Columbia Business Times February 2019

A BUSINESS TIMES COMPANY PUBLICATION FEBRUARY 2019 HEALTH

Jonathan Curtright CEO, MU Health Care

SEVEN YEARS IN THE MAKING PAGE 69

A SHARED MISSION PAGE 52

MU Health Care

HITS NEW MILESTONE

2 FEBRUARY 2019

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hether you made a New Year’s resolution to be more active, eat right, or embrace a healthy lifestyle (or whether you chose not to make any kind of resolution), you can't help but be bombarded everywhere you look and shop with the idea that health should be a priority in your life. As I scroll through Instagram, I see ads for an app that will act as my fitness coach. At the grocery store, I’m greeted with bags of lentils and flax seed at the MU Health Care store's entrance. When I glance at lifestyle magazine covers while waiting in the check-out line, I see five new dieting methods that are guaranteed to work. You probably have your own examples of how retail landscapes are urging you to think about your health this time of year. ON THE COVER But the idea of health extends beyond our personal, MU Health Care CEO Jonathan physical health. As business owners and executives, Curtright graces the cover of our you have to think of your business’s health and your annual Health Issue. He has been employees’ health. Then there is also the health of the with MU Health Care for almost three years. Photography by community to keep in mind. Anthony Jinson That’s a lot to juggle! We have done our best to cover many of those aspects of health in our annual Health Issue to keep you informed. From looking at new health-related businesses coming to town to exploring how business owners can offer their employees different health insurance options, the articles in this issue are sure to show you something you didn’t know before. My personal favorite in this issue is the article about the new isotope facility that will be built off of Discovery Parkway by Northwest Medical Isotopes in partnership with MURR in the next three years. David Morrison, one of our freelance writers, can take any subject and make an interesting article out of the information he gathers. He did it with the motor fuel tax article in our Government Issue and has done it again with this piece. It’s anything but dull, and now I know that you can ‘milk’ an isotope! (page 69). Another exciting development for the health community is MU Health Care bringing in $1 billion in net revenue and $100 million in operating revenue last year. We ask MU Health Care’s CEO, Jonathan Curtright, and CFO, Mike Blair, what contributed to that growth and what plans they have for the money (page 60). In terms of community health, we followed up with Heart of Missouri United Way to find out what organizations involved in their health impact are doing with the funding they’ve received and how United Way is sharing resources with the Columbia/Boone County Department of Public Health and Human Services to impact their health initiatives, on page 52. A BUSINESS TIMES COMPANY PUBLICATION

FEBRUARY 2019 HEALTH

Jonathan Curtright

CEO, MU Health Care

SEVEN YEARS IN THE MAKING PAGE 69

A SHARED MISSION PAGE 52

HITS NEW MILESTONE

Crème Brûlée Cheesecake CC’S CITY BROILER

Going to CC’s for a meal is already a treat in itself, but when you finish that meal off with this cheesecake, well, life can’t really be any better. It truly is crème brûlée in cheesecake form.

Crème Brûlée Bread Pudding FLAT BRANCH PUB & BREWING

The description from their menu says it all: “Sourdough bread baked in a sweet cream and cinnamon sauce. Served warm and finished with a bourbon caramel sauce.” I’m drooling.

SOPHIA'S

Many places in town will offer crème brûlée on their dessert menu, but not everyone gets it right. It has to be served at room temperature with just the right amount of caramelization so it doesn’t taste burnt. Sophia’s gets this classic right!

Emma Bentley, Editor Emma@businesstimescompany.com

ColumbiaBusinessTimes.com

Some have called me a pyromaniac because I like fire, so is it any wonder why I like desserts where sugar has been set on fire on top of them? Here are my favorites from across town!

Crème Brûlée

Cheers to your health and a new year!

CONNECT WITH US:

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Inside the Issue Behind the Scenes 20 UNDER 40 For the first time in 20 Under 40’s history, we opened the celebration party up to the public, and it was indeed a party! From watching aerial artists fly above our heads to listening to a live performance from the Greg Aker Trio thanks to the "We Always Swing" Jazz Series to sipping on libations provided by Les Bourgeois Vineyards and Logboat, it was an amazing night and opportunity to acknowledge the outstanding professionals we have in our community.

MARKETING REPRESENTATIVES Deb Valvo, Marketing Consultant Deb@BusinessTimesCompany.com Bonnie Hudson, Marketing Consultant Bonnie@BusinessTimesCompany.com Susie Sapp, Marketing Consultant Susie@BusinessTimesCompany.com MANAGEMENT Erica Pefferman, President Erica@BusinessTimesCompany.com Renea Sapp, Vice President ReneaS@BusinessTimesCompany.com Amy Ferrari, Operations Manager Amy@BusinessTimesCompany.com Beth Bramstedt, Editorial Director Beth@BusinessTimesCompany.com CONTRIBUTING PHOTOGRAPHERS Anthony Jinson, Justin Kelley, Tiffany Schmidt, Sadie Thibodeaux CONTRIBUTING WRITERS Kacen J. Bayless, Amy Begemann, Nickie Davis, Al Germond, Roger Higginbotham, Jodie Jackson Jr., Eli Marchbanks, Brenna McDermott, Kermit Miller, David Morrison, Asgar Zaheer SUBSCRIPTIONS Subscription rate is $19.95 for 12 issues for 1 year or $34.95 for 24 issues for 2 years. Subscribe at columbiabusinesstimes.com or by phone. The Columbia Business Times is published every month by The Business Times Co., Copyright The Business Times Co., 2008. All rights reserved. Reproduction or use of any editorial or graphic content without the express written permission of the publisher is prohibited. OUR MISSION STATEMENT The Columbia Business Times and columbiabusinesstimes.com strive to be Columbia’s leading source for timely and comprehensive news coverage of the local business community. This publication is dedicated to being the most relevant and useful vehicle for the exchange of information and ideas among Columbia’s business professionals. CONTACT The Business Times Co., 2001 Corporate Place, Suite 100 Columbia, MO, 65202 (573-499-1830) • columbiabusinesstimes.com

WOMEN OF EXCELLENCE Thank you to those who nominated the women of excellence in their life! We had close to 100 nominations, and it’s only our first year giving out these awards. Join us at the cocktail reception on February 26 to honor these women. Follow our social media channels for the reveals of the finalists and details on the reception location and time. Thank you to our sponsors Achieve Balance Chiropractic, Downtown Appliance Home Center, and Providence Bank.

Correction We incorrectly printed in our January 20 Under 40 Issue that Dr. Arminta Phelps is 38 years old. She is 36.

Contributors

Kermit Miller, KRCG 13

Brenna McDermott

Jodie Jackson Jr.

David Morrison

Kacen J. Bayless

@_BrennaMcD

@JJacksonJr

@DavidCMorrison

@KAC3N

Write to CBT editor Emma Bentley at Emma@BusinessTimesCompany.com COLUMBIABUSINESSTIMES.COM 17

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FEBR UARY 2019 VOL . 2 5 / ISSUE 8

TA B LE OF CON T EN TS

The Health Issue 15 FROM THE EDITOR 17 INSIDE THE ISSUE 21 CLOSER LOOK 22 BRIEFLY IN THE NEWS 25 BUSINESS UPDATE

Therapy Unlimited

28 NONPROFIT SPOTLIGHT

Ronald McDonald House Charities

30 CELEBRATIONS Stephens College

33 MOVERS & SHAKERS 35 P.Y.S.K.

Mike Ireland, The Bank of Missouri

39 11 QUESTIONS

Jason Gruender, Liberty Insurance Solutions

41 A CAPITOL CONVERSATION The Changing of the Guard

43 LOCAL PERSPECTIVE Nickie Davis, The District

45 LOCAL PERSPECTIVE

Asgar Zaheer, Truman VA Hospital

47 LOCAL PERSPECTIVE

Roger Higginbotham, MU Health Care

49 LOCAL PERSPECTIVE

Amy Begemann, Boone Hospital Center

51 OPINION: AL GERMOND City Changes

Teresa Goslin and Greg DeLine of Phoenix Health Programs

A Shared Mission Looking at which organizations the Heart of Missouri United Way partners with to further community health initiatives through the sharing of resources and funding.

85 NEW BUSINESS LICENSES 86 DEEDS OF TRUST 87 ECONOMIC INDEX 89 BY THE NUMBERS 90 THIS OR THAT John Glascock, City of Columbia

The Billion Dollar Mark

MURR-ging of Ideas

Out with the Old

In Focus: A Mental Health Tax

Earning $1 billion in revenue last year, MU Health Care already has a plan for how the money will be spent.

A partnership seven years in the making will bring production of an important isotope to Columbia.

High-premium health insurance plans are out! What should you be offering your employees instead?

Asking how much money the youth mental health tax has collected and where the money has gone.

20 FEBRUARY 2019

BUSINE SS • P EOP L E • VOIC ES • F YI

C LOSER LOOK

Closer Look

Good Food Co.

Nourish Café and Market

Pressed.

When opening her bakery and dessert bar in January 2018, owner Jill Rostine knew she wanted to make the best possible treats and create a sense of community among the shop’s patrons. Her baked goods stand out because she uses the highest quality ingredients from local vendors and everything is made from scratch. Rostine uses cheese from local farmers for her cheesecake, fresh vegetables from local farmers for soups and salads during the summer, and coffee from her shop’s neighbor, Fretboard, for her coffee cake. The sense of community is fostered through her downtown location. “I knew that it would be important for me to be out and in a community setting,” Rostine says. “I mean, that’s the whole vibe of a bakery, people coming and going as part of their day. If it’s not in the central part of the community, then that doesn’t work.” Having just celebrated their first anniversary, it would seem that Rostine has found the right recipe for a growing business.

The name says it all. When patrons visit Nourish Café and Market, they will find food that nourishes their body. “Nourish is a fast-casual, organic, locally-sourced, nutrient-rich food option,” says co-owner Kalle LeMone. Much of the inspiration behind the menu items at Nourish comes from co-owner Kimber Dean’s cookbook, which features food free of common allergens like gluten, soy, and dairy. The recipes also eliminate hydrogenated oils and processed sugar. “Plain and simple, we use the highest quality ingredients. We make everything from scratch, so you know that every time you come into Nourish, your body is being nourished,” says LeMone. Opened in the summer of 2016, Nourish will celebrate its third anniversary this year. LeMone says she and Dean are focused this year on paying attention to their customers’ preferences and executing new ideas for the menu.

Columbia’s newest rooftop bar, Pressed., is all about giving their customers a unique, sophisticated experience. “Pressed. strives to bring a sleek design and vibe that isn't found in Columbia,” explains Nathan Todd, a partner in the bar. “Many guests feel like they are transported to another place when they step off the elevators and get their first glance at our rooftop view. They fall deeper in love after experiencing one of our handcrafted cocktails.” The bar’s name was inspired by the fact that many of their cocktails include pressed juice and, of course, that wine is made from pressed grapes. Pressed. is also bringing a tasting experience to customers this year. “We are creating a tasting series that will offer guests the chance to experience some of the finest wines and spirits from not only Missouri, but from around the world,” says Todd. “We’re planning to kick off the series with a ‘Whiskeys of the World’ event.”

Location: 1023 E. Walnut St., Ste. 7 Website: goodfoodcomo.com Contact: 573-355-0188

Location: 1201 E. Broadway Website: nourishcafemarket.com Contact: 573-818-2240

Location: 803 Walnut St. Website: facebook.com/pressedcomo Contact: 573-424-6660

Are you starting a new business? Reach out to our team at Editor@BusinessTimesCompany.com COLUMBIABUSINESSTIMES.COM 21

BUSINE SS • P EOP L E • VOIC ES • F YI

Briefly in the News FEBRUARY 2019

BUSINESS

MISSOURI AIRBNB HOSTS EARNED $48 MILLION IN 2018 Airbnb announced that its Missouri host community earned a combined $48 million in supplemental income while welcoming approximately 483,000 guest arrivals to the state in 2018. There are now more than 4,500 Missouri hosts who share their homes via Airbnb, earning about $5,500 annually in supplemental income on average. Boone County’s total host income was $1.5 million with 16,300 guests.

C OMMUNIT Y

COLUMBIA AWARDED DISC GOLF CHAMPIONSHIP HOST FOR 2020 The Professional Disc Golf Association has named Columbia as the host of the PDGA Tim Selinske United States Masters Championship in May 2020. Columbia beat out eight other communities to secure the tournament, which will be hosted on the prestigious Harmony Bends Championship Disc Golf Course at Strawn Park.

“Bringing in large-scale events like this demonstrates why tourism is vital to Columbia’s economy.” — Amy Schneider, director, Columbia Convention and Visitors Bureau

22 FEBRUARY 2019

BR I EFLY I N T H E N EWS

H E A LT H

BOONE HOSPITAL CENTER FIRST IN MIDMISSOURI TO OFFER MITRACLIP PROCEDURE Boone Hospital Center became the first hospital in Mid-Missouri to offer the MitraClip for mitral valve repair. Mitral regurgitation is a condition where the heart’s mitral valve leaflets don’t close tightly, causing blood to flow backward from the heart’s left ventricle into the left atrium. Clinical data has proven that patients who undergo the MitraClip procedure have reductions in mitral regurgitation as well as reductions in hospitalizations for heart failure.

H EALT H

$1.3 MILLION PLEDGE TO WOMEN’S AND CHILDREN’S HOSPITAL

BUSINESS

C OMMUNIT Y

OPENWORKS EXPANDS TO COLUMBIA

NEW MISSOURI UNITED METHODIST CHURCH SERVICE

Due to the influx of new national companies in the area, OpenWorks has selected Columbia for its heartland expansion. OpenWorks offers a full-service commercial cleaning franchise that includes cleaning, janitorial, and maintenance services as well as integrated facility services through reputable local partners and franchisees.

