Commentary says rural hospitals should regionalize adult care, like they do with maternity and infant care

As rural hospitals seek new ways to survive, a commentary in The Journal of Rural Health suggests that one new model could regionalize adult health care in much the same way it has been regionalized for perinatal care, the care given before and after the birth of a child.

Image from WFPL

"Regionalization of health care is not a new approach," note the authors of the commentary, which could spark debate about ways to save rural hospitals.

The survival of rural hospitals is a real concern. Since 2010, at least 113 rural hospitals in the U.S. have closed, according to the Cecil G. Sheps Center for Health Services Research at the University of North Carolina.

Mosby's Medical Dictionary defines health-care regionalization as "the organization of a system for the delivery of health care within a region to avoid costly duplication of services and to ensure the availability of essential services."

"It may be a critical tool for the survival of rural community hospitals," write the commentary authors, Catherine Clary and Dr. William Kanto of Augusta University in Georgia, and Nikki King and and Tim Putnam of Margaret Mary Health in Batesville, Ind., 40 miles west of Cincinnati.

They explain that perinatal regionalization, which designates hospitals according to their ability to care for mothers and infants and uses those levels to determine where they should be best cared for, has resulted in "the decline of neonatal mortality and improving other perinatal statistics."

"Just as not all perinatal services could be provided in every community hospital, today there are specialized life-saving services (such as stroke, cardiovascular and trauma) available that cannot be fully supported by every rural hospital," they write. "However in an organized system of care, treatment can be initiated in the rural hospital and patients appropriately transferred, insuring universal access to these services and improved patient outcomes."

They also argue that specialized regionalization of adult care could free rural hospitals to expand some services, allow "vibrant telehealth" consultations that could allow patients to stay in their home facility with continuing support; and, if the partnership is with an academic medical center, provide opportunities for strong continuing-education programs.

They say such a model would include systems and protocols developed by the hospitals, and a strong telemedicine component; result in a growing respect and trust among the providers in the region that would lead to improved care and patient satisfaction; and make sure transferred patients would be returned back to their local hospital as soon as medically possible. That way, "The patient’s family incurs less expense and travel time," they write.

Also, prompt transfer demonstrates the specialty hospital's confidence in the rural hospital and providers, increases the patient and clinical volume of the rural hospital, and allows for post-discharge care to be conducted by local providers, they write:"The local hospital is the nexus for the continuing care for the patient; local providers are available to answer questions about medications, rehabilitation, and follow-up care, reducing the chance for error and confusion."

They add that being able to return a patient to their home facility is easier if the rural hospital has a "swing bed program," which allows a hospital bed to be used as an acute-care bed or a skilled-nursing bed, like in an advanced nursing home.

The authors conclude, "The survival of rural hospitals is an essential component in providing health care to a rural community, and rural hospitals are integral to the economic development and future growth of the community. With adult regionalization, patients receive required tertiary care, but the community hospital is supported through its use for rehabilitation and continued wellness."

Subscribe Sunday is a social media campaign encouraging citizens to subscribe to their local newspaper; let's join it!

By Al Cross

Director and Professor

Institute for Rural Journalism and Community Issues, University of Kentucky

Today is Black Friday. Tomorrow is Small Business Saturday. Next week come Cyber Monday and Giving Tuesday. There's a gap, and you can fill it with Subscribe Sunday on Dec. 1.

Unbranded GIF is free for anyone to use

#SubscribeSunday is a social media campaign encouraging citizens to subscribe to their local newspaper or its digital equivalent. The Boston Globe came up with the idea, the New England Newspaper and Press Association is promoting it, and so is The Rural Blog and its publisher, the Institute for Rural Journalism and Community Issues.

Subscriptions are becoming the lifeblood of journalism because so much advertising has moved to the digital space. That phenomenon has finally reached rural newspapers, which have been slow to get into the digital space. But that is where the audience is going, and #SubscribeSunday could be a good way to make citizens think about where they get their information.

