Friday, June 14, 2019

Two big stories on rural schools, poverty and drugs

EdSource recently published this story out of Oroville, California (population 15,000, and county seat of Butte County, California, population 220,000) and the New York Times yesterday published this story out of Minford, Ohio, (population 693).  

The EdSource headline is "Lost days: Poverty, isolation drive students away from school in California’s rural districts:  The state's highest rates of chronic absenteeism are in rural areas."  The story is about chronic absenteeism, a term used to refer to students who miss at least 10% of school days.  About 11% of California students--some 700K in all--are chronically absent, and about 10% of the state's 1000 districts had rates of chronic absenteeism as high as Oroville's.  Here are some data points:

  • Of the 98 districts with rates higher than 20 percent, 84 were in rural areas.
  • Of the 27 districts with rates higher than 30 percent, 26 were in rural areas.
  • Of the 40 counties where rates were above the statewide average, 30 are rural as identified by Rural County Representatives of California, a statewide group.

The story does not, however, define "rural," and Oroville is not "rural" by the U.S. Census Bureau definition, and Butte County is not "nonmetropolitan" by the Office of Management and Budget standard.

The story's lede personalizes the data.  It features Kaylee Adkins, now 20: 
The daughter of two heavy drug users, [Kaylee] lived a transient childhood — rarely staying for long in the same apartment, let alone the same school. She hardly saw her father who was in jail or prison throughout much of her childhood.
* * * 
When Kaylee, now 20, was in grade school, her mother’s pattern was to stay in a place until the eviction notice came, then run. Sometimes it would be to another part of Oroville, a rural town of about 15,000 people in Northern California’s Butte County where her family was from. Other times it would be out of state to small towns in Texas or West Virginia.
As you can see, the story is not only about absenteeism.  It is about the constellation of social problems that contribute to it, including poverty, drugs, housing challenges, and sheer distance.  Indeed, perhaps because I'm researching rural housing--really the rural housing crisis--right now, eviction looms large for me in this story. 

But the story is also about "family commitments."  You see, Kaylee's parents both died when she was in high school, so she wound up living with a niece after that.  But when her niece had children, Kaylee was expected to miss school to care for them.  So Kaylee wound up missing about a third of the days of her senior year of high school--even though she was living just a few blocks from the school in Oroville. 

Interestingly, the other story from EdSource that I've blogged about also featured Oroville.   That story was about high rates of school suspensions in rural schools, framed as the school-to-prison pipeline.  And I as I wrote there, one reason for that high rate of suspensions is likely a lack of resources because smaller school districts can't achieve economies of scale.  So I was pleased to see that this story on chronic absenteeism quotes an expert who acknowledges that rural challenge problem. 
[I]n rural areas they have the fewest resources and the least access to the newest information about how to combat this.
The second story, the one by the New York Times out of southern Ohio, focuses on younger children.  The headline is "Inside the Elementary School Where Drug Addiction Sets the Curriculum."  About half of the students in the featured elementary school have experienced drug abuse at home.  As with the California story, the journalist (here Dan Levin), leads with a student who illustrates the phenomenon:   
Inside an elementary school classroom decorated with colorful floor mats, art supplies and building blocks, a little boy named Riley talked quietly with a teacher about how he had watched his mother take “knockout pills” and had seen his father shoot up “a thousand times.” 
Riley, who is 9 years old, described how he had often been left alone to care for his baby brother while his parents were somewhere else getting high. Beginning when he was about 5, he would heat up meals of fries, chicken nuggets and spaghetti rings in the microwave for himself and his brother, he said. “That was all I knew how to make,” Riley said. 
Riley — who is in foster care and who officials asked not be fully identified because of his age — is among hundreds of students enrolled in the local school district who have witnessed drug use at home. Like many of his classmates at Minford Elementary School, Riley struggles with behavioral and psychological problems that make it difficult to focus, school officials said, let alone absorb lessons.
Levin details the Minford program, funded with $550 million in "student wellness funds" from the State of Ohio. 

Minford is in Scioto County, population 79,499,  "long considered ground zero in Ohio's opioid epidemic."  Some 9.7 million pills were prescribed here in 2010, "enough to give 123 to each resident."   The poverty rate in Scioto County is 23.9%.   When I "Googled" Scioto County, Ohio, the top "hits" were news stories about abused children and drug arrests.  Oh, and there was a story about the state reviewing 2700 cases decided by a recently retired Scioto County judge accused of alcoholism

Thursday, June 13, 2019

The end of a story that's gotten a lot of attention on Legal Ruralism: $6.2 million settlement closes industrial hog farm in my home county

I have spilled a lot of (proverbial) ink on this concentrated animal feeding operation (CAFO) story since 2013, when I wrote posts like this one (and note its two prior embedded posts) about an industrial hog farm that slipped by regulators to get a permit for siting in the watershed of Arkansas's Buffalo National River, a major tourist attraction and ecotourism revenue driver for the state.  These events happened in my "own backyard" (or at least that of my mom, as I no longer liver in Arkansas), which helps my explain my engagement (and outrage).  Never mind the many blog posts about the "hog farm" here on Legal Ruralism, I even wrote an academic journal article about this matter, as well as an op-ed in the Arkansas Democrat-Gazette.

I hadn't been following the matter very closely in recent months, though I knew the industrial hog farm owners, under contract with JBS of Brazil, had lost some recent legal bouts with environmental interests over renewal of permits, including permits for where they could spread the hog manure.

So, imagine my delight when the (Republican) governor of Arkansas, Asa Hutchinson, made what has been billed as a "surprise" announcement that the State of Arkansas had reached a settlement to pay the owners of the hog farm $6.2 million to close the operation and grant the State of Arkansas a conservation easement.  The owners of the hog farm will retain a "fee simple" in the farmland, which sits right on the banks of Big Creek (a Buffalo River tributary), and across that creek from the Mt. Judea School.  Most of the funds going to the buyout will come from the state's coffers, but up to a million will be paid by The Nature Conservancy.

Perhaps most interesting is that Governor Hutchinson commented today, when announcing the settlement while speaking to the 85th Annual Arkansas Municipal League Convention, commented  the permit to the CAFO should never have been granted.  That's a dig at his Democratic predecessor, Mike Beebe, on whose watch the permit slipped (or was pushed?) through the Arkansas Department of Environmental Quality.  I've never quite been able to figure out (and as far as I know, no one else has either), whether the primary culprit was an ignorant bureaucrat or one on the take from corporate or business interests.  When the hog farm was built--essentially in secrecy--the farmers were to be under contract with Cargill, but Cargill's hog operations were eventually sold to JBS.   As I detailed in my academic journal article, the USDA approved loans for the hog farm, but it did so with a particularly shoddy environmental impact statement that did not acknowledge environmental justice concerns (Mt. Judea is the poorest part of a persistent poverty county, Newton County).

Here's a quote about what's next, from today's coverage in the Arkansas Democrat-Gazette, as well as some early backlash against the settlement.
In the recent legislative session, the Farm Bureau narrowly failed in a push to remove hog farm regulation from the Arkansas Department of Environmental Quality and move it to an agency where local farmers have strong influence and without less scientific expertise. The governor had urged a delay in that legislation after it passed the Senate. It was pulled down after it ran into House opposition
Opponents had developed a scathing attack on the hog triangle created by the farm: The farm sends dollars to Brazil (JBS); JBS sends pork chops to China, the farm sends hog manure to the Buffalo River. 
It’s a big win for the governor, though some social media criticism has already broken out about the $6.2 million payment. “Negotiating with terrorists,” was how one environmentalist put it.
And here's Governor Hutchison's Tweet about the matter.

