By Mike Sherry
KHI News Service

Truman Medical Centers and four safety-net sites are preparing to launch a three-month pilot project aimed reducing the number of dental cases treated in the emergency room.

Organized through the regional Oral Health Access Committee, the “direct referral” pilot could reserve as many as 75 slots per week at the clinics for emergency cases sent from Truman.

Planners finalized some of the details at a meeting last week and said they expect to start the pilot in January.

“It would be great for us and great for patients,” said Dr. Jeff Hackman, clinical director of Truman’s Emergency Department. “I hope we can pull it off.”

The goal would be to treat patients no later than 12 to 24 hours after they arrive at the emergency room, said committee co-chair Dr. Michael McCunniff, chairman of the Department of Dental Public Health & Behavioral Science at the University of Missouri-Kansas City (UMKC).

The UMKC dental clinic would participate along with the Seton Center and Samuel U. Rodgers Health Center through its downtown and West Side clinics.

The cases the committee is addressing, McCunniff said, typically occur after-hours with the patient needing an abscessed tooth removed.

Getting patients seen quickly, McCuniff said, should lessen the likelihood of no-shows when emergency room staff make a referral to a dentist.

What the pilot also seeks to avoid, said Scott Lakin, director of the Regional Health Care Initiative, is the situation where emergency room patients get a list of providers and then are left to figure out the next steps on their own.

“You have people that have a real need for services going from clinic to clinic seeing if there is an opening,” he said.

That’s especially difficult, he said, for a safety-net population that sometimes has limited access to transportation.

Another goal, Lakin said, would be establishing dental homes for the patients, in the hopes that they could avoid emergencies through preventive care.

Officials said the cost of the pilot could be as low as $30, which would cover the monthly costs of a signing up with a scheduling website that all participants could access.

One change of practice contemplated through the pilot, according to the organizers, is to reduce the amount of pain medication patients receive in the emergency room.

If emergency room staff provides several-days-worth, officials said, the patients are more inclined to skip follow-up referrals, and then return to the emergency room in pain when their medication is gone.

“In other words,” said committee co-chairman Dr. Mike Jurkovich, dental director for Sam Rodgers, “they didn’t get 20 Vicodin through the ER, they maybe got two. And, they are going to be out of pain tonight, but when they wake up tomorrow, they are going to want to be (at an appointment) at 8 o’clock.”

Officials said they would also have to test how to maintain patient privacy in making referrals through the website. Further down the road, they said, they would like to figure out a way to share a patient’s entire electronic medical record.

The participants said they would also have to experiment with managing no-shows even through the emergency referrals.

But McCunniff and Jurkovich said there likely would be enough demand in the waiting room to fill unused slots. “There is always more need than there are resources,” Jurkovich said.

Jurkovich also said it would good to see if the pilot could put a dollar figure on the amount of savings achieved by Truman as the result of diverting patients from the emergency room or hospitalization.

Given that the main challenge in launching the pilot is getting up to speed on the scheduling website, the participants said it should not be difficult to launch.

“If you told us to start scheduling people tomorrow,” Hackman said, “we could make it happen.”

 (AP) — The average U.S. price of gasoline has dipped 2 cents a gallon in the past two weeks after a month of increases.

According to the Lundberg Survey released Sunday, the average for a gallon of regular is now $3.26. Midgrade averages $3.46 and premium is $3.61.

Of cities surveyed in the Lower 48 states, the lowest price, $2.84 a gallon, was in Tulsa, Okla.

Long Island, N.Y. had the highest, at $3.62.

Just a penny less was Los Angeles with an average of $3.61.

The lowest price in California was in Sacramento, $3.40.

The average price of regular in California is now $3.54, down a cent from two weeks ago.

 (AP) — A federal judge has ruled that Creighton University’s medical school must provide a deaf student with special equipment and interpreters to allow him to finish his last two years of medical school.

But the judge deemed that the university does not have to reimburse Michael Argenyi for more than $100,000 of his own money he spent in his first two years for those aids.

Argenyi was accepted to Creighton’s medical school in 2008 after disclosing that he was hearing-impaired and requesting accommodations for his disability to allow him to follow lectures and communicate with patients.

He sued in 2009, after leaving the school when the university refused his requests for interpreters — even though he offered to pay for them himself.