Missouri United Methodist Church is offering a new celebrative service called The City to cater to the call of university students, young professionals, and those with young families. The service features conversational teaching and music led by a full praise team comprised of vocalists, varied musicians, and multimedia presentations. The service is on Sundays at 10:45 a.m.

MizzouThon has announced a $1.3 million pledge to help with the future expansion and renovation of the neonatal intensive care unit at the Women’s and Children’s Hospital, including purchasing new specialized beds that help reduce stress on newborns and families. The funds also will support the hospital’s music therapy program. MizzouThon student leaders anticipate fulfilling this new pledge within five years.

“Through music therapy, children can connect with others, find an outlet for emotional expression, and also have some fun and focus on being a kid.” — Keri Simon, executive director, Women’s and Children’s Hospital

COLUMBIABUSINESSTIMES.COM 23

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Teleconferencing Technology working for business The Chamber of Commerce and the Columbia Convention and Visitors Bureau wanted a teleconferencing system to replace outdated electronics. They required unobtrusive, costeffective, reliable equipment that interfaced with existing software. Our solution included 360° omnidirectional microphones mounted into the conference table and a camera with pre-set viewing angles to pan, tilt, and focus. Our 40 years of experience can help you optimize your business productivity.

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BUSINE SS • P EOP L E • VOIC ES • F YI

BU SI N ESS U PDAT E

Families First And Foremost Therapy Unlimited serves children in the community by teaching them important skills and working with their families.

BY EMMA BENTL EY | P HOTOG R A P HY BY SAD I E TH I B O D E AUX

Laura Powell, owner of Therapy Unlimited COLUMBIABUSINESSTIMES.COM 25

B USINE SS • P EOP L E • VOIC ES • F YI

IT ALL STARTED WITH a desire to serve families in the Mid-Missouri area. Having worked for a few companies and organizations in Columbia as a speech pathologist, Laura Powell knew she wanted to see something different happen in Columbia. She wanted to see a therapeutic service business focused on the family, not just on the individual in need of therapy services. So she started Therapy Unlimited in the fall of 2014. “I started Therapy Unlimited just to give families more options for care in the middle of the state,” Powell explains. “My goal was to be very family-centered, to look at the family as a whole instead of just the individual.” When Powell and the other therapists see patients, they involve the patient’s family by letting them know what went on in the therapy room, what exercises were taught, and what skill the patient is trying to achieve. This enables the family to feel more confident in and knowledgeable about how to help the patient develop their skills and practice their exercises the correct way at home. “Our goal is to guide the family and try to facilitate carrying over those skills at home so that therapy isn’t just an isolated event because,

Therapy Unlimited's lobby.

26 FEBRUARY 2019

really, the family is the one that lives with them and helps them be who they are and strive to be every day,” says Powell. Almost five years after opening, and after identifying more community needs, their services have moved beyond the traditional speech and language therapies. LISTENING TO THE COMMUNITY Powell explains that the services she offers are created based on the needs of families. The services aren’t created on a whim or because of a trend in the industry; they’re practical and solutions-oriented. Sometimes these needs are witnessed by Powell firsthand, but often, families will come to her with ideas of what they would like to see or have access to. If there are services people wish were available, she does her best to make that wish a reality through new services and joint partnerships at Therapy Unlimited. “I try to meet the needs of the community by listening,” she says. “The services are really a response from things that I hear that families wish were available in Columbia. For example, I had some families that were wanting to have some diagnostic testing for an IQ test or for achievement testing.” Therapy Unlimited

didn’t offer that service, so Powell created a work around. “I recruited some people to administer IQ testing for me, and then Therapy Unlimited did language testing and achievement testing so that we were able to create a kind of diagnostic team for families that were seeking that outside of the school district,” she says. That service is now a permanent part of what Therapy Unlimited offers, thanks to an ask from the community last year. OTHER SERVICES Their diagnostic testing service is housed underneath the umbrella of academic services, one of eight umbrella focus areas. “We provide evaluations for speech concerns or any concerns that might have to do with daily life skills that may require occupational therapy,” says Powell. For example, the occupational therapists work with patients to help them with daily functions like putting on a coat and zipping it up and handwriting. In regards to speech concerns, Therapy Unlimited specializes in early childhood language services. Parents utilize this service when they want to know how to communicate with

BU SI N ESS U PDAT E

“The services are really a response from things that I hear that families wish were available in Columbia.” Finley with his self-esteem, speech, and eating habits. In nine months, he has caught up to where a 3-year-old should be with his speech. Corey has taken a personal interest in Finley and worked so hard to help Finley be where he needs to be and helped us as parents to better understand what we can do to help him in all aspects of his personal growth.”

their small children who aren’t meeting communication milestones, explains Powell. The therapist helps train parents on how to facilitate better communication with their child. They also work with patients on alternative and augmentative communication. This service helps children who don’t have a wide vocabulary or who aren’t verbal by giving them a device to help communicate their wants and needs. When families aren’t sure what services their loved ones might need, Therapy Unlimited will evaluate the patient to find any areas that may

be weak or that could be enhanced with therapy. The goal is to help the patient improve so that they can have better function. For one family, the difference they have seen in their son over a nine-month period is drastic. “We enrolled our son, Finley, in preschool because of severe separation anxiety, and the school quickly noticed that he was behind in his speech and eating habits. His teacher recommended Therapy Unlimited,” say Mark and Tiffany McLemore. “Corey, Finley’s therapist, has been a godsend and has tremendously helped

A LOOK AHEAD When asked what her business goals are for this year, Powell says that she hopes to continue meeting the needs of the community. “There are other things on the horizon, but they’re all in response to people asking for them,” she says. Powell says her business was created to serve the community. That’s why she was purposeful in choosing the name for her company. “Unlimited” is part of the name because she is not an inside-of-the-box thinker. If she has an open mind to other ideas, then she can adapt to what the families need. And she credits her employees for being able to serve and support families well. “We have a really awesome team of people,” she says. “Our team is strong, and we work cohesively. That’s important because as families walk through our office, they’re going to find that our environment here is not just family-centered in serving the families. My team, we all view ourselves as family together.” CBT

Therapy Unlimited 4200 Merchant St. 573-777-8783 therapyu.org COLUMBIABUSINESSTIMES.COM 27

BUSINE SS • P EOP L E • VOIC ES • F YI

A Home Away From Home Ronald McDonald House Charities of Mid-Missouri provides comfort and compassion for 35 years.

BY MA RY KATE H A F N ER | P HOTOG R A P HY P R OV I D E D BY R O N A L D MC DO N A L D H O U S E C H A R I TI E S

A RONALD MCDONALD HOUSE IS like any other house. It’s a place to rest and recharge, a place that holds memories whether good or bad, and a place to come together. What’s different about a Ronald McDonald home, though, is the families inside. A staple in communities across the United States, Ronald McDonald House Charities enable families to stay together during their child’s medical crisis and hospital stay by providing them a home away from home. 28 FEBRUARY 2019

Ronald McDonald houses relieve the stress on families of figuring out where their next meal is coming from, where they will spend the night, how will they do laundry, and their heaviest burden, how they’re going to afford everything. Ronald McDonald House Charities answers their call, free of charge. This support lets families concentrate on the care of their child. The Mid-Missouri chapter of RMHC started in 1983 and celebrated their 35-year anniversary last year. Last year also marked the fifth anniversary of the Mid-Missouri

RMHC’s new home, located by Women’s and Children’s Hospital. “The cool thing about this location is that we’re within walking distance of many specialty clinics and the hospital, but you can look east of us and it’s a neighborhood and a city park,” says Terri Gray, the chapter’s executive director.

BUILD IT AND THEY WILL COME Before Gray was the executive director, she spearheaded the fundraising for the new home. The new building doubled the size of

N ON PR OFI T

Ronald McDonald House Charities of Mid-Missouri Mission Statement To provide a home away from home that serves and sustains families of children being treated at area hospitals and health-related facilities.

Mid-Missouri Chapter founded 1983

In 2018, nearly 400 families stayed 5,480 nights at the Ronald McDonald House in Columbia.

2019 Board of Directors • Sally Silvers, president • John States, vice president • Tom Schwarz, treasurer • Harriet Most Yelon, secretary • Nick Allen • Kathleen Bruegenhemke • Kevin Czaicki • Josh Devine • Mark Fenner • Timothy Fete • Kelley Frink • Daniel Hoernschemeyer

the original house and fits 18 families. The home boasts wider hallways, private baths in guest rooms, and added recreational rooms like a library. In addition to the physical change of space, Gray also ushered in a new attitude, a caring and compassionate ethos from all those who interact with the families. “The most challenging issue on a day-today basis is that we’re dealing with families in extremely stressful situations,” says Gray. “There’s still a life back home that they’re trying to manage and they have a sick child or a child in need of treatment to deal with as well.” Anyone with a child in the hospital or in need of treatment is eligible to stay at the house, no matter their financial situation. The only requirement is a referral from a social worker. “They’re not in a hotel, where people are typically celebrating or vacationing. This is a house designed for families in medical crisis. I think there’s a lot of benefit in them coming together and sharing their stories and experiences,” says Gray. As part of the 35-year celebration, McDonald’s restaurants across Missouri hosted reunions for former RMHC families to reconnect. “There is a community feeling between families. Friendships have been formed here. We’ve had several people tell us they stay in touch with families who were staying here at the same time as them,” says Gray. “That’s a nice bonus of the house — to develop lifelong friendships.” In 2018, the average house stay was 12 nights; however, families have stayed for as long as four months at a time. It all depends on what the child needs. “Families more often than not check in without planning to be checking in that night,” says Gray. At 75 percent, the biggest group of guests come from the neonatal intensive care unit. Overall, 85 percent of the families at RMHC come from the Women’s and Children’s Hospital.

• Lindsey Jones

EXPANSION IN MIND

• Mark Mehle

“The house was designed to be able to add a wing, which would double the house in size,” says Gray. “The board is monitoring our numbers to see when we should add another wing, but as you know, it’s a huge undertaking.” While the house expansion would double

• Kyle Reynolds • Jacob T. Rowe • Jolene Schulz • Keri Simon

the number of guest rooms and offer more amenities, expansion would also increase staffing needs and overall costs. “Think about what you spend on a monthly basis and then multiply that by 18 families. It adds up,” says Gray. “I never want to put the organization in a position where we outdid ourselves and are in a situation we can’t afford.” The need for expansion is quickly growing. In 2018, nearly 400 families stayed 5,480 nights at the house. The house was full 91 percent of the year, often with a waitlist. RMHC and its local chapters are set up somewhat like federal and state governments: There is an overarching global entity that provides marketing or other support, but the day-to-day operations, including the $800,000 yearly cost of running the house, falls onto the chapter. “We’re not state supported. We’re not federally supported. We are not a United Way agency. We raise what we need,” says Gray. “Our primary funding comes from people living in Boone County, especially the Columbia area. The businesses are very supportive of us in terms of sponsorships and services they provide.” One possible expansion idea the board is exploring is installing a family room within the Women’s and Children’s Hospital. The family room would provide things such as hot meals and a break from harsh hospital surroundings. Gray says the board is interested, but the option is ultimately limited to the space available within the hospital. The discussion is always centered around “what’s the best way to serve more families?” Gray says. “I’ve been pleasantly amazed and humbled that the community supports us the way that they do and supports the families that stay here,” says Gray, “We cannot do it alone. We could not do it alone. The littlest gesture to the grandest gesture all adds up and it helps us do what we do and accomplish our mission — to serve families.” CBT

Ronald McDonald House Charities of Mid-Missouri 3501 Lansing Ave. 573-443-7666 rmhcmidmo.org COLUMBIABUSINESSTIMES.COM 29

A view of Sampson Hall.

1833

1975

2015

Stephens College is founded as a womenâ&#x20AC;&#x2122;s college.

Stephens offers its first physician assistant program.

Samson Hall is renovated into a stateof-the-art center for health sciences.

30 FEBRUARY 2019

BUSINE SS • P EO P L E • VOIC ES • F YI

C ELEBRAT I ON S

The First PA Graduating Class Stephens College embraces the future of health care with a new program.

BY ELI MARCHBA N KS | P HOTOG R A P HY P R OV I DE D BY STE P H E N S CO L L E G E

ACCORDING TO A RESEARCH ARTICLE in The Atlantic, we saw “health care surpass manufacturing and retail, the most significant job engines of the 20th century, to become the largest source of jobs in the U.S.” in 2017. Data from the Bureau of Labor Statistics reveals that this growth will continue as the health care industry expands to account for one third of the nation’s job growth from now until 2026. Rebecca Kline, director of marketing at Stephens College, explains how statistics such as these inspired the college to develop a School of Health Sciences to help students take advantage of this trend. “We were looking at health care and ways we can prepare students because health care is going to grow,” says Kline. Despite the projected growth for health care, the Bureau of Labor Statistics also anticipates a nursing shortage of 1.2 million by 2022; hospitals and health care systems as a whole will continue to struggle with shortages in primary care physicians, nurses, and home health aides. Hopefully, programs like Stephens’ can help fill the gap.

