WASHINGTON (AP) — President Barack Obama is ruling out the possibility that the U.S. will take military action to address growing violence in Ukraine.
Obama says the U.S. will stand firm with its allies to address the conflict in Ukraine, where the U.S. says Russia is backing pro-Russian separatists. But Obama says a military confrontation between the U.S. and Russia in the region, quote, “is not in the cards.”
But Obama is pointing to the NATO alliance as a deterrent for Russia. He says although Ukraine isn’t part of NATO, other nearby nations are. He says the U.S. takes its commitment to defend NATO allies “very seriously.” Obama will attend a NATO summit in Wales next week.
Obama spoke amid an escalation of violence in eastern Ukraine and fresh signs of Russia’s involvement.
SAN FRANCISCO (AP) — Hillary Rodham Clinton says the fatal shooting of an unarmed Missouri teenager and the violent protests that followed resulted from frayed bonds of trust in his racially divided community.
Thursday’s remarks in San Francisco were the former secretary of state’s first comments about Michael Brown’s Aug. 9 death in the St. Louis suburb of Ferguson.
As a potential Democratic presidential candidate, Clinton has been criticized for waiting so long to talk about the black teen’s shooting by a white police officer.
In a speech to a technology group, Clinton criticized the shooting and the numerous tense confrontations between protesters and heavily armed police.
She says U.S. streets shouldn’t look like war zones.
JEFFERSON CITY, Mo. (AP) — Dozens of new Missouri laws are taking effect, including ones that could make it harder for some fired employees to collect unemployment benefits and easier for high rollers to bet big bucks at casinos.
Thursday marked the standard effective date for laws that were passed during annual legislative session.
But some of this year’s most high-profile measures contained clauses delaying their effect until future years, including an income tax cut and a rewrite of the state’s criminal laws.
The unemployment measure that takes effect Thursday will make it harder for people to collect unemployment benefits after being fired for alleged misconduct such as repeated absences.
A separate law lets casinos offer lines of credit of $10,000 or more to big bettors who don’t want to carry around wads of cash.
NEW YORK (AP) — NFL players will be subject to a six-week suspension for a first domestic violence offense and banishment from the league for a second under a new policy outlined by Commissioner Roger Goodell.
In a letter and memo sent to all 32 teams owners Thursday, and obtained by The Associated Press, Goodell says he “didn’t get it right” in giving Baltimore Ravens running back Ray Rice a two-game suspension for allegedly hitting the woman who is now his wife.
He told teams to distribute to all players the memo in which he writes: “Domestic violence and sexual assault are wrong. They are illegal. They are never acceptable and have no place in the NFL under any circumstances.”
TOPEKA – The United States Department of Education today announced that it has approved Kansas’ request for a one-year extension for flexibility from certain provisions of the Elementary and Secondary Education ACT, also known as No Child Left Behind (NCLB), and has removed the state’s high risk status, which was placed on Kansas one year ago.
“We are pleased that the USDE approved our waiver, but we’re even more pleased that we have been able to gain their support for the unique approach Kansas is taking to using student growth in teacher and leader evaluations,” said Interim Kansas Education Commissioner Brad Neuenswander.
At the heart of the U.S. Department of Education’s August 2013 decision to place Kansas on high risk status of losing its ESEA flexibility waiver, was the issue of when and how to use student growth measures in teacher and leader evaluations. This year, Kansas’ education evaluation systems will incorporate student growth measures as a “significant” factor, however those measures will not be used to inform personnel decisions until the 2017-18 school year.
“We had concerns about the timeline for incorporating student growth measures into the evaluation process as well as the extent to which those measures should influence the evaluation,” said Neuenswander “The USDE listened to our concerns and ideas and we were able to win their approval for our model.”
Contributing to Kansas’ waiver approval was its work on the following:
Through the use of the Kansas Learning Network (KLN), the Technical Assistance Support Network (TASN), and the Multi-Tiered System of Support (MTSS) Project, Kansas has been able to align systems and processes already in place within its special education and Title I offices to support implementation of the principles of ESEA flexibility.
The Kansas State Department of Education (KSDE) makes differentiated and targeted technical assistance available to all local districts and schools through its TASN, which links individual needs directly to state-vetted service providers through a web-based request for assistance system.
KSDE is developing an accreditation process for all local districts that moves beyond looking solely at performance on assessments to examine a district’s holistic approach to serving the entire student and aligns with the state’s work in each of the three principles.
Kansas continues to work with the USDE to gain approval for the state’s model for accountability, which would allow for the use of multiple college and career assessments at the high school level, based on which assessment is most appropriate for the student’s post-secondary plans.
SEDALIA, Mo. (AP) — A 27-year-old Missouri man was being held on $1 million bond in connection with the slaying of a 6-year-old boy.
Online court records show Scottie Alan Willet of Columbia was charged Thursday with first-degree murder and armed criminal action in the child’s death. The Fulton Sun reports Willet was taken into custody Thursday morning in a Sedalia trailer park after an overnight manhunt.
