Friday, May 13, 2016

Nonprofit investigative news site posts warning on its opioid-prescriber database, fearing misuse

Obama threatens to deny federal aid to schools refusing transgender students bathroom choice

The Obama administration sent a letter to public schools today telling them to allow transgender students to use the bathroom that matches their gender identity, or risk losing federal funds. The letter, sent jointly by the Department of Justice and the Department of Education, says "under Title IX of the Education Amendments of 1972, schools receiving federal money may not discriminate based on a student’s sex, including a student’s transgender status." (Getty Images by Mark Ralston: Signs outside a restroom at Santee High School in Los Angeles)

The letter "does not have the force of law, but it contains an implicit threat: Schools that do not abide by the Obama administration’s interpretation of the law could face lawsuits or a loss of federal aid," , Julie Hirschfeld Davis and Matt Apuzzo report for The New York Times. "The move is certain to draw fresh criticism, particularly from Republicans, that the federal government is wading into local matters and imposing its own values on communities across the country that may not agree. It represents the latest example of the Obama administration using a combination of policies, lawsuits and public statements to change the civil rights landscape for gays, lesbians, bisexual and transgender people."

Texas Lt. Gov. Dan Patrick said the Lone Star state doesn't plan to comply, telling Noelle Walker of KXAS-TV or NBCDFW, "This will be the beginning of the end of the public school system as we know it... President Obama, in the dark of the night—without consulting Congress, without consulting educators, without consulting parents—decides to issue an executive order, like this superintendent, forcing transgender policies on schools and on parents who clearly don't want it." Patrick told other reporters that Texas, which gets $10 billion from the federal government for education, mostly for school meals, will find as much as money as possible to make up the loss of federal money. (Officially sanctioned prayer was taken out of schools, but not voluntary prayer.)

Attorney General Loretta E. Lynch said in the letter: “There is no room in our schools for discrimination of any kind, including discrimination against transgender students on the basis of their sex. This guidance gives administrators, teachers and parents the tools they need to protect transgender students from peer harassment and to identify and address unjust school policies. I look forward to continuing our work with the Department of Education—and with schools across the country—to create classroom environments that are safe, nurturing, and inclusive for all of our young people.”

Trump, with help of avid-sportsman son, is with the 'hook and bullet crowd,' energy lobbyist says

While not all Republicans have warmed to Republican presidential candidate Donald Trump, one group that the businessman seems to resonate well with is hunters and fishers, Phil Taylor reports for Environment & Energy Publishing. "With the help of his son, Donald Jr., an avid sportsman and ambassador for the campaign, Trump Sr. is saying all the right things to America's hunters and anglers. He's capturing endorsements and positive reviews from sportsmen's trade publications—hook, line and sinker." (Associated Press photo: Donald Trump Jr. greeting voters in New Hampshire)

"The Trump campaign has pledged to nominate a hunter to lead the Fish and Wildlife Service, aggressively fight lawsuits by anti-hunting groups, make wildlife habitat more productive, and control predators like wolves that prey on game species like elk," Taylor writes. "Most notably, Trump in January broke from the GOP establishment by pledging to oppose efforts to transfer federal lands to states, gaining plaudits from sportsmen across the political spectrum who oppose the privatization of federal lands, fearing it would reduce places to hunt and fish."

Mike Schoby, editor of Petersen's Hunting, which endorsed Trump, wrote on Jan. 31: "It says he is smart. It says he realizes that 13 million hunters and 80 million gun owners represent a large voting block, one that will likely agree with his policies on hunting and protection of Second Amendment rights."

Taylor writes, "Yet some Republicans say Trump's public-lands platform is alienating potential allies, particularly those in Congress and industry who oppose the federal government's massive landholdings and believe states could better manage them for activities like drilling, mining and logging. By catering heavily to hunters and anglers, Trump may be shooting himself in the foot." Mike McKenna, a GOP strategist and energy lobbyist, told Taylor, "They have made the calculation that the hook-and-bullet crowd is the relevant demographic here, but the reality is the professional hook-and-bullet crowd is a small group compared to [those who care] about federal land management in the West. I can't think of a single issue other than this one where he's so far out over his skis."

Taylor writes, "Key questions remain over how Trump would manage the roughly 640 million acres under the control of the executive branch primarily through the Bureau of Land Management, the Forest Service, FWS and the National Park Service. Would Trump roll back Obama administration oil and gas leasing reforms designed to keep drilling farther from national parks and backcountry areas while tightening regulations on hydraulic fracturing? Would he dismantle Obama's sage grouse plan by loosening restrictions on drilling, mining and grazing? What kind of influence would Trump exert on Endangered Species Act decisions that can affect hunters and energy companies?"

Bill Clinton met by cheers, miners' boos as he tries to keep the No. 3 coal state in his wife's column

Bill Clinton spoke at Prestonsburg Elementary School.
Former President Bill Clinton was met by cheers and boos in Eastern Kentucky coal country on Thursday while campaigning for his wife ahead of Tuesday's Kentucky primary, Mary Meadows reports for the Floyd County Chronicle. Hillary Clinton scored overwhelming victories in the county and the state in the 2008 primary against Barack Obama, but is at risk of losing the state to Vermont Sen. Bernie Sanders because of what has been dubbed as “Obama’s war on coal,” Meadows writes. While cheaper natural gas and difficult mining geology in Central Appalachia are the main reasons for the region's decline in coal, many in Eastern Kentucky blame Obama, and Democrats who support him, for the industry's downfall.

Clinton took booing miners in stride, telling them, in an apparent allusion to Donald Trump: “I’m not like a lot of people. You know, it doesn’t bother me to have protesters at rallies. I’m glad they come, because I think one of the biggest problems in America today is we seem to be less prejudiced about everything, except we don’t want to be around anybody that disagrees with us. Have you noticed that? And I think that’s a mistake. . . . You don’t have to agree with everything ... I believe, but I’m going to tell you we’re not going to get anywhere screaming at each other. ... What really matters is whether our children have a brighter future and whether we’ll be together or be torn apart.”

Clinton "talked about that economic revitalization plan supported by his wife and incentives that encouraged companies to create more jobs," Meadows writes. "He talked about the need to diversify the economy and pledged that if his wife is elected, he would volunteer to help the region, noting he grew up on a farm with no vehicle or toilet and stating that he understands what Eastern Kentucky is going through because he was governor of Arkansas when it faced tough economic times. He called for people to come together to work to find solutions."

