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Nebraska
HHS plans to award new 5-year Omaha child welfare contract worth $197 million to Kansas organization

LINCOLN — State officials plan to put a private Kansas agency in charge of overseeing the care of abused and neglected children in the Omaha area.

In a notice posted late Monday, officials said they intend to award St. Francis Ministries, formerly known as St. Francis Community Services, the new contract to manage child welfare cases in Douglas and Sarpy Counties.

The agency, based in Salina, Kansas, offered to do the job over five years for $197 million, less than 60% of the bid from the current provider, Omaha-based PromiseShip.

“Based on their proposal, we are confident St. Francis will deliver high quality case management and child protection services that strengthen families and build protective factors for Douglas and Sarpy County children,” said Dannette R. Smith, chief executive officer for the Department of Health and Human Services.

St. Francis, which is affiliated with the Episcopal Church, has subsidiaries in Nebraska and six other states, plus two Central American countries. The Rev. Robert Smith, dean, president and chief executive officer, said the agency was founded in 1945 as a boys home.

The Nebraska subsidiary provides a number of services, including foster care and adoption homes, family support services, intensive family preservation and reunification services, and family-centered treatment in the central and western areas of the state. The agency has been working in Nebraska since 2012.

PromiseShip, a private nonprofit formerly known as the Nebraska Families Collaborative, currently manages Omaha-area cases under a contract worth up to $71.5 million annually. It was the only other bidder for the new contract, offering to do the job for $341 million for five years.

Ann Pedersen, a PromiseShip spokeswoman, said the agency was reviewing its options concerning the bidding process, but pledged to continue working with the state to provide a seamless transition.

“After 10 years of achieving great progress in serving children and families, we are extremely disappointed with the decision of the state,” she said.

Documents posted on the state’s purchasing website show that PromiseShip outscored St. Francis in all categories except cost.

Matt Wallen, child and family services director for HHS, said both bidders had strong proposals, with cost being the main difference. He said state officials initially questioned the large variance but were confident about going with St. Francis following presentations from both bidders.

PromiseShip has held the Omaha-area contract since 2009, when the state tried to privatize child welfare statewide.

The agency, formed by Boys Town and other private Omaha-area child welfare agencies, is the only surviving contractor from that experiment. HHS employees manage cases in all other parts of the state. The contract with PromiseShip has been expanded and extended multiple times since then.

Before issuing a request for proposals, state officials hired The Stephen Group, a government-consulting agency based in New Hampshire, to analyze whether Nebraska should continue contracting out case management or whether state workers should resume that responsibility.

The report from that analysis was completed earlier this year but HHS officials have refused to release the report so far.

Wallen, however, acknowledged Tuesday that the decade of privatization has not produced the results sought.

A 2014 evaluation concluded that privatization had not produced “any measurable benefit” for the state. Since then, the state’s own data has shown similar outcomes for cases handled by state employees and those managed by PromiseShip.

Wallen put some of the responsibility on HHS officials. He said the state has not been consistent about the outcomes it wanted and did not give PromiseShip enough leeway to undertake innovative approaches.

“What we wanted to do was really give privatization a chance,” he said.

HHS sought bids earlier this year for a five-year contract with the option of two single-year extensions. The winning bidder will be in charge of about 40% of the state’s total child welfare cases.

The next step will be negotiating the actual contract, with the contract to be signed by July 1.

State officials will do an in-depth review of St. Francis’ readiness to provide services before the state starts referring children and families to the agency. Transition of new and existing cases is expected to be complete by Jan. 1 next year.

“Continuity of services is our No. 1 priority,” Wallen said.

HHS tried to put the contract out to bid in October 2016 for the first time since the privatization effort began. On March 30, 2016, officials announced that they had chosen to stick with the collaborative that later became PromiseShip. But the other bidder, Magellan Choices for Families, filed a protest.

Officials responded by rejecting both bids and, in May 2017, extended the PromiseShip contract. The contract expires at the end of this year.

Photos: Our best shots of 2019 (so far)

Health
Fortenberry shares story of daughter's heart defects during talks of human gene editing research

WASHINGTON — Years before he was elected to Congress, Jeff Fortenberry and his wife, Celeste, welcomed their third baby daughter to the world.

And then they received the terrible news: Kathryn had been born with multiple heart defects.

Fortenberry recalled being overwhelmed by all the medical information suddenly coming their way.

