Weekly that has been at odds with Mohawk Nation is named best small-circulation paper in Canada

For a copy of the editorial, click here.

The Rural Blog is almost entirely about events, trends, issues, ideas and journalism from and about the rural United States, but our colleagues in Canada share a language and most of the same approaches to journalism. There are lots of good newspapers in rural Canada, and some of them were recognized last week in the Canadian Community Newspaper Awards, sponsored by Newspapers Canada.

The winner for general excellence and best-all round newspaper in the smallest circulation class, up to 1,250, was The Eastern Door of Kahnawake, Que., in a mostly rural area across the St. Lawrence River from Montreal. Edited by Steve Bonspiel, the weekly has been at odds with the local Mohawk Nation tribal government. "I think a real congratulations to Steve is in order for persevering through community boycotts and incredible community divide," one of his Canadian colleagues in the International Society of Weekly Newspaper Editors said on the ISWNE list-serve, to which Bonspiel is a frequent contributor.

The winners in the next five larger classes were: 1,250-1,999, the Citizen, Blyth/Brussels, Ont.; 2,000-2,999, The Chief, Squamish, B.C.; 3,000-3,999, The Mountaineer, Rocky Mountain House, Alberta; 4,000-6,499, The Independent, Petrolia/Lambton, Ont.; 6,500-12,499, NWT News/North, Northwest Territories. A complete list of the awards is here.

Here's hoping a rural paper wins a Pulitzer Monday

Roy Peter Clark

Last year only two newspapers with circulation under 100,000 won Pulitzer Prizes—The Post and Courier in Charleston, S.C. and the Daily Breeze in Torrance, Calif. Neither of those communities are especially rural. When Pulitzer Prizes are announced Monday the big names in journalism are likely to be well represented, just as they are every year, but it's a good time to root for the little guy, the rural papers who work just as hard, if not harder, than the big papers, but get little credit outside their communities.

"Jealousy and careerism aside, most journalists feel pride in the accomplishments of any Pulitzer Prize winner, but especially winners from small papers with limited means," writes Roy Peter Clark of The Poynter Institute. "Let history be our guide. In 1953 the Gold Medal for Public Service went to two weekly newspapers in North Carolina, the Whiteville News Reporter and the Tabor City Tribune, with a combined circulation less than 7,000. The papers, led by Willard Cole and W. Horace Carter respectively, shared the prize. They had worked independently attacking the same evil: the night-riding terrorism of the Ku Klux Klan." They were the first weeklies to win.

Clark notes that Edward R. Murrow of CBS featured the papers in his "See It Now" program, saying in conclusion, "We suggest that if the fight against intolerance, bigotry, race prejudice, hatred and fear is to be won in this country, it must be won in the towns like the two we have seen here."

Other Pulitzer-winning rural journalists cited by Clark include: "Buford Boone, who won in 1957 for the Tuscaloosa News for editorials against mob violence against the integration of the University of Alabama ... Ira B. Harkey Jr., who won in 1963 for the Pascagoula Chronicle for defense of the rule of law in the desegregation of Ole Miss [and] Hazel Brannon Smith, who won in 1964 for the Lexington (Miss.) Advertiser for work that spoke against violence and injustice." Clark focuses on civil-rights crusaders, omitting the Point Reyes Light of western Marin County, California, which won in 1979 for its reporting on the Synanon cult, and several other rural winners.

"So in this the centennial year of the Pulitzer Prizes, let us declare a moratorium on weeping and gnashing of teeth over the economic woes of newspapers," Clark writes. "Let no editor be overheard saying, 'I once had 200 reporters to work with, now I only have 100.' Let any such lamentations be met with a quick trip through the history of Pulitzer Prizes devoted to social justice and equality. Let’s offer a prayer of thanks to the Coles, Carters, Boones, Harkeys, and Smiths of the world who, for the cause of justice, and with tiny staffs, put their lives and livelihoods on the line. If a small newspaper wins a Pulitzer on Monday, one of those voices cheering in the background will be mine." (Read more)

RFD-TV fights to stay on major cable networks

RFD-TV, which specializes in rural-interest programming, sometimes has to fight to stay on major cable networks, Michael Kosser reports for Variety.

Most of RFD-TV's viewers "live in small-town and rural areas, but it’s also available to America’s largest cities," Kosser notes. "And yet every so often a big city-headquartered cable carrier will announce that it is dropping the Nashville-based network from its programming."

To fight back, RFD-TV President Patrick Gottsch " turns to those viewers for help and they never fail to respond," Kosser writes. "The latest battle involves the January announcement by Verizon FiOS that it was dropping the RFD-TV network."

RFD-TV lost that battle, but "There may be promising news to come following the Federal Communications Commission’s vote to adopt a Notice of Inquiry to study how independent programmers fare in today’s contracting world of cable companies," Kosser reports.

Gotsch told Variety, “There’s a disconnect, and it’s a growing disconnect, between city and country, where the urban media executives and advertising executives just don’t have the connection with rural America like they used to have.”

"According to Nielsen, RFD-TV averaged 132,000 viewers in primetime for February, ranking 81st among just over 100 cable networks tracked," Variety reports. Billy Frey, the channel's chief marketing officer, told Kosser that almost half of U.S. cable and satellite viewers have access to RFD-TV, which has seen its audience increase 8 percent since 2014. “This type of entertainment is their life,” Frey said. “That’s why we fight, so it will always be there for them.”

Fracking takes center stage in New York primary, could play a role in several remaining conests

The next presidential primary will be Tuesday in New York, the only state that has prohibited hydraulic fracturing for oil and gas and tensions over the issue run high. Some say allowing it would destroy the state, while others say it is needed boost the state's economy, especially in struggling rural areas. "Whether or not the state should allow fracking had been a contentious issue for Democratic Gov. Andrew Cuomo for years," Philip Bump reports for The Washington Post. "It wasn't until after he won re-election in 2014 that Cuomo finally nixed fracking in the state, after previously suggesting that he might allow it in the economically depressed counties along the state's southern border." (Post map)

Fracking could continue to play a significant role in many of the remaining Democratic primaries, National Journal reports in a story that is at least initially behind a paywall.

"All three Republican candidates have supported fracking, but John Kasich banned it in Ohio parks" as governor there, notes Joseph Spector, Albany bureau chief for the Poughkeepsie Journal.

Democrat Hillary Clinton, a former New York senator who has supported fracking in the past, has taken a strategic and incremental attitude toward it, while Sen. Bernie Sanders of Vermont has been dogmatic and ambitious in his opposition, Bump reports. "It's more a complicated issue outside of New York City, where the drilling would happen and the much-needed jobs would appear. But there are an awful lot of environmentally sensitive Democrats in the city for whom the idea itself is unacceptable. Giving us three political positions: It should be allowed [Republicans], it held promise (Clinton), it can't happen (Sanders)."

