Feed has moved. To update it, click here and save changes.

[*] [-] [-] [x] [A+] [a-]  
[l] at 2/3/23 11:00am
by Nick Judin, Mississippi Free Press This article was produced for ProPublica’s Local Reporting Network in partnership with Mississippi Free Press. Sign up for Dispatches to get stories like this one as soon as they are published. JACKSON, Miss. — The freeze of early 2021 wasn’t the origin of Jackson, Mississippi’s water system collapse. But the winter storm introduced the country to Jackson’s aging and improperly maintained pipes and water plants, which failed and left residents without clean water for over a month. The crisis surged back in the summer of 2022, leaving residents without clean water for two months and drawing comparisons to Flint, Michigan’s lead-poisoning scandal, another banner example of America’s ruinous infrastructure systems. Here, as in Flint, the federal government stepped in: In November, the Department of Justice appointed a federal manager to take control of the beleaguered utility, and less than a month later, Congress approved $600 million exclusively for the city’s water system. But the rescue effort is already running up against the realities of local politics, reflecting historic tensions between Jackson and the rest of the state. For decades, state and city leaders have clashed over who should control local spending, services and infrastructure. Now, both the federal manager and the city’s mayor are warning that state politicians are attempting to take over Jackson’s water system, along with hundreds of millions in federal funds meant for repairing it. At the heart of the feud is Senate Bill 2889, introduced in mid-January by a lawmaker who says his only goal is to ensure the Mississippi capital’s water system is restored. The legislation would create a new regional water-authority board to oversee the system’s water, sewer and drainage systems. The governor and lieutenant governor would appoint a majority of the board. Over the years, state leaders including the current governor, Tate Reeves, have expressed skepticism about whether Jackson is capable of managing its own affairs. Federal agencies, including the Justice Department and the Environmental Protection Agency, have also questioned the city’s management of its water and wastewater systems. The latest move in the Legislature worries the manager, Ted Henifin, who says a regional authority could allow improvements and debt relief to flow out of Jackson and into suburban utilities that join the entity. “I believe the $600+ million in federal funding has created a monster in the Mississippi Legislature,” Henifin told the Mississippi Free Press and ProPublica in a written statement last week. A federal judge appointed Henifin to the position of interim third-party manager in late November. Ted Henifin was appointed by a federal judge to shepherd Jackson’s water system out of crisis. (Nick Judin/Mississippi Free Press) Jackson Mayor Chokwe A. Lumumba built on Henifin’s critique Monday. “It is a colonial power taking over our city. It is plantation politics. I have not been shy in the ways that I have referenced this,” he said. The mayor highlighted a litany of other proposed legislation that together would give Mississippi authority over segments of Jackson’s police and court systems. He called the legislative proposals a “unified attack” against the city’s autonomy. “It reminds me of apartheid,” he said. “They dictate our leadership, put a military force over us and we’re just supposed to pay taxes to the king.” The bill’s sponsor, state Sen. David Parker, R-Olive Branch, and Lt. Gov. Delbert Hosemann, whose office helped design the measure, strongly denied that attempts to divert federal funds were behind the legislation. After the news organizations asked Parker about some critics’ concerns, he and Hosemann agreed that the state should recoup none of the federal funds, and Parker pledged to introduce an amendment that would explicitly prohibit the use of the funds outside Jackson’s city limits. Henifin was unmoved, saying he was concerned that amendments could be overwritten later, and that a regional utility was the wrong solution for Jackson in any case. “We Need an Arbitrator” If the Senate bill becomes law, the Mississippi Capitol Region Utility Act would effectively give the state authority over Jackson’s water system once the federal manager’s authority lapses. That’s because it would grant the governor power to appoint three of the nine members, and the lieutenant governor two, giving statewide leaders, who are white, majority control over water, wastewater and stormwater utilities in Jackson, whose population is 82% Black. The mayor would get four appointments, including one that he would have to select in “consultation” with the mayor of nearby Byram, majority Black, and another chosen with the mayor of Ridgeland, a demographically mixed suburb. The board would then elect a president to formally lead the new regional utility. In an interview, Henifin said he believes Jackson’s system requires judicial and federal oversight to prevent the mismanagement of critical infrastructure funds, which he estimates would take years to properly spend. “I think at the end of the day we need an arbitrator, and I think that’s a federal judge in this case.” He said he believes this oversight should be extended to protect the federal dollars, estimating that five years of some form of oversight should be sufficient to lock in the necessary contracts and investments. He later said that legislative interference might threaten efforts to procure a contract to address the water system’s crucial staffing shortages because the prospect of a change in the water utility’s leadership while a long-term contract is still being executed could scare off large corporations. Although Parker and Hosemann were complimentary of Henifin in interviews with the Mississippi Free Press, Henifin says neither of the parties involved has ever consulted him. Indeed, he said that Hosemann’s office rebuffed his attempt to set up a meeting. Hosemann acknowledged that he had not spoken with Henifin yet but said he intended to “shortly.” “I Wanted to Be Very Sympathetic” Parker said that although he lives 200 miles from Jackson, he did experience the city’s water crisis firsthand. “I have a daughter that I live with during the legislative session,” he said. “I’ve spent numerous times walking down to the swimming pool and dipping water into a cooler, taking it back up to the toilet to flush. We live in an apartment complex that’s had to put portable facilities on the ground floor to allow people to go to the bathroom.” “I wanted to be very sympathetic and compassionate to the feelings of the mayor and other people who have spent a long time trying to seek answers to this problem,” Parker said. “So in setting up a board that would be overseeing the water and sewer system, my idea was to give the mayor four appointments on a nine-member board.” He said he believed the governor and lieutenant governor should appoint a majority of the board’s members because Mississippi’s failure to “provide the basic needs and services that our people deserve is reflected 100% back on the governor and the people in this building.” Sen. David Parker, R-Olive Branch, introduced Senate Bill 2889. He said his only goal is to ensure the Mississippi capital’s water system is restored. (Rogelio V. Solis/AP Photo) Parker said he initially believed that residents in Ridgeland drew water from Jackson’s treatment plant. Though the facility itself is located in Ridgeland, reporters told Parker that Ridgeland does not currently receive water from Jackson’s water system; they also told him that parts of Ridgeland may use Jackson’s greater sewage system. He then suggested the bill may have included that city’s mayor in light of that fact. He expressed surprise over Henifin’s comments and strongly denied any intent to divert money away from Jackson. “There is no intent on my part to stack a board in any way, shape or form that would give preferential treatment to the fringe areas of the water authority,” he said. “My hope would be that if the majority of the water authority is within the city of Jackson, I would hope that the governor, lieutenant governor and mayor would put people on the board from those geographic areas.” Parker said he intends to speak with Henifin as his bill makes its way through the Senate. “Crafting something like this is an extreme challenge.” The bill gives the surrounding municipalities a path to join the new capital water authority, transferring their assets and debts to it, a common feature of regional utilities. The news organizations asked Parker if any part of SB 2889 prevented that regionalization from allowing federal funds to be dispersed to utilities outside Jackson. Parker said he would look into that question. A day later, Hosemann said he had agreed with Parker that they should address any gaps that might allow money to be spent outside of the authority itself. Lt. Gov. Delbert Hosemann’s office helped craft SB 2889, which would allow the governor and lieutenant governor to appoint the majority of a newly created regional water-authority board. (Nick Judin/Mississippi Free Press) “It Is Plantation Politics” Lumumba said the feud over spending the federal funds highlights the friction between the state’s majority-white leaders and the majority-Black capital city. “It is plantation politics,” Lumumba said. “It’s consistent with this paternalistic relationship that the state of Mississippi believes that it maintains with the city of Jackson.” Lumumba compared it to the 1% Sales Tax Commission, a system the Legislature designed to assert control over spending derived from a special sales tax Jackson maintains to fund infrastructure projects. The mayor identified other bills as part of what he considers an assault on the city’s right to self-determination, including bills to expand the Capitol Police’s territory. Another bill would create an independent court system of unelected judges and prosecutors for that same area. Lawmakers said the legislation was needed to respond to a rise in crime rates. “It’s all a unified attack,” he said. In a response to additional inquiries, Hosemann’s Deputy Chief of Staff Leah Rupp Smith said they defer to Parker on the legislation but “share a desire with all parties to find a long-term solution,” and she said that a regional utility authority “has been viable in other parts of our state.” They said they planned to meet with Henifin the week after next. Parker said his conversations with the mayor have been “productive and congenial.” He added that they “share an interest in ensuring all people served by the systems have access to safe and reliable water and wastewater services at a fair and reasonable cost.” Lumumba called bills to transfer authority in Jackson to the state “plantation politics.” (Nick Judin/Mississippi Free Press) In recent years, Lumumba has clashed repeatedly with Hosemann over Jackson’s autonomy. “The last time I met with him, he said that I needed to look at a possible relationship with the state of Mississippi, because ‘what did I think, that Biden was gonna write me a check?’” “I recently told him I do, and he did,” the mayor said of Biden. Senior reporter Kayode Crown of the Mississippi Free Press contributed reporting.
