- Associated Press - Monday, March 31, 2014

Omaha World-Herald. March 30, 2014.

Nebraska steps forward on health care

The University of Nebraska Board of Regents is commendably focusing increased attention on meeting the health care needs of Nebraska’s minority, rural and underserved residents.

The regents have done this by giving the go-ahead to the University of Nebraska Medical Center to expand the work of its Center for Reducing Health Disparities.

This move can make a long-term difference by bolstering the impressive work across the state by a wide array of Nebraska institutions on the public health front.

Through medical screenings, health education and consultations, these organizations are addressing serious health issues including diabetes, heart disease, child health and obesity among Nebraska’s minority and rural residents.

To appreciate the importance of these efforts, take a look at some relevant health care statistics.

In 2012, the infant mortality rate for Nebraska’s white population was 4.6 per 1,000 births. But for African-American residents, the rate was 8.3. And for Nebraska’s Native Americans, it was 11.8. Just over 7 percent of white adults in Nebraska have been diagnosed with diabetes. The rate for Hispanics is 11.5 percent; for Native Americans, 11.3 percent; for African-Americans, 12 percent.

The diabetes mortality rate for Nebraska’s African-American population is “nearly three times the rate for the white population,” notes a report for the state Department of Health and Human Services, “while the rate for Native Americans is almost five times the white rate.”

As for rural residents, a look at a county-specific map from the Nebraska HHS shows that some of the state’s highest death rates from heart disease are found in rural counties in parts of northeast, central and south central Nebraska.

Public health departments, medical centers, the state HHS and nonprofits across Nebraska are working hard on these and other health care issues, and it’s good to see that UNMC’s College of Public Health - in operation only since 2007 but showing impressive energy and vision - will be stepping up its collaborations statewide.

Encouraging work is being done across Nebraska on this front. Here are three examples:

- The Community Action Partnership of Western Nebraska, an eight-county collaboration. The partnership helped 200 residents with high-risk diabetes. More than 275 Hispanic women attended an event on breast cancer awareness.

- East Central District Health Department, in Colfax and Platte Counties. Nearly 300 people were screened for cardiovascular disease, obesity and/or diabetes.

- Charles Drew Health Center, in north Omaha. During 2013, the center saw 1,694 patients with cardiovascular needs, 651 diabetic patients and 490 patients with asthma.

The state HHS, in compiling minority health care data, reports that more than 13,500 people were served during 2012-13, with health improvements recorded in 10,613 instances. Patients include members of Nebraska’s refugee population. Nebraska’s foreign language interpreter numbers for 2012-13, for example, show that health care services were extended to 1,485 Arabic/Kurdish speakers, 996 Vietnamese speakers and 361 Burmese speakers.

Public health efforts have produced some progress over the past decade, with declines in the death rate from heart disease and diabetes, and in the infant mortality rate, for Nebraska’s African-American, Native American and Hispanic residents. At the same time, though, the rates tend to be significantly higher than for white residents.

Much work remains to be done. Which is why it’s encouraging that the University of Nebraska will be stepping up its partnerships as organizations across the state continue to tackle this critical long-term challenge.


The Grand Island Independent. March 27, 2014.

E-cigarette ban for minors the state’s best approach

E-cigarettes, as they grow in popularity and availability, are presenting dilemmas for health advocates, schools and lawmakers throughout the country.

Electronic cigarettes are powered by batteries and use water vapor instead of the smoke of regular cigarettes. Typically the vapor contains nicotine and some sort of flavoring. The amount of nicotine can vary.

The debate has come because no one knows for sure if e-cigarettes pose health threats, and what specifically are the hazards.

Most are wisely falling on the side of caution. The Nebraska Legislature is close to passing a ban on minors using e-cigarettes. The law would treat e-cigarettes in the same manner as tobacco products.

This is a good move that is supported by most Nebraskans. Young people need to be protected from products that could be harmful and it makes sense that e-cigarettes be banned.

At least 27 states, including Kansas, Colorado and Wyoming, have already prohibited the sale of e-cigarettes to minors.

Schools are adopting many of the same policies, banning the use of e-cigarettes in the same way that smoking and the use of tobacco products are banned.

An interesting question is where e-cigarettes fall as far as bans on smoking in public places and businesses. The state Department of Health and Human Services has said they don’t fall under the state ban on smoking indoors at public places or businesses, but advises that businesses may want to ban them to avoid confusion.

E-cigarettes don’t use smoke, so the threat of secondhand smoke is mitigated. Because they don’t use smoke, the lung cancer and emphysema threat that comes from tobacco cigarettes isn’t present, e-cigarette supporters say.

On the other hand, there is little dispute that nicotine is addictive. That addictive characteristic is enough for many health advocates to say they are unsafe. Other than that, there hasn’t been enough study to know if they are safe.

“Are they safer than cigarettes?” said Sen. Russ Karpisek, who introduced LB863. “Probably. Are they safe? We don’t know.”

And that is where public policy is at: not knowing if e-cigarettes are safe.

The Legislature and health experts are saying it is better to err on the side of caution in protecting the health of young people. They are right. If when those young people are older and they accept the addictive potential and other possible risks, they can make the decision at that time whether to use e-cigarettes.


Lincoln Journal Star. March 29, 2014.

A better way to redistrict

With only nine days left in the legislative session, hopes will soon dim that state senators might approve a better system for drawing up district boundaries.

But there’s still time. Nebraska’s system could use improvement.

Senators spent time earlier this month debating a proposal introduced by Sen. Russ Karpisek of Wilber but have not yet reached a vote.

