If you stop at a roadside restaurant anywhere between North Dakota and Oklahoma, you might not immediately get a sense of culinary diversity. Many menus in rural and small-town middle America consist of high-calorie burgers and processed Caesar salads, along with a few trending items like Buffalo cauliflower or flatbreads. Of course, the region does include diverse cuisines, but you have to seek them out, and even those restaurants often depend on ingredients from massive food suppliers such as Sysco that tend to homogenize flavors. 

The middle of the country’s reputation for bland food completely ignores our Indigenous peoples. Within this core of America, dismissed by some as “flyover states,” lies a rich tapestry of culinary heritages. The states of Oklahoma, Nebraska, Kansas, Missouri, Arkansas, the Dakotas, and Iowa are home to 58 federally recognized tribes, each with unique food traditions, including the amazing agricultural heritage of the Mandan, Arikara, and Hidatsa; the bison-centered foodways of the Plains tribes like the Lakota and Cheyenne; and the many cuisines of tribes forced into modern-day Oklahoma after Andrew Jackson’s racist Indian Removal Act.

As a member of the Oglala Lakota from Pine Ridge, South Dakota, a chef, and a historian, I see the massive potential in harnessing, cultivating, and elevating the Indigenous culinary creativity that permeates this massive region. A broad, Native-led restaurant industry could become a huge driver of food-focused tourism. I imagine a world where we could travel across this terrain, stopping at Indigenous-focused restaurants representing the many tribes, and experiencing the true flavors of the area. 

In Nebraska, travelers could taste heirloom hominy made with Ponca corn, sage grouse with wild onions, or venison with prickly pear. In the Dakotas and the Great Plains, they might find smoked venison with the rich Lakota chokecherry sauce called wojapi, or antelope with nopales and rosehips. In Oklahoma, Cherokee cooks could whip up grape dumpling soup with stewed rabbit and bergamot-fried onion with turkey eggs and plums for those passing through. These restaurants, with menus rooted in game dishes, heirloom seeds, and wild plants, would fit within a broader Native movement that acknowledges the contributions of Indigenous peoples, educates the public, transcends colonial borders, and promotes understanding about the biodiversity existing alongside cultures.

There’s a long way to go before this dream can become a reality. Many non-Native diners, if they think of Indigenous food at all, can only conjure up fry bread, a survival food taught to us by the U.S. military. Unfortunately, this food, made with commodity ingredients provided by the U.S. government such as white flour and lard, has also contributed to the high rates of diabetes and heart disease that our people have historically suffered. Though fry bread is now an inextricable chapter of our foodways, it should in no way be considered the full story. Other Indigenous culinary identities have been buried, just as Native stories and art are distorted through non-Native gift shops, galleries, and even museums.

Moreover, Native communities are largely economically cut out from other parts of the tourism industry, which brings in billions of dollars a year to each heartland state. This is especially true for national and state parks, lands that Native communities have stewarded for countless generations (despite some attempts at co-management and small economic programs to funnel money to tribes). In South Dakota, for instance, Black Hills National Forest and Mount Rushmore attracted 3.6 million tourists in 2021, but the poverty rate on the nearby Pine Ridge Reservation is 53 percent. Pine Ridge, like all reservations, is still segregated, with scarce economic opportunities. As Native residents struggle to find any kind of economic peace and survive in food deserts off government-supplied rations and junk food from gas stations, they also continue the fight for their ancestral spaces.

At the same time, the tourism industry could be a powerful tool for change — and this renaissance is already happening, if slowly. Native chefs and food entrepreneurs are working hard to showcase their cultures and reclaim their narratives, one dish at a time. Native-owned restaurants are proving that they’re not just relics of the past preserving traditional dishes, but living, evolving blueprints that continue to nourish and sustain their communities economically, as well as nutritionally, culturally, and environmentally.

Take, for instance, the work of chef Nico Albert Williams at Burning Cedar, a catering and education nonprofit project out of Tulsa, Oklahoma. At pop-up dinners, Williams offers menus with contemporary dishes like seed-crusted venison chops, smoky cedar-braised brown beans, venison and hominy stew, and Cherokee bean bread. It’s just one of several operations, including 2024 James Beard semifinalist Natv, that is making Oklahoma a hub for regional dining experiences.

At Owamni, my restaurant in Minneapolis, my team focuses on decolonizing our diet, removing ingredients like wheat flour, dairy, sugar, beef, pork, and chicken, all items introduced to the region not long ago. Through our cuisine, we are showcasing what’s possible, with dishes like slow-braised elk tacos with fresh tortillas from Potawatomi corn — made at our Indigenous Food Lab — finished with tangy maple-pickled onions, grilled sweet potatoes with maple and chiles; or slow-smoked bison short rib with bitter aronia berries, finished with pickled squash. 

