Another benefit of the installation of a roundabout is improved traffic flow. The continuous circular flow of traffic around a roundabout will handle a larger volume of traffic and reduce delays, an important aspect to consider for this developing part of Kansas City. Since cars are not required to stop at a roundabout if no conflicts present themselves, this intersection will be more efficient for the nearby shopping centers, local businesses, and community members.

As one of your constituents and a frequent driver of this intersection, I understand the safety concerns of this road. The addition of this roundabout will make Kansas City safer and more efficient and will fulfill our city’s mission to improve public safety and to provide infrastructure improvements. As an elected official, it is your obligation to ensure the safety and well-being of all Kansas Citians. Please view the attached proposal for more benefits. Thank you for your consideration and feel free to contact me at mr@gmail.com with any additional questions.

Sincerely,

Matthew Rodrigues

Enclosed: Proposal

To: Dan Fowler, Councilman 2nd District; Heather Hall, Councilwoman 1st District Cc: Bob Heim, Department      Director of Platte County Public Works
From: Matthew Rodrigues
Date: 15 November 2018
Subject: A Proposal for the Addition of a Roundabout to the Intersection of N Ambassador Drive and NW Old Tiffany Springs Road

As a longtime resident of Platte County in Kansas City, Missouri, I often find myself driving through the intersection of N Ambassador Drive and NW Old Tiffany Springs Road. With each visit, I am constantly reminded of the dangers this intersection poses and the high amount of traffic located in this popular part of town. There have been several occasions of slamming on my brakes to avoid a fellow motorist who did not proceed through this intersection correctly and other times trying to avoid the broken glass on the road from a recent accident. In its current condition, this intersection is not contributing to the well-being of residents of Kansas City.

Located at the intersection of N Ambassador Drive and NW Old Tiffany Springs Road, a four-way stop is the current system in place to control the movement of traffic. However, road dividers located in between the lanes of traffic cause the intersection to be larger than usual. As a result, the uncommon layout of this four-way stop confuses drivers as it is hard to determine who arrived at the intersection first in order to follow the right-of-way rules. Not only does this confusion lead to more accidents, but it also causes a slower movement of traffic due to cautious drivers in fear of reckless motorists proceeding through this intersection. I propose that the city of Kansas City improve the functionality of this intersection by replacing the current four-way stop with a multi-lane roundabout. The addition of a roundabout would improve community and motorist safety by reducing the number of accidents, enhance the efficiency of the roadway by improving traffic flow, and also provide benefits to the environment.

Problem Description

The typical four-way stop consists of four stops signs directing traffic for four lanes, two lanes in each direction. However, at the intersection of N Ambassador Dr and NW Old Tiffany Springs Rd, the four-way stop is actually over eight lanes due to dividers positioned in between the different directions of traffic. Due to its large size and unique layout, this confusing intersection poses a safety threat due to the increased number of accidents at this location. According to the Missouri State Highway Patrol Statistical Analysis Center, there have been five reported accidents investigated by the Kansas City Police Department over the past three years at this particular intersection. In addition to the safety concerns of this accident-prone intersection, the increased need for precaution causes cars to drive slowly and for traffic to accumulate. This intersection is located on the corner of the Tiffany Springs MarketCenter, a popular shopping mall and is also just two miles from Zona Rosa Town Center, an upscale shopping center. New stores and developments are constantly being built in this area, such as the almost finished senior care & living facility located on the other corner of this intersection and is reported by the Kansas City Star newspaper to consist of “300 units and include more than 300,000 square feet of space when completed” (Ridder par. 6). New developments around this intersection, such as this large assisted living facility, will increase the concentration of residents in this area and will further hinder traffic flow and the movement of cars. There is also a new concern of having these elderly members of the community living right next to this dangerous intersection. The safety risks and high volume of traffic at this intersection contributes to the lack of an efficient roadway, and the need for an improved and more organized intersection in this popular part of town is apparent. The addition of a roundabout would alleviate these problems currently being faced and improve the Kansas City Northland community constituents you represent.

Solution Description

In order to improve the safety and efficiency of the intersection at N Ambassador Dr and NW Old Tiffany Springs Rd, I propose constructing a multi-lane roundabout to replace the current four- way stop. As defined by Jing Bie, an assistant professor at the University of Twente, along with other professors in the department of civil engineering, a “traffic roundabout is an unsignalized intersection where all vehicles travel in the same direction around a central island” (378). TheU.S. Department of Transportation Federal Highway Administration states that the average construction cost of a roundabout is $250,000 and takes approximately six months to build (“Intersection Safety” pars. 28-29). Although this cost is slightly high, it would be manageable using funds allocated in our city budget. Costs should be covered using the Kansas City’s 2018-19 fiscal year $1.66 billion budget, which was adopted to focus on increases to “public safety expenditures” (“2018-19 Budget” 1). This infrastructure improvement would enhance the safety of the intersection, and therefore it would be appropriate to use the money in this budget that was dedicated to increase public safety. Since this intersection already has multiple functioning roads in place, all that will need to be constructed is the central island to provide circularization of the roadway and the splitter islands to divide the different directions of traffic and to provide curvature of the roadways. For the short time needed to construct the roundabout, detours can easily be placed around this intersection using the nearby NW 88th St and N Mattox to direct traffic.

