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Bethany Baker, The World 

Marshfield's Tristin Lemmons defends a tackle from North Bend's Cole Langmead at North Bend High School on Friday. The Pirates defeat the Bulldogs, 55-10, to win their first Far West League championship.


Local
Annual report shows success in parole and probation programs

The Coos County Community Corrections 2017 Report shows positive numbers, either meeting or exceeding many of its goals.

Community Corrections creates probation and parole programs to help offenders make their way back to society without falling into old bad habits.

“We have the most comprehensive program, as far as trying to help people and get them steered in the right direction that we’ve ever had,” director of Community Correction Michael Crim said.

Community Corrections serves the county, but is funded through state grants, most of which come from Oregon Department of Corrections.

The report breaks down the amount of cases and the specifics of those cases that Community Corrections has tackled over the past year. Forty-nine percent of the 1,282 cases were either drug or theft related. It’s important to note that many cases do overlap. Someone could be released on probation for both a drug charge and an assault charge.

According to Community Corrections the number of offenders fluctuates around 600.

One well met goal was to have the percentage of parolees who repeat offenses is below the state average. The statewide average being 17.6 percent, with Coos County coming in at 10.7 percent of repeat offenders.

“The thing that we’re doing the best is communication," Crim said. "We have a lot of things at our disposal that we haven’t had historically, we have things like cognitive programs, and moral reconation therapy. The main thing that we’re great at is communication."  

While numbers for parolees are positive, numbers for probationers don’t look quite so good. The percentage of probationers who receive a new felony conviction within one year of admission to probation was 19.6 percent, which is 4.9 percent higher than the national average.

“One of our biggest problems is that we need more custody response, some people need to be held longer. There’s a segment that aren’t ready to change during what’s called the pre-contemplative stage. Some of those folks need to be kept out of society a little bit longer,” Crim said

Community Corrections is working with the Sheriff’s office to fix its custody response issue. The Sheriff’s office is in the process of making more beds in the jail available by recruiting the staff they need to run the jail at a higher capacity.

Ninety-five percent of Coos County offenders who complete their treatment through Community Corrections will not re-offend within a year of completing treatment.

“We’re leading the way around the state in having a prosecutor assigned to the Community Corrections department. We decided to assign a deputy DA to the Community Corrections office, and it’s been one of the best things we’ve ever done. There’s at least five other counties around the state that are copying our program. Having a deputy DA on our team that knows the cases as well as we do is one of the best things we’ve ever done,” Crim said.

Having a Prosecutor work with Community Corrections has also allowed new grant money through the Justice Reinvestment Grant. The grant is for developing between the district attorney’s office and Community Corrections to analyze cases that might be right for downward departure.

Downward departure are cases that qualify for a prison sentence, but on cases specifics are given the opportunity for probation. Of course, if offenders violate the terms of their probation they are sent to jail.

Coos County has a 40 percent success rate with downward departures, with the statewide success rate being only 30 percent.

The biggest problem that probation officers continue to face is drug abuse. So much so that their goal for the past year was to have 50 percent of all offenders test negative for illicit drug use at monthly screenings. They did not meet that goal, but they were close. Forty-five percent of offenders tested negative at monthly screenings.

The drug of choice for nearly half of all drug offenders in Coos County is methamphetamine, with 468 urine specimens testing positive for meth over the last year. However, opiates which account for 11 percent are on the rise here as they are across the U.S.  

Corrections met or exceeded all of its measurement criteria for sex offenders, which make up 14 percent of their case load. In Coos County, 90 percent of sex offenders who receive treatment will not be convicted of a new sex crime while under supervision.

Moving forward, Community Correction has developed a two-year plan. They plan to continue to refine our local system by utilizing evidence based tools, swift response, effective interventions, and aggressive enforcement.


Bethany Baker, The World 

Lindsay Reeves, the Coos Bay School District Nurse Coordinator, is one of only two full-time nurses that cover the entire district with the assistance of one additional part-time nurse.