I keep saying "citizens" because a target audience for such appeals should be people who have a sense of civic responsibility but don't fully appreciate the role of newspapers in democracy: the chief fact-finders, the independent watchdogs, those who speak truth to power, and help a community have a conversation with itself and set the public agenda.

It's also an opportunity to remind citizens who prefer to get their news from social media that they need to consider the sources of their information. The readership of news stories is driven mainly by social-media referrals, and such readers may not appreciate the difference in those secondary and primary sources.

They need to understand the three major types of information media. News media pay for journalism, which practices a discipline of verification; we determine facts and tell you how we know them. Social media have no discipline and no verification, and are mainly about opinion, not fact. Strategic media (advertising, public relations and marketing) use the other types and sometimes masquerade as news media when they try to sell you something: a good, a service, an idea, a cause, a politician, etc.

If citizens understand these basics, they should be more likely to subscribe to their local newspaper or its digital equivalent. One pitch of #SubscribeSunday is this: "As you plan your purchases for the big holiday shopping weekend, please consider investing in a strong democracy. Support independent local journalism and subscribe to your local news organization or give a subscription as a gift. Share your purchase on social media using hashtag #SubscribeSunday."

For more information on Subscribe Sunday contact Janelle.Nanos@globe.com or Heather.Ciras@globe.com.

Retired editor says saving local news means jettisoning nostalgia, focusing on three core values of journalism

In order to save local journalism, we have to let go of nostalgia and focus on three core values, writes retired editor and newspaper-association manager Dennis Hetzel.

The first, and most important, he writes, is that you shouldn't try to choose between quality and quantity of local news; you have to have both. "Here's my hypothesis: Outlets with 'lots of local news' do better with audience growth and retention and probably financially," Hetzel writes. "Alisa Cromer of Local Media Insider has been examining the traits of successful papers. Beyond geographic and demographic advantages, she found this commonality: 'For the super-healthy newspapers, exclusive local news is more than a product; it is their superpower.'"

Dennis Hetzel

Hetzel believes publications should put a higher priority on finding the best ways to harness artificial intelligence, social media, reader submissions, staff structures, partnerships with other organizations or publications, and other strategies that generate more local content but leave reporters time to report in-depth stories.

The second core value is mentoring and training new journalists, Hetzel writes. Young reporters have a harder time finding mentors these days because reporters and editors are often stretched thin and don't have the time. Also, publications generally have smaller training and travel budgets for professional development. Young reporters are passionate about what they do, but they can be lured to other professions with higher pay and better support. So news outlets, universities, press associations and news nonprofits must do a better job of nurturing young talent.

The third core value: great visuals and smart storytelling. Audiences love great photography and multimedia, but photography budget cuts have shifted the task to reporters with smartphones. "Sometimes that's good enough, but certainly not always," Hetzel writes.

Hetzel has been a reporter, editor, general manager and publisher at newspapers in Madison, Wis.; York, Pa.; and Cincinnati. In his 13 years as editor and publisher of the York Daily Record, the paper won awards from the Scripps Howard Foundation a Robert F. Kennedy Journalism Award.

Louisville newspaper tracks huge, powerful and violent drug cartel's invasion of small towns and rural areas across U.S.

The tentacles of a huge, powerful and violent drug cartel reach from Mexico into small cities and towns, the Louisville Courier Journal reports after a nine-month investigation in several states.

The "New Generation Jalisco Cartel," known by its Spanish name Cártel Jalisco Nueva Generación and acronym CJNG, is headed by Rubén "Nemesio" Oseguera Cervantes, or "El Mencho," for whom the Drug Enforcement Administration is offering a $10 million reward.

"CJNG’s increased distribution of fentanyl across the country has helped the synthetic opioid unseat heroin as the nation’s No. 1 killer," Beth Warren writes. "The billion-dollar criminal organization has a large and disciplined army, control of extensive drug routes throughout the U.S., sophisticated money-laundering techniques and an elaborate digital terror campaign, federal drug agents say."