(AP)Numerous traffic accidents were reported Saturday as a winter storm brought freezing rain and snow to Missouri.

Winter storm warnings were in effect for much of the state, except the extreme southeast, where flood warnings have been issued, said Julie Adolphson, a meteorologist with the National Weather Service in the Kansas City suburb of Pleasant Hill, Mo.

The freezing rain was expected to switch to snow in the evening hours in west-central and northwest Missouri. Adolphson said the snowfall would taper off overnight and end in most areas by daybreak. Forecasts called for the accumulations to range from 6 inches or more in northwest Missouri to 1 inch or less in an area from Clinton to Columbia.

Starting Sunday, temperatures were expected to begin dropping, with wind chills as low as minus 10 degrees forecast for Monday morning and minus 25 degrees possible for Tuesday morning in the northern third of the state.

On Christmas Day, the forecast includes a slight chance of light snow or rain in northwest and north-central Missouri, Adolphson said.

(AP) The centennial celebration is starting early for a foundation that continues to host late-night jam sessions, nearly 100 years after it was founded as a segregated union for black musicians.
The centennial isn’t until 2017 for the Mutual Musicians Foundation in the 18th and Vine Jazz District in Kansas City. But the foundation, whose building is a National Historic Landmark, will begin marking the occasion next year with a series of events.
Foundation vice president Anita Dixon said the purpose of the three-year roll out is to showcase Kansas City “as an international Mecca for jazz enthusiasts.”
Once known as Local 627 of the Musicians Protective Union, the organization’s founding members invented what came to become the Kansas City jazz style in the 1920s and 1930s.
Next year, the foundation will invite 10 bloggers widely known in the jazz world to come to Kansas City and write about the history of the music and the 18th and Vine area. Conferences on jazz and the city’s role in its development are set for 2015 and 2016 in partnership with the Historic Kansas City Foundation and the Smithsonian Institution, with a week-long celebration closing out the event in 2017.
When not hosting the late-night sessions, the foundation serves as a practice space for experienced artists and students alike. On many days it’s a meeting ground for some of the elder statesmen of K.C. jazz.

LANSING, Kan. (AP) — An inmate has been sentenced to 10 years and two months in prison for escaping from a Kansas prison with two other men in May.

Fifty-eight-year-old Randy Ridens was sentenced Friday in Leavenworth County for aggravated escape from custody.  He could have been released as early as this month on his previous burglary and theft cases.

The other two men Ridens escaped with from the Lansing Correctional Facility face charge in Kansas and Missouri. Those two men, Allen Hurst and Scott Gilbert, surrendered in Edgerton, Mo., after several hours of negotiations with law enforcement. They were accused of trying to ambush officers who pursued them and of attempting to kidnap the Edgerton mayor.

Ridens was caught later that evening as he entered Topeka.

(AP) — Missourians who live in rural areas are far less likely to have health insurance than those living near big cities, according to U.S. Census data.

The Associated Press examined county-by-county data for 2011, the most recent year available. The numbers show the uphill climb facing President Barack Obama’s health care overhaul in Missouri, which opted against setting up its own exchange and instead allowed the federal government to run it.

Missouri overall ranks right in the middle of the nation in the percentage of uninsured residents under age 65 — tied with Washington state at 25th with 16 percent uninsured. But in 34 of Missouri’s 115 counties, one-fifth to one-quarter of non-senior residents lack health insurance. Twenty-seven of those 34 counties have fewer than 25,000 residents.

(AP) – A disciplinary panel says a former Kansas courts research attorney violated the rules of lawyer conduct when she used foul language in tweets about former Attorney General Phill Kline.

The Topeka Capital-Journal reports (http://bit.ly/1fMMVBq ) the three-judge panel ruled Friday in the case of Sarah Peterson Herr, who was fired from her Kansas Court of Appeals job over her Twitter comments in November 2012.

Herr posted the tweets during an appearance by Kline before the Kansas Supreme Court as part of an ethics case about his investigation of abortion clinics.

Herr told the disciplinary panel she wrote “dumb things” and didn’t mean for the tweets to go public.

Herr’s lawyer says her client has been penalized enough. She’s asking that Herr receive the minimum sanction of an informal reprimand.