It is unfortunately still rare to find Indigenous food businesses like these. One barrier is trying to define Native American food in a country that has no idea what that means, especially breaking down the oversimplified category of “Native food” to reveal the immense diversity across foodways. Another barrier is financing; good luck finding any of the support required to start businesses on a reservation, without a rich uncle, outside investors, or even reliable access to a bank account. Racial inequalities are very much baked into the systems and institutions needed to launch a restaurant.

Dismantling these barriers would require a lot of work, but it could start in public spaces. State and city governments can purchase from Indigenous food producers, such as farmers, foragers, hunters, and fisheries, which would help strengthen and grow much-needed food economies. Indigenous offerings should be made available in schools and hospitals to help normalize these ingredients on menus. If we highlight foods and cultures so they are not only acknowledged but cherished, a future can develop where the richness of our collective heritage is a source of pride and inspiration for every American. We can learn to embrace our amazing diversity instead of fearing it.

Indigenous foodways are attainable models of sustainability, offering a proud connection to the land. They also provide a path to food sovereignty, enshrining the right for Native peoples to define themselves on their own terms. But even if those arguments aren’t acknowledged by those who have ignored Indigenous needs for so long, Native restaurants could begin to rewrite the reputation of “flyover country.” The heartland could become a more desirable tourist destination, not just for its natural beauty, but for its cultural and culinary heritage. With every plate of smoked venison, heirloom hominy, or stewed rabbit, we get a little closer.

You are on Native land, so let us celebrate the vibrant, varied tapestry that is the true heart of America.

Less than two years ago, neighbors near Brush Creek Boulevard and Troost Avenue had choices when they needed to pick up a prescription — or a carton of milk.

A CVS pharmacy stood on the northeast corner of their intersection. Its retail rival, Walgreens, was just a block south at Troost and Emanuel Cleaver II Boulevard. 

But today, a beauty supply store sits in the old CVS space. The pharmacy closed in April 2023. And the Walgreens, which had moved out five months before, remains empty. Weeds sprout through cracks in the parking lot and graffiti marks the drive-thru window.

Now people in this part of Kansas City, home to some of its poorest neighborhoods, may have to catch a bus just to fill a prescription. Even if the buses are running on time and it only takes 10 minutes at the drugstore, the round trip to the nearest CVS or Walgreens would take nearly two hours. 

“When you don’t have something close to where you live,” said Alana Henry, the former executive director of the Ivanhoe Neighborhood Council, “it makes life more complicated.”

Retail pharmacies are shutting down in places like Kansas City and Wichita across the country, posing a growing worry for health experts. It’s most acute where the incomes are lower, in urban cores and small towns where pharmacies act as convenience stores of the health care system. 

“When those community pharmacies close,” said Lucas Berenbrok, an associate professor at the University of Pittsburgh School of Pharmacy who has been mapping closures, “communities lose critical access.”

Why losing pharmacies matters

Kansas City has lost close to 100 pharmacies in the last 10 years. CVS closed at least 11 stores, including one on Independence Avenue this summer. Walgreens shut down five, and another on East 63rd Street is expected to close at the end of the September.

Nationally, Berenbrok’s mapping shows about 7,000 pharmacies shuttered since 2019. His analysis doesn’t yet include what’s believed to be a far smaller number of stores that have opened. 

“It matters that someone lost access to care,” Berenbrok said.

The closings come at a time when, an Associated Press analysis found in June, people in majority Black or Latino neighborhoods and rural residents already have the fewest pharmacies per capita. Pharmacies also tend to represent a critical source of health care — sometimes the only one. 

Some chain stores even operate urgent-care clinics, where patients can get tested for strep throat or prescribed an antibiotic.

When Walgreens and CVS pulled out of their Troost locations, residents said goodbye to two important anchors in their community, said Bill Drummond, a glass artist who lives in the nearby Manheim neighborhood. 

“Community health is what it was,” he said.

Yes, the prescriptions. But also a place to check your blood pressure, get a flu shot or other vaccination, get COVID tests. Most importantly, somebody there could answer medical questions. 

Russell B. Melchert, dean of the University of Missouri-Kansas City School of Pharmacy, said pharmacists have always filled that role. When COVID hit, that became even more clear. 

Pharmacies picked up some of the work that overcrowded hospitals or temporarily shuttered doctor’s offices would normally handle. And as the shortage of primary care providers increases wait times for appointments, the need for pharmacists keeps expanding.

“We have a gap in primary care services,” Melchert said. “And that’s for people who have health insurance. What about the many hundreds of thousands who don’t? They have nothing.”

Why are pharmacies closing?

To understand why pharmacies are closing, it’s helpful to understand the terrain that has shaped them: Steep climbs in the number of prescription drugs available and deep canyons in the profits those drugs bring in.

