After more than a century in downtown St. Paul, the St. Paul Winter Carnival’s signature daytime parade is marching off West Seventh Street and relocating to Grand Avenue come January.

The St. Paul Festival and Heritage Foundation announced Tuesday that the carnival’s King Boreas “Grande Day” parade will be held Jan. 25 in conjunction with the Grand Avenue Business Association, drawing more than 100 parade units to Grand from Dale Street to just past Lexington Parkway.

The rerouting is no small loss for downtown and no small gain for Grand, which is already well known for hosting the longstanding Grand Old Day parade and street festival, held each year as an unofficial kick-off to summer. The Winter Carnival, which was established in 1886 and is entering its 139th year, has a $3 million to $5 million economic impact on the city and state, according to organizers. It’s the oldest winter festival in the country and draws some 250,000 visitors to its events.

The 139th Winter Carnival takes place from Jan. 23 to Feb. 2. For more information, visit wintercarnival.com.

This story will be updated as more information becomes available.

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By Gretchen McKay, Pittsburgh Post-Gazette

PITTSBURGH — Sarah Tuthill has a pretty straightforward philosophy to assemble a food board for parties: Keep things simple, but also make your spread memorable by arranging the food and drinks thoughtfully.

The made-to-order cheese and charcuterie boards crafted at her tiny storefront and commercial kitchen, EZPZ Gatherings in Aspinwall, Pennsylvania, are a case in point.

Not only are the cured meats, seasonal fruits, homemade spreads and various cheeses drool worthy, but they’re also artfully designed to make a table look pretty.

The owner of EZPZ Gatherings Sarah Tuthill folds Prosciutto while making a summer caprese squeezers board in Aspinwall on Monday, Aug. 5, 2024. The summer caprese squeezers board is a part of a cook book recently published by Tuthill named “Gathering Boards,” and in the book she instructs people how to compose various picnic boards. (Esteban Marenco/Pittsburgh Post-Gazette/TNS)

Richly layered and vibrant, they boast a contrasting mix of colors and textures. Some are traditionally arranged on wooden boards, but depending on the theme or season, Tuhill also might add a touch of whimsy by using woven harvest baskets or wooden bowls. Or she might opt for modern and minimalistic by placing pieces on acrylic or melamine boards.

As she details in her recently released how-to book, “Gathering Boards: Seasonal Cheese and Charcuterie Spreads” (Rowman & Littlefield, $27.95), the Aspinwall native and Penn State University grad also has been known to line up crackers on the vintage shirt-sleeve ironing board she found in an antique store. Big on repurposing, she also likes to tuck candles, jars of olives or flowers into a primitive wooden tool caddy.

“A lot of it comes down to social media,” Tuthill says of her distinctive displays. “Everyone is posting these beautiful pictures, and the bar is raised. You can’t just slap things on a [plain] board.”

Aspinwall resident Sarah Zimmerman Tuthill’s new book “Gathering Boards” offers a step-by-step guide to creating cheese and charcuterie boards. (Courtesy of Sarah Zimmerman Tuthill/TNS)

Though she has always been a foodie and has dabbled in floral and interior design, Tuthill didn’t set out to be a food entrepreneur after graduating from college with a degree in advertising. Most of her career has been in communications, including many years as a freelance writer.

She only started toying with the idea of EZPZ Gatherings around 2018 because she longed to write a book and wanted to do something to “get my hands dirty” by doing it professionally.

“I love writing, but was drawn to doing something more hands-on, creating something tangible, but still creative,” she says.

While she has always loved to entertain and was known among family and friends for making beautiful hors d’oeuvres and other spreads, Tuthill knew she didn’t want to be a full-service caterer.

“So I zeroed in on appetizers,” she says, officially opening EZPZ Gathering in December 2019, just before the charcuterie craze took off during the COVID-19 pandemic.

Initially, Tuthill worked out of the food incubator kitchen her friend, Josephine Caminos Oria, opened in 2013. Then the pandemic hit “and I was done before I even started,” she says with a rueful laugh.

