graphic WEDNESDAY, SEPT. 7, 2022 Today’s Farm
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19SHAWMEDIA 20227,SepWednesday,•ShawLocal.comMedia/ValleySaukinSHORTAGEthemedicalfield
Is there a doctor in the farmhouse? Not as many as there should be, as rural hospitals struggle to
Rusty Schrader/SVM
We had lost a physician and it took us two and a half years to replace that individual. This was pre-COVID. Now we have another opening ... We have been looking for six months now. It’s just really difficult to recruit physicians, especially to our rural communities.
Those benefits include autonomy, work-life bal ance, flexibility and culture, she said.
Is there a doctor in the farmhouse?
BY TAMMIE SLOUP | FarmWeek
But one aspect that has evolved is residency pro grams for physicians, which have expanded training to include training in rural areas.
Trina Casner, president and chief executive officer of Pana Community Hospital and IHA board member, said recruiting for rural health care has been a chal lenge since she started her role in 2012.
Not as many as there should be, as rural hospitals struggle with workforce shortages
Both hospital chiefs said providing a supportive cul ture for staff is critical for retention and recruitment,
especially when it comes to pandemic burnout.
When the Illinois Health and Hospital Association conducted its Small and Rural Hospitals annual meet ing in Springfield this summer, worker retention and recruitment was a major theme.
According to the Association of American Medical Colleges, the U.S. is expected to have a shortage of up to 48,000 primary care physicians by 2034 — and the chal lenges of recruitment and retention in rural areas is even more challenging.
“We had lost a physician and it took us two and a half years to replace that individual. This was preCOVID,” Rogalski said. “Now we have another open ing because we have a physician who’s going to be retiring. We have been looking for six months now. It’s just really difficult to recruit physicians, especially to our rural communities.”
“And because if they’re happy here, then they’ll share that with their friends and family,” she said, add ing on the retention side, the hospital ensures their benefit package is as good or better than surrounding health care employers.
The state of Illinois also has been supportive with its Illinois National Health Service Corps State Loan Repayment Program.
“They can get some experience and exposure to what it’s like practicing medicine in rural areas, which might be attractive to some of them if they know how it can be a little different than practicing in an urban setting,” Casner said.
The program’s goal is to help communities recruit health professionals willing to practice full-time or halftime in federal health professional shortage areas. Pro gram funds are used to repay educational loans of phy sicians, nurse practitioners, physician assistants, nurse midwives, dentists and psychiatrists who agree to serve full-time or half-time in federally designated HPSAs in Illinois without regard for their ability to pay.
SHORTAGE cont’d to page 21
Casner, who grew up in Pana, said her hospital pro vides a recruitment bonus to employees, as they’re some of the best recruiters.
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Ted Rogalski
Two of the largest impacts on workforce include stress from the pandemic and a shortage of health care professionals, said Ted Rogalski, Illinois Health and Hospital Association (IHA) Board chairman and administrator of Genesis Medical Center, Aledo.
Illinois Health and Hospital Association Board chairman & administrator of Genesis Medical Center
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“We’re really focused on their health and well-be ing, making sure they have resources that they might need from a behavioral health standpoint, counseling standpoint, just making sure that we stay engaged with them,” Rogalski said.
One program aimed at increasing the bank of rural physicians in Illinois is the Rural Illinois Medical Student Assis tance Program (RIMSAP), sponsored by Illinois Farm Bureau and the Illinois State Medical Society.
BY TAMMIE SLOUP FarmWeek
cont’d from page 20
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quality care.
Just what the doctor ordered
Olivia White was a farm girl who wanted to be a pharmacist, but a medi cal student mentor opened her eyes to a different path.
SHORTAGE
The partnership started in 1948 and has helped more than 800 applicants hurdle financial need or borderline aca demic barriers to a medical education with a recommendation for acceptance into medical school and/or loan money.
PROGRAM cont’d to page 22
This story was distributed through a cooperative project between Illinois Farm Bureau and the Illinois Press Asso ciation. For more food and farming news, visit FarmWeekNow.com.Is there a doc tor in the farmhouse? Not as many as there should be, as rural hospitals strug gle with workforce shortages
Whenafterward.youask these three new doc tors why they pursued a career in health care, they point to these instances. Their stories also intertwine with their desire to practice in rural and underserved regions throughout their home state of Illinois — and there are plenty.
“I’ve recruited for advanced practi tioners because of that benefit,” Rogal ski said. “It’s a significant benefit that our urban areas cannot offer.”