Until the 1960s, pharmacies sold medicine directly to consumers. A patient left the doctor’s office with a prescription, took it to the neighborhood drugstore and paid whatever the pharmacy charged.

Then came prescription insurance coverage, which started small 60 years ago and quickly expanded. It reached near ubiquity in 2006 when Medicare added drug coverage. The industry helped open a flood of new drugs — and gradually determined what drugs you could get and how much a pharmacy would get from sales.

In 1950, every American took an estimated 2.4 prescription drugs each year. By 2015, that shot up to 17.3, according to a textbook written by Lawton Robert Burns, a management professor at the University of Pennsylvania.

Today, just under 10% of U.S. health care spending goes to drugs. That’s out of the $4.5 trillion on all health care, or $13,493 per person. In 1970, per capita health care spending was only $353, or around $2,000 in 2022 dollars.

The money to be made on prescription drugs drew chain pharmacies like CVS and Walgreens to buy out family-owned drugstores and build new stores — often within blocks of one another. 

But the chains’ building boom in the 1990s and early 2000s has been followed by retreat in the last decade. (It doesn’t help that the chains are also absorbing multi-billion dollar settlements of lawsuits over their roles in the opioid crisis. In 2022, CVS agreed to pay $5 billion, while Walgreens agreed to pay $5.7 billion.)

For reasons that involve the complicated way insurance companies reimburse pharmacies for drugs, profits from prescriptions began to fall. In many cases, they plummeted so much that pharmacists couldn’t cover their costs.

On top of that, buying habits changed. People started getting medicine through the mail and buying shampoo, toothpaste and other front-of-the-store products online.

That’s why the drugstore on your block may have closed or could be next.

The story is especially dire for small independent stores. The National Community Pharmacists  Association estimates that one independent pharmacy closed every day of 2023, and the organization expects a similar trend this year.

Even chain stores feel the pinch. 

CVS has closed 850 stores since 2022. It expects to close 50 more this year. Walgreens has closed 2,000 stores over the last decade. Now it’s deciding whether to shutter an additional 2,150 that the company calls “underperforming.” That’s one in four of its remaining retail locations.

Executives with Walgreens Boots Alliance Inc., Walgreens’ owner, told analysts in a June stock earnings call that they would only stick with stores that are making money. The rest have to go. 

Losing access to care

Tessa Schnelle, a pharmacist who has studied pharmacy deserts in rural Kansas, worries people underestimate the punch coming to the health care system. 

Her research found that 210 Kansas towns are in a rural pharmacy desert, which she defines as having residents who live 10 miles or more from a pharmacy. On average, people within those deserts live about 13 miles from a pharmacy. But she expects that to continue to get worse as more pharmacies are forced to close.

Schnelle, past president of the Kansas Pharmacists Association, often hears people dismiss concerns about pharmacies being far away. After all, people can get drugs through the mail. Or, as is happening in limited capacity, from a pre-stocked vending machine.

But those solutions easily fall apart without much scrutiny, she said.

“What if I have an ear infection?” she said. “And they’re going to prescribe an antimicrobial? There is no place for me to get that, and it’s going to take multiple days for me to get that from the mail order. … And there’s no one to educate me if I’m getting it from a (vending machine).”

The same goes for home delivery pharmacies, which are becoming more common, Schnelle said. Even if those services can get the medication to patients, having the drugs without the pharmacist has drawbacks.

Pharmacists play a much bigger role than just counting pills and putting them in bottles, she said. They’re looking for dangerous drug interactions and allergies. Or they’re listening to a patient’s symptoms and realizing that they might be having a reaction to a medicine.

“Pharmacists are the brakes,” she said. “They’re there for a reason.”

Missouri has two counties — Knox and Schuyler, in the state’s northeast — without any pharmacy. And 16 counties in the state have only one.

James Johnston added another county to the list with zero when he closed down Knox County Pharmacy in 2022. He’d opened it a decade earlier when he was already running Johnston Drug in Clarence, Missouri. 

The 38 miles between the two stores simply became too much.

“I just about wore all my people out,” he said. “You don’t get away very often and very seldom do you leave on time.”

He said the Knox County store “had a nice business.” But selling a pharmacy in the current market, when drug reimbursement rates are so low, is difficult. And selling a pharmacy in a remote town is even harder.

“No one would bite,” he said. “You are never off duty when you’re the one-man band.” 

Johnston sold his patient files to a grocery store pharmacy in Kirksville, 31 miles away. But he knows that wasn’t ideal for his customers.

A hard profession to sell

Meanwhile, across the board, pharmacies are having a harder time finding pharmacists — particularly in rural areas.

“It’s a crisis,” Melchert said. “But let me tell you how bad it’s going to get.”

