Tuesday, January 23, 2018

Texas editor-publishers talk about dealing with disasters

Mary Henkel Judson, left, listens to Laurie Ezzell Brown
A state the size of Texas can have a wide range of disasters in a short time. That happened last year, as Hurricane Harvey devastated parts of the Gulf Coast less than six months after 32 wildfires in the Great Plains burned 1.2 million acres, many of them in the Texas Panhandle, and 15,000 cattle died. At last weekend's Texas Press Association meeting on Galveston Island, in a session called "Come Hell or High Water," editor-publishers from each locale talked about how they dealt with the disasters.

Laurie Ezzell Brown of The Canadian Record said the March 6 wildfires came three months after an ice storm "had given the area its last precious moisture" but laid waste to power lines and "beautiful old-growth cottonwoods that lined Canadian’s streets," leading to "weeks of cleanup," but "That moisture, though, seemed like such a blessing" after months of drought. Then came the grass fires, sparked partly by power lines short-circuiting in 70 mph winds.

"My cell phone was blowing up with text messages . . . while I attempted to take notes of the scanner traffic I heard," Brown recalled. " At some point, my staff took over, and I headed out with a camera, driving toward what was by then a wall of smoke and flame that spanned the western horizon, and seemed to be moving at a speed I’d never seen before. I listened to the scanner in my car, trying to figure out where the fire was. It was everywhere. I’ve never heard fear in the voice of firefighters. I heard it that day — and night."

Then, "The wind suddenly reversed course, turned on a dime, and headed for Canadian. I got close to that black wall—close enough to hear it roar, feel its heat, and take a few photos as I braced myself against the wind. I headed back to town . . . It occurred to me that we were also in danger. That our equipment, our archives, our building, were unprotected. And that my staff had families and homes they needed to take care of. Some left, came back, left again."

The town survived, bit some people did not, including "a young man who worked in Canadian [and] headed to Lipscomb to take care of his pregnant wife," Brown recalled. He went missing, and his mother called the newspaper, asking for help. "I posted her plea online, but had to tell her the road had been closed. Every firefighter available was on the fire line. Every law enforcement officer, every emergency medical worker; they were doing anything that could be done. Someone did heed her plea and volunteered to help. They found Kade Koch just a couple of miles from his home. He had been overcome by smoke, left his car, become disoriented. They found him, but could not save him."

"The fire’s destructive power was mighty," Brown said. "In the aftermath, kindness was mightier. The response from across the state and region—in donations of money and hay, fence posts, volunteer fencing crews who just showed up and asked to be put to work, even replacement bulls—were overwhelming, and proved to be a powerful silver lining to the firestorm we weathered. So when I started hearing the news of Hurricane Harvey, I knew only too well what my friends at newspapers in those communities were facing."

Mary Henkel Judson of the Port Aransas South Jetty said she, her newspaper and her town are still recovering from the hurricane, which forced them out of town for five weeks.

"Recovery takes time," she said. "You’ve probably heard people say, 'It’s a marathon, not a sprint.' They’re right. . . . With a disaster comes PTSD, a.k.a. Mush Brain. There were times when I questioned whether I should be driving. Your memory goes. You don’t sleep. You’re confused. And we had it easy compared to others. Everyone around you is in the same boat. No matter how little damage you might have suffered, it’s tough to see your town battered and on life support."

But her final point was upbeat: "This is what journalists live for – the big story. It’s a tragic disaster and an adrenaline rush at the same time. Our staff did more than just rise to the occasion. They were spread from Mission to Dallas and every place in between – but they were writing stories, selling ads, making up ads, printing labels and everything necessary to get the paper put together and distributed. In the face of their own personal losses, they stepped up and kicked butt and I am beyond proud of them and grateful for their work and dedication."

Judson spent most of her time talking about what they learned, and offering advice. The above quotes and the following points are taken from her prepared remarks.

• You have to have a plan (and based on Laurie’s experience, everyone, not just those in hurricane zones, has to have a plan no matter where you are – floods, ice storms and fires can happen anywhere -- almost). Everyone on staff has to know what that plan is.
• Take your checkbook or whatever you need to make payroll (no one missed a check during the five weeks we produced the paper off-site, or since). Make sure you have enough money in escrow at your post office to mail at least one edition of the paper.
• Make arrangements with an out-of-town post office to mail your paper if your post office is shut down (ours was).
• Make arrangements with a printer; back up your server to an external hard drive and take it with you; be prepared to pay for offsite accommodations.
• You’ll need a line of credit with your bank, whether you use it or not. The amount depends on where you are and what your payroll is.
• Take advantage of your Facebook page and Twitter accounts and let your readers and followers know that you are providing them with vital information in real time, and that you’re the go-to source for the best and most accurate information they’re going to get about their hometown. That’s something they won’t get from television news that covers the story in broad strokes. All our hurricane-related information was free access on our website.
• Make a list – literally, of everything you need to take in order to publish remotely.
• Make arrangements in advance for air transportation to take photos.
• Now that we’ve done this, we’ll have a news budget planned -- story and photo assignments made, at the start of hurricane season. There are more stories to cover than the obvious, but you really can’t know this until you experience a disaster.
• We have a new perspective on how we approach our hurricane season coverage. Now we really do know what people need to know to be prepared. It won’t be the same old dog and pony show.
• Take “before” photos of the interior and exterior of your office (and home) as well as your vehicles, if any are left behind.
• Be more flexible than you usually are. Things can change on a dime.

Two shot dead, 17 injured in shooting at rural Ky. school

A helicopter lifts off from the Marshall County High School grounds after the shooting. (Image from Reuters TV)
Marshall County (Wikipedia map)
Two people were killed and at least 17 were injured this morning in a shooting at Marshall County High School in Benton, Ky., a town of about 4,300, Gov. Matt Bevin said. A 15-year-old girl died at the school and a 15-year-old boy died at a hospital, he said. Some news reports said 19 were injured; Bevin said those included the two fatalities. Five are in critical condition, NPR reports.

"The shooting occurred in the common area of the school before classes started, said Brian Roy, the former Marshall County sheriff, who has spoken with people at the scene," the Louisville Courier Journal reports. A sheriff's deputy arrested the shooter about nine minutes after the shooting. It happened around 8 a.m. CT just as students were headed to class, NBC reports.

The Marshall County Tribune-Courier reported on its Facebook page at 12:35 p.m. CT, "Two dead, 19 injured in school shooting; 14 injuries are gunshot-related. Five others are not gunshot-related. The shooter is a 15 year-old-male." The weapon was a handgun, State Police Commissioner Rick Sanders said at a news conference (video via Courier Journal). He said students, who recently had training in dealing with active shooters, reacted properly.

The online Marshall County Daily reports, "Two have been transported to Marshall County Hospital, at least one to Lourdes Hospital [in Paducah] and two life-flighted to Nashville hospitals with face, chest and leg injuries. . . . The name of the shooter has not been released." He will be charged with murder and attempted murder, officials said. Marshall County Attorney Jeffery Edwards said he would ask that the boy be tried as an adult.

Edwards "said it did not appear the gunman targeted specific people," the Courier Journal reports. Bevin and Sanders said they wouldn't answer questions, and the journalists didn't ask any. Sanders urged witnesses to talk to state police before talking to news media. "We don't want to do anything to hinder the prosecution," Sanders said.

