[Senate Hearing 110-800]
[From the U.S. Government Publishing Office]
S. Hrg. 110-800
PATH TO OPPORTUNITY:
JOBS AND THE ECONOMY IN APPALACHIA II
=======================================================================
FIELD HEARING
before the
COMMITTEE ON AGRICULTURE,
NUTRITION, AND FORESTRY
UNITED STATES SENATE
ONE HUNDRED TENTH CONGRESS
SECOND SESSION
__________
OCTOBER 23, 2008
__________
Printed for the use of the
Committee on Agriculture, Nutrition, and Forestry
Available via the World Wide Web: http://www.agriculture.senate.gov
U.S. GOVERNMENT PRINTING OFFICE
48-539 WASHINGTON : 2009
-----------------------------------------------------------------------
For sale by the Superintendent of Documents, U.S. Government Printing
Office Internet: bookstore.gov Phone: toll free (866) 512-1800 Fax: (202) 512-2250 Mail: Stop IDCC, Washington, DC 20402-0001
COMMITTEE ON AGRICULTURE, NUTRITION, AND FORESTRY
TOM HARKIN, Iowa, Chairman
PATRICK J. LEAHY, Vermont SAXBY CHAMBLISS, Georgia
KENT CONRAD, North Dakota RICHARD G. LUGAR, Indiana
MAX BAUCUS, Montana THAD COCHRAN, Mississippi
BLANCHE L. LINCOLN, Arkansas MITCH McCONNELL, Kentucky
DEBBIE A. STABENOW, Michigan PAT ROBERTS, Kansas
E. BENJAMIN NELSON, Nebraska LINDSEY GRAHAM, South Carolina
KEN SALAZAR, Colorado NORM COLEMAN, Minnesota
SHERROD BROWN, Ohio MICHEAL D. CRAPO, Idaho
ROBERT P. CASEY, Jr., Pennsylvania JOHN THUNE, South Dakota
AMY KLOBUCHAR, Minnesota CHARLES E. GRASSLEY, Iowa
Mark Halverson, Majority Staff Director
Jessica L. Williams, Chief Clerk
Martha Scott Poindexter, Minority Staff Director
Vernie Hubert, Minority Chief Counsel
(ii)
C O N T E N T S
----------
Page
Field Hearing(s):
Path to Opportunity: Jobs and the Economy in Appalachia II....... 1
----------
Thursday, October 23, 2008
STATEMENTS PRESENTED BY SENATORS
Brown, Hon. Sherrod, a U.S. Senator from the State of Ohio....... 2
Panel I
Baker, Kevin, former Meridian Employee, Jackson, Ohio............ 9
Demko, Margaret, President, Advocating for the Rights of Citizens
with Disabilities of Southeast Ohio, Albany, Ohio.............. 7
Farber, Katy, President, Highland County Chamber of Commerce,
Hillsboro, Ohio................................................ 5
Panel II
Shuter, Mark, President and Chief Executive Officer, Adena Health
System, Chillicothe, Ohio...................................... 21
Lanier, Sherrie, Development Director, Ohio Valley Regional
Development Commission, Waverly, Ohio.......................... 23
Lewis, Marsha, Senior Research Associate, Voinovich School of
Leadership and Public Affairs, Ohio University, Athens, Ohio... 24
----------
APPENDIX
Prepared Statements:
Baker, Kevin................................................. 34
Demko, Margaret.............................................. 36
Farber, Katy................................................. 39
Lanier, Sherrie.............................................. 43
Lewis, Marsha................................................ 49
Shuter, Mark................................................. 57
Document(s) Submitted for the Record:
Written letter from U.S. Department of Agriculture, Office of
the Secretary to Hon. Tom Harkin with attached fact sheet
on rural development....................................... 62
PATH TO OPPORTUNITY:
JOBS AND THE ECONOMY IN APPALACHIA II
----------
Thursday, October 23, 2008
U.S. Senate,
Committee on Agriculture,
Nutrition, and Forestry,
Chillicothe, Ohio
The committee met, pursuant to notice, at 11 a.m., at
PACCAR Medical Education Center, Kenworth Auditorium, 446
Hospital Road, Chillicothe, Ohio, Hon. Sherrod Brown,
presiding.
Present or submitting a statement: Senator Brown.
Mr. Metzger. Senator Brown, ladies and gentlemen, good
morning and welcome to the main campus of Adena Health System
and to the PACCAR Medical Education Center. My name is Ralph
Metzger. I am the Executive Director of the Adena Health
Foundation, and Senator, we are delighted that you have
selected this new and beautiful facility for the venue for our
United States field hearing. This is very exciting for us.
Thank you to his staff, Jeanne Wilson and David Hodapp, for
helping us with the arrangements, and thank you to Angel
Chitwood here at the Center and Jenny Dovyak of our Marketing
Department for managing all of the details.
The PACCAR Medical Education Center is now only 7 weeks
old. It was the result of the largest capital campaign in Ross
County. This Kenworth Auditorium and the PACCAR name on the
building honors the first $1 million gift, and that was from
PACCAR Foundation. PACCAR, Incorporated, is the parent company
of Kenworth Trucks and Peterbilt Trucks, and, of course,
Kenworth Trucks is our neighbor right across the street.
In this Center, Wright State and Ohio University are
teaching 54 nursing students at the bachelor's degree level.
The majority of these students are currently Adena employees,
or they will be when they graduate. Current practicing nurses
and physicians and technicians are receiving continuing
education here at this facility. Our surgeons and physicians
are teaching advanced skills and best practices to other
physicians and surgeons across the region and across the
country.
This Center features simulation training technology using
the most highly advanced human patient simulators to mimic over
72,000 signs and symptoms. So students learn from their
mistakes on mannequins before they ever touch a human patient.
Every event, every hand wash, every step is recorded by video
for instant feedback. Most importantly, we are showing children
and teens in Southern Ohio that professional education and
professional careers are available in Southern Ohio to enhance
the quality of life and health care in Southern Ohio.
Thank you and good day. We are very pleased you are here.
STATEMENT OF HON. SHERROD BROWN, U.S. SENATOR FROM THE STATE OF
OHIO
Senator Brown. Thank you. Thanks very much, Mr. Metzger,
and thank you all for joining us, not just the panelists, but
all of you that are students, that are employees of Adena, and
that are now part of this fabulous-looking facility, and I am
sure there is so much more, so thank you for that, Mr. Metzger,
very much.
Special thanks to Jenny and Angel for the work that they
did. I know that often they do most of the work and Mr. Metzger
gets most of the credit, but thank you. But he did credit them
very generously, so thank you for that.
Special thanks, too, to Commissioner Corcoran for joining
us and Mayor Sulzer. Thank you. I have heard, Mr. Metzger, I
have heard only good things already about this place, so
congratulations as you embark on your first few months serving
people of Southern Ohio.
The hearing comes to order. This is an official hearing of
the Senate Agriculture Committee. We have done--this is, to my
knowledge, only the second hearing that the Senate Agriculture
Committee has ever done in Ohio and the first one was yesterday
in Steubenville, and this hearing will be to discuss rural
health, as I think all of you know.
Today, we are especially pleased to be holding the event
not just in this part of the State, but holding it at the
PACCAR Center, a building that came about, as Mr. Metzger said,
through the foresight and the hard work and the dedication of
many of the Adena staff here today. Through their efforts, we
are sitting in one of the gems of Appalachian Ohio. Let me
congratulate everyone that has had a major role and a minor
role, too, in the creation of all of this.
This building is of special relevance today because one of
the topics that we will be covering is the lack of access to
health care that too many in Appalachian Ohio face. The
educators that now have an opportunity to teach here at the
PACCAR Center are going a long way to help solve this problem.
The students in the classrooms here today are the desperately
needed nurses and other health care specialists that we all so
much need in the years ahead.
The PACCAR Center is one of the most high-tech, cutting-
edge health care education facilities not just in the State,
but in the United States and in the world, and I understand
that a very small portion of Federal monies were used in
acquiring that technology. This is a perfect example of how the
United States Department of Agriculture funding can lead to
real change and success with huge local effort.
I would like to thank Senator Tom Harkin, who is the
Chairman of the Agriculture Committee, Chairman Harkin from
Iowa, for his support in these hearings and for his leadership
on the farm bill.
Finally, I would like to thank our witnesses, this first
panel, and I will introduce them shortly, and then a second
panel which we will hear from. We will hear testimony from the
witnesses and then ask questions and then we will do the second
panel shortly.
I would like to make a brief statement just about sort of
the purpose of this hearing and what we are seeing and what we
are hearing around the State and what you are also very
familiar with. Small-town Ohio, like the rest of America, is
hurting. Ohio's unemployment rate reached 7.4 percent this
summer, the highest it has been in a decade and a half. Even
prior to this economic downturn, Ohio still had hundreds of
thousands fewer jobs than it had prior to the last recession.
With aging infrastructure, with high unemployment, with
under-funded schools, with chronic access to affordable health
coverage, rural Ohio, and throughout rural Ohio and rural areas
throughout our nation already face daunting economic
challenges. For rural areas, an economic downturn like the one
we find ourselves in now has the impact of a kidney punch after
12 rounds in the ring.
Over one-half of Ohio's counties are rural and there is no
doubt these counties face significant obstacles. Of the ten
counties in Ohio with the highest unemployment, every single
one of them is rural. Of the ten counties in Ohio with the
highest poverty level, nine of those ten are rural. Of the ten
counties in Ohio with the highest percentage of people eligible
for Medicaid, nine of them are rural.
Federal policymakers, frankly, have not devoted enough
attention to rural America. We squander opportunities. We
dismiss unacceptable gaps in the kind of support that allows
families to lift themselves out of poverty and join the middle
class. It is time to instead invest in the tremendous potential
that rural America holds. Investment in rural communities is an
investment in the American economic engine and the American
dream.
We fought for these rural communities and small towns
across Ohio during the writing of the 2008 farm bill. USDA
Rural Development Programs encourage rural business expansion
and job creation and grants to expand, for example, to expand
broadband across rural Ohio. These programs have invested more
than $500 million in over 120 different projects in Ohio over
the past 2 years.
