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UPDATE: Chickasaw Co. infant died of neglect, parents charged

ALTA VISTA — The parents of a baby found dead in an infant swing in an Alta Vista residence in August have been charged with first-degree murder and felony child endangerment for his death.

Zachary Paul Koehn, 28, and Cheyanne Renae Harris, 20, identified as the biological parents of 4-month-old Sterling Daniel Koehn, were arrested Wednesday following a two-month investigation.

Bond was set at $100,000 cash only. The penalty upon conviction of first-degree murder is mandatory life in prison.

Court records indicate the child weighed less than 7 pounds and had died of neglect.

“The facts of this case go far beyond neglect and show circumstances manifesting an extreme indifference to human life,” a Chickasaw County sheriff’s deputy wrote in court records seeking charges against the parents.

Sterling was found dead the afternoon of Aug. 30 in the family’s apartment on Hilltop Avenue.

Deputies and medics had been called to the residence on Wilson Street on a 911 call at 12:57 p.m. that day and found the baby deceased in his powered infant swing.

According to court records, Koehn told authorities Harris had fed the infant around 9 a.m. and everything was fine, and then he checked again at 11 or 11:30 a.m. and the child was dead.

During the autopsy, the medical examiner found maggots in the boy’s clothing and skin, and the maggots’ development was studied by a forensic entomologist to determine a timeline.

“The study of the maggots growth and development indicated that the child had not had a diaper change, bath, or been removed from the seat in over a week,” the deputy wrote in court records.

Authorities said this was inconsistent with the parent’s statements, and the Iowa State Medical Examiner’s Office ruled the death was a homicide with the cause of death being failure to provide critical care.

The investigation into the case involved the Iowa Division of Criminal Investigation, the state medical examiner’s office and the Chickasaw County medical examiner.

Deputies said they were assisted Wednesday in locating the couple by deputies in Mitchell and Fayette counties, as well as the Charles City Police Department. Where they were arrested was not disclosed.

Chief Deputy Reed Palo asked anyone with further information regarding the case to contact him at 641-394-3121.

Koehn was arrested in September 2016 for allegedly bypassing the water meter to his mobile home in Riceville after utility workers turned off water service for nonpayment.

A charge of second-degree theft was dropped in February after he agreed to pay the city of Riceville $1,600 in restitution plus court costs.

In August, the Mitchell County Attorney’s Office asked the court to find him in contempt because he hadn’t been making payments on the agreement.

Residents, U of I students, talk future of Mason City's North End

MASON CITY | Tiffany Jacobson has lived on the North End for 13 years. She likes her neighborhood, enjoys seeing kids play outside on her block and takes pride in where she lives.

And with the Blue Heron Bar & Grille and Little Chicago opening on North Federal Avenue within the past few months, she hopes the city and community can continue to build and improve her end of Mason City.

"It's gotten a lot better aesthetically," Jacobson, 46, said of the North End. "I don't know how you can promote more businesses because these buildings are really old, but as long as they can make them look nice ... they're old buildings, and I don't want to see them torn down. It would just make it look more empty."

Jacobson's remarks came inside the Blue Heron Bar & Grille, the second leg of "Taste of the North End," an event organized by University of Iowa students, the Cerro Gordo County Department of Public Health and other organizations.

The event allowed students and North End residents to come together and discuss how to improve their part of town, while enjoying free food. The back room of Blue Heron was bustling with activity around 6:30 p.m. Thursday as University of Iowa students took notes while listening to residents.

One of those students was Sadya Islam, a graduate student in urban and regional planning. She said a lot of research and preparation went into Thursday's event, and was happy to see a large crowd Thursday.

"It's all about people," Islam, 28, said of the event. "The people living here, they need to talk with themselves, they need to figure out,' this is how I can improve my neighborhood.'"

Islam, North End residents and city officials identified several issues: a false stereotype about crime levels in the area, a need to better understand the local housing market and its affordability, and loans and other financial opportunities from city and utility services.

"How we get that is it's been stereotyped for years and years and years," Jacobson said of the crime issue. "Traditionally, the North is more of a middle class, working class [neighborhood] ... I just think the history of the North End is how we get that stereotype."