The incident came a day after a 16-year-old boy shot a 15-year-old girl in a school cafeteria in Italy, Texas, a town of about 1,850. The girl was hospitalized in Dallas. A student told The Associated Press that "she'd complained about the boy at least twice to school officials, including to a vice principal," the Dallas Morning News reports. Cassie Shook, 17, "said she first went to school officials after the boy allegedly made a 'hit list' in eighth grade and her name was on it."

Children's Health Insurance Program extended for six years

After 114 days without a long-term budget, the Children's Health Insurance Program is getting funding for the next six years as a piece of the bill that reopened the government Monday night. The program, which provides health insurance for 9 million American children, has enjoyed broad bipartisan support since its inception in 1997, but has been increasingly employed as a political carrot by Republicans, one which the Democrats refused until today.

"Last fall, Republicans proposed a plan to extend the CHIP program for an additional five years. But that plan included a series of deeply partisan spending cuts to cover the costs of extending CHIP — such as slashing Obamacare programs and Medicare — and Democrats refused to support the bill," Sarah Kliff reports for Vox. States scrambled for emergency funding over the next few months, but Republicans left the program on the back burner in favor of priorities such as repealing and replacing Obamacare, and pushing through a bill cutting taxes.

In its December bill to keep the government open, Congress gave CHIP emergency funding for mid- to late-January, but the two parties still couldn't agree for how to pay for it in the long-term. Republicans wanted states to eventually start paying a greater share of the cost, and Democrats didn't. A Congressional Budget Office estimate ended that debate, saying the elimination of the ACA's individual mandate made it cheaper for states to have CHIP than not.

Republicans added a six-year funding extension for CHIP onto the latest bill to tempt Democrats, who were holding out for action on the Deferred Action for Child Arrivals program. Democrats agreed after Senate Majority Leader Mitch McConnell said he would schedule a vote on a DACA bill "and related issues" by Feb. 8 if the government remains open. The Democrats are hoping that, when the funding bill runs out that day, they will have more leverage on DACA without CHIP hanging over their heads, Dylan Scott reports for Vox.

Fact-checking Trump claims of 'saving' coal country

President Trump's promise to end the "war on coal" and put miners back to work was a mainstay of his campaign, and his administration has taken decisive steps to overturn Obama-era mining and energy regulations, some at the behest of coal magnate Robert Murray. Trump's assertions that the industry is now starting to make a comeback prompted The Washington Post to take a closer look at whether such claims are true, Nicole Lewis reports. The short answer is: not really. Here's a highlight reel:

On Dec. 5 Trump said “If you look at what’s happened in West Virginia and so many different places, we’re sending clean coal. We’re sending it out to different places — China. A lot of coal ordered in China right now. So a lot of things are changing, and they’re changing very rapidly.” But the Post says that in 2015 and 2016, West Virginia exported virtually no coal to China. Also, "there is no such thing as 'clean coal.' Electricity-generating plants can mitigate some of the effects of burning coal by capturing carbon dioxide and burying it, but that doesn’t make the coal itself cleaner. And more important, the bulk of the exports of coal to China involve metallurgical coal, which is used to make steel, not generate electricity," Lewis reports.

Trump said at a rally in Pensacola Dec. 8 that "We’ve lifted the restrictions on American energy, including shale, oil, natural gas and clean, beautiful coal, of which we have 1,000 years of supply." The Post counters that, though the U.S. has the second-largest recoverable coal reserves in the world, the total amount of coal is hard to measure because it's buried underground. But based on the Energy Information Administration's best estimate, the country's coal reserves will last us a little more than 250 years.

Read the entire piece for the whole list of claims and facts, but the upshot is that the president has exaggerated the facts or taken credit for things outside his control.

Ky. attorney general files suit against national drug distributor for flooding some counties with opioids

Kentucky's attorney general has filed suit against a drug wholesaler, saying the company employed unfair, misleading and deceptive business practices to flood the state with highly addictive opioid painkillers.

Democrat Andy Beshear alleges that San Francisco-based  McKesson Corp. failed to report large volumes of opioid shipments in rural eastern Kentucky to state and federal authorities. The suit seeks an unspecified amount of money and an order to keep McKesson from committing false, deceptive or unfair acts.

Floyd County, Kentucky (Wikipedia map)
"The lawsuit said that in the time at issue, McKesson, which supplies pharmacies, had just under a third of the market share. In Floyd County, that means the lawsuit attributed to McKesson about a third of the 56.3 million doses of painkillers — or more than 1,400 per person — distributed from 2010 through 2016," Bill Estep reports for the Lexington Herald-Leader. "The company knew, or at least should have known, that much of the hydrocodone and oxycodocone it was distributing was being sold illegally and abused, the lawsuit argued."

Read more here: http://www.kentucky.com/news/state/article195929964.html#storylink=cpy

Suing drug manufacturers and distributors is an increasingly popular move among attorneys general, advocates, and Native American tribes. And Kentucky, which has been hit hard by the opioid epidemic, has seen success with suing drugmakers for the opioid epidemic: Purdue Pharma settled a civil suit filed in Pike County by a previous attorney general for misleading doctors, patients and regulators about the addictive nature of OxyContin.

Beshear's lawsuit is similar to a suit filed last year by the U.S. Justice Department, which alleged that McKesson failed to report suspiciously large orders for opioids in Kentucky and other states, which contributed to the rise in opioid abuse. McKesson settled the federal case for $150 million. In 2008 the company agreed to pay $13.25 million for similar violations but didn't fully comply with the restrictions set into place after the settlement.

Read more here: http://www.kentucky.com/news/state/article195929964.html#storylink=cp

Monday, January 22, 2018

Keys to fighting opioids in Appalachia: quash stigma, educate public and doctors, share success stories in media

The stigma of opioid addiction in Appalachia "not only keeps some from seeking help, but follows those who did — putting them at risk for relapse," the Knoxville News Sentinel's Kristi L. Nelson reports, on a six-month study that interviewed residents and held discussions with them.

“We interviewed people who had been in recovery for 20 years, and they said they were still viewed in their community as a ‘junkie’ and an addict and can’t get a job,” said Jennifer Reynolds of Oak Ridge Associated Universities, which did the study.

Jennifer Reynolds and Kristin Mattson of Oak Ridge Associated
Universities discuss their report on communication about opioids
in Appalachia. (News Sentinel by Brianna Paciorka)
Reynolds and ORAU colleague Kristin Mattson "found grass-roots community organizations — some made up of people in recovery or families who’d lost loved ones to addiction — are having some impact on the stigma," Nelson reports, but the two said, “We still have a long way to go.”

"The researchers noted some cultural attitudes that contribute to the problem," Nelson reports. "They include an expectation of privacy that keeps neighbors or friends from intervening; a willingness to 'share' pills with someone else experiencing pain; a lack of other opportunities, especially for younger people; and a normalization of dealing with pain by taking pills obtained from a doctor. . . . Some people, they found, don’t realize prevention efforts are aimed at them." One said, “I’m not taking opioids, I’m taking hydrocodone.” That's an opioid. “So they dismissed the message,” Mattson said.

