Hunger roundup: food banks struggle; Trump letter in USDA food boxes draws protests; maximum SNAP benefits go up

Here's a trio of hunger-related items:

Food banks seeing record increases in demand

Food banks have seen record increases in demand since the coronavirus pandemic began, but donations and volunteers are down, leaving them struggling to meet the needs of food-insecure Americans.

"Feeding America, a nationwide network of more than 200 food banks, projects a 6 billion to 8 billion meal shortfall in the next 12 months, a deficit that may be magnified with federal food assistance programs set to expire in the coming weeks and months," Laura Reiley reports for The Washington Post. "The Feeding America analysis estimates the total need for charitable food over the next year will reach 17 billion pounds, more than three times last year’s distribution."

Tens of millions of Americans have turned to food banks during the pandemic after losing their jobs or having their hours cut. "About 10 percent of American adults, 22.3 million, reported they sometimes or often didn’t have enough to eat within the past week, according to the Census Bureau’s most recent Household Pulse Survey fielded between Aug. 19 and 31. That is up from 18 million before March 13."

Rural Americans, especially children and seniors, are more likely to be food insecure. According to Feeding America, 2.3 million rural households face hunger. Though 63% of U.S. counties are rural, 87% of counties with the highest rates of overall food insecurity are rural. The organ notes that rural residents may have a harder time accessing food banks because of distance and transportation troubles. 

Letter from Trump in some food boxes; to enlarge, click on it.

Trump letters in food boxes criticized

Some are accusing the Trump administration of attempting to make political hay of the food insecurity crisis in a way that violates the Hatch Act. Lawmakers and ethics watchdogs are protesting the U.S. Department of Agriculture's recent requirement that federal contractors stuff signed letters from President Trump into food boxes for hungry families. 

The "$4 billion Farmers to Families Food Box Program has distributed more than 100 million boxes to those in need since May, with the aim of redirecting meat, dairy and produce that might normally go to restaurants and other food-service businesses," Helena Bottemiller Evich reports for Politico. "But organizations handing out the aid complain the program is now being used to bolster Trump’s image a month before a high-stakes election — and some even have refused to distribute them."

Some food banks are removing the letters because they don't want to be seen as endorsing a candidate and risk losing their nonprofit tax status, Reilley and Kim Bellware report for the Post.

Maximum SNAP benefits go up a little        

In related news about hunger, on Oct. 1, the Department of Agriculture increased the maximum benefit amounts for the Supplemental Nutrition Assistance Program by 5.3%. That translates to $34 more per month for a typical household of four receiving the maximum amount. Rural households are more likely to rely on SNAP benefits.

Tuesday afternoon webinar will discuss the challenges of HIV/AIDS prevention and treatment in rural America

The Rural Health Information Hub will host a free webinar at 3 p.m. ET Tuesday, Oct. 6, to discuss "recent increases in new HIV infections in rural areas, address barriers to HIV prevention and treatment services, and present on the committee's site visit and policy recommendations," according to the website. Click here for more information about speakers or to register for the webinar.

Specifically, the webinar will discuss recent a recent policy brief and recommendations the National Advisory Committee on Rural Health and Human Services wrote for the Department of Health and Human Services.

The NACRHHS paper made three major policy recommendations: 

1. HHS should modernize the Ryan White HIV/AIDS Treatment Extension Act of 2009 to better meet rural needs. That includes increasing funding to grow existing rural programs and encourage pilot programs, earmarking some funding opportunities for rural areas, giving preference to rural applicants in areas with a shortage of health-care professionals, and expanding telehealth to increase access to services and reduce stigma in rural areas.
2. HHS should increase rural access to pre-exposure prophylaxis for rural residents through the Health Resources & Services Administration's Community Health Centers Program and the Rural Health Care Services Outreach Program.
3. HHS should support a streamlined grant application process for cash-strapped rural providers, as well as more virtual grant-writing technical assistance for rural communities so they have a better chance of successfully applying for HHS funding.

FCC's broadband maps, long known to be flawed but still in use, could lead to even more waste of taxpayers' money

Though it has been known for years that the Federal Communications Commission relies on faulty data maps to see which rural areas need more broadband funding, the maps haven't been updated. In March, President Trump signed bipartisan legislation ordering the FCC to change how it collects and verifies broadband data, but it missed the Sept. 21 deadline, Dean DeChiaro reports for Roll Call.

"The agency’s plan to use the current maps to begin auctioning off $20 billion in rural broadband funding starting in late October has concerned lawmakers who want to ensure the money is spent wisely," DeChiaro reports.

The main problems are that major telecommunications companies have an incentive to overstate their rural reach. They also have the lobbying muscle to bend major projects their way, but when they get funding tend to save money by installing slower, cheaper DSL service instead of fiber-optic cable, according to research from the Purdue Center for Regional Development.

The faulty maps work in Republican FCC Chairman Ajit Pai's favor, since they falsely show that "his efforts to reduce regulations on internet service providers has helped reduce the number of unconnected Americans," DeChiaro reports. At a House committee hearing Sept. 17, Pai "blamed Congress, which he claimed has hamstrung the agency’s ability to fix the maps by withholding the necessary funding even though the agency approved a plan to fix the maps last year."

Fellow Republican commissioners Brendan Carr and Michael O'Rielly acknowledged problems with the maps, but defended efforts to correct them. They "said the maps set to be used in the Oct. 29 auction, which will sell off $16 billion of the $20.4 billion Rural Digital Opportunity Fund, are accurate. Carr said different maps, which will be used to auction off the remaining $4.4 billion later on, are flawed," DeChiaro reports. "Pai said that delaying the October auction to correct maps that will not be used until a subsequent auction would be a disservice to Americans without internet access."

Democratic commissioner Jessica Rosenworcel said the FCC has not made enough progress and accused the Republican majority of putting off vital improvements to the way it gathers data, DeChiaro reports. "We are careening towards a disaster with waste, fraud and abuse here," she said. "We’re giving out billions and billions of dollars a week before the election when we know our data is wrong."

Plugging forsaken oil and gas wells could cost $280 billion

"The American public is facing a potential bill of $280 billion for the cleanup of 2.6 million unplugged oil and gas wells, according to 'Billion Dollar Orphans,' a report from London-based think tank Carbon Tracker," Justin Mikulka reports for Desmog, a nonpartisan climate-scientist website. "While this number is alarming, it does not even include an estimated 1.2 million undocumented orphan oil and gas wells."

The petroleum industry defines "orphan wells" as those that don't produce oil or gas and have no financially viable operator to plug them. "With the current state of the oil and gas industry, the number of financially viable operators is rapidly decreasing while bankruptcies rise, which is exacerbating this whole issue," Mikulka reports. "One troubling aspect of this problem is that it should not exist. Regulators at both the federal and state levels have the tools in place to hold companies accountable for the costs of well plugging and abandonment. Yet those regulators have not used those tools, and now, as the industry is struggling financially, in many cases it simply may be too late."

Oil and gas companies must buy a surety bond to get a permit to drill a well, to ensure that the cost of plugging it will be covered, even if the operator goes bankrupt. "But regulators have set the limits for those surety bonds far below the actual costs to plug and abandon wells," Mikulka reports. "Carbon Tracker estimates that these bonds currently would only cover approximately 1% of the estimated $280 billion clean up tab — leaving the rest of the bill to be paid by the public."

