Lack of affordable child care is hurting young farm families’ ability to grow their businesses; could get Farm Bill help

"The United States has a child-care crisis, yet the issue remains largely invisible in the farm sector. For too long, the nation has ignored the fact that farm parents are working parents who must juggle child care while working what can be one of the most dangerous and stressful jobs in America," write Shoshanah Inwood and Florence Becot of Ohio State for The Conversation, a platform for jouralism by academics.

But that could change, now that two farm lobbies that are often at odds are on the same page for funding child care. "For the first time in history, the two largest farm organizations, the American Farm Bureau Federation and the National Farmers Union, have included child care in their policy priorities for the 2023 federal Farm Bill," Inwood and Becot report. "As rural researchers, our conversations with policymakers suggest that there may be bipartisan support to help increase access to affordable quality rural child care as lawmakers hear from families."

Inwood and Becot report that in the last 10 years, they have done research that "debunks the three most common myths that have kept child care in the shadows of farm policy debates and points to solutions that can support farm parents." Those are: "Child care is a not a problem in the farm sector . . . Farmers don’t want or need help with child care because they have family help [and] children can just come along when doing farm work." They elaborate:

"Nationally, three-quarters of farm families with children under 18 report difficulties securing child care because of lack of affordability, availability or quality. Almost half report that having access to affordable child care is important for maintaining and growing their farm business. . . . Almost half of farmers we surveyed said their own parents were too busy to help with child care, had died or were in declining health. . . . While wonderful places to grow up, farms can be dangerous, with large equipment, electric fencing, large animals, ponds and other potential hazards. Every day, 33 children are seriously injured in agricultural-related incidents, and every three days a child dies on a farm. Farm parents we spoke with recounted stories of children who died after falling out of a tractor, drowned when they fell into a pond, or were maimed by a cow. Almost all farm parents – 97% – have worried that their children could get hurt on the farm."

Farmers have mentioned many solutions, Inwood and Becot report: "free or affordable quality child care, before- and after-school programs, better parental leave policies for wage and self-employed workers, financial support for safe play areas on the farm, college debt relief, free college tuition and more affordable health insurance."

What's a community development financial institution? Knowing the answer could be key to a community's progress

The main obstacle to economic development in many rural areas is a shortage of capital for investment. One source of capital can be a community development financial instiution, one of the most important sources of venture capital in poor places. They invest federal and private-sector money in start-ups and other projects in economically disadvantaged communities.

The U.S. has more than 1,000 CDFIs, but “I don’t think they’re very well understood,” said Betsy Whaley, chief strategy officer the Mountain Association, a CDFI for Appalachian Kentucky. “Most projects couldn’t be funded by a traditional bank; banks won’t fund start-ups; they just won’t.”

The role of CDFIs in fighting rural poverty is being explored in a series of articles in Nonprofit Quarterly, co-produced by Partners for Rural Transformation, a coalition of six regional CDFIs in Appalachia, the rural West, Indian Country, South Texas, and the Mississippi Delta.

"CDFIs strengthen local economies, generate wealth that sticks, and foster agency and power among local people to determine their destinies. This is true in urban areas and, critically, rural communities," writes PRT President Jose Quinonez, who offers examples, starting with this one:

"In 2018, a nurse practitioner with over a decade’s experience opened an urgent care facility in her hometown of Clarksdale, Miss. When committing to opening the clinic, she was ready to invest her savings to open the facility, but she had no idea it would be so difficult to obtain the rest of the necessary financing. She had a strong business plan and the medical skills to succeed, but still faced difficulties getting banks or state agencies to back her. When she finally got a loan approved, the loan conditions included putting a second mortgage on her home, which she agreed to do. But home values in Clarksdale were so low that her house fell short of the minimum appraisal value, and the loan fell through. This is where Communities Unlimited stepped in, providing a small loan and technical assistance. Now, the urgent care center employs nine people and pays good wages in a community with low incomes and high unemployment. Moreover, the business provides critical services to an area with few health-care options."

ABC News spent a year in Uvalde, Texas, after the school shooting; its report is on the air tonight and Hulu tomorrow

Nicco Quiñones of ABC News films inside the home of Jerry and Veronica Mata. Their daughter Tess, pictured on the wall, was one of 19 students shot and killed in Uvalde, Texas, last May. (Photo by Jenny Wagnon Courts/ABC News via AP)

By David Bauder
Associated Press

After most mass shootings that capture the public’s attention, national news organizations will send reporters for a few days, a week maybe, before moving on. There’s always another community, another tragedy.

ABC News tried something different after 19 elementary school students and two teachers were shot and killed in Uvalde, Texas, last May. The journalists stayed.

For a year, ABC kept a team in Uvalde. The result is a nuanced portrait of what happens over time to a suffering community, as seen in the two-hour documentary, “It Happened Here — A Year in Uvalde,” that airs Friday on ABC and Saturday on Hulu.

“What we discovered has been profoundly moving and inspiring and, we hope, useful,” said ABC News President Kim Godwin.

The story’s richness is in the details: There are the children’s rooms left undisturbed since May 24, 2022, the brush a parent can’t give up because it contains a dead girl’s hair, the survivor made upset by the sound of a block of ice being cracked, and the once-carefree boy who worries a lot. And we see a father who sits at his daughter’s grave each night to talk to her.

There are those who lived but deal every day with survivor’s guilt, and there’s the mother who torments herself for not letting her daughter come home with her after a morning awards assembly.

Uvalde County (Wikipedia map)

ABC’s idea was born out of a desire to bring something new to stories that have taken on a numbing familiarity. “I don’t think that any community should be defined by a tragedy that befalls it,” said Cindy Galli, executive producer of ABC’s investigative unit.

A core team of about a dozen people were assigned to the project, a significant commitment at a time when ABC News, like many other news organizations, is cutting staff. The team, with reporters John Quiñones, Maria Elena Salinas and Mireya Villarreal, rotated in and out depending on other assignments.

The project enabled the journalists to get to know community members and build trust by talking to them without cameras running all the time, she said.

“One of the aspects of being in a small community is that we would run into people at Starbucks or the grocery store,” Galli said. “They knew that we were there and knew that we were there for the long haul.”

That was important to families dealing with their grief, said Kimberly Rubio, whose daughter Lexi was killed in the attack. Rubio was featured in a segment early in the film, talking about how she uses time spent jogging to reflect upon what happened to her daughter.

“It also helped that it wasn’t different reporters all the time,” Rubio said. “I had two that I worked with. It made it much easier for me to be vulnerable.”

