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dougthorpe-com · 1 month
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Leaders: Is Your Myopia Your Utopia?
Watch out for becoming too single vision in your leadership style.
When it comes to leadership and management, nearsightedness or myopia is a common occurrence. What does that mean? Is Your Myopia Your Utopia? Single vision Since effective leadership is part art as much as part science, I see too many managers taking a nearsighted look at their role and responsibility. Nearsightedness is called myopia. By this I mean we place more emphasis on the duties and…
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Self-Improvement Tips for Success | Personal business coaching houston
Your personal development and growth are built directly on the foundation of your self-improvement.  The more you embrace your own self-improvement the greater the possibilities in your business and life.  As a business coach, very often my primary role with clients transitions into that of a personal development coach and personal development coaching.
Today, business owners, executives, and managers have a wealth of information available on systems, processes and what I call the “how to” of how to have a successful business.  If marketing is a challenge there are hundreds of solutions and services.  If manufacturing to higher tolerances is the challenge, there are processes to achieve them.  Regardless, almost anything you need to improve business today can be found.
Yet, there is one area where you can’t call someone in or bring a company to institute a process without your active participation.  And, that area is your self-improvement.  Much has been written on self-improvement.  Some people call self-improvement personal development.  I will use the terms interchangeably here.  Why is self-improvement or personal development critical?
Quite simply, seldom will whatever you want in life exceed your self-improvement or personal development.  The following I have found to be useful guidelines for many clients when I am in the role of personal development coach and do personal development coaching.
Know your philosophy. Your philosophy is how you think.  Your world and your personal development can only become as large as your thinking.  What are the lids of your thinking?
Know your attitudes. How do you feel, your attitude, about what you think?  All thoughts are things.  Every thought has an emotion attached to it.  Thoughts are things.
Activity is the result of your thoughts and how you feel about your thoughts. If you wish for increased activity to accelerate your personal development than you must examine your thoughts and how you feel about them.  If your activity is not leading you to where you want to go then you must re-examine your philosophy and your attitudes.
At this point, to have the activity you want, you must be willing to amend your thinking.  When you amend your thinking and attitudes that is when you can create new habits and activity.  This is where a personal development coach and personal development coaching can be helpful.  It is important to have someone outside of yourself to support you in making the advances you want.  After all, if you are in the picture, it is hard to see yourself as you are.
Get More Info : Personal business coaching houston
Website : https://www.selfimprovement-tips.com/
Contact Us : Personal business coach houston
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Leadership Coaching services in houston
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Self-Improvement Coaching
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chenfwdw · 3 years
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Colors Decorating
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The Nineties may be the 'we' decade szemüveg csúszásgátló in which the walls of gender as well as race, semantically anyway, come toppling down. In this kind of forecast, it is always wise to watch Calvin Klein, who helped push the men's fragrance business to a dollars 1 billion a year phenomenon, and who unleashed the big boy body of Marky Mark on an unsuspecting public in his jeans campaigns. This season Klein introduces a unisex fragrance called 'cK One' (due in Europe next year) aimed at young multi cultural trendies, who, if they can't exchange body fluids, can at least swap this 'fresh and clean' scent.
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martaangeliniblog · 5 years
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I went on and I started scrolling through
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itssmithlove · 5 years
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I've eaten it before when not too strong
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data science in hyderabad
M Tech In Information Science
The assets who're hired from their campus, are indeed great additions to the system. They had been capable of fulfil our varieties of requirements within no time.
If you aspire to be Data Science professionals, this course can immensely help you to achieve your objective. The course is especially focussed on Python for core knowledge science programing; it additionally contains R as essential to allow professionals working in R. I obtained a Data Science job presents from Goldman Sachs, Mindtree, and Barracuda at a shot. Currently positioned in Mindtree, it was a pleasant experience with DataMites, the method, and the experiences resulting in success. Under the guidance of Ashok sir, the ideas were made straightforward to know. A newbie with a certification in Data Science can anticipate from INR 5 to 7 lakhs every year.
I learnt statistics , machine learning , python , numpy , scikit-learn , SQL. I even have taken online coaching and comfortably learnt from my residence. The period of the Data Science certification in Hyderabad is hours approximately. Students can opt for information science Instructors-led on-line coaching or classroom coaching in Hyderabad and both weekday or weekend courses. Most institutes listed above offer versatile batch timings to fulfill the wants of working professionals as nicely.
This programme is completely for professionals working within the business. For Data Science on-line Training Mind Q is among the best places. Thanks, Mind Q for helping me to start my career in Data Science. It additionally supplies a Data Science course in Hyderabad with a quality Training & Friendly surroundings to be taught. Mind Q is among the places for studying Data Science Course in Hyderabad. Gain an in-depth understanding of supervised studying and unsupervised learning fashions such as linear regression, logistic regression, clustering, dimensionality discount, K-NN, and pipeline.
They have a power-packed curriculum that enabled them to study by way of real-time practical examples and trade challenges. The trainers had been extremely educated and gave insights into their real-time implementing challenges and experiences. Hyderabad is likely one of the major cities of India that has an enormous IT population.
The program may even guide you in constructing your skilled resume, attending mock interviews to spice up your confidence and nurture you to nail your skilled interviews. Data Visualization utilizing Tableau Tableau is probably the most widely used information visualization software to resolve problems. This module will educate you everything you should learn about Data Visualization using Tableau. Text classification, Document vectors, Text classification using Doc2vec In this module, you'll study much more about Text Classification and Document Vectors utilizing Doc2vec. In this module, you will learn to convert unstructured text right into a structured text to discover related insights.
Besides being taught by an outstanding set of faculty, you will also be taught by senior trade leaders who would also deliver particular modules of the course. The DSE Program has been designed to help candidates jumpstart their careers within the area of Data Science. Hear from our candidates as they share their program expertise and transition tales.
Upon commencement from the program, candidates might be provided placement opportunities for three months from the date of graduation of the program. In this period, candidates do get help from the team by way of placement. The team will help the candidates to organize for the interviews by offering immense support by mentoring, reviewing Curriculum vitae, preparation for upcoming interviews. We do not present any accommodation for the candidates at our learning middle.
This project on this Data Science and Engineering course is most commonly used in the e-commerce trade. There has been 12 months on yr analysis on cash spent by franchises on the teams and their efficiency over IPL.
If you're new to these ideas you then don’t must be apprehensive about as we got you lined. Our Data Science Training In Hyderabad program covers the ideas right from the scratch to the core. Amid the rising demand for Big Data & Data Science throughout the trade verticals, this area has turn into a profitable career choice for folks from all walks of life. The distinguished job-roles in Data Science like Data Scientists, Data Analysts, and Machine Learning Engineers are regarded as the most popular job-roles in-demand. Also, a skilled Data Scientist is paid a wage as high as $113,309 a 12 months. As the Indian analytics business is increasing, securing a profession in Data Science would undoubtedly be a sensible profession choice.
Associate stage - This certification allows the learner to instantly participate in massive information and different analytics projects. Also validates the practical foundation expertise required by a Data Scientist. Data Science training in Hyderabad has a staff of certified trainers hand-picked from the multinational companies having a few years of actual-time working expertise as information scientists.
