This story is part of a series.

On a Tuesday afternoon, standing in front of the Islesboro Sewing Circle on an island off Maine’s MidCoast, Jane Wherren holds up items recently completed by members for the annual fundraiser. The president of one of the nation’s oldest sewing circles, called simply “circle” by locals, Wherren begins every meeting with show and tell. As sewing machines hum and knitting needles click, a dozen women glance up from their work to watch. “Look at these potholders with blueberry pie.” A woman calls out, “Who knitted those cute mother and baby socks?”

Standing in a 120-year-old building with one of the oldest sewing groups in the nation, you’d almost think you had stepped back in time. Then a voice calls out, “Those are gorgeous, can you zoom in?” 

The voice isn’t coming from the women in the room; it’s coming from a computer held by the circle’s secretary. To zoom in the woman walks closer to Wherren, turning the screen to capture the purses. Later in the meeting, when women sing happy birthday to one of its members, women both online and in person sing along. 

“We’ve been having hybrid meetings since the pandemic,” Wherren said. “We still do. We want to include everyone from our community, whether they’re homebound, in another state, or just unable to attend. Soon we’ll be teaching online sewing classes.”

Ten years ago, long before today’s unprecedented amounts of federal funding in rural Internet infrastructure, Roger Heinen watched Islesboro’s population drop precipitously. “We were facing an existential crisis,” he said. “There’s nothing like young people moving away to threaten the survival of an island community.”

In 2014, Heinen formed a small volunteer coalition to come up with a solution for the island of under 600 year-round residents. 

“Our coalition spent two years talking to lobstermen, selectmen, the hunting club, the school, and power brokers like the sewing circle,” he said. 

In 2016, voters approved a $3.8 million bond to fund the construction of a fiber-to-the-premises infrastructure capable of speeds of 1 gigabit per second. By 2018, Islesboro Municipal Broadband construction was complete and service was installed for all home and business subscribers.

“Getting the network off the ground was the hardest work I ever did,” Heinen said. “We (the town) knew that at the end of the day when the last ferry left, there was no government to save us. We were on our own.”

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It’s been nearly five years since Islesboro’s Municipal Broadband connected those first subscribers. Today, as unprecedented federal and state funding is funneled into high-speed broadband access, increasing numbers of coalitions are attempting to build publicly owned networks. In the last two years, numerous attempts in rural Maine have failed. Lack of financial resources is often cited as a factor. Some say campaigns by large telecommunications companies to undermine broadband utilities are another reason.

Heinen says another issue is the most important barrier to getting municipal broadband off the ground. 

“When I talk to towns, I tell them money is not the primary issue,” he said. “What’s most critical is the ability to create strong social capital. There is money out there. There are technical and financial consultants out there. Social capital building, though, that must come from the inside.”

Peggy Schaffer, Maine’s first director for broadband funding, now a strategic consultant and board member on the American Association for Public Broadband, echoed Heinen’s advice. 

“Though there is no clear path to success, strong community engagement is at the heart of most successful publicly owned utilities,” Schaffer said.

In June, one of Maine’s newest town-owned fiber optic networks, Leeds Broadband, will start marketing their service after nearly four years of navigating the murky challenges of garnering support and overcoming incumbent provider opposition. Joe McLean, the organizer of the network, building community understanding and support was important at every stage of the process.

“It’s been a long haul of hard work,” he said. “We’ve done a lot of coalition building as we’ve worked alongside our selectmen. Each stage has another level of community buy-in, from basic education to the benefits of high-speed internet, to why we can offer it cheaper and better.”

Both Heinen and McLean said the political disagreement between local elected officials and publicly owned broadband committees can be another impediment to implementation. “I’ve watched broadband committees who are on a completely different page with their selectmen and other people in town, arguing about the two different ideas rather than just getting to one good idea and trying to push it,” McLean said.

Having worked with dozens of coalitions promoting publicly owned broadband, Schaffer said one of the biggest mistakes coalitions make is presenting fiber-optic broadband as very technical.

“In reality, it’s a very human infrastructure,” she said. “When asking for money for publicly owned networks, committees need to realize that just because they’ve picked the right technology for their community, that doesn’t mean the community is going to buy into it.”

There’s no substitute for spending time to build local support, she said. 

“There’s so much work to do, committees often forget the importance of public outreach. If committees don’t (get buy-in), when the cable companies and the Spectrums come with their flyers, mailers, newspaper ads, and online attacks, run by people who make their living running these reaching people on a seemingly personal level, it’s too late to start to build support.”

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Relieved to have weathered some of these incumbent campaigns, McLean’s team is excited to begin marketing. “We’ll be putting up displays in the town office, at the farmers’ market, and other events around town,” he said. “We want everyone to understand that with this nonprofit model, the more people sign up the cheaper it can be. We are going to focus on being a local provider for our local community. We want people to know that in comparison to the incumbent provider, we can provide far better service for far less.”

Schaffer said the benefits of building strong social capital as part of municipal broadband projects are worth the effort. “We see it across the country,” she said. “Community-owned networks … put revenues back into the community. They increase speed and service while reducing prices. For communities who can bring these networks to fruition, the profits always exceed the costs. The challenge is getting the community on board.”

To do that, Heinen has some practical advice. 

“Make sure to include your sewing circle.”

The post Building Publicly Owned Broadband Starts with a Low-Tech Approach: Community Buy-in appeared first on The Daily Yonder.

If you want to see the latest way people are helping keep rural journalism healthy, look at Ohio.

When the media company Gannett closed the Oxford Press, the community paper in the town of Oxford, faculty at Miami University saw an opportunity to enlist their students in a hands-on learning experience providing local news.

They started the Oxford Observer, a weekly newspaper staffed by Miami students and professors. 

“It’s a community relationship, but it definitely benefits the students,” said Sacha DeVroomen Bellman, the Miami University journalism instructor who leads a class that acts as the paper’s newsroom. “This is a way they can get professional work.”

About 145 miles away, students at Ohio University are providing stories to the Athens County Independent, a digital start-up covering that county founded after its editor was unjustly fired from the area’s only daily paper. And faculty member Hans Meyer plans to keep ramping up stories from students.

To the north, at Kent State University, two faculty members lead the Ohio Newslab with a focus on providing stories to rural areas. The lab partners with four community news outlets that run stories from advanced reporting classes. The faculty have raised funds to pay students and an editor who works with the classes to shape up stories and mentor students. 

“We are covering some of the more sparsely populated sections of Ohio that don’t get much media attention,” said Susan Kirkman Zake, who coordinates the program with fellow faculty member Jacqueline Marino. “I really think that’s a good news niche for us to explore, both for students and the media landscape in Ohio, because media companies are really concentrated in cities.”  

And in the center of the state sits Denison University, which is revamping its journalism curriculum to empower student coverage of rural Licking County, Ohio. Those stories, published through The Reporting Project, are available for local media to pick up. When Intel announced the construction of a $20 billion chip plant in the city of New Albany, Denison’s project was the only media outlet to cover the project’s influence on its neighbors.

“We went and sat with Danny and Barbara Vanhoose, who have lived on Green Chapel Road for 50 years, right across the road from where Intel’s front door is going to be,” said Alan Miller, a Denison journalism professor who spent three decades at the Columbus Dispatch and covered the story with faculty member Jack Shuler and student Thu Nguyen.

“We just went and visited with them while they watched and got their reaction and had an outside-the-fence view, literally, of a very big news event that everybody else was covering from inside the fence,” he said.

Those four examples showcase a trend extending far beyond Ohio. Across the nation, student reporters and their colleges are stepping in as local news outlets disappear. At the Center for Community News, our team documents partnerships between local media and colleges, and in the last year we’ve found more than 120  — many focused on bolstering news in rural areas that have been neglected as big conglomerates eat up local dailies and whittle staffs to skeleton crews. 

The University of Vermont, where the center is housed, also runs a student reporting program that works with local media. In the last year, it has provided close to 300 stories for free to community papers and other local outlets. 