The ABC team filed more than 200 stories during its time in Uvalde, Galli said. Their presence enabled them to break news, such as when Quinones got the first interview with a woman falsely accused of leaving a door open at the school that the killer used for access.

Questions about why it took police more than an hour to enter the affected classrooms kept Uvalde in headlines longer than most mass shootings. ABC’s access deepened the documentary’s narrative retelling of the story, with recordings of a chilling 911 call from a trapped girl pleading for a police response to the gunman.

“I had a pencil,” said Arnie Reyes, a teacher injured that day whose recovery is followed by ABC. “It’s not the same battle.”

The documentary talks about tensions in Uvalde between affected parents and people who supported school administrators and police. That aspect of the story points out a hole in the ABC team’s reporting, although it’s not necessarily their fault: The network had trouble getting people in law enforcement and their supporters to talk.

Lexi’s dad, Felix Rubio, eventually resigned his job as a deputy police officer, explaining that he couldn’t go back to work with people who didn’t rush into the school to try and save the children.

The film also traces the growing activism of Kimberly Rubio and 10-year-old Caitlyne Gonzales in seeking legislation to prevent future school shootings.

John Quiñones (ABC News photo)

“There are vital details, nuances that are missed, when we as reporters parachute in and out” of a story, Quinones said.

The extended assignment meshed with how Quiñones likes to report such stories. He doesn’t see the point of reporters trying to force themselves on people when they don’t want to talk. There were times when he had to step away, like when a family he’d been talking to learned that their child might have survived if police had moved more quickly.

The entire experience was eye-opening for the network, Galli said. Following the Uvalde team’s lead, an ABC digital team is spending time in Buffalo, where 10 people were killed in a mass shooting, also in May 2022.

Quiñones, a Mexican American who grew up in nearby San Antonio, said the extended Uvalde assignment has been the most powerful story he’s ever been involved in.

“There’s no doubt in my mind that this is the kind of story that will live with me forever,” he said.

Quick hits: Electric co-op leader says broadband is key to rural jobs; how do you pronounce Appalachia? 'Apple-atcha!'

The Department of Agriculture announced Wednesday $11 billion in grant and loan opportunities to help rural communities access clean, reliable, affordable electricity, calling it "the single largest investment in rural electrification since the 1936 Rural Electrification Act." One program has $9.7 billion for renewable energy, zero-emission and carbon-capture systems. Another program has $1 billion in partially forgivable loans to renewable-energy developers and electric service providers for wind, solar, hydropower, geothermal, biomass and renewable energy storage projects.

An Illinois rural electric cooperative official told the Senate Agriculture Committee's Subcommittee on Rural Development and Energy Wednesday that broadband is the key to rural economic development. Jesse Shekleton, director of broadband operations at Jo-Carroll Energy, said federal broadband subsidies should flexible and “future-proof. . . . Consumer demands and needs for increased internet speeds continue to grow and are trending toward a need for multi-gigabit service by 2030.” 

How do you pronounce "Appalachia?" In Appalachia, Va., they say "Apple-atcha," and Kentucky teacher Willie Carver not only agrees, he provides a historical and linguistic basis for it: The region was named for the Apalachee, an indigenous people who lived in the Florida panhandle: "The first part of the word, appala, most likely means 'on the side' or 'by the water/river/sea.' . . . The chee part of the word most likely means 'people'." Read more on 100 Days in Appalachia.

Applications are due by June 1 for the Appalachian Regional Commission's Applachian Leadership Institute, a free economic-development training opportunity for Appalachia's public, private, and nonprofit leaders. If you live or work in Appalachia and are passionate about helping Appalachian communities thrive, learn more here.

"In rural areas, many property owners must build and maintain their own systems for drawing from groundwater for household use. Wells are a huge investment we rely on every day. But how much do you know about yours?" asks The Daily Yonder, where Donna Kallner answers.

Iowa editor reminds pork producers: 'The customer comes first' and Calif. voters say sows need room to turn around

By Art Cullen
Storm Lake (Iowa) Times Pilot

The U.S. Supreme Court cut sows some slack last week, which caused a lot of squealing around Iowa where we forget that the customer comes first.

The high court on a 5-4 vote last Thursday upheld Proposition 12, a 2018 California ballot initiative that drew 63% voter support, demanding that gestating sows be allowed room to turn around. Prop. 12 also called for cage-free poultry production and more space for veal calves.

The lawsuit was brought by the American Farm Bureau Federation and the National Pork Producers Council of Ankeny. They said they would evaluate their next steps.

Next steps should be getting with the program and responding to consumer concerns. . . . The poultry industry largely adapted to cage-free production years ago when McDonald’s demanded it based on consumer preference. The pork industry failed to heed the warnings and chose instead to fight the will of the people of California.

Art Cullen

Iowa is the leading purveyor of pork in the giant California market. The pork complex generally claims the costs of 24-foot gestation stalls will be catastrophic. Meatpackers were somewhat restrained. Hormel, for one, reported that complying with California production standards will have no material effect on the company’s bottom line. Tyson said it will comply.

The California electorate is not 63% liberal. It is a bellwether because of the sheer size of the Golden State economy. Voters were well aware potentially higher pork costs, and they were equally cognizant of threats to animal and human health from piling more livestock on top of more livestock.

Iowans are similarly aware, consistently voting for cleaner water while being rebuffed by legislators and agri-industry. The legislature continues to pass "ag gag" laws because they don’t like the picture of hogs jammed into confinement. They know what their nose tells them — that this is about enough, already. Yet more hogs keep coming.

The court’s ruling will require retrofitting of old sow facilities and will reduce throughput at the margins. It will not put swine feeders on the rocks. It will force the industry to change with consumer demand. We were told that we needed consistent, lean hogs of a certain structure because of consumer taste, when in fact it was to standardize the carcass for more efficient processing.

This is real consumer action at the ballot box. The court challenges the notion that the livestock industry can sneer at regulations and rationalize its excesses.

Not a single independent pork producer will be affected. Whatever is left of them. They did not depend on locking a sow down. They performed husbandry in the farrowing house. That costs more. Lord forbid that a producer with 30 sows might gain a foothold. . . .

Eventually, when the industry gets off its arrogance hangover, it will figure out that the customer is always right. Or, at least, that the Supreme Court has ruled. Let’s get on with raising hogs the way our customers actually want.

EPA moves to regulate inactive coal-ash landfills, most which are unlined and thus are more likely to leak or fail

Adapted screenshot of Earthjustice interactive map of coal-ash landfills, by status; for a larger version, click on it

The Environmental Protection Agency "is moving to close a loophole that had exempted hundreds of inactive coal-ash landfills from rules designed to prevent heavy metals like mercury and arsenic from seeping into groundwater," reports Lisa Friedman of The New York Times.

