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County officials at odds on hospital plan

Jeff Fox

Bracing for another surge of COVID-19 cases or another pandemic in the future, Jackson County officials are looking at significant upgrades for Truman Medical Centers, though it’s become a point of contention.

“We know that we have not seen the end of COVID, and we think it’s coming back and we’ll see some level of increase and what happens until we finally reach that stage where we have a vaccine,” TMC president and CEO Charlie Shields told county legislators two weeks ago. “But more importantly, we need to be ready for the next pandemic. So if you talk to epidemiologists – people that follow this – this is not the last time that we will see a pandemic of this size.”

TMC is the Kansas City area’s safety-net hospital, and its Lakewood campus at Lee’s Summit Road and Gregory Boulevard in particular serves a large number of Eastern Jackson County residents.

The County Legislature this week voted for $27.04 million for TMC upgrades, but County Executive Frank White Jr. hasn’t signed the measure. Neither has he signed a $314,395 measure, passed by legislators, for hazard pay for some county employees.

The money comes from CARES Act, which Congress passed early in the coronavirus pandemic. The county is spending much of its share – $122.7 million – on such things as contact tracing and personal protective equipment as well as reimbursing cities for their COVID-related costs – $18.3 million so far – but legislators also are on board with improving capacity and resilience at TMC.

Legislator Crystal Williams, D-Kansas City, said local officials lifted stay-at-home orders too early.

“We’re still not ultimately prepared to deal with what some other places have had to deal with. … I have real concern that we’re going to get hit hard,” she said recently.

Legislature Chair Theresa Cass Galvin, R-Lee’s Summit, echoed that.

“Over the past couple of weeks, we have seen large gatherings not practicing social distancing or using PPE,” she posted this week. “It will only take one person in one of those crowds to be positive for COVID to spread like wildfire and it probably has, people just have not shown symptoms yet. … The County Executive has told me we need to be prepared for the second wave expected this fall.”

White said he fully supports Truman Medical Centers but that the Legislature in its approach to distributing and overseeing the CARES Act money has expressed a “strong desire” to take power from the executive’s office.

“We’re co-equal branches of government,” he told legislators this week. “We should move simultaneously. We should respect each others’ responsibilities …”

White and legislators also are at odds over an advisory panel White appointed, led by former Kansas City Mayor Sly James, to suggest how the CARES money should be spent.

White said legislators are acting “as if the administration can’t be trusted to do their job. I find that offensive.”

Legislature Chair Theresa Cass Galvin, R-Lee’s Summit, told White that’s not the case.

“And I apologize that you felt that way,” she said, “and I’m sorry that you do feel that way because that’s not the intention of myself or anyone on the Legislature.”

She went on to mention several meetings in recent weeks with Truman Medical Centers officials and members of White’s administration.

“I really don’t know what more TMC could do to be more transparent and to vet this any further,” Galvin said. “And I think it’s really sad. It seems like egos are taking the place, and they’re hurting and getting in the way of us doing what’s the greater good for Jackson County.”

Galvin and White had a brief verbal sparring match before legislators turned back to the TMC issue.

“We’re feeling our way through this process,” Williams said. “I don’t see that anyone is trying to take power away from someone else, at least not from my point of view.”

Williams told White that she gets more grief from citizens about the county’s image and actions than he does because she’s closer to the people.

She added, “I think just all need to grow up and do our work.”

Hospital improvements

The $27.04 million measure on White’s desk would pay for improvements at both TMC campuses – Lakewood and Hospital Hill, at 23rd and Charlotte in Kansas City – that officials say could be done late this year or early in 2021. They include:

• Converting waiting room space to triage space at Hospital Hill.

• Adding 15 “negative-pressure isolation rooms” – that’s where the most serious COVID patients often end up – at Hospital Hill. There are five now.

• Creating an “electronic ICU” at Lakewood, meaning some patients on ventilators could stay there rather than being sent to Hospital Hill.

• Adding ICU beds at Hospital Hill. Dr. Mark T. Steele, chief clinical officer, told legislators late last month that those are frequently at capacity.

• Another 20 ventilators at Hospital Hill. It has 24 now. “And there have been days recently where we’ve had 18 of those in use,” Steele said. “And fortunately we didn’t have a big wave of COVID, but if we were to get a subsequent big wave or some future pandemic you can see that we would be overwhelmed pretty quickly and not have ventilators to call upon.”

“We realize that this is a big ask,” Shields told legislators, “but I think it’s how you look at using some of those federal dollars. Our belief would be that it puts you in a place to better address the surge should COVID come back but as importantly – maybe more importantly – for the next pandemic that comes along.”

Limiting disease

Legislators also recently were reminded of the prime importance of contact tracing, that is, finding all of the people recently in contact with a newly diagnosed COVID patient and monitoring those people for a couple weeks. Legislators last month approved funding to increase that through the county Health Department.

“In general, some folks believe that health care slows down this epidemic, but in reality health care doesn’t slow it down,” Kansas City Health Director Rex Archer told legislators in mid-May. “It can change the number of people that die, but it is the disease investigation and contact tracing that stops the epidemic. ... So if we don’t get this piece on board, we’ll never be able to treat our way out of this problem.”

He added, “The real issue is we needed these folks three months ago, already trained. We are so far behind on this outbreak that anything that delays the process is costing people’s lives and putting us at risk of having to go back on safe-at-home kinds of things and closing down some of the activities that we’re opening up.”

As of Thursday, the Jackson County Health Department reported 650 cases of COVID-19 in Eastern Jackson County, up from 528 at the same time last week, including 20 confirmed deaths (18 last week). The department covers the county outside of Kansas City.

The Health Department is listing presumed recoveries and hospitalizations from COVID-19. Recovery cases are those who survived 30 days beyond the initial onset of COVID symptoms. That total is 314, up from 255 last week. There are 97 current cases with hospitalization.

The highest ZIP Code case totals in The Examiner coverage area, according to the Health Department:

• 64055 (southern Independence); 67 cases, or 197 per 100,000 residents

• 64052 (southwest Independence); 55 cases, or 273 per 100,000 residents

• 64014 (Blue Springs); 46 cases, or 185 per 100,000 residents

• 64050 (northern Independence and Sugar Creek); 42 cases, or 188 per 100,000 residents

• 64075 (central eastern-most area of Jackson County, including Oak Grove); 39 cases, or 311 per 100,000 residents

The department noted three facility outbreaks of double-digit cases, with 55 cases at the Lee’s Summit Pointe Health and Rehabilitation, 20 at The Parkway Senior Living in Blue Springs and 19 at Oak Grove Nursing & Rehab.

In Kansas City, the Health Department has confirmed 1,275 cases through Thursday, including 27 deaths and 110 required hospitalizations, up from 1,111 cases and 25 deaths last week.

A database maintained by the Mid-America Regional Council shows 5,734 confirmed cases and 206 deaths among the nine-county metro area through Thursday, with 85,509 people tested (40,000 this past week).

– Examiner staff