WICHITA, Kan. (AP) — The Democratic challenger to Kansas Secretary of State Kris Kobach has released the past three years of personal income tax information and is challenging her opponent to do the same.

Jean Schodorf released her return transcripts on Wednesday in a bid to force Kobach to prove his claim that he spends only an average of 4.9 hours per week on his private law practice. Critics contend Kobach spends too much time outside Kansas as the architect of anti-immigration laws across the nation.

Kobach says he has already made public how much time he averages in his private law practice and calls Schodorf’s move a political stunt.

Schodorf’s returns listed total annual income ranging from $51,128 to 136,098. Her federal income taxes ranged between $2,374 and $18,234 during those three years.

 

By Jim McLean
KHI News Service

TOPEKA — The lobbyist for a group of advanced practice Kansas nurses seeking a compromise with doctors on scope of practice legislation was not expecting much heading into the first round of talks.

But the marathon session held late last week changed Mary Ellen Conlee’s outlook.

“I’m much more optimistic,” Conlee said.

For three years, Conlee and a group of advanced practice registered nurses have been pushing for legislation to allow APRNs to establish their own primary care practices. Current law requires that ARPNs work under so-called “collaborative practice agreements” with supervising doctors.

The nurses say the agreements, which often don’t result in any meaningful collaboration or supervision, are a needless restriction on their ability to practice to the full extent of their training. Doctors say the agreements are needed to protect patients.

Many other states have broadened scope of practice laws to give APRNs more independence. But Kansas lawmakers have yet to hold a hearing on the issue, largely because of opposition from doctors.

The negotiating sessions are an attempt to craft a compromise bill before the Legislature returns in January.

Productive start

“I think both sides are cautiously optimistic that there is going to be a way to address this,” said Jerry Slaughter, executive director of the Kansas Medical Society. “There are no guarantees or anything, but I think both sides are working hard.”
Kansas doctors, Slaughter said, opposed the legislation because they thought it was overly broad and didn’t set clear limits on what ARPNs would and would not be permitted to do. The way doctors read the bill, it would have allowed nurses to perform surgery.

“They (the nurses) said, ‘Oh no, that’s not what we intend,’ and we said, ‘Well, if you read the bill that’s what it says.’ And they said, ‘That’s not what it says.’ We kind of went back and forth on that,” Slaughter said, characterizing the discussion to date.

“So, now we’re saying, let’s just be clear about it,” he said.

Much of the first session, which lasted several hours, was devoted to nurse educators describing in detail the academic and clinical training that ARPNs are required to complete. The discussion was led by Monica Scheibmeir, dean of the Washburn University School of Nursing, and Diane Ebbert, director of advanced practice programs at the University of Kansas School of Nursing.

“I think based on the questions that were asked, most of them (doctors) left the meeting with a much better understanding of the width and breadth of nurse training,” Scheibmeir said. “Content was covered that really helped bridge the gap in knowledge. There were some aha moments.”

But key issues remain

While off to a promising start, negotiators still must deal with issues at the heart of the dispute. And the two sides continue to see those issues very differently.

The nurses say that allowing APRNs to establish independent practices would increase access to quality primary care in areas of the state where there are too few doctors. But the doctors say that allowing APRNs – and other providers with less training – to independently practice medicine could produce fragmented and substandard care.

“We don’t look at this as a stand-alone issue,” Slaughter said. “We’re just trying to be consistent because we think there has to be a structure that promotes quality patient care. The rules have to be clear.”

And the trend of allowing mid-level practitioners to do more is creating a confusing environment for doctors, he said.

“It’s a very dynamic space with a lot of people with different training all trying to do the same thing,” Slaughter said. “We have to have a consistent approach here or this is just going to be a mess.”

In addition to APRNs, several provider groups ranging from paramedics and pharmacists to optometrists and dental hygienists are urging lawmakers in states across the country to broaden scope of practice rules.

Missouri lawmakers earlier this year passed controversial legislation to create the provider classification of assistant physician. The measure, signed by Gov. Jay Nixon in July, allows medical school graduates who haven’t completed their residencies to work in medically underserved areas of the state as primary care doctors.
It’s clear that many doctors see the trend as a threat. A report published in 2012 by the Physicians Foundation called it “one of the most persistent and vexing challenges facing physicians.” The report urged doctors to go on the offensive in an effort to restore the primary care physician as the “linchpin of the nation’s health care system.”

“Failure to do so – and the resulting influx of mid-level providers into that role – will ultimately leave us with a rudderless model of patient care that will result in greater fragmentation, higher costs and inferior outcomes,” wrote authors Stephen Isaacs and Paul Jellinek.

