Saturday, September 09, 2017

Charges against reporter dropped; he appreciates support from employer, journalists and public

Dan Heyman
(Gazette-Mail photo)
By Al Cross
Institute for Rural Journalism and Community Issues

ANAHEIM, Calif. -- The West Virginia reporter arrested for trying to question Health and Human Services Secretary Tom Price won his case this week, but told a journalism conference that he would have been more likely to plea bargain if not for the support he received from his employer, journalism groups and the public. "People really love the First Amendment," Dan Heyman of Public News Service said at the Excellence in Journalism convention in Anaheim, Calif. "They found it shocking to see a headline, 'Reporter arrested while asking questions.'"

Heyman said he was holding his recorder toward Price as they walked through a hall of the state Capitol, and when he wouldn't answer questions, "I tried to reach past the security people and I was promptly arrested for that." He noted that the Charleston Gazette-Mail later reported that Price was trying very hard to focus on the opioid crisis, the reason for his visit, and was working hard to avoid questions about the health-care debate in Congress. The newspaper "filed a public records request for security footage of the event," it reported. "The Division of Protective Services denied the request."

The charge, disruption of governmental process, was dropped Wednesday. "Kanawha County Prosecuting Attorney Chuck Miller said that while Heyman may have been somewhat overzealous in his questioning, his conduct was protected under the First Amendment to the U.S. Constitution and not criminal behavior," Jake Zuckerman reported for the Gazette-Mail. Heyman said he may file a complaint against the division because it lied in its account of the incident. Bruce Sanford, chief counsel for the Society of Professional Journalists, said at SPJ's Legal Defense Fund auction Saturday that the division falsely claimed that officers had told Heyman not to bother Price. 

Heyman spoke via Skype on a Friday panel titled "Enemies of the People: The Job of Journalists in 2017" at the conference sponsored by SPJ, the Radio Television Digital News Association and the National Association of Hispanic Journalists. The title was taken from a line President Trump used to refer to the news media, and RTDNA Executive Director Dan Shelley said, "We believe there is a direct relationship between highest ranking public figures . . . giving permission to people who don't understand the media's role in society to lash out in more horrific ways."

Shelley said RTDNA formed a Voice of the First Amendment Task Force six months ago due to increasing reports of harassment of local reporters, and there have been dozens more since. He said the goal is to "try to help the public understand responsible journalism is essential to their daily lives," and showcase good examples of it. He said the Committee to Protect Journalists' US Freedom Tracker lists at least 20 arrests of journalists and 16 assaults on those "just trying to do their jobs."

Friday, September 08, 2017

Research associates use of painkillers with one-fifth of recent shrinkage in size of U.S. workforce

Brookings Institution map; click on it to see a much larger version.
Princeton University economist Alan Krueger found in 2016 that almost half of prime working-age (25-54) men who are not in the labor force take pain medication daily, two-thirds of them by way of prescriptions. He has taken a closer look at the data, and says increased use of opioids could account for one-fifth of the recent shrinkage in the American workforce—as defined by the rate of participation in the labor force, the proportion of people employed or looking for work.

Krueger's new paper and data, published in the Fall 2017 edition of Brookings Papers on Economic Activity, "suggests that the increase in opioid prescriptions from 1999 to 2015 could account for about 20 percent of the observed decline in men’s labor-force participation during that same period, and 25 percent of the observed decline in women’s labor-force participation," Fred Dews reports for the Brookings Institution. "Over the last 15 years, the labor-force participation rate fell more in counties where more opioids were prescribed."

Labor-force participation has been declining for about 15 years, "reaching a near 40-year low of 62.4 percent in September 2015," Dews notes. "The participation rate of American women had fallen from the top group of OECD countries to near the bottom," according to the international Organization for Economic Cooperation and Development.

Krueger suggests that while much of the decline comes from the aging population "and other trends that pre-date the Great Recession (for example, increased school enrollment of younger workers), an increase in opioid prescription rates might also play an important role in the decline, and undoubtedly compounds the problem as many people who are out of the labor force find it difficult to return to work because of reliance on pain medication," Dews writes.

But is the trend more because people on painkillers are less likely to work, or because people not working are more likely to be on painkillers? “Regardless of the direction of causality, the opioid crisis and depressed labor-force participation are now intertwined in many parts of the U.S,” Krueger writes.

The research reveals regional differences in medical practices. "A 10 percent increase in the amount of opioids prescribed per capita in a county is associated with a 1 percent increase in the share of individuals who report taking a pain medication on any given day, holding health and other factors constant," Dews reports.

FCC holds teleconferences to discuss telemedicine

The Federal Communications Commission’s Connect2Health Task Force is continuing to hold virtual listening sessions about all aspects of broadband-enabled health, mostly meaning telemedicine. The goal is to solicit info from non-traditional stakeholders and those outside the Washington, D.C., area. Registration is closed, but digital recordings will be published on the FCC's website, and are sure to be a goldmine of interesting discussion. Interested parties can submit
Here's a list of the virtual listening sessions, both past and future, and the stakeholder groups that are invited to participate in each:
  • Week of Aug. 7 Health Care Provider Forum: e.g., Health system administrators and CIOs, clinicians and other health care providers (including allied health professionals); community health officials and clinicians; small medical practices; public safety and EMS professionals; and researchers.
  • Week of Sept. 11: Rural and Consumer Issues Forum: e.g., Associations and advocacy groups representing rural interests, Tribal land, people with disabilities, veterans, and older Americans.
  • Week of Sept. 18: Technology and Broadband Services Forum: e.g., Telecommunications carriers, broadband services providers, manufacturers, innovators, and entrepreneurs.
  • Week of Sept. 25: Policymakers Forum: e.g., Federal policymakers; state and local health officials (or their representatives) and other policymakers; associations representing state,  county, and city health officials and policymakers; state and local officials involved in developing technology and broadband policies and strategies. 
Click here for more information about the teleconferences.