Clinton said in Thursday's debate in Brooklyn: "I don't think I've changed my view on what we need to do to go from where we are, where the world is heavily dependent on coal and oil, but principally coal, to where we need to be, which is clean renewable energy, and one of the bridge fuels is natural gas... So we did say natural gas is a bridge. We want to cross that bridge as quickly as possible, because in order to deal with climate change, we have got to move as rapidly as we can."

Sanders responded: "Here is a real difference. This is a difference between understanding that we have a crisis of historical consequence here, and incrementalism and those little steps are not enough. Not right now. Not on climate change. ... We have got to tell the fossil fuel industry that their short-term profits are not more important than the future of this planet."

Rural Minnestota legislators want state money to help keep rural grocery stores open

More than one-third of rural Minnesota grocery store owners don't expect to be in business in five years, according to a survey by the University of Minnesota Regional Sustainable Development Partnerships and the Minnesota Center for Survey Research. Store owners say the main problem  is competition from chain stores that offer cheaper prices.

Help could be on the way, state-government correspondent Don Davis of Forum Communications reports in his Capitol Chatter blog. State Rep. Rod Hamilton, R-Mountain Lake, is seeking a $10 million appropriation to help stop businesses from closing, although he admits it will be tough in a year when money is scarce. "While Hamilton’s bill has more debate in his and other committees, a bill similar to the one he wrote awaits a final Senate committee hearing. Another Hamilton measure, which is not moving in the Senate, would spend $600,000 to extend a $2 million appropriation granted last year to compensate farmers for providing fresh produce to food shelves."

Separate legislation would help provide food for food shelves, which often buy from small stores, Davis writes. Also, "Gov. Mark Dayton and other Democrats have been especially strong in calling for additional money to help Minnesota’s minority and other poor communities. The governor frequently has said money should be used statewide, including rural communities." (Read more)

Vilsack, others to discuss cost of rural poverty at forum Monday; available via audiocast

The Farm Foundation will host a free interactive forum, "The Cost of Poverty in Rural America," Monday from 9 to 11 a.m. EDT at the National Press Club in Washington. The forum, which will consist of PowerPoint presentations and a question-and-answer session, will include Agriculture Secretary Tom Vilsack; Purdue University Extension Director Jason Henderson and William Bynum, CEO of Hope Enterprise Corp. and Hope Credit Union, a regional community development financial institution and policy center in Jackson, Miss.

To register to attend the event, click here. To register to participate in the audiocast, click here. For those unable to attend in person or listen to the live audiocast, an audio file of the discussions will be posted in the Forum Archives after the event.

"Rural poverty is a complex, multi-dimensional problem for which there are no simple answers," said Farm Foundation President Neil Conklin. "Decades of change in the structure of rural economies, accompanied by demographic changes, have raised the economic prospects in some areas while others have been left behind. Rural poverty, which is so at odds with our sometimes idyllic vision of small town and rural life, makes us uncomfortable and tempts us to ignore the issue. That is not the answer. With this Forum, Farm Foundation seeks to bring many voices into a constructive conversation of how we attack the cancer that is poverty in rural America."

Rural Mass. man surprises neighbors by leaving $1.4 million to local library in honor of wife

A rural Massachusetts library received a surprise $1.4 million donation from the will of a quiet, antisocial man who wanted to honor his late wife, who was an avid user of the library, Andy Rosen reports for The Boston Globe. Anthony Ralys, a retired barber in Athol, population 11,000, was known as "a simple man with spare tastes, he never said much—a peculiar quality for a small-town barber—and guarded his money so carefully it was rumored the couple had never once been out to dinner."

Anthony and his wife Katherine were a "quiet, thrifty couple, who showed virtually no outward signs of wealth," Rosen writes. Relatives say the couple made good investments, mainly in municipal bonds, and were always extremely frugal," which may be an understatement. They kept the same fixtures and furnishings for decades and "Anthony used to make his own neck strips from paper towels and once built a flyswatter out of a coat hanger and a piece of vinyl upholstery." They rarely bought new clothes and often talked about taking a vacation but never did.

Still, no one knew how much money the couple had and the gift to the library was completely unexpected, Rosen writes. Debra Blanchard, who worked at the library for 43 years and retired last year as director, said the will "made it clear the gift was in his wife’s memory, as well as his own" and that money was for “renovations, additions, or building improvements.” Blanchard told Rosen, “I think it’s sweet that it was so important to him because it was so important to her."

Md. paper an example of weakened local coverage, writer says in Columbia Journalism Review

Most of the focus on troubles of the newspaper industry has been on metropolitan papers, and rightly so; they have lost a greater share of their revenue than community papers, reducing their role as the nation's leading journalistic watchdogs. But there has been a similar erosion among community newspapers, many of which have also become weaker as they have lost revenue.

Kent County, population 20,000, is the
least populated county in Maryland.

One example is the Kent County News of Chestertown, Md., Miranda Spivack reports for Columbia Journalism Review. Until 2012, it was a crusading weekly that filed about one complaint per year with the state Open Meetings Compliance Board, including one against University of Maryland trustees for their secret talks about joining the Big Ten Conference. "The open-meetings board criticized the trustees, who promised to be more accountable to the public. Closer to home, the paper broke stories and filed complaints about the Kent County library board’s failure to keep accurate meeting minutes, to address one member’s chronic absenteeism, and to hold public sessions, all while it ran up a deficit of about $200,000. The seven board members were replaced."

The paper was part of Chesapeake Publishing Corp., a chain that "kept regular tabs on Maryland’s Eastern Shore as it grew into a bedroom community," Spivack reports. In 2007, the papers were sold to American Consolidated Media, which in 2014 sold them to Adams Publishing Group. "The Kent County News now has four reporters and one editor, down from a staff of seven in 2009. Its journalists are expected, like so many others, to do more with less, filing short daily stories for the online edition while also meeting their weekly print deadlines. They’re rarely able to carve out time for in-depth investigations. Since March 2012, when [Kevin] Hemstock was replaced by Daniel Divilio as editor, the paper has run few deeply reported accountability stories. Since early 2014, it has filed no complaints about closed government meetings. . . . Hemstock left in 2012 after refusing to lay off staffers for a second time in three years." Now a member of the Millington Town Council, he told Spivack that local governments "think they can run amok."

It took the Kent County News two years to report on Apex Clean Energy's plans to build a wind farm with 30 to 50 turbines 500 feet tall, and when it did, its "single-source story, which quoted Tyson Utt, a director of development at Apex, was written by Editor Daniel Divilio, who says that it came about after Apex officials contacted the paper seeking publicity," Spivack reports. The story "failed to report that the county’s carefully hashed-out, seemingly airtight zoning laws had left a hidden, gaping loophole" for the state to approve turbines taller than 120 feet. But the paper reported nothing else about the proposal for another year, and refused to publish a letter about it, saying it exceeded its length limit, Spivack reports.

"An anti-turbine group . . . eventually, without much help from the local government and media, pieced the puzzle together," and Apex changed its plans, proposing a solar-energy facility, Spivack writes in her 4,200-word story. Without the citizen activists, "Residents might not have known about the Apex project until it was a done deal."

