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Nebraska
Devastating Missouri River flooding shows officials that changes are needed to reduce risks

NORTH SIOUX CITY, S.D. — Three historic floods on the Missouri River — 1993, 2011 and 2019 — have made it clear that something needs to change if flood risks are going to be reduced on the lower half of the river.

Not enough changed after 1993 and 2011, as this year’s flooding made abundantly clear.

So the affected states — Nebraska, Iowa, Kansas and Missouri — are joining with the U.S. Army Corps of Engineers to undertake a multiyear study of options to reduce flooding on the lower Missouri.

Brig. Gen. D. Peter Helmlinger, commander of the Northwestern Division of the corps, cited the study as part of the path forward during Wednesday’s U.S. Senate field hearing on Missouri River management. Sen. Mike Rounds, R-S.D., hosted the hearing.

“We need to do something different from just rebuilding the systems we have now,” Helmlinger testified at the hearing. “What that something looks like, I can’t speak to the details.”

Already the corps has spent more than $1 billion repairing levees along the river, and that’s with about two-thirds of known projects accounted for.

The Missouri River is home to North America’s largest reservoir system, six massive dams on the upper river. Below those dams is an extensive network of levees and other structures that work to constrain the river.

But as this year’s historic flooding proved, none of that was any match for nature. Most of the rain and snow fell below the flood-control dams, and such a glut of flooding poured into the Missouri River basin that 350 miles of levees were damaged, Helmlinger said.

“(The flood) demonstrated that we have insufficient capacity to carry water safely through the lower basin,” Helmlinger told Rounds and the approximately 50 people gathered for the hearing in City Hall at North Sioux City.

The four affected states are in the midst of agreeing to the jointly funded study, which will likely take a couple of years to complete, Helmlinger said.

Some solutions are more feasible than others, but the list of options includes higher levees, a wider flood plain (moving levees farther out), additional dams and fewer chokepoints, Helmlinger said.

Other options that have been discussed at the local level include moving homes and businesses out of harm’s way.

Should they stay or should they go? After flood, tiny village of Winslow could relocate

In order to survive, should the flood-prone town follow in the footsteps of Niobrara — which has moved twice, once in 1881 and again in the 1970s — and just pack up and move to higher ground? The residents of this little village with a population that hovered around 100 even before disaster struck are pondering a pivotal question about its future.

Already, the states have begun working with the corps on a study of chokepoints, those obstructions along the river that cause water to back up. Typically these are bridges and related infrastructure.

Highway 2 in Iowa has been one such chokepoint, and Iowa has expedited its replacement after this year’s flood. At a cost of about $34 million, that bridge is being replaced with one that is wider and provides more room for water to flow under it.

Similar chokepoints exist farther downstream, including the old Plattsmouth bridge.

Higher levees will cost more money, and if the plan produces that as a solution, those long-term improvements won’t slow down existing repairs, Helmlinger said.

Giving the river more room to roam by moving levees farther away from the water is controversial because it means buying up farmland. Helmlinger said purchasing land for any levee setbacks would be done with willing buyers.

“We’d want to work with willing individuals who are ready to sell land to improve the flood plain, and we know there would be individuals against that,” Helmlinger said.

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Dams aren’t high on the list of probable solutions, Helmlinger said, for two reasons. First, they’re costly, and second, most of the good dam sites already have been taken. If dams were built, they would be along tributaries, not the main stem of the Missouri.

Public input will be part of the process, Helmlinger said in response to a question from Rounds.

“It seems to me if I were a landowner or lived along the river, I’d be concerned … I’d lose some of my property based on new recommendations,” Rounds said.

Rounds pushed for two issues that he believes will help.

First, Rounds said the installation of a system of 600 snow-water sensors in the plains along the Missouri River is overdue. The system, which measures the water content of snow, is needed so that the corps can more accurately estimate spring runoff. The sensors have been on the drawing board for some time, but have been delayed by lack of funding. Those delays have driven home the need to tie funding to projects so that the money can’t be spent elsewhere, Rounds said.

