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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) — The California Legislature has sent a bill to Gov. Gavin Newsom that would let counties offer fewer in-person voting options as they hold the November election in the midst of the pandemic. Newsom has already signed a law requiring counties to mail ballots to voters ahead of the Nov. 3 election. County election officials are having trouble securing enough polling places because of the pandemic. California continues to have problems with missing data on virus infections throughout California. State officials have acknowledged California has been undercounting virus cases due to a technical issue with a database used to collect test information from labs. 695

SACRAMENTO, Calif. (AP) — California's ballot harvesting law is creating controversy this election year. The law allows individuals to collect ballots from voters and return them to county election offices. Republicans have set up unofficial drop boxes in some counties with closely contested U.S. House races. State officials say the boxes are illegal and have ordered the party to remove them. But party leaders say they are using the boxes to collect ballots as the law allows. At least one Democratic campaign is using neighborhood hubs where designated volunteers receive ballots at their homes from voters. 620

RICHMOND HEIGHTS, Mo. – Authorities are searching for a person of interest following a shooting at a St. Louis area mall that left one person dead and another injured Wednesday.The St. Louis County Police Department said on Twitter that the two people were shot at the St. Louis Galleria Mall in Richmond Heights shortly before 12:34 p.m. CT.When officers arrived at the scene, police say they located the adult male victims. One victim, a man in his early 20s, was pronounced deceased at the scene and the other was transported to an area hospital for life-saving treatment.The department said it does not consider the shooting an active shooter incident.Police believe two groups of people got into some sort of dispute inside the mall and the altercation escalated into a shooting. Several suspects were reportedly seen fleeing the scene. 849

SACRAMENTO, Calif. (AP) — California has already moved to automatically expunge the records of those convicted of qualifying marijuana crimes. Now, Democratic lawmakers and advocates want to erase the records of those who have served their time for other crimes.The lawmakers and dozens of supporters rallied in sweltering heat Tuesday supporting two Assembly-approved bills that would automatically expunge arrest and conviction records for an estimated 1 million residents who are already entitled under existing law because they have completed their sentences and supervision."Right now, if you serve your time you still can't get housing, you still can't get work, you still get treated like a criminal," said San Francisco Assemblyman Phil Ting, who authored one of the bills.His bill would require the state attorney general to catalog qualifying arrest and conviction records of lower-level felonies and misdemeanors so they can be cleared. That's similar to a law that took effect Jan. 1 requiring the attorney general to identify by July 1 those who are eligible to have their records scrubbed because California legalized recreational marijuana in 2016 and made the reduction in legal penalties retroactive.Supporters of Ting's bill and a related bill by Oakland Assemblyman Rob Bonta said the current expungement system is too cumbersome and too few take advantage even if they qualify. They count more than 4,800 California legal restrictions on those with convictions."Every right should be restored," said state Sen. Nancy Skinner of Berkeley. "Once you've done your time, that's enough."Jay Jordan, executive director of the nonprofit Californians for Safety and Justice that organized the rally, said he served eight years in prison for a robbery he committed at age 18, and still bears the consequences 15 years later."I can't sell real estate, can't sell used cars, can't sell insurance, can never adopt, I can't coach my son's Little League team, can't join the PTA, can't chaperone him on field trips," he said. "It just harms people. It doesn't make economic sense, doesn't make public safety sense."A state association of law enforcement records supervisors opposes the bill, saying it would be costly and burdensome when people can already petition to have their records expunged. Legislative analysts said the bills could cost tens of millions of dollars, though Jordan said that would be offset by the economic benefits of letting more former felons get jobs.The bills awaiting consideration in the state Senate would "unnecessarily put the burden on records management personnel, who are short staffed and without sufficient resources, to move arrest dispositions to an automated system, a very labor intensive and cost-prohibitive task," objected the California Law Enforcement Association of Records Supervisors, Inc. The group fears it would also create a legal liability for agencies that inadvertently miss a qualifying record.The lawmakers propose to use technology that can search for qualifying records, which Ting said can greatly reduce the time and cost. 3099