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More than 23,000 initial shots of COVID-19 vaccine have been administered across Missouri so far. But before doses are even delivered, a herculean amount of work has gone on behind the scenes to ensure its smooth arrival.

Approved as a vaccinator with the state, Alps Pharmacy, an independent, locally-owned pharmacy in the Springfield area, has had to assess all possibilities as they await their first shipments to start administering doses to long-term care facilities.

Leah Gregory has started most of her days reaching out to vendors she never thought she would work with in her role as director of clinical services for Alps Long Term Care Pharmacy.

“I’ve worked with people in refrigeration to try and purchase ultra-low freezers. I’ve worked with dry ice vendors,” Gregory said. “Those were all infinite phone calls and emails and follow ups. And so it’s definitely a process that you have to stay on top of because so many people want this all at one time.”

As of Tuesday, 285 facilities across the state were approved to administer the vaccine, according to a news release from Gov. Mike Parson’s office. 

Missouri’s first week-and-a-half of vaccinations is in the books, but with details changing day to day, unforeseen delays and more than 700 additional facilities expected to be approved in the coming weeks, providers still have plenty of questions.

On the Department of Health and Senior Services’ weekly planning calls, questions have ranged from whether personal protective equipment will be included with vaccine shipments to how doses will be redistributed from one facility to another.

Meanwhile, CVS will begin administering vaccinations in nearly 600 of Missouri’s long-term care facilities on Monday — a key facet of the state’s effort to vaccinate some of the state’s most vulnerable residents, whose deaths have made up nearly half of all COVID-related deaths in the state.

Hy-Vee has been ramping up hiring, with the hopes of bringing on 1,000 technicians in order to administer COVID vaccines in eight states, including Missouri.

“This whole thing has been kind of fly by the seat of your pants,” Ron Fitzwater, the CEO of the Missouri Pharmacy Association said in an interview earlier this month. “We haven’t been through this before.”

Pharmacies have had to quickly assemble systems and put plans in place. For smaller, community pharmacies that are often located in more rural areas, having access to a vaccine will be critical, Gregory said.

Roughly 16 percent of the independently owned rural pharmacies in the U.S. shut down between March 2003 and March 2018, according to a 2018 policy brief from the RUPRI Center for Rural Health Policy Analysis based at the University of Iowa. 

During that time period, 16 of Missouri’s rural ZIP codes either went from one or more pharmacies to one, or from one to zero.

“Those patients are just as important as any patient that lives within a 10-mile radius of a larger chain pharmacy,” Gregory said.

To ensure Alps Pharmacy would be prepared, Gregory looked into purchasing an ultra-cold freezer, and possibly a portable one too, that could constantly monitor the temperature to keep Pfizer’s vaccine at the necessary minus 94 degrees.

“As a small company, looking at liquefying $15,000 for vaccine storage that you don’t even know if you’re going to need in November, we had to make a pretty hard choice about where we wanted to fall in the pecking order,” Gregory said.

But they’ve been able to find solutions. If they receive shipments of Pfizer’s vaccine, the pharmacy has lined up dry ice suppliers to replenish the special containers that the vaccines arrive in.

They’ve prepped clinical screenings and created intake forms to ensure they have the necessary information for insurance, billing and data entry. And they’ve enlisted the help of pharmacy interns from the University of Missouri Kansas City School of Pharmacy in Springfield. 

What might take Gregory an entire day to vaccinate 120 nursing home residents, could take just a few hours with the help of two interns.

Gregory estimates her staff have poured in at least 120 hours to prepare for doses they likely won’t get for weeks. The long hours have left Gregory feeling tired — but excited — for the chance to help usher in a small sense of normalcy back to their community.

“We’ve proceeded forward without a lot of information about whether this will make financial sense to us or not,” Gregory said. “But we do know that for the rest of the country to heal and persevere and move forward, we’re going to have to answer this call.”

CareSTL Heath, a Federally Qualified Health Center that provides affordable healthcare to underserved communities throughout St. Louis, is expecting its first shipment of both Pfizer and Moderna’s vaccines in a week, a spokeswoman said.

Angela Clabon, CareSTL Health’s CEO, said the center will take away lessons learned from its flu shot clinics and COVID testing efforts and apply them to distributing a COVID vaccine. CareSTL has been trying to reach residents in as many ways possible, from setting up drive-through sites and going directly to them.

Reaching sometimes transient residents in order to make sure they come back in three to four weeks for their second dose of a COVID vaccine will be a challenge, Clabon said. In some instances, when COVID test results took five days to get back, “believe it or not some persons’ phones disconnected in that time,” Clabon said.

But despite the questions that remain in the early stages of planning for the vaccine’s arrival, Clabon knows CareSTL will be there.

“When you’re responsible for your community, you just don’t say no,” Clabon said. “You just deliver.”

