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Nebraska prison watchdog says death of inmate might have been prevented with regular health exams

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Nebraska prison watchdog says death of inmate might have been prevented with regular health exams


LINCOLN — The dying of Nebraska jail inmate Niccole Wetherell from cervical most cancers might need been prevented if she had acquired common, preventive well being examinations, based on a state jail watchdog.

The Inspector Normal of the Nebraska Correctional System, in a report Tuesday, stated the Nebraska Division of Corrections is out of compliance with a 2015 state regulation that requires the company to ascertain an digital well being document system that will decide whether or not inmates acquired common exams, resembling pap smears.

This stack of paper recordsdata comprises the medical information of state jail inmate Niccole Wetherell.
(Courtesy of the Workplace of the Inspector Normal for Corrections)

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As a substitute, the report stated, the division principally makes use of “a jumble” of paper information that embrace “handwritten nurses’ and physicians’ notes, which are sometimes barely legible.”

9 years between pap smears

Niccole Wetherell went 9 years between pap smear exams earlier than a 2019 examination that confirmed her most cancers had unfold to her mind, lungs, kidneys and liver and was deemed inoperable.

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Wetherell, 40, died on Feb. 26, 2021, on the medical unit of the Nebraska Correctional Heart for Girls in York.

A spokeswoman for the Nebraska Division of Corrections stated the company was withholding remark in regards to the report till Thursday, when a state legislative committee will probably be holding an interim listening to on well being care points inside state jail.

Niccole Wetherell

Niccole Wetherell (Courtesy of the Nebraska Division of Corrections)

However in formal responses to the report, Corrections acknowledged that it might have an digital monitoring system up and working by the tip of the yr that will observe when inmates are due for “preventative and power care.”

Wetherell had been on the state girls’s jail since 1998, after being sentenced to life in jail for first-degree homicide for her half within the slaying of 19-year-old Scott Catenacci.

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She was amongst a gaggle of six folks, ages 16-20, who attacked Catenacci in a Bellevue park, stabbing him no less than 57 instances.

A mannequin prisoner

In keeping with the Inspector Normal’s report, Wetherell had turn into a mannequin prisoner, serving as a peer mentor as a “lifer” to present hope to fellow inmates in what could seem to be a “hopeless state of affairs.”

Her final documented pap smear was in September 2010, which indicated she was unfavorable for most cancers.

She suffered from irregular bleeding in 2015, then a recurrence in 2018, the report acknowledged. After sending an inmate interview request to medical workers in June 2019, she underwent a pap smear in August of that yr.

The examination and a follow-up examination by a obstetrician-gynecologist discovered that Wetherell was constructive for squamous cell carcinoma, a sort of pores and skin most cancers which is the commonest type of cervical most cancers.

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‘Extremely survivable’

That type of most cancers, the Inspector Normal’s report stated, is “extremely survivable if detected early.”

A forensic pathologist who testified on the required grand jury investigation into her dying stated that “extra frequent surveillance” might need prevented her dying.

The federal Workplace on Girls’s Well being recommends that ladies ages 30-65 obtain a pap take a look at each three years, the report famous.

Why hadn’t such exams been given extra continuously?

The nurse practitioner, who’s the first care supplier at York girls’s jail, advised the Inspector Normal that “till lately, due to the division’s lack of digital well being information, the ability medical division had no technique of monitoring when sufferers had been due for Pap smears and different preventive care.”

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Nurse used Excel spreadsheet

Because of the Wetherell case, the nurse practitioner stated she started monitoring affected person visits with a Microsoft Excel spreadsheet.

In keeping with the report, Corrections initially responded to the 2015 regulation requiring digital medical information for inmates by looking for to rent a contractor to supply such a system. In 2017, the division was allotted $150,000 to rent a advisor to assist implement such a system.

However in 2018, Corrections Director Scott Frakes testified in opposition to a invoice that will have appropriated one other $500,000 for the digital medical information system, saying it was “untimely.”

The division, Frakes stated, was transferring towards implementation in the summertime of 2019.

In October 2018, the division acquired responses from 10 business distributors to a “request for data” about such digital well being monitoring methods, and in 2019, the company was allotted $1.3 million to maneuver ahead with the system.

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However formal bids to supply the system had been by no means sought, the Inspector Normal’s report acknowledged, and as a substitute, Corrections modified course and determined to create its personal system in-house with the state Workplace of the Chief Info Officer.

A yr in the past, the division reported that the primary elements of its digital monitoring system had been launched on June 30, 2021, however they didn’t embrace options associated to routine inmate medical care.

“It’s unclear when the system will probably be absolutely carried out,“ the Inspector Normal’s report acknowledged.

The submit Nebraska jail watchdog says dying of inmate might need been prevented with common well being exams appeared first on Nebraska Examiner.