Physicians and rural isolation are part of the problem. "Every focus group had members who said physicians provided them or family members, including children, larger-than-necessary quantities of opioids; a few said they’d gotten 'pushback' from doctors when refusing pills, even when patients told doctors they were in recovery for opioid addiction," Nelson writes. Few, if any, pain-control alternatives are available in small rural communities, such as physical therapy, massage or acupuncture.

The residents said physicians need more training on how to inform patients about opioid use and abuse, and communities need more places to dispose of drugs, as well as better education about drugs, how to properly use opioids and what to ask doctors. Some also called for "random drug testing of youth — to link them with services, not punish them; better access to treatment, including medication-assisted therapies such as suboxone and methadone; peer support for those hospitalized after an overdose or jailed after a drug crime; and more nonjudgmental messages framing addiction as a long-term health problem rather than a moral failing."

The discussion groups also "suggested sharing detailed stories that could make a difference: how it feels to have your child removed because of your drug use; why your mother might be relieved you’re in jail because she knows — at least that day — you aren’t dead; how a legally obtained prescription from a doctor can lead to addiction; and how people do find a way back."

Reynolds, who is ORAU's section manager for health communication, recommends that the news media report more success stories so readers who use opioids don't feel discouraged. At least one recovering addict in Appalachia is being very proactive in taking his story to the public through local newspapers. Phillip Lee of Albany, Ky., writes a column for the Clinton County News and other area newspapers, free of charge.

Reynolds and Mattson's report, "Communicating About Opioids in Appalachia," was produced with two other federal agencies, the Appalachian Regional Commission and the Centers for Disease Control and Prevention. It is based on interviews with 25 people in 12 of the 13 ARC states and a dozen focus groups in the Central Appalachian towns of London, Ky.; Kingston, Tenn.; Oneida, Tenn.; and Princeton, W. Va.

Senate Republicans blame expansion of Medicaid for increased opioid deaths, but research debunks claim

"Republicans in the U.S. Senate are trying out an interesting scapegoating tactic when it comes to the escalation of the nation’s opioid crisis. They are pointing the finger of blame at Medicaid, the federal-state program that provides health care coverage to millions of low-income Americans," Quinn Libson reports for Route Fifty.

The root of their argument: The expansion of Medicaid under Obamacare has increased patients' access to prescription medications, including opioids; some of those patients abuse their prescription opioids and some sell them on the black market. So says a report released Jan. 17 by Sen. Ron Johnson of Wisconsin. Johnson, who chairs the Senate Homeland Security and Governmental Affairs Committee, held a hearing that day with the goal of revealing the "unintended consequences" of Medicaid. In July 2017, Johnson wrote a letter making the same claim to the Department of Health and Human Services' inspector general, saying: "Because opioids are so available and inexpensive through Medicaid, it appears that the program has created a perverse incentive for people to use opioids, sell them for large profits, and stay hooked."

But the facts don't bear out that argument, Quinn reports. Andrew Goodman-Bacon, an assistant professor of economics at Vanderbilt University, and Emma Sandoe, a health-policy Ph.D. student at Harvard University, analyzed Johnson's claim. According to their findings, published in Health Affairs, the claim is not credible for three main reasons: "First, trends in opioid deaths nationally and by Medicaid expansion status predate the ACA. Second, counties with the largest coverage gains actually experienced smaller increases in drug-related mortality than counties with smaller coverage gains. Third, the fact that Medicaid recipients fill more opioid prescriptions than non-recipients largely reflects greater levels of disability and chronic illness in the populations that Medicaid serves. While we do not reject the possibility that public policy has played a role in our current prescription abuse crisis, on balance we find little evidence to support the idea that Medicaid caused or worsened the epidemic."

Cheap corn bad for Iowa farmers, good for hog producers

Iowa Soybean Association photo
Higher pork export profits combined with low-cost feed have prompted a boom in swine barn
construction in Iowa, where a third of U.S. hogs are raised. Permits for hoghouses in the state are at a five-year high, according to data from the Iowa Department of Natural Resources

Hog feed is attractively priced because U.S. corn prices are around $3.50 a bushel, almost $1 less than three years ago. Meanwhile, rising incomes in China, India and other nations have increased global demand for pork. U.S. hog farmers have been quick to respond, increasing the U.S. hog herd to an all-time high of 73.2 million head as of Dec. 1, 2017, up 3- to 4 percent in one year.

"DNR’s 2017 statistics showed that approvals for construction of new hog barns capable of holding more than 1,250 head, and expansions of existing ones totaled 451, up nearly 12 percent from 2016," Theopolis Waters reports for Reuters. "The U.S. hog herd reached an all-time high 73.2 million head as of December 1, 2017, according to the U.S. Department of Agriculture."

New meat packing plants are keeping pace with the increased hog population. "Industry slaughter capacity in 2017 grew 8 percent vs. 2016 after new or revamped facilities came online in Minnesota, Michigan, Missouri, and Iowa, said John Nalivka, president of Oregon-based Sterling Marketing," Waters reports. "He expects capacity to rise another 6 percent in 2018 when another Iowa plant comes online."

Telemedicine shortens ER waits in rural hospitals

Emergency patients in rural hospitals that use telemedicine have shorter wait times than in those that don't have such technology, according to a study from the University of Iowa. Patients wait an average of six minutes less to see a live clinician; if the first clinical assessment is done via telemedicine, 42 percent of the patients in the study saw wait times nearly 15 minutes shorter. And patients who needed to be sent to other hospitals were able to get transferred more quickly because they were assessed more quickly and by more qualified specialists via telemedicine at the first hospital, John Commins reports for HealthLeadersMedia.

The study's lead author, Nicholas Mohr, an emergency physician and associate professor at the Carver College of Medicine at the University of Iowa, said the minutes saved could be the difference between life and death for a rural patient with a serious health problem: "Especially in remote hospitals, that 15 minutes saved could change outcomes for patients with particular conditions that we would expect would be most sensitive to that, such as severe trauma, stroke, myocardial infarction." Mohr is also a researcher with the university's Rural Telehealth Research Center.

The study showed that telemedicine is a valuable tool for the small number of cases that rural hospitals can't effectively assess and treat on their own. "The consultation rate was about 3.5 percent, meaning that if 30 people walked into a rural emergency department, 29 were going to be treated without ever consulting the TM provider," Mohr told Commins. "But, that 30th person is the one that the local clinician pushes the button and asks for help."

The study looked at data from 2,857 emergency department cases in 14 hospitals in Kansas, Nebraska, North Dakota, and South Dakota that use telemedicine services from Avera eCARE Services, an emergency department telemedicine provider based in Sioux Falls, S.D. The telemedicine cases were matched with non-telemedicine control cases.

Telemedicine is becoming increasingly popular with rural hospitals, Mohr notes, as broadband access to rural areas improves. In North Dakota, 80 percent of critical access hospitals use telemedicine. "Mohr says that telemedicine is not the silver bullet that will remove obstacles to healthcare access in rural America, but he sees it as part of the solution," Commins reports.

Tennessee newspapers observing Public Notice Week

The Tennessee Press Association has declared this to be Public Notice Week, designed to remind citizens of the value of public notices -- legally required advertising, usually by local governments. "Legal ads" have become a larger share of newspaper budgets due to declines in circulation and advertising. Meanwhile, local officials across the country continue to ask state legislators to reduce or eliminate laws requiring legals to be published as paid public notice in newspapers. For state data, via an interactive map from the Public Notice Resource Center, click here.