[*] [+] [-] [x] [A+] [a-]  
[l] at 2/3/23 4:00am
by Ash Ngu ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive our biggest stories as soon as they’re published. In 1990, Congress passed the Native American Graves Protection and Repatriation Act, which pushed for museums, universities and other organizations that possessed Native American human remains to return them to Indigenous communities. But our reporting shows that many institutions still hold many of those remains in their collections. Last month, ProPublica published a database that allows you to search the repatriation records of these hundreds of institutions. But the full story of repatriation goes beyond the numbers, as illustrated by our story about a state museum in Illinois that was built on Native American burial mounds.​​​​ This guide is for reporters who want to take a deeper dive on repatriation at institutions in their area. Watch an Informational Webinar With Our Reporters. 1. Understand the Repatriation Process. Key terms Human remains: The physical remains of a person of Native American ancestry. Each inventory record lists the minimum number of individuals (MNI) represented by the remains. We’ve avoided referring to Native American remains as “collections” or “sets of remains” in our reporting, though the terms are commonly used. Instead, to highlight the humanity of the individuals, we have opted for phrases like “remains of Native Americans” or “ancestral remains.” Associated funerary objects (AFO): Items found with human remains that are also in an institution’s possession. Also consider using “funerary belongings.” Inventory: Item-by-item descriptions of human remains and associated funerary objects. The institution that holds them provides this list to the federal government and potentially affiliated tribes. Cultural affiliation: A shared group identity connecting a present-day tribe with an earlier group. The standard for establishing affiliation is a preponderance of evidence. Preponderance of evidence: A legal burden of proof that is met when something is more likely than not. Culturally unidentified: Remains and items for which no culturally affiliated tribe has been determined, according to the institution that holds them. Disposition: When culturally unidentified remains and associated funerary objects are transferred to tribal control through geographic affiliation instead of cultural affiliation. Notice of inventory completion: A notice published in the Federal Register when an institution determines that certain remains and funerary objects are culturally affiliated with one or more tribes, or will repatriate based on a geographical link. More information is available on the NAGPRA site’s glossary page. Read up on the law and regulations. NAGPRA applies only to institutions that receive federal funds and have Native American human remains or cultural items. The law provides a process for consultation and repatriation. The National NAGPRA Program, which operates under the Department of the Interior, helps administer the law. The program runs a website that provides useful resources on terminology; compliance; inventory records; the duties of the NAGPRA Review Committee, which monitors and reviews the implementation of the law; annual reports to Congress; enforcement; and more. To understand the law’s goals and how it has been implemented, read the text of the act and the history of legislative intent. The Department of the Interior administers the law and has issued a series of regulations since 1990. Notably, in 2010 the department created a pathway for the return of remains and items whose cultural affiliation cannot be established. This year, the department is seeking to update the regulations to expedite the repatriation process. To show what the law requires of institutions, the NAGPRA Community of Practice, a network of people who work on NAGPRA, created a flowchart and museum guide. The National Park Service also has an in-depth guide on NAGPRA compliance. (National Park Service) Repatriation can be requested by direct descendants, by federally recognized tribes and Alaska Native entities, or by Native Hawaiian organizations. Institutions are not required to consult with tribes that lack federal recognition. However, in some cases museums have chosen to consult directly with these tribes, or with a federally recognized tribe acting as an intermediary. Institutions may repatriate Native American remains to multiple tribes. In these cases, the tribes often work together to determine what they’d like to do with the remains. 2. Dig Into the Data. Search the ProPublica NAGPRA database. Our tool adds visuals and a search function to a data set maintained by the National Park Service that itemizes all the Native American human remains and associated funerary objects that roughly 600 institutions have reported to the federal government. The data set includes information on the state and county that remains and objects were taken from, which institutions hold them and whether they have been made available for return. You can type the name of an institution, tribe or state into the search box, or click on counties in the national map to learn more. All institutions, tribes and states are listed at the bottom of the page. State and county pages: If you want to start exploring geographically, each state has a page (e.g., California) that lists the institutions in the state that hold remains or items from anywhere in the country. The page also lists what institutions hold remains and items that were originally taken from that state. It also shows the percentage of remains each institution has made available for return and to which tribes. From the state pages, or from the map on the main page, you can drill down to county pages (e.g., Apache County, Arizona), which show the status of human remains originally taken from that county. Sometimes institutions make conflicting decisions about human remains and items taken from the same area. State and county pages make it easy to identify these disagreements. For example, federal agencies have been generally more likely than museums to repatriate remains taken from the Southwest area. Further reporting could explain why some institutions have kept remains and objects while others have returned them. Institution pages: The institution pages (e.g., University of Arizona) provide a summary of where the ancestral remains in an institution’s inventory were taken from and which remains the institution has not made available for return. The timeline chart on these pages shows the institution’s progress since NAGPRA was passed and can identify important events in the institution’s history. For example, the Tennessee Valley Authority did not start making remains available for return until the 2010s. Since then, a majority of the Native American remains in its possession have been made available for return. What changed? A critical government audit sparked reform. Keep in mind that some institutions, like Stanford University, completed repatriations prior to NAGPRA’s passage. The data ProPublica published only reflects what institutions have reported since the law came into effect. We have no way to consistently track repatriations before that. Tribe pages: ProPublica for the first time made the NAGPRA data set searchable by tribe (e.g., Chickasaw Nation). The pages show where Native American remains that have been made available for return to a tribe were taken from and which institutions returned them. They also include a list of institutions that may have ancestral remains taken from counties of interest to each tribe. This information can help NAGPRA coordinators identify tribes that should potentially be contacted about unrepatriated remains. Keep in mind that institutions may make remains available for return to multiple tribes and that the remains listed on tribes’ pages are not necessarily exclusive to one tribe. Request inventory record data from the National NAGPRA Program. The National NAGPRA Program has additional detail on specific inventories broken down by institution, state or county. This information can help reporters understand how remains were acquired and make comparisons between institutions. The level of detail that institutions provide varies. Due to concerns about looting, we decided not to publish specific information about the sites that remains were taken from, unless the site is already commonly known, like a national monument or state park. Caveat and contextualize the data. The data is self-reported by institutions. Institutions give a minimum estimate of how many Native Americans’ remains they hold, and they frequently adjust these numbers. Some institutions subject to NAGPRA have failed to report the remains in their possession. As a result, the numbers are best taken as low-end estimates. The data can appear deceptively precise. When speaking generally about what an institution has, we recommend rounding numbers to the nearest tens or hundreds. For example, “The University of California, Berkeley reported still having the remains of at least 9,000 Native Americans” instead of 9,075. Some institutions claim that all of the human remains subject to NAGPRA in their holdings are “available for return.” What they mean is that everything has the potential to be returned, pending a tribal claim, consultation, determination by the institution and publication of a notice detailing the list of tribes eligible to claim the remains. We use “made available for return” only for remains that have already been through that process, and the only step left is for the specified tribes to decide what they’ll do with the remains. The physical transfer of remains can take time. Tribes might not have the money, space or capacity to complete this last step. Also, tribes sometimes establish agreements under which remains stay in the care of museums but legal control of them is transferred to the tribes. That said, many of the remains described as “made available for return” have been physically returned. We’d like to say when physical return occurs, but the federal government doesn’t collect that data. If you contact an institution individually, it may share this information. 