Representative David Prestin on Rural Issues, Veterans, Childcare, and Healthcare in the U.P.

In this episode of the Rural Insights Podcast, David Haynes and Student Researcher Brenna Musser talk to Representative David Prestin from the 108th House District. They discuss the top issues affecting the district, including the need for more opportunities, housing, and jobs to improve the quality of life in the Upper Peninsula.

They also delve into the challenges faced by veterans in rural areas, the childcare crisis worsened by the COVID-19 pandemic, and the shortage of healthcare specialists in the U.P. Preston emphasizes the importance of addressing these issues through policy changes, investment, and removing bureaucratic hurdles.

Topics discussed include the need for more opportunities and revitalization in the U.P., challenges faced by veterans in rural areas and the lack of accessibility to advanced care, the childcare crisis and the need for regulatory reform to support cottage-style facilities, the shortage of housing and the impact of high labor and material costs, and the scarcity of healthcare specialists and the importance of attracting and retaining medical professionals in rural areas.

Transcript

David Haynes:

Good day, everyone. This is David Haynes again with another edition of Rural Insights Podcast, Whispers, Noise, and Rumors. And we're really delighted today to have Representative Preston with us from the 108th House District. His district runs all the way over from Chippewa County on the east is all the way through Delta and into Menominee Delta and it's a pretty geographically large district. Is it the largest representative now in the U.P.?

David Prestin:

There's been some discussions, but I've been doing some measuring. I think I've got the largest geographic district, but yeah, it's close between myself and Rep. Markkanen.

David Haynes:

Yeah, I thought so because he comes, I live in Big Bay and I think he comes all the way down the Big Bay in Marquette County, the northern county. Well, thank you for joining us and Brenna Musser who is our student researcher, is joining us today and she may or may not ask a question. I'll leave that up to her.

And she not only is a brilliant researcher, but she's a star soccer player at Northern Michigan University, so we're delighted to have her. Representative-

David Prestin:

Fantastic.

David Haynes:

Thanks. What do you think are the top couple of issues to the people of the 108? Just from a policy point of view of what's really important to them that the state legislature could do?

David Prestin:

Just the overlying issues with me are really just trying to provide more opportunity and whether that be through housing, jobs and just availability of a quality way of life up in the U.P. is something that I've been after. I've watched its decline. My mom was born and raised in Menominee County, in Stevenson in particular. So I've been coming to the U.P. my entire life and I've watched as the decades have rolled on just a continual decline, especially in the rural parts of the upper peninsula.

And I think we all see the shuttered up resorts, restaurants scattered all throughout the U.P., especially in the district that I represent. And they designated the Bitter Root Project, which I was involved in and I was happy to see it come to fruition as a renaissance zone, and I really think we need to look at the U.P. as a whole renaissance zone that needs to be reinvigorated. I think the U.P. has so much potential that's untapped yet and I see it as a blank canvas that's really yet to be be painted.

David Haynes:

So you have a very diverse district. You have some very, very rural areas which every representative in the U.P. does and you have some, if you will, metropolitan areas, certainly Sault Ste Marie and Menominee and Marinette, that whole region bordering over in Wisconsin are really big and tourism tends to drive a lot of that.

One of the issues though that we're, whether it's rural or metropolitan that we've written a lot about is veterans. I'm a veteran, I'm an Air Force veteran, and the issues that they have in rural areas and the isolation and the difficulty of life. Any specific things with veterans in your district or the U.P. that we could do that you think?

David Prestin:

Well, as a two-term county commissioner in Menominee County, so our veteran affairs officer was a big part of it. My neighbors were both, one was a Vietnam veteran, one was deployed in the Gulf. So the veteran community in the U.P. is they're there. It's a little more difficult for them. I think in some ways the U.P. suits some and maybe inhibits others, especially when it comes to accessibility to advanced care or needs that veterans with certain disabilities or PTSD may be suffering through.

But in the U.P. you do the best that you can with what you have and I see that in Menominee, in Delta in Schoolcraft as I tour these counties, they're all doing the best that they can with what they have. And I'll tell you, we're a community. The U.P. it's a place of community and the one thing that I'm always impressed by is when somebody's in need, there's usually always somebody there, a neighbor to lend a helping hand.

David Haynes:

Yeah, I think that's true. And I think as you know for veterans, that's very much true with Contact a Buddy program and others who veterans helping, reaching out, watching for veterans with PTSD or other issues, they may need help. That clearly is very true. And I think one of the other strengths is that we have the Oscar Johnson Veterans Hospital in Iron Mountain and serves the whole U.P. It's one of the highest rated in the country.

But we hear a lot about what you just said. Isolation, difficulty with maybe service-related disabilities and where to go for help when you're 180 miles from someplace. So what about issues, do you hear much about childcare? We hear a lot about this where people saying, "I could go to, even if I get a job, I've got to pay more in childcare than I do for my house payment for my rent. And even if I could afford it, the availability..." Is childcare an issue in the 108th House District?