The one commenter on that Tweet said, "More of that Republican Socialism.  It's only bad when they're helping the poor."   Hutchinson has drawn national attention to Arkansas for his advocacy and imposition of work requirements for safety net programs, such as the state's Medicaid expansion.  

Wednesday, June 12, 2019

In the competition between rural and urban for resources, this pretty much sums it up

The media (Sac Bee and New York Times) have given lots of attention in recent days to the just-revealed cause of the Ranch Fire, one of the fires in the Mendocino Complex that led to the largest wildfire in California's history last summer.  The fire burned through chunks of Lake, Mendocino, and Colusa counties in late summer 2018, destroying more than 150 homes.  Fighting it cost "tens of millions of dollars."  Here's an excerpt (from the NYT story) about the fire generally:
The fire burned 410,203 acres of California wild lands, an area half the size of Rhode Island, and killed a firefighter who was struck by a falling tree. Although it was one of the largest fires, it was far from the deadliest. The fire in Paradise, Calif., in fall 2018 killed more than 80 people.
There's a lot of "rural" in the story, especially if you associate buried wasps nests with rurality, but it was this quote from Jill Cowan, writing in today's New York Times California newsletter, that really caught my eye re rural-urban difference and--more precisely--urban primacy.  Cowan quotes a neighbor (Ms. Parker) of the man who inadvertently started the Ranch fire.  She lives along Highway 20 between Ukiah and Upper Lake: 
Ms. Parker shrugged as she described how Caltrans allows vegetation to proliferate along the side of the highway in front of her house.  
“We are in a rural area,” she said. “Cities are always going to come first.”
By the way, the dateline for the NYTimes story is Potter Valley, population 646.  (I passed near there and took some photos along this stretch of Highway 20 in early July, 2018, a few weeks before that fire).  And the photo caption for the NYT story mentions Ladoga, population 197 (in Colusa County).

As for urban primacy in pretty much all things, see a related post here.  

On access to transportation and health (and jobs, poverty and disability) in rural America

NPR reports today from upstate New York on the intersection of disability, rurality, poverty, and employment, with something of a focus on transportation as another feature of that cycle of poverty.  Here's the excerpt I wish to highlight: 
Having good access to transportation — or not — has a huge impact on the health of people living in rural parts of the country, says Dr. Kirsten Bibbins-Domingo, a professor of epidemiology and biostatistics at the University of California, San Francisco who studies the health of vulnerable populations. 
The story, by Selena Simmons-Duffin, quotes Bibbins-Domingo: 
If you go to less populated areas — rural areas — access to a car that functions well [and] the costs for gas becomes such an essential element.  Both to drive to seek medical care, as well as to drive to access the other resources that are necessary to pursue good health. 
Simmons-Duffin goes on to quote Bill Erickson of Cornell re: employability of people with disabilities.
Since the Great Recession, rural counties really haven't seen as much employment growth as urban counties. Also just the types of jobs that are available to those sorts of communities may be tending toward, you know, requiring people to be able to move things physically or whatever. 
And the limitations that the individual with disabilities may have may be preventing them from being able to do those particular types of jobs — or employers can't provide the accommodations that may be necessary.
On that latter point, see this excellent NPR story from 2013.   

Saturday, June 8, 2019

A story of rural extremes, out of Scotland

NPR's Celeste Noche reports today from the Outer Hebrides of Scotland, a remote region in the northwest of the United Kingdom.  This lovely feature story, with fabulous photos, provides a window into extremely remote rural living by focusing on the importance of what, in the United States, we call a bookmobile.  Here's the lede:
In Stornoway, the biggest town in Scotland's Outer Hebrides islands, a yellow van sits on a narrow, one-way street. The Gaelic word leabharlann is painted on the front, back and sides, with its English translation, "library," on the front and sides. 
Driver Iain Mackenzie has loaded his books in the van, organized his customers' orders and is preparing for his last run of the week on the island of Lewis and Harris. The 16-year-old van runs three days a week, covering more than 800 miles of rugged roads to deliver books to more than 800 residents.
Many of the residents featured in the story are elderly and/or disabled, but the story also touches on the importance of the mobile library for serving children and youth, including with efforts to keep the Gaelic language alive.

The broader context, of course, is population loss:
As rural high streets — the centers of local businesses — begin to disappear, and schools, jobs and other opportunities have seeped away to large cities, villages across the isles are facing depopulation and a decrease in resources. A 2007 Outer Hebrides Migration Study reported a 43% population decline between 1901 and 2001, as well as a long-term decline in the number of women of childbearing age, resulting in more deaths than births each year. "The key drivers of population change are the limited job opportunities available," the study said.
Noche explains that, under salient U.K. ecological definitions, "73% of the Hebridean population qualifies as very rural remote, defined as 'areas with a population of less than 3,000 people, and with a drive time of over 60 minutes to a settlement of 10,000 or more.'"  Stornaway, the largest population cluster on the Outer Hebrides, is home to some 8,000 residents. 

One of the mobile librarians, Steven Bryden, who is quoted throughout the story, touches on the lack of anonymity that marks rural communities, while also defying that stereotype.
There's a perception in [small villages] where everybody knows everybody, but it isn't always the case.  There are a lot of people on their own who are just missed. It's just keeping an eye out on people.
Bryden also comments on the extreme loneliness of living so remotely: 
A man in the [Harris] bays once told me, "The last person I saw was you."
This reminds me of another recent story out of a remote corner of the United Kingdom, the Lake District, a story that also featured many elderly.  I blogged about that story here.  Like this story from the Outer Hebrides, the Lake District story also implicated services for remote populations, but the English story was one of services lost to austerity policies, while the Scottish story was one of a service preserved (two new library vans to serve the islands and save the service).

Friday, June 7, 2019

North Carolina and Virginia take steps to address rural broadband

I have written fairly extensively in the past about the barriers imposed by lack of access to broadband infrastructure in rural spaces. Broadband is almost essential for economic growth and for helping to bridge the resource gap. Access to broadband opens doors, it allows students in isolated communities to enroll in courses that may not be offered at their local school, a farmer to have a new market to sell his crops, and in a world where broadband is a necessity, rural communities to successfully compete with their urban and suburban counterparts. Unfortunately for many people, mostly in rural areas, access to broadband is still an impossible dream. I have written in the past about New York's attempts to address this article. In this piece, I am going to talk about the work of North Carolina and Virginia, who have both recently taken steps to address this problem.

In Virginia, it is estimated that 600,000 people, roughly the population of Vermont, lack access to broadband. According to the Virginia Charter of Commerce, this represents roughly 47% of rural Virginia. This means that a sizable number of rural Virginians live in communities that do not have access to broadband infrastructure, a significant barrier to economic growth. In fact, according to Evan Feinman, Virginia's Chief Broadband Officer, many companies will disregard an entire community if they do not have access to broadband.

This issue also affects North Carolina. While North Carolina does not have an official number for how many in the state lack access to broadband, they do believe that the current figure of 93.7% of households having access is inaccurate and inflated. Both states have a shared problem however, the telecom providers are not playing ball on telling them exactly where the gaps are, which hinders their ability to address the issue.

Despite the existing barriers however, both states are persisting in their battle to expand access. North Carolina governor Roy Cooper recently signed legislation overturning the ban on electric coops using federal funding to expand broadband access. The legislation also clarified that it is legal for coops to use fiber that had been deployed to provide electricity for the secondary purpose of providing broadband service. In Virginia. Governor Ralph Northam signed legislation that created a pilot program that would allow electric utilities to utilize their infrastructure for middle mile deployment of broadband infrastructure. Northam and Cooper have also signed legislation that would appropriate funding to providers to expand their broadband infrastructure into rural spaces. By signing legislation that involves providers in the expansion of broadband, both governors may have created a mechanism for getting information on where the gaps exist and provided a means to address them. I would argue however that both states need to commission independent studies into broadband availability in order to reduce the reliance on providers to give information about gaps.

