Congress fails to fund rural crisis hotline network

SIOUX FALLS, S.D. — An audible and collective groan of disbelief and frustration emanated from rural behavioral health professionals gathered here earlier this week for a regional conference, when they learned that both houses of Congress passed agriculture appropriations bills that did not include funding for a stress assistance network geared to help farm and ranch families.

When asked to picture farm life, many people invision idyllic settings like the ones painted by reknown Iowa artist Grant Wood. The true realities of farm life, however, are often isolation, depression and hopelessness.

The Farm and Ranch Stress Assistance Network, authorized (but not funded) by the 2008 farm bill, would create a national crisis hotline for rural workers and also mandates additional behavioral health services in geographically rural regions. While some states have hotlines and some capacity to provide behavioral health services designed for agricultural workers, others have nothing in place.

Statistics show that the presence of such services can reduce rural violence and suicides, which are currently on the rise.

“How many deaths will it take?” asked Mike Rosmann, executive director of AgriWellness, an Iowa-based nonprofit that promotes accessible behavioral health services for underserved rural populations. “[This] leaves farm people with fewer options to deal with mounting stress. It is especially true for livestock and dairy producers, although the picture is much bigger than just those industries because grain prices are declining and costs of production are rising above the value of products in the marketplace.”

U.S. Sens. Tom Harkin and Chuck Grassley of Iowa pushed for the creation of the stress assistance network as a part of the farm bill. Harkin, a Democrat who chairs the Senate Agricultural Committee, had requested $5 million be provided to the program during appropriations debate. Grassley, a Republican, and Democratic Sen. Tim Johnson of South Dakota also argued for “appropriating the maximum amount possible” in a letter sent to the agriculture appropriations subcommittee in May.

“Farming is one of the most stressful and dangerous occupations in the United States,” Grassley said in December 2007, while urging members of his own political party to stop their attempts to block inclusion of the network in the farm bill. “There are environmental, cultural and economic factors that put farmers and ranchers at a higher risk for mental health problems. Stress is agriculture contributes to rates of depression and suicide that are double the national average. This is true even in good times for farmers.”

Indeed, as senators who opposed creation of the network were quick to point out, the agriculture community at the time of the farm bill debate was flourishing. That is unfortunately not the case today as farmers brace against overall economic decline, suffer massive product price reductions and battle against misinformation about disease. Under these circumstances, and without a safety net, health care professionals are worried that the nation will once again witness breakdowns within agricultural communities similar to those seen during the 1980s farm crisis.

“The consequence of all of this is that there will be mounting frustration,” Rosmann said. “There is also a greater likelihood that more and more people will be frustrated to the point that they are going to do something because they feel like government isn’t listening. We have to have parity of behavioral health care for rural and urban people.”

The appropriations bills will now be taken into a conference committee where the differences between them will be reconciled. During the appropriations conference process, according to a spokeswoman in Grassley’s office, congressional rules do not permit funding for an item that was not previously contained in either the House or Senate versions of the bill. If the conference committee did attempt to include the funding, any member could object — and, given the debate during this item’s authorization in the farm bill, some lawmaker probably would.

“I worked very hard to put the Farm Stress Assistance Network in the farm bill,” Harkin said during a conference call Thursday morning with reporters. “It was attacked … during the farm bill debate, but we persisted and got it in. I just haven’t been able to get funding for it yet. The Republicans would not sign off on my efforts on this.”

There is also some speculation that funding could be included in overall health care reform, but such inclusion would likely be left to a newly created health care committee through recommendations from the U.S. Department of Health and Human Services.

In that type of scenario, the U.S. Department of Agriculture would have much less influence in terms of ensuring urban-rural parity. Further, if health care reform does not include a public option and/or if preventive behavioral health services like the stress assistance network aren’t considered essential services, already cash-strapped rural families would be more likely to have to pay additional premiums to access insurance coverage for such services.

“I’m disappointed that the agriculture appropriations committee failed to see the positive benefits of this program,” Grassley said in a statement to The Iowa Independent. “Farmers continue to see drastic market swings and difficult weather patterns. The assistance of the Farm and Ranch Stress Assistance Network would be a tremendous help to many feeling the impact of problems out of their control.”

The fiscal 2010 Agriculture, Rural Development and FDA Appropriations approved by the Senate includes nearly $101 billion in mandatory spending, an increase of roughly $13 billion from what was enacted in 2009, and just over $24 billion in discretionary spending, an increase of roughly $2.5 billion from 2009. The House bill calls for nearly $23 billion in spending, an increase of roughly $2.3 billion from 2009. The appropriations bill funds nutritional programs, food and drug safety initiatives, international food aid, USDA research and rural development programs.