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Congress on Monday night approved and sent to President Donald Trump the first major COVID-19 relief measure since the spring, a sprawling spending bill that would provide $900 billion in pandemic-related aid but still didn’t go far enough for many Democrats.

House leaders divided the bill into two parts and passed the emergency relief portion on a 359-53 vote. Another portion, which included Pentagon and other spending for the coming year, passed 327-85. The Senate combined the two bills and cleared the package in an overwhelming 92-6 vote shortly before midnight.

The White House has signaled Trump will sign the 5,593-page measure.

So what’s in the bill?

DIRECT CHECKS

—$166 billion in another round of economic impact payments that will go directly to Americans.

—$600 stimulus checks for individuals that begin phasing out at an income of $75,000 and $1,200 for married couples phasing out at an income of $150,000, as well as $600 for each child dependent.

—Language stating that taxpayers without a Social Security number are ineligible to receive stimulus payments unless married to a spouse that has a Social Security number or children with them.

UNEMPLOYMENT 

—$120 billion in unemployment insurance.

—An additional $300 a week in benefits for the jobless, through March 14.

—An extension of the Pandemic Unemployment Assistance program, which expanded coverage to the self-employed, gig workers and others in non-traditional jobs.

—An extension of the Pandemic Emergency Unemployment Compensation program, which provides additional weeks of federal unemployment benefits to those who exhaust their state benefits

BUSINESSES

—Extension of a  tax credit to employers who offer paid sick leave.

—$284 billion in loans through the Paycheck Protection Program.

—$20 billion for grants through the Economic Injury Disaster Loans program.

—$15 billion for struggling live event venues. There is a set-aside of $2 billion for eligible entities that employ not more than 50 full-time employees.

—$15 billion in grants to employees of passenger air carriers, passing to workers through each carrier. Provides $1 billion in grants to employees of contractors.

CHILD CARE 

—$10 billion to help keep child care providers open.

—$10 million for the National Child Traumatic Stress Network.

FOOD ASSISTANCE

—A 15 percent increase in benefits for six months for recipients of the Supplemental Nutrition Assistance Program, or food stamps, at a cost of $13 billion. SNAP eligibility is also expanded for certain college students, including those eligible for federal or state work study.

—$5 million to expand a program in SNAP online purchasing.

—$400 million for the Emergency Food Assistance Program, to be used through Sept. 30, for food banks and pantries.

—Emergency costs covered for child nutrition programs, such as  school meals and child and adult care food programs, during the pandemic.

—$175 million for additional emergency food assistance through the USDA for older Americans, including $7 million for tribal nutrition assistance.

—$614 million to Puerto Rico and American Samoa for nutrition assistance, including $14 million for the Commonwealth of the Northern Mariana Islands.

FARMERS

—$11 billion to USDA to help agricultural producers, growers and processors.

—$100 million to support specialty crop producers and address supply chain issues.

—$100 million to support local farmers, farmers markets and others disrupted by the pandemic, through the Local Agriculture Market Program.

HEALTH 

—An end to surprise billing in emergency and scheduled care.

—$1.25 billion to support research and clinical trials related to the long-term effects of COVID-19.

—$4.25 billion to provide increased mental health and substance abuse services and support.

—A one-time, one-year increase in the Medicare physician fee schedule of 3.75 percent.

VACCINES

—$20 billion to purchase more vaccines and therapeutics.

—$8.75 billion to aid in distributing vaccines.

—$22 billion to states to pay for testing and tracing efforts.

HOUSING 

—$25 billion in rental assistance and an extension on the eviction moratorium until the end of January next year.

FUNERALS

— Up to $2 billion through states for families with funeral expenses due to COVID-19 through Dec. 31. The bill requires the Federal Emergency Management Agency to provide this assistance, and waives an otherwise required 25% state match.

EDUCATION

—$54.3 billion in emergency relief funds for K-12 schools. That will include school facilities repairs and improvements in heating, ventilation, and air conditioning systems projects to improve indoor air quality. Funds will also address learning loss among students.

—$4 billion for a schools relief fund to be administered by governors. Of that, $2.75 billion will go toward grants for non-public schools. States are barred from using the money for school vouchers or tax credit scholarship programs.

—$22.7 billion for emergency relief for colleges and universities, including $908 million for grants at for-profit colleges and $1.7 billion for Historically Black Colleges and Universities, tribal colleges and minority-serving institutions.

—$7 billion for increased access to broadband internet, including $3.2 billion in an emergency fund for low-income families’ access through the FCC and $1 billion for a tribal broadband fund.

—$819 million for outlying areas and Bureau of Indian Education-operated and funded schools and Tribal Colleges and Universities.

TRANSPORTATION

—$2 billion to help with operation costs for airports, including economic relief for concessionaires.

—$10 billion for state departments of transportation that can be used to replace funds lost by other sources of revenue.

—$1 billion for Amtrak, and prevents any further employee furloughs.