Justification

An alternative solution for the replacement of the four-way stop would be the installation of traffic signals. According to the Institute of Transportation Engineers, the cost for a traffic signal can range from “$50,000 to more than $200,000 based on the complexity of the intersection” (“Traffic Signals” 2). Although traffic lights might end up being cheaper than the installation of a roundabout, this does not provide the best solution to this problem. The Washington State Department of Transportation has stated that “studies have shown that roundabouts are safer than traditional stop sign or signal-controlled intersections” (“Roundabout Benefits” par. 1). As elected officials, you should want what is best for our community and should choose the solution that will provide the safest results. In addition, “roundabouts eliminate hardware, maintenance and electrical costs associated with traffic signals, which can cost between $5,000 and $10,000 per year” (“Roundabout Benefits” par. 11). The addition of a roundabout would also provide a better return of investment compared to traffic signals. When considering the 20- year service life of roundabouts, for every dollar spent “there was a return of approximately $13 to be realized through crash reduction” (“Intersection Safety” par. 30). Roundabouts would be more effective compared to traffic signals by providing a safer intersection and would actually save the city money by cutting costs associated with accidents and the maintenance of traffic lights.

One major benefit of converting the four-way stop intersection of N Ambassador Dr and NW Old Tiffany Springs Rd to a multi-lane roundabout is the reduction of accidents and the increase to motorist safety. A study conducted by the Insurance Institute for Highway Safety has found that “roundabouts reduced injury crashes by 75 percent at intersections where stop signs or signals were previously used for traffic control” (“Roundabout Benefits” par. 2). This improvement in safety is mainly a result of the reduction of possible points of vehicular conflicts compared to a traditional intersection. A two-lane roundabout has eight vehicle-to-vehicle conflicts while a two-lane road intersection has 32 vehicle-to-vehicle conflicts. Additionally, the “geometric curvature ensures that travel speeds on the circulatory roadway are typically less than 30 miles per hour” (“Intersection Safety” par. 6). This lane curvature forces drivers to slow down before entering a roundabout, resulting in fewer accidents. The curvature also requires drivers to travel in one direction, which limits the severity of crashes and helps to “eliminate the possibility for T- bone and head-on collisions” (“Roundabout Benefits” par. 7). The addition of a roundabout would provide major benefits to the safety of motorists by reducing the severity and number of accidents, decreasing the number of conflict points, and by forcing drivers to drive slower.

Not only does the addition of a roundabout improve motorist safety, but also pedestrian safety. Alfonso Montella, associate professor in the department of civil, architectural and environmental engineering at the University of Naples Federico II, along with other researchers found that “due to the reduction of vehicle speed, roundabouts improve pedestrian crossing opportunities and safety” (1222). One important key feature of roundabouts for pedestrians is the splitter island refuge area, which is in agreeance with the policy considerations from the U.S. Department of Transportation. This provided space allows pedestrians to pause on the splitter island, where they “can consider one direction of conflicting traffic at a time, which simplifies the task of crossing the street” (“Policy Considerations” 32). The ability to take a break in between crossing different directions of traffic would allow pedestrians to take their time and to be safer. The addition of this roundabout would improve public safety and is supported by the mission statement of the city that you as an elected official serve and represent. As stated on the Kansas City, MO government website, “The mission of the City of Kansas City, Missouri is to deliver quality, customer-focused municipal services with an emphasis on public safety,…[and] infrastructure improvements” (“Budget Process” par. 3). These are the goals that you strive to abide by each day to make Kansas City a better place for all. This infrastructure improvement would increase the overall well-being and public safety for motorist and pedestrians and reduce the number of accidents at this intersection.

Another benefit of installing a roundabout is the improvement of traffic flow. With the continuous and circular movement around a roundabout, “it is unnecessary for traffic to come to a complete stop when no conflicts present themselves” (“Policy Considerations” 28). Since traffic is not required to stop, roundabouts can handle more traffic which would greatly improve the movement of cars through this intersection. Additionally, studies from Kansas State University measured the traffic flow at intersections before and after the addition of a roundabout and found that “installing a roundabout led to a 20 percent reduction in delays” (“Roundabout Benefits” par. 10). The ability for less congestion and a quicker movement of traffic in this busy part of town would be widely appreciated by members of the community. In accordance with the mission of Platte County Public Works, “The Platte County Department of Public Works continually strives to provide superior performance of infrastructure services to our citizens in order for them to enjoy an enhanced quality of life” (“Platte County” par. 2). The addition of a roundabout would improve the infrastructure of this part of Kansas City, and enhance the quality of life by increasing the efficiency of this intersection with less delays and a better flow of traffic.

Not only do roundabouts enhance public safety and traffic flow, they provide benefits to the environment. Roundabouts are able to provide a reduction in delays because “even when there are heavy volumes, vehicles continue to advance slowly in moving queues rather than coming to a complete stop” (“Policy Considerations” 29). The continuous movement of traffic allows for a reduction in noise and air pollution. Cars are able to consume less fuel from having to stop and go due to complete stops, which also produces less emissions (“Policy Considerations” 29). Improvements to the environment are also in agreeance with the mission of Kansas City. This city is to deliver services with an emphasis on “public health, and the environment” (“Budget Process” par. 3). A roundabout would fulfill the mission of Kansas City by providing a healthier and cleaner environment for the community through its increase in public health and its reduction of emissions and air pollution.

Conclusion

The intersection of N Ambassador Dr and NW Old Tiffany Springs Rd is a dangerous four-way stop that needs to be improved. This intersection is frequently the cause of car accidents and also generates traffic problems for this developing part of Kansas City. With the conversion of the current four-way stop to a multi-lane roundabout, the concerns over safety and traffic flow will be resolved. As studies have found a large reduction of traffic accidents and delays after the installation of a roundabout, the community will greatly benefit from this infrastructure improvement. Roundabouts have also been found to make our community healthier with additional benefits to the environment. As elected officials and representatives of Kansas City, it is your obligation to ensure the safety and well-being for all residents of Kansas City. It is your responsibility to be aware of community problems and where there is need for improvements. With your involvement in committees dealing with transportation and public safety, you hold the power to make this change for the community. If you truly strive to follow the mission of Kansas City, we can achieve these goals by improving this intersection. With your help, the addition of a roundabout at the intersection of N Ambassador Dr and NW Old Tiffany Springs Rd will ensure that Kansas City residents are safe, efficient, and healthy.