Jamie Lane, another North End resident, thinks some issues stem from the appearance of the North End: boarded up and vacant houses, poorly maintained lawns and a lack of "curb appeal."

He sees opportunity, however, in his end of town, and hopes other city improvements can help — specifically the proposed River City Renaissance Project.

"We see the potential, that's really why we're here," Lane, 56, said. "And we're excited about more downtown development, and hope it will grow outwards."

Kelli Gerdes, a health promotion manager with the Cerro Gordo Department of Public Health, sees that potential. Her department was responsible for helping provide some relevant data to University of Iowa students, and providing logistical help for Thursday night's event.

Gerdes said improving the buildings should destigmatize a high crime perception in the North End, and added her department and city officials could do a better job of informing residents and landlords about services that save them money.

She also said one of her specific focuses is helping residents stay healthy.

"When I look at the North End, are there sidewalks connecting to parks so kids can go and play and feel safe traveling there?" Gerdes, 31, said. "Can you cross the street safely? Are there crosswalks, are there traffic lights where they need to be? So different things like that."

With the input coming from residents, the Department of Public Health and other city officials — Cerro Gordo County Supervisor Tim Latham and Development Services Department Director Steven Van Steenhuyse were present Thursday — University of Iowa students will be compiling some sort of strategic plan, said Travis Kraus, 42, assistant director for the Iowa Initiative of Sustainable Communities at the university.

That report, scheduled to be published next May, would likely involve community and city input, Kraus added. He commended the students for their work, and property owner Russ Hardy for opening up a commercial space next to Little Chicago, where "Taste of the North End" concluded Thursday night.

"You could point to certain things that are keys to unlocking and activating the neighborhood," Kraus said of possible development. "The commercial vacant spaces are one of those things."

"I've been hearing people not just interested in eating food, but also talking about things they would like to see happening," he added.

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Albert Lea 'Save Our Hospital' effort raises over $100K

The Albert Lea-Save Our Hospital organization has raised more than $101,000 in tax-deductible donations since July, a number the organization said will help in its mission to keep a full-service, acute-care hospital in Albert Lea.

“The fundraising committee has done a tremendous job, and we’ve all worked hard to demonstrate the integrity of our movement,” said Jennifer Vogt-Erickson, a Save Our Hospital member. “We’ve received donations from across the country, and that shows incredible support from both community members and also people with long-lasting, long-distance ties to Albert Lea.”

The funds will give the organization future options with public relations and other steps, Vogt-Erickson said. Those options are expected to become clear after the release of the results of the feasibility study by health care consulting firm Quorum Health Resources LLC.

Save Our Hospital is splitting the cost of the maximum $75,000 cost with the city of Albert Lea and Freeborn County, which is expected to include an analysis of the Albert Lea hospital, analysis of market conditions for sustainability and future options.

The analysis was sought after Mayo Clinic Health System officials in June announced plans to move most inpatient services from Albert Lea to Austin. Though the hospital sits about 12 miles over the Iowa-Minnesota line, many North Iowans are affected by the changes. 

Save Our Hospital members have discussed speaking with state legislators to see if state laws can be changed so rural communities can have more of a say in health care services.

Paul Thissen, former Minnesota House Speaker and candidate for Minnesota governor, signaled he would be open to changing those laws earlier this month at a rally in Albert Lea.

Members have discussed sharing stories of how the transition is affecting them, as well as their hopes of taking back a full-service, acute-care hospital in Albert Lea.

Save Our Hospital members attended DFL and GOP gubernatorial debates in Rochester within the last two weeks.

Weekly 6 p.m. Sunday meetings at the American Legion will shift to meetings the first and third Sundays of each month.

At Sunday night’s meeting, Save Our Hospital leaders spoke highly of the community effort that has been undertaken in the process.

“I know Mayo didn’t expect this level of intensity from us, and they really hope that we go away, but are we going to go away?” asked fundraising committee chairman Al Arends, drawing a loud “No” from the audience.

“No community has risen to challenge giant Mayo like you people have,” he said, drawing applause from the audience. “That’s what makes Albert Lea such a great place to live in.”

Leaders will meet with a possible second provider Nov. 1.

Save Our Hospital second provider committee chairman Craig Ludtke said though the provider’s vision was originally smaller than they were hoping for, conversations to increase the plan are underway.