No Hollywood script: What happens when a newly stronger liberal visits her rural hometown?

Connie Philips, Hannah Ross, Emily Phillips Reyes and Emily's husband Cristian Reyes talk at the county fair in Clark County, Missouri. (Washington Post photo by Matt McClain)
It's a Hollywood staple: Outsider goes to rural area, culture clash ensues, sometimes with hilarity. Or, person leaves small town, expands world view, comes home, causes drama. But how do such situations play out in real life? It's a topic that seems to fascinate The Washington Post's Stephanie McCrummen. In July she wrote a thoughtful piece about what life is like for a Muslim doctor who moved to small-town Minnesota, especially since President Trump's election. And this week the Post ran her story tracking 22-year-old Emily Phillips Reyes on a visit to her small home town of Kahoka, Mo. Reyes became far more liberal during and after college, and was nervous about what her family would think about her, how she should to talk to her family, and whether they would accept her Guatemalan-born husband, Cristian. Kahoka, population 2,007, is mostly white and Republican, and almost three of every four of its votes went to Donald Trump.

Kahoka, Missouri
(Sperling's Best Places map)
"All the way home, she had thought about how she was supposed to act in this place she loved but now felt so conflicted about. How was she going to talk to people when every conversation seemed to slip into arguments about the fate of America? How was she going to get along for three days at a county fair?" McCrummen writes. "At a moment when the phrase 'cold civil war' was being used to describe the nation’s seemingly irreconcilable differences, coming home was beginning to feel like crossing over to the other side."

Emily's relationships back home had become increasingly bumpy, as her personal convictions changed. But she had loved going to the Clark County Fair since she was a girl, and had promised to help her parents run their concession booth for three days. So she went, and McCrummen's story highlights the awkward, delicate navigation of her visit. Her husband Cristian pitched in, trying hard not to draw attention to himself as an immigrant. He had been raised in rural Missouri since he was eight, and showed up to meet Emily at the fair wearing a shirt with a huge American flag. He was, he told her, in "full PR mode."

But controversial topics kept coming up in conversations, parts of which McCrummen reports verbatim, and everyone involved had to choose whether to engage in arguments that would not likely change anyone's mind. "Maybe the best path forward was avoidance, Emily thought. Avoid Trump, avoid all related controversial subjects. Talk about biscuits and fries and the demolition derby and appreciate what Kahoka was, not what it wasn’t," McCrummen writes. That approach worked, for the most part. And after the controversial topics were stripped away, what was left were the everyday conversations between people who love each other, even if they don't understand each other's beliefs so well any more. The story is a good weekend read.

Infant mortality hits rural black population hard

A new report by the federal Centers for Disease Control and Prevention has some grim statistics for African American women and for women living in rural area, especially those who are both. One key finding is that infant mortality is higher in rural areas for all races. But infant mortality for all African American babies is much higher, no matter where they live. As Maggie O'Neill of the Daily Mail summarizes, "Black babies born in rural areas of the US are three times more likely to die at birth than city-born white infants."
Axios chart by Chris Canipe; click on it for a larger version
The CDC's findings on rural infant mortality make sense, "since people in rural counties are farther away from hospitals and doctors," Bob Herman reports for Axios. More and more rural hospitals are either closing down or shuttering their obstetrical services, so more than half of rural counties don't have a place where women can go to give birth.

Besides race, the CDC teases out several other specific categories in which rural infant mortality is higher. The mortality rate for postneonatal babies (aged between one and 12 months) is 49 percent higher in rural areas. And though mortality rates for every age group of mothers are higher in rural mothers, the difference is especially pronounced in women who give birth at age 40 or up. Infant mortality in that age group is 54 percent higher than in the same age group in urban areas.

Rural population loss widespread in Eastern U.S.

The Daily Yonder covers rural population loss in an article that breaks down new research published by John Cromartie, a geographer with the USDA Economic Research Service. Here's what the Yonder gleaned from his report:

The population of rural America decreased for a "record-breaking" sixth year in a row, but not just because young adults are migrating to cities. It's because overall mobility is at an all-time low, so the people who stay tend to be older, and now there are more deaths than births in rural America.

"County population change includes two major components: natural change (births minus deaths) and net migration (in-migrants minus out-migrants)," the Yonder notes. Since 2010, 462,000 more people moved out of rural areas than moved in. But there were only 270,000 more births than death in rural areas, so the net loss was was about 192,000. In the past, births and in-migrants have almost always outnumbered deaths and out-migrants, so the population grew. But now, "declining birth rates, increasing mortality rates among working-age adults, and an aging population have led to the emergence of natural decrease (more deaths than births) in hundreds of U.S. counties, most of them rural counties. Lower rates of natural change resulted in 325 rural counties experiencing sustained natural decrease for the first time during 2010-16, adding to 645 rural counties with natural decrease during 2000-09," the Yonder reports.
Daily Yonder map. Click to enlarge.
The Eastern U.S. is seeing the biggest areas of natural decrease, especially in New England, Northern Michigan, the Southern Coastal Plains, and Appalachia. The map shows areas in the Western U.S. that have grown; this is largely because of a boom in energy jobs, and also because of minorities, including immigrants.

