Program lets one pharmacist serve several rural drug stores, allowing them to stay open

TelePharm software (DTN photo by Mark Tade)

An Iowa man is using technology to help provide pharmacy services to under-served rural areas, Claire Vath reports for DTN The Progressive Farmer. Roby Miller, who saw firsthand his rural pharmacist father forced to close operations, has come up with a software solution called TelePharm that allows one pharmacist to both fill and approve prescriptions remotely for several drug stores.

"In addition, the pharmacist can consult with patients via a videoconferencing feature on the software," Vath writes. Miller told her "It allows the pharmacist to work in a traditional town and also be in the small town with certified technicians working in the store. ... We either help a current pharmacist keep a store open, or we go into a community and work with them to put in our own pharmacy."

Miller said that in 2016 TelePharm has either opened or helped keep open 101 rural pharmacies around the Midwest and in Texas, Vath writes. Miller told her, "We're still working to expand by facilitating conversations with more state organizations and rural economic development association. And the void we're filling is the infrastructure of quality of life for a community."

Bayer paying Mass. $75,000 fine for deceptions about pesticides' risk to bees and environment

Bee Informed graphic

Bayer CropScience will pay the state of Massachusetts a $75,000 fine for failing to properly advertise the hazards of pesticides to bees and the environment, under an agreement between the company and the state, Gabriel Dunsmith reports for Greenwire. State Attorney General Maura Healey said it is the first time a major chemical manufacturer "has submitted to a court order regarding false advertising related to bees and other pollinators." Bayer will be forced to change its advertising in Massachusetts.

Healey, said Bayer "misled and deceived consumers" with "numerous misleading claims ... about the safety of its pesticide products, including falsely advertising that they were similar to giving 'a daily vitamin' to plants, when in fact, they are highly toxic to honeybees and other pollinators in the environment."

Neonicotinoid-based pesticides have been partly blamed on declining bee populations, along with varroa mites, disease and poor nutrition and food supply. Bees are responsible for more than $15 billion in increased U.S. crop value each year. Honeybees lost 28 percent of colonies last winter, up from 22 percent the year before.

Bayer spokesman Jeff Donald said the company denies any wrongdoing and agreed to the settlement "to avoid the time and cost associated with litigation," Martha Kessler reports for Bloomberg News. He said "The firm’s crop science division believes the advertising related to the products involving neonicotinoid chemistry was 'at all times accurate and transparent'."

Seven who occupied wildlife refuge facility are found not guilty of federal conspiracy charges

Defendant David Fry was released after the verdict.
(Oregonian photo by Stephanie Yao Long)

The leader of January's armed takeover of a facility at the Malheur National Wildlife Refuge in Oregon was acquitted Thursday, with six other defendants. "The verdicts finding Ammon Bundy, older brother Ryan Bundy and five others not guilty of a federal conspiracy drew elation from defense attorneys who spent five weeks arguing that the armed takeover amounted to a time-honored tradition of First Amendment protest and civil disobedience," Maxine Bernstein reports for The Oregonian.

"Prosecutors had argued the case was simple: The refuge occupiers took control of a wildlife refuge that wasn't theirs. The heavily armed guards that manned the front gate and watchtower during the 41-day takeover, in and of itself, was 'intimidating,' and prevented officers from the U.S. Fish and Wildlife Service and U.S. Bureau of Land Management from carrying out their work. But defense lawyers said they believe the jury held true to the judge's instructions, and couldn't find beyond a reasonable doubt that their 'intent' was to prevent the federal employees from going to work."

Fred Barbash of The Washington Post looks at the implications:

“I fear this ruling will embolden other militants to use the threat of violence and I worry for the safety of employees at our public land- management agencies,” said John Horning, executive director of WildEarth Guardians, in a statement. “It is entirely possible there will be threats or intimidations from militants that believe such actions are justified by this verdict.”
Lisa Ludwig, described as a standby counsel for Ryan Bundy, told the Oregonian that “maybe this is a lesson that that’s not the way to engage with these people who want nothing more than just to be heard …”
By contrast, Jennifer Rokala, executive director of the Center for Western Priorities, said the decision puts park rangers and scientists at great risk just for doing their jobs and will “undoubtedly embolden extremist groups.”

Federal agency proposes recovery plan for salmon, steelhead trout in Columbia and Snake rivers

Columbia and Snake rivers (Salmon Aid map)

The National Marine Fisheries Service on Thursday released a proposed recovery plan to protect chinook salmon and steelhead trout on the Snake and Columbia rivers in the Northwest, Keith Ridler reports for The Associated Press.

"In May, a federal judge in Portland ruled that the massive habitat restoration effort by the U.S. government doesn't do nearly enough to improve Northwest salmon runs, handing a major victory to conservationists, anglers and others who hope to someday see the four dams on the Snake River breached to make way for the fish," Ridler reports. "The judge ordered the government to come up with a new plan by March 2018."

Officials said changes need to be made in how dams are operated to improve migratory conditions for protected runs in Snake River, Ridler writes. They "also said habitat needs to be improved in tributaries where fish spawn and in the Columbia River estuary where young fish transition to ocean life."