The major benefits embrace weekly assignments, mock interviews, module clever initiatives and case studies, specially formulated research material along with complete career guidance and placement help. I took up many courses, however I could not get a job, then one of my friends suggested joining a data science course as there is a big demand in the field. Then I came throughout Digital Nest in Hyderabad after plenty of analysis. This is one of the best Data Science institute in Hyderabad for learning Data Science Course.
Ideal for graduates with 0 – 3 years of experience & degrees in B. From August 2018 semester, CSE division is providing a brand new MTech programme generally known as MTech in Data Science . It is an extension to the Executive MTech in Data Science programme and is equivalent to regular MTech programme. This FAQ incorporates curriculum, syllabus and different particulars concerning the MDS programme. Yes, we will share a gentle copy of the Data Science course material with college students. Yes, demo courses might be offered for all the programs at thoughts Q Systems that can help in deciding to take up the course. Anyone can take up Data Science course training, there are no such complicated conditions for this course.
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Classroom is provided in selected location corresponding to Singapore – Singapore, Hyderabad-India, Hyderabad - India, Amsterdam – Netherlands, Houston – USA. Please examine with the co-ordinators about coaching options in your location. Hyderabad has a perfect talent growth ecosystem to allow beginners to senior professionals to change to Data Science field.
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dougthorpe-com · 2 months
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Change and Progress, Are They Twins?
In today’s complex business world, change is hard. Companies venturing through major culture shifts, mergers or other forms of change often struggle to make it to the end. The idea that people hate change is a phenomenon that is taught, coached and wrestled with in many ways, shapes, and forms. Regardless of your mindset about CHANGE, there is one vital aspect you should explore. PROGRESS is…
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Self-Improvement Tips for Success | Personal Business Coach Houston
Your personal development and growth are built directly on the foundation of your self-improvement.  The more you embrace your own self-improvement the greater the possibilities in your business and life.  As a business coach, very often my primary role with clients transitions into that of a personal development coach and personal development coaching.
Today, business owners, executives, and managers have a wealth of information available on systems, processes and what I call the “how to” of how to have a successful business.  If marketing is a challenge there are hundreds of solutions and services.  If manufacturing to higher tolerances is the challenge, there are processes to achieve them.  Regardless, almost anything you need to improve business today can be found.
Yet, there is one area where you can’t call someone in or bring a company to institute a process without your active participation.  And, that area is your self-improvement.  Much has been written on self-improvement.  Some people call self-improvement personal development.  I will use the terms interchangeably here.  Why is self-improvement or personal development critical?
Quite simply, seldom will whatever you want in life exceed your self-improvement or personal development.  The following I have found to be useful guidelines for many clients when I am in the role of personal development coach and do personal development coaching.
Know your philosophy. Your philosophy is how you think.  Your world and your personal development can only become as large as your thinking.  What are the lids of your thinking?
Know your attitudes. How do you feel, your attitude, about what you think?  All thoughts are things.  Every thought has an emotion attached to it.  Thoughts are things.
Activity is the result of your thoughts and how you feel about your thoughts. If you wish for increased activity to accelerate your personal development than you must examine your thoughts and how you feel about them.  If your activity is not leading you to where you want to go then you must re-examine your philosophy and your attitudes.
At this point, to have the activity you want, you must be willing to amend your thinking.  When you amend your thinking and attitudes that is when you can create new habits and activity.  This is where a personal development coach and personal development coaching can be helpful.  It is important to have someone outside of yourself to support you in making the advances you want.  After all, if you are in the picture, it is hard to see yourself as you are.
Results are the accumulation of your philosophy, attitude, and activity. If you wish for different results all you need to do is go back and amend your philosophy and attitude.  In turn, this will change your activity which will change your results.
Get More Info : Personal Business Coach Houston
Website : https://www.selfimprovement-tips.com/
Contact Us : self improvement tips for success
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olgagarmash · 3 years
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Kansas mental health providers look to the future with new hotline looming and COVID-19 pandemic fading – The Topeka Capital-Journal
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Decades ago, travelers entering Topeka would have seen an unexpected motto beckoning them as they pulled into town.
“Welcome to Topeka, Kansas, the psychiatric capital of the world.”
The city’s credible claim to that title was in large part predicated on the presence of the world-renowned Menninger Clinic, whose iconic clock tower loomed in the background of the sign.
Karl Menninger’s eponymous institution was a heavyweight in the behavioral health world, bringing top-flight researchers and practitioners to Kansas, although the facility eventually left for Houston in the 2000s.
In 2021, community health centers in Kansas are seeing a marked uptick in interest due to strain brought on by the COVID-19 pandemic and improving attitudes toward mental health more broadly.
That could increase further next year, when the 988 crisis line rolls out, with a goal of making mental health support as easy to access as other core services.
But these forces come after years of funding and staffing challenges. Now, providers are looking to new models as a way to ensure the sustainability of their services going forward.
More:Feeling off? Here is how to know when to seek mental health support and where to turn.
“We have had the history as a state of being a national leader,” said Kyle Kessler, executive director of the Association of Community Mental Health Centers. “And so for us to get the infrastructure back in terms of our workforce and our priorities in behavioral health and helping healthcare overall, we can be a national leader again.”
Demand for mental health services on the rise — even pre-pandemic
It is no secret that the COVID-19 pandemic has prompted widespread concern about mental health, with anxiety and depression increasing during the last year due to lockdowns and uncertainty about the virus and the economy.
Even before the pandemic, community mental health centers saw a 10% increase in patients since 2016.
Throughout much of 2020, those numbers actually dropped off for some groups, with residents confined to their homes. For providers who deal primarily with children and young adults, schools weren’t in session to refer individuals in need of care.
But that trend is beginning to change.
For Family Service and Guidance Center in Topeka, director Brenda Mills noted that the previous high-water mark for calls to their crisis services line was 89. Recently, that number was over 120.
Karen Smothers, director of clinical operations for FSGC, noted that young people who previously had a difficult time in a school environment actually were helped by the pandemic, as they had less of a need to socialize and engage with their peers. 
Students who needed the most support were those who felt isolated without their usual social and school environments when the switch was made to remote learning.
More:Damon Parker is a championship wrestling coach. He’s battling for his mental health.
Now, with a return to physical classes, albeit with disorienting mitigation efforts, both groups of youths are feeling adrift and in need of support.
“When classes resumed, I think it’s just maybe a clash of everything going on between the youth who were feeling really withdrawn before trying now to resume their routine,” Smothers said. “And then in the meantime, the youth who typically would struggle now are being thrown back in the classroom, and are having those same conflicts again.”
Normally, early summer is a quieter time for the clinic, as school ends and families go on vacation. Not this year, however.
“Right now we’re slammed, we’re absolutely bursting at the seams with referrals,” Smothers said.
‘We need to see real commitment’
It is likely that demand will further increase over the next year, with mental health advocates in Kansas well aware of the national rollout of the 988 crisis line.
Lawmakers approved $3 million to help the three crisis lines in Kansas currently operating expand their staff and infrastructure.
But currently 30% of all calls are sent out of state due to high volume, according to Monica Kurtz, vice president for external programming at the Kansas Suicide Prevention Headquarters in Lawrence.
This often comes down to a lack of staffing. More than 100 hours of training are needed to ensure workers, either volunteer or paid, have the tools needed to answer calls from Kansans in distress.
