PALM DESERT, Calif.—From a financial standpoint, things are largely looking good—if you live in an urban area. In the heartland, the picture is far from rosy.

"The challenges confronting rural America now seem more daunting than at any time in recent memory," Tom Halverson, CEO of CoBank, noted in the introduction to its recent report on "The Rural-Urban Divide."

That schism—and how to bridge it—was the subject of a session at NRECA's CEO Close-Up, where one word kept popping up: broadband.

"The job growth we're seeing in urban places in part depends on having access to that technology," said Brian Cavey, CoBank senior vice president, government affairs.

He said it's crucial to be able to "attract back the generation that goes to school" and while away discovers how much easier life is with high-speed internet.

But it's more than just employment. Cavey pointed to what he called "probably the most troubling" bit of data, which concerns the health of rural Americans.

"Part of that is access to information. Part of that is direct access to health care—ease of getting health care, ease of getting wellness treatment. And as a result we have unhealthier conditions for a lot of people in rural settings when you compare that to what's going on in urban settings," said Cavey.

The problem is exacerbated as small rural hospitals continue to close, he said. Enhancing telemedicine—which allows professionals to diagnose patients remotely—would help. But for that you need broadband.

Central Iowa Power Cooperative (CIPCO) knows firsthand about health care issues, having given a huge boost to a rural hospital served by distribution member Pella Electric Cooperative. And not everything concerns broadband.

"This was a critical infrastructure project," said Bill Cherrier, CIPCO's CEO. "This was critical to this community."

Cedar Rapids-based CIPCO and Pella-based Pella Electric Cooperative were able to secure the hospital a $1.4 million loan through the Rural Economic Development Loan and Grant program, or REDLG. It's helping pay for a $15 million project to renovate the hospital, add a primary care clinic and make other improvements.

"Anything we do like this really helps the vitality of that community," said Cherrier.

CIPCO has undertaken more than 40 such projects, providing some $12 million in financial support to create nearly 600 jobs and retain 1,800 others. Another example is providing $1.7 million in REDLG loans to Southwestern Community College.

"It really helps demonstrate the commitment to education within our rural areas," said Cherrier.

As for which economic development projects CIPCO chooses to support, Cherrier said there's one fundamental he always looks at.

"It not only needs to benefit the community, but it needs to benefit our members," said Cherrier. "And it should benefit our members in terms of load growth or market growth to help support the utility itself."

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