Works Cited

“Budget Process – City Goals.” KCMO GOV, City of Kansas City, kcmo.gov/finance/about- finance/budget-office/city-goals/.

“Intersection Safety.” U.S. Department of Transportation Federal Highway Administration, U.S. Department of Transportation Federal Highway Administration, Feb. 2010, safety.fhwa.dot.gov/intersection/innovative/roundabouts/case_studies/fhwasa09018/.

Jing Bie, et al. “Circulatory Markings at Double-Lane Traffic Roundabout: Comparison of Two Marking Schemes.” Journal of Transportation Engineering, vol. 134, no. 9, Sept. 2008, pp. 378–388. EBSCOhost, doi:10.1061/(ASCE)0733-947X(2008)134:9(378).

Montella, Alfonso, et al. “International Overview of Roundabout Design Practices and Insights for Improvement of the Italian Standard.” Canadian Journal of Civil Engineering, vol. 40, no. 12, Dec. 2013, pp. 1215–1226. EBSCOhost, doi:10.1139/cjce-2013-0123.

Problem Description

Universities across the nation have implemented outstanding programs to help minority and first-generation students. K-State is no exception. Countless clubs and organizations, in addition to numerous academic resources, specifically target these groups in order to make the transition into university life easier. However, new students from small, rural towns have experienced the same difficulties as the groups mentioned above, but do not receive the same help. In a National Public Radio (NPR) article, authors Elissa Nadworny and Jon Marcus describe this issue as a nationwide one. The article summarizes the sources of the struggles these rural, small-town students face. They range from financial troubles, due to the lower incomes associated with small towns, to academic troubles, caused by lack of exposure to college courses in their small high schools. The article also reports that only 59% of rural students go straight to college in comparison to the 67% of suburban students (Nadworny, 2018). At first glance, this issue may seem to be one that does not impact the university as a whole but rather impacts only a slice of the student population. However, this problem has far-reaching implications at the university. The difficulty these students experience adjusting could be linked to lower retention rates from freshman to sophomore year.

A page on the K-State website is dedicated to reporting graduation and retention statistics for the university. A graph of the freshman-to-sophomore retention rate shows the percent of undergraduate students who have returned to K-State following the completion of their freshman year. In the fall of 2019, K-State had an 85.8% freshman-to-sophomore retention rate (Kansas, 2019). This is a high rate but is lower than the retention rates at other universities. The same page compares the retention rates of K-State to other universities. For example, Auburn University and North Carolina State University both had retention rates of 92% and 94%, respectively, in the fall of 2016. In comparison, K-State’s retention rate was only 85% that year (Kansas, 2019). This discrepancy indicates that something must change about K-State’s approach to helping first-year rural students. The discrepancy also demonstrates that a program focused on targeting the struggles first-year rural students face will increase the freshman-to-sophomore retention rate at K-State.

Solution Description

In order to improve the retention rate of small-town students, I propose that the Office of Student Success implement a peer mentorship program for these small-town freshmen. The mentors will be older students from similar small-town backgrounds assigned to a group of freshmen. All small-town freshmen will be assigned to a mentor for the entirety of their first year at K-State. Mentors will organize one mandatory meeting per semester but will be encouraged to engage their advisees in activities outside of these meetings. In addition, mentors should make themselves available to their mentees via email or groupchat to ensure a meaningful connection. Mentors will be a guide to all the resources available to students and a role model that freshmen can look up to. The resources in question are all the programs that the Office of Student Success and other offices around campus already provide such as tutoring, financial aid counseling, and first-generation student support. They will be working on a volunteer basis, but the program could attract mentors by advertising the benefit of having this experience on a resume. Advertisement can include posters, emails, and promotions on social media. Additionally, advising faculty will be asked to inform their advisees about the opportunity to become peer mentors.

The training for mentors could be covered by the funding allotted to the Office of Student Success for Educational Supportive Services (ESS) as the peer mentorship program will act as an extension of ESS. Funding for ESS comes from the United States Department of Education as well as the university itself (Educational, 2019). The major cost for the volunteers and the Office itself will be the time required to make this program a success. Training will take place during break periods. The training will consist of workshops that give mentors the skills and knowledge to create lasting relationships and provide their mentees with the best resources K-State has to offer.

Justification

The issue of high drop-out rates among rural students is a nationwide one. Other solutions have been implemented by other universities to remedy this problem. In the NPR article mentioned previously, the authors mention a solution implemented by the University of Michigan to help rural students. The university began to extend its Kessler Presidential Scholarship Program to rural students instead of keeping the program exclusive to first-generation urban students (Nadworny, 2018). While this solution, if implemented at K-State, is sure to assist small-town students with the costs associated with attending university, it does not address the issue of the academic gap between rural and suburban or urban students due to lack of access to college- level material in high school. My solution will address this problem because the peer mentors will be able to point their mentees in the direction of the phenomenal tutoring services already provided by K-State. My solution is attractive to the Office of Student Success and the university as a whole for several other reasons.