The ash from coal-burning power plants contains lead, lithium, mercury and other toxic metals that "can pollute waterways and drinking water supplies and have been linked to health effects, including cancer, birth defects and developmental delays in children," Friedman notes. EPA Administrator Michael Regan "said the rule would help to protect low-income communities of color, where the overwhelming number of old landfills are located." Many are in rural areas.

The proposal is part of a settlement between EPA and environmental groups. It "would require those responsible for the coal ash to monitor groundwater supplies and clean up any contamination from the landfills," Friendman writes. "About half of all the coal ash in the United States — more than a billion tons, according to one study — has gone unregulated. The new rule is expected to face opposition from utilities and fossil-fuel supporters in Congress."

The Tennessee coal-ash disaster (Photo by Wayde Payne, AP)

The first federal regulations were spurred by the 2008 failure of a coal-ash pond at the Tennessee Valley Authority's coal-fired plant at Kingston, Tenn., "one of the largest industrial disasters in U.S. history," Friedman notes. "Landfills that stopped receiving ash before October 2015 were exempt from the rules." Those inactive landfills, most of which are not monitored, are more likely to be unlined and thus more of a threat, EPA said.

Feds want to allow leasing of federal land for conservation; critics call it a back-door attack on grazing, mining, drilling

Cattle graze along a section of the Missouri River in the Upper Missouri River Breaks National Monument near Fort Benton, Montana. Much federal land in the West is used for grazing. (Photo by Matthew Brown, The Associated Press)

The Biden administration's plan to sell leases of federal land for conservation, just like it does for "oil drilling, livestock grazing and other interests," has drawn "pushback from Republicans and ranchers," reports Matthew Brown of The Associated Press. 

"The proposal is stirring debate over the best use of public land, primarily in the West," Brown writes. "Opponents . . . are blasting it as a backdoor way to exclude mining, energy development and agriculture. Tracy Stone-Manning, director of the Bureau of Land Management, said the proposed changes address rising pressure from climate change and development. She said it would make conservation an 'equal' to grazing, drilling and other uses while not interfering with them."

The bureau, part of the Interior Department, "has a history of industry-friendly policies for the 380,000 square miles it oversees, an area more than twice the size of California," Brown writes. "Those holdings put the agency at the center of arguments over how much development should be allowed." At the first virtual public meeting about the proposal, "There was no opportunity for public comment, and the agency screened questions . . . Officials acknowledged receiving numerous queries about grazing and drilling potentially being excluded. Brian St. George, acting assistant director for the bureau, said the conservation leases would not 'lock up land in perpetuity'."

Stone-Manning said conservation-leased property could still be used for hunting or recreation. "Democratic U.S. Sen. Catherine Cortez Masto of Nevada — where the federal land bureau controls about two-thirds of the land — urged the administration to work with ranchers and farmers before finalizing the proposal."

Online forum Tue. will examine what can be done to spur higher education in rural areas that have few colleges

More than 10 million U.S. adults live in an area that does not have any public institution of higher education within a one-hour drive, "which poses an incredible challenge for prospective students," says the Chronicle of Higher Education, which asks: "What can be done to help students in these places achieve an education?"

To answer the question, the Chronicle is holding an online forum, “Education Deserts: Supporting Rural Regions With Few Colleges,” at 2 p.m. ET Tuesday, May 23, to explore ways to expanding educational opportunities in what it calls "education deserts." To register, click here.

The speakers will be Laura Beamer, lead researcher on higher-education finance at the Jain Family Institute; Andrew Koricich, executive director of the Alliance for Research on Regional Colleges and  associate professor of higher education at Appalachian State University in Boone, N.C.; and Alyssa Ratledge, a research associate in postsecondary education at MDRC (formelry the Manpower Demonstration Research Corp.). Chronicle senior reporter Eric Kelderman will host.

Review of award-winning Demon Copperhead by a survivor of the opioid epidemic helps explain it, and Appalachia

Described by Appalachian journalist-author Beth Macy as "a voice for the ages—akin to Huck Finn or Holden Caulfield—only even more resilient," the voice of Demon Copperhead could become an classic look at a slice of Appalachian life and spirit. It won this year's Pulitzer Prize for fiction, Appalachia's first since James Agee's A Death in the Family in 1958, and has received accolades from The New York Times, Oprah's Book Club and The Washington Post. Although impressive, those praises lack the depth and personal perspective of a review by Appalachian Jessica Miller, writing for Youth Communication, a nonprofit publisher of teen-written stories and curricula to help educators strengthen youth's social and emotional skills. Here's an edited verrsion:

By Jessica Miller

Barbara Kingsolver

Barbara Kingsolver dedicates her Pulitzer Prize–winning novel Demon Copperhead to survivors of the opioid crisis and foster care. It wouldn't be an exaggeration to say that the book is dedicated to me: I am an Appalachian who was put in foster care thanks to, in part, my father's opioid addiction.

Reading the novel, I felt vindicated and relieved that the author voiced all the things I want to explain to people who don't understand where I come from. Transforming Charles Dickens's novel David Copperfield and its explorations of institutional poverty in Victorian England into a saga set in the beginning days of Appalachia's opioid epidemic, Kingsolver compassionately shows how exploitative industries—like logging and coal mining, big-box retailers like Walmart, and pharmaceutical companies like Purdue Pharma—have taken advantage of Appalachia for the sake of profit. The resulting opioid epidemic and poverty in the region have led to a child welfare crisis: Kentucky, my home state, had 8,863 youth in care in 2022, up 27 percent from 2012.

In the novel, the main character, Demon, is put into foster care because of his mother's addiction. His foster parents expect him to "pay his way"—either using his foster care stipend as family income or forcing him to work on farms and junkyards. In one house, he suffers from nicotine poisoning when he is forced to harvest tobacco crops. In another, a barely fed Demon is made to sleep on an undersized air mattress in a dirty laundry room. . . . Ultimately, Demon suffers from addiction himself. . . .  Kingsolver discusses not only the myriad ways people become addicted to opioids but also what opioids can do to a person—from constipation to prostitution.

Demon laments that "God made us the butt of the joke universe," but this is a situation both Demon and Appalachian people at large contend with through humor of our own. . . . That's also part of the reason, I think, Kingsolver emphasizes the colorful nicknames we rednecks end up calling each other: They're life-affirming. Hotmail Cox, Rat Hole, Cow Pen, and Snotty Nose are some nicknames from my family and friends. Kingsolver similarly bestows goofy nicknames on her characters, such as Fast Forward and Maggot. We may be a gaggle of people largely invisible to the outside world, but our nicknames assert that we are someone to our community, even if we—and our names—don't make much sense to anyone but ourselves.

