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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) — California's job growth is now in its 113th month, tying the expansion of the 1960s as the longest on record as the world's fifth largest economy continues its recovery from the Great Recession, officials announced Friday.The country's most populous state needs between 8,000 and 9,000 new jobs each month to keep up with its growing workforce. But for the past nine years, California has averaged 29,200 new jobs each month, according numbers released Friday by the state Employment Development Department.The more than 3.2 million jobs California has added since 2010 account for more than 15% of the country's job gains over that time. Friday, the state's unemployment rate dipped to 4.1% for July, tying a record low first set in 2018."In every way the American economy is substantially impacted by how California is doing," Democratic Gov. Gavin Newsom said Friday at an unrelated news conference. "We continue to be optimistic, but not naive."The United States' trade war with China could put California's job gains in peril, according to Michael Bernick, a former director of the California Employment Development Department who is now special counsel with the Philadelphia-based law firm Duane Morris.Analysts have been warning for a year that tariffs on Chinese imports could threaten U.S. job growth. So far, that hasn't happened, but the Trump administration recently intensified the conflict by imposing 10% tariffs on 0 billion in Chinese imports, raising fears China would respond with tariffs on U.S. exports.Earlier this month, federal trade officials announced they would delay tariffs on about 60% of those imports until December."There is no reason we can't expect continued strong employment throughout 2019 in the absence of some external event. And the tariffs are that potential event," Bernick said.California's booming economy was felt earlier this year when Newsom signed a state spending plan that included an estimated .5 billion surplus, the largest in at least 20 years. But Newsom and others have been cautious about spending it, warning the country is due for a recession given the unusual length of the recovery."It is what keeps me up at night," California Treasurer Fiona Ma said Thursday about a possible recession. "Our president moves the market every day through his Twitters, and that is very unnerving for us."California's unemployment rate was lowest in the San Francisco Bay Area, where the country's tech industry is headquartered. Bernick said while Silicon Valley itself does not account for many jobs in the state, the money it produces has fueled a surge in accompanying industries including finance, real estate and retail.The unemployment rate was highest in the Central Valley, reflecting the seasonal demands of the state's billion agriculture industry. Imperial County in Southern California had an unemployment rate of more than 20% as surveys reported more than 14,000 people were out of work. 2992

SACRAMENTO, Calif. (AP) — California lawmakers are considering proposals that would make the state the first in the nation to offer government-funded health care to adult immigrants living in the country illegally.Democratic Gov. Gavin Newsom has proposed covering immigrants 19 to 25.A proposal in the state Senate would expand that coverage to include people 65 and older, while the Assembly is considering a bill that would extend benefits to all low-income immigrants 19 and older.California already covers immigrants 18 and younger regardless of their status.A final decision on wider coverage may come down to cost.Newsom estimates his plan covering young adults would cost million a year. Legislative staffers estimate the Senate's plan could cost 4 million and the Assembly proposal .2 billion annually.Newsom estimates California will have a .5 billion budget surplus. But he has urged lawmakers to constrain spending, warning the next recession could cost the state billion in revenue. 1019

SACRAMENTO, Calif. (AP) — A peaceful protest in a sleepy suburb that’s home to the head of the California National Guard was among four demonstrations monitored by National Guard spy planes. That's according to a report by the Los Angeles Times. The four planes took to the skies over cities in June to monitor protests following the killing of George Floyd. Three watched demonstrations in Minneapolis, Phoenix and Washington, D.C. But the target of the fourth was the Sacramento, California, suburb of El Dorado Hills. Authorities have not explained how and why that neighborhood was chosen when other cities that had seen property destruction and street clashes were not.The head of the California National Guard, Maj. Gen. David S. Baldwin, lives in El Dorado Hills, according to the Times. Baldwin told the Times that he didn't recall whether he approved the mission and his residence had "nothing to do with" the deployment. 938

SACRAMENTO, Calif. (AP) -- Amid national angst over racial inequities in the criminal justice system, California voters rejected Proposition 25, an effort to roll back reforms targeting mass incarceration and reinstate tougher criminal penalties.But rejecting Prop. 25 meant the overturning of a state law that would have ended what critics call a predatory cash bail system.Analysts said Wednesday that the seeming incongruence does not undermine voters' recent shift away from get-tough practices.Rather, the bail change fell victim to an unusual coalition of opponents, leaving supporters scratching their heads on how to proceed.More than six in 10 voters backed reduced criminal penalties that they endorsed in previous ballot measures. 749

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