Firstly, the community born out of a peer mentorship group will increase feelings of well-being and belonging among students. Students who feel welcome and happy at their university are more likely to do well and continue their education, which is the goal of the Office of Student Success. An article from Harvard’s Graduate School of Education written by Victoria Jones summarizes the findings of a study by Professor Christina Hinton on the effect of happiness on student performance. Hinton found that happiness among students is strongly correlated with the culture of the school and relationships with teachers and their peers (Jones, 2015). The peer mentorship program, if implemented at K-State, would provide meaningful connections among members of the group as well as a connection with the student mentor. The Office of Student Success strives to increase retention and graduation rates. Both goals would be met following a successful implementation of this program. Small-town freshmen will be motivated by their peers and mentors to not only stay at K-State but to complete their degrees successfully. Although successful implementation will require lots of time and effort from the Office and the peer mentors, the rewards are enormous because increased retention and graduation rates make K-State more appealing to potential students across the globe.

Second, peer mentorship programs are known to increase academic achievement and improve grades. A research study lead by Dr. Birgit Leidenfrost on the impact of peer mentoring on university students was conducted in 2014. Leidenfrost and others concluded that not only did such programs increase social well-being among students, they also found that freshmen that participated achieved a higher GPA and completed more credit hours than non-participants (Leidenfrost, 2014). The findings of this study show that not only are peer-mentored-freshmen happier, they also do better in school. This is incredibly important to the Office of Student Success and K-State in general. Higher academic achievement may not only lead to higher retention rates but may also increase graduation rates. As mentioned before, these are goals of the Office of Student Success that would be reached with the implementation of my solution.

Finally, the peer mentors are older students who will be trained by the Office of Student Success to point their mentees in the direction of programs already available that are designed to address the struggles of new students. In this way, no new major programs have to be created and implemented at the university, which would cost lots of both time and money. As mentioned in the solution description section, peer mentors will work on a volunteer basis so only an investment of time is required in addition to small costs incurred during training which will be adequately covered by funding for ESS. A peer mentorship program is beneficial to the Office of Student Success because it will achieve the Office’s goal of bridging academic and student service operations. Peer mentors will be the bridges between their freshmen mentees and all the services the university has to offer. As an example, a small-town freshman approaches their mentor about how to email a professor. This particular freshman has never had to write an email following formal guidelines. The freshman asks their mentor to proofread the email. Since the mentor is an upperclassman, they understand how professors should be addressed in a formal email. In addition, because of their background, the mentor understands the struggles all of their freshmen mentees face when coming to university, such as writing formal emails to professors.

But why has this affected our town in the first place? The reason is that landlords are able to charge a higher rent price to students because they usually rent per room rather than the entire house. According to Jason Hartman, a real estate consultation company, a home that would rent to a family for $1,000 could be rented to students by the room for almost $2,000. Because of this, landlords have an incentive to charge exorbitantly high prices due to the high demand for student housing. Without many affordable housing options, students are forced to go homeless and sleep in their vehicles or surf their friends’ couches, rent an affordable place in hardly livable conditions, or rent a high-priced property in good condition and risk facing food insecurity or other major financial stress. The culmination of these situations has a negative effect on student performance and university dropout rates. If the city does not put a stop to the exploitative behavior of landlords in Manhattan, these consequences will continue to collect and become a larger problem that is much more laborious to solve than simply implementing further regulations.

Solution

The solution to the exploitation of students by landlords in Manhattan is simple: enact legislation to prevent it from happening in the first place. This legislation would have multiple facets to address the different issues that surround the issue of price gouging and property negligence. A major component of the legislation would be the imposition of rent control in Manhattan. According to an article by Amy Bergen, writer for Money Under 30, rent control is a policy that limits how much landlords can charge in rent and may include limitations on the grounds for eviction and the timing of rent price increases. The goal of rent control is to keep housing at an affordable price and is specifically designed to benefit low- and middle-income renters, like students, which is why it is a great solution to the problem of price gouging.

Another component of the proposed legislation is an ordinance to ensure that properties rented by students are properly inspected for city code enforcement on a regular basis. Currently, city code inspections for low income properties rented by students are few and far between, which has allowed some of these properties to fall into desperate need of proper maintenance. Take Tuttle Terrace for example. Tuttle Terrace is a rental neighborhood with many student inhabitants that is owned and managed by a sole company. As reported by Renters Together MHK, Tuttle Terrace is riddled with broken windows, slumping roofs, and crumbling exterior walls, yet many still choose to live there because the rent is cheap. This level of disarray has only been achieved because the city has neglected to properly enforce housing ordinances on the property management company; however, this is not an issue specific to Manhattan. An article by Karen Black, professor at the University of Pennsylvania, describes how a Pennsylvania town solved this issue with an increase in city code inspections for student housing. The city of Bethlehem, Pennsylvania made a deal with the local college to split the cost of code enforcers specifically dedicated to inspecting and enforcing student rental properties to ensure that students are living in healthy, safe homes. A system like this would greatly benefit the students of Kansas State by ensuring that landlords maintain their properties in good condition and students are not forced to live in houses that are falling apart. For this reason, it is a great solution to prevent landlords from taking advantage of student’s need for affordable housing.

An alternative to this solution is to have the City Commission incentivize the construction of new housing. By the laws of supply and demand, an increased supply of housing will decrease the demand for it and, subsequently, the rent price. However, there are many issues associated with this solution that prevent it from being the best option. An article by Alan Greenblatt, writer for Governing, states that apartment construction – as well as vacancy rates – reached a peak in 2017. The new construction was mainly focused in large cities with high costs of living. Since vacancy rates are increasing, people are simply moving from one house to another and not filling the additional housing. A higher vacancy rate means less tax revenue for the City and possibly lower economic growth for the area because of the decreased amount of rent being paid into property management companies. Furthermore, in cities that have seen a rise in new construction, there may now be a great surplus of housing. Jonathan Spader, a researcher for Harvard University’s Joint Center for Housing Studies, states that so many houses and apartments have become available that now demand is starting to taper off and have no direct effect on pricing (Greenblatt). Because new construction can be easily overdone due to the long timeline it takes to complete, this solution is not the best.

