A new report released earlier this week says that rural Americans experience more chronic health conditions such as diabetes and heart disease than urban and suburban residents, have greater difficulties accessing high-quality care, and from 2014 millions more of them will likely participate in Medicaid and government-subsidized insurance.

At the same time, more use of technology, such as broadband access that would increase telehealth solutions, can help ease strain on the system and further promote healthier outcomes in rural communities, according to the paper released by the UnitedHealth Center for Health Reform & Modernization.

The paper, titled “Modernizing Rural Health Care: Coverage, Quality and Innovation,” explores how health reform implementation, particularly health insurance expansion, will increase the need for innovative care models and points to technology and a stronger role for rural primary care as promising solutions.

It also reports the results of a new Harris Interactive survey of 2,000 patients and more than 1,000 primary physicians in rural and urban areas.

“The next few years will be times of considerable stress on rural health care, but also times of great opportunity, since across the country there are already impressive examples of high-quality care, tailored to the distinctive needs of the local community,” said Simon Stevens, UnitedHealth Group executive vice president and chairman of the UnitedHealth Center for Health Reform & Modernization.

“The challenge for all involved in rural America now is to build on that track record of innovation and self-reliance, so as to ensure that all Americans – wherever they live – can live their lives to the healthiest and fullest extent possible,” Stevens added.

The new report includes new findings on coverage, access and quality, as well as detailed suggestions for improvement.

Rural coverage

The report contains new projections showing that around five million rural residents may join Medicaid and other insurance plans as a result of the planned 2014 coverage expansions – which would represent a higher percentage increase than in urban areas.

Already almost one-third of people in rural areas depend on Medicare and Medicaid, compared with one-quarter in urban areas.

Rural access

Coverage is not the same as access to high-quality care. More than half of rural primary care doctors report that patients they refer to specialty care have to travel an average of about 60 miles. Furthermore, the 2014 coverage expansions will place increased pressure on rural care delivery.

The good news for rural areas is that a higher proportion of rural primary care physicians surveyed said they were currently accepting new Medicaid patients (84 percent vs. 65 percent of urban primary care physicians).

And looking forward to 2014, 59 percent of rural primary care doctor respondents plan on accepting new Medicaid patients, compared with only 44 percent of their urban counterparts.

However, the report also finds that around 11 million rural residents currently live in areas where primary care supply is relatively low but where the increase in the insured population will be high relative to other counties.

Partly as a result, almost half of rural primary care physician respondents expect a primary care shortage over the next few years (compared with 37 percent of urban primary care doctors).

Rural care quality

The report finds that both rural consumers and rural primary care physicians rate the quality of local care lower than do their urban and suburban counterparts.

While nearly two-thirds (63 percent) of urban and suburban residents assess the quality of their local health care as ‘excellent’ or ‘very good,’ only half of rural residents do so (49 percent).

Nearly a quarter (24 percent) of rural residents say their local care is only ‘fair’ or ‘poor,’ compared to 12 percent of urban and suburban residents who believe that.

New data in the report also pinpoint the need to improve health screening and preventive care in rural areas.

Practical solutions

Given these challenges, there is an urgent need to deploy at scale innovative new rural care models. The working paper identifies a range of options, drawing on successful private and public examples in particular parts of the country.

The report goes on to call for: new incentives and reimbursement models for rural primary care physicians; a bigger role for the 24,000 rural nurse practitioners and physicians assistants; greater provider collaboration across rural areas and with urban health care systems; innovative models using mobile health clinics; faster rural uptake of electronic health records; well-designed market incentives for rural areas; and greater engagement by rural consumers in improving their health.

The paper offers several concrete steps to promote greater use of rural telemedicine and telehealth:

• expanding rural broadband connectivity to enable growth of telemedicine adoption;

• improving and aligning reimbursement approaches across payers to encourage greater use of telemedicine across rural settings;

• improving availability of telemedicine technologies to consumers; and

• reducing regulatory barriers to use of telemedicine technologies and health professionals.

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NORTH COAST, Calif. – On Thursday state officials reduced the estimates of the size of a Mendocino County fire burning near Covelo.

The Pass Fire, which broke out just after noon on Wednesday, had previously been estimated at 800 acres, but Cal Fire said on Thursday that the blaze was 644 acres.

The fire is located on Hams Road Pass in the Hulls Mountain area northeast of Covelo, Cal Fire said.

