Oregon rural hospitals losing revenue, laying off workers

By ANDREW SELSKY

SALEM, Ore. (AP) — Rural community hospitals in Oregon are seeing revenue plunge and resorting to laying off and firing employees to cope with a ban on elective surgeries while health officials battle the coronavirus outbreak.

Some hospitals have seen revenue decline as much as 60% in a month, said Becky Hultberg, CEO of the Oregon Association of Hospitals and Health Systems.

“Staffing is one of the hospital’s most significant costs. So as revenue declines, some hospitals have been forced to furlough or lay off staff,” she said.

Hospitals in the state have enough capacity to handle an expected peak in virus cases later this month, according to projections, but the association says it’s too early to relax the restrictions.

Hospitals in other states are also losing revenue. On Wednesday, 19 U.S. senators — Democrat and Republican — warned that “without intervention, COVID-19 will close hundreds of rural hospitals across the country, and tens of thousands of rural patients will lose access to their nearest emergency room.”

The senators, including Democrat Jeff Merkley of Oregon, told U.S. Department of Health and Human Services Secretary Alex Azar that a $100 billion federal relief fund for health care providers should prioritize rural facilities, with 20% directed to the operations.

Oregon Gov. Kate Brown on March 17 ordered that all elective and non-urgent medical procedures be cancelled or rescheduled until at least June 15 to preserve masks and other protective equipment for the state’s COVID-19 response.

Some hospitals also lost revenue because fewer people visited emergency rooms, opting instead for virtual visits with a medical professional, fearing an ER could expose them to the virus.

Claims for unemployment insurance reflect the scope of the job losses. In the past week, the Oregon Employment Department received 8,800 unemployment claims from workers in health care and social assistance fields, up from 396 three weeks earlier. Only accommodation-food services workers filed more claims.

In Oregon’s remote southwest corner along the Pacific Ocean, Curry Health Network has laid off, furloughed or cut back the hours of 192 employees. That’s more than half of the staff who work in the network’s hospital in Gold Beach and several medical clinics. Managers, meanwhile, took a 20% reduction in pay.

“We work on a very small margin,” said Cheryl McDermott, a spokeswoman for Curry Health Network. “If we can’t do elective procedures, patient volume is dropping and it has a very strong financial impact. Additional funding is definitely needed for us and other hospitals throughout the United States.”

Sara Dickerson, a family nurse practitioner, was laid off by the network on Tuesday.

“What is most upsetting to me was the treatment of my medical assistant, who was terminated on March 31,” Dickerson told the Curry Coastal Pilot newspaper. She said the assistant now has no medical insurance.

The Oregon Association of Hospitals and Health Systems has asked the governor for $200 million in new state funding to be allocated directly to hospitals to address urgent needs and keep providing services.

The state, however, is also expected to have less money because the newly unemployed are no longer paying income taxes.

Hultberg said her group recognizes that significant budget challenges lie ahead but added: “People count on hospitals in a crisis.”

U.S. Rep. Greg Walden, a Republican representing a wide swath of eastern and central Oregon, has also urged that rural hospitals be prioritized for money approved by Congress.

“Our rural community hospitals are struggling financially right now in large part because the governor shut down any elective procedures,” Walden said.

Oregon is not expected to see a big spike in COVID-19 cases as long as people keep staying home and maintain social distancing when out on urgent errands, state health officer Dean Sidelinger said.

“We know it comes at a huge sacrifice,” Sidelinger said about the manageable number of cases. “People have lost their jobs. Our small and large businesses are suffering.”

The peak of the outbreak is expected around April 22 in Oregon, according to a projection by the Institute for Health Metrics and Evaluation, noting there should be more than enough hospital beds and ICU beds available.

Hultberg, however, is not advocating that restrictions on elective procedures be relaxed.

“I would rather be having the conversation today about hospital sustainability than the conversation about mortuary capacity,” Hultberg said. “It is too early to talk about changing course.”

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Andrew Selsky is on Twitter at https://twitter.com/andrewselsky

Virus sparks prison riot, hits more WA long-term care homes

SEATTLE (AP) — Inmates at a Washington state prison staged a large protest following new coronavirus diagnoses at the facility and health officials say they continue to see high numbers of cases in the state’s long-term care facilities.