Additionally, the apartments and houses that are being built are not affordable to the average student or low-income family. Most of them are in the luxury tier because they bring in the most money to property managers and cities. The national supply of rental units costing less than $1,250 per month is ever decreasing as the supply for high end apartments has skyrocketed (Greenblatt). This solution would likely only bring about more luxury housing in Manhattan; therefore, it is not a good solution to address the problem of student housing.

Justification

Further legislation and rent controls stand out as the optimal solutions to exploitative landlords and rent gouging because of the benefits they will offer to those affected by the problem. Not only will legislation mandating code inspections of student housing ensure that students are living in adequate conditions, it will require property managers to properly maintain their homes and subsequently keep property values in the area from dipping when older homes are allowed to fall apart. The stability of property values created by these policies should be a great inventive to the city to enact them. Additionally, by placing rent controls on student housing, the City of Manhattan can be certain it will maintain a low vacancy rate by becoming more affordable for students. Every year, enrollment rates continue to decline as the costs of attending a four-year college are ever-increasing. If the city were to place a ceiling on rent prices, more students would likely be able to attend Kansas State due to the decreased cost of attendance, in turn filling more rental properties and generating more revenue for Manhattan. The increase in revenue generated from a lower vacancy rate would likely outweigh the costs of lost revenue from the imposition of a rent ceiling. For this reason, rent controls and further legislation are the optimal solutions for the City of Manhattan.

Furthermore, if rent controls were imposed, the quality of life would increase, and more Kansas State students would be willing to stay in Manhattan after graduation and contribute to the local economy. By limiting the amount of money students have to shell out for rent, they are likely to experience less financial stress and enjoy their time in Manhattan much more. A study of college students done by Jonas Annell and Felix Terman of Kristianstad University found that place satisfaction, or how much a person enjoys being in a certain place, and cost-efficiency were the top determinants of how willing recent college graduates were to stay in their college town. If students were more satisfied with Manhattan and did not have to pay as much to live here, more recent graduates would stay here for good. An influx of ambitious, educated new graduates would lead to the creation of new businesses, attraction of new talent, an increase in tax revenue for the city, and possibly a new generation of potential leaders of Manhattan (Annell). These things would only benefit Manhattan, which is why the City Commission should support legislation and rent controls in support of students.

However, the City Commission should not support rent controls and further legislation for their sole benefit. They should also support this solution because of the effects, both direct and indirect, this solution would have on the community of Manhattan. The direct effect on the citizens on Manhattan, students and not, would be the decrease in financial strain due to rent controls and an increased sense of personal security and autonomy from new policies in support of renters rather than the landlords. These benefits of the proposed solution would have the collective effect of increasing the quality of life and satisfaction in Manhattan, in turn increasing the attractiveness of the city to others looking to move here. The indirect effect of the proposed solution results from the increased revenue generated by the city as property, income, and other taxes associated with rental housing and property management. With more revenue, the city of Manhattan can contribute more money into bettering the community. They could build more parks and green spaces, sponsor more community-wide events, and invest more money into the local school district. The community, not just college students, would greatly benefit from a solution such as the one proposed, which is why the City Commission should support it.

Conclusion

Overall, the City Commission should support rent control and further rental policies in Manhattan because it will greatly benefit the students and the community. Doing so will help maintain property values of houses around campus, keep the vacancy rates low by increasing the demand for housing, make more Kansas State graduates willing to stay, and allow advancements to be made in amenities and schools funded by the city. After all, students are a large and important part of the Manhattan community and deserve to be treated as so.

 Solution Description

In order to improve Kansas State University (KSU) sexual assault prevention and awareness strategies, and thereby decrease sexual assault and sexual violence, I propose a four-tiered solution that focuses on primary prevention, or preventing violence before it occurs, and follows the CDC’s four-level social ecological model (Figure 1) (Dills et al., 2016). The overlapping rings in the model illustrate how factors at one level influence factors at another level. The model demonstrates the connection between individual, relationship, community, and societal factors (Dahlberg et al., 2002). On the individual level, the Office of Student Life and Office of the Chief Financial Officer and Budget Office provide a timeline regarding funding and institutionalizing the position of Sexual and Relationship Violence Prevention Specialist for Fiscal Year 2023. On the relationship level, Kansas State University should mandate that all incoming students complete the Wildcats Make a Pact bystander intervention training at Orientation and Enrollment. Wildcats Make a Pact is a bystander intervention training that provides participants with the skills to help them intervene safely when they see behavior that puts others at risk for violence, victimization, or perpetration (Kansas State University, 2021). On the community level, the Office of Institutional Equity (OIE) and the Center for Advocacy, Response, and Education (CARE) Office collaborate with the KSU Student Governing Association (SGA) to create an informational campaign that promotes and educates students about available resources, including, but not limited to, informational flyers inside all campus bathroom stalls, utilizing social media to exhibit and explain the process of reporting an instance of sexual or relationship violence, encouraging instructors to promote resources at least once per semester, and including a permanent link to resources on the sidebar of the K- State Today publication. On the societal level, an administrative framework for investigating Independent Student Organizations, especially for violations of Title IX, harassment, or discrimination, should be developed. The CDC asserts that:

For a campus to have a comprehensive approach, strategies should be in place to prevent violence as well as respond to violence after it has occurred. Primary prevention of sexual violence should complement secondary prevention strategies that address the immediate needs of a survivor after an assault, and tertiary prevention strategies that address longer-term follow up and support. (Dills et al., 2016)

These four initiatives individually serve a unique role in sexual assault prevention and awareness at K-State. In conjunction, though, they build on and within one another to create an intersectional, comprehensive prevention program that fulfills primary, secondary, and tertiary prevention strategy needs, making certain the audience receives messages multiple times to ensure a sufficient dose of and exposure to the intervention.