Education
Schools fight to keep nurses
More Medicaid cuts narrowly avoided last month when Graham-Cassidy bill failed

COOS COUNTY – School nurses are being stretched thin making student health care more difficult to provide.

Medicaid cuts in 2007 prevented schools from being able to keep a nurse in every building. Some districts lost all of their nurses.

In September, the Graham-Cassidy bill was proposed by Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.) that would have not only dismantled Medicaid expansion and system subsidies to help people afford health insurance, but it would have impacted education’s ability to keep nurses onsite.

"Over and over, Republicans in Congress have tried to pass a plan to rip health care from millions, and the American people keep rising up to stop it,” U.S. Sen. Jeff Merkley of Oregon wrote in an email to The World. “When Senate Republicans geared up for one last attempt to slip a repeal bill through, teachers' unions, students, and countless other Oregonians took a stand against eviscerating Medicaid; gutting protections for people with preexisting conditions; and devastating school health systems. It was thanks to grassroots America that once again, we were able to rise up and defeat this diabolical scheme before it was too late.”

Part of the grassroots effort to stop the bill was Teri Jones, the Zone 4 Director for the Oregon School Employee Association (OSEA) and the library media clerk for the Coos Bay School District. When she went to Washington D.C. in September to lobby against the bill, she found chaos on the Congress and House floors. Where one bill fails, she said, it’s never really gone.

“When we got there to lobby, the Graham-Cassidy bill was being put forth to make major cuts to health care and education, so it became what we were speaking about,” Jones said. “Of course, we didn’t know for sure what we were going to lobby for until we arrived because it is just so chaotic over there. The health care act is gone and then is back and then is gone again all in the same day. When I spoke with Sen. Jeff Merkley he said, ‘Don’t ever think anything is gone.’”

School nurse crisis

Jones and the other OSEA representatives chose to lobby against the Graham-Cassidy bill because of its impact on school nursing. When a nurse isn’t in a building to help a student, the responsibility falls onto school secretaries.

“At the Coos Bay School District, we have amazing secretarial staff but even so, having insulin injections become part of my job duties would make me uncomfortable because I don’t have medical training,” Jones said.

“It’s not a good situation,” Lindsay Reeves, nurse coordinator for the Coos Bay School District, said. “Secretaries are handling their duties and tasks and then are expected to do nursing tasks on top of it, which they do under the license of a registered nurse, so my license, which isn’t fair to them either.”

Jones posed a hypothetical situation where a student at Madison Elementary discovers he or she is diabetic. As a child, “you don’t know when there is a trigger and they need to be monitored carefully.”

There is no nurse in the Madison building, so giving insulin to students with diabetes is a daily routine. Reeves pointed out that insulin is a potentially deadly drug that if administered in the wrong dose could prove fatal.

“If they are trying to manage the phone and then administer insulin safely, that is a difficult thing,” Reeves said.

Blossom Gulch Elementary School secretary, Taryn Kirk, is one of the people who fills in for Reeves when she isn’t in the building. Kirk explained that the extra nursing duties add more work to her day but most importantly, “It’s detrimental to all the students in the school.”

Not only that, but school nurses help keep watch over medically fragile students, connect them to community resources if a student doesn’t have health insurance or if they are homeless, or help them find resources for health needs such as a new pair of eyeglasses. Nurses also help students who find themselves in a mental crisis.

“Without nurses, all of this would slip through the cracks,” Reeves said.

Though the National Association for School Nurses recommends one full time nurse per 750 students, it is not a requirement.

Before the last recession hit, the Coos Bay School District had one nurse in every building. After the recession, the district was faced with either cutting nurse positions funded through Medicaid, or having to pay for those positions themselves.

“We decided nurses are important and we wanted to keep them,” Coos Bay School District Superintendent Bryan Trendell said.

When Medicaid funds began to dry up, the district moved away from relying on that money to pay for school nurses.

“Currently we receive a small chunk out of this budget from Medicaid, which is about $10,000,” Trendell said. “At one point it had grown high in our district and became a sizable chunk of $80,000, but this was over five years ago when the superintendent at the time and our business manager decided to use that money to pay for a part time nurse.”