Addressing the broadband issue is going to important for rural Virginia and North Carolina. Northern Virginia and the Research Triangle are both tech hubs and a lack of broadband availability prevents that economic prosperity from spilling over into the rural corners of these states. I am encouraged by the progress that both states have made in recent months and hope to see it continue.

Thursday, June 6, 2019

A historical nugget: Great Depression era Yale Law graduates opted for rural practice

During a dive into some historical research, I came across an interesting nugget in The Boston Globe. In the October 24, 1932 edition of the newspaper (see right), it was reported that an increasing number of Yale Law graduates were opting for rural practice. The story attributes this partially to a decline in corporate recruiting, a fact that should not be surprising given that the country was struggling through the Great Depression at the time. The article is interesting because it provides a snapshot into a different era of rural lawyering and an era when lawyers began looking away from cities.

The article also notes that the role of the "country lawyer" in leadership, as opposed to the urban lawyer who seemingly just accumulated great wealth. While this is a slight simplification, it does speak to the historical role of the lawyer as a leader in their community. In a city, a lawyer is just another professional whereas in a smaller town, they may be one of just a few. As I have heard from rural lawyers in my research, a rural lawyer is rarely ever off the clock. The lack of anonymity in a rural community often does not allow for a rural lawyer to clock out and simply go home.

On April 23, 1891, over 41 years before the publication of this piece, the Globe reported on the retirement of Judge John Hopkins from the bench in Worcester County, Massachusetts. In his retirement speech, Judge Hopkins said, "I know of no position more honorable than a country lawyer and no position in which a lawyer can be of more use to his fellow man."

In 1932, Yale Law sent its graduates out to take that position. I aspire to see that happen again.


Wednesday, June 5, 2019

Rural California wins one (a rarity) in special election

Calfiornia's most rural politician has just defeated an urban (or, at best, suburban) politician for State Senate District 1.  The winner is not college educated.  The loser has a Bachelors degree from Harvard and a J.D. from Yale Law School.  Brian Dahle, the winner, has been mentioned in five prior blog posts here, one of them mentioning the occasion of his visit to my Law and Rural Livelihoods class several years ago.   Dahle garnered 53.4 % of the vote, and  his Ivy-educated opponent just 46.6%  One striking fact is that Dahle carried every nonmtro county by a considerable margin, while Kiley carried every metropolitian county--except Shasta County, the least metro of the metros, in the would-be State of Jefferson, which I'll discuss below.

As I have written elsewhere, it's hard to gain traction on rural issues in California because only about 2% of the state's population live in rural places, at least as "rural" is defined (admittedly, narrowly) by the U.S. Census Bureau (population clusters of less than 2,500 or open territory).  That trend was defied a few days ago when Brian Dahle of Lassen County (population 34,895, population density 7.39/square mile) defeated Kevin Kiley of Placer County (population 348,432, population density 230/square mile) to become California's newest State Senator.  Just as telling in terms of where these candidates come from spatially and culturally, Dahle is a seed farmer from Bieber, California, population 312.  (While Bieber is in Lassen County, it is on State Hwy 299, in the corner that connects Shasta County to very sparsely populated Modoc County, which may say something about the Shasta County vote; see below).  Kiley lives in the Placer County suburb of Rocklin.

District 1 includes all or part of 11 California counties and stretches from north Lake Tahoe to the Oregon state line.  Among the counties included in the district are all or parts of four metropolitan counties, including Sacramento County (1.4 million), Placer County (population 348.432), El Dorado County (population 181,058), and (much farther north), Shasta County, (population 177,223).

The California Secretary of State's page about this special election is here.  The Sacramento Bee's minimal coverage of the election is here.  The Redding Record Searchlight's coverage is here.  The Lassen County Times is here, though I was unable to click through to a story about the election, which might have been interesting since Dahle served on the Lassen County Board of Supervisors for 16 years before he was elected to the California General Assembly.

Here are the (approximate) votes (and population counts) for the Senate District's nonmetropolitan counties:

Lassen County, population 34,895: Dahle got 81.5% of the 4,000 votes.
Alpine County, population 1,175Dahle got 73.5% of the 223 votes.
Sierra County, population 3,240: Dahle got 67.2% of the 860 votes.
Plumas County, population 20,007: Dahle got 65.7% of the 4,400 votes.
Modoc County, population 9,686Dahle got 87.1% of the 1,857 votes.
Siskiyou County, population 44,900: Dahle got 69.7% of the 7,331 votes.
Nevada County, population 98,764Dahle got 67.1% of the 15,000 votes.

And here are the votes for the metropolitan counties--well, parts of some of those counties:

Sacramento County (partial 10.2%):  Kiley got 71.8% of about 21,000 votes.
Placer County (partial, 62.9%): Kiley got 60.8% of 38,000 votes
El Dorado County (all):  Kiley got 56% of about 31,000 votes.
Shasta County (all):  Dahle got 82.2% of about 28,000 votes.

The prior State Senator for this district was Ted Gaines, who lives in El Dorado Hills, a posh suburb/exurb of Sacramento, just over the Sacramento/El Dorado County line.  Thus, the election of Dahle, the seed farmer with a high school education, is quite a shift culturally and experientially.

In the run up to this run off, some controversies about the Senate District 1 election were reported in the Bee here and here.  Regarding the former, I can't help wonder if the lack of anonymity associated with rural people and places played a role in its possible efficacy (leaving aside, for now, the very dodgy ethics) of the mailer threatening to disclose folks' voting records.  The latter story describes how these two Republicans (Dahle and Kiley) were the top two vote getters in the primary, while the Democrat, a woman from the Truckee/Lake Tahoe area, came in third. Needless to say, it's a conservative district.

Cross-posted to Working Class Whites and the Law

Monday, June 3, 2019

New Mexico forms working group to address rural lawyer shortage

Law 360 reports today on an initiative out of New Mexico that seeks to respond to the rural lawyer shortage there, as well as to the lack of affordability of legal counsel to those who might be considered "middle class."  Here's the lede:
Twenty-one percent of New Mexico’s counties have five or fewer lawyers, and two counties have no attorneys at all. These legal deserts, a huge access to justice barrier, have forced the state court system to take a hard look at possible solutions.
* * * 
District Judge Donna Mowrer, who oversees courts in two counties that have just 58 total attorneys for a combined population of nearly 70,000 people, told Law360 that the inspiration for the idea came from Washington, which has allowed limited license legal technicians, or LLLTs, to help low-income litigants in family law disputes since 2015.
Mowrer sits in in the Ninth Judicial District, in Portales, New Mexico, population 12,280, not far from the larger and better known Clovis, population 38,962.  Together, the counties for which these cities are the seats, Roosevelt and Curry, respectively, are home to 70,000 people and 58 attorneys, which is not a bad ratio.  Some other data points in the story are more sobering: 

  • one county has no lawyer (but a journalist from that county will serve on the working group)
  • 51 percent of newly filed civil cases in 2018 had at least one party without an attorney, up significantly from 2011, when pro se litigants appeared in just 36% of civil cases.