David Prestin:

Oh, definitely. It was an issue before Covid and I think post-Covid, Covid really exacerbated it to almost on an exponential level as far as what I'm seeing. That's a tough one, especially in our rural communities. Again, and that's another aspect that here in Lansing there's a lot of stuff that's going on and not a lot of stuff that's really getting down to the grassroots and going after some of these problems like you're bringing up with childcare.

I'd love to be talking about that right now. Unfortunately that's not on the agenda. And with us being in minority in all three branches, we don't dictate the agenda. The agenda's pretty much handed to us. So you take your wins and you fight the fight when you can. But that's definitely an area where I think more care, more due regard needs to be paid attention to and just clearing a lot of the landmines and the walls that are in the way.

Some of the Legacy Childcare facilities, they're really put in a pickle when it comes to current regulation. And I think we got to have an honest look at childcare and how to best handle it going forward. And that's going to take some dynamic thinking on a lot of people's parts.

David Haynes:

You're right, and it's about, also about regulation, state regulation and federal regulation. Even if you can get people to do the care, then you've got to deal with all the regulation of somebody who's only going to take four kids.

David Prestin:

And that's really the hurdle is the regulatory reform that needs to happen to clear some of these headwinds that are preventing people from starting up a cottage style childcare facility. So I look forward to the day when we can have those discussions, but we're not there yet.

David Haynes:

Not there. What are some of the issues you think are U.P. wide? I know veterans are, and I know childcare. Are there other issues as you look at the 108th and you talk to your colleagues from the U.P. that really are U.P. wide issues that the legislature ought to be spending some head time on?

David Prestin:

It's not only the legislature, but it's our local units, the government. Housing's a big one. The U.P. is, as you drive through, we've got an aging infrastructure when it comes to single family homes and there would definitely be many more people relocating to the U.P. if we have more housing availability. So I think housing and affordable housing going forward is a key one.

Opportunity, job growth, especially jobs and job availability on the eastern side. I see the east, when you look at Marquette, Marquette's thriving, so is the Menominee area and to that extent, Escanaba in Delta. But when I look to the west, I see an area that is in desperate need where a couple of industries, if they lost them, they would really be in a bind up there. And to have all your eggs in one basket like some of these counties do, it's just you need to see them thriving better, more diverse in the jobs market than what they have right now.

David Haynes:

Yeah, housing is a tough one to solve, isn't it? I Mean, is it private sector driven? Is it public sector driven? What role can you do? And for a private developer, you're not going to build housing you can't make money on, I mean it's-

David Prestin:

Right. And that's just it and it's exacerbated by the labor crisis and material cost. I mean, when you're talking about fair market value of some of these homes, you can't build them for the price that you're going to need to sell them for. I mean the cost to market value ratios are completely skewed right now just due to building material costs and our supply chains as well as our labor costs. Our labor costs are through the roof because there's just not enough people out there to build these homes that we need and you look out on the horizon. And I don't see any relief. We're in a population contraction, especially when it comes to skilled trades.

David Haynes:

Yes, I just read too, the article, I think I put it in one of my columns, I think it's over half the skilled trades community is over the age of 45 now. I think it's a big number, whatever it is-

David Prestin:

Yeah.

David Haynes:

... and it's just not being replaced.

David Prestin:

I used to own, for those of your listeners that don't know, I used to own Cedar River Plazas. That's a truck stop. It's right in between Escanaba and Menominee.

David Haynes:

Sure.

David Prestin:

And I can remember having several talks with truckers that, I'm 57, so having several talks with truckers and we would talk about, "Boy, we really don't know what's going to happen when our demographic fully retires from the system." And I continue to have these conversations with friends and people here in Lansing as well as back in the district that are similar to my age, anywhere from 45 to 60.

And when that demographic retires, it's looking pretty tough. It's something that we need to be mindful of going forward. I just attended an event at the Union Hall in Escanaba with four kids that, I think four kids that got apprenticeships in the trades, but we need more.

David Haynes:

Yeah. Yeah, and of course in your district, you're fortunate you have Bay College with a trades program, but serving a good part of the 108 makes a big difference. The other issue is, and the last one I'll bring up to you is healthcare on your far Eastern end in the Sault War Memorial, after years of fighting to be independent, did an arrangement with the University of Michigan Health System through mid-Michigan.

And I've talked to the former administrator's, a very good friend of mine and made a huge difference in access to healthcare coming up 75 and also telemedicine. But there's a saying going around that the one thing you can't find in the U.P. as an ologist, a specialist. You can't find a dermatologist, you can't find an endocrinologist, an oncologist. I know in Marquette, the oncology practice has one doctor, I think it had seven a year and a half ago.

Certainly that's true all over. People, and you know representing Escanaba, people go to go to Green Bay to get healthcare often. What do you think we can do about healthcare in rural areas? This really is a phenomenon across the country, a lack of specialists. And some of the issues, we already talked about housing and childcare and things like that, but what are some of the things that the state of Michigan could be doing to help rural healthcare?