These programs are not internships in the traditional sense. Students of course can get great experiences interning directly with newsrooms, but many of those internships have disappeared, and beleaguered editors can’t be expected to dive deep with their rookies on each and every story. 

But colleges can. 

In university-led reporting programs, experienced former journalists vet and assign and edit student work and work with local news outlets to assign stories that otherwise would go uncovered. 

It’s a win-win. Papers get content and students get experience. 

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Richard Watts is the director of the University of Vermont’s Center for Community News, an organization that documents and brings together university-led reporting projects around the country. Justin Trombly is the editor of the Community News Service, the University of Vermont’s academic-media partnership.

The post Colleges and Students Are Stepping Up to Help Rural Newspapers appeared first on The Daily Yonder.

A shortage of quality housing and struggling downtowns were among the top challenges rural community members face, according to consultants who help small towns identify and solve problems.

Save Your Towns is an Oklahoma and Mississippi-based group co-founded by Becky McCray and Deb Brown. They work to educate people on low- or no-cost solutions to problems in small towns across the U.S. and elsewhere. 

Since 2015, the women have been surveying residents about their towns. Survey participation is voluntary and self-selected, not based on scientific polling methods, but the online survey does offer a range of responses from people who identify as rural.

This year’s survey found that in addition to housing and downtowns, other challenges were not enough volunteers, losing young people, and a lack of childcare. 

Brown said the top community assets are natural resources, outdoor recreation, tourism, committed people in a good workforce, effective leaders, and arts, culture, and events. 

“Having said all of that, there are some big disconnects,” she told the Daily Yonder. “We uncovered that between what rural people want and what services and assistance are commonly offered to them.”

Brown said business owners and leaders said usable buildings are harder to find than loans, and they showed little interest in needing support with business plans or pitch competitions. 

The survey was open from November 11, 2022, to January 31, 2023. A total of 315 responses were collected online from subscribers and visitors to SaveYour.Town and SmallBizSurvival.com, from media coverage and cooperating groups that publicized the survey.

Respondents self-identified themselves as rural, and 206 identified themselves as business owners. Participants included 295 from the United States, 11 from Canada, and six from Australia.

The self-selected participants were more optimistic about the economy than people who participated in the Daily Yonder’s 2022 scientific, randomized poll of rural voters.

In the Daily Yonder’s survey in October, nearly three quarters of rural respondents said the economy was not working well for them, and half said they expected their financial situation would get worse in the next year.

Poll director Celinda Lake said at the time that she was stunned by the depth of pessimism in the responses.

In the SaveYour.Town survey, nearly 40% of participants responded positively to the question, “Do you think your community will be better off in 10 years?”

“Rural people were twice as likely to say they were optimistic about their community’s future, as were negative about their community’s future,” she added. About half of respondents were neutral on the question.

“I was very happy to see how optimistic people were. And I think the thing that really surprised me, I was really pleased and surprised to see that events and arts and culture and education, and tourism were listed as one of the top community assets.”

McCray said the pair love to hear that people are using the survey results for educational purposes.

“We know it gets global attention,” McCray said. “Because what rural people say they need doesn’t always match the things that they’re offered, or the stories that we read, or the things that we hear on TV, or the reports, for example.”

The post Rural Communities Are Upbeat About the Future Despite Persisting Issues appeared first on The Daily Yonder.

This story was originally published by the Rural Monitor.

As a librarian in Peck, Idaho — a self-described “one-woman show” in a community of just under 200 people — Doreen Schmidt’s workdays begin with an unusual routine.

First, Schmidt checks the air quality monitor installed on the side of the library building. Next, she chooses a flag that best matches the results: green for healthy, red for unhealthy, or yellow for in-between.

And at 10 a.m. every Tuesday and Thursday, when the Peck Community Library opens its doors, Schmidt hangs the flag outside, announcing the air quality of the day to students in the one-room schoolhouse across the street, post office-goers, and other community members passing by.

This routine is one of several initiatives that the Peck library and eight others in rural northern Idaho have adopted in partnership with the Nez Perce Tribe’s Air Quality Program in an effort to raise awareness of the health risks posed by wildfire smoke and steps that local residents can take to protect themselves against it.

“We librarians became informed [about air quality] so that we can inform our communities,” said Schmidt, who serves as branch manager of the Peck Community Library. “The partnerships and the connections we make through the libraries are really important, because the library is the hub of our community.”

Across the western U.S., wildfire smoke is increasingly recognized as an urgent public health issue for urban and rural dwellers alike. But rural communities face some unique challenges when it comes to collecting and spreading information about wildfire smoke and its health impacts — and, in response, uniquely rural solutions are emerging.

“Smoke has become more and more prevalent as a topic of concern in rural communities, but there’s still a lag” when it comes to making sure rural residents know how best to protect themselves against smoke exposure, said Savannah D’Evelyn, PhD, a postdoctoral fellow in the University of Washington’s Department of Environmental and Occupational Health Sciences. “We need to be thinking about smoke just as much as we’re thinking about fire.”

Rural Risks

Unhealthy air quality can affect any person who is exposed: immediate impacts of breathing in smoke may include coughing, difficulty breathing, headaches, irritated sinuses, and a fast heartbeat, according to the Centers for Disease Control and Prevention. But some populations are especially at risk, including the elderly, children, pregnant women, and people with conditions including asthma, heart disease, and Chronic Obstructive Pulmonary Disease (COPD), a rising cause of death in rural America. Wildfire smoke can also negatively impact mental health in rural communities, a study from University of Washington researchers found, with rural study participants reporting increased anxiety, depression, isolation, and a lack of motivation during smoke episodes.

As public health researchers learn more about the physical and mental health impacts of wildfire smoke, including in rural communities, a clearer picture of who is most at risk has started to develop, according to Elizabeth Walker, PhD, an Affiliate Assistant Professor in the University of Washington’s Department of Environmental and Occupational Health Sciences and one of the authors of the mental health study. People who tend to be particularly vulnerable during smoke episodes include lower-income residents, those with outdoor occupations, and people experiencing housing insecurity or homelessness, said Walker, who is also the founder of Clean Air Methow, a nonprofit program that provides information and resources to help residents of Washington’s rural Okanogan County protect themselves against unhealthy air quality.

For these particularly at-risk groups, avoiding smoke exposure altogether is often not an option. Rural-based industries such as agriculture, forestry, and outdoor recreation often revolve around outdoor work, exposing employees to unhealthy air throughout the workday. And in small communities that lack indoor public gathering spaces with clean air, residents without housing — or who don’t have sufficient air filtration systems in their homes — may have nowhere to go to escape the smoke; in places that do have community spaces with clean air, it may not be practical or affordable for some residents to travel long distances from their homes to use them.

In some rural communities where wood-burning stoves are commonly used during colder months, smoke is inescapable even in winter: residents may experience exposure year-round, compounding the health impacts without seasonal relief.

“If people are getting a much higher exposure, either due to outdoor work or to their housing conditions, those folks really need to be targeted for providing whatever interventions we can,” Walker said.

Monitoring the Problem

For many rural communities, protecting against wildfire smoke exposure is made significantly more difficult by the fact that there is no way of knowing exactly how much smoke is in the air on any given day.

Information about air quality is often limited in rural areas, with air quality monitors more densely concentrated around larger population centers. The result is what D’Evelyn refers to as “monitoring deserts”: places where smoke is palpable in the air but where a lack or shortage of monitors leaves exact air quality levels unknown, making it more difficult for communities to gauge what sort of health protection measures are needed.

“We [air quality researchers] tend to focus on areas that are densely populated, because you already have air quality issues there from things like traffic and industry,” said Danilo Dragoni, PhD, Bureau Chief of the Nevada Division of Environmental Protection’s (NDEP) Air Quality Planning Bureau. “In rural communities where only indirect methods of measuring air quality are available, the understanding is that air quality is relatively good. But when you have wildfires and smoke, you go from a decent air quality to a very bad air quality in the range of a few days.”