Sending calls out-of-state isn’t ideal, Kurtz said.
“We do pretty strongly believe that Kansans are best served by Kansans,” she said. “We have a better idea of what goes on in our state, and what resources are available for folks.”
But KSPHQ has seen a 50% increase in calls in recent years, and the rollout of 988 could see that number double or even triple as it becomes more established.
The funding, included in the state budget, puts Kansas ahead of other states in getting 988 up and running, Kessler said.
But Kurtz pointed out that a more aggressive funding proposal — which would add a 50 cent-per-line surcharge on Kansans’ cellphone bills — stalled. The extra funds from that bill could have expanded response services, particularly in western Kansas, she noted.
And while legislators can take another whack at the issue next session, Kurtz said she was uneasy with having to ask legislators to maintain funding each year.
“It’s not enough to just say it with your words, we need to see action,” she said. “This is a critical issue, has been a critical issue for the last decade. And we need to see movement on it, we need to see real commitment.”
Staffing challenges hit providers across Kansas
Advocates argue funding hasn’t kept pace for community mental health providers either.
From fiscal year 2007 to fiscal year 2020, funding for community mental health centers fell by 16%, according to the Disability Rights Center of Kansas. That’s despite those facilities serving 30,000 additional patients.
And funding struggles can mean staffing issues, particularly for facilities that compete with other states to attract high-level practitioners.
That includes Four County Mental Health in southeast Kansas, whose offices are mere miles away from the Oklahoma border.
Executive director Greg Hennen said he had an administrator leave to go across the border, where she made more as an entry-level therapist than she did as a more senior worker in Kansas.
“Right now, yeah, Oklahoma kills us,” Hennen said. “Their master’s level therapists are starting out $20,000 higher than we can start ours out at.”
More:Menninger clock tower could soon be demolished; owner hopes buyer will step forward
About 1.3 million Kansans live in an area where the U.S. Department of Health & Human Services deems there to be a dearth of mental health workers.
Even when facilities have an adequate number of therapists, finding entry-level workers can be a challenge. Mills noted that she often has to compete against fast food outlets and big box stores.
“It was tough before the pandemic, but it has gotten worse,” she said.
For Hennen, the struggles have meant fewer personnel in area schools. While districts might want counselors around three times a week, the lack of staff might mean someone is there only once a week.
And in Topeka, Smothers said they have had to lean on more telehealth and group therapy sessions, at least for some patients, in an effort to triage care and deliver the required services.
“I don’t know what to expect a month from now or two months from now,” she said. “It feels like uncharted territory.”
Could new model boost mental health treatment?
Mental health advocates are hopeful that a potential solution is in the cards.
In 2014, Congress approved an experimental program for clinics, one designed to increase partnerships between mental health facilities, hospitals and law enforcement, as well as offer 24/7 crisis care and beefed-up substance abuse treatment.
In exchange for using proven, evidence-based strategies to advance those goals, facilities would get a higher Medicaid reimbursement rate — meaning more money to boost their bottom line.
Kansas wasn’t an initial participant in the so-called certified community behavioral health center model, but two of its neighbors, Oklahoma and Missouri, were. The program has since become permanent and has expanded to dozens more states.
That has compounded the challenges for providers in border regions, like Four County Mental Health in southeast Kansas.
But Four County elected to go it alone, obtaining a grant from Washington to begin the process of converting to a CCBHC model — the first provider in Kansas to receive that backing.
“It really has a nice impact not only on the patient, but also on the community in general,” executive director Hennen said of the facility’s early experiment with the program.
More:History Guy: Topekan Menninger changed how society views the mentally ill
The new model means more of an emphasis on integrating behavioral health with other care. After an individual sees a psychiatrist, they can walk across the hall to a primary care physician to address high blood pressure or diabetes.
And while this may mean more money is spent upfront, providers argue there is a cost savings for society as a whole on the back end.
“You may be spending more on behavioral health care, but all of a sudden, you’re saving money on the primary care side, particularly where hospital inpatient hospitalizations and (emergency room visits) are concerned,” Hennen said.
State lawmakers approved more money to help get Kansas facilities formally approved as CCBHCs, allowing them to eventually access the greater funding opportunities that title allows.
Some providers are already laying the groundwork to become CCBHCs. Central Kansas Mental Health Center, for instance, got a $4 million grant to expand their services earlier this year.
Advocates aren’t yet ready to rechristen Topeka as a global behavioral health capital. But they do profess a genuine excitement for the future for Kansas’ mental health system.
For Mills, the director of Family Service and Guidance Center, the growth in mental health awareness has been building for some time.
“It maybe took the pandemic for people to recognize that, though I think some people were getting it before,” she said. “But this has been a long road to try to get this awareness and education out there about how critical the need is for people to be mentally healthy.”
If you or someone you know may be struggling with suicidal thoughts, you can call the U.S. National Suicide Prevention Lifeline at 800-273-TALK (8255) any time day or night, or chat online.
source https://wealthch.com/kansas-mental-health-providers-look-to-the-future-with-new-hotline-looming-and-covid-19-pandemic-fading-the-topeka-capital-journal/
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stephenmccull · 3 years
Text
University of Missouri Settles Lawsuits Over Knee Surgeries Involving Veterinarian
COLUMBIA, Mo. — The University of Missouri has settled a collection of personal injury and false advertising claims over knee surgeries for $16.2 million, in what appears to be one of its largest public payouts in recent years.
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This story also ran on St. Louis Post-Dispatch. It can be republished for free.
The 22 plaintiffs, a handful of whom were minors, filed suits from 2018 through 2020 over “BioJoint” surgeries pioneered by two university employees, orthopedic surgeon Dr. James Stannard and veterinarian Dr. James Cook. The procedure involves a complex operation that the Mizzou BioJoint Center’s website calls a “biological joint restoration,” replacing parts of the knee with cadaver bones or cartilage to treat arthritis or joint damage. Some plaintiffs alleged in court documents that the procedure was sold to them as a way to avoid a traditional artificial knee replacement.
Plaintiffs alleged in court documents that Stannard did not advise plaintiffs that “the surgery he was proposing has a failure rate as high as 86%.” Court documents argued the surgeries were “experimental” and “unproven” and sometimes left patients requiring follow-up surgeries and even total knee replacements, including for young patients.
The defendants denied those allegations in the court filings and the university settled the cases without admission of liability or negligence after the claims against Cook, Stannard and another employee were dismissed. The Mizzou BioJoint website says the program does not have 10-year data on effectiveness because the surgeries are “based on improvements to the traditional techniques.” Unlike prescription medicines or medical devices, surgical procedures aren’t directly regulated by federal or state agencies.
On Thursday, KHN obtained the settlement agreements, which were signed in February, through a public records request.
Michelle Mello, a Stanford University professor of law and medicine, said settlement amounts often reflect the public relations value to those sued as well as the value of what the plaintiffs could have gotten at trial.
“On a per capita basis, that seems like high damages, so there is something going on that’s not great for the university,” Mello said.
“We are pleased to resolve this litigation,” Jonathan Curtright, CEO of University of Missouri Health Care, said in a statement. “Providing safe, quality care is always our top priority, and we remain committed to excellence in restoring joint health and function for eligible patients. We are confident in the expertise and dedication of our staff and the innovative, science-based services offered by the Missouri Orthopaedic Institute and the Mizzou BioJoint program.”
