The insurer Cigna will no longer require pre-authorization for prescriptions to treat opioid addiction under the terms of a national settlement announced late Thursday by New York Attorney General Eric Schneiderman. Doctors and patients complain that while it may be common to require doctors to get prior approval for other prescriptions, a delay in getting medication-assisted treatment (MAT) for heroin addiction can be deadly, as addicts can easily relapse and overdose. While pre-authorizations should just take hours, it can often take days if there are problems with the paperwork.
As of Friday afternoon, Oct. 14, 2016, 83 endangered Key deer had been euthanized because of an infestation of the New World screwworm. The screwworm, not seen in the U.S. since the 1960s, is leaving open wounds on the deer and then eating the flesh until the deer is incapacitated. U.S. Fish & Wildlife, in partnership with the Florida and U.S. Dept. of Agriculture, are working hard to eradicate the Screwworm and keep it contained to the lower Keys. New World screwworm flies have now caused the euthanization of nearly 10 percent of the endangered Key deer population — and things could get worse before they get better now that the flies have been found on more than just Big Pine and No Name keys.
AEM hopes to help find answers to the infrastructure challenges facing the U.S. agriculture sector. Under its Infrastructure Vision 2050 thought-leadership initiative, AEM will seek innovative ideas and best practices to address those challenges in the context of current and future U.S. infrastructure trends. AEM is calling for papers and research that focus on one of two specific areas: 1) the movement of agriculture products from farm to market or 2) the movement of equipment from farm to farm. "How we plan to transport agriculture products from farm to market or equipment from one farm to another in the future, relying on our current infrastructure, are crucial questions that AEM wants to help answer," said AEM President Dennis Slater. "This call for papers provides us with a platform to help shape the future of U.S. infrastructure for both the agriculture community and rural America."
Those who try to pass off pets as service animals in Maine now face a $1,000 fine under a new law. The Maine Human Rights Commission says many people in the disability community are unaware of the changes, which include a new category called assistance animals. Such animals are either trained or determined to be necessary to provide comfort and support to people with physical or mental disabilities.
A new poll finds a stark geographic division in the nation’s culture and politics. The study was conducted by Gallup for the University of Virginia’s Institute for Advanced Studies in Culture. The polling finds deep distrust in the nation’s institutions and leaders. For example, less than 5 percent of all respondents to the survey believe America is “strongly improving” while nearly six out of 10of those polled agree that the “American way of life,” which is undefined in the poll, “is rapidly disappearing.” Distrust in American institutions — Wall Street, government, science — has been rising since at least the mid-1960s. Indeed, a decline in trust is a feature in all industrialized countries. A good number of Americans feel powerless and marginalized. What this poll finds, however, is that the levels of personal alienation differ with population density. “Alienation rates are twice as likely to be very high in the most rural areas as in the denser cities; three-and-a-half times more likely if you have only a high school diploma than a graduate degree; and four times more likely if you are in the lowest income bracket than if you belong in the highest income bracket,” write James Davison Hunter and Carl Desportes Bowman. Hunter and Bowman make it clear that all Americans are dissatisfied with the way things are going. But, they add, “When one considers all dimensions of disaffection together and looks to their cumulative impact, one sees the greatest intensity of total disaffection in a population that tends to be more male than female, disproportionately represented among Baby Boomers, and among those who reside in the lowest density parts of the country, though not in any particular region of the country.” The poll finds that “about half (53%) of all who have a very high disaffection live in the lowest two levels of population density. If you live in the least populated rural areas, you are twice as likely to be in the highest category of disaffection.”
Purdue University’s annual Indiana Farm Fatality Summary reported 28 farm-related deaths in 2015, a 10 percent increase from the 2014 total of 25. However, overall trends are still declining. Statistics were collected by the Purdue University Agricultural Safety and Health Program from news reports, Internet searches, personal interviews and reports from individuals and Extension educators. Tractor and farm machinery accidents continue to be the most commonly reported cause of fatal injury, with overturned tractors accounting for 39 percent of deaths in 2015. All but one documented death from overturns in the past 20 years have involved tractors that were not equipped with a Rollover Protective Structure (ROPS), a frame or bar that keeps the driver from being crushed if the vehicle flips or rolls over. Other causes of death in 2015 included falling from buildings or horseback, becoming pinned under equipment, being kicked or rammed by an animal, accidental smoke or chemical inhalation and drowning.