It was a treat to read . . . because the adequate representation of Appalachian people is hard to come by. Appalachian people are portrayed as being crazy, stupid, and dangerous. Being the "dog of America," as Kingsolver puts it, has real consequences: Appalachian communities have been continually exploited and discriminated against. Once, while I was meeting a board member for one of my scholarships, he told me an unfunny joke about incest in Eastern Kentucky [which has no higher prevalance of reported incest than the rest of the nation]. It was frightening to know that I could have been denied a scholarship I desperately needed just because he has negative views about the Appalachian end of the state.

Dickens didn't write David Copperfield with Victorian England's most underprivileged audience in mind; they probably couldn't afford to buy the novel, even if they were literate and had enough free time to read it. . . . The wisdom of the book isn't meant for me. Many of the realities Kingsolver lays bare are ones I've already lived through. . . . Its power lies in Kingsolver's impressive ability to craft Demon's realistic interior and share it with readers who wouldn't otherwise have his firsthand experience.

My favorite part of the book is when Demon muses, at his biological mother's funeral, that people tend to withhold sympathy from those who are struggling in an attempt to build "a wall to keep out the bad luck." It can be difficult for people to recognize that their socioeconomic comfort is basically just a product of "luck"—the cards they were dealt at birth. Instead of acknowledging that the house always wins and that the game is always rigged, they imagine that they're winning the game of life by their own virtue and skill, or at least that the difference between winners and losers is fundamental and justifiable. Demon Copperhead allows readers to see a side of the wall they otherwise might not. More than that, it urges readers to tear down that wall, to stop "building the wall with [themselves] still on the lucky side." For 550 wild and wonderful pages, Demon's Western Virginian reality is your reality.

Feds try to head off the newest big danger in illicit drugs; xylazine is cheap and causes rotting flesh wounds

Xylazine is legal only as a sedative for animals.
(Photo by Derek Montgomery, The Washington Post; click to enlarge)

Pain pills, heroin, synthetic opioids, fentanyl--what else can drug mixers cut into illegal drugs? Xylazine, that's what. It's a central-nervous-system depressant that is often mixed with fentanyl and can cause a deep stupor, reports Caroline Anders of The Washington Post: "It's known to cause rotting flesh wounds that, left untreated, can lead to amputations." Worsem it's a drug seller's dream: "It's extremely inexpensive, allowing sellers to extend their stores of heroin and fentanyl even further, and some users say it extends the sedative and euphoric effects of the opioids," Anders reports.

Xylazine is FDA-approved for veterinary use; its illegal use began to be noticed in the early 2000s, but "then became rampant in Philadelphia, and is now spreading across the United States. The Drug Enforcement Administration said the sedative was present in 23 percent of fentanyl powder and 7 percent of pills it seized in 2022," Anders writes. "Over 3,000 people died of xylazine-related overdoses in 2021 — triple the fatalities recorded the year before. But, importantly, those overdoses were all from mixtures of xylazine and opioids like fentanyl or heroin. . . . It's unclear exactly how xylazine interacts with opioids, though researchers are looking into the question."

"Last month, the Biden administration designated xylazine mixed into fentanyl as an emerging threat . . . . trying to prioritize federal resources to address the drug from the supply and demand side, both boosting testing and treatment and restricting the illegal supply of the tranquilizer," Anders reports. "In March, lawmakers also introduced bipartisan legislation that would classify the drug as a controlled substance." Rahul Gupta, director of the White House Office of National Drug Control Policy, told Anders that one of the key lessons the government learned from the fentanyl crisis is that "this two-pronged approach is crucial," Anders reports. "He said focusing only on how to cut off the drug supply is futile." Gupta told her, "If we do not address the unmet treatment needs for people with addiction, we will continue to suffer the same fate."

The government's move to criminalize xylazine hasn't made everyone happy. "Harm-reduction advocates argue the government is heading down the wrong path ... saying that the approach will just lead manufacturers and dealers to come up with new, potentially more dangerous substances to cut into their supply," Anders writes. "In the coming months and years, the administration's plan to tackle the crisis from multiple sides will be tested. But regardless of its effectiveness, experts say there will always be a new emerging threat." Mary Sylla of the National Harm Reduction Coalition, told Anders, "It's literally like whack-a-mole, right? We try to stop this here, and then something else pops up."

Rural women have high death rates from cancer; sending them interactive DVDs increased screeing rates, study finds

Photo by Angiola Harry, Unsplash

Still using DVDs? You're not the only one. Some cancer researchers have discovered the medium can be an excellent rural outreach tool. They sent tailored, interactive DVDs to women in rural Ohio and Indiana "to educate and remind them to be screened for breast, cervical and colorectal cancers — three cancers that account for 40% of new cancer cases and a quarter of cancer deaths among U.S. women each year, according to the Centers for Disease Control and Prevention," reports Nada Hassanein of USA Today. "Timely screenings are important to catch disease at an earlier stage, but rural women have lower rates of screening for all three of those cancers. In the study, "Women who received a DVD were nearly twice as likely to obtain all the screenings compared to women. And those who were also paired with a patient navigator by phone had a six-fold greater chance of getting a screening, according to the study by researchers from Ohio State University and the state."

Connecting medical education and treatment with rural residents required an intentional, unique approach. The study, published in the American Medical Association's JAMA Network Open, involved 960 women, ages 50 to 74, who were not up-to-date on screenings. DVDs were used because "Many rural residents still lack broadband, which hinders telehealth services," Hassanein reports. The DVDs "provided information to patients about risk, age group, family history and the benefits of screening, said study coauthor Electra Paskett, a cancer epidemiology professor." The study used as navigators social workers who called the women to help set up screenings and find assistance to navigate barriers like transportation.

Paskett told Hassanein, "The question still is access: Not only broadband access, internet access, but access to a computer or a smartphone, which is not universal." Hassaneon writes, "Tailored approaches can really move the needle in helping patients get screened, as seen throughout the pandemic with community-level vaccination campaigns, Paskett said."

Cancer kills a disproportionate share of rural women. "More than half — 58% — of the rural aging population 65 and older are women," Hassanein reports. "While cancer rates are slightly lower in rural areas compared to urban, cancer-related deaths are significantly higher — 180 deaths per 100,000 compared to 158 in urban areas, the CDC reports."