—$14 billion in aid for transit systems.

CLIMATE CHANGE

—Phase out of the use of hydrofluorocarbons (HFCs), which is a potent class of greenhouse gases that are used in refrigerators and air conditions, by 85% over the next 15 years.

—$35.2 billion in research and development for a clean energy bill for the next decade on technologies that combat climate change such as energy storage, carbon capture, among others.

—A delay in a scheduled phase out for renewable and investment tax credits.

What’s out of the stimulus bill:

—Student loan relief: The package does not extend the suspension of student loan interest and payments, which is set to expire at the end of January.

—Direct aid to state and local governments: Democrats unsuccessfully sought billions in new funding for cash-strapped state and local governments. But it does allow any states with unused dollars from the CARES Act to spend those dollars in 2021 instead of returning any remaining funds at the end of this month.

—Liability protections: Republicans unsuccessfully sought legal protections for business owners from COVID-related lawsuits when employees become sick.

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Last week, as celebratory photos of healthcare workers receiving the first doses of a coronavirus vaccine flooded social media, frontline staff at Liberty Hospital waited in anticipation — knowing their shipments would be coming this week.

The ultra-cold freezers sat waiting. Staff who had prepared to administer doses were standing by.

Instead, the hospital was told by the Missouri Department of Health and Senior Services Friday that it would not be receiving any vaccine this week as expected. Clay County’s other major medical center, North Kansas City Hospital, hasn’t received any doses yet either.

Hospital staff expressed frustration that frontline workers would now have to wait even longer for a vaccine that they hoped would usher in the beginning of the end to a 10-month pandemic that has been unlike anything they have ever experienced. 

By Monday, after a flurry of emails and calls over the weekend, the department appeared to reverse course. It notified the local state senator’s office that Truman Medical Center in Kansas City would redirect 975 doses to North Kansas City Hospital. Of those, 250 would then be sent to Liberty Hospital.

It’s unclear how many hospitals across the state faced similar delays, and the process has left some calling for greater transparency as to where and how vaccines are being allocated. The confusion underscores the challenges of equitably distributing a limited supply of a highly sought-after vaccine at a scale that hasn’t been seen since polio.

Dr. Keith Neuenswander, an anesthesiologist and director of Liberty Hospital’s anesthesiology department, said Sunday that it’s “completely unforgivable” that the hospital’s emergency room staff haven’t yet been given an opportunity to receive a first dose.

Meanwhile, he said, other hospital systems around the state received enough in their initial shipments that they were able to begin vaccinating healthcare workers who don’t interact with COVID patients.

“We’re in absolute shock,” Neuenswander said Sunday afternoon. 

Over the weekend, the hospital struggled to get answers. Dr. Robin Morris, a family practice physician at the Liberty Clinic and executive team lead for family practice, said that DHSS said it was trying to prioritize larger hospital systems and certain geographic areas.

Morris said the department told Liberty Hospital it didn’t meet certain deadlines, which the hospital disputes, and that the allocation system was “first come, first serve” — a point she said was never relayed throughout the application process.

Emails between Liberty Hospital and DHSS show that subsequent requests before the deadline to order doses went unanswered and that the hospital was later told it would be among the first 50 slated to receive vaccine shipments.

“Excuses do not help,” Neuenswander said. “And that’s all we’re getting.”

In a statement Monday afternoon, Lisa Cox, a spokeswoman for DHSS, said changes in allocation estimates at a federal level “resulted in reduced supplies and not all orders being fulfilled as originally requested.”

Supply is extremely limited, Cox said, and although a hospital may submit an order request, that “doesn’t equate to an order.”

“Only the state can order vaccine,” she said, “and we have more requests than supply available.”

Last week, DHSS Director Randall Williams said Missouri may receive up to 30 percent less of the second dose of Pfizer’s COVID vaccine than it had anticipated. Other states reported similar reductions, and Gen. Gustave Perna, the chief operating officer for Operation Warp Speed, apologized Saturday and cited a miscalculation in how many doses could be shipped.

“However, through collaborative efforts between DHSS, area hospitals and our federal partners, vaccine shipments will be available for both Liberty Hospital and North Kansas City Hospital this week,” Cox said.

Cox said the department would not provide specific details about doses being sent to each site, but that the shipment would come from redistributions from doses other hospitals had received.

“North Kansas City Hospital has learned it will be receiving its first shipment of the vaccine this week and will begin initiating its vaccination program once it arrives,” Libby Hastert, a spokeswoman for the hospital, said Monday afternoon.

Mindy Warner, a spokeswoman for Liberty Hospital, said Monday night that supply scenarios changed throughout the day and that the hospital is still working with DHSS to secure doses.

State Sen. Lauren Arthur, a Democrat from Kansas City whose district encompasses both hospitals, said Monday afternoon that receiving doses will help in starting to protect frontline workers.

