Salespeople push expensive drugs with samples at clinics; some doctors are banning their visits

Tired of pushy drug company representatives trying to talk them into purchasing and prescribing higher priced medication, doctors at a practice in the 6,000 town of Madras, Ore., decided in 2006 to ban drug reps from their office, and have openly promoted the idea that others should follow suit, Markian Hawryluk reports for The Bulletin in Bend. Bulletin photo by Ryan Brennecke: Dr. Doug Lieuallen with patient Reba Powell)

In the six months before Madras Medical Group enforced the ban, it had 199 visits from drug reps, with 23 bringing lunch for the office staff. An analysis of 46 drug samples left by the reps showed that the average cost of getting those drugs by prescription was $90 per month, when generics were available for 38 of the drugs at an average cost of $22 per month. "Samples are primarily given to promote the use of the more expensive, brand-name drugs, which in the end may be no more effective than lower-cost generics," Hawryluk writes. "But studies show that once a patient is started on a medication with a free sample, he is rarely switched to a lower-cost alternative."

Other businesses in the area have followed suit, with St. Charles Family Care in Bend no longer seeing drug reps, and Bend Memorial Clinic, the region's largest multi-specialty clinic, saying it will cut ties within its primary care offices this year, Hawryluk reports. From April, 2012 to March, 2013 the number of drug reps in the U.S. dropped from 105,000 to 72,000, according to market-research firm Cegedim Strategic Data. "Spending on drug samples fell from $8.4 billion in 2007 to $6.3 billion in 2011. And the number of drug rep visits that included samples dropped 35 percent from 116 million in 2007 to 76 million in 2011. Some of that may be due to the economic downturn, and some to the large number of brand-name drugs whose patent protection has expired in recent years." (Read more)

The situation at Madras Medical was featured in the Journal of the American Board of Family Medicine. The report "suggests that improved health care and significant reductions in drug costs might be attained by breaking up the age-old relationship between physicians and drug company representatives who promote the newest, more costly and often unnecessary prescription drugs," according to a release from Oregon State University. Dr. David Evans, who was a physician at Madras Medical when the ban took effect, said in the report: “This is a culture change, one that’s already happening but still has a ways to go, especially in smaller private practices. The relationship between physicians and drug company representatives goes back generations, and it took a methodical, deliberate campaign to change it." (Read more)

Rural banks continue to thrive by knowing their communities, and offering services people want

While large banks continue to knock off mid-size banks by offering all the bells and whistles that come with joining a national, and sometimes worldwide corporation, small, rural banks continue to survive and thrive by offering a personal touch and service larger banks can't afford to offer, Brendan Greeley reports for Bloomberg Businessweek. Even though the number of U.S. banks has dropped from 12,000 to 6,000 since 1980, community banks, defined by the Federal Deposit Insurance Corp. as having less than $1 billion in assets, hold 70 percent of the deposits in rural areas. Most community banks serve one, two or three counties.

"Small banks in rural areas do a better job of what is generally considered Banking 101: underwriting home mortgages and loans to farms and small businesses," Greeley writes. "According to the FDIC in every five-year period since 1991, a lower percentage of loans from community banks has gone bad. Richard Brown, the FDIC’s chief economist, says small banks have a competitive advantage with 'nonquantitative' (sometimes called 'soft') information—knowledge of their customers and the local economy." (Read more)

Health law has special rules for Native Americans

Native Americans have a different take on health reform than the rest of the country. "Longstanding treaties with the federal government guarantee all Native Americans free health care. As a result, the Affordable Care Act exempts them from paying a penalty if they choose not to purchase insurance," Christine Vestal writes for Stateline. "More than 2 million Native Americans receive free health care at federally supported Indian health facilities. Many others receive care from tribal facilities and urban Indian organizations."

That doesn't mean Native Americans are healthier than the rest of America. In fact, "5.2 million Native Americans have poorer health and less access to health care than the rest of the U.S. population," and 30 percent are uninsured, Vestal writes. And getting Native Americans to enroll hasn't been easy. Roxane Spruce Bly, who is working with New Mexico’s health insurance exchange to provide outreach to Native Americans, told Vestal, “It’s the biggest thing to happen in Indian health in my lifetime. It solves so many problems for Indian people," but she said purchasing health insurance is a foreign concept to most tribal members. (Census Bureau chart)

The Affordable Care Act even favors Native Americans, with no open enrollment deadlines, and "members with incomes below 300 percent of the federal poverty level ($34,470 for an individual) are exempt from paying deductibles and copays, so they can purchase the cheapest plans without worrying about out-of-pocket expenses," Vestal notes. "All tribal members, no matter what income level, are exempt from out-of-pocket payments if they receive services from Indian health facilities. And unlike employers, tribes can pay exchange premiums for their members without paying taxes."

Also, "new provisions make it easier for Indian health facilities to accept payments from other insurers, including Medicaid, Medicare and private insurance," Vestal reports. "The new law also expands the types of services the facilities can offer and requires inclusion of behavioral health and substance abuse treatments. For Indians enrolled in Medicaid, Indian health providers receive a fee-for-service that is much higher than other providers receive. In addition, they can collect fees from private insurers if Native Americans take advantage of the exchanges." (Read more)

Grants to help rural Kansas counties find ways to improve health care as population shrinks

In an effort to find ways to improve rural health care in Kansas, six western counties "will be part of a $1.5 million initiative aimed at improving their healthcare systems in ways that can be duplicated by medical providers in other rural areas that are challenged by shrinking populations, recruiting difficulties and mounting financial pressures," reports the Hays Post in northwestern Kansas. "Health Futures Taskforces in each of the communities will receive $40,000 to hire local coordinators and work with a national consultant to develop improvement plans."