Right now, the district employs two full-time nurses and one part-time nurse. If the Medicaid account builds up again the next two years, the district can beef nursing up.

“If more cuts to Medicaid were made, it depends on what they would cut if it impacts us,” Trendell said. “Right now we’re not sure because everyone is unsure what is coming out of the federal government. Any type of cut in Medicaid at this point wouldn’t affect us because we’ve separated ourselves from it, but it would impact our future ability to build the account up to fund more nurses because we don’t have enough. What we’re doing now is filling the gaps.”

Though Coos Bay Schools separated itself from relying on Medicaid funding for nurses, smaller districts weren’t able to do the same. Some local districts either purchase nursing services through the Education Service District (ESD), while others can’t find any nursing services.

The Central Curry School District isn’t close enough to ESD offices to contract with them. According to Trendell, Central Curry Schools have tried working with their local hospital but are having trouble getting cooperation.

“There’s frustration because they have needs and are scrambling to figure it out to make sure their kids are getting what they need,” Trendell said.

The World reached out to the Central Curry School District for comment but received no response.

“Medicaid certainly concerns us,” Trendell said. “We want a clear picture so we can plan. If reduction in funding impacts us, we need to build our budget.”

“Preaching to the choir”

OSEA's Jones has seen unending cuts to education funding since the recession and while other parts of the economy began to recover, education never did.

“The problem with education is when a program like art and music gets cut, they don’t come back,” Jones said. “Education isn’t playing catch up, it’s just hanging on. I think federally they would like to say schools are a state’s responsibility, but when you put it on a state budget, where are you taking it from? Mental health? Fire and police?”

Jones lobbied during the Oregon state legislative session to find a better funding source for education rather than “steal from each other.”

While Jones lobbied in D.C., she met with Merkley, U.S. Sen. Ron Wyden and Rep. Peter DeFazio. However, she didn’t get to see Rep. Greg Walden or any local Republican representatives.

“We try to see people overseeing committees important to our issues,” Jones said. “Usually we will speak to them, but we didn’t get those appointments this time. Either they were too busy with the chaos, but no one said they couldn’t speak to us because . . . well, they had no excuse. I didn’t see a single Republican and that bothers me. All we did was preach to the choir. Were we heard? Yes, but everyone said they wished they could help but again, they were part of the choir.”

Jones urged the public to watch what is being done for Medicaid and education in D.C. because “this isn’t a time to have your head in the sand.”

As the library media clerk at Madison Elementary, Jones recently picked a book to read to students called “The elephant in the dark.”

“It’s about how people in the story are so busy arguing that what they are touching is a snake or a tree trunk that they aren’t listening to each other,” she said. “I picked it for a reason. It’s time we all start listening to each other.”


Local
Rural health care providers working to meet demand

COOS BAY— Local health care providers are making some headway in addressing the lack of primary care physicians, an issue that plagues communities across the nation, but they aren’t there yet.

Several ongoing projects in the area are working to address the need, like the proposed resident housing in Coos Bay, the future expansion of Southwestern Oregon Community College’s (SWOCC) nursing program and the new medical facility planned for Port Orford.

All these initiatives aim to aid the ailing community by offering more providers to the area.

“We’re not there yet, but we’re making progress,” Suzie McDaniel, Bay Area Hospital’s chief human resources officer, said.

She said the state is starting to understand the dilemmas rural Oregon is facing with healthcare.

“The community, the state, the school districts, everybody realizes that the impending shortage is at crisis level and people are just partnering together to help solve that problem,” McDaniel said.

Some of the solutions include the campus for rural health, in which Oregon Health and Science University students do rotations in the area. One of the goals is to retain some of the students that cycle through.

“This is a much more aggressive approach then we’ve had in the past,” Western Oregon Advanced Health CEO Phil Greenhill said, “This is an opportunity for an experience for them to live here for awhile.”

RECRUITING

McDaniel said one of Bay Area Hospital’s main focuses is work force development and physicians are at the top of the list.

“We’re working on recruitment strategies, incentive programs, educational loan forgiveness- all kinds of different things. So yeah, I’m optimistic that we’re moving in the right direction,” McDaniel said.