"The Snake River and its tributaries in Idaho, Oregon and Washington state at one time supported more than half of the Columbia River basin's summer steelhead and more than 40 percent of the spring and summer chinook salmon," Ridler notes. "But in the 1990s the two runs were listed as threatened under the Endangered Species Act. The ultimate goal, managers say, is to have self-sustaining populations so the fish can be delisted, a move that could take 50 to 100 years." The estimated cost over the next 10 years just for habitat work is $139 million. (Read more)

Trump's anti-immigration remarks fueling traffic for white supremacist websites, says researcher

Donald Trump's anti-immigration, anti-Muslim remarks have caused a spike in traffic to websites of white supremacists, says a Vanderbilt University researcher who tracks white-nationalist internet groups, Jim Patterson reports for Vanderbilt. Sophie Bjork-James, a post-doctoral fellow and lecturer of anthropology at the Nashville university, said Jewish journalists have been particularly targeted with a rise in anti-Semitic language.

Bjork-James told Patterson, "The Trump campaign has given the white nationalist movement a long-awaited opportunity to spread its message to a national audience. Trump’s messages about limiting immigration and banning Muslims from the U.S. have given the movement one of its largest membership boosts in decades, which will have impact long after this election cycle."

Bjork-James said that Don Black, founder of the white nationalist website Stormfront, "claims a 30 to 40 percent spike in web traffic in 2015 after Trump’s anti-immigration and ban Muslim speeches," Patterson writes. The Daily Stormer, a neo-Nazi website created in 2013, averages 1.9 million visitors per month, up from 1.2 million in 2015. (Read more)

Georgia approves new coal ash rules; environmentalists say rules not strong enough

The Georgia Department of Natural Resources on Wednesday unanimously approved new rules for storage, handling and disposal of coal ash, Dan Chapman reports for The Atlanta Journal-Constitution. "The new rules apply to more coal-ash storage and disposal sites than covered by federal law. Landfills that accept ash must routinely test groundwater for contamination. And landfill neighbors, via their county commissioners, must be alerted if any leaks occur."

Chapman notes, "The vote comes two days after The Atlanta Journal-Constitution reported that arsenic and other toxic metals — at levels 20 or 30 times federal drinking water standards — have been discovered in the groundwater near a half-dozen Georgia Power plants."

Jeff Cown, director of the state’s Environmental Protection Division, said "the rules will safeguard Georgia’s land and water" and that stricter monitoring and cleanup is possible in the future, Chapman writes. Environmentalists said the rules don't go far enough. Chris Bowers, a senior attorney with the Southern Environmental Law Center, said in a statement: “We continue to advocate for stronger, more protective rules, especially in light of the fact that initial groundwater monitoring results show high levels of coal ash contaminants. Leaving the ash behind in unlined, leaking pits is not an acceptable solution for Georgia.” (Read more)

Halloween is by far most dangerous day for kids, especially in rural areas that lack sidewalks, lights

Lights make it easier for drivers to see kids. (Party City photo)

Halloween can be one of the most dangerous days of the year for children, especially in rural areas that lack sidewalks or adequate street lighting. On average, twice as many children are killed by a car walking on Halloween than on any other day, reports Safe Kids Worldwide, a research group that advocates for childhood safety.

The most important safeguard is to make sure children are visible to drivers. This can be done by having them carry glow sticks or flashlights, wear reflective tape or stickers and choose light colors, Jennifer Wetzel reports for the Vanderbilt University Medical Center. Parents should make sure children are not wearing masks that obstruct their vision, or loose clothes that cause them to trip when crossing the street. If there are no sidewalks, children should walk facing traffic as far to the left as possible and should only cross the street at corners and use traffic signals and crosswalks, if available. For more tips, click here.

Last year 52 percent of all highway fatalities from 6 p.m. on Halloween night to 5:59 a.m. on Nov. 1 involved a driver or a motorcycle rider with a BAC of .08 or higher, says the National Highway Traffic Safety Administration.

Fear of election violence leads some schools to close, or polls to be moved from schools

This year's presidential election has gotten testy, not just among the candidates, but among voters, creating worries that there will be verbal and physical confrontations on Election Day. That has caused some polling places to be moved out of schools and for some schools to cancel classes for Nov. 8, Patrick Whittle and David Sharp report for The Associated Press. "The fear is that the ugly rhetoric of the campaign could escalate into confrontations and even violence in school hallways, endangering students."

Classes have been canceled in Falmouth
for Election Day. (Best Places map)

Schools in Falmouth, Maine, will be closed on Election Day and additional police officers are scheduled to work, Whittle and Sharp report. Police Chief Ed Tolan told AP, “If anybody can sit there and say they don’t think this is a contentious election, then they aren’t paying much attention.”

Whittle and Sharp write, "Some of those anxieties have been stoked by Donald Trump’s repeated claims that the election is rigged and his appeal to his supporters to stand guard against fraud at the polls. Some are worried about clashes between the self-appointed observers and voters." Alpay Balkir, whose son attends the school in Falmouth, which doubles as a polling place, told AP, “If it’s going to be as chaotic as they say it’s going to be, it’s a good thing. Kids should stay out of it. I don’t know what the environment is going to be like.”

"It’s difficult to say how many school-based polling places have been moved this year, given how decentralized the voting process is across the country," the reporters write. "But state and local officials say voting has been removed or classes have been canceled on Election Day at schools in Illinois, Maine, Nebraska, New Hampshire, Ohio, Pennsylvania, Wisconsin and elsewhere."

Drug prices are top Obamacare issue for voters

Why Republicans don't like Obamacare (Kaiser chart)

High prescription-drug prices and other out-of-pocket costs are more important to voters than proposed changes to federal health reform, says a poll by the Kaiser Family Foundation, Julie Rovner reports for Kaiser Health News. About 60 percent of Republican respondents still want the law repealed, but are split on why. Among that group, 31 percent said the law “gives government too big a role in the health care system,” while 27 percent said “the law is just one of many indications that President Obama took the country in the wrong direction.”