Celebrate News Engagement Day on Tuesday, Oct. 6; you can make it part of National Newspaper Week, Oct. 4-10

Tuesday is News Engagement Day. It's a day to encourage people to read, watch, like, tweet, post, text, email, listen to or comment on news, says website, which offers resources for participation in the day.

Though it's not affiliated with National Newspaper Week, which goes from Oct. 4-10, the two observations can easily be combined. 

The day is an opportunity for local news outlets to remind readers (and potential readers, on social-media platforms) why it's important to read the news, and how local journalism and news literacy affects democracy and the wellbeing of communities.

Click here for more information, resources or ideas about how to promote News Engagement Day. The program is sponsored by the Association for Education in Journalism and Mass Communication.

Twice-weekly paper in Arkansas, closed by GateHouse Media, now has local owners and higher circulation

Helena-West Helena, in Phillips
County, Ark. (Wikipedia maps)

A little over a year ago, GateHouse Media shuttered the Helena World, one of Arkansas' oldest newspapers. But soon thereafter, local entrepreneurs Chuck Davis and Andrew Bagley bought it, and today it's thriving, Stephen Steed reports for the Arkansas Democrat-Gazette.

The twice-weekly paper had 625 paid subscribers when it closed. Now? "For a recent issue, the World sent out 416 copies to subscribers and had 422 single-copy sales, Bagley said. Circulation has topped 900 in recent weeks, boosted by the return of high-school football," Steed reports. "Single-copy sales spike when "there's a piece of juicy crime news," Bagley said. A goal is 1,000 copies a week, through subscriptions ($100 a year) and single-copy sales at ($1 each)." 

Davis and Bagley now publish the paper once a week, but make sure it has at least two sections with at least a dozen pages per edition. Besides Bagley and Davis, they have a bookkeeper, two freelance writers, and a new editor coming in on Nov. 1, which Bagley says will free him up to concentrate on selling ads, Steed reports from the city of Helena-West Helena, the product of a 2006 merger.

Advertising has plummeted due to the pandemic, but the paper received a $3,000 state grant and $13,000 from the Paycheck Protection Program that helped it stay afloat, Steed reports.

States keep prisoners in county jails to prevent covid-19 outbreaks in prisons, which causes problems in localities

Some states have slowed or halted the transfer of people from county jails to state prisons in an effort to prevent spread of the coronavirus in prisons. Not only has that resulted in overcrowding in county jails, which can make the virus spread faster among detainees, but it stretches the resources of the jails, Alex Sakariassen reports for Kaiser Health News.

Montana is one state that implemented such a policy for a time. It has the second-lowest prison infection rate in the nation. Colorado, California, Texas, and New Jersey also suspended inmate intakes from county jails this spring, Sakariassen reports, "But it’s also shifted the problem. Space was already a rare commodity in these local jails, and some sheriffs see the halting of transfers as giving the prisons room to improve the health and safety of their inmates at the expense of those in jail, who often haven’t been convicted."

Sakariassen adds, "Unlike convicted offenders in state prisons, most jail inmates are only accused of a crime. They include a disproportionately high number of poor people who cannot afford to post bail to secure their release before trial or the resolution of their cases. If they do post bail or are released after spending time in a jail with a covid outbreak, they risk bringing the disease home with them."

Quick hits: automated harvesting, pandemic misinformation and a 1921 battle on U.S. soil you probably never heard of

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.

The Appalachian Leadership Institute at the Appalachian Regional Commission has announced the 40 fellows for its class of 2020-21. Read more here.

What will automated harvesting mean for rural areas, farmworkers and farmers? Read more here.

House and Senate Democrats proposed spending $1 million to study how misinformation and disinformation have affected the coronavirus pandemic response. Read more here.

A new book, The Road to Blair Mountain, is a fascinating account of "the biggest battle on U.S. soil that most Americans have never heard of," a reviewer says.

Interior secretary to lead Bureau of Land Management for now; Trump administration may appeal Pendley's ouster

The Interior Department will not name a new acting director for the Bureau of Land Management "after its leader was ousted by a federal judge, top officials told employees in an email obtained by The Hill. Instead the job will be left to Interior Secretary David Bernhardt," Rebecca Beitsch reports. 

A federal judge in Montana ruled Friday that the BLM's controversial acting director, William Perry Pendley, had served unlawfully for 424 days. "The decision was in response to a suit from Montana Gov. Steve Bullock (D), who argued Pendley, whose nomination to lead the BLM was pulled by the White House last month, was illegally serving in his role through a series of temporary orders," Beitsch reports.

"The president cannot shelter unconstitutional 'temporary' appointments for the duration of his presidency through a matryoshka doll of delegated authorities," wrote Judge Brian Morris in a 34-page ruling.

An Interior Department spokesperson said an appeal is planned but did not give a timeline, Kirk Siegler reports for NPR.

New project to seek federal aid, tax incentives and more to revitalize local news

A diverse coalition of local news organizations is backing a new project, Rebuild Local News, that aims to help local news organizations stay afloat—and editorially independent—with funding through federal funding, tax credits for advertisers and philanthropists, and more. 

The idea is the brainchild of Steve Waldman, president and co-founder of Report for America, and expands on a recent article he wrote proposing many of the same ideas. Read more here.

How Trump's false claims of voter fraud have helped disenfranchise voters; report covers election security issues

A New York Times package details how President Trump has persistently spread false or misleading claims about voter fraud to lay the groundwork for disputing the election should he lose. He has also used his authority and influence over the federal government to prop up flimsy claims of voter fraud and disenfranchise people likely to vote for Democrats, Jim Rutenberg reports. 

Meanwhile, a special report from StateScoop and EdScoop provides a broad look at current election-security issues, from cybersecurity to misinformation.

Opioid overdoses rising during pandemic despite expanded telehealth

Opioid overdoses and related deaths are on the rise in most states, despite hopes that expanded telehealth implemented during the pandemic would make obtaining addiction treatment easier, Heather Kagan reports for ABC News. Kagan is an internal medicine resident physician at The Johns Hopkins Hospital and a contributor to the ABC News Medical Unit.

The problem is widespread. On Aug. 14, the American Medical Association reported that more than 40 states had reported an increase in opioid-related mortalities. There are several likely reasons expanded telehealth hasn't spurred a decline in such deaths, according to Caleb Banta-Green, a principal research scientist at the University of Washington's Alcohol and Drug Abuse Institute.

Telehealth isn't "the magic solution," Banta-Green told Kagan. It's "great" for people who already receive addiction treatment, he said, but most people with opioid addictions aren't receiving treatment. 

Also, Kagan notes, many people struggling with opioid use are homeless or have other mental-health disorders. Many people with mental-health disorders don't seek help, and many don't have access to a phone, wi-fi, or other devices that could help facilitate telehealth addiction treatment, according to Farzan Sasangohar, director of the Applied Cognitive Ergonomics Lab at Texas A&M University. The pandemic has exacerbated that lack of access, he told Kagan.

Former coal baron Bob Murray, who fought against black-lung regulations, has filed for black-lung benefits

"Robert E. Murray, the former CEO and president of the now-bankrupt Murray Energy, has filed an application with the U.S. Department of Labor for black-lung benefits. For years, Murray and his company fought against federal mine safety regulations aimed at reducing the debilitating disease," Brittany Patterson and Dave Mistich report for Ohio Valley ReSource. 