CJNG’s network reaches into "the mountains of Virginia, small farming towns in Iowa and Nebraska, and across the Bluegrass State" of Kentucky, Warren reports. "A cartel member even worked at Kentucky's famed Calumet Farm, home to eight Kentucky Derby and three Triple Crown winners. . . . CJNG even established a cell in south-central Virginia, buying or renting a cluster of modest homes in Axton — an unincorporated community of roughly 6,500. CJNG members have followed relatives or friends who left Mexico for the U.S. to find jobs. The cartel exploits its connections with otherwise hard-working immigrants, said Dan Dodds, who leads DEA operations in Kentucky, Tennessee and West Virginia."

Warren writes, "The cartel's expansion into smaller, unexpected communities began to mushroom about five years ago as U.S. intelligence analysts tracked its movements far beyond border towns and major hubs. Smaller towns. Smaller police forces. More unchecked opportunities. . . . In Hickory, North Carolina: CJNG used local drug dealers to move meth into the poor, addicted mountain region."

Jaeson Jones, a former Texas Department of Public Safety captain who tracked drug cartels for years, "said CJNG and other cartels often use unlikely rural areas near cities for storing and distributing drugs, away from heavy policing and nosy neighbors," Warren writes. "Houses are cheap. Backroads, plentiful. Cartels often maintain several houses in such areas: One for the local boss and his family, and another where the drugs come in and get cut up and distributed, there's another to deal with the money, and another where cartel associates live, he said."

Andrew Nester, the state prosecutor in Henry County, Virginia, told the CJ, "It’s very rural, it’s very remote. Maybe that’s the draw. Once you’re established, no one talks." But Chris Kenning reports that after "a drug task force got an informant inside in the Axton area . . .investigators saw links stretching to Winchester" in northern Virginia. The package also includes reporting from Kala Kachmar in Hickory and Lenoir, N.C.

Quick hits: Congress revives surprise billing legislation; rural and urban Dems differ on Trump impeachment

Here's a roundup of stories with rural resonance; if you do or see similar work that should be shared on The Rural Blog, email us at heather.chapman@uky.edu.

Rural and urban Democrats show starkly different opinions on a possible Trump impeachment. An interesting read before Thanksgiving dinner political conversations. Read more here.

Volunteer firefighters want to spend Thanksgiving with their families too, so here are some tips on how not to burn your house down if you deep-fry your turkey. Read more here.

After months of inaction, House and Senate committees are once again negotiating on bills to address surprise medical billing. High air ambulance bills make this particularly germane in rural areas. Read more here.

Want a dirt-cheap live Christmas tree? All you need is a hacksaw and a Bureau of Land Management Permit. Read more here. Read more here.

Federal prosecutors launch criminal investigation against manufacturers and distributors of opioid painkillers

"Federal prosecutors have opened a criminal investigation into whether pharmaceutical companies intentionally allowed opioid painkillers to flood communities, employing laws normally used to go after drug dealers, according to people familiar with the matter," Corinne Ramey reports for The Wall Street Journal. "Prosecutors are examining whether the companies violated the federal Controlled Substances Act, a statute that federal prosecutors have begun using against opioid makers and distributors this year." Under that law, companies must monitor commonly abused drugs and report suspicious orders.

The U.S. attorney for the Eastern District of New York has sent grand-jury subpoenas to at least six companies: drugmakers Teva Pharmaceutical Industries Ltd., Mallinckrodt PLC, Johnson & Johnson and Amneal Pharmaceuticals Inc.; and distributors AmerisourceBergen Corp. and McKesson Corp. All the companies have denied responsibility and said they followed all laws concerning manufacture and distribution of prescription opioids, Ramey reports.

But according to recently released Drug Enforcement Administration databases, billions of pills were distributed across the country between 2006 and 2012, with disproportionate numbers sent to rural areas struggling with opioid addiction. More than 2,600 communities, counties, and Native American tribes have alleged in federal lawsuits that the companies didn't report suspicious orders, in order to maximize profits. Most of the suits were consolidated into a few large cases, and most companies have settled out of court.