“Even just having a couple hundred doses, that makes a difference and has the potential to save lives,” Arthur said. “And I think it represents that as a state, we’re not going to let people feel neglected or ignored.”

‘Left out in the cold’

Located north of the Missouri River, Liberty Hospital and North Kansas City Hospital are both public hospitals and the two largest in Clay County. Their coverage area is broad, accepting patients over 100 miles away up to the Iowa border.

They have about 650 beds between the two of them, and just this weekend were treating over 140 COVID patients, Morris said.

“To lock an entire county out when it serves a huge area and is, by population, the fifth largest in the state, doesn’t seem very logical,” Morris said Sunday afternoon, later adding, “It feels like we’re getting a little bit left out in the cold.”

It’s unclear how many hospitals the delays may have affected.

Steve Edwards, the president and CEO of CoxHealth, tweeted Monday afternoon that the full shipment of 7,000 doses would not be arriving at Cox Medical Center South in Springfield Monday night, and that shifting the vaccines its Branson and Monett locations received would ensure the 300 employees already scheduled to receive vaccinations Monday would still get them.

“We have been told the full allotment will arrive tomorrow,” Cox wrote. “We are from the show me state, so when we have it in hand I will be confident. It is a huge operation to ship this much vaccine, so we (will) try not to be too (impatient).”

Last week, Mosaic Life Care in St. Joseph told News-Press NOW that the expected date for a vaccine shipment changed three times.

Other states, like Texas, have published lists on which providers will be receiving vaccines and how many. DHSS did not respond to a request last week on whether the locations of sites receiving initial vaccine shipments in Missouri would be made public.

“I think all of that information should be public facing. And at the very least, other providers should have a glimpse into who’s receiving what and how those decisions are being made,” Arthur said. “I would hope that there is some sort of standardized rubric that’s informing that decision making.”

Arthur said she understands complications with the vaccine’s rollout were likely as the state embarks on a brand-new vaccination effort on a massive scale. But transparency needs to be paramount, she said, for residents to have a sense of fairness in the distribution.

‘We are living on the edge’

The news of delays left hospital staff disappointed and feeling crushed. Without a vaccine in hand and an expected post-holiday surge of cases, Neuenswander is concerned that already strained staffing levels could be decimated.

“One of my biggest concerns is, it could go through a department like wildfire,” Neuenswander said. “And we could get to a point to where if two or three anesthesiologists get it at the same time, half of our operating room has to shut down.”

They’ve been lucky. So far, only three anesthetists have contracted COVID — and never at the same time. Without a vaccine, it becomes not just a staffing issue, but potentially a safety issue if surgeries are delayed. 

“It’s inexcusable that there’s any hospital that is not able to have access to the vaccines as early as possible,” Neuenswander said, later adding, “I just feel that the state has totally dropped the ball. And they’re putting patients and providers at risk at Liberty and North Kansas City.”

As elective procedures were paused early in the pandemic, Neuenswander’s team shifted to helping intubate COVID patients within the ICU. With a team of seven anesthesiologists and 15 anesthetists, if one is out due to COVID, then 24-hour shifts stretch into 36-hour workdays to ensure there’s enough staff on hand.

Morris has been working with COVID patients directly, swabbing multiple patients a day. Each time she suits up in her personal protective equipment, the same set of questions runs through her mind: Are her goggles tight enough? Are her gloves on right? Is there anything she’s missing?

“And you go and do it. And when you come out, you undo all of that and hope that you did everything right,” Morris said. “It’s a tough way to live on a day-to-day basis. It’s created a lot of tension overall. It has taken a lot of the enjoyment out of medical practice when you’re that worried about it.”

Most staff eat lunch alone in their cars to minimize any potential exposure. When Morris returns home each night, a small part of her always agonizes, could she be sick and not know it yet, potentially bringing the virus home to her family?

“We are living on the edge right now, and it’s frustrating,” Morris said. 

“I know that to them a delay of a day or two doesn’t seem like much,” Morris said of the state, “but to us those hours stretch on.”

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A Cole County judge on Monday threw out a lawsuit alleging limitations on the number of medical marijuana licenses issued by the state were unconstitutional. 

Cole County Circuit Judge Patricia Joyce ruled that the regulations at the heart of the lawsuit were “properly promulgated and are in compliance with Missouri’s laws and Constitution.” She ruled in favor of the state on all counts and ordered plaintiffs to pay court costs. 

The Callicoats, a family from Sarcoxie, Mo., sued the state earlier this year after their license to open a cultivation facility was denied. 

The lawsuit contended that the limit on the number of medical marijuana licenses and a “geographic bonus” that favored applicants in high-unemployment ZIP codes were unconstitutional, citing the state’s right to farm amendment. 

During an October trial, the family’s attorney also argued that outside groups and individuals had undue access to top state officials — and that access led to an opaque process and contributed to the decision to cap the number of licenses granted.

