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Rural hospitals across the country are in a difficult spot right now. COVID-19 is hitting them harder than many metropolitan hospitals as they deal with issues of lower staffing.According to the National Center for Biotechnology Information, about 20% of our nation’s population lives in rural areas, yet less than 9% of our nation’s physicians practice there.Add on the fact that according to CDC data, COVID is killing rural Americans at a rate 3.5 times higher than those living in metropolitan areas, and this issue is affecting staff and patient care.“I’m very worried about rural health care because rural health care is teetering on the brink right now,” said Dr. Kurt Papenfus, an ER doctor at Keefe Memorial Hospital in rural Cheyenne Wells, Colorado. “There’s a darkness in this illness that I can’t say I’ve said about any other illness.In late October, Dr. Papenfus contracted COVID-19 as he was traveling back from the Northeast to visit his daughter.“I was very cognizant and was wearing a mask at all times, social distancing, and washing my hands,” Papenfus said. “But I remember having this thought on the train that this is a super-spreader event.”When he got home, Papenfus got tested and was confirmed positive for COVID-19. The diagnosis put Keefe Memorial in a tailspin as he served as the only ER doctor in the small 25-bed hospital.“We are a trauma level four hospital so keeping that physician on staff 24/7 is what we are required to do,” said Stella Worley, Keefe Memorial’s CEO. “And it is getting to be more of a challenge to have hired physicians out here in rural [America].”Within minutes of learning of Dr. Papenfus’ COVID-positive diagnosis, Worley was on the phone with several different hospitals working to find a replacement. Within a few hours, they had settled on a former ER doctor who moved to another hospital in Texas a few months prior.After she agreed, Keefe Memorial paid the doctor to drive 10 hours from Texas to Colorado and fill in immediately as Papenfus recovered at home for the next two weeks.“Worst-case scenario is you would have to divert patients if there’s no one in the door to care,” said Worley.Populations in rural America tend to be older, poorer, and less insured than the nation at large, according to the National Conference of State Legislatures.Since 2010, hospital closures in rural America have been growing as there have been 118, including 17 last year.The closures only exacerbate a growing lack of health care coverage in rural America, said Dr. Dan Derksen, a rural health care expert and family physician“Once a critical access hospital (25 beds with a 24/7 emergency department and at least 35 miles from another facility) closes, they almost never come back,” he said. 2756

SACRAMENTO, Calif. (AP) — Californians soundly rejected a costly ballot measure Tuesday that would have allowed more rent control as a way to alleviate the state's housing crisis.Proposition 10 trailed by a roughly 30-point margin with nearly 4 million votes counted.It was one of the most expensive and contentious items on the ballot, attracting more than 0 million in campaign contributions.Opponents said the measure would have lowered real estate values and further decreased the state's already limited housing supply by discouraging building. Supporters argued more rent control would protect low-income people from being priced out of their homes.The failure of the measure preserves restrictions on rent control on apartments built after 1995, single-family homes and condominiums. It also preserves rules preventing cities and counties from telling landlords what they can charge new tenants.California has a disproportionately high rate of homelessness, and nearly a third of California renters spend more than half their income on rent, according to the state's housing agency.In light of their defeat, supporters called on Gov.-Elect Gavin Newsom to freeze rent increases and pressure lawmakers to repeal the restrictions Proposition 10 sought to end."The burden to act returns to the governor and the Legislature, who should work to represent Californians, not Wall Street landlords," said Christina Livingston, one of the leaders of the Proposition 10 campaign.Newsom opposed the measure, but said he would work to address the housing crisis.The nonpartisan Legislative Analyst's Office predicted the initiative would have lowered the value of rental properties. Economic research generally shows that rent control benefits some individual renters but it limits supply overall and raises rents because it decreases incentives to build.RELATED CONTENT 1876