The trend of rural population loss may reverse, depending on how well the economy does, but the Yonder says, "Even if temporary, this small but historic shift to overall population loss highlights a growing demographic challenge facing many regions across rural and small-town America: population growth from natural increase is no longer large enough to counter-cyclical net migration losses."

Senate committee debates how to fund Children's Health Insurance Program, expiring Sept. 30

The debate over the Patient Protection and Affordable Care Act is still going strong, but there's another health-care program with a firmer deadline looming. The Senate Finance Committee heard testimony Thursday about how to extend funding for the Children's Health Insurance Program. Federal funding for the popular $15 billion program will expire Sept. 30 if no provisions are made, Ken Terry notes for Medscape. CHIP has enjoyed wide bipartisan support since Sens. Orrin Hatch (R-Utah) and the late Ted Kennedy (D-Mass.) co-authored the original bill in 1997. Since that time the uninsured rate for children has decreased from 9.6 million to 3.3 million, a drop of more than 67 percent.

There are two main possibilities for how to move forward with CHIP. "Hatch noted that Congress could either reauthorize CHIP, which he said would require extensive debate and possibly policy changes, or it could extend CHIP short-term because there isn't enough time for a policy debate before CHIP funding expires," Terry reports. But while Hatch favors extending CHIP, fellow Finance Committee member Sen. Ron Wyden (D-Ore.) favors a reauthorization. "A short-term extension, he said, would just mean kicking the can down the road, and putting off a decision until December would lead to some states running out of CHIP money."

At the hearing, Anne Schwartz, executive director of The Medicaid and CHIP Payment and Access Commission, which advises Congress on Medicaid and CHIP issues, said the commission recommends a five-year reauthorization of CHIP to reduce uncertainty for states during this "transitional period" of health care reform. In January the commission had also recommended that Congress extend the increase in federal matching rates for CHIP through 2022. "The Affordable Care Act (ACA) raised those rates by 23 percentage points through 2019, so this would be a 3-year extension. Currently, 11 states and the District of Columbia have federal matching rates of 100 percent, and 22 other states have rates of 90 to 99 percent. These higher rates have persuaded some states to expand children's health coverage, Schwartz said."

Thursday, September 07, 2017

Building more fire-resilient communities

A controlled burn outside Bend, Oregon. (Route Fifty photo by Michael Grass)
As one of the worst wildfire seasons in recorded history burns through the Western United States, a story from Michael Grass of Route Fifty examines how emergency responders, public officials and other stakeholders can help ensure safety for towns built on the edge of rural areas prone to wildfire. Forest managers call such areas the "wildland-urban interface."

Bend, Oregon, is one such town. U.S. Forest Service personnel employ regular controlled burns in the nearby forests to clear out dry undergrowth that could cause uncontrollable wildfires. Regular burns keep the trees healthy too, and provide a habitat for some species.

"We’re looking at developing our communities in a very different way than we did 10 years ago, or even five years ago," said Romy Mortensen, the vice president of sales and marketing of Brooks Resources, a development company with long roots in Bend and central Oregon.

But development can be a contentious topic in Bend, a town of 90,000. "Forest management—and by extension, the emergency managers who have to deal with wildfires—sits uncomfortably at the intersection of policy discussions involving environmental conservation, land use and property rights," Grass reports. For instance, smart development in wildfire-prone areas includes leaving a buffer of undeveloped space between homes and flammable acreage. But county officials who gathered to hear from Mortensen were concerned about their property rights being violated.

The answer to such concerns is complicated. "Land-use planning rules, depending on which state or locality you’re in, can vary considerably across the West. In Oregon, the situation is more regulated, meaning that private property rights fall under the context of the state’s larger land-use plan," Grass reports. So developers and local planners must work with each other to find a middle path where property rights are respected while safety parameters are observed. But even following strict safety protocols is no guarantee of safety. "The only true way to prevent wildfires from destroying homes and threatening communities is not build in vulnerable forests in the first place. But that’s a tough sell for local officials across the West," Grass writes.

Synthetic opioids caused surge in drug overdoses

Lethal doses of heroin and fentanyl
(New Hampshire State Police Forensic Lab photo)
New figures from the National Center for Health Statistics say that skyrocketing drug overdose deaths in 2016 stem from a surprising source. "Synthetic opioids like fentanyl overtook both heroin and prescription painkillers in terms of overdose deaths," German Lopez reports for Vox.

Of the more than 64,000 drug overdose deaths in 2016, "traditional opioid painkillers, such as OxyContin and Percocet, were involved in about 14,400 overdose deaths in 2016, and heroin was involved in more than 15,400. Non-methadone synthetic opioids like fentanyl, meanwhile, were linked to more than 20,100 overdose deaths. Remaining overdose deaths involved other drugs, such as cocaine (which also increased)," Lopez reports.

Vox graphic. Click to enlarge.

The opioid epidemic began mostly after patients became addicted to legal prescriptions for painkillers. But when the government cracked down on such prescriptions, many addicted patients turned to heroin and synthetic opioids like fentanyl. Fentanyl is used legally as an anesthetic or for chronic pain management, but is also often illegally manufactured and mixed with other drugs.
Fentanyl is particularly dangerous because it's cheap, identical in appearance to heroin, and powerful--up to 100 times more potent than morphine, and many times stronger than heroin.

"Drugs users generally don’t know when their heroin is laced with fentanyl, so when they inject their usual quantity of heroin, they can inadvertently take a deadly dose of the substance. In addition, while dealers try to include fentanyl to improve potency, their measuring equipment usually isn’t fine-tuned enough to ensure they stay below the levels that could cause users to overdose. Plus, the fentanyl sold on the street is almost always made in a clandestine lab; it is less pure than the pharmaceutical version and thus its effect on the body can be more unpredictable," Allison Bond reports for Stat News.