Screening is only a start. Robin Yabroff, an American Cancer Society scientist, told Hassanein, "It's also important to make sure that they maintain that cancer screening – that if they do have an abnormal screening test, that they get timely follow up. It's a part of the bigger process. Not only is regular screening important, but should someone be diagnosed with cancer, making sure they have access to timely and high-quality cancer care.”

To get more teachers, some states try a new mode of training them: apprenticeships, to earn while they learn

Lina Horton earned a bachelor’s degree without spending a dime
on tuition. (Photo by William DeShazer, The Washington Post)

Using apprenticeships to train workers began in the Middle Ages, but what is old can be made new again; states are using the model to train new teachers, reports Moriah Balingit of The Washington Post. Balingit met with a once aspiring educator, Lina Horton, who gave up her dream of teaching because of the cost of college and the need for a paycheck. "Horton is part of a grand experiment to see what happens when the apprenticeship model — used to train generations of plumbers, electricians and carpenters — is applied to teaching, allowing trainees to earn money while they learn their craft and earn their credentials. In exchange, many of the programs require graduates to commit to a certain number of years of service in high-needs schools."

The country's severe teacher shortage is worst in rural and poorer places, "forcing some schools to pare down classes, hire unqualified adults or put students in self-guided online courses," Balingit notes. "Teachers matter more for student achievement than any other aspect of schooling and can influence whether a child graduates high school, attends college and earns more as an adult. Interest in teaching is plummeting; a decline chalked up to low pay and deteriorating work conditions. . . . . But the popularity of the apprenticeship programs suggests there is an untapped talent pool: people who have the desire and the heart — but not the financial means — to become a teacher. . . . Teaching apprenticeships are getting a major boost from the Labor Department, which last year began offering them federal certification, a distinction that gives them access to millions in job-training funds. Over the last 17 months, programs in 16 states have been certified, including some poised to take on hundreds of trainees. . . . While debates rage over transgender student rights and the teaching of race and U.S. history, teacher apprenticeships are a rare education policy initiative that have bipartisan support."

The college-based apprenticeships, which lead to a degree, also have the added benefit of helping schools diversify their teaching staff. "By intentionally recruiting local candidates, districts have been able to build teaching candidate pools that better reflect the demographics of the community," Balingit adds. "They have also had success recruiting from the ranks of teacher assistants, who are more diverse than teachers. Tabitha Grossman of the National Center for Teacher Residencies said removing financial barriers has been key in recruiting more teachers of color."

Churches donated to candidates with conservative agendas; town rejected their picks; donations are under investigation

Campaign signs outside polling location at Willis Church of
Christ in Abilene, Texas. (Photo by Johnathan Johnson, ProPublica)

The issue of local churches' involvement in elections, often present but rarely highlighted, has come to the forefront in Abilene, Texas, Jessica Priest of ProPublica reports. While the Internal Revenue Service has consistently looked away from churches donating or even sermonizing in support of candidates, some in this city of 125,000 did not. "Voters in West Texas decisively rejected three conservative Christian candidates who campaigned on infusing religious values into local decision making. . . . But the support the candidates received from local churches during the race has prompted calls for state and federal investigations and triggered a local political reckoning," Priest reports. Weldon Hurt, who was elected mayor over one of the candidates, told Priest, "I think there should definitely be some penalties. . . . I think there has to be a way to curtail this from happening again. . . . I think there should be some discipline to these churches."

ProPublica and The Texas Tribune reported a day before the May 6 election that "three churches had donated a total of $800 to the campaign of Scott Beard, a pastor who was running for City Council," Proest writes. The donations violate The Johnson Amendment, a measure named after its author, former president Lyndon B. Johnson, when he was Senate majority leader, which prohibits nonprofits from intervening in political campaigns. "Beard, a senior pastor at Fountaingate Fellowship, said the donations were a mistake and that he would be returning the money. But within days after Beard's defeat to retired Air Force Col. Brian Yates, a national group that espouses the separation of church and state demanded that the IRS revoke the churches' tax exemptions."

Among the three conservatives who lost "touted their involvement in an effort to get abortion outlawed in Abilene. . . . . And all three candidates spoke about the need to prohibit family-friendly drag shows within the city limits and establish community standards. . .   [to] protect children. Beard said in interviews that those standards should be based on 'Judeo-Christian principles' that he believes serve as the nation’s foundation," Priest reports. "Yates, Beard’s opponent, said it was overly simplistic to cast the election as a fight between religious conservatives and fiscal ones. He said he too is a Christian who opposes abortion. A key difference, he said, was that he and his allies don’t believe that establishing community standards is the role of government. . . . .The local Republican Party endorsed Beard. . . In the end, the three candidates each lost by at least 29 percentage points, according to unofficial final results."

While Beard's Johnson Amendment violations may go unchecked -- there is only one publicly known example of the IRS revoking a church's tax exemption -- "The church donations may also violate Texas election law, which prohibits both nonprofit and for-profit corporations from making political contributions to candidates or political committees," Priest notes. "The Texas Ethics Commission is charged with investigating such violations and can assess a civil penalty of up to $5,000 or triple the amount at issue, whichever is greater, said J.R. Johnson, the commission's executive director. . . . Violations are considered third-degree felonies. Beard has had at least two pending state ethics complaints filed against his campaign."

Mountain Valley Pipeline gets key green-light decision, pleasing Sen. Joe Manchin, but more court action is in store

Pipes for the Mountain Valley Pipeline on Brush Mountain near
Blacksburg, Va. (Photo by Melissa Golden, The New York Times)

The Biden administration has again "granted a crucial permit for the Mountain Valley Pipeline, a project championed by U.S. Sen. Joe Manchin III of West Virginia," reports Lisa Friedman of The New York Times. The Forest Service's decision would allow the pipeline "to run through 3.5 miles of Jefferson National Forest, which straddles West Virginia and Virginia." The pipeline is "intended to carry gas about 300 miles from the Marcellus shale fields in West Virginia across nearly 1,000 streams and wetlands before ending in Virginia. It also delivers a significant victory to Manchin, a Democrat who strongly supports fossil fuels and who faces a potentially difficult re-election campaign next year. . . . Some are interpreting the approval as the administration's attempt to placate Manchin, who in recent weeks has railed against what he calls the Biden administration's 'radical climate agenda.'"