A column in the most recent issue of the Kansas Medical Society’s e-newsletter outlined the group’s concerns with the legislation.

The nurses lobbying for independent-practice legislation in Kansas say they’re not attempting to replace primary care doctors. Rather, they say, they’re attempting to expand access to primary care by practicing to the full extent of their training. And they say multiple studies show that allowing them to do so doesn’t compromise patient care.

Based on those studies, the Federal Trade Commission recently urged state policymakers to lift “anti-competitive” restrictions on APRNs, saying in a report that practice limits such as those imposed by Kansas law “can deny health care consumers the benefits of competition, without providing significant countervailing benefits.”

The next step in the Kansas negotiations, said Conlee, the lobbyist representing the nurses, is to get down to details on the issues that continue to stand in the way of an agreement.

“Both sides are going to come back with some specific suggestions for how to move forward,” she said.

A date for the meeting hasn’t been set, but Conlee said it will take place in late September or early October.

ST. LOUIS (AP) — Missouri Gov. Jay Nixon has named a new state public safety director, nearly three weeks after the police shooting of Michael Brown led to violent protests in a St. Louis suburb.

The governor announced Wednesday that former St. Louis police chief Daniel Isom will take over as director of the Missouri Department of Public Safety on Sept. 1.

Nixon says he’ll replace Jerry Lee, who is retiring after almost three years as director.

Nixon has come under criticism for the state’s response to protesters and looters following the Aug. 9 shooting of the black 18-year-old by a white Ferguson police officer. Nixon eventually put the State Highway Patrol in charge and called in the National Guard.

The public safety director oversees both the patrol and the guard.

 

JEFFERSON CITY (AP) – A prominent criminal defense attorney raised concerns about a Missouri ballot measure that would allow allegations of past wrongdoing to be used against people facing child sex abuse charges.

Attorney Kim Benjamin, of Belton, is the past president of the Missouri Association of Criminal Defense Lawyers. She said Wednesday that proposed Constitutional Amendment 2 could result in more wrongful convictions for people falsely accused of sex crimes.

The proposal would allow prosecutors to use allegations of past criminal actions against defendants facing new sex-related charges involving victims younger than 18. It would essentially undo a 2007 Missouri Supreme Court decision that struck down a similar state law.

Prosecutors and police are supporting the measure.

Benjamin says defense attorneys haven’t raised money for an organized campaign against it.

PHILIP MARCELO, Associated Press

CAMBRIDGE, Mass. (AP) — A U.S. journalist says he is overwhelmed to learn of the efforts that went into securing his release from a Syrian extremist group.

Peter Theo Curtis made his first public remarks Wednesday outside his mother’s home in Cambridge, Massachusetts, after being freed three days earlier.

Curtis says he had no idea during his time in captivity that so many “brave, determined and big-hearted people” were working for his release. He says he is also grateful for the many people who have welcomed him back since his return.

The 45-year-old writer was released by al-Nusra Front, a Sunni extremist group.

Curtis returned to the United States on Tuesday and was reunited with his family.

LAWRENCE, Kan. (AP) — A Lawrence man was sentenced to life in prison without the possibility of parole for at least 25 years for multiple child pornography crimes.

Douglas County District Attorney Charles Branson says 46-year-old Michael J. Limburg was sentenced Tuesday for 10 counts of promoting sexual performances and four counts of possessing child pornography.

The Lawrence Journal-World reports that investigators found images of child pornography on computer disks belonging to Limburg. A forensic examination of Limburg’s computer also turned up numerous searches for terms associated with child pornography.

 

KANSAS CITY, Mo. (AP) — Law enforcement authorities are looking for a man who stole a Kansas City police cruiser, which was later found abandoned in northwest Missouri.
Kansas City police say the man, who they described as emotionally disturbed, stole the cruiser about 2:30 a.m. Wednesday.
KSHB-TV reports Missouri Highway Patrol troopers found the vehicle about 4:20 a.m. on the side of Interstate 35 between Bethany and Cameron in northwest Missouri. A shotgun was missing from the car.

Details about the suspect and how he managed to steal the car were not immediately available.

OSAGE CITY, Kan. (AP) — Osage County officials say a 20-year-old man whose body was found along a highway during the weekend died in a hit-and-run.

Sheriff Laurie Dunn said Tuesday an autopsy confirmed that Timothy Kemble of Carbondale was hit by a car before his body was found Sunday morning along Kansas 56.

WIBW-TV reports  authorities are still searching for the vehicle that hit Kemble and are asking anyone with information to call 1-877-OS-CRIME.