These projects include $700,000 to build a child
development center in Jackson County, the county directly to
the Southeast where Mr. Baker is from; funding for dump trucks
and road maintenance equipment for Pike County would have come
under the farm bill, the county directly south of here; and in
Ross County, USDA Rural Development funded 19 miles of water
lines to rural customers worth almost $2.5 million. Rural
Development provided $1.2 million to finance 60 units of
affordable housing and $4 million for the construction of a new
water treatment plant.
These projects wouldn't have occurred without a farm bill
and without funding for Rural Development Programs. USDA Rural
Development funding can help communities in many different
ways. Some comes in the form of grants to communities for water
and sewer and public safety projects. Others provide loans and
loan guarantees for small businesses and rural housing
projects. These loan guarantees in particular have seen a
dramatic increase in usage during the recent credit crunch.
Some lenders simply won't provide funds to small businesses in
rural housing without the additional security provided by farm
bill Rural Development Programs. The farm bill funds so many
programs that matter to Ohio and we have made important strides
toward providing additional investments in rural areas of our
State.
As Ohio's first Senator to serve on the Agriculture
Committee in 40 years, I will fight to keep these vital
programs alive, to continue them, to enhance them, to ensure
Ohioans living in rural areas receive the kind of support that
will help them thrive. The farm bill provided a needed boost,
but the people in small towns and rural communities clearly and
obviously deserve more. That is why we are having this hearing
today.
Over the past 20 months, I have conducted about 120
roundtables across the State--Ms. Farber was in one, Mr. Baker
was in one recently--where I have listened to 15, 20 activists
in the community just talk to me about concerns and ideas that
they have about their communities. Most of those roundtables
were held in rural Ohio.
The kinds of questions--we hear questions, how can the
Federal Government play a role to help rebuild small towns in
Appalachia and across Ohio? I have heard questions, what kinds
of investments in infrastructure are needed to revitalize our
rural communities and make them competitive in this world
economy? How can we support small businesses who are struggling
in the face of the credit crunch and the uncertainty of the
financial crisis?
These are questions our witnesses will help us answer
today. I look forward to their remarks and our questions and
discussion.
I would close by noting that Randy Hunt, the Director of
USDA Rural Development Programs in our State, in Ohio, was
invited to testify today. The Bush administration did not allow
him to attend. Mr. Hunt is a dedicated and well-respected
public servant to this State, and as USDA Rural Development
Programs play a significant role in addressing the challenges
rural communities face, I know everyone here would have
appreciated hearing Mr. Hunt's perspective on the critical
issues facing our State.
I regret the decision of Secretary Schafer and the Bush
administration because I don't think it is in the best interest
of the people I serve, but today's hearing is too important to
get mired in politics. The hearing is not about the Bush
administration or Republicans or Democrats. It is about people
and communities fighting to overcome daunting economic
challenges. So it is in the nation's best interest to support
their success, and Congress and the administration alike have
an obligation to promote the nation's best interests. That is
not partisan, that is simply a fact.
So I would like to introduce the first panel and then we
will begin statements. Please keep your statement to around 5
minutes. If you go a little over, it is OK. Then I will ask
questions after you are finished.
Our first panel is Katy Farber, who is a native of Highland
County, Ohio. She is a small businesswoman and professor at
Southern State and President of the Highland County Chamber of
Commerce.
Margaret Demko of Albany, Ohio, lives in Athens County. She
is President of Advocating for the Rights of Citizens with
Disabilities of Southeast Ohio, Southeast Ohio Coordinator for
Ohio Consumers for Health Coverage, and serves on the Ohio
Development Disabilities Council. She is a terrific advocate
for her own child and for people needing health care all over
the State and I am particularly thankful for what you do.
And also on our panel is Kevin Baker of Jackson, Ohio, a
former employee of Meridian Automotives, whose workers were
locked out a couple of years ago. Mr. Baker, along with 300 of
his coworkers, lost their jobs. They were locked out for almost
2 years before being laid off and then the plant closed. It is
nice to see you again, Mr. Baker. Thank you for joining us.
Ms. Farber, if you will begin.
STATEMENT OF KATY FARBER, PRESIDENT, HIGHLAND COUNTY CHAMBER OF
COMMERCE, HILLSBORO, OHIO
Ms. Farber. My name is Katy Farber and I am the President
of the Highland County Chamber of Commerce and I appreciate the
invitation and opportunity to present this information at
today's hearing. The USDA Rural Development Programs have
provided support to Highland County in the past and for that we
are grateful. We are, however, in need of an increased
assistance in light of the economic realities of today and the
looming economic devastation of the pending DHL decision to
close its Wilmington, Ohio, hub operation.
The current economic downturn is affecting each sector of
our country, but is having what many believe is a
disproportionately negative effect on rural Southwest Ohio, and
in particular Highland County. The issues are many and cut
through each sector that make up our local economy.
Local tax revenues and the fees that are collected for the
general fund are down, limiting the ability to meet the
increasing demands on a county and local government level to
provide services. This severely affects the day-to-day
operations of law enforcement, the courts, and all departments
dependent upon both county and municipality revenues.
From the first quarter of 2007 to the first quarter of
2008, Highland County had the highest percentage of jobs lost,
6.2 percent, of any county in the State, according to Job and
Family Services statistics. The decline in employment
opportunities and the thousands of pending job losses is
forcing families to choose what bills can be paid and what
available cash must be used to take care of the family's basic
needs. Foreclosure rates continue to increase, climbing some
300 percent over the last eight to 10 years.
Many people are becoming desperate. Local agencies, a last
resort rescue resource for many citizens in our area, are
seeing increased demands for goods and services while being
faced with lower contributions from both Federal funding
streams and the private sector. The result is straining the
resources and limiting the ability to help our neediest in the
county. For example, Highland County Community Action
Organization served 27 percent of the Highland County
population in 2007 and has seen a significant increase in new
families served in 2008.
The impact on small, local businesses, those employing five
to 15 people, is marked in Highland County. Within the last 2
months, we have lost at least seven storefront retail
operations because of the slow economy. Bankruptcy has closed
the door of a small manufacturer and threatens others. A long-
established restaurant shuttered its windows, unwilling to risk
reinvestment in upgrades when patronage continues to decline
due to the economy. An upstart manufacturing operation eager to
open a new facility and add jobs continues to be caught in a
battle with EPA regulations and requirements that keep it from
opening operation. The ongoing struggle for many small
businesses to borrow funds for operation due to the tight
credit market is significantly affecting commercial competence
and growth.
Highland County also has a large agriculture industry.
Grain producers faced a 100 percent increase in crop output
costs for 2008 and now face a 50 percent drop in grain prices.
This will devastate a significant number of family farms. The
impact will compound the current financial problems for local
businesses.
Beyond the economic recession that is affecting all of this
country, and beyond the struggles we face as a rural American
county, Highland County is bracing for the significant impact
of an additional job loss from 20 percent of our total county
workforce should DHL realign its Wilmington operation. Over
1,800 Highland County residents work at the Wilmington Air
Park, directly employed by DHL, ABX Air, or ASTAR. Add to that
the additional job losses directly or indirectly related to the
$54 million loss to our local economy and that situation
becomes grim. Our hospitals, already taxed with a 9.5 percent
increase in uncompensated care, may be pushed beyond their
means to stay in operation when additional residents no longer
have health insurance. There will not be a social service
agency or municipality and county operation that will not be
affected by this financial catastrophe.
When we examine the greatest areas of needs within Highland
County, they all certainly lead to the all-encompassing
category of economic development--the ability to attract and
retain business and industry to provide good-paying jobs for
our citizens, stabilize the local housing market, support the
education systems throughout the county, and contribute to the
overall tax base of our local communities and Highland County.
To compete for business and industry opportunities, we need to
be able to level the playing field.
Rural Highland County, like its neighbors, needs assistance
with six specific areas: Community infrastructure, broadband
availability, health care access, education, transportation,
and marketing. My written testimony details specifics about
these challenges and I invite everyone to review those points.
Without the continued support of the USDA Rural Development
Programs, Highland County will not be able to weather the storm
that we currently face. In Highland County, as in many parts of
rural America, economic development is the difference between
the hope of prosperity or continued decline. I urge this
committee to work to increase the investment in rural
initiatives that support the infrastructure upgrades, health
care access, educational support, broadband capabilities, and
specific economic development programs, including the
marketing, that connect rural entities to the opportunities for
commercial and industrial development.
Thank you.
[The prepared statement of Ms. Farber can be found on page
39 in the appendix.]
Senator Brown. Thank you, Ms. Farber.
Ms. Demko.
STATEMENT OF MARGARET DEMKO, PRESIDENT, ADVOCATING FOR THE
RIGHTS OF CITIZENS WITH DISABILITIES OF SOUTHEAST OHIO, ALBANY,
OHIO
Ms. Demko. Good morning, Senator Brown. I am honored to be
able to speak with you here this morning in Chillicothe.
As you mentioned, my family lives in Albany, a small
village in the west corner of Athens County. We as a family are
one of the 8,900 families in Athens County that do not have
access to health care coverage. My daughter with Down Syndrome
does not qualify for Healthy Start, and as a family, we are
unable to purchase private coverage due to several preexisting
conditions.
When I speak about my family's access to care, obviously, I
speak first about Emily. She needs intensive speech, physical,
and occupational therapies to help her reach her best
potential. When I looked for these facilities in the Athens
area, I found only Ohio University for physical therapy and
speech, and there the therapists are grad students who change
every 3 months as their school schedules change. This was not
the answer for Emily and she still needed occupational therapy
for her fine motor skills. Those skills would be being able to
hold a pencil, turn the page of a book, put a sticker on her
shirt.
As a family, my husband and I looked into Nationwide
Children's Hospital Therapy Services in Columbus. While a long
way from home, we knew this was the best place for her to get
the start she needed toward reaching her best potential. We
signed her up for therapy, taking on the out-of-pocket expenses
of each therapy, but also the total cost of getting there and
being there for the day. There was 77 miles of travel one way,
with gas at astronomical rates. We sold our van, bought a
compact car to try to fight the costs. I tried packing a lunch
for us since the costs of eating out were also hurting our
budget. But my daughter has particular eating issues, so
packing food became too difficult as she grew.