Back to the drawing board

No one would have blamed her if she threw in the towel. But Tuthill dug in, using the downtime to continue honing her packaging skills and further educate herself about cheese varieties, flavors, textures and production methods.

“It was a blessing in disguise,” she says.

A Classic cheese and charcuterie board sits on display inside EZPZ Gatherings in Aspinwall on Monday, Aug. 5, 2024. The cheese and charcuterie was made by owner Sarah Tuthill who recently published the cookbook “Gathering Boards,” which instructs people how to compose various picnic boards. (Esteban Marenco/Pittsburgh Post-Gazette/TNS)

Because so many were stuck at home and in search of hobbies, it also allowed her to start teaching online classes. “So many Zoom book clubs wanted cute snacks,” she remembers. “People wanted to learn and experience something rather than just sitting around.”

The public’s desire to create beautiful gathering boards at home only grew once pandemic restrictions were lifted and the charcuterie board craze exploded.

Today, the one-room storefront Tuthill took over in 2022 — one of the first local niche businesses focused on creating boards for dinner parties, graduation parties and other celebrations — now doubles as a “boarding school” in which fellow Pittsburghers can take workshops to learn the art of cheese and charcuterie styling.

As she notes in her book, “The truth is, you don’t have to be a culinary genius to throw a good party. In fact, you don’t have to know how to cook at all. By merely presenting food and drinks in an inventive, beautiful or whimsical way, you can turn the ordinary into the extraordinary.”

A picnic basket alongside various Various picnic board sit on display inside EZPZ Gatherings in Aspinwall on Monday, Aug. 5, 2024. The the basket and boards were made by owner Sarah Tuthill who recently published the cookbook “Gathering Boards,” which instructs people how to compose various picnic boards like the ones seen. (Esteban Marenco/Pittsburgh Post-Gazette/TNS)

Many of her ingredients are sourced locally at specialty shops (Pennsylvania Macaroni Co. is a favorite haunt) but she also fills her boards with items from chain grocery stores like Trader Joe’s. “It’s a little bit of everything, depending on the season.”

Tuthill was approached to write her book on boards in 2022 in the most Pittsburgh manner. A woman saw a story about Tuthill’s shop and her background as a writer in a local paper. “And lo and behold, she cut it out like grandmas do and sent it to her son,” who works for Rowman & Littlefield Publishing. And the rest, she says, “is history.”

She closed her shop at the beginning of 2023 to focus on the project, and did most of the writing last summer. The tome hit bookshelves on May 13, and can be found on Amazon and in Barnes & Noble.

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Meant as a “how-to-do-it” for people who like to entertain, the book — beautifully photographed by Kari Hilton and sprinkled throughout with family stories — includes specific suggestions for each season, along with styling tips. The section on summer gathering boards, for instance, includes “Picnic in the Park” and “Lakeside Snackle Box” boards while fall features a “Game Day Tailgate Box” and a Halloween-inspired “CharBOOterie.”

Along with a handful of recipes for go-to dips and sides, Tuthill offers tips on serving temperatures, knife selection and serving sizes. She also includes suggestions for wine pairings and decor, along with tips on glassware, lighting, party flow and post-party clean-up.

For an end-of-summer picnic, Tuthill recommends focusing on foods that are easy to pack and eat, and can withstand some heat, such as the skewers and Chautauqua Salad featured below.

“And of course a [pre-made] cocktail or fancy drink is always fun,” she says. She suggests using mason jars for a summer sangria because they’re super cute and close tightly.

“You just pour ice and vodka over the top,” she says, “and it’s all self contained.”

Summer on a Stick

A summer caprese squeezers board sits on display inside EZPZ Gatherings in Aspinwall on Monday, Aug. 5, 2024. The summer caprese squeezers board was made by owner Sarah Tuthill who recently published the cookbook “Gathering Boards,” which instructs people how to compose various picnic boards. (Esteban Marenco/Pittsburgh Post-Gazette/TNS)

Serves 6, PG tested

Skewers make for stress-free (and mess-free) picnicking, and take the guesswork out of what goes with what. This summer spin on Caprese salad swaps out the tomato for slices of juicy peach.