He scoured the latest scientific literature for treatments, including the potential use of adult stem cells to grow a new aorta for her.

“What parent wouldn’t search the world over for a cure for their child?” Fortenberry said as he recounted the story Tuesday to other members of the House Appropriations Committee.

The Lincoln lawmaker decided to share that story as the panel wrestled with whether to preserve restrictions on human gene editing research.

The committee was considering its annual agriculture spending bill, legislation that covers funding for rural development, conservation and a host of other areas — but also funding for the Food and Drug Administration.

Fortenberry, the top Republican on the agriculture appropriations subcommittee, favors keeping the restrictions on gene editing research.

The stem cell research Fortenberry had read about turned out to be premature. Instead, Kathryn received a dozen surgeries over the years and now has multiple mechanical devices in her heart.

As a result of those advanced treatments, though, she has the possibility of living a full, normal life. If she’d been born two decades earlier, she would have had a significantly shortened life expectancy, Fortenberry said.

Today she’s in college, a standout student who will be turning 19 this summer.

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He brought up his daughter’s experience as evidence that life-saving medical innovation can be possible while also guarding against unintended consequences and ethical dilemmas. He also talked about the danger of diverting resources to treatments that aren’t viable.

For the past few years the agriculture spending bill has included language barring the FDA from considering clinical trials “in which a human embryo is intentionally created or modified to include a heritable genetic modification.”

Democrats dropped the language from an earlier version of this year’s bill, in part to spark discussion about it.

Those who favor the restrictions point to cases such as the Chinese scientist who announced last year that he had created genetically modified twin babies. And now there is evidence the twins may face a shorter life span as a result.

But others say the prohibition was slipped into law from the start without any debate and that it ties the FDA’s hands inappropriately by not allowing the agency to review specific circumstances of individual proposals.

Some therapies prohibited by the language could actually be researched ethically, they argue.

After listening to Fortenberry, Rep. Debbie Wasserman Schultz, D-Fla., shared her own emotional story of being diagnosed with breast cancer.

She discovered that she had an inherited gene mutation that carries a higher risk of breast and other forms of cancer. She spoke of how her own children will have to be tested for that gene when they are older.

And she talked about the possibility that science will advance to a point where they could have the offending mutation — and the corresponding potential for sickness and death — eliminated from the family tree.

“That’s incredibly important,” she said. “This is not ‘2001: A Space Odyssey,’ or ‘1984’ or a mad scientist playing games with genetic material. There are real opportunities ... to try to cut off the passing on of genetic mutations that can have dramatic, life-altering implications.”

Over Schultz’s opposition, the prohibition was restored on a voice vote and the committee then voted to advance the overall spending bill.

The committee chairwoman Rep. Nita Lowey, D-N.Y., sided with Fortenberry in supporting the restrictions but said she did so reluctantly and stressed that Congress needs to thoroughly examine the merits of the research.

“While some may feel a moral obligation to oppose this research, others of us feel that we have a moral obligation to allow advances in science so fewer parents will have to watch a child die of a heritable disorder and to help eradicate terrible, deadly diseases that can be passed down from generation to generation,” Lowey said.

In an interview later, Fortenberry reiterated that science has to be tied to ethical considerations and that lifting the prohibitions would send a signal to maverick researchers that the restraints are off, a move that would endanger everyone.

He also spoke about how proud he is of his daughter and reflected on sharing such a personal story with his colleagues.

“When you have a child, it’s like watching your own heart walk outside your own body,” Fortenberry said.

17 rare and unusual health stories out of Omaha

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FIRST IN THE WORLD-HERALD
Developer seeks entertainment district on 62 acres near Werner Park, a 'vision' years in the making​

When people stream out of Werner Park after an evening baseball game, they have to drive a few miles if they want a meal or a beer. The ballpark is surrounded by empty fields, a recreation area and a housing development.

The baseball team itself has succeeded in the Omaha area’s fastest-growing county. When Sarpy County landed the Storm Chasers a decade ago, hopes were high that commercial development would sprout in the stadium’s shadow along Nebraska Highway 370 — a hope that’s now beginning to take shape.

Developer Jerry Torczon has taken first steps that could transform the area into a one-stop shop for entertainment, dining and drinking.