Despite numerous calls from lawmakers and community members, Mayo Clinic Health System has consistently refused to put a pause to the transition, saying doing so would put patients at risk due to a staffing crisis.

Mayo Clinic and the city of Albert Lea agreed to enter facilitated dialogue to discuss the transition, but the hospital system stated it would not decide to pause the transition during discussions.

The first part of the transition — the moving of the intensive care unit to Austin — is complete.

Inpatient surgeries are expected to move to Austin in January, and the behavioral health center will move from Austin to Albert Lea in 2019. Labor and delivery services will be the last to relocate to Austin in late 2019 or early 2020. 

Mayo Clinic Health System declined to comment on Save Our Hospital fundraising.

Chris Zoeller / CHRIS ZOELLER, The Globe Gazette 

People walk to and from the entrance of the Mayo Clinic Health System in Albert Lea, where officials plan to consolidate its inpatient services to its Austin, Minnesota, location.

Miller: Make opioids the ‘last-resort’ treatment

DES MOINES — Iowa Attorney General Tom Miller told a conference aimed at combating opioid addiction Thursday that the culture of American medicine needs to change so powerful prescription drugs are viewed as “the very last resort” rather than as a common option for pain.

Miller took aim at large pharmaceutical companies that profited from the rise in painkiller use as having caused a shift in public perception. He later told reporters he is working with other state attorneys general to bring legal action similar to past successful challenges to the tobacco industry.

“What has happened is awful,” said Miller in pointing to a national epidemic in opioid-related deaths and addictions. “Twenty years ago, opioids were used in a very limited way. They were used as a pain remedy of very last resort. They were used with a great deal of caution and respect because of the addictive nature of opioids.”

However, he said, the perception gradually changed in part due to pain associations funded by drug companies that focused on treating injuries with high-strength medications. He applauded new efforts by pharmacies that are limiting opioid prescriptions to only seven-day supplies for acute pain.

“We really have to address this problem and address it dramatically because so much is at stake,” Miller told a conference held as part of Gov. Kim Reynolds’ Opioid Awareness Week. It featured discussions about strategies to reduce opioid misuse and evolving responses to a national epidemic, and a gripping testimonial by a Dubuque man battling his way back from a heroin addiction.

According to the Iowa Department of Public Health, there were 2,274 admissions for opioid treatment in the state in 2016 and 180 opioid-related deaths that year.

Reynolds said Iowa has taken a multifaceted approach to combating the opioid epidemic through prevention, treatment and recovery efforts that include using the state’s prescription drug monitoring program, expanding drug “take back” initiatives in all 99 counties, expanding naloxone access and specialized treatment through local health care providers, and improving specialized professional training and education for health care professionals through licensing boards and medical schools.

“We know that we need to do more,” said Reynolds, who laid out a four-point proposal she hoped would “produce transformational results” once implemented.

Reynolds said she would like to increase prescriber use of Iowa’s prescription monitoring program, which after nine years of operation has only about a 43 percent signup rate. She said efforts are underway to modernize the system. One the technology advances are in place, she expects to see greater participation. But she said she is not ready to make use of the database mandatory for prescribers, as some states do.

“Our hope is that once the program is upgraded and innovations are made that we will see more doctors using it. There’s a growing sense of urgency in the medical community to grab onto this tool and to use it,” said Steve Lukan, director of the Governor’s Office of Drug Control Policy.

Reynolds advocated “Good Samaritan” legislation that would shield drug users from prosecution if they seek help for someone who is overdosing, similar to laws enacted in some form by many other states.

She also promoted efforts to reduce opioid prescribing to prevent misuse in Iowa, improve intervention for Iowans misusing or addicted to opioids and enhance treatment — particularly medication-assisted treatment for opioid-addicted Iowans.

The Iowa conference was held the same day President Donald Trump called the opioid epidemic the “worst drug crisis in American history” and said his administration is declaring it a public health emergency.

The declaration means the federal government will waive some regulations, give states more flexibility in using federal funds and expand telemedicine treatment.

Both Reynolds, a Republican, and Miller, a Democrat, applauded Trump’s announcement.

“Whatever he declared is helpful,” Miller said, “but it’s going to take an awful lot of other things to make this work.”