Higher speed limits killed 33,000 people from 1993 to 2013, insurance institute says

Increasing speed limits led to 33,000 traffic deaths from 1993 to 2013, including 1,900 deaths in 2013, "essentially canceling out the number of lives saved by frontal airbags that year," says a report by the Insurance Institute for Highway Safety. Charles Farmer, IIHS vice president for research and statistical services and lead author of the report, said "Although fatality rates fell during the study period, they would have been much lower if not for states' decisions to raise speed limits."

The researchers said 33,000 deaths is a low estimate. They "considered only increases in the maximum speed limit, which often applies only to rural interstates, but many states also increased speed limits on urban interstates. Other states increased speed limits on one section of road and later extended the higher limit to other sections. Those subsequent changes weren't factored in." Since 2013, several states have increased speed limits. (IIHS graphic)

The study looked at 41 states and Washington D.C., with nine states omitted "because they had relatively few vehicle miles traveled each year, leading to wide fluctuations in their annual fatality rates," reports IIHS. Researchers "looked at deaths per billion miles traveled by state and roadway type. Taking into account other factors that affected the fatality rate—including changes in unemployment, the number of potential young drivers (ages 16-24) and per capita alcohol consumption—researchers found that each 5 mph increase in the maximum speed limit resulted in a 4 percent increase in fatalities. The increase on interstates and freeways, the roads most affected by state maximums, was 8 percent." (IIHS map: Maximum speed limits as of January 2013)

Okla. lawmakers want to eliminate Essential Air Service; state doesn't qualify for subsidies

A pair of Republican lawmakers from Oklahoma have called for an end to the Essential Air Service program, saying it wastes $275 million per year on flights for few passengers, Chris Casteel reports for The Oklahoman. Sen. James Lankford said "It is simply unfair to expect families in 99 percent of cities to subsidize convenient travel options for passengers flying in and out of the Essential Air Service airports. Congress should recognize that this 37-year temporary program is no longer essential and should eliminate it." The program provides 113 separate commercial flights to rural and remote areas. (Wikipedia map)

"The Essential Air Service has long been a target of lawmakers and outside groups seeking to cut government spending," Casteel writes. "No Oklahoma communities are eligible for the subsidies; Enid and Ponca City were dropped from the program a decade ago. Lankford and [Rep. Steve] Russell have introduced separate measures to eliminate all funding for the program, which, according to Lankford, can cost federal taxpayers more than $500 per passenger." (Read more)

Walla Walla area investing in recreational activities for developmentally disabled adults

Walla Walla, Wash., is investing in recreational activities for the region's developmentally disabled adults, who have limited opportunities once they age out of the student programs and summer camps, Sheila Hagar reports for the Walla Walla Union-Bulletin. “As we call it: ‘When the school bus doesn’t come anymore’,” Susan Atkins, coordinator for Washington state’s Parent to Parent (P2P) program, told Hagar.

P2P, which "provides emotional and informational support to families with kids with developmental disabilities through local chapters and coordinators," has support from Democratic Gov. Jay Inslee, who signed into law a bill proposed by local Rep. Maureen Walsh "for increasing the statewide reach of P2P." (Union-Bulletin photo by Greg Lehman: College Buddies program)

For the first time Walla Walla is forming a co-ed softball team for players with and without disabilities, Hagar writes. "The city has agreed to some rule flexibility for the special-needs players, and there are allowances for teams that want to play half-seasons. It makes for what looks a promising marriage of need and solution," said Amy Harris, who has a special-needs daughter. She told Hagar, "I’m really excited to try something different. This has never been done before.”

The Valley Disability Network, a nonprofit founded in 2014 that runs P2P, "has been able to offer bowling, holiday parties, basketball, coffee klatches and Challenger baseball for people up to age 22," Hagar writes. Pickle ball has recently been added  and the network "also sponsors no-host dinners for parents once a month, where legal, legislative, health and educational information is dispersed, and moms and dads can talk honestly about the challenges of parenting a special-needs adult." Also, Whitman College and Walla Walla University students "participate in the local Buddies program, meeting with their developmentally disabled partners throughout the school year for various activities."

Nonprofit list nation's 10 'most endangered' rivers

American Rivers, a non-profit conservation organization, has released its annual report of the nation's most endangered rivers. The list changes from year to year, often with few or no repeats, so it's not really a comprehensive list of "most endangered" rivers. That's mainly a public-relations gimmick. But the list does give attention to rivers that don't get much notice outside their watersheds.

"These rivers all have two things in common: they’re threatened by mismanagement or various sources of pollution, and they’re all facing major policy decisions in the coming year that could either exacerbate those threats or rein them in," Katie Valentine reports for Climate Progress. "Millions of people depend on these rivers for drinking water, and the waterways are crucial habitats for a wide array of aquatic life."

No. 1 on the list is the Apalachicola-Chattahoochee-Flint River Basin that "provides 70 percent of the drinking water for metro Atlanta," Valentine writes. "But the rivers have been embroiled in a water dispute between Alabama, Florida, and Georgia for decades, and the states, along with Congress and the Army Corps of Engineers, haven’t managed the rivers as well as they should have, according to the report" Other rivers on the list, in descending order, are: San Joaquin River; Susquehanna River; Smith River; Green-Duwamsh Rivers; Pee Dee River; Russell Fork River; Merrimack River; St. Lawrence River; and Pascagoula River. (American Rivers map)

Scotts subsidiary Ortho announces it will phase out type of pesticide harmful to bees, other pollinators

Insect control product maker Ortho announced on Tuesday "it would begin 'to transition away' from using chemicals that are harmful to honeybees and other pollinators, responding to growing pressure from environmental advocates," Roger Yu reports for USA Today. "The Marysville, Ohio-based company, which is a subsidiary of ScottsMiracle-Gro, will discontinue neonicotinoid-based pesticides for outdoor use. The move follows Lowe's and Home Depot's announcements last year that they will stop selling neonicotinoid-based products in their garden care sections." (Bee Informed graphic)

"Ortho also plans to work with the Pollinator Stewardship Council, an advocacy group that supports beekeepers, to start a customer education program and lobby for the use of label language that clarifies the purchase of non-neonic pesticides," Yu writes. Last year, honey production fell 12 percent among producers with five or more colonies, according to a U.S. Department of Agriculture survey. Declining bee populations have been partially blamed on pesticides. Bees are responsible for more than $15 billion in increased U.S. crop value each year. (Read more)

GOP nomination could turn on unbound delegates

 Pittsburgh Tribune-Review delegate poll

The battle for the Republican presidential nomination could come down to the votes of unbound delegates at the Republican National Convention, Philip Rucker reports for The Washington Post. Among states still picking delegates, Pennsylvania has 54 unbound slots and West Virginia 31. "Other states and territories, from Colorado to Wyoming to Guam, will also send squads of unbound representatives. These are the swing voters of the GOP nominating contest, nearly 200 activists and elected leaders beholden to nothing except their personal judgment and empowered to make or break candidacies."