The World-Herald on Tuesday learned of his plans for a private 62-acre mixed-use development on the south and east side of the ballpark. The development — called “Generations” in county documents — is anticipated to create $210 million in new taxable value in Sarpy County.

“This is very good news,” Sarpy County Administrator Dan Hoins wrote in an email to county officials, “and many of us have held this vision for years.”

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Torczon told The World-Herald that Generations is slated to have “entertainment features,” including the possibility of bars, restaurants and shops. Hoins’ email indicated that Torczon will seek an entertainment district designation for the area.

Entertainment districts — like the Capitol District in downtown Omaha and The Railyard in Lincoln — typically also include a common area where alcohol can be taken from venue to venue.

The area of development is bounded by Highway 370 on the south and the Werner Park property on the north and stretches from 120th to 126th Street.

To be clear, plans for the development are in the early stages, and nothing has been finalized. The project cleared its first hurdle last month during a Papillion Planning Commission meeting, but more specific details have not been made public. The development’s completion is probably years down the line.

If Torczon does seek an entertainment district, the area would first have to be annexed by Papillion. Under state law, only cities can grant such districts.

Questions arose whether development would come to fruition when in 2017 the sanitary and improvement district that encompasses much of the land near the ballpark filed for bankruptcy. But officials at the time said they weren’t concerned.

In part because of the SID’s bankruptcy, Sarpy County expects to help with the cost of roads in the development. The county placed $1 million in its budget last year and plans to request another $1 million this year.

Torczon is a longtime developer who has launched multiple Sarpy County subdivisions. In the mid-2000s, he helped guide the Shadow Lake development site. His company, BHI Development, has transformed pieces of farmland into neighborhoods including North Shores — the neighborhood directly north of Werner Park — Ashbury Farm, Ashbury Creek and Granite Lake.

Even as commercial development has eluded the Werner Park area, housing has blossomed near the ballpark. A $100 million plan to build 500 housing units of various sizes is underway northwest of the stadium. Apartment complexes are rising to the east and west. And there’s plenty more developable land within a few miles around Werner.

During the 2018 season, the ballpark welcomed nearly 346,000 fans, according to Martie Cordaro, president and general manager of the Storm Chasers.

And by the time “Generations” could open, another sports team will call Werner Park home. Next spring, Omaha’s new professional soccer team will begin play at the stadium, bringing another subset of fans to the area.

Cordaro said he’s excited about the prospect of any developments that complement the success of the Storm Chasers.

“Any development along 370 is a positive for Sarpy County and the metro area,” Cordaro said. “We’ve been eager to be a part of (developments near Werner Park) dating back to 2009, when we agreed to permanently keep Triple-A baseball here in the metro area.”

Omaha's tallest buildings

Articles
AMERICAN LIFE IS FOREVER CHANGED BY MASS SHOOTINGS
Now common are PTSD, school drills, condolences ready for the next tragedy

Pardeep Singh Kaleka

CHICAGO (AP) — Pardeep Singh Kaleka has surveyed the landscape of an America scarred by mass shootings.

Seven years ago, a white supremacist invaded a Sikh temple in Oak Creek, Wisconsin and killed six worshippers — among them Kaleka's father, who died clutching a butter knife he'd grabbed in a desperate attempt to stop the shooter. Now, whenever another gunman bloodies another town, Kaleka posts a supportive message on social media. Then later, either by invitation or on his own initiative, he'll journey to the community to shore up others who share his pain.

He's been to Newtown, Connecticut. Charleston, South Carolina. Pittsburgh. "We've become kind of a family," Kaleka said.

It's true. The unending litany of mass shootings in recent years — the latest, on Friday, leaving 12 dead in Virginia Beach, Virginia — has built an unacknowledged community of heartbreak, touching and warping the lives of untold thousands.

All the survivors, none of them unscathed. The loved ones of the living and dead. Their neighbors, relatives and colleagues. The first responders, the health care workers, the elected officials.

The attacks have changed how America talks, prays and prepares for trouble. Today, the phrases "active shooter" and "shelter in place" need no explanation. A house of worship will have a priest, a rabbi or an imam — and maybe an armed guard. And more schools are holding "lockdown drills" to prepare students for the possibility of a shooter.

Post-traumatic stress disorder was once largely associated with combat-weary veterans; now some police and firefighters tormented by the memories of the carnage they've witnessed are seeking professional help. Healing centers have opened to offer survivors therapy and a place to gather. Support groups of survivors of mass shootings have formed.