THE HEALTH CARE OF TOMORROW Health care is changing and evolving. The skyrocketing growth of the health care industry also comes with soaring costs that are forcing “everyone to look at all the alternatives for health care providers,” says Kline. This is opening doors for students by offering them more degree options. One alternative degree program that the Stephens School of Health Sciences offers is

the Master of Physician Assistant Studies, a graduate program, started only two years ago, for students who want to become licensed health care providers. “They [physician assistants] can diagnose illnesses and help develop treatment plans,” says Kline. “They are often the principal health care providers for many patients, especially in rural areas.” “They can write prescriptions, with some restrictions on a few medications,” adds Eric Johnson, a licensed PA and director of the program. The first class from the PA program, consisting of 20 students, graduated in December. “We know that 18 of those students have already passed their national board exams, and we just haven’t yet gotten the test results back for the other two,” says Johnson. Fourteen students secured employment prior to graduation in areas ranging from emergency medicine, orthopedics, and pulmonary-critical care to psychiatry, dermatology, and sleep medicine. Of the remaining six students, three elected to complete a fellowship at MU to further their education. When it comes to graduates from similar programs outside of Stephens, Johnson explains that the national average for job placement is about 33 percent. With a job placement rate of twice that, the Stephens’ PA program is certainly something to boast about. “The clinical rotations [part of the PA program] really help with job placement because students often find places where they want to stay,” Kline says. Stephens will also help students secure jobs in the field of medicine. “The tuition costs are

much lower than the tuition cost of medical school, and yet the payoff is still quite high,” Kline says.

MORE THAN ONE OPTION Another degree option within the School of Health Sciences is health information administration. “It’s one of the programs that most people probably don’t think about,” Kline says. It takes a large staff to maintain the computer systems at hospitals, and members of that staff need to be well versed in both the technical skills and the medical terminology required for such positions. “This option is popular with ‘career changers’ or with nurses who want to make a change and get off their feet,” says Kline. This degree can also be completed entirely online. “More and more students are becoming interested in the broader health sciences,” says Kline. “Exercise science is popular, as are our pre-physical therapy classes, pre-OTA [occupational therapy assistant], pre-PA, etc.” The enrollment numbers bear further witness that the current opportunities provided by Stephens are in high demand. In August 2018, the cap for the PA program was increased to 30 students. “We had almost 900 applications for those 30 seats,” says Johnson. “It’s very competitive.” CBT

Stephens College 1200 E. Broadway 573-442-2211 stephens.edu

2016

2018

2019

The PA graduate program enrolls their first class.

First class from the Master of Physician Assistant Studies program graduates.

Dr. Julia A. Moffitt becomes the new dean of health sciences. COLUMBIABUSINESSTIMES.COM 31

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B U SINESS • PEOP LE • VOIC ES • F YI

M OVER S & SH AKER S

Movers & Shakers FEBRUARY 2019 BOZOIAN

Klingner & Associates P.C. Klingner & Associates P.C. welcomed Harry BOZOIAN as business development manager and Joseph BINDBEUTEL as a business development specialist. Both men will find solutions for clients in need of municipal engineering, water resources engineering, environmental engineering, and architecture services throughout the Columbia area. Bindbeutel previously served the Missouri Attorney General’s Office as chief counsel for the consumer protection and agriculture and environmental protection divisions. Bozoian served as the director of the Missouri Department of Natural Resources and as acting director and deputy director of the Missouri Department of Agriculture

Brian Rysdam Brian Rysdam, principal clinical specialist in the cardiac rhythm management division at Medtronic, was recognized in December 2018 with the Suscipio Society Award. The Suscipio Society annually recognizes service excellence in the Medtronic Cardiac and Vascular Group. Rysdam distinguished himself by living the Medtronic Mission through his technical excellence, customer service, customer education, patient focus, and sales support.

Kelley Frink Kelley Frink will be the next chief financial officer at Veterans United Home Loans. Frink began her Veterans United career in 2013 and most recently served as controller for the nationwide mortgage lender. Frink is a graduate of MU and a licensed CPA. Frink will transition to the role during the first quarter of 2019.

Taylor Burks Taylor Burks has been appointed by Governor Mike Parson to be the director of the Division of Labor Standards in the Missouri Department of Labor and Industrial Relations. Burks was appointed Boone County clerk in 2017 by then-Governor Eric Greitens after clerk Wendy Noren resigned for health reasons. He has worked for the UM System and served in the U.S. Navy.

Christine Orey Central Bank of Boone County has named Christine Orey assistant vice president, regional sales manager. Orey will be responsible for performance in sales, service, and operations in her branches and for providing leadership and support to branch managers. Orey started with Central Bank in 1999 as a teller. In 2015, Orey was named regional sales manager after serving as branch manager at multiple Central Bank locations.

Columbia Safety & Supply Columbia Safety & Supply promoted both Zach DUDENHOEFFER and Mark ANDERSON. Dudenhoeffer will move to the role of account manager from inside sales associate. Since 2014, Dudenhoeffer’s dedication, knowledge, and passion for at-height gear has made him an excellent on-site resource for clients in the western part of Missouri, the company said. Anderson will be promoted from account manager to national sales manager. As national sales manager, Anderson will be working with a team of account managers that support the Columbia Safety & Supply brand across the company’s three locations in Columbia, Atlanta, and Dallas.

Caroline Andriano True Media announced the promotion of Caroline Andriano to vice president of human resources. Since 2012, Andriano has led the company’s HR department, where she focuses on employee relations and engagement, talent acquisition, comprehensive benefit programs, and employment law compliance. She holds senior level certifications from SHRM and HRCI and a Missouri Life and Health Insurance license. CBT

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RYSDAM

FRINK

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Are you or your employees making waves in the Columbia business community? Send us your news at Editor@BusinessTimesCompany.com COLUMBIABUSINESSTIMES.COM 33

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P E R S ON YOU SH OU LD KN OW

MIKE IRELAND REGIONAL PRESIDENT FOR CENTRAL MISSOURI | THE BANK OF MISSOURI | AGE: 44 Job description: I oversee regional bank operations and help execute the bank’s strategic plan throughout Central Missouri. I’m also responsible for providing support and guidance to our regional leadership team and community bank presidents. Years lived in Columbia: 19 years. Original hometown: Trenton, Missouri. Throw a rock in Columbia and you’re likely to hit someone from my hometown. Education: Bachelor’s in marketing from Missouri Western State University. Favorite volunteer activity: I recently finished my final term on the Ronald McDonald House Charities of Mid-Missouri board of directors, serving the last two years as board president. Executive Director Terri Gray and her team are an amazing group. It was a privilege to serve alongside them. Professional background: I’ve been in the banking industry my entire career, 20 years altogether. I spent a majority of that time, 17 years, with Commerce Bank serving in retail, small business, and commercial leadership roles. I joined The Bank of Missouri in 2018 as regional president for Central Missouri. A favorite recent project: I recently had the opportunity to participate in the Heart of Missouri United Way’s 2018 Financial Stability and Economic Mobility Community Summit. The event convened providers, community leaders, and other stakeholders to define next steps to create access to economic success for everyone in our community. A Columbia businessperson I admire and why: Columbia Public Schools

Photography by Anthony Jinson

COLUMBIABUSINESSTIMES.COM 35

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P E R S ON YO U SH OU LD KN OW

superintendent Dr. Peter Stiepleman. The energy and enthusiasm he brings to a conversation is contagious, and I like surrounding myself with people like that. We recently had a laugh over coffee about the similarities between the banking industry and education in relation to the balance between customer experience and risk management. I grew up in rural northern Missouri and he was raised on Long Island. We have different backgrounds and different views on certain topics, but we also have common ground, like our work together on the United Way Board of Directors. Why I’m passionate about my company: The Bank of Missouri is committed to treating employees like family and putting the customer at the center of everything we do. Our regional structure also allows us to develop and execute a consistent strategy across our Missouri footprint. We serve communities similar in size and have the same objectives across markets. My next professional goal: Continue to build on the solid foundation that others, including David Keller, have built here in the Columbia market. As we’ve recently transitioned to a regional structure, our top priority is integrating the surrounding communities to fully leverage that model. I’m also looking forward to serving on the bank’s strategic planning committee as we look at ways to grow using technology. How I want to impact Columbia: In my new role, I have a renewed energy for helping Columbia grow responsibly. When we fund a new project (new business, working capital, development, whatever), we’re creating a structure that’s good for the customer and the bank and is ultimately good for our economy. If I weren’t doing this for a living, I would: I think I’d enjoy health care administration. In my previous role, I led the bank’s regional health care banking effort. I had the opportunity to observe leaders like Jonathan Curtright at MU Health Care navigate the challenges of the health care industry. Like banking, health care is a highly regulated and complex industry, so the similarities could make it a good fit. 36 FEBRUARY 2019

What people should know about this profession: It’s equal parts sales and risk management. I’m always surprised by the number of people who are surprised bankers consider themselves salespeople. I certainly don’t mean selling for the sake of selling a product, but successful banks understand the importance of educating customers and offering solutions. What I do for fun: Most of my free time is spent with family. My wife, Ellen, and I have three kids: Isabelle, 11, Josie, 8, and Henry, 5. Brad Eiffert once told me you’ll never regret investing in ways to spend time with your family on the Katy Trail, so we recently bought bikes for each of us. Brad was right. Accomplishment I’m most proud of: My marriage to my wife, Ellen. Everyone likes her way better than they like me. I 100 percent guarantee people are reading this and nodding in agreement. Greatest strength: I like to think it’s the capacity to connect with people.

Greatest weakness: I’m too much of a giver . . . and I’m too organized. Kidding! Unfortunately, my weaknesses are actual weaknesses. I tend to make myself the center of the universe. It’s a daily exercise of reorienting myself to focus more on serving other people. Biggest lesson learned in business: Focus more on others than yourself. Also, there’s a difference between management and leadership; they go hand-in-hand but are distinctly different. Favorite place in Columbia: We discovered the True/False Film Fest a few years ago. The first year, I told my wife, “This is amazing, we’re totally going to Sundance next year!” We’ve never made it to Sundance. We also love spending time at our church. Most people don’t know that I: I come from a very musical family. People seem surprised by that and find it interesting for some reason. My sister was a voice major in college, my brother-in-law performs at Legends Theater in Branson, and my nephew was on last season of NBC’s The Voice. CBT

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B U SINESS • PEOP LE • VOIC ES • F YI

Q&A JASON GRUENDER Owner, Liberty Insurance Solutions

1. What’s your background? Born and raised in Columbia, I graduated from Hickman High School in 1998. After earning my electrical engineering degree from MU in 2003, I began in the electrical construction industry and earned my professional engineer’s license in 2009. July 1, 2016, marked the day I began managing Liberty Family Medicine, which is owned by my wife, Dr. Bridget Gruender. After seeing the large need for affordable health care options, I acquired my health insurance license in the middle of 2018 and started Liberty Insurance Solutions. The insurance company concentrates on medical cost-sharing programs, which have turned out to be a great alternative to traditional health insurance for many individuals and small businesses. 2. Tell us about your job. I spend a lot of time trying to stay current with all of the changes in electrical construction and health care by attending seminars and conferences in addition to searching for any alternatives that might provide better and more cost-effective coverage for Liberty Fami-

1 1 QU EST I ON S

ly Medicine patients. Each week includes multiple open-house style information sessions as well as presentations to business owners and small groups about medical cost sharing and level-funded insurance plans. Many non-glamorous tasks that come along with managing Liberty Family Medicine, like cleaning the clinic, buying supplies, and payroll, occur on the weekends.

7. Did you start your career in the health insurance industry? No, I started my career in electrical construction and continue full-time to this day. After working as an engineer in St. Louis for two years, my wife and I relocated back to Columbia. Since 2005, I’ve worked for Meyer Electric Company and became a co-owner and vice president in 2015.

3. What does your typical day look like? My day usually begins with an early morning visit to the gym, where I read up on health care and medical cost-sharing during my cardio routine. I generally bid and manage electrical projects as well as field health care-related phone calls out of an office in Liberty Family Medicine. With our medical cost-sharing program taking off like wildfire, enrolling individuals and business groups into the program is usually accomplished in the evenings.

8. What are some challenges you face in your job? It is difficult for many people to think outside the box when it comes to health care, which presents a unique challenge when discussing options for health coverage. The current health care system, however, has pushed people to seek options beyond traditional insurance and open their minds to the possibility of something different and possibly better.

4. What drew you to your position? I have been by Dr. Gruender’s side every step of the way throughout medical school, residency, and this amazing community to show people a better way to provide primary care. I’m constantly amazed at just how broken the entire medical system is and how hard it seems to be for some people to afford quality health care. Small business owners face the same struggle, and many times they can’t afford to offer health benefits. I couldn’t let Dr. Gruender have all the fun trying to fix the health care system!

9. Describe a success you’re most proud of. Liberty Insurance Solutions developed a relationship with Sedera Health, a company that provides a medical cost-sharing program for groups. We were the first to introduce Mid-Missouri to them and we’ve been able to provide complete health care coverage when paired with Liberty Family Medicine for a good number of small businesses who previously had no affordable options. Going one step further, a partnership was established with the Shared Health Alliance, which built an enrollment portal and collects the monthly contribution toward Sedera Health for individual clinic members of Liberty Family Medicine.

5. What don’t people know about the alternative health insurance industry that they should? The use of medical cost-sharing plans as an alternative to traditional health insurance has seen an enormous increase in the last 10 years. Medical cost-sharing programs take a commonsense approach to paying for health care expenses, and costs for the programs are actually affordable for many people. There are also no predetermined “enrollment” periods, meaning you can join at any time. 6. What would people be surprised to know about your job? Everything I do related to Liberty Insurance Solutions centers around Liberty Family Medicine and its patients. I feel very strongly about people having a primary care doctor with whom they can have a personal relationship.