6 slices chilled prosciutto (slightly thicker slices work best)

1 ripe peach, sliced

6 small mozzarella balls (cherry-sized)

6 fresh basil leaves

Skewers or toothpicks

Fold prosciutto into ribbons: Fold a single slice in half longways, then gently fold it back and forth like an accordion. Pinch the bottom while fanning out the folds.
Thread a piece of peach onto a toothpick, followed by mozzarella ball, basil leaf (folded in half or into quarters if large). Finish with a prosciutto ribbon, then place onto a serving platter. Repeat with remaining ingredients.

— Sarah Tuthill

Mason Jar Sangria

A mason jar sangria sits on display inside EZPZ Gatherings in Aspinwall on Monday, Aug. 5, 2024. The mason jar sangria was made by owner Sarah Tuthill who recently published the cookbook “Gathering Boards,” which instructs people how to compose various picnic boards and beverages. (Esteban Marenco/Pittsburgh Post-Gazette/TNS)

Serves 2, PG tested

Mason jars make the perfect vessel for individual cocktails-to-go and can be found in just about any supermarket or craft store.

1 ripe peaches, sliced

1 ripe plumb, sliced

1/2 cup berries

3 ounces vodka

6 ounces dry white wine

6 ounces lemonade

1 12-ounce can sparkling water or club soda

Fill 2 half pint jars with seasonal fruit (You can use the same ones you’re serving for your picnic!)
Top each with a shot of vodka and 2 shots of white wine. (I prefer a dry white like sauvignon blanc in the summertime.) Add a couple ounces of something sweet like lemonade or lemonade concentrate.
Screw on the lids, give them a shake and let the jars sit in the refrigerator for a few hours or overnight.
Pack them up and when you’re ready to enjoy, top off with chilled soda water and add a festive straw.

— Sarah Tuthill

Chautauqua Salad

A Chautauqua salad sits on display inside EZPZ Gatherings in Aspinwall on Monday, Aug. 5, 2024. The Chautauqua salad was made by owner Sarah Tuthill who recently published the cookbook “Gathering Boards,” which instructs people how to compose various picnic boards. (Esteban Marenco/Pittsburgh Post-Gazette/TNS)

Serves 2-4, PG tested

“This salad is a key component of our family’s favorite summer meal” in Chautauqua, N.Y., writes Tuthill.

There, it’s almost always served alongside nothing more than corn on the cob and a crusty loaf of bread on nights when it’s too hot for the oven or grill. But it’s also a refreshing salad that’s perfect for a picnic.

3/4 cup red wine vinegar

1/2 cup granulated sugar

1/4 cup virgin olive oil

1 large cucumber, peeled and sliced thinly

2 large tomatoes, sliced

Prepare dressing: In a shallow bowl, dissolve sugar in the red wine vinegar. Whisk in the oil.
Gently fold in tomatoes and cucumbers and allow to sit, at room temp, for at least 20 minutes.

— Sarah Tuthill

©2024 PG Publishing Co. Visit at post-gazette.com. Distributed by Tribune Content Agency, LLC.

By Aaron Bolton, MTPR and KFF Health News

Missoula is one of Montana’s largest cities but is surrounded by rural mountain communities where cattle ranching is king. Despite the latitude and altitude, in recent years this region has experienced punishing summer heat waves.

It has been difficult for residents to adapt to the warming climate and new seasonal swings. Many don’t have air conditioning and are unprepared for the new pattern of daytime temperatures hovering in the 90s — for days or even weeks on end. Dehydration, heat exhaustion, heatstroke, and abnormalities in heart rate and blood pressure are among the many health complications that can develop from excessive exposure to high temperatures.