Firefighters continued the work of constructing and improving containment lines, and improved and held fire lines and put out hot spots, with Cal Fire reporting that the blaze was 45-percent contained as of Thursday evening. It is expected to be fully contained on Saturday.

On Thursday the number of personnel on the fire totaled 921, more than double the number of the previous day, according to Cal Fire's reports.

One injury was reported, according to the Thursday report.

Approximately 52 engines, 33 fire crews, one air tanker, three helicopters, six dozers and seven water tenders also were on scene, according to Cal Fire.

Cooperating agencies include Cal Fire, Brooktrails Fire Department, Covelo Fire Department, Laytonville Fire Department, Little Lake Fire Department, Redwood Valley/Calpella Fire Department, Ukiah Valley Fire Protection District, US Forest Service and the California Department of Corrections and Rehabilitation. Mendocino National Forest was taking part in the unified command.

Cal Fire reported that costs to fight the fire so far total $ 867,000.

No structures are threatened, and the fire's cause is under investigation, Cal Fire said.

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LAKE COUNTY, Calif. – The scorching summer sun can turn an automobile into a deadly oven-on-wheels for young ones, pets and adults alike.

The California Highway Patrol (CHP) warns the public about the dangers of leaving children, loved ones or pets unattended inside a vehicle while parked in the hot, summer sun.

“It takes mere minutes for the temperature inside of a vehicle to become deadly, even in the shade,” said CHP Commissioner Joe Farrow. “Never leave children, pets or anyone unable to care for themselves in the car, even with the windows rolled down.”

Leaving an unattended child in a car is illegal, so if you see one, call 911 immediately. It can mean a matter of life or death.

The national, nonprofit organization 4 R Kids Sake designated August as “Purple Ribbon Month,” to raise awareness and educate the public about the dangers of leaving a child unattended in a vehicle.

In recognition of “Purple Ribbon Month,” CHP officers will attach a purple ribbon to the antenna of their patrol cars as a gentle reminder to not leave children in the vehicle.

This action is part of a campaign to remember 6-month-old Kaitlyn Russell who died Aug. 15, 2000, when she was left alone in her babysitter’s car for about two hours.

“Kaitlyn’s Law” states that anyone who leaves a child 6 years or younger inside a vehicle without the supervision of someone at least 12 years old can be fined $100.

“It takes very little effort to take a child or loved one with you,” said Commissioner Farrow. “It is not worth it to leave them in the car, even for a few moments.”

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LAKE COUNTY, Calif. – The Lake County Registrar of Voters Office reported this week that Aug. 12 is the end of the filing period for several vacancies on local school, fire and special districts boards.

Registrar of Voters Diane Fridley said that the filing period ends at 5 p.m. Aug. 12 in order for candidates to be on the ballot for the Nov. 8 General District Election.

The following vacancies will be up for election this November.

EDUCATION

• Mendocino-Lake Community College District: Trustee Area No. 1, one vacancy, file in Mendocino County; Trustee Area No. 3, one vacancy, file in Mendocino County; Trustee Area No. 4, one vacancy, file in Mendocino County; Trustee Area No. 7, one vacancy, file in Lake County.

• Kelseyville Unified School District: Three vacancies.

• Lake County Board of Education: Trustee Area No. 1, one vacancy; Trustee Area No. 2, one vacancy.

• Lakeport Unified School District: Three vacancies.

• Lucerne Elementary School District: One vacancy.

• Upper Lake Union Elementary School District: Two vacancies.

• Upper Lake Union High School District: Two vacancies.

SPECIAL AND FIRE DISTRICTS

• Kelseyville Fire Protection District: Two vacancies.

• Lake County Fire Protection District: Three vacancies.

• South Lake County Fire Protection District: Three full terms, one two-year unexpired term.

• Anderson Springs Community Services District: Two vacancies.

• Butler-Keys Community Services District: Three vacancies.

• Hidden Valley Lake Community Services District: Three vacancies.

• Adams Springs Water District: Two vacancies.

• Buckingham Park Water District: Two full terms, two two-year unexpired terms.

• Callayomi County Water District: Two vacancies.

• Clearlake Oaks County Water District: Three vacancies.

• Cobb Area County Water District: Two vacancies.

• Konocti County Water District: Two vacancies.

• Scotts Valley Water Conservation District: Division I, one vacancy; Division III, one vacancy.

• Upper Lake County Water District: Three vacancies.