3. Gather Documents. Search the Federal Register for notices. When an institution establishes a connection between tribes and remains, it must publish a list of the tribes eligible to make a repatriation claim. These notices are published in the Federal Register and are searchable. Try searching for “Notice of Inventory Completion,” followed by the name of the institution or tribe you’re interested in. Tribes and institutions sometimes change their names, so the present-day name may not exactly match what’s listed in the notice. Notices describe the Native American remains and associated funerary objects being made available for return. They contain information on which tribes were consulted, how the remains came to be in the institution’s possession, and who to contact at the institution. Occasionally, the evidence used to determine a cultural affiliation or disposition of the remains is also included. Request records. Other documents can aid in reporting on NAGPRA. Look for records that: Detail how the institution acquired the Native American remains and items reported in its inventory (also known as their provenance). Explain the behind-the-scenes decision-making on whether to repatriate and the evidence used. Show the quality of relations between the institution and tribes. Records you can seek include: Original inventories or summaries of Native American remains and cultural items that institutions send to tribes. Copies are sent to the National NAGPRA Program. Excavation field notes. Many remains were removed in federally funded excavation projects or by academically oriented field schools in the 20th century, and both of those endeavors often produced significant archives. Loan files that document requests and transfers of Native American remains and objects between institutions, potentially for research purposes. Notes or internal email correspondence from NAGPRA staff, faculty, administrators, legal counsel, tribes or colleagues at other institutions. Materials and notes used during consultations. Institutions often prepare materials for their meetings with tribes and take notes. Recordings of consultations. During the pandemic, many meetings were held over Zoom and may have been recorded. Tribal claim documents. These may contain information that tribes do not want shared publicly because they are culturally sensitive or could aid looters. Determination records. These may explain the rationale behind determinations of cultural affiliation or disposition. NAGPRA Review Committee transcripts. Disputes are often brought before committee, and you can search for mentions of tribes, institutions or regions. Grant application materials. When institutions apply for NAGPRA or other government-funded grants, the application materials and statements supplied may provide insight into their budgets and intent. You can request these records from the agency that administers the grants. Historical documents, such as field notes and annual reports, that may not be online. Appraisal documents for objects. Note that while freedom of information laws make it possible to request records from public institutions, private institutions’ records are much harder to obtain. In those cases, you may have luck by requesting records from amenable institutions or groups that have corresponded with or worked on consultations with them. 4. Talk to People With Experience. The history of the taking and repatriation of Native American remains and cultural items varies by region. Familiarize yourself with the history of Indigenous peoples and institutions in your area. Talk to tribal and institutional representatives to understand how efforts to repatriate have proceeded since NAGPRA’s passage in 1990. There may have been several rounds of consultation between tribes and institutions. And when repatriation efforts stretch back 30-plus years, it may help your reporting to piece together a chronology of who represented each group. Talk to representatives of tribal nations. Learn the basics of repatriation before approaching sources. Be prepared to explain why you’re interested in reporting on this topic. Look up the tribe’s page on ProPublica’s NAGPRA database as a starting point to understand which institutions they may have consulted with already. Tribes generally have designated NAGPRA specialists. Often, they are a tribal historic preservation officer or cultural director. Use these directories to find a point of contact: National NAGPRA Program Contacts Database National Association of Tribal Historic Preservation Officers directory Tribal Leaders Directory: Department of the Interior Native Hawaiian Organization List: Department of the Interior Reach out to tribal reps early, since they can be very busy. Know that tribes have different views on how best to repatriate. Tribes are not always ready to repatriate and don’t always want remains to be physically returned. Sometimes multiple tribes make competing claims that take time to sort out. Tribes may be open to respectfully conducted research. Also, keep in mind that tribal leaders may not want to discuss repatriation and might not see news coverage as beneficial, especially if they’re in the middle of consulting with institutions and need to maintain those relationships. Repatriation can be a private issue in some cultures, and some do not have a cultural protocol for handing the dead. Ask about successes and challenges the tribe has faced in their repatriation work. Have tribes had sufficient funding to pursue consultation and repatriation? What has been positive or negative about their experiences? Have institutions been proactive in reaching out to them and sharing information about ancestral remains and cultural objects in their collections? It’s critical that both tribes and institutions have sufficient funding to work on consultations and repatriations. Many tribes and institutions don’t have a dedicated, paid staff member to work on NAGPRA issues, and even when that role exists, turnover can be high. Stable funding allows for long-term relationship-building between tribes and museums who often must engage with each other over years to complete the process. Talk to museum representatives. The number of people involved in NAGPRA work varies by institution. Some institutions have full-time NAGPRA coordinators, while others rely on individuals who have other responsibilities, often as professors or curators. Some institutions list a NAGPRA contact on their websites. Otherwise, you can find out who to talk to by looking at the National NAGPRA contacts database. If the institution has published a notice in the Federal Register, those often include contact information, and you can find them with a “Notice of Inventory Completion” search as explained above. Some questions we suggest asking: Is the data maintained by the National NAGPRA Program accurate? If the institution says the data is out of date or inaccurate, ask it to elaborate on specifically what is incorrect and to update its federal records. What efforts have been made to consult with tribes on remains that have yet to be repatriated? When did the museum last reach out to tribes? Some institutions say they have followed the law because they invited tribes to consult when the law was first passed and they didn’t get a response. That approach doesn’t match the spirit of the law. Some tribes have several dozen institutions holding human remains and objects that could potentially be repatriated to them, creating a burdensome workload for tribes. How were decisions about whether to repatriate made? Who have been the decision-makers? If an institution has not repatriated remains taken from a specific region or site, while others have, get in touch with the ones that did repatriate and ask why their determinations were different. How does the institution fund NAGPRA work? How many staff positions are dedicated to it? What is the institution’s policy on research, teaching, display, imaging and circulation of human remains and cultural items that are potentially subject to NAGPRA? NAGPRA does not prohibit these practices, but tribes often find them to be disrespectful. Lastly, keep in mind that even if a museum is not listed in the database, it might have unreported Native American remains that are subject to NAGPRA. Small or private institutions that have received federal funding might not understand that they are subject to the law. In a 2021 article, Indian Country Today looked into whether institutions that had accepted stimulus funds may be subject to NAGPRA. Talk to people involved with repatriation. People have been working on repatriation for a long time, and it’s important to understand the variety of opinions on how to approach the issue. Perspectives on NAGPRA have been shared in academic publications dealing with fields such as law, museum and heritage studies, Native American studies, anthropology and archaeology. The NAGPRA Community of Practice is a network dedicated to supporting the implementation of the law. The group offers training resources and holds meetings twice a month. The NAGPRA Review Committee’s members are nominated by tribes and national museums or scientific organizations. The National NAGPRA Program can be reached at NAGPRA_info@nps.gov. Get in touch with us. If you publish a story about repatriation using our data, let us know! You can contact our reporting team to share stories or ask questions at repatriation@propublica.org. We have also solicited tips about repatriation from readers across the country. With the permission of those who wrote in, we may share tips with local newsrooms. If you are interested in being part of this effort, let us know by emailing us with the subject line “Interested in Tips.” Help Us Investigate Museums’ Failure to Return Native American Human Remains and Cultural Items