Interestingly, the New Mexico judiciary seems to be viewing favorably a program to license paralegals.  The program they are looking to as a model, however, has not been terribly successful in Washington State, where it has been running for the past few years.  At best, only tepid success was reported to the California Commission on Access to Justice when we considered a few years ago the Washington program, which licenses "limited license legal technicians."  One big problem with the Washington program:  the state's law schools are unwilling or unable to divert (from the education of JD students) the resources necessary to support the training of the LLLTs.  In Washington, LLLTs are licensed to handle family law matters.  Utah recently adopted a similar program, and there the para-professionals handle only landlord-tenant and debt collection matters. 

Mowrer also commented on the access-to-justice challenge for middle-income and modest means clients, saying that "a key selling point is the notion that firms can actually have LLLTs in their offices to accommodate those who can’t afford a traditional counsel." 
She also pointed out that firms need not be limited by geographic area. Being based in a city like Albuquerque won’t necessarily prevent a firm from hiring a technician in a rural area.
* * * 
We don’t have extra attorneys in the rural areas, and we’ve seemingly priced even the middle class out of an attorney.
Given the relative lack of success of the Washington program (at least as presented to the Cal Commission on Access to Justice a few years ago), it'll be interesting to see how Utah's program fares and where the New Mexico working group goes.   

Thursday, May 30, 2019

When rural and urban compete for resources

That's the scenario at stake in the proposal of the Centers for Medicare and Medicaid Services  to shift some reimbursement funds to rural hospitals.  Because the pot of money is (apparently) fixed, this is a zero sum game, meaning that urban hospitals will lose what/if rural ones gain.  Bloomberg Law reports this morning under the headline, "Rural Hospitals See $200 Million Medicare Win at Cities' Expense."  Here's the lede from Tony Pugh's story:
Low-wage rural hospitals would see more than $200 million a year in additional Medicare payments under a Trump administration plan to shift money from urban hospitals in areas with higher wages, a leading health-care law firm found. 
The proposal by the Centers for Medicare & Medicaid Services is designed to cut payment disparities between urban hospitals and rural facilities. Rural clinics and hospitals are struggling in many states that haven’t expanded eligibility for Medicaid under the Affordable Care Act. 
Since the proposed rule was published earlier this month, "hospital associations in states with higher concentrations of urban facilities" have been protesting.  Pugh cites the analysis of the Hall Render law firm, which shows, for example, that California's Medicare payments would be reduced by $108 million annually.  Other big losers would be New York ($41 million); Massachusetts ($19 million) and New Jersey ($18 million).  Southern states stand to gain most, presumably because the South is the most rural region in the nation.  The reductions would be phased in, taking full effect in 2021.

Sarah Jane Tribble, covering the same issue for NPR, provides an illustration of the "wage index," which has been around since the 1980s. 
[It] means under the current index a rural community hospital could receive a Medicare payment of about $4,000 to treat someone with pneumonia while an urban hospital received nearly $6,000 for the same case, according to CMS.
They "why" for the shift is hinted at in the article's opening line:  the wages paid by rural hospitals are lower than those at their urban counterparts, and Medicare reimbursements have typically been pegged to an "area wage index."  This has meant rural hospitals with low local labor costs have typically received lower Medicare payments than urban ones, albeit for rendering the same services.  A related story on NPR, by Sarah Jane Tribble, is here.

I'm very sympathetic to the needs of rural hospitals, and I'll be fascinated to see if this proposal goes into effect because I've never seen a proposal that takes from the urban (rich?) and gives to the rural (poor?) implemented--at least I cannot recall such a circumstance.  For example, since it was published in 2010, I have been pondering the careful word choice of the California Commission on Access to Justice Report, "Improving Access to Civil Justice in Rural California," framed to avoid a rural-urban contest for funding streams.  Here's a quote of one of the key recommendations from that report:
2.  Expand Funding for Rural Legal Services The significant lack of funding for California’s rural legal aid programs must be addressed. All legal aid programs face the challenge of inadequate resources, including programs in urban as well as in rural areas; therefore any initiative to address the severe lack of resources in rural areas should not be developed in a way that unnecessarily undermines urban programs. The goal is to increase the total resources available for all legal services programs across the state, not merely to reallocate existing resources. 
In fact, what has happened in the years since that report was published is that per "poor person" funding for legal aid organizations serving rural populations has fallen relative to that for organizations serving urban populations.  This just emphasizes again how hard it is for rural institutions to get their "fair share" of funding in all sorts of contexts.

Maybe this Robin Hood-like move at CMR will go forward, however, at least if the Trump administration sees it as currying favor with the president's rural "base." 

Tuesday, May 28, 2019

Suddenly, (small-scale) farming is hip everywhere (including the developing world)

An alternate headline might have been:  African millennials follow in the footsteps of their US counterparts (or might it be the other way around?).  In any event, the catalyst for this post is Sarah Maslin Nir's New York Times story, dateline Agotime Beh, Ghana, "Millennials 'Make Farming Sexy' in Africa, Where Tilling the Soil Once Meant Shame."  Here's the lede:
After he graduated from university, Vozbeth Kofi Azumah was reluctant to tell anyone — even his mother — what he planned to do for a living. 
“I’m a farmer,” he said, buzzing his motorcycle between freshly plowed fields on a recent afternoon. “Here, that’s an embarrassment.” 
In some parts of the world, farmers are viewed with respect and cultivating the land is seen as an honorable trade. But in a region where most agriculture is still for subsistence — relying on cutlass, hoe and a hope for rain — farming is a synonym for poverty.

But Mr. Azumah is among a growing number of young, college-educated Africans fighting the stigma by seeking to professionalize farming.
The entire story is well worth a read.  An interesting factoid:  60% of Africa's population is under the age of 24, but the average age of a farmer is 60.  This trend is similar to that in the US, where farmers are a rapidly aging group.  Seems like that might be changing, albeit slowly, on both continents; at least one can hope.

Monday, May 27, 2019

For rural folks (including physicians), things are tough all over (including in Russia)

The New York Times reported out of Russia a few days ago that physicians in rural areas (even those in the western part of the country; we're not talking Siberia) are striking for better wages.  The dateline is Okulovka, in the Novgorod region between St. Petersburg and Moscow, and the story is headlined "In Russia's Provinces, the Doctor Is In (the Streets)."  Andrew Kramer's story, however, is not only about health care professionals, it is about the enormous divide between the haves and have nots in Russia, the latter often languishing in the "the provinces."  As Kramer expresses it, Okulovka "might just as well come from a different century," and the photos certainly give that impression.  About a third of the residences have no indoor plumbing, and the life expectancy there is among the very lowest in Russia.  (A prior post out of this region is here).   

Here's an excerpt from Kramer's story that focuses on state of health care, in particular doctors' salaries. It discusses the situation of Dr. Korovin, a general and colorectal surgeon: 
One issue gaining traction in particular is the impoverishment of doctors in rural Russia. After a medical procedure, it is more often the doctor than the patient who winds up with sticker shock — not because the payments are so outrageous, but because they are so small. 
Dr. Korovin, who is paid about $8,670 a year and extra for after-hours operations, recently treated a man with a stab wound to his lower abdomen.
* * * 
For that hour-and-a-half, after-hours operation, the hospital, which is funded by Russia’s state-run insurance program, paid Dr. Korovin 500 rubles, or $7.70.
It's thus not surprising that physicians and nurses are pressing for "local authorities fulfill a decree signed by Mr. Putin that doctors be paid twice the average salary of the region where they work."  In the Novgorod area, that would be about $11,448, about a third more than Korovin now earns.  Compare that to the average salary for a physician in the U.S., which is $313,000.  Indeed, where hospitals are able to keep their doors open, jobs in healthcare are critical to sustaining rural economies

Interestingly, Dr. Korovin says he voted for Putin, "we all voted for Putin."  That brings me to this terrific line from Kramer's story:
But the brush fires of provincial discontent highlight the disconnect between Russia’s chest-thumping rise abroad and its stagnating economy at home.
As in the earlier Russia story about which I posted nearly six years ago, there seems to be a big disconnect between the local and the national in Russian politics.  Putin is attractive as a strongman on the national stage, which may help him escape backlash over failures of lower scales of government. 