In 2023, the country had 14,000 pharmacy graduates.

“Within four years,” he said, “that number is going to be about 8,000.”

That is well below the 13,500 new pharmacists the U.S. Bureau of Labor Statistics estimates will be needed annually to make up for those retiring or leaving the profession.

The UMKC Pharmacy School, which is at less than 70% capacity, is typical. Pharmacy schools across the country are seeing declining enrollment, even though pharmacists can make six figures straight out of school. Scholarships and student loan forgiveness can also get thrown in. Some chains pay signing bonuses.

2023	Mean annual salary – Pharmacist	Mean annual salary – Technician
KC Metro	$134,310	$42,750
Missouri	$132,570	$39,960
Kansas	$129,300	$39,820
National	$134,790	$43,330

Enrollment was falling off before the pandemic. COVID just made things worse. Melchert suspects some would-be students may not see the profession in a very positive light after a trip to a crowded chain store, where frazzled pharmacists may juggle telephone calls, administer vaccines and scroll through computer files.

“People just don’t know what it is we do,” Melchert said. 

He and other pharmacy school deans argue that people don’t know just how big a role pharmacists play in modern health care. They are doing all they can to draw more people into the profession. That includes consulting with large corporate owners like CVS and Walgreens about how to improve working conditions, and training high school students to take jobs as pharmacy technicians.

Nate Rockers, who owns Rockers Pharmacy in Paola, Kansas, said he wouldn’t dream of asking either of his two sons to join him and take over the family store.

“I can’t envision being in business for 20 more years and retiring as a pharmacy owner,” he said. “I don’t know if pharmacy will be around as we know it in five years if we don’t do something. Once the ship sinks, it doesn’t come back up.”

The post Missouri and Kansas keep losing pharmacies, and a key part of health care appeared first on The Beacon.

In rural Kansas, if you’re between the ages of 21 and 39ish, you might be considered a PowerUp —  but not just because of your age or location. A PowerUp is someone who is rural by choice. 

“The name was created to illustrate the goal of empowering and moving younger people in rural communities into positions of leadership and influence,” Simone Elder said. 

She is the PowerUp & Engagement Manager for the Kansas Sampler Foundation (KSF), which focuses on preserving and sustaining rural culture. “For years, returning to rural has gotten a bad rap — the perception that it’s less than or someone failed at their bigger endeavors elsewhere,” Elder said. But KSF has been working to shift that mindset. 

Despite old narratives about small towns being places to escape, grassroots leaders and policymakers in rural communities nationwide are exploring ways to attract young people to these places and make them feel at home there.

For example, KSF is challenging residents to envision new possibilities by getting out on the back roads to experience overlooked assets in their hometowns. “Through the Big Kansas Road Trip, we help Kansans and other visitors from outside the state to see Kansas with new eyes,” Elder said. 

After identifying PowerUps as some of the strongest assets available, KSF has emphasized cultivating rural influencers. “There’s tremendous value in having an older person visibly and intentionally elevate the work of younger people in rural,” Elder said. 

Many PowerUps KSF has interviewed express wanting a sense of community, especially when it comes to raising kids, and a number have voiced entrepreneurial aspirations. Elder noted that while being rural by choice can mean loving where you live, it can sometimes feel lonely or frustrating. “It doesn’t mean you chose wrong,” she said. It’s about having a strong network of champions that can move forward together.

In neighboring Nebraska, Megan Helberg has become one of those champions. Fifteen years ago, she was a “returner.” Similar to Kansas, Nebraska was having an issue telling its own story. “We used to kind of joke about how small we were,” Helberg said. “But we started to realize that people listen to what you say.” 

Helberg, who decided to return despite that old narrative, is now a local rancher and secondary school teacher. She also sits on the Board of Directors for the Nebraska Community Foundation and serves as chairperson for the Calamus Area Community Fund. 

She is one of many spreading the message that young Nebraskans should go explore but then bring their greatness back. “We need you here, we want you here, and you can make a great life here,” she said. In 2024, her school’s senior class had six graduates, all of whom are heading off to college. But 75% are committed to coming back to help with an existing business or start one of their own. 

Creating the climate for those kinds of endeavors is where the community fund comes in, relying on unrestricted endowments, local bank accounts that accept donations from community members. Only the accumulated interest can be spent and all funds must be poured back into the community.

“It has been absolutely transformational,” Helberg said. In her area, the community fund has supported the renovation of neglected homes, making the properties available again to combat the housing crisis. Two new childcare centers have also opened with local support, as well as additional funding sources.

While these grassroots efforts show the power of community when everyone joins in, there is also critical work happening at the policy level across the country. New Hampshire-based Stay Work Play is a non-profit making it easier for young people to call the Granite State home. 