[*] [+] [-] [x] [A+] [a-]  
[l] at 2/3/23 3:00am
by Rob Perez, Honolulu Star-Advertiser This article was produced for ProPublica’s Local Reporting Network in partnership with the Honolulu Star-Advertiser. Sign up for Dispatches to get stories like this one as soon as they are published. Can the federal government underwrite mortgages for homes in Hawaii on a spot where there may be buried bombs from World War II? The answer depends on which federal program insures the loans. When it comes to the one for Native Hawaiians, the answer has been an emphatic no. But when it comes to more traditional mortgages for the general public, a different federal program has been saying yes. The Honolulu Star-Advertiser and ProPublica reported in November how the U.S. Department of Housing and Urban Development in late 2014 restricted some mortgage lending in a region of Hawaii’s Big Island known as the Waikoloa Maneuver Area, concerned that buried bombs still posed a danger to thousands of residents. Funds would flow again, officials said, once the military removed any unexploded devices and once the state deemed the land safe. That policy effectively froze lending for many Native Hawaiians, who relied on HUD-backed loans to develop homesteads within a historic land trust, parts of which were located in an area with a potential for unexploded ordnance, known as the UXO zone. But new documents and interviews show that the Federal Housing Administration, which is part of HUD, has insured loans for people seeking to buy homes on land outside of that trust but still within the UXO zone — long before officials declared any parcels there safe from unexploded ordnance. The new revelations raise questions about federal policy and whether the HUD restrictions unfairly targeted Native Hawaiians — or put others at risk. “I don’t understand why they would allow it for some properties but not for others,” said Eric Brundage, a former Army explosive ordnance disposal expert who has helped with recovery and detonation of UXO in the Waikoloa area. “That just doesn’t make sense to me.” According to federal data, between 2015 and 2018, FHA insured 19 loans in a ZIP code with land in the heart of the UXO zone. That area contains no trust land. The ZIP code’s largest residential community, Waikoloa Village, is in a sector considered at higher risk for UXO danger than some of the Native parcels. As recently as 2018, workers were still finding evidence of possible explosives, unearthing nearly 370 pounds of munition debris — some on land that had been checked before. The state Health Department, which oversees remediation work, did not approve any parcels within this sector for residential use until 2019. On paper, the FHA lending seemed to be at odds with HUD’s regulations for department investments at the time, which required all property for use in its programs to be free of contamination of all sorts. In a document on the Waikoloa Maneuver Area policy, the department said “the unmitigated presence of unexploded ordnance presents an unacceptable risk to the health and safety of occupants and conflicts with residential property use.” In practice, though, HUD told the Star-Advertiser and ProPublica that its policy did not apply to the FHA loans. In an email to the news organizations, the department did not explain why, only noting that federal backing flows from two separate programs. FHA insures single-family mortgages offered to the general public while HUD runs a separate lending program for Native Hawaiians seeking to live on trust land. The latter entails “a different and more direct role” for the department because it has a “trust like relationship” with Native Hawaiians, a department spokesperson said. U.S. Sen. Brian Schatz, a Democrat from Hawaii, said in a statement to the news organizations that he is concerned about the impact of the HUD policy on the state Department of Hawaiian Home Lands, which oversees the Native trust. That department, he said, is now subject to “more onerous restrictions on building and financing than any other landowner in the state.” Schatz said he was working with federal and state agencies “to find a path forward to make it easier to finance and develop on Hawaiian Home Lands while continuing to keep people safe.” HUD officials in Washington did not make anyone available to be interviewed for this story. Instead, they provided a written statement. “HUD is committed to providing access to mortgage financing for our Native American and Native Hawaiian communities,” wrote Jason Pu, administrator of the department’s western region that includes Hawaii. “HUD is working with our partners in the federal government and the State of Hawaii to examine state and federal regulations and to ensure that further developments in the Waikoloa Maneuver Area are appropriate and safe.” It’s unclear from federal data, which does not identify the exact location of the loans, whether any Native Hawaiians seeking to live on trust land benefited from FHA lending. When asked whether FHA insured any such loans, HUD did not answer directly, only saying that FHA “never ceased making available” insurance for mortgages on properties located on trust lands in the UXO zone, provided the loans complied with all “applicable requirements.” It did not specify those requirements, though it noted that lenders have the responsibility to “ensure compliance with state and local laws governing the subject property and the associated mortgage financing.” Native beneficiaries and mortgage brokers told the Star-Advertiser and ProPublica that they had witnessed some cases in which FHA loans were unavailable to people on trust lands in the UXO zone. Shirley Gambill-De Rego, a Big Island mortgage manager, recalled one case in 2015 in which an FHA loan for a client was denied when the lender learned the property was in the Waikoloa Maneuver Area. The lender believed the UXO risk to be too great, she said. As the Star-Advertiser and ProPublica reported in November, the cleanup effort on trust lands is years behind schedule, with hundreds of Native Hawaiians waiting to develop ancestral lands. The trust, created by Congress more than a century ago, was intended to return Native people — especially impoverished ones — to their ancestral lands, a kind of reparations for the harms of colonization. Anyone at least 50% Hawaiian can apply for a residential lease to buy or build on trust land. The responsibility for the delay rests, in part, with the U.S. Army Corps of Engineers, which has been plagued by shoddy work and multiple regulatory disputes. The Corps previously said that it is “committed to getting the remediation done right to ensure these areas are safe,” and that every acre that goes through the process “is a success toward restoration of lands.” But some members of Hawaii’s congressional delegation are losing patience. Last month, U.S. Sen. Mazie Hirono, a Hawaii Democrat, wrote to leaders of four federal and state agencies, including HUD, saying the problems highlighted by the Star-Advertiser/ProPublica reporting have made clear that implementing an interagency approach will be critical to ensuring lands become safely available for residential construction. Specifically, she called for a working group made up of HUD, the Corps, the state Department of Health and the state Department of Hawaiian Home Lands. That group, she said, should determine the necessary steps to clear and secure the land “as quickly as possible” to ensure the state and federal governments meet their obligation to provide safe, affordable housing options to beneficiaries of the Native Hawiian land trust. “Today, there are more than 6,000 beneficiaries on Hawaii Island who are waiting for land, and for many of them, HUD financing will be the best or only option for building an affordable home,” Hirono wrote in her Jan. 11 letter. Native Hawaiian leaders note that, so far, relatively few munitions have been found in Puukapu, the largest trust parcel in the UXO zone. Yet beneficiaries are still waiting on the Corps and state regulators to officially clear the area. Many have leases that flag their land as being located in a UXO zone. Gambill-De Rego, the mortgage broker and a Puukapu beneficiary, said she has helped some beneficiaries whose older leases did not contain that flag but has had to tell many others that they can’t get mortgages until the UXO issue is resolved. “This is not fair at all,” she said. Ian Lee Loy, a former member of the state commission that oversees the trust lands, noted that many Native Hawaiians have already waited years — and sometimes, decades — for the opportunity to establish homesteads on the Big Island. “Everything you’ve uncovered is shameful,” he said. Agnel Philip of ProPublica contributed data analysis.