Missouri State Highway Patrol spokesman Sgt. Paul Reinsch told the newspaper the Callaway County Sheriff’s Office called the patrol at 3:15 a.m. asking to use its helicopter to search for a suspect near Millersburg.
The Sedalia Democrat reports Willet was located through a cell phone ping, and a handgun was found in his vehicle.
Authorities have scheduled a news conference for later Thursday afternoon.
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SEDALIA, Mo. (AP) — A 27-year-old man is in custody as a person of interest for the death of a 6-year-old central Missouri boy.
The Fulton Sun reports the man was taken into custody Thursday morning in a Sedalia trailer park on a Pettis County warrant for littering.
Missouri State Highway Patrol spokesman Sgt. Paul Reinsch told the newspaper the Callaway County Sheriff’s Office called the patrol at 3:15 a.m. asking to use its helicopter to search for a suspect in the Little Dixie Conservation area, near Millersburg.
The Sedalia Democrat reports the suspect was located through a cell phone ping, and a handgun was found in his vehicle.
Authorities haven’t released any details about the relationship between the man and the boy or the circumstances of the child’s death.
MANHATTAN, Kan. (AP) — Kansas State University has announced that a health and wellness course will be its first “massive open online course.”
The school joins dozens of leading universities that have begun offering free, digital versions of their most popular courses. The so-called MOOCs allow tens of thousands of students to take a class at the same time. But dropout rates often hover around 90 percent.
The Kansas State course will teach about the changes that can be made to improve health, physical fitness and overall well-being. The first cycle of the course will be taught Oct. 6 to Nov. 15, with content remaining open to students until Dec. 12.
Assistant human nutrition professor Linda Yarrow says the class format encourages instructors to be creative and innovative in their educational offerings.
Dr. Roger Warren, who runs Hanover Hospital in Washington County, says the three managed care organizations that administer Medicaid claims owe his hospital about $140,000 – more than half of the facility’s monthly budget.-photo by Andy Marso
By Andy Marso
KHI News Service
HANOVER — The rural hospital that Dr. Roger Warren leads is owed about $140,000 by the three insurance companies the state contracted with to administer Medicaid, and as he walks the halls, Warren is able to point out exactly what that money means to his full-service medical clinic.
Hanover Hospital’s updated sprinkler system mandated by new fire regulations was about $80,000. In the lab, there’s the Envoy 500 blood testing machine he bought in 2012 for $30,000. In the small cafeteria that serves residents of the hospital’s skilled nursing wing, there’s an industrial dishwasher that cost about $20,000.
Not a big deal,” Warren, 83, said of the dishwasher dollar amount. “Used to be a big deal.”
The unpaid KanCare claims are reaching “big deal” status in Warren’s ledger book. The amount outstanding represents more than half of the north-central Kansas facility’s monthly budget, and Warren said creditors still expect to be paid no later than the fifth of next month, no matter how much he’s owed.
“Going broke is not a fiction with us,” Warren said.
Implementation issues
At a recent legislative oversight hearing, officials from the Kansas Department of Health and Environment said none of the three KanCare companies — Amerigroup, Sunflower State Health Plan and United HealthCare — had met contractual goals for timely claims payment in 2013. KanCare, which launched in January 2013, moved virtually all the state’s 380,000 Medicaid enrollees into health plans run by the three companies.
Representatives of the Kansas Hospital Association say they have worked to address the payment delays and, though claims processing has improved, that work continues.
Hospital association members on the KanCare Implementation Technical Advisory Group were set to meet Thursday with representatives of KDHE and the managed care organizations. Tish Hollingsworth, the hospital association’s senior director of finance and reimbursement, said it will be the group’s third collaborative meeting this year, after eight last year, and will have a “robust agenda.”
“We’re just still hammering away at the implementation issues,” Hollingsworth said. “It just seems like there’s always something, when you have a transition this big, that will crop up.”
The problems at Hanover Hospital appear to stem from the 25-bed skilled nursing wing included in the facility.
Melissa Minge, Hanover’s billing clerk, said the claims-processing employees at the managed care organizations insisted the hospital first bill Medicare on claims that she says the federal health care program for seniors couldn’t pay.
Minge said the MCO employees tell her “they’ll look into it,” but little gets resolved quickly.
With 60 employees and a $3 million annual budget, Hanover Hospital is more vulnerable to cash flow issues, says Dr. Roger Warren. It’s one of two hospitals in Washington County.- photo by Andy Marso
“Very seldom do you hear back,” she said. “You have to call them again. And again and again and again.”
Sheryl Adam, the hospital’s financial officer, said most of the unpaid claims come from one MCO, United HealthCare, but that doesn’t necessarily mean the others are easier to work with.
“We are having trouble with Amerigroup and Sunflower also, but I think most of our patients are United HealthCare and that’s why they stick out,” Adam said.
Tim Spilker, president of United HealthCare Community Plan of Kansas, said the company is aware of the billing problems with Hanover Hospital and is working to correct them.