All in all, the trips each week would cost us over $500
when all therapies, food, and gas were added together. I
consider my family to be one of the lucky ones, since we had
the gas money to get where we needed to be for Emily and we
were able to essentially run a tab of therapy bills at
Children's Hospital. We kept this up for over 2 years until
school-age therapy services were able to kick in.
We also were able to take her to Nationwide Children's
Hospital for developmental disability clinic appointments,
where an issue with her eyes was caught, a blood test to rule
out thyroid disease was completed, as well as the need for
orthotic shoe inserts was found. This essentially is a one-stop
shop for services for children like Emily. There are clinics in
rural health departments, but there are no areas that have all
the tests be able to run that day on the spot.
My daughter is not the only one who has had issues
accessing the care she needs in her own backyard. My husband
has a history of severe kidney stones. When he had an attack
this July, I chose to drive him 35 miles right here to Adena
Medical Center when he was working right around the corner from
an emergency clinic. Someone asked me why I would choose to do
so. I couldn't imagine the bill that would come to an uninsured
person from a for-profit clinic who has no program to assist
financially. I ran a huge risk of my husband passing out or
having something more serious happen to his kidneys, but I knew
that as a family, we could not take on a bill of several
thousands of dollars and be expected to pay it within 30 days,
as had happened to us in the past.
Senator Brown, I am not the only family that lives in
Southeast Ohio that has trouble accessing health care and
health care specialists. I live in an area where two adjacent
counties, Meigs and Vinton, do not have an emergency room or an
emergency clinic within 25 miles. Meigs County does not have
911 services. The vast amount of these counties are remote
areas where most folks do not have the most basic of services,
let alone the gas money or proper transportation to get to that
life-saving clinic.
Yet another health care issue that hits Southeast Ohio hard
is dental care. There are very few dentists. Athens has some
dentists, but some won't take Medicaid, some won't take
uninsured without full payment, and there are no pediatric
dentists at all. Again, we have to head north toward Columbus
for that service.
This is a health care issue that can reach well beyond oral
health. When there are oral health issues, sometimes there is
missed work or school, systemic infections, and many other
serious complications. All that aside, it is always harder to
move forward with a job interview or with a school presentation
if you are missing teeth or experiencing extreme halitosis.
When we talk about access to services, there are so many
more things to consider than the immediate health of the
children and the adults in my hometown areas. If Emily doesn't
get speech therapy this week, it won't hurt her immediately.
What it will do, however, is potentially slow down her growth
in her ability to speak. Not having adequate occupational
therapy will not harm her immediately, either, but eventually
her inability to stick a sticker on her shirt, stack blocks, or
color with a skinny marker may turn out to be something that
stops her from reaching her potential.
Simple skills like this are building blocks for life skills
she would use every day for the rest of her life. She needs
these skills so she can speak intelligibly enough to be able to
ask for what she wants, write her name, turn the page of a
book, punch the buttons on a calculator to balance a checkbook,
or even hold down a good job. All these services are connected
to her future. Many other families are also experiencing the
same, yet are unable to reach the services they and their
children need.
I work every day in my line of work to find and talk to
families just like mine who are having issues accessing health
care. I assure you, Senator Brown, that my family is not
unique. I get calls almost every day from folks much worse off
than my family that are trying to figure out what they can do
to get their family the care they need without the ability to
travel outside the area. I have made this work my life passion,
to listen to, advocate for, and try to direct to the right
people these families that are in crisis with their health. I
am sure that it is reassuring to talk to someone like me who
also lives these issues every day, but we need to do more than
talk. We need to find a solution to the access and cost issues
in this great and beautiful part of Ohio.
As a family, we make hard choices every day about our
health care and we provide everything we can for our daughter
and for each other since we know that healthy parents raise a
healthy child. What we need is a government and a President on
our side to help us. We are willing to put into the system what
we can. What we need is the door to be open and make sure
health care is affordable, achievable, and accessible, not only
for my family, but so many thousands just like us.
Thank you.
[The prepared statement of Ms. Demko can be found on page
36 in the appendix.]
Senator Brown. Thank you, Ms. Demko.
Mr. Baker.
STATEMENT OF KEVIN BAKER, FORMER MERIDIAN EMPLOYEE, JACKSON,
OHIO
Mr. Baker. I would like to thank you, sir. It is an honor
and a privilege. April 21, 2006, 300-plus workers at Meridian
Automotives here in Southeast Ohio were locked out of their
job. Some people had worked there over 30 years, most right out
of high school. There were many married couples who both lost
their job at Meridian. Most of us had family working in this
factory. I myself had seven relatives who worked at Meridian
Automotives.
We worked 6 days a week mandatory and the maintenance crew
7 days a week. We were all dedicated workers, responsible
workers who took pride in their job. April 21 changed that
immediately. Our lives changed when the company brought in
immigrants to do our job, some found to be illegal.
We stood on the picket line for the better part of 2 years.
Along the way, many tragic events would unfold. Pretty much all
of us began to lose our self-worth. The pride we had in working
6 days a week and providing a living for our loved ones was now
starting to die off. After a year on the picket line, a beloved
union brother took all he could take and ended his life with a
gun. None of us had seen this coming, especially from this man.
Families started to lose their homes within the first year.
Depression set in with many of our union brothers and sisters.
Pretty much everyone lost their health care unless provided by
a spouse not working at Meridian. To this date, many of the
workers have not found work and the ones in their 50's and 60's
may never find a job in this area or affordable health care.
Some of the people who lost their job at Meridian now work as
far away as Cincinnati, and for some, the coal mines of West
Virginia.
What we need, Senator, is broadband in our area so people
can search the job sites and educate themselves on what we
could be doing in our area and the surrounding area to provide.
Many of us have family right here in Southeast Ohio and don't
want to move to the city just to have high-speed Internet or
more job opportunities. We need jobs here in our part of the
State and we need them now.
Some of our union brothers and sisters have gained
employment at the local Wal-Mart starting at minimum wage or
just above that. Many of us were educated right here in the
Appalachians, and for many of us, we are behind the times when
it comes to joining today's workforce. We live in the richest
country in the world, but right in the heart of it all are the
Appalachians, where I have witnessed the destruction of over
300 lives.
We need help here and we need it now. We are the heartland
and we want to work. We need jobs in our area and we do need
them now. We need affordable health care and someone to help us
with our bills so we can go to school and get the education we
need to survive in today's world, and we need job training.
Broadband would help with that, with the online degrees and the
online schooling.
I don't want to see anyone else lose their home or, even
worse, lose their life because of this. We are asking for your
help here in the Appalachians of Ohio. We need work. We need
our self-worth back. And we want to work. We know what it takes
to survive and we need your help to regain our belief system in
not only ourselves, but in our leaders and our elected
officials. Please bring our area up to date with broadband and
bring businesses to our area. We believe we can do anything,
but we do need your help getting started once again. There are
simply no jobs here in Southeast Ohio and these are desperate
times.
Senator Brown. Thank you, Mr. Baker.
Mr. Baker. Thank you, sir.
[The prepared statement of Mr. Baker can be found on page
34 in the appendix.]
Senator Brown. Thank you for being with us.
All the statements will be in the official record. If any
of you wants to add anything--you had said, Ms. Farber, you
have a written statement that may be longer. If you can just
let us know all that. Joe Shultz in the second row there staffs
the Agriculture Committee for us. He is joined here by Beth
Thames, Dave Hodapp over here, and Jeanne Wilson, who may still
be outside in case anybody else arrives late.
Thank you all for your testimony.
Ms. Farber, let me start with you. You had said that 27
percent, if I heard you right, 27 percent of people in Highland
County have gotten some services from Community Action. Would
you outline those? I know LIHEAP and some nutrition. Tell me
what exactly that is.
Ms. Farber. It goes the gamut of whether it is heat
programs, there are Gator [ph.] programs, a dental assistance
program, just things that supplement our social services system
in the State, but it is also financial counseling, different
things that homeowners can come in to access. Ohio now has a
benefits bank and Community Action is completely--I think they
have 27, or 20-some trained staff members that can reach out,
and some of the services involve connecting so that people who
have never had to come for help who we are seeing come in the
lines more than ever know where they can go.
But the President, or the Director of Community Action--we
are caught between a rock and a hard place because some of the
people we--she has to almost say, ``You are not poor enough.
You are not poor enough to access the programs that we can
offer you,'' and almost have to say, try another 90 days. So we
are forcing people just to go down to the lowest levels without
giving them some assistance along the way.
Senator Brown. So is your recommendation that Community
Action be given sort of a wider scope of ability to serve, I
mean, not just more appropriations perhaps, but given a wider
range of what they are allowed to do?
Ms. Farber. Well, that would be wonderful, yes.
Senator Brown. Well, what specifically would you----
Ms. Farber. Specifically--you know, you kind of caught me
off guard here, Senator, because I can't really speak for all
of the Community Action Programs, but yes, I think that the
scope needs to be--the income levels at this point, because do
we have to let everyone, especially those who are--there are
people losing their jobs in the Wilmington Air Park because
they can't afford--they have not been laid off or warn noticed.
They can't afford to keep going to work because the hours have
been cut back so dramatically. So now they are coming to look
for assistance. Well, their previous 12-month employment, their
tax records show that they are earning a good living. So you
can't give them that money right now and they are----
Senator Brown. And come next year, they wouldn't be earning
a good living. I mean, they are not now, but it would show
then. Are there significant, already, ASTAR, ABX, and DHL
employees that have lost their health insurance?
Ms. Farber. There are significant and growing numbers every
day of those employees who are being forced to walk away from
the job because they can't afford to stay there for their
families.
Senator Brown. So where are they going?
Ms. Farber. Some are leaving. Some are just picking up
part-time jobs. But yes, if they walk away, they have no
unemployment. I mean, there is no compensation.
Senator Brown. So DHL--my understanding, and I know a lot
of people in Clinton, Highland, Adams, Brown, the whole region,
Montgomery, Clark, Green, that work there. Some number of them,
I know, are farmers that work whatever number of hours to get
health care. What is that requirement? How many hours must they
work to get insurance? Is it 20 or 30? It is----
Ms. Farber. The formula--it was about 28. The formula is
changing, of course, as the scene changes up there, but it was
mostly night sort operations, so it would be four or five
nights a week, five or 6 hours a night, depending on the load
required, and then they would have full health care benefits.