SACRAMENTO (AP) — California on Thursday temporarily banned insurance companies from dropping customers in areas affected by more than a dozen recent blazes, invoking a new law for the first time as homeowners in the wildfire-plagued state struggle to find coverage while carriers seek to shed risk.The order from Insurance Commissioner Ricardo Lara will last for one year, and it only covers people who live inside or next to the perimeter of 16 different wildfires that burned across the state in October. The Department of Insurance estimates the moratorium will affect 800,000 policies covering millions of people in portions of Los Angeles and Riverside counties in Southern California and Sonoma County in the northern part of the state.The move comes as regulators are aggressively trying to assist homeowners in wildfire-prone areas who say they are being pushed out of the commercial insurance market as climate change makes fires larger and more frequent.RELATED: Cal Fire: Acres burned across the state is much lower in 2019 than 2018Seven of the 10 most destructive wildfires in California history have happened in the last five years — including 2018′s Camp Fire, which destroyed roughly 19,000 buildings and killed 85 people in and around the Northern California town of Paradise. That blaze alone generated more than billion in insurance claims, according to the Department of Insurance.Since 2015, state officials say insurance companies have declined to renew nearly 350,000 policies in areas at high risk for wildfires. That data does not include information on how many people were able to find coverage elsewhere or at what price.One of those homeowners is Sean Coffey, who said he and his wife have struggled to maintain fire insurance on their home in Oakland.“The pattern repeated itself almost every year since we bought our house. We would have (coverage) for 10 months. In the fall, we would get a notice we are being dropped,” he said.RELATED: Study: Alien grasses are making more frequent US wildfiresCoffey now buys fire insurance from the California Fair Access to Insurance Requirements Plan, an insurance pool mandated by state law that is required to sell policies to people who can’t buy them through no fault of their own. He must purchase a second policy to cover risks other than fire.FAIR Plan policies in wildfire-prone areas have grown an average of 8% each year since 2016, according to the Department of Insurance. Last month, Lara ordered the FAIR Plan to begin selling comprehensive policies next year that cover more than just fire damage. FAIR Plan Association President Anneliese Jivan called that order “a misguided approach,” saying it will make all of the plans more expensive.Lara has the authority to order the moratorium under a bill he authored while in the state Senate last year that was signed into law by former Gov. Jerry Brown. The law took effect in January, and this is the first time regulators have used it.In addition to ordering the moratorium, Lara called on insurance companies to voluntarily stop dropping customers solely because of wildfire risk.RELATED: Bigger, longer blackouts could lie ahead in California“I believe everyone in the state deserves this same breathing room,” Lara said.A spokeswoman for the American Property Casualty Insurance Association did not immediately respond to a request for comment.While state officials rush to assist homeowners, a new report from California Auditor Elaine Howle said the state did not do enough to protect non-English speaking, elderly and other vulnerable residents during three of the state’s most devastating fires in recent years.The audit covered Butte County, site of 2018′s Camp fire, plus the 2017 Thomas Fire that burned more than 281,000 acres in Ventura County and 2017 fires in Sonoma County that killed 24 people. The audit found none of the three counties had assessed its residents to determine who might need extra help and whether resources were available to help such people, such as transportation, during a natural disaster.The audit also scolds the state oversight agency, the Governor’s Office of Emergency Services, for failing to assist counties in developing such plans and reviewing any plans in place.Howle says it was impossible to determine whether lives could have been saved “if the counties had planned differently or more fully implemented the best practices”her office recommends in the report.” But she noted that “inadequate plans and insufficient planning are proven contributors to failure.” 4561

SACRAMENTO, Calif. (AP/KGTV) — California Gov. Gavin Newsom on Friday signed a law that will make the state the first to allow employers, co-workers and teachers to seek gun violence restraining orders against other people.The bill was vetoed twice by former governor Jerry Brown, a Democrat, and goes beyond a measure that he signed allowing only law enforcement officers and immediate family members to ask judges to temporarily take away peoples' guns when they are deemed a danger to themselves or others.They were among 15 gun-related laws Newsom approved as the state strengthens what the Brady Campaign to Prevent Gun Violence calls the nation's toughest restrictions."California has outperformed the rest of the nation, because of our gun safety laws, in reducing the gun murder rate substantially compared to the national reduction," Newsom said as he signed the measures surrounded by state lawmakers. "No state does it as well or comprehensively as the state of California, and we still have a long way to go."Newsom also signed into law AB 893, which prohibits gun and ammunition sales at the Del Mar Fairgrounds. The bill was introduced by Assemblyman Todd Gloria in February. The ban is set to go into effect in 2021.Anyone who violates the law could face a misdemeanor charge, according to the bill. Before the law was signed, Gloria called the bill a "victory for gun sense and making our communities safer in San Diego."State Senate President pro Tempore Toni Atkins (D-San Diego) said the bill "offers tangible, real steps to keep all California residents safe."“I congratulate Assemblymember Todd Gloria for getting AB 893 signed into law by Governor Newsom today. AB 893 responds to our community’s desire to stop selling guns and ammunition on state property, specifically at the Del Mar Fairgrounds," Atkins said in a release. "This bill offers tangible, real steps to keep all California residents safe by closing off another pathway for criminals to move guns from the legal market to the unregulated one.”Gun shows have been hotly debated at the Del Mar Fairgrounds over the last year. In September 2018, the 22nd DAA's Board of Directors temporarily suspended the shows until safety policies were developed. The decision ended the Crossroads of the West gun show after nearly three decades.Friday, Michael Schwartz, executive director of the San Diego County Gun Owners political action committee, said the bill was discriminatory.“Banning a gun show on just one state owned property, but not on all is proof positive that this is discrimination based on political bias and has nothing to do with safety. We are opposed to discrimination against a group of law-abiding citizens who are simply practicing their civil rights," Schwartz wrote. 2774

SACRAMENTO, Calif. (AP) — The Trump administration will not immediately give billion it revoked from California's high-speed rail project to another project, according to a legal agreement reached Wednesday between the two.The Federal Railroad Administration announced last week it was revoking the money, prompting California to sue on Tuesday. Beyond the lawsuit, the state planned to seek a temporary restraining order halting the federal government from giving the money to a different rail project.The new agreement means the state won't file the restraining order, but it does not change the status of the lawsuit.California is trying to build a high-speed rail line between Los Angeles and San Francisco, a venture expected to cost upward of billion. The 9 million is for a segment of track already under construction in the Central Valley that must be completed by 2022.The Federal Railroad Administration has argued California hasn't made progress and can't meet that deadline. California, meanwhile, has faulted the federal government for cutting off the partnership with the project and says it has no basis for revoking the money several years ahead of the deadline.The agreement signed Wednesday says the money won't be awarded elsewhere unless the federal government goes through its typical process for awarding grant money. It says the Trump administration has no current plans to start that process, which would take at least four months. 1473

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