In his claim, which is still in the early stages of evaluation, the 80-year-old former coal baron said he heavily depends on an oxygen tank and that he is "near death." He qualifies for black-lung benefits, he wrote, because he worked in an underground mine for 16 of the 63 years he has worked in the industry, and after that went underground "every week until I was age 75," Patterson and Mistich report. But in a 2019 interview with NPR, he said he had a lung disease that was not caused by working in underground mines.

"Reached by phone, Murray declined an on-the-record interview for this story," Patterson and Mistich report. "He disputed that he ever fought against regulations to quell the disease or fought miners from receiving benefits. Murray also threatened to file a lawsuit if a story was published that indicated he had fought federal regulations and benefits."

Medicaid and Children's Health Insurance Program total enrollment jumped by more than 4 million in first half of 2020

Enrollment in Medicaid and the Children's Health Insurance Program increased by more than 4 million in the first half of 2020, according to newly released federal data. 

"The 5.7 percent jump between February and June came as millions of people lost their jobs — and, for many, their health insurance too — amid the public health emergency. Also, a coronavirus relief package Congress passed in mid-March barred states from cutting eligibility and disenrolling beneficiaries during the pandemic," Tami Luhby reports for CNN. "More than 2.4 million adults enrolled in Medicaid, an increase of 7.2%. Also, 1.4 million kids signed up for Medicaid or the Children's Health Insurance Program, a jump of 4.1%. (This data does not include Arizona and the District of Columbia, which did not report the breakouts for adult and child enrollment for one or more months covered in the report.)"

The increase reversed a slow decline in Medicaid enrollment and uninsured Americans since mid-2017. But it was less than some experts had predicted in the spring because some workers were only furloughed instead of laid off, and therefore got to keep their work-based health insurance, Luhby reports.

Free resources available to help parents, teachers and bosses keep young farmworkers safer

The Healthier Workforce Center of the Midwest is offering free resources to help farm supervisors, parents, and teachers protect teens and young adults working on farms. The resources, which are available in English and Spanish, include online training, classroom training, YouTube videos, and safety posters.

The HWC is a partnership of the University of Iowa’s College of Public Health, Washington University in St. Louis, and the Nebraska Safety Council. It is one of six Total Worker Health Centers of Excellence funded by the National Institute for Occupational Safety and Health.

Fact-checking rural issues and more in presidential debate

President Trump and Democratic challenger Joe Biden faced off in Cleveland last night in a widely panned slugfest. Biden made a few false and misleading claims, but, in the words of CNN's Daniel Dale, "We had an avalanche of lying from President Trump." Most of Trump's claims weren't new and had been repeatedly found false, Dale said.

The debate, moderated by Fox News anchor Chris Wallace, covered six topics: the candidates' records, the Supreme Court, the pandemic, the economy, race and violence in cities, and the integrity of the election, though the candidates frequently went off-topic. Click here for a full transcript of the debate.

Here's a rundown of topics with rural resonance mentioned in the debate, as well as fact-checking:

The debate began with a discussion of Supreme Court nominee Amy Coney Barrett, who Biden insinuated would help reverse Roe v. Wade, but Trump said "you don't know her view" on the case. The president said previously that he hadn't spoken to Barrett about her views on the case, but when asked on "Fox & Friends" if she would help reverse the decision, Trump said "I think it will work out."

Biden also objected to Barrett because, he said, she would help the Trump administration nullify the Patient Protection and Affordable Care Act, costing 100 million Americans with pre-existing health conditions their insurance. They wouldn't necessarily lose coverage, but might have to pay more for it or have more difficulty obtaining it.

FactCheck.org noted only those who seek individual health plans would be at risk of being denied insurance, and only 6% of people get coverage on the individual market. Before the ACA, employer-based insurance, which covers 49% of the population, couldn't wholly deny insurance on such grounds, but insurers could deny coverage for some conditions for a limited period after a lapse in coverage. 

Told by Wallace that he has not produced a comprehensive health-care plan to replace the ACA, Trump said drug prices will be coming down 80% to 90%. Insulin, which had been expensive, is now "so cheap it's like water." Trump signed four executive orders on drug prices in July, including one on insulin, but it's still unclear how they'll be implemented and whether they'll result in large price reductions on prescription drugs. And insulin is still just as expensive as it was before the order for most people, Nicholas Florko reports for Stat.

Biden said he wants to keep the ACA and add a public option to it, and rejected Republican arguments that it would end private insurance. Trump alleged that Biden supported "Medicare for All," but Biden said that his public option would be for people poor enough to qualify for Medicaid.

Biden said 10 million people lost their employer-sponsored insurance during the pandemic, but the study he cited also said all but 3.5 million of them would find insurance elsewhere, FactCheck reports.

On the pandemic, Biden accused Trump of not taking social distancing seriously, and said that Trump's own head of the CDC said that 100,000 lives would be saved if everyone wore masks and observed social distancing. Biden mistakenly attributed the quote to the head of the Centers for Disease Control and Prevention. Instead, the projection comes from the University of Washington’s Institute for Health Metrics and Evaluation, FactCheck reports. However, the CDC chief did agree in Senate testimony that face masks are a critical health tool.

Trump insisted that he has handled the pandemic well, and "We got the masks, we made the ventilators," and said the U.S. was "weeks away from a vaccine" and "far fewer" people are dying when they get infected with the coronavirus. 

A federal relief bill provided billions for hospitals to get protective personal equipment, ventilators and more, but rural hospitals, often at the end of supply chains, had a harder hard time getting critical supplies. Trump was incorrect about how quickly a vaccine may come, though he has encouraged vaccine companies to speed up their development and production. Trump said the vaccine could be available in weeks, but members of his administration have said it might not be widely available until summer. Trump suggested that any delay in the vaccine would be political, but there is no evidence to support that, FactCheck reports.

Biden, meanwhile, said a vaccine wouldn't be distributed at all until summer, but that glossed over the possibility that people with the greatest need for it could receive it this year, FactCheck reports.

Trump said several times that Biden wants to "shut down the country" during the pandemic. In an Aug. 21 interview, Biden said that he will "do whatever it takes to save lives because we cannot get the country moving until we control the virus." That included shutting down the country if scientists recommended it. However, Biden has said he doesn't think it's necessary, FactCheck reports.

Trump said his administration had built the "greatest economy in history." That's false, according to The Washington Post's Fact Checker. (Also, rural economies took much longer to recover from the Great Recession than the nation overall.)

Trump blamed the wildfires in California on poor forest management, but the state and local governments only control 3% of the forests there. The federal government owns and manages 57% of the state's forests.

After the debate, "False stories about Joe Biden’s health continued to spread on social platforms," Elizabeth Dwoskin of The Washington Post reports.

Two more presidential debates are scheduled, in Miami Oct. 15 and Nashville Oct. 22. Vice President Mike Pence and Sen. Kamala Harris will debate in Salt Lake City Oct. 7.

Updated federal rules loosen many rural nursing homes' requirements for employee coronavirus testing

Updated federal rules mean many rural nursing homes won't have to test their employees for the coronavirus as often. That could be problematic because the pandemic is increasingly shifting to rural areas.

On Tuesday the Centers for Medicare and Medicaid Services changed some definitions of its color-coded county ranking system, which determines how often nursing homes must test employees, Alex Spanko reports for Skilled Nursing News. The "stoplight" system bases testing requirements on a county's percentage of residents testing positve for the virus, among other factors. Those with less than 5 percent positivity are green, between 5% and 9% is yellow, and 10% and above is red. 