John Remus, chief of water management for the Missouri River Basin/Omaha District of the corps, told Rounds that the first phase of that system is getting underway and as soon as sensors are installed, the corps will begin drawing data from them. That means this winter the corps will begin getting data — albeit a limited amount — on the amount of water bound up in Plains snowpack.

Second, Rounds said he’d like to see the corps match water releases from the dams to long-term cycles of dry and wet years — in other words, the corps should have been releasing more water earlier this year and more than normal through the winter given that the region in the midst of a years-long wetter than normal cycle.

“(The corps) does too much based on an average,” Rounds said. “It appears to me that you could have bigger tools if you make the assumption we’re in a wet cycle.”

Helmlinger and Remus said it’s not possible to make annual decisions based on years-long weather patterns. However, the corps can make adjustments based on short-term forecasts such as an expectation of a wet spring or summer.

Historic wet years can be followed by historic droughts — that was the case in 2011 and 2012, when the Missouri River basin swung wildly between extreme runoff and extreme drought, Remus pointed out.

Release too much water during a wet year and you might not have enough water in the reservoirs to release downstream in dry years — even though that water is needed for downstream operation of such things as nuclear- and coal-powered electric plants, municipal water supplies and barge travel.

Corps officials told Rounds that changing the river’s management based on trends would require a change in the Master Manual, the guidebook to the river. That’s politically divisive and takes years because of competing interests on the river.

Rounds himself said after the hearing that he didn’t think the Master Manual would be reopened, despite pressure from some riverside property owners to do so.

”Not at this point,” he said.

This report includes material from the Associated Press.

Photos: Major flooding hit Nebraska and Iowa towns in March

Articles
Policy will affect status of kids of some who serve nation abroad
CITIZENSHIP

NEW YORK — The Trump administration says children adopted overseas by U.S. military personnel and government employees serving abroad will no longer be guaranteed citizenship.

A "policy manual update" issued Wednesday by the U.S. Citizenship and Immigration Services also would affect the children born to noncitizen government employees before they are naturalized.

The new policy means that some members of the military and government employees would no longer be able to automatically pass on their citizenship to their foreign-born children if they themselves haven't lived in the U.S. for a specified amount of time.

Previously, these families were considered to be residing in the U.S. even while stationed overseas, for immigration purposes. They will be able to apply for citizenship for their children before they turn 18.

The policy won't affect citizens serving in the military or working for the government overseas or change birthright citizenship for children born within the U.S., according to Ken Cuccinelli, acting director of U.S. Citizenship and Immigration Services.

"This policy update does not affect anyone who is born a U.S. citizen, period," Cuccinelli said in a statement.

The agency said the policy was changed to conform more closely with the Immigration and Nationality Act. It "rescinds previously established USCIS policy, which stated that certain children who were living outside the United States were considered 'residing in' the United States."

Experts say it will affect relatively few people, but they would have to go through an expensive and lengthy application process to obtain citizenship.

"The harder it is to become a U.S. citizen, the fewer people who get to participate in civic life," said César Cuauhtémoc García Hernández, a law professor at the University of Denver.

García Hernández said that throughout U.S. history, the residency requirements to pass on citizenship to children have shifted, but previous administrations have taken a broader view of who met those standards. "We are dealing with a small number of people who are particularly sympathetic because they're people who have decided to join the U.S. military," he said. "It's people who have gone out of their way to say we're willing to serve the U.S. government."

San Diego immigration attorney Kathrin Mautino called the policy change "significant," adding it would make it more difficult for the parents of some children born abroad to prove that those children are U.S. citizens and, later when they're grown up, for the children themselves to prove they automatically became U.S. citizens in the past.

Mautino called U.S. citizenship "a precious right" and warned that the added paperwork and processes, which all must be completed before a child turns 18, increase the chance that "some children will lose out completely."