More than 9,600 people have tested positive for COVID-19 and at least 446 have died, according to the Department of Health.

State Health Officer Dr. Kathy Lofy said there are signs that the state has begun to “flatten the curve” but said people should continue to stay home and keep their distance from others.

“We are no where near being out of the woods here,” said Secretary of Health John Wiesman. “This virus can easily spring back.”

Lofy said as of April 5 authorities had identified the virus in 126 of long-term care facilities. Washington’s first large coronavirus outbreak was at the Life Care Center in Kirkland, Washington, which has been linked to dozens of deaths.

Inmates at the Monroe Correctional Complex held a demonstration on Wednesday night after six inmates tested positive at the prison, according to the Washington State Department of Corrections. The latest two cases at the facility that can house up to 2,500 inmates were men aged 68 and 28.

Corrections officers used verbal orders, pepper spray and rubber pellets to get the demonstrators under control, but the inmates ignored those efforts, officials said. Both housing units were evacuated and the situation was under control soon afterward. No one was injured.

The six men who tested positive were transferred to an isolation unit, where the health care team provided monitoring and support. Corrections officials are conducting an internal investigation.

Five correctional staff members have also tested positive.

Gov. Jay Inslee said Thursday that he recognizes the concerns inmates and their families have about the virus inside correctional facilities, and is trying to balance inmate needs with public safety.

“DOC has been working closely with the Department of Health to implement strategies around testing, social distancing, quarantine, isolation and other practices to prevent the spread of this virus,” he said.

A handful of inmates at the Monroe facility are asking the state Supreme Court for help. They previously filed a petition asking the court to order Inslee and corrections Secretary Steve Sinclair to immediately release inmates over the age 50, those with underlying medical conditions and inmates who are within 18 months of their release date.

On Thursday, they filed an emergency motion, asking the court to immediately act on their requests and test everyone who’s being held at the prison.

“It appears that DOC may be using a show of force rather than take other more appropriate public health measures to resolve the legitimate concerns of people trapped in MCC-MSU,” their motion said. “People living in MCC-MSU are scared and not being appropriately protected.”

The Washington Supreme Court responded to the emergency motion Thursday with a letter saying the state must respond to the motion by 9 a.m. Friday.

Inslee and Sinclair held a press conference Thursday afternoon to discuss the way the state is handing the prison system as the COVID-19 continues to grow.

Corrections officials are screening all people in the prison system for symptoms and they stopped visitations weeks ago, Sinclair said. They’re also working to release some non-violent offenders who are within 60 days of their release, he said.

Inslee said that group of offenders would include people who are over 60 and have underlying health conditions that make them more vulnerable to a negative outcome should they contract the disease.

Sinclair said they were following the health department’s guidelines on testing for COVID-19, and are only testing people who have symptoms. He later said that they have had six inmates test positive and they are awaiting results on 54 other cases.

Two residents at the Spokane Veterans Home tested positive for the disease and one of those residents died on Wednesday, officials said. The residents were roommates and were isolated when their symptoms appeared.

The resident had been on end of life care for some time and had underlying medical conditions, officials said. The other resident who tested positive remained at the facility and symptoms have lessened, officials said.

“I want to say how incredibly grateful I am to the staff at the Spokane Veterans Home, who are coming to work each day to serve our veterans and their families,” said Patrick McNabb, administrator of the Spokane Veterans Home.

State health officials continue to distribute personal protective equipment to front-line workers across the state, Wiesman said. As of March 16, they had shipped 2.2 million items to health care providers, including N95 masks, surgical masks, gloves, gowns and face shields.

They have 3.8 million items that are being processed for shipment, he said. Hospitals, EMS workers and long-term care facilities that are handling positive cases are getting top priority for these supplies, he said.

Rapid virus testing machines delivered to 3 rural Oregon hospitals

Three rural hospitals in Oregon will get COVID-19 rapid testing instruments, Gov. Kate Brown announced on Wednesday. 

The first hospitals to receive the Abbott ID NOW machines are Curry General Hospital in Curry County, Pioneer Memorial Hospital in Morrow County, and Lake District Hospital in Lake County.

The point-of-care COVID-19 testing machines are capable of returning positive or negative test results in minutes. The three hospitals will begin validation testing this week, and rapid testing will not be immediately available to the public, Brown said in a release.