Joe Gerth of The Courier-Journal reports that Clinton "talked about students at Morehead State University who are working on nano-technology satellites that are going up to the International Space Station. 'Don't tell me we can't bring different kinds of jobs to Eastern Kentucky,' he said. 'And don't tell me somebody over a certain age can't learn this stuff. I'm pleading with you to think about it. Think about your life, your children's lives, your grandchildren's lives,' Clinton said."

Quinoa getting so popular that it could become a big thing in California, No.1 agricultural state

Quinoa ("KIN-wah"), a native crop of South America's Andes Mountains, could be on the verge of being the next big California-grown crop that feeds the nation, Geoffrey Mohan reports for the Los Angeles Times. If quinoa, which is now being harvested in Southern California's Imperial Valley, near the Mexican border, "proves profitable here, California could dominate yet another niche crop, as the grain-like seed graduates from health-craze fad to a popular ingredient in energy bars, cereals and even drinks. Acreage dedicated to quinoa may reach into the thousands in the next two years in California, a state that already is a hub for quinoa imported from South America. That's about where kale was in 2007 before it took off." (Times photo by Irfan Khan: Quinoa grown in Southern California)

"Chenopodium quinoa is not a grain, but a pseudo-cereal, an herbaceous annual that's a cousin to beets, chard and spinach and offers a balanced suite of 10 amino acids. Its leaves make a sweet pesto, but it's the seeds that land on consumers' plates," Mohan writes. "There are at least 120 varieties of quinoa, and plant scientists have sifted through most of them trying to figure out which can grow well outside the high and dry altiplano that sprawls across Peru and Bolivia." Quinoa has been grown in the U.S. in Colorado, the Pacific Northwest, Idaho, Northern California, and now in the heart of the Sonoran Desert in Southern California.

"Andean nations now export more than 40,000 tons of quinoa, valued at $111 million—a nearly 40-fold increase since 2002, according to the United Nations Food and Agricultural Program," Mohan writes. "More than half of that goes to the U.S." One concern among U.S. growers new to the product is that quinoa "is nearly identical to lambsquarters (Chenopodium album), an invasive weed that can be toxic to livestock and hosts a virus that can ruin alfalfa, which is planted on more acreage in Imperial Valley than any other crop, and ranks second in sales value only to the cattle that eat it." (Read more)

Big Candy's move away from GMO products hurts beet farmers, helps sugarcane industry

Farmers growing genetically modified beets are losing the Big Candy war to sugarcane farmers, who are struggling to keep up with growing demand for non-GMO products, Dan Charles reports for NPR. Eight years ago many beet farmers made the switch to mostly using genetically modified versions of the crop, which can tolerate the weedkiller glyphosate (Roundup). "About half of all sugar in the U.S. comes from sugar beets and the other half comes from sugarcane. Now, for the first time, sugar traders are treating these as two different commodities, with two different prices."

Michael McConnell, an economist with the U.S. Department of Agriculture's Economic Research Service, said beet sugar sells for 3 to 5 cents less than cane sugar on the spot market, Charles writes. "It means that buyers are paying 10 to 15 percent more for cane sugar. Meanwhile, the amount of beet sugar looking for buyers has been increasing, while there's a shortage of cane sugar. That shortage is bad enough that sugar users, such as candy companies, are asking the USDA to allow more imports of cane sugar to ease the shortage."

In 2015 Hershey Co., one of the top sugar users in the country, switched from using beet sugar to cane sugar, Charles writes. Deborah Arcoleo, the firm's director of product transparency, told Charles, "We started reformulating Hershey's Kisses, Hershey's milk chocolate, and Hershey's milk chocolate with almonds, to move from beet sugar to cane sugar, and that's complete. Now we're looking to do that across the rest of our portfolio, to the extent that we can."

EPA says its new methane-emissions rules for oil and gas industry could save more than they cost

The Environmental Protection Agency on Thursday released regulations that "require oil and gas companies to plug and capture leaks of methane from new and modified drilling wells and storage tanks, not older, existing wells," Coral Davenport reports for The New York Times. "EPA estimates that the rules will cost companies around $530 million in 2025, but it also estimates that they will yield companies savings of as much as $690 million from reduced waste, a potential net benefit of $160 million. The agency said the regulations would lower methane emissions by 510,000 tons in 2025, the equivalent of 11 million metric tons of carbon dioxide."

"The new methane rules are the latest part of a broader push by President Obama to cut greenhouse-gas emissions from industries across the economy," Davenport writes. "EPA regulations would cut carbon-dioxide emissions from cars, trucks and power plants, and new rules are in the works to reduce emissions from airplanes. Many of those regulations could face years of litigation before they can go into force."

EPA said the rules will help "cut methane emissions 40 to 45 percent below 2012 levels by 2025 and forms a key part of the U.S. plan to meet its Paris climate agreement pledge," Valerie Volcovici reports for Reuters. "The rule, first proposed last August, outlines safeguards for preventing the escape of methane from new and modified oil and natural gas infrastructure, the largest source of those emissions in the U.S. EPA also launched an 'Information Collection Request' that requires companies to provide details about their existing oil and gas facilities from autumn 2016 until early 2017. This is the first step toward regulating existing sources, which accounts for 90 percent of U.S. methane emissions."

Oil and gas industry groups have vowed to fight the regulations. Kyle Isakower, vice president for regulatory policy at the American Petroleum Institute, told Davenport, “It doesn’t make sense that the administration would add unreasonable and overly burdensome regulations when the industry is already leading the way in reducing emissions. Imposing a one-size-fits-all scheme on the industry could actually stifle innovation and discourage investments.”

Thursday, May 12, 2016

Poultry-plant workers say they're denied bathroom breaks, forced to relieve selves at work stations

Workers at major poultry processing plants are routinely denied bathroom breaks, says a report by Oxfam America, an arm of the international anti-poverty and injustice group, Workers say they have been threatened with punishment or dismissal for asking for bathroom breaks, often urinate or defecate at their work stations, and have resorted to wearing adult diapers. In an effort to avoid needing to use the bathroom, workers said they restrict intake of liquids, often to dangerous levels. The report consisted of complaints from workers at plants run by Tyson, Perdue, Sanderson Farms and Pilgrim's. (News Journal photo)

"Supervisors deny requests to use the bathroom because they are under pressure to maintain the speed of the processing line, and to keep up production," says the report. "Once a poultry plant roars to a start at the beginning of the day, it doesn’t stop until all the chickens are processed. Workers are reduced to pieces of the machine, little more than the body parts that hang, cut, trim, and load—rapidly and relentlessly."