Joyce wrote in her decision Monday that the constitutional amendment that voters approved in 2018 legalizing medical marijuana “expressly contemplates licensing limitations and authorizes the department to implement such limits, if it so chooses.”

The license caps “do not conflict with or violate the Right to Farm amendment,” Joyce wrote. That’s because, she said, “the right to farm does not apply to the cultivation of marijuana.”

The limits were put into place, Joyce said, “after thoughtful deliberation of both their constitutionality and practical effect.”

The state had a compelling interest in limiting licenses, she wrote, and that was preventing illicit activities and excess medical marijuana.

Limiting the number of licenses available, she wrote, “allows for the proper and active regulation of the controlled substance within the medical marijuana marketplace from cultivation to manufacture to dispensing.” 

The geographic bonus has been a point of controversy and focus of many of the hundreds of appeals of denied licenses. But Joyce wrote that the Callicoats lack standing to challenge the rule because they would not have received a license even if they received those bonus points. 

They wouldn’t have even received a license, she wrote, if the bonus points were taken away from all other applicants. 

There were 582 applicants for a cultivation license, 1,218 for a dispensary license and 430 for an infused-product manufacturing license, Monday’s ruling stated. The state issued 60 cultivation licenses, 192 dispensary licenses and 86 manufacturing licenses. 

Joyce also noted that the department met with potential stakeholders before implementing regulations, but “did not turn away anyone who wanted to meet” prior to the rules and regulations being implemented. 

The department solicited hundreds of comments, held multiple public forums and posted draft rules on its website prior to the rule promulgation process beginning, Joyce said. 

A spokeswoman for the Callicoat family could not immediately be reach by The Independent for comment on Monday’s decision.

Whether or not the family decides to appeal Monday’s ruling, more than 700 appeals of rejected licenses are still pending with the Administrative Hearing Commission. And last week, a Pennsylvania businessman sued in federal court seeking to strike down a requirement that medical marijuana licenses go to businesses owned by residents of the state.

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A Democratic state lawmaker from St. Louis facing censure by the Missouri House says he will not resign as legislative leaders begin imposing sanctions recommended by the House Ethics Committee.

State Rep. Wiley Price IV told The Missouri Independent Friday that he did not intend to give up his seat in the House after the committee found he had lied under oath and harassed an employee who reported that he told them he had sex with an intern.

In a text message to The Independent, Price said he would make further statements about the case “soon.”

In a letter dated Thursday, House Minority Leader Crystal Quade, D-Springfield, informed Price that she would not appoint him to any committees when the new legislative session begins next month.

Price was also stripped of his current seat on the House Utilities Committee, but Quade noted that move was symbolic because “the House of Representatives isn’t expected to meet again this year.”

Price is also a member of the Special Committee on Career Readiness, the Special Committee on Criminal Justice and the Special Committee on Government Oversight. 

“Since the House Speaker has direct appointment authority over the other three committees on which you currently serve, your continued membership on those committees will be at his discretion,” Quade wrote.

By removing him from his committee post, Quade told Price she was implementing one of the recommendations of the committee report, which also includes the call for the House vote to censure him and to require him to pay $22,492 to cover the cost of the investigation.

The report also recommends Price be forbidden from employing an intern and any legislative assistant assigned to work for him do so under the supervision of House administration.

Alleged cover-up

In the report issued Wednesday, the 10-member committee endorsed findings that Price had tried to prevent his legislative assistant from reporting him after he told her that he and an intern had sex.

The report concluded that Price committed perjury in his testimony, obstructed the investigation and “compromised the ability of the House to provide a respectful, professional work environment.”

House policies adopted in the fall of 2015 in response to the scandal that forced House Speaker John Diehl to resign state that “no state representative or House Officer may engage in any amorous or romantic relationship” with employees or interns.

The report details the events that led to the investigation and Price’s attempts to cover-up his relationship with the intern. He threatened to fire the legislative assistant if she reported his statement, as required under House rules.

The report also says he committee perjury during the committee’s investigation, attempted to coerce the legislative assistant to change her story and that his attorney breached the confidentiality of the process by recording it.

The response from Quade is the first concrete step to implement the committee’s recommendations. Her initial response on Wednesday did not mention any specific steps she would support.

Now that the House Ethics Committee investigation is complete, the next step will be for the full House to evaluate the evidence and determine the appropriate action, Quade said.

“We expect that process to be conducted in a swift and fair manner when the legislature reconvenes in January,”

That was in contrast to House Republican leaders, who quickly issued a joint statement  on Wednesday endorsing the recommendations.

“We will pursue the recommendation for censure that was unanimously approved by the five Republicans and five Democrats who make up the committee,” the GOP leadership stated.

Calls for resignation

Several lawmakers have gone farther, calling on Price to resign and criticizing Quade for not demanding Price step aside.