It can happen anywhere and to anyone, said Missoula firefighter Andrew Drobeck. He remembers a recent 911 call. The temperature that day had risen to over 90 degrees and a worker at a local dollar store had fainted. “She’s sensitive to the heat. Their AC wasn’t working super good,” Drobeck said. “I guess they only get a 15-minute break.”

Drobeck said many of the heat calls his department receives are from seniors who struggle to stay cool inside their older homes. Montana’s population is among the oldest in the country. About 1 in 4 residents are over 60. Those over 65 are especially vulnerable to heat-related illness, according to the Centers for Disease Control and Prevention. As people age, their bodies don’t acclimate to heat as well as they did when they were younger, including not producing as much sweat.

In July, a heat dome that settled over much of the western U.S. baked the region and shattered two types of temperature records: daily highs, and number of consecutive days over 90 degrees. Although the Northwest, including western Montana, is typically cooler, the region experienced record-breaking heat this summer.

Emergency responders like Drobeck have noticed. Drobeck says 911 calls during heat waves have ticked up over the last few summers. But Missoula County officials wanted to know more: They wanted better data on the residents who were calling and the communities that had been hardest hit by the heat. So the county teamed up with researchers at the University of Montana to comb through the data and create a map of 911 calls during heat waves.

The team paired call data from 2020 with census data to see who lived in the areas generating high rates of emergency calls when it was hot. The analysis found that for every 1 degree Celsius increase in the average daily temperature, 911 calls increased by 1%, according to researcher Christina Barsky, who co-authored the study.

Though that may sound like a small increase, Barsky explained that a 5-degree jump in the daily average temperature can prompt hundreds of additional calls to 911 over the course of a month. Those call loads can be taxing on ambulance crews and local hospitals.

The Missoula study also found that some of the highest rates of emergency calls during extreme heat events came from rural areas, outside Missoula’s urban core. That shows that rural communities are struggling with heat, even if they get less media attention, Barsky said. “What about those people, right? What about those places that are experiencing heat at a rate that we’ve never been prepared for?” she said.

Barsky’s work showed that communities with more residents over 65 tend to generate more 911 calls during heat waves. That could be one reason so many 911 calls are coming from rural residents in Missoula County: Barsky said people living in Montana’s countryside and its small towns tend to be older and more vulnerable to serious heat-related illness.

And aging in rural communities can pose extra problems during heat waves. Even if it cools off at night, an older person living without air conditioning might not be able to cope with hours of high temperatures inside their home during the day. It’s not uncommon for rural residents to have to drive an hour or more to reach a library that might have air conditioning, a community center with a cooling-off room, or medical care. Such isolation and scattered resources are not unique to Montana. “I grew up in the Upper Peninsula of Michigan,” Barsky said. “There are no air-conditioned spaces in at least 50 miles. The hospital is 100 miles away.”

Heat research like the Missoula study has focused mostly on large cities, which are often hotter than outlying areas, due to the “heat island” effect. This phenomenon explains why cities tend to get hotter during the day and cool off less at night: It’s because pavement, buildings, and other structures absorb and retain heat. Urban residents may experience higher temperatures during the day and get less relief at night.

By contrast, researchers are only just beginning to investigate and understand the impacts of heat waves in rural areas. The impacts of extreme heat on rural communities have largely been ignored, said Elizabeth Doran, an environmental engineering professor at the University of Vermont. Doran is leading an ongoing study in Vermont that is revealing that towns as small as 5,000 people can stay hotter at night than surrounding rural areas due to heat radiating off hot pavement. “If we as a society are only focused on large urban centers, we’re missing a huge portion of the population and our strategies are going to be limiting in how effective they can be,” Doran said.

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Brock Slabach, with the National Rural Health Association, agrees that rural residents desperately need help adapting to extreme heat. They need support installing air conditioning or getting to air-conditioned places to cool off during the day. Many rural residents have mobility issues or don’t drive much due to age or disability. And because they often have to travel farther to access health care services, extra delays in care during a heat-related emergency could lead to more severe health outcomes. “It’s not unreasonable at all to suggest that people will be harmed from not having access to those kinds of services,” he said.

