Collaboration Key to Addressing Issues of the Rural West

In a departure from previous gatherings, the 2018 Eccles Family Rural West Conference took the form of an academic workshop focused on collaborative governance. Panels explored how collaboration in rural communities can foster greater environmental sustainability and better health outcomes.

Bill Lane Center for the American West

The Rural West Conference is an annual interdisciplinary gathering workshop that brings together academics, practitioners, and policymakers to share knowledge and ideas about the rural West, catalyzing scholarship and solutions to this region’s pressing problems. Each spring, the Lane Center travels to a different location in the West, growing the network of individuals and organizations invested in identifying solutions to challenges of rural policy, health and environment.

This year, the Yakima Basin served as the backdrop for the Sixth Annual Eccles Family Rural West Conference. Situated in central Washington, the Yakima area is home to a diverse agricultural landscape supported by the Yakima River. In recent years, sustainable irrigation and access to water have been controversial issues that have demanded the attention of numerous local, state, and federal government actors. In a departure from earlier conferences, the 2018 gathering took the form of an academic workshop focused on collaborative governance with the goal of understanding what makes collaboration successful. Specifically, panels explored how collaboration in rural communities can foster greater environmental sustainability and better health outcomes. The topics under consideration ranged from how to better allocate water, manage wildfires, and promote better health in the rural West.

As a result of the Yakima workshop, the Bill Lane Center for the American West has developed several projects devoted to examining issues discussed in Yakima. This summer, under the direction of Bruce Cain, the Center will launch two research projects that explore:

• The Center will examine the occurrences of wildfire in the state of Washington between 2010 and 2013 and measure their impact on health, especially among disadvantaged communities. Using data from Medicaid claims, we will explore whether wildfires are associated with higher occurrences of respiratory and cardiac illnesses. This project will be a collaboration with Washington State University.
   
• In collaboration with the Sean Parker Center for Allergy and Asthma Research at Stanford, the Center will explore how air pollutants impact the immune system and the progression of asthma and allergies in and around Fresno, California. We will provide a broad analysis of health risks, as cardiovascular events and other diseases are linked to pollution exposure, as well as strategies to minimize exposures. We look forward to keeping you posted on our results.

Video Recap: Collaboration and Compromise in the Rural West 

Opening Session: Not All Rural Western Issues Are New

This year’s gathering was opened by David M. Kennedy, Co-Founding Director of the Bill Lane Center for the American West. Kennedy, who was born and raised in Washington, also helped launch the Center’s Rural West Initiative in 2009. In his opening remarks, Kennedy described how many of the issues concerning rural American Westerners a century ago are still present today, particularly with regard to access to transportation, education, communications, and health care.

“How does our western region come together to deal with problems?” asked Bruce E. Cain, the Eccles Family Director of the Bill Lane Center. “We talk about the West as if it’s a region, but in reality,” he said, “it is a lot of fractured forms of government.” To deal with regional problems like climate change or health care, he said, “we have to overcome all these institutional barriers that we put in.”

Challenges and Possibilities in Wildfire Management

Wildfires, which burn across federal, state, and private lands without regard to land ownership, are a perfect example of an issue demanding collaboration among many western stakeholders. The conference’s first panel, moderated by Stanford professor David Brady, explored the question of how fire managers can confront the growing wildfire threat more proactively and effectively.

Western wildfires have become more expansive, prolonged, and damaging, said Alissa Cordner of Whitman College in Walla Walla, Washington. Cordner, a sociologist and environmental studies professor, spent several years shadowing fire crews in Central Oregon, where increased fire risk has come up against dramatic population growth and increased tourism in towns like Bend. “It creates a really difficult policy landscape for fire managers,” she said, as they try to balance controlled burns with the air quality concerns of residents and business owners.