• Villa Blue Estates Water District: Three vacancies, two-year terms.

For more information contact the Lake County Registrar of Voters Office, 707-263-2372.

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CLEARLAKE, Calif. – The service of a search warrant by the Sheriff’s Narcotics Task Force Wednesday morning resulted in two arrests, the seizure of approximately a quarter of an ounce of methamphetamine, and the seizure of more than $300 for asset forfeiture.

Capt. James Bauman of the Lake County Sheriff's Office said Brenda Joyce Redoble, 59, and Dennis Eugene Baker, 60, of Clearlake were arrested in the operation.

Bauman said that on July 28 narcotics detectives secured a search warrant for Redoble's person and home and at 7 a.m. Wednesday, Aug. 3, detectives served the warrant at Redoble’s home on Eureka Avenue in the city of Clearlake.

When narcotics detectives entered the home, four people were detained without incident, including Redoble and Baker, Bauman said. Baker was determined to be under the influence of a controlled substance and arrested.

During a search of the home, detectives located approximately a quarter of an ounce of methamphetamine packaged for sales and $300 in currency concealed between the mattresses of Redoble’s bed in her bedroom, Bauman said.

Narcotics sales paraphernalia, digital scales, a glass “meth” pipe and additional currency were found concealed in a file cabinet drawer in the same bedroom. Bauman said a further search of the home revealed four additional “meth” pipes concealed in the living room and in Baker’s bedroom.

He said Redoble was arrested for possession of a controlled substance for sales and possession of narcotics paraphernalia. Baker was arrested for being under the influence of a controlled substance and possession of narcotics paraphernalia.

Both were transported to the Lake County Hill Road Correctional Facility and booked. Redoble's bail was set at $10,000 and Baker's at $3,000. Baker and Redoble both later posted bail and were released, jail records showed.

The other two detainees were released at the scene, Bauman said.

The Sheriff’s Narcotics Task Force can be contacted through its anonymous tip line at 707-263-3663.

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NORTH COAST, Calif. – Hundreds of firefighters were on the fire lines Wednesday fighting a blaze in Mendocino County that burned several hundred acres in just a few hours.

The Pass Fire was reported shortly after noon on Wednesday on Hams Pass Road in the Hulls Mountain Area northeast of Covelo, according to Cal Fire.

By the middle of the afternoon the fire had reached 800 acres. Cal Fire's last report of the evening, at 8:30 p.m., had the fire held at that size, with 25 percent containment.

Responding along with Cal Fire were the US Forest Service and the California Department of Corrections and Rehabilitation.

Cal Fire said there were 450 personnel involved in the firefighting effort, along with 35 engines, 16 fire crews, nine air tankers, three helicopters, six dozers and seven water tenders.

No structures were threatened, and full containment is expected this Saturday, the agency reported.

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The Bureau of Ocean Energy Management, Regulation and Enforcement (BOEMRE) said Wednesday that it is beginning a two-year, comprehensive study of coastal and marine archaeological sites along the Pacific Coast of the United States.

The study will analyze and inventory marine archaeological resources on the Pacific Outer Continental Shelf and existing historical sites located on the West Coast.

Findings from the study will be used in future environmental analyses and may trigger specific steps to mitigate potential environmental impacts associated with future construction and deployment of offshore renewable energy facilities.

 

“A thorough understanding of coastal and marine resources is critical to adequately assess potential effects of future offshore renewable energy technology testing and commercial development,” said BOEMRE Director Michael R. Bromwich. “The findings of this study will assist us in future siting decisions and enhance our ability to identify effective methodologies for protecting those resources.”

 

It has been more than 20 years since BOEMRE has conducted a marine archaeological study offshore California, Oregon and Washington.

Since that time, there have been a number of significant archaeological discoveries along the Pacific coast, including historic shipwrecks and now submerged prehistoric sites.

The study is intended to broaden the understanding of known and potential submerged cultural resources, as well improving our understanding of potential visual impacts to coastal historic properties along the Pacific coast.

BOEMRE marine archaeologists and environmental scientists will use these findings for environmental assessments and use them as a basis to mitigate potential adverse effects of future offshore renewable energy activities.

This study builds on similar efforts in the Atlantic and Gulf of Mexico to create standardized geo-referenced databases of non-renewable cultural heritage resources.