Calif. dam investigators say visual inspections can't predict failure, and could be a nationwide problem

Forensic investigators say there were plenty of red flags that could have alerted inspectors before the , disastrous flood from California's Oroville Dam, and they hope other dam inspectors are paying attention. In an interim report Sept. 5, investigators said "The state and federal officials who inspected Oroville Dam relied too heavily on visual inspections, ignoring blueprints, construction records and other documented clues that could have warned them about the dam’s troubled flood-control spillway long before it fractured in February. The fracture led to near-catastrophe and the evacuation of thousands of residents," Dale Kasler and Ryan Sabalow report for The Sacramento Bee.
Many U.S. dams are rated "high hazard." Click on FEMA map to enlarge it.
The investigators were hired by the state's Department of Water Resources to study the cause of the flood. They aid the spillway fracture was probably caused by cracks in the concrete and a faulty drainage system under a sometimes too-thin concrete chute. "Visual inspections alone, conducted annually by DWR and once every five years by the federal government, wouldn’t allow regulators to pull all the clues together and point to the likelihood of failure," the Bee reports.

The investigators say similar problems could be happening in other dams all over the country, and inspectors may not catch them if they continue to overrely on visual inspections. "The panel called on regulators to supplement visual checks with painstaking reviews of original design and construction specifications, as well as maintenance records, with an eye toward finding 'design shortcomings' that contrast with current state-of-the-art practices," the Bee reports. "The reviews should go beyond spillways and take in the entire dam structure."

Federal dam inspections are handled by the Federal Energy Regulatory Commission. In May, FERC said it was re-evaluating dam safety inspections because of Oroville. FERC's most recent inspection of the Oroville dam in 2014 "concluded that the a failure of the flood-control spillway at Oroville was so unlikely that there was no need to plan for such an emergency," the Bee reports.

Insurer leaves part of Va. without individual Obamacare plans; Ky. now has just one choice

Two insurers announced this week that they will stop offering individual marketplace insurance in areas of Virginia and Kentucky in 2018. It's a manifestation of insurers' deep uncertainty about the future of health care in America. Congress may still try to repeal the Patient Protection and Affordable Care Act, which established the marketplace exchanges; the Trump administration has cut funding for advertising ACA plans by 90 percent; and President Trump has threatened to withhold the federal cost-sharing subsidies that make it possible for insurers to offer deeply discounted plans for the poor. Insurers have until Sept. 27 to make final commitments for 2018, Anne Mathews reports for The Wall Street Journal.

The first insurer to announce withdrawal this week, Optima Health, will cut its Virginia footprint in half. That means that around 70,000 Virginians will have no insurance options next year unless another insurer steps in to fill the gap, Mathews writes. In other states where all insurers withdrew, others specializing in plans for low-income people have stepped in to fill the vacuums. All U.S. counties in had Obamacare insurance choices as of Aug. 25.
Bloomberg interactive map updated as of Sept. 7. Click on image to enlarge. Click here for interactive version.
Optima, owned by major hospital system Sentara, said in a press release that it would only offer individual insurance in areas supported by Sentara hospitals. "A spokeswoman for Optima Health said that the insurer’s decision was tied to other insurers' withdrawals from Virginia’s exchange, which left the company concerned that it would enroll more people than it could handle if it maintained the broad geographic footprint that it had earlier filed to offer. Anthem, which is withdrawing and pulling back from exchanges in many states, announced on Aug. 11 that it would leave the Virginia marketplace next year," Mathews reports.

Anthem similarly announced on Sept. 6 that it would cut in half the number of Kentucky counties in which it will offer individual Obamacare plans in 2018. "Anthem's decision to sell individual plans in just 59 counties in Kentucky comes more than two months after the Blue Cross Blue Shield insurer filed proposed rates for health plans in 2018 for all 120 counties in the state," Dan Mangan reports for CNBC. "So far, Anthem has announced that it will significantly reduce its Obamacare footprint next year in nine out of the 14 states where it currently sells individual health plans both on and outside of government-run marketplaces." The pullback in those states will not affect Anthem's group insurance or Medicaid plans.

The Kentucky Department of Insurance told Mangan that the areas Anthem is vacating will be covered by CareSource, which specializes in managing Medicaid programs for the poor.

Federal transportation program lives on to help small, rural projects; Trump wants to end it

TIGER improved US 491 in New Mexico. The road was once called the "Devil's Highway" due to its former number (US 666) and the frequent fatalities caused by safety hazards. (Indian Country Today photo by Alysa Landry)
The popular federal program TIGER (Transportation Investment Generating Economic Recovery) may be endangered, but it's open for now. "State and local governments will have a chance in the coming weeks to vie for a portion of $500 million in federal transportation funding through a popular grant program that President Trump has called for eliminating," Bill Lucia reports for Route Fifty. Congress allocated funds for the program in May; money will be available through Sept. 30, 2020, but the Transportation Department told Lucia that it plans to award all of the available funds in this round of funding.

The office said "special consideration" will be given to certain rural projects that "'emphasize improved access to reliable, safe, and affordable transportation' for rural communities—and particularly projects in these places that might address public health and safety and boost economic growth and competitiveness," Lucia reports. Grants generally must be between $5 million and $25 million, but rural projects have a minimum price tag of $1 million. The deadline to apply is Oct. 16.