A survey of 266 Alabama poultry workers by the Southern Poverty Law Center found that nearly 80 percent of said they are not allowed to take bathroom breaks when needed, says the report. Another survey, in Minnesota, revealed that 86 percent of workers said they get fewer than two bathroom breaks per week. Many workers said bathroom breaks are limited to five minutes and no sympathy is giving to pregnant or menstruating women.

"By law, companies are required to grant their employees access to bathrooms," with processing plants using a system where one worker swaps places for another one who needs a break, Roberto Ferdman reports for The Washington Post. "But the system is either flawed or being eschewed by supervisors, according to Oxfam. Workers reported waiting for more than an hour for someone to swap in, if anyone came at all."

Tyson and Perdue, the only companies to respond to requests from Oxfam, denied the accusations. Gary Mickelson, senior director of public relations for Tyson, told the Post in an email: "We're concerned about these anonymous claims and while we currently have no evidence they're true, are checking to make sure our position on restroom breaks is being followed and our team members' needs are being met."

Feds say fire that led to 2013 deadly explosion at Texas fertilizer plant was intentionally set

The 2013 explosion at a fertilizer plant in West, Texas, which left 15 people dead, has been ruled intentional and is being pursued as a criminal act, Manny Fernandez reports for The New York Times. "Federal officials said the fire that preceded the blast that day had been 'incendiary,' or intentionally set. All accidental and natural fire possibilities were tested and eliminated, officials said... Officials announced a reward of up to $50,000 for information leading to the arrest of those responsible." (CNN photo: remains of the fertilizer plant in 2014)

"The explosion left a crater 93 feet wide and 10 feet deep," Fernandez writes. "Ten of the 15 people killed were volunteer firefighters and other emergency workers; more than 260 others were injured. Of the town’s 700 homes, about 350 were affected, including 193 that were destroyed or severely damaged. Three schools, a nursing home and a 50-unit apartment complex were destroyed or heavily damaged."

"The type of agricultural chemical that set off the explosion—ammonium nitrate—was sold at the plant to farmers for use as a fertilizer," Fernandez writes. "In normal storage conditions, ammonium nitrate is difficult to ignite, but intense heat and other unusual conditions can cause it to detonate. It was used by Timothy J. McVeigh in the Oklahoma City bombing in 1995."

EPA today to unveil regulations to reduce methane emissions from oil and gas industry

The Environmental Protection Agency is expected today to unveil "a rule to target methane emissions from new or modified oil and gas facilities, the first regulations to tackle the greenhouse gas from the sector, two sources briefed on the matter said," Valerie Volcovici reports for Reuters. "The proposal is expected to require new and modified oil and gas processing and transmission facilities to find and repair methane leaks, capture natural gas from hydraulically fractured oil wells and limit emissions from pumps and other types of equipment."

"It will help achieve a broader Obama administration strategy to cut methane emissions 40 to 45 percent below 2012 levels by 2025, the EPA said, and forms a key part of its climate change strategy," Volcovici. "Cutting methane will also help the United States achieve the goal it pledged in the Paris climate change agreement to cut its greenhouse gas emissions up to 28 percent below 2005 levels by 2030." (Read more)

Trump's promises to re-open shuttered coal mines will be next to impossible to fulfill, analysts say

Republican presidential candidate Donald Trump easily won West Virginia on Tuesday and is expected to have the same success next week at Kentucky's primary. A large part of Trump's success in both states has been his promise to bring back lost coal jobs, something analysts say is a promise that will nearly impossible to deliver, Evan Lehmann reports for ClimateWire. John Deskins, director of the Bureau of Business and Economic Research at West Virginia University, told Lehmann, "It's very, very, very unlikely he could do something to get coal back to where it was seven years ago." (AP photo: Trump with miners in West Virginia)

That didn't stop Trump from telling West Virginia miners last week "to get ready to be 'working your asses off' in reopened mines if he's elected," Lehmann writes. "Trump told supporters, "I'm thinking about the miners all over this country. We're gonna put the miners back to work. We're gonna put the miners back to work. We're gonna get those mines open."

Easier said than done. "Chiza Vitta, an analyst with the credit rating service Standard & Poor's, sees two ways that Trump might try to fulfill his promise to reopen the mines," Lehmann writes. "The first is a protracted effort to turn back a number of environmental regulations, like the pending Clean Power Plan curbing greenhouse gases from power plants. Other regulations might also have to be targeted to achieve a widespread revival, including rules governing toxic air pollutants. Some Republican energy advisers see that as a politically tenuous exercise. The second scenario is more severe and even less likely, Vitta said. Trump could ask Congress to provide subsidies to the coal industry to make it more competitive with natural gas." Vita told Lehmann, "That seems to me a very, very low probability."

Environmentalist from coal country finds conflicts there and in college, wants to go back w/degree

"Heat of the Moment," an ongoing climate change project by WBEZ 91.5 in Chicago, focuses its latest story on a young environmentalist who left coal country for college, only to discover that what she really wanted was to return home with an education and a purpose. Ashley Funk grew up in Mount Pleasant, Pa., in the southwestern part of the state, Rebecca Hersher and Shannon Heffernan report for WBEZ. "When Ashley was a young girl the family lived in a house that had huge piles of dark dust behind it. The piles were a really fun place to play. Funk and her twin sister would go out there and build things kind of like sand castles. They would come inside with the dust in their hair, on their hands and around their eyes. They didn’t know how dangerous it was." (WBEZ photo by Stephanie Strasburg: Ashley Funk)

As a teenager Funk became interested in climate change when she "found out the black dust she and her siblings played in as children wasn’t safe," Hersher and Heffernan write. Funk, who started talking more and more about sustainability, carbon emissions and the problems with energy companies, was contacted by Our Children's Trust, a national group "that works with young people to participate in lawsuits over climate change. They help young people sue the government on the grounds that children have a human right to a healthy environment when they grow up. Funk became a plaintiff in an Our Children’s Trust lawsuit against the state of Pennsylvania over its carbon emissions. If they won, Pennsylvania would be forced to limit those carbon emissions." Funk lost the case and said she was treated poorly in her hometown for opposing the industry that supported many residents.