The change reflects the larger push from the Trump administration to make legal immigration to the U.S. more difficult, said Martin Lester, of the American Immigration Lawyers Association's Military Assistance Program.

"They're harming the interests of U.S. service members and U.S. government employees who are overseas doing difficult jobs in difficult places because we sent them there," Lester said. "I can't for the life of me figure out why our government would want to turn around and change a policy to make it harder on them and harder on their children."

The initial release of the policy caused widespread confusion among immigration advocacy groups, lawyers and the media. Cuccinelli's statement was released several hours after the policy memo in order to clarify inaccurate interpretations.

"It's important to have clearcut guidance that is easy to understand, and this is anything but easy to understand," García Hernández said.

The Center for Immigration Studies, which seeks to limit immigration, praised the policy, but some in the military community took a dimmer view.

The change is a "gratuitous slap at military members," said Charles Blanchard, the former general counsel for the Air Force and Army. The Modern Military Association of America called the change "preposterous" and called on Congress to take action.


Health
Omaha clinic tallies $4 million in annual savings by reducing hospital, ER visits

By using a beefed-up type of teamwork in caring for patients, an Omaha outpatient clinic has tallied more than $4 million in cost savings in a year, mostly by reducing hospital and emergency room visits.

In a new study, Creighton University and CHI Health researchers who followed a group of high-risk patients at the north downtown clinic found improvements in diabetes control and reductions in hospitalizations, emergency room visits and the total cost of patients’ care.

Patient costs, specifically, decreased by 48.2%, said Joy Doll, an occupational therapist and one of the authors of a report on the study.

“If we don’t collaborate, we can’t stop that kind of utilization,” she said.

The study, results of which were published recently in the Annals of Family Medicine, was conducted at Creighton University Medical Center-University Campus. CHI Health opened the outpatient clinic near 24th and Cuming Streets in January 2017.

The clinic was built to promote collaboration among health care professionals in different fields, following what’s known as an interprofessional collaborative practice model, said Thomas Guck, a psychologist and professor of family medicine at Creighton and the report’s senior author.

While more primary care clinics are adding collaborative elements, such as pharmacy and behavioral health, the University Campus brings together a number of them, including occupational and physical therapy, Guck said.

As part of Creighton’s family medicine residency program, those health professionals are also training future health care providers in the collaborative model, he said.

In addition, they’re preparing students for an ongoing shift in how health care providers are paid. Medicare and Medicaid and some commercial insurers increasingly are paying providers according to how well they keep patients healthy, such as keeping their blood pressure or diabetes under control. That’s compared to the current “fee for service” model.

Such efforts are seen not only as good for patients but also for health care’s bottom line, because those patients are less likely to require costly hospitalizations or ER visits. Indeed, some local clinics focusing on providing a more collaborative type of care also have reported improvements in patient’s health measures and cost.

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Plenty of studies have shown that an interprofessional collaborative practice model can lead to better, less costly outcomes in patients with specific conditions, such as diabetes and heart disease.

But previously, according to the researchers, no one has studied whether the interprofessional model can do the same with high-risk patients, such as those with frequent ER or hospital visits, in a primary care clinic.

Among those included in the study were some who had visited the ER 50 times in the previous six months, with many of those visits attributed to behavioral health problems or chronic pain, followed by diabetes, said Doll, executive director of Creighton’s Center for Interprofessional Practice, Education and Research.

Under the model, staff huddle for 10 to 15 minutes each morning and afternoon to discuss patient needs. Small groups may see patients together or consult with one another throughout the day. Guck, for instance, often spends time in physical therapy helping work through chronic pain problems, which often have a psychological component.

The researchers compared patients’ results from the year before the clinic opened to those during its first year of operation. After the first year, the researchers reported reductions of 16.7% in ER visits, 17.7% in hospitalizations and 48.2% in total patient charges.