The administration has been repositioning some environmental policies, which disappoint environmentalists and scientists, but the president is working to straddle several camps. Friedman reports, "Biden needs Manchin, as well as moderate Republicans, to achieve his goals. They are considered key to passing legislation that the White House says is critical for speeding the construction of new wind, solar and other renewable energy projects. . . . Biden has taken steps to bolster fossil fuels and placate centrists while also trying to deflect Republican criticism that his climate policies are harming American energy security. His administration approved the enormous Willow oil project in Alaska and increased exports of liquefied natural gas from Alaska. Both projects were supported by Manchin and Sen. Lisa Murkowski, an Alaska Republican who is also an important swing vote for  Biden."

While the permitting decision is important, "The Mountain Valley Pipeline is not a done deal" because of court action, Friedman notes. A lawsuit is challenging the Fish and Wildlife Service's decision in favor of the pipeline," and more suits are expected. Also, "The Bureau of Land Management, which is responsible for approving pipelines that cross state lines, must decide whether to issue required permits."

Lawsuits warn of environmental damage. "Last year the U.S. Court of Appeals for the 4th Circuit ruled that the government's environmental reviews had 'inadequately' considered the impacts of erosion, among other issues. . . . The national forest is home to five protected species, including the endangered candy darter, a colorful freshwater fish, as well as old-growth forest. . . . Jessica Sims, Virginia Field Coordinator for Appalachian Voices, an environmental group that opposes the pipeline, said the Biden administration decision "'grossly underestimates the lasting environmental harms from the project.'"

Postal Service's new rural letter-carrier scheduling system is causing pay cuts; one carrier says they're 'pretty scared'

Photo by Yannik Mika, Unsplash

"Thousands of letter carriers at the U.S. Postal Service are starting to see new schedules that have reduced their hours and cut their pay," reports Eric Katz of Government Executive. "The changes are part of a revamping of the pay structure for rural employees, named the Route Evaluated Compensation System, which is a process that has been years in the making and subject to a series of delays. The new work schedules were slated to go into effect last month but were repeatedly pushed back as the United States Postal Service sought to iron out kinks." They took effect May 6.

For rural letter carriers, the roll-out of RECS was expected, but the information the USPS gave them was inconsistent. David Dayen of The American Prospect reported: "Two years ago, as RECS was getting finalized, workers were told that most carriers would see modest changes at most. . . . But losing four hours a week can translate into an annual salary cut of $8,000, according to letter carriers who spoke on condition of anonymity. . . . the National Rural Letter Carriers' Association union said it was working to resolve disputes over implementation." NRLCA :has filed a national grievance on the plan, saying USPS has withheld details on the data that underlies the new hour and pay calculations," Katz reports.

According to a union estimate, "about 66% of rural letter carriers are now seeing their pay reduced," Katz writes. "David Rodriguez, a rural letter carrier, said his post office employs 12 mail men and women, and 11 of them have lost hours under the new system. Some employees had their hours reduced so severely they will only be conducting auxiliary routes, which further reduces pay. He told Katz, "It's hurting a lot of us. We're all pretty scared." Katz reports, "Postmaster General Louis DeJoy recently told reporters the decision predated him, and the matter was out of his hands." Dejoy said: "That was a negotiated process, an arbitrated process. That was done a long time before I got here. And it's, you know, it's unfortunate, but, I mean, it is what it is, and I didn't decide it."

Rural letter carriers are not paid hourly like city carriers. "USPS has historically conducted occasional hand counts of the mail to determine the hours and pay for employees in rural locations, but the 2012 arbitration decision upended that process," Katz explains. "The rural letter carriers union and postal management worked for years on developing the electronic replacement before finally deploying it last year. Several letter carriers who spoke to Government Executive said they received little training on how to properly log their work and criticized management for a lack of transparency."

Small Town and Rural Students College Network creates pathways for rural students to institutions seeking diversity

STARS students are all from rural areas. (Photo via STARS)

Rural America is big and diverse and includes some 9.7 million high school students that a group of public and private colleges and universities are working to tap into, writes Kristi Eaton of The Daily Yonder. "The Small Town and Rural Students (STARS) College Network is bringing together 16 higher education institutions to share best practices for rural and small-town students and offer opportunities for students to experience the colleges up close. . . . While nearly all rural students say that it is important to continue their education beyond high school, less than one-third of 19 to 24-year-olds from rural areas are enrolled in college. . . . That's compared to 42% from metro areas."

Majorie Betley, senior associate director of admissions at the University of Chicago and the acting executive director of the STARS College Network, told Eaton, "Having rural and small-town students on their campus is incredibly important to have their perspectives in conversations in the classroom. . . . It's 20% of the United States. And they're severely underrepresented on most college campuses. So that was part of the impetus: our college campuses don't represent what the United States really represents."

STARS boasts schools like Brown, Yale, CalTech and Vanderbilt. "Once on campus, many institutions have Rural Student Alliances," Eaton writes. Betley told her, "They're student-run organizations, but they're closely tied with our efforts like these are relationships that we've built with these students starting back when they were in high school. Now they're on our campuses… and I think relationship building is a really important part of that." Eaton adds, "Betley said the number of rural students at the University of Chicago has grown from about 3% at baseline to 9% currently."

Eaton reports, "Jeremiah Quinlan, dean of undergraduate admissions at Yale University, . . . said people think Yale only accepts one type of student, and that perception needs to change." Quinlan told Eaton, "Our faculty really value teaching diverse students. And we have found that bringing students here from the widest possible array of backgrounds, neighborhood backgrounds, family backgrounds, high school backgrounds, can all be really powerful for our campus community."

To join STARS, member sites must commit to reaching rural students and families with uniquely rural-oriented tools. Its website says: "Every Network member is committed to supporting rural and small-town students and their families through additional programming, including virtual sessions, free on-campus programs, and local sessions with rural and small-town high schools and community-based organizations."

The heart of homesteading is gleaning from the land, creating community and meeting life on your own terms

Natalie Bogwalker's daughter steals a bite before preparing
a wild salad. (Photo by Travis Dove, The Washington Post)

Since the 1960s, farmsteading has been an option for people who want to meet life on their own terms through farming, animal husbandry and lifestyle choices that lean on nature and community bonds for support, reports Chris Moody of The Washington Post. "It’s a common misconception that the goal of homesteading is total self-sufficiency, says Natalie Bogwalker, 44, owner of Wild Abundance, a hands-on education center that teaches homesteading skills near Asheville, N.C. She defines homesteading simply as 'living in a way that meets a lot of your needs from the land.' That can include gardening, permaculture, carpentry, building infrastructure. . . . A veteran homesteader who has been living largely off the land for more than 20 years, Bogwalker says community is a crucial part of making the lifestyle sustainable."