Register for free First Amendment webinar

The National Press Foundation is taking us back to the basics about our First Amendment with a free one-hour webinar at noon EST, Jan. 31. 

First Amendment 101 will cover "everything you need to know about the origins and evolution of the First Amendment, from James Madison’s role to court rulings that shaped its meaning to its critical significance to journalism today."

The featured speakers will be Stephen Wermiel, a professor at the American University Washington College of Law, and Lata Nott, the executive director of the Newseum Institute's First Amendment Center

Advanced registration is required; click here to do so.

Friday, January 19, 2018

How a small Pennsylvania town stood up to racism

Sarah Muir and her son celebrate a MLK Day event in Titusville. (Photo by Ashleigh English)
It's a commonly seen narrative in the news media that the election of Donald Trump emboldened racists. But in a small town in northwestern Pennsylvania that went heavily for Trump, the election--and the emboldened racists--caused "profound soul-searching" that led to an anti-racism campaign called "Stand Up Together."

Most of the 5,601 residents of Titusville are white, and they voted heavily Republican in every major race on the ballot in 2016. And though the town's African-American residents rarely experience violence, some say they saw an uptick in verbal harassment, bullying and racial profiling in the weeks leading up to Election Day in 2016.

It can be easy not to take such microaggressions seriously, but then something happened that caused Titusville's leaders to sit up and take notice. In October, African-American college student Tyra Hollinger was buying snacks at a gas station "when she and her friends were confronted by the driver of a pickup truck who proudly displayed a Confederate flag in his rear window," Jon Jeter reports for Mint Press News. Later, she and her friends told local cafe owner Sarah Muir about the incident.

Muir was appalled, and told her husband Brent. Brent was able to figure out who drove the truck and called the town's police chief, Harold Minch. Minch realized that the truck belonged to the son of one of the town's most respected families and called the young man in to his office to "read him the riot act".

"We want our college students to feel comfortable and to enjoy their college years," said the 55-year old Minch, who describes himself as a lifelong Republican, albeit one experiencing a crisis of faith in the Trump era. "I sure as heck enjoyed mine and a lot of us are committed to letting our African-American students know that we’ve got their back."

Brent Muir told Jeter that he was just "fed up" and that he and other locals have taken it upon themselves to deal with the surge in aggression they've seen over the past year.

The Stand Up Together project kicked off with the town's first-ever Martin Luther King Jr. Day celebration in January 2017, and has been going strong ever since. "On Friday nights, the town drunk and his drinking buddies teach young, dreadlocked black men from Philadelphia and Cleveland to roast marshmallows and hot dogs over a campfire, and tell tall tales," Jeter reports. "Young black women babysit the Muirs' adopted Puerto Rican daughter almost every weekend, braiding her hair and eating so much free food that university administrators call to inquire if they’ve lost their meal card. When a customer photographed a “N—– Job Application” posted on the bulletin board of the only hardware store in town, the university stopped doing business with the store."

No one is under the illusion that racism is a thing of the past, but the project has produced results. Local college student Briana Davis told Jeter, "I just know that as a woman of color, I feel welcomed and free here."

New poll about news media, trust and democracy shows partisan divide; Republicans define 'fake news' broadly

A new survey of more than 19,000 U.S. adults sheds some light on why public trust in the news media is at an all-time low. The key takeaway is that Americans think the news media is an important part of our democracy, but they don't think the media is fulfilling that role. The survey is part of the Knight Foundation Trust, Media and Democracy initiative, and is one of the largest on this topic. It as done by the Gallup Organization. (Click here to read the whole report.)

On Jan. 23, The Washington Post will broadcast live a series of panels exploring the implications of the survey, featuring Judy Woodruff of PBS and Bret Baier of Fox News. You can tune in at PostLive from 9:30 to 11 a.m. ET. Ten findings that stood out from the survey:
  1. 84 percent of Americans think the news media is key to democracy, but only 44 percent can name an objective news source.
  2. There's a sizeable difference in how people belonging to different political parties view the news media: while 54 percent of Democrats have a very or somewhat favorable opinion of the media, only 32 percent of Republicans do.
  3. More news sources can bring more confusion. 58 percent of Americans think having more news sources makes it harder to feel well-informed, while 38 percent say it's easier. And people these days are less satisfied with the sources they see: 50 percent of adults say there are enough sources to sort out facts, as opposed to 66 percent in 1985. 
  4. People are worried about fake news: 73 percent say the spread of inaccurate information on the internet is a major problem with news coverage, more than any other potential kind of news bias. Only 50 percent feel confident that the public can see past the bias to discover the real facts. Less than 33 percent say that they personally are confident they can tell when a news source is reporting hard news and not commentary or opinion.
  5. What is fake news? Opinions vary. Most people believe that knowingly reporting false information as if it were true is fake news. Forty percent of Republicans say that even accurate information is fake news if it casts a certain politician or political group in a negative light.
  6. Whose responsibility is it to inform Americans? 48 percent overall and 53 percent of Republicans said it's individual citizens' job to inform the public, and 48 percent overall and 53 percent of Democrats said it's the news media's job to do so.
  7. Most people believe that the internet, news aggregators, citizen videos and cable news have had a positive impact on the U.S. news over the past 10 years, but 54 percent say the impact of social media sites like Facebook and Twitter has been negative. 53 percent say that political leaders using social media to directly communicate with the public is more negative than positive.
  8. 64 percent of Americans say they share news stories on social media, but 68 percent of that group says they mostly share stories with people who hold similar beliefs. 
  9. 57 percent of people think the way internet platforms choose news stories for them is a major problem for democracy, but opinions are divided over whether such platforms should be regulated: 49 percent are in favor of such regulations, and 47 percent are opposed. 
  10. A person's age and political party is strongly tied to their trust in the news media. Older Americans and Democrats tend to trust the news media more, while younger people and Republicans mostly distrust it.

Country store owner says the work wasn't what he expected

Teago General Store owner Chuck Gunderson, far right, listened to customers. (Valley News photo by Jennifer Hauck)
The residents of South Pomfret, Vermont, see the Teago General Store as a community hub where they can have a cup of coffee with a neighbor and catch up on the local news. But owner Chuck Gunderson, with his reserved demeanor, says he's the "antithesis of what a general store owner should be," Matt Hongoltz-Hetling reports for the Valley News in White River Junction, Vt. and Lebanon, N.H. When he bought the store on the auction block 30 years ago, he didn't realize that social skills would be involved.

"I kind of pictured myself sitting at the desk up front there, with plenty of time to read or write or do whatever I wanted and, you know, sell a few canned goods and things like that in between," Gunderson said.

"Instead," the News reports, "the reserved Gundersen soon found out that his customers — like many patrons of a vanishing breed of Vermont country stores — were interested in more than the hodgepodge assortment of sponges and mousetraps, Snapple and YooHoo, peanut butter and hand-warmers arrayed on the shelves above the well-worn floor boards. They valued the building as a community center — a place where they could strike up a conversation, learn local news and share a cup of coffee with a neighbor."

