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Rural News

America's Rural Hospitals Are Dangerously Fragile

The Atlantic | Posted on January 17, 2018

This is the story of a small-town, publicly-owned hospital that, after thriving for decades, is struggling and now in all likelihood about to be appended to a large regional health-care system. The tale of Berger Municipal Hospital is, like that of many sectors of the American economy, one defined by industrial consolidation and the costs that come with it. Last November, however, Circleville’s voters chose another direction, one that, in other places, has resulted in an economic hit to the community—mostly in the form of job losses and stagnant wages—as well as a lowered quality of care. At the urging of city and county leaders, and Berger’s administrators, residents voted to allow local politicians and the hospital’s board to begin a process to turn Berger, one of the last publicly owned and operated hospitals in the state, into a nonprofit private corporation. Following that, Berger would most likely be integrated into a larger regional system, probably the Columbus-based nonprofit Ohio Health, with which Berger has an ongoing relationship. The hospital and the local leaders campaigned hard for that approval, but not because it was the ideal future they envisioned. They feared that Berger wouldn’t survive any other way.

Rural areas short on workers turn to overseas professionals

High Country News | Posted on January 17, 2018

Cherie Taylor, CEO at Northern Rockies Medical Center in Cut Bank, Montana, currently has four Filipino nurses on her staff. The rural health facility employs a total of 12 full-time registered nurses, which includes 10 floor nurses and two nursing administrative positions. “We have a national registered nurse shortage and all the U.S. nurses cannot fill the vacancies,” Taylor says. “Thank goodness a lot of baby boomers are hanging on and not retiring, or we would be in a national crisis right now.” Taylor adds NRMC might be recruiting a fifth Filipino nurse if she can’t fill her last RN vacancy with a nurse from the U.S. Shelby Schools Superintendent Elliott Crump knows first-hand about the teacher shortage in Montana. The Montana Office of Public Instruction reported 638 full-time openings in the state’s “difficult or hard to fill” teaching positions in 2016-17 and Crump’s school district had four of them. When no qualified applicants from Montana — or anywhere else in the United States — applied for those jobs, he started looking outside the United States and ended up hiring four teachers from the Philippines.

Can rural towns stem the trend of population decline?

High Country News | Posted on January 17, 2018

“I’m really into formulas,” says Choteau Area Port Authority board member Blair Patton. “People who are successful know the formula. You do not have a successful small community accidentally. There is a focused, purposeful action that leads into that.” The downward population trend and the loss of school-age children and jobs that support families are forcing Choteau and other rural Montana communities to think strategically about confronting and reversing these declines.The Choteau community has been proactive through the years. The community partnered with Montana State University on an economic development project and with MSU Extension on an anti-poverty initiative. The city established a Revolving Loan Fund to help existing businesses and start-ups.In September, the Choteau City Council created the Choteau Area Port Authority — a board that has statutory power to aid economic development. Port authorities are supported by property taxes, grants and other revenue and may or may not involve a “port” of any kind.

How to turn a struggling small town around

High Country News | Posted on January 17, 2018

This story is the first installment of a three-part series focusing on the challenges and solutions for affordable housing in Boulder, Montana.rom that work came ten goals and strategies for implementing those goals. Among other items, the goals cover downtown revitalization, marketing the community, developing affordable workforce housing to attract those priced out of the housing market in the larger nearby communities, and expanding growth options by extending city utilities.One major accomplishment that came from the citizen efforts was the successful passage of legislation to establish a $500,000 Boulder Development Fund. A citizen board has been appointed to oversee the usage of those funds.Other concrete accomplishments in process include the creation of a community Master Plan, the appointment of a city planning board, application opportunities for an affordable housing development, the development of a capital improvement plan for the city and the start of a downtown growth policy. Efforts are also underway to establish targeted economic districts.

The ‘scenery economy’ reinvigorates a Montana town

High Country News | Posted on January 17, 2018

As the holiday season gets its start on a clear morning in late November, Main Street here looks like something out of a Hallmark movie. A window washer cleans down storefronts along blocks of historic brick buildings — a candy store, a microbrewery, coffee shops, restaurants, antique stores. Wreaths hang off ornate light posts. The surrounding hills are scattered with snow. Banners hung from windows and balconies celebrate the high school football team, the Titans, which has won a state 8-man class championship the previous weekend. This was a much different scene a quarter century ago. By the early 90s, the mining, timber and agriculture jobs the town was built on in the 1860s had faded, leaving businesses shuttered, many properties owned by the bank. The motto of the one-time silver boomtown — “Founded on hope” — seemed tarnished.These days, though, Philipsburg’s historic district is one of the state’s small-town success stories — its buildings restored and bustling, with brightly painted facades that have won national recognition in places like Sunset Magazine. If there’s anywhere in rural Montana that’s managed to make the shift from the mines-and-mills industry of the past to the scenery economy of the New West, it’s here.

How to turn motorized rec into a sustainable economy

High Country News | Posted on January 17, 2018

Mining and ranching is the main economy of Challis, Idaho. When the Thompson Creek Mining Company, a molybdenum mine west of Challis, ended their mining operations in 2014, the bust in the economy rattled the community. At its peak, the molybdenum mine employed around 400 people, accounting for more than half of Custer County’s tax roll. Today, around 50 remain. “They were the largest employer but now they are probably the second largest,” said Greg Webster, owner of The Bent Rod outdoor store and president of Challis’ Chamber of Commerce. “They were like Santa Claus for everything and everyone. When that kind of stuff shuts down, it kind of kicks you in the stomach and makes you figure out what you are going to do next.” Like many communities in the West, Challis is looking to tourism to help diversify and bolster their economy.  “It is sort of the chicken and the egg,” said Webster. “There are a lot of communities that are quite the places to go for people to ride their bikes, little breweries popping up and little mountain-type groups. You have to get the trail systems so people know about it before you can get people to come.”While the community did not initiate the trail, the businesses that have shifted their business model and embraced the visitors are seeing an economic boost.

Washington Senate committee advances bill on rural water wells

Capital Press | Posted on January 17, 2018

A bill to reopen rural Washington to new wells unanimously passed the Senate Agriculture and Natural Resources Committee on Thursday, an unprecedented but tenuous bipartisan response to the Hirst court decision. The committee’s lead Republican, Moses Lake Sen. Judy Warnick, said she expects the full Senate to vote on the legislation in the next few days.“This is a necessary bill for the fishermen and all the people who want to live and work in rural areas,” she said.Senate Bill 6091 proposes short-term regulations for new household wells. By mid-2021, rules drawn up by watershed panels would prevail in some basins. The plans would set limits on water withdrawals and authorize projects to more than offset water diverted from streams by new wells.

Interior plans to move thousands of workers in the biggest reorganization in its history

The Washington Post | Posted on January 16, 2018

Interior Secretary Ryan Zinke launched an unprecedented effort Wednesday to undertake the largest reorganization in the department’s 168-year history, moving to shift tens of thousands of workers to new locations and change the way the federal government manages more than 500 million acres of land and water across the country. The proposal would divide the United States into 13 regions and centralize authority for different parts of Interior within those boundaries. The regions would be defined by watersheds and geographic basins, rather than individual states and the current boundaries that now guide Interior’s operations. This new structure would be accompanied by a dramatic shift in location of the headquarters of major bureaus within Interior, such as the Bureau of Land Management and the Bureau of Reclamation. Moving thousands of employees around the country would require congressional authorization. Zinke said the Trump administration plans to negotiate the reorganization in the upcoming budget approval process. “This proposal is concerning because it appears to eliminate the Navajo Regional Office of the Bureau of Indian Affairs,” said  Sen. Martin Heinrich (D-N.M.). “A change of this magnitude should only come after extensive, meaningful government-to-government consultation with the affected tribes.  On its face, this looks more like a dismantling than a reorganization.” The politics of moving employees is often difficult, Jewell said. Interior sought to consolidate the BLM offices for New Mexico and Arizona because the topography of the states is so similar. “Congress came after us. You would’ve thought we were ending the world as we knew it. Politicians came out of the woodwork,” Jewell said. “You throw up your hands and say it’s not worth it. If you’re a politician it looks like your district lost and another district won.”At a budget hearing in June, Zinke defended a $1.6 billion proposed budget cut at Interior, saying he planned to shave 4,000 positions from the workforce. In September, he said a third of Interior’s staff was “not loyal to the flag,” meaning the Trump administration.

Animal research helps pets, too

JAVMA | Posted on January 14, 2018

This past October, the Foundation for Biomedical Research launched its "Love Animals? Support Animal Research" campaign to educate the public about how animal research has improved the health and welfare of companion animals. Similar public outreach efforts have focused on the benefits to human health derived from animal research, such as development of vaccines for polio and hepatitis A and B. "Love Animals? Support Animal Research" takes a new approach by highlighting a lesser-known issue: how animal research has led to innovations in veterinary medicine that help sick and injured cats and dogs.Animal research has improved and saved the lives of countless companion animals, according to a promotional brochure, which cites the following examples: vaccines to prevent distemper, rabies, infectious hepatitis, tetanus, parvovirus, and feline leukemia; technologies such as CT, MRI, and ultrasonography to help diagnose potentially deadly diseases; lifesaving emergency care for dogs and cats injured by cars; advanced surgical procedures to treat joint and ligament problems in dogs and cats, to transplant organs, and to implant pacemakers; and nutritional products to help puppies and kittens grow into

Trump declared an opioids emergency. Then nothing changed.

Politico | Posted on January 12, 2018

President Donald Trump in October promised to "liberate" Americans from the "scourge of addiction," officially declaring a 90-day public health emergency that would urgently mobilize the federal government to tackle the opioid epidemic. That declaration runs out on Jan. 23, and beyond drawing more attention to the crisis, virtually nothing of consequence has been done.Trump has not formally proposed any new resources or spending, typically the starting point for any emergency response. He promised to roll out a “really tough, really big, really great” advertising campaign to spread awareness about addiction, but that has yet to take shape. And key public health and drug posts in the administration remain vacant, so it’s not clear who has the authority to get new programs moving. A senior White House official disputed the assessment of inaction, saying the emergency declaration has allowed the president to use "his bully pulpit to draw further attention to this emergency that he inherited." The official added that the declaration has enabled federal agencies to "really change their focus and prioritize the crisis," and that getting an effective media campaign underway "takes time."