Businessman Donald Trump and Texas Sen. Ted Cruz have been re-focusing their attention on undecided delegates, Rucker writes. Trump's campaign recently opened an office in Charleston, W.Va., "and is trying to persuade more delegate candidates to commit to Trump. Allies are arguing that Trump would be best to guide coal country out of its chronic economic despair." Cruz's campaign "has methodically recruited supporters to run as unbound delegates in places such as Pennsylvania and West Virginia and plans an intense push to persuade those who will have a vote on the convention floor."

Three of West Virginia's delegates have already been selected— two say they will vote for the candidate that wins the state's popular vote on May 10—but the other 31 delegates will not be selected until the primary, Hoppy Kercheval reports for the Charleston Gazette-Mail. "Three delegates will be chosen from each of the three congressional districts in the primary election. The final 22 are called at-large delegates. There are 220 candidates for those 22 positions. Like the other delegates, each will have the presidential candidate they support next to their name, unless they are uncommitted. While they are elected statewide, no more than seven can come from each congressional district, for a total of 21, and no more than two can come from the same county. Additionally, the top vote-getter statewide wins a delegate spot."

The Pittsburgh Tribune-Review did a poll and got responses from 110 of the 162 people running to be delegates from Pennsylvania, by congressional district. It found that 61 of the 110 said they would vote for the candidate who wins statewide or in their respective congressional districts in the April 26 primary, Tom Fontaine and Salena Zito report for the Tribune-Review. "Nearly one-third—or 32 of them—said they are committed to Donald Trump, Ted Cruz, John Kasich or Marco Rubio, who has dropped out."

Congressional report: Men make 21% more than women, but numbers much higher in many states

States with large rural populations have some of the biggest gender pay gaps in the U.S., according to a report by the Joint Economic Committee of Congress. Louisiana has the biggest gender pay gap, with men earning 34.7 percent more than women. Utah is second, at 32.4 percent, followed by Wyoming, 31.2%; West Virginia, 30%; North Dakota, 28.7%; Alabama, 27.4%; and Idaho, 27.2%. Washington, D.C., has the smallest gap, with men earning 10.4 percent more than women. New York is the state with the smallest gap, 13.2 percent. (For an interactive map click here)

"For women of color, the losses are even steeper," Clare O'Connor reports for Forbes. "Compared to white men, African American women, on average, are paid only 60 cents on the dollar. Latinas are paid only 55 cents on the dollar. The gap only worsens as women age. While women between 18 and 24 earn 88 percent of what their male counterparts earn, women over age 35 earn only 76 percent of what men their age make."

Overall, women earn 79 cents for every dollar earned by men, up from 59 cents in 1974. In every state a significant gap still exists. 

Peabody Energy, nation's top coal producer, files for Chapter 11 bankruptcy protection

"In a much-anticipated move, the nation’s top coal producer, Peabody Energy, this morning sought Chapter 11 bankruptcy protection from creditors while it tries to reorganize its finances amid the continuing decline of the mining industry," Ken Ward Jr. reports for the Charleston Gazette-Mail. "Peabody lawyers filed the company’s bankruptcy petition in U.S. Bankruptcy Court for the Eastern District of Missouri in St. Louis, where the company is based."

Peabody officials "called the move a 'major step to strengthen liquidity and reduce debt amid an unprecedented industry downturn,'" Ward writes. "All of the company’s mines and offices are continuing to operate in the ordinary course of business and are expected to continue doing so for the duration of the process, Peabody said. Peabody, founded in 1883, produced more than 175 million tons of coal and employed nearly 5,000 miners in the U.S. in 2015, according to disclosures the company filed with the U.S. Mine Safety and Health Administration." Last month Peabody announced it was cutting 235 jobs, or 15 percent of its workforce, at North Antelope Rochelle in the Powder River Basin.

Laid-off Wyoming coal miners, who helped boost local economies, are left with few job options

Former Peabody miner Sean Seems stands
behind a plastic screen at an Alaska gold
mine. Former colleagues have been calling
him about Alaska jobs, he says. (WyoFile)

Last month's announcement of the first major coal-mining layoffs in Wyoming's Powder River Basin—Peabody Energy and Arch Coal cut a combined 465 jobs—has left miners who have helped fuel Wyoming's economy for decades with few, if any, options, Dustin Bleizeffer reports for WyoFile. "For 40 years, Gillette, Campbell County and all of Wyoming have feasted on revenues from mining coal—spending billions of dollars on roads, pipelines, schools and other public facilities, and socking away billions in savings. The corpus of Wyoming’s Permanent Mineral Trust Fund stands at more than $7 billion (bolstered mostly by coal, oil and natural gas). The Wyoming State Treasurer’s Office says it invests a total $19 billion."

But since last month’s layoffs, "many families here are asking, what’s left for the workers?" Bleizeffer writes. "Not much. Not directly. There are no state-initiated jobs programs for those who are laid off in the energy sector. Unlike Alaska, there is no mineral royalty payment to Wyoming citizens. Instead, the state spends millions on infrastructure, K-12 and secondary education, various economic development strategies and on promoting the coal, oil and gas industries themselves."

"Mine layoffs have rattled the foundations of Gillette, Wright, Douglas and other communities in northeast Wyoming, which were already suffering from major losses in oil and gas jobs," Bleizeffer writes. "While local leaders proclaim resilience, there’s also a lot of fear and anger. For coal miners in particular, the fear is of losing perhaps the best-paying job they’ve ever had. Wyoming coal miners, on average, gross $82,000, according to state figures. Miners also face the possibility of leaving towns where they have lived what some might consider a charmed blue-collar life — excellent schools, excellent (some say extravagant) public facilities and a real sense of community where neighbors, in one way or another, all rely on the energy industry." Most of the anger is directed at President Obama and his "war on coal."

"Wyoming lost more than 5,000 jobs last year, most of them in energy-producing regions," Bleizeffer writes. "The biggest job loss in Campbell County from third quarter 2014 to third quarter 2015 was in oil and gas, which shed 750 jobs compared to 115 direct mining jobs during the same period, according to state senior economist David Bullard. However, those losses in mining jobs—now at 580—may be of more concern. Oil and gas jobs are like icing on Campbell County’s cake—sometimes it’s thick and sometimes it is thin. Mining, however, has been an economic stabilizer that has helped service companies survive and even diversify in drilling downturns."

Newsrooms should train community members to provide skillful, responsible breaking-news reports

With the widespread use of smart phones with cameras, newsrooms have a responsibility to train the community in verification, news literacy and eyewitness media, writes Josh Stearns, director of journalism and sustainability at the Geraldine R. Dodge Foundation, for First Draft: "Bringing communities into the news process is a powerful way to spread journalistic values, train residents on reporting processes and foster user generated content that is more useful for newsrooms."

One source is the Breaking News Consumer's Handbook, published by On the Media. The handbook offers 11 tips—mostly basic journalism etiquette that community members might not be aware of—for covering breaking news.