"The grants require that the improvement plans be based on data from community health assessments and performance evaluations of their healthcare systems," the Post reports. Groups that submit plans that have potential to take their health care systems to higher performance levels with be eligible for implementation grants of at least $440,000. Kim Moore, president of the United Methodist Health Ministry Fund, which is spearheading the initiative, told the Post, “This is really an opportunity to have a very data-driven approach to looking at the long-term issues facing these health systems and to developing ideas for how to address them. Our goal was to find four energetic, forward-thinking rural communities. We want something that really deals with the ongoing structure, the ongoing working environment and the culture of that health system.” (Read more)

Virtual college at high school helps rural, at-risk teens in Texas earn college credits

A college in Texas is bringing classrooms to at-risk teens in the rural remote area of Presidio, a town of 4,200 near the Mexican border, by giving students the means to earn two years of college credit by the time they graduate high school, Lindsay Weaver reports for the Odessa American. As part of the program, the University of Texas of the Permian Basin in Odessa uses virtual classrooms to reach students who live too far from a college to attend it in person.

The program, which in May was awarded a $215,000 grant from The Meadows Foundation, is being promoted as the state's first entirely virtual college high school. State Sen. Kel Seliger (R-Amarillo) told Weaver, “It’s worth some state investment. Let’s be honest, Presidio is not the only community like Presidio. This should be done everywhere in the country. It has unqualified success in Texas.” Seliger's request for funding to allow more independent school districts to house early college high schools was not supported during the most recent legislative session. (Read more)

Obama calls for a Farm Bill but sounds like he's not up to date on the congressional negotiations

President Obama called on Congress today to pass three things: "a responsible budget ... immigration reform ... and a farm bill." But he did not sound up to date on the status of the Farm Bill.

"The Senate has already passed a solid bipartisan bill," Obama noted. "It's got support from Democrats and Republicans. It's sitting in the House waiting for passage." Well, not really.

The House had some trouble passing a farm bill but finally did, and it and the Senate have named a joint conference committee to work out the differences. But Obama continued, "If House Republicans have ideas that they think would improve the farm bill, let's see them. Let's negotiate. What are we waiting for? Let's get this done."

"This has to make you wonder how high a priority the Farm Bill really is for the White House," said Al Cross, director of the Institute for Rural Journalism and Community Issues (publisher of The Rural Blog) and political columnist for The Courier-Journal in Louisville.

Obama said, "We should pass a farm bill, one that American farmers and ranchers can depend on—one that protects vulnerable children and adults in times of need—one that gives rural communities opportunities to grow and the long-term certainty that they deserve."

Don't expect lawmakers to even begin discussing the Farm Bill until Oct. 28, Jerry Hagstrom reports for DTN The Progressive Farmer. Senate Agriculture Committee Chairman Debbie Stabenow (D-Mich.) told DTN that the Farm Bill could be added to the budget bill, which is supposed to be done by mid-December, "but warned that the bigger issue would be whether the House and the Senate reach an agreement on the budget. Stabenow said she is certain that the Farm Bill conferees will come to an agreement but is not certain about the budget conferees. Whether the Farm Bill could be attached to the budget bill would depend on 'how it is done,' she said." 

This leaves many worried about when a new farm bill might be passed. Hagstrom writes: "Farm lobbyists fear that it will be difficult to reach a House-Senate agreement on the farm bill, especially on cuts to food stamps. Some groups hope the farm bill might be included in a budget deal that members of Congress would feel forced to support while others worry that Stabenow [and other leaders of the agriculture committees] would lose control of the Farm Bill to congressional leadership and President Barack Obama as they work out the larger deal."

Thad Cochran of Mississippi, the ranking Republican on the Senate committee, told DTN in an email: "As part of a sustainable budget plan, I hope we can reach a long-term agreement on a Farm Bill to provide producers and consumers with certainty and to preserve the security Americans enjoy by our ability to generate independently food and fiber for ourselves and for the world. The farm bill this body adopted earlier this year would help accomplish those goals and save $23 billion over the next five years." But a Cochran spokesman added to the email: "The reference of the Farm Bill in context of the budget is meant in broad terms, as part of an effort to curb government spending by at least $23 billion. The senator is not specifically advocating at this point that the Farm Bill be added to a budget resolution, as some have suggested might occur." (Read more)

Virginia weekly publishes compelling multimedia project about a long-debated bypass

"Snow Fall," The New York Times' highly acclaimed multimedia narrative about an avalanche, came out in 2012, garnering attention and excitement about the potential for such reporting, Corey Hutchins reports for the Columbia Journalism Review. After the success of "Snow Fall," similar productions showed up on the horizon, ascribing to a similar design, focusing on sports stories or outdoor adventures. These narratives came from large newsrooms such as The Washington Post and Grantland.

This fall, C-Ville Weekly, a newspaper in Charlottesville, Va., with a circulation of about 25,000, produced "The Road," which Hutchins calls "A wonky, detailed but compelling multimedia project" about a proposed US 29 bypass around the town "and attempts to reset the public debate at a crucial point in the decision-making process."

The state estimated that grade-separated interchanges (overpasses/underpasses) would do more to shorten delay times on US 29 than the bypass would.

"The Road" has videos, graphics, maps, audio from public meetings editorial cartoons and a comment feature. Hutchins says one reviewer aptly described it as "exhaustive, but not, despite its wonkish policy implications, exhausting." C-Ville Weekly created "The Road" with help from Vibethink, a local web design firm. The collaboration allowed the paper to complete the project with a very low budget.