Todd DeFreece, CHI’s vice president of operations for the health center, said team concept was successful not only in ensuring that patients received high-quality care but also in reducing costs for patients and the health system. The clinic sees some 6,500 primary care patients.

It also provided a bonus — a significant drop in burnout among health care providers, a growing concern in health care.

Previously, Doll said, the clinic had ranked among the lower two-thirds among CHI Health’s 151 clinics in terms of employee engagement. Now it’s among the system’s top clinics. Employee retention is high, which produces its own cost savings.

The researchers have begun analyzing results from a second group of patients they began following in 2017. While those results still are preliminary, the researchers are finding that they’re similar to those for the 2016 group. And they’ve been able to sustain the results among the 2016 patients. The researchers also have hosted visits by people from other institutions interested in the model.

“This will hopefully be the first of multiple studies that will demonstrate that,” Doll said.

17 rare and unusual health stories out of Omaha

Metro
Speed of traffic on 84th Street causes doubts about safety of Papillion crosswalk where girl was struck

Abby Whitford

Bright flowers and a princess balloon stirred in the wind as cars and trucks zipped past the makeshift memorial in downtown Papillion, some going as much as 11 mph over the speed limit, others driving more cautiously.

A week had passed since a 10-year-old girl died after being struck in a crosswalk, and some drivers, no doubt thinking of the girl’s death as they approached the intersection, tapped their brakes just before passing the memorial.

In the wake of Abby Whitford’s death, some Papillion residents have questioned the safety and practicality of the crosswalk in which she was hit, a crosswalk that — despite the charming nature of downtown Papillion — sees tens of thousands of vehicles a day.

The city has said it will review the crosswalk after the conclusion of a police investigation.

Abby was using the crosswalk near Washington (84th) and Second Streets just before 4 p.m. Aug. 20 on her way to Sump Memorial Library when she was struck by a car. She died later at a hospital.

The 19-year-old woman driving the vehicle that struck the girl remained at the scene, police said.

Each day, between 30,000 and 40,000 vehicles traverse the intersection where Abby was struck, according to 2017 city-provided data.

That means on the busiest days, vehicles nearly twice the population of Papillion pass through the crosswalk.

Those traffic figures may be at odds with how some local leaders and residents view the quaint downtown area, lined with a shoe repair business, an ice cream parlor and a barbershop. Nearby, an American flag mural decorates the side of a building.

That Americana vision of a main street is often employed by city leaders, including Mayor David Black, as one of Papillion’s strengths. Residents, too, choose the city or stay put because of its smaller, suburban vibe.

But observe the intersection for an hour, as cement trucks and semis haul their loads, as lead-footed, impatient drivers interact with the 25 mph speed limit, and it’s clear many motorists are simply passing through on 84th Street, a state highway.

“That’s certainly a challenge when it comes to educating those people,” Papillion spokesman Trenton Albers said.

For at least 30 years, the crosswalk at Second and Washington was a simple one, with painted lines in the road.

As traffic levels increased, it became more challenging for pedestrians to cross. They also had the option of crossing at an intersection with a traffic signal a block away, but it was the only option that forced traffic to stop.

So in 2017, the city looked into adding enhancements to the Second Street crosswalk with the goal of providing safer access to pedestrians, Albers said.

“It was basically impossible to cross that other crosswalk unless (traffic) was totally clear,” Albers said.

After learning of other cities across the country that use crosswalks with in-pavement lights, Albers said, Papillion leaders decided to install their own.

But drivers were confused by the lights or didn’t notice them during the day. The city began hearing of or seeing people failing to yield to pedestrians. A few months later, the city added flashing beacons and speed boxes that show drivers their speed.

REECE RISTAU/THE WORLD-HERALD 

A crosswalk is marked with signs and lights on 84th Street in downtown Papillion.

Mike Weaver, who has lived in Papillion since 2002, said he was one of the people who complained to the city in 2017 when it became clear that drivers were not responding well to the crosswalk.