Stannard and Cook did not return requests for comment about the cases Thursday. Todd Hendrickson, an attorney for the plaintiffs, said the settlement agreements prohibited the lawyers and plaintiffs from speaking on the matter.
Central to the dispute in the consolidated lawsuits is how Cook was presented, given that veterinarians and veterinary surgeons are not generally allowed to perform medicine on humans. The lawsuits allege Stannard was negligent for allowing Cook to perform parts of the Mizzou BioJoint surgeries on plaintiffs “without appropriate medical direction and supervision.”
Some patients allege in court documents they did not know when they underwent the procedures that Cook was not a “medical doctor or a licensed physician.” In at least five of the plaintiffs’ cases, court documents say Cook was sometimes listed on medical records as “surgeon — other.”
And documents in one case said he was listed as a “surgeon.” The defendants deny Cook was listed as a surgeon in response to that case but said he was listed as part of the surgical team. An additional filing by defendants said Cook was “orthopedic technologist — surgery certified” and that he joined the surgery team for the “majority of such surgeries performed by Dr. Stannard.”
In one filing, the defending attorneys said Stannard and Cook had no obligation to tell patients that Cook was neither a medical doctor nor a licensed physician at any time prior to the operations because “surgery commonly includes persons in the operative suite who are not licensed physicians.”
Many new medical techniques are tested on animals before they get to humans, so veterinarians may be involved in pioneering medical research, said Dr. Patrick McCulloch, vice chairman of Houston Methodist’s orthopedic surgery department.
“It’s not uncommon to have vets as part of your research team, but it would be uncommon to have them as part of your clinical patient care team,” he said.
“You have to be licensed as a physician to perform surgery on a human being,” added Jeff Howell, executive vice president of the Missouri State Medical Association.
Cook is known as an expert on surgery for other species. He recently performed two operations on a tiger at a Chicago-area zoo, the second after the more ambitious initial procedure did not succeed, the Chicago Tribune reported.
He holds the titles of William & Kathryn Allen distinguished chair in orthopedic surgery at the University of Missouri’s medical school, chief of the school’s orthopedic research division and director of operations and research for the Mizzou BioJoint Center. The state paid Cook $301,892.04 in 2020.
Stannard, one of the highest-paid University of Missouri employees other than top athletic coaches, received a state salary of $981,977.52 for 2020. Among his titles are chief medical officer for procedural services, medical director of the Missouri Orthopaedic Institute and chairman of the medical school’s orthopedic surgery department. He’s also a team doctor for Mizzou athletes.
Stannard’s salary is nearly double that of Mun Y. Choi, president of the University of Missouri System. Missouri Gov. Mike Parson, meanwhile, earned $133,820.88 in 2020.
A university spokesperson told the St. Louis Post-Dispatch in August that Stannard had grown the Missouri Orthopaedic Institute from two surgeons to 30, and that only 2% of his salary comes from tuition dollars.
Part of the lawsuits’ claims hinge on the university’s advertising of the novel procedures, which had aired locally in Missouri during a Super Bowl and appeared at Chicago’s O’Hare International Airport. Some of the plaintiffs alleged the extensive advertising led them to reach out to the Mizzou BioJoint Center to seek relief for their knee pain.
Such direct-to-consumer marketing of medical devices and surgery has been growing in recent years, following the success of ads for pharmaceuticals, according to McCulloch.
Still, Mello said, it is relatively uncommon for a university to advertise the availability of these techniques or products. She said the advertising claims likely allowed the plaintiffs’ legal team to negotiate a higher settlement amount because of false advertising allegations in addition to the medical malpractice claims.
KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.
USE OUR CONTENT
This story can be republished for free (details).
University of Missouri Settles Lawsuits Over Knee Surgeries Involving Veterinarian published first on https://smartdrinkingweb.weebly.com/
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gordonwilliamsweb · 3 years
Text
University of Missouri Settles Lawsuits Over Knee Surgeries Involving Veterinarian
COLUMBIA, Mo. — The University of Missouri has settled a collection of personal injury and false advertising claims over knee surgeries for $16.2 million, in what appears to be one of its largest public payouts in recent years.
Tumblr media
This story also ran on St. Louis Post-Dispatch. It can be republished for free.
The 22 plaintiffs, a handful of whom were minors, filed suits from 2018 through 2020 over “BioJoint” surgeries pioneered by two university employees, orthopedic surgeon Dr. James Stannard and veterinarian Dr. James Cook. The procedure involves a complex operation that the Mizzou BioJoint Center’s website calls a “biological joint restoration,” replacing parts of the knee with cadaver bones or cartilage to treat arthritis or joint damage. Some plaintiffs alleged in court documents that the procedure was sold to them as a way to avoid a traditional artificial knee replacement.
Plaintiffs alleged in court documents that Stannard did not advise plaintiffs that “the surgery he was proposing has a failure rate as high as 86%.” Court documents argued the surgeries were “experimental” and “unproven” and sometimes left patients requiring follow-up surgeries and even total knee replacements, including for young patients.
The defendants denied those allegations in the court filings and the university settled the cases without admission of liability or negligence after the claims against Cook, Stannard and another employee were dismissed. The Mizzou BioJoint website says the program does not have 10-year data on effectiveness because the surgeries are “based on improvements to the traditional techniques.” Unlike prescription medicines or medical devices, surgical procedures aren’t directly regulated by federal or state agencies.
On Thursday, KHN obtained the settlement agreements, which were signed in February, through a public records request.
Michelle Mello, a Stanford University professor of law and medicine, said settlement amounts often reflect the public relations value to those sued as well as the value of what the plaintiffs could have gotten at trial.
“On a per capita basis, that seems like high damages, so there is something going on that’s not great for the university,” Mello said.
“We are pleased to resolve this litigation,” Jonathan Curtright, CEO of University of Missouri Health Care, said in a statement. “Providing safe, quality care is always our top priority, and we remain committed to excellence in restoring joint health and function for eligible patients. We are confident in the expertise and dedication of our staff and the innovative, science-based services offered by the Missouri Orthopaedic Institute and the Mizzou BioJoint program.”
Stannard and Cook did not return requests for comment about the cases Thursday. Todd Hendrickson, an attorney for the plaintiffs, said the settlement agreements prohibited the lawyers and plaintiffs from speaking on the matter.
Central to the dispute in the consolidated lawsuits is how Cook was presented, given that veterinarians and veterinary surgeons are not generally allowed to perform medicine on humans. The lawsuits allege Stannard was negligent for allowing Cook to perform parts of the Mizzou BioJoint surgeries on plaintiffs “without appropriate medical direction and supervision.”
Some patients allege in court documents they did not know when they underwent the procedures that Cook was not a “medical doctor or a licensed physician.” In at least five of the plaintiffs’ cases, court documents say Cook was sometimes listed on medical records as “surgeon — other.”
And documents in one case said he was listed as a “surgeon.” The defendants deny Cook was listed as a surgeon in response to that case but said he was listed as part of the surgical team. An additional filing by defendants said Cook was “orthopedic technologist — surgery certified” and that he joined the surgery team for the “majority of such surgeries performed by Dr. Stannard.”
