President Trump on Thursday directed the Department of Health and Human Services to declare the opioid crisis a public health emergency, taking long-anticipated action to address a rapidly escalating epidemic of drug use.But even as he vowed to alleviate the scourge of drug addiction and abuse that has swept the country — a priority that resonated strongly with the working-class voters who supported his presidential campaign — Mr. Trump fell short of fulfilling his promise in August to declare “a national emergency” on opioids, which would have prompted the rapid allocation of federal funding to address the issue.His directive does not on its own release any additional funds to deal with a drug crisis that claimed more than 59,000 lives in 2016, and the president did not request any, although his aides said he would soon do so. And he made little mention of the need for the rapid and costly expansion of medical treatment that public health specialists, including some in his own administration, argue is crucial to addressing the epidemic. Mr. Trump said his plan would include a requirement that federally employed prescribers be trained in safe practices for opioid prescriptions, and a new federal initiative to develop nonaddictive painkillers, as well as intensified efforts to block shipments of fentanyl, a cheap and extremely potent synthetic opioid manufactured in China, into the United States.He also said he would act to suspend a rule that currently prevents Medicaid from funding many drug rehabilitation facilities.
Tesla has begun making good on its promise to help Puerto Ricorebuild its energy grid after a devastating hurricane caused massive damage on the island. On Tuesday, Tesla announced via Twitter that Hospital del Nino in Puerto Rico is "first of many" solar and storage projects going live.
More than 130 organizations representing ranchers, farmers, foresters, conservationists, sportsmen and women, and businesses have endorsed a set of unifying principles to achieve rural economic health, a productive agricultural sector, provide for human needs, and protect the landscapes in which we live and work. While people will always find differences, it is our innate ability to work together that enables us to survive, raise families and create prosperous communities. Place-based collaboration, built on strong relationships and trust, is a proven and successful strategy to resolve long-standing conflicts. Communities and organizations are working together to restore and manage forests and rangelands while creating local jobs. Though not a panacea for all of the challenges we face today, place-based collaboration is an essential framework for implementing successful social, economic and environmental solutions.
Large manufacturing firms in rural America are at least as likely as similar urban firms to use innovative methods that can contribute to job creation and increased earnings, a new report says. Though preliminary, the study may indicate that there are exceptions to the oft-repeated rule that economic innovation is the nearly exclusive purview of urban-based businesses.“The findings in this report regarding the prevalence of rural innovation challenge the conventional wisdom that rural nonfarm innovation is relatively rare and idiosyncratic,” the report says. While large rural manufacturers had an innovation edge, that finding did not hold true for small and medium-sized rural manufacturers, the study shows.
Of the 122 hospitals that have closed since 2005, 60% have been in the South. The hospitals that have closed are more likely to serve people of color and lower-income communities.“To conclude, from this study, communities served by hospitals at high risk of financial distress had significantly higher percentages of residents who were black, who did not graduate high school, and are unemployed, again high-needs communities,” Dr. Pink reported. The communities also had high levels of fair-to-poor health, obesity, smoking and risk factors for potential years of lost life.“This really is a very worrisome finding, because, essentially, it’s saying that the communities that are served by these hospitals are more vulnerable,” Dr. Pink said. “They are at increased risk of losing access, perhaps exacerbating some health disparities, as well as the loss of hospital and other types of local employment, which could make the consequences of closure even more concerning.”
If Congress spent more money to prevent fires, it wouldn’t have to spend so much to fight them. Advocates and politicians from both parties agree. But that doesn’t appear to result in any action. We’ve grown accustomed to disagreement creating political impasse. But is political division so bad that there’s no progress even when folks agree on a solution? That’s the question Western conservation groups are asking as they push Congress to reform the way the government allocates funding to fight wildfires. “I’ve never seen anything like it,” said Dylan Kruse of Sustainable Northwest. “We have more than 100 legislators from both parties in agreement. We have more than 200 organizations calling for the same legislative package. Everybody knows we need to fix this problem. And still, while disaster funding is moving, once again the chance to solve the problem is lost.”Kruse’s frustration, along with a chorus of other rural voices in the West, is about how the federal government spends more and more money fighting catastrophic wildfires while reducing money from programs that could keep the fires from getting out of hand in the first place.A further complication is that wildfires are not treated like other disasters, such as hurricanes and flooding, where Federal Emergency Management Agency (FEMA) funding can support emergency response and re-building.
House Bill 5099 would prohibit counties and cities from putting any public funds into a government-owned or -managed network. The tight restrictions would replace Michigan’s current municipal-network limitations. So-called “municipal networks,” which are built or managed with local government involvement, are seen as a way to create competition and jumpstart broadband access in areas where commercial telecommunications companies have not stepped in to provide adequate service.A law already exists mandating safeguards against bad municipal financial decision-making.“There are statutory restrictions, competitive bidding with an industry bias built in, mildly onerous separate accounting and projection requirements, industry-biased geographic limitations and artificial time delays,” says Michael J. Watza, head of the governmental litigation and affairs practice at the Kitch Drutchas Wagner Valitutti & Sherbrook law firm.The bill does allow local governments to contract with private companies to provide internet access. Michigan is one of 21 states that limit or ban publicly owned networks. Michigan’s existing law dates to 2001. It requires cities to get council approval, issue a request for proposals to the private sector, and wait 61 days for responses. If fewer than three “qualified” internet service providers respond, the city can take on the project—but only after it prepares and presents to council a cost-benefit analysis that predicts costs and number of subscribers, and posts this publicly for 30 days.Assuming cities decide to move forward and no ISP responds, there must be a public hearing to authorize construction, and then a CPA must review the document. Cities must pay for all of these tasks.