Part of its approach is non-partisan, issues-based advocacy informed by statewide data collection. Take, for instance, Stay Work Play’s Policy & Pints series, which gathered young locals at area breweries for focus groups to identify barriers to feeling welcome and secure in New Hampshire. 

Unsurprisingly, housing and childcare were high on the list. “We’re not experts ourselves in housing or childcare, but we do work with partners across the state for whom this is their business,” said Will Stewart, executive director. 

Stay Work Play is supporting greater investments in the state’s workforce housing fund and advocating for the ability to build smaller units on smaller lot sizes. “Things that young families need to get a toehold here in the state,” Stewart said. 

In addition, he’s seen “a return to older models,” like employer-supported housing. Some companies are paying existing employees to house new ones until they’re able to secure stable living situations. A leading healthcare provider has also been exploring options to develop on land already under its ownership. “But they’re just one example of a company that’s looking for novel solutions,” Stewart said. 

Beyond these logistical factors, social infrastructure is a key element that’s sometimes less talked about. In New Hampshire, young residents reported high satisfaction with “being able to get out of work and 30 minutes later be on the ski slopes or out hiking or on a paddleboard,” Stewart said. But making friends or finding a date can mean an ever-expanding search radius on social apps. The need for more “third places” where people can gather organically is strongly felt. 

As small towns rise to the challenge, sharing a new narrative through effective branding and marketing is essential. Stewart points to Littleton, a rural New Hampshire town that has cultivated a buzzing downtown, food and drink scene, and outdoor recreation network. 

For potential “returners” who may not have been back except for holiday dinners, “they probably don’t have an understanding of places, like Littleton, that have changed, and to use a scientific term, gotten cooler,” Stewart said. That’s an opportunity for a redefined rural place to find its people.

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Caroline Tremblay is a freelance writer who covers Radically Rural, an annual two-day summit on rural issues held in Keene, New Hampshire. This year’s event, featuring the people and organizations cited in this story, will take place September 25-26. For more information, and to register for this year’s summit, visit radicallyrural.org.

The post Young Americans Returning to Rural for More than Just Holiday Dinners appeared first on The Daily Yonder.

In Kirksville, Missouri, an entire floor of the hospital sits empty. The community could easily fill beds with patients — if only it could hire nurses and other workers to tend to them.

Just up U.S. 63 near the Iowa border, the Schuyler School District can’t keep teachers on the payroll.

A manufacturer wants to open its doors in the area, but worries about finding workers.

Although the open jobs may suggest otherwise, plenty of people want to live in rural Missouri — if they could find somewhere to live. The housing shortage across the state makes that difficult and thwarts efforts to draw workers and fuel local economies.

In smaller communities, homes are often old and need thousands of dollars in renovations to become livable, or they are newly built and more expensive than what many people can afford.

The rise in institutional investors that own and rent out single-family homes makes things worse, said Paula Hubbard, a real estate agent in Bolivar, Missouri.

“We face the same dilemma that everyone faces across the country,” Hubbard said.

But in a small town like Bolivar, every housing unit counts.

“We feel it on a smaller scale,” Hubbard said. “The difference of one, two or three houses has a reverberating effect in our community.”

Missouri’s affordable housing dilemma

Missouri’s population is consistently growing, though some parts of the state are seeing more growth than others.

And while the population grows, the supply of affordable housing wanes. A 2020 report from the Missouri Housing Development Commission found a shortfall of nearly 128,000 affordable rental units in the state. For every 100 low-income households in Missouri, only 31 affordable units were available.

The report stated that rural affordable housing projects aren’t perceived as a priority, despite 48% of the agency’s spending going to rural areas.

Another 8,300 affordable units will likely lose their status as affordable housing units by 2030 and consequently no longer qualify for tax credits, said Jeff Smith, the executive director of the Missouri Workforce Housing Association.

When those tax credits — handed out to developers in return for keeping rents low — expire, the landlords can charge higher market rates.

And new housing units aren’t built at a rate that matches the low-income units that sunset.

“At the rate we build through (the program),” Smith said, “we don’t come anywhere close to replenishing the number of units that lapse out of affordability each year.”

In Hubbard’s area, the hospital is in the middle of an expansion. But she’s concerned about where the staffers who will work in that hospital will live.

“As far as entry-level affordable homes, it’s almost impossible,” Hubbard said. “In every instance, it is a struggle to find someone the right house.”

Developers get subsidies for building low-income housing, and they see demand to build new homes for upper-middle class families. In the meantime, those who fall outside of those categories are short on options.

It’s a chronic problem in Missouri. With interest rates high, homeowners don’t want to sell, leaving inventory low. And homebuilders aren’t keen to drop a brand-new development into a small community when they aren’t sure enough people can afford to buy them.

