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 <img src="https://media.eaglewebservices.com/public/2020/9/1600293679889.jpeg" alt="Gov. Laura Kelly meets via Zoom with leaders in rural health care Wednesday." />
 <figcaption>Gov. Laura Kelly meets via Zoom with leaders in rural health care Wednesday.</figcaption>
 </figure>By CRISTINA JANNEY Hays PostDuring a virtual conference call Wednesday, rural hospital administrators told Gov. Laura Kelly local control will be important as the state rolls out a vaccine for COVID-19&nbsp;The governor said she doubted a vaccine will be available by Election Day, but she hoped Kansans could start being vaccinated by first of the year.Melissa Atkins, CEO of the Graham County Hospital in Hill City, said she wanted officials to be sure any vaccine for the virus is ready to be mass distributed to the public."We talked earlier this morning in our medical staff meeting about what the implications would be if we release it too quickly," she said.The medical community has struggled to get the public to accept flu vaccines, she said."I feel we are at a good place now with the flu vaccine, and everybody is pretty much a believer," Atkins said, "but if we would let the COVID vaccine get out there and not be effective or have some adverse effects , it could ruin people's perception about vaccines for a long, long time."Harold Courtois, CEO of Memorial Health System in Abilene, said rural communities have significant numbers of older adults, which are at higher risk from the virus. He wanted to make sure those counties would receive adequate allocations of vaccine to cover those residents.Kelly said health officials are developing a priority list for the vaccine, and the elderly and high-risk patients are going to be given a higher priority.Allen Van Driel, CEO of Smith County Memorial Hospital, said what works in urban communities does not work in rural communities. He said Smith County Memorial has a strong relationship with its local health department."I think what we should concentrate on as the vaccine does become available, let the local authorities have a strong say in how we provide it in our own communities," he said. "We have good emergency preparedness programs in place that include mass vaccination, and we need to let those processes work, rather than having a process that works in Topeka or Wichita or where ever that is dictated to us from larger cities."The governor said she saw the desimination of the vaccine much like the state responding to a wildfire or a flood."The state is really the resource, but the folks who do the implementation are on the ground and in the communities," she said.&nbsp;<h2>Governor extends SCHIP benefits</h2>The governor announced she will be extending a provision that will allow children to be served an additional year by the State Children's Health Insurance Program, which is also known as SCHIP.Before the pandemic, children aged out of the program when they turned 19. The extended coverage will be valid through the end of 2020.<h2>Gov. continue Medicaid push</h2>The governor also took the opportunity to make another push for Medicaid expansion.All of the states surrounding Kansas have approved Medicaid expansion, which Kelly said made Kansas "an island in the Midwest."Chad Austin, president of the Kansas Hospital Association, said he was concerned not expanding Medicaid in Kansas has placed the state at a competitive disadvantage in terms of recruiting medical providers.<h2>Rural hospitals discuss COVID challenges</h2>Dr. Ronald Robinson, CEO of the Goodland Regional Medial Center, said health officials are having difficulty determining the prevalence of the virus in the community.He said the community has the ability to do antibody testing, but is having difficulty implementing the testing in the community.Courtois said Abilene is lacking PPE, especially N-95 masks, which concerns him as the flu season ramps up.Van Driel said rural medical providers have used telemedicine throughout the pandemic, but reimbursements from some providers, including Medicare, are lower for telemedicine than for in-person visits.He said some private insurers are now discontinuing coverage for telehealth, especially for primary care, as if the pandemic were over."We have the broadband capability here,"&nbsp;Van Driel said. "We can provide the services. We have the providers, but if we can't get paid for it, it has a significant impact on the financial stability of the health system."

NW Kan. rural hospital leaders urge local control for COVID-19 vaccine rollout