“Expanding rapid testing in Oregon is key to ensuring we have the capacity to track and contain new cases, keep Oregonians healthy and safe, and prevent future outbreaks,” Brown said. “Rather than taking hours or days to return a test result, these instruments are capable of returning positive or negative test results in minutes. This capability is especially crucial in our more remote communities, where rapid testing will help minimize the amount of travel needed for trips to the doctor’s office.”

The U.S. Department of Health and Human Services (HHS) sent Oregon 15 testing machines, the same number being sent to all other states, along with a small supply of testing kits and materials.

“I want to be very clear: the number of testing kits we have received from the federal government for these new machines does not even come close to approaching the need we have in Oregon right now,” Brown said. “I am committed to working with our federal partners to secure additional test kits as Abbott and other companies ramp up their production capacity.”

Although Oregon received 15 Abbott ID NOW instruments, the federal government shipped five boxes of testing kits with the machines, with 24 tests in each box.

Until more Abbott test kits are secured, the additional rapid testing machines cannot be distributed to priority areas.

With limited supplies, OHA will distribute Abbott ID NOW resources based on the following criteria:

  • Areas of the state with no access to COVID-19 testing.
  • Areas of the state with a limited number of first responders.
  • Areas of the state where courier services for the state public health lab and commercial labs are limited or unavailable.
  • Areas with a high population of older adults and other at-risk groups.
  • Areas where hospitals or clinics do not already have access to an Abbott ID NOW instrument.

Nearly 400 virus deaths in Washington state

SEATTLE (AP) — A look at coronavirus-related developments in Washington:

NEARLY 400 DEATHS

Health authorities in Washington on Tuesday announced more than 20 new coronavirus deaths in the state, bringing the total to at least 394.

According to figures from the Department of Health, there are more than 8,600 confirmed cases in Washington. The bulk of the cases and deaths are in King and Snohomish counties.

For most people, COVID-19 displays mild or moderate symptoms, such as fever and cough that clear up in two to three weeks. For some, especially older adults and people with existing health problems, it can be more severe, causing pneumonia or death.

WASHINGTON LEGISLATURE MIGHT BE CALLED BACK BEFORE JANUARY

Washington Gov. Jay Inslee says the Legislature may need to be called back for a special session because of the coronavirus outbreak. The Legislature isn’t schedule to return until next January, but Inslee said it was probable they may need to return, “given the extent of the economic damage that we have suffered.” He said the timing of that is uncertain, but he said that he was ready to call the Legislature back early if more aggressive steps for spending was needed before the end of the year. He noted that the state had already dispersed $120 million from $200 million the Legislature allocated to COVID-19 response before they adjourned last month.

SMALL BUSINESS EMERGENCY GRANTS

Inslee announced the state is opening up an application process for grants that will provide up to $10,000 for businesses with up to 10 employees. Businesses can use the money to pay rent, utility bills, supplies and other operating expenses. The $5 million in funding for the grants comes from the governor’s strategic reserve fund and will be administered by the state Department of Commerce. Businesses can apply at coronavirus.wa.gov.

BUSINESS RESILIENCY PROGRAM:

The Department of Commerce is providing a business resiliency assistance program that is partnering with various organizations to ensure that businesses have access to help that is available. Help is also available for small businesses who might be eligible for forgivable small loans through the Small Business Administration.

FOOD BANKS STRUGGLING

Inslee also on Tuesday announced an effort to resupply Washington’s food banks, which are running low due to the coronavirus outbreak.

Inslee says because of increasing demand supplies at the state’s food banks have dropped to dangerously low levels, with an estimated 1.6 million people — double the usual number — in expected to seek food aid.

The relief effort called WA Food Fund, is being managed by Philanthropy Northwest, a network of philanthropic organizations. The effort will combine business and philanthropic dollars with individual fundraising to have the most effect.

PERSONAL PROTECTION EQUIPMENT

To date, the state has ordered more than 90 million items including face shields, surgical and respirator masks, gowns and gloves. About 6 million items have arrived since the middle of last month and the remainder are on the way, officials said Tuesday. More than 82 million of those items have been ordered by the Department of Enterprise Services through suppliers. More than 1.5 million of the items already received come from the federal stockpile, and more than 591,000 items have been donated.