“We know what the root cause is,” he said. “We’re working with them to ensure the claims that were incorrectly recouped are addressed. From their perspective they’d probably say ‘No, we haven’t received the money yet.’ But we expect that will happen in the next one to two weeks.”
Spilker called the Hanover problems an “isolated incident with a certain (claims) processor.”
“We really take accountability if we’ve screwed something up, and this is a place where we’ve really inaccurately or inappropriately applied Medicare,” he said.
Spilker said his company has been processing better than 97 percent of all claims within state-mandated deadlines. The state’s standard of 100 percent is a high bar to clear, he said, but one the company supports.
Problems for ‘mom-and-pop’ hospital
Hollingsworth said the hospital association heard of similar billing problems last year for other hospitals that also include skilled nursing facilities.
“Early in 2013 that was something United HealthCare and all of the MCOs struggled with: payments to nursing homes, skilled nursing facilities, intermediate swing beds, the non-hospital services hospitals are providing,” she said.
Hollingsworth said United HealthCare has cleared up most of those issues for new claims as well or better than the other two companies.
That’s little consolation to Warren, who runs what can best be described as a “mom-and-pop” hospital, with a lab, X-rays, emergency room and surgical capabilities.
He and his wife are the only physicians, but his son – a surgeon who lives in Hiawatha – now flies in to perform most surgeries because Warren can no longer stand long enough. The 47,000-square foot facility has 60 employees and operates on a budget of about $3 million annually.
Medicare accounts for most of that budget. But Adam said Medicaid reimbursements, now KanCare, make up about 10 percent, and that 10 percent was more reliable before January 2013, when the state turned the management of the program over to the three for-profit companies.
“We never had any trouble when it was state-run,” Adam said. “Never had any problems. It’s like jumping through hoops and pulling teeth to get them to pay now.”
Warren said other critical access hospitals might be better able to absorb the late payments because they can go to their county governments and ask for help. But Washington County is one of the few rural counties that has two such hospitals, and Warren said the portion of the tax base that Hanover shares with the county hospital is small and maxed out.
When cash flow is strained he has made payroll by dipping into the funds of the hospital’s charitable foundation, which is underwritten largely by he and his wife. He said those funds are meant to be used for capital improvements and with creditors closing in, but his options are limited.
“We’ve got to where nobody feels too charitable toward us,” Warren said. “They don’t want to wait for 30 days to get their money, they want it right now, and they’re worried about if they don’t get it from us right now, we won’t be here next month.” Closer to home
The prospect of a future without Hanover Hospital was dispiriting to a table of senior women eating lunch Tuesday in the nursing facility’s small dining room.
The county hospital is 15 miles away and there’s another facility 18 miles east across the county line in Marysville. But Hanover Hospital allows local seniors in need of care to stay closer to home and draws from some of those communities as well.
“I came from Marysville,” Donita Cohorst said. “Hanover is so much better. Marysville has a new hospital, but I’d rather be here because of the care.”
Another woman at Cohorst’s lunch table said she came to Hanover from Nebraska.
Hanover’s two-story brick hospital sits on a town square that features a wooden bandshell bedecked in American flag bunting and a white building that doubles as city hall and a fire department.
Standing at the hospital entrance, Warren pointed to another brick building on the square, where a car dealership used to be. Hanover, like many rural communities, has contracted since he started as the hospital’s administrator in 1960. It’s grown a bit since 2000, but the population is still estimated at just short of 700 people.
Warren said he could have retired years ago or made more money picking up shifts at short-staffed ERs in other communities.
But in Hanover, his patients and staff all know him. In Hanover, he has built something despite financial challenges.
“I like practicing here,” Warren said. “I love it.”
HIAWATHA, Kan. (AP) — A group of residents in Hiawatha are trying to bring a movie theater back to the northeast Kansas town.
Hiawatha’s Twin Theatre closed about a week ago after voters in April rejected an initiative that would have funded the construction of a new city-owned theater.
Now, a nonprofit group called Hiawatha ACES has launched a fundraising drive to buy and renovate the 40-year-old Twin Theatre.
The St. Joseph News-Press reports the group estimates it would cost $200,000 to update the theater. For now, small improvements and maintenance will begin, with a goal of reopening the theater by the holiday season.
However, a second proposal to fund a city-owned movie theater will be on the ballot in November. If it passes, the plans to renovate the Arrow Twin will stop.
WICHITA, Kan. (AP) — Cessna Aircraft’s Independence plant has delivered the 10,000th single-engine airplane built at the plant since the first delivery in June 1996.
The company says the milestone plane, a Cessna Skyhawk, was delivered recently to Liberty University in Lynchburg, Virginia, along with two other Cessna Skyhawks.
The Wichita Eagle reports that the airplane has a custom paint job noting the milestone.
Cessna builds most of its single-engine piston products in Independence, including the Skyhawk, Turbo Skylane JT-A, Stationair and TTx.
It also produces the Citation Mustang and Citation M2 jets. The company’s Garmin avionics training center is also at the plant.
