Rural development hearing addresses mental health, electricity, energy
At a Senate Agriculture Committee hearing on rural development last week, a Michigan State University dean and a Kentucky health care administrator said that rural America needs both telemedicine and rural health care professionals while other witnesses on a stakeholder panel talked about rural electric and energy programs.
Jeffrey Dwyer, director of the Michigan State University Extension and senior associate dean for the school’s College of Agriculture and Natural Resources, told the committee that the university has “committed significant financial and human resources to helping farmers and those who love and care for them learn to identify the warning signs of stress, learn how to approach people suffering, listen empathetically and find resources.”
He also noted that Michigan State has been awarded a $1 million grant from the Substance Abuse and Mental Health Services Administration (SAMHSA) to create evidence-based trainings on opioid misuse prevention, treatment and recovery.
But Dwyer said that in a 15-week road trip through Michigan he “found some common themes became evident in our rural counties:
▪ “Rural Michigan is not equipped to care for aging baby boomers. According to the U.S. Census Bureau (2019), 17.5% of rural populations are 65 or older compared to 13.8% in urban areas. The challenges associated with the availability of medical specialties that serve the unique needs of older individuals, limited transportation, and limited access to innovative housing and smart-home options create unique challenges in rural America. Moreover, long-term care in the United States is still disproportionately provided by families, particularly spouses/partners and adult daughters. The availability of familial care options is less in rural areas due to the outmigration of younger generations and increasing likelihood that older people will not move to new areas.
▪ “Our cries to ‘end the stigma’ and encourage people to talk openly about mental health concerns will go unheeded as long as there is a shortage of mental health professionals. Creating networks of mental health and community behavioral health experts who can work closely with clinical experts locally and through telemedicine can be part of the answer.
▪ “Many communities are in favor of creating substance-abuse facilities, but they don’t have adequate staffing. My MSU Extension colleagues in the Upper Peninsula are helping with this shortage by partnering with the Michigan State Police on a project called ‘In Plain Sight.’ They have set up travel trailers to mimic a teen’s bedroom and demonstrate common red flags so that parents and caregivers can learn where young people may hide or disguise illegal substances. We can work together on brick-and-mortar projects to house these much-needed services, but none of that matters if we don’t have qualified professionals to staff them. The key is to make rural communities a place where health care professionals want to live, work and raise their families.”
Michael Stanley, CEO of Grace Health, which serves southeastern Appalachian Kentucky, said he wanted to “share my appreciation” for the USDA Distance Learning and Telemedicine (DLT) grant awards that his organization has received.
“Grace Health sees telemedicine as an opportunity to improve the work environment for health care providers and thus assist in provider retention,” Stanley said. “Innovative strategies such as telemedicine provide access to resources and support for both the patient and the provider giving the provider a more realistic chance of ‘making a difference’ that isn’t always possible when these resources are not accessible.”
Stanley said that Grace Health has expanded telemedicine to 36 sites including six primary care clinics, one women’s health clinic, 19 school-based health centers, seven nursing homes and one hospital. Services include primary care, consultations, behavioral health and patient engagement.
“In my personal opinion, telehealth is part of the answer to our primary care physician shortage in the rural, underdeveloped areas of our country,” Stanley said.
Keith Hayward, general manager and CEO of the North East Mississippi Electric Power Association, said electric co-ops are still disappointed that the 2018 farm bill changed the “cushion of credit” in escrow-like accounts that allow Rural Utilities Service (RUS) borrowers to manage variations in income by making deposits during times of surplus and drawing to pay RUS debt during a deficit so that the interest rate the utilities receive will over time be equal to the rate paid on one-year Treasury bonds.
“These retroactive changes will jeopardize long-term co-op business plans and result in higher electricity costs for people in rural America – those the farm bill intends to serve,” Hayward said. “In addition, these cuts eliminate an important money management tool that can be tapped during times of emergency, giving certainty to the electric cooperative and the federal government.” He added that the electric co-ops support a provision that allows account holders to use their balances to pay down and refinance RUS debt.
Hayward also said that the co-ops see an unintended consequence of the 2017 tax reform law: Grants from a variety of federal, state and local governments to assist in providing services to their members for purposes such as storm restoration (FEMA), renewable energy development, energy efficiency and conservation, economic development, or rural broadband initiatives are regarded as income. This means “co-ops could face difficulty in maintaining their tax-exempt status if they take government grants to restore power after a natural disaster, bring broadband service to rural residents, boost economic development in local communities or create energy efficiency programs,” he said.
Hayward said that “fortunately” Sens. Rob Portman, R-Ohio, and Tina Smith, D-Minn., and Reps. Terri Sewell, D-Ala., and Adrian Smith, R-Neb., have introduced the Revitalizing Underdeveloped Rural Areas and Lands (RURAL) Act (S. 1032/H.R. 2147), which will allow co-ops to accept grants without jeopardizing their tax status. But he noted that these bills have not been scheduled for a vote in either the House or Senate and said, “The entire rural electric cooperative family urges Congress to pass this legislation.”
Bryan Sievers of Sievers Family Farms in Stockton, Iowa, representing the American Biogas Council, said that “unfortunately” the 2018 farm bill provides less mandatory funding than previous farm bills for energy title programs, and he urged the committee to express its support to the appropriators for fully funding the programs.