Senator Brown. So the impact obviously of closure of those
8,000 jobs would be as heavy in rural areas as it is in cities
and communities, right?
Ms. Farber. The exposure--the estimated exposure for this
closure, if we will call it that, to the health care systems in
the immediate Highland, Fayette, Clinton region is $63 million.
That is what it will take out of the health care system for
those uninsured.
Senator Brown. What is the Chamber of Commerce doing and
what is the community doing as the Governor and I and others
fight this job loss? We are not giving up yet and it is
definitely not over yet. But what--and as I think you know, we
have gotten someone from the Department of Labor and we have
gotten some people in the administration--the Bush
administration has been cooperative on this--to prepare if that
happens. What are you doing? What is the Chamber doing? What is
the community doing overall in Highland County specifically on
preparing if this job loss happens?
Ms. Farber. Since the beginning of June, we formed our own
local, and I shy away from the term ``task force'' because it
just--but we have our own local group that works closely with
the official DHL process of local communities, but on our own,
we are making plans. We have the faith-based community
involved. We have talked to our lenders as a group, our health
care providers, trying to get them to lay on top of our current
situation in the economy what this will mean. We have got to
exist. Our county has to make payroll. We have to keep our
courts going, our law enforcement. So we are reaching out to
try to build the reality that could come to us very soon.
The Economic Recovery Coordinator that we are waiting to
come, that EDA has funded, we are trying to align--the Chamber
is trying very much to work with the county commissioners and
other entities to align an economic development strategy that
will be able to take advantage of this person who is helping us
recover in the area to attract and retain.
Senator Brown. It strikes me that--I mean, I have seen good
cooperation among the commissioners in each county with each
other, so this is sort of two-pronged, if you will. One, what
do we do to help people that are losing jobs in terms of
providing services, and second, what do we do to grow the
economy to displace as many of these jobs as we can with other
kinds of jobs. So you feel comfortable that proper attention is
paid to both?
Ms. Farber. We are getting there. We can use all the
support we can get.
Senator Brown. No, I understand.
Ms. Farber. And expertise. You know, we are not really
high-end at this. We are a county that has no four-lane access
and we have a very limited budget. So any resources and
expertise that can come to the table to help us plan for the
future--we will have to take care of the people who are--our
county residents that are caught in this, and I believe that we
our county can rise up to do it because that is the way we do
it in Appalachia. But for the future, we need to be able to
compete with everybody else who wants businesses to come to
town. So that is, I think, in the pipeline and we are aligning
to that and we just hope that it continues.
Senator Brown. I have noticed from DHL, ABX, and ASTAR that
it is not unlike Meridian, I mean, much bigger, but not unlike
Meridian in that a lot of husbands and wives both work there. I
saw what happened in Meridian when husband and wife both lost
their $13 or $14-an-hour job and kids couldn't go to college
then and kids stopped right at the end of the semester and all
of that.
One last question. What do you make of the delay in not
signing the agreement between DHL and UPS?
Ms. Farber. I think a good business proposition is not
looking so good anymore perhaps, frankly.
Senator Brown. Is that cause for optimism for us?
Ms. Farber. Not necessarily.
Senator Brown. OK.
Ms. Farber. To be candid, I don't think so. I just want to
segue back just 1 second to something you said, husbands and
wives and families. I made a call to our domestic violence
agency that covers both Clinton and Highland County in our
case. They have already seen a 20 percent increase in cases
since the May 28 announcement and nothing has really happened,
because the people who had been warn noticed have been given
severance packages. They are entitled to unemployment
compensation. They have some assistance. It is the strain and
stress of wondering when the shoe is going to drop.
Senator Brown. A 20 percent increase in domestic violence
reported cases since May. That is Highland County only, or that
is----
Ms. Farber. That is Clinton and Highland, and it is
predominately Clinton. But they have three times as many--their
workforce is three times as affected there.
Senator Brown. Are you prepared, and I am going to ask Mr.
Baker this in a moment, too, but are you prepared for the
mental health counseling and all that? Are the agencies in
Highland and Clinton, the two counties I guess you know best
about this, are they prepared for the onslaught?
Ms. Farber. They are trying.
Senator Brown. OK.
Ms. Farber. They are at the table. We talk very openly
about what we are going to need. And again, they are stretched
because of cuts in funding as they are, and the people that we
are going to need to help don't have any money in their
accounts to pay for those services.
Senator Brown. OK. Thank you. Thanks for your service.
Ms. Farber. Thank you.
Senator Brown. Ms. Demko, thank you for telling your story,
and every time I have heard you tell it, it is so moving. Thank
you for that.21If you have a child with disabilities and you
aren't as worldly as you are, say, and you aren't as
knowledgeable about this and you don't have as many connections
as you have built over the last year-and-a-half since I first
met you, year-plus, where do you start? If a parent, a couple
of parents have a child that is disabled and they are looking
for help and they don't know Margaret Demko and they don't know
people in the county seat, where do they start? What is the
first thing they do?
Ms. Demko. I think the first thing they are going to do is,
sadly, sometimes Children's Services ends up at their doorstep
because someone sees that they are not helping their child. And
then possibly Help Me Grow will get involved, and through Help
Me Grow, they tend to find services for them, and that is
really Help Me Grow's job, at least in our county, is to help
these folks walk through the system and figure out who it is
they need to contact next, which district are they in, and
which school district can help them, what services are
available for them right now.
Before I started looking on my own, when Help Me Grow came
to my home, they didn't know where to send me for speech
therapy. They didn't know where to send me for physical
therapy. And they found OU and it just wasn't the right fit for
us. And so I am afraid that what happens is these kids don't
get the services that they need until they are school-aged
because then the school finds the problems. The school calls
home and says, we need to have an Individualized Education
Plan, or an IEP, and by the way, we are going to put your child
into services. We are going to put them into speech therapy.
But in our district--in Athens County, there are five
school districts, not including Athens City Schools, and there
is one physical therapist, one speech therapist, and one
occupational therapist to serve all of the children with
disabilities or needs in that entire county. My daughter gets
less than 20 minutes of therapy a week, and most of that is
group therapy because there are three other children in her
class that need the same therapy services.
So I am not sure exactly where these parents go. My hope is
that they start to look and they start to ask questions,
because broadband is not available in a lot of the areas, so it
is not easy to just jump online and take a look and try to find
where they need to go.
It is scary. I have met families who have just let--they
didn't realize there was a problem until they got to school,
and then sometimes some of those problems are harder to
overcome and harder to break through when you start at age
five, when they could have been in school at age two-and-a-half
or three, because there are services available.
Senator Brown. When did you start with Emily?
Ms. Demko. I fought to get her into school. This is her
first year that she is in school. She is three. She will be
four on Election Day. And I fought to get her in school. I
fought eight different child care providers to allow her to
attend half an hour a day so that she could get socialization
programs, because there are no play groups or places that
accept children with disabilities in our area. I finally found
a church that was willing to let me come in, but it was very
strict rules and lots of questioning and issues with her having
a disability. And so I found someone who welcomed me in Albany.
So I started this past summer with her going 3 days a week. But
now she is in public schools.
Senator Brown. So the biggest, it sounds from piecing
together what you said, the biggest hole in coverage and care
and help for children with disabilities is prior to their first
year in school. That is when we just--our society doesn't reach
them very well.
Ms. Demko. That is my experience.
Senator Brown. That is your experience.
Ms. Demko. That is my experience, being that she is only
four. However, with folks that I work with, I also see a huge
gap happen after they are out of school, because what happens
to these folks once they are 18? Where do they go? What do they
do if they don't qualify for sheltered workshop or they don't
qualify for any of the other programs that the county might
have? What happens to those folks then? Are there social
support networks? Do those things happen? I don't have the
answers to that because I am dealing with the early childhood
situation.
Senator Brown. And I know the fear--I have talked to a lot
of parents--the fear they have that they are going to go before
their disabled child----
Ms. Demko. It is a huge fear.
Senator Brown. and just the fear that you live with your
whole life, I assume.
Ms. Demko. It is a fear that my husband and I have. What
happens down the lane, because we don't have any other
children. So what happens to her? What support network is out
there to help take care of her if she is able to be
independent, which that is my hope and she is on that road, but
she is still going to need some support. And who is it, and is
that program going to be funded in 16 years when she needs it,
or however long that takes? It is a huge fear.
Senator Brown. Can you imagine and try to share with us
what Emily would be like today if she hadn't had the early
intervention you did? Can you contrast that? Can you see that
at all clearly----
Ms. Demko. I can----
Senator Brown [continuing]. By looking at other children
and looking at her progress and all? Share that with us.
Ms. Demko. I can. It took me 13 months to come to grips
with the reality that I had a child with a severe disability,
and during that 13 months, I did not have her in any program by
choice. I was in great denial. She was not sitting up. She was
not doing those developmental milestones that she should have
been doing by the age of 13 months.
When I started looking into services and getting the
services, that I finally pulled myself up by the bootstraps and
said, this is what she needs, she walked before she was two,
which is not a feat--it is a huge accomplishment for a child
with Down Syndrome. She is only 36 inches tall at almost 4
years old and she walks without tripping. She walks without
braces. She does things that I was told she would absolutely
100 percent never do.
Senator Brown. And that would not have happened if you had
not done----
Ms. Demko. I don't believe it would have. I don't believe,
if I had not went out there and looked for the services that I
needed and found what I needed and found the right answers. You
know, it was because of asking questions that I put myself on
the board of Developmental Disabilities. I found out about the
Developmental Disabilities Council in Columbus. I needed the
answers and I wanted access to services for her because she
deserves that and she deserves as much access to everything
that she needs to make her gain to her best potential.
She right now uses about 75 vocabulary words and over 100
signs, sign language, American Sign Language, and I just don't
believe that that would have happened if we had not had some of
the intervention and the access that happened with Nationwide
Children's and with some of the local folks that just talked me
through things.