In one filing, the defending attorneys said Stannard and Cook had no obligation to tell patients that Cook was neither a medical doctor nor a licensed physician at any time prior to the operations because “surgery commonly includes persons in the operative suite who are not licensed physicians.”
Many new medical techniques are tested on animals before they get to humans, so veterinarians may be involved in pioneering medical research, said Dr. Patrick McCulloch, vice chairman of Houston Methodist’s orthopedic surgery department.
“It’s not uncommon to have vets as part of your research team, but it would be uncommon to have them as part of your clinical patient care team,” he said.
“You have to be licensed as a physician to perform surgery on a human being,” added Jeff Howell, executive vice president of the Missouri State Medical Association.
Cook is known as an expert on surgery for other species. He recently performed two operations on a tiger at a Chicago-area zoo, the second after the more ambitious initial procedure did not succeed, the Chicago Tribune reported.
He holds the titles of William & Kathryn Allen distinguished chair in orthopedic surgery at the University of Missouri’s medical school, chief of the school’s orthopedic research division and director of operations and research for the Mizzou BioJoint Center. The state paid Cook $301,892.04 in 2020.
Stannard, one of the highest-paid University of Missouri employees other than top athletic coaches, received a state salary of $981,977.52 for 2020. Among his titles are chief medical officer for procedural services, medical director of the Missouri Orthopaedic Institute and chairman of the medical school’s orthopedic surgery department. He’s also a team doctor for Mizzou athletes.
Stannard’s salary is nearly double that of Mun Y. Choi, president of the University of Missouri System. Missouri Gov. Mike Parson, meanwhile, earned $133,820.88 in 2020.
A university spokesperson told the St. Louis Post-Dispatch in August that Stannard had grown the Missouri Orthopaedic Institute from two surgeons to 30, and that only 2% of his salary comes from tuition dollars.
Part of the lawsuits’ claims hinge on the university’s advertising of the novel procedures, which had aired locally in Missouri during a Super Bowl and appeared at Chicago’s O’Hare International Airport. Some of the plaintiffs alleged the extensive advertising led them to reach out to the Mizzou BioJoint Center to seek relief for their knee pain.
Such direct-to-consumer marketing of medical devices and surgery has been growing in recent years, following the success of ads for pharmaceuticals, according to McCulloch.
Still, Mello said, it is relatively uncommon for a university to advertise the availability of these techniques or products. She said the advertising claims likely allowed the plaintiffs’ legal team to negotiate a higher settlement amount because of false advertising allegations in addition to the medical malpractice claims.
KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.
USE OUR CONTENT
This story can be republished for free (details).
University of Missouri Settles Lawsuits Over Knee Surgeries Involving Veterinarian published first on https://nootropicspowdersupplier.tumblr.com/
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shaizstern · 4 years
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Article from NYT: To Build Emotional Strength, Expand Your Brain
The quest to understand something new is a key factor to building the resilience necessary to weather setbacks and navigate life’s volatility.
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Monika Aichele
By Kerry Hannon
This article is part of a series on resilience in troubled times — what we can learn about it from history and personal experiences.
Eight years ago, while working as an assistant Cuyahoga County prosecutor in Cleveland, Gayle Williams-Byers was in the throes of a serial killer case when she decided to take horseback-riding lessons.
This summer, in the midst of the coronavirus pandemic, Ms. Williams-Byers, 46, now a South Euclid Municipal Court judge, started free online classes in American Sign Language offered by Gallaudet University in Washington. She also took a webinar in labor trafficking. In recent years, she has enrolled in a variety of classes and workshops, including one on how to get a commercial driver’s license — not something she plans to act on any time soon.
“I don’t have a reason to use these things in my professional life, but learning helps me to focus better,” Ms. Williams-Byers said. “It’s also something that I have some control over. I take classes in subjects I am just wildly interested in learning about it. When I expand my brain, my wingspan is greater. It lets you get a little higher, to get above the headwinds.”
Ms. Williams-Byers’ quest to understand something new is an example of what many career coaches, authors and experts view as a key factor to building the resilience necessary to weather setbacks and navigate life’s volatility.
The theory: To deal effectively with change, it helps to be engaged in changing yourself. “One of the things that makes us resilient is that when we see a challenge, and when we face a struggle, we engage with it, rather than shut down,” said Simon Sinek, author of “The Infinite Game” and “Start With Why.”
“What I have learned from my career is that something I learned over here helps me over there,” he said. “Even if I don’t know that is happening, any kind of learning benefits all aspects of life.”
Embrace Your Passions
Mr. Sinek, for instance, is a dance lover. “My dancer friends kept telling me I should take classes, and it would help me and my love of the medium. I begrudgingly agreed, and I took some basic ballet classes.”
Even though it was for personal enrichment, those classes helped his developing work as a public speaker. “My posture is much better,” he said. “I move more effortlessly across the stage from my hips, instead of my shoulders.”
When you’re in the process of learning, your viewpoint changes, and you spot connections that you never noticed before. “Resilience is about being adaptable in a variety of different circumstances,” said Dorie Clark, who teaches executive education at Duke University’s Fuqua School of Business and is the author of “Reinventing You.”
“It is a combination of being able to pick yourself up when there are setbacks, but also it is about having the kind of cross-training necessary to be flexible in an uncertain world where we don’t know what is around the corner,” Ms. Clark said.
Learning Requires Determination
This all may require pushing yourself — not the easiest of tasks in times of crisis. “If they are relatively senior professionals, it has been years, or decades, since they have not been good at something, and it can be enormously psychologically stressful to have to face that,” Ms. Clark said. “Inevitably, when you are in the early stages of learning something you haven’t done before, you are probably going to be bad at it — at least not very good.”
Two years ago, Ms. Clark entered a program to train as a musical theater lyricist. “People in this program have master’s degrees in musical theater writing,” she said. “At first, having to surround myself with people who truly had exponentially more expertise was humiliating on a regular basis, but it was invigorating and inspiring.”
Stay Curious
Being resilient has a lot to do with perspective. “People who commit themselves to a life of learning show up with curiosity,” Mr. Sinek said. “They show up with interest. They show up with a student’s mind-set. You don’t have to be curious about everything. You have to be curious about some things.”
Those who routinely and consciously engage in learning become more confident about their ability to figure things out once a crisis hits, according to Beverly Jones, an executive career coach and author of “Think Like an Entrepreneur, Act Like A CEO.” “Each time they hit a bump, they spend less time lamenting and quickly turn to determining what they must learn in order to climb out of the hole,” she said.
Moreover, learners develop a more optimistic mind-set, which helps them jump into action, according to Ms. Jones. “In part, this is because each time you become aware of learning something new it feels like a victory,” Ms. Jones said. “You maintain the positivity that is a key to resilience.”
Tailor Your Learning
An important element to remember is that people learn in different ways, Mr. Sinek said. “I can’t read a book a week. I learn by having conversations. I like talking to people who know more than me about any particular subject. I love peppering them with questions. And I love trying to say back in my own words what I think they are telling me to see if I understand it.”
Right now, with his speaking engagements on hold, Mr. Sinek is studying kintsugi, the Japanese art of putting broken pottery pieces back together with epoxy and a painted gold solution, which highlights the breaks. The concept: By accepting blemishes and flaws, you can produce an even sturdier, more striking, piece of art. On a deeper level, it functions as a symbol of the human experience.