C-Ville Weekly Editor Giles Morris said in a Google Hangout interview that he and his team weren't daunted by the fear that they didn't have the resources to take on the project. "You can't measure it . . . by the amount of money you throw at it," he said, expressing gratitude for Vibethink's help.

The project included sound bites that readers could play at will.

Joshua Hatch, senior editor for data interactives at the Chronicle for Higher Education, talked with Hutchins about the unique opportunities for news presentation through multimedia projects like this one. "Each of these media has to serve a purpose, and you use them for a reason," he said. He said it's valuable to decide which part of the story should be told through audio and which through visuals.

When asked about the ideas behind the topic for the production, Morris said, "[We were looking for] a story that could have a real impact in the local conversation. We felt like this was a real chance to lay things out on the table for the public." (Read more)

Almost half of public school students qualify for food aid; rural Southern states stand out

In 2000, low-income children were a majority of public-school students in only four states: Kentucky, Mississippi, Louisiana and New Mexico. In 2011, that number jumped to 17, including almost every state in the rural South.

The Southern Education Foundation, the nation’s oldest education philanthropy, looked at the number of public schools' students from preschool to 12th grade who were eligible for free and reduced-price meals during the 2010-11 school year, Lyndsey Layton reports for The Washington Post. A family of four could earn no more than $40,793 per year to qualify for the program in 2011. Overall, 50 million public school students, or 48 percent of the total, qualified for food aid, Layton writes. The share was highest in Mississippi, where 71 percent qualified. A state-by-state breakdown of is available here.  (Post graphic)

Michael A. Rebell, executive director of the Campaign for Educational Equity at Columbia University in New York, told Layton there was a link between poverty and lack of education: “When you break down the various test scores, you find the high-income kids, high-achievers, are holding their own and more. It’s when you start getting down to schools with a majority of low-income kids that you get astoundingly low scores. Our real problem regarding educational outcomes is not the U.S. overall—it’s the growing low-income population.” (Read more)

To read the full report click here.

GOP blasts Park Service director for closing parks

Jonathan Jarvis

Because of the federal government shutdown, National Park Service Director Jonathan Jarvis had to furlough 20,000 employees, or 85 percent of his staff, leaving some parks such as the National Mall in Washington, D.C., which employs 300, with only 12 working employees. But that didn't stop House Republicans on Wednesday from blasting Jarvis for closing parks, with GOP members saying the director violated federal law by barricading them and national monuments when there was no apparent imminent threat, Laura Barron-Lopez reports for The Hill. The shutdown cost the government $32 million per day in lost fees at national parks.

At Wednesday's joint hearing of the Oversight and Government Reform and Natural Resources committees, Republicans questioned the barricading of the World War II Memorial and other monuments on the mall, contending that they were not barricaded during the shutdown in 1995. Jared Huffman (D-Calif.) replied, "The shutdown in 1995 wasn't some shining model; monuments were closed." He told Jarvis, "Despite the over the top, made for media accusations and sound bites in this kangaroo court, we have no reason to believe you have done anything wrong."

"The battle raged to the end over whether the NPS had violated federal law, with Jarvis receiving the brunt of the GOP's questions while Democrats apologized on their behalf," Barron-Lopez writes. "It is very clear that the promises you make have no value," Oversight Committee Chairman Darrell Issa (R-Calif.) said. Rep. Peter DeFazio (D-Ore.) defended Jarvis, holding a mirror before the Republican side of the aisle while saying, "If my Republican colleagues would look at me, I can show them who is responsible. Here, here's who is responsible for shutting down national parks." (Read more)

Rural Futures Conference scheduled Nov. 3-5

The theme of this year's Rural Futures Conference, scheduled Nov. 3-5 in Lincoln, Neb., is "Beyond Boundaries," which "encourages all of us to step beyond our boundaries and work together to create positive rural futures," according to a release from the Nebraska-based Rural Futures Institute. The conference "will celebrate the importance of rural and create energy and enthusiasm for new and innovative ways to address complex opportunities and challenges."

Features speakers are author and educator Clay Jenkinson, the director of The Dakota Institute, and Tom Koulopoulous, founder of the Delphi Group, a Boston-based think tank. Registration is $150, or $40 for students. For more information or to register, click here.

Study: Relative quiet helps poor rural children's verbal memory, but hurts their visual memory

Noise pollution—or lack of it—is the reason low-income rural children score better in verbal memory tests than low-income urban children. However, rural children perform worse than their urban counterparts in visual memory tests, according to a study by Dartmouth College, Priya Ramaiah reports for The Dartmouth, the college's student-run newspaper. Although there were differences between low-income rural and urban students, high-income rural and urban children had comparable scores.

(From The College Network Blog)

The tests, which were part of the Automated Working Memory Assessment, were given to 186 sixth-grade students from high-and-low-income rural areas, and high-and-low-income urban areas, Ramaiah writes. The study's author, education professor Michelle Tine, concluded that noise pollution—traffic, crowds, building signs, lights—has a negative affect on low-income urban children's working memory, while the lack of noise pollution helps low-income rural children's working memory. But lack of noise pollution hurts the visual memory of low-income rural children, who don't use the tool as much as low-income urban children, Tine concluded. This suggests that teachers in low-income rural areas should focus on verbal instruction, while teachers in low-income urban areas should focus on instruction through visuals. (Read more) The study is available online in the Journal of Cognition and Development, which is behind a pay wall.