Grant Gingerich was about 3 years old when his mother was diagnosed with breast cancer.
Illinois has 86 small and rural hospi tals throughout the state. As significant economic engines, small and rural hos pitals have created approximately 76,350 jobs in Illinois and have a total economic impact of $13.7 billion annu ally, according to the IHA.
Rogalski said urban health care doesn’t necessarily translate to better
21SHAWMEDIA 20227,SepWednesday,•ShawLocal.comMedia/ValleySauk
“A lot of our rural health care pro viders are high quality and easier to access,” he said. “And if our rural communities utilize the services, they’ll be there for the long term.”
Program addresses need for rural physicians
According to the Rural Health Infor mation Hub, rural communities in Illi nois have nearly 50% fewer physicians per capita than urban areas. This puts rural regions, which tend to include more low-income and older adults, at risk for poorer health outcomes.
Andy Meister underwent orthopedic surgery when he was 28 and had a life-changing conversation with the sur geon
TODAY’S FARM COVER STORY
22 20227,SepWednesday,•ShawLocal.comMedia/ValleySauk MEDIASHAW
In return, students must agree to practice medi cine in an approved rural community in Illinois for a set number of years, depending on their situation.
West Point, then joined the Army, and is currently a member of the Army National Guard. He earned an aerospace engineering degree from the University of Illinois, then served as a missionary, and eventually took a job with Caterpillar after getting married. He also owned a cleaning business and rental properties.
“That’s where I got my interest as far as health care,” Gingerich said. “Growing up in the place that I did, I feel like I can relate to the problems and the issues that really are pervasive in most rural areas as far as accessing health care.”
He credits RIMSAP for helping him overcome barri ers as a nontraditional student applying for medical school.“Despite my competitiveness on paper, I knew there would be barriers that would come up when I have a relatively unique background,” Meister said. “RIM SAP gave me the opportunity to sit down in front of the board, many physicians, many of whom working with the population I want to serve some day.
“Agriculture wasn’t high on my list of career choices. And I didn’t like being in a small commu nity and so I kind of rebelled a little bit,” said White,
“He tells me his story, and he really just gushed about the service he was able to provide his nation,” Meister recalled. “He was so excited to get up for work.”
“They’re farmers, they’re just like my family. And you sit across the table and get to tell them your story. ... It seemed to me our values aligned very well. They wanted someone to come back home and serve rural Illinois.”
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Gingerich, now 26, is in his fourth year as a medi cal student in Peoria and will soon begin applying to residency programs. He plans to specialize in either family or emergency medicine.
She transferred to the University of Iowa, where she majored in human physiology and was able to job shadow different health care professions. She was also encouraged by a medical student mentor in her student interest group.
After an orthopedic surgical procedure, Meister chatted with his doctor, unaware the conversation would lead to a life-changing career switch.
The exposure to rural health care facilities through RSPP also provided the personal guidance and atten tion the students desired.
“That’s when I kind of learned that helping people in the sense of being a physician was something that I would really enjoy doing and I related well to people in rural areas,” said White, who graduated from the SIU General Surgery Residency Program last month.
INITIALLY, WHITE WAS EAGER to see the world outside of her small town of Warsaw, located in Hancock County where her father, Victor Kerr, and brother, Nathaniel, run the family farm.
In September, she will start practicing at the same hospital as a general surgeon.
The three doctors encourage potential medical stu dents to consider practicing in rural Illinois. From a cheaper cost of living to the feeling of community, there’s a multitude of benefits.
“I heard that story and thought, ‘Oh my gosh, it’s not too late.’ I thought maybe I could have that, too.”
White’s husband, Logan, an IFB member, pointed her to RIMSAP during her application process.
who attended college in Florida for a year. “I pretty rapidly realized that while (living in Florida) was a wonderful experience, it just wasn’t where I fit.”
“I honestly think that every medical school should have some sort of rural medicine program if not a rural medicine rotation, because otherwise I don’t think students even consider or get the exposure of what it’s like in some of these areas and really get to see the benefit and the upsides to what it’s like in that kind of practice,” Gingerich said.
As part of their agreement with RIMSAP, partici pating students must apply to the University of Illi nois College of Medicine’s Rural Medical Education Program at its Rockford campus or the Rural Student Physician Program (RRSP) at its Peoria campus.
This story was distributed through a cooperative project between Illinois Farm Bureau and the Illinois Press Association. For more food and farming news, visit FarmWeekNow.com.