The new rules loosen testing thresholds. "Counties with 20 or fewer tests over 14 days will now move to ‘green’ in the color-coded system,” CMS said in a press release. "Counties with both fewer than 500 tests and fewer than 2,000 tests per 100,000 residents, and greater than 10 percent positivity over 14 days — which would have been ‘red’ under the previous methodology — will move to 'yellow'."

"The difference between a 'red' county and a 'yellow' county is substantial: Under new rules announced at the end of August, providers in 'red' counties must test their staffers twice weekly, as compared to weekly for 'yellow' areas and once per month in the lowest-level 'green' counties," Spanko reports.

CMS made the change after governors of rural states complained that some rural counties seemed to have relatively high positivity rates because of low testing numbers. That meant nursing homes had to conduct staff testing "at a higher frequency than necessary," according to the CMS press release.

Rural counties hit record high for new coronavirus infections last week; see the latest county-level data

Daily Yonder map shows rates of new coronavirus infections reported Sept. 20-26;
click the image to enlarge it or click here for the interactive version.

"The number of covid-19 cases reported in rural counties climbed by more than 61,000 last week, setting a record for new infections in a single week and placing half of all rural counties on the White House’s red-zone list," Tim Murphy and Tim Marema report for The Daily Yonder. "The number of new infections in rural America was 14 percent higher last week compared to the previous period, according to the Daily Yonder’s analysis. Since mid-September, the weekly number of new infections in rural counties has climbed by 48%. A record-breaking 990 of the nation’s 1,976 rural counties were on the red-zone list last week, meaning they had an infection rate of 100 or more new cases of Covid-19 per 100,000 in population."

Red zones are defined by the White House Coronavirus Task Force as places that have at least 1 new coronavirus infections per 1,000 people in one week. Click here for more data, graphs, and in-depth exploration of that data from the Yonder.

Mountain Valley Pipeline regains three key permits, moving it closer to resuming construction

"A path across nearly 1,000 streams and wetlands was cleared Friday for the Mountain Valley Pipeline," Laurence Hammack reports for The Roanoke Times. "The U.S. Army Corps of Engineers reissued three permits for the natural gas pipeline being built in Virginia and West Virginia, nearly two years after they were invalidated by a federal appeals court." 

The decision brings the project one step closer to resuming construction, but it's not the only hurdle facing the controversial project, which halted construction in August 2019 following a lawsuit over its impact on endangered species.

"Also on Friday, the U.S. Forest Service released its proposal for the 303-mile pipeline to pass through the Jefferson National Forest, an approval that was struck down in a separate ruling by the 4th U.S. Circuit Court of Appeals," Hammack reports. "A decision on that permit is not expected until the end of the year."

The environmentalists who filed suit against the pipeline project sent a letter to the U.S. Department of Justice asking for an administrative stay of the stream-crossing permits. "Derek Teaney, with the nonprofit law firm Appalachian Mountain Advocates, wrote that he intends to file a legal challenge," Hammack reports. "Teaney represents the Sierra Club, Center for Biological Diversity, West Virginia Rivers Coalition, West Virginia Highlands Conservancy, Indian Creek Watershed Association, Wild Virginia, Chesapeake Climate Action Network and Appalachian Voices."

Private equity-owned hospitals more likely to be in low-income, rural areas

On average, hospitals owned by private-equity firms are more likely to be in low-income, rural areas, according to a study published in the Annals of Internal Medicine this week. Read more here.

Chris Wallace won't fact-check candidates at tonight's debate, but several news outlets plan to do so live

Many pundits have lauded the choice of Fox News' Chris Wallace as the moderator for tonight's presidential debate in Cleveland, based on the veteran reporter's solid handling of a 2016 presidential debate and his history of pushing back in interviews, especially with President Trump. But the "Fox News Sunday" anchor said he won't fact-check the candidates during the debate, and said on Sunday that his job is to be "as invisible as possible."

Frank J. Fahrenkopf, co-chair of the Commission on Presidential Debates, the bipartisan nonprofit group that runs the debate, told CNN on Sunday that Wallace and other moderators are not expected to be fact-checkers. Fahrenkopf said that, if one candidate says something incorrect during the debate, it's the other candidate's job to bring it up.

However, the lack of live fact-checking may leave many viewers with faulty information, "particularly given Mr. Trump’s tendency to hurl false and baseless claims at his opponents," Michael Grynbaum reports for The New York Times. That's because many viewers don't read fact-checks afterward.

"Lying works on live television," said Mark Lukasiewicz, dean of the Lawrence Herbert School of Communication at Hofstra University, in the same CNN segment as the Fahrenkopf interview. Live fact-checking is "generally not terribly effective," Lukasiewicz said. 

Nevertheless, several major news outlets plan to provide fact-checking live online. USA Today will livestream the debate online with a nationwide team of journalists providing facts and context on-screen during the debate. Click here to view their livestream and see the list of political reporters who will be weighing in.

The Washington Post's Fact Checker team, headed by Glenn Kessler, will also do live fact checks during the debate accessible from a blog on the homepage. NBC News and CNN will also do live blogs of the debate with fact-checking and analysis.

New poll shows Trump with a large rural lead over Biden, but a closer race than four years ago

Half of rural voters plan to cast ballots for President Trump, according to a new poll by DTN/The Progressive Farmer and Zogby Analytics. That's a 17-point lead over Democratic challenger Joe Biden, whom 33% said they would vote for. Eleven percent of respondents said they are undecided, Dan Miller reports for DTN. 

In 2016, Trump led Hillary Clinton 46% to 24% in a similar survey by the same pollsters. Now, Trump has a smaller lead and a lower share of committed voters than last time, and Biden has a higher share of committed voters than Clinton did.

Other findings from the poll:

• The three top issues that rural voters said will affect how they vote in local, state, and national elections are the economy (62%), health care (48%), and protection of Second Amendment rights (39%).
• The economy is especially important to Republicans (74% said it was an important issue) and Southerners (67%).
• Rural Democrats are the only demographic who said health care is significantly more important than other issues affecting their votes, with 64% saying it was the top issue.
• Similarly, rural Democrats are the only demographic that rated climate change as one of their top issues; 48% said it was important, compared to 27% of respondents overall.
• 53% of respondents said they approve of Trump's performance as president, including his handling of the pandemic.
• 42% of respondents strongly or somewhat disapprove of Trump's job performance.
• Support for Trump is highest in the politically important Central Great Lakes region, where he enjoys support from 55% of rural voters, 60% of seniors age 65 and over, and 57% of married rural adults.
• 59% of farmers in the poll said their operations would be struggling financially if not for direct federal aid through USDA's Market Facilitation Program and the Coronavirus Food Assistance Program.
• 57% of farmers said Trump's focus on agriculture policy has improved their farming and/or ranching financial outlook, and that the 2018 Farm Bill has provided an adequate safety net for their operation.
• 56% of farmers said Trump's emphasis on trade negotiations with China and the U.S.-Mexico-Canada Agreement has led to higher income potential for their farming operation.
• 54% of farmers said that environmental rules and regulations have not hurt their ability to manage their operation.
• 54% of farmers said that farming has been profitable over the past four years.
• 39% of rural adults said agriculture is worse off than it was in 2016, 23% said it's better off today, 22% of rural adults said it's about the same, and 17% were undecided.
• 67% of Democratic respondents said agriculture is worse off than four years ago.
• 40% of Republican respondents said agriculture is better off than four years ago.
• Almost 40% of those in the East, Great Lakes, and Western states said agriculture is worse off than four years ago, compared to about 33% of respondents in the South.