So I think I would have a 4-year-old who would be very
disabled, still wearing the braces that she started wearing,
possibly not chewing and eating the way that--you know, she
eats just like every other little 4-year-old, hot dogs and
chicken nuggets and what not, and I don't believe that all of
that would be happening for her today.
Senator Brown. She is a lucky little girl to have you as a
mother.
Let me ask one other question a bit different from that.
Ms. Demko. Sure.
Senator Brown. It strikes me that one of the biggest gaps
or holes or problems in our health care system is the lack of
availability, particularly in rural Ohio, but also inner-city
and also any kids that are relatively low-income, is the hole
in dental care and the effect that that has on--there is a
clinic in Cincinnati, a federally qualified health center, that
has done a lot of work. They have expanded their coverage, if
you will, to dental care, and mostly in low-income areas. One
of the things they have done is working not just with children,
but working particularly preventive care with children.
They showed me pictures 1 day of a young, very handsome
young man that had just found his first job. He was 22 or
something. And they showed a beautiful smile, and they showed
the same picture of this young man before he had dental work,
and he had terribly discolored teeth, missing teeth. They just
talked to me about his difficulty in finding a job when he
looked that way versus after his surgery. I mean, it just gives
you such impetus. We have got to do better with children's
dental care.
Talk to me about disabled children's access to dental care.
Is it even more severe than low-income children generally
getting dental care?
Ms. Demko. Generally, yes, because there is more challenges
that you face with a child with a disability. They may not
understand what is happening when someone comes at them with
the instruments. It may be difficult to hold them down or to
restrain them. There is not a dentist near us and I am ashamed
to say that Emily has not seen a dentist for several reasons.
First, because I just don't think she can handle--I don't think
I can find a dentist that can talk to her----
Senator Brown. You would need a pediatric dentist, for
sure----
Ms. Demko. I would need a pediatric dentist, for sure, and
I would need someone who would have had experiences with a
child that small with a disability, a cognitive disability. You
know, I just don't--everything becomes more complicated when
you throw in a disability, whether that be cerebral palsy or
Down Syndrome or autism. Everything becomes--there is another
stumbling block to get through. And sometimes--you know, there
are some doctors and dentists who will not accept a child with
a disability because they don't have the experience and they
don't want to deal with that.
So not only would we have to go--from Athens, Pickerington
is the closest dentist. I am not sure how many miles that is,
probably about 60 miles. That is the closest pediatric dentist.
From there, then you would have to go to Children's.
When I was at the developmental disability clinic, they
actually told me that they would possibly have to put her under
some type of sedation in order to get the dental work done, or
even looking and cleaning her teeth, and I am not sure that I,
first, want to take on that. That is a huge expense, to put a
child under sedation, but it is also a huge risk to put a child
under sedation, and so it is very--there are definitely some
more things that have to happen when you have a child with a
disability. You have to explain it and sit down with it and
figure it out, and I think that there may not be many dentists
that have that kind of wherewithal.
We also have FQHCs in our area and they have expanded into
dental care in Meigs and Vinton County and they have seen a
huge up-rise in how many folks come to see them.
Senator Brown. Thank you.
Mr. Baker, I first apologize that some of the questions I
asked you at the roundtable, I may ask similar questions of you
because I want your comments on the record, if you would.
When the 300 of you were locked out in 2006----
Mr. Baker. Yes.
Senator Brown [continuing]. What were you told? Did the
community reach out in terms of mental health services, in
terms of food banks or Food Stamps, in terms of what options
you had for health care? Did you personally, and you said you
had several family members there and other coworkers, did you
get anybody reaching out to you much?
Mr. Baker. Well, mostly, it came on the picket line, people
coming by giving money, giving food. As far as the reaching out
for mental health, no, that was not there. I don't know why.
Like I told you in my statement, we had a man who took his
life. He went out trying to find other work. He was in his 50's
and just he couldn't take it and he ended his life.
Senator Brown. Well, you told us at the roundtable how he
loved his job.
Mr. Baker. He did. He loved his job and he was a good
person, too. He was a deacon in his church and just a good man,
you know, the kind of guy that whistled while he was at work,
whistle while you work. He was just a good man. And it was very
tragic, because I knew him personally. I knew his kids. He was
a wonderful father, a wonderful person. To think that it got so
bad for him mentally that he would end his life, it still
troubles me today because I see it in other people that worked
there. I see them defeated. I went through a bout of it myself.
I went through disbelieving in the system. I didn't understand
how a company could just up and leave with really no recourse.
It is like they just kind of got away with it.
Senator Brown. So they first--in the middle of the
contract--you are a steelworker, right?
Mr. Baker. Yes, a steelworker.
Senator Brown. They locked you out in the middle of the
contract, brought in replacement workers, and then over time
then shut the plant down a year and a half later, or 2 years
later.
Mr. Baker. Well, first, they replaced us with immigrants,
if you don't mind, and then after about 2 months of that,
because we were told that they had to have translators for the
people they had brought in, and that wasn't working out, so
after about--I think it was about 60 days, they started hiring
locally, and even some of the local business owners sent their
workers in, construction, to actually help this company finish
up and move out.
It was very discouraging to see the staples of our
community actually help this business finish and leave, you
know. It is like we didn't matter anymore, the 300 people that
were probably using these construction companies to do things
for them, hiring them out, and the local businesses that we
were all a part of by being in that area. Some of them turned
on us. Now that company is gone and those staples of the
community are still there, the ones that helped this company.
Some of them sent their maintenance workers in to help them
tear down the presses, to get the presses out of the factory.
It was hard, because I have known these people myself. I am
40 years old and I have known a lot of these people there most
of my life. To see the ones coming in and out of the picket
line and telling us the things--I have kids, I have this, I
have that. It was discouraging.
Senator Brown. I remember at the picket line 2 years ago,
the busses were either painted--the windows were either painted
black----
Mr. Baker. Yes, painted.
Senator Brown [continuing]. Or there was something black
over them, a curtain or something, or paper or whatever. So
later on, you knew who was crossing the line and you knew who--
--
Mr. Baker. Yes. After a while, we began to know. Yes, I
knew----
Senator Brown. And they were people you grew up with?
Mr. Baker. I would say as many as 70 percent of them, local
people----
Senator Brown. What are they doing now, those replacement
workers?
Mr. Baker. Some of them were actually--you mean the people
that replaced us?
Senator Brown. Yes.
Mr. Baker. Some of them were actually even granted
unemployment benefits, which, I mean, I don't see how that
worked. But they didn't go through the rigorous beforehand, the
drug tests, the--it was just a lot of training involved to do
what we did. We ran big presses and they were just bringing
these people criminals, like I told you, immigrants, anybody
that they could get in that building, and some what I would
have thought were good people beforehand. They just were
replacing like we were nothing. Like I said, some of us had
been there--well, I was there 10 years, but I have got a
brother-in-law who was there 25 years, other relatives that
were there as long as 30 years.
Senator Brown. They were making $12, $13, $14 an hour?
Mr. Baker. We were up to just over $14 an hour.
Senator Brown. With a 401(k)?
Mr. Baker. Yes, a 401(k).
Senator Brown. And some decent health benefits?
Mr. Baker. Yes. The health benefits were good. They did
diminish over time because the company was originally Goodyear,
and Goodyear is a bigger name, bigger business. And then
another company called Cambridge bought it. It was only around
a couple of years. Things started to diminish starting with
them. And then when Meridian took over, they basically wanted
rid of our union. They wanted to get rid of the 401(k)--
matching the 401(k), it was. The treatment changed. We went
from being able to help each other, having steak dinners to
raise money for someone that might be having trouble in the
plant, to when Meridian took over a lot of that did go away.
They didn't support us as much as Goodyear did, if that makes
any sense.
Senator Brown. It does. Let me ask one more question. You
said at the beginning, when you talked about Mr. Parker and--
that was his name?
Mr. Baker. Yes, Steve Parker.
Senator Brown [continuing]. And how much he liked going to
work. Talk to us about that. One of the things I think the
public misses and that I hear more and moire in these
roundtables and just talking one-on-one to you is people's
sense of self-worth. When a plant closes, it is not just loss
of income, loss of health care, family problems, communities
having to lay off firefighters and police, as Ms. Farber said,
what happens to the whole income of the----
Mr. Baker. It is like dominoes. It just----
Senator Brown. But even more than that, what I don't think
we think about enough is sort of people's self-worth, that work
is such an important part of our lives, no matter our job. Even
if we don't always like our job, it is still such an important
part of our lives. Talk about your sort of feelings and what
you saw from others as they lost their jobs and as they were
locked out----
Mr. Baker. Well, immediately, I started seeing people lose
their homes. I know a family of four that lives in a camper on
his mother's property because he couldn't keep up with his
bills. He is still living in that camper, two-and-a-half years
later, on his mother's property. Coincidentally, his mother
retired from that company.
But with Steve, like I said, I mean, he brought me and my
wife firewood while working. He was just a community man and a
really good man. He whistled gospel songs while he was loading
the wood out of his truck and stacking it for us, just a
friendly man. To think that he went from that to putting a gun
to himself and shooting himself is hard to me really to fathom.
I can't even imagine where he must have been at that time.
I do wish he would have reached out to us. I was told that
he did reach out to get help in like a mental treatment
facility and they put him on medication, and I guess the
medication just made him feel weird. That is what his family
told me, that it just kind of made him feel weird. Within 2
days of coming out of that facility is when he took his life. I
do wish he would have reached out, but he had so much pride, I
don't think he wanted anyone to know how much he was suffering.
His son has taken on a business and his daughter is a nurse. I
mean, he was a good father. You get that stuff from having a
good support group, and that is what he was, was a support for
his kids. Not having that, I told them, I want you to know how
lucky you are to have had such an, if you don't mind, an
awesome father, because I didn't have that. I never had that
and I have always envied that. To see where they are because of
that support system was a beautiful thing and I didn't want
them to focus so much on his loss as the fact of how lucky they
were to have had such a great father. I envied him for that. I
don't know if envy is the right word, but I sure would have
liked to have had that myself. But Steve was a good guy.