10. What inspires you to get up each day and make a difference? Knowing that I’ll be spending my day working on the electrical construction of something new and amazing in Columbia or helping individuals, families, and local business owners work toward a better health care solution. 11. Tell us something about you that we wouldn’t learn from your resume: I once spent the summer traveling around with a NASCAR truck team as part of their pit crew. I also have my pilot’s license, and though I don’t get to fly as much as I’d like, it is definitely one of my favorite hobbies. CBT

Check out more questions and answers from other Columbia professionals online at ColumbiaBusinessTimes.com.

COLUMBIABUSINESSTIMES.COM 39

40 FEBRUARY 2019

BU SI N ESS • PEO P LE • VOIC ES • F YI

A CA P I TO L CON VER SAT I ON

The Changing of the Guard BY KRCG 13’ S K ER M I T M IL L ER

A NEW LEGISLATIVE SEASON BEGAN in Jefferson City in January with familiar faces in unfamiliar places. The resignation of former Governor Eric Greitens at the end of May 2018 set off a chain reaction that has replaced most of the statewide office holders. Last year delivered a different governor, lieutenant governor, attorney general, and state treasurer . . . all without the benefit of ballot action. At this writing, Missouri still awaits the decision of the Missouri Supreme Court on the constitutionality of the appointment of Mike Kehoe as lieutenant governor, who replaced Mike Parson, who replaced Greitens. On December 19, 2018, Parson named southwest Missouri State Representative Scott Fitzpatrick to replace Eric Schmitt as state treasurer. That job came open with the appointment of Schmitt to replace Josh Hawley as attorney general after Hawley was elected to the U.S. Senate. (Are you dizzy yet?) If 2019 delivers nothing more than stability, it’s a plus. Right now, the spotlight falls on the transition from Hawley to Schmitt as the attorney general. The question as yet unanswered is how much tinkering Schmitt will do to the structure and priorities of his new office. When Hawley took over two years ago, the attorney general’s office changed political party for the first time in a quarter century. The Republican had campaigned on a promise of reorganization. But in recent weeks, published reports have detailed problems with management and morale. By most accounts, Hawley raised eyebrows by scrapping an entire division devoted to environmental law and by turning over senior responsibilities to young lawyers who had worked on his campaign. And he leaves the office under the cloud of an official investigation by Secretary of State Jay Ashcroft over claims that Hawley violated state laws by

allowing his outside campaign consultants to sit in on office staff meetings and set agendas for taxpayer-paid personnel. If Schmitt, then, is inclined to scale back, it likely would not surprise anyone. But he sits down at the table with a full plate in front of him. The office ends 2018 with nearly two dozen high profile initiatives, investigations, and lawsuits pending. The state of Missouri is suing big pharma over the proliferation of opioid drugs. A trial over claims that manufacturers have put consumers at risk is still more than a year away. The attorney general is still in a battle with Backpage.com over whether the site’s willingness to publish adult personal ads promotes human trafficking. (Missouri has beaten back a federal First Amendment lawsuit and now seeks criminal and civil sanctions against the website and its lawyers.) The attorney general’s office also has taken the St. Louis Housing Authority to court over claims that public housing has become substandard. At this writing, the state still awaits a court ruling on its claims against Ripley Entertainment and Branson Duck Vehicles, the companies that operated the boat that sank last summer in Branson, killing 17 people. (Missouri’s suit claims that the operators misled customers about the risks of duck boats.) And, on December 14, on the eve of the 2018 deadline to sign up for medical coverage under the Affordable Care Act, a federal judge in Texas struck it down as unconstitutional in a lawsuit to which Missouri is a party. Schmitt faces a decision of whether to remain involved when, as senior Democrats have promised, the case goes forward on appeal. At the same time, the Hawley staff has opened high profile investigations of Google, over the collection and use of consumer data, and of the Catholic church in Missouri, over its handling of claims of child sexual abuse by

clergy. The latter is complicated by the attorney general’s lack of subpoena power, a situation which Hawley complained hampered his probe last spring of the use of a message-deleting app by the Greitens’ staff. During that investigation, Hawley said he wanted to change the subpoena policy through legislation. Schmitt must consider these priorities, along with Hawley’s initiatives to combat human trafficking, to provide legal assistance to military veterans, to eliminate a backlog of untested rape kits, to rein in robocalls, and to change the administration of the legal expense fund that pays successful discrimination and human rights claims against state agencies. (Hawley believes the law should be changed to require those agencies to absorb at least a portion of those claims in their operating budgets, providing an incentive to change bad behavior.) In early December 2018, Hawley and Schmitt made a public show of the transition process by inviting capitol reporters to sit in on a briefing of the Schmitt transition team by the Hawley senior staff. Hawley was more gregarious in his presentation. Schmitt was more measured in his responses, making no specific commitments on office organization, staff, or projects and priorities. He has talked about maintaining the fight against federal government overreach and about a greater emphasis on combating crime. Toward that end, just before Christmas, Schmitt named Tom Albus, a federal prosecutor in St. Louis who has spent that career chasing fraud and corruption, as his first assistant attorney general. Overall, Schmitt told reporters he will put a priority to the continuity of service. (See paragraph 3, “stability.”) CBT Kermit is an award-winning 45-year veteran journalist and one of the longest serving members of the Missouri Statehouse press corps.

Kermit Miller anchors the 6 and 10 p.m. news for KRCG 13. You can reach Kermit at kmiller@krcg.com COLUMBIABUSINESSTIMES.COM 41

42 FEBRUARY 2019

B USINESS • PEOPLE • VOIC ES • F YI

LOCA L P E R S P EC T IVE: N I C KI E DAVI S

Have You Toured Your Town? BY N ICKIE DAVIS

YOU CAN LIVE A FULL, well-cultured life in Columbia. We have multiple festivals: True/False Film Fest, Roots N Blues N BBQ Music Festival, Citizen Jane Film Festival, Unbound Book Festival. We’ve got some wicked sports ball fields for the Missouri State High School Activities Association and Show-Me State Games. There are multiple art galleries: Sager Braudis Gallery, Dogwood Artist Workspace, The Columbia Art League connected to the Missouri Theatre, Bluestem Missouri Crafts, Tellers Gallery & Bar, Ragtag Cinema, Lakota Coffee, ARTlandish Gallery, Orr Street Studios, and Main Squeeze, to name a few. We also have many parks to hike, bike, and walk. But what actually keeps us here? What keeps us coming back?

If you’ve lived in Columbia for any amount of time, you have either known someone who has moved away for a period of time or you’ve done it yourself. *slow hand raise* Columbia is like a black hole; you come here and you never leave. If you do decide to move, it won’t be long until you’re back. Two years? Maybe three? But believe me, you will be back. I’ve seen it over and over again. What is it about COMO that draws us in? We could state the obvious. Traffic is never that bad — yes, even when the students are here. It takes all of 15 minutes to get across town. Rent is relatively cheap. (I said “relatively.”) The price of living, in general, is not bad in Columbia. There is a bar or coffee shop or church around every corner, so we can all have our “Cheers” bar and “Cheers” coffee shop — our hangouts and well-known favorites.

We’ve got stunning sunsets and sunrises. Locals still sit on stoops outside and watch cars go by as they gossip. At the same time, young professionals sit outside at a rooftop bar and do the same. And here we get to the heart of what I believe it is that keeps people coming back to Columbia. There is so much to do, to be, and to see here. Shopping. From local boutiques in The District to shops on the south side (yes, we are coming along on the south side) to the mall and big box stores on the west side. We have boutiques that specialize in vintage records, video games, handmade jewelry, aromatherapy, and books. We have bookstores! And the food — restaurants upon restaurants! There are more than 30 restaurants in The District alone and many of them have second or third locations scattered throughout Columbia. You will also find specialty places like bakeries, butcheries, kombucha bars, and specialized grocery stores. There are so many amazing places to eat that COMO even has its own culinary tour. Don’t forget the entertainment! We have so many theaters that you could see a different show almost every night of the week: Missouri Theater and Jesse Hall, Columbia Entertainment Company, GreenHouse Theatre Project, Talking Horse Productions, Missouri Contemporary Ballet, University Concert Series, TRYPS Kids, PACE Youth Theater, and Maplewood Barn Theatre. Columbia also hosts “We Always Swing” Jazz Series, one of the most well-known jazz concert series in the nation. There are also more low-key activities, like visiting our fantastic library, exploring the African-American Heritage Trail, checking out the dog parks, or seeing your favorite band at one of the killer concert venues. You will also find open mic nights, comedy shows, board game nights at Craft Beer Cellar, and pop-up yoga at different locations at least twice a week. And don’t forget the weather! There is a season for everyone. You know the saying: “If you don’t like the weather, wait five minutes.” If you get bored in Columbia, maybe you just need to get out and tour your town! CBT

Nickie Davis is the director of outreach for the Downtown Community Improvement District. COLUMBIABUSINESSTIMES.COM 43

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B USINESS • PEOPLE • VOIC ES • F YI

LOCA L P E R S P EC T I VE: T R U M AN VA

Uncovering an Invisible Injury BY ASGAR ZA HEER | P HOTOG R A P HY P R OV I D E D BY TR U M A N VA

ACCORDING TO THE CENTERS FOR Disease Control and Prevention, traumatic brain injury, or TBI, accounted for approximately 2.8 million injuries and deaths in the U.S. in 2013. Advanced age is the leading cause of TBI in the civilian population; however, the Department of Defense identified more than 300,000 service members who sustained training- or combat-related TBIs in 2014. Also known as an “invisible injury,” TBIs are a major health hazard and potential risk factor for post-traumatic stress disorder and chronic neurodegenerative disorders such as Alzheimer’s disease. With brain injuries on the rise in both civilian and military populations, I’m developing a core study to better understand the effects of TBIs. A TBI disrupts the brain’s normal function because of concussive force — usually through a severe bump, blow, or shock to the

head. Those who experience a moderate to severe TBI may endure temporary or permanent changes to cognitive thinking and balance. Troops who serve on the battlefield risk exposure to IEDs, improvised explosives that are highly sophisticated and, when detonated, emit acoustic, electromagnetic light and thermal energies in addition to pressure shock waves. The exact nature of the TBI that results from this kind of blast exposure is extremely difficult to diagnose in the field, which leads to a lack of precise medical care. Additionally, diagnosing a TBI is complicated due to the overlapping symptoms of PTSD. To better understand complex changes to the brain at the molecular and cellular levels following a TBI, Truman VA has teamed-up with Catherine Johnson, PhD, assistant professor of mining and nuclear engineering at Missouri S&T, and Zezong Gu, PhD, associate pro-

fessor of pathology and anatomical sciences at MU. This unique team has developed an open field-based blast research facility in Rolla. The facility will serve as a national resource for the investigation of the effects of open field blasts that mimic battlefield-related incidents. Our partnership gives us the advantage of multi-disciplinary expertise that supports pre-clinical studies on the effects of service-related TBIs. Neurotrauma from TBIs induces unpredictable and complex inflammatory responses in the brain that vary from one person to another. The variations depend upon several factors, including injury location and the extent of damage to the brain. Neuroinflammation is a major contributor to the progressive brain injury process induced by TBI. The brain cells damaged by the shearing, tearing, and stretching caused by a TBI event causes cascading inflammation. In fact, the main injury after TBI may continue for months or years and could lead to secondary injury. We feel this cascading inflammation induces neurological impairment and neurodegeneration. Therefore, targeting specific inflammatory pathways following neurotrauma may be an effective treatment option to preventing additional effects, such as Alzheimer’s disease, later in life. My team will monitor the response of several biomarkers to different forms of treatment. Our current hypothesis is that some inflammatory markers may not only induce acute effects, but also cause later issues such as PTSD and dementia. Ultimately, our long-term goal is to identify new therapeutic targets that can be used to effectively slow-down, prevent, and treat neurodegenerative disorders. As base examples, we will analyze biological fluids such as urine, blood, and cerebrospinal fluid in acute TBI cases. These biomarkers will be used for diagnostic and predictive purposes in military trainees, veterans, and active duty personnel. CBT The four-year open field-based blast core study is funded by a $1 million USD award from the Veterans Health Administration’s Office of Research and Development.

Asgar Zaheer, PhD. is a research career scientist at Harry S. Truman Memorial Veterans’ Hospital. COLUMBIABUSINESSTIMES.COM 45

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LOCA L P E R S P EC T I V E : M U H EALT H CAR E

Mizzou Urgent Care from its current home, in the South Providence Medical Park, to a new location less than a mile north. The new urgent care will be located next door to Mizzou Therapy Services. When it opens this spring, Mizzou Urgent Care will continue to offer care and lab services for non-life-threatening illnesses and injuries. The move means we’ll have additional space available for primary care services at the medical park.

UNIVERSITY HOSPITAL EXPANSIONS

Patients at the Heart of Growth BY ROGER HIGGINBOTHAM | PHOTOGRAPHY PROVIDED BY MU HEALTH CARE

IF YOU’VE LIVED IN COLUMBIA FOR EVEN JUST A FEW YEARS, you’ve seen how much our city has grown and evolved during your time here. At MU Health Care, we’ve been growing and evolving right alongside it. Over the dozen years I’ve served at MU Health Care, I’ve seen our academic health system expand to meet the needs of Missourians. This growth stems from our dedication to saving and improving lives, and that means we must be diligent in managing a precious commodity: space. We’re constantly striving to make the most of this valuable resource. This means modifying and renovating existing structures to maximize their use. In some cases, new construction may be necessary. We have several projects in store for 2019 and beyond that will help us deliver the best possible experience for our patients. Here’s a peek into some of our major renovation and construction projects planned for Mid-Missouri.