Sunday, May 26, 2019

And now for my 147th post on "defining rural"

The occasion for this post is Andrew Van Dam's piece in today's Washington Post, "The real (surprisingly comforting) reason rural America is doomed to decline."  It's partly about ecological definitions of rural and urban.  When Van Dam contacted me about 10 days ago, while writing this story, I referred him to the "defining rural" tag on this blog.  That's when I realized I'd written more than 140 posts on the topic--an average of once a month since I founded this blog about 12 years ago.  Van Dam found me, by the way, via my 2006 law review article, "Rural Rhetoric." 

Basically, Van Dam is using the federal government's classification schemes for rural/urban and metro/nonmetro to put a positive spin on the ongoing urbanization of America. This treats the process  or system as s a zero-sum game, which it basically is.  If rural is the remainder of that which is not urban, then as places grow and population clusters get large enough to meet the threshold for "urban"--or more precisely "metropolitan" (a county-level designation)--that which is designated or defined as rural shrinks.  It seems inevitable, right?   Van Dam uses a clever farm team v. big league analogy: 
In a way, rural areas serve as urban America’s farm team: All their most promising prospects get called up to the big leagues, leaving the low-density margins populated by an ever-shrinking pool of those who couldn’t qualify.
The problem with the analogy is that it could be read to suggest that rural people can't "qualify" for urban life--that if they could, they'd move to town where the successful folks inevitably go.  That is, you could read it at the individual level, as another way of looking at the rural brain drain.  On the other hand, you could also read it as referring just to the population clusters rather than to the individuals--those that grow will be redefined as urban.  I think this latter construction is Van Dam's intent. 

It's also worth noting that Van Dam's approach does not really account for the fact that many places are not only "not growing" and therefore not becoming urban, they are in fact shrinking.  Population loss--and not only stasis-- is a huge part of the rural American story right now--and it's not just loss to cities; it is natural decline because of low birth rates and such. 

In any event, read this clever piece in its entirety and note the references to Amanda Kool's recent piece in the Daily Yonder and to the fabulous demography work of Dan Lichter of Cornell, Kenneth Johnson of the University of New Hampshire/Carsey Institute, and John Cromartie of USDA, who have been tracking the extent to which "rural" places (as defined by the U.S. Census Bureau) are being subsumed into "metropolitan counties" (as defined by the Office of Management and Budget).

Then there are my quotes about the cultural angle on all of this:  how people and places "stay rural" culturally in spite of their "places" transmutation (by a government definition) into "metropolitan."  I also talk about how easy its gotten for policy makers to overlook rural needs, in part because of elite/progressive disdain for rural folks, which was also a theme of this piece, which showed how the rural bashing is not just a Trump-era phenomenon; it started in the 2008 election season.

Thanks to Van Dam and WaPo for the high profile treatment of an issue so important to those of us who advocate for and value the rural.  Here's to another 150 (or so) posts on "defining rural" in Legal Ruralism's next dozen years. 

Wednesday, May 22, 2019

Water, water everywhere, but not a drop to drink?

Oconaluftee River, Cherokee, North Carolina
March 2019 by Lisa R. Pruitt
It's an old adage, and it's one that (somewhat) accurately describes a phenomenon as much (or more) associated with rural America than urban places:  lack of clean, accessible, reasonably priced drinking water.

The lack of potable water in many places in rural America is a topic that has been on my mind for  a while.  It's been brought back to the fore by this recent story in the New York Times about the water crisis in California's Central Valley, in this case in East Orosi (population 495) in the Great Central Valley.   Jose del Real reports under the headline, "They Grow the Nation's Food, but They Can't Drink the Water."  Here's an excerpt:
Water is a currency in California, and the low-income farmworkers who pick the Central Valley’s crops know it better than anyone. They labor in the region’s endless orchards, made possible by sophisticated irrigation systems, but at home their faucets spew toxic water tainted by arsenic and fertilizer chemicals. 
* * *

Today, more than 300 public water systems in California serve unsafe drinking water, according to public compliance data compiled by the California State Water Resources Control Board. It is a slow-motion public health crisis that leaves more than one million Californians exposed to unsafe water each year, according to public health officials.
Del Real quotes Susana De Anda, a water-rights organizer:
Clean water flows toward power and money,Homes, schools and clinics are supposed to be the safest places to go. But not in our world.
As for solutions, well, Gov. Gavin Newsom "has proposed a tax of about $140 million on urban water districts and the agriculture industry to pay for redevelopment in districts serving unsafe water."

I'm delighted that my colleague, Camille Pannu who directs the Aoki Water Justice Clinic at UC Davis is quoted in the story:
Flint is everywhere here.  
Pannu also comments on a local conflict between East Orosi and its bigger neighbor, Orosi, population 8,770.
Because Orosi has clean water, they don’t want to take on rate payers from East Orosi who they think are so poor they’ll skip out on their bills. Unfortunately, you have poor people versus poorer people.
I'm so grateful for the work Prof. Pannu does, even more so that our UC Davis law students have the opportunity to do real legal work to redress injustices such as these.

A November, 2018 story by Jack Healy, out of Armenia, Wisconsin (population 707) also compared a rural water crisis to the higher profile one in Flint, Michigan.  The headline for that story was "Rural America's Own Private Flint:  Polluted Water Too Dangerous to Drink."  People in Armenia are among those who no longer drink the water, or even want to shower with it, because it is contaminated with run off from poorly regulated industrial farms.  Healy explains: 
In Wisconsin and other Midwestern states where Republicans run the government, environmental groups say that politicians have cut budgets for environmental enforcement and inspections and weakened pollution rules. In Iowa, for example, the Republican-led Legislature dismissed a package of bills that would have blocked any new large-scale hog operations until the state cleaned up its nitrogen-laden rivers and streams.
The Trump administration is now proposing to weaken federal clean water regulations, too.

He quotes 77-year-old Gordon Gottbehuet of Armenia, whose "nitrate contaminated well sits next to a field injected with manure." 
The regulations favor agriculture. When they keep cutting enforcement and people, there’s nobody to keep track of what’s happening.
But the problem is not limited to the Midwest, as Healy writes: 
Now, fears and frustration over water quality and contamination have become a potent election-year issue, burbling up in races from the fissured bedrock here in Wisconsin to chemical-tainted wells in New Hampshire to dwindling water reserves in Arizona.
I've written about the issue of CAFO contamination of rivers here, in particular a river in my home county in Arkansas.  (That matter is also the subject of many posts here on Legal Ruralism; here is just one).

In any event, these stories of poor water quality in rural America are in sharp contrast to images like the one at the top of this post, a photo of a dramatically clear stream that flows through the Smoky Mountains (North Carolina) town of Cherokee, which I visited in March.  I took the photo because the steam was so strikingly clear, though the photo doesn't quite do justice to that quality.  I'd not seen a stream that clear since I was in Glacier National Park in 2011. 