[*] [-] [-] [x] [A+] [a-]  
[l] at 2/2/23 4:00am
by Duaa Eldeib ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive our biggest stories as soon as they’re published. A growing number of lawmakers across the country are calling for action following a ProPublica investigation that revealed the failures of federal agencies and health care providers to reduce the country’s stillbirth rate. More than 20,000 pregnancies in the U.S. annually end in stillbirth — the death of an expected child at 20 weeks or more — an alarming figure that exceeds infant mortality and is 15 times the number of babies who died of Sudden Infant Death Syndrome, or SIDS, in 2020. As many as 1 in 4 stillbirths may be preventable, experts say; the figure is even higher as a baby’s due date draws closer. “With the tremendous advances we’ve made in modern medicine, we should be doing everything we can to prevent Americans from experiencing stillbirth,” Sen. Jeff Merkley, a Democrat from Oregon, said in a statement to ProPublica. “Yet recent reports and data clearly show that we are not living up to that promise in our nation.” Merkley and other lawmakers have called for additional funding for stillbirth research, data and prevention. They highlighted the increased risk for mothers who have had a stillbirth to suffer complications or die during or soon after childbirth. “It is absolutely unconscionable that hundreds of expectant and new moms are dying every year from preventable causes in this country. Equally as shocking is the high number of stillbirths that occur throughout the nation,” said Sen. Tammy Duckworth, an Illinois Democrat. “No one should die from preventable causes, and I will continue to work to improve our health system so mothers can feel safe and supported.” The Eunice Kennedy Shriver National Institute of Child Health and Human Development, which is part of the National Institutes of Health, last year formed a stillbirth working group. In January, the group recommended that the NIH and the Centers for Disease Control and Prevention support additional research on stillbirth causes, risk factors, data and prevention. The national stillbirth rate in 2020 was 5.74 per 1,000 live births and fetal deaths, according to CDC data. Provisional data for 2021, the most recent available, puts the rate just slightly better at 5.68. Among wealthy countries, the U.S. ranks as one of the worst in reducing its stillbirth rate. Stark racial disparities have compounded the crisis. Black women are more than twice as likely — and in some states around three times as likely — as white women to have a stillbirth, according to 2020 data from the CDC. That year, CDC data shows the national stillbirth rate for Black women was 10.3, compared with 4.7 for white women. ProPublica told the story of Brooke Smith, a Black mother from New York who delivered her stillborn daughter after going to the hospital twice in the weeks leading up to her due date with concerns about her baby. Both times doctors sent her home. “Brooke Smith’s pregnancy experience is heartbreaking and unacceptable, and I heard too many stories like hers while writing the Black Maternal Health Momnibus Act,” said Rep. Lauren Underwood, an Illinois Democrat, playing off the word “omnibus” — a common term for legislation that packages several bills together. “Stillbirth deserves more awareness and resources.” The “Momnibus” is a set of 12 bills aimed at reducing maternal mortality and health disparities. Underwood, who along with Rep. Alma Adams, D-N.C., supported stillbirth prevention legislation as co-chairs of the Black Maternal Health Caucus, said stillbirth will be a priority for the group this year. The caucus, she said, has focused on stillbirth since its creation in 2019. In New York, Democratic Sen. Kirsten Gillibrand said in a statement to ProPublica that “Black mothers continue to face significant health care inequities and we must take action.” Lawmakers had already been working on two key stillbirth bills last year, and though both faltered, they remain determined to see them pass. Gillibrand was one of several legislators who co-sponsored a bill introduced in the Senate in March that aimed to reduce stillbirth rates by funding data collection, awareness efforts, research and fetal autopsy training. Sen. Cory Booker, D-N.J., expects to reintroduce the legislation. The stillbirth rate for Black women in New Jersey and New York is higher than the national average. The bill was named after Autumn Joy, the stillborn daughter of New Jersey mother and maternal health advocate Debbie Haine Vijayvergiya. For more than a decade, Haine Vijayvergiya has advocated for policy changes to prevent stillbirth. The Stillbirth Health Improvement and Education (SHINE) for Autumn Act would have been the most comprehensive federal stillbirth legislation ever. “Eleven and a half years ago, I made a promise to Autumn. I promised her that I would protect others from ever knowing this kind of devastation,” she said. “And I cannot bear to think about what the future holds if we do not get SHINE passed one day soon.” Lawmakers in December came close to passing another stillbirth bill, the Maternal and Child Health Stillbirth Prevention Act, which had been introduced by Merkley and Adams in March and achieved bipartisan support, including from Sen. Bill Cassidy of Louisiana and Rep. Ashley Hinson of Iowa, both Republicans. The legislation would have added stillbirth research and prevention to the list of activities approved for federal maternal health funding. Merkley, who plans to reintroduce the bill, said he remains “passionately committed” to passing it. Emily Price, the chief executive officer of the nonprofit Healthy Birth Day, championed the legislation. The group is best known for creating a “Count the Kicks” app that helps pregnant people track their baby’s movements and establish what is normal for them. Research shows that after 28 weeks, changes in fetal movement, including decreased activity or bursts of excessive fetal activity, are associated with an increased risk of stillbirth. Price said she has never been more optimistic about the future of stillbirth prevention in America. “I do believe that change is coming. It is slow because of how long stillbirth has been ignored in this country, how long it’s been so taboo, how long there has been a belief that babies just die,” she said. “But we know better now.” ProPublica found that a lack of research, data and fetal autopsies were significant barriers to better understanding stillbirths. No federal agency has launched a national campaign to reduce the risk of stillbirth or adequately raise awareness about it. A CDC spokesperson said that as the agency learns more about stillbirth, it will work to translate that knowledge into prevention efforts, including possible awareness campaigns. ProPublica also revealed how a series of government decisions early on in the pandemic led to confusion, low vaccine uptake among pregnant people and allowed misinformation to flourish. Research shows unvaccinated women who contracted COVID-19 during pregnancy faced a higher risk of stillbirth, but pregnant people were excluded from initial clinical vaccine trials. The CDC contributed to the confusion with vague early messaging about whether pregnant people should get vaccinated and waiting eight months to specifically recommend the vaccine to pregnant people. Sen. Elizabeth Warren, the Massachusetts Democrat who early on had been monitoring the effects of the pandemic on pregnant people, reintroduced legislation in December that called on public health organizations to provide timely guidance to reduce health risks to mothers and babies during a pandemic and also to assess the impact of not including pregnant people in clinical trials for COVID-19 vaccines. That bill stalled. Warren said she would continue her efforts. “Failure to listen to women, particularly Black and brown women, when they say they’re experiencing pain can have grave consequences — from serious complications to maternal death to stillbirths,” she said. Help Us Report on Stillbirths
[*] [-] [-] [x] [A+] [a-]  
[l] at 2/2/23 3:00am