Congress and the Obama administration created TIGER during the Great Recession to boost the economy. During eight previous rounds of funding, the DOT has awarded $5.1 billion in grants. Trump's justification for ending it is that it funds projects that only benefit localities, not states or regions. "Congressional appropriators in the House and Senate have taken different positions on whether to fund TIGER grants in fiscal year 2018,." Lucia reports. "A House appropriations bill that covers transportation does not include money for the grants. But a Senate bill provides $550 million. A similar dynamic has played out in prior years where the House proposes slashing the program, the Senate backs funding, and ultimately money gets allocated for the grants."

Wednesday, September 06, 2017

More than half of rural counties don't have a hospital that delivers babies

It's well-known that rural women are having an increasingly hard time accessing obstetric care, but a new study from the journal Health Affairs provides solid data. "In 2004, 45 percent of rural counties lacked a hospital with obstetrics services. About one in 10 rural counties lost those services over the next decade, and by 2014, 54 percent of communities lacked those services. That leaves 2.4 million women of childbearing age living in counties without hospitals that deliver babies," Carolyn Johnson reports for The Washington Post. Counties with lower median incomes and higher percentages of African American women of reproductive age were less likely to have access to a hospital with a maternity ward.

In some cases the loss of obstetric services stems from entire rural hospitals closing, and in other cases cash-strapped hospitals are forced to cut services such as obstetrics in order to stay open. Obstetrician-gynecologists face the highest malpractice insurance rates of any specialty, which makes it an expensive proposition for hospitals. Low numbers of births also factor into hospitals feeling that obstetrical services are expendable. And obstetricians might not want to relocate to rural areas.

The study's findings underscore the health and accessibility disparities between rural and urban women. Rural women "are more likely to report having fair or poor health, be obese, smoke cigarettes, commit suicide and have cervical cancer than their urban counterparts," Johnson reports. "But the recent trend could exacerbate disparities in reproductive health, too. One recent study found that rural areas had made far fewer gains in improving infant mortality compared with the rest of the country."

A federal program, the National Health Service Corps, may help address the problem of rural obstetric access. Through the program, medical students can have their schooling paid for if they practice in an underserved community for a set period of time. Megan Evans, an OB-GYN at Tufts Medical Center in Boston, has been working with the American Congress of Obstetricians and Gynecologists to define underserved communities according to areas of need--including lack of obstetrical care. A bill to identify areas that need maternity care has passed the House and has been introduced in the Senate.

Texas Observer's Rural Reporting Project aims to help readers and journalists understand rural life

A fascinating new piece from the editor of the Texas Observer introduces its Rural Reporting Project, an effort to delve deep into what life is like in rural Texas communities. "Rural America is neither a late-night comedy joke nor a Rockwellian portrait of wholesome values. It’s a diverse community that deserves to be treated with respect," Forrest Wilder writes. And it's more important than ever for journalists to understand that. After Donald Trump was elected, national news media engaged in a season of navel-gazing; journalists wondered how they missed the anger and resentment felt in rural America and vowed to pay more attention and re-engage in rural communities.

But the rural-urban conflict is one that Texas knows. Wilder writes that Texan journalists have long grappled with the state's "peculiar dichotomy": the state trades on its rural, cowboy image, but more than 80 percent of Texans live in urban areas. "Yet Texas also has the largest rural population of any state: 3.8 million people. We contain multitudes — uneasy multitudes increasingly at odds. No wonder our politics is so riven," Wilder writes.

Rural and urban Americans often misunderstand each other, but share many problems such as stagnant wages, income inequality, lack of access to health care, and racial conflicts, Wilder notes. And the urban journalists who get the most bandwidth don't always recognize that, he says. So the Rural Reporting Project will zero in on what life's like out in rural Texas. "Getting a nuanced understanding of rural communities is critical to bridging divides and promoting community understanding," Wilder writes. "We need full portraits, not caricatures. Readers need to better understand how the glorified myth of 'real America' stacks up against the actual plights faced by those in small towns." Stay tuned.

A last request to honor a community journalist: subscribe!

Kurt Gaston
After Kansas journalist Kurt Gaston passed away Aug. 2, his family made a touching request: "In lieu of flowers, please consider purchasing a subscription to a daily or weekly newspaper," said the obituary.

Gaston, 61, was a long-time news editor who learned the business at his father's newspaper, then called The Ellsworth Reporter. He was the managing editor at the Jefferson Gazette in northern Ohio and the Baytown Sun in East Texas, as well as a host of Kansas papers: The Sterling Bulletin, The Southwest Daily Times, The Osawatomie Graphic, and The Norton Telegram.

We can think of no better tribute to a fellow journalist than to
help his life's work keep going. It's especially needed now, at a time when news outlets are getting less money from advertising and need to get more from their audiences. As the bumper sticker from the Institute for Rural Journalism and Community Issues, publisher of The Rural Blog, says:

Ky. shows what happens after ACA advertising cut

Proponents of the Patient Protection and Affordable Care Act fear that the recent decision to cut advertising will hurt enrollment for 2018, but Department of Health and Human Services officials argue that the money was being spent inefficiently. It's difficult to determine the truth, but research on the state of Kentucky might offer an indicator, and a roadmap for the future of the ACA under President Trump's administration. "Kentucky provides a great test case for what happens when Obamacare transfers from a supportive administration that goes all-in on enrollment to a hostile one that cuts back on outreach," Dylan Scott reports for Vox.

In 2014, then-Gov. Steve Beshear, a Democrat, embraced the ACA and created of the country's best-working insurance exchanges, or marketplaces. State officials worked hard to encourage as many people as possible to sign up for private coverage or Medicaid; many more were newly eligible for Medicaid because of Beshear expanded it under the ACA. The result? "By the end of 2015, as Beshear's tenure came to a close, Kentucky had tied Arkansas for the biggest drop in the uninsured rate under Obamacare, from 20.4 percent to 7.5 percent in two years," Scott reports.