Tuesday, May 21, 2019

Financial insecurity, health care deficits plague rural Americans

National Public Radio reported today on rural Americans financial precarity and health care access woes.  The story, by Joe Neel and Patti Neighmond, reports on on a poll of rural Americans conducted by Harvard's T.H. Chan School of of Public Health and the Robert Wood Johnson Foundation.  It's the second such poll conducted by these partners in less than a year.  The first was last fall, and the results are the focus of this blog post.  This second poll focused on rural Americans' access to health care, which in theory has improved with the passage and implementation of the Affordable Care Act, as well as on economic security.  Here's a summary of the findings, which are reported in greater detail (and with some cool graphs) in the NPR story:
A substantial number (40%) of rural Americans struggle with routine medical bills, food and housing. And about half (49%) say they could not afford to pay an unexpected $1,000 expense of any type.
This latter finding and the question on which it is based seems linked to this story, which is not limited to the rural, from several years ago, as well as this one from early 2019.

The findings regarding health care access are also telling, not least because they speak to the practical realities of getting care--as in getting to the health care provider when material spatiality gets in the way.  Here's a breakdown of the survey's findings: 
Of those not able to get health care when they needed it, the poll found that 45% could not afford it, 23% said the health care location was too far or difficult to get to, and 22% could not get an appointment during the hours needed.  (emphasis added)
On rural hospitals in particular, Neighmond and Neel report that rural America has lost 106 rural hospitals since 2010.  The current census of rural hospitals is 1,860, of which more than a third, 673, are at risk. 

Finally, the story reports on sense of community, a topic oddly absent from the lede:
Yet even with the high levels of financial insecurity that we found, there is abundant optimism and satisfaction with the quality of life in rural America. Almost three-quarters (73%) of rural Americans rate the overall quality of life in their local community as excellent or good. And a majority (62%) are optimistic that people like them can make an impact on their local community. 
The story quotes Dee Davis of the Center for Rural Affairs regarding his observations of rural Kentucky; he makes his home in Whitesburg:
People may be living a more hardscrabble existence than folks in the suburbs or a lot of the folks in cities, but it doesn't mean they're not living a decent life.  Most people are pretty happy with it; they've got friends and neighbors they rely on and they're where they want to be.
NPR quotes a Whitesburg resident and activist, whose husband was recently hospitalized, regarding this phenomenon: 
My neighbors come and mow my grass, feed cattle, get eggs every day for the last few weeks.  That says so much to me. [It] makes me feel the emotion now of what it feels like to have such warm, wonderful support and I know that's the blessing of living in rural America.  
The survey found that 49% of rural Americans volunteer with an organization that works "to make their local community a healthier place to live."

N.B.  "Rural" was defined for purposes of this survey as not living in a metropolitan area, and on that definition, don't miss this piece

Wednesday, May 15, 2019

Rural poverty and its consequences: Here, there and everywhere

A few major stories about rural poverty and related aspects of rural disadvantage have caught my eye in the past few days, first from the United States and then yesterday out of the north of England.  Population loss, the elderly, and the high cost of service delivery to rural populations are implicated in them.  Two of the stories feature extraordinary photography.

The first is this major piece in the Washington Post on the looming closure of a hospital in Fairfax, Oklahoma, population 1,380.   Eli Saslow, journalist extraordinaire, brings us not just another story of a down-on-its-luck, near death rural hospital, but of the juxtaposition of this pending closure against the circumstances of community:
Childhood poverty climbing up above 30 percent. Accidental deaths doubling in the past decade. Increasing rates of diabetes, heart disease, drug addiction and obesity.
Saslow then puts what's happening in Fairfax, a town in Osage County, population 47,987, and co-terminous with the Osage Nation, in national context:
More than 100 of the country’s remote hospitals have gone broke and then closed in the past decade, turning some of the most impoverished parts of the United States into what experts now call “health-hazard zones,” and Fairfax was on the verge of becoming the latest. The emergency room was down to its final four tanks of oxygen. The nursing staff was out of basic supplies such as snakebite antivenin and strep tests. Hospital employees had not received paychecks for the past 11 weeks and counting. 
The only reason the hospital had been able to stay open at all was that about 30 employees continued showing up to work without pay, increasing their hours to fill empty shifts and essentially donating time to the hospital, understanding what was at stake.
In 2016, the 15-bed Fairfax Community Hospital had been purchased by EmpowerHMS, a Florida-based company that held itself out as “a savior for struggling rural hospitals.” Soon after the takeover, however, Empower began to default on some of the hospital's bills.  Fairfax was one of nine of Empower's hospitals that had since declared bankruptcy; another four had already closed.

The story includes an interesting profile of Dr. James Graham, 67, who has served the hospital and community for 41 years.  Yet with his malpractice insurance premium unpaid by Fairfax Community Hospital, Graham was on the verge of losing his license.  Be sure to give the story a read in its entirety.  Another recent story about a rural hospital closure is here, those one from NPR, featuring Fort Scott, Kansas, population 8,087, and county seat of Bourbon County.

The second big story is out of the United Kingdom's Lake District, in northern England.  Specifically, it features the town of Alston, population 1128, in northeastern Cumbria.  Wikipedia notes that Alston is a market town with several "listed buildings" and also an Area of Outstanding Natural Beauty, surrounded by moors.  Yet the story reported by Ceylan Yeginsu is as depressing as they come, as are Laetitia Vancon's extraordinary photos, particularly those of elderly residents and their living conditions.  A major cause of the human suffering:  government austerity.  The opening excerpt features 77-year-old Trevor Robinson:
Mr. Robinson’s isolation, shared by thousands of older people in Britain, is the result of a chain of cause-and-effect that stretches from rural Cumbria to the halls of power in London. He used to ride a subsidized bus to town until the local council discontinued the route. The council was responding to steep budget cutbacks stemming from the Conservative-led government’s decade-long austerity program.
* * *
But a free bus pass [for the elderly] is of little use if buses no longer reach you, and many retired people have discovered that apparently minor cuts — the elimination of a bus route, the closing of a tiny health care center, community center or post office — can profoundly upend their lives.
Cumbria is impoverished and rapidly aging, yet Alston is an hour from the nearest hospital bed. Yeginsu quotes Peter Thornton of the Cumbria County Council:
It’s always been expensive to deliver services to rural communities because the population is so spread out. But since the central government cuts that started in 2010 this becomes more of a challenge each year.
Cumbria is in the part of England commonly referred to as the Lake District, where tourists have long flocked to walk the moors and enjoy lakeside mansions.  But one of the photo captions observes: 
The idyllic landscape masks pockets of deprivation, inequality and poor health comparable to some inner-city areas.
This reminds me of a thread of the work of British geographer, Paul Cloke, who wrote about the juxtaposition of rural poverty with natural beauty.  I quoted him in my article about rural environmental injustice a few years ago:
Hard times” can be “naturalized in to [such] landscapes” (Cloke, 1997:264), causing rurality to “signify itself as a poverty-free zone” (Cloke, 2006:381). The idyll-ised rural thereby “both exacerbate[s] and hide[s] poverty in rural geographic space” (Cloke, 2006:381).
The third story I'll excerpt here is a bit older, having been published in the wake of California's Carr wildfire last year.  That fire struck Shasta and Trinity counties.  Sam Harnett reports for KQED, the San Francisco area NPR affiliate, "Low-income Communities Struggle to Recover after a Wildfire."  His vignettes of fire victims are nuanced and haunting, but he also provides extraordinary data such as this:
A paper published last year by the National Bureau of Economic Research analyzed 90 years of natural disaster data. It found that major catastrophes increase a county's poverty rate — the percentage of people living below the poverty line — by an average of 1 percent. That's because disasters encourage those who are well off to leave, and it makes those with low income poorer.  (emphasis added)
Indeed, I see Harnett has reported frequently on various aspects of California wildfires.  Another story about disparities in disaster recovery is here, from High Country News.  Sara Viner reports, "Fires are indiscrimiant.  Recovery isn't."