Newsrooms can also lead by example. "A number of newsrooms are making public debunking a part of their work. See for example Gizmodo’s Factually and The Washington Post’s regular coverage of 'What Was Fake on The Internet This Week.' At their best, these posts don’t just point out fake photos and rumors but also explain how the authors were able to debunk them — what tools they used, what they looked for, the questions they asked."

"It is not enough to simply report accurately," Stearns writes. "Today we need newsrooms to also help debunk misinformation, especially during breaking news. And we should enlist our communities in that effort. During breaking news we turn to our communities, to social media, to piece together what is happening, to find sources and collect images and photos from the ground. We rely on them in those moments. As such, we should do everything we can to help people understand how best to help create and share more trustworthy information."

By engaging readers, newsrooms can train them to be active participants and eyewitnesses, Stearns argues. As readers learn how to take videos and photos and create social media updates more useful to newsrooms, that helps debunk misinformation and stop the spread of rumors. For readers, newsroom engagement will help them become more aware of their rights, allow them to report safely and consider journalistic integrity, while also making journalism more transparent, accountable and valuable.

"This should be a service we provide to our readers, but through collaborations with libraries, schools, local nonprofits we can reach even more people," Stearns writes. "My experience working at the intersection of journalism and communities is that people are hungry for tools and strategies to better identify trustworthy news and information and how to sort through the flood of info they face, especially around crisis, disasters and controversial issues in their communities." (Read more)

Rural children more likely to be readmitted to hospitals, have more complex chronic conditions

Rural children are more likely than their urban counterparts to be readmitted to hospitals within 30 days, says a study by researchers at Yale University published in Pediatrics. The study, which analyzed 672,190 admissions to 41 children's hospitals in 2012, also found that rural children traveled, on average, 68 miles to a hospital, compared to 12 miles for non-rural children; were more likely to live in low-income households (53 percent to 24 percent); and 20 percent of rural children lived in areas with doctor shortages, compared to 4 percent of non-rural children. The average hospital stay for rural children cost about $8,507, compared to $7,814 for non-rural children. (Yale map: Percentage of discharges from children’s hospitals to rural areas and rural HPSAs by hospital)

Rural children are more likely to suffer from complex medical conditions—44 percent to 37 percent, says the study. "Complex medical conditions treated at children's hospitals include heart problems, congenital heart disease, cystic fibrosis, Down syndrome and various lifelong health challenges caused by prematurity, according to the Children's Hospital Association," Steven Reinberg reports for HealthDay. Lead researcher, Dr. Alon Peltz said "greater coordination of services provided by community and pediatric hospitals would help." He told Reinberg, "This may include better use of technologies, such as telemedicine, or policies that support better integration between children's hospitals and rural doctors and community hospitals."

Post-Sept. 11 regulation keeps EPA from publicly identifying chemical facilities that violate rules

 Texas chemical plant where 15 people died in 2013 explosion

The good news is that the Environmental Protection Agency knows which chemical facilities are not following safety protocols. The bad news is that EPA can't tell the public. The agency has identified 13 to 15 potential violators since the deadly 2013 fertlizer explosion in West, Tex., Sam Pearson reports for Greenwire. "At least two outliers remain out of compliance. But their identities remain a secret thanks to post-Sept. 11 regulations administered by a different agency, the Department of Homeland Security. Unlike an earlier generation of environmental laws, including the Clean Air Act and Clean Water Act, programs launched under the umbrella of DHS were crafted largely without any sense of transparency in mind."

"It's just one example of the secrecy that keeps the identities of problem plants hidden—a luxury not afforded to gross violators of air, water and other traditional environmental laws," Pearson writes. "For these programs, the public can search using free online tools to identify industrial facilities that emit hazardous chemicals into the air or water at levels exceeding permitted amounts. The secrecy surrounding chemical plants makes it hard for the public to know what DHS is doing to protect them. DHS didn't respond to multiple requests for comment on this story."

"EPA said it could release only information that did not identify the facilities," Pearson writes. "In the two pages of correspondence the agency disclosed, an unidentified chemical facility tried to make the case that EPA was mistaken in its assessment of the quantity of chemicals it used and thus it did not have to participate in the risk management program." (Read more)

Congress may forgive young farmers' student loans

In an attempt to interest more young people in taking up farming, "Congress is considering a bill that would add farmers to the list of occupations that qualify for a federal program that forgives student loans for public service workers, such as teachers and police officers," Jen Fifield reports for Stateline. The average age of U.S. farmers is 58, up from 51 in 1982, and "the number of farmers who had been operating their farm for less than five years fell 23 percent from 2007 to 2012, to 171,550." That could spell trouble for an industry that "provided nearly one of every 10 jobs in the U.S. in 2014. And every dollar in farm exports in 2014 stimulated another $1.27 in business activity." (USDA graphic)

Student loan debt is especially tough for farmers, many of whom don't make enough money farming to make ends meet, Fifield writes. "The average farm income in 2012 was $2,229 for beginners and $26,217 for established farmers, while off-farm income—which can include a spouse’s job, interest and dividends—was $111,130 for beginners and $82,104 for established farmers." At the same time costs are rising, with agricultural land increasing from $2,300 to $3,020 per acre from 2011 to 2015, and the "average cost of a 95-horsepower tractor increased from $62,000 in 2005 to $107,970 in 2015."

New York started a small student-loan forgiveness program for farmers last year and the Wisconsin Legislature is considering doing the same, Fifield writes. The programs have their limits. Eric Hansen, policy analyst at the National Young Farmers Coalition, said farmers have a harder time making monthly loan payments, mainly because many "get paid once a year, at the end of the harvest season. And they have to spend money before they make it, which makes access to credit vital." A NYFC survey of new or aspiring farmers "found that those with student loan debt owed on average $35,000. Of those, 28 percent said that because of their debt, they didn’t pursue farming or are waiting to start. Many also said they couldn’t get credit because of their loans."

"And although forgiving student loans may help some starting farmers, it won’t reach the bulk of them," Fifield writes. "Spending for the New York program was capped at $100,000 last year and $150,000 this year, and the Wisconsin bill would cap spending at $60,000 in the first year, gradually increasing to $300,000 by 2020.To be eligible for the New York program, a farmer must have graduated in the last two years. In Wisconsin, the proposal is five years. Yet half the new farmers who responded to the NYFC survey said it took five years or longer to get started. Nearly half of new farmers are older than 35." (Read more)

Preliminary report: 2015 safest year ever for U.S. miners; 28 died in accidents last year

2015 was the safest year on record for U.S. mining, in terms of number of deaths and fatal and injury rates, according to preliminary Mine Safety and Health Administration data, reports Occupational Health and Safety. Last year 28 miners died in accidents, down from 45 in 2014. While there was less coal mining, reducing the numbers of fatalities and injuries, the rates per hour worked were also down.

"The fatal injury rate for all mining was 0.0096 (per 200,000 hours worked), the lowest in mining history and down from 0.0144 in 2014 and 0.0110 in 2011 and 2012," OHS reports. "The fatal injury rate for coal mining in 2015 was 0.0121, also the lowest rate ever. The previous fatal-injury-rate low was set in 2011, during a period of peak employment in the coal industry."

"The all-injury rate, as reported by mine operators, also fell to a new low of 2.28 n 2015, with coal's all-injury rate falling to 2.88, the first time it dropped below 3.0, and metal and nonmetal's all-injury rate dropping to a new low of 2.01," reports OHS. "MSHA citations and orders issued also fell by 11 percent in 2015. Assessed penalties dropped to $62.3 million, with approximately 2 percent of violations not yet assessed."

MSHA Administrator Joe Main, assistant secretary of labor for mine safety and health, said in a press release, "The progress we made in 2015 is good news for miners and the mining industry. It is the result of intensive efforts by MSHA and its stakeholders that have led to mine site compliance improvements, a reduction of chronic violators, historic low levels of respirable coal dust and silica, and a record low number of mining deaths." A final report is to be released in July.

D.C. forum Monday to focus on cost of rural poverty

The Farm Foundation on Monday will host a free interactive forum, "The Cost of Poverty in Rural America," from 9-11 a.m. EDT at the National Press Club in Washington D.C. The forum, which will consist of PowerPoint presentations and a question-and-answer session, will include: Agriculture Secretary Tom Vilsack; Jason Henderson, extension director at Purdue University; and William Bynum, CEO of Hope Enterprise Corp. and Hope Credit Union, a regional community development financial institution and policy center in Jackson, Miss. To register to attend the event, click here. To register to participate in the audiocast, click here. For those unable to attend in person or listen to the live audiocast, an audio file of the discussions will be posted in the Forum Archives after the event.

Nonprofit radio station provides a unique perspective for Central Appalachia

WMMT 88.7 FM is the 15,000-watt noncommercial community radio station for Appalshop, a nonprofit arts, media, and education center in southeastern Kentucky that has served Appalachian residents since 1969. Anna Clark reports for Columbia Journalism Review that the station, which was launched in 1985, "isn’t your ordinary public radio station. WMMT takes its tagline—'Real People, Real Radio'—seriously. The station is largely powered by 50 volunteer DJs who play and say whatever they wish, barring a scarce few rules about what’s allowed on air. Anybody can come in, go through training and a few supervised on-air segments, and get a regular time slot. The result is an unusually eclectic sound: community elders and 20-somethings, people who prefer to play bluegrass music and people who talk, and people who span the political and religious spectrums. The one common thread is deep roots in the community." (WMMT photo: DJ Jim Webb)

Orange line shows extent of WMMT's primary coverage area

Al Cross, director of the Institute for the Rural Journalism and Community Issues, which publishes The Rural Blog, told Clark, “It serves to be a unifying influence for that region. The counties in the central Appalachian coalfield have always been somewhat isolated from each other because of geography—the mountains. It helps to have media outlets look at things regionally and tell people in Eastern Kentucky, northeast Tennessee, southern Virginia, and southwest West Virginia that they have some things in common.” He said reliable news coverage is even more important now as the region deals with job losses in the coal industry.

Clark writes, "Appalshop was founded by Bill Richardson, a Yale architecture student who studied low-income housing and poverty, and had been struck by his first visit to Appalachia in 1966 for a school project. After graduating, he used a small federal grant to provide young people with video cameras and help them develop a community film workshop. Then, as now, Appalshop documentaries tend to be largely non-narrated, giving space for subjects to tell their own stories. In 1990, one of the workshop’s documentaries, about the fight against strip mining of land without the consent of surface owners, won a duPont award for broadcast journalism."

Cross told Clark he would like to see WMMT reach a wider and more mainstream audience: "They present information and entertainment that isn’t available anywhere else, but a lot of times people forget about the left end of the FM dial." The station is also available online. (Read more)

Judge vacates de-listing of West Virginia's Blair Mountain from National Register of Historic Places

Zinn Education Project map shows several coalfields, now
considered part of one single Central Appalachian coalfield.
(Click on image for a larger version)

On Monday a federal judge in Washington ruled that the U.S. Interior Department wrongly removed West Virginia's Blair Mountain from the National Register of Historic Places in 2009, reports Ken Ward Jr. of the Charleston Gazette-Mail. The judge said the determination to de-list Blair Mountain—"made at the urging of a lawyer for coal companies that own potential mining sites in the area—violated federal law, in part because it was based on 'very little, if any, indicia of reasoned decision-making." In 1921, the 1,600-acre site was home to a bloody battle in southern West Virginia over union organizing. It has been targeted for surface mining by mountaintop removal.

District Judge Reggie B. Walton "said that federal officials had simply rubber stamped a state recommendation, did not independently verify the accuracy of a list of objecting landowners, and failed to act in a transparent manner," Ward writes. "Walton sent the matter back to the Interior Department for the 'exercise of reasoned decision making.'" Walton had earlier ruled that citizens lacked standing to challenge the de-listing, but that was overturned by the U.S. Court of Appeals for the District of Columbia. (Read more)

Death rates for rural whites, especially women in their 40s, continue to increase

The rural-urban gap in the death rate gap among white Americans—especially women—continues to widen, Joel Achenbach and Dan Keating report for The Washington Post. Since 1990, "Death rates for rural white women in midlife have risen by nearly 50 percent."

Among rural white women in their late 40s, the death rate has risen 30 percent, from 228 out of every 100,000 women in 2000 to 296/100,000 today. "White men are also dying in midlife at unexpectedly high rates. But the most extreme changes in mortality have occurred among white women, who are far more likely than their grandmothers to be smokers, suffer from obesity or drink themselves to death." Other factors are a rise in heroin and opioid addiction among rural whites and that more rural women today work, which increases stress and other poor health factors.

"Public-health experts say the rising white death rate reflects a broader health crisis, one that has made the U.S. the least healthy affluent nation in the world over the past 20 years," Achenbach and Keating write. "In affluent countries, people generally enjoy increasingly long lives, thanks to better cancer treatments; drugs that lower cholesterol and the risk of heart attacks; fewer fatal car accidents; and less violent crime. But progress for middle-aged white Americans is lagging in many places—and has stopped entirely in smaller cities and towns and the vast open reaches of the country."

In rural Victoria County, Texas (Best Places map), "deaths among women 45 to 54 have climbed by 169 percent, the sharpest increase in that age group of any U.S. county," Achenbach and Keating write. "The death rate climbed from 216 per 100,000 people to 583." Lisa Campbell, medical director for the Victoria County health department, "said a third of adults in the county are obese, roughly in line with the national average. Also, 1 in 5 smokes—well above the national average—and people can still light up in restaurants and other public places."