The United States Department of Agriculture convened this discussion, and others like it across the state and across rural America, because the opioid epidemic is not just a big-city issue. And the only way that the scourge can be addressed, Baldwin said, is through cooperation among leaders at the local, state and federal level.“We have not done our job, until we create a better and more effective partnership with regard to funding the services that we need,” Baldwin said. The U.S. Congress has done its part — but not completely, according to Baldwin. The Senate’s passage in July of the Comprehensive Addiction Recovery Act was intended to offer more treatment options — including diversion programs like drug court — as well as address the sources of opioid addiction, including prescriptions of opium-based painkillers.However, the funding of CARA, a proposed $1.1 billion, of which about $13 million would come to Wisconsin, did not get congressional approval.For that reason, Baldwin said, “CARA is comprehensive, in my mind, in name only.”
One of the nation’s most popular travel booking sites is taking a stand on animal welfare by halting the sale of tickets to attractions that let tourists ride or touch wild or endangered animals. TripAdvisor announced plans to adopt the changes by early 2017, partly in response to pressure from animal rights groups to stop selling tickets to attractions that they feel exploit animals without offering any educational value. Representatives of the booking site declined to name which attractions would no longer be listed but described them as places where tourists come in contact with captive wild animals or endangered species, including attractions where people ride elephants, pet tigers and swim with dolphins.
Electric cooperatives offer a promising way for small cities and rural areas in North Carolina to build access to high-capacity broadband. But state laws hamper those efforts, and large commercial providers are in no hurry to fill the gap, according to the Institute for Local Self-Reliance. Commercial internet providers are making progress with fiber-to-the-home and other high-capacity services in major urban parts of North Carolina, the report says. But in rural areas, fiber and higher-capacity build outs are few and far between, the report says. The big exception is areas that have cooperatives that have gotten into the broadband game. “Examining the rural areas with high-quality access shows a common denominator: cooperatives,” said the report, which was written by H.R. Trostle and Christopher Mitchell of the Institute for Local Self-Reliance. “North Carolina has eight telephone cooperatives and each of them has already invested in fiber-optics; six of them have already replaced or aim to replace all their old copper with fiber-optics. Some of them are bringing fiber-optics to nearby areas outside.” The report says its not just telecommunications cooperatives that have the potential to help rural areas make progress on high-capacity broadband. Electric cooperatives may also provide internet service, but – like phone cooperatives – they can’t expand internet hook-ups beyond their primary service area. Additionally, state law prohibits power cooperatives from accepting federal loans or grants for internet projects and limits the amount of capital they may invest in communications services. The report recommends repealing those state laws.
A recent internal federal investigation reminded us of why elections are important — and how damaging it is that discussion of issues affecting rural America is nearly missing from this presidential campaign. The Office of Inspector General of the federal Health and Human Services Department released two reports criticizing the care provided in 28 hospitals directly operated by the federal Indian Health Service. The Associated Press reports that “the often substandard quality of care at hospitals serving Native Americans is the result of outdated equipment and technology, lack of resources, and difficulty attracting and keeping skilled staff.” The health care offered at Indian Health Service hospitals would have been an interesting topic for Sunday night’s presidential debate. But, again, there was little offered to rural voters, except, perhaps for Democrat Hillary Clinton’s comments on what the country owed coal mining regions. Clinton allowed that a clean energy future (and low natural gas prices) were changing the energy economy. “But I also want to be sure that we don’t leave people behind,” Clinton said. “Those coal miners and their fathers and grandfathers, they dug that coal out, a lot of them lost their lives. They were injured. But they turned the lights on and they powered their factories. I don’t want to walk away from them.” Republican Donald Trump continued during the debate to equate “inner city” with black Americans. “I would be a president for all of the people — African Americans, the inner cities,” he said. “You go into the inner cities and you see it’s 45 percent poverty, African Americans now 45 percent poverty in the inner cities.” As the Washington Post reports, this was wrong on several counts. First, the poverty rate among African Americans in metro areas is 26 percent. He also misses the five million African Americans who live in rural areas or small towns. Most of those people live in the South. The Post has a good map showing that there is a huge swath of rural America with large percentages of African American residents.