Helping rural populations adapt will be a challenge. People in rural places need help where they live, inside their homes, said Adriane Beck, director of Missoula County’s Office of Emergency Management. Starting a cooling center in a small community may help people living in town, but it’s unrealistic to expect people to drive an hour or more to cool off. Beck said the Missoula County Disaster and Emergency Services Department plans to use data from the 911 study to better understand why people are calling in the first place.

In the coming years, the department plans to talk directly with people living in rural communities about what they need to adapt to rising temperatures. “It might be as simple as knocking on their door and saying, ‘Would you benefit from an air conditioner? How can we connect you with resources to make that happen?’” Beck said.

But that won’t be possible for every rural household because there simply isn’t enough money at the county and state level to pay for that many air-conditioning units, Missoula County officials said. That’s why the county wants to plan ahead for heat waves and have specific protocols for contacting and assisting vulnerable rural residents.

“Ideally we’d be in a situation where maybe we have community paramedics that can be deployed into those areas when we know that these events are going to happen so they can check on them and avoid that hospital admission,” Beck explained. She added that preventing heat-related hospitalizations among rural residents can ultimately save lives.

This article is from a partnership that includes MTPR, NPR, and KFF Health News.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs of KFF — the independent source for health policy research, polling and journalism.

©2024 KFF Health News. Distributed by Tribune Content Agency, LLC.

By Shalina Chatlani, Stateline.org

Mercedes Dodge was raised by first-generation immigrant parents from Peru in a modest home in a rural part of southeastern Texas, where there weren’t many health care providers. Sometimes they had to travel to Houston, over an hour and a half away, to get basic health care.

Partly because of that experience, Dodge became a physician assistant. Since 2008, she has provided psychiatric and primary care services to adults and children, many of whom come from communities like hers.

Dodge, who now lives in Austin, Texas, has built up a loyal base of patients, including many who are part of military families. But when any of them move out of Texas, she has to stop treating them, even via telehealth, unless she gets a license to practice in that state.

“I do my best and collaborate with them, but they already feel alone,” Dodge told Stateline. “I wonder, ‘Why can’t I be the glue? Why can’t I step over state lines and provide the care that they deserve?’”

Mercedes Dodge, a physician assistant in Austin, Tex. Dodge holds PA licenses in multiple states so she can continue to see patients who move away from Texas. More states are joining a multistate compact that allows PAs to practice across state lines. (Courtesy of Mercedes Dodge/TNS)

Physician assistants, commonly known as PAs, are licensed clinicians who have a master’s degree and can practice in a range of specialties. Their three years of training typically includes 3,000 hours of direct patient care, and they are an increasingly critical part of the health care workforce, which in many states isn’t keeping pace with a growing and aging population.

By 2028, the nation as a whole will be short some 100,000 critical health care workers — doctors, nurses and home health aides — according to a new report from Mercer, a management consulting firm.

The looming shortage is one reason why 13 states have joined the PA Licensure Compact, a multistate agreement that allows PAs to practice in any participating state, without having to get an additional license.

Delaware, Utah, and Wisconsin enacted the legislation in 2023.

Colorado, Maine, Minnesota, Nebraska, Oklahoma, Tennessee, Virginia, Washington and West Virginia followed suit this year. Ohio became the latest state to enact it in July.

The PA compact is one of several that have emerged over the past several years, especially since the expansion of telehealth services during the COVID-19 pandemic. There are similar compacts for doctors, nurses, occupational therapists and social workers.

One challenge has been completing the background checks required for providers who want to practice under the compacts. For example, Pennsylvania’s participation in the nursing and medical licensure compacts was delayed as the FBI denied the state access to its fingerprint database. They later reached an agreement on how to move forward.

