections (SNDOC) for her warrant and on requested charges of&nbsp; possession of methamphetamine, possession of drug paraphernalia, operating a motor vehicle with an expired tag and no vehicle liability insurance.

The passenger, Jeff D. Pressgrove, 55, of Topeka, was arrested, booked into the SNDOC and on requested charges of possession of methamphetamine and possession of drug paraphernalia.

<figure>
 <img src="https://media.eaglewebservices.com/public/2023/8/1691331910292.png" alt="Moten photo Shawnee Co." />
 <figcaption>Moten photo Shawnee Co.</figcaption>
 </figure>SHAWNEE COUNTY —Law enforcement authorities are investigating two suspect on drug allegations after a traffic stop.Just after&nbsp;11p.m. August 3, a deputy with the Shawnee County Sheriff’s Office conducted a traffic stop on a red 2003 Dodge Dakota&nbsp;with an expired license plate near SW Topeka Boulevard and SE 45th Street with an expired license plate, according to Deputy Abigail Christian.During the investigation, the deputy located illegal narcotics.The driver, Crystle T. Moten, 37, of Topeka, had a misdemeanor warrant for her arrest. Moten was booked into the Shawnee County Department of Corrections (SNDOC) for her warrant and on requested charges of&nbsp; possession of methamphetamine, possession of drug paraphernalia, operating a motor vehicle with an expired tag and no vehicle liability insurance.<figure>
 <img src="https://media.eaglewebservices.com/public/2023/8/1691332095296.png" alt="Pressgrove-photo Shawnee Co." />
 <figcaption>Pressgrove-photo Shawnee Co.</figcaption>
 </figure>The passenger, Jeff D. Pressgrove, 55, of Topeka, was arrested, booked into the SNDOC and on requested charges of possession of methamphetamine and possession of drug paraphernalia.

Wanted Kansas suspect caught transporting meth

By&nbsp;SOFIA RESNICK <a href="https://kansasreflector.com/2023/03/30/u-s-judge-rules-insurers-dont-have-to-cover-many-free-preventive-health-services/">States Newsroom</a>

Pharmaceutical sciences professor Chris Adkins was perusing news on his computer in December when he came across an item that fascinated him: Anti-abortion groups had sued the U.S. Food and Drug Administration to force a recall on a commonly used abortion drug.

Adkins teaches future pharmacists at South University School of Pharmacy* in Savannah, Georgia. His early-career research focused on cancer drugs, but mifepristone is among the many drugs he’s familiar with. Adkins understood from the<a target="_blank" href="https://www.acog.org/clinical/clinical-guidance/practice-bulletin/articles/2020/10/medication-abortion-up-to-70-days-of-gestation">&nbsp;medical literature</a>&nbsp;that the FDA-approved two-drug abortion regimen has a high safety and efficacy record. So, it surprised him to read<a target="_blank" href="https://www.newsfromthestates.com/article/suspect-science-and-claims-center-abortion-pill-lawsuit">&nbsp;plaintiffs arguing</a>&nbsp;this medication is so unsafe it needs to be pulled from the market. But what he still can’t get over is the research U.S. District Judge Matthew Kacsmaryk cited liberally to order a suspension of mifepristone’s FDA approval earlier this year.

That<a target="_blank" href="https://www.newsfromthestates.com/article/after-scotus-ruling-disappointed-abortion-foes-vow-keep-attacking-abortion-pill">&nbsp;ultimately blocked</a>&nbsp;April 7 ruling in Alliance for Hippocratic Medicine v. FDA relied on a handful of studies authored by many of the same anti-abortion activists directly involved in suing the FDA. Kacsmaryk leaned hard on a<a target="_blank" href="https://journals.sagepub.com/doi/10.1177/23333928211053965">&nbsp;2021 study</a>&nbsp;that was designed, funded and produced by the research arm of one of the most powerful anti-abortion political groups in the U.S. The judge cited this paper — which looked at Medicaid patients’ visits to the emergency room within 30 days of having an abortion — to justify that a group of anti-abortion doctors and medical groups have legal standing to force the FDA to recall mifepristone.

“Here, the [plaintiff medical] associations’ members have standing because they allege adverse events from chemical abortion drugs can overwhelm the medical system and place ‘enormous pressure and stress’ on doctors during emergencies and complications,”&nbsp;<a target="_blank" href="https://storage.courtlistener.com/recap/gov.uscourts.txnd.370067/gov.uscourts.txnd.370067.137.0_17.pdf#page=7">Kacsmaryk wrote</a>.

But U.S.-based global academic publisher Sage Publishing, which publishes thousands of journals including “Health Services Research and Managerial Epidemiology,” is now investigating this study and the peer review process it went through after Adkins contacted the journal in April with a pile of red flags. Last week Sage published an “<a target="_blank" href="https://journals.sagepub.com/doi/10.1177/23333928231189400">expression of concern</a>” about the paper.

“As part of the investigation, we are looking into Dr. Adkins’ concerns as well as any concerns related to conflict of interest,” Sage spokesperson Camille Gamboa told States Newsroom in an email. The lead author of the paper, James Studnicki, who works for the anti-abortion think tank Charlotte Lozier Institute, is also on the<a target="_blank" href="https://journals.sagepub.com/editorial-board/HME">&nbsp;editorial board</a>&nbsp;of “Health Services Research and Managerial Epidemiology.” Gamboa said that Studnicki, in accordance with his journal’s<a target="_blank" href="https://publicationethics.org/core-practices">&nbsp;ethics guidelines</a>, was “not involved in the decision-making process for this article.”

Adkins dissected this paper the way he used to as a onetime peer reviewer. He told States Newsroom that the authors exaggerated their findings and visually misrepresented them in ways that are “grossly misleading.” And that’s led to legal consequences. Except, he said, their study doesn’t actually show what Kacsmaryk said it does: that medication abortion leads to significantly high rates of complications.

“I can’t prove that there was intent to deceive, but I struggled to find an alternative reason to present your data in such a way that exaggerates the magnitude,” Adkins said. “They’re misrepresenting its conclusions to begin with. That’s my frustration with this whole process.”