NEW PRIMARY CARE CLINICS The population of northeast Columbia continues to grow, and there’s a need for more access to primary care services in the area. We’re planning to build a new primary care clinic near Battle High School that will enable us to better serve the community. We envision opening a 20,000- to 30,000-square-foot clinic that will house primary care and obstetric services, a pharmacy, and laboratory and radiology services. We haven’t set a construction start date, but we anticipate the clinic will open in about two years. We’re also actively exploring locations for an additional primary care clinic in the southwest area of town.

A NEW LOCATION FOR MIZZOU URGENT CARE In the four years since we opened the South Providence Medical Park, the need for health care services in southern Columbia has risen sharply. This spring, we will be relocating

In October 2018, we opened our newly expanded and remodeled emergency department at University Hospital. That project was phase one of a two-part project to renovate the western side of the hospital. This fall, we’ll be completing phase two, which will bring 24 additional inpatient rooms for adults with medical and behavioral health issues. When we opened our patient care tower at University Hospital in 2013, we knew we needed to plan ahead for expected growth. We left vacant space on the third and fourth floors of the tower that we could one day finish to suit our needs. That time has come. By this summer we’ll be adding six new state-of-the-art surgical suites and 25 new pre- and post-operation rooms in the patient care tower.

A NEW LOOK FOR WOMEN’S AND CHILDREN’S HOSPITAL We’re proud to have Mid-Missouri’s only hospital dedicated to women and children, and we’re making substantial investments in the facility. Starting later this year, we expect to kick off a three-year effort to bring significant improvements to Women’s and Children’s Hospital. We have plans to give the hospital a modern and fresh look while also adding additional space to accommodate a growing demand for our services. These and other facilities investments are guided by a master facilities space plan that serves as a road map for future construction projects. But, ultimately, our decisions are steered by the needs of our patients. As our community grows, we’ll continue to put the needs of our patients at the forefront of our decisions. CBT

Roger Higginbotham is the executive director of support services for MU Health Care. COLUMBIABUSINESSTIMES.COM 47

HANG ON TIGHT In 2017, the S&P 500 did something it’s never done before- increased in value 12 out of 12 months. Due to this unprecedented event, my notso-bold prediction for 2018 was a call for more volatility. And boy did we have it, with the S&P 500 seeing two corrections of approximately 10 percent in the first and fourth quarters of the year. With a variety of issues in front of us there is a chance this volatility will persist into 2019.

The question becomes, how do you handle volatility? First, maintain emotional composure.

The price of the stock market plays an interesting game with our heads. It’s the one thing in the world I know of that people want less of when it goes down in price, and more of when it goes up. Think about this; if you were in the market for a new car, would you be more or less excited if the price were 10 percent off? Why don’t we feel the same way when the stock market is 10 percent off?

Second, revisit your risk tolerance and time horizon.

If you’re feeling nervous about the market fluctuations, see if anything has changed. If it hasn’t, remind yourself that you’re in this for the long haul. If something material has changed, it could make sense to modify your holdings.

Lastly, make sure you’re diversified.

By spreading your assets across multiple asset classes and market capitalizations, you can expect to reduce the amount of risk and overall correlation your portfolio is exposed to, and therefore, weather these bouts of market fluctuations with less volatility.

What’s in your portfolio?

The opinions voiced in this material are for general information only and are not intended to provide or be construed as providing specific investment advice or recommendations for any individual security. To determine which investments may be appropriate for you, consult your financial advisor prior to investing. There is no guarantee that a diversified portfolio will enhance overall returns or outperform a non-diversified portfolio. Diversification does not protect against market risk. Securities offered through LPL Financial, member FINRA/SIPC. 48 FEBRUARY Investment advice2019 offered through Good Life.

Travis Cook

Convergence Financial 200 E. Southampton Drive, Suite 102 Columbia, MO 65203

573.818.2264 Convergence-financial.com

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LOCA L P E R S P EC T I V E : BOON E H OSPI TAL

Boone Hospital's Heart Program Update BY AMY BEGEMANN | PHOTOGRAPHY PROVIDED BY BOONE HOSPITAL CENTER

WHO DOESN’T LIKE TO BE FIRST? Whether that’s first in line, top of your class, or winning in sports, we all want to be our best and do our best. With our fourth year as U.S. News & World Report’s No. 1 hospital in Mid-Missouri, Boone Hospital Center is definitely no stranger to being first — and now we have another first. Boone Hospital and its cardiology service line continuously strive to provide excellent care for patients and the most beneficial services available. In the last month, we launched MitraClip as part of our structural heart program and were the

first to do so in Mid-Missouri. Now we’re ready to expand on another significant aspect of our cardiology service line, our cardiac rehabilitation program. In the coming months, as the region’s premier heart hospital, Boone Hospital will introduce Pritikin ICR — intensive cardiac rehabilitation — to enhance and provide the best care for prevention and treatment of heart disease. Boone Hospital is one of 36 hospitals nationwide licensed to provide this program. We are thrilled to be able to take a proactive approach and bring this advanced comprehensive aspect

to our patients and communities. Pritikin ICR enhances our cardiac rehabilitation program and extends it beyond the importance of exercise and the education people need once they’ve had a cardiovascular event, adding a focus on the patient’s well-being, a healthy mindset, and healthy eating to improve their quality of life. Patients who’ve suffered from a qualifying cardiovascular event, including heart attack, angioplasty and stents, bypass or valve surgery, angina (chest pain), or cardiac transplant, can be enrolled in the Pritikin ICR program. Patients can begin the program immediately following a heart event. Pritikin ICR is easily adapted to be completed in three to 12 weeks, depending on the patient's availability. The 72-session intensive cardiac rehab enhances the conventional 36-session cardiac rehab, enabling a more comprehensive series of exercise, nutrition, and stress management sessions for improved outcomes. Pritikin ICR can prevent patients from returning to the hospital with another cardiac event after undergoing interventions like stents or bypass surgery. All of this is accomplished through overall lifestyle improvements. The sessions offer a mix of exercise, individual education, and group workshops facilitated by Boone Hospital’s registered nurses, exercise physiologists, and dietitians, including heart-healthy cooking classes and instruction on healthy grocery shopping and meal planning. The program is custom-designed to fit each individual's needs with personal counseling to reinforce education, provide coaching, and track the patient’s progress. By partnering with Pritikin to bring this program to our community, Boone Hospital continues to make strides to give our cardiac patients the tools and resources they need for a healthy lifestyle and a healthy heart! CBT Boone Hospital Center is a 392-bed full-service hospital that provides progressive health care programs, services, and technology to residents in 25 Mid-Missouri counties. The hospital was named the top hospital in Mid-Missouri by U.S. News & World Report for 2015-2018 and is designated as a Magnet Hospital for Nursing Excellence by the American Nurses Credentialing Center.

Amy Begemann is the cardiology and cardiovascular surgery service line director at Boone Hospital Center. COLUMBIABUSINESSTIMES.COM 49

50 FEBRUARY 2019

B U SINESS • P EOP L E • VO ICE S • F YI

OP I N I ON : AL GER M ON D

filling six seats. How much more of a challenge would it be to fill additional council seats? Steps should be taken to reverse negative public attitudes about running for office and serving on the council. We all know council meetings are too long, but no one has figured out ways to streamline the process. Maybe there should be term limits. A charter review commission may sound like a swell idea, but it will probably come for naught. Its efforts will be torn apart by the increasingly corrosive band of the activists who will never be satisfied by what transpires.

A LOOK AT THE CITY ITSELF

A City Forecast Amid Change BY A L GERMON D

PROPS TO JOHN GLASCOCK, PE, who has hit the ground running as acting city manager. He’s listening to, talking to, and renewing the confidence of those who serve the city while wondering about their jobs and where the city was headed. The easy part for this former public works director will be ministering to and stabilizing the hard, technical realms Columbia was originally chartered to provide: police and fire protection, water, electricity, sewage, and other public works including streets and the quixotic mass transit system. What will prove more vexing to this licensed professional engineer will be the softer, less technical challenges demanded by city council members, pressed as they are by the growing horde of community activists. A temporary fill-in with an easy out after a few months and no more than three years by his own account, Glascock may end up liking the job more than he originally thought. That is if he isn’t worn down by all the controversies that have been tearing our fair city apart.

THE CITY COUNCIL To no one’s surprise, the councilmen representing wards three and four will serve another three years. They were unchallenged with no one even willing to try and take them on. Lost are the opportunities for a spirited discussion about the city and where it is headed. Are they invincible? Perhaps. Overwhelming incumbent popularity among their relatively small base of sycophants has hastened our increasingly complacent attitude toward municipal government. While we readily complain about the state of affairs, not a single one of us wants to serve, with council seats increasingly locked down as long as those on the council wish to serve. Elections? Why bother. Let the mayor choose who sits on the city council and be done with it. What’s really needed is a thorough review of the City Charter, which is about to reach its 70th birthday. There should be additional council seats reflecting trebled growth since 1949. How about moving from the present six seats to eight or perhaps ten seats? But we have trouble enough

For those whose sport it is to glide across a hardened surface, now it is to Jefferson City one must go to roller skate. The Empire Roller Rink recently closed after an 80-year run. The state capital also continues to be the destination for those who skate on ice. Why is it that Columbia, with its vaunted, highly-praised Parks and Recreation Department, hasn’t been able to include venues for ice and roller skating in its catalog of attractions? When Mitch Murch opened Columbia Ice Chalet in 1975, he presented the community with a beautiful facility we were all very proud of, but it failed a few years later. So a city half the size of Columbia has rinks for those who skate, but we don't. Maybe it's the same reason we don’t have a municipal auditorium and a convention center. Columbia visitors often ask questions about our growing metropolis. Among others — why are there so many people begging for alms at major intersections? Why don’t we do something about them, help them? It’s hardly something we should be proud of. Visitors also wonder why the routes to various medical facilities are so poorly marked. As eyes grow weaker, they wish our street signs were larger and more visible and that block numbers were put on street signs. But we don’t have those here, for some reason. Maybe it’s the same reason why there are no electronic signs, not even in front of a church or school building. But we’re different here, and for the majority of us, we apparently prefer things the way they are, and not for outsiders to wish upon us. CBT Al Germond is the host of the Columbia Business Times Sunday Morning Roundtable at 8:15 a.m. Sundays on KFRU. He can be reached at algermond@businesstimescompany.com. COLUMBIABUSINESSTIMES.COM 51

TWO ARE BETTER THAN ONE The United Way and Columbia/ Boone County Department of Public Health and Human Services partner together to engage community health concerns.

BY MARY KATE HAFNER

PHOTOGRAPHY BY ANTHONY JINSON

52 FEBRUARY 2019

Photo submitted by United Way

COLUMBIABUSINESSTIMES.COM 53

national organization with a local chapter and a public health department with a city and county reach are partnering up and sharing resources to help further their shared mission: to create a healthy and prosperous community. Together, Heart of Missouri United Way and the Columbia/Boone County Department of Public Health and Human Services hope to make a big impact on health in Mid-Missouri. One specific way they’re working together is through evaluating and classifying the community’s health needs through Community Health Assessments. While not a new tool, the CHAs were revamped by the health department in 2013. Instead of solely relying on secondary data, the department wanted to add in the community’s voice and chose to do so through surveys and focus groups. Andrew Grabau, executive director of the Heart of Missouri United Way, serves on the steering committee responsible for reviewing the health assessments. After looking over the information, the steering committee uses the health assessment to create action steps for improving the community’s health, which then becomes the Community Health Improvement Plan, also referred to as CHIP. “The experience for me, serving on the steering committee, has been incredibly valuable on a number of levels,” says Grabau. “One, because we dovetail it with the work we’re currently doing. Two, it helps in guiding the future work we’re going to do.” United Way shares their diverse connections to the community with the health department to ensure CHIP is inclusive and benefits everyone. “We want to make sure, as a community, that there is a larger collective impact to the work that we’re doing,” says Grabau. “Being a part of the assessment helps us in being a part of that.”

THE CHANGING IDEA OF PUBLIC HEALTH The initial 2013 health assessment brought up concerns such as inaccessible sidewalks and public transportation, focus areas that don’t usually come to mind when considering public health. “What we’re seeing (in the health assessments) is not what we would think of as traditional issues that public health would address,” says Scott Clardy, assistant director of the 54 FEBRUARY 2019

>> Part of the funding Lutheran Family and Children's Services of Missouri receives from Heart of Missouri United Way goes toward their young parents therapeutic support group and supportive services (counseling, parenting education, and case management) for the teen parents they work with.

COLUMBIABUSINESSTIMES.COM 55

Photo submitted by United Way

Columbia/Boone County Department of Public Health and Human Services. “We’re being more innovative and more responsive to our community by addressing the issues they see.” The World Health Organization defines health as “a state of complete physical, mental, and social well-being, rather than the mere absence of disease or infirmity.” This open definition lends itself to a more holistic concept of health. It implies that health sinks into every part of our lives, from our social media use to daily commutes. This concept was supported in 2018 by the United Way’s four health initiatives: basic needs; mental health; medical and dental issues; and safe, healthy, and affordable housing. These health initiatives help determine where funding from the organization would go. “There’s three recurring things that surface during all our different focus groups and all our different meetings around the health assessment,” says Grabau. “I’m hearing that mental health is a concern, basic needs are a concern, and affordable housing. This is what I’ve heard across all age ranges.” “If those are the health concerns of the community, and those are the things that need to be 56 FEBRUARY 2019

addressed to increase the health of the community, then those are the things that we need to be working on,” says Clardy.