Thursday, May 9, 2019

Krugman in NYT reveals how Trump's policies hurt rural folks (with a focus on farms/ag)

Paul Krugman today published a column in the New York Times, titled "Trump is Terrible for Rural America." To a great extent, Krugman conflates rurality with agriculture, as with his focus on tax "reform" and tariffs:
The Trump tax cut largely passes farmers by, because they aren’t corporations and few of them are rich. One of the studies by Agriculture Department economists that raised Trumpian ire showed that to the extent that farmers saw tax reductions, most of the benefits went to the richest 10 percent, while poor farmers actually saw a slight tax increase.
Krugman notes that nearly half of U.S. produced soybeans and wheat are exported, and Trump's expanded trade war has sent grain markets sharply lower.

The other big theme of the editorial is the differential impact of cuts to the safety net, noting that rural America relies disproportionately on the safety net:
 Of the 100 counties with the highest percentage of their population receiving food stamps, 85 are rural, and most of the rest are in small metropolitan areas. 
* * * 
Medicaid is also a key factor keeping rural hospitals alive; without it, access to health care would be severely curtailed for rural Americans in general.
Lastly, Krugman takes up the question, "What's a Trumpist to do?"  There he talks about rural folks' perception that coastal elites condescend to them, a topic I wrote about here.  Have a read for yourself. 

P.S. A postscript on agriculture and trade is here

Tuesday, May 7, 2019

Crime in rural Maine (Part II): Miscellaneous

I'm following up here on my earlier blog post about local media coverage of crime and related issues in micropolitan Maine, with the first installment here.  I'm going to present other issues here as bullet points:

From the Courier-Gazette (of Knox County and surrounding communities for 173 years) of April 25, 2019, four of seven front page stories implicate crime and policing.  A fifth story is about the City of Rockland seeking legal costs in a fight over a zoning law:

  • "Former lawyer pleads not guilty."  This reports that Anita Volpe, 73 of Tenants Harbor (part of the village of St. Geroge), accused of stealing tens of thousands of dollars from three "vulnerable" people pleaded not guilty.  
  • "Man accused of assaulting pregnant girlfriend deported"  This story reports that a 34-year-old Bosnian man awaiting trial on the charge was deported.  He had been living in Cushing, population 1,534, and Hope, population 1,536.
  • "Policing comparison set for heating," dateline Thomaston (population 2,781), reports that residents will have the opportunity to ask questions and look at the cost comparisons for law enforcement at a public hearing.  Implicated is the decision whether to disband the Thomaston Police Dept. and contract with the Knox County Sheriff's Department to provide police protection.  I noticed that a headline in the Hancock County paper, which I visited online, was also discussing closure of one of the municipal police departments.  
  • "South School burglarized, doors damaged," reports on damage done to South School, an elementary school in Rockland, population 7,297. Among other things, the nurse's office was broken into and students' medications stolen.  

The Bangor Daily News April 29, 2019 edition includes a few national news items, including the Poway, California synagogue shooting.   The only local crime story is "Still unauthorized, Church of Safe Injection expands."  The "church" is a free naloxone distribution site at a public square in Bangor.  This "mobile syringe exchange" has distributed "more than 600 naloxone kits and hundreds of clean syringes in its six months." 

One pattern I noticed from reading many different papers was that, the smaller the community the paper served, the greater the number of crime and criminal justice stories--or at least the more prominent the stories were.  Larger papers were, of course, covering not only state but also some national stories. 

Friday, May 3, 2019

A cross-generational "fix" for rural population loss in Korea

The New York Times last week published this heart-warming story out of rural South Korea.   The headline is "Running out of Children, South Korea School Enrolls Illiterate Grandmothers," and the dateline is Gangjin County, population 49,254.  The nation's birth rate is one of the lowest in the world, having fallen dramatically in recent decades; it is now less than one child per woman.  As in most of the places suffering population loss, the areas hit worst are rural
where babies have become an increasingly rare sight as young couples migrate en masse to big cities for better paying jobs. 
Like other rural schools, Daegu Elementary...has seen its students dwindle. When Ms. Hwang’s [the 70-year-old who is the story's central character] youngest son, Chae Kyong-deok, 42, attended it in the 1980s, it had 90 students in each grade. Now, the school has only 22 students in total, including one student each in its fourth- and fifth-grade classes.
One of the things that I love about this story and what is happening in this rural area is the way it is bringing or keeping generations together.  Ms. Hwang rides the school bus with her three grandchildren.  Also striking is the fact that these elderly women are in need of literacy.  Journalist Choe Sang-Hun explains:
Decades ago, Korean families often focused what little resources they had on educating their sons. Many girls were expected to stay home and look after younger siblings while their parents worked outside.

Wednesday, May 1, 2019

Crime in rural Maine, as reported by (state and local) media (Part I): child deaths at the hands of caregivers

As will be clear from my last few posts, I have been in Maine for the last several days.  I spent the last few days mid-coast to downeast, between Portland and Acadia National Park.  This took me through Sagadahoc (35,293), Lincoln (population 34,457), Waldo (population 38,786), Knox (population 39,744) and Hancock (population 54,418) counties.  I found myself perusing the local newspapers--and listening to Maine Public Radio--as often as I could.  One theme that jumped out at me was crime in these largely rural environs.  In this post, I'm going to recount some of the headlines about crime, with particular attention in this Part I about child deaths at the hands of caregivers.

First, as I drove on April 30 and May 1, Maine Public Radio frequently repeated news of a conviction of a Wiscasset woman who had killed a 4-year old child in late 2017.  What was never clear from the broadcast  news stories was whether the child was Gatto's own?  Probably not, or that would have been specified.  But what was the woman's relationship to the child and how did she have the "opportunity" to neglect her?

In search of more information, I came across this story (from early April) in the Portland Press-Herald, which reveals so much.  Among other critical bits of context, the story reveals that Shawna Gatto, the 44-year-old convicted of "depraved indifference murder" was effectively the victim's grandmother.  That is, Gatto was engaged to the victim's grandfather, which raises really interesting issues of gender expectations and double standards.
[Assistant Attorney General Donald] Macomber cast Gatto as a woman who was overwhelmed by the circumstances of her life. She had raised two boys of her own and was looking forward to spending time with her fiancĂ©, Stephen Hood. Then one of her sons had a child and she became a full-time baby sitter. Then Chick, the daughter of Hood’s son, was placed with them because both of her parents struggled with substance use disorder. Finally, Gatto’s son had another child.

“She went from an empty-nester to caring for two toddlers and an infant, “all day, every day, by herself” the prosecutor said.

“She said she didn’t have any ‘me time,’” [Assistant Attorney General Donald] Macomber said, adding that Gatto would often call her mother to “let off steam” about how challenging the children were. “On Dec. 8, they talked for two hours."
Interestingly, the prosecutor seems to have played up Gatto's selfishness in wanting "me time." Indeed, it seems clear the woman was overwhelmed by caring for three young children.

That said, the injuries to the child were extensive:
at least 15 distinct injuries that were consistent with acute child abuse ... Chick died from blunt force trauma to the abdomen, which lacerated her pancreas, but she had head trauma as well, including a bruise that had forced one eye swollen shut.
Gatto's lawyer said at one point that he would argue the injuries were accidental, noting the child "was born drug-affected and was developmentally delayed and clumsy."  The population of Wiscasset, the seat of Lincoln County, is 3,732, but I note that Gatto was tried by a judge in Augusta.  I haven't read in any press a reason the trial was held in a neighboring county, but I did read that Gatto waived her right to a jury trial.