Funk, who said she didn't feel like she belonged in Mount Pleasant anymore, left in the fall of 2012 to attend Wellesley College in Massachusetts, where she declared a major in environmental studies. There, she discovered the false impressions people had of her home, Hersher and Heffernan write. Her peers didn't understand how food stamps—something Funk's family relied on—worked, and they had limited knowledge of hydraulic fracturing; Funk's mom leased her family’s land to Chevron for fracking. Funk told told WBEZ, “I remember getting so frustrated. Either the professor or someone in class would say something completely wrong."

Hersher and Heffernan write, "After leaving Mount Pleasant, for what she thought was for good, Funk wants to go home. And it’s the issues that drove her away to begin with that are making her want to return to Mount Pleasant. Because she feels like that’s where there’s work to be done, where there’s a reckoning to be had over climate change, not in a place like Wellesley where everyone is removed, and for the most part agrees with each other. But instead, in a town where hills are made of coal debris and people need fracking dollars just to get by. Where the conversations about this are messy, and that’s the point. And so, nothing certain, but Funk’s plan is to double back. She’ll be able to pick up a lot of things where she left off, including her lawsuit. After the first one was tossed—there’s been some revisions. They’ve filed it again. Ashley Funk’s a plaintiff this time too."

Taking 'endangered' tag from Yellowstone-area grizzlies could damage the species, critics say

Environmentalists and Native Americans have been vocal critics of the U.S. government's plan "to lift Endangered Species Act protection of the grizzly bear in and around Yellowstone National Park," Laura Zuckerman reports for Reuters. "The U.S. Fish and Wildlife Service formally proposed in March that grizzlies in the Yellowstone area—spanning parts of Wyoming, Montana and Idaho—be removed from the list of threatened species, citing data showing their numbers have rebounded to healthy levels." The public comment period for the proposal ended on Wednesday.

"Much of the discontent has focused on the prospect of grizzlies in the region becoming open to trophy hunting under state management plans put in place once federal safeguards are removed," Zuckerman writes. There are about 700 grizzly bears in the Yellowstone area, "up from as few as 136 bears when they were listed as threatened throughout the Lower 48 states in 1975, after decades of being hunted, trapped and poisoned to near-extinction."

"Sportsmen and ranchers, who wield considerable political clout in the region, point to growing bear-human conflicts as grizzlies expand their territories in search of food," Zuckerman writes. "Environmentalists argue grizzlies' recovery could falter if they are forced to contend with new pressures posed by hunting of the species outside the park. They caution that grizzlies already face a decline in a key food source, whitebark pine nuts, due to climate change."

Farmer's creation turns almost any window air conditioner into a food storage machine

Photo by Ron Khosla
A small farmer in upstate New York has "created a technology called CoolBot that turns almost any window air conditioner into a food storage machine for about an eighth of the cost of a walk-in refrigeration unit," reports The Food Fix. The device, created by Ron Khosla, "can make the air conditioners reach the freezing point of water and maintain these temperatures through multiple sensors. His innovation could help reduce food waste and post harvest losses." To listen to the podcast featuring Khosla, click here.

Rural Mo. official's anti-gay remarks protected under First Amendment, says city attorney

Saint Robert, Mo. resident Daniel Kallman 
will perform in the June show
A rural alderman who used his private social media account to publicly bash a local drag queen event is protected under the First Amendment, said the city attorney of Saint Robert, Mo., reports Darrell Maurina, publisher of the Pulaski County Daily News. In referring to a local drag show event scheduled for June, Alderman Allan Johannsen wrote: "Why don't you guys act right and find a nice woman instead of a person of the same sex. ... I think queers need to stop trying to recruit more perverts this sick mental illness is not any better than child molesters. The desire of someone wanting someone of the same sex and wanting to have sex with a child is a sick perversion. These people need some serious mental health treatment."

The "city council adopted a social media policy several years ago which limits use of social media not only by city employees and volunteers but also by city elected officials," Maurina writes. "However, City Attorney Tyce Smith said the policy was not applicable to Johannsen’s comments and that 'personal opinion is one of the most highly protected rights of the United States.' In addition, Smith said Johannsen 'is an elected official who privately retains First Amendment rights' and that 'his public status is immune from punitive action for privately expressed opinions.'”

Smith wrote in a letter to George Lauritson, mayor of the town in south-central Missouri, neat Fort Leonard Wood: "The facts as I understand them are that Mr. Johannsen did not access social media with city provided resources. Mr. Johannsen provided a personal opinion outside of his role as a member of the St. Robert Board of Aldermen. The U.S. Supreme Court in Garcetti v Ceballos … outlines the First Amendment precedent allowing a public official, whether elected or otherwise, to express his private opinion outside of his official position. In this case, Mr. Johannsen clearly was stating a personal opinion. As such, that personal opinion is one of the most highly protected rights of the United States.”

Some news organizations have accused Maurina of using the newspaper to try to get the show cancelled, Danny Wicentowski reports for Riverfront Times in St. Louis. Maurina denies those allegations, but said he would like to see changes, writing in a Facebook post: "I regularly defend things I don't like. That's what free speech means. Nobody can stop this event, but it can be put in a location where it isn't near a children's athletic facility. It doesn't have to have the doors open at 6 p.m. with the show beginning at 8 p.m."

Wednesday, May 11, 2016

Honeybees lost 28% of population over winter; more beekeepers need to treat for mites

Honeybees took a big hit this winter, losing 28 percent of colonies, up from 22 percent the year before, Seth Borenstein reports for The Associated Press. The losses are about average over the past decade, but are higher than the 17 percent beekeepers consider acceptable. It's still down from a peak of 36 percent nine years ago. University of Montana bee scientist Jerry Bromenshenk said he believes last year's losses are greater than reported, because the statistics come from a survey by the U.S. Department of Agriculture that relies on self-reporting. Deaths are blamed on varroa mites, pesticides, disease and poor nutrition and food supply. Bees are responsible for more than $15 billion in increased U.S. crop value each year. (Bee Informed graphic) 

"For 2015-2016, the overall colony loss rate was 44 percent, which is also up from the previous two years, but scientists only started surveying summer deaths in 2010," Borenstein writes. Dennis vanEngelsdorp, an assistant professor of entomology at the University of Maryland, said "one problem is backyard beekeeper hobbyists who don't treat their bees for mites with pesticides, even organic ones. Their hives die and survivors full of mites head to new hives, spreading the problem." (Read more)

Americans twice as likely to get news through smartphones than newspapers, says study

Americans are twice as likely to access news through smartphones than newspapers, says a study commissioned by Nielsen and the Knight Foundation. Television remains the top source of news, but smartphones are second. Of the 144 million U.S. adults who own smartphones, 89 percent access news and information through the devices. "While mobile users only spend 5 percent of mobile time on news, on average, the time they do spend includes 'hard' news about current events and global news, as opposed to routine weather reports and other forms of 'soft' news." Since 2011 the number of adults who own smartphones has risen from 46 percent to 82 percent.