The poll only sought responses from rural residents; see the end of Miller's article for a demographic and geographic breakdown of responses.

Podcast explores cracks in the health-care system; first episode discusses closure of rural Kansas hospital

Where It Hurts, a new podcast that kicks off today, explores the growing cracks in America's health-care system that often leave people vulnerable. The first season, "No Mercy," chronicles how Fort Scott, Kansas, a community of about 8,000 on the Missouri border, lost its only hospital, and what happened to the the townspeople after Mercy Hospital Fort Scott closed its doors. 

The podcast is a collaboration between Kaiser Health News and St. Louis Public Radio. "No Mercy" is hosted by KHN's Sarah Jane Tribble, who spent more than a year and a half reporting on the fallout from Fort Scott's hospital closure.

You can find the podcast here, or anywhere else podcasts are available.

Officials fear cyberattacks to voting systems before election

Federal officials fear that, just before or after the election, hackers will try to get into voting systems and "sow chaos and uncertainty" with tactics such as freezing voter registration data, election poll books, or the computer systems of the secretaries of state who certify election results, Nicole Perlroth and David Sanger report for The New York Times.

Attacks have been ramping up, including a recent attack on Tyler Technologies, a Texas company that sells software that states and cities use to display results on election night. It's "the latest of nearly a thousand such attacks over the past year against small towns, big cities and the contractors who run their voting systems," Perloth and Sanger report. "Many of the attacks are conducted by Russian criminal groups, some with shady ties to President Vladimir Putin’s intelligence services. 

Federal investigators aren't sure whether the attack on Tyler was a run-of-the-mill ransomware attack, in which hackers lock data until they're paid a ransom in cryptocurrency. But some of Tyler's clients noticed outsiders trying to log into their systems after the attack, Perloth and Sanger report. 

"With only 37 days before the election, federal investigators still do not have a clear picture of whether the ransomware attacks clobbering American networks are purely criminal acts, seeking a quick payday, or Trojan horses for more nefarious Russian interference," Perloth and Sanger report. "But they have not had much success in stopping them. In just the first two weeks of September, another seven American government entities have been hit with ransomware and their data stolen."

One cybersecurity expert said it's likely that local governments will be hit by hackers around the election, Perloth and Sanger report.

"The proliferation of ransomware attacks that result in data theft is an evolution in Russian tactics, beyond the kind of 'hack and leak' events engineered against the Democratic National Committee and Hillary Clinton’s campaign chairman, John Podesta, in 2016," Perloth and Sanger report. "By design, whether the attacks are criminal or state sponsored is not clear, and the attacker does not always have to be successful everywhere. Just a few well-placed ransomware attacks, in key battleground states, could create the impression that voters everywhere would not be able to cast their ballots or that the ballots could not be accurately counted — what the cybersecurity world calls a 'perception hack.'"

Rural schools struggle with lack of broadband

Rural school districts are more likely to hold in-person classes during the pandemic, but many that choose distance learning are having a rough time because of poor or absent broadband connectivity. The lag has led many rural districts to worry that their students will fall behind urban and suburban students.

"This pandemic has shone a glaring light on a lot of inequalities," Kirk Siegler reports for NPR. "The federal government estimates that more than a third of rural America has little or no internet. In numerous recent interviews, educators have told NPR they’re concerned the rural-urban divide will only worsen if kids can’t get online to learn."

Many rural districts have had to get creative, from providing kids with tablets or Chromebooks and sending out buses outfitted with wifi hot spots to delivering paper copies of schoolwork to students who don't have internet or cell phone service at home. "Still, it’s widely held that hot spots aren’t a long-term solution for rural learning, especially since cell service can be spotty, if sometimes non-existent in more rugged areas of the West in particular," Siegler reports.

Some rural leaders have lobbied Congress for a public-works project to build out broadband to rural areas, much like the government paid to bring electricity to rural areas during the 1930s, Siegler reports.

Time to start planning promotion of National Newspaper Week, coming Oct. 4-10: 'America Needs Journalists'

Cartoon by Terry Wise

If you're at a newspaper, it's time to start planning promotion of the 80th annual National Newspaper Week, held from Oct. 4-10. The observance, sponsored by the Newspaper Association Managers of the U.S. and Canada, is meant to recognize the service of newspapers and their employees.

This year's theme is "America Needs Journalists," a concept the Iowa City Daily Iowan helped develop. Click here for free content and suggestions for how to make the theme local. You can also access archived materials from years past to spark your imagination.

Acting Bureau of Land Management director has served unlawfully for over a year, federal judge rules

William "Perry" Pendley

"A federal judge in Montana has ordered William Perry Pendley, the acting director of the Bureau of Land Management, to leave the position after finding that he had served unlawfully as acting director for 424 days," Maria Cramer reports for The New York Times. He was also barred from using any authority to make decisions about federal lands, according to the 34-page ruling issued Friday by Judge Brian Morris of the U.S. District Court for the District of Montana.

The ruling hits at a core tactic of President Trump, who prefers to appoint directors in a temporary capacity so they don't have to be confirmed by the Senate and are more beholden to Trump for their jobs. The last Senate-confirmed BLM director, Neil Kornze, left in January 2017, Cramer reports. Since then, Trump has appointed five acting directors, with Pendley as the latest one in July 2019. He nominated Pendley to fill the position permanently in July, but soon withdrew the nomination after the move drew attention to Pendley's controversial views about public lands, the environment, and other issues.

However, even after Pendley's name was withdrawn over concerns that he might hurt Republicans in tight Senate races out West, Pendley continued to run the BLM. That violates the Federal Vacancies Reform Act, which limits acting officers from serving for more than 210 days without Senate confirmation, the judge ruled. "The ruling also prevented Interior Secretary David Bernhardt, who appointed Mr. Pendley, from picking another person to run the bureau," Cramer reports.

Gov. Steve Bullock of Montana, who is in a tight race with Republican incumbent Steve Daines for a Senate seat, filed the lawsuit in July against Pendley and Bernhardt, Cramer reports. His is one of the races most likely to be affected by Pendley's tenure at the BLM. Colorado Sen. Cory Gardner, a Republican also in a tough race, could also be put in a politically inconvenient spot if forced to vote on Pendley's confirmation.

U.S. judge orders census extension, says some populations — including rural — could lose funding and representation

A federal judge ruled late Thursday that the 2020 census count must continue through the end of October instead of wrapping up at the end of September, Zach Montellaro reports for Politico. The government is expected to appeal the ruling.

The pandemic has seriously delayed the decennial count in rural areas and other places with hard-to-count populations, heightening the risk of an inaccurate count. "As early as mid-April, just weeks into the country shuttering during the pandemic, the Census Bureau pleaded with Congress to extend deadlines for the count for 120 days," Montellaro reports. "The proposed deadlines would have pushed field collection until the end of October, with apportionment data — the population count used for determining the number and population of each state's congressional districts — being submitted to the president by April 30, 2021 instead of by years' end."

Congress never granted the extensions, and in early August, Census Bureau director Steven Dillingham, a Trump appointee, announced it would withdraw its request for an extension and deliver the results to Trump by the end of 2020 (a decision that came from outside the bureau, according to the Commerce Department's inspector general).