NUCLEAR RESERVATION

The majority of the 11,000 employees at the Hanford Nuclear Reservation, the largest single employer in eastern Washington, are working from home because of the coronavirus pandemic.

The U.S. Department of Energy said about 10% to 15% of Hanford’s workforce is working on the sprawling site that contains the nation’s largest quantity of radioactive waste left over from the production of nuclear weapons. Another 60% are working from home or otherwise telecommuting at the site near Richland in southeastern Washington state, the agency said. The rest are off work, but continue to be paid, the agency said. The site went to this ”essential mission-critical operations posture″ in late March and it continues this week, the agency said.

Hanford was established during the Manhattan Project in World War II. The site made the plutonium for the atomic bomb dropped on Nagasaki, Japan.

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This story has been updated to correct the number of deaths to at least 394, instead of 294.

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AP writer Rachel La Corte contributed from Olympia, Wash.

Track and field worlds, set for Eugene, rescheduled for 2022

MONACO (AP) — Track and field’s world championships were rescheduled for July 15-24, 2022, on Wednesday, the first major sports event repositioned in the wake of the 12-month postponement of the Tokyo Olympics due to the coronavirus pandemic.

The track worlds, which draws around 1,800 athletes from more than 200 countries, will still be held in Eugene. Hayward Field was expanded and remodeled for the event that was originally to take place in August 2021.

Instead of simply pushing back the worlds by a year, the new dates were chosen to coordinate with other major events set for 2022.

The Commonwealth Games, which draws athletes from more than 70 countries in a wide array of sports, are scheduled for July 27-Aug. 7 in Birmingham, England.

The European track championships in Munich, Germany, will be held during the multi-sport European Championships from Aug. 11-21.

“This will be a bonanza for athletics fans around the world,” World Athletics president Sebastian Coe said.

It will mark the first outdoor world championships held in the United States, and will be the first worlds to be held in an even-numbered year. They had been held in odd numbered years since they started in 1983.

The delay sets up track and field for a long stretch of yearly major events: The Olympics in 2021, worlds in 2022, then again in 2023 in Budapest, followed by the Paris Olympics in 2024 and another world championships at a site still to be determined in 2025.

“It would offer athletics center stage at a very public point of the year,” Coe said in an interview last month. “So let’s look at it from a slightly optimistic way of being able to punch our sport into the homes of many more people over a four-year consecutive cycle.”

Coe came under criticism when Eugene was awarded the event because of his ties to sportswear company Nike, which was founded there.

The 2020 European track championships scheduled for Aug. 25-30 in Paris are under review.

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More AP sports: https://apnews.com/apf-sports and https://twitter.com/AP_Sports

Gorge highway closure expanded after visitors trespass

PORTLAND, Ore. (AP) — All public land is closed within the Columbia River Gorge National Scenic Area because of the coronavirus outbreak, but that hasn’t stopped some people from showing up and trespassing onto parks and trails.

Following the influx, the Oregon Department of Transportation announced Tuesday that it will shut down seven additional miles of the Historic Columbia River Highway, which leads to many of the area’s most popular hikes and waterfalls, The Oregonian/OregonLive reported.

The highway will now be closed from Larch Mountain to Angels Rest from 8 a.m. to 8 p.m. daily. The department previously closed the scenic highway from Angels Rest to Ainsworth.

Existing closures haven’t stopped some 200 cars an hour from showing up, according to transportation officials. Many visitors have also disregarded barricades and thrown signs off the road.

Officials working to maintain the widespread closure report contacting visitors about once every four minutes.

Following an earlier decision by the Oregon Parks and Recreation Department, the U.S. Forest Service closed all public land in the Columbia Gorge on March 26, supporting Oregon Gov. Kate Brown’s executive order banning all nonessential travel, issued March 23.

Oregon inmates sue over COVID-19 response

PORTLAND, Ore. (AP) — A group of inmates concerned about contracting COVID-19 filed a lawsuit Monday against Oregon Gov. Kate Brown and the leaders at the Department of Corrections.

The civil rights lawsuit, filed in U.S. District Court by the Oregon Justice Resource Center on behalf of the inmates, alleges the DOC has not taken the necessary steps to slow the spread of the virus inside its 14 institutions where more than 14,000 inmates live, Oregon Public Broadcasting reported.