Since he has just sold the store, Gundrson is reflecting on his 30 years there: what he did to improve the place, his not-so-secret passion for rock 'n' roll as a moonlighting disc jockey, and his frequent columns in the Vermont Standard about his experiences minding the shop. When customers realized he loved music and literature, they began striking up more conversations. "It hasn’t brought me out of my shell so much as maybe it’s brought other people into my shell," Gunderson told the News.

At 73, Gunderson was ready to retire. He sold the store to Kathleen Dolan, a Pomfret resident who moved from New York City 15 years ago. She's already making plans for how to improve the store, and says the it will be there for decades to come.

Energy Department photographer loses job after leaking photo of Secretary Perry hugging coal magnate

Perry and Murray embracing
Department of Energy photographer Sim Edelman has been fired after leaking photos of Energy Secretary Rick Perry hugging coal magnate Robert Murray, the head of Murray Energy, the nation's largest coal company.

Edelman took the photos last year at a private meeting between Perry and Murray, who was a major campaign donor for Trump. One showed the men hugging, and another included the cover sheet of a confidential wish list that Murray brought to the meeting, calling for coal-friendly policy and regulatory changes. The Trump administration has fulfilled most of Murray's requests on the action plan, the contents of which have recently been revealed.

Leaking the photos seemed like "the right thing to do — exercising my First Amendment rights to get the information out there," Edelman told Ben Protess of The New York Times. The photos were published by liberal magazine In These Times on Dec. 6. The day afterward, the Energy Department put Edelman on administrative leave, then fired him later. He has filed a complaint with department's inspector general and is seeking federal whistleblower protection. In the complaint, he accuses the department of retaliation and asks for his job back, or at least the ability to recover his laptop and other personal belongings that were seized from him when he was placed on administrative leave.
The leaked photos of Murray's wish list

FBI probing whether Russians gave to NRA to help Trump

The Federal Bureau of Investigation is investigating whether a Russian banker with ties to the Kremlin illegally funneled money through the National Rifle Association to help Donald Trump become president, Peter Stone and Greg Gordon report for McClatchy Newspapers. It is illegal to use foreign money to influence federal elections.

Alexander Torshin, the deputy governor of Russia's central bank, has a close relationship with Russian President Vladimir Putin and has been implicated in a money-laundering scheme in Spain in 2016. A nearly 500-page report in the Spanish investigation called him a "godfather" in major Russian criminal organization called Taganskaya. Torshin is also a lifetime NRA member, and hosted two dinners for a high-profile NRA delegation in Moscow in 2015, then met with Donald Trump Jr. at the NRA's 2016 convention in Louisville.

The convention meeting "matters because Torshin was involved, through an intermediary, in what was described in an email sent to Trump campaign aides as a 'Russian backdoor overture.' Jared Kushner, Donald Trump's son-in-law, denied his request for a meeting with the candidate on an email chain that allegedly also included aides Rick Dearborn, Paul Manafort and Rick Gates," Julia Glum reports for Newsweek. "Senate investigators argued Tuesday that Kushner had not turned over the messages to them, as they'd requested as part of their probe into the Kremlin's meddling in the election. Kushner's attorney denied it."

Journalists can't determine the extent of the FBI's evidence for the claim, but the NRA spent a record $55 million on the 2016 elections, including $30 million to support Trump; that's three times more than the NRA gave to Mitt Romney in the 2012 race. Most of that money came from a part of the NRA that doesn't have to disclose its donors. They may have spent more like $70 million, according to sources close to the NRA, since groups don't have to report spending on internet ads or field operations like get-out-the-vote drives.

"It’s unclear how long the Torshin inquiry has been ongoing, but the news comes as Justice Department Special Counsel Robert Mueller’s sweeping investigation of Russian meddling in the 2016 election, including whether the Kremlin colluded with Trump’s campaign, has been heating up," Stone and Gordon report. "Torshin is among a phalanx of Putin proxies to draw the close attention of U.S. investigators, who also have tracked the activities of several Russian billionaires and pro-Russian Ukrainian oligarchs that have come in contact with Trump or his surrogate."

Thursday, January 18, 2018

County-level maps show one reason opioid epidemic worsens: lack of treatment, especially medication-assisted

HIV/AIDS advocacy group amfAR offers three maps that illustrate some reasons for the worsening opioid epidemic. They show three things: the number of substance-abuse treatment facilities in each county, which facilities provide at least one medication for opioid addiction, and which provide all three kinds of available medications for opioid addiction, German Lopez reports for Vox.
mfAR maps; clicking on the images will enlarge them slightly.
The first map makes clear that there are a lot of coverage gaps, especially in rural America. It likely understates the level of addiction treatment available in some areas, since doctors can prescribe medication-assisted treatment (MAT) drugs like buprenorphine through a special waiver in their general practice, and that wouldn't show up on the first map, so they did this one:
The number of MAT facilities is markedly smaller, 41.2 percent of the 12,000-plus facilities, German reports. That's an issue, because MAT is "widely considered by experts to be the gold standard in opioid addiction care," German reports, cutting mortality rates among opioid addicts by half or more. MAT is considered so effective that President Trump's commission on the opioid crisis called for a big expansion of MAT.

The last map shows an even smaller subset of treatment facilities: those that offer all three kinds of MAT. "The individual types of medications don’t work for everyone — nothing in addiction treatment does — so it’s important to provide multiple options," German reports.
One reason for the lack of substance-abuse treatment facilities is social stigma, but another is federal funding. "In the past few years, for example, the only new federal effort to dedicate a serious amount of money to the opioid crisis was the Cures Act, which committed $1 billion over two years," German reports. But experts say tens of billions of dollars are needed annually to deal with the opioid epidemic.

Stanford University drug-policy expert Keith Humphreys told German, "Crises in a nation of 300 million people don’t go away for $1 billion. This is the biggest public health epidemic of a generation. Maybe it’s going to be worse than AIDS. So we need to go big."

Bipartisan report says not all rural areas need a hospital

According to a new study by the Bipartisan Policy Center, a one-size-fits-all approach won't work in curing rural America's health care woes. BPC and the Center for Outcomes Research and Education spoke with more than 90 national thought leaders and key stakeholders about the state of rural health in the Upper Midwest states of Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota and Wyoming.

They wanted to understand the real-world implications of federal health policies, discover what health-care challenges the area is facing, and identify ways rural health care could improve. The report could be useful to policy makers in other parts of the U.S., since the problems found are not unique to the Upper Midwest.

One conclusion of the report that could surprise or upset many people: Not every rural community needs a hospital. The Rural Emergency Acute Care Hospital Act proposes turning critical-access hospitals in some communities from inpatient care centers to rural emergency centers or other useful facilities.

The report also recommends creating funding mechanisms for rural health care that reflect specific problems in rural areas, such as low population and high operating costs. It also recommends that rural communities start grooming young, local residents to become health-care workers through middle school, and high-school programs that encourage their interest. Finally, the report recommends expanding telemedicine services, noting that broadband availability is an ongoing problem in doing so.

FCC chairman proposes $500 million for rural broadband

Federal Communications Commission Chairman Ajit Pai has proposed an order that would provide $500 million in additional funding to bring broadband internet to rural America. The funding would go to cooperatives and small telecommunications companies. The proposed order hasn't been released yet, so more details aren't yet available.