If the probe results in charges, the case could become the biggest criminal prosecution to date of drug companies for the opioid epidemic. "Executives and companies can face civil charges under the Controlled Substances Act for not reporting signs, like suspicious orders, that could indicate drugs are being used for nonmedical purposes," Ramey reports. "Criminal charges require prosecutors to prove an effort to willfully and intentionally avoid such requirements, legal experts said."

Humility key to peaceful holiday talk, policy advocate writes

As we head into Thanksgiving, Richard Nelson of Kentucky's Commonwealth Policy Center offers suggestions for peaceful conversations among "family members of differing political persuasions." The center says it advocates "values of life, marriage and fiscal responsibility," so Nelson has a religious focus, but also some thoughtful and practical advice:

"Insulating ourselves and our thoughts on important, even controversial subjects, may avoid tough conversations, but hardly garners understanding that brings us closer to our families and loved ones. . . . So how do we rise above our unhealthy tribalism that's reduced us to the sum of our political opinions?

"Start with recognizing that the crazy Republican or discontented Democrat sitting next to you is first and foremost a person endowed with dignity by the Creator. They're a person made in God's image. Believing this tempers your opinions with great humility, which drives away arrogance in a heartbeat.

"Realize that your opinions aren't everything. If you're around long enough you'll find that they change over time. Gasp! You might even be wrong! Cast away unhealthy suspicions and build your conversation upon goodwill and charity toward opponents, even if they're sitting right next to you. Especially if they're sitting right next to you.

"Adopt an attitude of gratefulness. It drives away discontent. We may be creatures with different experiences, persuasions, and markedly differing political opinions but we are creatures made to live in community. We need each other and we need to figure out how to dialogue with one another civilly and respectfully.

"This means we ought to listen carefully. Not simply thinking about the logical flaws or how to dismantle Uncle Bob's political theories. But try to understand their life experiences and worldview. Doing these things may help us to recapture the lost art of conversation."

One week out from Giving Tuesday, here are some reminders of why supporting rural journalism matters

We'll get straight to the point: the Institute for Rural Journalism and Community Issues needs your support. We work hard all year to help rural journalists all over the United States, but as a non-profit organization we rely on donations. With Giving Tuesday a week away, we ask you to begin considering how much you would like to donate to IRJCI so we can continue providing vital services to rural journalists. It's not just us asking, though:

Bill Ketter, senior vice president for news at Community Newspaper Holdings Inc., writes for us: "One of the great dangers to our democratic system is the erosion of local news sources to connect the people’s interests and concerns with the community’s welfare. The Institute for Rural Journalism and Community Issues combats this peril through its advocacy for news outlets in America’s small towns and cities. I say that from experience of working with the Institute and what it has meant to my company’s group of community newspapers."

Sheila Hagar, education reporter and columnist for the Walla Walla Union-Bulletin, writes: “We all know being a journalist in a rural area is a challenge, and not just being unable to shop for groceries incognito. Resources are limited, beats are measured by many square miles. The trainings that helps us stay current and connected are often out of reach geographically and — increasingly — financially. While there are plenty of places to see global news, The Rural Blog aggregates stories from areas like the one I report in. Not only have I gained numerous story ideas and found resources I could use, but our newspaper has benefited from reading about how similarly-sized news organizations are doing things. To have a publication that pulls in rural news every day makes me feel supported.”

Thanks for those kind words. If you value our work, please donate here.

Court bars meat industry from blocking California law that mandates better living conditions for food animals

"A federal judge in Los Angeles refused to stop California from enforcing a voter-approved measure requiring farmers to provide more space for animals being raised for food," Jonathan Stempel reports for Reuters. "U.S. District Judge Christina Snyder ruled on Friday that the North American Meat Institute, whose members include processors such as Tyson Foods and retailers including Walmart, did not deserve a preliminary injunction against enforcing the measure known as Proposition 12."

Voters approved Prop. 12 last November. The law mandates minimum amounts of living space for calves raised for veal, breeding pigs and egg-laying hens. It also bars the sale of raw veal, pork, or eggs from animals raised in spaces that don't meet that minimum requirement.