The survey of 1,205 adults this month found that 70 percent said they understand Hillary Clinton's health care plan very well or somewhat well, but only 51 percent said the same of Donald Trump. Most respondents didn't rank health care high for the most important issue in who they were voting for president. It came in fifth among Democratic respondents, at 9 percent, and sixth among Republicans, at 5 percent. The most important issue for Democrats was the candidates, while the economy and jobs was No. 1 for Republicans. (Pie charts: how well respondents said they understood Clinton and Trump health-care plans)

The biggest response to 13 questions about health-care priorities was "Making sure that high-cost drugs for chronic conditions, such as HIV, hepatitis, mental illness and cancer, are affordable to those who need them," with 74 percent of respondents agreeing. Also, 63 percent agreed that "Government action to lower prescription drug prices" should be a high priority.

Making sure health-insurance plans have enough provider networks of doctors and hospitals ranked third. Also ranking high were protecting people from high costs from seeing a doctor not covered by their plan, and providing quality information on health care provided by doctors and hospitals; the price of doctors’ visits; tests and procedures; and which doctors and hospitals are covered under plans.

"As with the health law itself, semantics matter in this debate over whether to include a government plan to compete with private plans," Rovner writes. "Even in describing the same concept, a much larger majority (70 percent) favored the idea of 'creating a public health insurance option to compete with private health insurance plans' than favored 'creating a government-administered public health insurance option to compete with private health insurance plans' (53 percent)." (Read more)

Fracking linked to chemicals that cause leukemia, lymphoma, says Yale study

Hydraulic fracturing operations to get oil and gas can be linked to higher risks of leukemia and lymphoma, says a study by the Yale School of Public Health published in Science of the Total Environment. Researchers evaluated 1,177 chemicals that can be released into the air or water as a result of fracking. They found 111 potential water contaminants that included 14 known human carcinogens, 6 probable human carcinogens and 29 possible human carcinogens. Of those 49 they found that "17 had evidence of an increased risk of leukemia and/or lymphoma."

Carcinogenicity classification of chemicals related to unconventional oil and gas development

More than 80 percent of the chemicals "lacked sufficient data on cancer-causing potential, highlighting an important knowledge gap," Denise L Meyer reports for Yale. "Of the 119 compounds with sufficient data, 44 percent of the water pollutants and 60 percent of air pollutants were either confirmed or possible carcinogens. Because some chemicals could be released to both air and water, the study revealed a total of 55 unique compounds with carcinogenic potential. Furthermore, 20 chemicals had evidence of increased risk for leukemia or lymphoma specifically."

Lead author Nicole Deziel, an assistant professor at Yale, told Meyer. “Previous studies have examined the carcinogenicity of more selective lists of chemicals. To our knowledge, our analysis represents the most expansive review of carcinogenicity of hydraulic fracturing-related chemicals in the published literature.”

Report by gun-control group ranks states based on homicides of one woman by one man

Violence Policy Center, a nonprofit that advocates gun control, has released its annual report, "When Men Murder Women," which ranks states based on homicides of women by men. The report uses data from the Supplementary Homicide Report submitted to the FBI for 2014, the most recent year available. It only counts incidents involving one male attacker against one woman, which it says is the scenario pro-gun campaigns use to promote female gun ownership. All the murders were not by gun, but the study says guns are the most widely used weapon when men murder women. The victims do not necessarily know the attackers, so not all cases are the result of intimate-partner violence.

Alaska, which had 11 reported instances of a man murdering a woman in 2014, tops the list with a homicide rate of 3.15 per 100,000 people. Louisiana is second (2.15), followed by Nevada (1.98), Oklahoma (1.94), South Carolina (1.73), New Mexico (1.71), South Dakota (1.65), Georgia (1.62), Tennessee (1.58) and Texas (1.44). Texas had the most overall deaths, at 195. California was second (178), followed by Georgia (84), Pennsylvania (72), Michigan (67) and New York (63).

The report confirmed that the murder trend has declined in recent years, dropping from a national average of 1.57 murders per every 100,000 women in 1996 to 1.08 per 100,000 in 2014, a drop of 31 percent. (Instances of a man murdering a woman from 1996-2014)

Second round of federal funding announced to revitalize coal communities; $28M for 42 projects

The Obama administration on Wednesday announced a second round of funding to help revitalize coal communities hurt by the industry's downturn, caused in part by the administration's environmental regulations.

The funding includes $28 million to support 42 economic- and workforce-development projects in 14 states—Arizona, Colorado, Indiana, Kentucky, Michigan, Montana, North Carolina, Ohio, Tennessee, Pennsylvania, Utah, Virginia, West Virginia and Washington.

In August, $38.8 million in funding was announced for 29 projects to help revitalize coal communities in Kentucky, West Virginia, Ohio, Pennsylvania, Virginia, Texas and Alabama. 

The grants are part of President Obama's promise, which he made during his 2013 climate-change speech at Georgetown University, when he said, "We're going to give special care to people and communities that are unsettled by this transition." All the money was appropriated by Congress, which Obama is asking for more. For a full list of the funds announced Wednesday click here.