For now, mifepristone remains legal (except in the<a target="_blank" href="https://www.newsfromthestates.com/see-data-reproductive-rights?eType=EmailBlastContent&amp;eId=0df6a929-cf53-4ee2-bb17-92127ecce75d">&nbsp;14 states with total abortion bans</a>). But this high-stakes federal lawsuit is ongoing,&nbsp;<a target="_blank" href="https://www.newsfromthestates.com/article/appeals-court-judges-embrace-anti-abortion-speculation">awaiting a decision</a>&nbsp;from the conservative 5th U.S. Circuit Court of Appeals. And while Sage determines whether this study should have been published in the first place, plaintiffs continue wielding it as one of their best defenses against a safe drug protocol that is now the most common method of terminating a pregnancy (and&nbsp;<a target="_blank" href="https://www.acog.org/womens-health/experts-and-stories/the-latest/what-to-know-about-abortion-and-miscarriages-with-or-without-mifepristone">managing miscarriages</a>) post-Roe v. Wade.

Wading into politically charged science fights is new territory for Adkins. So is advocating for abortion rights, something he says he didn’t believe in when he was growing up in Amarillo, Texas, where the lawsuit was coincidentally filed. He said his views on abortion (and gender and climate science) radically shifted when he left his conservative hometown for graduate school and then became a scientist.

“I have significant concerns about the merits, legality, and use of shoddy studies and personal anecdotes to upend national healthcare policies essential to women’s reproductive health and bodily autonomy,” Adkins told States Newsroom. “To go out and say this drug needs to be, you know, removed from the market, it’s not honestly paying tribute to what the true science really is saying.”

Roe v. Wade was overturned on Adkins’ birthday last year — about a year before he would meet his first child. Living in South Carolina, where laws about pregnancy termination have toggled throughout the year, Adkins has been thinking often about the consequences of ending federal abortion rights. He’s grateful his wife didn’t have any pregnancy complications, but he worries about her reproductive freedom going forward, and that of their weeks-old daughter.

“I now have a daughter that is born in a world where there is no Roe v. Wade, no federal recognition that women have the right of bodily autonomy,” Adkins said. “And just, I don’t know. … I’m going to support her in whatever way I can.”

This lawsuit ultimately hinges on scientific questions: Was the science strong enough to justify the FDA’s approval of abortion drugs more than 20 years ago and then its relaxing of certain restrictions? And does the data predominantly show that medication abortion is safe and effective? Evidence in the affirmative, presented by the FDA’s defense team,<a target="_blank" href="https://www.nytimes.com/interactive/2023/04/01/health/abortion-pill-safety.html">&nbsp;outweighs</a>&nbsp;that of plaintiffs in volume and medical journal prestige.

Most drugs approved by the FDA come with some risk of side effects, but mifepristone’s risk level is<a target="_blank" href="https://www.newsfromthestates.com/article/washington-fda-lawsuit-part-larger-strategy-preserve-abortion-access">&nbsp;significantly lower</a>&nbsp;than many commonly used over-the-counter drugs. In 23 years,<a target="_blank" href="https://www.fda.gov/media/164331/download">&nbsp;28 out of more than 5 million</a>&nbsp;medication-abortion patients have died, but not all necessarily because of mifepristone. Some died of sepsis, ectopic pregnancies, homicide and drug overdoses.

Still, plaintiffs who sued the FDA to revoke mifepristone’s approval&nbsp;<a target="_blank" href="https://www.newsfromthestates.com/article/suspect-science-and-claims-center-abortion-pill-lawsuit">rely on studies that have been criticized — and on speculation</a>&nbsp;about a potential spike in future adverse events.

Many U.S. scientists and mainstream national medical institutions like the American Medical Association have asked the courts<a target="_blank" href="https://www.ama-assn.org/delivering-care/public-health/ama-court-don-t-overturn-fda-approval-mifepristone">&nbsp;not to overturn</a>&nbsp;FDA approval of mifepristone, and have called out the<a target="_blank" href="https://www.ama-assn.org/about/leadership/judge-s-ruling-mifepristone-has-no-basis-medical-science">&nbsp;misuse of science</a>&nbsp;in the lawsuit. And yet, the conservative federal judges assigned to the case have<a target="_blank" href="https://www.newsfromthestates.com/article/appeals-court-judges-embrace-anti-abortion-speculation">&nbsp;been nodding along</a>&nbsp;to plaintiffs’ hyperbolic arguments that abortion via medication leads to<a target="_blank" href="https://www.newsfromthestates.com/article/suspect-science-and-claims-center-abortion-pill-lawsuit">&nbsp;overwhelmed emergency rooms and blood supply shortages</a>.

One study that appears to have convinced Kacsmaryk that mifepristone causes high amounts of severe adverse events was authored by a half-dozen longtime anti-abortion activists. The study, “<a target="_blank" href="https://journals.sagepub.com/doi/10.1177/23333928211053965">A Longitudinal Cohort Study of Emergency Room Utilization Following Mifepristone Chemical and Surgical Abortions, 1999–2015</a>,” was funded by the Charlotte Lozier Institute, the research arm of the influential Susan B. Anthony Pro-Life America, which works to elect federal and state anti-abortion lawmakers. The study was published in November 2021, exactly one year before plaintiffs filed in the Amarillo court. Charlotte Lozier filed a “<a target="_blank" href="https://lozierinstitute.org/wp-content/uploads/2023/02/CLI-Final-Brief.pdf">friend of the court brief</a>,” citing its research.

All but one of the eight authors are affiliated with the Charlotte Lozier Institute, including principal author James Studnicki, who is the institute’s vice president and director of data analytics. Currently everyone on the&nbsp;<a target="_blank" href="https://journals.sagepub.com/editorial-board/HME">editorial board</a>&nbsp;of “Health Services Research and Managerial Epidemiology” works for a university except for Studnicki, who until 2016 was a university professor focused on health policy and management for&nbsp;<a target="_blank" href="https://content.govdelivery.com/attachments/INAG/2019/08/27/file_attachments/1273796/77-2%20-%20Exhibit%20B.pdf#page=15">most of his career</a>. Now he works for an anti-abortion think tank and in recent years has served as a paid expert witness that defends anti-abortion laws in federal court.