"The Meat Institute had argued that enforcement would hurt producers and consumers by increasing food costs, and violated the U.S. Constitution’s Commerce Clause by requiring out-of-state producers to comply or face the sales ban," Stempel reports. But the judge said there was no evidence the law substantially burdened interstate commerce, even if it meant less profit for producers. A Meat Institute spokesperson said the group may appeal the decision.

Acting chief of BLM says it will defer to local law officers

William Perry Pendley, acting director of the Bureau of Land Management, wrote in a recent Las Vegas Review-Journal op-ed that the agency's law enforcement personnel will defer to local law enforcement officials, Jennifer Yachnin reports for Energy & Environment News.

The op-ed is all the more relevant after President Trump recently expanded a pilot program that sends national park rangers to the U.S.-Mexico border to help stop drug trafficking and illegal immigration. The move sparked concerns that visiting park rangers might step on the toes of local law enforcement. Pendley's op-ed appears to be an attempt to allay such fears.

"The bureau is reaching out to local sheriffs to ensure that rangers recognize that, although local law enforcement bears primary responsibility for enforcing state and federal law, Rangers are there to assist — lending their expertise to better local communities," Pendley wrote. "Rangers, therefore, partner with local law enforcement, while recognizing that counties are a governmental arm of sovereign states. Maintaining that deference is essential to making BLM a truly productive and valued partner to Western communities."

Interior Department spokesperson Melissa Brown said Pendley's remarks don't signal a change in policy, but rather as a reminder of current policy. She also said the Interior is considering an overhaul of BLM's law enforcement, which now includes about 200 uniformed officers and 70 special agents who patrol 245 million acres of public lands, Yachnin reports. The scope of BLM rangers' authority has been controversial in Congress; several lawmakers have sought to overhaul or eliminate it, Yachnin reports.

Tune in today for webinar on USDA farm income forecast

Tune in at 1 p.m. ET today for a free webinar discussing the latest Farm Income Forecast, which the U.S. Department of Agriculture's Economic Research Service will release tomorrow. The forecast will be published here.

The USDA releases estimates each year in February, August and November, covering a wide range of data and predictions concerning the farming sector's economic health. ERS economist Carrie Litkowski will discuss updated data and forecasts on farm income and wealth, cash receipts, other sources of income such as government payments and insurance, production expenditures, off-farm income, and breakouts by major commodities and regions. Register here.

Feral hogs attack and kill rural Texas woman

States have become increasingly aggressive in the battle to cull feral hogs. Here’s a grim reminder why: A pack of feral hogs attacked and killed a rural Texas woman on her way to work this week, Kim Bellware reports for The Washington Post.

The victim, 59-year-old Christine Marie Rollings, was a caregiver for a senior couple in Anahuac, a town of 2,200 on the north end of Trinity Bay 50 miles east of Houston. She was scheduled to arrive at her clients' home at 6 a.m. but never showed up. One of the clients soon discovered Rollings' body between her car and the front door. The official cause of death was blood loss, Bellware reports. "In my 35 years, I will tell you it's one of the worst things I've ever seen," Chambers County Sheriff Brian Hawthorne said at a press conference Monday.

Though feral hog populations have been booming in the U.S., deaths are rare; Hawthorne said there have been fewer than six reported nationwide, Bellware reports.

After its only grocery closes, Fla. town opens its own store

Mayor Sean Lynch in Baldwin Market. (Washington Post photo by Antonia Farzan)

Baldwin had a problem. In 2018, the community's only grocery store shut down, leaving the Florida town of about 1,600 in the same county as Jacksonville with few options for fresh, local groceries. The nearest grocery was 10 miles away, and the only local options were fast food from a nearby truck stop or canned goods from the Dollar General. Since the town has a significant population of seniors and the poor, many of whom don't drive or must share a car, leaving town for food isn't usually feasible, Antonia Farzan reports for The Washington Post.