 

 

BOEMRE funds approximately $30 million per year for scientific studies in the Gulf of Mexico, the Atlantic, the Pacific and the Arctic and is responsible for regulating activities on the 1.7 billion acres of U.S. offshore area on the Pacific Outer Continental Shelf.

As part of this national program, the Pacific Region manages research in physical oceanography, biology, ecology and socioeconomics.

For information on the BOEMRE Environmental Studies Program, visit www.boemre.gov/eppd/sciences/esp/index.htm.

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CLEARLAKE, Calif. – Three men accused of taking part in a June attack on a family that left a child dead and five others wounded made a Tuesday court appearance at which a judge determined their joint preliminary hearing would take place in September.

Kevin Ray Stone, 29, of Clearlake, and Clearlake Oaks residents Paul William Braden, 21, and Orlando Joseph Lopez, 23, appeared before Judge Stephen Hedstrom in Lake County Superior Court's Clearlake Division on Tuesday afternoon for both the setting of their preliminary hearing date and the completion of Stone's arraignment.

The three men are accused of taking part in a late-night shooting in Clearlake on June 18 that killed 4-year-old Skyler Rapp and wounded his mother, Desiree Kirby, as well as her boyfriend, Ross Sparks, and his brother, Andrew Sparks, and friends Ian Griffith and Joseph Armijo.

Each of the men are facing more than a dozen charges – including murder, mayhem, and numerous counts of attempted murder and assault with a deadly weapon, along with special allegations for use of firearms and great bodily injury.

Stone would enter a not guilty plea to the charges and denial of the special allegations on Tuesday. Braden and Lopez previously entered not guilty pleas.

Watching from the audience was Clearlake resident John Hamner, grandfather of Ross and Andrew Sparks, and step-great-grandfather of Skyler Rapp. He said afterward that seeing the men in court was the hardest thing he's ever done.

Stone, Braden and Lopez were accompanied in court on Tuesday by their defense attorneys – Komnith Moth, Doug Rhoades and Stephen Carter, respectively, with District Attorney Don Anderson handling the prosecution.

“This ultimately is anticipated to be one joint preliminary examination?” Hedstrom asked the attorneys.

“That's our understanding,” said Rhoades.

The attorneys originally proposed the preliminary hearing to begin on Sept. 27, with Anderson estimating it would take five days to complete the proceeding.

However, Rhoades said of Anderson's time estimate, “That has the potential of actually being conservative.”

Rhoades estimated that the hearing could take as many as seven days, or about two weeks in court time.

With three defendants and three attorneys, the case has some inherent scheduling challenges.

In working out the scheduling, Carter brought up the possibility of the preliminary hearing's time frame conflicting with another homicide prosecution – that of former Maine resident Robby Beasley – in which he also is defense counsel.

The Beasley case has been set for trial on Oct. 3; however, with a general time waiver in place, that trial can be adjusted to accommodate the preliminary hearing, said Hedstrom, and Carter indicated there are other issues with the Beasley case that may result in it being rescheduled anyway.

While Rhoades said the scheduling should work for him, Moth has a murder trial set to start the first week of September which he said he hoped would be completed within three weeks but could conflict if it ran long.

During the Tuesday afternoon appearance, Stone also was arraigned in the case. Braden and Lopez – who were taken into custody within days of the shooting – were arraigned late in June, but Stone was on the run for two weeks before he was arrested in Santa Rosa.

Moth entered a plea on Stone's behalf of not guilty on all counts and the denial of all special allegations.

Hedstrom briefly adjourned court while Moth filled out a time waiver form for Stone. When court was back in session Hedstrom directly addressed all three defendants, asking them if they understood the process, explaining that they had the right to have a preliminary hearing in a continuous session and that their attorneys were advising that they waive that right.

Stone, sitting in the jury box in front of Moth, turned to his attorney and said he hadn't explained that. Moth leaned in to explain it, with Stone then acknowledging to the judge that he understood, and he and his co-defendants then agreed to waive the continuous preliminary hearing.

Hedstrom set the preliminary hearing for the men on Sept. 28 in a department to be determined. He said the preliminary hearing assignment hearing will be held at 8:15 a.m. Sept. 23 in Judge Andrew Blum's Department 3 courtroom. A preliminary hearing readiness conference will be held at 8:15 a.m. Sept. 20 in Hedstrom's courtroom.