COMMUNITY AFFECT Lutheran Family and Children's Services of Missouri wants to push the needle forward for community health through their work with youth. The organization addresses the mental and social factors of health by offering counseling services across age groups and specialized issues such as teen pregnancy and adoption. A Heart of Missouri United Way funded agency, Lutheran Family and Children’s Services will receive $55,960 annually from 2017 to 2020. This financial support is part of Heart of Missouri United Way’s annual health impact allocations. The Heart of Missouri United Way and Grabau have a focused concern on mental health and how it’s tied to social isolation. “What it means for an individual to not have that social capital — that is so important around everything that we do, not only mental health, but physical health,” says Grabau, “You can see where social isolation can be detrimental to anyone at any stage, from a young child all the way to a senior.”

The 2018 Status Report on Missouri’s Substance Use and Mental Health from the Division of Behavioral Health reports that there was an increase from 2015 to 2017 of 195 diagnosed anxiety disorder cases, 11 cases of diagnosed adjustment disorder, 67 diagnosed cases of impulse control disorder, and 10 cases of psychotic disorder. Increases occurred between 2015 and 2017.

COLLABORATING FOR PROGRESS A community focus and health crisis affecting almost every community across the country is the abuse of alcohol and illicit drugs. Boone County is no exception. The number of Boone County residents discharged from emergency rooms with an opioid diagnosis increased from 77 people in 2004 to 188 people in 2014. Drug addiction and drug sales directly impact two of the 2018 health initiatives: safe, healthy, and affordable neighborhoods and mental health. That’s why some of United Way’s funding went to Phoenix Health Programs, an organization dedicated to providing treatment for people with drug and alcohol addiction.

Heart of Missouri United Way

HEALTH IMPACT 2017 ALLOCATIONS GOAL: Promote healthy behaviors in our community.

TARGETS: Increase the number of community members who: • Live a healthy lifestyle • Eat well and are physically active • Avoid substance abuse, smoking, and teen pregnancy • Access physical, mental, and dental health care

BOYS & GIRLS CLUB - $32,800 • Great Futures Start Here: Triple Play Program — Body & Mind CITY OF REFUGE - $32,364 • Community Health Advocates Program and Refugee PTSD Counseling COLUMBIA CENTER FOR URBAN AGRICULTURE - $59,402 • Opportunity Gardens FAMILY COUNSELING CENTER - $120,000 • School-based Services and Outpatient Services FAMILY HEALTH CENTER - $64,532 • Children’s Dental Care Access and Cavities Prevention Program GREAT CIRCLE - $24,300 • Impact US LUTHERAN FAMILY AND CHILDREN'S SERVICES - $55,960 • Pregnancy and Parenting PHOENIX HEALTH PROGRAMS - $87,000 • Enhance Opioid Treatment for Young Adults COLUMBIABUSINESSTIMES.COM 57

>> Phoenix Health Programs puts their United Way funded dollars towards their clinic, which helps young adults fighting addictions and offers them treatment options. The money will specifically be used for opioid treatments. 58 FEBRUARY 2019

In 2017, Phoenix Health Programs reported that 62 percent of their program participants’ illicit drug use decreased to zero percent over a six-month period. Program participants’ alcohol use decreased from 49 percent to 16 percent over the course of six months. For context, national opiate relapse rates without treatment hover around 90 percent, according to the National Institute of Mental Health. In a 2018 CBT interview about Phoenix Health Programs, Heather Harlan, a prevention specialist and adolescent counselor at the organization, emphasized the importance of community support with progress. “We’ve had employers bring employees in here with substance abuse problems to get them help and told us that their jobs will be waiting on them once they get better,” Harlan said. “Knowing that a job is waiting can really give people a lot of motivation to get better.” The organization works as a community partner with both Heart of Missouri United Way and the Columbia/Boone Department of Public Health and Human Services. From 2017 to 2020, Phoenix Health Programs will receive $87,000 annually from Heart of Missouri United Way to put towards their enhanced opioid treatment for young adults. In 2017, the Heart of Missouri United Way allocated $443,994 total to health impact. “There are health outcomes tied to afterschool programs. There are health outcomes tied to financial counseling programs, to everything that we do. Just because we fund agencies under ‘health impact’ doesn’t mean that the other ones don’t have health targets,” says Grabau. Overall, Phoenix Health Programs typically receives 78 percent of its funding from government entities, but 40 percent of that government funding comes specifically from the state of Missouri and local governments.

TODAY AND BEYOND The partnership between Heart of Missouri United Way and Columbia/Boone County Department of Public Health and Human Services has elevated the community voices affecting change in the areas that need it most. “The public health system is not the public health department,” says Clardy, “The public health system is all kinds of folks that are involved in caring for the health of the community.” As it is the core of United Way, community is the core of health. CBT COLUMBIABUSINESSTIMES.COM 59

60 FEBRUARY 2019

REACHING New Financial Heights Wh e re will MU H ealt h C are â&#x20AC;&#x2122;s $ 1 b i l l i o n i n ne t reve nue f ro m 2 01 8 g o? BY JOD IE JAC KSON JR . | PH OTO G R A P H Y BY A N TH O N Y J I N S O N & J U STI N K E L L E Y

COLUMBIABUSINESSTIMES.COM 61

f not for a pleasant 55-degree day in December 2017, the leadership team at MU Health Care might look different, and Chief Financial Officer Mike Blair wouldn’t have helped shepherd the local health system’s ledger to an eye-popping $1 billion net revenue total for the first time ever. Wooed from central Minnesota to interview for MU Health Care’s vacant CFO post, Blair was initially lukewarm about leaving his position as vice president of a smaller hospital system. While the change in mid-December weather raised his interest, it was ultimately the health system’s topto-bottom embrace of the lofty “triple aim” of health care that erased any reluctance for a second interview. “Consistent story,” Blair says, reflecting on his initial impression of MU Health Care’s team. “When I look at what’s happening here, in the focus on delivering high-quality care, and look at what we’ve done from a financial standpoint, it really reflects that patients are coming here because they like what they have here.” The triple aim, a framework developed by the Institute for Healthcare Improvement, promotes the pursuit of better patient care, better health for the overall population, and lower costs. The triple aim has led MU Health Care to adopt new ways to manage patient care and create a robust network of primary care physicians, which have been important steps that have led to such a healthy bottom line. Nationwide, the picture is not so bright for many health systems, evidenced by a tally of 93 mostly rural hospitals that closed in 2018 and another 14 hospitals that have filed or plan to file for bankruptcy. Not so for MU Health Care. “The last several years, but especially last year, arguably have been some of the best years in the history of MU Health Care, by any metric you want to look at,” says MU Health Care CEO Jonathan Curtright.

$1 Billion, $100 Million What does the $1 billion total net patient revenue mean for MU Health Care? For starters, the healthy revenue cycles allow the health system to have, also for the first time ever, an operating income of $100 million. Blair and Curtright don’t minimize the $1 billion and $100 million headlines, but they readily offer perspective: more patients generating more revenue also create more costs. “We have to pay for all those things that allow us to deliver care,” Blair says. Some $250 million was required for pharmaceutical costs and surgical and medical supplies, then there’s the $100 million for needed cash flow and operating income for the day-to-day business of health care. The expenditures also include debt and interest payments, contributions to the

Ribbon cutting for the opening of University Hospital's newly renovated emergency department in October 2018. 62 FEBRUARY 2019

COLUMBIABUSINESSTIMES.COM 63

- At A Glance -

MU Health Care 2018 Numbers 64 FEBRUARY 2019

6,936 staff members across all sites

25,800 major surgical operations

Just under 79,500 ER and trauma visits

680,624 clinic visits across all sites

Sinclair School of Nursing, and $18 million for MU’s School of Medicine, which trains close to 500 new doctors each year, Blair says. Seven percent of net patient revenue is reinvested in capital, with the emergency department and operating suite expansions being two notable recent examples. But the biggest price tag corresponds with the biggest reason that patient experience scores and revenue have soared, Curtright says. The total for wages, salaries, and benefits comes to $500 million. “Happy, growing, developing, and satisfied employees lead to outstanding patient care and service to our patients,” Curtright says. “Our goal is to be the employer of choice in Central Missouri. We are very much moving in the right direction.”

Gaining Market Share The numbers also show that the health system’s share of the health care market is also growing, up from 22 percent to 29 percent in the 25-county region since 2014. “That’s a big, big jump, and every one percent of increase represents tens of millions of dollars of net patient revenue,” Curtright says. “But you’re not going to have that growth if you don’t have outstanding physicians and outstanding staff working in outstanding facilities. If you do all those things, the numbers — the finances — tend to follow.” The $1 billion and $100 million totals account for the entirety of the MU Health Care system: University Hospital, Women’s and Children’s Hospital, Missouri Psychiatric Center, Missouri Orthopaedic Institute, and the Ellis Fischel Cancer Center. Affiliates include Capital Region Medical Center, in Jefferson City, Columbia Family Medical

Group, Columbia Surgical Associates, and Rusk Rehabilitation Center. In 2018, the health system reached an average daily census of 400 patient beds filled — a 25 percent increase from the previous two years — and the network of 50-plus primary care clinics had 680,000 patient visits. Curtright points to strong employee satisfaction metrics, a growing and vibrant primary care network, and the health system’s relationship with the MU School of Medicine as parts of “the secret sauce that has made us successful.” He includes the university’s connection with health information technology giant Cerner and the local Tiger Institute for Health Innovation, a private–public entity coordinated between MU and Cerner, as a crowning piece of that recipe. “We’re here to save and improve lives, and we want to be Missouri’s premier academic health system,” Curtright says, citing MU Health Care’s mission and vision statements. “And that system of care is going to be stitched together with information technology.”

Health IT Is King Health systems that underestimate the value of cutting-edge health IT expertise likely will pay a price, literally. The financial elephant in the health care room is the industry’s seismic shift from the traditional fee-for-service payment model to a new model that promotes value-based care. The new model, spearheaded by the Centers for Medicare and Medicaid Services, or CMS, with commercial, non-government health insurers slowly following suit, requires hospitals, clinics, medical groups, and physicians to show that patients and patient populations are receiving quality care.

A pharmacist offers assistance at Mizzou Specialty Pharmacy Services.

14.2 percent growth the 25-county service area market share since fiscal year 2014.

1.6 million lab tests

226,465 patients

7.4 million pharmacy doses

MU Health Care was recognized as one of the “150 Top Places to Work in Health Care” by Becker’s Hospital Review in 2017 and 2018. COLUMBIABUSINESSTIMES.COM 65

“If we could get in our time machine and go forward 20 years, I’ll bet you there is still an outstanding, highly complex, traditional hospital that’s sitting right here. Without a doubt. But more and more, there’s going to be fewer of those places.” – Jonathan Curtright, CEO, MU Health Care

66 FEBRUARY 2019

Health IT and patient data are the centerpieces of the new reality of value-based care. The complex metrics of quality care and value-based care will lead to payment boosts for high-performers and, conversely, lower reimbursement for hospitals and clinics that can’t produce data to prove quality care. It’s no secret that the electronic, digital world of health care, with a mind-boggling number of data points, is expensive, but it’s necessary for health systems to meet CMS’s and commercial insurers’ quality measures. Blair says he is charged with building healthy budget reserves to help “cushion” against the transition to value-based care payment models and potential decreases in government reimbursements. Just over 60 percent of MU Health Care’s revenue comes via Medicare and Medicaid, he says. If the health system is faced with the need to expand or to deal with lower insurance reimbursements, the reserves will be available, Blair says. MU Health Care is not publicly traded, there are no shareholders or investors who receive dividend checks, and, despite ongoing misconceptions among some in the public, the health system does not receive money from the university or from the state, Curtright says. “We’re a business that has to very, very much perform and perform well, because we have got a ton of resource demands every year,” he adds.

Good News and Challenges With a daily census now topping 400 patients, the hospital system must become more efficient at managing patients, Blair says. “The moment a patient is admitted, we need to start a discharge plan” dictated by needed treatment, he adds. “We have to address this in the next few years.” But new buildings are not good options. As Curtright says, “Brick and mortar is expensive.” Increasing its primary care network is another important goal for meeting both future needs and value-based care’s focus on preventive health services to provide the best care in the least expensive setting. To that end, MU Health Care has purchased land next to Battle High School, in east Columbia, for a new primary care health center. Curtright says the system is also looking at the

southwest part of the city for a location for another primary care site. The addition of primary care clinics coincides with a growing shortage of primary care physicians. Curtright gives a nod to the MU School of Medicine and a unique residency track that encourages more doctors to become family physicians. Boone County is among the 100-plus counties in the state that has a shortage of primary care doctors. The Missouri Hospital Association’s 2017 annual workforce report brightened the spotlight on the shortage and painted an even more dire picture for rural areas. “All evidence describes a primary care shortage that will increase throughout time,” the report states. “We are now at a crossroads where the primary care crisis and health care reform meet.” Innovation and technology are indeed changing the faces of hospitals across the country. Many hospitals were originally built to support a complex system of laboratory, radiology, pharmacy, physical therapy, and other services that were ancillary to surgical suites, emergency departments, and other traditional medical services. But many of those services are now moving off-site or are provided by surgery centers, just one of the factors that has spelled doom for smaller hospitals. Case in point: Blair pointed out that 60 percent of surgeries are currently done on an outpatient basis. Research indicates that within 10 years, that number will rise to 85 percent. “We need to transform every two or three years if we’re going to be successful,” Blair says. “We’re trying to anticipate what all these future trends are and make sure we are renovating and innovative so we’re relevant 10 years from now.” Curtright says the development of sub-specialists through the MU School of Medicine is already key to that transformation. “If we could get in our time machine and go forward 20 years, I’ll bet you there is still an outstanding, highly complex, traditional hospital that’s sitting right here,” Curtright says. “Without a doubt. But more and more, there’s going to be fewer of those places.” CBT

MU Health Care opened a newly expanded and renovated emergency department at University Hospital in October 2018. COLUMBIABUSINESSTIMES.COM 67

68 FEBRUARY 2019

MILKING A PARTNERSHIP SEVEN YEARS IN THE MAKING MURR and Northwest Medical Isotopes come together to manufacture an isotope not produced in the country since the 1980s, despite the countryâ&#x20AC;&#x2122;s heavy usage of the product.