Primary care doctors are highly sought after across the nation and sorely needed in rural areas, where residents are more likely to suffer from chronic illnesses and lifestyle diseases.

Around one-fifth of Americans live in rural areas but less than one-tenth of physicians practice there, according to the National Rural Health Association.

In addition, rural patients have more frequent occurrences of diabetes and coronary heart disease than their metropolitan counterparts.

McDaniel said if action isn’t taken, soon there won’t be enough healthcare providers.

Demand is outpacing supply, inundating new doctors with recruitment offers, according to physician search firm Merritt Hawkins.

The firm’s president Mark Smith described the situation as a “feeding frenzy” in a statement.

These findings could paint a very grim picture for healthcare’s future, especially for rural areas, but North Bend Medical Center’s medical staff recruitment specialist is optimistic, as are many other healthcare officials in the area.

Christy Wright said the medical center has recruited nine physicians in the last year and those additions have directly impacted the center’s waiting list.

“A little over a year ago we had a patient waiting list of about 1,000 people, that’s dwindled down in the last year to about 160 people at this time,” Wright said.

She thanks some of the recruitment, in part, to a desire for a shift toward a slower-pace lifestyle and a work, life balance.

“More and more people are really warming to the idea of not living in those metro areas and that’s why we’re having more success I think,” Wright said.

She said she doesn’t sugar-coat it, she tells candidates that it’s a rural area without malls or many chain restaurants, but she also highlights the natural beauty and recreation options.

“They see the ocean, they see our beaches, they hear that Dr. Shimotakahara surfs every morning before he comes to work,” Wright said, “They think that is just incredible and they want to try that lifestyle.”

But for Wright it’s not just about attracting physicians to the area.

“We want to retain them, it’s not just about getting somebody here,” Wright said, “We don’t want somebody to come and just stay for a year or two.”

WOAH’s Greenhill said medical professionals have to find that the South Coast lifestyle fits their needs.

“When medical professionals really learn what we have to offer here and get an opportunity to know our medical community quite often they will make a decision to come here,” Greenhill said.

INFRASTRUCTURE

McDaniel said the area hasn’t built the infrastructure to produce the number of professionals that are needed. Southwestern Oregon Community College’s new Health and Science Technology program is a step in the right direction, but McDaniel anticipates an even higher demand.

“We’re working on that, we’re making progress. But even then, in 2020 when we have that new building we’re still only going to be able to put out about 50 (nurses). We’re probably going to need two to three times that,” McDaniel said.

She said there are coalitions in other states, where hospitals have partnered with schools to build hospital learning pods.

“I think rural Oregon, rural anywhere is going to have to look at different ways of getting healthcare provider strength,” McDaniel said.

For McDaniel the big issue is capacity.

“The biggest obstacle is the lack of capacity in the academic setting both with faculty and clinical spots,” McDaniel said, “I think the biggest plus is that a lot of really smart people have realized that this problem is just potentially catastrophic and they’re working on solutions.”

CHANGES TO HEALTHCARE COVERAGE

Right now healthcare providers are waiting to see what changes will come from recent health insurance discussions in Washington D.C.

“Now with the changes that President Trump has put into play, we don’t know what that’s going to mean,” McDaniel said, “Everybody’s kind of in a holding pattern waiting for the new standards to be written.”

WOAH’s Greenhill has similar concerns to when the House Republicans' American Health Care Act was released in March.

Now, Greenhill is concerned that the uninsured will use the Emergency Room as a substitute for primary care coverage.

“Our biggest concern is if a lot of the ACA members on the exchange are priced out of the market and choose not to buy that insurance, that will mean they just end up in our ER without insurance coverage,” Greenhill said.

If that were to happen, it would increase the bad debt on the hospital.

Already, Greenhill said he’s seeing premiums increase by 20-percent a year.

Despite the various obstacles both locally and federally, Wright, McDaniel and Greenhill have all said they’re optimistic about the future.

“I think we’ve got a really, really good medical community,” Greenhill said.