by David Armstrong, Patrick Rucker and Maya Miller ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive our biggest stories as soon as they’re published. Also: Do you have experiences with health insurance denials? Please get in touch. In May 2021, a nurse at UnitedHealthcare called a colleague to share some welcome news about a problem the two had been grappling with for weeks. United provided the health insurance plan for students at Penn State University. It was a large and potentially lucrative account: lots of young, healthy students paying premiums in, not too many huge medical reimbursements going out. But one student was costing United a lot of money. Christopher McNaughton suffered from a crippling case of ulcerative colitis — an ailment that caused him to develop severe arthritis, debilitating diarrhea, numbing fatigue and life-threatening blood clots. His medical bills were running nearly $2 million a year. United had flagged McNaughton’s case as a “high dollar account,” and the company was reviewing whether it needed to keep paying for the expensive cocktail of drugs crafted by a Mayo Clinic specialist that had brought McNaughton’s disease under control after he’d been through years of misery. On the 2021 phone call, which was recorded by the company, nurse Victoria Kavanaugh told her colleague that a doctor contracted by United to review the case had concluded that McNaughton’s treatment was “not medically necessary.” Her colleague, Dave Opperman, reacted to the news with a long laugh. “I knew that was coming,” said Opperman, who heads up a United subsidiary that brokered the health insurance contract between United and Penn State. “I did too,” Kavanaugh replied. UnitedHealthcare Employees Discuss the Denial of Chris McNaughton’s Claim David Opperman is an insurance broker who works for UnitedHealthcare. Victoria Kavanaugh is a nurse for United. In this recorded phone call from 2021, the two express relief that a doctor has turned down Penn State student Chris McNaughton’s claim as “not medically necessary.” Opperman then complained about McNaughton’s mother, whom he referred to as “this woman,” for “screaming and yelling” and “throwing tantrums” during calls with United. The pair agreed that any appeal of the United doctor’s denial of the treatment would be a waste of the family’s time and money. “We’re still gonna say no,” Opperman said. More than 200 million Americans are covered by private health insurance. But data from state and federal regulators shows that insurers reject about 1 in 7 claims for treatment. Many people, faced with fighting insurance companies, simply give up: One study found that Americans file formal appeals on only 0.1% of claims denied by insurers under the Affordable Care Act. Insurers have wide discretion in crafting what is covered by their policies, beyond some basic services mandated by federal and state law. They often deny claims for services that they deem not “medically necessary.” When United refused to pay for McNaughton's treatment for that reason, his family did something unusual. They fought back with a lawsuit, which uncovered a trove of materials, including internal emails and tape-recorded exchanges among company employees. Those records offer an extraordinary behind-the-scenes look at how one of America's leading health care insurers relentlessly fought to reduce spending on care, even as its profits rose to record levels. As United reviewed McNaughton’s treatment, he and his family were often in the dark about what was happening or their rights. Meanwhile, United employees misrepresented critical findings and ignored warnings from doctors about the risks of altering McNaughton’s drug plan. At one point, court records show, United inaccurately reported to Penn State and the family that McNaughton’s doctor had agreed to lower the doses of his medication. Another time, a doctor paid by United concluded that denying payments for McNaughton’s treatment could put his health at risk, but the company buried his report and did not consider its findings. The insurer did, however, consider a report submitted by a company doctor who rubber-stamped the recommendation of a United nurse to reject paying for the treatment. United declined to answer specific questions about the case, even after McNaughton signed a release provided by the insurer to allow it to discuss details of his interactions with the company. United noted that it ultimately paid for all of McNaughton’s treatments. In a written response, United spokesperson Maria Gordon Shydlo wrote that the company’s guiding concern was McNaughton’s well-being. “Mr. McNaughton’s treatment involves medication dosages that far exceed FDA guidelines,” the statement said. “In cases like this, we review treatment plans based on current clinical guidelines to help ensure patient safety.” But the records reviewed by ProPublica show that United had another, equally urgent goal in dealing with McNaughton. In emails, officials calculated what McNaughton was costing them to keep his crippling disease at bay and how much they would save if they forced him to undergo a cheaper treatment that had already failed him. As the family pressed the company to back down, first through Penn State and then through a lawsuit, the United officials handling the case bristled. “This is just unbelievable,” Kavanaugh said of McNaughton’s family in one call to discuss his case. ”They’re just really pushing the envelope, and I’m surprised, like I don’t even know what to say.” The Same Meal Every Day McNaughton on the Penn State campus, where he first enrolled in 2020 (Nate Smallwood, special to ProPublica) Now 31, McNaughton grew up in State College, Pennsylvania, just blocks from the Penn State campus. Both of his parents are faculty members at the university. In the winter of 2014, McNaughton was halfway through his junior year at Bard College in New York. At 6 feet, 4 inches tall, he was a guard on the basketball team and had started most of the team’s games since the start of his sophomore year. He was majoring in psychology. When McNaughton returned to school after the winter holiday break, he started to experience frequent bouts of bloody diarrhea. After just a few days on campus, he went home to State College, where doctors diagnosed him with a severe case of ulcerative colitis. A chronic inflammatory bowel disease that causes swelling and ulcers in the digestive tract, ulcerative colitis has no cure, and ongoing treatment is needed to alleviate symptoms and prevent serious health complications. The majority of cases produce mild to moderate symptoms. McNaughton’s case was severe. Treatments for ulcerative colitis include steroids and special drugs known as biologics that work to reduce inflammation in the large intestine. McNaughton, however, failed to get meaningful relief from the drugs his doctors initially prescribed. He was experiencing bloody diarrhea up to 20 times a day, with such severe stomach pain that he spent much of his day curled up on a couch. He had little appetite and lost 50 pounds. Severe anemia left him fatigued. He suffered from other conditions related to his colitis, including crippling arthritis. He was hospitalized several times to treat dangerous blood clots. For two years, in an effort to help alleviate his symptoms, he ate the same meals every day: Rice Chex cereal and scrambled eggs for breakfast, a cup of white rice with plain chicken breast for lunch and a similar meal for dinner, occasionally swapping in tilapia. McNaughton at his home in State College, Pennsylvania. When he fell ill with ulcerative colitis he was forced to stop playing college basketball. (Nate Smallwood, special to ProPublica) His hometown doctors referred him to a specialist at the University of Pittsburgh, who tried unsuccessfully to bring his disease under control. That doctor ended up referring McNaughton to Dr. Edward Loftus Jr. at the Mayo Clinic in Minnesota, which has been ranked as the best gastroenterology hospital in the country every year since 1990 by U.S. News & World Report. For his first visit with Loftus in May 2015, McNaughton and his mother, Janice Light, charted hospitals along the 900-mile drive from Pennsylvania to Minnesota in case they needed medical help along the way. Mornings were the hardest. McNaughton often spent several hours in the bathroom at the start of the day. To prepare for his meeting with Loftus, he set his alarm for 3:30 a.m. so he could be ready for the 7:30 a.m. appointment. Even with that preparation, he had to stop twice to use a bathroom on the five-minute walk from the hotel to the clinic. When they met, Loftus looked at McNaughton and told him that he appeared incapacitated. It was, he told the student, as if McNaughton were chained to the bathroom, with no outside life. He had not been able to return to school and spent most days indoors, managing his symptoms as best he could. McNaughton had tried a number of medications by this point, none of which worked. This pattern would repeat itself during the first couple of years that Loftus treated him. In addition to trying to find a treatment that would bring McNaughton’s colitis into remission, Loftus wanted to wean him off the steroid prednisone, which he had been taking since his initial diagnosis in 2014. The drug is commonly prescribed to colitis patients to control inflammation, but prolonged use can lead to severe side effects including cataracts, osteoporosis, increased risk of infection and fatigue. McNaughton also experienced “moon face,” a side effect caused by the shifting of fat deposits that results in the face becoming puffy and rounder. In 2018, Loftus and McNaughton decided to try an unusual regimen. Many patients with inflammatory bowel diseases like colitis take a single biologic drug as treatment. Whereas traditional drugs are chemically synthesized, biologics are manufactured in living systems, such as plant or animal cells. A year’s supply of an individual biologic drug can cost up to $500,000. They are often given through infusions in a medical facility, which adds to the cost. McNaughton receives an infusion of medication to treat his ulcerative colitis at a medical facility in