The suit asks a judge to mandate a social distance of 6 feet or more between inmates in all of the DOC’s facilities. If that can’t be accomplished, the lawsuits ask that a three-judge panel review cases and reduce the number of prisoners in DOC’s facilities so it is possible.

So far in Oregon, three inmates at the Santiam Correctional Institution in Salem have tested positive for the virus, the agency said Monday. A total of five DOC staff members have also tested positive. Two work at the Santiam prison and three work at the Oregon State Penitentiary in Salem.

The inmates named in the lawsuit have asthma and other respiratory ailments, some are HIV positive, others are elderly.

Last week, DOC Director Collette Peters told OPB in an interview her agency was doing everything they can to keep people safe but acknowledged the challenges of social distancing in a prison.

“We have been working around the clock to prepare ourselves for stopping the spread of COVID-19 in our institutions,” Peters said.

The lawsuit acknowledges DOC has taken some measures but argues they’re not enough. The lawsuit says older adults and those with underlying medical issues face serious illness or death.

Image: Oregon DOC Facebook page

Officials opt to keep schools closed in Washington state

OLYMPIA, Wash. (AP) — Schools in Washington state will remain physically closed for the remainder of the school year while more than 1.2 million public and private K-12 students continue distance learning at least until mid-June due to the coronavirus outbreak, officials said Monday.

Schools have been shut statewide since March 17 and were initially scheduled to reopen April 27. That was extended until June 19 — when the spring term ends — and schools were encouraged to continue distance learning.

The order also asks schools to start planning for a potential expansion of the closures into the summer and fall, though Gov. Jay Inslee said officials would explore whether it was possible to bring students back for graduation later in the year.

Schools Superintendent Chris Reykdall said the decision was tough, but the risks of returning students to school too soon were high due to the pandemic.

“A rush back to school puts significant risk in learning continuity that at this time would not be better than the model we are developing and advancing at a distance,” he said. “We do not want that curve to suddenly spike up because we acted too quickly to come back.”

The closure of schools creates challenges in the area of equity for some students, Inslee said, explaining there will be limited on-site options in certain circumstances, such as students learning English as a second language, and for students with disabilities, as long as social distancing and proper hygiene practices are followed.

“We know that distance learning could never replace the learning and other benefits that students get from attending school in person,” Inslee said. “But this unprecedented health emergency demands that we take this step, both for the sake of our children and for our community.”

Last week, Inslee extended orders to keep non-essential businesses closed and most of the state’s residents home through May 4, saying the measures must remain in place an additional month in order to minimize the spread of the virus. Violation of the order is a misdemeanor, but the governor’s office has said the goal is education, not to arrest people.

There have been more than 330 COVID-19 deaths and more than 7,900 cases in the state. For most people, the coronavirus causes mild or moderate symptoms, such as fever and cough that clear up in two to three weeks. For some, especially older adults and people with existing health problems, it can cause more severe illness, including pneumonia, or death.

Officials have been cautiously optimistic that the state’s strategies have helped avoid the levels of infections and deaths seen in other states. On Sunday, Inslee said the state will return more than 400 of the 500 ventilators it has received from the federal government so the equipment can go to New York and other states hit harder by the coronavirus.

Washington received 500 ventilators last month from the Strategic National Stockpile.

California to loan 500 ventilators to national stockpile

SACRAMENTO, Calif. (AP) — California Gov. Gavin Newsom announced Monday the state would loan 500 ventilators to the national stockpile for use by New York and other states experiencing a crush of coronavirus-related hospitalizations.

California chose to loan some of its equipment because it is not yet in as dire a situation as New York, now the nation’s epicenter for the crisis, said Jesse Melgar, a spokesman for the governor. Newsom said state modeling shows California will hit its peak of cases sometime in May.

“I know that if the tables were turned and we were experiencing a hospital surge, other states would come to our aid and provide ventilators just as we are today,” Newsom said in a statement.

Newsom’s decision follows Oregon and Washington committing to transfer ventilators to New York.

California has been hunting for ventilators to boost its own supply for weeks. Officials requested 10,000 ventilators from the national stockpile, though it has received none. Los Angeles got 170 ventilators from the stockpile, though many were broken.