For one thing, it requires patience. “It turns out the epoxy dries slowly,” Mr. Sinek said. “If you do all the pieces at once, it all just falls apart again. I want to be done with my project and move on to the next. I can’t. I have to stick one piece and hold it for an uncomfortable amount of time and then let sit for 24 hours.”
There are myriad paths to learning from taking part in a free online class to reading a nonfiction book to watching a documentary to a complete immersion in a grade-free educational experience.
Chip Conley, 59, for example, founded the Modern Elder Academy, in Baja, Mexico, a group dedicated to midlife learning.
The academy’s core curriculum is based on helping people move from a fixed to a growth mind-set in midlife and beyond, according to Mr. Conley. “Those with a fixed mind-set define success as winning, which becomes problematic when they face difficult circumstances,” he said. “Those with a growth mind-set define success as learning. They’re not trying to prove themselves, but instead improve themselves, so they get less focused on the results and more focused on the journey.”
At the academy, options include collaborative bread baking, improv comedy, learning how to surf or do yoga for the first time and penning a poem to offer to your cohort.
Academic and Online Options
There are also educational opportunities for nontraditional students at some top universities through academic or yearlong programs for executives and other professionals. Students can audit classes, attend lectures, and work on projects with graduate and undergraduate students.
These include the Stanford Distinguished Careers Institute, Harvard’s Advanced Leadership Initiative, the University of Notre Dame’s Inspired Leadership Initiative, the University of Minnesota’s Advanced Careers Initiative, and the University of Texas at Austin, which offers the Tower Fellows Program.
Three years ago, Glenn Lowenstein, 60, was ready for a new challenge. The Houston resident had sold Lionstone Investments, the real estate investment company he founded in 2001, to Ameriprise. “It was a hard decision,” he said. “The business had been my dream, and then I lived the reality of it for 20 years, and all of a sudden there was a void. It was scary. When there is nothing in front of you, that’s where the resiliency has to come in.”
His solution was to return to campus. Two years ago, he was a Towers fellow. “You have to put yourself out there in an environment you have not been in before,” he said. “It’s a combination of confidence in yourself, enjoyment in exploration and going toward your fear.”
As a fellow, Mr. Lowenstein, for example, enrolled in an advanced graduate philosophy seminar. “It was way above my head,” he said. “I would try my hardest to follow every single word of the conversation. It was fascinating to me the way the graduate students articulated their arguments. It was super esoteric stuff, but I would walk out and be ‘wow, I am learning a new way to communicate here.’”
The best part, though, was his time on campus: “It was so cool to be in an environment where I wasn’t the expert,” he said. “I wasn’t the person relied on to know everything, so I could sit back and enjoy the process of learning, and that’s positive energy. My aim is to keep my mind and body and spirit healthy. I don’t think you can do that without learning.”
For those who can’t afford the time or money required for a high-level fellowship or university program, there are myriad paths to learning. Free or reasonably priced online classes are available through sites like Coursera, EdX, The Great Courses, LinkedIn Learning, MasterClass, Skillshare, TED Talks and Udemy.
Other options (online these days) include adult education centers, local libraries, community colleges and universities, and Osher Lifelong Learning Institutes. One Day University, a subscription service ($7.95 a month), offers five livestreaming lectures a week and recorded talks.
For Ms. Williams-Byers, learning is “that extra oomph to turn off the crazy in life and pour yourself into something that is fantastic that you can benefit from,” she said.
That explains her decision to take up a new sport during a particularly difficult case. “I had dealt with murder cases before, but this was unsettling,” she said. “I could feel myself disconnecting from the case because of the emotional drain. The hourlong lessons refocused my mind, so I could bounce back when I returned to the office.”
Original Article: https://www.nytimes.com/2020/09/02/health/resilience-learning-building-skills.html
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dougthorpe-com · 2 months
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Leaders: If you Confuse, You Lose
There’s an old saying in the sales world. “The confused mind says NO.” Clearly that has big implications when trying to sell a product or service. A prospect who gets confused by your sales pitch will revert to a NO answer all the time. On the other hand, a clear, concise explanation of the thing you are trying to sell will help close the deal. The same is true of leadership responsibility. A…
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rickhorrow · 5 years
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10 To Watch : Mayor’s Edition
RICK HORROW’S TOP 10 SPORTS/BIZ/TECH/PHILANTHROPY ISSUES FOR THE WEEK OF OCTOBER 14 : MAYOR’S EDITION
with Jacob Aere
A single tweet from Houston Rockets GM Daryl Morey escalated into a geopolitical crisis, pitting the NBA's progressive brand against the influence of Chinese money. According to CNN Business, all of the NBA's official Chinese partners have now suspended ties with the league in the wake of Morey’s provocative (and soon deleted) tweet about Hong Kong freedom last week. And months after paying billions of dollars to extend its streaming deal with the NBA, Tencent Holdings has "suspended all reports/streaming of Houston Rockets." Notably, nearly 500 million people in China watched the NBA on Tencent last season. The New York Times further quoted a source who stated that “China’s punitive response could cost the Rockets around $25 million this season,” and Yahoo Sports last Wednesday reported that “at least five unnamed teams fear that the $116 million salary cap projected for the 2020-2021 season could drop by as much as 10-15%.” Obviously, the NBA has significant business interests in China. At the same time, it has positioned itself as the most progressive of mega American sports leagues by supporting social activism. Will those values be upheld now that the league's bottom line is at risk?
Elsewhere in MLS, DC United has ended their broadcast deal with subscription-based streaming service FloSports after less than a year. The four-year local media rights deal, which was only signed in January, was worth a reported $12 million, according to the Washington Post. The team’s final regular-season home game of the year, against FC Cincinnati on October 6, was made available to all fans for free through a live stream on DC United’s official website. The move brings to an end what proved to be a problematic deal for DC United. Fans of the franchise were initially unhappy at having to pay between $5.99 and $8.99 per month for FloSports, which was compounded when the streaming service suffered technical difficulties. DC United’s draw against New York City FC in March, for example, was marred by interruptions. The partnership never fully recovered and now the club is on the hunt for a new local media rights partner in time for next year.
The Los Angeles Chargers are struggling to sell personal seat licenses at SoFi Stadium. One high ranking team executive told JohnWallStreet that Dean Spanos’ organization is roughly $350 million short of their initial $400 million target. While it’s not uncommon for large scale construction projections to be slightly off, off by nearly 87.5% is an abnormally wide miss. An initial study conducted by Legends subsidiary CSL suggested that the market could support $1 billion worth of PSL sales (Rams: $600 million, Chargers: $400 million). When the Chargers stumbled with CSL’s suggested pricing, a second study was done and the team’s sales target was lowered to $150 million. But Spanos’ club isn’t even close to reaching that number. A source said that while the Rams are nearing $500 million in PSL sales, the Chargers have sold only $50 million worth. Rams owner Stan Kroenke is understandably upset about his tenant’s inability to move PSLs. Those revenues are supposed to go towards the new venues’ constructions costs (about $5 billion) and Kroenke is responsible for the difference. The Chargers’ second class citizen status in L.A. has also made it difficult for them to sell high-priced products.