Justification

First, the funding and institutionalization of Sexual and Relationship Violence Prevention Specialist Jessica Henault, a critical position for sexual assault prevention and awareness at K- State, would reassure students of K-State’s commitment to sexual assault prevention and awareness, produce concrete improvements to campus climate and safety, and position K-State to employ more individuals dedicated to resolving sexual assault and violence issues. The CDC emphasizes that universities must “identify champions” throughout different sectors and communities on campus who can make and keep prevention visible (Dills et al., 2016). Specialist Jessica Henault is that champion. She has done an extraordinary job in her position thus far through education of K-State members, advocacy for survivors, response to sexual assault when it occurs, and overall prevention efforts. K-State must institutionalize the Sexual and Relationship Violence Prevention Specialist to ensure students observe demonstrable commitment to sexual assault prevention and awareness from K-State. Corey Bowman, Associate Vice Provost for Student Services/Title IX Coordinator at the University of Central Missouri, explains that:

Students who have experienced sexual or gender-based violence are more likely to be retained and graduate if they have ongoing access to a trusted, primary campus contact who can act as both a knowledgeable guide and empowered “barrier buster” on a wide range of academic and non-academic challenges. (Bowman, 2016)

K-State will also put itself on track to fund and institutionalize a number of prevention specialists comparable to that of other colleges such as KU who, as stated earlier, have six specialists. A wider team of specialists means greater reach and effectiveness across campus, something that K-State requires to improve upon its current sexual assault prevention and awareness infrastructure.

Second, expanding the proven Wildcats Make a Pact (WMAP) bystander intervention training model to Orientation and Enrollment will exponentially increase its reach and effectiveness, particularly in getting sexual assault prevention and awareness information in front of first-year students when they first arrive at K-State. WMAP has already reached hundreds, if not thousands of students, particularly individuals from Greek organizations, and will continue to reach hundreds more as the CARE office works diligently to support and educate students.

However, program institutionalization through Orientation and Enrollment would exponentially increase the impact WMAP has on students, staff, and faculty. The CDC expresses that prevention messages across different audiences must be consistent and reinforced over time (Dills et al., 2016). Prevention training should be provided to incoming K-State students during both enrollment and throughout their time here at K-State. WMAP expansion to yearly orientation and enrollment would also ensure leadership buy-in, a key aspect of effective and sustained prevention efforts according to the CDC (Dills et al., 2016). A litany of extraordinary individuals who serve in ideation and creation of orientation would be included in the expansion and support of WMAP. They would not only foster innovative implementation ideas, but also advocate for greater prevention and awareness efforts in other areas of K-State, having realized WMAP’s positive impact up until now and possible positive effect it could have on our campus climate in the future.

Third, a multi-faceted informational campaign created by the Office of Institutional Equity (OIE) in collaboration with the Kansas State University Student Governing Association will provide valuable information and resources and empower students, staff, and faculty to get involved in sexual assault prevention and awareness measures. Stephanie Lott, the recently appointed Director of OIE and Title IX Coordinator, has dramatically improved OIE processes to support incidences of gender discrimination such as sexual harassment and violence. However, they have expressed to me and other students on multiple occasions the need for improved marketing of information and resources. Student Governing Association role as a liaison between students and administration means they are uniquely positioned to develop and promote a multidimensional informational campaign that fills that need. Student leaders have a meaningful role to play in the development, implementation, and evaluation of prevention programming. They can create messages that resonate and can be heard by different campus audiences, serve as an accountability measure to administration, and spread information to student populations that need it most. Student encounters with these resources on a daily basis will obviously provide education, but, more importantly, create a culture of advocacy and safety. K-State students, who merely perceive resources created by their campus for the specific purpose of improved knowledge and responsibility, will feel safer existing in their various spaces, perhaps becoming advocates for sexual assault prevention and awareness and possibly even encouraging other students to attend K-State.

Kansas State University. (2021, February 11). Enrollment summary by academic year. Retrieved December 3, 2021, from https://www.k-state.edu/registrar/archive- donotuse/statistics/enrbyyr.html

Haven, S. (2014, July 16). Will campus sexual-assault probes affect enrollment? McClatchy DC Bureau. https://www.mcclatchydc.com/news/crime/article24770584.html

Kientz, C. (2019, October 24). Wildcats Make a Pact [Review of Wildcats Make a Pact]. K-State. https://www.k-state.edu/care/wmap/

Leonard, N. (2021, April 20). CARE prevention specialist educates K-State community about relationship, sexual violence. The Collegian. https://www.kstatecollegian.com/2021/04/20/care-prevention-specialist-educates-k- state-community-about-relationship-sexual-violence/

RAINN. (2000). Campus sexual violence: Statistics. Rainn.org. https://www.rainn.org/statistics/campus-sexual-violence

Reid, L. (2018, October 19). Sexual assault on college campuses. UAB Institute for Human Rights Blog. Retrieved December 4, 2021, from https://sites.uab.edu/humanrights/author/lereid/