Mayors, doctors, police and other leaders who've endured these crises are paying it forward — offering comfort, mentoring and guidance to the next town that has to wrestle with the nightmare.

Former Oak Creek Mayor Stephen Scaffidi, who'd been on the job just four months at the time of the 2012 Sikh temple attack, remembers a call that night from the mayor of Aurora, Colorado, where 12 people had been fatally shot at a movie theater less than three weeks earlier.

"He gave me the best advice I could ever receive in that moment: 'Be calm. Reassure your community. And only speak to what you know. Don't speculate, don't pretend to be an expert on something that you're not,' " Scaffidi recalled.

Last year, two days after the fatal shooting of 17 students and staff at Marjory Stoneman Douglas High School, Christine Hunschofsky, mayor of Parkland, Florida, met the mother of a 6-year-old killed at Sandy Hook Elementary School who offered a road map into the future.

"She forewarned me of many of the things that we would encounter," Hunschofsky recalled. "She said at first it will seem like everyone comes together. Then it seems like a tsunami that hits the community. People become very divided. This is all normal after a mass trauma."

Three months later, it was Hunschofsky's turn. She sent a message to the incoming mayor of Santa Fe, Texas, where a school shooting left 10 dead. "She told me this is not going to be the hardest day and harder days are coming," recalled Mayor Jason Tabor. " 'Prepare for that.' She was 100% right."

The two mayors have since become fast friends and Hunschofsky visited Santa Fe. "We're bonded for life," Tabor said.

Mass shootings account for a tiny percentage of homicides, but their scale sets them apart. In 1999, the Columbine shooting shocked the nation with its unforgettable images of teens running from the school with their hands up — scenes repeated in other similar attacks years later. Today, the public sees and hears about these events as they unfold, through live-streamed video or tweets.

Each tragedy is horrifying, but the sense of it-can't happen-here has worn off.

"We're a desensitized society," said Jaclyn Schildkraut, a criminologist at the State University of New York at Oswego.

"There is an element of mass shooting fatigue where we've gone from ONE MORE," she said, her voice rising with exasperation, "to add another one to the list. Everybody immediately goes for the gun argument ... and maybe throw a little mental health in there, but we really don't have a consistent, prolonged conversation about these events and how to prevent them."

Studies have offered some hints of their emotional wallop. The National Center for PTSD estimates that 28% of people who have witnessed a mass shooting develop post-traumatic stress disorder and about a third develop acute stress disorder.

Laura Wilson, an assistant professor of psychology at the University of Mary Washington in Virginia, conducted a meta-analysis — an examination of data from 11 studies of PTSD symptoms among more than 8,000 participants who ranged from those who had witnessed shootings to those who just lived in the communities in a 20-year period. She found that the greater the exposure — someone who was at the scene or who lost a friend or family — the greatest risk of developing PTSD. But, in her work, Wilson has found that other factors, including previous psychological symptoms and a lack of social support, also played a role in increasing the likelihood.

"Mass shootings are a different type of trauma," Wilson said. "People are confronted with the idea that bad things can happen to good people. ... Most people have a hard time reconciling the idea that a young, innocent person made the good decision to go to school, was sitting there, learning and was murdered. That does not make sense to us. ... It just rattles us to our core."

Andyet, some people don't fully appreciate the lasting psychological wounds of those who escaped physical harm.

A study conducted by a University of Nevada-Las Vegas professor after the 2017 Route 91 Harvest Festival shooting that left 58 people dead found that PTSD levels for those at the concert remained elevated at least a year later. Most of these people had a friend, family member or co-worker asking — as early as 1½ months after the event — why they were still troubled.

"Almost everyone had someone say, 'Get over it. Why are you letting this bother you?' " said Stephen Benning, a psychology professor who conducted the research. Those kinds of remarks were associated with increased levels of PTSD, which lasted longer than depression.

April Foreman, a psychologist and board member of the American Association of Suicidology, likens exposure to mass shootings to a flu epidemic that affects the entire community in different ways.

"When we have these mass casualty events, it's like an outbreak of a virus," she said. "Some people might be immune or not susceptible to that strain. Some people are going to get a little sick, some people are going to be very sick. Some people might have compromised immune systems and if they're exposed they have a very high risk for life-threatening illness. Suicide is ... the extreme outcome."