I see families losing their health care, like you mentioned
there. Some of the people had to pull their kids out of college
because they couldn't afford the next semester. I am still
seeing that. I talked to a man the other day who is in his
50's. He can't find work. No one wants to hire him. I am seeing
that a lot still in our area. A lot of people cannot find work,
especially the older ones.
I myself am 40 and I am having trouble finding a good solid
job. Telemarketing, I am doing some carpentry work. I lost my
self-worth, too. I felt good, even, like you said, I didn't so
much like it, but there was a pride in getting up and working 6
days a week that they just took away from us in the blink of an
eye. It has been very devastating for the community, even the
pizza shops and the things right around Meridian there. They
have told us they are hurting now because we don't work there
anymore and the building sits there empty while they lease it
and do nothing with it. There is a lot to it.
Senator Brown. Thank you. My wife said after the roundtable
when she talked to you, she told me what a good father you are
because----
Mr. Baker. I have a son with spina bifida and my heart goes
out to you. You seem like an awesome mother.
Senator Brown. But as Mr. Parker was a very good father for
his kids----
Mr. Baker. A great father.
Senator Brown [continuing]. My wife was convinced you are
for your son, so thank you.
Mr. Baker. Thank you.
Senator Brown. Thanks to all three of you, and if you would
like to stick around, certainly feel free to for the next
panel. Thanks again for your openness and candor and service
you all three give to your community. If you have anything else
you want to add, you can, as I said, in writing give it to Joe
Shultz and we will get it in the committee record. Thanks very
much, Mr. Baker, Ms. Demko, and Ms. Farber. Thank you.
We will bring the second panel up and take a two or three
minute break if people want to do that, if people want to
stretch or whatever.
[Recess.]
Senator Brown. Thank you all, and thanks for your patience.
We went a little over on the first panel and I apologize.
The second panel will include, from right to left, your
left to my right, Mark Shuter, President and CEO of Adena
Health System of Chillicothe, and I am sure he is so proud of
all of this complex, as Mr. Metzger is. Mr. Shuter has worked
in the health care field for more than 20 years. He is a native
of Portsmouth. It is nice to see you. Thanks. Downtown
Portsmouth is coming back. I was just there. They are doing a
lot of interesting things in downtown Portsmouth. I was in a
meeting in one of their old abandoned some building that they
made into an apartment complex. It is really pretty neat.
Sherrie Lanier is Development Director of the Ohio Valley
Regional Development Commission in Waverly. She is a Southern
Ohio native. She is filling in for the Executive Director of
the Commission, John Hemmings II. We are glad to have her with
us today.
And Marsha Lewis is a Senior Research Associate at the
Voinovich School of Leadership and Public Affairs at OU. She is
a native of Jackson County and is getting her Ph.D. in
education and research, is that right?
Mr. Shuter, please keep to about 5 minutes, if you can, and
I will do questions. Thank you.
STATEMENT OF MARK SHUTER, PRESIDENT AND CHIEF EXECUTIVE
OFFICER, ADENA HEALTH SYSTEM, CHILLICOTHE, OHIO
Mr. Shuter. [Off microphone.] Adena's vision is to be the
best health care system in the nation, and what we feel is
geography is not a determiner of quality and we are determined
to provide the best health care for more than 500,000 people in
our service area.
Adena provides care through our two inpatient hospitals,
our main campus, Adena Regional Medical Center of 237 beds, and
then a 25-bed critical access hospital in Greenfield. We have
additional campuses, a satellite here in Chillicothe, Jackson,
and Waverly.
Well, in our region, Chillicothe is considered the big
city, and here at our main campuses, our services include open
heart surgery, interventional cardiology, cancer care,
minimally invasive hip surgery, spine surgery, and an after-
hours pediatric urgent care. Our medical staff of 250 gives our
patients convenience and comfort in knowing they can receive in
or near their home the primary care and specialty care that are
common in metropolitan areas.
Being the best means that Adena must continually expand our
services and provide patients with up-to-date technologies and
best practice medical care, and telemedicine is one of those
areas I want to speak about because it has infinite
possibilities. In fact, we have already witnessed this impact
in our critical care newborn area, where through our
partnership with Nationwide Children's Hospital in Columbus,
and Adena's relationship with Children's is one of the first of
a kind in Ohio, in Adena's maternity unit, we began utilizing
in 2006 this unique capability of telemedicine with Nationwide
Children's, where our neonatologists assist Adena pediatricians
with clinical assessments via high-definition video
conferencing. In just its first year, telemedicine reduced by
half the number of newborns transferred to Columbus, and these
families avoided the travel costs, overnight accommodations,
and the stress of transfer and separation.
In November 2007, we received from our Congressman Zack
Space news of being selected to implement a $14 million Federal
Communications Commission project for building a fiber optic
network throughout our region. Then just last month, we
received from your office, Senator Brown, news of the United
States Department of Agriculture grant that will enable Adena
to expand its telemedicine capability beyond the nursery to
other hospitals in Southern Ohio. These grants will enable us
to provide more of the best care to our patients in what is, as
we have heard this morning, a medically underserved area.
We are working with other health care systems through the
Regional Health Care Information Organization and through the
Appalachian Health Information Exchange. This is a voluntary
association of health care providers that is developing an
integrated health information system.
We know that in order to provide this best care, we must
continually expand and stay ahead of this curve, and there are
several other information technology projects at Adena that we
would like to inform you about that are critical to our
patients.
They are, first, an online portal that will feature the
opportunity for patients to schedule their appointments and
refill prescriptions. Patients will have the ability to access
the information virtually anywhere through the Internet, and
this is rolling out in the next 6 months.
Our electronic health record, a collection of patient
health information, includes progress notes, problems,
medications, vital signs, medical history, immunizations and
test results.
Third is E-scribing, which enables health care providers to
send prescriptions to pharmacies electronically and order
refills. This will include bedside medication verification with
scanners and hand-held devices to reduce medication errors.
Fourth, telemetry equipment for home health patients that
we can transmit test results directly to our physicians.
Five, continuing advances in telemedicine through our
partnerships with other hospitals in Columbus. Now we are
focusing on a stroke patient care network with Riverside
Methodist and maternal-fetal medicine with Ohio State
University Medical Center.
And then finally, an innovation to train and equip all
volunteer emergency squads in Ross and Vinton Counties with
satellite telemetry for electrocardiogram transmission from the
squad of the emergency departments. Why satellite? Cell phones
and radios in the hills are unreliable.
Now looking to the immediate future for information
technology and rural health care, here is what we need. I bet
you thought that was coming. First is the FCC Rural Health
Pilot Project mentioned earlier. This is an amazing example--
and again, that is the $14 million grant--of providing public-
private cooperation in broadband capacity in our region. The
FCC is paying 85 percent of the costs while eligible health
care providers provide the other 15 percent. Adena Health
System, for example, will be stretched to pay our match when
costs are incurred, but other less financially resourceful
providers cannot afford the match. Thus, they will not connect
to the network and this will be a major concern for
implementation and adoption of technology where it is needed.
Second, as we mentioned earlier, federally qualified health
centers and independent rural practitioners must establish
electronic health records. At the same time, their Federal
reimbursements are diminishing. Many cannot afford the costs.
We will help where we can, although as you know, we are
restricted in some part by the Stark Act, but Federal and State
assistance is needed to help them fund those records.
Third, Federal funds would be well spent to help this so-
called door-to-balloon time for chest pain patients in rural
areas nationwide. This is the time required to receive a heart
attack patient from the door until they get their stents. If
the hospital knows in advance the patient is having a heart
attack, we can help intervene. We have proven that basic and
intermediate EMTs can reliably attach these 12-lead EKGs to the
patient, but the paramedic-level EMTs have long been permitted
to do this under State-controlled scope-of-practice rules. But
the trouble is, paramedics usually don't work on our volunteer
squads and volunteer squads are the norm in rural areas. So
grants are needed to help the training in this area and for the
equipment in rural areas to provide this service.
Finally, I would just like to say thank you for the
opportunity to speak today about what we think information
technology can do for rural health care, and this is an
exciting and challenging time in health care. At Adena, we are
committed to bringing this technology to our patients.
[The prepared statement of Mr. Shuter can be found on page
57 in the appendix.]
Senator Brown. Thank you, and you have made huge process,
it sounds like.
Ms. Lanier, thank you. It is good to see you again.
STATEMENT OF SHERRIE LANIER, DEVELOPMENT DIRECTOR, OHIO VALLEY
REGIONAL DEVELOPMENT COMMISSION, WAVERLY, OHIO
Ms. Lanier. My name is Sherrie Lanier. I am the Development
Director for the Ohio Valley Regional Development Commission. I
want to thank you for giving us the chance to be here today and
testify to the importance of the USDA and other programs to
rural Southern Ohio.
We have a longer, more detailed written testimony that I
have submitted to Joe and I am just going to, I think, talk
about some of the challenges facing our counties and our
communities as far as infrastructure and economic development.
Ohio Valley Regional Development Commission is a regional
planning and economic development agency that works with 12
counties in Southern Ohio to direct Federal, State, and local
funding resources to those communities, give technical
assistance to the communities, to make some of these programs
available, and help the communities implement them.
We have a longstanding relationship with the USDA Rural
Development Program. They have been integral in many, many
projects throughout Southern Ohio because we seem to be kind of
behind the eight-ball in many of our counties for a combination
of reasons. In Appalachia, the poverty rate is higher. The
unemployment rate is higher. Combine that with a lower per
capita income, a lower median income. That means our
communities have a much lower and limited tax base to work from
when they are trying to provide utilities to their residents.
The USDA programs, along with the Appalachian Regional
Commission programs and Economic Development Administration
programs have really been lifesavers for many of our
communities in these rural counties. They really have nowhere
else to go unless--you know, they could go the traditional
route, in a sense, to get loans, but they would be the higher-
interest loans. If it is based on their ability to pay it back,
sometimes they would not get it, these small villages. They
don't have enough residents. But yet you have the residents in
dire need of improved water--or there is access to water,
access to sewer. Many of them have their own onsite sewer
systems and they are failing if they have them in the first
place.
So it becomes--it is an economic development issue, but it
is a health issue when you get into all of those things. It
just--one thing builds on the other as far as needing to get
some of these basic infrastructure programs in place.