Telemental therapy brings mental health doctors to rural areas; some state laws present barriers

Telemental therapy—also called virtual therapy, telepsychiatry or telebehavioral health—is helping to address a severe mental health professional shortage in rural and remote areas, Jon Frandsen reports for Stateline. "Telemental health services, using secure video hookups and high-definition cameras, make it possible for patients to get help without seeing a therapist in person. And the technology allows providers in areas with lower demand to treat patients in areas with higher demand."

South Carolina, which began embracing teletherapy in 2007, "now has telepsychiatry units in 24 ERs across the state that can connect with network providers 16 hours a day, seven days a week," Frandsen writes. Ed Spencer, the head of the state’s telepsychiatry program, said the network treats an average of 400 patients a month and has treated 30,000 patients since being launched.

"Building on the ERs’ success, South Carolina expanded its network of teletherapy providers to 60 public mental health centers and satellite offices statewide," Frandsen writes. A similar program launched in North Carolina in 2010 and in 2013 was expanded statewide through 2017. (Dark blue states participate in the Interstate Medical Licensure Compact. For an interactive version click here)

One barrier has been state laws "that can make it difficult to practice teletherapy across state lines," Frandsen writes. "The biggest barrier, perhaps, is licensing. States generally require that doctors be licensed in the same state as the patient they are treating. That could mean a mental health care provider would have to have multiple licenses to treat patients across state lines."

"Some states work out license reciprocity arrangements, especially with neighboring states," Frandsen writes. "New Jersey, which generally lags behind most of the rest of the country in updating its laws to address telemedicine, passed a law in 2014 that allows for reciprocity as long as the other state license is in line with New Jersey’s license requirements."

"State compacts that make one license acceptable among all the member states are another solution backed by telehealth providers," Frandsen writes. "Some critics, however, argue that the compacts give too much power to medical and other professional boards, which can make regulations more restrictive, not less. Seventeen states have signed on to such a compact covering doctors, including psychiatrists. But compacts covering other types of mental health practitioners such as psychologists, family therapists and therapeutic social workers are still being drawn up." (Read more)

Rural/urban battle heating up in Iowa on who will pay for water pollution clean up

A rural/urban battle has been brewing in Iowa for nearly two years about who is to blame for polluting Central Iowa's water supply and who should foot the bill for cleanup. In 2015 Des Moines Water Works sued rural northwest counties of Sac, Calhoun and Buena Vista to make farmers comply with federal clean-water standards that apply to factories and commercial users. Farmers asked for more time to improve voluntary methods of reducing pollution. (Mother Jones graphic)

Experts and environmentalists say the suit could have national implications over who is responsible for water pollution that originates from cropland that is often hundreds of miles away.

"For the lawsuit to be successful, a court must first decide if the fertilizer-rich water running off the fields comes from under the ground," David Biello reports for PBS NewsHour. "If a court decides it is groundwater, then Des Moines Water Works have a valid case. If a court decides the runoff is storm water running off the surface of the fields, then Des Moines Water Works has no case."

Bill Stowe, chief executive officer of Des Moines Water Works, said farm runoff from Central Iowa forced them to build the world's largest nitrate removal facility to deliver clean water to customers, Biello writes. Stowe told him, "It’s the ag folks that really are driving this problem. And, in this state, we regulate, and some would argue over-regulate, cities and towns. But we leave unregulated industrial agriculture. And, of course, agriculture is the king of the block. Therefore, leave it alone, and hopefully a voluntary system will bring in conservation practices that will improve water quality. We say, no pun intended, hogwash to that, hasn’t worked, won’t work."

Buena Vista County Supervisor Dale Arends, who is named in the lawsuit, said the lawsuit "would change agriculture if Des Moines Water Works gets what they want," Biello reports. Arends told him, "If they were able to come out here and tell us how much water we could remove from our soils to make them farmable, you would turn Central Iowa back into a swamp, which is what it was 150 years ago. They have forced themselves to spend over three-quarters-of-a-million dollars. They have forced us to spend over a million dollars, and nothing has really changed." (Read more)

Workplace health insurance premiums taking a greater share of paychecks, says study

Income growth is not keeping pace with rising costs of workplace health insurance premiums, says a study released this week by The Commonwealth Fund, a nonpartisan health and social issues research organization. "Despite a recent surge, income growth has not kept pace in many areas of the U.S. employee contributions to premiums and deductibles amounted to 10.1 percent of U.S. median income in 2015, compared to 6.5 percent in 2006. These costs are higher relative to income in many southeastern and southern states, where incomes are below the national average."

Nationwide, "the cost of a family policy went up an average of 5.1 percent annually before 2010 and 4.5 percent after," Bill Estep reports for the Lexington Herald-Leader. "That likely reflects a drop in health care costs across the country, the study said. Premiums still went up, however." In Kentucky, for example, "the average employee cost of a single-person policy went up from $3,791 in 2006 to $5,984 in 2015. The cost to employees for a family plan rose from $9,864 to $16,622 in that time. That was below the national average of $17,322." (Herald-Leader graphic)

In nine states "premiums for single coverage continued to increase at a relatively high rate," Estep writes. In Kentucky, one of those nine states, the average annual increase "was 5.4 percent from 2006 to 2010 and only slowed to 5 percent a year since." Researchers say that's why many Americans with insurance see their health care costs as unaffordable, because of premiums and deductibles taking a greater share of income.

"The growth in the number of plans with deductibles, and the size of those employee contributions, is a particular issue," Estep writes. "In 2006, there were no states where the average deductible topped $1,000, but in 2015 every state but Hawaii had average deductibles higher than $1,000, the report said."

