Proposed cuts to Medicaid would put hospitals in jeopardy in rural states, where health care services are already scarce, according to new research by the Georgetown University Center for Children and Families.

In Alaska, the cuts would be especially challenging. More than 23% of the nation's rural residents of childbearing age are covered by Medicaid, including in Alaska.

Trevor Storrs, president and CEO of the Alaska Children's Trust, said reductions in Medicaid benefits would fall directly on those who live in remote locations, areas only accessible by boat, small plane or snow machine.

"We know 40% of births are paid by Medicaid and that percentage even increases as we go out into our rural communities," Storrs pointed out. "Why is that key? Because some of our communities are 50 people. There is no medical, there is no support."

He pointed out Alaska's rural communities relying on Medicaid are already suffering hospital closures and those remaining open are having to reduce or eliminate obstetric services.

The effects of the proposed cuts would also stretch across the lower 48 states.

Joan Alker, executive director of the Georgetown University Center for Children and Families, said across the country, in at least 20 counties, about half of the women of childbearing age are covered by Medicaid, mostly people in rural communities facing unique challenges.

"Rural communities tend to have lower income than metro areas," Alker explained. "Medicaid, as important as it is for moms and babies nationwide, is even more important in rural areas and small towns."

The report showed more than 20% of women in urban areas also receive Medicaid funding for childbirth and postnatal services, and will also face difficult choices if the cuts are made.

Everybody loves to get something free and right now, kids aged 12-17 can get a fishing and hunting license at no cost from the Nevada Department of Wildlife.

The license is good for one year and normally sells for $15.

Bobby Jones, outdoor connection coordinator for the Nevada Department of Wildlife, said the free licenses are funded by donations to the Nevada Youth License Fund.

"This is actually the third year that the program's been active," Jones explained. "We keep it open as much as possible. We're just limited by the amount of donations that we have. Right now, we have almost 2,000 available and they go fast."

Youth can get a free license on the Nevada Department of Wildlife website or wherever the licenses are sold. Children under age 12 do not need a fishing license. The state said almost two-thirds of the kids who have taken advantage of the program in the past have never had a hunting or fishing license before.

Jones emphasized the program is designed to tempt kids to leave the digital world behind for a short time and enjoy some time outdoors. It could lead them to even consider a nature-based career like wildlife biology, forest management or outdoor education.

"Essentially what we're up against is a lot of kids are engaged in their phones and social media, TV," Jones pointed out. "They're constantly bombarded with things. We're trying to make it a little bit easier for them to enjoy the outdoors."

Some of the most popular fishing spots include Lahontan in the Fallon area, Wild Horse and South Fork in Eastern Nevada, and Lake Mead down south.


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The University of Nebraska is addressing a shortage of lawyers who represent the state's most vulnerable children, especially in rural areas.

The attorneys are being equipped to work with kids who have suffered through physical, emotional, or financial trauma - and are often living in poverty.

Of Nebraska's 5,500 licensed attorneys, only 7% of them practice in rural areas.

Michelle Paxton, director of the Nebraska Children's Justice and Legal Advocacy Center, said two thirds of child neglect and abuse cases originate outside the Lincoln and Omaha metro areas, in what she calls "rural legal deserts."

"We have twelve counties in Nebraska with zero attorneys living in those counties," said Paxton. "We have 22 with less than three."

Paxton said that there are too few qualified rural child justice attorneys, which means lawyers may drive hundreds of miles for juvenile cases, creating delays and court backlogs.

The University of Nebraska program will add lawyers trained to handle issues unique to children in low-income families.

Attorneys who work on juvenile court cases are getting the tailored knowledge they need, but Paxton added that the program is also creating an opportunity for those attorneys to network and get support from other lawyers in the field - who are often isolated.

"And so they don't often have another attorney doing this type of work that they can rely on for support and mentorship," said Paxton, "and our program provides that support and mentorship so that they are not only willing to continue working in juvenile court, increase their hours in juvenile court and increase their commitment. "

The advocacy center will also develop a case-tracking tool, enabling people to find an attorney online.

Support for this reporting was provided by Lumina Foundation.



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Statistics show one in five children in Texas struggles with hunger.

Approximately 10,000 students a day are getting a nutritious meal through the Summer Food Service Program offered by the Houston Food Bank. The meals are distributed across the food bank's 18-county region.

Jourdan Stansberry, senior manager of education programs for Houston Food Bank, said they partner with summer camps, churches and other nonprofit organizations to serve the students. She added anyone who is not near a meal site can take advantage of their non-congregate option.

"Sites that are considered rural by the Texas Department of Agriculture," Stansberry explained. "It's a grab-and-go model where families can pick up the meals, It's like a five-day bundle of frozen meals, breakfast and snacks, so 10 meals all together. They're able to pick it up and take it home."

Locations of the meal sites in the Houston area and across Texas are available at the Department of Agriculture's Summer Meal Site Map. The meals are available to anyone 18 years old or younger or students with a disability, up to 21 years old.

The meals are distributed at more than 250 sites around the Houston area. Students do not have to register to take advantage of the meals. Stansbury emphasized it is a great way to ensure kids have access to fresh fruits and vegetables during the summer. She added the menus consist of more than just a sandwich and chips.

"One thing that I know has been pretty popular is our orange chicken with rice, and we also have broccoli, vegetable-medley side that goes along with that. We saw also chicken tikka masala," Stansbury outlined. "We try to expose them to different meals, not only healthwise but also culturally."

The Houston Food Bank expects to distribute around 800,000 meals this summer. The meal program runs through Aug. 8.


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