The study found that 70 percent of respondents get their news from television, 54 percent from social networking websites or apps, 43 percent from media websites or the radio, 34 percent from media apps and 27 percent from newspapers. Only magazines, at 16 percent, scored lower than newspapers. Young millennials (ages 18–24) are three or four times "more likely than typical online adults to go to news content from Instagram, Pinterest and Snapchat. African-Americans are 2.5 times more likely than typical online adults to go to news content from Twitter." (Knight graphic: sources used for news)

The study does suggest that growth of smartphone use for news is slowing, "suggesting a plateau might be near," Benjamin Mullin reports for Poynter. The growth of mobile apps, in particular, has slowed, with adoption rates mostly flat across the industry (with the exception of Flipboard). The stagnation of growth among news apps has come as users are spending an increasing amount of time on social media, according to the report. Mobile news seekers spend an average of 5 percent of their time on news every month. But 27 percent of their time is spent on social networking sites like Facebook and Twitter. Nearly two-thirds of Facebook's users (70 percent) use Facebook for news every day" and "people who read about news on social media often talk about it in person."

Fewer than 2% of U.S. farmers are African Americans, but numbers are steadily growing

While the number of farmers continues to decline, a rising number of African Americans are farming, Leah Penniman, a New York farmer and educator, writes for YES! Magazine. "These farmers are not just growing food, either. The ones you’ll meet here rely on survival strategies inherited from their ancestors, such as collectivism and commitment to social change. They infuse popular education, activism, and collective ownership into their work."

Overall, black farmers only make-up less than 2 percent of all farmers, a far cry from a century ago, when numbers were much higher, Penniman writes. She took a look at five African American individuals or groups that are making a living farming, including the Tuskegee United Leadership and Innovation Program (TULIP) in Alabama. "Members grow traditional African-American crops such as okra, corn, squash, watermelon, eggplants, cucumber, tomatoes, peppers, and a special variety of purple sweet potato bred by George Washington Carver, a renowned black agriculturalist. They supply three local grocery stores and two restaurants, and train their neighbors to start their own home gardens." (Yes! graphic)

Fewer than 1% of rural Medicare beneficiaries received care via telemedicine in 2013, study finds

Telemedicine is touted as a way to get more specialty care to people in rural areas without making them travel to urban centers. Despite a 28 percent increase in rural telemedicine visits among Medicare beneficiaries from 2004 to 2013, only 0.7 percent of rural beneficiaries received a telemedicine visit in 2013, says a study by researchers at Harvard Medical School, published in The Journal of the American Medical Association. More than 40,000 rural Medicare beneficiaries received a telemedicine visit in 2013, averaging 2.6 visits each for 107,955 total visits, up from 7,015 visits in 2004. (Harvard graphic: Rates of telemedicine visits per 1,000 rural Medicare beneficiaries in states with and without telemedicine parity laws)
The study found that "most visits occurred in outpatient clinics; 12.5 percent occurred in a hospital or skilled nursing facility. Mental health conditions were responsible for 79 percent of visits. Rural beneficiaries who received a 2013 telemedicine visit were more likely to be younger than 65 years, have entered Medicare due to disability, have more illnesses, and live in a poorer community compared with those who did not receive a telemedicine visit."

Researchers wrote: "Proposed federal legislation would encourage greater use of telemedicine through expanded reimbursement. In contrast to others, we found that state laws that mandate commercial insurance reimbursement of telemedicine were not associated with faster growth in Medicare telemedicine use. Our results emphasize that nonreimbursement factors may be limiting growth of telemedicine including state licensure laws and restrictions that a patient must be hosted at a clinic or facility."

Tribes to create monarch butterfly habitat in Okla.

National Geographic photo
Seven Native American tribes in Oklahoma announced Tuesday that they are partnering to create a monarch butterfly habitat, Heide Brandes reports for Reuters. The tribes "will plant crucial vegetation for the butterflies, including milkweed and native nectar-producing plants, on their lands. The tribes will work with the University of Kansas’ Monarch Watch program and the Euchee Butterfly Farm in Bixby, Okla. The project is supported by a grant of about $250,000 from the National Fish and Wildlife Foundation."

Insecticides and illegal logging in designated habitats are largely blamed for destroying milkweed plants, which are the main source of food for the butterflies, whose numbers fell 90 percent in recent years after reaching 1 billion in 1996. The U.S. Fish and Wildlife Service in February started a conservation fund for the butterfly and in September announced the first round of grants totaling $3.3 million from the fund.

"The butterflies spend the winter in Mexico and then go through several generations as they fly north, through Oklahoma, on their long migration to Canada," Brandes writes. "While an estimated 1 billion monarchs migrated in 1996, only about 35 million made the trip in 2013, according to Marcus Kronforst, a professor of ecology and evolution at the University of Chicago who has studied monarchs. Their numbers have rebounded in recent years but are still well below what they were two decades ago."

Tuesday, May 10, 2016

Coal country becoming presidential battleground; polls show Ohio and Pennsylvania up for grabs

Hillary Clinton's continued decline in the Appalachian coalfield and Donald Trump's surging popularity there could spell trouble for the Democratic candidate this fall, Michael Finnegan reports for the Los Angeles Times. That has been evident during trips by both candidates into Appalachia, where Clinton is still reeling from her comment that she would "put a lot of coal miners and coal companies out of business" with policies to fight climate change, while Trump has been winning over voters by promising to bring lost coal jobs back without saying how. Clinton's apologized for her statement, but it was often taken out of context, and Republicans are hammering her on it. (AP photo by Steve Helber: Trump supporters in Charleston, W.Va.)

A Quinnipiac University survey released today has Trump leading Clinton in Ohio 43 percent to 39 percent, while Clinton holds narrow leads—43 percent to 42 percent—over Trump in Pennsylvania and Florida. The survey has Vermont Sen. Bernie Sanders beating Trump in all three states, by margins of 43 percent to 41 percent in Ohio, 47 percent to 41 percent in Pennsylvania and 44 percent to 42 percent in Florida. Peter A. Brown, assistant director of the poll, said, "At this juncture, Trump is doing better in Pennsylvania than the GOP nominees in 2008 and 2012. And the two candidates are about where their party predecessors were at this point in Ohio and Florida." No Republican has won the presidency without winning Ohio' electoral votes, and Pennsylvania has voted Democratic for president since 1988.