State College. After initially paying for his treatment, UnitedHealthcare began rejecting his insurance claims. (Nate Smallwood, special to ProPublica.) McNaughton had tried individual biologics, and then two in combination, without much success. He and Loftus then agreed to try two biologic drugs together at doses well above those recommended by the U.S. Food and Drug Administration. Prescribing drugs for purposes other than what they are approved for or at higher doses than those approved by the FDA is a common practice in medicine referred to as off-label prescribing. The federal Agency for Healthcare Research and Quality estimates 1 in 5 prescriptions written today are for off-label uses. There are drawbacks to the practice. Since some uses and doses of particular drugs have not been extensively studied, the risks and efficacy of using them off-label are not well known. Also, some drug manufacturers have improperly pushed off-label usage of their products to boost sales despite little or no evidence to support their use in those situations. Like many leading experts and researchers in his field, Loftus has been paid to do consulting related to the biologic drugs taken by McNaughton. The payments related to those drugs have ranged from a total of $1,440 in 2020 to $51,235 in 2018. Loftus said much of his work with pharmaceutical companies was related to conducting clinical trials on new drugs. In cases of off-label prescribing, patients are depending upon their doctor’s expertise and experience with the drug.“In this case, I was comfortable that the potential benefits to Chris outweighed the risks,” Loftus said. There was evidence that the treatment plan for McNaughton might work, including studies that had found dual biologic therapy to be efficacious and safe. The two drugs he takes, Entyvio and Remicade, have the same purpose — to reduce inflammation in the large intestine — but each works differently in the body. Remicade, marketed by Janssen Biotech, targets a protein that causes inflammation. Entyvio, made by Takeda Pharmaceuticals, works by preventing an excess of white blood cells from entering into the gastrointestinal tract. As for any suggestion by United doctors that his treatment plan for McNaughton was out of bounds or dangerous, Loftus said “my treatment of Chris was not clinically inappropriate — as was shown by Chris’ positive outcome.” The unusual high-dose combination of two biologic drugs produced a remarkable change in McNaughton. He no longer had blood in his stool, and his trips to the bathroom were cut from 20 times a day to three or four. He was able to eat different foods and put on weight. He had more energy. He tapered off prednisone. “If you told me in 2015 that I would be living like this, I would have asked where do I sign up,” McNaughton said of the change he experienced with the new drug regimen. When he first started the new treatment, McNaughton was covered under his family’s plan, and all his bills were paid. McNaughton enrolled at the university in 2020. Before switching to United’s plan for students, McNaughton and his parents consulted with a health advocacy service offered to faculty members. A benefits specialist assured them the drugs taken by McNaughton would be covered by United. McNaughton receiving infusions of medicine used to treat his ulcerative colitis (Nate Smallwood, special to ProPublica) McNaughton joined the student plan in July 2020, and his infusions that month and the following month were paid for by United. In September, the insurer indicated payment on his claims was “pending,” something it did for his other claims that came in during the rest of the year. McNaughton and his family were worried. They called United to make sure there wasn’t a problem; the insurer told them, they said, that it only needed to check his medical records. When the family called again, United told them it had the documentation needed, they said. United, in a court filing last year, said it received two calls from the family and each time indicated that all of the necessary medical records had not yet been received. In January 2021, McNaughton received a new explanation of benefits for the prior months. All of the claims for his care, beginning in September, were no longer “pending.” They were stamped “DENIED.” The total outstanding bill for his treatment was $807,086. When McNaughton’s mother reached a United customer service representative the next day to ask why bills that had been paid in the summer were being denied for the fall, the representative told her the account was being reviewed because of “a high dollar amount on the claims,” according to a recording of the call. Misrepresentations McNaughton, center, at his home in State College with parents David McNaughton, left, and Janice Light, right. (Nate Smallwood, special to ProPublica) With United refusing to pay, the family was terrified of being stuck with medical bills that would bankrupt them and deprive McNaugton of treatment that they considered miraculous. They turned to Penn State for help. Light and McNaughton’s father, David, hoped their position as faculty members would make the school more willing to intervene on their behalf. “After more than 30 years on faculty, my husband and I know that this is not how Penn State would want its students to be treated,” Light wrote to a school official in February 2021. In response to questions from ProPublica, Penn State spokesperson Lisa Powers wrote that “supporting the health and well-being of our students is always of primary importance” and that “our hearts go out to any student and family impacted by a serious medical condition.” The university, she wrote, does “not comment on students’ individual circumstances or disclose information from their records.” McNaughton offered to grant Penn State whatever permissions it needed to speak about his case with ProPublica. The school, however, wrote that it would not comment “even if confidentiality has been waived.” The family appealed to school administrators. Because the effectiveness of biologics wanes in some patients if doses are skipped, McNaughton and his parents were worried about even a delay in treatment. His doctor wrote that if he missed scheduled infusions of the drugs, there was “a high likelihood they would no longer be effective.” During a conference call arranged by Penn State officials on March 5, 2021, United agreed to pay for McNaughton’s care through the end of the plan year that August. Penn State immediately notified the family of the “wonderful news” while also apologizing for “the stress this has caused Chris and your family.” Behind the scenes, McNaughton’s review had “gone all the way to the top” at United’s student health plan division, Kavanaugh, the nurse, said in a recorded conversation. Victoria Kavanaugh Complains to a United Contractor That McNaughton’s Coverage Request Is “Insane” McNaughton had been on the treatment for three years and it had put his disease in remission with no side effects. The family’s relief was short-lived. A month later, United started another review of McNaughton’s care, overseen by Kavanaugh, to determine if it would pay for the treatment in the upcoming plan year. The nurse sent the McNaughton case to a company called Medical Review Institute of America. Insurers often turn to companies like MRIoA to review coverage decisions involving expensive treatments or specialized care. Kavanaugh, who was assigned to a special investigations unit at United, let her feelings about the matter be known in a recorded telephone call with a representative of MRIoA. “This school apparently is a big client of ours,” she said. She then shared her opinion of McNaughton’s treatment. “Really this is a case of a kid who’s getting a drug way too much, like too much of a dose,” Kavanaugh said. She said it was “insane that they would even think that this is reasonable” and “to be honest with you, they’re awfully pushy considering that we are paying through the end of this school year.” Victoria Kavanaugh Describes Penn State as a “Big Account for Us” On a call with an outside contractor, the United nurse claimed McNaughton was on a higher dose of medication than the FDA approved, which is a common practice known as “off-label prescribing.” MRIoA sent the case to Dr. Vikas Pabby, a gastroenterologist at UCLA Health and a professor at the university’s medical school. His May 2021 review of McNaughton’s case was just one of more than 300 Pabby did for MRIoA that month, for which he was paid $23,000 in total, according to a log of his work produced in the lawsuit. In a May 4, 2021 report, Pabby concluded McNaughton’s treatment was not medically necessary, because United’s policies for the two drugs taken by McNaughton did not support using them in combination. Insurers spell out what services they cover in plan policies, lengthy documents that can be confusing and difficult to understand. Many policies, such as McNaughton’s, contain a provision that treatments and procedures must be “medically necessary” in order to be covered. The definition of medically necessary differs by plan. Some don’t even define the term. McNaughton’s policy contains