Besides trying to close the rural broadband gap, the order would "institute new regulations aimed at preventing abuse of the Connect America Fund and promote broadband access in tribal lands," Mallory Locklear reports for Engadget. The Connect America Fund, also known as the Universal Service High-Cost Program, is an FCC program to expand telephone and broadband services to rural areas. Under the program, "the FCC provides funding to local telephone companies to subsidize the cost of building new network infrastructure or performing network upgrades to provide voice and broadband service in areas where it is lacking," according to the FCC website.

The proposed order "comes on the heels of President Donald Trump signing an executive order that speeds up federal permitting for broadband expansion in rural areas and makes it easier for wireless operators to put cell towers on federal lands," Jake Smith reports for ZDNet. "As part of a Connect America Fund promise, AT&T has been rolling out wireless internet to rural areas since April of last year and as of September, it had launched its services in 18 states," Locklear reports. 

Americans without a college degree, more common in rural areas, are dying 'deaths of despair,' researchers say

"The data are clear: Life is getting harder and harder for Americans without college degrees. People with a high-school education or less tend to face worse economic prospects and have poorer health," Sarah Brown reports for The Chronicle of Higher Education.

The increase in mortality among middle-aged white Americans who don't have a college degree is primarily due to "deaths of despair" caused by alcohol, drugs and suicide, according to researchers at Princeton University. President Trump won 67 percent of white voters without a college degree, a demographic that can be a rough analogue for rural America, and he performed particularly well in counties with the highest mortality rates from these deaths of despair.

Dunklin County (Wikipedia map)
Is the despair connected to why people voted for Trump? Brown went to Missouri's rural Bootheel to find out what the locals thought. In Dunklin County, where only 10 percent of adults have a 4-year degree, 76 percent of voters went for Trump. The life expectancy there is 72.6 years, 6.5 years less than the national average. Because of job losses in the manufacturing and agricultural sectors over the past few decades, more people are relying on government assistance.

Brown talked to several people who expressed disdain for people who receive public aid because they're "too lazy to work." One man, David Ross, said that he has open positions at his trucking and excavation company that he can't fill. "If there were less government assistance, he says, maybe more people would be forced to take the jobs that are available, even if the work isn’t glamorous," Brown reports.

The county was devastated in 2006 when Emerson Electric Co., its largest employer, closed its plant in the county seat of Kennett. Many of the jobs went to Mexico., so Trump's emphasis on bringing manufacturing jobs back to the U.S. resonated in Dunklin.

Some locals noted that those who go to college don't tend to come back, since there are no high-skill jobs available in the area, so boosting college attendance among small-town teenagers isn't a cure-all for rural America's woes. Many rural high schools lack the resources to offer Advanced Placement courses that can help prepare them for college and possibly earn course credit. In Illinois, a new program will help 75 students at 10 rural high schools take AP courses, The Associated Press reports. If the program is successful, Lt. Gov. Evelyn Sanguinetti, who leads the Governor's Rural Affairs Council, says the program may expand.

Another California movement seeks to create a 51st state

The proposed New California map
The difference between rural and urban areas in a state can be striking, and California has seen several separatist movements, mostly to break off the rural north. The latest one goes farther, "separating rural areas in California from the state's coastal cities and Sacramento, with supporters saying the state has become 'ungovernable,'" Julia Manchester reports for The Hill.

The conservative-oriented movement says California is a "failed state" because of its high taxes and declining health care. "There’s something wrong when you have a rural county such as this one, and you go down to Orange County which is mostly urban, and it has the same set of problems, and it happens because of how the state is being governed and taxed,” founder Robert Paul Preston told CBS Sacramento.

"Unlike other separation movements in the past, the state of New California wants to do things by the book, citing Article 4, Section 3 of the U.S. Constitution and working with the state legislature to get it done," CBS reports. "The group is organized with committees and a council of county representatives, but say it will take 10 to 18 months before they are ready to fully engage with the state legislature." Abby Hamblin of the Los Angeles Times writes that the effort is a long shot, to say the least. But it could be a barometer for rural sentiment.

Wednesday, January 17, 2018

Rural hospitals in states that expanded Medicaid have been six times less likely to close than in states that didn't

Rural hospitals in states that expanded Medicaid were six times less likely to close than those in states that didn't, according to a study published in the January edition of the journal Health Affairs. "Richard Lindrooth, a professor at the Colorado School of Public Health and lead author of the study, says hospitals saw more people showing up to hospitals with that insurance — so Medicaid payments increased. That helped the hospitals' bottom line," John Daley reports for NPR.

Lindrooth and his team of researchers at the University of Colorado examined national hospital data and local market conditions from the four years leading up to the Patient Protection and Affordable Care Act (2008-2012) and the two years after the act took full effect with Medicaid expansion (2015-2016). They found that about half the hospital closures in non-expansion states could have been averted through Medicaid expansion. Expansion-state hospitals had more insured people, so they made more money and provided less free care, reducing cost margins, he told Daley.

Jason Clecker, CEO of Delta Memorial Hospital in rural western Colorado, said Medicaid expansion helped his hospital's finances. Between 2011 and 2016, the number of Medicaid patients seen in his hospital increased from 10 percent to 20 percent, and since the hospital had to provide less free care, it saved more than $3 million. "Our bad debt decreased significantly, and the uninsured rate decreased significantly," Cleckler told Daley. "It's pretty remarkable, and I would venture to say that most hospitals, even ones with a lower percentage of Medicaid, have experienced a similar story."

Cleckler also said Medicaid was a "mixed bag" for rural health care providers, since reimbursement rates are sometimes very low. Because of that, some providers won't accept or limit the number of Medicaid patients they'll accept.

Kentucky partnership creates system to track drug overdoses, to help fight opioid epidemic

Kentucky has been hit hard by the opioid epidemic, but the state is trying to fight it with innovative efforts to gather more specific data about overdose deaths. The Kentucky Injury Prevention and Research Center, a partnership between the state Department for Public Health and the University of Kentucky College of Public Health, built a "drug-overdose fatality surveillance system" that combines information sources like death-certificate information, post-mortem toxicology analysis, and victims' prescription history to get a better picture of which drugs are killing people and under what circumstances.

"The efforts that KIPRC and the state have made to improve this data have led to crucial findings, including that Kentucky’s crisis isn’t one crisis, but many," Kathryn Casteel reports for FiveThirtyEight. "Different parts of the state are afflicted with different drugs. Northern Kentucky, for example, has a high prevalence of heroin and fentanyl — a synthetic opioid that is more deadly than heroin and other types of opioids — while in the eastern part of the state, prescription opioids are still the main concern.
KIPRC chart; click on the image to enlarge it.
"We’re not doing this for the sake of research," Svetla Slavova, a biostatistician with KIPRC, told Casteel. "We provide actionable data for policymaking, treatment and prevention. We’re trying to be responsive and provide data that will help make these decisions." Because of KIPRC's research, Van Ingram, the executive director of the Kentucky Office of Drug Control Policy, said he was able to push legislation increasing the availability of the anti-overdose drug naloxone.

One of KIPRC's biggest efforts is to make death-certificate information more uniform across the state, because "even the smallest differences in language can leave overdose deaths uncounted," Casteel reports. Sarah Hargrove, a data management analyst for KIPRC and former autopsy technician for the state, is spearheading the effort. It's tough going, since some coroners in the state's 120 counties, many of them small, have limited resources and funding, and many have little medical experience.