Dr. Donna Harrison, another co-author, was until recently the CEO of the American Association of Pro-Life Obstetricians and Gynecologists, one of the plaintiff medical groups suing the FDA over mifepristone. Another author is longtime anti-abortion activist David Reardon, who has a record of criticized research that tries to&nbsp;<a target="_blank" href="https://www.nytimes.com/2007/01/21/magazine/21abortion.t.html">directly link abortion to depression and suicide</a>.

The Studnicki et al. 2021 longitudinal study looked at people who had a surgical or medication abortion between 1999 and 2015. The researchers used data from 17 states that allow state Medicaid funding of abortion, and identified more than 400,000 abortion patients. Of those they found that more than one-quarter visited an emergency department within 30 days of having the abortion. Over the 16 years, they found that there were progressively more emergency room visits following a medication abortion than a surgical procedure. The&nbsp;<a target="_blank" href="https://lozierinstitute.org/public-health-threat-chemical-abortion-leads-to-significantly-higher-rate-of-er-visits/">authors claim</a>&nbsp;that between 2002 and 2015, there was a 500% increase in emergency room visits from people who had had a medication abortion within 30 days.

Following the study’s release in 2021, Studnicki penned an&nbsp;<a target="_blank" href="https://www.newsweek.com/fdas-dangerous-unscientific-abortion-decision-opinion-1659296">opinion piece in Newsweek</a>, calling the study’s findings “clear and alarming.” “Post-abortion emergency room visits are increasing following any type of abortion, but visits following a chemical abortion are growing faster,” Studnicki wrote.

But Adkins and other researchers told States Newsroom that some of these findings are missing important context, and that the study’s major flaws are related to methodology and in how they communicate their findings:

Studnicki did not respond to a request for comment. He continues to defend the study, and recently&nbsp;<a target="_blank" href="https://www.washingtonpost.com/health/2023/04/13/abortion-pill-safety/">told the Washington Post</a>&nbsp;that abortion rights groups are discounting ER visits as serious matters and underplaying potential complications from abortions involving mifepristone. He blames academic and media bias for the criticism the Charlotte Lozier Institute’s work has received.

“We have a very biased media,” Studnicki&nbsp;<a target="_blank" href="https://www.youtube.com/watch?v=mYwEC_CMW60">said on the Canadian podcast Pro-Life Guys</a>&nbsp;earlier this year. “Our media outlets are largely pro-abortion in their ideological posture. And we fight against that every day. But we’re just going to keep pounding on the rock basically.”

Adkins argues there is bias within Charlotte Lozier’s science and within the conservative courts hearing the Alliance for Hippocratic Medicine v. FDA lawsuit. Federal Judge Kacsmaryk used this paper (and a&nbsp;<a target="_blank" href="https://pubmed.ncbi.nlm.nih.gov/35633832/">follow-up 2022 analysis</a>&nbsp;published in the same journal, by the same researchers) to argue that mifepristone leads to high complication rates. This summer the Charlotte Lozier team produced yet&nbsp;<a target="_blank" href="https://www.dovepress.com/getfile.php?fileID=90478">another study</a>&nbsp;using Medicaid data, this time published in the International Journal of Women’s Health, which concludes that a first pregnancy abortion compared with birth is associated with “significantly higher subsequent mental health services utilization.”

“The fact that, you know, the judge really gives a lot of credit to a very niche, a very small pocket of doctors that don’t fully represent consensus, that’s one of my big problems,” Adkins said.

In his April 7 ruling, Kacsmaryk also echoed plaintiffs’ arguments that the FDA has been undercounting adverse events related to mifepristone and<a target="_blank" href="https://storage.courtlistener.com/recap/gov.uscourts.txnd.370067/gov.uscourts.txnd.370067.137.0_17.pdf#page=47">&nbsp;cited the other big finding</a>&nbsp;in the Studnicki paper, which is that some patients who have taken abortion drugs but come to the emergency room for observation or treatment are miscoded as miscarriage patients.

“Consequently, the treating physician may not know the adverse event is due to mifepristone,” Kacsmaryk wrote. “Studies support this conclusion by finding over sixty percent of women and girls’ emergency room visits after chemical abortions are miscoded as ‘miscarriages’ rather than adverse effects to mifepristone. Simply put, FDA’s data are incomplete and potentially misleading, as are the statistics touted by mifepristone advocates.”

The 5th Circuit Court of Appeals in its&nbsp;<a target="_blank" href="https://storage.courtlistener.com/recap/gov.uscourts.ca5.213145/gov.uscourts.ca5.213145.183.2_1.pdf">ultimately blocked April ruling</a>&nbsp;to temporarily reinstate old restrictions on medication abortion, referenced many of the same studies as Kascmaryk to justify the plaintiff doctors’ position, writing: “the risk of severe bleeding with chemical abortion is five times higher than from surgical abortion.”

Adkins said he believes that how the Charlotte Lozier team presented their data visually lends for judges to be misled about the significance of the paper’s findings. For example,&nbsp;<a target="_blank" href="https://journals.sagepub.com/doi/full/10.1177/23333928211053965">Figure 3</a>&nbsp;showed about 800 emergency room visits in 2015 within 30 days of a medication abortion, out of more than 5,000 abortion-related visits, but the authors inexplicably used two different y axes to plot these numbers, making it possible to conclude that medication-abortion-related visits were numbered in the thousands.

“Scientific communication is something I deeply value, and I think this is an example of one way that misuse of science through improper communication can influence how public policy manifests itself, through a result of dishonest science,” Adkins said. “It really makes the likelihood of someone misreading that and then, for instance, Kacsmaryk coming back and saying the alleged adverse events from chemical abortion drugs can overwhelm the medical system. Well, maybe he didn’t scrutinize these figures if he read this paper. That’s a highly plausible outcome here because he’s basically thinking, ‘Oh, my gosh, look at these numbers. They’re skyrocketing.’ When they’re really kind of not.”

For now, Adkins impatiently awaits the results of Sage’s probe into this study. A few months ago, he wrote a letter to Georgia U.S. Rep. Earl L. “Buddy” Carter, one of&nbsp;<a target="_blank" href="https://twitter.com/i/web/status/1620916653830868992">the few</a>&nbsp;licensed pharmacists in Congress, who joined other Republicans in supporting the plaintiffs’ lawsuit against the FDA. Carter is outspokenly anti-abortion, but Adkins tried to appeal to the congressman’s inner pharmacist.

“All practicing US pharmacists publicly recite an oath which affirms pharmacists’ embracement and advocacy for ‘changes that improve patient care,’” Adkins wrote in the letter, which he says the congressman never answered. “The case rendered in Amarillo only deteriorates patient care and sows unnecessary distrust of scientific and medical institutions in the United States.”

*Chris Adkins said his opinions are his own and do not reflect the opinions or positions of South University.

Study cited by judge in abortion-pill case under investigation

MISSION, Kan. (AP) — A shooting early Sunday at a Kansas convenience store left a suspect dead and a police officer shot and hospitalized, Lenexa police said.

Leading up to the shooting, Lenexa police said they were searching for a reportedly stolen car. When officers found the vehicle, police said the driver struck a patrol car and fled.

Lenexa police chased the vehicle on Interstate 35 until two suspects got out and ran to a QuikTrip convenience store in Mission, Kansas.

Police from multiple agencies were trying to arrest the suspects when gunfire broke out. A suspect was shot and killed, and an officer was shot and hospitalized. Another suspect was arrested.

Lenexa police have not yet identified either of the suspects or the injured officer.

A Johnson County law enforcement team that is charged with reviewing officer-involved shootings is investigating.

<figure>
 <img src="https://media.eaglewebservices.com/public/2023/8/1691356366635.png" alt="A Johnson County law enforcement team that is charged with reviewing officer-involved shootings is investigating.-photo courtesy KCTV" />
 <figcaption>A Johnson County law enforcement team that is charged with reviewing officer-involved shootings is investigating.-photo courtesy KCTV</figcaption>
 </figure>MISSION, Kan. (AP) — A shooting early Sunday at a Kansas convenience store left a suspect dead and a police officer shot and hospitalized, Lenexa police said.Leading up to the shooting, Lenexa police said they were searching for a reportedly stolen car. When officers found the vehicle, police said the driver struck a patrol car and fled.Lenexa police chased the vehicle on Interstate 35 until two suspects got out and ran to a QuikTrip convenience store in Mission, Kansas.Police from multiple agencies were trying to arrest the suspects when gunfire broke out. A suspect was shot and killed, and an officer was shot and hospitalized. Another suspect was arrested.Lenexa police have not yet identified either of the suspects or the injured officer.A Johnson County law enforcement team that is charged with reviewing officer-involved shootings is investigating.

Suspect killed, Kansas officer hospitalized after gunfight

By Paul Hamel <a href="https://nebraskaexaminer.com/2022/02/08/state-approved-use-of-pesticide-coated-seed-corn-for-ethanol-plant-a-decade-ago/">Nebraska Examiner</a>

LINCOLN — Drivers on Nebraska roads are putting the pedal to the metal and getting pinched for it.

In July, troopers with the Nebraska State Patrol stopped 118 people for speeding at 100 mph or more — the most since July 2020.

Another 505 tickets were written for lead-footed driving of between 90 and 99 mph in July.

The Patrol reported that in 2023, 85 drivers per month, on average, have been ticketed for traveling above 100 mph and 421 per month for speeds between 90 and 99 mph.

The peak in tickets came during a national “Speed Catches Up with You” campaign, from July 10-31, to deter speeding.

“The statistics are clear: Speeding plays a factor in a large percentage of serious injury or fatal crashes,” said Col. John Bolduc, the Patrol’s superintendent.

The Insurance Institute for Highway Safety,&nbsp;<a target="_blank" href="https://www.iihs.org/topics/bibliography/ref/2258">in a 2022 study in Virginia,</a>&nbsp;blamed the COVID-19 pandemic — and the emptier roads that resulted — for a 50% increase in excessive speeding.

<figure>
 <img src="https://media.eaglewebservices.com/public/2023/8/1691327548724.png" alt="Traffic flows along Interstate 80 east of exit 432. (Rebecca S. Gratz for Nebraska Examiner)" />
 <figcaption>Traffic flows along Interstate 80 east of exit 432. (Rebecca S. Gratz for Nebraska Examiner)</figcaption>
 </figure>By Paul Hamel <a href="https://nebraskaexaminer.com/2022/02/08/state-approved-use-of-pesticide-coated-seed-corn-for-ethanol-plant-a-decade-ago/">Nebraska Examiner</a>LINCOLN — Drivers on Nebraska roads are putting the pedal to the metal and getting pinched for it.In July, troopers with the Nebraska State Patrol stopped 118 people for speeding at 100 mph or more — the most since July 2020.Another 505 tickets were written for lead-footed driving of between 90 and 99 mph in July.The Patrol reported that in 2023, 85 drivers per month, on average, have been ticketed for traveling above 100 mph and 421 per month for speeds between 90 and 99 mph.The peak in tickets came during a national “Speed Catches Up with You” campaign, from July 10-31, to deter speeding.“The statistics are clear: Speeding plays a factor in a large percentage of serious injury or fatal crashes,” said Col. John Bolduc, the Patrol’s superintendent.The Insurance Institute for Highway Safety,&nbsp;<a target="_blank" href="https://www.iihs.org/topics/bibliography/ref/2258">in a 2022 study in Virginia,</a>&nbsp;blamed the COVID-19 pandemic — and the emptier roads that resulted — for a 50% increase in excessive speeding.

Lead-footed driving over 100 mph leads to peak in State Patrol tickets

WASHINGTON (AP) —The Justice Department has asked a federal judge overseeing the&nbsp;<a href="https://apnews.com/article/trump-indicted-jan-6-investigation-special-counsel-a79f2d3683c7591058635c9b3d870070">criminal case against former President Donald Trump</a>&nbsp;in Washington to step in after he released a post online that appeared to promise revenge on anyone who goes after him.