In Nevada, smoke from a series of wildfires near the California-Nevada border in recent years served as a wake-up call of sorts for state officials, Dragoni said. During these episodes, the bureau received phone calls from emergency managers and school district officials in rural northern Nevada requesting air quality information, as information found online “didn’t really match what they were experiencing on the ground.”

“We realized that the coverage in terms of air quality monitoring was not enough,” Dragoni said. “Wildfire smoke is very unpredictable and can change very rapidly. So they started calling us to say, ‘Hey, can you give us more information?’ And we realized that we couldn’t really do it.”

To start to fill these gaps, NDEP purchased dozens of PurpleAir sensors — air quality sensors that are relatively inexpensive and easily installed, but less accurate than regulatory-grade monitors — to loan to rural communities across the state at no cost. The department has also partnered with the Desert Research Institute (DRI) — the nonprofit research arm of Nevada’s state higher education system — on a grant-funded project to improve and expand wildfire smoke air quality monitoring infrastructure and public information resources for rural communities statewide. The program, which began in 2021 and is ongoing, included the installation of roughly 60 smart technology air quality sensors as well as additional communication resources to identify gaps in public knowledge around the health risks of wildfire smoke in rural communities and develop new educational materials.

“Risk communication messaging around wildfire smoke is directly informed by air quality data,” said Kristin VanderMolen, PhD, an assistant research professor of atmospheric sciences at DRI. “And so for these counties where there isn’t quality data, messaging becomes difficult because, you know, what do you say?”

In Pershing County, Nevada — a county of roughly 6,500 people spanning more than 6,000 square miles — a lack of reliable air quality monitoring made measuring air quality difficult during wildfire season.

“Other than looking outside and seeing that your visibility was reduced, there was no quantitative method for determining how bad the smoke was,” said Sean Burke, Director of Emergency Management for Pershing County.

But the health impacts were evident, especially during the smokiest part of the season, Burke said: As an EMS worker, he saw a noticeable increase in asthma and COPD exacerbations when the smoke was thick.

Participating in the DRI-NDEP project has provided Pershing County with new tools to measure smoke particles in the air. Making sure that local residents understand the extent of the health risks involved — and how they can best protect themselves — can still be challenging, though, Burke said.

“I talked to one old fellow who said, ‘If I want to know how the smoke is, I’ll look out my window,’” Burke recalled. “I think, generally speaking, people get it: There’s smoke, and it’s not great. But I don’t think they understand necessarily just exactly how bad it can be, particularly if you’re in one of those sensitive health categories.”

‘Harnessing Toughness’

Smoke exposure levels tend to be higher in rural communities, according to D’Evelyn, in part because fires are often closer to home. The nearer and bigger the fire, the worse the smoke episode likely will be — but the more likely it is that air quality will be overshadowed by concerns about the fire itself.

“Fire is always the top concern because in rural communities, a fire can come right through and burn down your home,” D’Evelyn said. “And so this concept of being concerned about smoke exposure has been secondary on people’s minds — they’re much more worried about fire, which makes sense.”

A “long-term historical familiarity and cultural tolerance for smoke” in many rural communities in the West may also contribute to the perception that smoke isn’t an urgent public health issue, Walker said.

“When something is familiar to you, you tend to underestimate the risk that it poses,” she said. “The classic example is that people routinely think that being in a car is safer than being in an airplane. Smoke is woven into our experiences here, so it’s often not seen as something that can cause severe health risks.”

A public outreach campaign by Clean Air Methow over the past year has focused on changing these perceptions, using messaging that leans into what were identified through community focus groups and surveys as the “top three values” of the region: determination, grit, and family.

“Toughness is a strength to harness in rural communities, and we’ve tried to design the campaign around the idea that toughness means protecting and caring for other people and promoting awareness of who the most vulnerable groups are,” Walker said. “Maybe someone in your family or your neighbor falls into one of those vulnerable categories, even if you don’t, and they might need some help taking steps to protect their well-being and health.”

Within the Nevada communities participating in the DRI-NDEP project, “people are generally familiar with wildfire smoke risk exposure, and they’re generally familiar with who tends to be more vulnerable or at risk,” VanderMolen said. “But when it comes to mitigation strategies, there is a little bit of fine-tuning to be done.”

In rural northern Idaho, finding — and communicating — the most effective mitigation strategies has meant taking into consideration the unique needs of the region.

“Five or ten years ago, the messaging was just, ‘Stay indoors,’” said Mary Fauci, an Environmental Specialist with the Nez Perce Air Quality Program. “But many people up here don’t have air conditioning and have to keep the windows open to cool their house down at night, which brings in wildfire smoke. So the general acknowledgement was that we need to either change the messaging or provide means of help to get people to change so that they can be ready and resilient.”

Trusted Sources

In rural environments, information about smoke and its health impacts may be most effectively disseminated by sources close to home, research has found.

In a series of interviews and focus group discussions with residents of rural and tribal communities in north central Washington, D’Evelyn and other University of Washington researchers found that participants generally trusted local sources of information — such as tribal or local governments, or informal community communication networks — more than non-local sources, such as the state or federal government agencies. The research was conducted and published in collaboration with the Confederated Tribes of the Colville Reservation and the Okanogan River Airshed Partnership.

Interviewees also “overwhelmingly” described local and community channels — such as community information boards, local news, friends and family, and social media — as their main sources of information on air quality and smoke risk, according to the report.

Within any given community, “networks of communication are super varied,” D’Evelyn said. “There will be Facebook groups that 30% of the community is incredibly active in, and then there’s another percentage of the community that doesn’t even have internet access at their home and doesn’t want to. Making sure that you’re tapping all of the different communication networks that are necessary is really important.”

In Pershing County, a lack of real-time media coverage has made it difficult to keep community members informed about air quality and health risks in a timely way, Burke said. With the nearest television station in Reno, roughly 100 miles away, the local newspaper — which publishes once a week — is the primary source of local news.

“If you’re in a larger metropolitan area, you would expect to see something on the local news about hazardous levels of smoke, but we kind of fall outside of the major reporting area,” Burke said. “Our single largest challenge is getting the word out effectively.”

To do this, Pershing County and other rural communities have had to find alternative methods for communicating risk to the public. In Pershing County, those methods include posting information in public places — such as senior centers, community centers, and hospitals — and on social media, though spotty or nonexistent internet access in some rural areas can make the latter more difficult. In another Nevada county participating in the DRI-NDEP project, traveling U.S. Forest Service field technicians plan to deliver pamphlets with smoke information to particularly remote communities without reliable cell phone service or internet access.

To reach a diverse range of Okanogan County residents, Clean Air Methow has taken a diverse approach to its public messaging that includes billboards, print materials, radio spots, bar coasters, and social media posts. As part of a recent outreach campaign funded by the Washington State Department of Ecology, the organization and regional partners distributed more than 3,000 copies of a Smoke Ready Checklist, which lists instructions and best practices for minimizing smoke exposure — including setting up a do-it-yourself air cleaning system at home, making a plan for vulnerable household members, gathering N95 masks, and ideas for staying “mentally strong and engaged” throughout wildfire season — in both English and Spanish.

With funding from an Environmental Protection Agency grant, Clean Air Methow also made box fan air filters available for free to community members, with more than a dozen pop-up displays with information about how to get one set up at health clinics and social service organizations throughout the county.

Partnerships with “trusted partners” in the community, such as healthcare and social service providers and fire safety entities, have been key to Clean Air Methow’s success in distributing information about smoke exposure and protection strategies, according to Walker.

“Everything we have ever accomplished has only been on the basis of those strong partner networks and relationships,” she said.

A Community Effort

In northern Idaho, the Nez Perce Air Quality Program has found a different kind of trusted partner in the region’s community libraries.

The program began by approaching a handful of libraries in 2012, to ask whether one of the program’s interns could host presentations on air quality safety as part of the libraries’ summer reading programs. From there, the relationships grew, with more libraries signing on to host summer reading presentations on air quality and STEM (science, technology, engineering, and mathematics) subjects.