"The reversal infuriated municipalities, community groups and experts, who warned of the prospect of a rushed and deeply flawed count that would affect everything from House apportionment and redistricting to how roughly $1.5 trillion in federal spending would be directed over the next decade," Montellaro reports. The federal court echoed those concerns in its ruling.

Voter registration deadlines approach; this year's increases in new registrations lag those of 2016; blamed on pandemic

In many if not most states, the deadline to register to vote in the Nov. 3 election is next Monday or Tuesday, so this would be a good week for news outlets to remind their audiences of that. It's more important than usual because the novel coronavirus has caused a decline in voter registration rates, Peter Miller of the Brennan Center for Justice at New York University reported last week.

"We analyzed registration rates in 21 states and found that the pandemic has led to a drop-off in new registrations in 17 states relative to the 2016 cycle," Miller reports. "We limited our analysis to the states that make monthly counts of registered voters available on the website of the relevant chief elections official." Here's a screenshot of Miller's table:

"It’s important for those who have not registered to vote to do so as soon as possible," Miller writes. "It’s also important for regular voters to double-check with their local election administrators that they are indeed registered to vote to avoid any problems this election season."

Tues. webinar will explore election issues in rural America

At 11 a.m. CT on Tuesday, Sep. 25, Agri-Pulse will hold a free webinar exploring issues affecting rural America and how they could influence rural voters' turnout and choices. That includes the pandemic, natural disasters such as wildfires, jobs, broadband and other infrastructure, workforce development, and rural economic development challenges.

Managing Editor Spencer Chase will moderate a discussion between Rep. Xochitl Torres Small, D-N.M, Rep. Dusty Johnson, R-S.D., and the Association of Equipment Manufacturers' Kip Eidberg. Agri-Pulse, which covers agricultural news, expanded its election coverage of ag-related issues in 2016 and is continuing that this year with its Campaign 2020 series.

Click here for more information or to register for the webinar.

Covering a pandemic: Don't let fatigue and friction stop you

Illustration from Medium.com

By Al Cross
Director and professor, Institute for Rural Journalism and Community Issues, University of Kentucky

Just as some people are tiring of taking precautions against the novel coronavirus, helping it spread, I'm sure some newsrooms are tiring of covering it. And that helps it spread, too, by making it seem less of a threat, and discouraging precautions.

And I fear that some newsrooms aren't just tired of covering the pandemic, but have scaled back their coverage because of objections from people who think the pandemic is overblown or even a hoax that will fade after the election.

Let me be quick to say that I haven't seen such a trend in the newspapers I read regularly, but I tend to read high-quality newspapers, so that's not probative evidence.

What I do know is that news organizations all over the country are getting pushback. 

"No matter how carefully we report . . . for the first time, our readers are questioning the credibility of our reporting on the virus, and that's dismaying," said Les Zaitz, editor-publisher of the weekly Malheur Enterprise in eastern Oregon.

Zaitz made the comment on a panel during the Society of Professional Journalists conference this month, and I followed up with him via email.

"We consistently have people telling us they don't believe the numbers we report about total coronavirus infections, and the positive testing rate," he wrote. "They accuse us of being in league with government officials to overstate the cases. Some say this is to effect more government control over people. We cite our sources, link to those government sources, and regularly explain the data in plain terms.

He added, "We also get pushback in reporting on when government imposes restrictions (limiting restaurants, for instance). We are accused of fear-mongering and trying to panic people. Again, we clearly cite our sources."

I got similar reports from some editors of Landmark Community Newspapers, with the help of Editorial Director John Nelson, who surveyed them at my request.

"The most intense feedback has been on social media, specifically Facebook," wrote Editor Hugh Willett of the Roane County News in East Tennessee. "We are posting the regular updates on positives cases, deaths, etc., that come from the county mayor’s office. These posts generate a large number of responses and quickly deteriorate into name calling over mask use, government overreach, etc."

In nearby Campbell County, LaFollette Press Editor Robby O'Daniel said "We’ve received basically no feedback on the stories in the paper," but on social media, "Routinely, a handful of commenters spam the thread with thoughts questioning the legitimacy of the pandemic and accusing us of bias and fear-mongering when simply relaying facts from the Tennessee Department of Health."

"We have gotten a lot negative feedback on Facebook," wrote Editor Travis Jenkins of The News & Reporter in Chester, S.C. "Lots of folks calling it the 'plandemic' and so forth. Lots of people arguing masks don’t work, it infringes on their rights, and such as that. Anytime we post anything about mask ordinances or covid, it goes berserk."

Ben Sheroan, who edits one of Landmark's two dailies, The News-Enterprise in Elizabethtown, Ky., wrote that the paper "sees a lot of rude remarks and argumentative interaction on posts about daily covid reports and other covid-related stories."

Sheroan said the paper has sometimes changed its coverage "by simply being responsive to questions raised. For example, adding the positivity rate in a subsequent daily report, or providing data about the number of people hospitalized in a neighboring county. We have found sources to do stories about people who have lost family members or suffered illness."

Editor Miranda Cantrell on the job in Morgan County, Kentucky

The stories of the sick are important, to impress upon skeptical readers that covid-19 is a real disease, and a tough one. Leads can come from social media. That's what the Licking Valley Courier, an independently owned weekly in West Liberty, Ky., did when a county official posted on Facebook, "For those who don’t think covid-19 is real, it is. I tested positive."

Editor Miranda Cantrell put a note at the end of her story about the official's post, asking other victims to tell their stories, because readers in her Eastern Kentucky county wonder "whether the effects are as severe as mainstream media outlets have reported."

Yes, they do, but they are more likely to trust a local news outlet than one based somewhere else, so local editors and reports have a responsibility to tell the story of the pandemic and not flinch from friction or fatigue.

"Our main obligation is to give information to the public that's authoritative, truthful and important," Stat Executive Editor Rick Berke said during another SPJ session. He said it's "urgent" to write more stories "about how bad this is and how it affects people."

Berke, who covered politics for The New York Times, recalled that covering the topic after the 2001 terrorist attacks "was really hard because everyone was so nice to each other," so he was shocked to see the pandemic "become so politicized."

Another editor in the session, Steve Riley of the Houston Chronicle, said some readers are suspicious of national newspapers. He said anytime his paper publishes a front-page story from the Times or The Washington Post, both of which President Trump has attacked, it gets "emails that seem scripted from Fox News . . . It's our job to cut through the crap and provided unfettered, straight, reliable news, no matter where it falls."

Times science correspondent Donald McNeil Jr. said, "Every organ of government has been corrupted in this pandemic . . . Our role in this pandemic has been more important in many more crises in this country because there has been such an effort to suppress the truth, and we're fighting that."

Riley advised, "Be engaged with your critics." He said he tries to "explain in a calming way the role that we have. . . . the folks will at least nod their head and appreciate the response."

Some parents deliberately sending coronavirus-infected kids to class, possibly because of a lack of child care

Though many school districts are doing distance learning this fall, some schools (more likely rural ones) are holding in-person classes. As those schools attempt to keep staff and students from spreading the coronavirus, they're running into an unexpected problem: some parents are deliberately sending their coronavirus-infected children to school. 

That's happened several times in suburban Washington and Ozaukee counties in Wisconsin, according to the counties' public health department officer, Kirsten Johnson, Alec Johnson reports for the Milwaukee Journal Sentinel. "I think for us, the biggest challenge for us that we’re experiencing right now is people are just being dishonest," Johnson said. "They don’t want their children to be quarantined from school. They don’t want to have to miss work. In doing that, they’re jeopardizing the ability to have school in person and other people’s health."