But in December 2015, Republican Matt Bevin was sworn in as governor. He cut off all state funding for ACA advertising, which led to a four-week enrollment with no ads. "That's where a quartet of researchers associated with the Robert Wood Johnson Foundation and the Wesleyan Media Project come in," Scott reports. "They took a look at the difference between strong outreach for the law and the bare minimum — an imperfect but still telling analogue to what Obamacare will experience nationwide this coming year."

After comparing ACA enrollment in Kentucky with ads vs. without ads, the researchers found that TV advertising was responsible for 450,000 weekly page views and 20,000 unique visitors to the exchange website, but made no notable difference in calls to the exchange's call center. In other words, Scott writes, there's empirical evidence to back up the logical assumption that less advertising leads to less engagement and less enrollment. "That's bad news for the health of the marketplaces," he writes. "Sick people are probably going to find a way to sign up for insurance no matter what. It's the healthier people, whose enrollment is essential to keeping costs down for insurers, who are more the targets of Obamacare advertising."

EPA might ban spraying of dicamba, blamed for widespread crop damage, after cut-off in 2018

The Environmental Protection Agency may ban sprayings of the herbicide dicamba after a set deadline next year, Tom Polansek and Emily Flitter report for Reuters. The deadline could be as early as the first half of 2018. After dicamba is sprayed on crops, it sometimes dries into a fine powder that is picked up and spread by the wind. This has reportedly caused damage to 3.1 million acres of soybeans this year--about 3.5 percent of U.S. plantings. Arkansas and Missouri issued temporary bans on dicamba spraying and Tennessee announced restrictions on its use because of those reports. A ban could hurt sales for Monsanto, which sells dicamba-tolerant soybean seeds as well as DuPont and BASF, which sell dicamba herbicides.

EPA officials have said that "significant changes" need to be made in rules for dicamba usage, and held at least three conference calls since July with knowledgeable regulators and experts from affected states. The big question is when the cut-off date will be. If it's early enough in the year, farmers would only be able to spray fields before soybeans sprout, protecting vulnerable crops in adjacent fields. Monsanto spokesperson Christi Dixon told Reuters that the EPA might not ban dicamba sprayings on soybeans that had already sprouted. "State regulators and university specialists from Arkansas, Missouri, Illinois, Iowa and North Dakota are pressuring the EPA to decide soon on rules guiding usage because farmers will make planting decisions for next spring over the next several months," Polansek and Flitter report.

The possible ban is not the EPA's only response to the dicamba issue. The agency has also asked state officials to consider more training for farmers who use dicamba, and has considered both tighter restrictions on dicamba use, and removing it from sale to the general public.

Tuesday, September 05, 2017

Unwinding of DACA could put unwelcome attention on 'dreamers,' especially in rural areas

President Trump's decision to unwind the Deferred Action for Childhood Arrivals program that his predecessor ordered in 2012 will resonate in many rural places, where DACA beneficiaries and their families have become integral parts of the economy and social fabric. They are likely to get more attention, some of it unwelcome, as Congress debates whether to continue the program for undocumented immigrants who were brought to the U.S. as children.

"Most were 10 years old or younger at the time of entry," the Center for Rural Affairs reported in March. "These children grew up attending the same schools, watching the same television, and living in the same neighborhoods as children who were born in the U.S. Today, the average DACA recipient is 22 years old, has a job, is pursuing higher education, and makes $17 an hour; more successful than the average American born in the country ages 20 to 24."

Sperling's Best Places map
The center, based in Nebraska, cites the town of Schuyler, where the population of 6,200 is about 70 percent Latino, many of whom work at a Cargill Inc. beef processing plant. It quotes Mayor David Reinecke: "Schuyler would be dead without Latinos." And wherever Latinos are prevalent, the DACA beneficiaries known as "dreamers" are likely to be, too.

In rural areas, they may find that life will become more difficult. Cindy Carcamo of the Los Angeles Times reports, "In rural America and places where there are very few immigrants — being a Dreamer can be very isolating, said Roberto Gonzales, a Harvard University sociologist who has been studying DACA and its recipients throughout the nation."

Gonzales told Carcamo, “In the absence of federal immigration reform states, counties and municipalities have been left to craft local solutions to a broken immigration system. . . . While mayors in cities like New York, Los Angeles, and Seattle have pledged to remain sanctuaries for undocumented immigrants, smaller rural areas will not be able to shield young people. And in less populated areas, young immigrants may be more vulnerable to apprehension and hate crimes.”

Upward mobility in rural America varies widely, and its upside has a downside: out-migration

Upward mobility is a defining tenet of the American Dream, but it may be out of reach for most people in some rural areas. And in rural areas with upward mobility, there's a downside: the upwardly mobile leave.

There is "great variation" in rates of upward mobility in rural areas, according to Eleanor Krause and Richard Reeves of the Center on Children and Families at the Brookings Institution. They published a report this month detailing their studies on social mobility, as first studied by their colleague Raj Chetty. The analysis is notable for its inclusion of the nation's most rural counties.

"Certain rural counties have some of the highest mobility rates in the country, while others are 'mobility traps,' where children born to disadvantaged circumstances are extremely unlikely to get ahead," they write in an article about the report.