David Prestin:

Well, just to set the stage for 15 years I've been, I've served on Mid-County Rescue Squad as an EMT and when I [inaudible 00:14:26] at the station, I went back to school at Bay College and became a paramedic that was just before the pandemic, so I ended up spending the last three years actually at Bay Hospital down in Marinette as a hospital-based paramedic.

So I spent about 60% of my time in the ER. So I got to see firsthand a lot of the stuff that you're referring to and the lack of ologists and the specialties, especially pediatrics, is they're leaving the U.P. exponentially. In fact, not too long ago, there was a span of time and I'm sure Marquette it out, but wasn't a pediatrician. And they're level two. Most of them are level three, level four critical care access points.

And yeah, you're right, we rely on telemedicine for a lot of neuro interventions and then we do a tremendous amount of transportation on the paramedic level down into Wisconsin, specifically Green Bay, Milwaukee, and Madison, depending on the specialty that's needed. And I don't see that getting any better.

Healthcare was in trouble going into the pandemic, and the pandemic really took a toll on all healthcare services from doctors to nurses to EMS. It was both a physical, psychological toll and the numbers of both EMS and medical professionals that I witnessed personally retire was startling to say the least.

Going forward, we just have to continue to put more and more emphasis on making it desirable to practice in the U.P., to practice medicine in general because it's a nationwide shortage. It's not just exclusive to the U.P. There are shortages everywhere. So I don't see this getting any better. But the one thing that helps stabilize this phenomenon that we're in, and I think we're going to be in for a while, is the ability to transport to higher levels of care.

So right now I just signed on to a bill package that helps stabilize quality of life issues for nurses on patient to nurse ratios. I think I saw that firsthand as being a big issue in our hospital as well as I know it was happening because I was hearing stories from other hospitals, just nurses, medics, doctors, just overwhelmed because everybody thought that after the pandemic that healthcare was going to get kind of a break and quite the opposite happened.

As soon as the mask came off and people let their guard down, we started to notice that there was a little bit of a lag effect on people's immune system and people actually got a little bit sicker and we had a lot of coagulopathy issues and things are still dicey and I think this is going to be a tough summer, but hopefully we work our way through that and like I said, we can get healthcare realigned, bring a quality of life back to the profession and try to start to shore up the ranks as things go forward.

David Haynes:

Yeah, we had some research we put on our website and in my column that talked about teachers and nurses leaving the profession in huge numbers, in just very big numbers for the reasons you just described. One last... Brenna, do you have anything you want to ask?

Brenna Musser:

Actually, yeah, I have been holding onto the question I didn't quite get a chance to jump in. You were mentioning growing, U.w Wide issues growing the availability, job availability on the east side of the U.P. in contrast to Marquette and the western side of the U.P. other cities. What kind of job availability, specifically or specific industries were you thinking about you would like to see grow?

David Prestin:

Boy, as an entrepreneur you never know what's going to pop up. Just having that availability, putting policy in place that allows an entrepreneur to invest and for the state to not get in the way. And I can tell you for someone that bought a truck stop that had been shut down for almost two years, pulled it out of bankruptcy and got it restarted, I noticed that a lot of the issues that were preventing my success were bureaucratic related with the state of Michigan.

So really just opening things up so that the entrepreneur and that private money, private equity can flow into some of these economically depressed zones. And that's, one of the things that I've been thinking about is trying to create renaissance zones where there's actually incentives to go in and invest into some of these communities and get things going, whether it be hotel, hospitality, you name it.

Because a lot of those areas that I'm talking about have a great trail system as well as a tourism system during winter and summer. So I see a lot of ability there, but there's just not a lot of investment. Right now we're seeing some significant investment up Munising, which that gives me hope because when I see that, I see the ability across the rest of the Eastern portions as well as some of the western portions up through Big Bay and things like that that have really been withering.

So really just trying to get government out of the way so that free market equity can flow into the area is what's the most important to me, because a lot of these counties, they have all their eggs in baskets like the prison system, healthcare, things like that, schools. Those are the major employers and they're needed, local government, those are all needed, but they shouldn't be the backbone of the economy. The backbone of the economy should be the private sector. And that's really what I'm looking to see happen in the U.P. It's almost an inversion when you think about it in the U.P. as far as who the primary employer is.

David Haynes:

Well, Representative-

Brenna Musser:

That's a good answer.

David Haynes:

... thank you. I say to folks all the time that we ought to spend time thanking people who run from local government to state representative to statewide office. It's a huge sacrifice and to you and your family to try to serve democracy and to serve the public good, so thank you very much for doing that and for taking time away from your family and business to serve. And thank you for taking the time to do this podcast. I thank you very much and I hope you'll do it again with us soon.

David Prestin:

Oh, absolutely. Reach out anytime.

David Haynes:

Good deal. Thank you, sir. Have a great day. Brenna, thank you.

David Prestin:

Thank you both.

Brenna Musser:

Thank you, Representative. Thank you for your time.

David Prestin:

Have a great day. Bye-bye.

Brenna Musser:

Take care.

David Haynes:

You too.