Dannon says it will phase out using milk from cows fed GMO feed; farmers, dairy groups criticize move

Dannon, the world's largest yogurt maker, announced that it is moving away from using milk sourced from cows fed biotech grain, Rick Barrett reports for the Milwaukee Journal Sentinel. The company, which said consumer demand for non-GMO products led to the decision, said in a statement: “This is the beginning of the transformation of the company’s Danimals, Oikos and Dannon brands, which over time will evolve to contain non-GMO ingredients. Starting in 2017 and completing the transformation by the end of 2018, Dannon will go one step further to ensure that the cows that supply Dannon’s milk for these three flagship brands will be fed non-GMO feed."

Farm and dairy groups have criticized the decision, saying it could "dangerously turn the clock back on farming practices and is little more than a misleading gimmick," Barrett writes. Nancy Kavazanjian, a grain farmer and chairperson of the U.S. Farmers and Ranchers Alliance, called the decision “marketing fluff” and said it "amounts to a major step backward in truly sustainable food production."

The American Farm Bureau Federation, National Milk Producers Federation and U.S. Farmers and Ranchers Alliance were among groups that sent a letter to Dannon that states: “Under the guise of providing consumers more choices, your pledge would force farmers to abandon safe, sustainable farming practices that have enhanced farm productivity over the last 20 years. In our view, your pledge amounts to marketing flimflam, pure and simple. It appears to be an attempt to gain lost sales from your competitors by using fear-based marketing and trendy buzzwords, not through any actual improvements in your products. Neither farmers nor consumers should be used as pawns in food marketing wars."

Criminal prosecutions from EPA investigations lowest in 20 years; water pollution tops list

Criminal prosecutions in fiscal year 2016 from Environmental Protection Agency investigations are the lowest in 20 years, says a report released Tuesday by Transactional Records Access Clearinghouse, a research center at Syracuse University. Through the first 11 months of the fiscal year there have been 81 prosecutions, which is on pace for 88 for the year, down 20 percent from last year and down from 182 five years ago. (TRAC graphic: prosecutions by fiscal year)

Criminal prosecutions resulting from EPA referrals to federal prosecutors peaked at 198 during FY 1998 when President Clinton was in office and reached 196 during President George W. Bush's first year in office, researchers said. "The decline in prosecutions has been driven largely by the decline in EPA criminal referrals. During the Obama administration federal prosecutors filed criminal charges in 43.1 percent of EPA referrals, compared with 40.2 percent during the prior Bush administration."

Of this year's investigations 63 led to convictions, with 61 pleading guilty, researchers found. Of the 63 convictions, 19 involved water pollution, eight were for air pollution and six for hazardous waste management. Of the 63 convictions, 22 received prison time. The longest sentence was 121 months (10 years) and the average sentence was 12 months. (Read more)

American Muslims say Trump has made it harder for them; hate being preached in rural areas

Former FBI agent John Guandolo giving an
anti-Muslim speech Oct. 17 in rural Warroad, Minn.
(MPR News photo by Monika Lawrence)

Is Donald Trump spreading an anti-Muslim message that is fostering hate and racism in rural America? Some American Muslims say the presidential race has been worse for them than after 9/11, because unlike in 2001, there is now a "ring leader" championing mainstream hate, as a Somali refugee in Minnesota told M.J. Lee of CNN.

"Trump has run a hard-line, anti-immigration campaign built on promises to erect a wall and deport millions of undocumented immigrants. Last December, he announced a proposal to ban Muslims from entering the country," Lee reports after interviewing 40 Muslims around the nation. "Perhaps most disturbing about this election, many said, is the perception that Trump has helped to normalize animosity toward and suspicion of Muslims in the U.S. . . . He has suggested that profiling would be an effective strategy to prevent terrorism." Lee's story has no response from the Trump campaign.

Anti-Muslim campaigns have become common place in rural Minnesota, John Enger reports for Minnesota Public Radio. "North and central Minnesota have become fertile ground for traveling speakers who have built national careers spreading alarm about the danger they say Islam poses inside U.S. borders. At dozens of rural churches and schools, speakers have warned crowds about refugees and called on them to be prepared to oppose Muslims in Minnesota. This comes at a time of mounting political tension over immigration ahead of the contentious presidential election."

Former FBI agent John Guandolo, who travels the country giving anti-Muslim speeches, told a crowd in Warroad, Minn., "Are you prepared? Are you prepared for the two or three dozen jihadis in, pick a city in Minnesota, with mortars or shoulder-fired rockets? You don't think they can get those in the United States?" Another featured speaker in rural Minnesota, Usama Dakdok, also travels the country preaching against Islam, including claims that it's a cult, not a religion, Enger writes.

Mike Buffington, who owns several rural newspapers in Georgia, shared an exchange he had on Facebook with a local community member and Trump supporter who compared Muslims to rats that need to be exterminated. The poster wrote: “I have first hand dealings with muslins [sic] and can tell you what they think and how they will act when they reach a critical mass. You were raised in a rural county, but not in the country. If you ever heard of having a rat killing??? Well when rats are in numbers to be a problem you have to go out and get rid of all of them, that includes males females and all little rats, because we all know a little rats grows up to be a big rat and then the problem starts again.” Buffington wrote, "Vile. Disgusting. Deplorable.I will only identify this man as 'LP' here. He’s known in the community, a former military man and a self-proclaimed Christian. And yet he openly calls for murdering men, women and children who have done nothing wrong simply because they have different religious beliefs than he does. . . . It’s time for civilized Americans to speak out against people like LP whose soul has gotten lost in the flood of hatred that is washing over our political landscape. Silence is acquiescence. "

Anti-Muslim groups have called for stricter border security and have protested Muslim burial grounds and a proposed mosque, calling Muslims terrorists and rapists. A recent study also found that Americans, on average, think Muslims make up 15 percent of population. The actual figure is 1 percent.