FOR GINGERICH, RIMSAP’s stamp of approval made all the difference in his application to medical school.“Ihad average scores when it came to applying to medical school, and it made it very hard for me to shine as an applicant,” said Gingerich, who grew up in Sherrard, a community of 600 in Mercer County that he remembers fondly rallying around his family during his mother’s cancer treatment.
MEISTER, NOW 34, JUST STARTED HIS FIRST OF FIVE YEARS OF ORTHOPEDIC SURGERY res idency at Penn State Health Milton S. Hershey Medical Center. But his journey into health care didn’t start until his late 20s. After high school, the Chillicothe native attended the United States Military Academy at
“We do see a bit of inflation hedge with farmland,” said David Oppedahl, senior business economist at the Chi cago Fed. “Farmers and investors are interested in locking in value there through purchasing farmland.
BY DANIEL GRANT | FarmWeek
This follows increases of Illinois farmland values between 2020 and 2021 of 26% for excellent ground to an average of $14,700 per acre, 24% for good ground ($10,710 per acre) and 21% for average land ($7,455 per acre), according to the Illinois Society of Professional Farm Managers and RuralLastAppraisers.yearmarked just the fourth time since 1970 Illinois farmland val ues increased 20% or more in a calen dar“Weyear.have to get the younger gener ation into farming but, with these farmland prices, many can’t afford to buy a $15,000 or $20,000 piece of dirt and then have to deal with the high input costs on top of that,” Spinosa said.A low turnover rate of farmland, about 2% per year, and intense com petition also continues to drive the market and put the squeeze on some potential buyers.
This story was distributed through a cooperative project between Illinois Farm Bureau and the Illinois Press Association. For more food and farming news, visit FarmWeekNow.com.
FARM REAL
“In the current inflationary envi ronment, ag’s been helped by some factors (commodity prices received by farmers increased 31% compared to last year, prior to a recent sell off in the market),” he noted. “At the same time, input costs are going up a lot, so that squeezes AgAmericamargins.”encourages farmers, particularly those among the younger generations, to build relationships with lenders and fellow farmers. Young farmers can also help farms advance in the future with the intro duction of technology and by staying in touch with consumer needs, Spi nosa
23SHAWMEDIA 20227,SepWednesday,•ShawLocal.comMedia/ValleySauk
Millennials getting priced out of the farmland market
It recently reported more than 40% of U.S. farmland is owned by people older than 65. And now younger gen erations, who often have fewer resources compared to veteran farm ers, are facing another real estate bar rier to enter the ag industry as farm land prices surge.
A significant increase in farmland prices and low turnover rate are mak ing it more difficult for many farmers to expand their operations.
Farmers remained the top buyer of farmland in the state last year, but just barely, at 52%. Investors reeled in 33% of farmland purchases and insti tutions grabbed another 10%, with the remaining 5% made up of individuals who purchased land for recreational purposes, according to ISPFMRA.
TODAY’S ESTATE
Building relationships is also vital for farmers in the highly competitive market for rental ground. Of the farmers enrolled in Illinois Farm Business Farm Management, just 23% owned their land, 30% was a crop share and 47% was a cash rental arrangement in 2021.
And perhaps the demographic of farmers getting squeezed the most in the current economic environment are millennials, those between the ages of 26 and 41, according to AgAmerica, the nation’s largest nonbank agricultural lender.
“It’s so tough to maintain an opera tion when it comes to rising operating and input costs,” Pat Spinosa, direc tor of business development at AgAmerica, told FarmWeek. “Then, when you look at expansion, it’s nearly impossible for some people when you look at these prices.”
“We’venoted. got a generational gap between who’s farming now and we’ve got millennials coming into farming,” he said.
“When you think about inflation, interest rates and rising operating costs, now is the time to build rela tionships with lenders and have part nerships with someone who fits in your operation and helps you get through these tough times.”
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The Federal Reserve Bank of Chi cago reported farmland values in its district increased 23% during the first quarter of 2022 compared to last year.
When lawmakers rewrite the farm bill credit title, Brown said, they should ensure everyone who could qualify for a federal farm loan has equal access it, and that farm operating and farm ownership loan limits keep pace with surging input and land costs.
reforms offered by Brown, including U.S. Rep. Rod ney Davis, R-Taylorville, who said limiting access to ag lending entities like the Farm Credit System “will only discourage individuals ... from seeking careers in farming and agriculture.”
“And I would ask that we have predictability going into the next farm bill,” Brown said. “We have so much volatility throughout my operation, through out the ag economy. If we know what we’re dealing with we can better shape (our operations) ...we can plan better, and that provides us peace of mind.”