But KIPRC is making headway. "Researchers were able to determine the specific drugs that were involved in 97 percent of drug overdose fatalities in 2016; that’s compared with 82 percent using death certificates alone," Casteel reports. The also used the surveillance system "to find which drugs were most commonly involved in deaths linked to a combination of substances, as well as which drugs were involved in overdose deaths among people of different age groups and genders."

Analysts think Ky.'s newly approved Medicaid work requirement poses little political risk

"On Jan. 12, Kentucky became the first state to get federal permission to suspend Medicaid coverage for "'able-bodied' adults who don't complete 80 hours per month of community engagement activities," like employment, education, job-skills training and community service," Tony Pugh reports for McClatchy's DC bureau. And though Kentucky is one of the poorest states and its residents the sickest, Pugh found the decision is unlikely to have much political blowback. A 2017 Kaiser Family Foundation poll found that 70 percent of Americans support work requirements for Medicaid recipients, and Bevin is betting deep-red Kentucky feels the same way.

Kaiser Family Foundation chart. Click here for more information.

Read more here: http://www.mcclatchydc.com/news/politics-government/article194990909.html#storylink=cpy
In Kentucky and other states with many low-income residents, people who work--and often struggle to pay for health care--tend to resent those who get government-subsidized health care, according to Al Cross, director of the Institute for Rural Journalism and Community Issues. "If you can say, 'All we’re doing is requiring people to be more active participants in their health care and require some work-related activities,' I think the general population looks at that and says, 'What’s the matter with that?'" Cross told Pugh.

"Supporters say the Medicaid work policy will cut government dependency, weed out people who don’t really need the assistance and build work ethic among low-income enrollees," Pugh reports. "Critics say the requirement will be expensive to administer, provide an unnecessary barrier to coverage and penalize people who can’t work due to undiagnosed medical problems." Kentucky's new policy estimates nearly 100,000 fewer Kentuckians will have health coverage in five years, than if the policy were not implemented.

Eight other states with Republican governors (Arkansas, Arizona, Indiana, Kansas, Maine, New Hampshire, Utah and Wisconsin) and one state with a Democratic governor (North Carolina) have asked the Trump administration for the green light to enact similar requirements. Several of those states could be battlegrounds in statewide and congressional elections in November. But the Medicaid work requirements aren't likely to be a problem for most Kentucky Republicans, since there are no statewide races this year.

The traditionally lower turnout among low-income voters who would be affected by the measure could also help protect Republicans, Cross said. And it's worth noting that the Kentucky counties with the highest Medicaid rates backed Bevin in 2014, mostly because of social issues such as religion, abortion and anti-Obama sentiment.

But the political dynamics at play in Kentucky may not apply in other states. "It may depend on rival Democrats making a linkage between Medicaid and overall concerns about health care and insurance," Pugh writes. Democrats are likely to emphasize health coverage in elections this year, since 3.2 million Americans lost health coverage in 2017 and it's an issue that most people care about. A poll by Hart Research Associates last week showed that voters cared about health care more than the economy, taxes, immigration, or terrorism in the 2018 congressional elections.

Tuesday, January 16, 2018

Feb. 2 is entry deadline for Scripps Howard Awards, including a $10,000 prize for community journalism

Entries for the 2017 Scripps Howard Awards, which include a category for community journalism, will be accepted through 11:59 p.m. local time Friday, Feb. 2.

First place in each of the 16 categories carries a $10,000 prize. New this year is the Impact Award, formerly called Public Service, which will honor the year's best work from all winners. Finalists will be announced Tuesday, Feb. 27; winners will be announced Tuesday, March 6. The awards are sponsored by the Scripps Howard Foundation, started by the E.W. Scripps Co., parent firm of Scripps-Howard Newspapers. For more information click here.

Walmart fires about 3,500 store co-managers

In the days since Walmart announced that it was raising its starting wage, giving out employee bonuses and expanding paid parental leave, the mega-chain has quietly tightened its belt in other areas. On Jan. 12, the company announced it is laying off about 3,500 salaried store co-managers, replacing them with 1,700 lower-paid assistant store managers, Matthew Boyle reports for Bloomberg.

Hours after Walmart's Jan. 11 announcement about the wages, which it credited to the recent corporate tax cut, the news media got wind that Walmart had abruptly closed 63 Sam's Club stores across the nation, with 9,400 employees. Some workers only found out that they had lost their jobs when they showed up to work to find a sign printed on the barred door. Ten of the Sam's Clubs will be turned into distribution centers for online orders, and employees will have the opportunity to apply for jobs there.  

Business Insider reporter Hayley Peterson, who broke the Sam's Club story, said on NPR, "It's highly unusual for companies as big as Walmart to not give employees notice about store closings," but that focusing on its online operation is a sound strategy for competing with Amazon.

Private grain buyers working with senators to change tax-overhaul provision that favors grain cooperatives

"Republican U.S. senators are working with some of the world's biggest agricultural merchants to undo a last-minute provision in the tax overhaul that threatens to distort the grains market and starve private firms of corn, soy and wheat supplies," Tom Polansek reports for Reuters. "The provision gives farmers a 20 percent deduction on payments for sales of crops to farmer-owned cooperatives, but not for sales to private or investor-owned grains handlers." The language was intended to help co-ops and their farmer-owners because the tax overhaul eliminated a part of the tax code that had benefited them for more than a decade.

"If legislators do not address the provision by the autumn harvest, private grain companies could lose out on deals to buy billions of bushels of corn and soybeans," Polansek reports. "Farmers already are looking at how they can transfer grain stored at private elevators to co-ops to take advantage of the new law."

Co-ops defended the new tax law. "Chris Pearson, chief executive of the South Dakota Wheat Growers co-op, said on Twitter on Wednesday that the law 'gives farmers some nice tax advantages when doing business with the ORGANIZATION THEY OWN!'" Polansek reports.

Large private grain traders like Cargill Inc. and Archer Daniels Midland Co., which would lose out with the provision, have urged senators to change it, and it looks like they're listening. The National Council of Farmer Cooperatives and the National Grain and Feed Association have been working with Republican Sens. John Hoeven of North Dakota, John Thune of South Dakota and Pat Roberts of Kansas to find a more palatable solution. The Department of Agriculture said last week that it expects a solution soon.

Trump's Task Force on Agriculture and Rural Prosperity calls for connectivity, quality of life, other goals

Agriculture Secretary Perdue on RV listening tour (USDA photo)
On Jan. 8 the Interagency Task Force on Agriculture and Rural Prosperity gave President Trump its report on ways to improve life in rural America. The report identified five "Calls to Action": Achieving e-Connectivity for Rural America, Improving Quality of Life, Supporting a Rural Workforce, Harnessing Technological Innovation and Developing the Rural Economy. Each call to action included a list of recommendations for legislative, regulatory and policy changes to help implement each call to action.

"To achieve the objectives set out in the report, the task force also recommends the president establish a federal commission on agriculture and rural prosperity that would meet at least bi-annually and prepare regular reports to the president on its progress," Jenny Schlecht reports for AgWeek. "It also recommends establishing a stakeholder advisory council to advise the commission and establishing a managing director to oversee both the commission and the advisory council."

Trump established the task force April 25 and made Agriculture Secretary Sonny Perdue its chair. It solicited public feedback by holding listening sessions and taking comments from the public online. Perdue also went on a 30-state RV tour.