To erode small-town culture is to erode the culture of the nation. Small towns have always risked losing young people for good, but especially after the Great Recession, the American economy has conspired against returners. Economic and agricultural concentration, declining industries, and lower wages aren’t giving younger people much reason to go home. Many small towns are becoming older, poorer, less educated. Small towns and rural areas send a disproportionate number of their children into the military. America’s food is grown around small towns. And as was made clear last year, smaller towns, acting together, can do a lot to elect a president. “In certain parts of the country those towns functioned as the glue that held everybody together,” Conn says. But if such initiatives are to succeed, Conn suggests, they’ll have to listen to Arthur Morgan and stay open-minded. Immigrants can boost local economies; small towns should welcome them, not oppose them. Government is not the enemy of small towns, but many in small towns have grown to distrust government at all levels: The TVA, a giant federal project, was largely a success, and so was rural electrification, another federal project. Today, many small towns rely heavily on state and federal money to keep their economies afloat. Resentment of cities, especially the often mistaken impression that cities soak up all the government spending, is counterproductive. Even Morgan recognized that “the village was too small a unit to fulfill the destinies of human society.” The United States needs its cities. But it need its small towns and rural areas, too.
But Iowa’s marketplace is arguably in the worst shape in the country at a time when Republicans are intent on dismantling Obamacare, creating further stress on the wobbly exchanges. And Trump’s decision to gut funding for outreach and marketing activities ahead of open enrollment is likely to have an outsize effect in a state in which many customers are certain to be confused by their options. How did Iowa get to this precarious point? Decisions in Washington and Des Moines certainly played a role, but critical choices by state regulators, insurers and other key players also contributed to the tumultuous climate. For many Iowans—as many as 72,000 could be affected by Medica’s rate increase—it means terrible options for obtaining medical care. It was always going to be difficult to build a viable individual insurance market in a predominantly rural state like Iowa. One big reason for that: Insurers have little bargaining power with major health care providers that they need to create viable networks for their customers. California, which has a thriving Obamacare marketplace, has more than four times as many residents per square mile than Iowa.But there were also crucial developments that further undermined Iowa’s marketplace from the outset. The state’s dominant insurer, Wellmark Blue Cross and Blue Shield, which controls about three quarters of the state’s market, decided not to sell plans on the Obamacare marketplace from the outset. There was just one other state nationwide, Mississippi, where the dominant Blue plan opted not to participate. State regulators also made a critical decision during the first open-enrollment season in 2013: They decided to allow plans that don’t meet the coverage requirements of the Affordable Care Act to remain in place. That became possible after the Obama administration, facing an intense backlash over canceled plans and the disastrous launch of HealthCare.gov, gave states the option of grandfathering in noncompliant plans. As of May, more than half of the state’s individual market—roughly 80,000 individuals—remained in noncompliant plans. Nationwide, that figure is closer to 10 percent, according to data crunched by Charles Gaba, who runs a blog that tracks Obamacare enrollment.That meant a huge chunk of potential customers didn’t shop for coverage on the fledgling marketplace because they already had plans. And since those Iowans were able to get coverage prior to Obamacare’s prohibition on discriminating against individuals with expensive medical conditions, it’s almost certain they’re disproportionately healthy. The end result: A much smaller and more costly population ended up enrolling through the marketplace.
New smart farm technologies can give America’s growers the ability to monitor crop conditions in real time, respond to technical problems before machinery breaks down in the field and consult with the world’s foremost agronomic experts with the push of a button. That is, as long as they’ve got five bars of service and plenty of internet bandwidth. If not, the smartest piece of technology isn’t worth its weight in good, quality fertilizer. And, according to Eric Lescourret, the Director of Strategic Marketing at AGCO Corporation, that dearth of rural bandwidth is the bottleneck that’s standing between American farmers and the next great breakthrough in agricultural productivity.“That’s the dilemma, that our farmers out there are collecting more data for every seed they plant than they can process,” Lescourret says. “All of them are located in rural areas, and the broadband infrastructure is not keeping up.” “There are a lot of areas that are very slow,” Lescourret says of AGCO’s use of Smart Farm technologies in rural areas. “We still have to rely on USB sticks to transfer data, and the reason is we don’t have cellular data coverage. If we don’t have it, we can’t transfer the data accurately.”And in a business like farming where hours and minutes can be the difference between success and failure, Lescourrett says having to hand deliver data from the farm site to agronomy experts could do more than endanger the source of America’s food crops-it risks the nation’s strategic geopolitical standing with its trade partners and competitors.