BY DAVID MORRISON

PHOTOGRAPHY BY ANTHONY JINSON

COLUMBIABUSINESSTIMES.COM 69

NORTHWEST MEDICAL ISOTOPES LLC scouted out more than a dozen locations around the United States when they were making plans to build a new radioisotope production facility. The Corvallis, Oregon, company needed a place with a top-flight research reactor nearby plus a pool of trained potential employees to help run the facility once it became operational. It needed a place that could offer enticing tax incentives to build, as well as one that was relatively close to one of the two national distribution centers for the generators needed to prepare the isotope it would produce — Molybdenum-99 — for use in hospitals, or at least some place close to an airport that could shuttle its product to one of the centers. MU’s research reactor has been operating at 10 megawatts since 1974, making it the nation’s highest-power university reactor, and runs 6.5 days a week all year long. MURR has produced decades' worth of employees trained in working with radioactive materials. The university also just happened to have a parcel of land in Discovery Ridge Research Park, just south of Interstate 70 and east of U.S. Highway 63, about a 10-minute drive from Columbia Regional Airport and a 125mile jaunt from one of those generator distribution centers, in St. Louis. (The other is in Boston.) Oh, and Boone County was able to offer about $7 million in tax abatements.

An injection of Tc-99m, paired with an imaging machine, can give doctors a real-time, surgery-free view of how the patient’s blood is flowing. Northwest, with irradiation support from MURR, will produce the Moly-99 and then ship it to a radiopharmaceutical manufacturer, which then separates the Tc-99m and puts it into a kit for usage in hospital settings. “The vernacular in the industry is a ‘cow,’” MURR Director J. David Robertson says. “We send the Moly-99 and a technician ‘milks’ the Technetium-99m from the Moly-99 cow we’re generating.”

MAKING THE ISOTOPE DOMESTICALLY The U.S. has experienced intermittent shortages in the isotope in recent years as elements of the supply chain have been interrupted, resulting in a warning from the Society of Nuclear Medicine and Molecular Imaging of a “significant shortage” internationally as recently as November.

Around 2009, the federal government started getting involved. “They felt that we needed to start having a domestic supply because we can’t just deal with international supply,” Haass says. “It’s something that is so important. When we use 80 percent of the worldwide demand and it’s all coming internationally, that didn’t make any sense, and it affected our health care.” Congress passed the American Medical Isotopes Production Act, which authorized the domestic production of medical radioisotopes like Moly-99, in 2012. Northwest was founded in 2010 in anticipation of a move like this and, starting in 2012, it began contracting MURR for research into methods for developing Moly-99. They needed to be able to ensure a safe, fast, efficient model all the way from production through distribution. “It’s a short-lived isotope, so you need to be able to move things around efficiently,” says MURR Associate Director Ken Brooks. “I often

THE ISOTOPE DETAILS Within the next three years, the plan is for Northwest to be producing Molybdenum-99, dubbed “Moly-99” for short, for hospital patients all over the country from its brand-new facility in Columbia. MURR will play a key supporting role, irradiating low-enriched uranium and shipping it to the facility for Northwest to convert into Moly-99. “The U.S. consumes about 80 percent of worldwide Moly-99, and it has not been produced domestically since the 1980s,” says Northwest Chief Operating Officer Carolyn Haass. “Our country has been developing a strategy for the production of Moly-99 since 2007. MURR has supported Northwest in research and development of Moly-99, which has helped them advance their science.” The utility of Moly-99 is in one of its “daughter products,” Technetium-99m. The most common radioisotope used in nuclear medicine procedures in the U.S., Tc-99m is used more than 35,000 times a day for imaging purposes. Say, for example, a patient is experiencing a blockage in the supply of blood to their heart. 70 FEBRUARY 2019

MURR reactor

Artist renderings of the facility provided by Northwest Medical Isotopes.

COLUMBIABUSINESSTIMES.COM 71

â&#x20AC;&#x153;The U.S. consumes about 80 percent of the worldwide Moly-99, and it has not been produced domestically since the 1980s. Our country has been developing a strategy for the production of Moly-99 since 2007.â&#x20AC;? - CAROLYN HAASS 72 FEBRUARY 2019

Mo-99 dispensing system

describe it, as many in the industry do, as melting ice cubes. But there’s not a Yeti cooler to stop this from melting.” Northwest announced its plans to build the production facility in Columbia in 2014, but it did not receive the final go-ahead from the U.S. Nuclear Regulatory Commission until May 2018. In September, the Boone County Commission voted to approve a tax break for the future $108 million Northwest facility at Discovery Ridge, one that provides for a 50-percent property tax abatement from Boone County and its taxing districts for the next decade. Haass says the plan is to begin construction on the approximately 69,000-square-foot facility next summer. The project is slated to take about 17 months, with an average daily workforce of 38 employees and a peak of 82 needed during the construction process. After construction is complete, the facility will undergo a “cold commissioning,” in which it will run through all its processes using water to make sure everything is functioning properly. Once that’s done — and once all the applicable permits and licenses are cleared — the facility goes “hot.” “That means we can bring in the uranium,” Haass says. “That still takes us three to six months. You just can’t start up the facility and

have it work the next day. You have to make sure everyone is trained from a cold perspective before going into real operations.” All in all, Haass estimates that the facility will be entirely operational by late 2022. As part of the tax incentive stipulations, Northwest has agreed to create and maintain at least 85 jobs that pay at or above the county average wage. Haass estimates that the facility will employ 104 for the first couple of years, with a peak employment of 138 for the 40-year operational life of the facility. About 85 to 90 percent of those workers will be recruited from the Columbia area, Haass says, all but some senior management and senior-level engineer positions. “The idea is there’s a need to have a domestic supply of Moly-99, both in case you ever had a situation where you closed the borders for bringing in those melting ice cubes, if the government ever chose to do that, and just to strengthen the supply chain,” Robertson says. “It’s a very precarious supply chain today. We have significant amounts of activities and workforce development for people to get the training and understand the quality programs required for working with radioactive materials. That’s attractive to businesses.”

THE ADVANTAGES FOR OUR COMMUNITY Aside from the infusion of high-paying jobs that Northwest will be bringing to the community, Brooks and Robertson see two more distinct advantages that the Northwest facility will bring to Columbia, MU, and MURR. First, the prestige of being involved in the process of producing such a crucial component to the health care industry. Second, the influx of research seed money that the arrangement with Northwest will provide. Robertson says MURR has already worked with industry partners to develop treatments for inoperable liver cancer and to help manage the pain of bone cancer, and they’ve helped create a brain imaging agent as well. The cachet and financial support from the association with Northwest will continue opening up those opportunities. “No other research reactor on the planet operates as reliably and frequently as ours,” Brooks says. “When you’re talking about supplying short-lived radioisotopes, that’s a way the university can serve the nation in a really deep and meaningful way. And the university is forever looking for new ways to generate revenue to fund additional research. That’s how it’s meaningful for the university.” CBT COLUMBIABUSINESSTIMES.COM 73

74 FEBRUARY 2019

OUT

OLD

High-premium plans are out and other benefit trends small business owners need to know.

BY BRENNA M c DERMOTT

COLUMBIABUSINESSTIMES.COM 75

AS HEALTH INSURANCE costs continue to rise, sticking with a grandfathered plan is no longer the most effective use of a small business’s funds — or its employees. Instead, employers should re-evaluate available health plans and focus on educating employees about utilizing preventive care and understanding their benefits.

RE-EVALUATE THE STATUS QUO

It’s easy for a small business owner to simply renew their health plan year after year. Business owners are busy and maybe don’t understand enough about health plans to feel confident in making a change, says Kerri Roberts, director of operations and human resources at TIG Advisors. But it’s critical that businesses educate themselves — it could save them and their employees big bucks. For many employers, it might feel like switching from a high premium plan to a high deductible plan would disappoint employees or feel like a decrease in coverage, but in some cases, Roberts says, employees could end up paying less. “I see people get absolutely shocked that they could save money on a high deductible health plan,” she says. The monetary savings gathered from a shift in health plans from a low deductible and high premium plan to a high deductible health plan (paired with a health savings account) typically comes from overall health care spend. “It’s just a misconception that people need to get educated about,” she says. Roberts is seeing many employers move toward high deductible plans. “We recommend to employers that are trying to offer more affordable plans that they would maybe deposit in an HSA for their employees to incentivize employees to go to a high deductible health plan,” Roberts says. Another option: A few large organizations could choose to become self-insured and pool their resources to open a shared employer clinic and then encourage employees to use it. Roberts forecasts that shared employer clinics will also become a popular option.

‘WELLNESS’ PROGRAMS ARE OUT

Walking contests and chair massages at work are not effective ways to provide a “wellness” experience at work, Roberts says. For starters, those added benefits are not cost effective. They’re also not sustainable in a small business and are often ill-conceived and unrealistic. “I see a lot of companies talk about having wellness options, but I don’t see many companies successfully launch them and then follow up with them,” Roberts says. And if employers want to provide a benefit like a Fitbit for every employee, they could work with their insurance adviser to see if the insurance carrier offers any subsidies to help. 76 FEBRUARY 2019

COLUMBIABUSINESSTIMES.COM 77

FLEXIBILITY IS KEY

There is more flexibility for employees now because health insurance carriers are offering customizable plans, says Philip Naught, benefits manager of Naught-Naught Insurance Agency. “Where one employee might be younger, have a family, and have particular needs, and another employee maybe is a more mature empty nester that’s more financially stable and has a different level of risk tolerance, every employee could, therefore, customize a benefits package to their needs,” Naught says. This customization allows for more control over costs for employers and it makes the plans more useful for employees, who will often select plans based on age and income. For example, an employer could commit a certain contribution toward each employee, and then each employee could elect to purchase extended benefits beyond that, Naught says.

ASSOCIATION PLANS

Roberts said another trend is utilizing association health plans, a special pooled solution fashioned for small businesses to address the rising costs of health care. If a business belongs to an association that offers a special association plan (the Missouri Chamber of Commerce is one), they can access these potentially less expensive plans.

OTHER BENEFITS

Naught encourages business owners to also offer dental, vision, and life insurance in the benefits packages, as they’re great for attracting employees. “We always advise employers to consider adding or offering disability coverage, even if it’s on an employee-paid basis,” Naught says. “Protecting one’s family’s income should be part of a person’s financial planning.” Another popular benefit is offering an employee assistance program, which offers counseling via phone or in-person. The program, available from many carriers, might offer mental health counseling, legal resources, or referrals. It’s an affordable benefit and many employers simply purchase the product for employees, he says. “I do see a trend of employers really trying to do their best to make sure their employees have the best,” Naught says. “There’s a reality of working within a budget, but they really do want to make sure all their employees are taken 78 FEBRUARY 2019

care of inside and outside of the workplace. And that’s why those employee assistance programs are becoming more popular.”

EDUCATING EMPLOYEES

As plans become more customizable and employees shoulder more of the burden for health insurance, businesses should make sure they’re educating employees about their benefits, Naught says. “When you’re pushing your employees to those plans with low deductibles and high premiums, you are kind of putting it all on the employee, and a lot of times employees just take those as a safety net,” Roberts says. “They don’t do research, they’re not proactive with their health care.” For instance, many plans will cover blood work twice a year — that could be a critical way to prevent illness and health care expenses down the road — but employees might not even be aware it’s a benefit. “The more people know what they do and don’t have to pay for, the more they would take advantage of that,” Roberts says.

INITIATING BENEFITS AT YOUR COMPANY

For business owners considering offering benefits for the first time, start slow, Naught says. Many employers start with health coverage and expand down the road. Trouble with recruitment and retention is usually a good indicator that it’s time to start offering benefits. “Advisers such as myself can help share what’s competitive in any given industry to help recruit and retain employees,” Naught says. Ask other business owners for references and look for an adviser who is independent and impartial to the insurance carrier, one that brings value added such as information, technology, and tools. Confirm the adviser will shop and market to multiple carriers when researching products, he says. “Unless you’ve got somebody in your HR department, and a lot of small businesses don’t even have an HR department, you’ve got no one really being proactive on how employees can take full advantage of health care,” Roberts says. CBT

COLUMBIABUSINESSTIMES.COM 79

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80 FEBRUARY 2019

IN FOCUS

THE HELP THEY DESERVE

How a 2012 mental health tax ballot issue is improving the lives of Boone County residents. BY KACEN J. BAYLESS

IN FOCUS

n September, former First Lady Michelle Obama took the stage at Chaparral High School in Las Vegas as part of a week-long “When We All Vote” rally to encourage residents to register and vote. Obama’s message was simple: Voting is how democracy works. To prove this, she cited several examples in her speech of communities coming together to vote on important issues. One of those examples hits close to home for Mid-Missourians. “There’s a little county in Missouri, Boone County,” she said. “There were families struggling to get their children the mental health care they needed. Hundreds of families had been requesting counseling services for their kids, but the resources weren’t there. So the folks in Boone County came together — they came up with a plan to fund children’s mental health care. They gathered up the signatures they needed to get the issue on the ballot and then they got out and voted, and today, just a few years later in Boone County, they’re providing counseling for kids who need it.” The plan Obama referenced went before voters in 2012. Boone County voters passed a permanent quarter-cent sales tax, allowing for one cent of every $4 spent to go toward youth services in the county. The tax goes into the Children’s Services Fund, which funds psychiatry, counseling, and emergency shelter programs. The tax currently generates about $6.7 million a year. A Missouri statute lists out the types of services that may be funded by the Children’s Services Fund. A few of the 11 types of services listed are: temporary shelter, outpatient treatment programs, unmarried parent services, counseling, psychological evaluations, and crisis intervention. After the tax was passed, in 2012, $4,741,873 in revenue was collected for the Children’s Services Fund in 2013. But how is the fund doing now?