Part of the problem may be the lack of child care, especially in rural areas where child care is already scarce. And the problem may be getting worse. Researchers warn that nearly half of the nation's child-care centers could shutter because of the pandemic, Kavitha Cardoza reports for NPR. 

In the 11-county Appalachian region of Ohio, for example, the number of child-care centers has declined by more than 80 percent since 1999, and that was before the pandemic, which is rapidly accelerating closures, Rachel Dissell reports for Eye on Ohio., the nonprofit, nonpartisan partnership between the Ohio Center for Journalism and the nonprofit Fuller Project.

Ga. nursing-home scheme may cost taxpayers $76 million

A federal investigation said the owner of a Georgia nursing home chain improperly used a legal loophole to score $300 million in bonus payments for his chain. That could cost Georgia taxpayers $76 million, Max Blau reports for Georgia Health News, in partnership with ProPublica's Local Reporting Network. 

Twenty years ago, Ronnie Rollins, who owned a for-profit chain of nursing homes, thought of an unorthodox way to qualify for bonus Medicaid payments meant to go to non-profit nursing homes. By having non-profit partners apply for bonus payments, Rollins believed he could convince federal officials that the non-profits owned the agencies, Blau reports.

Because the idea pushed the limits of the law, Rollins asked the Georgia Department of Community Health for approval. The department agreed, as long Rollins gave the department a portion of the bonus payments; officials "hoped to use the money to help stabilize Medicaid reimbursement rates for providers across the state," Blau reports.

Over the next 20 years, Rollins built one of the state's largest non-profit health-care networks, today called Community Health Services of Georgia, and brought in about $300 million in bonus payments. In the 2017 fiscal year, CHSGa brought in over $650 million in total revenue, Blau reports.

Federal officials say Rollins' workaround threatens the state's ability to collect Medicaid funds. In 2014, the Centers for Medicare and Medicaid Services ruled that some of Rollins' bonus payments were inappropriate; payments under the program have halted, and CMS is seeking $76 million in repayment from the state. The state has appealed, but if it fails, taxpayers will be on the hook for repaying the money.

Since Medicare and Medicaid reimbursements to the chain halted six years ago, the nursing homes have reported below-average staffing levels, more than twice the average deficiencies as the average nursing home in Georgia, and the chain has been fined more than $1.2 million for violating patient-safety standards, according to the GHN and ProPublica investigation. The chain's 55 nursing homes also have a 4.9% covid-19 death rate, compared with the statewide average death rate of 3.3% for nursing homes.

Quick hits: fires spark conspiracy theories, threaten Oregon timber economy; lack of students hurts college towns

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.

Small college towns feel the financial pain from the lack of students. Read more here.

Montana officials struggle to get rural residents counted in the census. Read more here.

The decision to shorten the census schedule came from outside the Census Bureau, according to the Commerce Department's inspector general. Read more here.

Conspiracy theories about Western wildfires, including claims that some were started by antifa arsonists, are making things harder for emergency responders. A Facebook official discusses the company's efforts to remove misinformation about the fires and their broader attempts to quell the spread of misinformation online. Read more here.

Oregon's timber economy faces an uncertain future after record wildfires. Read more here.

In slumping energy states, plugging abandoned wells could provide an economic boost. Read more here.

Rural queer communities connect via oral history project

Rae Garringer
(National Geographic photo by Annie Flanagan)

Rae Garringer grew up on a sheep farm in West Virginia, but felt isolated as a queer person in Appalachia. So Garringer, who uses nonbinary them/them pronouns, set off on a cross-country trip in the summer of 2014 to interview other rural LGBTQ+ rural residents, a la StoryCorps. They interviewed 30 people in 30 days, recording more than 45 hours of tape. That became the seed of an oral history project called Country Queers, which has recently begun a podcast sharing those interviews and more, Nicole Blackwood reports for National Geographic.

The new podcast, which includes a 2018 interview with author Silas House, seeks to amplify "often unheard stories of rural queer experiences across intersecting layers of identity including race, class, gender identity, age, religion, and occupation," according to the website. The website also includes written transcripts and photos from over a dozen more interviews. 

Garringer and other project collaborators want the project to help preserve rural queer histories, show the broader world that rural Americans are not all straight and white, push back against the popular narrative that queer people only thrive in cities, and help queer rural residents to feel connected and build community even though many are geographically isolated.

But, "Even as the project grows, the goal remains the same: figuring out what the future can look like," Blackwood reports.

"As much as this project has been about amplifying people’s stories and raising our visibility, there is such a personal piece for me ... like, how do we do this?" Garringer told Blackwood. "How do we thrive in these places?"

USDA creates unusual new channel to get pandemic stimulus money into tobacco farmers' pockets

"U.S. government aid payments to tobacco farmers will be channeled through a new account within the office of the agriculture secretary, an unusual move that bypasses the normal mechanism for distributing farm aid and stokes concerns about how the government is using covid-19 stimulus," P.J. Huffstutter and Tom Polansek report for Reuters: "The U.S. Department of Agriculture on Friday said it will pay up to $100 million to tobacco farmers from Congress’ coronavirus economic stimulus package, as part of a $14 billion assistance program for farmers hurt by the pandemic."

The new account had not previously been reported, but a USDA official told Reuters that "the agency opened the new account because of how Congress apportioned money from the CARES Act passed in March. and to simplify the process of paying farmers," Huffstutter and Polansek report. "Lawmakers typically apportion emergency funds to an agency and existing accounts set up at the division that would handle a program, according to agricultural and government analysts."

Most federal crop subsidies are paid through the Commodity Credit Corp., a federal agency, but the 2004 tobacco buyout barred tobacco farmers from receiving CCC funds, Huffstutter and Polansek report. Instead, Congress specifically allocated the non-CCC aid to the USDA secretary's office. The USDA representative said Congress would have specifically excluded tobacco farmers from receiving funding if it didn't want them to receive any money.

However, "Some economic and legal experts said the 2004 law eliminated the government’s role in funding tobacco price supports and worry the Trump administration is not being transparent," Huffstutter and Polansek report. "The reality is that Congress would have to explicitly authorize paying tobacco farmers," said former Obama administration official Jonathan Coppess, currently the director of the Gardner Agriculture Policy Program at the University of Illinois.

Tobacco growers were excluded from the first round of pandemic aid announced in April. Graham Boyd, executive vice president of the Tobacco Growers Association of North Carolina, told Reuters that tobacco farmers in his state lost about $200 million in potential sales to China because of export shutdowns during the pandemic.

The new payments would benefit farmers in swing-state North Carolina, the nation's top tobacco producer, where President Trump and Democratic challenger Joe Biden are neck and neck in the polls. However, the USDA representative told Reuters there was nothing improper about the account.

NPR graphics show covid-19 deaths' shift to rural America

Weekly percentage of covid-19 deaths by county urbanization level (NPR graph)

The covid-19 pandemic's toll of deaths has surpassed 200,000, and an increasing share of those are rural, Sean McMinn, Ruth Talbot and Jess Eng report for NPR. The article has a series of maps and charts that can help readers visualize the trend. Read more here.

New report details pandemic's impact on rural households

Five new reports detail the coronavirus's impact on U.S. households, including in rural areas. NPR, Harvard University's T.H. Chan School of Public Health, and the Robert Wood Johnson Foundation collaborated on the project, which gathered data through interviews with more than 3,400 adults across the nation (543 were rural).