“I’m not sure why this isn’t clear to the Democrat leadership in the (House),” State Rep. Travis Fitzwater, R-Holt’s Summit, wrote in a series of tweets on Wednesday. “(Quade’s) statement on it today isn’t enough. It isn’t enough to protect our interns. And, it isn’t enough to change the culture of sexual harassment in the building.”

I think @ImWithWiley should resign from the #moleg.

For reference, here’s the House Ethics Committee findings –> https://t.co/VHsomi62qd

A #thread on some thoughts why and my time in the Missouri House:

— Travis Fitzwater (@travisfitzwater) December 17, 2020

Price was unopposed this year for a second term to represent the 28th House District, which includes the area around Forest Park in St. Louis. He was initially elected in 2018 after winning a primary and an unopposed election in the fall.

Refusing to demand Price’s resignation undermines work done after Diehl’s resignation to change the culture of the House, Fitzwater wrote.

“After the fallout of a former speaker, Republican John Diehl, being caught in an inappropriate relationship with an intern, something had to be done,” wrote Fitzwater, who worked on the new policies barring even consensual, romantic relationships between lawmakers, employees and interns. “And, that was probably just the tip of the iceberg on sexual harassment in the building. Many things had to change.”

Fitzwater contrasted Quade’s lack of specifics in her statement Wednesday with her criticism of Republican leadership and her calls for the House to refuse to seat state Rep.-elect Rick Roeber, R-Lee’s Summit, accused by his adult children of sexually abusing them while they were young.

Republicans have decided that Roeber will not be allowed to caucus with them after he is sworn in Jan. 6. They also promised the House Ethics Committee will investigate the case after he is a member. The committee has no authority over candidates for the House.

“As the leader of the Democrat caucus, and someone who has been more than vocal about a rep-elect who hasn’t even been sworn in yet, she sure has dropped the ball on wanting one of her own caucus members to have to be held to account for their actions,” Fitzwater wrote.

The Independent tried to reach several Democratic House members Thursday for comment on the committee report and how the caucus should handle his case. Most could not be reached.

State Rep. Gretchen Bangert, D-Florissant, said she has no issues with Quade’s statement. 

Bangert noted that the ethics committee found “no proof” Price actually did have sex with the intern.

Price denied it in his testimony, which the committee found was not credible. The intern denied it in an interview with an investigator but declined to testify under oath to the committee.

“I am sure our leadership is discussing it and trying to figure out what steps they are going to take at this point in time,” Bangert said.

The calls for Price to resign intensified on Friday.

Yamelsie Rodríguez, president and CEO of Advocates of Planned Parenthood of the St. Louis Region and Southwest Missouri, released a statement acknowledging that there is “a real racist history of Black men being wrongly accused of sexual misconduct in this country.”

However, she said, “it is also true that in this instance, there is a detailed and credible report documenting repeated abuses of power by Rep. Price.”

“Rep. Price’s actions have contributed to a hostile and unsafe work environment in the Missouri Capitol,” Rodríguez said, “and he should resign immediately.”

Joining Rodríguez in calling for Price to step down was Mallory Schwarz, executive director of NARAL Pro-Choice Missouri.

“The report of abuse of power by Rep. Wiley Price this week leaves only one conclusion to be drawn,” Schwarz said. “He is unfit to serve and must immediately resign.”

Rebecca Rivas of the Independent contributed to this report.

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WASHINGTON — In four years in office, U.S. Education Secretary Betsy DeVos failed to broaden her appeal beyond the moment she won a wild Senate confirmation fight by the closest of margins. She didn’t even try.

Instead, the billionaire Michigan native and Republican megadonor championed private and charter schools, often trying to funnel federal funding toward them. Her full-throated support outraged Democrats in Congress, riled the nation’s powerful teachers unions and never registered as a major priority for the Trump administration.

In higher education, she resuscitated for-profit colleges and wrote sweeping regulations on campus sexual assault to give more weight to the accused, generating an onslaught of criticism.

When COVID-19 upended education as never before, DeVos pushed overwhelmed local leaders to physically reopen their schools and attempted to use emergency funds to aid private education.

Now DeVos will leave office next month facing the prospect that many of her principles will be spurned and rules overturned by her Democratic successor. Perhaps it’s not surprising, then, that even her ideological allies are divided about her legacy.

“She certainly made her mistakes, and she was certainly different than anybody ever anticipated an education secretary to be. But I don’t think it’s as negative as people think,” said Jeanne Allen, the founder and CEO of the Center for Education Reform, and a DeVos supporter.

“You’re going to see in the years ahead that she had an impact on how people think about how kids are learning,” Allen said. “She says constantly that there should be no one-size-fits-all school for kids. Now a lot of people are saying that. I don’t think it’s a coincidence.”

But Mike Petrilli, the president of the Thomas B. Fordham Institute, a conservative education think tank, views DeVos’ four years as a missed opportunity.