Tredinnick, L. (2020, October 22). Sexual assault prevention with student-athletes: Exploring perceptions of the campus climate and awareness of sexual assault policies and resources. Journal of Interpersonal Violence. https://doi.org/10.1177/0886260520967144

Thank you so much,

Rachel Thurman

Encl. A Proposal for Presentations to Improve Health Literacy in Decatur County

Introduction

A 2019 article in Cardiology Magazine (“Recognizing,” 2019) details the story of a patient, a middle-aged man with heart failure. To manage this condition, he had been prescribed a beta- blocker, metoprolol succinate. Recently, however, his medication had been swapped to carvedilol. After some startling side effects, such as extreme fatigue and a reduced heart rate, the patient ceased taking any of his heart medication. When a pharmacist asked him why, the patient cited the two symptoms. The pharmacist immediately realized the issue upon looking at his medication list: the patient was still taking the metoprolol in addition to his newly swapped carvedilol. When the pharmacist asked why he hadn’t stopped taking the metoprolol, the patient told him, “Nobody told me I was supposed to.” This is a prime example of the consequences of low health literacy.

Problem

Health Literacy is defined by the CDC (2021) as “the degree to which individuals have the ability to find, understand, and use information and services to inform health-related decisions and actions for themselves and others.” According to a Health Literacy map created by UNC Chapel Hill, 38% of Decatur County residents have basic, or below basic, levels of Health Literacy (“National Health,” 2014). This ranking places them in Quartile 1, which accounts for the lowest literacy levels in the state. Not only does this result have negative health impacts for our patients, but it can also have negative impacts on the UPMC Endeavor Decatur County Rural Health Center, economic and otherwise. As a longtime employee of UPMC, I have seen many different examples, from missed appointments, to noncompliance, and even to a situation of a patient putting himself at risk for a blood clot because he was confused about post-operative procedures following a knee replacement. Most of the time, these examples are not signs of irreverence, but simply of ignorance. Low health literacy can be costly; according to many studies, low health literacy is correlated with many negative health outcomes. Some examples are higher mortality, being unable to interpret labels (prescription and nutrition), incorrectly taking medicine, and being less likely to utilize preventative services (Berkman et al., 2011).

There is also an increased risk of unnecessary hospitalization and readmission (Berkman et al., 2011). Patients, right here in our own community, have low health literacy. This means that they are, at times, afraid to ask questions. They could be more likely to be confused by treatment plans and can jeopardize their wellbeing by jumping to conclusions or making assumptions about their own health. The question is—what can we, as a clinic, do to combat this problem? The answer is bi-monthly, patient-centered presentations, with a focus on topics that enhance health-literacy.

Solution

I propose that the Decatur County Rural Health center partner with The Endeavor Foundation, the committee that is responsible for community engagement and community wellbeing. Any funds necessary would be provided by The Endeavor Foundation, as this is their purpose, but most of the program would be conducted through a volunteer basis and would not incur a significant cost. The Decatur County Rural Health center would be responsible for using the multipurpose room to conduct bi-monthly presentations. This room can accommodate approximately 46 individuals. Topics would be presented by various providers, healthcare professionals, and other relevant community members within the UPMC system. Topics and related information could be acquired using many sources: UPMC’s online resource library or the knowledge of the UPMC professionals themselves. All these resources, found within the online library, are free and available to UPMC Healthcare providers. This access would ensure that the information is accurate, evidence based, and unbiased. This would also ensure that the information is coming directly from UPMC and will be representative of their ideals and brand. Subject matter will be relevant to health literacy and will be patient-centered. Patient-centered care is defined as “[p]roviding care that is respectful of, and responsive to, individual patient preferences, needs and values, and ensuring that patient values guide all clinical decisions” (Brewer). These topics could be tailored to fill many of the gaps that are found in low Health Literacy levels. Should UPMC choose to provide refreshments to those that attend the presentations, this would cost The Endeavor Foundation approximately $11.00 per month. The Endeavor Foundation would also be responsible for the management of the roster of providers and other volunteer-presenters, the schedule of topics, and identifying the specific gaps found in Decatur County to aid in determining what the topics will be. This roster will be comprised of familiar faces, those who are present within the clinic and the main UPMC campus in Coudersport, Pennsylvania. This way, patients are familiar with the person who is presenting. Additionally, this program will count toward the mandatory volunteer hours required by each provider, which would be a good incentive for them to participate.

Your colleague, Destiny Amur, PT, DPT, Endeavor Foundation committee member, has already volunteered to take responsibility for these tasks. An example of a typical month would be as follows: Consider October, which is Breast Cancer awareness month. Session 1, the first week, would consist of the local oncologist discussing topics such as cancer itself, progression, and the process of chemotherapy and radiation in language that is simple for the attendees to understand. The second month could be a technician or a representative of Oncology, providing information on where to find treatment centers or support groups, explaining the insurance- aspect of receiving cancer treatment, etc. Again, it would be done in very simple language, at an appropriate pace. These topics could change monthly, or even biweekly, depending on the schedule Destiny creates. These topics could focus on medication management, chronic disease, nutrition, or family medicine.