Rebecca Miller, a doctoral student at Stanford University, focused on the devastating fires in Northern California in the fall of 2017 and how they exposed the complexity of agencies and jurisdictions responding to wildfire. She described how funding disputes may have impeded Cal Fire’s response to mutual aid requests from local fire agencies as the Tubbs fire grew out of control last October. Citing the total of 175 unfulfilled mutual aid requests in the first couple of hours of the fire, she said that “to not get that aid early was incredibly destructive.” 

John Giller, the recently appointed regional director of fire management for the US Forest Service, offered a personal perspective from his three decades as a firefighter for the Forest Service. He reminded attendees that wildland firefighting is one of the most dangerous jobs in the country, with an average of 17 firefighters killed each year over the last half-century. “If any other industry had those numbers,” said Giller, “we’d be in uproar.” At the conclusion of the panel, Giller provided a grim forecast for the future of wildfires in the American West as they burn beyond the traditional calendar– even past New Year’s Day. “We are no longer dealing with fire seasons, we are dealing with fire years,” said Giller.

Lastly, Pat Shea, director of the Bureau of Land Management during the Clinton Administration, discussed the challenges of funding wildfire management. “The way we fund wildland operations is abysmal,” he said. “We need to have a fund that’s like FEMA. It’s available and predictable at both the local, county, and state level, and there needs to be a ‘czar,’ if you will, of firefighting.”

Toward a Healthier Rural West

Phillip Polakoff led a panel that explored three problem areas of rural health and health care: institutions and programs to support treatment; strenuous and sometimes dangerous rural occupations like farming; and the problem of retaining health care professionals in rural communities.

Kevin Harris, a health policy specialist with the William D. Ruckelshaus Center at the University of Washington, said that the quality of care varies dramatically depending on where you live. “When you start looking at hospitals in very rural areas,” he said, “whether they’re community hospitals or critical access hospitals, you find that they’ve been struggling for a very, very long time.” Harris said that core institutional reforms in financing health care will be necessary to bolster rural institutions.

Bidisha Mandal, a health economist at Washington State University, described a study in Oregon that found a surprising effect of expanding Medicaid availability: an increased use of emergency medical care. However, she said that high emergency department use “does not necessarily mean that it’s unnecessary when it comes to rural residents,” and that a lack of specialized doctors to diagnose chronic conditions may be a contributing factor to rural patients’ use of the ER.

Gabriel Garcia, professor emeritus at Stanford Medical School, reminded the attendees of one of the most vulnerable populations in rural communities: migrant agricultural workers. “Their fieldwork is dangerous,” he said, “not only because of the injuries that we see in the field, but also because of chronic illnesses and disability that comes from the fieldwork.” He said that studies have shown that farm work actually requires far more skill than previously appreciated. “What we need to figure out,” he said, “is how do we reframe our view of the migrant in our communities so we actually treat them in the way that they would like to be treated.”

John McCarthy described leaving a cherished rural practice and deciding “that I was going to figure out a way to get more colleagues out there.” Now the Assistant Dean for Rural Programs at the University of Washington School of Medicine, McCarthy said he spent seven years mentoring a fellow resident of rural Tonasket, Washington before she was ready to take over. “That’s how long it took,” he said, “to get a physician back into my position so they were fully staffed.”

Tom Scandalis, Dean of the Pacific Northwest University of Health Sciences in Yakima, discussed his school’s efforts to train more health care providers who will remain in rural communities through their careers. “Recruit locally and regionally,” is their strategy, he said, “educate locally and regionally, and bring them back to the communities they came from.”

Mike Maples, the CEO of Community Health of Central Washington in Yakima, worked as a rural physician for decades. He said that residents sometimes have low expectations of rural doctors. “If it’s a doctor that would come to my town, they must not be much of a doctor,” was an attitude he encountered sometimes. “On the one hand they do want the help,” said Maples, “on the other hand, they can be very suspicious of strangers bearing gifts.”