Prosecutors on Friday requested that U.S. District Court Judge Tanya Chutkan issue a protective order concerning evidence in the case, a day after Trump pleaded not guilty to charges of&nbsp;<a href="https://apnews.com/article/explain-charges-trump-indictment-jan-6-investigation-7efd7577e41f0cbf9c697fa4613f93a3">trying to overturn his 2020 election loss</a>&nbsp;and block the peaceful transition of power. The order, different from a “gag order,” would limit what information Trump and his legal team could share publicly about the case brought by special counsel Jack Smith.

<a href="https://storage.courtlistener.com/recap/gov.uscourts.dcd.258149/gov.uscourts.dcd.258149.1.0_2.pdf">Click here to read</a>&nbsp;the latest indictment&nbsp;

Chutkan on Saturday gave Trump’s legal team until 5 p.m. Monday to respond to the government’s request. Trump's legal team, which has indicated he would look to slow the case down despite prosecutors’ pledge of a speedy trial, then filed a request to extend the response deadline to Thursday and to hold a hearing on the matter, saying it needed more time for discussion.

Chutkan swiftly denied that extension request Saturday evening, reaffirming that Trump must abide by Monday's deadline.

Protective orders are common in criminal cases, but prosecutors said it's “particularly important in this case” because Trump has posted on social media about "witnesses, judges, attorneys, and others associated with legal matters pending against him."

Prosecutors pointed specifically to a post on Trump's Truth Social platform from earlier Friday in which Trump wrote, in all capital letters, “If you go after me, I’m coming after you!”

Prosecutors said they are ready to hand over a "substantial" amount of evidence — “much of which includes sensitive and confidential information” — to Trump's legal team.

They told the judge that if Trump were to begin posting about grand jury transcripts or other evidence provided by the Justice Department, it could have a “harmful chilling effect on witnesses or adversely affect the fair administration of justice in this case.”

Prosecutors' proposed protective order seeks to prevent Trump and his lawyers from disclosing materials provided by the government to anyone other than people on his legal team, possible witnesses, the witnesses' lawyers or others approved by the court. It would put stricter limits on “sensitive materials,” which would include grand jury witness testimony and materials obtained through sealed search warrants.

A Trump spokesperson said in an emailed statement that the former president's post “is the definition of political speech,” and was made in response to “dishonest special interest groups and Super PACs.”

Chutkan, a former assistant public defender nominated to the bench by President Barack Obama, has been&nbsp;<a href="https://apnews.com/article/capitol-siege-only-on-ap-donald-trump-government-and-politics-sentencing-de394dd56b3251aac5a50014f4d6afa7">one of the toughest punishers of rioters</a>&nbsp;who stormed the Capitol in the Jan. 6, 2021, attack, fueled by Trump’s baseless claims of a stolen election.

The indictment unsealed this past week accuses Republican Trump of brazenly conspiring with allies to spread falsehoods and concoct schemes intended to overturn his election loss to Democrat Joe Biden as his&nbsp;<a href="https://apnews.com/article/donald-trump-losing-election-lawsuits-36d113484ac0946fa5f0614deb7de15e">legal challenges floundered in court.</a>

The indictment chronicles how Trump and his allies, in what Smith described as an attack on a “bedrock function of the U.S. government,” repeatedly lied about the results in the two months after he lost the election and pressured his vice president,&nbsp;<a href="https://apnews.com/article/pence-jan-6-trump-indictment-ab36fd360a0850562a07d1b404f15d69">Mike Pence</a>, and state election officials to take action to help him cling to power.

Trump faces charges including conspiracy to defraud the U.S. and conspiracy to obstruct Congress’ certification of Biden’s electoral victory.

It's the third criminal case brought this year against the&nbsp;<a href="https://apnews.com/article/2024-presidential-candidates-who-is-running-e89fbfee94e7e7980594a9ce3994fec7">the early front-runner</a>&nbsp;in the 2024 Republican presidential primary. But it’s the first case to try to hold Trump responsible for his&nbsp;<a href="https://apnews.com/article/jan-6-committee-final-report-trump-bcfea6162fe9cfa0d120e86d069af0e4">efforts to remain in power</a>&nbsp;during the chaotic weeks between his election loss and the attack by his supporters on the&nbsp;<a href="https://apnews.com/hub/capitol-siege">U.S. Capitol on Jan. 6, 2021.</a>

Smith has also charged Trump in Florida federal court with&nbsp;<a href="https://apnews.com/article/trump-classified-documents-indictment-miami-court-e9412bb71b63ab1b7cfb8e8b122e9809">illegally hoarding classified documents</a>&nbsp;at Trump's Mar-a-Lago estate and thwarting government efforts to get them back.

The magistrate judge in that case agreed to a protective order in June that prohibits Trump and his legal team from publicly disclosing evidence turned over to them by prosecutors without prior approval. Prosecutors are seeking another protective order in that case with more rules about the defense team's handling of classified evidence.

After his court appearance on Thursday in the Washington case, Trump characterized the prosecution as a “persecution” designed to hurt his 2024 presidential campaign. His legal team has described it as an attack on his right to free speech and his right to challenge an election that he believed had been stolen.

On Saturday night to more than 1,000 attendees at the South Carolina Republican Party's 56th annual Silver Elephant Gala, Trump kept up his attacks on Smith, sticking to his usual caricature of the prosecutor as “deranged" for pursuing charges against him.

Smith has said prosecutors will seek a “speedy trial" against Trump in the election case. Judge Chutkan has ordered the government to file a brief by Thursday proposing a trial date. The first court hearing in front of Chutkan is scheduled for Aug. 28.

Trump is already scheduled to stand trial in March in the New York case stemming from&nbsp;<a href="https://apnews.com/article/donald-trump-arraignment-hush-money-81225510ef7638494852816878f612f0">hush-money payments made during the 2016 campaign</a>&nbsp;and in May in the classified documents case.