Counties with the highest rates of upward mobility tend to have better K-12 education, more stable families, and stronger local job markets. Those counties also have the highest outward migration rates, especially among youth and young adults -- so much so that the outward migration is draining the local populations there. In short, the rural areas with upward mobility are losing the successful people produced there.
Brookings Institution chart; click on it for a larger version
The report lists three approaches to improving upward mobility in rural America: Improve the quality of life for kids and teenagers, make sure rural areas have broadband connectivity, and invest in family-planning initiatives so rural residents can better plan the number and timing of their pregnancies. These measures may not significantly improve rural retention of upwardly mobile populations, but the authors say the most important goal is to help young people succeed in life, wherever that may be.

Summit discusses possible solutions to growing problem of wild-horse overpopulation in West

Wild horses play near Reno, Nevada. (Reno Gazette-Journal photo by Andy Barron)
At a summit on Aug. 22-24, officials said that "swollen populations of federally protected wild horses roaming 10 Western states are starved and damaging rangelands," Michelle Price and Scott Sonner report for The Associated Press. "Members of Utah’s congressional delegation and a U.S. Interior Department official speaking at the National Horse and Burro Summit in Salt Lake City all described an unsustainable population of wild horses that’s nearly three times the size that federal officials think the rangeland can support."

Suzanne Roy with the American Wild Horse Campaign says that horse-protection advocates were not invited, and says the summit catered to agriculture interests that want to slaughter wild horses. But a wildland resources professor at Utah State University, Terry Messmer, said the summit was attended by people who care about the horses' welfare as well as Western rangeland management.

"A report by Congress’ General Accounting Office made public last week noted that the U.S. Bureau of Land Management removed nearly 135,000 horses from the range between 2000 and 2016 but the population on the range doubled and the number of horses in holding facilities increased sevenfold. The BLM asserts that U.S. rangeland can sustain fewer than 27,000 horses and burros, but there are more than 72,000 wild horses on the rangeland and about 46,000 in holding facilities," AP reports. The horses sometimes compete for resources with grazing animals owned by ranchers.

Participants in the summit were divided about the solution to the problem. Some say contraceptive vaccines will check the population humanely. Aurelia Skipworth, deputy assistant interior secretary for fish and wildlife and national parks, said euthanization is also part of the solution, and that Congress must also pass President Trump's budget request to allow wild horses to be sold without requiring buyers to guarantee the horses won't be resold for slaughter. U.S. Rep. Chris Stewart (R-Utah) said at the summit that he supports state-level management of the problem, and that euthanization is a kinder solution than food slaughter for what he calls a companion animal.

Knight News Match offers $2 million for nonprofit news outlets that raise money from small donors

The John S. and James L. Knight Foundation and the Democracy Fund are teaming up to offer $2 million in matching funds in 2017 to support nonprofit journalism, with another $750,000 pledged to help nonprofit organizations get off the ground and become sustainable. Small donors are invited to pledge donations to the nonprofit news program of their choice, and Knight will match them, up to a total of $2 million. The Knight Foundation and the Democracy Fund are seeking more partners to increase the ceiling on what they call Knight News Match.

The program raised $1.2 million in matching donations from small donors last fall, funding 57 nonprofit news organizations. To be eligible, organizations must be full members of the Institute for Nonprofit News as of September 2017.

Jennifer Preston of Knight said in a press release that journalism is "essential to building informed and engaged communities" and that nonprofit news organizations are increasingly filling the void created by deep cuts in traditional newsrooms. "In the face of the hollowing out of the traditional industry, nonprofit news sites offer a chance to restore local coverage and deliver expert beat reporting, but they require the support of their communities. Whether you can give five dollars or five hundred to the participating nonprofit news organization of your choice, News Match will double it."

Obamacare repeal unlikely for now; some in GOP want to fix it, others want to let it devolve

If Republicans still want to repeal the Patient Protection and Affordable Care Act with a simple majority, they'll need to do it by the end of September. The Senate parliamentarian ruled Sept. 1 that the Senate's 2017 budget resolution, which included instructions on repealing the ACA through the budget-reconciliation process that gets around filibusters, will expire at the end of the month.

"That means that Republican senators will either have to pass a new budget to repeal health care with a simple majority or they will have to have 60 votes a filibuster-proof majority to make changes to Obamacare," Lauren Fox reports for CNN. "The parliamentarian's decision would also mean that Congress will have to pass a new budget if it wants to overhaul the tax code using reconciliation." The Senate returns from recess today.

A repeal of the ACA would likely hurt rural areas where many residents rely on Medicaid expansion or federally subsidized individual marketplace plans for coverage. Insurers are scheduled to finalize their 2018 rates for marketplace plans today, Paige Cunningham reports for The Washington Post. Premiums for such plans could increase 20 percent if insurers don't receive subsidies from the federal government, which President Trump has threatened to withhold.

Some prominent Republicans are joining Democrats in trying to ensure that the government pays the subsidies. "A top Senate health-care committee (Health, Education, Labor and Pensions, or HELP) is bringing in five state insurance commissioners and five governors tomorrow and Thursday for two days of bipartisan hearings aimed at stabilizing the marketplaces next year. The governors include one Democrat — Colorado Gov. John Hickenlooper — and four Republicans: Massachusetts Gov. Charlie Baker, Montana Gov. Steve Bullock, Utah Gov. Gary Herbert and Tennessee Gov. Bill Haslam," Cunningham reports.

Cunningham says Senate Republicans are unlikely to try to repeal the ACA, since "all the same obstacles they faced (most significantly, how to align moderates and conservatives on an approach to Medicaid) are still present." But she thinks Republicans may simply try to starve out the ACA instead of outright repealing it, as evidenced by the Department of Health and Human Services' decision last week to slash funding for ACA advertising and helpers.