With Braden and Lopez dismissed, Stone and Moth remained along with Anderson, as Stone still had to enter pleas on another case involving several alleged probation violations and allegations related to driving on a suspended license, Anderson said later. Moth entered not guilty pleas to all of the charges in the second case.

Hamner said his family is continuing to recover from the shootings, which he called, “a complete ambush.”

“I don't understand it. I just don't understand it,” he said.

According to Hamner, he had never seen Stone or Lopez before the Tuesday court appearance, but he said he saw Braden at his daughter's home the day before the fatal shooting. Hamner said he was going into the home as Braden was leaving.

He said another of his grandsons had been jumped by several individuals in the days before the shooting.

Hamner said he will continue to show up to the court appearances as the case moves forward.

“I will be at every one,” he said. “I don't care if they take it out of county.”

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CLEARLAKE OAKS, Calif. – A local man sustained minor injuries as the result of a single-vehicle collision on Tuesday.

Charles Williams, 77, of Lucerne was injured in the crash, which occurred at around 10 a.m. Tuesday, according to California Highway Patrol Officer Kory Reynolds.

Williams was driving a 1993 Toyota pickup eastbound on Highway 20 near Clearlake Oaks, traveling at about 45 miles per hour, when he went off the road, Reynolds said.

According to Reynolds, Williams' pickup struck a tree before it overturned.

Williams suffered minor injuries to his right arm and head, said Reynolds.

Reynolds said alcohol was not a factor in the crash.

Area resident Johnny Miskill posted on Lake County News' Facebook page on Tuesday his concerns about how the crash scene was handled, noting there were no signs or flares up to warn about it. He said he and others were almost involved in collisions near the scene as a result.

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LAKE COUNTY, Calif. – The trailer for the movie Francis Ford Coppola filmed in Lake County last year has made its debut.

The three-and-a-half-minute trailer for “Twixt” was posted to YouTube on Tuesday, Aug. 2.

Lake County residents will recognize downtown Kelseyville and Clearlake, and “The Woodpecker” shop on Highway 20 in Nice, with its assortment of bat and bird houses and recycled wood furniture.

The gothic horror tale stars Val Kilmer, Elle Fanning, Bruce Dern and Ben Chaplin, and follows the story of a mystery writer's visit to the small town of Swann Valley and his subsequent exploration of a young girl's murder.

According to writer Russ Fischer, Coppola appeared on a panel at Comic Con last month and shared a look at his plans for the film, including presenting parts of it in 3D.

Coppola also plans to take an interactive approach to presenting the film. Fischer reported that Coppola will undertake a 30-city tour later this year in which he and his team will create different versions of the movie depending on where it's viewed and audience reaction.

The movie will have its world premiere at the Toronto Film Festival in September.

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SACRAMENTO – State officials said they are assisting a federal investigation into a salmonella outbreak linked to the possible consumption of ground turkey that has caused six illnesses in California, including one death.

“The California Department of Public Health is actively supporting the federal government’s multi-state investigation of salmonella cases reported and is coordinating with local health departments across California to monitor for additional cases,” Kathleen Billingsley, chief deputy director of the California Department of Public Health (CDPH), said Tuesday.

On Monday the U.S. Department of Agriculture (USDA) and the Centers for Disease Control and Prevention (CDC) identified ground turkey as a possible source of the salmonella contamination and CDPH is in regular contact with our federal partners as the investigation about the source of contamination continues.

To guard against salmonella infection, CDPH urges consumers to thoroughly cook poultry to 165 degrees, wash all surfaces immediately after contact with raw meat or poultry and to refrigerate raw and cooked meat within two hours of purchasing or cooking.”

The illnesses in this outbreak are from Salmonella Heidelberg – a bacteria that is resistant to many commonly prescribed antibiotics.

According to the Centers for Disease Control and Prevention the outbreak has sickened 77 people in 26 states. The illnesses first emerged in March and have been reported as recently as last month.

On Aug. 1, the CDC and USDA identified ground turkey as a possible source of the salmonella contamination.

In California, one fatality was reported from Sacramento County, which also reported one additional case linked to the outbreak. The other four cases were from the following counties: Los Angeles (1), Riverside (1), San Diego (1) and San Francisco (1).

Most people infected with salmonella bacteria develop diarrhea, fever and abdominal cramps 12 to 72 hours after infection.

The illness usually lasts four to seven days and most people recover without treatment. In some cases, however, the diarrhea may be so severe that the patient must be hospitalized.

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