Justification

Obviously, the main goal for these efforts is to improve health literacy in Decatur County for our patients. It is simple to say that we could, and should, do this for no other reason than the positive health outcomes. A 2011 systematic review published in the Annals of Internal Medicine by Berkman et al. states higher levels of health literacy are directly correlated with decreased mortality, hospitalizations, and readmissions, and increased overall health status. Elderly patients with advanced health literacy are also more likely to interpret their medication labels correctly, meaning they can understand how and when to take (or stop) a medication (Berkman, et al., 2011). However, the implementation of bi-monthly, patient-centered, Health Literacy presentations at the UPMC Endeavor Decatur County Rural Health Clinic would be beneficial for a plethora of other reasons. Firstly, such a program is a direct representation of UPMC’s vision and core values. It would increase the level of community engagement, forging new connections and nurturing existing ones with patients and non-patients alike. Most importantly, this solution will generate positive economic value for the clinic itself.

One segment of UPMC’s model calls for “redefining health care” by “serving the underserved and disadvantaged, and advancing excellence and innovation throughout health care” (UPMC, n.d.). Individuals with low health literacy are among the most disadvantaged there are within the healthcare system. Research has shown that low health literacy is more of a predictor of disparities in healthcare than race or even socioeconomic status. UPMC’s fight to redefine healthcare includes these individuals. By making every effort possible to raise these numbers, UPMC will be adhering to several of its 5 Core Values. This includes, but is not limited to, “Responsibility and integrity” and “Excellence and innovation” (UPMC, n.d.).

Another beneficial aspect of implementing this solution is that it would enhance community engagement and community visibility. Not only would it engage the citizens of Decatur County, but it would market the program. Ever since Clearfield-Jefferson County Primary Care Associates opened their Decatur County location, UPMC has been losing patients at an exponential rate. In a personal conversation with you, Terri, you told me that we have lost a total of 128 patients from our caseload, which is a huge number considering we are one of the smallest counties in Pennsylvania. Community engagement is essential to expose the residents of Decatur County to not only UPMC Providers but also to our services and our values. This solution would give our patients a clear picture of who cares and why. We could distribute literature and business cards at these meetings for patients as well, provided for free from the Marketing department. This marketing opportunity will allow us to potentially improve numbers in areas such as new-patient acquisition (as the providers build rapport and trust with these individuals) and current caseload retention. Sending familiar faces out into the community and talking directly to our patients are going to be the most appealing methods.

Decatur County is full of citizens that want someone local—they’re more likely to trust someone they’ve worked with before and more willing to listen to what they have to say.

This benefit directly brings me to my final point: the economic impacts of health literacy. Ever since the implementation of the Affordable Care Act, Centers for Medicare Services have been penalizing hospitals for “unnecessary readmissions,” especially when a patient is returning to the ER and utilizing services within 30 days after a previous emergency room discharge. As many as 82% of hospitals were penalized by Medicare. In addition to steep penalties, Medicare reimbursement is being reduced by as much as 3%, which can add up very quickly considering how many patients have Medicare (Stinebuck, 2022). In a 2021 blog post, Brian Brewer points out that patients with low health literacy are more likely to have more hospital stays and emergency room visits, and this factor can cost the healthcare system as much as 280 million dollars alone. He also highlights other negative financial benefits that come from low health literacy, such as gaps in care and the lack of service utilization. These gaps mean that patients with low health literacy levels are less likely to seek preventative care and preventative services, such as getting vaccinations or wellness exams, and are also more likely to skip or no show for appointments (Brewer, 2021). This also is very costly to the healthcare system: missed appointments account for more than 150 billion dollars in accrued costs, with each no-show appointment, on average, costing individual clinics over 200 dollars per incident (Brewer, 2021). Conversely, according to the Health Resources & Services Administration, patients possessing higher levels of health literacy are more likely to exhibit adherence to care plans and medications and are much more likely to utilize preventative and specialty services offered by healthcare systems. It also reduces the risk of hospital readmissions (Health Resources & Services Administration, 2017).

There have been other solutions proposed to address these issues. Recently, attempts have been made to address low health literacy rates by focusing entirely on physicians’ direct interactions with patients. According to the Centers for Disease Control and Prevention, this includes encouraging physicians to use basic language, create a welcoming environment, and ask simple questions to verify understanding (CDC, 2021). However, this should be less of a methodology to improve health literacy but more of a baseline expectation for all providers. Furthermore, this alternative solution negates addressing health literacy at the source: the patients themselves. Many of the negative outcomes are going to impact the patient, rather than the physician, so it makes more sense to address the issue with a patient-centered approach. 82% of patients claim that high-quality customer service is the leading influence in choosing care or choosing to continue care with a provider (Brewer, 2021). Any attempt to prioritize the individual patient is going to be crucial in both acquisition and retention.

Conclusion

As I have shown you, low health literacy can have a huge negative impact from many perspectives. The implementation of such a program aligns perfectly with UPMC’s mission statement and core values, which include innovation and representation of undeserved communities. Patients, first and foremost, can have negative health outcomes, such as increased mortality, increased hospitalization, and increased risk of disease development. Secondly, there is also a huge economic burden to the healthcare system. Hospitals can be penalized by Medicare for unnecessary readmissions, which are more prevalent in patients with lower health literacy levels. Clinics can also lose money from no-show appoints, care gaps, and underutilization of healthcare services. However, by implementing bi-monthly, patient- centered presentations given by UPMC providers on varying topics meant to improve health literacy, there will be a mutually beneficial outcome. First, patients will be given the tools and information necessary to improve health literacy rates in Decatur County, thus accounting for positive health outcomes, such as reduced admissions and the increased utilization of preventative services. This benefit has the potential to increase revenue for the clinic and could also decrease the risk of unnecessary readmissions, liberating UPMC from subsequent penalty from Medicare. Finally, this endeavor will also increase community engagement and visibility, allowing patients to connect with the providers personally. I urge you to consider this proposal for the well-being of our patients, our company, and, perhaps more importantly, ourselves.