Housing experts point to the idea of the “missing middle housing,” like smaller homes or duplexes that more people can afford. It’s housing that isn’t eligible for tax credits or other construction subsidies. Despite the demand, those styles of homes aren’t popular among developers.

A nonprofit regional planning commission in northeast Missouri thinks it has found a path to catalyze growth.

How northeast Missouri wants to solve its housing shortage

The Northeast Missouri Regional Planning Commission covers six counties in the top right corner of the state, including Adair, where Kirksville is located.

The group conducted a housing needs study and found that the area had the capacity for another 450 housing units. Employers and real estate agents who responded to the survey said they mostly need housing for workers.

To meet that demand and with buy-in from local electric cooperatives, the planning commission created a fund to build homes in the $180,000 to $240,000 range.

The commision wants to start with one home in each of the six counties it covers. The homes will be sold to the first eligible buyer, so bidding wars that drive up the prices won’t be a factor. To minimize the strain on local utilities, they’re building on lots where homes have been demolished or abandoned.

Derek Weber, the executive director of the planning commission there, said that 65% of the homes in the area were built before 1960. Those homes have a median price of $90,000. Another 20% of the homes in the area were built after 2008 and have a median price of $400,000.

That leaves a sizable gap when it comes to affordable homes.

“The middle 10% is your workforce housing,” Weber said, “and there’s just no stock.”

Because Missouri’s regional planning commissions are nonprofits, they and others who use the potential state program to build homes won’t profit when they sell them. Instead, the purchase price of one home goes to building another. And so on. Local lumberyards and construction companies will still get paid, but developers won’t make a profit from the sale of the homes.

Weber stole the idea from Nebraska. In 2017, Nebraska passed a rural workforce housing grant, which created a nearly $30 million fund to distribute to nonprofits across the state to build housing units to help attract workers to rural areas.

The northeast planning commission broke ground on its first project in March. And it wants Missouri to expand the program across the state.

Republican Rep. Greg Sharpe, who represents the area in Jefferson City, introduced legislation that mirrored Nebraska’s program during the 2024 legislative session.

During a hearing on the legislation, Michael Scheib, the CEO of Tri-County Electric Cooperative, a partner on the project, said that the Schuyler School District and area hospitals are interested in purchasing one of their homes.

“When we sit down with superintendents, they’ll say, ‘We get a teacher for one or two years, but the housing isn’t very good,’” Scheib said. “Schuyler schools are actually thinking about buying one of those houses and making it where a couple of young teachers could live in that house.”

Hospitals are eyeing the same approach when it comes to finding housing for their traveling nurses, he said.

“That’s my neighbors that can’t be served at that hospital because they can’t get nursing,” Scheib said, “because they don’t have places for those nurses to live.”

The planning commission and its partners believe that the undertaking is a way to slowly stir growth in their communities.

“We’re not looking to make a profit. We are looking to grow northeast Missouri,” Weber said during the hearing. “We’re trying to serve our community and create a way to bring a workforce to our region.”

With limited traction on the bill in 2024, Weber thinks next year will bring better luck. After the groundbreaking and as the word spread across the state, other groups like the Southeast Missouri Regional Planning Commission are watching to see if they could mimic the structure.

Despite all of the need for housing across Missouri, Weber said he felt that lawmakers in Jefferson City didn’t realize how bad the problem is.

“From the lawmakers I’ve spoken with, they look at it like it’s not their priority to get involved,” Weber said. “I don’t think they’ve attached the amount of homes we have to the workforce needs.”

The post Why rural Missouri schools and hospitals might become homebuyers appeared first on The Beacon.

Summer may be half over by the time Kansas families get extra food aid meant to see them through long hot days when school breakfasts and lunches disappear.

For Missouri families, the aid may not arrive until a new school year is well underway.

But that still beats the 13 states where families won’t be getting any help with summer groceries because state leaders skipped the federal government’s new $2.5 billion summer food assistance program known as Sun Bucks.  

Public health advocates, pointing to growing food insecurity among low-income Kansans and Missourians, said they are pleased — and somewhat surprised — that this time conservative politicians in their states accepted federal aid.

“It was surprisingly pretty easy,” said Christine Woody, food security policy manager with Empower Missouri. “I thought there was going to be a lot of pushback.”

Missouri and Kansas, both controlled by Republican-dominated legislatures, could have done as  they did with Medicaid expansion and opted not to accept federal dollars, advocates said. Missouri voters later passed a ballot measure that expanded the low-income health insurance program anyway. But Kansas still hasn’t opted in. 

The states also could have followed the lead of Iowa, where Republican Gov. Kim Reynolds rejected the summer food aid, saying the program didn’t do enough to ensure that kids got nutritional food. Or Texas, which turned down the federal program because state bureaucrats said it came with too many technical hurdles and required too many matching state tax dollars.