The PA compact grants a “privilege to practice,” allowing PAs to practice in participating states without getting an additional license. The nursing compact gives nurses a multistate license, while the physician licensure compact just expedites the licensing process.

Some large states, such as California and New York, don’t participate in compacts for doctors, nurses, social workers or PAs. Some state lawmakers in those states say joining interstate compacts would reduce the quality of their states’ health care workforces, because other states require lower standards of education and training.

“We are proud that New York’s high standards have resulted in our state being an international destination in health care,” New York Democratic Assemblymember Deborah Glick wrote in an op-ed last year for the Times Union newspaper in Albany. “While it’s possible that it may make sense at some point for New York to join a licensure compact, we should pause before we allow a quick fix to lower New York’s standards.”

In other states, such as Texas, doctors who have succeeded in limiting the “scope of practice” of Texas PAs oppose the compact because they believe it might allow out-of-state PAs to go beyond those limits for their patients who reside in Texas. The American Medical Association and its state affiliates argue that allowing PAs to provide care traditionally provided by physicians puts patients at risk.

Dr. G. Ray Callas, president of the Texas Medical Association, said he values the role that physician assistants play in the health care system, but that his organization objects to any measure that might “give PAs authority to do more in health care than they are trained to do.”

“TMA is not opposed to appropriate, expedited licensure, but we do oppose these compacts when they expand scope of practice and create a patient safety issue, lowering the standard of care in Texas,” Callas said in a statement.

Supporters of the compact say that fear is unfounded, and that the agreement has no effect on state scope of practice rules. The model legislation for the compact specifies that PAs who treat patients in another state can only do so “under the Remote State’s laws and regulations.”

Last year, the Texas legislature considered legislation to join the PA compact, but it died in the state Senate.

Monica Ward, president of the Texas Academy of Physician Assistants, said her group will keep pushing for the bill.

“In the rural areas of Texas, there is absolutely a need and a shortage of health care providers,” Ward said. “We’re surrounded by multiple states, so it’s nice to be able to reduce those administrative burdens, paperwork and possibly fees for those that are looking to work in Texas.”

It will take 18 to 24 months for the compact to become fully operational and for PAs to apply for the privilege to practice in other areas. The compact commission also needs to create a data system to keep track of licenses.

This model of licensure may not have worked even five years ago, said Tennessee Republican state Rep. Jeremy Faison, who sponsored his state’s compact legislation.

“It would have had major pushback and people would have asked, ‘What are you trying to do? We like to control what we’re doing in our state,’” said Faison. “But because we live in a global society and people move around so much more than ever before, I think the average person has embraced this.”

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Faison told Stateline that for states such as Tennessee, which borders eight states, joining the compact makes economic sense because it will encourage people to move to the state.

Financial stability was 32-year-old Aneil Prasad’s motivation for getting a compact nursing license. He moved from New Orleans to Asheville, North Carolina, last year.

“It allows people to seek out better-paying jobs and move themselves ahead, buy houses and have better health and education and all that,” Prasad said. “And then the less competitive places are forced to raise their wages in order to attract people.”

After moving from Louisiana to North Carolina with his multistate license, Prasad said his wage increased from $21 an hour to $36 an hour. He notes that while the multistate license for nurses costs a bit more than a regular license, it would be much more expensive for him to apply for a new license in every state.

Since Texas hasn’t joined the PA compact, Dodge maintains active licenses in her home state as well as Alaska, California, Florida, New Mexico and Washington. She said the process to get them was expensive and time-consuming. Licenses can cost upward of $500 and can take three to nine months to obtain. Dodge said it’s been worth the trouble to help her patients, but she would appreciate an easier pathway.

“I got all these state licenses to follow my patients,” she said. “So when the PA compact license gets enacted in Texas, I hope it’s going to help me continue following my patients and I’ll be the glue that they need.”

Stateline is part of States Newsroom, a national nonprofit news organization focused on state policy.

©2024 States Newsroom. Visit at stateline.org. Distributed by Tribune Content Agency, LLC.