We have had success stories in the Village of Vinton in
Gallia County, the Village of Highland in Highland County, new
gravity-feed sewer systems that provided access to residents in
those areas that they did not have it before. It may only be
200 people, but those 200 people needed that for both health,
safety, and development reasons.
On the business and industry side, the city of Jackson, we
worked with them, with the former Luigino's Plant, now Bellisio
Foods, to expand their wastewater treatment plant. Luigino's
wanted to do a plant expansion, but because of the increased
food production, the wastewater treatment plant couldn't handle
it. Four hundred new jobs were on the line, 1,000 existing
jobs. They had the choice of going to Minnesota or somewhere
else, taking everything, and the USDA with some other programs
stepped in and we were able to help get them funding for that
wastewater treatment expansion. Luigino's added 400 jobs and
saved 1,000 jobs. That is just one big example of how these
programs--how important they are.
It is so important because one builds on another and
depends on another. If we lose almost any of these sources,
these small communities would have to either go the traditional
route, which in today's market, many communities, they can't
sell bonds. Nobody will take it on. And they can't get a loan,
even if they were willing to pay the higher interest rates. If
they could do that, then they are passing those rates on to
consumers that can't afford them in this area.
So in conclusion, I just want to again express the
importance of the USDA Rural Development Programs to us in the
area, both at the very basic community development level, and
then taking it into an economic development level. Thank you.
[The prepared statement of Ms. Lanier can be found on page
43 in the appendix.]
Senator Brown. Thank you, Ms. Lanier.
Ms. Lewis, welcome.
STATEMENT OF MARSHA LEWIS, SENIOR RESEARCH ASSOCIATE, VOINOVICH
SCHOOL OF LEADERSHIP AND PUBLIC AFFAIRS, OHIO UNIVERSITY,
ATHENS, OHIO
Ms. Lewis. Thank you, Senator Brown, for the opportunity to
address this committee on important issues in support of rural
communities. My name is Marsha Lewis and I have worked at Ohio
University's Voinovich School of Leadership and Public Affairs
for 15 years. We have worked on many projects with USDA Rural
Development and other Federal agencies and have a longstanding
partnership with State Director Randy Hunt and many others
throughout the agency.
The work we do at Ohio University is in line with the
mission of USDA Rural Development, to build partnerships and
provide a broad set of services to improve the quality of life
in rural areas. USDA Rural Development accomplishes this
through a continuum of programs that help develop all of the
crucial components of the infrastructure it takes to keep rural
communities viable, foster economic growth, and compete
globally.
That continuum of services is what we focus on through
programs like the Appalachian New Economy Partnership, which is
the University System of Ohio program strengthening the
region's competitiveness by focusing on the three critical
pieces to economic growth: Education, local government
capacity, and business development. Any solution must involve
all three.
We, for example, are currently working closely here with
Ohio University-Chillicothe Dean Rich Bebee and a group of
public and private sector entities, including Adena, on
innovative economic growth strategies for this part of the
region. Our role is to provide the best available economic and
demographic data so that the communities can make strategic
decisions and target their efforts. We do almost all of our
work through partners, through projects like the EDA-funded
Community Economic Adjustment Program targeted at places like
Jackson County that have suffered because of auto industry
downsizing.
Through a project called the Mayor's Partnership for
Progress which Chillicothe Mayor Joe Sulzer started a number of
years ago, the Voinovich School brings together mayors and city
managers from cities and villages throughout Appalachian Ohio
to share information and resources, meet collectively with
Federal and State partners on a regular basis, and tackle
economic and community development challenges faced by
municipalities.
So much of our work is in conjunction with our Federal and
State and local partners and much of it involves direct
operational assistance to help businesses grow at the local
level. With OVRDC, OSU Extension, and others, we identify
startup businesses and existing businesses that have high
growth potential and develop long-term consulting engagements
to assist in making improvements and making them sustainable.
Since 2005, this partnership has provided assistance to over
1,700 businesses and entrepreneurs and assisted businesses in
securing $62 million in new loans, $80 million in government
contracts, $3.5 million in funds from individual investors, and
$8 million in venture capital funding, venture capital funding
that was not available in most of the region before this
partnership began.
USDA Rural Development has historically been a critical
partner in efforts to provide a comprehensive continuum of
assistance to support economic growth. Through the support of
the Voinovich School's collaborative efforts, like the
Appalachian Ohio Regional Investment Coalition, USDA has
invested critical resources, time, and expertise to help
develop strategies for Appalachian Ohio. This past June, the
Voinovich School, USDA Rural Development, and the U.S. Small
Business Administration and the Treasury cosponsored a lender
seminar focused on USDA guaranteed lender programs and how
these loans can support local business growth.
As an important component of the direct assistance to
businesses in Appalachian Ohio, the Voinovich School and many
partners are in the second year of TechGROWTH Ohio, a unique
partnership focused on early stage businesses and entrepreneurs
in technology sectors. In mid-October, just this past month,
TechGROWTH gave the first pre-seed funding check to a Southeast
Ohio-based interactive digital media company with a vision for
social networking capacities via the Internet. With each
milestone, this firm will receive further joint funding from
TechGROWTH in technology-based economic development.
In many Appalachian Ohio communities working hard to move
forward, the technology infrastructure is still lacking. Yet
technology infrastructure has become a basic utility without
which communities cannot remain viable. This is why USDA Rural
Development's work to expand broadband access is so important
to the region.
In addition, the agency's support of renewable and
alternative energies, such as Hocking College's Advanced Energy
Campus in Logan, is an important project that will help rural
Appalachia be competitive in this emerging market.
This facility here, the PACCAR Medical Education Center, is
a prime example of that collaborative work. The Voinovich
School is currently conducting some research on college access
for Appalachian Ohio students. In a survey of over 1,200 of
last year's high school seniors in the region, close to 30
percent of the respondents wanted to enter a nursing or allied
health field. With health care targeted by both Ohio Department
of Development and the Ohio Board of Regents as one of the
State's high-growth industries, facilities such as this provide
critical training opportunities to build the type of workforce
vital to Ohio's current and future economic viability.
Efforts to develop the health care sector is a prime
example of why the work of USDA Rural Development and its
partners is crucial and why development projects are not
discrete, but interconnected. Keeping our rural communities
viable to continue to attract professionals, such as those in
the health care field, is hard work and costly.
The building blocks for any kind of development involve
solid physical infrastructure. Many communities in our region
are in need of the first line of water or wastewater pipe.
Others, such as many of our small cities, have aging
infrastructure that no longer meets State and Federal
requirements. Economic hardships that hit families throughout
the region make it painful, if not impossible, to raise utility
rates to the level necessary to upgrade or in some cases even
maintain the critical infrastructure needed for economic
development and make communities that people want to live,
relocate to, and stay in.
Our region needs the partnership and assistance provided by
these programs and we respectfully ask that USDA and other
Federal agencies continue and expand assistance to rural
communities so that we rural citizens earn decent wages, raise
healthy families, and live in communities that provide great
quality of life for everyone. Thank you.
[The prepared statement of Ms. Lewis can be found on page
49 in the appendix.]
Senator Brown. Thank you. Thanks very much, Ms. Lewis.
Mr. Shuter, talk to me about--thanks to all of you, the
testimony from all three of you. Almost everybody here has
talked about the importance of broadband. Give me the
intersection of--explain to me the intersection of what we do
with broadband, with telemedicine, and with FQHCs in Southeast
Ohio, and really anywhere, but how we--I don't think when
people talk about broadband they think enough about
telemedicine. I also think that as this whole hospital and
particularly what Mr. Metzger and all of you are doing now
here, PACCAR is such a jewel for Appalachia, and with the
proliferation of FQHC, it just seems that we don't--would you
just explain the synergism of it to me, if you would, where we
come together on all of this?
Mr. Shuter. Well, I think it is important to note that, I
mean, the grant to build this network throughout the region, it
is pretty much a ten-county area, and again, it is not going to
be exclusive for health care. This will be available for
industry, business, government all to be able to tap into it.
But relative to health care, the big shift here is we are
in roughly in another year and a half rolling out all of our
electronic record, including these portals that will have the
ability to now connect at home. If you think through that
connection at home, the average person over age 65 has roughly
15 medications and so they are going to have an electronic link
to their primary care doctor, their pharmacy, whoever their
health plan vendor is, as well as gain access directly for
appointments, but more importantly, will be able to get
information back to the practitioners to maintain health
status.
Roughly, if you look, we do a million encounters a year,
roughly--the studies are 20 percent of the population is
generating 80 percent of that through chronic health care
conditions. So the vision here, the bigger issue is long-term,
is really regionally along with our partnership with Ohio
University and the RIO is to really understand this in the
chronic disease population and find ways through the Internet
to keep people at home.
We partner with federally qualified clinics in almost all
of our communities we serve. The key thing is we still have
that little bridge gap of getting them connected, but the key
thing is to get them access to broadband. Second, help them
adopt electronic health records, and again for the same
purpose. As homes get more online with connected to the ring,
again, to be able to provide that health status, shift that
service away from having to go to a clinic to be able to get it
in their home.
Relative to the synergy of this building, we will be having
national speakers coming in several weeks, again, providing the
opportunity for health care providers to bring updates, and
this topic would be cardiology, but we also have the capability
through this building to connect into that ring, and again, we
are going to be connected to provide more education. Wright
State does our nursing school. We are connected such that we
can do remote classes. And so I think the opportunities
relative to the education system, I think are kind of infinite,
as well.
The particular niche around telemedicine, there is, again,
more and more. We have the nursery coming online. Stroke will
be coming online. There is now increasing use of robots that
will be able to be steered remotely because of all of this
connection by a specialist really around the world to be able
to provide specialty consultations, either in remote hospitals
or in clinics and eventually at home.
Senator Brown. Thank you.
Ms. Lanier, you had given the example of the infrastructure
of what you were able to do with USDA and others on preserving
those jobs and expanding the jobs. You mentioned Gallia County
and Highland County, I think. Give me an example of how--we all
talk about infrastructure, whether it is broadband or whether
it is highways, roads, bridges, sewer systems, whatever. Give
me specifically what USDA's involvement, what infrastructure
did in one or both of those communities, if you could.