Perspectives on the Yakima Basin Integrated Plan

The third panel reflected on the process of developing the Yakima Basin Integrated Plan. A sweeping 30-year plan to reallocate increasingly limited water resources among farmers, communities, and wildlife, it was enacted after many years of litigation that gave way in 2009 to a mediated negotiation among former adversaries. The plan has been praised for making the Yakima Basin a great place for families, fish, and farms; but others argue that it has unappreciated environmental impacts. Several of the original architects of the plan were participants on the panel: Peter Dysktra, a Seattle-based attorney with Plauche & Carr LLP; Tom Ring, an environmental consultant with the Yakama Nation; and Urban Eberhart of the Kittitas Reclamation District.

Panelists discussed why and how the plan was designed to satisfy the numerous needs for water in the Yakima Basin. Dykstra described the plan as an effective example for collaborative environmental policymaking. However, Bob Tuck, a Yakima-based natural resources consultant, still believes the plan still doesn’t address several environmental concerns, particularly in regard to sustaining fish and wildlife in the basin. Tuck believes the plan needs a “reality check” and that there is a need for ongoing collaboration. The panel was moderated by Craig Thomas, Professor and Associate Dean at University of Washington’s Evans School of Public Policy.

Models for University-Based Collaborative Governance

The final panel addressed how collaborative governance can provide a tool to further identify solutions to issues in the rural West. In particular, it highlighted best practices in university-based collaborative governance for addressing environmental, economic, and health issues in the region.

Michael Kern, director of the William D. Ruckelshaus Center at Washington State University, described the role of his center in collaborative policymaking and the future prospects for this process in environmental management. “For too many people,” said Kern, “I think collaborate just means ‘work with other people,’ with the inferred postscript of ‘because you have to.’” But, he said, “collaborative governance means something more specific, and at its best it’s not entered into because you have to, but because you want to, or because you expect that you will achieve more by doing so.” To that end, he described several projects the Ruckelshaus Center helped facilitate, from a commission formed after a tragic landslide that killed 43 people in Oso, Washington to an assessment of Columbia River salmon populations.

Craig Thomas suggested that university-based collaborative policymaking has limits: academics can provide topical expertise but political or bureaucratic restraints still exist, and the participants can take time to commit to the process. “People shop for venues they go to where they think they can get what they want,” he said, “and collaborative partnerships tend to be the venue of last resort.”

Nicola Ulibarri, a professor at the University of California-Irvine, presented case studies of environmental regulation in which collaborative decision-making was effective, such as a dam relicensing in central Washington, and California’s Integrated Water Management Program. She said that one of the most important tasks was “really making sure that everybody was on the same page, that nobody felt left out of this process.” Looking at the Federal Energy Regulatory Commission’s dam relicensing process, she said “what you see is that more collaborative processes yield stronger and more tailored environmental protections.”

Gabriela Munoz-Melendez, a professor at El Colegio de la Frontera Norte in Mexico, illustrated how the Tijuana River binational watershed has been managed through a collaborative international process. The panel was moderated by Bruce Cain, Eccles Family Director of the Bill Lane Center for the American West.

Keynote Address by Hilary Franz, Washington Commissioner of Public Lands

The workshop concluded with a keynote address by Hilary Franz, who was sworn in as the state of Washington’s Commissioner of Public Lands in January 2017. In this capacity, she oversees 5.6 million acres of state-owned lands, the majority of which are considered rural. Franz described how many of the state’s most pressing environmental issues disproportionately impact rural communities, whether drought, wildfires, or the management of species, ecosystems, and resources. But, as she noted, the state fundamentally relies on rural communities for several key reasons. “Our rural communities are truly going to be the place that we absolutely depend on, from growing the food we eat, to the wood that houses us, and caring for the lands and the clean waters that we all depend on,” said Franz.

Looking Ahead to Rural West 2019

We want to thank all those who contributed to the Sixth Eccles Family Rural West Conference. Later this fall, we will be announcing details for Rural West 2019. If you’d like to receive updates on our research and the 2019 conference, please email jdougher [at] stanford.edu (jdougher[at]stanford[dot]edu)

Related Links

Rural West Conference 2018 Page