Georgia has become a battleground and 'ground zero' for voting discrimination, rights group says

Half a million have already voted early in Georgia.
(Associated Press photo by John Bazemore)

In Georgia, which has become a presidential battleground state, voting-rights advocates say as many as 100,000 registrations have not been processed, have accused officials of providing limited early voting sites, and have sued them for refusing to extend voting registration deadlines in regions affected by Hurricane Matthew, Vanessa Williams reports for The Washington Post.

Kristen Clarke, president and executive director of the Lawyers’ Committee for Civil Rights Under Law, told Williams that Georgia “is unique in that a lot of the suppression we’re seeing is at the local level, with elected officials in communities that are smaller and more rural, and are not under the microscope in the same way that state elections officials are. . . . Georgia is ground zero, if you will, when it comes to voter suppression and voting discrimination that we’re seeing this election season.”

The American Civil Liberties Union filed suit last week to extend registration in six counties affected by the hurricane. Williams writes, "Republican Secretary of State Brian Kemp, who oversees elections, responded by taking to Twitter to rail against 'left-wing activists,' whom he accused of trying to disrupt the election." He wrote, “We can’t sit back and watch the radical left create chaos in our state. Stand with me and protect Georgia elections!”

Williams reports, "Voting rights advocates in Georgia say Republican state and local election officials are undermining the fairness of the vote by passing laws and adopting procedures that deter minorities and young people, groups that typically vote Democratic." They "have challenged laws and procedures enacted by Kemp that they said would make it harder for people to register to vote and would unnecessarily kick people off the voting rolls. In one county, advocates say they stopped an effort by local officials to move a polling precinct that served predominantly black voters from a gymnasium to the sheriff’s office."

U.S. Rep. John Lewis, D-Atlanta, said last week that the Obama administration should appoint election monitors in Georgia, the Atlanta Journal-Constitution reports.

What impact will a Clinton or Trump presidency have on agriculture?

What impact would Hillary Clinton or Donald Trump have on agriculture if elected? One strength for Clinton is her close ties with Agriculture Secretary Tom Vilsack, says Marshall Matz, who specializes in agriculture law and was counsel to the Senate Agriculture Committee and chairman of the Obama for President Agriculture Committee in 2008, in a column for Agri-Pulse.

Clinton, who has said her agenda is "very much in line" with what Vilsack did in Iowa as governor, said, "We have to stand with our farmers, give them the tools and support they need to boost both production and profits," Matz writes. "Recognizing that the vast majority of Americans who live in rural America don't farm, or rely on second jobs," she "has made a strong commitment to the broader needs or rural America." Clinton also has put "emphasis on clean energy jobs, broadband, high speed Internet, health care and rural education."

The Trump campaign has focused on regulations that it says are hurting farmers. Doug Keesling, a member of the Trump agriculture advisory committee, writes for Agri-Pulse, "Regulations from the Environmental Protection Agency, for example, often are drawn up with little regard for their effect on U.S. agriculture, or for farmers' ability to feed the world's growing population. Tax regulations-such as those that cover the inheritance of estates-can have costly consequences that prevent farms from being passed on intact from generation to generation."

"And a growing body of unfair trade restrictions and one-sided trade pacts continue to hinder the international flow of U.S. agricultural products that often account for our largest exports to many foreign countries," he writes. "Companies that ship to several states also have to deal with state labeling issues with conflicting states laws. Rising labor costs have cut into farmers profits in an industry that relies heavily on manual labor to plant and harvest crops."

Growing agri-tourism and local-food industry boosts income for farmers and other landowners

Locavore Farm in Grant Park, Ill. has found success
through agri-tourism (Journal photo by Tiffany Blanchette)

Agri-tourism is booming. The U.S. Census of Agriculture reports that in 2012, the last year covered by the census, 13,334 farms grossed $674 million from agri-tourism, up from 3,000 farms grossing $128 million four years earlier, Mary Hall reports for the Daily Journal in Kankakee, Ill. Of those farms, one-quarter were in the Midwest.

Only 8 percent of Illinois farms "have some kind of recreational side business and most make less than $5,000 per year on it," Hall writes. But most of the participants are "small, family-owned farms that are opening their doors to tourists who want to pick their own apples, see where their beef is raised or simply wake up to a sunrise over a corn field. The biggest growth areas are those just outside of metropolitan areas. And it's often tied to the local food movement. While city populations get more dense, there's also a push to experience the natural—through local food, urban gardening or taking a short drive south to the country for the weekend."

For example, Locavore Farm in Grant Park, Ill. (Best Places map) puts together an Oktoberfest event that features food and music and draws 500 visitors, Hall writes. Dinners for the year, which sold out on July 1, will serve 2,400 people from June to November. The success of places like Locavore Farm, which has been featured in national magazines, "lets tourist get a taste of the rural life" and lets "farms take advantage of their unique nostalgic and family appeal."