There is bipartisan interest in the bill, however, which has been designated a priority bill by the Legislature’s executive committee. This week Karpisek said he still believes there is time for a vote before the session ends.

The bill, which is identical to one introduced previously by Sen. Bill Avery of Lincoln, would create an independent six-member commission. Two commission members of different party affiliation would be selected by each congressional legislative caucus.

Commission members would be prohibited from participating in political campaigns or running for office for two years. Lobbyists and office holders and their relatives would be barred from the commission.

Around the country voting districts have become absurdly shaped as partisan redistricting drew maps designed to ensure maximum party advantage. The results, political scientists say, is that elected officials are more extreme in their views and less likely to compromise.

Redistricting occurs every 10 years after the national census. Two decades ago the courts threw out maps drawn up by the Legislature. The plan approved on the basis of the 2000 census was less controversial, but partisanship was on full display. It’s nonsensical, for example, that Beatrice was placed in the 3rd Congressional District while Norfolk was included in the 1st district with Lincoln.

While the system in Karpisek’s bill is an improvement, one has to wonder why senators don’t just try to replicate the system used in Iowa, which is widely admired around the country and roundly praised by both Iowa Republicans and Democrats.

It requires bureaucrats in the Iowa Legislative Service Agency to draw up district maps without regard to any political or election data. They cannot even take into the account the home addresses of incumbents.

This can disrupt political careers. After the last redistricting in Iowa, 10-term congressional incumbent Tom Lathan moved to avoid a challenge with fellow Republican Steve King. Latham was able to return to Congress after a narrow victory over 16-year veteran Leonard Boswell, a Democrat.

But Boswell nonetheless supports the redistricting system. “The negative impact on Republicans and Democrats has been pretty well-balanced over time,” Boswell told the Boston Globe. “It’s works pretty good. More states should do it.”

No other state has adopted the Iowa plan, which was approved in 1980. Dominant political parties are always loathe to give up the power to select their own voters. But the fact that the Iowa system exists at all shows that miracles do happen.


Scottsbluff Star-Herald. March 29, 2014.

Prisons: Legislature hopes probation and drug and mental treatment will relieve crowding

The Nebraska prison system is a mess, thanks to a lack of executive oversight and years of legislative neglect.

Sentencing is a sham. A criminal given four to eight years in prison is most likely to serve only about two, thanks to “good time” policy that cuts sentences in half, with virtually no penalty for misbehavior behind bars. That fosters contempt of cops and courts by putting dangerous thugs back on the street before they’ve served adequate time.

While they’re in prison, those who need it can’t get mental health treatment. Programs designed to prepare inmates for success among law-abiding citizens aren’t adequate for the task.

Worst of all, prisons are overcrowded. Nebraska lockups now hold about 1,700 more prisoners than their design capacity, which leaves the state exposed to a civil rights lawsuit that could cause a federal court to order the release of inmates or construction of a new prison. When lawmakers consider a solution, it usually centers on “non-violent” offenders - which often means criminals who haven’t yet graduated to violence. It doesn’t mean they’re the sort of people we want lurking in our neighborhoods. Yet one proposal being discussed would divert more such inmates to probation. Another would send surplus state prisoners to serve their time in county jails.

Left out of the deal is a demand by Gov. Dave Heineman, Attorney General Jon Bruning and others to require violent inmates to “earn” good time rather than get it automatically. Opponents say it would make overcrowding worse.

They call it being smart on crime.

And it’s not cheap. Two bills being discussed in the Legislature would:

- Spend $5 million on vocational and life-skills training within prisons, such as job training for welders and car mechanics.

- Spend $3.8 million to expand statewide the Specialized Substance Abuse Supervision program, an alternative to prison for felony drug offenders. New reporting centers to treat and monitor released inmates would be established in Hall and Platte counties and existing services would be expanded in the Omaha and Lincoln areas.

- Provide an additional $5 million to expand services for mentally ill inmates and those being released from prison.

- Create a state prison reform task force.

- Provide $200,000 for the University of Nebraska at Omaha’s criminal justice department to track the success of prison reforms.

- Spend $200,000 to study if a vacant building at the former Hastings Regional Center could be converted into a facility to house mentally ill inmates.

- Provide $500,000 for loan forgiveness for law school graduates willing to practice a minimum of three years in underserved rural areas. An individual lawyer could receive up to $6,000.

Simply building a new prison, meanwhile, would cost between $100 million to $150 million and cost $30 million a year to operate, including about $35,126 a year to house each inmate.

Some choice.

Sentencing an inmate to probation is estimated to cost between $2,274 and $3,019 per year, which is fine if it works. But most prisoners wind up where they are by scheming to game the system. If probation worked, prison cells wouldn’t be overbooked. Many inmates are gang members or drug addicts, who threaten public safety even if killing or beating people isn’t part of their resume.

But at least some effort and money will be invested in prison alternatives. If job training, mental health care, drug treatment and probationary supervision get the job done, we’ll be all for it. Less crime is always welcome. But starting earlier, by giving schools more help in dealing with trouble-makers, might help. So would stronger efforts to identify and reform juvenile offenders before they turn dangerous.

If simply reducing the prison population is the only goal, the effort is going to fail miserably. State government might save itself the expense of a new prison, but the cost will be passed along to communities. Scottsbluff already has one of the state’s highest crime rates, thanks to drug traffickers, meth cooks and addicts. We want them where they can’t cause more trouble, not running loose in our streets.

The good news in that regard, perhaps, is that $500,000 to encourage those young lawyers to practice in Nebraska’s small communities. If fewer criminals are behind bars, at least they’ll have less trouble finding a lawyer the next time they need one.

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