Finnegan writes, "Clinton's bungled remarks on coal's grim future—'I misspoke,' she conceded last week—opened the way for Trump to strengthen his bonds with the voters she offended. Trump has played to public anger over efforts by President Obama, Clinton and other Democrats to scale back the burning of coal and other fossil fuels that contribute to global warming. Trump has dismissed global warming as a 'canard,' 'hoax' and 'total con job,' citing cold snaps as evidence," though weather is not the same as climate. Trump could pay for rejecting science, Finnegan wriues: "Ohio, Virginia and Pennsylvania all include big metropolitan areas where Clinton's plans to fight global warming resonate with many moderates." At the same time, economists doubt any president can stop coal's decline. (Read more)

Army Corps sides with Native Americans in Wash., denies permit for nation's largest coal port

North America's largest proposed coal port has been blocked. "The U.S. Army Corps of Engineers, the agency reviewing permits for the deep water port project," agreed with the Lummi Nation on Monday that it could not grant a permit for a project that would infringe on the tribe’s treaty-protected fishing rights, Lynda Mapes reports for The Seattle Times. "The terminal would have brought some of the largest ships afloat into the usual and accustomed fishing waters of the Lummi up to 487 times a year to load and unload bulk commodities, principally coal, bound for Asian ports."

The proposed port had led to heated debates in Whatcom County, Washington, for years. Samantha Wohlfeil reports for The Bellingham Herald. Supporters said it would bring much-needed jobs, while critics said it would lead to increased train traffic and pollution. "Those backing the project have a few options to possibly revive it. SSA Marine, the developer of the project, can change the project so it doesn’t significantly impact treaty rights, reach an agreement with Lummi Nation so the tribe withdraws its objection or sue in federal court." (Proposed terminal)
Bob Watters, senior vice president of SSA Marine, said of the ruling: “This is an inconceivable decision. Looking at the set of facts in the administrative summary it’s quite obvious this is a political decision and not fact-based. We are very disappointed that the GPT project has become a political target rather than being addressed on the facts. The terminal promises to deliver substantial benefits through economic development, the creation of family-wage jobs, and the generation of significant taxes.”

Legal experts said the decision "followed federal obligation to protect tribal treaty rights and the habitat that makes those reserve rights meaningful," Mapes writes. Robert Anderson, director of the Native American Law Center at the University of Washington School of Law, told her, “This is based on a long line of precedent. You can’t have a right to fish without a decent environment.”

Nearly 6M low-skill, low-wage factory workers get government aid; most prevalent in South

About 6 million low-skilled manufacturing workers—half of the U.S. total—are earning such low wages that they have to rely on government assistance to make ends meet, says a study by researchers at the University of California-Berkeley. Nine of the 11 states with the highest participation rates in public programs are in the South, where manufacturing jobs typically pay lower and unions are less prevalent, Jim Tankersely reports for The Washington Post.

In 2013 the median manufacturing production wage was $15.66, with 25 percent of workers earning $11.91 or less, states the report. "In decades past, production workers employed in manufacturing earned wages significantly higher than the U.S. average, but by 2013 the typical manufacturing production worker made 7.7 percent below the median wage for all occupations. During the same time period productivity in the U.S. manufacturing sector increased at a rate one-third higher than in the private, non-farm economy overall." Manufacturing production wages now rank in the bottom half of all jobs in the U.S., says the National Employment Law Project.

Researchers found "that between 2009 and 2013 the federal government and the states spent $10.2 billion per year on public safety net programs for workers (and their families) who hold frontline manufacturing production jobs," says the study. Overall, 34 percent of families "of frontline manufacturing production workers are enrolled in one or more public safety net program" and 50 percent of families with workers hired through staffing agencies.
The majority of families are using public safety-net programs because of low wages, not because they aren't getting enough hours, the study found. "The families of 32 percent of all manufacturing production workers and 46 percent of those employed through staffing agencies who worked at least 35 hours a week and 45 weeks during the year were enrolled in one or more public safety net program."

The study's authors "say the simple explanation of what's happening is that many manufacturing jobs do not pay as much, per hour, as Americans expect them to," Tankersley writes. "Other statistics also suggest that manufacturing jobs are losing their advantage as a gateway to the middle class. In 1990, the average non-supervisory hourly wage in manufacturing was 6 percent higher than the average non-supervisory wage in the economy at large. Today, according to Labor Department statistics, the manufacturing wage is 5 percent lower on average than the economy at large."

Former Kansas newspaper owner bequeaths $2 million to his rural community

Schmitty and Web Hawkins
A rural Kansas community received a surprise $2 million gift from the former owner and publisher of the Osawatomie Graphic and Louisburg Herald, Tom Eblen reports for the Kansas Press Association. "As he neared the end of his newspaper career in the late 1990s, Web Hawkins learned something that he had never expected. He was rich, or at least comfortably well-off." Web and his wife Schmity had no children, and left money to the Kansas Newspaper Foundation; his alma mater, the University of Missouri School of Journalism; the Osawatomie YMCA and others. "But there was plenty left. So Web and Schmitty decided together that they would bequeath the rest to the Osawatomie community, the place where they had made their living. That would be about $2 million to be disbursed by a committee of the Hawkinses' friends for deserving projects in their hometown." Web died on April 8. His wife died in 2009.

"In 1959 Web signed a contract to run Nelson Reppert's Osawatomie Graphic-News for two years and to buy a half-interest in the paper," Eblen writes. "Within two years, Web and Gladys, known as Schmitty in the newspaper fraternity, had completed the purchase and later official changed the name to the Osawatomie Graphic. Then it was off to the races, Web doing the journalism that he loved and Schmitty keeping an eagle eye on the business side. They were a power couple before power couples were featured in the popular press."