Navajo agree to stop roundups for horse slaughter while pursuing alternatives to population control

After publicly supporting horse slaughter because 75,000 feral horses were costing them $200,000 a year in property damage and range, the Navajo Nation has reversed its stance and agreed to work with former New Mexico Gov. Bill Richardson "to find more long-term and humane solutions to the horse overpopulation problem," Jeri Clausing reports for The Associated Press. The Navajo, who have been rounding up and selling horses, knowing some would likely end up in slaughter plants in Mexico, said they will suspend horse roundups while working with animal-rights groups "to develop and implement alternative policies to manage feral horse populations. Possible solutions include equine birth control, adoption, land management and public education." (Albuquerque Journal file photo: The Navajo reservation has 75,000 wild horses) 

Navajo Nation president Ben Shelly said, “Our land is precious to the Navajo people as are all the horses on the Navajo Nation. Horses are sacred animals to us. Both the land and the animals must be responsibly managed. For too long, this issue has gone unaddressed, putting us in the situation we are today where chapters are facing real problems with uncared for animals damaging local land and domestic livestock. I am thankful we can partner with agencies that have resources to help us find real long-term solutions.” (Read more)

Congress lifted its four-year-old ban on horse slaughter in 2011, and several companies have attempted to open plants after passing inspections by the Department of Agriculture. In August, a New Mexico federal judge blocked the opening of slaughterhouses in New Mexico and Iowa. Owners of the Iowa plant said they would no longer seek to slaughter horses, but the owner of the New Mexico plant vowed to keep fighting to open his business.

Federal health-insurance website still has problems but 1 million people have managed to register on it

When enrollment began on Oct. 1 under the Patient Protection and Affordable Care Act, the federal government's health-insurance website was flooded with uninsured Americans seeking coverage. Two weeks later, visits to the site have dropped 88 percent, and reports show that less than 1 percent of people who went online the first week were able to successfully obtain insurance, Juliet Eilperin reports for The Washington Post. The use of the site, and state-based sites, is a topic of an Association of Health Care Journalists webcast to be held Thursday at 2 p.m. ET.

"Of the 9.4 million unique visitors to the site during the first week, roughly a third attempted to register, and 1.01 million completed registration," according to analysis released by Kantar US Insights from a study by nonpartisan research firm Millward Brown Digital. The group, "which tracks the online activity of 2 million Americans—or 1 percent of all Internet users in the United States—said that roughly 36,000 Americans signed up for an insurance plan online the first week." (CNN graphic: penalties for not being covered by health insurance)

The Obama administration said those numbers are inaccurate, but hasn't released its own data. It says that information will be released on a monthly basis. Health and Human Services Department spokeswoman Joanne Peters told Eilperin: “HealthCare.gov received 14.6 million unique visits in the first 11 days, showing the intense demand for quality, affordable health insurance. While traffic is down somewhat from its peak on day one, it remains high as Americans continue to seek to learn more about their new coverage options.”

Aneesh Chopra, who served as the White House’s first chief technology officer during President Obama’s first term, told Eilperin that the important number was that 1 million Americans created an online account. He told her, “Account creation is always the holy grail. That’s the moment that matters. In one week, a million people began a process that will result in affordable coverage. That means a lot of people are going to ultimately get the product.” (Read more) (Millwood Brown Digital graphic)

Report finds increases in accidents, arrests and STDs in rural Pennsylvania counties with fracking

The rate of heavy-truck accidents, sexually transmitted diseases and incidents of disorderly conduct increased in rural counties in Pennsylvania after the commercialization of hydraulic fracturing in 2005, according to Food and Water Watch, a Washington, D.C.- based consumer lobby, the Daily Yonder reports. The study compared data from 2000-05 and 2005-10 to compare changes in the 23 rural counties with hydraulic fracturing to the 12 rural counties where it doesn't. (Food and Water Watch graphics)

The average number of heavy-truck crashes per year in heavily fracked counties (at least one well for every 15 square miles) rose from 284 from 2000-05 to 304 from 2005-10, an increase of 7.2 percent, while the number of accidents in counties with no fracking fell 12.4 percent after fracking began in 2005, according to the report. Disorderly conduct arrests in heavily fracked counties rose from 1,336 to 1,564, an increase of 17.1 percent, compared to an increase of 12.7 percent in other rural counties. The average reported cases of chlamydia and gonorrhea was 62 percent greater in heavily fracked rural counties than in rural counties with no fracking.

The report says, "The shale oil and gas boom generates tangible social costs that undermine the quality of life in rural communities. Communities and states must take these real costs into account when they consider approving controversial new oil and gas fracking. These fracking-associated social costs further demonstrate the shortsighted investment and expansion of dirty fossil fuels." To read the full report click here.

Coal is troubled in U.S., but it will be the world's top fuel source by 2020, consulting firm predicts

Despite President Obama's efforts to replace coal with more climate-friendly fuels, the high demand for coal in China and India, and the fact that in Asia coal is cheaper than other resources, will cause coal to surpass oil as the most in-demand fuel in the world by 2020, energy consultancy firm Wood Mackenzie said Monday at the World Energy Congress in South Korea, Florence Tan reports for the Huffington Post. "Global coal consumption is expected to rise by 25 percent by the end of the decade to 4,500 million tonnes of oil equivalent, overtaking oil at 4,400 million tonnes," the firm said. (Associated Press photo by Andy Wong: Coal mine in Mongolia)

William Durbin, president of global markets at Wood Mackenzie, told Tan that China, the leading consumer of coal, has no alternative to the resource "with its domestic gas output limited and liquefied natural gas imports more costly than coal." China "will drive two-thirds of the growth in global coal use this decade" with about 50 percent of the 600 gigawatt of new power generators to be built over the next five years to be coal-fired.