Ms. Lanier. Sure. In the----
Senator Brown. And what it meant to the residents or to
economic development down the line.
Ms. Lanier. In both cases, in the Villages of Vinton, which
is in Gallia County, and Highland, which is in Highland County,
they did not have any sewage treatment. All the residents had
their own septic tanks, many of which were failing and were
discharging either barely treated or raw sewage into either the
storm sewers or into area creeks. The funding allowed them to
run sewer lines and build, in one case, in Vinton, to build a
treatment plant. In Highland, they basically just built the
sewer lines and pumped it to the Village of Leesburg, to their
treatment plant. In that case, they had an agreement with them.
Senator Brown. Can you give an example of where it meant
some kind of economic development? I mean, you gave the big
example. Is there something else that you have done that----
Ms. Lanier. In the Village of Highland, there were four
businesses that were able to connect to the system----
Senator Brown. What kind of businesses were those?
Ms. Lanier. Pardon me?
Senator Brown. What kind of businesses were they, retail?
Ms. Lanier. Retail, yes. Retail and service.
Senator Brown. OK.
Ms. Lanier. They were able to connect to the system and
retain the jobs that they had there in the village and keep
those----
Senator Brown. What kind of sewer rates are they paying in
Vinton?
Ms. Lanier. I don't really know the exact rate. I know,
because of the low-interest loans and the grants, it is the
absolute cheapest that they can make available.
Senator Brown. Do you know how it compares to people in the
city of Chillicothe or in the city of Hillsboro or----
Ms. Lanier. Much cheaper than the city of Chillicothe.
Senator Brown. OK. Thank you.
Ms. Lewis, one of the roundtables I did, it was at the
Voinovich Center and I was really struck by the entrepreneurial
activity of Southeast Ohio and especially right there. They
talked about Hocking and the alternative energy. Talk to me
about what we do to make this. I have noticed around Ohio we
have in this State now, we are in the top, I believe, five in
the country in investment in solar energy in terms of
businesses and we are in the top five in the investment of wind
turbines and it is sort of an untold story and an unknown story
and it is going to get bigger. We have the largest solar
manufacturer in the country near Toledo. What struck me about
what was going on in Athens and Hocking was how much was going
on with installation of solar panels and all that.
How do we make this region, from your work in development
and particularly in economic development, how do we make this
region--pull that together to really get these--to help these
businesses to see more businesses grow and to sort of fan out
outside of just Athens and Hocking, where I think most of the
energy has been, in alternative energy specifically?
Ms. Lanier. Right, and I think alternative energy, we all
know that virtually every community in the country is looking
to alternative energy as sort of the next wave of economic
growth, but in our region in particular, which has a long
history of an energy-based economy, it makes particular sense.
I think the work of the universities, the work of Hocking
College and the work of Ohio University in looking at these
things is certainly what is making that cultivate in that
particular part of the region.
But I think, again, that continuum of services and that
access to capital, getting the venture capital in the region
and getting people who have ideas and communities that have the
natural resources--for instance, in Jackson County, looking at
how to overcome the downsizing and the Meridian closure and the
other things that have hit the county hard, what are the
natural resource-based products that we have there that would
lend themselves to, for instance, solar panel production, and
how can we change over that manufacturing to something like
that with the silica and the sand and the clay and the things
that you need for some of those things?
So I think it is that continuum of services, everything
from access to all kinds of capital at every stage of those
businesses' lives, whether that be angel investment, venture
capital, and then also some sophisticated business support
services that we don't have in this region. Sometimes access to
special patent attorneys or access to specialized labs to bring
some of these things to fruition and to production, I think are
important.
But also, kind of a regional approach to thinking about
what do we want to pursue? What do the data show that we could
support? And how do we target that best and how do we do that
regionally? We talk a lot about regionalism, but that is hard
to do. It is hard to bring local leaders together with these
State and Federal agencies and really focus and be strategic
and use the data to say this is something that we should pursue
and let us pool our resources to figure out how to do that.
So I think not only business development assistance, but
also the work with governments and local leadership on how to
do that and how to take a regional focus, to grow that out of
just the little, sort of the core area where it is now and use
some of the manufacturing and the natural resource base that we
have here to be able to grow that.
Senator Brown. How old is the Hocking program?
Ms. Lanier. It is fairly new, within the last couple of
years. OU's Coal Research Center has been around for a while,
but just now getting infused with capital so that they can do
some of that research. We have got other things going on, an
engineering professor at Ohio University looking at ammonia-
based fuel cell development and even starting a little bit of
some prototype manufacturing of that. So those things have--
people have been thinking about them for a number of years, the
last 5 years or so, but just in the last couple of years, they
have really started to take off.
Senator Brown. Thank you.
Let me ask one question of each of you. Take a couple of
minutes to answer it, if you would. The same question of all
three of you, and then we will adjourn. If there is one thing
that you could ask my office or the Federal Government to do,
other than send you millions of dollars, but if there is one
thing that you could ask us to do, what would it be? I call on
you first so that they have the advantage of thinking about
this answer longer than you do, but Mr. Shuter, give me one
major thing----
Mr. Shuter. You have taken the No. 1 off the table.
Senator Brown. Yes, right.
Mr. Shuter. You know, I think when you go through our list
of issues, I think this issue of the connectivity--well, first
of all, the grant that we received to build the broadband
network is huge, but still the issues around the edges of
helping this region, helping the organizations that are
struggling to pay that match of 15 percent to connect to that
broadband network, which will take some loosening of the
regulations.
And second, I think there will be needed some assistance
for especially the smaller providers, the federally qualified
clinics, to help them adopt the full electronic health record,
which is going to need to happen for us really to--still the
issue of reducing utilization while improving quality is going
to be the key challenge in front of health care for the next
decade.
Senator Brown. OK, good answer.
Ms. Lanier.
Ms. Lanier. OK. Well, aside from more money, just the--if
we could lessen some of the bureaucratic strings or
restrictions from the various agencies or programs as to what
things can be used for, how it can be used----
Senator Brown. Give me one example.
Ms. Lanier. Well, with--say the Economic Development
Administration funding, and theirs and the USDA in some of
their cases are very similar. The funding can only go to
essentially a public entity, is how it would--a city, a county,
a port authority, something like that. Many of the cases in our
area, I was Economic Development Director in Jackson County for
several years, so I am used to dealing with this firsthand. The
land in our industrial parks are mostly private. So when we go
to try to get funding to build access roads, to build sewers,
to put water lines out, we can't access these funds.
Senator Brown. Ms. Lewis.
Ms. Lewis. Well, I think one of the key priorities has to
be relieving the stress on local communities and continuing to
infuse money into the region for infrastructure development.
And technology infrastructure certainly is a very key
component, but also the physical infrastructure components that
make communities viable, that make communities places where
people want to live and can live and that are healthy and
vibrant.
Our local communities, our counties, our small cities that
have aging infrastructure are really up against a wall in terms
of trying to upgrade that, trying to replace that, trying to
meet new mandates, new State and Federal mandates, and really
need help from the State and Federal Government in order to be
able to provide the basic infrastructure that is the building
block for any other economic development.
I think relief in that, public works, basic infrastructure
projects, and more support from the Federal Government to be
able to fund those and make it so that the rates are livable
for the people in Appalachian Ohio, I think is really crucial.
Senator Brown. Thank you.
Thank you all. Thanks for your comments, your provocative
thoughts, and feel free, as I said, to submit in the next few
days anything additional. And anyone else here that feels that
they want to submit any information to us can do the same. I
appreciate that.
Again, Mr. Metzger, thank you for hosting this at your
beautiful facility. I look forward to coming here many times in
the future.
The hearing is adjourned.
[Whereupon, at 12:40 p.m., the committee was adjourned]
=======================================================================
A P P E N D I X
October 23, 2008
=======================================================================
[GRAPHIC] [TIFF OMITTED] 48539.001
[GRAPHIC] [TIFF OMITTED] 48539.002
[GRAPHIC] [TIFF OMITTED] 48539.003
[GRAPHIC] [TIFF OMITTED] 48539.004
[GRAPHIC] [TIFF OMITTED] 48539.005
[GRAPHIC] [TIFF OMITTED] 48539.006
[GRAPHIC] [TIFF OMITTED] 48539.007
[GRAPHIC] [TIFF OMITTED] 48539.008
[GRAPHIC] [TIFF OMITTED] 48539.009
[GRAPHIC] [TIFF OMITTED] 48539.010
[GRAPHIC] [TIFF OMITTED] 48539.011
[GRAPHIC] [TIFF OMITTED] 48539.012
[GRAPHIC] [TIFF OMITTED] 48539.013
[GRAPHIC] [TIFF OMITTED] 48539.014
[GRAPHIC] [TIFF OMITTED] 48539.015
[GRAPHIC] [TIFF OMITTED] 48539.016
[GRAPHIC] [TIFF OMITTED] 48539.017
[GRAPHIC] [TIFF OMITTED] 48539.018
[GRAPHIC] [TIFF OMITTED] 48539.019
[GRAPHIC] [TIFF OMITTED] 48539.020
[GRAPHIC] [TIFF OMITTED] 48539.021
[GRAPHIC] [TIFF OMITTED] 48539.022
[GRAPHIC] [TIFF OMITTED] 48539.023
[GRAPHIC] [TIFF OMITTED] 48539.024
[GRAPHIC] [TIFF OMITTED] 48539.025
[GRAPHIC] [TIFF OMITTED] 48539.026
=======================================================================
DOCUMENTS SUBMITTED FOR THE RECORD
October 23, 2008
=======================================================================
[GRAPHIC] [TIFF OMITTED] 48539.027
[GRAPHIC] [TIFF OMITTED] 48539.028
[GRAPHIC] [TIFF OMITTED] 48539.029
[GRAPHIC] [TIFF OMITTED] 48539.030
[GRAPHIC] [TIFF OMITTED] 48539.031
[GRAPHIC] [TIFF OMITTED] 48539.032
[GRAPHIC] [TIFF OMITTED] 48539.033
[GRAPHIC] [TIFF OMITTED] 48539.034
[GRAPHIC] [TIFF OMITTED] 48539.035