“Libraries have a lot more than books, and I think communities and the public are starting to realize that there’s other things they can do,” said Johna Boulafentis, an Environmental Specialist with the Nez Perce ERWM Air Quality Program. “Following through, showing up, and having our intern be there started to really build that trust.”

The Nez Perce Tribe has had a robust air monitoring system in place on its reservation since the early 2000s. But some of the area’s smallest communities, including Peck, were without their own air monitors — leaving mini monitoring deserts in a landscape where air quality can change abruptly from town to town.

When the Air Quality Program approached Schmidt in 2021 to ask whether the Peck Community Library would be interested in installing a PurpleAir Monitor and putting out a flag each day to help inform community members about air quality, Schmidt says she was “thrilled.”

Students at Peck Elementary School across the street — a one-room schoolhouse with 34 students ranging from kindergarten through sixth grade — have also embraced the program enthusiastically, using the flag to determine whether it’s safe to play outside for recess during fire season. At noon, when the students come over to the library for programming, they check on the PurpleAir sensor and help Schmidt to update the flag if needed. And “at the end of the day, after school, they’ll run across the street to see if they can check on it again,” Schmidt said with a laugh.

The Nez Perce Air Quality Program has expanded its partnership with participating libraries to include other community outreach efforts in addition to the flag program, such as hosting “Build Your Own Sensor” workshops for local junior high school students and demonstrations for the public on how to build an air filter out of a box fan. Box fan air filters are displayed inside the library entrances as well, with librarians available to answer questions about air quality.

Libraries aren’t the only community partners that the Nez Perce Air Quality Program relies on to help spread public awareness. The program has worked with health agencies, school districts, tribal housing entities, and others to share air quality information and teach strategies for minimizing smoke exposure and has distributed educational materials throughout the community in both English and the Nez Perce language.

But the multigenerational scope of community libraries gives them a unique ability to reach people of all ages and walks of life, Schmidt said.

“If you ever want adults to pay attention, you teach the kids,” Schmidt said. “They bring it home and they really want to make sure that their parents or grandparents, or whoever their caregiver is, are understanding what they’re learning.”

While the impact of the program is difficult to measure in numbers one year in, there is anecdotal evidence that adults are paying attention as well. Several older men living in Peck have asked Schmidt to help them install air quality apps on their cell phones after seeing the colorful flags out front, and at least one library visitor reported back that he had made his own box fan air filter after seeing the display.

Perhaps the most notable indicator of the program’s impact, however, showed up on Peck’s Main Street after the flag program began: One man, noticing that the flags were only updated the two days a week that the library was open, made his own flags to display in his front yard on the days the library was closed.

“To see that person using his own saw and equipment and taking all those steps to display a flag in his yard, and then going into a library and seeing that they have their fan filter going, has been really inspiring,” Boulafentis said. “It makes you want to say, ‘Hey, what should we try together next?’”

“For the community to get excited about it and then see other people participating,” Schmidt added, “brings out the good in us all.”

The post Rural Communities Find Unique Solutions to Protect Against Wildfire Smoke Exposure appeared first on The Daily Yonder.

Cathy Topper stood at the door to her house looking over the field of solar panels visible from just about anywhere on her property. 

“I finally have gotten to the point where I don’t cry all the time,” she said, as we sat at her kitchen table. 

The shades were drawn throughout the house so she wouldn’t have to see the solar array while going about her day.

Solar farms have been popping up all around Montezuma County, Colorado, over the past few years. Montezuma County, sitting at 6,000-7,000 feet in elevation, gets 300+ days of sun a year. With the high elevations keeping temperatures cooler, and a significant amount of sun, the region is an ideal place for solar development.

Topper has lived in her house on agricultural land outside Cortez, Colorado, in the Four Corners region for 31 years. She hopes to pass down the house and land to her son. She said it was a peaceful place to live, with views of the fields to the north and Sleeping Ute Mountain to the southwest. 

That changed in June 2022 when the solar farm, a project of Empire Electric Association (EEA), began construction. Since then, Topper said the sound of jackhammers has filled the air every day, seven days a week. 

A Long List of Concerns

The location of solar development can be a major point of contention for residents, especially those who have to look at solar projects every day. For Topper, the issue is about the way the installation has disrupted the peace of her rural life. But people have other concerns about solar installations, including solar arrays installed on irrigated agricultural land, which render it useless for agricultural production. 

In 2004, Colorado was the first state to enact a renewable energy standard (RES), requiring 30% renewable energy for investor-owned utilities, and 10% or 20% for municipalities and electric cooperatives. Rural electric coops, including Montezuma County’s Empire Electric Association, and Tri-State Generation and Transmission Association, where Empire Electric buys most of their electricity, have been ramping up their transition toward renewable energy in the past few years.

Mike Conne, who lives adjacent to another Empire Electric solar array at Totten Lake, was worried about wildlife in the area and how the solar project would affect the animals. During the permitting process for the Totten Lake solar project, Conne attempted to convince the county that the solar project should go elsewhere, on the Bureau of Land Management (BLM) land, away from residential and agricultural land. However, the land used for the Totten Lake solar project was already owned by Empire Electric. “It made economic sense to use that property to generate additional revenue for our members through a lease with the array developer,” said Empire Electric in an email.

One of Conne’s biggest concerns was the bald eagle nest next to the Empire Electric-owned property. Colorado Parks and Wildlife recommends placing any development at least a quarter mile from any eagle’s nest. OneEnergy Renewables, the developer for the Totten Lake project, followed these recommendations and curved the solar project to provide a quarter-mile radius around the nest. OneEnergy also completed construction before nesting season. Now, Conne worries about a housing development going in across the street from the solar array, within the quarter-mile radius of the eagle’s nest.

The Totten Lake solar project was completed and brought online in December 2022. Now, Conne has seen deer get hit by cars because they walk on the road instead of crossing the newly-fenced-off land with the solar array.

Perry Will, a Colorado State Senator for District 5 and former wildlife officer, said that any time you take land out of production by fencing it off, you’re reducing wildlife habitat, especially for ungulates like deer and elk who need fields and sagebrush for critical winter range. “It’s impacting the habitat,” Will said. “It’s really no different than paving it over as a parking lot or putting up a building. It’s still habitat loss.”

Conne was also frustrated with the amount of land degradation that took place while the solar construction was underway. “I expected that they were just gonna put the panels over the vegetation. They completely destroyed the whole area,” he said as he showed photos of a machine grading the 12-acre property next to Conne’s house. 

In response to questions about landowner concerns, Empire Electric said in an email that “During the permitting phases for both the Totten Lake and Montezuma solar generators there were landowners adjacent to the projects who came forward with concerns about the facilities being built near their homes. EEA [Empire Electric] worked with the solar developer and the county planning and zoning board to ensure the projects complied with statutory requirements and also addressed individual member concerns. In the end, all parties were able to come to terms and the projects were approved. In our opinion, the process allowed members with concerns to have their concerns addressed in a fair manner.”

Topper said that when the solar project was announced, she and her neighbors fought it, but they lost the battle. Nathan Stottler, associate director of project development for OneEnergy Renewables, says that he should have reached out to neighbors earlier in the project development for this specific project. During the permitting process, however, there is built-in time for public comment. When neighbors like Topper came to the public comment meetings with frustrations, OneEnergy did make some allowances like moving the project 50 feet from the property line, building an 8-foot-tall privacy fence (which you can still see over from most spots on Topper’s property), and promising to plant 6-foot tall trees for privacy once the project is finished. 

“We’re held to a higher standard than oil and gas because oil and gas is an established use,” said Stottler, “And to the extent we can, we try to welcome that, we want to be better, we want to do better. I work in solar for a reason, because I want to fight climate change.”

A Legal and Logistical Maze

Empire Electric’s contract with Tri-State dictates that the co-op is only allowed to generate up to 5% of its own electricity and must buy the rest from Tri-State. If Empire Electric was able to generate more of its own electricity with solar, electricity prices could go down. But because of the current contract, community members like Topper do not receive any financial benefits from having a solar project in their backyard. 