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Consultant sees $531M in trims to NE state government • Nebraska Examiner

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Consultant sees $531M in trims to NE state government • Nebraska Examiner


LINCOLN – A highly-paid consultant is projecting that Nebraska state government could cut $531 million in spending within a year if it more sharply focused on system-wide outcomes that better serve its customers, and tapped more federal and state reserve funds.

In a 57-page report after a year on the job, Utah-based Epiphany Associates said it has identified “an incredible capacity for change and improvement in Nebraska’s state government” that added up to more than a half-billion in savings.

(Getty Images)

It identified four areas in particular where changes would result “in the biggest return on investment.”

Those are the child welfare and Medicaid divisions within the Department of Health and Human Services, the Lincoln Regional Center, and the inmate rehabilitation and reentry program within the Department of Corrections. 

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Part of Pillen’s plan

About half of the projected savings — about $256 million — would come from removing financial “buffers” in state budgets, such as reducing fiscal reserves, eliminating unfilled staff positions and tapping additional federal funds to cover expenses now handled with state tax funds.

The rest of the projected savings would come from reduced indirect costs such as data analysis systems ($8.7 million), improved contracting with private suppliers ($73.5 million), better return on economic development grants ($22.4 million), improved return on information technology spending ($32.5 million) and better focus on system-wide performance ($138 million).

Gov. Jim Pillen, who made hiring Epiphany a key part of his plan to reduce local property taxes, has already begun urging state agencies to apply for more federal funds to displace state financing of services, and moved to eliminate hundreds of long-unfilled state jobs. The report said that Nebraska ranks very low, 40th in the country, in its “per-capita balance of payments” with the federal government.  

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Gov. Jim Pillen addresses attendees at a property tax town hall in Plattsmouth.
Gov. Jim Pillen addresses attendees at a property tax town hall in Plattsmouth in May. (Zach Wendling/Nebraska Examiner)

Pillen spokeswoman Laura Strimple told the Nebraska Examiner on Friday that the governor is pleased with the work of Epiphany so far and looks forward to more of its work.

She said he supports the “systems approach” used by the consultant, and the idea that state government needs to improve its monitoring of state spending to produce “the best outcomes.”

“When state systems improve in quality, there’s the potential for saved resources to be repurposed in other ways, or to reduce overall expenses,” Strimple said in response to emailed questions.

She added that Pillen agreed with Epiphany that Nebraska has too much sitting in reserve funds — nearly $2 billion — “that could be put to better use.”

State Sen. Rob Clements of Elmwood. Dec. 6, 2023. (Zach Wendling/Nebraska Examiner)

Reaction to the report from two key senators was more mixed.

State Sen. Rob Clements of Elmwood, who heads the budget-writing Appropriations Committee, said that one of his least favorite sayings is “we’ve always done it that way.” He said he encourages new employees at his bank to suggest ways to improve efficiency.

Clements said that while he had not yet read the report, he supported contracting with Epiphany with the assurance that its recommended budget cuts can occur “without a drop in services.” He added that he would have to review the suggestion that reserve funds should be cut.

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In its report, Epiphany emphasized that cutting spending does not necessarily mean a reduction in services and that increasing funding does not always equate to better outcomes. 

Lincoln Sen. Danielle Conrad, who served several years on the Appropriation Committee, struck a more cautious tone, and said the report leaves a lot of questions unanswered.

She said that while it’s appropriate to “take a fresh look at ideas to reduce state budgets, most of (Epiphany’s) aren’t that fresh.”

“The ones that are will need a lot more analysis,” Conrad said.

For instance, she said that it’s already accepted that luring more federal funds to the state is a good idea, and that it can save money if prison inmates are better prepared to return to society — another Epiphany recommendation.

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Conrad said she was most skeptical about a suggestion that Nebraska significantly pare back its cash reserve fund — the so-called “rainy day fund” — that is used when state tax receipts plummet in an economic downtown.

Doing that, the senator said, risks ruining the state’s reputation as a fiscally sound state. In its last rankings of best states, U.S. News & World Report rated Nebraska No. 3 in the nation as the most fiscally responsible.

$10 million consultant contract

A Lincoln think tank that monitors state budgets has seen the report, and Open Sky Policy Institute expressed concerns about straying from current state budget practices in which the State Legislature — not the governor’s office — determines how state tax dollars are to be spent. Rebecca Firestone, the executive director of Open Sky, said it raises separation of powers concerns.

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Epiphany was hired for $10 million over four years to cut state spending and improve services.

In its report, it faulted past state efforts at “continuous improvement” of state programs as missing the mark by focusing on individual parts of a system, rather than the system, and its outcomes, as a whole.

State Sen. Danielle Conrad of Lincoln. (Zach Wendling/Nebraska Examiner).

