As more than a dozen Adams County department heads presented their 2021-22 budgets, several of those departments decreased their request from what was asked for the previous fiscal year.
The budgets were presented at the Adams County Board of Commissioners meeting on Tuesday.
While the changes in budgets weren’t directly tied to personnel, several department heads said they have struggled to fill vacancies and retain employees with the current wage steps.
County Attorney Donna Fegler-Daiss and Public Defender Shon Lieske each said it has been hard to hire lawyers for their respective departments when prospective hires can work for nearby counties making up to 20% more.
Not all of the departments decreased their asking.
As Adams County continues to plan for its new justice center on the south edge of Hastings, costs for housing prisoners continues to rise. The jail budget saw a 12.8% increase from what was requested during the previous fiscal year — $2.95 million up from the $2.61 million budget for 2020-2021.
The Sheriff’s Office budget saw a 10.7% increase — $2.61 million up from $2.36 million.
County Board members voted 7-0 to repeal the 23-year-old resolution that permitted up to a 5-cent levy for townships.
Adams County voters approved during the 2018 election discontinuing the township form of government. That change went into effect in January.
Townships were established by counties primarily to oversee maintenance of rural roads.
A few of the townships turned over a balance to the county when the townships were discontinued.
Highway Superintendent Dawn Miller said the county can spend out of an available township fund to maintain the roads in that township.
Now, they are no longer township roads. They are secondary roads according to the county designation.
The townships averaged a levy of .0001 cents from 2017 to 2019. Levies during that time ranged from nothing to nearly 2 cents.
Those townships averaged about $2,673 in maintenance and $6,802 in gravel according to 2021 rates. The total annual average for gravel plus maintenance is $151,588.
Miller initially figured $153,706 would be enough for the Roads Department for gravel and maintenance.
That amount would only cover about five miles of township road per township at current costs, however.
“(The Road and Bridge Committee) relooked at these valuations and said $231,643.87, which would give you nine miles of township of new gravel at current gravel,” she said.
In other business, the board:
Unanimously approved as Bo
Participation may have been down in certain aspects of Adams County Fairfest 2021, but enthusiasm was way up.
Following 2020, when the novel coronavirus disease, COVID-19, pandemic shut down most fair activities, officials said the public was ready to celebrate.
“I think it went really smooth,” said Julie Ochsner, Adams County 4-H and youth development assistant. “I think we had kids that were really, really excited about being able to be back together again. I saw lots of kids hanging out and giving each other hugs that they hadn’t seen since last year we really didn’t get to get back together.”
She said it was important for the youth to be able to have a real fair.
Numbers were a little bit down.
“I think people maybe got the idea or habit that they didn’t have to do anything (after 2020),” Ochsner said. “They were fine not doing stuff. It’s going to be hard to get them back into the whole process of doing projects and exhibiting things. Livestock is a lot of work, and there’s a lot of choices for kids anymore. We hope the kids make the choices to do the 4-H projects.”
Robin Stroot, open class chairwoman, also said the number of open class entrants was down.
“I think it went really well just not knowing what was going on as far as coming post-pandemic,” she said. “I’m just not sure what to have expected because when you’re home a lot of people had a lot of stuff they could get done. Myself, I usually enter things, but I gave things away after I got them done. We had a really good turnout. We were down 100 exhibitors.”
Photography was really down.
Some people weren’t aware of the schedule and missed the submission deadline.
“I suspect next year it will be fuller,” Stroot said.
Stroot did say there was about double the number of quilts from previous years.
“It really made a great display along with all the artistry of the different crafts,” she said. “We had a lot of young kids who brought stuff in. It was great. It was really much better than expected.”
Open Class was in a new area this year, in the west side of the activities building instead of east side.
Stroot said it was a little hard to figure out at first how things would be displayed.
“We just didn’t know what to expect,” she said. “But really the people of Adams County turned out. It was still just a beautiful showcase of talent that we have in the Open Class.”
Fairgrounds manager Jolene Laux was effusive when talking about Fairfest 2021.
“I think it went awesome,” she said. “We had some good numbers come through with the carnival, with fair attendance and even at the concerts. It was a lot higher than what we’ve seen for quite a few years.”
She did say participation was down at the demolition derby with around 20 cars. Laux said there are typically about 60 vehicles involved.
The carnival started a little slow on Wednesday of the fair, but attendance ramped up quickly.
“Saturday was probably the highest number we’ve seen,” Laux said. “I don’t know if I’ve even seen it that high since I’ve been here. The lines were super long and people were having to wait a while. I’m just glad they stuck around and kept on riding.”
The Friday and Saturday concerts of Riley Green and Gary Allan each saw attendance of over 2,000. Laux said concert attendance typically has been around 1,200.
“So getting it over 2,000 that was a good thing to see,” she said. “We just saw it all over the grounds. Even after talking to the vendors inside and outside, they were seeing some good stuff, too.”
The South Heartland District Health Department recorded nine new cases of the novel coronavirus disease, COVID-19, among district residents during the week of July 11-17, and saw its overall test positivity rate for the week jump from 1.52% to 5.92%.