States ranked by cancer deaths linked to smoking

A study by the American Cancer Society, published in JAMA Internal Medicine, ranks every state for cancer deaths in 2014 related to smoking, and the top five states are all in the South. The study looked at 12 cancers: acute myeloid leukemia and cancers of the oral cavity and pharynx; esophagus; stomach; colorectum; liver; pancreas; larynx; trachea, lung, and bronchus; cervix uteri; kidney and renal pelvis; and urinary bladder. Among the 167,133 deaths in 2014 from those cancers, 28.6 percent were attributed to smoking. (States and D.C. ranked by cancer deaths related to smoking in 2014)

Kentucky had the highest percentage of cancer deaths related to smoking, 34 percent. Arkansas (33.5 percent) was second, followed by Tennessee (32.9), West Virginia (32.6), Louisiana (32.6), Alaska (31.4), Missouri (31.3), Alabama (31.3), Oklahoma (31.1) and Nevada (30.9).

The study also ranked states by smoking-caused cancer deaths among men (103,609) and women (63,524). Nine of the top 10 states for men and six of the top 10 states for women were in the South. Arkansas led in deaths among men, with 39.5 percent. Utah was the only state under 30 percent, at 21.8. Among women, Kentucky had the highest percentage 29. Utah had the lowest, at 11. Only Utah, California and Hawaii were under 20 percent. (Read more)

Volunteers in Maine are providing free basic services to allow rural seniors to age at home

Volunteer Dave Brown, 75, insulates the floor
of a house in coastal Maine (Stateline photo)

As Maine's large rural population ages, volunteer groups have popped up to provide services to allow seniors to remain at home as they age, Jenni Bergal reports for Stateline. One group, Harpswell Aging at Home, which includes many seniors, does home repairs for free, such as insulation, repairing damaged floors or doors, sealing foundations, installing rain gutters and storm windows and fixing fire hazards. Other groups offer rides, donate fresh fruits or vegetables or help give caregivers a break.

These are much-needed services that can be a model for any state, Bergal writes. The number of seniors 65 and older in the U.S. is expected to reach 77 million by 2035, up from 48 million now. One-third of Maine's population is expected to be older than 65 by 2032.

"Local governments cannot afford to pay for all the services needed to help seniors stay in their homes. State governments face the same dilemma," Bergal writes. "And retrofitting a house for aging people can be expensive. It can cost $800 to $1,200 to widen a doorway to accommodate a wheelchair, $1,600 to $3,200 for a ramp, and up to $12,000 for a stair lift. That’s what makes Maine’s growing volunteer network so valuable."

Jess Maurer, executive director of the Maine Association of Area Agencies on Aging, said more than 60 communities have started, or are in the process of starting, programs to help seniors age in their homes, Bergal writes. Maurer told her, “There isn’t enough money in Maine to deal with this problem. It’s going to have to be community by community, using volunteers and public and private resources.”

Democratic clusters of population in urban areas keeping party from turning red states blue

Democrats don't want to live in the rural regions they need to populate to get enough votes to turn red states blue, Alec MacGillis reports for The New York Times. "Democrats today are sorting themselves into geographic clusters where many of their votes have been rendered all but superfluous, especially in elections for the Senate, House and state government. This has long been a problem for the party, but it has grown worse in recent years."

Bill Bishop, co-founding editor of the Daily Yonder, chronicled this phenomenon eight years ago in "The Big Sort," MacGillis writes. Bishop's theory helped "explain why red-blue maps of so many states consist of dark-blue islands in the cities surrounded by red exurbs and rural areas, a distribution that is also driven by urban concentrations of racial minorities and by the decades-long shift in allegiance from Democratic to Republican among working-class white voters." (Big Sort map: Presidential election by county in 1976)

"That hyper-concentration of Democratic votes has long hurt the party in the House and state legislatures," MacGillis writes. He notes that in Ohio Republicans won 75 percent of the U.S. House seats in 2012 despite winning only 51 percent of the total votes. (Big Sort map: Presidential election by county in 2004)

"That imbalance can be explained partly by Republican gerrymandering," MacGillis writes. "But even if district lines were drawn in rational, nonpartisan ways, a disproportionate share of Democratic votes would still be clustered in urban districts, giving Republicans a larger share of seats than their share of the overall vote. Winning back control of state legislatures in Pennsylvania and Michigan could help Democrats in redistricting after 2020. But it would help more if their voters were not so concentrated in Philadelphia and Pittsburgh, Detroit and Ann Arbor."

He sites three reasons for changes: geographic mobility, education and economic gaps. While lower income people once migrated for better opportunities, those more likely to migrate now are highly educated, typically moving to metro areas, MacGillis writes. Also, higher educated people are more likely to vote Democratic. Currently, Democrats hold a 12-point edge in party identification among those with a college degree or more, when the parties were even on that score in 2004. Also, the U.S. economic gap between the wealthiest cities and the rest of the country has grown considerably, with economically dominant cities tending to be in deep-blue states. (Read more)

DEA investigators say officials purposely hampered attempts to slow rise of opioids

Drug ­Enforcement Administration investigators say attempts to staunch the rise of opioids were derailed by interference from higher ups, Lenny Bernstein and Scott Higham report for The Washington Post. When DEA 10 years ago "began to target wholesale companies that distributed hundreds of millions of highly addictive pills to the corrupt pharmacies and pill mills that illegally sold the drugs for street use" the industry fought back, and administrators caved to industry pressure." (Post graphic: Opioid cases pursued by DEA)

"Former DEA and Justice Department officials hired by drug companies began pressing for a softer approach," Bernstein and Higham write. "In early 2012, the deputy attorney general summoned the DEA’s diversion chief to an unusual meeting over a case against two major drug companies." Joseph T. Rannazzisi, who ran the diversion office for a decade before he was removed from his position and retired in 2015, told the Post, “That meeting was to chastise me for going after industry, and that’s all that meeting was about.”