Instead, Kansas agreed to take part almost as soon as Congress passed funding for the summer food assistance program in December 2022. And Missouri made its participation official earlier this year, just before a deadline.

The program will provide an additional $120 per child for summer groceries to an estimated 266,000 Kansas children and 429,000 Missouri children. Even if the dollars won’t reach families at the start of the summer, and possibly not before summer is over, the money will still help.

“I personally know kids whose only meal for the day is what they have in school,” said Ruchi Favreau, director of nutritional services for the Kansas City, Kansas, public schools.

The extra dollars this summer will extend a lifeline for them and thousands of other kids around the state.

“It can make a huge difference,” said Karen Siebert, public policy and advocacy adviser for Harvesters Community Food Network, which works with food banks in Missouri and Kansas. “Especially now with food inflation where it is, even if it’s not here for the summer, hopefully in arrears, (the extra money) can help.”

The climbing cost of food, combined with the end of pandemic-era government aid programs, contributed to a sharp rise in the number of Americans considered to be living with food insecurity. The term describes people who don’t have enough to eat and don’t know where their next meal will come from. 

The national anti-hunger advocacy group Feeding America’s May report says 13.5% of Americans met the criteria for food insecurity in 2022, the most recent year data is available, compared with 10.4% in 2021. 

That amounts to 44 million Americans, or one in every seven people, and includes 13 million children. That is a major jump. In 2021, the report said, about 34 million Americans were considered food insecure. 

Feeding America estimates that 13% of Kansans faced food insecurity in 2022, compared with just under 10% in 2021. That included about 131,430 children or 19%, up from 94,000 or about 13% in 2021.

In Missouri, the group estimates that about 15% of the population faced food insecurity in 2022, compared with 11.6% the previous year. In 2022, that number included almost 255,000 children, close to 19%, compared with 177,000 children or almost 13% in 2021.

Dr. Heidi Sallee, a St. Louis pediatrician who is the incoming president of the Missouri chapter of the American Academy of Pediatrics, said she sees the consequences of food insecurity every day when patients come in with iron deficiency anemia. The condition, often caused by an unhealthy diet, means kids don’t have enough red blood cells carrying oxygen to their organs and brain.

“They’re more tired,” she said. “They don’t have as much energy. And it can affect their development and learning.”

She hopes the extra food aid coming to families through the summer EBT program will help parents buy meat and green leafy vegetables, foods they need to reverse iron deficiency anemia.

“Our bodies absorb nutrients through fresh food,” she said.

But fresh food can be difficult, if not impossible, for many families to afford during the summer. Families increasingly rely on public schools to feed their children breakfast and lunch. When summer comes and those meals go away, many families run into trouble. Sun Bucks is supposed to help cover the gap.

Similar to food aid offered to poor families during the COVID pandemic, the summer EBT program gives families extra money through an electronic benefit transfer card. The benefit comes to $40 per month for each eligible child.

Children 7 to 17 years old are eligible if they received food assistance through SNAP (the Supplemental Nutrition Assistance Program, sometimes called food stamps), Temporary Assistance for Needy Families (TANF) and/or foster care benefits at any point during the school year. Children who qualify for free and reduced-price lunch at school also qualify.

Funds will be loaded on existing food assistance accounts or issued as separate EBT cards, which families can spend at grocery stores or markets. Children already enrolled in food assistance programs will automatically get the summer bump, so cumbersome paperwork won’t be necessary.

Federally subsidized summer meals will continue to be offered through some schools and organizations like the Boys and Girls Clubs. And free meals-to-go are available in some areas. But those established programs were leaving behind thousands of kids whose families lacked easy access to transportation, advocates said. Summer EBT cards, which will be mailed directly to qualifying families, give parents more flexibility to buy groceries so their children can eat at home.

While the federal government bears the bulk of the cost associated with the summer EBT program, which is administered through the U.S. Department of Agriculture’s Food and Nutrition Service agency, states pay half the cost to administer it. That comes to $1.9 million in Kansas. In Missouri, the state will spend $1.3 million this summer and has budgeted $6.6 million, which still needs approval, for next year.

Kansas families will begin seeing payments from the summer EBT program at the end of July. And families with children who qualify who don’t receive payments automatically can put in an application after Aug. 12.

Missouri waited longer to opt into the summer program. Funding wasn’t approved until May and approval from the USDA is still pending. That’s why Missouri families probably won’t be getting their summer payments until sometime in the fall.

Next, anti-hunger advocates said they will be watching debate around the $1.5 trillion federal farm bill that funds the SNAP program. Republicans on the House Agriculture Committee want to effectively cut the program by limiting changes to the formula used to determine benefits. 