"Many of the recommendations throughout the report involve improving cooperation among federal agencies, establishing additional task forces, reducing regulatory burdens and finding better ways to utilize existing resources," Schlecht reports.

Monday, January 15, 2018

Transportation Secretary Chao tells automakers not to forget about rural areas as they develop self-driving vehicles

Transportation Secretary Elaine Chao
(Detroit Free Press photo by Kathleen Galligan)
As it develops self-driving vehicles, the automobile industry must keep rural communities in mind, Transportation Secretary Elaine Chao told industry leaders Sunday at the North American International Auto Show in Detroit.

Chao said autonomous vehicles have "tremendous potential" to improve safety and drive economic growth, "but she also said that automakers need to ensure that self-driving cars are accessible to people who live outside big cities," Nathan Bomey reports for USA Today.

"We want to be inclusive as well and consider how this technology can benefit rural America," Chao told Bomey in an interview. Self-driving cars are likely to be first available in ride-sharing fleets in metropolitan areas in 2019, "but not everyone lives downtown," Chao said in her speech. "And it is worth noting that rural America accounts for a disproportionately large share of highway fatalities. So, automated technology (has) an important role to play in rural mobility and safety."

Chao is married to Senate Majority Leader Mitch McConnell of Kentucky, one of the more rural states.

Farmworkers getting older; many have chronic ailments and spotty health coverage; production in California slows

Farmworkers harvesting in California, the No. 1 agricultural state (Photo from University of California, Davis)
As immigration from Mexico slows, "Harvesting U.S. crops has been left to an aging population of farmworkers whose health has suffered from decades of hard labor," Sarah Varney of Kaiser Health News reports for the Los Angeles Times. "Older workers have a greater chance of getting injured and of developing chronic illnesses, which can raise the cost of workers' compensation and health insurance."

Federal data show that the average age of a farmworker in the U.S. is 45, and that fewer have migrated from Mexico in recent years. "Researchers point to a number of causes: tighter border controls, higher prices charged by smugglers, well-paying construction jobs and a growing middle class in Mexico that doesn't want to pick vegetables for Americans," Varney reports.

Varney gives several examples of injuries and ailments that can result from working in the fields. "Many farmworkers don't have health insurance and pay what they can for medical care. Those who have immigration papers rely on Medicaid," she writes. "Only workers with legal status agreed to be interviewed for this story. Most farmworkers, however, are not working in this country legally, and their health coverage is spotty. They are employed by subcontractors who are supposed to offer them health insurance, but seven years after the passage of the Affordable Care Act, there's no good accounting for how many employers are complying with the law."

Farmer Brent McKinsey told Varney, "You start to see your production drop, but it's difficult to manage because there aren't the younger people wanting to come in and work in this industry." McKinsey "says farmers are trying to mechanize planting and harvesting to reduce their labor needs. But machines can only do so much, McKinsey said. You can replace the human hand in a factory, perhaps. But out here, the fields are bumpy and the winds are strong, and you need people to bring the plants to life."

Northern Utah daily runs reported Trump quotation, with a note directing reader complaints to the president

President Trump's vulgar comment about African countries and Haiti forced news organizations to decide whether they would report the verbatim quotation reported by Democratic Sen. Dick Durbin of Illinois, and if so, how they would handle it. Perhaps the most interesting approach was taken by The Herald Journal of Logan, Utah, which ran the Associated Press story with a headline that used the verbatim quotation and followed it with an editor's note:

"Since President Donald Trump's statement about immigrants from certain areas of the world is taking over the story on the immigration deal being negotiated in Washington, we will be using the president's language verbatim in print and online. Feel free to direct your complaints about the president's choice of language via postal service to 1600 Pennsylvania Ave NW, Washington, DC 20500, online at https://www.whitehouse.gov/contact/ or via Twitter @realDonaldTrump."

Readers' limited comments on the story were favorable. One called it "priceless."

The Herald Journal is published by Seattle-based Pioneer News Group, which also has papers in Washington, Oregon, Idaho and Montana. Some of its larger papers, such as the Idaho State Journal in Pocatello and the Bozeman Daily Chronicle in Montana, ran the story with the headline but without an editor's note.

Jan. 30 is deadline to seek Hillman Prizes, which recognize journalism that advances social and economic justice

Jan. 30 is the deadline for nominations for the 2018 Hillman Prizes, which honor investigative journalism and commentary that advance social and economic justice. "Winners exemplify reportorial excellence, storytelling skill, and public service impact," says the Sidney Hillman Foundation, named for a pioneer of the labor movement.

The categories for work published or premiered in 2017 are newspaper reporting, magazine reporting, nonfiction book, web journalism (material that appeared online but not in print), broadcast journalism, (at least 20 minutes in total package length) and opinion and analysis journalism in any medium. Each carries a $5,000 prize.

There is no fee to enter. A cover letter and the nominated material are the only requirements. View the entry form and instructions. See previous winners here. Winners will be announced in April 2018. Each honoree is awarded travel to New York City for the awards ceremony on May 8.

Saturday, January 13, 2018

Work requirements, likely coming to Medicaid in several states, will be problematic in rural areas short of jobs

The Trump administration gave Kentucky the power to impose work requirements on Medicaid beneficiaries Friday, granting the first of what are expected to be many "waivers" of normal Medicaid rules under a new policy the administration declared days earlier.

Kentucky has many rural areas that are short of jobs, so state officials say they plan to phase in the program, reaching such areas last, under federal rules that "allow states to account for local conditions, such as high unemployment in certain areas or other factors, to provide exemptions from a work requirement," Dylan Scott reports for Vox.

Rural areas could have "less robust transportation, and fewer social support services, all things that might lead a state to provide an exemption from the work requirement," Scott writes. Because rural areas are "more likely to be white . . . the result, intentional or not, is that black people on Medicaid — because they are more likely to live in urban areas, where those grounds for exemption are less likely to be found — could face a higher burden under these waivers."

UPDATE, Jan. 15: Phil Galewitz and Pauline Batrolone of Kaiser Health News explain why implementing work requirements will be complicated.

The Kentucky plan will require Medicaid members to report changes in their income, employment or volunteer status, and require them to pay small, income-based premiums, or be dropped from the program for six months. They could re-enroll more quickly by taking a health- or financial-literacy course, but critics of the plan say the reporting and payment system (to be handled by managed-care companies) will be a bureaucratic obstacle that will keep some people from getting health care.

“Documenting compliance will often not be trivial, and even small hassle costs can discourage people from signing up for insurance coverage,” Matt Fiedler, who covers health care policy for the Brookings Institution, told Scott. “Higher hassle costs will likely cause meaningful reductions in Medicaid coverage even among people who are working.” Kentucky's waiver proposal predicted that without it, the state's Medicaid rolls in five years would have about 95,000 more people than with it, the only reasons given being "program non-compliance" and "participants are expected to transition to commercial coverage," but doesn't explain how they will be able to afford that.

"Any approved waivers are expected to be swiftly met with legal challenges," Scott writes. "The issue hinges on whether requiring work for Medicaid can be construed as furthering the goals of the Medicaid program, which contains no explicit reference to encouraging work." Most Medicaid beneficiaries work. Among those who don't, here are the reasons they give: