TASK DEFINITION: Given a paragraph, generate a claim that is supported by the given paragraph. 1) The claim must contain information from within the paragraph. 2) A sentence within the paragraph can be used as a claim. 3) The claim should not have contradictions within the paragraph. 4) The claim should be at most one sentence long.
PROBLEM: In July 2020, social media posts and news reports claimed that a Missouri school district asked parents to sign COVID-19 “death” waivers in advance of the academic school year. The waiver went viral after a Twitter user shared it. The focus on the word “death” came from an article published by online tabloid Raw Story that extrapolated language from the waiver meant to release Hazelwood School District (HSD) in Missouri from legal liabilities in the event a child dies “in any way related to COVID-19.” While it is true that HSD issued a waiver related to COVID-19, Anthony Kiekow, HSD director of communication and public relations, told Snopes that parents would only be required to sign if their child planned on participating in summer athletic programs. The waiver asked that a parent confirm their acknowledgment of the public health crisis “related to the Coronavirus Disease 2019 (‘COVID-19’)” and confirmed that they would not allow a child to participate in programs if they showed any symptoms of COVID-19 or had been exposed to anyone diagnosed with the disease or awaiting test results. It further notes: The undersigned agrees to release, discharge, hold harmless and indemnify the Hazelwood School District, it’s agents, employees, officers, Board of Education members, insurers and others acting on the District’s behalf (the Releasees”), of and from any and all claims, demands, causes of action and/or legal liabilities for injuries to or death of my child occurring during, or resulting from, or participation in the above-mentioned program or activity and related in any way to COVID-19, even if the cause, damages or injuries are alleged to be the fault of or alleged to be caused by the negligence or carelessness of the Releasees. Such verbiage is not uncommon in school athletic waivers and headlines referring to the document as a COVID-19 “death” waiver were “sensationalizing” and largely misleading, added Kiekow. The waiver was created by the Missouri United School Insurance Council (MUSIC), a non-profit program that provides insurance coverage for Missouri public schools and community colleges. Snopes spoke with MUSIC Executive Director Mark Stockwell who said that the organization supplied all member school districts with two waiver templates recommended for summer athletic programs and not necessarily for those that take place during the academic school year. Kiekow confirmed that the waiver was sent in late June 2020 and was intended for parents whose students typically participate in summer athletics. He noted that required athletic waivers and documents from the previous school year were “very different from this waiver,” but that language related to COVID-19 is likely to be the “new norm for sports.” For the 2020-21 school year, the district announced that it would be offering families the option of selecting “100% virtual school” or a blended option that includes both virtual and in-person learning. A statement issued by HSD further reads that: Parents who want their child to participate in athletics are asked to sign a waiver. This year’s waiver includes language about COVID-19 to ensure that parents can make an informed decision… Our district has implemented unprecedented safety precautions in all of our buildings; however, it is important for parents to understand that school districts can only mitigate the risk of COVID-19. No district, organization, or business can offer 100% protection against exposure to a global pandemic. Visit the Centers for Disease Control website for more information about COVID-19. Parents of HSD students who choose to allow their children to attend in-person class would not be required to sign a COVID-19 waiver. When asked why HSD adopted this policy, Keikow replied via text message that “athletics are optional” and that a waiver for in-person instruction is “just not something that we’re requiring.” EdCounsel, a Missouri-based law firm that represents over 200 public school districts, wrote in a blog post that state “law is not clear” on whether school districts can require that families sign a COVID-19 waiver for students attending in-person instruction, but liability waivers for extracurricular activities are largely exempt.

SOLUTION: A Missouri school district asked parents to sign a COVID-19 liability waiver in advance of the 2020-2021 school year. 

PROBLEM: The state Department of Public Health says they notified the school this week of plans to investigate and ensure that students and employees will be screened quickly to see if they were infected. On Wednesday, the state and university began identifying students enrolled in classes, as well as faculty and staff, who might have been in close contact with the student. Symptoms can include chest pain, chronic coughing, coughing with blood, chills, fever and loss of appetite. Testing is scheduled to begin on Thursday.

SOLUTION: Alabama to test Auburn students, employees for TB.

PROBLEM: The move isn’t permanent — although Lowry would like to practice medicine in a smaller community one day. The rural Cumberland native spent three weeks in October at a St. Croix County hospital as a resident. She’s part of the nation’s only rural OB-GYN residency, a UW Health program that recently added Western Wisconsin Health in Baldwin to its roster of rural hospital training sites. The program brings young OB-GYNs — doctors who provide women’s reproductive health and care for pregnant women before and after birth — to rural Wisconsin communities for short-term rotations. The long-term goal? Getting young OB-GYNs to come back permanently, the Leader-Telegram reported. “Since 1996, there were about 20% of Wisconsin counties without obstetric care units in their hospitals,” said Dr. Ryan Spencer, director of the UW Health OB-GYN residency programs. “That’s increased to 40% of counties without an OB care unit, most recently in 2016.” One of the biggest issues rural women face during pregnancy is “just sheer distance,” said Dr. David Hirsch, OB-GYN and chief of staff at Marshfield Medical Center-Eau Claire. “Even in a relatively large rural community like Ladysmith (in Rusk County), people might live an hour from there,” Hirsch said. Another problem for mothers: Getting to a hospital that regularly delivers babies. Just over half of rural Wisconsin hospitals — 56% — provide obstetric delivery, but a few hospitals have been discontinuing those services over the last decade, according to a July report from the Wisconsin Office of Rural Health. Eleven rural Wisconsin hospitals closed their OB units in the last 10 years, according to the report. In larger cities, mothers have several options for obstetric delivery. Mayo Clinic Health System, Marshfield Clinic Health System and HSHS Sacred Heart Hospital deliver babies in Eau Claire; obstetric delivery is also available in Chippewa Falls, Menomonie, Barron and Rice Lake. Mayo Clinic Health System-Northland in Barron is expanding its birth center, a nearly $1 million project adding four new rooms for labor, delivery and postpartum and building upgrades that are expected to be complete in early 2020. But for women who live far from those cities, delivery is a tricky service, because babies come on their own time, Lowry said. “In some cases . you may still only need to drive 15 to 30 minutes down the road to get to a place,” Lowry said. ”(That’s) not nearly as concerning as people who potentially are driving more than an hour to get to an OB-GYN . I think that’s one of the biggest things that’s a problem at this point.” The good news? Ninety-nine percent of Wisconsin women of childbearing age live within 30 minutes of a hospital with obstetric delivery, according to the report. In smaller communities, hospitals train emergency departments to deliver babies in a pinch. ″(Emergency room delivery) is not optimal, but faced with the resource challenge we’re talking about, it helps provide a safety net,” Hirsch said. Looking ahead Of Wisconsin’s 72 counties, 27 have no OB-GYN, according to UW Health. But some health officials say a lack of OB-GYNs is only part of a larger problem — that running obstetric units in small communities simply isn’t feasible. Spencer began seeing the problem in the early 2000s. But rather than simply cutting services, some rural hospitals are closing altogether. “We started seeing an increase in rural hospital closures across the country,” Spencer said. “We do see a significant worsening of the problem over time, especially related to women’s health and obstetric care.” Some hospitals can’t afford to keep an obstetrics unit, Hirsch said. Delivery is safest at a facility with an intensive care unit, operating room, anesthesiologist, emergency department and experienced nurses, he said. “It’s difficult, the resources you need to have available to run labor and delivery,” Hirsch said. Keeping multiple OB-GYNs on hand is an expensive business. To support a whole community around the clock with an on-call schedule, at least three providers are needed, said Alison Page, CEO of Western Wisconsin Health in Baldwin. For a small hospital an hour away from a large city, three OB-GYNs means “well over $1 million in expenses,” Page said. “It’s not going to support that.” Western Wisconsin Health has two OB-GYNs. The hospital delivers about 250 babies each year, up from about 40 babies per year four years ago, Page said. Midwives and family practice doctors help fill in the gaps. But even in a fully-staffed obstetrics unit, providers can’t keep their competency if there aren’t many babies born in a rural community. “Providers have to have a certain number of births, cesarean sections, things like that so they can demonstrate they’re competent,” Page said. And fewer young women are moving to smaller communities, said Jeff Euclide, chief administrative officer of Marshfield Medical Center-Ladysmith. “I don’t think it’s a secret that rural areas aren’t as attractive to the childbearing population as the city,” Euclid said. Finding a fix Lowry grew up in a “tight-knit community where everybody knows everybody” in rural Cumberland, where doctors knew and cared for their neighbors. “That was the experience I had growing up, and (was what) I pictured I’d do with my future career in medicine,” Lowry said. Plenty of medical students are interested in the OB-GYN field, Spencer said — but new OB-GYNs aren’t getting experience working in rural communities. That’s where Wisconsin’s rural residency program comes in. In the program, newly-graduated OB-GYNs practice at rural sites throughout Wisconsin in rotations. Health organizations in Portage, Waupun, Monroe and most recently Baldwin, about 20 miles (32 kilometers) from the Minnesota border, are the training sites. “We’re beyond pleased, thrilled to be selected as a partner,” Page said. “They had heard we have two OB-GYNs here.” The program started in 2016, and will yield its first graduate in 2021. Lowry plans to graduate in 2022. One of Western Wisconsin Health’s OB-GYNs will likely retire in five years, Page said. For more rural hospitals, she said, this is an obvious answer. “How do I attract an OB-GYN who could be working at United Hospital or in Eau Claire? You start with people that came from rural places, love rural places, and they want to practice here,” Page said. ___ Information from: Leader-Telegram, http://www.leadertelegram.com/

SOLUTION:
Looking for answers to rural Wisconsin OB-GYN shortage.