That appeared to be a jab at the 26-employee Center for Operational Excellence created under then-Gov. Pete Ricketts that was eliminated by the current governor. Pillen opted instead for Epiphany, which Utah officials credited with improving efficiency of executive branch agencies in that western state by 35%.

Pillen, when he signed the contract, told the Omaha World-Herald that he was seeking “breakthrough change” in state spending. The contract calls for cutting at least 3% of state general funds in the first year, and 6% in the second. 

The cost-cutting effort is part of his goal of reducing local property taxes by 40% – a goal which has prompted Pillen to suggest a special session of the State Legislature later this month. 

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Recommendations, observations

Among other recommendations and observations in the report:

 —  Draw down existing Cash Reserve Fund and General Fund unobligated balances. The report recommended reserves of between 4% and 8% of the general fund based on the stability of Nebraska’s tax base.  

The state’s cash reserve fund is expected to hold $800 million by fiscal year 2027, about 14% of the general fund, the report stated, and unobligated funds in the budget are expected to be $700 million by that time, or about 12% of the general fund budget. The report said that two recent fiscal downturns — the Dot-Com recession of 2001 and the pandemic — saw state tax receipts drop by 3.7% and 8.6%, respectively.

 — Between 2021 and 2023, costs in the Nebraska child welfare program increased an inflation-adjusted 6% ($53.7 million), while the average number of children served per month decreased by over 4% and the average days it took to establish permanency for children increased by 108 days. That, the report said, is an example of how more spending does not improve services.

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 — Stop projects and resources that are dedicated to things that, although well intentioned, are not generating system-level results for the customers they serve. 

True improvements must result in better outcomes for the primary customer — not the internal bureaucracy, the report stated. State staffers, it added, spent “significant time” on projects that do not have a defined result or outcome.

 —  The state could save $73.5 million in the next year by improving its contract procurement processes. The state awarded nearly $20 billion in contracts for goods and services during the 2022-23 fiscal year, but procurements often are not held accountable for their impact (or anticipated impact) to system performance or outcomes. (Sen. John Arch, the Speaker of the Legislature, is leading an effort to improve contract selection and performance under a bill passed this year.)

 — Improve return on investment for grants awarded by the Department of Economic Development by better targeting specific industries and identifying and tracking specific outcomes. That could save $14.8 million.

“In some cases,” the report said, “(DED) grants were awarded to large corporations who would have likely done business in Nebraska regardless.”

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Cooper resigns from Nebraska football team

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Cooper resigns from Nebraska football team


LINCOLN, Neb. (KOLN) – Evan Cooper, the Huskers’ secondary and defensive pass game coordinator, has resigned, according to a Nebraska football spokesperson.

The spokesperson said the resignation was for personal reasons.

Cooper has been apart of Rhule’s coaching staff since 2013.

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Hall County Historical Society shares history of experimental government program in Nebraska

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Hall County Historical Society shares history of experimental government program in Nebraska


WOOD RIVER, Neb. (KSNB) – The Hall County Historical Society visited the senior center in Wood River to tell the story of an experimental government program from the 1930s.

Rural Rehabilitation was an experimental government program that spanned across the United States and started in 1934. One of the locations that met the criteria for the program was Hall County.

Michelle Setlik, Vice President of Hall County Historical Society, said 10 Hall County families were selected for the Farmstead Project.

“Hall County was chosen for the Farmstead Program because it met the criteria for the federal government,” said Setlik. “It had good quality soil, it had water, it had enough people that needed assistance that were on the relief roles and it had land available for the government to purchase for the project.”

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The following conditions had to be met:

  1. The area needed to have an agricultural history
  2. A large number of families eligible for relief had to live in the area
  3. An adequate water supply (either rainfall or irrigation) had to be present
  4. The site had access to markets for the produced goods
  5. There had to be suitable land available for purchase in the area

The communities for the Farmstead Program were selected by NERA (National Economic Research Associates) and supporting agencies. The families also had to meet a certain criteria to be considered for the program.

Criteria for selected families include:

  1. The family must have been on the relief rolls of the county where the project was being constructed
  2. The head of the household had to be between the ages of 35-50
  3. There had to be 4-6 members of the family

According to the historical society, in order to be considered for the Farmstead Project, families had to submit an application that was then reviewed by three different agencies.

Each Farmstead Family received the following:

  • Four room cottage
  • Small barn
  • Chicken House
  • Poultry yard
  • Land for garden and small orchard
  • Seeds
  • Livestock: two cows, 100 hens, 300 chickens

Once families agreed to the terms, they were given a one-year lease on the property for a nominal fee and after a one-year probation period they could be eligible to purchase the property on a 15-year payment plan, according to the historical society.

Setlik said the Hall County Historical Society is celebrating their 100th anniversary this year and have plans to make 12 new historical markers for the county.

One of those markers will be put at the site of the Farmstead homes in Grand Island off of Highway 34 on Farmstead Road.

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