"The Hawkinses eventually owned several weeklies in Kansas, including the Louisburg Herald, Emporia Times, Linn County News and had partial interest in the Hillsboro Star-Journal and Herington Times," Eblen writes. Web also was involved in the Kansas Press Association, which he served as president in 1970. "He was president of the National Newspaper Association in 1988; KPA awarded him the Clyde M. Reed Master Editor Award in 1996 and the KPA Hall of Fame in 2005. He also served on the Columbia Missourian's board of directors for several years. In 1998, Web and Schmitty retired." (Best Places map)

Osawatomie native Larry Byers, who worked for Web several years before taking over the Herington Timeswith purchasing help from Web, told Eblen, "I know that Web and Schmitty put a lot of thought on the matter over a long period of time. The foundation will prove most beneficial to Osawatomie residents for decades to come. The people of Osawatomie will eventually come to recognize that Web and Schmitty were genuinely interested in the betterment of their town long after their passing." (Read more)

Longtime journalist in rural Nevada, known as 'Grandma with Attitude,' dies at 71

Anne Pershing
Most rural communities are blessed with a handful of treasured citizens, people "who labor in obscurity except in their hometowns, where they are key pieces of the civic infrastructure," said Al Cross, director of the Institute for Rural Journalism and Community Issues, which publishes The Rural Blog. One of those people was Anne Pershing, who did community journalism for 33 years in Fallon, Nev., and was known in more recent years as "Grandma with Attitude" for her columns championing the rights of senior citizens, Marcella Corona reports for the Reno Gazette-Journal, which published the columns. Pershing died on Thursday at 71.

Pershing "was nominated for a Pulitzer Prize in Public Service for her work on a series on child leukemia in Fallon from 1999 to 2002," Corona writes. "She was also awarded the Associated Press Public Service award in 2001. Pershing was also the president of the Nevada Press Association board from 1993 to 1994. She served on the board for 13 years and earned the NPA President’s Award in 1999. She was inducted into the Nevada Newspaper Hall of Fame in 2009."

NPA Executive Director Barry Smith told Corona, "She had that relationship with Fallon, as somebody who knew everybody in town. She was willing to stand by them if they were willing to stand up for themselves." Smith said Pershing was proud "of covering gay and lesbian issues 'in a small, conservative town long before they became an accepted cause.'" He told Corona, "She was a mom and a grandma to her own family, of course, but also to anybody she cared about—and that was a lot of people, from wayward kids to governors. Anne told them what they needed to hear, whether it was a mild scolding or a word of encouragement. And either way, she probably followed it up with a plateful of fudge."

In her final column, which appeared on Sunday, Pershing wrote about Mother's Day. She wrote: "Mother's Day is Sunday, May 8, which means the phone lines will be on fire all around the country with people calling to pay homage to Mom. And for those of us who have lost our mothers, we will quietly pay our respects and embrace the memories of our beloved mothers, each in his or her own way."

Monday, May 09, 2016

Heroin and prescription drugs are different opiates affecting different parts of U.S., Globe notes

Stories about an increase in opiate addiction and opiate deaths, growing concerns in rural areas, are missing the fact that opiates are made up of two distinct categories—heroin and prescription painkillers, Evan Horowitz reports for The Boston Globe. "Reacting to these very different epidemics with a set of policies focused on 'opioids' may ultimately prove inadequate, even counterproductive. Because heroin and prescription opioids are killing different people, in different ways, across different parts of the country."

"Heroin deaths are largely concentrated across New England and the Midwest, and heroin victims tend to be young men in their 20s and early 30s," Horowitz writes. "By contrast, prescription opioids are killing people all across the country, especially people aged 45-54 and including a substantial number of women. Perhaps most critical, a Globe anaylsis of death certificates compiled by the Centers for Disease Control shows a marked shift towards heroin, which once contibuted to less than 15 percent of opioid overdose deaths and now accounts for nearly 40 percent." (Globe map: Prescription opioid deaths per every 100,000 people in 2014)
Prescription opioid deaths, led by a rise in popularity of OxyContin, increased by 300 percent from 1999 to 2010, Horowitz writes. During that same time heroin deaths increased from .7 deaths per every 100,000 people to 1 death per every 100,000 people. But from 2010 to 2014, heroin deaths tripled, partly due to cheaper heroin and a concentrated effort by law enforcement to crack down on prescription drug abuse. Heroin deaths are far more rare in states such as Oklahoma, Kansas, Idaho and Wyoming, where "less than one in five opioid-related deaths stem from heroin." (Globe map: Heroin deaths per every 100,000 people in 2014)
"Prescription drug overdoses are most common among middle-aged Americans, 45-54, who account for about 25 percent of all prescription opioid deaths," Horowitz writes. "When you add in 55-64 year olds, you capture nearly half of all overdoses from prescription drugs. With heroin, the situation is reversed. It’s the 25-34 year olds who suffer most, with an overdose rate vastly higher than any other age cohort. This complicates the familiar story of opioid abuse, where people get hooked on prescription drugs before shifting to heroin. For young people, this may indeed be a real risk. One 2012 study suggested that 3-4 percent of opioid addicts do make the switch to heroin. But this doesn’t seem to be happening among older Americans. For that age group, the prescription drugs themselves are the big risk."

EPA chief: Coal communities in danger of being left behind, with or without Clean Power regulations

Environmental Protection Agency chief Gina McCarthy (Getty Images photo) said coal-dependent communities are "at risk of being 'left behind' as the country moves away from coal power," Timothy Cama reports for The Hill. McCarthy, who was participating in a discussion on Friday with science educator Bill Nye, also said that the move away from coal, which she said would happen even without President Obama's clean power regulations, "is causing a net increase in jobs." She told Nye, “On the whole, what’s happened is jobs continue to grow. What happens, though, is some communities may get left behind."

Nye asked McCarthy about the decline of coal in West Virginia and Kentucky, where presidential candidates have been stumping in advance of Tuesday's primary in the Mountain State and the May 17 primary in the Bluegrass State, Cama writes. McCarthy said "recognizing the harm to coal communities does not mean that the country should abandon efforts to cut greenhouse gas emissions or other harmful effects from coal." She told Nye, “You don’t change the entire dynamics of the economics for those communities or deny they exist. You invest in those communities so they continue to have opportunities moving forward.”

McCarthy said Obama's administration will "invest in coal country and help communities adjust to new economic development and educational opportunities, among other measures," Cama writes. "Lawmakers from both parties, along with the White House, have backed a similar proposal they call the Reclaim Act, which would use abandoned mine fees for coal country transitions. The Supreme Court put the administration’s main rule threatening the coal industry, the Clean Power Plan, on hold in February. Obama pledged last year that the U.S. would cut its greenhouse gas emissions 26 percent to 28 percent by 2025, when compared with 2005 levels."