"Abundant supply is also supporting demand for coal," Tan writes. "Excess supply and faltering demand growth have depressed global coal prices this year. European coal futures have tumbled more than 20 percent, while Australian coal prices have plummeted from the record $130 per tonne hit in 2011 to around $80 per tonne as China's demand grew slower than expected. High fuel import costs and nuclear issues will support coal use throughout Northeast Asia, while in North America coal is still competitive in many locations despite abundant low-cost shale gas." That is not the case in Central Appalachia, where coal has become much more expensive to mine than in other areas. (Read more)

Free webcast Thursday will explore rural Americans' use of new health-insurance marketplaces

If you lack health insurance, you're more likely to live in a rural area. Put another way, if you're rural, you're more likely to lack health insurance. Nearly one in five uninsured Americans live in rural areas, while only a sixth of the U.S. population does. For those reasons, the federal health-reform law is especially important to rural areas, but "In the launch of health insurance exchanges across the country, one issue that has not been explored much is how the marketplaces will affect rural Americans," says the Association of Health Care Journalists. So, AHCJ is holding a webcast at 2 p.m. ET Thursday to explore how rural Americans will use the health-insurance exchanges that opened Oct. 1.

The panelists will be Al Cross, director of the Institute for Rural Journalism and Community Issues, which publishes The Rural Blog; Alan Morgan, CEO of the National Rural Health Association; and Jim Doyle, who covers the business of health care for the St. Louis Post-Dispatch. AHCJ health-insurance topic leader Joseph Burns will serve as moderator.

Viewers of the one-hour webcast will be able to ask questions after the panelists' initial presentations. Registration is not required for the free webcast; a link to it will appear on this AHCJ web page shortly before the webcast begins.

EPA reportedly in favor of scaling back biofuel blending requirement, to no more than 10 percent

While the Environmental Protection Agency has said 15 percent ethanol is safe for cars, a leaked proposal by EPA shows to supports scaling back biofuel blending requirements to 10 percent next year, a move that's good news for oil refineries and bad news for proponents of biofuels, who "have argued for years that the blend wall is largely a fiction constructed by an oil industry that doesn't want to cede any more share of a shrinking U.S. gasoline market," Cezary Podkul reports for Reuters. Most car warranties only cover up to 10 percent ethanol, and most service stations don't sell the 15 percent blend for fear of legal risks.

"If approved, the proposed cut in the biofuel mandate in 2014 to 15.21 billion gallons from 18.15 billion would mark an historic retreat from the ambitious 2007 Renewable Fuels Standard law that charted a path toward ever-greater use of clean, home-grown fuel, which the biofuel industry counts on to underpin bank loans and new factories," Podkul writes. There are already threats of lawsuits. Bob Dinneen, president of the Renewable Fuels Association, an industry group, told Podkul, "Let me be clear: any plan to roll back the targets ... under the guise of addressing the blend wall would be patently unlawful." 

The EPA is standing behind a 2007 Congressional general waiver built into the law that allows the agency to reduce ethanol volume "if enforcing the law were to cause economic hardship; or if it were simply not feasible due to 'inadequate domestic supply'," Podkul writes. While ethanol supply is not a problem, last year's drought "prompted a waiver petition from several state governors and food producers concerned about the soaring price of corn, the main ingredient for domestic ethanol production. EPA denied the request. This year, with the blend-wall concerns forcing a jump of almost 2,800 percent in the cost of credits used to enforce the ethanol mandate, the agency itself is proposing for the first time to use a waiver, citing a lack of usable fuel." EPA says in its draft proposal, "We interpret the term 'inadequate domestic supply' as it is used under the general waiver authority to include consideration of factors that affect consumption of renewable fuel." (Read more)

Researchers say climate change is affecting North American forests, their insects

"Climate change is making North American forests more vulnerable to insects and disease but is helping some trees grow faster and increase their resistance to pests, a team of researchers from Dartmouth University said Monday," Lenny Bernstein reports for The Washington Post. Researchers, who looked at more than 500 scientific studies since the 1950s, "said that warmer temperatures and increased carbon dioxide in the atmosphere are boosting tree growth, which could have a positive impact on economies that depend on timber and wood pulp and could help pull carbon out of the ecosystem."

"Researchers found 27 insects and 22 diseases that are 'notable agents of disturbance' in North American forests," Bernstein writes. "Some areas devastated by insects or disease may be restored because of continued warming, with insects dying off because temperatures are too high for them, Weed said. But warming also allows insects to flourish and exaggerates their natural role in keeping forests healthy, the researchers found. Various types of bark beetles (above) for example, are doing more damage than expected, they said." (Read more) To read the full report click here.

University advises rural Arkansas to make up for loss of jobs by developing existing resources

After a steady decline in manufacturing jobs in rural Arkansas, 53,000 since 2000, state officials have determined that The Natural State can no longer depend on manufacturing firms to provide jobs. Instead, a new economic-development strategy calls on communities to find new ways to develop existing resources, according to the Rural Profile of Arkansas 2013, written by the University of Arkansas Division of Agriculture. “It’s an entirely different way to approach economic development,” said Dr. Wayne Miller, one of the authors of the profile “What we’re trying to promote is more indigenous growth, more entrepreneurial opportunities.”

Arkansas ranks 49th in the number of adults with college degrees, and only 13 percent of rural residents have one, compared to 24 percent in urban areas of the state and 30 percent nationally. Democratic Gov. Mike Beebe stressed that connection between higher education and economic development in a recent speech, saying: “There is a correlation and a tie between education and economic development, and specifically between our roles in higher education. Inevitably, they all require a higher and higher skill level and a higher and higher degree of education in order to be productive.”