Jess McClelland and Alex O'Neill didn't pursue the homesteading life; it's more like they discovered it. McClelland told Moody, "We had never even thought about homesteading seriously until Covid. . . . It made traveling around and moving seem not like an option anymore. We were finally stopped somewhere long enough where we realized we could do this and have a garden. And once we started, it was like, 'Oh my God, this is the best thing in the world.' In January 2022, McClelland and O'Neill bought a two-bedroom, one-bath white country house tucked in the Appalachian high country." Moody adds, "They are modern-day homesteaders who have traded contemporary conveniences such as Uber Eats deliveries and a reliable internet connection to grow much of their own food and — as much as possible — live off the land in rural Appalachia."

Each homesteader individual has their own story. "Homesteaders are motivated by a range of forces, from a longing to take more control over life to wanting to seek a better diet, says Jessica Shelton, editor of Homestead.org. Most of all, it provides an opportunity to pursue a home life on your own terms," Moody reports. Shelton, who grew up on a 300-acre cattle farm in the Ozark mountains, told him, "Some are sick of the hustle and bustle of modern life. Others want to move away from commercialism and all the plastic packaging that comes with it."

"Bogwalker says she initially had a purist attitude. . . . Focusing on developing wild survival skills while foraging food and growing what she couldn't find. When she moved to North Carolina, she lived in a bark hut she constructed herself. . . . In 2011, she bought a seven-acre piece of mountain land. . . . She built a 12-by-16-foot log cabin from white pine trees on the land. . . .Hundreds of people visit the property each year. They learn carpentry, permaculture gardening, foraging and natural building in open-air pavilions while camping on the property or staying in rental homes nearby."

Beginning life as a homesteader can be expensive and daunting. "For newcomers to homesteading, Bogwalker offers sound advice: Go slow. Instead of immediately investing thousands of dollars in building projects and agricultural tools, observe the land carefully for a full year before diving in," Moody reports. She told him, "Burnout happens when you don't do things like take a Sabbath or associate your self-worth with your productivity and purism. The idea that you're a failure if you don't grow 90 percent of your own food? That's when people quit."

LGBTQ+ Eastern Kentuckians are refuting Appalachian stereotype of intolerance, creating a regional community

Cara Ellis, left, at Pikeville Pride's booth at the Hillbilly Days
Festival in Pikeville, Ky. (Photo by Ryan C. Hermens, Herald-Leader)

LGBTQ+ Eastern Kentuckians aren't big-city transplants, as you might think; they're native Appalachians reaching out to break stereotypes and form a supportive community, reports Rick Childress of the Lexington Herald-Leader. Childress' visit to the "Pikeville Pride" booth during Hillbilly Days, Pikeville's annual festival "celebrating all things Appalachia," provides a good example. "Members of Pikeville Pride sat at a booth strewn with rainbow flags and banners. The grassroots organization works to highlight Eastern Kentucky's LGBTQ+ community. . . . In a town and region long assumed to be unwelcome to LGBTQ+ people, members were met with honest questions, smiles, thank yous and even a 'grandma' who got their grandson their 'first pride flag,' said Cara Ellis, who is Pikeville Pride's president and a Pikeville native." Ellis said, "I never thought we would have this in this town."

Outreach allows the group to support young people who may struggle. "It's never been necessarily easy to be gay in the mountains, and a ratcheting up of anti-LGBTQ rhetoric and legislation, both in Kentucky and nationally, will make life harder for those who are out in rural communities," Childress writes. "The suicide rate among LGBTQ youth is much higher than their peers. A national survey conducted last year by the Trevor Project, an organization that provides crisis help for LGBTQ youth, found that 45% of LGBTQ youth seriously considered suicide in the past year. . . . But that suicide rate goes down if students come from households that affirm their gender identity, attend an LGBTQ-affirming school or live in an accepting community."

The group's presence at events like Hillbilly Days provides a human face inviting conversations that educate the region. "They also defied a common misconception that Ellis said she's encountered in her work with Pikeville Pride," Childress reports. "Many assume that those in the group have moved in from bigger cities and aren't native Appalachians. Ellis told him, "It's like, no, we've been born here. . . . We've been raised here. We're from here; we stay here." Childress adds, "According to Jonathan Coleman, a historian and co-founder of the Faulkner Morgan Archive, a nonprofit that saves and shares Kentucky's LGBTQ history, the typical narrative about Eastern Kentucky is incomplete. Coleman said: "The story of what it is to be queer in Eastern Kentucky is always a really flattened-out, simple narrative. . . . You leave if you can, as soon as you can. You're traumatized, and then you try to escape. That, of course, is not accurate for lots and lots of folks."

Pikeville's 2020 population was 7,754.
(Sperling's Best Places map)

Pikeville Pride continues to provide a supportive community "especially in a place where an accepting group of people hasn't always been easy to find," Childress reports. "The group started in 2017 as an organized counter-protest to a white-nationalist march in the city's downtown. After that protest, about 20-25 people continued to meet. They decided to put together Pikeville's first pride event in 2018 in an attempt to 'highlight the diversity and inclusion that we actually do have here in Pikeville, that maybe people don't realize,' Ellis said. . . . . Tonya Jones, who, along with her wife, has fostered multiple LGBTQ+ youth in Pike County, was among the original group that started the organization, said they had a free hugs booth at the first event." Jones told him, "I had someone just come up and just wrap their arms around me and just start bawling. Because they said it was the first time anyone accepted them for who they truly were."

Questions and answers about the end of the national public-health emergency for Covid-19: There are many changes

By Kate Yandell
SciCheck, a service of FactCheck

May 11 marked the end of the federal public health emergency for Covid-19, bringing changes to health care and public benefits. These differences include changes in the cost of Covid-19 tests and treatments and the potential loss of access to free Covid-19 vaccines for people who are uninsured.

The biggest change originally tied to the emergency designation has already gone into effect. The public-health emergency allowed states to keep millions of people on Medicaid regardless of eligibility in exchange for extra federal aid. But this continuous enrollment requirement ended March 31, and states are asking Medicaid members to reconfirm their eligibility.

The emergency began in January 2020 and was renewed every 90 days after that by the secretary of the Department of Health and Human Services. Following pressure to end the emergency with the introduction of the Pandemic is Over Act in January, the Biden administration announced on Jan. 30 that it would let the emergency declaration expire May 11.

The end of the public-health emergency is not the definitive end of pandemic-related policies. Some, including some changes to telehealth coverage and expanded access to free vaccines, are still in effect.