Opioid and heroin overdoses have "been particularly devastating in working-class and rural communities," Achenbach and Keating write. "Another killer is related to heavy drinking. Deaths of rural white women in their early 50s from cirrhosis of the liver have doubled since the end of the 20th century, The Post found. Suicides are also on the rise. The suicide rate is climbing for white women of all ages and has more than doubled for rural white women ages 50 to 54. Other trends may be contributing to the die-off, including obesity. Americans are the heaviest people in the world outside of a few Pacific Island nations; more than a third of adults in the U.S. are considered obese."

"The average American woman today weighs as much as an American man did in the early 1960s." Achenbach and Keating write. "Researchers point out that this generation of white women has experienced a revolutionary change in gender roles over the past half-century, surging into the workforce while typically retaining traditional duties as domestic caregivers—a dual role to which many women of color have long been accustomed. White women often find themselves harried in ways their grandmothers could never have imagined." (Read more)

For poor Americans, where you live plays a major role in how long you live, county-level data show

While many studies have shown that rich people live longer than poor people, says a study with county-level data published today in the Journal of the American Medical Association says life expectancy among poor people varies based on variety on geographic differences. "Life expectancy for individuals in the lowest income quartile [the bottom fourth] were significantly correlated with health behaviors such as smoking, but were not significantly correlated with access to medical care, physical environmental factors, income inequality, or labor market conditions," researchers stated. "Life expectancy for low-income individuals was positively correlated with the local area fraction of immigrants, fraction of college graduates and government expenditures."

The study found that "shorter life expectancies for the poor, measured at age 40, were most closely correlated with places that had lower exercise rates and higher rates of smoking and obesity," Christopher Ingraham and Emily Badger report for The Washington Post. "For men, the gap between the top and bottom 1 percent nationwide is nearly 15 years. For women, it's 10 years. And these disparities have widened since 2000. People in the top 5 percent have gained about three years of life expectancy. People at the bottom have gained almost nothing." (Post maps)

The study, "based on the tax and Social Security records of everyone in America between 1999 and 2014 with a valid Social Security number and earnings, gives the most precise look yet at a pattern that has long troubled health experts: In America, the richer you are, the longer you live. But what's especially striking is that the poor live even shorter lives in some places than others," Ingraham and Badger write. "They have longer life expectancies in affluent, cities with highly educated populations, such as San Francisco, New York and Los Angeles. Among the 100 largest commuting zones ranked by the researchers, six of the top eight for low-income life expectancies are in California, a state with a strong safety net and a history of regulating where you light your cigarette or what comes from your car's tailpipe."

"Geography also matters much more for the poor than the rich," Ingraham and Badger write. "The health behaviors of the wealthy are similar wherever they live. For the poor, their likelihood of risky behaviors such as smoking depends a great deal on geography, on whether they live in a place where smoking is common or where, as in San Francisco, cigarettes have been shunted out of view." (Read more)

Corn growers told to keep vigilant for suspected seed thieves from China, other countries

Iowa corn growers are keeping a weary eye out for a Chinese attack. It's not a joke. Growers are being vigilant ever since seven Chinese nationals "were accused by U.S. authorities in 2013 of digging up seeds from Iowa farms and planning to send them back to China," Julia Edwards reports for Reuters. One of the nationals pleaded guilty in January to the crimes, which "has laid bare the value—and vulnerability—of advanced food technology in a world with 7 billion mouths to feed, 1.36 billion of them Chinese."

"The number of international economic espionage cases referred to the FBI is rising, up 15 percent each year between 2009 and 2014 and up 53 percent in 2015," Edwards writes. The FBI said most of the cases involve Chinese nationals. "In the agriculture sector, organic insecticide, irrigation equipment and rice, along with corn, are all suspected to have been targeted, including by Chinese nationals."

In response to threats "U.S. law enforcement officials are urging agriculture executives and security officers to increase their vigilance and report any suspicious activity," Edwards writes. "But on a March 30 visit to Iowa, Justice Department officials could offer little advice to ensure against similar thefts, underlining how agricultural technology lying in open fields can be more vulnerable than a computer network or a factory floor." The agricultural sector is basically being told to build fences and have guards, which many say are impractical solutions, "due to the high cost and impracticality of guarding hundreds of thousands of acres." Monsanto—one of the firms whose seeds were targeted—said it safeguards its genetically modified organism (GMO) technology by protecting its computers, patenting seeds and keeping fields unmarked." (Read more)

Rural S.D. weekly on the scene to keep local readers informed about Keystone Pipeline oil spill

A TransCanada Keystone Pipeline spill that leaked 16,000 gallons of oil near Freeman, S.D., April 2, caused the pipeline to be shut down until Sunday, when it resumed operating on a lower pressure than normal, reports KELO-TV in Sioux Falls. The local paper, the weekly Freeman Courier, has been on the scene since the spill, keeping local residents well informed. (Courier photo by Jeremy Waltner: Workers at the spill eight miles south of Freeman)

"Winds blew strong across the South Dakota prairie on Friday as work continued just south of a busy Highway 18, as cars and trucks screamed by," the Courier reports. "It's a busy west-east state highway anyway, but the widespread attention of the oil spill likely drew additional traffic. A few cars slowed as they passed by. A man sat in a pickup on the north perimeter of the scene, next to a road closed sign, on security detail. A mile south was another man in another pickup checking people in. This is the outlet for the massive side dump trucks hauling dirt."

"Inside the mile-long blocked-off section of gravel road, which is located about five miles from TransCanada’s pump station near Freeman, workers work," reports the Courier. "Some of them are locally-hired contractors, others are with TransCanada, says David Dodson, the public information officer with TransCanada stationed at incident command on site. He describes the work as 'digging and looking.' Dodson said about 100 men and women are working the scene around the clock on a rotation basis."

4-H expanding in urban areas in bid to boost Hispanic and African American membership

4-H clubs will soon be expanding into urban and suburban areas in a quest to attract Hispanic and African American youth, T. Rees Shapiro reports for The Washington Post. (Post photo by Katherine Frey: Mica Biamonte, 12, gives a demonstration on how to sew a pillow to her fellow 4-H'ers on April 7, 2016, in Damascus, Md.)

The new effort is part of a campaign to add 4.2 million Hispanic or African American members by 2025. About half of the six million 4-H members from kindergarten to high school are white, with 1.7 million members Hispanic or African American. Jennifer Sirangelo, chief executive of the National 4-H Council, told Shapiro, "We just know we need to break out of this limited view that people have of 4-H. We’re still connected to our roots in agriculture, but we are so much more.”

In an attempt to attract more urban youth "the transformation will involve emphasizing 4-H projects surrounding science, technology, engineering and math—the STEM fields—promoting activities such as rocketry or building drones," Shapiro writes. "Sirangelo said that demographic data collected by the organization shows that there are about 30 million children in the country who are underserved and could benefit from leadership­-development programs such as 4-H." She told him, “We want to ensure that our program has a welcome mat in every community. We know if we don’t get them ready for leadership, we may have a huge leadership void affecting every industry and sector in the future.” The National 4-H Conference is being held through Thursday in Washington D.C.