But trading the 1950 Ford Ferguson T20 for cash was not enough.
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While Brown was able to acquire some land through the lending programs, he still faced the “inefficiencies of government that oftentimes prevent new and beginning farmers from gaining access to the programs they need to stay afloat until they have their feet under them.”
Brown also said USDA should revise and align its definition of a beginning farmer and rancher and better communicate and educate farmers on ag lend ingNathanprograms.Kauffman, Kansas Federal Reserve Bank vice president, said those changes will be vital as farm loan interest rates continue to increase, as demand for farm loans are expected to “rise nota bly” and as capital spending is expected to decline for the first time since 2020.
“I still needed some help to keep things running and the loan programs that were available for young, beginning and underserved producers came through for me in one of the most difficult and stressful times of my life,” he said.
Despite receiving initial financing, those evergreen farmers are forced to seek more loans to keep growing and to remain competitive with other, larger farms, Brown said. But because they are new to the industry, those farmers don’t have the production or credit his tory required by FSA to qualify for a lending program.
That cycle has hit even harder with soaring fertil izer, equipment and land costs — some Illinois ag land sells for $20,000 per acre and cash rents keeping rising — Brown said, telling the panel that loan limits and caps on operation notes should be increased in the upcoming legislation.
Brown, who grows corn and soybeans in Macon County, recently testified before the U.S. House Ag Committee on behalf of Illinois Farm Bureau. He was one of five panelists advocating for reforms to the credit title of the 2023 farm bill.
“Some producers may face more substantial credit challenges than others,” Kauffman said. “While the strength of farm income these past two years is likely to sustain credit conditions in agricul ture for some time, some borrowers may face height ened financial stress in the year ahead if costs con tinue to rise, and commodity prices ease further.”
FARM
TODAY’S FINANCING Farmers just want the credit they deserve
24 20227,SepWednesday,•ShawLocal.comMedia/ValleySauk MEDIASHAW
Illinois farmer tells lawmakers: Farm financing reforms needed
“While that was a difficult and emotional step to take, the survival of my farm for the next generation is my top priority, just like it was for the generation that passed it on to me,” Brown told federal lawmak ers July 14, his voice cracking.
Brown recounted his difficult experiences navigat ing the Farm Service Agency’s (FSA) Direct Farm Own ership Joint Financing Loan and Marketing Assistance Loan programs and the Natural Resource Conservation Service’s (NRCS) Conservation Stewardship Program
One of Adam Brown’s most painful financial deci sions was selling the first tractor his father rode.
BY TIMOTHY EGGERT | FarmWeek
Brown agreed, noting about 35% of new operating and real estate notes that come to Farm Credit Illi nois are from young, beginning and small farmers.
This story was distributed through a cooperative project between Illinois Farm Bureau and the Illinois Press Association. For more food and farming news, visit FarmWeekNow.com.
(CSP), in which he enrolled to finance buying out other heirs to his late grandfather’s farm estate.
Many members of the committee echoed the
More access to locally grown produce means more food sold.
The program has become so popular that on the first day of the 2022 season, the market ran out of vouchers for the extra benefits. It’s also popular with
25SHAWMEDIA 20227,SepWednesday,•ShawLocal.comMedia/ValleySauk
Strengthening links in the food chain is a SNAP
By fiscal year 2020, more than $371,000 in benefits were spent at 94 farmers markets across Illinois, representing 1.1% of the $3.37 million in total bene
In FY 2020, about 4.5% of the total $74.11 million U.S. SNAP benefits were spent at 4,656 farmers mar kets.“Quite frankly, it has huge economic and health benefits to the community,” Janie Maxwell, execu tive director of the Illinois Farmers Market Associa tion, told
A growing number of farmers markets accept food assistance cards
LINKS cont’d to page 26
The experience in DeKalb largely aligns with a statewide trend.
TODAY’S FARM FARMERS MARKETS
“(UsingFarmWeek.LINKatfarmers markets) means a regu lar stream of income to a farmer at the market, increased sales and a larger customer base that can utilize the farmers market and bring them more profits,” Maxwell said.
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A FarmWeek analysis of USDA Food and Nutri tion Service (FNS) data found both the number of Illinois direct marketing farmers and farmers mar kets accepting LINK have soared since the policy was first established nearly 15 years ago. So have the amount of LINK benefits spent on food sold directly by those farmers and at those markets.
fitsTheredeemed.same progression has played out at the national level.