Another key is looking for more inventive ways to create jobs around resources communities already have, the report says. Instead of shipping crops of animals to other states for processing, the processing could be done in Arkansas, and "Instead of depending solely on the fresh fruit market, many are now producing jams, jellies and juices for sale to consumers and even selling byproducts, such as seeds and husks, to the health food market." Other ideas include having communities build on their tourist opportunities, as well as finding ways to add value to the timber and rice industries.

Diminishing coal industry spurs calls for economic diversification in Eastern Kentucky

As its coal industry shrivels, Eastern Kentucky will need a way to diversify its job base, according to a regional economic-development organization. The Mountain Association for Community Economic Development is asking lawmakers to establish a strategic fund for the region's economy and use coal severance-tax money to make it happen.

Herald-Leader photo by Charles Bertram

Eastern Kentucky lost more than 5,700 coal jobs in the last two years. Some people believe federal environmental rules are the reason, but many industry analysts say the low price of natural gas is the major factor, Bill Estep reports for the Lexington Herald-Leader. The decline in coal production has meant a decline in revenue from the state severance tax on coal, notes Russ Cassady of the Appalachian News-Express in Pikeville.

The MACED plan calls for using 25 percent of the severance tax, which could not only be used to set the plan immediately in motion but also to provide for other needs. State Rep. Leslie Combs of Pikeville seemed to favor of the plan but pointed out that "many local officials would oppose splitting coal-severance money away from their already-tight budgets," Estep writes. Harlan County Judge-Executive Joe Grieshop told Estep that giving up money now would be hard, but could benefit everyone in the long run" "Our situation will not improve without major overhaul."

Severance-funded projects have helped counties recently, but haven't been part of a big plan to boost the economy. "Piecemeal projects will never be as successful as those implemented in conjunction with a wider vision for how each piece works together," MACED said in its report. It recommended a new Appalachian commission that would promote "broad participation in creating a development plan, solicit the best ideas for the region's economic transition, and promote coordination," Estep reports.

Rural policy expert laments choices congressional leaders have made on rural and farm interests

The appointment of a conference committee to negotiate a final Farm Bill was "apparently good news" for agriculture and rural lobbies, but the larger story is a change in the structure for making decisions on those issues, devaluing the House Agriculture Committee, "and this is a major setback for ag and rural interests," Charles "Chuck" Fluharty, president and CEO of the Rural Policy Research Institute, writes for Agri-Pulse.

"This fact will probably be little discussed publicly, for fear of political reprisal," writes Fluharty, left. "Most advocates remain in denial regarding this subtle usurpation of historic Ag Committee standing; and, given the great relief that any conference is actually occurring, much will be overlooked. But this conference has been out of the actual control of the House chairman and ranking [Democratic] member for some time, as much has been unfortunately framed to a large degree by differences between leadership perspectives within the U.S. House, and reflective of the far deeper ideological differences which reside there."

Fluharty notes that the federal-government shutdown and lack of a Farm Bill are keeping South Dakota ranchers from getting aid to deal with the aftermath of last week's blizzard, preventing rural entrepreneurs and first-time homebuyers from closing loans, and leaving "poor rural children and families left without critical child care or nutrition programs. . . . The tragedy for rural America is that so many of the congressional members who have supported this shutdown are doing so with the understanding that their rural constituents are ideologically behind them, and support their actions. This may have been so from a safe distance, with the excitement of the ideological war and easy victory before them. Hubris, once again. However, the reality of battle, its actual chaos and costs create new urgencies, far more pressing. Hopefully, these lessons are now being learned." (Read more)

PBS documentary follows a culturally diverse group of rural New Mexico teenagers

The daily lives and challenges of six rural teens in New Mexico are getting a national audience, with Thursday's PBS premiere of "Our Time is Now." The documentary follows a wide range of characters who represent the cultural and economic diversity of the state, which the film's trailers says has the most diverse rural population in the U.S. and one of the lowest high-school graduation rates.

The documentary shows how the students "work toward finishing high school, wrestle with personal challenges and pursue their dreams," Adrian Gomez reports for the Albuquerque Journal. Director Erin Hudson told Gomez,“I’m really excited that audiences will get to see a side of New Mexico that goes unseen. It’s great to have this opportunity on such a big scale." Four of the six cast members now attend New Mexico State University, Tiffany Acosta reports for NMSU. Another attends Eastern New Mexico University, where he was named to the dean's list in the spring, according to a release from the college.

Filmmakers spent two years following the teens. The PBS website describes the film and characters: "Waylon is Navajo and lives without running water or electricity and helps provide the basic needs for his family; Jimmy faces the challenges of poverty and lives with a family torn apart by addiction; Juan balances his English-speaking school and his Spanish-speaking home; Mitch stays rooted in her Pueblo traditions as she works hard to be the school’s valedictorian; Vicky lost her mother and must hold down a fast-food job to help support her family; Tiqua must separate from the stability of her fifth-generation farm family. The film follows the students as they face complex economic realities and straddle their hopes and dreams of childhood with the responsibilities of adulthood."

Sign of change: Biomass plant will replace some power lost from closing of coal-fired plant in E. Ky.