The retired contractor said he was “livid” when he heard of Abby’s death.

“People are bad drivers anyway, but when you’re heading north or south on Washington and those lights are flashing, people don’t know what’s going on there,” Weaver said. “It’s very confusing.”

Weaver said he thinks the city may be at odds with itself, promoting rapid growth as it hangs onto its status as a smaller community.

“You can’t have it both ways,” Weaver said.

The enhancements made to the crosswalk cost $90,000, according to the city.

The crosswalk model in downtown Papillion was not devised by the city, Albers noted: The traffic control devices all conform to standards established by the Federal Highway Administration.

The additional lights Papillion added a few months after the in-pavement lights — called Rectangular Rapid Flash Beacons — “enhance safety by reducing crashes between vehicles and pedestrians at unsignalized intersections ... by increasing driver awareness,” according to a 2009 study by the highway agency.

Papillion adding more lights at downtown crossing after in-ground crosswalk lights found ineffective

Two crashes have been reported at the Second and Washington crosswalk, according to Papillion Police Chief Scott Lyons.

The first was the crash that killed Abby. The second, which occurred Friday, was a two-car rear-end crash that Lyons attributed to an increase in driver awareness of the intersection.

Even so, the Papillion Police Department has been spending extra time and money on speed enforcement at the crosswalk since Abby was struck.

In the week and a half since the crash, the department has stopped more than 300 drivers in the area, Lyons said. Officers are working overtime. The department is prioritizing enforcement at the crosswalk.

“We take it very personally, the safety of our citizens,” Lyons said. “We take it very personally that people don’t obey traffic laws.”

Asked if the Police Department had an opinion on the crosswalk when the lights were added two years ago, Lyons said no.

“I’m not a traffic engineer,” he said. “That’s not my role.”

Lyons said he hopes people will use this crash to learn more about crosswalk safety.

“You’re pressing the button as an alert to traffic to let them know that you intend to cross the crosswalk,” Lyons said. “But you’ve still got to wait for cars to stop, and you’ve got to give cars a reasonable amount of time.”

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Jane Terry is the senior director of government affairs for the National Safety Council, which works to eliminate preventable deaths at work, in homes and on the road.

Terry said educating the public about changing or new infrastructure is a vital component of ensuring a smooth implementation, which the city and law enforcement did.

The police made a video instructing motorists how to drive in the intersection. Albers said the city contacted local media, made social media posts and put information on the city’s cable channel before the changes were made.

“You know you’re going to have a learning curve with it,” Albers said. “I think we felt pretty comfortable with the information we had put out.”

Each school day afternoon, Phil Rivera estimates that he sees at least 50 kids walking downtown as he tinkers with bicycles or helps customers at Greenstreet Cycles.

Papillion Middle School and Trumble Park Elementary School are both nearby.

After learning of Abby’s death, Rivera, a cyclist who knows all too well the dangers of the road, decided to conduct a test.

He attached his cellphone to his dashboard, hit record and drove south on Washington Street. As he came down the hill that leads into the city’s downtown, Rivera took his foot off the accelerator, letting his vehicle coast as it approached the crosswalk.

“You hit at least 35 (mph) by the time you get to that (crosswalk), not touching the gas at all,” Rivera, 30, said in an interview.

Rivera said he has noticed an increased police presence near the crosswalk. Drivers, too, seem more aware right now.

But Rivera said he’s not hopeful.

“Come back in two weeks,” he said. “It’ll be back to normal unless the city does something about it.”

Terry said that as cities like Papillion deal with these kinds of tragedies, it’s important that leaders gather all the relevant stakeholders — city planners, downtown business owners, schools, families who live nearby — as they work to make the area safer.

The crosswalk’s future is unclear. Albers said the city will consider police investigation findings when officials review the crosswalk. They may bring in an independent third party, he said.

Could the crosswalk be taken out?

“That’s certainly a possibility,” Albers said.

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