As of Friday, California had access to 4,252 ventilators, Newsom said. Melgar said Monday the state is boosting that number by rehabilitating thousands of broken ventilators and procuring thousands more from other places. But he declined to provide a rough estimate of how many ventilators the state now possesses.

Hydrogen fuel cell manufacturer Bloom Energy has dedicated a portion of its production plants in California and Delaware to repairing old ventilators. As of last week, the San Jose-based company had repaired 515 ventilators, with more on the way. The company says it has the capacity to repair up to 1,000 per week.

Virgin Orbit, billionaire Richard Branson’s company that makes rockets, has developed a prototype for a “bridge ventilator” designed to help patients breathe until they can be put on a traditional ventilator. The company is awaiting federal approval before it can begin mass producing the model, which was developed in partnership with researchers at the University of California, Irvine.

Newsom touted both as part of California’s efforts to procure ventilators. Asked Saturday if California would share medical supplies with other states, Newsom told reporters the state was “working day and night to find new ventilators.” But, he said, if the state was in a position to share medical supplies or to team up with other states to bulk purchase such supplies “absolutely, unequivocally we will do that.”

Newsom was expected to hold a daily press briefing Monday afternoon.

Washington Gov. Jay Inslee said Sunday the state will return more than 400 ventilators of the 500 it got from the federal government so they can go to New York and other states. Inslee, a Democrat, said his statewide stay-at-home order and weeks of social distancing led to slower rates of infections and deaths in Washington, which saw the first serious coronavirus outbreak in the country.

Oregon Gov. Kate Brown on Saturday said 140 ventilators would be sent from her state to New York, saying at this point Oregon doesn’t need them.

While the federal government hasn’t given California any ventilators from the national stockpile, it has sent other supplies. As of last week, California had received roughly 837,000 N-95 masks, 1.31 million gloves, nearly 2 million surgical masks, as well as face shields, surgical gowns, coveralls and 2,000 medical station beds, according to the White House.

California has recorded more than 15,000 cases of COVID-19 virus infections and at least 320 deaths, according to the latest data compiled by Johns Hopkins University. New York, meanwhile, has more than 123,000 cases and more than 4,000 deaths. For most people, the coronavirus causes mild or moderate symptoms, such as fever and cough, that clear up in two to three weeks. For some, especially older adults and people with existing health problems, it can cause more severe illness, including pneumonia and death.

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Associated Press reporter Adam Beam contributed to this report.

Arlene Schnitzer, philanthropist and arts lover, dies at 91

PORTLAND, Ore. (AP) — Arlene Schnitzer, a philanthropist who gave away more than $150 million to thousands of civic projects in Portland and helped bring arts in the city to another level, has died. She was 91.

Her son, Jordan Schnitzer, said she died on Saturday after having some intestinal issues.

“In the end, at 91, I think she just decided she’d had a pretty amazing life,” Jordan Schnitzer told The Oregonian/OregonLive.

Portland’s Arlene Schnitzer Concert Hall is named after her. She and her husband, Harold Schnitzer, who died in 2011 at age 87, helped establish the Center for Northwest Art, and a curatorial and awards program.

“Both my parents were proud Portlanders,” Jordan Schnitzer said. “They were born and educated here. It was their village, they used to say. They felt if they didn’t help build the institutions in this town, who would?

Bruce Guenther, former chief curator of the Portland Art Museum, said the Schnitzers transformed philanthropy by making large donations, and that other wealthy patrons begin doing so also.

Harold and Arlene Schnitzer donated to a variety of causes. Recipients included New Avenues for Youth, community gathering places such as the Oregon Zoo, schools such as the University of Oregon and Lewis and Clark College, Jewish cultural agencies such as the Mittleman Jewish Community Center, and arts institutions from the Oregon Symphony and Oregon Ballet Theatre to the Portland Opera and Portland Art Museum.

The couple’s main way of donating was through the Harold & Arlene Schnitzer CARE Foundation, funded by the sale of the Claremont Hotel for $88 million.

“I think of her as a big wave,” said Lucinda Parker, a painter who met Arlene when they were both art students in the 1950s. “She encouraged and embarrassed everyone to do what she was doing. She made her way. She had no fear.”

Harold and Arlene Schnitzer met in 1949 and were married five weeks later after Arlene proposed.