<figure>
 <img src="https://media.eaglewebservices.com/public/2023/8/1691091392217.png" alt="Former Presiden Donald Trump as he arrives Thursday in Washington for the arraignment-photo courtesy CSPAN" />
 <figcaption>Former Presiden Donald Trump as he arrives Thursday in Washington for the arraignment-photo courtesy CSPAN</figcaption>
 </figure>WASHINGTON (AP) —The Justice Department has asked a federal judge overseeing the&nbsp;<a href="https://apnews.com/article/trump-indicted-jan-6-investigation-special-counsel-a79f2d3683c7591058635c9b3d870070">criminal case against former President Donald Trump</a>&nbsp;in Washington to step in after he released a post online that appeared to promise revenge on anyone who goes after him.<figure>
 <img src="https://media.eaglewebservices.com/public/2023/8/1691329048946.png" alt="" />
 <figcaption></figcaption>
 </figure>Prosecutors on Friday requested that U.S. District Court Judge Tanya Chutkan issue a protective order concerning evidence in the case, a day after Trump pleaded not guilty to charges of&nbsp;<a href="https://apnews.com/article/explain-charges-trump-indictment-jan-6-investigation-7efd7577e41f0cbf9c697fa4613f93a3">trying to overturn his 2020 election loss</a>&nbsp;and block the peaceful transition of power. The order, different from a “gag order,” would limit what information Trump and his legal team could share publicly about the case brought by special counsel Jack Smith.<a href="https://storage.courtlistener.com/recap/gov.uscourts.dcd.258149/gov.uscourts.dcd.258149.1.0_2.pdf">Click here to read</a>&nbsp;the latest indictment&nbsp;Chutkan on Saturday gave Trump’s legal team until 5 p.m. Monday to respond to the government’s request. Trump's legal team, which has indicated he would look to slow the case down despite prosecutors’ pledge of a speedy trial, then filed a request to extend the response deadline to Thursday and to hold a hearing on the matter, saying it needed more time for discussion.Chutkan swiftly denied that extension request Saturday evening, reaffirming that Trump must abide by Monday's deadline.Protective orders are common in criminal cases, but prosecutors said it's “particularly important in this case” because Trump has posted on social media about "witnesses, judges, attorneys, and others associated with legal matters pending against him."Prosecutors pointed specifically to a post on Trump's Truth Social platform from earlier Friday in which Trump wrote, in all capital letters, “If you go after me, I’m coming after you!”Prosecutors said they are ready to hand over a "substantial" amount of evidence — “much of which includes sensitive and confidential information” — to Trump's legal team.They told the judge that if Trump were to begin posting about grand jury transcripts or other evidence provided by the Justice Department, it could have a “harmful chilling effect on witnesses or adversely affect the fair administration of justice in this case.”Prosecutors' proposed protective order seeks to prevent Trump and his lawyers from disclosing materials provided by the government to anyone other than people on his legal team, possible witnesses, the witnesses' lawyers or others approved by the court. It would put stricter limits on “sensitive materials,” which would include grand jury witness testimony and materials obtained through sealed search warrants.A Trump spokesperson said in an emailed statement that the former president's post “is the definition of political speech,” and was made in response to “dishonest special interest groups and Super PACs.”Chutkan, a former assistant public defender nominated to the bench by President Barack Obama, has been&nbsp;<a href="https://apnews.com/article/capitol-siege-only-on-ap-donald-trump-government-and-politics-sentencing-de394dd56b3251aac5a50014f4d6afa7">one of the toughest punishers of rioters</a>&nbsp;who stormed the Capitol in the Jan. 6, 2021, attack, fueled by Trump’s baseless claims of a stolen election.The indictment unsealed this past week accuses Republican Trump of brazenly conspiring with allies to spread falsehoods and concoct schemes intended to overturn his election loss to Democrat Joe Biden as his&nbsp;<a href="https://apnews.com/article/donald-trump-losing-election-lawsuits-36d113484ac0946fa5f0614deb7de15e">legal challenges floundered in court.</a>The indictment chronicles how Trump and his allies, in what Smith described as an attack on a “bedrock function of the U.S. government,” repeatedly lied about the results in the two months after he lost the election and pressured his vice president,&nbsp;<a href="https://apnews.com/article/pence-jan-6-trump-indictment-ab36fd360a0850562a07d1b404f15d69">Mike Pence</a>, and state election officials to take action to help him cling to power.Trump faces charges including conspiracy to defraud the U.S. and conspiracy to obstruct Congress’ certification of Biden’s electoral victory.It's the third criminal case brought this year against the&nbsp;<a href="https://apnews.com/article/2024-presidential-candidates-who-is-running-e89fbfee94e7e7980594a9ce3994fec7">the early front-runner</a>&nbsp;in the 2024 Republican presidential primary. But it’s the first case to try to hold Trump responsible for his&nbsp;<a href="https://apnews.com/article/jan-6-committee-final-report-trump-bcfea6162fe9cfa0d120e86d069af0e4">efforts to remain in power</a>&nbsp;during the chaotic weeks between his election loss and the attack by his supporters on the&nbsp;<a href="https://apnews.com/hub/capitol-siege">U.S. Capitol on Jan. 6, 2021.</a>Smith has also charged Trump in Florida federal court with&nbsp;<a href="https://apnews.com/article/trump-classified-documents-indictment-miami-court-e9412bb71b63ab1b7cfb8e8b122e9809">illegally hoarding classified documents</a>&nbsp;at Trump's Mar-a-Lago estate and thwarting government efforts to get them back.The magistrate judge in that case agreed to a protective order in June that prohibits Trump and his legal team from publicly disclosing evidence turned over to them by prosecutors without prior approval. Prosecutors are seeking another protective order in that case with more rules about the defense team's handling of classified evidence.After his court appearance on Thursday in the Washington case, Trump characterized the prosecution as a “persecution” designed to hurt his 2024 presidential campaign. His legal team has described it as an attack on his right to free speech and his right to challenge an election that he believed had been stolen.On Saturday night to more than 1,000 attendees at the South Carolina Republican Party's 56th annual Silver Elephant Gala, Trump kept up his attacks on Smith, sticking to his usual caricature of the prosecutor as “deranged" for pursuing charges against him.Smith has said prosecutors will seek a “speedy trial" against Trump in the election case. Judge Chutkan has ordered the government to file a brief by Thursday proposing a trial date. The first court hearing in front of Chutkan is scheduled for Aug. 28.Trump is already scheduled to stand trial in March in the New York case stemming from&nbsp;<a href="https://apnews.com/article/donald-trump-arraignment-hush-money-81225510ef7638494852816878f612f0">hush-money payments made during the 2016 campaign</a>&nbsp;and in May in the classified documents case.____

Prosecutors ask judge to issue protective order after Trump post appearing to promise revenge

CLAY COUNTY—Law enforcement authorities are investigating an alleged burglary and asking the public for help identifying suspects.

