This month, a North Dakota network of rural hospitals enters its second year of trying to make local operations more efficient, so they can keep the doors open for patients and keep their local communities thriving.

The Rough Rider High-Value Network was announced in October 2023. It is made up of 23 independent, critical access hospitals in smaller towns and cities across the state. Leaders from the facilities share best practices and ways to keep costs lower.

Kylie Nissen, executive director of the North Dakota Rural Health Association, said she is encouraged by the effort, knowing the long-standing struggles hospitals and clinics in these areas have faced.

"It's not only closures that we're concerned about, it's rural community members (who) don't want to see their hospital bought out by a large system, too," Nissen observed. "Because then, the decision-making and the care for their local community just isn't there."

Since it began, the collaborative has secured at least two desirable contracts with commercial health insurers, benefiting all member hospitals. In its August forecast, Becker's Hospital Review reported five North Dakota hospitals were at immediate risk of closing within the next two to three years.

Nissen pointed out the ripple effect of keeping the hospitals independent and running efficiently, while improving patient care, can be felt across an entire community.

"Health care is huge when it comes to economics," Nissen stressed.

She added a healthier population, that does not have to travel as far for appointments or other care needs, results in a stronger workforce. She acknowledged they are still navigating challenges, like reducing maternal care "deserts," noting federal grants are competitive. The state of North Dakota chipped in $3.5 million to help get the Rough Rider Network started.


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The American Postal Workers Union is pushing back against proposed changes to the Postal Service they said would slow delivery.

Among other things, the proposal aims to cancel afternoon deliveries and pick-ups for areas more than 50 miles from a regional hub. Postmaster General Louis DeJoy said elimination of night pickups could save the post office more than $3 billion a year.

Daniel Cortez, director of industrial relations for the Oregon Postal Workers union, said reducing services does not make sense financially.

"To think that eliminating services, reducing standards, basically providing the American people with less reliable service is somehow going to make money, it's nonsense," Cortez contended.

The charges are the most recent in a series included in Dejoy's 10-year "Delivering for America" plan. The union said DeJoy, who was appointed under President Donald Trump, has already raised prices for stamps while closing post offices across the country, especially in rural communities.

Cortez noted although rural communities would be hit hardest by this latest proposal, urban centers will also be affected. He explained the Postal Service has been shutting down processing centers in the state, making Portland the sole distribution site for all of Oregon, which means more mail delays for everyone, including Portlanders.

"If the clerks and the employees in the main plant are processing mail for the rest of the region, that means they're not at that same time processing Portland's mail," Cortez emphasized.

The changes come as first class mail volume has fallen 30% in a decade, with fierce next-day delivery competition. Although the Postal Service said under the new proposal most first class mail will not be affected, Cortez argued management is already failing to meet its lowered delivery standards from 2021. He added mail never used to sit around.

"First class mail was always moving until it got to where it needed to go," Cortez recounted. "That's just what everybody understood about the service that we're required to provide to the American people."

North Dakota has 30 available workers for every 100 open jobs. To help confront workforce shortages, the state is now accepting grant applications to kick-start solutions at the local level.

The Department of Commerce's Regional Workforce Impact Program invites towns, cities and their business development groups to seek out the grants.

Arik Spencer, president and CEO of the Greater North Dakota Chamber of Commerce, said providing seed money to foster innovation in worker recruitment might boost rural areas at a competitive disadvantage.

"Whether it is starting manufacturing ventures or doing other creative things," Spencer outlined. "To the extent that this can help those, maybe, small communities or underserved communities get people to move there and bolster their workforce, we think that's a positive outcome."

Spencer pointed out the innovation might look like closing affordable housing gaps, which he said is a common roadblock around the state. He and other stakeholders monitoring the labor landscape still hope for broader support when the Legislature reconvenes early next year. North Dakota's labor shortage woes appear to be more pressing than its neighboring states.

Spencer noted no matter the size of the community, applicants appear to be in the driver's seat in coming up with fixes that work for their populations.

"While living in Fargo may be attractive to some people, maybe living in Watford City's attractive to others," Spencer acknowledged. "This grant program allows those regional communities to figure out their own solutions and tackle those with the support of the state."

The application period began this week and runs through Jan. 21. There are grant caps for certain categories. For example, a local coalition focused on recruiting talent can receive a grant of up to $250,000. The cap is higher for infrastructure needs related to worker recruitment, such as child care centers.


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Groups from across Michigan are sounding the alarm on the effect Republican-backed policies would have on people in rural parts of the state.

In a recent webinar by the group Progress Michigan, leaders say policies laid out in Project 2025 are in stark opposition to the needs facing rural Michiganders. Representatives from Indigenous tribes, public school teachers and family farmers gave their views on the potential changes if the GOP regains power.

Dakota Shananaquet, member of the Little Traverse Bay Bands of Odawa, said she fears for her people's basic rights.

"The Project 2025 Agenda is a right-wing power grab that would harm Indigenous communities, our sovereignty and the ability for us to exercise our vote," Shananaquet asserted. "It would make outcomes worse by defunding health care and education programs."

Project 2025 is a 900-page document outlining plans for a conservative takeover of the federal government. Republican presidential candidate Donald Trump has disavowed any part in developing the document. However, dozens of former Trump administration officials contributed to the proposals.

Bob Thompson, president of the Michigan Farmers Union, which represents hundreds of small and medium-family farms, said the GOP plans to eliminate programs helping independent farmers implement conservation and clean energy goals, and most of the federal farm program's current financial safety net features.

"Family farmers operate on narrow margins and need the protection of many of the very programs that Project 2025 seeks to eliminate," Thompson explained. "Most elements stand against what rural folks want for our families and our future here in Michigan."

Gary Wellnitz, Northern Michigan field representative for the American Federation of Teachers-Michigan, said Project 2025 would have negative and destructive effects on public schools across the state.

"It's going to make the safety in our public schools far worse," Wellnitz contended. "We're going to see small schools closing down, We're going to see teachers losing jobs by the thousands if this were to take hold."


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