FIVE YEARS LATER Community Services Department Director Kelly Wallis, who oversees the Children’s Services Fund, says the tax revenue started accruing in April 2013 and has increased a little each year since. However, due to a projected decrease in sales tax revenue this year, Wallis says the fund’s revenue will not continue to increase at the same rate as previous years. After collecting more than $4.7 million in revenue in 2013, the revenue collected for the Children’s Services Fund jumped to over $6.4 million in 2014, around $6.6 million in 2015, $6,766,350 in 2016, and $6,775,920 in 2017. (The revenue difference between the last two years, obviously, is relatively small.) Wallis says the Children’s Services Fund has very low overhead expenses. The revenue from the tax pays for the salaries of Wallis and three other staff members, and that’s it; the rest of the funds go toward programming. When residents in Boone County passed the tax, with 57 percent of the vote, Wallis says the ballot stated that the tax would go toward improving the safety and well-being of children and the strengthening of families. And that has remained the mission of the Children’s Services Fund since its creation.

CHOOSING ORGANIZATIONS TO FUND The Boone County Children’s Services Board allows organizations in the community to apply for funding each year through a request for proposal

82 FEBRUARY 2019

REVENUE AMOUNTS FOR THE CHILDREN’S SERVICES FUND FOR 2013 THROUGH 2017 2013 $4,741,873.15

2014 $6,438,173.00

2015 $6,617,337.24

2016 $6,766,350.66

2017 $6,775,920.00

C h i l d re n ' s S e r v i ce s Fu n d process. This usually takes place during the summer months. The proposals are reviewed by the board and staff members, explains Wallis. The board then lets organizations know their decision in the winter. Every two years, the board sends out RFPs to any organizations that fit the fund’s specifications. In those in-between years, the Children’s Services Board can also send out targeted requests to pay for services that meet a specific need in the community like youth homelessness or early childhood services. Although specific numbers on programs and total revenue for the Children’s Services Fund in 2018 won’t be released until this spring, Wallis says her department accepted open requests for children’s services funding through 35 proposals totaling $7.8 million. There is only about $6.5 million estimated this year to fund these requests, so the board had to be selective in choosing which programs to fund. In 2017, the Children’s Services Fund allocated over $6.7 million towards 33 organizations. The amounts given ranged from $5,655 to $701,516. Of the 33 contracts, eight funded MU programs, which covered almost 50 percent of the total money available. Some of the major programs funded in 2017 include Central Missouri Community Action, Burrell Behavioral Health, and the grand opening of the Family Access Center of Excellence, an MU-based center that provides access to mental health services for families with children. The board reviews several pieces of information in order to decide which programs to fund and which to cut. “We want to know that the services provided are research-based, that the capacity of the organization to deliver the services is there, whether the service is needed in the community, and if the outcomes that they’re proposing are something that we’re wanting for our community,” Wallis says. Many of the programs originally funded by the Children’s Services Fund continue to be funded. Wallis says she’s seen good results from a lot of programs, but occasionally staff members and the board don’t receive

“The folks in Boone County came together — they came up with a plan to fund children’s mental health care. They gathered up the signatures they needed to get their issue on the ballot and then they got out and voted, and today, just a few years later in Boone County, they’re providing counseling for kids who need it.” –Former First Lady Michelle Obama

the necessary information needed to justify continued funding of a program. Other times, Wallis says, a program will choose not to re-seek funding themselves due to a variety of reasons. When judging the success of the fund each year, Wallis says she and her staff examine each organization funded and its impact on the community.

“We make every organization submit data to us about the outcomes they are able to achieve with the kids and families that they serve, and we take all that information and look at all the kids they serve,” she says. “It’s one thing to provide a service, but it’s another thing to really benefit the children and families that are being served, so we’re really looking at that information.” CBT

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Deeds of Trust WORTH MORE THAN $500,000

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You’re on the guest list. MidMoTix is your local option for conveniently selling and purchasing tickets to events in the Mid-Missouri area.

$5,500,000

$930,000

Columbia Manor Inc. LT 1 Juniper Ridge

Spratt, Sheldon & Natsuko Central Bank of Boone County LT 21B Rokes Bend Plat 2

$3,400,000

$930,000

RVR Enterprises Inc. LT 103 Crosscreek Center Plat 1

Spratt, Sheldon & Natsuko Central Bank of Boone County LT 144 Copperstone Plat 1

$2,550,000

$872,500

Furnell Investments Inc. LT 1 BL 3 R D Poages Add

Gessing, Heather & Kendall Landmark Bank STR 26-49-14//E

$2,200,000

$810,775

Oil Investments RTK LLC

Bianco, Frederick John & Sarah Jo Landmark Bank STR 8-47-11/E/SW SUR BK/PG:4331/31 AC 10 FF Tract 109

Mid America Bank

Central Bank of Boone County

The Callaway Bank

Central Bank of Boone County LT 1 Goda’s Leatherwood Center $1,900,000

Columbia Manor Inc. Mid America Bank LT 1 Juniper Ridge

midmo TIX FOLLOW US: Interested in learning more? Contact us at info@MidMoTix.com

86 FEBRUARY 2019

$1,500,000

Crown Power & Equipment Co. LLC Central Bank of Boone County STR 19-49-12//NE SUR BK/PG: 994/427 FF Tract 1 W/ESMT $1,165,000

B M K Properties LLC Central Bank of Boone County KT 6 Liberty Square BLK 3

$750,000

Ashland MHC LLC JAJ LLC STR 11-46-12/NW/SW SUR BK/PG: 4945/103 $600,000

Rental Solution LLC CJLS Real Estate Transfer LLC LT 304 Old Hawthorne Plat 3 $500,000

Loah LLC; Grey Box Properties; Rericha, James & Katie Fenton, David E & Caryn R LT 25 FF BARKWELLS SUB

$1,110,000

West Creek Properties LLC Mid America Bank

432 deeds of trust

STR 2-48-12//NW SUR BK/PG: 742/101

were issued between

FF Except

11/27 and 12/24 CBT

BUSINESS • P EOPL E • VOIC ES • FY I

Economic Index LABOR

HOUSING

OCTOBER 2018

NOVEMBER 2018

United States

Total single-family

Labor force: 162,723,000

home sales: 152

Employment: 156,952,000

Existing single-family home

Unemployment: 5,771,000

sales: 132

Rate: 3.5 percent

New construction single-

For over a decade, our goal has been to increase the

family home sales: 20

effectiveness of nonprofit leaders and impact of the

Missouri

Single-family homes average

Labor force: 3,045,706

listing sold price: $227,701

Employment: 2,968,995

Single-family homes median

Unemployment: 76,711

sold price: $190,500

Rate: 2.5 percent Boone County Labor force: 99,098 Employment: 97,352 Unemployment: 1,746

Single-family homes active listings on the market: 776 Single-family homes average

Labor force: 67,717

So They Can

Strengthen Our Community organizations they serve. We do this by providing a portfolio of capacitybuilding services includes: Leadership Coaching and Development Strategic Planning

days on market: 48

Board Training and Retreats

Single-family homes pending

Strengths-Based Team Building

listings on the market: 121

Rate: 1.8 percent Columbia

We Strengthen Nonprofits

Skills-Based Workshops Facilitation of Retreats & Meetings

UTILITIES DECEMBER 2018

Employment: 66,524

Succession Planning Executive Transition Management Organizational Capacity Building Assessment

Unemployment: 1,193

Water

Rate: 1.8 percent

December 2018: 49,417 December 2017: 49,107 Change #: 310 Change %: 0.631

CONSTRUCTION NOVEMBER 2018

Number of customers receiving service on January 1, 2019: 49,452

Residential building permits: 5

Electric

Value of residential permits:

December 2018: 50,623

$1,869,666

December 2017: 50,192

Commercial additions/

Change #: 431

alterations: 6

Change %: 0.859

Value of commercial

Number of customers

additions/alterations:

receiving service on January 1,

$666,282.54

2019: 50,675

To learn more, visit or call:  NewChapterCoach.com |  573.228.9600

CBT COLUMBIABUSINESSTIMES.COM 87

ADVERTISER INDEX ACCOUNTING PLUS..................................................................................................... 91

LANDMARK BANK.......................................................................................................... 2

ACHIEVE BALANCE.................................................................................................... 80

MEDIACOM.........................................................................................................................4

ANTHONY JINSON PHOTOGRAPHY.................................................................... 42

MERCEDES OF COLUMBIA.......................................................................................40

ANYTIME FITNESS....................................................................................................... 34

MIDMOTIX........................................................................................................................ 86

ATKINS, INC.................................................................................................................... 38

MY SISTER'S CIRCUS...................................................................................................37

BIG TREE MEDICAL HOME.................................................................................. 8 & 9

NATHAN JONES LAW................................................................................................. 85

BMW OF COLUMBIA................................................................................................... 50

NAUGHT NAUGHT INSURANCE AGENCY.......................................................... 80

BROCKMEIER FINANCIAL SERVICES...................................................................32

NEW CHAPTER COACHING......................................................................................87

COLUMBIA MARKETING GROUP...................................................................... 6 & 7

ORGANIZE THAT SPACE........................................................................................... 80

COMPASS CHIROPRACTIC.................................................................................. 8 & 9

PCE, INC............................................................................................................................ 18

CONVERGENCE FINANCIAL.................................................................................... 48

PROVIDENCE BANK.................................................................................................... 44

D & M SOUND................................................................................................................. 24

REALTY EXECUTIVES - HEATH HIGGINS............................................................ 10

EVEXIAS.............................................................................................................................. 5

SOCKET............................................................................................................................ 20

GFI DIGITAL....................................................................................................................... 3

STANGE LAW FIRM...................................................................................................... 88

GREAT CIRCLE...............................................................................................................37

THE BROADWAY HOTEL............................................................................................ 18

HAAS ACCOUNTING................................................................................................... 46

THE CLUB AT OLD HAWTHORNE......................................................................... 24

HAWTHORN BANK...................................................................................................... 92

TRUE FALSE FILM FEST............................................................................................ 79

HEART OF MISSOURI UNITED WAY............................................................. 12 & 13

TRUMAN VA HOSPITAL............................................................................................. 68

I-70 CONTAINER........................................................................................................... 44

UNIVERSITY OF MISSOURI HEALTH CARE..........................................................11

INSIDE THE LINES........................................................................................................ 34

WILSON'S FITNESS......................................................................................................74

JC TOTAL HEALTH........................................................................................................ 16

WOMEN'S WELLNESS CENTER.............................................................................. 14

88 FEBRUARY 2019

B U SINESS • P EOP L E • VOIC ES • FY I

BY T H E N U M BER S

IN COLUMBIA IN 2017 THERE WERE:

108

Primary care physicians for every 100,000 people in Boone County

Dentists for every 100,000 people in Boone County

Source: Data USA

2,063

STD office visits

201

annual exams given

8.3%

9.2%

Percentage of people under the age of 65 with a disability in Boone County as of 2018

Percentage of people in Boone County under the age of 65 without health insurance

Source: United States Census Bureau

19,102 immunizations administered

Source: Columbia/Boone County Public Health and Human Services 2017 Annual Public Health Report COLUMBIABUSINESSTIMES.COM 89

B U SINESS • P EOP L E • VOIC ES • FY I

T H I S OR T H AT

JOHN GLASCOCK City of Columbia, Interim City Manager

Mac Details

Big Picture

Cursive

Early Bird Cinema Michael Jackson Firefox 9-5 Learn At Your Desk

Chrome Flexibility Teach In a Meeting

Cake

City

Planner Traditional Certain Country

Save

Spend

Summer

Winter

Cat Passenger Car Ocean Optimistic Business

Dog Driver Plane Mountains Realistic Casual

Solo

Team

For Here

To-go

Books

90 FEBRUARY 2019

The Beatles

Pie

Skeptical

1. Being an engineer, it depends on the discussion. 2. Both. 3. Mother Nature. I prefer to be outside whenever possible. 4. Pencil and paper. 5. 7 a.m. to 5 p.m. 6. Walking around talking to staff. 7. Discussion. 8. Extrovert at work, introvert during personal time. 9. Face-to-face.

Netflix

Beer

Modern

A M E N DME N TS A N D CONDI TI ONS

Night Owl

Wine

Improviser

Photography provided by John Glascock

Magazines

Reading

Writing

Creative

Analytical

Introvert

Extrovert

Podcast Cluttered Concept Fiction Text Soup

Playlist Minimalist Execute Nonfiction Call Sandwich

Meet our Payroll Team! PAYROLL MADE EASY.

Leave it all to us! 573.445.3805 | www.AccountingPlusInc.com Schedule an appointment online! Come see us for your Business Accounting & Tax needs! 1604B Business Loop 70W | Columbia, MO Right across from Cosmo Park! COLUMBIABUSINESSTIMES.COM 91

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