On Friday, police received a report of an aggravated burglary and attempted robbery in the 700 block of Liberty Street. in Clay Center, according to a media release. The suspects fled before officers arrived. They are described as&nbsp;two black males between the ages of 15 and 20 years old. They 5-foot-8 and 5-foot-10 and&nbsp; had shoulder-length dreadlocks.

One suspect was wearing an orange hoodie, camouflaged pants, one black shoe and one white shoe.

The other suspect was wearing a white or light gray zip-up jacket with a hood, blue jeans with two medium-sized holes on both pant legs and black shoes. He also had some of the ends of his dreadlocks dyed white. 

No weapons were reported to have been used.&nbsp; Anyone has knowledge or knows the identity of either suspect, please notify the Clay Center Police Department at 785-632-2121, and do not contact either of the suspects.

<figure>
 <img src="https://media.eaglewebservices.com/public/2023/8/1691322563658.png" alt="Security camera images Clay Center Police" />
 <figcaption>Security camera images Clay Center Police</figcaption>
 </figure>CLAY COUNTY—Law enforcement authorities are investigating an alleged burglary and asking the public for help identifying suspects.On Friday, police received a report of an aggravated burglary and attempted robbery in the 700 block of Liberty Street. in Clay Center, according to a media release. The suspects fled before officers arrived. They are described as&nbsp;two black males between the ages of 15 and 20 years old. They 5-foot-8 and 5-foot-10 and&nbsp; had shoulder-length dreadlocks.One suspect was wearing an orange hoodie, camouflaged pants, one black shoe and one white shoe.<figure>
 <img src="https://media.eaglewebservices.com/public/2023/8/1691323645822.png" alt="" />
 <figcaption></figcaption>
 </figure>The other suspect was wearing a white or light gray zip-up jacket with a hood, blue jeans with two medium-sized holes on both pant legs and black shoes. He also had some of the ends of his dreadlocks dyed white. No weapons were reported to have been used.&nbsp; Anyone has knowledge or knows the identity of either suspect, please notify the Clay Center Police Department at 785-632-2121, and do not contact either of the suspects.

Police ask for help to ID Kansas burglary suspects 

Maternal health advocate says prospective parents worry about child care, birth complications

By RACHEL MIPRO <a href="https://kansasreflector.com/2023/04/05/kansas-lawmakers-debate-definition-of-female-and-male-for-county-jails/">Kansas Reflector</a>

TOPEKA —&nbsp; Kansas documented the state’s lowest-ever recorded birth rate for the 2022 year, according to a preliminary report.

The Kansas Department of Health and Environment’s&nbsp;<a target="_blank" href="https://www.kdhe.ks.gov/DocumentCenter/View/29633/Preliminary-Birth-Report-2022-PDF">annual report</a>&nbsp;shows the number of births in the state dropped slightly from 2021. Last year’s report&nbsp;documented 34,697 births in 2021, with a birth rate of 11.8 per 1,000 people. The preliminary 2022 report recorded 34,376 births across the state, with a birth rate of 11.7 per 1,000 people.

Seven counties accounted for about 60% of the state’s births for the year: Douglas, Geary, Johnson, Leavenworth, Sedgwick, Shawnee and Wyandotte.

Unmarried mothers made up 36% of all births with 12,370 reported. The rate of births to teenagers between the ages of 15-19 remained at 4.7%, unchanged from the previous year’s rate. Most births were recorded for mothers between the ages of 25-29, with 10,579 births. The next most prolific age bracket was mothers between 30-34, with 9,799 births.

The 2022 birth rate is the lowest rate recorded since the state began keeping vital records in a centralized system in 1911. The state has recorded declining birth rates since 2008, reflecting a national downward trend.

Brenda Bandy,&nbsp;executive director of the Kansas Breastfeeding Coalition, said she frequently heard from young women who were concerned about childbirth complications in recent months, a concern that she hadn’t encountered before in her 20 years of work in the field.

“I can tell you for the first time, I am hearing people are afraid of childbirth,” Bandy said. “And I have never heard that before. They appear to be perfectly healthy, young women that are contemplating having birth and they’re actually worried about their safety. And I think the national conversation about maternal mortality, moms dying in childbirth, the complications, many of them are very public.”

“It gets the public’s attention,” Bandy added. “I’m hearing this from women of all races, but predominantly women of color.”

Women across the U.S. face a heightened risk of dying from pregnancy or pregnancy-related complications in recent years, a study from the Institute for Health Metrics and Evaluation and Mass General Brigham found.

Researchers in the study conducted a&nbsp;<a target="_blank" href="https://jamanetwork.com/journals/jama/article-abstract/2806661">state-by-state analysis of maternal deaths</a>&nbsp;rates for 1999-2019 and found Kansas experienced some of the nation’s largest spikes in terms of American Indian and Alaska Native populations, and had consistently high risk levels for Black mothers.

The study also found&nbsp;<a target="_blank" href="https://kansasreflector.com/2021/05/13/racial-disparities-in-infant-mortalities-persist-despite-record-low-rates-in-kansas/">Black mothers in the state</a>&nbsp;had higher death rates than the surrounding states in many of the years studied. In 2019, Black women were more than twice as likely to die from pregnancy-related causes in Kansas as in Missouri, Nebraska and Colorado.

Bandy said child care and parental leave also were important factors for potential parents. Kansas currently faces a child care shortage.

“We don’t make it easy to be a parent, especially a parent with a newborn,” Bandy said. “If you survive childbirth, then having to manage and navigate that return to work when maybe you don’t have any paid leave.”