Baldwin, in Duval County (Wikipedia)

So Sean Lynch, mayor of the staunchly Republican town, proposed opening a grocery store operated by the local government. "Abandoned by mainstream supermarkets whose business models don’t have room for low profit margins, both urban and rural communities nationwide have turned to resident-owned co-ops or nonprofits to fill the gap," Farzan reports. "But Baldwin is trying something different. At the Baldwin Market, which opened its doors on Sept. 20, all of the employees are on the municipal payroll, from the butcher to the cashiers. Workers from the town’s maintenance department take breaks from cutting grass to help unload deliveries, and residents flag down the mayor when they want to request a specific type of milk."

Lynch said the city isn't trying to make a profit, but if the market is profitable, the money will go back into improving the city. A few other towns have done the same thing, with good results. "Notably, these experiments in communal ownership are taking place in deep-red parts of the country where the word 'socialism' is anathema," Farzan reports. And a collectively owned, government-run operation like Baldwin Market is socialist by definition. "But in many rural, conservative communities struggling to hang on to their remaining residents, ideological arguments about the role of government tend to be cast aside as grocery stores shutter because of population decline and competition from superstores."

Many small towns are struggling to attract new residents, and not having a grocery store can be a deal-breaker. So "food access becomes almost like a utility that you have to have for the town to exist," said David Procter, director of the Rural Grocery Initiative at Kansas State University. Lynch thinks along the same lines. "We take the water out of the ground and we pump it to your house and charge you," Lynch told Farzan. "So what’s the difference with a grocery store?"

Trump orders national-park rangers to the Mexican border

President Trump is sending rangers from some of the country's largest national parks "to the U.S.-Mexico border to help stop drug traffickers and illegal immigration," the USA Today Network reports. "The orders have come as Congress has refused to fund Trump’s border wall, the signature promise of his presidential campaign."

Parks tapped for rangers include the Great Smoky Mountains National Park, the Blue Ridge Parkway, Rocky Mountain National Park, Zion National Park and Shenandoah National Park and others. "Most rangers have been detailed to one of two border sites: Cabeza Prieta National Wildlife Refuge in Arizona and Big Bend National Park in southwest Texas," USA Today reports. The Great Smoky Mountains park "was asked to send two park rangers for two-week details at the border, but only sent one," according to a park spokeswoman.

The program began as a pilot in May 2018, "then expanded in October amid record numbers of border crossings," USA Today reports. "Park officials say they’ve been told they should continue sending rangers to the border through September 2020."

Just in time for Thanksgiving, op-ed explores the wedge politics has driven through the middle of many families

Teri Carter

Thanksgiving can be a political minefield for family members who hold vastly different opinions, but this op-ed from a rural Kentucky writer offers a note of hope about love overcoming politics.

Teri Carter, a self-described liberal feminist, hadn't spoken to her Trump-loving father in Missouri since about a month after Trump's inauguration. "He posted a Ku Klux Klan meme on his Facebook page. I demanded he take it down. He refused. I insisted. He unfriended me. Then he stopped calling. I stopped visiting. And that was that," Carter writes for The Washington Post.

But Carter drove to rural southeast Missouri earlier this month because her stepmother has late-stage chronic obstructive pulmonary disease. The visit forced Carter and her father to talk, and they were able to find common ground on many topics.

"How happy I am to be with my dad after those three lost years. And lost over what? Yet I know I am not alone," Carter writes. "How many loved ones have you stopped calling, blocked, unfollowed or unfriended? How many friends and family members do you simply avoid these days, choosing to skip your niece’s wedding or make other plans for the holidays? How many of you, like me, just stopped going home?"

Gannett-GateHouse merger spawns analysis and comment

A lot of ink has been spilled over the newly approved merger of GateHouse Media into the new Gannett Co. Inc. Here's a roundup of some interesting articles, op-eds, editorials, and general think pieces on the topic.

The company's estimates of annual cost savings from the merger have increased from about $200 million in July to upwards of $400 billion. Ken Doctor at Harvard University's NiemanLab talks about what those cutbacks could look like in local newsrooms. Read more here.

The merger could deepen America's local news crisis, writes Clara Hendrickson for the Brookings Institution. Read more here.

Marc Tracy of The New York Times gives the nuts and bolts of the merger and a decent overview of the major questions surrounding it. Read more here.

