Under nearly impenetrable hospital payment rules, Medicare must reimburse a state’s urban hospitals for employee wages at least as much as it reimburses its rural hospitals. As a result, Nantucket sets the floor for wage reimbursements at hospitals across the state. And because Nantucket’s wages are high, due to its remote island location and steep cost of living, that has created bonuses for many other Massachusetts hospitals in recent years.
Not this year. Consultants hired by Partners made several errors that led to lower wages being reported to Medicare for Nantucket Hospital. They overestimated hours, thereby reducing the hourly rate, and did not include enough higher-paid physician hours and overtime pay, according to an e-mail from the Massachusetts Hospital Association obtained by the Globe.
Those mistakes, combined with another smaller adjustment to Nantucket’s wages, would result in a “steep and extraordinarily serious’’ decline in Medicare payments, wrote the association’s general counsel, Timothy Gens, in the e-mail. He said “the situation is further complicated by the fact that the [Medicare] deadline for corrections has passed.’’ The rates affect the next fiscal year, beginning in October.
The Alberta government recognized Earth Day April 22 by announcing $15 million to be available annually, over the next five years, for public and private land conservation projects.
The funds were allocated in the recent budget and will support the Land Trust Grant Program and the Land Purchase Program, according to an Alberta Environment news release.
The two programs are used to promote voluntary conservation of private land and to buy land the province considers to be of high conservation value.
Earlier this year, six different land trusts were granted $5.89 million for 22 different projects. They will help conserve more than 13,300 acres of land, said the release.
Land trusts use the money to buy easements or undertake stewardship projects.
In early March, a resident of the small Colorado towns of Drake and Glen Haven — situated within northern Colorado’s Big Thompson River Canyon — reported noticing funky gray water in a side creek of the river and a murder of crows picking at a few dead fish. A few days later, March 7, a large plume of more cloudy water ran down the Big Thompson, leaving behind a massive fish kill. Colorado Parks and Wildlife officials now confirm that more than 5,600 fish, mostly rainbow and brown trout, died in the Big Thompson and its North Fork, and are blaming concrete from a bridge reconstruction project, part of the state’s massive recovery and reconstruction effort following the September 2013 floods.
The die-off is alarming news for the Big Thompson, a popular fly fishing river among tourists and locals, which formerly generated an annual $4.3 million for the region. Larry Rogstad, Colorado Parks and Wildlife Area Manager, says the “iconic” fishery is also important as one of the only rivers in Colorado with wild rainbow trout free of whirling disease. The 2013 floods had already knocked back the river’s fish populations, and Rogstad estimates the recent incident killed more than half of the estimated fish within an eight-mile-long downstream stretch of river.
Concrete can include toxic compounds and is very alkaline — which can be lethal to fish. High alkalinity was documented in the Big Thompson downstream of the bridge construction for eight river miles to a Loveland water-treatment plant in the days following the apparent concrete spill. Since then, water-quality levels have returned to normal, and officials continue to monitor any effects.
Agriculture Secretary Tom Vilsack announced today that USDA is soliciting applications for grants to establish broadband in unserved rural communities through its Community Connect program. Community Connect is administered by USDA's Rural Utilities Service and helps to fund broadband deployment into rural communities where it is not economically viable for private sector providers to provide service.
USDA plans to award up to $11.7 million in grants through the Community Connect grant program. The grants fund broadband infrastructure to help foster economic growth by delivering connectivity to the global marketplace. The grants also fund broadband for community centers and public institutions.
Kraftig Brewing Co. founder William K. "Billy" Busch is now offering $1 more than his siblings in his effort to buy Grant's Farm in south St. Louis County.
Busch on Monday increased his offer for the attraction to $26,000,001. He is offering an additional $8 million to buy the family mansion and 22 acres that adjoin the popular attraction that includes 900 animals and is home to some of the Budweiser Clydesdales. It opened in 1954.
Grant's Farm has long been owned by the Busch Family, founders of Anheuser-Busch. Anheuser-Busch InBev, formed when the Belgian brewer purchased Anheuser-Busch in 2008, leases Grant's Farm from the Busch family.
Last year, four of the six siblings tried to sell it to the St. Louis Zoo, which would have used it for a third campus and breeding site for endangered animals.
Billy Busch, with the support of one brother, sought to buy Grant's Farm himself, originally offering $24.2 million. The zoo announced in March it was no longer interested, and the other four siblings made a $26 million offer in April to buy it from a trust.
"I do not want to get into a bidding war with my brothers and sisters, who I love, but if they and their advisers have been so intent on getting the Trust to sell Grant's Farm, why do they now want to buy it?" Billy Busch asked in a statement. "Why not authorize the trust to sell it to me? My plan would benefit each of us."
In recent years, state government has taken a more active role in helping provide citizens with greater access to reliable broadband Internet. By using funding or incentives to encourage providers to expand broadband into underserved areas, policymakers hope to address equity issues involving access, as well as the role that access plays in terms of improved education, economic development and even public safety.
In June of last year, Iowa lawmakers approved legislation (HF 655) that provides property tax abatements to companies that install equipment to build out broadband infrastructure throughout the state. In August, Gov. Terry Branstad announced that an additional 90,000 Iowa households would have access to high-speed Internet as a result of the plan.
This session, lawmakers in Wisconsin and Minnesota have also weighed proposals for making broadband service more available throughout their states. Wisconsin’s AB 820, signed into law in March, seeks to expedite development in the state’s most remote areas by reducing bureaucratic and fiscal barriers for service providers.
Shepherd made his own opportunity here in Whitesburg. He decided to open a restaurant on the main street. It's called Heritage Kitchen, and the food is homey and fresh. "Growing up, you don't know what you want to do," Shepherd said. "It just doesn't seem like the place, there's no opportunity, unless you wanted to work in the coal mines, so I was like, well, I'm getting out of here where there's nothing to do. But you just keep wanting to come home."
That theme — coming home — is one that echoes throughout the hills of Letcher County.
Agriculture Secretary Tom Vilsack described the depth of poverty in rural America at a Farm Foundation Forum Monday, while at a separate meeting, Lisa Mensah, his top assistant on rural development, called for increased access to broadband as a way to give an economic boost to underserved communities.
Vilsack, speaking at the National Press Club, stressed the importance of targeting USDA resources in rural counties that are persistently impoverished - where at least 20 percent of the county's population has been living in poverty for the last 30 years or more.
Nationwide, there are between 350 and 384 of these “persistent poverty” counties (PPCs) and about 85 percent of them are rural. Of the rural PPCs, about two thirds are located in the Old Confederacy and about one-fourth are within Arkansas, Louisiana and Mississippi, referred to as the Mid-South.
“In the Mid-South, there are 39 PPCs and 35 of those (have a population that is) majority black,” said forum participant Bill Bynum, the CEO of a community development bank called Hope Credit Union Enterprise Corp., which provides affordable financing to underserved communities across Arkansas, Louisiana, Mississippi and Tennessee.
From February 2015 to February 2016, unemployment remained higher in nonmetropolitan areas. The rural heartland did better than the South or the eastern coalfields.
What’s it like to grow old in rural America?
When it comes to attention and medical resources, “we’re kind of underrepresented,” said Dr. Bill George, who practices at Beartooth Billings Clinic in Red Lodge. “People sometimes feel forgotten.”
The rural American population is older: About 15 percent of residents are 65 or older, compared with 12 percent in urban areas, largely because many people have left in search of education and jobs.