Rannazzisi vowed to continue the campaign, Bernstein and Higham write. "But soon officials at DEA headquarters began delaying and blocking enforcement actions, and the number of cases plummeted, according to on-the-record interviews with five former agency supervisors and internal records obtained by The Post."

The number of civil case filings against distributors, manufacturers, pharmacies and doctors dropped from 131 in fiscal year 2011 to 40 in fiscal year 2014, Bernstein and Higham write. During the same time period, the immediate suspension orders, the DEA’s strongest weapon of enforcement, dropped from 65 to nine. "The slowdown began in 2013 after DEA lawyers started requiring a higher standard of proof before cases could move forward."

"Several DEA officials on the front lines of the opioid war said they could not persuade headquarters to approve their cases at the peak of the epidemic," Bernstein and Higham write. "They said they confronted Clifford Lee Reeves II, a lawyer in charge of approving their cases, to no avail." Jim Geldhof, who was the diversion program manager in the Detroit field office when Reeves took over at DEA headquarters in 2012, told the Post, “It was like he was on their side, not ours. I don’t know what his motive was, but we had people dying. We were in the throes of a major pill epidemic.” (Read more)

State police departments seeing a shortage of applicants; low pay one reason

State police in Washington are among the
state's lowest paid officers (Stateline graphic)

Many state police departments are struggling to staff positions, Sarah Breitenbach reports for Stateline. "It’s a problem that state police departments—which patrol highways, assist local officers, and serve as the only law enforcement in some rural areas—are facing across the country. A combination of low pay, baby-boom retirements and recruitment troubles has left state police departments short of manpower." Staffing shortages are leading to large sections of rural highways going unpatrolled.

"Beyond salaries, continuously tight budgets across many states can take a toll on troopers’ morale," Breitenbach writes. "Outdated equipment, the disappearance of fringe benefits like cellphone allowances, and the demand for overtime work in exchange for comp days that they may not even have time to take have convinced many officers to head for the exits."

"Attracting replacements is increasingly difficult as recruits favor the many municipal police departments that pay more than their state counterparts," Breitenbach writes. In Virginia, for example, state police applications were down 50 percent between February to August, with only 31 percent of applicants actually showing up for testing.

One theory for fewer applicants is rising tensions between police and community members, Breitenbach writes. Another reason could be that it can take up to a year to hire a new officer—including tests and training—while other professions can hire much more quickly.

Medicaid limitations affect availability of opioid addiction meds, especially in South, Great Plains

Rate of buprenorphine prescriptions paid
by Medicaid by state (Pew graphic)

Medicaid limitations in some states make it difficult to treat opioid addiction, Christine Vestal reports for Stateline.

While all states reimburse for buprenorphine—the most widely used opioid addiction medication—"the fees Medicaid pays doctors are considered too low and the paperwork too time-consuming to attract an adequate number of providers willing to treat Medicaid enrollees with addictions," Vestal writes.

"In addition, coverage provisions such as prior authorizations, dosage and duration limits, requirements that patients 'fail first' at cheaper treatments that do not include medication, high copays and excessive counseling requirements make it difficult for Medicaid enrollees to get effective treatment for the chronic, lifelong disease of addiction," Vestal writes.

Many of the state's where Medicaid pays for the lowest share of buprenorphine are in the South and Great Plains, led by Mississippi, where the state's program only pays for four percent of prescriptions, Vestal writes. "Alabama, Arkansas, Florida, Georgia, Kansas, Louisiana, Montana, Nebraska, Tennessee, Texas, Oklahoma and Utah each pay for 10 percent or less of buprenorphine prescriptions."

From July 1, 2015 to June 30 of this year U.S. pharmacies dispensed 12.5 million prescriptions for buprenorphine, a 6.4 percent increase over the previous year, Vestal writes. "Commercial insurers paid for 57 percent of prescriptions, Medicare paid for 7 percent, and patients paid out-of-pocket for 11 percent of all retail sales."

Shelves bare at grocery store in impoverished rural Appalachian town; owners blame coal downturn

There are not many options at the Foodland in Grantsville, W.Va.
 (Gazette-Mail photo by Christian Tyler Randolph)

Poverty, lost coal jobs and competition from big chain stores are being blamed for bare shelves at the only grocery store in a rural Appalachian West Virginia town. Officials for the Foodland in Grantsville, W.Va.—the next closest store is 25 miles away—say economic struggles in the town of 650 has adversely affected sales, Max Garland reports for the Charlette Gazette Mail. A Foodland spokesperson said that "With the workforce in the state still adjusting to the loss in coal jobs and natural gas prices taking a hit, locals don’t have enough disposable income to buy as much food and keep the store afloat."

In 2013 in Grantsville (Best Places map) 27.6 percent of the population was below the poverty line and the current per capital income is $16,616, well below the state average of $23,237, Garland writes. In Calhoun County, 16.7 percent of people do not have reliable access to healthy foods, above the state average of 15.3 percent, according to a 2014 study by the hunger-relief organization Feeding America.

Foodland officials also blame competition from big chain stores Walmart and Kroger, Garland writes. Officials said Foodland is expected to get a food delivery Friday, it's first in weeks, and that the delivery will lead to operations hopefully getting back to normal.