“Her tenure was a gift to the teachers unions, even though that’s not what she intended,” he said. “Her signature issue was school choice. The only fair way to assess the impact she had on that was that she hurt the cause. She made it harder for people on the center and the left to support school choice and charter schools.”

Petrilli acknowledged that any Trump nominee would have likely met intense resistance from teachers unions and liberal groups. But DeVos’ background reinforced caricatures that school choice supporters are wealthy and out-of-touch, Petrilli said, even though he said those stereotypes are false.

“She was just not the right messenger,” he said. “I wish she had stepped down earlier, because she hurt her own cause.”

DeVos’ office declined to comment for this article, beyond sharing a list of the secretary’s accomplishments in office.

As for President-elect Joe Biden, he has not yet announced his nominee for the job but has made it clear what he doesn’t want.

“First thing, as president of the United States — not a joke — first thing I will do is make sure that the secretary of education is not Betsy DeVos. It is a teacher. A teacher. Promise,” Biden said on the campaign trail in 2019.

What’s an education secretary’s supposed to do?

Americans have vastly different expectations from the U.S. Department of Education.

The agency plays a limited role in everyday schooling, since most decisions are made by states, school boards and school districts, and funding is mostly collected from state and local taxes.

Congress handed even more power to states when it passed the Every Student Succeeds Act five years ago. The new law relaxed many of the federal accountability measures that Congress put into place during the administration of George W. Bush.

“One of the most misunderstood aspects about the role of an education secretary, is that [people expect that the education secretary is] supposed to be engaged in every single policy effort going on around the country,” said Allen.

That hands-off approach explains why DeVos instituted a hiring freeze and oversaw a 10 percent decrease in the number of departmental employees, in tandem with a Trump administration initiative to trim the size of government.

DeVos also rescinded many Obama-era policies, ranging from accommodation of transgender students to racial disparities in student discipline. Her office counted 29 major “deregulatory actions” that the agency took under her leadership.

Liberals, on the other hand, view the agency as a critical player in enforcing civil rights and delivering more resources for disadvantaged students.

“If you’re someone who prioritizes equity as the goal, if you believe that there is a really important federal role play in ensuring education and civil rights, if you are really concerned about inadequate resources going to kids who have been through for generations have been beat down by racism, and fundamentally, if you support public schools, you have been waiting for January 20th for a long time,” said Phillip Lovell, the vice president of policy development and government relations at the Alliance for Excellent Education, a group that focuses on improving high school education for historically underserved students.

During the DeVos stint in office, Lovell said, the Department of Education gave too much deference to states when it came to crafting strategies to deal with inequities in the classroom. Under ESSA, states have to submit their plans to the federal agency. DeVos’ team did require some states to revise their plans, but Lovell said her agency didn’t scrutinize state plans enough.

In states like Michigan and Connecticut, he said, many of the schools that needed the most help did not qualify for additional federal aid. Because students of color are concentrated in lower-performing schools, they were disproportionately affected by those state formulas.

But Lovell and many other experts expect the department to dramatically shift under Biden’s presidency.

“Just as school choice was the beating heart for the DeVos administration, I think that educational equity will be the beating heart for the Biden administration,” he said.

Pitting public vs private schools

John Schilling, the president of the American Federation for Children, an organization that DeVos chaired before she was tapped as secretary, said DeVos made significant strides in advancing school choice.

Her office distributed more than $130 million for the federal Charter Schools Program, which it directed primarily toward schools in “opportunity zones.”

The opportunity zones are areas designated by governors as economically distressed, in order to attract investors seeking federal tax breaks. DeVos also tried, unsuccessfully, to use money from a March coronavirus relief package to support a broader swath of private schools.

Schilling said it takes time to get Congress on board for broader changes.

“When she was talking about elevating the issue of school choice, and rethinking and reimagining K-12 education, that’s where it’s all going,” he said.

But Nina Rees, the president and CEO of the National Alliance for Public Charter Schools, said in a statement that, even though DeVos supported charter school expansion, “her attention was mostly on efforts to expand access to private school choice.” By contrast, she said, the Obama administration left a “lasting legacy” in support for charter schools.

Charter school enrollment grew by 11 percent since the end of the Obama administration, according to the Center for Education Reform. There are now more than 7,300 charter schools teaching 3.3 million students.

Randi Weingarten, the president of the American Federation of Teachers union, said the Obama administration supported public schools. “The Trump administration does not, and has done nothing to help or support it. It essentially undermined [public education] for four years through budget cuts and destabilization,” she said.

Weingarten, who is rumored to be a candidate to succeed DeVos, faulted the Education secretary for budget proposals that would have cut funding to programs such as free student lunches, the Special Olympics and need-based federal aid.

“It was as if she was put there to be obstructionist,” Weingarten said. “It was as if she was put there to dismantle public schools.”