Stottler, who grew up in rural Minnesota, understands how the view of a solar farm is not what residents desire. However, he said that if people see themselves as a part of the regional community and county, there are more direct benefits to having solar installed locally, including keeping money in the community and stabilizing electricity prices.

“OneEnergy is going to be pumping more tax money into Montezuma County, and that’s a big thing that wouldn’t have happened if you were buying your power from out of state or out of county,” said Stottler. Because Empire Electric, a locally owned cooperative, owns these solar farms, anyone who purchases electricity from Empire Electric keeps their dollars in the community instead of sending it out of the county to a coal or natural gas plant elsewhere.

Other Southwestern rural electric coops such as Kit Carson in Taos, New Mexico, and Delta Montrose in Southwest Colorado have bought out of their contract with Tri-State and are now pursuing 100% solar energy during the day, which can stabilize and lower electricity costs for residents. 

One of the reasons solar developers choose a specific parcel of land is access to roads, power lines, and substations. If the power is being sold to a transmission company, there need to be transmission lines nearby. The Totten Lake and Montezuma Solar projects are only for distribution through Empire Electric Association, which means they need to be located near Empire Electric-owned distribution lines. EEA is not allowed to back feed power onto the transmission grid because of their contract with Tri-State, which means they are only allowed to generate the minimum daytime load (typically determined by the amount of power used from a substation in the middle of the day) and they cannot use Tri-State owned transmission lines to distribute the power produced by the solar arrays.

Stottler said the siting of solar development has three phases. 

“It has to be in Empire’s territory, [and] it has to be on their distribution lines,” said Stottler. The project also needs to be adjacent to a substation. 

For smaller solar projects like the Montezuma (5 megawatts) and Totten Lake (2.5 megawatts), there is not much wiggle room for moving farther away from distribution lines and substations. Building new infrastructure isn’t feasible because the profit margins are much smaller than they would be for a larger, transmission-size solar project. 

“Some of the prime agricultural land is also the prime land for solar energy production because it’s flat and it gets a lot of sun,” said Tyler Garrett, Rocky Mountain Farmers Union’s director of government relations. “The worry is that that [land] will be taken and we’ll be gradually decreasing the amount of land that’s available for agriculture.” 

Bob Bragg, Topper’s neighbor and an agricultural journalist, said that it’s important for developers to consider the people who live near solar arrays. “We’re so hellbent on putting in solar installations that we want it close to the substations, when in reality maybe we need to spend a little bit more money to get those to where they’re not impacting someone’s home who lived there for a very long time,” Bragg told the Daily Yonder.

Garrett worries a lot about farmland being taken out of production with the development of more and more solar farms across the West. He sees agrovoltaics — the marriage of solar and agriculture — to be the best path forward. 

One way agrovoltaics can work is to raise solar panels high enough for farming or ranching to take place beneath the solar installation. Colorado-based farm Jack’s Solar Garden is working with the Colorado Agrovoltaic Learning Center to educate farmers and ranchers about what this could look like.   

Byron Kominek, director of the Colorado Agrovoltaic Learning Center, agreed. “We have well over 10,000 acres of solar panels in Colorado as far as I understand, and we’re going to have millions of acres of solar panels across our country in the coming years,” said Kominek, “It would be unfortunate if all that land just goes to dirt or weeds or gravel or any degraded state.”

The potential of agrovoltaics is still being explored in Colorado and around the country. In Colorado, a bill was signed on May 19th, 2023, that will provide half a million dollars in grant money for agrovoltaics and conduct a study on the opportunities and challenges with agrovoltaics in Colorado. 

Conne said he loves solar but would prefer to see development away from homes and with less land degradation. He said he would support more agrovoltaic development with cattle or sheep to maintain the agricultural nature of rural areas. He sees BLM land as a good opportunity for future solar development as well as landfills. “I love solar, I really do,” said Conne, “but there’s a lot of things that need to be changed in the future.”

The post Solar Farms in Colorado: Fossil Fuel-Free Energy Comes With Controversies appeared first on The Daily Yonder.

This story was originally published by Homegrown Stories.

When storms on the Pine Ridge reservation, home of the Oglala Nation, in South Dakota begin to build, they can be seen from miles away. Above rolling hills, clouds turn into waves and bring the rain. Strong gusts of wind stir up the smell of dirt and sagebrush. Wildlife begins to move along the Badlands long before the weather hits ground and radio broadcasts from KILI radio station warn the community of what’s to come. Evidence of the storm comes slowly at first, setting the scene and then it hits all at once.

In the same way storms build power, slowly and intentionally, there’s something else gaining momentum on Pine Ridge. People that have been too long at the mercy of colonialism and industrialization have begun to gather, organize, and build the foundation for a more prosperous tomorrow. Red Cloud Renewable has been a landmark for sustainability on Pine Ridge, but there was a crucial piece missing in order for the efforts being made in renewable energy to work: housing. Solar panels on poorly insulated, mold-infested homes cannot solve the energy crisis on the reservation.

In 2015, Pine Ridge was hit with several severe storms which prompted the Federal Emergency Management Agency (FEMA) to send 50 trailers to aid people during the flooding. This temporary housing is still being used today.

It is estimated that 89% of people living on the Pine Ridge reservation are in need of housing. According to the American Indian Humanitarian Foundation, at least 60% of the homes on Pine Ridge are without water, electricity, adequate insulation, or sewage systems. Summers can reach a blistering 110 degrees Fahrenheit and higher, while winters can drop to -50 degrees. It is not uncommon for monthly heating bills to reach $500 during the winter months.

With the average per capita salary of $7,000-$9,000 per year, an energy alternative is not just a means of cutting costs, it’s survival.

Solar energy goes a step further than just being a more cost effective form of energy, it also connects the old way of life for the Lakota people to a new way of living. It has the power to give Indigenous people back autonomy by giving people the option to live off-grid.

After spending six years traveling and learning about solar and all of its applications, Henry returned to Pine Ridge to put what he had learned to work. In 2002, he began doing research on thermal solar heating panels, which led him to turning an old freezer door into a solar heater. Using reclaimed materials from a landfill, some metal and an exhaust tube connected to his car battery, Henry built a heater fueled by the sun. Not long after that, he found himself volunteering to do some solar heating installations with a nonprofit. This would lead him to opening Lakota Solar Enterprises, creating jobs for two employees, and himself.

By 2003 they had started manufacturing heating panels. After meeting with the former U.S. Secretary of the Interior Stewert Udall, Henry secured funding to continue building what he started. With the mission of creating economic opportunities and lessening what Red Cloud calls the tribes’ “moccasin print,” he began working with other tribes.

Red Cloud Renewable became a certified training program and created over 500 jobs across those tribes. This allowed Henry to hire 12 more employees to his own operation as well. These partnerships began to grow and build on each other. “That partnership beginning from 1997, I firmed up and did everything that I could to train myself around solar electric grid-tied battery based systems, standalone systems and then brought a training facility, the first ever of its kind in Indian Country,” explained Henry. Since then, Red Cloud Renewable has added programs in food sovereignty, natural-home builds and reforestation.

Not one of these programs functions fully on its own. Without economic and job security, a community has fewer resources to focus on food sovereignty. Without well-insulated and energy-efficient housing, renewable energy cannot function at its full potential. That housing also needs to be affordable for the community that it intends to serve. Red Cloud Renewable has dabbled in various sustainable housing projects and methods but more recently has partnered with a nonprofit, InOurHands.

Founded by Jason Mackie and Aaron Resnick, InOurHands is working with the Oglala Sioux Tribes and others to address the need for proper housing on the reservation. “There’s a need here for about 20,000 homes,” explained Jason, who has been working with Red Cloud since 2018. “And it’s been common in my five years out here. In fact, every year, somebody that we know, a family member of theirs, has died of exposure, during the night, in their own home, because maybe they thought they’d wait it out, wait another night, and then it got a little bit too cold,” said Jason.