In addition, the department already has logged four new confirmed cases of COVID-19 for the week that began Sunday.
The uptick in case activity has pushed the district’s risk dial reading, assessing the danger from further local spread of the virus and its variants, back into the yellow zone after several weeks of the needle being pegged on the line between green and yellow.
The new risk reading, 1.3, is up from 1.0, which was squarely on the line between low risk (green zone) and moderate risk (yellow zone).
The South Heartland district encompasses Adams, Webster, Clay and Nuckolls counties. Health department offices are in Hastings.
The test positivity rate is the number of new positive cases confirmed by laboratories for the week divided by the total number of tests administered in that same time period.
The positivity rate within the general population climbed from 3.13% to 7.96% for July 11-17. The rate among residents and employees of long-term care facilities remained at zero for the fifth straight week.
Since March 18, 2020, a total of 4,944 South Heartland residents have been confirmed positive for COVID-19. A total of 92 have died of the disease, based on information from official Nebraska death certificates.
The 92nd death is newly confirmed, following receipt of another death certificate for an individual previously recorded as a positive case of COVID-19.
In addition, sequencing has confirmed a second case of COVID-19 in the district (the case itself had been reported previously) is attributable to the B.1.617.2 variant of the virus, otherwise known as the highly transmissible Delta variant.
In her weekly Tuesday night news release updating COVID-19 news and statistics for the health district, Michele Bever, health department executive director, said the 14-day average of daily new cases per 100,000 population increased to 2.1 after being at or below 0.9 since June 4.
“Given the increase in cases, increase in positivity and the recent identification of cases caused by the Delta variant of concern, our overall local risk of COVID-19 has edged up into the moderate (yellow) zone,” she said.
Vaccination numbers continue to inch upward. As of this week, 50% of eligible South Heartland residents (age 12 and up) have received at least one dose of a COVID-19 vaccine, and 47% of eligible residents are fully vaccinated.
Thirty-nine percent of all district residents are fully vaccinated, and 41% of all residents have received at least one dose.
Bever said South Heartland compares unfavorably to the United States as a whole in terms of its vaccination track record.
“Our COVID-19 vaccination rates in South Heartland continue to lag behind the national averages,” she said.
According to the New York Times vaccine tracker (July 20), in the U.S. overall, 48.7% of residents are fully vaccinated and 56.1% have received at least one dose. Of those 12 years and older who are eligible to receive the vaccine, 57% are fully vaccinated and 65.7% have received at least one dose.
“And, while an outstanding 81.8% of South Heartland residents age 65+ are fully vaccinated, only 8% of 12- to 15-year-olds are fully vaccinated (3% have received a first shot), 16% of 16- to 19-year-olds are fully vaccinated (3% have received a first shot), and 29% of 20- to 34-year-olds are fully vaccinated (3% have received a first shot),” Bever said.
With the Delta variant ascendant nationwide, the need for vaccination here at home is strong, she said.
“With the Delta variant causing surges in cases around the country and with younger individuals getting sick and needing hospitalization, we are encouraging everyone age 12 and older who hasn’t been vaccinated to make an effort to do so now,” Bever said. “The COVID-19 vaccines protect against severe illness caused by the coronavirus variants. If you haven’t been vaccinated, don’t wait. Getting your first dose of the COVID-19 vaccine soon means you could be fully vaccinated in time for back-to-school and fall activities.”
South Heartland will offer a walk-in COVID vaccination clinic with Pfizer vaccine July 29 from 5-7 p.m. at the west end of the Allen’s building, 1115 W. Second St., in Hastings.
In preparation for school, Bever encourages families to bring their children age 12 and above (minor children must be accompanied by parent or guardian). Others also are welcome.
Those attending should enter at Allen’s west door. Masks are required. Participants may register in advance at vaccinate.ne.gov.
All three COVID-19 vaccine products – Pfizer BioNTech, J&J Janssen and Moderna — are available in the health district. SHDHD’s vaccine webpage (southheartlandhealth.org) includes a list of locations offering vaccine in the South Heartland District and which vaccine products are offered at each site.
The list is updated frequently to include new times, dates, whether walk-ins are accepted, and, if needed, how to make an appointment at each site. In addition, many health care providers in the district are offering COVID-19 vaccine to their patients.
Bever encourages residents to contact their personal doctor or the health department if they have questions about the vaccine. Contact South Heartland District Health Department at 402-462-6211 or 877-238-7595.
E arlier this year, former Hastings resident Ryan Ernst became the first psychologist in Iowa to be licensed to practice psychiatric medicine.
Ernst is a 1993 graduate of Hastings High and 1997 graduate of the University of Nebraska-Lincoln.
He became a psychologist in 2002 after receiving a doctorate in psychology from Nova Southeastern University in Fort Lauderdale, Florida.
He became the first psychologist in Iowa to be licensed to practice psychiatric medicine in April after completing the additional training needed for a master’s degree in psychopharmacology.