Free webinar to teach youth to stay safe from electrical accidents and falls

The National Children's Center for Rural and Agricultural Health and Safety will host a free webinar on how to prevent falls and electrical injuries among youth in agriculture. "Falls and electricity are among the most common hazards encountered in agriculture," Scott Heiberger writes in a press release.

The webinar will be hosted by Youth Agricultural Safety Specialist Marsha Salzwedel with the Children's Center. It will be ideal for school ag classes, but is also appropriate for community education events. According to the press release, "Salzwedel will explore the different types of falls experienced on farms and how to protect against them, including fall protection systems. She’ll discuss issues associated with electrical hazards and strategies to prevent injuries and fatalities when working around electricity. Salzwedel also will address 'Stand T.A.L.L.', a concept that empowers youth to 'Talk, Ask, Learn, Live', so that they adequately understand work tasks. The session will conclude with a brief overview of other free instructional materials that can be used in combination with the fall and electrical materials to create a more comprehensive agricultural safety program."

The webinar will take place from 3:30 p.m. to 4:30 p.m. CT on Sept. 13. Attendance is free but you must register here.

Sunday, September 03, 2017

Ex-coal executive nominated to head MSHA

President Trump's pick to head the federal mine-safety agency is David Zatezalo, who "repeatedly clashed with federal regulators when the Obama administration Labor Department tried to step up industry-wide enforcement in the wake of the worst U.S. coal mining disaster in a generation," Ken Ward Jr. reports for the Charleston Gazette-Mail.

The White House announced a long list of appointments Friday night that included Zatezalo to be assistant secretary of labor for mine safety and health, subject to Senate confirmation, which would make him the boss of the Mine Safety and Health Administration. It said Zatezalo retired in 2014 as chairman of Rhino Resources, where he had been president, CEO and chief operating officer.

In 2010 and 2011, "The company had a series of run-ins with MSHA over safety and health conditions at mines in West Virginia and Kentucky" when the Obama administration was strengthening enforcement following 29 deaths at a West Virginia mine. MSHA accused Rhino of a pattern of violations, "a long-unused MSHA tool for cracking down on repeat violators of safety and health standards," Ward notes. "Rhino improved and MSHA backed off, but the company’s safety performance quickly deteriorated again, prompting a second pattern of violations letter."

Meanwhile, MSHA blamed a death at a Rhino mine in Kentucky on the company’s inadequate efforts to control mine walls, and it paid $44,500 in fines. Earlier in 2011, at another Rhino mine in Kentucky, "MSHA had taken the unusual action of seeking a federal court injunction against the company when it discovered mine employees giving advance notice of an agency inspection to miners working underground," Ward writes. A judge granted a restraining order.

United Mine Workers of America President Cecil Roberts said through a spokesman, “It is my hope that Mr. Zatezalo will take the tough stance on enforcement that is needed to reign in the rising level of serious injuries and fatalities. We look forward to meeting with him and sharing ideas on how to best protect the nation’s miners and reduce the number of fatalities,” which have been rising.

The White House release said, "Zatezalo began his mining career in 1974 with Consolidation Coal Co. [now Consol Energy] as a UMWA laborer, became a foreman and subsequently general superintendent for Southern Ohio Coal Co. and General Manager of American Electric Power’s Windsor Coal Co. He later rose to be vice-president of operations of AEP’s Appalachian mining operations. Mr. Zatezalo also worked in Australia for Broken Hill Proprietary, Ltd. as a general mine manager. Mr. Zatezalo is a mining engineering graduate from West Virginia University."

National Academies say strip-mine health study is only one Interior has suspended, refuting agency

When the Interior Department suspended a National Academies of Science, Engineering and Medicine study on the possible health effects of large-scale surface coal mining in Central Appalachia, it said it was part of a review of all grants and partnerships costing more than $100,000. But the study "is the only one of eight current Interior-funded National Academies projects that has been put on even a temporary hold, according to Academies officials," Ken Ward Jr. reports for the Charleston Gazette-Mail.

"Seven other projects with funding of $100,000 or more are continuing without any such orders from the department or anyone else in the Trump administration," Ward reports. "The mountaintop-removal study, with a $1 million price tag, is the largest of the studies. The total Interior funding for the other seven is roughly $2.8 million, according to National Academies officials," who are part of a "private, non-profit institutions that provide independent, objective analysis and advice to the nation to solve complex problems and inform public policy decisions related to science, technology, and medicine," Ward notes.

Steve Gardner
The scientific journal Nature objected to the suspension of the study, calling it a rare event and noting that little research has been done in the area, partly due to opposition from the coal industry. "Coal companies funded a major effort to try to discredit the mountaintop removal health studies, targeting especially the work of Michael Hendryx, a former West Virginia University researcher who co-authored many of the peer-reviewed papers on the subject," Ward writes. "Among the coal industry critics of the research was J. Steven Gardner, a Kentucky mining engineer identified by Environment & Energy News as the front-runner" for director of the Office of Surface Mining Reclamation and Enforcement, which contracted for the study. Basing his story on "multiple sources," reporter Dylan Brown wrote, "Gardner's name has been in the rumor mill since shortly after Election Day."

Gardner "was part of a multi-company team hired to analyze the potential economic impacts of the Stream Protection Rule, the Obama administration's seven-year quest to impose new restrictions on coal-mining pollution," Brown notes. "Gardner testified before Congress that he and other team members refused to change their assumptions for calculating the rule's impact under pressure from OSMRE and were subsequently fired. OSMRE, for its part, argued that work by Gardner and his colleagues was shoddy and both sides parted ways after not renewing their contract."