The Press-Herald report links to two related stories, one about the death of a 10-year-old in Stockton Springs (population 1,591),  just up the coast, a few months after Chick's death.  That death was also at the hands of a caregiver.  Another linked story is about the need for reform in Maine's child protection system.

Yet a third similar child death case from the mid-coast Maine area was on the front page of the April 25, 2019 issue of The Republican Journal, a weekly "serving twenty-six communities in Waldo County for 190 years."  The story by Jennifer Osborne (of the Ellsworth American, reporting on Hancock County) reports that a  judge had ruled that 21-year old Savannah Smith would be held without bail in the killing of two-year-old Kloe Hawksley, the daughter of Smith's boyfriend.  The death had occurred about 19 months earlier, but Smith was apparently not arrested until April of 2019, following the indictment by a grand jury.  Two of Smith's own three children had been taken into the custody of the the Maine Dept. of Health and Human Services on the day of Kloe's death, and the third child (apparently born just before Smith's arrest) was residing with its biological father.  At the bail hearing, the defense attorney (based on Bangor) had argued that Smith is "local," with numerous family members living in Bucksport, and also poor:
Her life is local.  Her set of contacts is local.  This is a family of limited means.  Most of them do not own property.
Later Smith's attorney spoke to the media on the courthouse steps:
Smith is young and never been in trouble.  She's upset.  Plus she gave birth three days before she was arrested.  I feel for her.  Hopefully, we'll sort this whole thing out.
Smith has been living in a Bucksport motel since the toddler's death, but a Maine DHHS supervisor testified about concerns over the woman's unstable living situation, in part because "methamphetamine users" have been living in the hotel room with Smith.  Plenty of tragedy all around in this story, and no doubt a lack of social service and other supports in this rural area.  As with the Wiscasset story, I find myself wanting to know more about the roles played by the man in the children's lives--here, Kloe's father, and in the case of Chick, the child's grandfather, who apparently lived with the woman convicted in the child's death.  How is it that women came to be charged but not men.  What evidence exculpated the men?  It would be great if the journalists told us more, and we can only assume the courts in the respective cases probed or will probe where the father and grandfather were and why the blame fell on the women.

Page A7 of that April 25, 2019 issue of the Republican Journal, under "Crime & Courts," reports on "Grand Jury Indictments" and "Waldo County Unified Court Closes Cases," and it also features a "Police Blotter."

I'll return to Part II of this series shortly; it will address the array of other rural criminal justice issues that showed up in the (mostly local) media during my recent visit.

Tuesday, April 30, 2019

My Rural Travelogue (XXII): Back in rural (aging, white and gentrified) Maine after nearly a decade

I have spent the past few days in Maine, following the Maine Law Review's symposium on rural access to justice.  I'd thought seriously about heading up to "The County" (Aroostook), but my energy waned, and it's been easy just to hug the coast, which is so gorgeous and enticing. Plus, there is plenty of rural to see here, including as I passed the mid-coast area and up to what locals call "Down East," as far as Acadia National Park.   (Does "down" here mean south--in contrast to the far northern and inland parts of the state, such as Penobscot, Piscataquis and Aroostook counties?)

As I began this post and was trying to figure out what "number" it would be, I saw that my very first Rural Travelogue post, from 2008 (!) was about rural Maine--specifically the south coast area around Ogunquit.  I guess I had not quite figured out the photo thing at that point because the post doesn't feature any!  I'll try to make up for that with a few in this one.

Winnegance Bakery/Cafe/General Store
I headed out of Portland, Maine on Monday morning and persisted along Route 1 rather than traverse the first part of the journey along I-295, which my traffic app kept nudging me to do.  I thus saw the commercial areas of towns like Yarmouth and Falmouth en route to Bath, where I headed down the peninsula to Phippsburg, population 2,216, and eventually to Popham Beach, where remains of Popham Fort (which guarded the entrance to the Kennebec River dating back to Revolutionary War times) can still be explored.  (Interestingly, Phippsburg, like the Sagdahoc County seat of Bath, is part of the Portland-South Portland-Biddeford Metro area).  I'd planned to have lunch at one of the restaurants farthest south on the peninsula, like Spinney's which my guidebook told me is "open every day."  Turns out Spinney's, like so many service establishments in coastal Maine, is a seasonal establishment, which means that "every day" runs from May 1 (or so) 'til Labor Day.  (Also turns out that Spinneys, like a number of establishments I've seen in coastal Maine and in other rural parts of the United States, is for sale; this largely seasonal, service industry business looks rough).

As I worked my way back north on the peninsula, I stopped to take photos of lots of sights, including the Phippsburg school (looks like elementary only) and the town hall and fire station.  I'd already stopped at the Phippsburg Congregational Church and Phippsburg Library as I traveled south.  I took a photo also of the VFW/hunting club, too, which was somewhat more rustic than the other public buildings.

Regulars at Winnegance Bakery/Cafe/General Store
Driving toward Bath and passing through a wide spot in the road called Winnegance, I saw that the General Store/Restaurant/Bakery there was much busier (based on the number of cars in the slip of a "parking lot" out front) than it had been on my way south.  I also noticed that the establishment had gotten favorable mention from my guidebook, so I pulled in.

The place was nearly full, but I was able to grab a table near the door.  The largest table in the place was full of elderly white women--half a dozen or more, clearly local regulars.  Shortly after I arrived, a stooped elderly man, also white, arrived; they knew him and invited him to join them.  Several other patrons of the restaurant were also elderly and white, though a mixed race, multi-generational family and some motorcyclists were also there.  Still, I couldn't help think how this scene represented what I've repeatedly heard about Maine (from Mainers)--it's the oldest and whitest state in the nation, which is interesting because the public buildings tend also to be white ....  (Well, that's what people say--a quick Google search reveals that Vermont is "whiter" by a smidgen, and New Hampshire is third).
Winnegance Bakery/Restaurant/General Store
Had a great meal (salad with fresh hake and some incredible seafood chowder) before heading back to Highway 1 for my trek on up the coast.  Next stops, Wiscasset (Lincoln County, Sheepscot River), Waldoboro (Lincoln County, Medomak River), and Camden (Knox County).
View in front of Winnegance Bakery/Cafe/General Store

Saturday, April 27, 2019

Maine Law Review symposium: Ensuring Equal Access to Justice for Rural Maine

It was my great honor to participate in this symposium yesterday and today in Waterville, Maine, hosted by Colby College and Maine Law School.  A highlight was the inclusion of attorneys and judges from across Maine, including from remote places with exotic sounding names like Piscataquis County (population 17,000), Calais (population 3,123), and Presque Isle (population 9,078).  A photo of the participants in the panel on Ensuring Access to Justice in Maine's Rural Communities is shown here (with speakers from Presque Isle, Dover-Foxcroft, Camden and Fort Kent, and a moderator with Pine Tree Legal Services): 

Maine Law students who have been the beneficiaries of rural fellowships that have permitted them to work with practitioners in some of these rural communities were also present.  Sadly, that two-year rural fellowships program is coming to a close--in part because of a widespread sense that the Maine Law School does not deserve funding for such enterprises when it primarily educates students to work in Portland (the largest city, population about 65,000), where they earn hefty salaries.  Kudos to Maine Law Review editors Mac Walton and Hannah Wurgaft for putting together this really terrific event.  It was also edifying to see and meet audience members from around Maine, including non lawyers who simply care about their state.

Highlights from academic speakers included Maybell Romero's talk on race/ethnicity and prosecution in the mostly white state of Maine; Nicole Huberfeld's talk on rural health care delivery in relation to universal norms; and Hannah Haksgaard's talk on rural practice as public interest.   I believe that the video-recording of the entire conference will ultimately be available online.