A declaration allowing the Food and Drug Administration to grant and maintain emergency-use authorizations for measures to combat COVID-19 has no stated end date. This means that authorized treatments and vaccines, such as Paxlovid and the bivalent Moderna and Pfizer/BioNTech vaccines, can remain in use.

How will this affect Covid-19 testing?

Costs of Covid-19 testing for individuals will rise, which the Kaiser Family Foundation called the “widest ​​ranging impact” directly resulting from the end of the public health emergency.

People on Medicaid will still be able to get free at-home or health care provider-ordered tests through September 2024, before potentially facing costs. However, the requirement that insurers cover eight at-home Covid-19 tests per month ended for most other people on May 11. Private insurers and Medicare Advantage plans could decide to keep offering this coverage, while traditional Medicare will no longer offer free at-home tests.

Tests ordered by health care providers will also get more expensive for individuals. As of May 11, private insurers and Medicare Advantage plans will be able to charge patients for these tests and related visits, following the normal rules of their health care plan. People on traditional Medicare will still be able to get provider-ordered tests for free, but they may pay for visits associated with the tests.

Depending on funding and supplies, other government programs offering free tests will continue, including a Centers for Disease Control and Prevention program designed for uninsured and other disadvantaged people. AHHS says says that the mail-order at-home test program will continue through the end of May.

How will it impact Covid-19 vaccines and treatments?

The end of the public-health emergency will not immediately change the availability and costs of Covid-19 vaccines or oral antiviral treatments. This is because the emergency constituted just one of multiple layers of laws and policies that make vaccines and some treatments free.

Currently, Covid-19 vaccines and oral antiviral drugs, such as Paxlovid, are sourced from the federal government’s own supply. These doses must be offered at no cost regardless of whether there is a public-health emergency.

However, the government supply of vaccines is only expected to last through the summer or early fall, depending on demand. It is also possible that a new version of the Covid-19 vaccine will come out, and these will be provided commercially rather than through government purchases.

Even after the federal vaccine doses run out, most people with insurance will still get recommended Covid-19 vaccines for free. Some laws requiring free vaccines for Medicaid and Medicare recipients were enacted during the pandemic, while requirements for no-cost coverage of any recommended vaccines from in-network providers were already in place for people with private insurance.

“It’s really the uninsured who will be the most challenged because there’s no permanent guarantee,” said Jennifer Kates, senior vice president and director of global health and HIV policy at the KFF.

To fill this gap, the Biden administration has proposed a Vaccines for Adults program, similar to the Vaccines for Children program, which provides free vaccines to children whose families couldn’t otherwise afford them. Congress has not been willing to enact this program, however.

On April 18, the administration announced the Bridge Access Program, which will temporarily provide vaccines and treatments to the uninsured. This depends in part on the government purchasing vaccines and treatments, but also on pharmaceutical companies being willing to provide them for free. “It’s not permanent and it’s unclear how far it will go,” Kates said.

The federal supply of Paxlovid will be depleted by early fall, Kates said, and some people with private insurance or Medicare will face cost sharing, just like with other drugs. As with Covid-19 tests, people on Medicaid will continue to have access to free Covid-19 drugs through September 2024.

Vaccine mandates and other changes

The Biden administration has announced it will lift most federal vaccine mandates. These mandates are winding down around the same time as the public health emergency but were ended by a separate action.

Mandates for health-care workers at facilities that treat patients on Medicare and Medicaid will end soon, with more details to come. The administration also announced an end to vaccine requirements for Head Start and federal workers, although these mandates had already been blocked by courts.

Some other policies and changes allowed during the public-health emergency will remain. For instance, many telehealth-related changes for people on Medicaid and Medicare have been made permanent or extended through the end of 2024, Kates said. Changes to rules about limits on take-home doses of methadone and access to controlled substances via telehealth will also be extended, with the intention to eventually make some permanent.

Many changes will not be immediately obvious to the public, although they could have an indirect impact. Just to name a couple examples, hospitals will no longer receive extra money from Medicare for treating hospitalized COVID-19 patients and a number of waivers are ending, such as relaxed rules on what types of care different providers can give.

Post and Courier spotlights South Carolina's lax septic-tank rules, which allow human waste to pollute waters people use

Residents swim in James Island Creek. Septic-tank waste contributes
to the creek's pollution. (Photo by Henry Taylor, The Post and Courier)

South Carolina's lax approach to septic-tank installation and maintenance must be addressed before extensive harm to nearby water sources cannot be undone, reports John Ramsey of The Post and Courier in Charleston. The Post and Courier's says the state has failed to address "the growing challenges coastal counties face from existing septic tanks as well as the challenges they continue to face as developers increasingly propose new neighborhoods served by dozens or even hundreds of these below-ground sewer systems. . . . Septic-tank systems work well, at least when they're properly installed and properly maintained. And when they aren't near the groundwater table, it is increasingly difficult to achieve along the coast where that table is expected to rise along the seas in the decades to come."

Septic tanks can and do fail, but "the buried nature of septic tanks makes them difficult to monitor, at least until a major failure takes place," Ramsey notes. "A 2015 Michigan study showed a direct link between tainted waterways and the density of nearby septic tanks, but no such study has been done here." Western Carolina University professor Rob Young told Ramsey: "I really worry about the impact of long-term sea level rise on septic systems. It's a much more silent problem, and honestly, I don't think we have done the science to understand the level of failure and what's really ending up in our surface water from these failing systems."

The Post and Courier's editorial board writes, "Both James Island and Shem creeks often reflect a dangerously high amount of fecal contamination, due at least in part to failing septic tanks. Swimming in these waters can be a dicey proposition at best, and that's sad. Taxpayers already are paying for multimillion-dollar, long-term projects ($17 million and counting) to try to limit that pollution by hooking up more nearby homes to sewer lines. . . . Ramsey accurately summed up South Carolina's approach to septic tanks as 'hands-off:' The state isn't even equipped to say how many tanks exist, much less whether they are still working well. That needs to change."

Taking tank-management practices from nearby states could provide the groundwork for change, the editorialists say: "The state also should change its requirements for how thick a layer of soil must exist between the septic tank's drain field and the groundwater. Our rules permit as little as 6 inches between the two, while Alabama and Georgia require at least 2 feet. That's particularly important given how groundwater levels are projected to continue to rise. . . . The most outrageous aspect to the situation [is] how little state officials have seemed to learn. . . We repeat our call for state lawmakers to engage on this issue in a more meaningful way, as other Southeastern states have done or are doing. Tennessee has additional rules for developers of large subdivisions served by septic tanks. Why not us?"

And where does your state rank in the regulation of these tanks that can get rank?