Using a material known as cellular concrete, Red Cloud Renewable and InOurHands have developed a version of a tiny home that ranges in cost from $7,500 to $9,000. The dome-shaped homes are naturally insulated, take only a few days to assemble, are fireproof, and can be heated with a small solar panel. “It’s important to me that we can give something to someone that will sustain them for a really long time and allow them to cultivate some hope and participate in their community and help heal other wounds,” said Aaron.

The first phase of the partnership was focused on training, building warming shelters, and providing one home per each of the nine districts on the reservation. They are also laying the groundwork so that this project can continue to grow beyond addressing housing insecurity. In the future, they hope to train more Lakota people in building the domes, so that others can start their own businesses. InOurHands was granted $700,000 from the Turner Foundation, Kind World, and the Minnie Miracle Foundation to continue this work, and the organizations will continue to build on a charitable basis for families with the greatest need. In the future, these homes will be built by Lakota-owned businesses. Families will be able to purchase the homes with a mortgage that the Lakota Federal Credit Union has agreed to underwrite.

“It’s at that point, we need to be coming together. Our native history with a non-native history has been a terrible time,” said Henry. “But we’re still in that history book. We’re just in a new chapter and we know now what we can do and what we should be doing. And then we can close the book, bring it to a better ending.”

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Homegrown Stories is a storytelling project from the advocacy group Western Organization of Resource Councils. It celebrates the hardworking people across the West doing things right. The people of these stories are creating community-based food systems, investing in clean energy economies and jobs, supporting just transition work, and fighting for a sustainable future.

The post Renewable Energy Meets Affordable Housing on South Dakota’s Pine Ridge Reservation appeared first on The Daily Yonder.

For nearly 30 years, a little radio station started in the cornfields of rural Ohio made a name for itself. Now, more than a decade after it played its last song, it’s doing that again.

At the end of May, WOXY, known to legions of fans as 97X, will resurrect its “Modern Rock 500” one last time. It’s a tribute, organizers said, to a small-town station that rocked the radio world, first locally, then nationally and beyond. 

Back to the Future 

Back in the ‘80s and ‘90s, 97X was the modern rock radio station in southwestern Ohio. And it was my radio station from my first days on campus at Miami University. From its first song — U2’s “Sunday Bloody Sunday” — until its last internet broadcast in 2010, the station was the center of the new music universe for a generation of young people, like me, who lived for something different.

Essentially, 97X and I were both freshmen at Miami then. The radio station had previously been WOXR, playing Top 40 hits, and uncensored versions of Steppenwolf’s “The Pusher,” and Neil Young’s “Cowgirl in the Sand” to appeal to Miami’s college crowd. When Doug and Linda Balogh bought the station in 1981, they asked Miami students what they wanted to hear. The answer was modern rock. So the Baloghs delivered, playing music no one else in the area was giving airtime to.

According to music historian Robin James, WOXY was the sixth modern rock station in the U.S. In her book, “The Future of Rock and Roll: 97X WOXY and the Fight for True Independence,” she says FCC regulations kept the station small, but what it lacked in strength it made up for in individuality.

“The station started off in ‘83 basically copying L.A.’s KROQ (pronounced Kay-rock) playlist,” James said. “By the ‘90s though, 97X was sort of the place for new and different music.”

I spent my first semester at Miami that year trying to figure out who I was and where I fit in. In my world, you smiled at people you met on the street and “punk” was something you dressed up as on Spirit Day if you wanted to be really edgy. My roommates thought I was a rube. But when I heard 97X for the first time, I realized there was more to life than Journey. 97X didn’t play the big hair bands and southern rock my roommates were listening to. They listened to “Faithfully.” I started listening to “Burning Down the House.”

Listening to 97X set me apart. Suddenly, I had this sense I belonged to a new club of shared interests and ideals that were different from most of the rest on campus.

Behind the Music

Oxford back then was just a jumble of concrete amidst miles of cornfields between Dayton and Cincinnati. It was a primarily Republican college in a primarily Republican area in a primarily Republican state.

But 97X was a ministry of liberal ideology in the midst of a campus full of trust fund babies and future country club members. Transmitting to Dayton, Cincinnati, and Northern Kentucky, it broadcast a new sound.

“In high school, I lived in Northern Kentucky at what must have been the very outer edge of their broadcasting radius,” recalled Chris Eddie, now one of the owners of Smiley Pete Publications in Lexington, Kentucky. “I’d have to say my most memorable experience happened at 97Xtra Beats … an all-ages, monthly event held at Bogart’s in Cincinnati … (It) was right as Nirvana‘s ‘Smells Like Teen Spirit’ and Red Hot Chili Peppers’ ‘Give it Away’ had recently come out. The usual, gothy/mopey alterna-girls exploded into dance like it was a New Kids on the Block concert. I knew something had changed in the world of music.”

In 1988, the station rose to fame in the Tom Cruise, Dustin Hoffman film “Rain Man.” Filmed in Cincinnati, the movie featured Dustin Hoffman’s Raymond Babbitt repeating the station’s tagline “97X, BAM! The Future of Rock and Roll.”

From there its notoriety grew.

“They grew to have a national reputation,” James said. “’Rolling Stone,’ for several years in the ‘90s, named them one of the top radio stations in the country. Then later on, ‘Rolling Stone’ named them the last great independent radio station.”

And it was too. Until it wasn’t.

By ‘88, I had left school and was living in Cincinnati, a single girl listening to alternative tunes, hitting raves and pub crawls when I could. I worked as a reporter for the alternative newsweekly “Cincinnati CityBeat,” and 97X was our media partner. As time went on, though, I moved into more corporate jobs and listened to the station less. Then the ‘90s came, replacing concerts and clubbing with marriage and kids.

But during that time, 97X kept its own unique sound and purpose, even as other stations all started to sound the same, James said.

“Basically, everyone was buying up radio stations then syndicating content nationally,” she said. “It was kind of like the ‘Walmart-ification’ of radio.”

WOXY maintained its modern music focus and its independence. It may have even been the radio station that broke Coldplay into American markets, she said.

Former program director Mike Taylor isn’t too sure about that. But he does know it became harder and harder for independent radio stations like WOXY to compete with the corporate big boys. In 2004, Taylor said, the Baloghs sold the license to 97.7 FM, but kept the WOXY name and the station’s music library. The station went online as WOXY.com, one of the first radio stations in the country to have a primarily online presence. Taylor said the station’s reach was suddenly the world.

“I was looking to try and reach people in New York, L.A., San Francisco, and London,” he said. “If we would get an internet request from somebody from some far reaching location, that’s what really primed my pump.”

Online, the station’s reach was international. 

“In the early 2000s, a music critic in Brazil was a really strong advocate for 97X,” James said. “The station had a huge Brazilian audience to the point that when (WOXY) had a Brazilian band called The Mosquitoes in for a lounge act, they had them record [the tagline] ‘97X, The Future of Rock and Roll’ in Brazilian Portuguese.”

The station moved to Austin, Texas, Taylor said, and new investors helped keep it afloat. The station couldn’t sustain itself, though, and in 2010 Taylor played the station’s last song, “Answer to Yourself” by The Soft Pack.

Fans of the station, however, continued to talk about it. A podcast sprung up, Rumblings from the Big Bush, hosted by former WOXY DJs Dave Tellmann and Damian Dotterweich, that recounted the days of 97X. In other online spaces, fans put together 97X Reddit threads, blogs, Facebook groups, and Spotify playlists. Some fans say they continue to listen when they can.

“My first memory of 97X was walking into a store in Tri-County Mall that (was playing) these fun, different tunes that I had never heard before,” Jo Ivey, a former ad rep for “Cincinnati CityBeat” said. “To this day, Morphine’s ‘Cure for Pain’ will stop me in my tracks. Concrete Blonde’s ‘God is a Bullet’ reminds me how little time has changed, and I still find time over the Memorial Day weekend to find the Modern Rock 500 online.”