Here's an emblematic sign of change in the Central Appalachian coalfield: A coal-fired power plant is closing and its owner will replace part of the electric generating capacity by purchasing more expensive power from a biomass plant in the coalfield, founded by the son of one of the region's most prominent coal operators. (NPR photo by Noah Adams: Big Sandy plant)

The Kentucky Public Service Commission last week approved a 20-year contract allowing Kentucky Power Co. to close its Big Sandy plant near Louisa and buy electricity generated by a biomass plant to be built by ecoPower, the Kentucky Press News Service reports. This change could lead to an increase in monthly bills for 173,000 customers and hurt a school system that receives nearly half a million dollars per year on tax revenue from the power plant, WYMT-TV in Hazard reports.

Kentucky law generally promotes lower-cost electricity, but a law passed by the state legislature this year allows utilities to include in their rates the cost of power from biomass plants. The chairman of ecoPower is Richard A, Sturgill, son of William B. Sturgill, a former state energy secretary who was a powerful, influential and sometimes controversial coal operator, largely due to his strip mines.

The agreement between the two power companies "promotes the inducement of an innovative energy-related business located in Kentucky that would advance the public purposes of achieving energy independence, creating new jobs and new investment and creating new sources of tax revenues," the PSC said in its order.

Kentucky Power said construction of the plant will employ 230 people for two years, and the plant will employ 30 people and create an additional 225 jobs for loggers and truckers. "The utility also argued that the ecoPower contract will spur economic development in its service territory and diversify its generation portfolio, which now relies largely on coal," the PSC said.

Kentucky Attorney General Jack Conway, who wants to run for governor in 2015, said he is considering legal action. His spokesperson told WYMT that "Kentucky Power did not thoroughly evaluate other options available to it, such as purchasing the power on the market from other electric utilities. Additionally the company did not conduct an economic feasibility study as the law." (Read more)

State-run health exchanges more successful than federal; how many in your county lack coverage?

"While many people have been frustrated in their efforts to obtain coverage through the federal exchange, which is used by more than 30 states, consumers have had more success signing up for health insurance through many of the state-run exchanges, federal and state officials and outside experts say," Abby Goodnough writes for The New York Times.

Rural people are more likely to lack health insurance. Click here to find out how many people in your county are uninsured.

"Individual state operations are more adaptable," Alan R. Weil, executive director of the National Academy for State Health Policy, told the Times. "That does not mean that states get everything right. But they can respond more quickly to solve problems as they arise." Some states don't require potential participants to create an online account before researching insurance and comparing costs, which has contributed to their success.

More than 40,000 people applied and were found eligible for state-run insurance in New York, and successful programs are in progress across the nation in states such as Washington State, California, Connecticut, Kentucky and Rhode Island, Goodnough writes.

Several of these state-run exchanges, including Minnesota, Nevada and Rhode Island, have reported issues because they need the federal marketplace's assistance with verifying an applicant's identity, Goodnough reports.

Daniel N. Mendelson, the chief executive of Avalere Health, a research and consulting company, said, "On balance, the state exchanges are going better than the federal exchange. The federal exchange has, for all practical purposes, been impenetrable. Systems problems are preventing any sort of meaningful engagement."

Wash your chicken: More than 300 salmonella cases linked to Foster Farms plants

Since Tuesday, the federal Centers for Disease Control has reported 317 cases of salmonella outbreak traced to Foster Farms with at least one case in 20 states and Puerto Rico and 232 cases in California, where the poultry was processed, Lynne Terry reports for The Oregonian. The number could be higher, but the CDC has furloughed 70 percent of its workers due to the government shutdown, and daily updates have not been available. Despite tests showing chickens in one plant had a 25 percent incidence rate of salmonella, more than double the 10 percent rate allowed, the U.S. Dept. of Agriculture, as of Friday, had not required a recall of the product. (Photo by Terry: Stores posted a notice from Foster Farms about the outbreak next to packages of raw poultry) The Oregonian initially reported on the outbreak on Oct. 7, then again on Oct. 8 when 280 cases were reported.

It's not the first time the plants in Fresno and Livingston have had poor tests. Between January and September inspectors found "poor sanitary dressing practices, insanitary food contact surfaces, insanitary nonfood contact surfaces and direct product contamination," Terry reports. 

More than 40 percent of people stricken with Salmonella have been hospitalized, which is about double the usual rate, Terry writes. "The strains of Salmonella heidelberg implicated in the outbreak are resistant to commonly prescribed antibiotics." Michael Hansen, senior scientist at Consumer Reports, told Terry, "We’re fundamentally outraged that the USDA is not requiring a recall. This isn’t regular Salmonella. It's resistant to multiple antibiotics." (Read more) (Food Safety News graphic: Reported salmonella cases linked to Foster Farms) 

Oil company waits 11 days to tell the public about big oil spill in North Dakota

More than 20,000 barrels of crude oil spilled from a pipeline in North Dakota, and farmer Steven Jensen discovered it on Sept. 29 while harvesting wheat; the public wasn't informed for 11 days. Oil was gushing from the pipeline "like a faucet, four to six inches spewing out," Jensen told Todd Melby and Selam Gebrekidan, reporting for Reuters. The North Dakota Health Department was informed that day.

"State officials said they believed the spill to be much smaller than it actually was and said that was one of the reasons no public announcement was made for 11 days," Aljazeera America reports.

Kris Roberts, an environmental geologist with the department, told Aljazeera that although companies have to notify the state of spills, the state isn't required to release that information to the public. Alaska, Oklahoma and Texas, also major oil-producing states, also do not require government to publicly report spills. Oil and gas are regulated only by states, except for interstate pipelines, federal land and offshore wells.

"It shows an attitude of our current state government and what they think of the public," Don Morrison, executive director of the Dakota Resource Council, told Aljazeera. "It's definitely worrisome. There is a pattern of current state government not to involve the public."