Lovell, from the Alliance for Excellent Education, agreed.

“It’s really unfortunate to have someone as the head of the U.S. Department of Education who fundamentally doesn’t seem to support public schools,” he said.

What’s next for the most well-known Education secretary in decades is unclear, though her home is in Michigan.

Advocates for school choice who know DeVos predict she will continue to be a force.

“As an education reformer and as her friend, I’m just deeply appreciative that she was willing to do this public service for the last four years. It takes a lot of courage,” Schilling said. “I think having been in the arena for the last four years in the way that she has, I have a feeling that she will come out of this even more determined to fight for the things that she believes.”

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WASHINGTON — A wrongful death lawsuit filed in connection with a Tyson meat packing facility in Iowa alleged that managers secretly took bets on how many employees would get sick from COVID-19.

Tyson fired seven managers at the Waterloo pork processing plant following an independent investigation into the betting allegations and a wave of national publicity.

But labor advocates say that suit and others like it would have little chance of success in court if Republicans in Congress succeed in passing legislation that would shield businesses from pandemic-related lawsuits.

Senate Republicans dropped their insistence that a liability provision be included in a bipartisan COVID-19 relief package that could pass Congress as soon as this weekend.

Union advocates worry that the measure could spring back to life next year, arguing that it would harm workers and undercut the incoming Biden administration’s plans to control the pandemic.

If passed, a liability shield provision championed by a senior member of the Senate GOP would prevent workers and consumers from bringing lawsuits against employers who don’t take proper safety steps to limit exposure to the virus.

The AFL-CIO wrote in a Dec. 12 letter to senators that the provision by Texas Sen. John Cornyn would also prevent states from stepping in with their own enforcement of workplace standards to keep employees safe from coronavirus exposure.

“The draft proposal specifically bars enforcement of state occupational health and safety standards,” wrote William Samuel, the director of government affairs at the AFL-CIO. “So states that have adopted strong OSHA standards to protect working people from the virus in the absence of federal action, such as Virginia and California, would be prevented from enforcing them.”

The liability shield language is a redline issue for Republicans, who for months have argued that companies, hospitals, universities, local governments and other businesses need protection from customers and workers who could potentially flood them with COVID-19 related lawsuits.

Republicans say such shields are routine.

“There is Democrats’ apparently strong opposition to enacting any kind of legal protections to aid the reopening—targeted, temporary liability reforms are a common feature of national emergencies or strange events,” Senate Majority Leader Mitch McConnell, R-Ky., said during a floor speech on Dec. 11.

Democrats and labor groups have pushed back, pointing out that the Cornyn provision creates a high bar for workers to prove an employer willfully endangered or exposed them to the virus. Cornyn introduced his bill in July, the Safe to Work Act, that would shield businesses from COVID 19-related lawsuits, and Republicans wanted to attach the Cornyn bill as a section in the latest relief package.

Democrats say the liability fight is why relief has gotten held up to the end of the year. “At a time of such great crisis, there is one reason why America’s two major parties have not gotten together during the time of acute national emergency, and that is because the Republican leader has demanded a partisan poison pill, a sweeping corporate liability shield be included in any legislation, otherwise he won’t let it pass,” Minority Leader Chuck Schumer, D-N.Y., said on the Senate floor on Dec. 11.

Cornyn’s bill prevents state and federal Occupational Safety and Health Administration agencies from enforcing workplace safety measures for two-and-a-half years, such as social distancing, required mask wearing and proper areas for handwashing.

That would mean that if the Biden administration wants to direct OSHA to implement COVID-19 standards or for the agency to conduct any enforcement, the provision would prevent that from happening for an extended period. And any discrimination cases on questions such as race, sex and disability that have to do with coronavirus would also be on hold for two-and-a-half years.

The liability shield question has dogged emergency relief talks. A draft  of a proposal for emergency relief from a bipartisan group earlier this month would also establish a “nationwide gross negligence standard for COVID-19 exposure, medical malpractice, and workplace testing claims.”

Judy Conti, the government affairs director at the National Employment Law Project, said that a nationwide standard would require workers to have the highest proof of burden for “gross negligence.”

“You would have to essentially prove that employers knew that what they were going to do would cause people to die, but they did it anyway,” Conti said.

The debate over liability comes as workers in places ranging from meatpacking plants in Pennsylvania to Amazon warehouses are filing suits against their employers for not following COVID-19 guidelines or providing proper protective equipment.

In Congress, the liability fight has caused so much controversy that the bipartisan group of senators split their COVID-19 relief package into two parts. One part included aid both parties agreed on, such as extensions of unemployment benefits, food assistance, a paycheck protection program, COVID-19 testing and vaccine distribution.

The other part was $160 billion in aid to state, local and tribal governments— strongly backed by Democrats—and the liability shield for companies that Republicans wanted. It now appears neither will make it into a final relief deal.

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