Reunion Tour

In recognition of that lasting impact, during this year’s Memorial Day week, WOXY will stream the “97X Modern Rock 500 Countdown” online on Inhailer Radio. The broadcast will be a 40th Anniversary “chef’s kiss” to the station’s beginnings, Taylor said. Featuring five 100-song sets led-in by former WOXY disc jockeys, the countdown will air on Inhailer’s website and apps from May 22 to 26, and will re-air over the Memorial Day weekend, with an archived version available after May 29. 

Taylor said it’s like getting the band back together.

“I had over 30 people, myself included, that responded with wild enthusiasm to do this,” he said. “We crafted kind of an all-time 500 if you will. We had to kind of limit things a little bit, so the only songs that would be eligible were songs that had previously appeared on the Modern Rock 500 at least once.”

The result will be a mash-up of 20th century “modern rock” songs put together with 21st century technology, he said.  

Times have changed since WOXY was at its prime. Radio isn’t the same now that everyone has the opportunity to be their own DJ, he said. But he hopes, like the original, this 500 will have an impact.

Now that I’m older — much older — I can see the impact the station had on me. I still listen to alternative rock, and routinely share new music with my kids. I introduced them to K-Flay and Shakey Graves. They told me about The Bahamas and Twenty One Pilots. They tell me I’m not like other moms. Apparently, other moms my age are still listening to Journey.

Taylor said he doesn’t know if the station will continue to affect listeners. 

“I know once this finally hits there’s going to be some outlet out there that’s going to label this as the most pathetically boomer thing ever,” he said. “But my take away from doing this is that it’s just like anything else — how can you tell the impact of something as it’s happening?”

For many, WOXY was an introduction to a world of music we never would have heard otherwise. And it left indelible memories.

This last Modern Rock 500 may be the last memory 97X creates, Taylor said.

A memory of the future of rock and roll.

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The post The Future of Rock ‘n’ Roll – from the middle of rural farmlands appeared first on The Daily Yonder.

At just 5 weeks old, Waylon Williams is a trailblazer. He’s the first baby born in Primary Care Centers of Eastern Kentucky’s new women’s residential center. The facility, called Beacons of Hope, offers temporary housing for women confronting substance use disorder.

That recovery housing for women is available in a rural, financially challenged community is noteworthy. That it’s available for women with babies is remarkable. Equally so is the fact that Primary Care Centers of Eastern Kentucky (PCCEK) is a rural health clinic (RHC), and recovery housing is not among the services rural health clinics typically offer. A men’s residential center is soon to open.

Beacons of Hope is an extension of PCCEK’s Pregnancy & Beyond, an addiction-treatment program that offers obstetrical services, medication for substance use disorder, prenatal education, pediatrics, and counseling – services that in so many rural communities nationwide are in critically short supply or entirely absent.

The town of Hazard, where the largest of PCCEK’s four clinics is located, is in Perry County. Perry County ranks 117th among Kentucky’s 120 counties in health outcomes. Life expectancy is 67, as compared with 78.5 for the country.

Addressing such challenges requires the full force of a health care ecosystem that includes hospitals, clinics, private practices, public health agencies, and a range of support services. Rural health clinics play a critical role in this ecosystem. “They’re an important part of the primary care landscape,” said John Gale of the Maine Rural Health Research Center.

RHCs are safety net providers whose original mandate was primarily to increase access to care for those on Medicaid or Medicare. They provided primary care and perhaps a few other services. But the Rural Health Clinic program has evolved over the years, and some clinics, like Primary Care Centers of Eastern Kentucky, have expanded their roles quite considerably.

Among the health care services, PCCEK offers are dentistry, a diabetes center, a women’s health center, extensive radiology and imaging, a range of behavioral health services, a pharmacy, and a hospice care center. It offers a sliding scale for fees.

PCCEK has nurses in each school in the county system. It has an event space where it hosts maternity fairs and Easter, Halloween, and Christmas gatherings, and which in the wake of the region’s catastrophic flooding last July served as a distribution center for food and supplies.

And with such a wide array of services, CEO Barry Martin contends, PCCEK is addressing arguably the greatest challenge to rural health care: a shortage of health care professionals.

Gale said the projection is that there’ll be a shortage of 50,000 or more primary care providers nationwide by 2032, and that the majority of those available aren’t likely to want to practice in rural areas.

It’s taken some time, Martin said, to impress upon newly minted health care professionals that Perry County is a promising place to build a career, but his message appears to be resonating. He’s especially focused on enticing young people from the region to head back home and hang a shingle at PCCEK.

“Come back here,” Martin urges them. “Look at what we’ve built. It’s not a double-wide on the side of the road.”

Meeting Needs, Steady Growth

The Rural Health Clinic program was launched in 1977 as a Carter administration initiative. The impetus was to make it more viable for rural providers to stay in business with a relatively heavy load of Medicaid and Medicare recipients and few patients with private insurance by offering higher reimbursement for those federal programs.

RHCs must be in a health professional shortage area. They must take a team approach to care: physicians working with a staff of nurse practitioners, physician assistants, certified nurse midwives, and others.

The number of RHCs has grown significantly over the past decade or so. In 2010, there were fewer than 4,000; today, there are 5,270. They’re in every state except Alaska.

RHCs differ from federally qualified health clinics (FQHC) in that FQHCs can’t be for-profit providers and must be governed by a board of directors of which the majority of members must be patients of the clinic and demographically representative of the community. FQHCs must offer primary care and preventive and enabling (such as case management and transportation) services. In meeting these stipulations, they receive higher reimbursement from the federal government.

PCCEK is a for-profit entity. It launched in October of 2003 in a 6,700-square-foot facility with 15 employees offering family medicine, pediatrics, simple X-rays, ultrasounds, and a lab. In 2008, it expanded into a 30,000-square-foot building, and in 2015 into its present Hazard location, a 60,000-square-foot complex, formerly a Kmart. It also has clinics in the nearby towns of Hindman, Hyden, and Vicco.

More than 39,000 unique patients came through PCCEK’s doors last year, Martin said, for a total of 180,000 encounters. The clinic employs more than 400 people.

‘Ease a Little Bit of the Burden’

“I like to say that we provide services from the head to the toe and the womb to the tomb,” Martin said. “And that is true.”

Care for diabetics is an urgent need in this region. In 2021, Kentucky had the sixth highest diabetes death rate in the country. The Kentucky Department for Public Health reports that between 2000 and 2018, the number of diabetes diagnoses had doubled. Perry County has among the highest incidence rates in the state.

PCCEK operates the Mary E. Martin Diabetes Center for Excellent (named in honor of Martin’s mother). It’s the only diabetes facility affiliated with the University of Kentucky’s Barnstable Brown Diabetes Center. It offers comprehensive case management.

“We try to ease a little bit of the burden,” said Martha Bailey, a registered nurse and licensed diabetic educator from nearby Letcher County. “We’re doing preventive maintenance. We’re talking to them about their diabetes.”

Before PCCEK opened its diabetes center, people routinely drove 250 miles roundtrip to Lexington to see a doctor. Many simply went unexamined, undiagnosed.

“They may come in here and have an ulcer they didn’t even know they had,” Bailey said. “We’ve had patients come in that had tacks in their feet. They didn’t know it until we did the exam.”

PCCEK is the only place in Eastern Kentucky offering pedicures specifically for diabetics. “When they do the foot care here,” she said, “That’s their time to be pampered.”

The center also provides $10 vouchers for the local farmers’ market. “With the people on fixed incomes, that helps them eat a little bit healthier,” Martin said.

Immersion in a Community

John Jones serves as PCCEK’s medical director and oversees the diabetes center and Beacons of Hope. He’s a Hazard native, and while he believes that being homegrown certainly helps in most effectively reaching his patients – “We just know each other. The trust is there.” – he hastens to add that trust can likewise be built in those who come from elsewhere, assuming you’re willing to make yourself known in the community.

“I think it’s a little different than the stereotype,” Jones said. “They’ll accept you with open arms. It’s just about being out there.”