In an editorial published May 27 in The Kansas City Star, U.S. Rep. Mark Alford of Missouri’s 4th District, a Republican who sits on the House committee, said SNAP had become too large. The program, he wrote, “was never intended to become a lifestyle but rather a life vest.”

Meanwhile, Missouri will have to revamp how it administers its SNAP program after a federal judge ruled in May that the Department of Social Services’ long wait times, denial of benefits and other issues had violated federal laws.

The post Missouri and Kansas families will be getting money for kids’ summer meals — eventually appeared first on The Beacon.

Kansas Governor Laura Kelly dedicated this year’s fall to traveling around her state and talking with constituents and community leaders about expanding Medicaid.

In a state where 60 rural hospitals are at risk of closing, forcing the legislature to expand Medicaid would be a lifeline, she said in an interview with The Daily Yonder. Her new campaign, “Healthy Workers, Healthy Economy” aims to help residents understand what Medicaid expansion could mean for rural hospitals, rural residents, and the state’s economy.

“There’s no doubt that Medicaid expansion is not enough to rescue rural hospitals,” she said. “But without Medicaid expansion, there is no doubt that rural hospitals will close.”

In 2013, the Affordable Care Act expanded Medicaid coverage to most adults with incomes up to 138% of the Federal Poverty Level, or about $41,400 a year for a family of four. To date, nine states – Alabama, Florida, Georgia, Kansas, Mississippi, Tennessee, Texas, South Carolina, and Wyoming – have not expanded Medicaid.

North Carolina’s Governor Roy Cooper signed legislation into law that directed the state to expand Medicaid, but the implementation of that expansion has been stalled awaiting legislative action.

Kelly said since 2013, Kansas has seen eight of its rural hospitals close. The latest, Herington Hospital in Herington, Kansas, closed on October 9 after 104 years. The hospital said the decision stemmed from lengthy financial struggles and low patient volumes.

More could follow. According to a study released in July by the Center for Healthcare Quality and Payment Reform (CHQPR), more than half of Kansas’ rural hospitals, 60 out of 104 (58%), are at risk of closure. The report found that the states with the most rural hospitals at risk of closing are Kansas, Texas, Tennessee, Mississippi, Georgia, and Alabama – all of which have failed to expand Medicaid.

Study after study has shown that health outcomes for rural residents in states that did not expand Medicaid are worse than outcomes for their counterparts in states that did expand Medicaid. In 2020, a look by Kaiser Family Foundation at more than 400 studies done since 2013 found that states that did expand Medicaid saw improvements in healthcare access, financial security, and health outcomes among other things.

Kelly said Kansas only needs to look to its neighbors to see the benefits.

“We can only judge the impact of not expanding Medicaid by looking at the states around us that have,” she said. “It’s clear that Kansas has sicker populations and populations with more mental health issues.”

Brian Barta, CEO of William Newton Hospital in Winfield, Kansas, (population 11,726 in 2021), said failure to expand Medicaid impacts more than just rural residents. His hospital saw revenues decline after the pandemic. According to reports, the hospital had $41.5 million in total patient revenue in 2022, with $49.3 million in total operating expenses. Even with $3.5 million in grants and other revenue, the hospital still ended 2022 being $4.3 million in the red.

“It is estimated that Medicaid expansion will help over 150,000 Kansans and continued failure by the state legislature to support Medicaid expansion undermines the physical, emotional, and economic health for all of Kansas,” Barta said during a September press event announcing Kelly’s “Healthy Workers, Healthy Economy” campaign.

The closure of a rural hospital impacts more than just rural residents though, Kelly said. Closed rural hospitals mean communities lose much-needed jobs and tax revenue.

“When a rural hospital closes, it impacts not just the physical health of our communities, but it also impacts the economic health of our communities,” she said.

Kelly said expanding Medicaid is her number one priority for the 2024 legislative session. While some other governors have taken action through executive order, Kelly said her hands are tied. Under the previous administration, legislation was passed that required any Medicaid expansion could only be done by the legislature. So far, she’s tried five times to get that kind of legislation passed.

And while it’s not the first time she’s fought this fight, this time, she said, she’s taking it to the voters.

“Expanding Medicaid and ensuring that every Kansan has access to affordable, high-quality health care is the smartest, sanest way to keep our state moving forward,” Kelly said. “I encourage every Kansan to call their legislator and tell them to demand that legislative leadership give them a chance to vote for Medicaid expansion.”

She said she recognizes that her efforts may not influence legislators and that constituents may not either. But with every legislative seat up for re-election in 2024, if she can’t move legislators, she hopes her efforts will at least influence the outcome of the election, she said.

The post Expanding Medicaid to Help Rural Hospitals a Priority for Kansas Governor appeared first on The Daily Yonder.