Tesoro, the company that owns the pipeline, told Aljazeera that repairing the damage will cost around $4 million and take anywhere from several months to several years. Before this happened, concerns were already multiplying about the safety of the U.S. pipeline network, Melby and Gebrekidan report.

The oil hasn't affected any water sources, Eric Haugstad, director of contingency planning and response for Tesoro, told Amy Dalrymple, reporting for Forum Communications. "Though authorities said no water sources were contaminated, no wildlife was hurt, and no one was injured, local environmentalists remain skeptical," Aljazeera reports. "When seven acres of agricultural land is affected and they say there was no environmental impact, it defies common sense and logic," Morrison said.

Brian Kalk, chairman of the North Dakota Public Service Commission, told Aljazeera that while the commission usually receives word about even the smallest spills, it wasn't notified about this one until Thursday. "There is almost a million gallons of product on the ground and we need to find out what happened. I'm upset that we didn't find out until yesterday."

Cleanup crews continue to work 24 hours per day digging trenches and using "super sucker" vacuum trucks to clean up the damage, Haugstad told Dalrymple. "The pipeline was shut immediately, and the leak is now contained," Tesoro spokeswoman Tina Barbee told Melby and Gebrekidan.

Offering free meals to all kids in schools with high poverty rates gets more of them to eat breakfast

Schools participating in a program that provides free breakfast and lunch to all students in high-poverty schools have significantly increased student participation in school lunch and breakfast programs, Charles Edwards reports for Education Week.

Schools participating in the "community eligibility option" have increased student participation by 13 percent in the lunch program and 25 percent in the breakfast program during the first two years of its availability and eliminated significant administrative costs, according to the Washington-based Food Research Action Center and the Center on Budget and Policy Priorities.

West Virginia achieved a 10 percent increase in breakfast participation in the first year, and collectively, Illinois, Kentucky and Michigan achieved a 25 percent increase over the first two years, reports Edward.

The program allows high-poverty schools to serve all students free breakfasts and lunches without individually identifying children as eligible. Schools get about the same amount of reimbursement from the Department of Agriculture that they did under the existing system—but without the paperwork. The reimbursement is based on the total number of meals served, reports Edward.

The traditional way to determine eligibility for free or reduced breakfast and lunch required families to fill out a parent-income survey, which could discouraged them from enrolling. The new eligibility option has been rolled out incrementally since it was authorized by Congress in 2010, and all eligible schools in the country may participate beginning in the 2014-15 school year.

Now, the percentage of a school's children who are already enrolled in other federal need-based program or are homeless, migrant, in Head Start or in foster care, determines the eligibility of the school, reports Edward. If a school has an enrollment of at least 40 percent of such directly certified children, it is eligible. Some districts combine all their schools to include those that are below 40 percent.

Participation in the program has exceeded the original expectations, with more than 2,200 schools signed up in the first seven states allowed to participate. The original projection estimated 300 schools would participate over 10 years, reports Edward reports.

UPDATE, Oct. 24: Joy Pullman of the Heartland Institute, a free-market think tank, attacked the program on "Fox and Friends," saying "The problem we have [with] poor children right now is obesity, and not the fact that they're not getting enough calories." Media Matters for America, a liberal counterforce to conservative information outlets, offered research disputing the claim.

Algae in Lake Erie, fed by farm runoff, threaten drinking water for 11 million people

Toxins from blobs of algae on western Lake Erie are threatening the drinking water for 11 million people, and cities and towns are dishing out large sums of cash to combat the toxins, which are worsened by phosphorus from farm fertilizer and other sources that run off into the lake, John Seewer reports for The Associated Press. Toledo will spend an extra $1 million this year—in addition to the $3 million it already spends on water treatment—to combat the toxins. Ottawa County is considering a fee increase next year to cover the added expenses of testing and treating the water, and last month Carroll Township, west of Toledo, ordered its 2,000 residents not to use or drink tap water. (AP photo by D'Arcy Egan: White foam is created by a release of chemicals from dying algae blooms)

"Algae blooms during the summer and early fall have turned the water into a pea-soup color in recent years," Seewer writes. "The unsightly surface has scared away tourists, and toxins produced by the algae have contributed to oxygen-deprived dead zones where fish can't survive. The algae growth is fed by phosphorous from farm fertilizer runoff and other sources, leaving behind toxins that can kill animals and sicken humans. What makes combating these toxins a challenge for operators of water treatment plants is that there are no standards on how to handle the problem or federal guidelines on what is a safe amount in drinking water." (Read more)

Colorado becomes first state in 56 years to have a legal, commercial hemp crop

Several states have been pushing legislation to have the first legal hemp crops, but one Colorado man is the first to do it, harvesting the nation's first commercial hemp crop in 56 years, Steve Raabe reports for The Denver Post. Hemp advocates say Ryan Loflin's 55-acre crop in southeastern Colorado's Baca County "is a landmark event that could one day lead to larger-scale domestic farming of hemp for industrial uses such as food additives, cosmetics and building materials." Loflin's crop is small, but Tom Murphy, national outreach coordinator for advocacy group Vote Hemp called it "quite significant symbolically." (Post photo by Aaron Ontiveroz: Loflin's hemp seeds) 

Even though Colorado's passage of Amendment 64, which is scheduled to take effect next year, paved the way for legal cultivation of hemp, Loflin planted his crop earlier this year, Raabe writes. "Loflin said some of his hemp seed will be pressed for oil and subsequently purchased by Dr. Bronner's Magic Soaps, a major user of hemp oil." (Read more)