Kansas follows a national trend of declining birth rates as<a target="_blank" href="https://www.cdc.gov/nchs/data/vsrr/vsrr028.pdf">&nbsp;access to contraception improved, more women entered the workforce and concerns rose over high costs of childrearing amid inflation. The COVID-19 pandemic also has been an ongoing factor.</a>

A preliminary&nbsp;<a target="_blank" href="https://www.cdc.gov/nchs/data/vsrr/vsrr028.pdf">analysis of 2022 birth records</a>&nbsp;by the U.S. Centers for Disease Control and Prevention’s National Center for Health Statistics found the country’s 2022 birth rate remained below pre-pandemic levels, though the numbers were roughly equivalent to 2021 figures.

Overall, there were 3,661,220 recorded U.S. births in 2022, a “nonsignificant decline” from 2021’s 3,664,292 recorded births, with a general fertility rate of 56.1 births per 1,000 women ages 15 to 44.

Sarah Hayford,&nbsp;a professor of sociology at Ohio State University who studies national birth rate trends, said U.S. birth rates had been declining since the great recession of 2008.

Hayford said economic instability was a factor in the low rates.

“Everybody who studied these issues kind of thought that after the recession was over, birth rates would go back up and sort of come back to more the levels that they have been,” Hayford said. “And we’ve just never seen that rebound from after the Great Recession and birth rates have continued to decline.”

<figure>
 <img src="https://media.eaglewebservices.com/public/2023/6/1687826476734.png" alt="Women across the U.S. face a heightened risk of dying from pregnancy or pregnancy-related complications in recent years" />
 <figcaption>Women across the U.S. face a heightened risk of dying from pregnancy or pregnancy-related complications in recent years</figcaption>
 </figure><h2>Maternal health advocate says prospective parents worry about child care, birth complications</h2>By RACHEL MIPRO <a href="https://kansasreflector.com/2023/04/05/kansas-lawmakers-debate-definition-of-female-and-male-for-county-jails/">Kansas Reflector</a>TOPEKA —&nbsp; Kansas documented the state’s lowest-ever recorded birth rate for the 2022 year, according to a preliminary report.The Kansas Department of Health and Environment’s&nbsp;<a target="_blank" href="https://www.kdhe.ks.gov/DocumentCenter/View/29633/Preliminary-Birth-Report-2022-PDF">annual report</a>&nbsp;shows the number of births in the state dropped slightly from 2021. Last year’s report&nbsp;documented 34,697 births in 2021, with a birth rate of 11.8 per 1,000 people. The preliminary 2022 report recorded 34,376 births across the state, with a birth rate of 11.7 per 1,000 people.Seven counties accounted for about 60% of the state’s births for the year: Douglas, Geary, Johnson, Leavenworth, Sedgwick, Shawnee and Wyandotte.Unmarried mothers made up 36% of all births with 12,370 reported. The rate of births to teenagers between the ages of 15-19 remained at 4.7%, unchanged from the previous year’s rate. Most births were recorded for mothers between the ages of 25-29, with 10,579 births. The next most prolific age bracket was mothers between 30-34, with 9,799 births.The 2022 birth rate is the lowest rate recorded since the state began keeping vital records in a centralized system in 1911. The state has recorded declining birth rates since 2008, reflecting a national downward trend.Brenda Bandy,&nbsp;executive director of the Kansas Breastfeeding Coalition, said she frequently heard from young women who were concerned about childbirth complications in recent months, a concern that she hadn’t encountered before in her 20 years of work in the field.“I can tell you for the first time, I am hearing people are afraid of childbirth,” Bandy said. “And I have never heard that before. They appear to be perfectly healthy, young women that are contemplating having birth and they’re actually worried about their safety. And I think the national conversation about maternal mortality, moms dying in childbirth, the complications, many of them are very public.”“It gets the public’s attention,” Bandy added. “I’m hearing this from women of all races, but predominantly women of color.”Women across the U.S. face a heightened risk of dying from pregnancy or pregnancy-related complications in recent years, a study from the Institute for Health Metrics and Evaluation and Mass General Brigham found.Researchers in the study conducted a&nbsp;<a target="_blank" href="https://jamanetwork.com/journals/jama/article-abstract/2806661">state-by-state analysis of maternal deaths</a>&nbsp;rates for 1999-2019 and found Kansas experienced some of the nation’s largest spikes in terms of American Indian and Alaska Native populations, and had consistently high risk levels for Black mothers.The study also found&nbsp;<a target="_blank" href="https://kansasreflector.com/2021/05/13/racial-disparities-in-infant-mortalities-persist-despite-record-low-rates-in-kansas/">Black mothers in the state</a>&nbsp;had higher death rates than the surrounding states in many of the years studied. In 2019, Black women were more than twice as likely to die from pregnancy-related causes in Kansas as in Missouri, Nebraska and Colorado.Bandy said child care and parental leave also were important factors for potential parents. Kansas currently faces a child care shortage.“We don’t make it easy to be a parent, especially a parent with a newborn,” Bandy said. “If you survive childbirth, then having to manage and navigate that return to work when maybe you don’t have any paid leave.”Kansas follows a national trend of declining birth rates as<a target="_blank" href="https://www.cdc.gov/nchs/data/vsrr/vsrr028.pdf">&nbsp;access to contraception improved, more women entered the workforce and concerns rose over high costs of childrearing amid inflation. The COVID-19 pandemic also has been an ongoing factor.</a>A preliminary&nbsp;<a target="_blank" href="https://www.cdc.gov/nchs/data/vsrr/vsrr028.pdf">analysis of 2022 birth records</a>&nbsp;by the U.S. Centers for Disease Control and Prevention’s National Center for Health Statistics found the country’s 2022 birth rate remained below pre-pandemic levels, though the numbers were roughly equivalent to 2021 figures.Overall, there were 3,661,220 recorded U.S. births in 2022, a “nonsignificant decline” from 2021’s 3,664,292 recorded births, with a general fertility rate of 56.1 births per 1,000 women ages 15 to 44.Sarah Hayford,&nbsp;a professor of sociology at Ohio State University who studies national birth rate trends, said U.S. birth rates had been declining since the great recession of 2008.Hayford said economic instability was a factor in the low rates.“Everybody who studied these issues kind of thought that after the recession was over, birth rates would go back up and sort of come back to more the levels that they have been,” Hayford said. “And we’ve just never seen that rebound from after the Great Recession and birth rates have continued to decline.”