New managers shake up a rural hospital to save it; story and similar one are good coverage examples

The troubles of rural hospitals can be hard for rural news media to cover in detail, partly because they are special kinds of businesses and their managers are often unwilling to be forthcoming about problems. But it’s important to get them to open up, because few local institutions are as important or, in some communities, as much at risk. One of the best stories I have ever read on the managerial changes at a rural hospital is excerpted below. This the second such story in a week from Harris Meyer of Modern Healthcare; the other was about a nearby hospital. The articles are excellent examples of how to cover rural hospitals. --Al Cross, director, Institute for Rural Journalism and Community Issues, publisher of The Rural Blog

Stace Holland (Modern Healthcare photo by Harris Meyer)

The crisis in rural hospitals is driven not only by changes in federal reimbursement and patients' increasing preference for larger hospitals, but in some towns by managerial shortcomings that may follow local tradition but hurt the bottom line. Changing those practices can be difficult, but the new administrator of the Pineville Community Hospital appears to be having success as he grabs the bull by the horns.

Longtime rural hospital administrator Stace Holland has put PCH "on the road to recovery by cutting costs, bringing in more federal funds and getting staffers to change their ways," Modern Healthcare reports in a long story than delves into the details, from specific expense cuts to clashes with physicians.

The 120-bed hospital is staffed for only 30 (not counting a 26-bed nursing unit) and was losing $6 million a year. Eight months after taking over as CEO, "Holland is well on the way to turning around a struggling not-for-profit facility that still expects to lose $3 million this year. With support from the Plano, Texas-based Community Hospital Corp., which took over management of the hospital in October 2014, Holland already has made significant progress toward stabilizing its finances," Harris Meyer reports.

"Holland faced a challenge that is all too familiar to rural hospital leaders around the country: declining patient volumes; a preponderance of low-paying Medicare, Medicaid and uninsured patients; public and private rate squeezes; high incidence of chronic disease and drug abuse; difficulty in recruiting physicians; and a shortage of funds to invest in new equipment and services. . . .  To save the hospital, whose previous CEO served nearly 40 years, Holland, Chief Nursing Officer Dinah Jarvis, and CHC knew they had to take tough steps that would unsettle physicians, staffers and local residents accustomed to the old comfortable ways."

The new ways included a partnership with the Baptist Health hospital in Corbin to help PCH compete with the Appalachian Regional Hospital in nearby Middlesboro, partly with a 12-bed geriatric psychiatry unit; a federal rural health facility license that significantly boosted Medicare and Medicaid payments," and "clinical protocols to improve quality of care and reduce readmissions," which were so frequent in 2013 and 2014 that they drew Medicare's maximum penalty, Meyer reports. But the new protocols, such as "pre-discharge education of congestive-heart-failure patients about medication use and weight monitoring," riled some physicians.

Dr. Steven Morgan told Meyer, “They want to pound square pegs into round holes.” Dr. Shawn Fugate said he had to fight with CHC for "what he thought were adequate nurse staffing levels, and that CHC is making too many important decisions from afar," Meyer reports. As an employee of CHC rather than the hospital, Holland can "speak frankly," Meyer writes. "He recently told an older surgeon who serves on the board that it was time for him to retire."

Pineville is on the old Wilderness Road (in red) and US 25-E.

Pineville Mayor Scott Madon told Meyer, “Stace has an unbelievable task in what he's dealing with. He's trying to reinvent the rural hospital. He has to change the whole thinking, and people don't like it.” But longtime hospital board member David Gambrell, a real-estate agent whose son will start as a family physician there soon, said Holland's approach has been “refreshing. . . . We need that kind of honesty. It's taken Stace coming here to see we needed a new vision.”

Meyer reports, "Local leaders see the Pineville hospital's survival as pivotal to the future of the town and Bell County, which . . . has lost many coal-mining jobs. They say the hospital, the city's largest employer, is key to their economic redevelopment efforts. . . . The Pineville hospital has strong customer loyalty. Its staff—most of whom are local residents who have worked there for many years—have deep ties to the patient population." Wilma Sizemore, a 70-year-old disabled woman who was admitted in mid-February for bronchitis and dizziness, told him, “I wouldn't doctor nowhere else but this hospital. They treat me like family here.”

National Newspaper Assn. seeks contest judges

The National Newspaper Association, the leading organization of community newspapers in the U.S., is seeking judges for its annual Better Newspaper Contest. It needs to have judges lined up by Thursday, and judging is due by April 29. To sign up and pick categories, go to https://nna.formstack.com/forms/judgenna2016. If you need more information, contact Lynne Lance of NNA at lynne@nna.org.

Many rural areas, led by Central Appalachia, rank high in overdoses; some blame limits on treatment

"People in rural areas of Appalachia are more likely to die early deaths than in other parts of the country," and a big reason is that they "die from drug overdoses at greater rates than the rest of the country," writes Kery Murakami, the Washington, D.C., reporter for Community Newspaper Holdings Inc.'s CNHI News Service.

Murakami notes that in Leslie County, Ky., and Boone County, W.Va., about 80 of every 100,000 residents overdosed each year in 2012 to 2014. "That’s six times the national rate," and second and third in the nation, he writes, citing the annual County Health Rankings done for the Robert Wood Johnson Foundation by the University of Wisconsin Population Health Institute. Several other Appalachian counties in Kentucky and West Virginia rank high.

"In 16 percent of counties — generally in rural areas — more than 20 per 100,000 die from drug overdoses," Murakami reports. The rates are high partly because "addicts in some parts of the country get turned away by doctors and are not given a drug called buprenorphine that is used to kick opioid addictions," Murakami reports, citing addiction experts. "Buprenorphine causes less euphoria and physical dependence and can ease withdrawal and cravings."

However, "Federal law caps the number of patients to whom a doctor is allowed to prescribe the drug, out of concern of creating places where large numbers of addicts receive opioid-based medication. Such treatment hubs, much like methadone clinics, bring unwanted community opposition, said Mark Parrino, president of the American Association for the Treatment of Opioid Dependence. That limits treatment choices in rural areas, where one doctor might be the only one licensed to prescribe buprenorphine for hundreds of miles."

The Department of Health and Human Services is moving to ease the limits, and Sens. Ed Markey, D-Mass., and Rand Paul, R-Ky., want to go even further. "But some addiction experts are concerned that raising the caps on buprenorphine will nudge the country toward treating addiction with medication rather than counseling, Murakami reports. The department’s proposed rules would require mental-health care, which is often hard to get in rural areas. The senators’ bill would not.

“Turning people away from the most evidence-based treatment we have for a chronic, life-threatening disease is heart wrenching for a doctor,” Dr. Kelly Clark, president-elect of the American Society of Addiction Medicine, told CNHI. “Rural areas have been hit hardest by this round in overdoses, which is the worst round of overdose deaths in our country.” She said medication is especially important in rural areas because opioid use spreads among families. “In rural areas, you’re treating the person, their parents and grandparents,” she said. “Entire families are addicted. It’s not like saying, ‘Stay away from certain friends,’ if they’re shooting up with their sister and their mother.”