He and his wife, Joni, have three children: Gylz, 19; Grey, 15; and Milan, 10.
Prior to pursuing his psychopharmacology degree, Ernst had been working for Madonna Rehabilitation Hospital in Lincoln for about nine years as a neuropsychologist.
Ernst continues to live in Lincoln, but now works for the Clarinda Regional Health Center in Clarinda, Iowa.
“It was something I was interested in even before graduate school,” he said of becoming a prescribing psychologist. “I worked at a clinic for a psychologist here in Lincoln. It was a passion of his, and I got introduced to it — the idea of psychologists prescribing — through that psychologist who was kind of my mentor at the time. It was always something I was interested in, but it was always kind of out of my reach because there were no states around Nebraska that allowed psychologists to prescribe until Iowa passed their bill in 2016. That opened the door for this being more of a realistic possibility for myself.”
Historically, only medical doctors such as psychiatrists and other physicians were able to prescribe medications for mental health conditions.
The U.S. Department of Defense launched a program in 1989 to train psychologists in medicine.
That eventually led to New Mexico being the first state to pass a bill into law allowing appropriately trained psychologists the ability to prescribe medications for mental health conditions.
Iowa passed a similar law in 2016 that went into effect in 2019 with associated legislative rules and regulations.
Iowa became the fourth of five states that currently allow prescribing psychologists. Besides New Mexico and Iowa other states are Louisiana, Illinois and Idaho.
Ernst started a separate master’s degree in clinical psychopharmacology in 2017. It was the next available class after the bill in Iowa passed.
The 2 ½-year program concluded with clinical hours, which is a component that is required prior to being licensed.
He found the Clarinda Regional Health Center in Clarinda.
It is a Critical Access Hospital in a town of about 5,000 people.
The hospital had been using psychiatric telehealth services through a psychiatrist in Omaha.
Ernst needed supervised hours. It was an agreement with a mutual benefit.
He started at Clarinda Regional Health Center in December 2019, working as a psychologist while also doing his residency.
Chuck Nordyke, CEO of Clarinda Regional Health Center, estimated prior to Ernst’s arrival, the hospital provided about 150 mental health visits a year through telehealth services.
Nordyke, who has been at Clarinda Regional Health Center for three years, said the need for expanded mental health services was quickly apparent.
“When I got here that was the biggest thing I heard from the community was ‘We need mental health services, we need mental health services,’ ” he said.
A local principal, who had met Ernst and knew he was looking for a hospital in which to do his residency, put Nordyke in touch with Ernst.
Nordyke thought Ernst was a great fit.
“At this point, it’s only been a little over a year of us being open, we have the largest mental health practice in southwest Iowa,” Nordyke said. “We’ve grown from having nothing to being the biggest player in this corner of the state for sure.”
Clarinda Regional Health Center now averages more than 500 mental health visits per month.
“To say that this has exceeded our expectations, especially within the first year, is an understatement,” Nordyke said. “It is a huge, huge practice for us.”
He was intrigued by Ernst’s background in psychology.
“Ryan is a trained neuropsychologist,” he said. “So he has advanced training on the psychology side. After talking with Ryan, I liked his approach. I liked his background working with Madonna and that rehab component.”
Around the same time Ernst started there, the hospital was hiring its first mental health nurse practitioner in Benn Rayment.
“Those two took the lead in developing the practice and hiring the next folks and growing it to where it is now,” Nordyke said.
Psychologists have different training than psychiatrists when it comes to mental health, he said.
“So to be able to bridge those two, the medicine with the training the psychologists have, I think was going to be a huge win for us,” he said. “Ryan fits Benn, and Benn fits Ryan; they work together tremendously.”
Ernst will see children as young as 5 all the way up to patients in their 90s.
“There are some real limitations of using telehealth only, and that’s really for any aspect of health care,” he said. “It’s great for some circumstances, but as the main delivery method of mental health services there are some real shortfalls to that. It’s very important in providing mental health services — especially counseling or psychotherapy — to people there has to be this established trust. I think that is difficult to establish sometimes when you have never really been in the same room as somebody before and have only seen them on a TV screen.”
Nordyke said Clarinda Regional Health Center is working to promote the fact it is the first hospital in Iowa with a practicing psychologist.
Ernst and Nordyke have talked about establishing a residency program for other psychologists who would like to go through the training with him.
Clarinda is 94 miles from Lincoln. Ernst makes that drive twice a day, four days a week, spending Wednesdays at home working as a neuropsychologist. He writes reports and assesses patient brain functions.
As the first prescribing psychologist in a neighboring state but still living in Nebraska, Ernst advocates for allowing prescribing psychologists. He has testified in committee hearings for several bills at the Nebraska Legislature.
He said it’s an ongoing effort for the Nebraska Psychological Association to see this bill passed.
“The reason why there was initial interest in psychologists being able to prescribe psychiatric medications is simply because of the lack of access to care that people have,” he said. “It tends to be worse in the rural areas and of course most of Nebraska is rural, so you could imagine that’s an issue for a great number of Nebraskans.”