A lawsuit is holding up redevelopment of the Oakland Coliseum site, and MLB Commissioner Rob Manfred threatens relocation. According to JohnWallStreet, Oakland Mayor Libby Schaaf confirmed last Tuesday that MLB Commissioner Rob Manfred has threatened relocation of the Oakland Athletics if the city fails to drop a lawsuit filed to prevent Alameda County from selling its stake in the land on which the Oakland Coliseum sits to the team; the city wants the county’s 50% share, but lacks the funding necessary to make the purchase. A’s owner John Fisher intends on redeveloping the 155-acre site to help pay for a new $850 million “privately financed” waterfront ballpark and mixed use space. It should be noted that “many people believe the most logical solution is to build a new ballpark - much less expensively - on the Coliseum site.” Manfred has made it clear, however, that construction of the Howard Terminal ballpark and the Coliseum redevelopment project (which does not include construction of a new sports venue) are a package deal. Unless the lawsuit goes away, the city risks losing the A’s to Las Vegas, just as it lost the Raiders.
U.S. Olympic and Paralympic Committee relaxes Rule 40 guidelines. The guidance relates to Rule 40 of the Olympic Charter, which restricts the use of athletes’ names and images for advertising purposes. U.S. Olympic and Paralympic athletes will be able to thank personal sponsors, appear in advertisements for those sponsors and receive congratulatory messages from them during next year’s Tokyo Games under guidance released last Tuesday by the U.S. Olympic and Paralympic Committee. Official partners will maintain exclusive use of Team USA and Olympic Games logos and imagery, but athletes’ personal sponsors will be permitted to run generic ads. The same brands will no longer face a deadline to put a campaign into market prior to the Olympics and will have more freedom on social media. The loosening of marketing rules gives athletes more freedom to benefit from sponsors they deal with directly, rather than limiting advertising to official partner companies of the USOPC and IOC. Are you listening, NCAA?
AdWeek shows how the NFL connects television, advertising, and American culture. This month, AdWeek notes, network TV “returns once more with a shiny slate full of fall debuts. It’s an annual ritual of foreordained failure, with the vast majority of shows unlikely to survive to see a second season. Only one form of broadcast programming really matters anymore, economically for the media industry and existentially for American culture: sports, broadly—and the NFL, specifically.” Some of the metrics are obvious: 19 of the 20 highest-rated broadcasts in TV history have been Super Bowls. More than a billion people reportedly tuned in for the 2018 World Cup final. Other stats are more surprising: At peak, 93 of the top 100 rated shows in a single season were sports programs. Tellingly, through Week 5 of the 2019 season, over 142 million people tuned into an NFL game, with each game averaging 16.7 million viewers across TV and digital, a 6% increase over last year. Streaming is up 51%, and all 20 of the top 20 highest-rated TV programs this season are NFL games.
The Sacramento Kings will reward fans with CryptoTokens that contributes towards charity. According to CoinDesk, the Sacramento Kings are the first U.S. pro sports team to develop a crypto token for fan rewards. “Kings Token” will pair with a predictive gaming platform the team has developed in anticipation of the legalization of sports betting in California. Last year, the Kings became the first pro sports team to mine cryptocurrency, setting up a program called MiningForGood that donates the funds to charity and now they are even donating to loyal cryptocurrency to fans. Kings Tokens will exist within a token wallet added to the team’s Golden 1 Center app, which tracks the engagement and accumulated points. Fans can earn rewards through the predictive gaming platform and redeem those points for access to unique events, signed merchandise or courtside tickets. This initiative is getting fans involved with current tech advancements in crytocurrency while also helping the MiningForGood program which donates the funds to charity.
The NBA’s San Antonio Spurs Silver & Black Giveback program awards $180,000 to local nonprofits. According to News 4 San Antonio, the $180,000 in facility grants have been given to three local nonprofits whose programs serve the youth of San Antonio and support SBGB’s mission to empower youth through service and sports. Grant recipients include Rise Recovery, the San Antonio Zoo, and Good Samaritan Community Services. Rise Recovery aims to help teens, young adults, and families overcome the effects of drugs and alcohol while also partnering with the community in education and prevention and were granted $100,000 to provide furniture, fixtures, and equipment for the sport court and surrounding outdoor educational classroom at their new campus. Meanwhile, the San Antonio Zoo will use the $75,000 Operation Renovation facility grant to renovate the San Antonio Zoo Education Center, which hasn’t been renovated since it was first occupied in 1984. Lastly, Good Samaritan Community Services was awarded $8,222 to purchase two evaporative cooling units for outdoor basketball courts. The SBGB program will help to keep youth in San Antonio active, educated, and comforted.
The World Health Organization (WHO) announced a four-year deal with FIFA to promote healthy lifestyles through football globally. According to SportsPro, the agreement includes multiple areas of collaboration, including: Advocacy to promote a healthy lifestyle through football; Policy alignment to ensure tobacco-free environments at FIFA events; encouraging national football federations to adopt tobacco-free policies, including at stadiums; and enabling WHO to provide technical advice to FIFA on health matters; Building on FIFA events to institute lasting improvements in health and safety; Joint programs and initiatives to increase participation in physical activity through football, in line with WHO guidance, as well as working with national associations and networks of WHO goodwill ambassadors, football players, coaches, and volunteers to increase physical activity through football. While we continue to take smoke-free sporting environments and related health initiatives for granted in the U.S., that’s not the case in much of the rest of the world.The new WHO-FIFA tie up can make inroads in these policies that benefit all sports fans.
Merging Vets and Players (MVP) charity teams up with the Atlanta Falcons to reduce military and veteran suicides.  According to KOAM News, the MVP charity aims to bring together combat veterans and retired professional athletes to help them adjust to life outside their professions. The organization has set up chapters in four major U.S. cities, and the Atlanta branch is working closely with the Atlanta Falcons. MVP was founded by FOX's NFL insider, Jay Glazer, and Nate Boyer, U.S. Army Green Beret Veteran and former NFL athlete who played for the Seattle Seahawks in 2015. After recently running some physical activities as a group, MVP coaches run “The Huddle” – a 1:15 long support group where participants are coached to be proud of their scars. Some of MVP's ambassadors include former NFL players Michael Strahan, Olin Kreutz, and Chris Long, who have struggled with retirement. By crossing the interactions between NFL and combat veterans, both ex-players and veterans can help express their emotions and struggles in a positive way.
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Decades ago, travelers entering Topeka would have seen an unexpected motto beckoning them as they pulled into town.
“Welcome to Topeka, Kansas, the psychiatric capital of the world.”
The city’s credible claim to that title was in large part predicated on the presence of the world-renowned Menninger Clinic, whose iconic clock tower loomed in the background of the sign.
Karl Menninger’s eponymous institution was a heavyweight in the behavioral health world, bringing top-flight researchers and practitioners to Kansas, although the facility eventually left for Houston in the 2000s.
In 2021, community health centers in Kansas are seeing a marked uptick in interest due to strain brought on by the COVID-19 pandemic and improving attitudes toward mental health more broadly.
That could increase further next year, when the 988 crisis line rolls out, with a goal of making mental health support as easy to access as other core services.
But these forces come after years of funding and staffing challenges. Now, providers are looking to new models as a way to ensure the sustainability of their services going forward.
More:Feeling off? Here is how to know when to seek mental health support and where to turn.