Trust was of the essence after the July flooding. Jones tells of a father, mother, and daughter who were swept from their home, strapped themselves to a power pole, and hung on. The family now lives with relatives.

When it rains, Jones said, the child is terrified; she has nightmares and flashbacks. When he talks to the dad about exploring counseling, “I think he doesn’t hear that from me as a doctor; he hears it from me as a friend.”

Dealing with such issues – or dealing, on a day-to-day basis, with a patient who’s homeless with no way to refrigerate their insulin, or one with no transportation to make an appointment – such things aren’t taught in medical school. You learn through immersion in a community.

Martin trusts he’s creating an environment that will draw young professionals into his community.

A Continuum of Care

Nathan Baugh, executive director of the National Association of Rural Health Clinics, believes the RHC program isn’t well understood among decision-makers in Washington. FQHCs, he suggests, get more attention and are thus more likely to receive grant funding and be recipients of favorable policy decisions.

“It’s been a long-term struggle for us,” Baugh said, though he feels some progress has been made in the pandemic, with the two programs being treated more equitably for federal allocations and resources. “We were happy to see that. But we still have a massive granting and understanding deficit relative to the FQHC program.”

In Eastern Kentucky, Barry Martin believes the benefits of a comprehensive rural health clinic to a region and state are clear. Nearly 200,000 annual health care visits speaks volumes. Moreover, “The governor is looking for people like us to help develop a second-chance workforce,” Martin said, “and that’s what we’ll be doing with Beacons of Hope.”

The big-picture objective for all stakeholders is a continuum of care: health, housing, employment, well-being.

“I got lucky,” Brittany Williams said of finding a temporary home at Beacons of Hope for herself and her son Waylon. “They’ve taught me self-control,” she said, “and structure. They’ve helped me structure my life.” She’s hopeful about the future.

The post Rural Health Clinics with ‘Head-to-Toe and Womb-to-Tomb’ Care appeared first on The Daily Yonder.

Students and staff in rural Maine are using teletherapy to help access much-needed behavioral health services. 

Baileyville, Maine (pop. 1,318), was experiencing a youth mental health crisis in their community and a severe shortage of mental health providers. The problem reached a precipice in 2021 and 2022, said Kate Perkins, deputy director for U.S. program development at MCD Global Health. Of the more than 4,500 fully or conditionally registered clinical social workers in Maine, fewer than 4,000 live in the state, and fewer than 50 in Washington County, the easternmost county in Maine where Baileyville is located. 

“One of the things that we were seeing is the result of Covid,” Patricia Metta, superintendent of AOS 90 school district, which includes the Woodland Elementary and Woodland Junior-Senior High School, told the Daily Yonder. “We saw kids not returning back to school, many of them had gotten so used to being in their homes for at least a year, that their social issues, they couldn’t handle being social. They didn’t know how to deal with social issues.”

There were also several suicides, both within the school system and the community at large, she said. 

The country as a whole is grappling with a lack of physicians, but it is more acute in rural areas. A 2021 Association of American Medical Colleges (AAMC) study found that the U.S. could see a shortage of between 37,800 and 124,000 physicians by 2034. 

To combat the negative health effects, a collaborative effort coordinated by MCD Global Health now gives students and staff at Woodland Elementary and Woodland Junior-Senior High School in Baileyville, and across the county’s AOS 90 school district, access to virtual behavioral health services and other needed resources. A $500,000 matching grant from Point32Health Foundation helped the community get started on the initiative. Additional funding helped the program reach a total of $1.5 million in resources. 

Since the program began, 30 students have been matched with behavioral health providers in person and virtually. The program is on track to serve a total of 80 students by July 31, 2023. The school district has 380 students across four schools.

“We do see kids reaching out for help. They’re asking to see their provider. They’re asking for their teletherapy sessions,” Metta said. “We see them talking to people. And we do believe that eventually that will lessen their anxiety. And we are seeing kids come to school more. Attendance has really improved.”

The program started through a community assessment in August 2021 that found access to behavioral health resources as an urgent need, Metta said. Initially, officials put teletherapy equipment in both schools and weren’t sure what the result would be, she added. 

“We thought, there’s a couple of kids that will take advantage of it,” she said. “Well, since then, we’ve lost our full-time provider. And every day we’re picking up more and more kids on teletherapy…And if they can’t relate well with the in-house provider, then they have the option of teletherapy as well. So it’s a win-win for everybody.”

Jessica Melhiser, children’s program manager at Aroostook Mental Health Services Inc. and care navigator for the program, said in a statement that the program has transformed health and well-being for students and families in the communities. 

“Students are getting the support they need and sharing the benefits with their classmates, their families, and others who need help. It brings hope to the hallways,” she said. 

Perkins said they haven’t solved all the problems, nor are they trying to. 

“What we have done is rebuild confidence and re-ignite belief that it can get better,” she said. “The early work was really slow. It took a long time to build trust. It took the local leaders seeing us deliver, in terms of getting matching funds or equipment, for them to believe us when we said that this or that was viable and could get funded.”

Metta said the program had initiated other positive movements, like creating a food pantry and a garden for students. 

“I think as a result of the teletherapy program, and the community, the rural community getting involved, that’s what it took, in order for this to be successful.”

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Last week’s monthly job report from the Bureau of Labor Statistics was better than expected, but another recent report from the bureau shows rural America still has a way to go to get back to pre-pandemic employment levels.

In April the bureau released its annual average employment report for 2022. As the name implies, this report takes jobs data for the entire year and produces a single average employment number for each county in the U.S. This data provides a longer-term view than monthly reports of how the American economy is performing for working people.

The good news is that rural America added nearly 738,000 jobs in the last two years. The bad news is that these gains didn’t completely offset the 953,000 jobs rural America lost during the first year of the pandemic.

In 2022, there were 1.1% fewer jobs in rural counties than there were in 2019. Metropolitan counties had on average about 1% more jobs last year than before the pandemic.

There are important regional variations on these general trends. But on average, job prospects were more limited in rural counties.

• Rural counties had 215,00 fewer jobs in 2022 than in 2019.
• Six out of every 10 rural counties had fewer jobs in 2022 than in 2019.
• A majority of metropolitan counties (56%) had more jobs last year than three years ago.

Regional Variation

• States in the Northeast, Great Lakes region, and the Great Plains had a higher percentage of rural counties that lost jobs.
• Other regions with a larger proportion of counties with job losses were along the Texas border and gulf, the Black Belt South, coastal California, and parts of the Rocky Mountain West.
• Fourteen states saw gains in metropolitan employment while losing jobs in rural counties.
• States with the biggest negative gap between metro and rural employment change were Colorado (metropolitan employment grew 3.6% while rural employment fell 4.2% for a gap of 7.8 points) North Dakota (metropolitan employment grew 3.8% while rural employment fell 3.6 points, for a gap of 7.4 percentage points), and Texas (metropolitan employment grew 5.5% while rural employment remained flat, for a gap of 5.5 points).

Variation by County Types

• Counties in medium-sized metropolitan areas (250,000 to 999,999 residents) had the biggest growth in jobs, at 1.3% for 2022 compared to 2019.
• The suburbs of major metropolitan areas (1 million or more residents) were a close second with a 1.1% gain in employment.
• The core counties of major metropolitan areas and small metropolitan counties (under 250,000 residents) had growth in jobs since the pandemic, but just barely. The core counties of major metros saw job growth of 0.6% while small metros employment grew 0.3%

Monthly Job Gains

The most recent county-level monthly job reinforces the prospects of slow job recovery in rural counties. Rural counties added about 85,000 jobs in February 2023 compared to the previous February, a gain of 0.4%.

Definitions: Major metros have 1 million or more residents, Medium metros have 250,000 to 999,999 residents, Small metros have under 250,000 residents. Nonmetro areas are counties that are not within a metropolitan statistical areas (OMB 2013). Nonmetro is used synonymously with rural in this analysis. Core counties are the central counties of metropolitan areas, generally containing the areas' major cities. Suburbs are metro counties lying on the periphery of these metro areas.

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