The first report details the pandemic's impact on households in major cities, the second examines its impact on households by race and ethnicity, and the third focuses on the general impact to U.S. households. The fourth and fifth reports have not been released yet. The fourth will focus on households with children and the fifth will focus solely on rural households.

Though none of the first three reports focus on rural households, the third report has some interesting data on rural households. Among its findings:

• 42% report facing serious financial problems during the pandemic.
• 31% say they've used up all or most of their savings.
• 21% report serious problems paying credit cards, loans or other debt.
• 10% report not having any household savings prior to the pandemic.
• 43% say that at least one adult in the household has lost their job, lost their business, been furloughed, or had their wages or hours reduced. 
• Among rural households with job or wage losses during the pandemic, 66% report facing serious financial problems.
• 34% report having either no high-speed internet connection at home or problems with their internet connection that interfere with their ability to do their jobs or schoolwork.
• 24% say that someone in their household has been unable to get medical care for a serious problem when they needed it during the pandemic, and 56% of those respondents who were unable to get care report negative health consequences as a result.

New online course aimed at making mental-health care more accessible to farmers and other rural residents

A new online course, Rural Resilience, aims to make mental-health care more accessible to farmers and other rural Americans. The program, created by the Michigan State University and Illinois State University Extension programs, "helps participants learn to recognize signs of stress, identify effective coping strategies, respond to suicidal behavior, and connect with appropriate resources," Foodtank reports. "The course also offers specialized mental health crisis training for employees of institutions with direct contact with farmers, such as unions, insurance companies, and credit servicers."

The majority of rural counties, home to 273,000 small farms, don't have enough mental-health care practictioners, according to a 2018 report from the University of Michigan's School of Public Health. "Compounding the problem, some farmers lack health insurance coverage for mental health care. Instead, these services can require out of pocket payments, which 87 percent of farmers agree is a barrier to treatment, according to a survey from the American Farm Bureau Federation," Foodtank reports.

Stigma can also prevent many farmers from seeking help, but leaving mental-health problems untreated can be deadly: farmers have a higher suicide rate than the general population, according to a recent report from the Centers for Disease Control and Prevention, Foodtank reports.

Many rural hospitals on the financial brink as pandemic loans come due; stopgap funding bill has some relief

Federal loans in the form of advance payments from Medicare kept many struggling hospitals afloat during the earlier days of the pandemic, but the loans must be repaid this month, unless hospitals get a reprieve in a stopgap funding bill moving through Congress.

Officially, full repayment of the loan is due this month, and many hospitals say they still can't afford to pay up. If they don't, federal regulators are supposed to "stop reimbursing the hospitals for Medicare patients’ treatments until the loan is repaid in full," Sarah Jane Tribble reports for Kaiser Health News. 

The stopgap apprpriations measure passed by the House on Monday includes partial relief for all hospitals. It "would extend the start of the repayment period for hospitals and the amount of time they are allowed to take to repay," Tribble reports. "The continuing resolution that includes this language about relief for hospitals (among many, many other things) is still being hammered out, though it does face its own deadline: It must be approved by the House and the Senate within the next nine days or the federal government faces a shutdown."

Some rural hospitals are afraid to spend the loan money because losing Medicare reimbursements would be crippling; at many such hospitals, Medicare payments make up 40 percent or more of their revenue, Tribble reports.

"The federal Centers for Medicare and Medicaid Services has not yet begun trying to recoup its money, with the coronavirus still affecting communities nationwide, but hospital leaders fear it may come calling for repayment any day now." Hospital leaders across the country told Tribble that CMS has not communicated with them about when or whether they'll adjust the payment deadline, and a CMS spokesperson didn't respond to questions by press time. 

More than 65 percent of the nation's small, rural hospitals, many of which were already struggling before the pandemic, took out loans from Medicare's Accelerated and Advance Payments Program because they were the first funds available, Tribble reports. CMS cut off new loan applications for the program in April.

"The program, which existed long before the pandemic, was generally used sparingly by hospitals faced with emergencies such as hurricanes or tornadoes. It was expanded for use during the coronavirus pandemic — part of billions approved in federal relief funds for health care providers this spring," Tribble reports. "A full repayment of a hospital’s loan is technically due 120 days after it was received. If it is not paid, Medicare will stop reimbursing claims until it recoups the money it is owed — a point spelled out in the program’s rules. Medicare reimburses nearly $60 billion in payments to health care providers nationwide under Medicare’s Part A program, which makes payments to hospitals.

Health officials and researchers fear the pandemic could accelerate the closure of rural hospitals, which would reduce rural health-care access, rural economies, and trigger a rise in local death rates. Another pressure many are facing: a federal appeals court recently ruled that the Department of Health and Human Services can continue to cut certain drug reimbursements for safety-net hospitals by nearly 30%.

Rural coronavirus infections jump 30% over the past week; see the latest county-level data

New coronavirus infection rates from Sept. 13-19. Daily Yonder map;
click the image to enlarge it or or click here for the interactive version.

"The number of new Covid-19 infections in rural America jumped by 30 percent last week last week, reversing a short-lived decline in new cases  Tim Murphy and Tim Marema report for The Daily Yonder. ""New deaths from covid-19 also grew last week, increasing by 20% and bringing the total number of rural Americans who have died as a result of the pandemic to 18,128." The Daily Yonder's analysis of new coronavirus infections and deaths covers Sept. 13-19. 

The jump put a record number of rural counties on the red-zone list."The number of rural counties on the red-zone list climbed to 909 last week. The previous record was set the first week of September, when 806 rural counties were on the list," Murphy and Marema report. The White House Coronavirus Task Force defines red zones as counties with 100 or more new cases per 100,000 in population. 

Click here for the latest county-level data on new coronavirus infections and deaths as well as more data breakdowns from the Yonder.

House passes bipartisan bill to fund government through Dec. 11; deal includes expanded farm aid, food assistance

In a 359-57 vote on Tuesday night, the House passed a bill to keep the government funded through Dec. 11, following a compromise on farm aid and food assistance.

"The bipartisan agreement between House Speaker Nancy Pelosi (D., Calif.) and Treasury Secretary Steven Mnuchin, reached just hours before the vote, is expected to smooth the bill’s passage in the GOP-controlled Senate and avert a partial shutdown when the government’s funding expires next Thursday," Kristina Peterson and Lindsay Wise report for The Wall Street Journal. The Senate is expected to vote on it this week.

The bill "would add to the spending bill $21 billion sought by the White House for the Commodity Credit Corp., or CCC, a Depression-era program designed to stabilize farm incomes that permits borrowing as much as $30 billion from the Treasury to finance its activities. The agreement prohibits any payments from going to fossil fuel refiners and importers, a concern of Democrats, and includes roughly $8 billion in additional nutrition funding," Peterson and Wise report. "President Trump has tapped the CCC program to finance both trade relief and coronavirus-related aid for farmers, a second round of which he announced at a campaign rally in Wisconsin last week. But the program has traditionally been used to send out payments established under bipartisan farm bills, some of which the Agriculture Department had said could be subject to delays as soon as October."

The bill also adds $8 billion for food assistance. "That includes a one-year extension of a program expiring at month’s end that would provide funding to families of school-age children to buy groceries, replacing the free or reduced-price meals they would have received at school, "Peterson and Wise report. "They also expanded the program to include children at child-care centers affected by the pandemic."