Don Seiffert of the Boston Business Journal ominously notes that more than 80 percent of the 200 dailies in the company are losing circulation faster than the national average, and 10% are declining at twice that rate or faster. Those papers could be first in line for cuts, he speculates. Read more here.

The merger is a good thing because it's a cost-effective way to keep local news alive, writes the editorial board for The Record in Stockton, California. Read more here.

Publisher James Bennett of The Daily Herald in Columbia, Tennessee, near Gannett-dominated Nashville, tries to reassure readers that the paper's focus will remain local, even though the former GateHouse paper is now owned by Gannett. He says readers will benefit from having access to Gannett content. Read more here.

Report for America helps Associated Press fund statehouse reporters in 14 states, for 18 months starting in June

News coverage of state governments, which has been declining for two decades, will get a boost in 14 states next year and in 2021 with funding to The Associated Press from Report for America, an initiative of The GroundTruth Project.

Applications for the jobs will open Dec. 2 and the journalists will begin reporting in June. They will be in Colorado, Indiana, Kansas, Michigan, Minnesota, Mississippi, Nevada, New Mexico, North Carolina, Ohio, Oregon, South Carolina and Utah. "A data journalist will support their efforts and work to bring policy journalism to all 50 states," AP reports.

“An investment in AP at the statehouse is an investment in the health of an entire state news ecosystem,” Noreen Gillespie, AP's deputy managing editor for U.S. news, said in the story. “We are pleased to be working with Report for America to ensure citizens have better and more access to information about their government at work, from budgets and policy issues to holding elected officials accountable.”

The journalists will also report on state and federal elections; issues related to voter access, vote suppression and vote security; and "break news on the impact of new administrations and changes of power at the state level," AP reports. Most states elect governors and legislators next year.

“One of the most important crises facing our democracy is the alarming shortage of local news coverage about state government, which determines much of the public policy affecting the lives of Americans,” Report for America President Steven Waldman said in the story. Charles Sennott, CEO of The GroundTruth Project, added: “Although Congress gets far more attention, state government has at least as much impact and garners far fewer headlines.”

The new reporters' work will be available to non-AP news organizations, such as nonprofit news outlets, public radio stations and independent online sites, and AP will distribute many stories produced by other Report for America journalists who are already covering statehouses.

Some rural counties can't get real local news via satellite TV

For about 870,000 American households, most of them rural, the local television news is anything but. Because they can't pick up broadcast signals from a TV station, they must rely on the network affiliate stations from their satellite TV providers, and sometimes those news stations are hundreds of miles away and have no interest in them, Grant Schulte reports for The Associated Press.

Dianne Johnson lives in western Nebraska, where the news stories on her satellite TV all come from Denver, over 200 miles away. That frustrates Johnson, who wants to know more about local and state politics, sports, and weather. "Johnson’s plight is part of a congressional dispute pitting local broadcasters against satellite television providers, who are frequently the only option for viewers in America’s most remote corners," Schulte reports.

There are two causes, AP notes: "The first is a federal law that lets satellite providers import distant broadcast signals to those 'neglected markets' at a steep discount, even though the local news subscribers see may not be relevant. The law was initially passed in 1988 to help small, fledgling satellite TV providers compete with cable companies that were viewed as monopolies at the time. It’s set to expire at the year’s end, but satellite providers are lobbying Congress to extend it for another five years."

If the law expires, satellite providers would no longer send distant news to rural viewers but would probably have to pay more to add local broadcast stations to their offerings. Local broadcasters could extend the reach of their signals to reach more rural viewers, but that would require federal approval, and the Federal Communications Commission has essentially not allowed broadcast stations to do so for nearly a decade, Schulte reports.

"The second challenge for rural viewers is a federal law that sets the boundaries for the nation’s media markets," Schulte reports. Media markets are based on a map drawn by Nielsen Media Research. Local leaders who feel their county is in the wrong media market can appeal to the FCC, but it's a complicated and time-consuming process. WYMT-TV in Hazard, Ky., has been fighting its battle for more than a decade.