BY TIMOTHY EGGERT | FarmWeek
That was DeKalb Farmers Market manager Vir ginia Filicetti’s reasoning when she opted to allow people to buy vendors’ fruits and vegetables with federal food assistance. The market received autho rization to do so under LINK — Illinois’ version of the Supplemental Nutrition Assistance Program (SNAP).“The bulk of our customers at the market are LINK users, which is a huge incentive for the mar ket and our vendors,” Filicetti told FarmWeek in a recent interview. “Vendors get LINK customers and customers get fresh vegetables and fruit from localThefarmers.”weekly market is the only one in DeKalb County that accepts LINK dollars and matches those dollars through LINK Up Illinois. The match ing program allows LINK card holders who spend
$25 at farmers markets to receive a matching $25 that can be spent on market fruits and vegetables.
In fiscal year 2010 — the first full market season when vendors could accept LINK dollars — just over $41,000 in benefits were redeemed at 22 markets across Illinois, accounting for 0.14% of the $2.78 mil lion in total benefits redeemed.
For every $1 of LINK benefits redeemed at a farm ers market, about $1.71 is reinvested back into the community hosting the market, according to Max well.“That’s huge,” Maxwell added. “If you’re a LINK user, you could go to a local big-box store, but that’s still supporting a large corporation. Here you’re sup porting a local producer and their products.”
In FY 2010, around 1.2% of the total $64.70 million in U.S. SNAP benefits were redeemed in direct sales at 1,611 different farmers markets.
“It’svendors.anincentive for vendors to come back each year — a big chunk of their revenue from the mar ket comes from LINK spending,” Filicetti said, not ing average LINK dollars spent each week at the market totals around $400.
“We even have non-LINK customers asking about the program,” she said. “A lot of vendors are totally supportive of the program, they communicate that and
“Hopefully, in the future we’ll have the popularity or the funds to be able to fund it across the whole market,” he said. “It’s like any government program — use it or lose it.”
The rules for using LINK dollars at farmers markets or in a direct sale with a farmer, like at a roadside produce stand, are simple: The money can be used for most any fresh food product, except hot ready-to-go meals.
“It really streamlines the process and there’s no confusion between vendors and customers,” Filicetti said.
Despite other markets’ and individual farmers’ success with LINK customers, Greenwood doesn’t plan to renew his own authorization to accept the benefits.
This story was distributed through a cooperative project between Illinois Farm Bureau and the Illinois Press Association. For more food and farming news, visit FarmWeekNow.com.
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He estimated it would take 12 hours a week plus other costs to facilitate the pro gram for each vendor.
Greenwood said he still supports the program, and he’s working with a local organization to apply for a grant to cover the market’s costs of implementing it.
The policy gets more complicated, however, for the individual vendor or the market itself, which must use electronic benefits transfer (EBT) equipment for LINKMaxwelltransactions.saidbuying EBT equipment has been a minor barrier preventing some markets or farmers from partici pating in the program, but grants are available to offset some of the cost.
“I thought it would kind of take off for our market,” Greenwood said. “Unfortu nately, I did not get the response I was hopingGreenwoodfor.” estimated no more than 10 customers with LINK benefits bought his tomatoes, lettuce and other fresh pro duce during the 2021 market season.
26 20227,SepWednesday,•ShawLocal.comMedia/ValleySauk MEDIASHAW
That was the case at the twice-a-week Macomb Farmers Market, where spe cialty grower and market manager John Greenwood in 2021 first applied as an individual direct marketing farmer because the larger market didn’t have the resources to implement LINK accep tance for every vendor.
‘Use it or lose it’
Maxwell said.
“Another vendor that does take LINK, she sells meat, she has gotten a better response,” Greenwood said. “I don’t know if I’m typical or not, but down here
The larger hurdle is faced by volun teer-run markets, which often don’t have the staff or the capital to adminis ter the LINK program at their market,
in west-central Illinois, that (low response) is the case.“
Greenwood said he isn’t sure what’s behind the low response — it could be a lack of education or other factors like the COVID-19 pandemic and inflation.
LINKS cont’d from page 25
How it works
“We’r e all volunteer managers and members. We rarely have the time to get everything else done let alone the admin istrative work to run SNAP,” he said.
Filicetti said she attributes part of the DeKalb Farmers Market’s success to word of mouth and relationship building between customers and vendors.
In DeKalb, market organizers attempted to ease the equipment burden by implementing an EBT token system, wherein LINK customers charge their LINK card in exchange for dollar-equiva lent tokens. Customers give vendors the tokens, which are returned to market officials, who reimburse the vendors.
those who can’t accept LINK are bummed out they can’t accept those dollars.”