McCarthy told Nye, "We have already taken considerable steps. We have planned ahead. And for crying out loud, what we have is a pause in the Clean Power Plan. If anybody knows anything about EPA in writing rules, we rock at it, we do them legally, we do them on the basis of sound science. And while there is a pause, there’s no pause in the action in the United States towards renewable energy and energy efficiency. We are going in exactly the direction our rule demanded, and we’re doing it because the markets demand it. We could not be in better shape than we are today.” (Read more)

Reporter with ties to militia groups, who covered Oregon occupation, is arrested with machine gun

A reporter who covered the occupation of the Malheur National Wildlife Refuge was arrested on Friday after a search of his home found a Browning M2, a .50 caliber machine gun, Les Zaitz reports for The Oregonian. Michael R. Emry (Oregonian photo by Mark Graves), a former weapons manufacturer who "described himself as an 'embedded' reporter with a militia group called 3% of Idaho ... was charged in a federal complaint of unlawful possession of a machine gun not registered to him and unlawful possession of a firearm with an obliterated serial number, the FBI said in a statement."

An affidavit, which said the machine gun could fire 550 to 650 rounds per minute, said "Emry admitted that he took the M2 from the shop where he works in Idaho about a month and a half ago," without the shop owner's knowledge, Zaitz writes. Emry was scheduled to appear in federal court today. A Facebook page controlled by Emry posted on Friday: "We don't know the charges—presumably it was because of the Malheur occupation. Michael was there as media and nothing more. For those of you who might think about cheering at the news, keep in mind that there are two issues involved here—freedom of the press and freedom of speech."

The 3% of Idaho group participated in a Jan. 2 rally in Burns hours before the refuge takeover, Zaitz writes. The group disavowed knowledge of the takeover, but its leaders were a regular presence throughout the 41-day occupation. The group at one point arrived at the refuge in a convoy of heavily armed members, who said they were there to shield the refuge occupiers from law enforcement. Occupation leaders sent them away." Emry's site also praised Grant County Sheriff Glenn Palmer, who is under criminal investigation by the state Justice Department about his dealings with the armed militants. 

Emry said "he was helping Grant County citizens establish a committee to investigate media reporting and, if necessary, conduct trial-like hearings on the accuracy of stories," Zaitz writes. "Emry earlier this week conducted a meeting of what he called the Committee of Correspondence, identifying three local residents who participated on the committee. County records show they all hold appointments from Palmer as special deputies—citizen volunteers." (Read more)

North Carolina governor suing feds to keep controversial transgender bathroom law on books

Republican Gov. Pat McCrory has filed a lawsuit against the U.S. Justice Department to save North Carolina's new and controversial bathroom law, Michael Gordon reports for The Charlotte Observer. McCrory is asking a federal court to clarify whether the law discriminates against transgender people as the Justice Department contends. McCrory wants the court "to overturn a federal prosecutor’s assertion last week that HB2 violates Title IX of the Civil Rights Act as well as the Violence Against Women Act."

"The law, which was passed by the General Assembly after the city of Charlotte extended LGBT protections, including a provision that allowed transgendered people the right to use the bathroom with which they identified," Gordon writes. "The resulting firestorm over HB2 has cost the state hundreds of new jobs, concerts and other events and made North Carolina a target of international criticism. The law is already the target of a federal lawsuit filed by the American Civil Liberties Union and other groups. HB2’s provision that limits transgender bathroom usage to the sex of an individual’s birth risks the loss of billions in federal dollars flowing into the state, the groups said last week in a joint statement. Title IX bans discrimination at schools, universities and any education program receiving federal money. North Carolina receives billions in federal education dollars every year."

McCrory, who’s in a tough re-election fight, "said HB2 is a common-sense law that makes bathrooms safer for women and children," Gordon writes. McCrory said in a statement: "The Obama administration is bypassing Congress by attempting to rewrite the law and set restroom policies for public and private employers across the country, not just North Carolina. This is now a national issue that applies to every state and it needs to be resolved at the federal level. They are now telling every government agency and every company that employs more than 15 people that men should be allowed to use a women’s locker room, restroom or shower facility.”

EPA inadvertently releases statement saying glyphosate (Roundup) is not likely a carcinogenic

The U.S. Environmental Protection Agency inadvertently posted on its website that "glyphosate is not likely to be carcinogenic to humans," Todd Neeley reports for DTN The Progressive Farmer. EPA has since deleted the post, calling it a mistake. "The document was described as the final report of a cancer assessment review committee (CARC) on the health effects of pesticides. The CARC report had yet to be reviewed by a scientific advisory board. EPA said Monday the advisory board is slated to complete its review by year's end, when an EPA assessment is finalized or released," Neeley writes.

"The CARC concluded that the epidemiological studies in humans showed no association between glyphosate exposure and cancer of the following: oral cavity, esophagus, stomach, colon, rectum, colorectum, lung, pancreas, kidney, bladder, prostate, brain (gliomas), soft-tissue sarcoma, leukemia, or multiple myelomas," Neeley writes. "The International Agency for Research on Cancer, or IARC, in Lyon, France, assessed the carcinogenic potential of glyphosate in March 2015. The IARC concluded glyphosate was 'probably carcinogenic to humans'."

Monsanto, which markets glyphosate under the brand name Roundup, has been critical of the IARC assessment, was quick to take advantage of the EPA error, Neeley writes. Hugh Grant, Monsanto's chairman and CEO, said in a statement: "No pesticide regulator in the world considers glyphosate to be a carcinogen, and this conclusion by the U.S. EPA once again reinforces this important fact. Glyphosate has a 40-year history of safe and effective use. Unfortunately, last year's inconsistent classification by IARC generated unwarranted concern and confusion about this important agricultural tool. This rigorous assessment of the data by EPA builds on the sound conclusions of both the European and Canadian regulatory authorities and once again makes it clear that glyphosate does not cause cancer." (Read more)

iVantage Health Analytics names top 100 rural hospitals, top 100 critical-access hospitals

iVantage Health Analytics has released its list of the Top 100 Rural and Community Hospitals and top 100 Critical Access Hospitals. iVantage said in a statement: "These top performers are excelling in managing risk, achieving higher quality, securing better outcomes, increasing patient satisfaction and operating at a lower cost than their peers. These two groups serve as a benchmark for other rural facilities as they strive to achieve similar results and provide a blueprint for successfully navigating the uncertainty of the new healthcare." For more information see ivantageINDEX.com.