“We have had the history as a state of being a national leader,” said Kyle Kessler, executive director of the Association of Community Mental Health Centers. “And so for us to get the infrastructure back in terms of our workforce and our priorities in behavioral health and helping healthcare overall, we can be a national leader again.”
Demand for mental health services on the rise — even pre-pandemic
It is no secret that the COVID-19 pandemic has prompted widespread concern about mental health, with anxiety and depression increasing during the last year due to lockdowns and uncertainty about the virus and the economy.
Even before the pandemic, community mental health centers saw a 10% increase in patients since 2016.
Throughout much of 2020, those numbers actually dropped off for some groups, with residents confined to their homes. For providers who deal primarily with children and young adults, schools weren’t in session to refer individuals in need of care.
But that trend is beginning to change.
For Family Service and Guidance Center in Topeka, director Brenda Mills noted that the previous high-water mark for calls to their crisis services line was 89. Recently, that number was over 120.
Karen Smothers, director of clinical operations for FSGC, noted that young people who previously had a difficult time in a school environment actually were helped by the pandemic, as they had less of a need to socialize and engage with their peers. 
Students who needed the most support were those who felt isolated without their usual social and school environments when the switch was made to remote learning.
More:Damon Parker is a championship wrestling coach. He’s battling for his mental health.
Now, with a return to physical classes, albeit with disorienting mitigation efforts, both groups of youths are feeling adrift and in need of support.
“When classes resumed, I think it’s just maybe a clash of everything going on between the youth who were feeling really withdrawn before trying now to resume their routine,” Smothers said. “And then in the meantime, the youth who typically would struggle now are being thrown back in the classroom, and are having those same conflicts again.”
Normally, early summer is a quieter time for the clinic, as school ends and families go on vacation. Not this year, however.
“Right now we’re slammed, we’re absolutely bursting at the seams with referrals,” Smothers said.
‘We need to see real commitment’
It is likely that demand will further increase over the next year, with mental health advocates in Kansas well aware of the national rollout of the 988 crisis line.
Lawmakers approved $3 million to help the three crisis lines in Kansas currently operating expand their staff and infrastructure.
But currently 30% of all calls are sent out of state due to high volume, according to Monica Kurtz, vice president for external programming at the Kansas Suicide Prevention Headquarters in Lawrence.
This often comes down to a lack of staffing. More than 100 hours of training are needed to ensure workers, either volunteer or paid, have the tools needed to answer calls from Kansans in distress.
Sending calls out-of-state isn’t ideal, Kurtz said.
“We do pretty strongly believe that Kansans are best served by Kansans,” she said. “We have a better idea of what goes on in our state, and what resources are available for folks.”
But KSPHQ has seen a 50% increase in calls in recent years, and the rollout of 988 could see that number double or even triple as it becomes more established.
The funding, included in the state budget, puts Kansas ahead of other states in getting 988 up and running, Kessler said.
But Kurtz pointed out that a more aggressive funding proposal — which would add a 50 cent-per-line surcharge on Kansans’ cellphone bills — stalled. The extra funds from that bill could have expanded response services, particularly in western Kansas, she noted.
And while legislators can take another whack at the issue next session, Kurtz said she was uneasy with having to ask legislators to maintain funding each year.
“It’s not enough to just say it with your words, we need to see action,” she said. “This is a critical issue, has been a critical issue for the last decade. And we need to see movement on it, we need to see real commitment.”
Staffing challenges hit providers across Kansas
Advocates argue funding hasn’t kept pace for community mental health providers either.
From fiscal year 2007 to fiscal year 2020, funding for community mental health centers fell by 16%, according to the Disability Rights Center of Kansas. That’s despite those facilities serving 30,000 additional patients.
And funding struggles can mean staffing issues, particularly for facilities that compete with other states to attract high-level practitioners.
That includes Four County Mental Health in southeast Kansas, whose offices are mere miles away from the Oklahoma border.
Executive director Greg Hennen said he had an administrator leave to go across the border, where she made more as an entry-level therapist than she did as a more senior worker in Kansas.
“Right now, yeah, Oklahoma kills us,” Hennen said. “Their master’s level therapists are starting out $20,000 higher than we can start ours out at.”
More:Menninger clock tower could soon be demolished; owner hopes buyer will step forward
About 1.3 million Kansans live in an area where the U.S. Department of Health & Human Services deems there to be a dearth of mental health workers.
Even when facilities have an adequate number of therapists, finding entry-level workers can be a challenge. Mills noted that she often has to compete against fast food outlets and big box stores.
“It was tough before the pandemic, but it has gotten worse,” she said.
For Hennen, the struggles have meant fewer personnel in area schools. While districts might want counselors around three times a week, the lack of staff might mean someone is there only once a week.
And in Topeka, Smothers said they have had to lean on more telehealth and group therapy sessions, at least for some patients, in an effort to triage care and deliver the required services.
“I don’t know what to expect a month from now or two months from now,” she said. “It feels like uncharted territory.”
Could new model boost mental health treatment?
Mental health advocates are hopeful that a potential solution is in the cards.
In 2014, Congress approved an experimental program for clinics, one designed to increase partnerships between mental health facilities, hospitals and law enforcement, as well as offer 24/7 crisis care and beefed-up substance abuse treatment.
In exchange for using proven, evidence-based strategies to advance those goals, facilities would get a higher Medicaid reimbursement rate — meaning more money to boost their bottom line.
Kansas wasn’t an initial participant in the so-called certified community behavioral health center model, but two of its neighbors, Oklahoma and Missouri, were. The program has since become permanent and has expanded to dozens more states.
That has compounded the challenges for providers in border regions, like Four County Mental Health in southeast Kansas.
But Four County elected to go it alone, obtaining a grant from Washington to begin the process of converting to a CCBHC model — the first provider in Kansas to receive that backing.
“It really has a nice impact not only on the patient, but also on the community in general,” executive director Hennen said of the facility’s early experiment with the program.
More:History Guy: Topekan Menninger changed how society views the mentally ill
The new model means more of an emphasis on integrating behavioral health with other care. After an individual sees a psychiatrist, they can walk across the hall to a primary care physician to address high blood pressure or diabetes.
And while this may mean more money is spent upfront, providers argue there is a cost savings for society as a whole on the back end.
“You may be spending more on behavioral health care, but all of a sudden, you’re saving money on the primary care side, particularly where hospital inpatient hospitalizations and (emergency room visits) are concerned,” Hennen said.
State lawmakers approved more money to help get Kansas facilities formally approved as CCBHCs, allowing them to eventually access the greater funding opportunities that title allows.
Some providers are already laying the groundwork to become CCBHCs. Central Kansas Mental Health Center, for instance, got a $4 million grant to expand their services earlier this year.
Advocates aren’t yet ready to rechristen Topeka as a global behavioral health capital. But they do profess a genuine excitement for the future for Kansas’ mental health system.
For Mills, the director of Family Service and Guidance Center, the growth in mental health awareness has been building for some time.
“It maybe took the pandemic for people to recognize that, though I think some people were getting it before,” she said. “But this has been a long road to try to get this awareness and education out there about how critical the need is for people to be mentally healthy.”
If you or someone you know may be struggling with suicidal thoughts, you can call the U.S. National Suicide Prevention Lifeline at 800-273-TALK (8255) any time day or night, or chat online.
via Wealth Health
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