a five-part definition, including that the treatment must be “in accordance with the standards of good medical policy” and “the most appropriate supply or level of service which can be safely provided.” Behind the scenes at United, Opperman and Kavanaugh agreed that if McNaughton were to appeal Pabby’s decision, the insurer would simply rule against him. “I just think it’s a waste of money and time to appeal and send it to another one when we know we’re gonna get the same answer,” Opperman said, according to a recording in court files. At Opperman’s urging, United decided to skip the usual appeals process and arrange for Pabby to have a so-called “peer-to-peer” discussion with Loftus, the Mayo physician treating McNaughton. Such a conversation, in which a patient’s doctor talks with an insurance company’s doctor to advocate for the prescribed treatment, usually only occurs after a customer has appealed a denial and the appeal has been rejected. When Kavanaugh called Loftus’ office to set up a conversation with Pabby, she explained it was an urgent matter and had been requested by McNaughton. “You know I’ve just gotten to know Christopher,” she explained, although she had never spoken with him. “We’re trying to advocate and help and get this peer-to-peer set up.” McNaughton, meanwhile, had no idea at the time that a United doctor had decided his treatment was unnecessary and that the insurer was trying to set up a phone call with his physician. In the peer-to-peer conversation, Loftus told Pabby that McNaughton had “a very complicated case” and that lower doses had not worked for him, according to an internal MRIoA memo. Following his conversation with Loftus, Pabby created a second report for United. He recommended the insurer pay for both drugs, but at reduced doses. He added new language saying that the safety of using both drugs at the higher levels “is not established.” When Kavanaugh shared the May 12 decision from Pabby with others at United, her boss responded with an email calling it “great news.” Then Opperman sent an email that puzzled the McNaughtons. In it, Opperman claimed that Loftus and Pabby had agreed that McNaughton should be on significantly lower doses of both drugs. He said Loftus “will work with the patient to start titrating them down” — or reducing the dosage — “to a normal dose range.” Opperman wrote that United would cover McNaughton’s treatment in the coming year, but only at the reduced doses. Opperman did not respond to emails and phone messages seeking comment. McNaughton didn’t believe a word of it. He had already tried and failed treatment with those drugs at lower doses, and it was Loftus who had upped the doses, leading to his remission from severe colitis. The only thing that made sense to McNaughton was that the treatment United said it would now pay for was dramatically cheaper — saving the company at least hundreds of thousands of dollars a year — than his prescribed treatment because it sliced the size of the doses by more than half. When the family contacted Loftus for an explanation, they were outraged by what they heard. Loftus told them that he had never recommended lowering the dosage. In a letter, Loftus wrote that changing McNaughton’s treatment “would have serious detrimental effects on both his short term and long term health and could potentially involve life threatening complications. This would ultimately incur far greater medical costs. Chris was on the doses suggested by United Healthcare before, and they were not at all effective.” It would not be until the lawsuit that it would become clear how Loftus’ conversations had been so seriously misrepresented. Under questioning by McNaughton’s lawyers, Kavanaugh acknowledged that she was the source of the incorrect claim that McNaughton’s doctor had agreed to a change in treatment. “I incorrectly made an assumption that they had come to some sort of agreement,” she said in a deposition last August. “It was my first peer-to-peer. I did not realize that that simply does not occur.” Kavanaugh did not respond to emails and telephone messages seeking comment. When the McNaughtons first learned of Opperman’s inaccurate report of the phone call with Loftus, it unnerved them. They started to question if their case would be fairly reviewed. “When we got the denial and they lied about what Dr. Loftus said, it just hit me that none of this matters,” McNaughton said. “They will just say or do anything to get rid of me. It delegitimized the entire review process. When I got that denial, I was crushed.” A Buried Report While the family tried to sort out the inaccurate report, United continued putting the McNaughton case in front of more company doctors. On May 21, 2021, United sent the case to one of its own doctors, Dr. Nady Cates, for an additional review. The review was marked “escalated issue.” Cates is a United medical director, a title used by many insurers for physicians who review cases. It is work he has been doing as an employee of health insurers since 1989 and at United since 2010. He has not practiced medicine since the early 1990s. Cates, in a deposition, said he stopped seeing patients because of the long hours involved and because “AIDS was coming around then. I was seeing a lot of military folks who had venereal diseases, and I guess I was concerned about being exposed.” He transitioned to reviewing paperwork for the insurance industry, he said, because “I guess I was a chicken.” When he had practiced, Cates said, he hadn’t treated patients with ulcerative colitis and had referred those cases to a gastroenterologist. He said his review of McNaughton’s case primarily involved reading a United nurse’s recommendation to deny his care and making sure “that there wasn't a decimal place that was out of line.” He said he copied and pasted the nurse’s recommendation and typed “agree” on his review of McNaughton’s case. Dr. Nady Cates, a United Medical Director, Explains That He Copied and Pasted the Text of His Decision to Deny McNaughton’s Care In the deposition, Cates tells McNaughton’s lawyer that he copied the recommendation of Pamela Banister, a nurse for United, rather than writing his own decision. Watch video ➜ Cates said that he does about a hundred reviews a week. He said that in his reviews he typically checks to see if any medications are prescribed in accordance with the insurer’s guidelines, and if not, he denies it. United’s policies, he said, prevented him from considering that McNaughton had failed other treatments or that Loftus was a leading expert in his field. “You are giving zero weight to the treating doctor’s opinion on the necessity of the treatment regimen?” a lawyer asked Cates in his deposition. He responded, “Yeah.” Attempts to contact Cates for comment were unsuccessful. At the same time Cates was looking at McNaughton’s case, yet another review was underway at MRIoA. United said it sent the case back to MRIoA after the insurer received the letter from Loftus warning of the life-threatening complications that might occur if the dosages were reduced. On May 24, 2021, the new report requested by MRIoA arrived. It came to a completely different conclusion than all of the previous reviews. Dr. Nitin Kumar, a gastroenterologist in Illinois, concluded that McNaughton’s established treatment plan was not only medically necessary and appropriate but that lowering his doses “can result in a lack of effective therapy of Ulcerative Colitis, with complications of uncontrolled disease (including dysplasia leading to colorectal cancer), flare, hospitalization, need for surgery, and toxic megacolon.” Unlike other doctors who produced reports for United, Kumar discussed the harm that McNaughton might suffer if United required him to change his treatment. “His disease is significantly severe, with diagnosis at a young age,” Kumar wrote. “He has failed every biologic medication class recommended by guidelines. Therefore, guidelines can no longer be applied in this case.” He cited six studies of patients using two biologic drugs together and wrote that they revealed no significant safety issues and found the therapy to be “broadly successful.” When Kavanaugh learned of Kumar’s report, she quickly moved to quash it and get the case returned to Pabby, according to her deposition. In a recorded telephone call, Kavanaugh told an MRIoA representative that “I had asked that this go back through Dr. Pabby, and it went through a different doctor and they had a much different result.” After further discussion, the MRIoA representative agreed to send the case back to Pabby. “I appreciate that,” Kavanaugh replied. “I just want to make sure, because, I mean, it’s obviously a very different result than what we’ve been getting on this case.” MRIoA case notes show that at 7:04 a.m. on May 25, 2021, Pabby was assigned to take a look at the case for the third time. At 7:27 a.m., the notes indicate, Pabby again rejected McNaughton’s treatment plan. While noting it was “difficult to control” McNaughton’s ulcerative colitis, Pabby added that his doses “far exceed what is approved by literature” and that the “safety of the requested doses is not supported by literature.” In a deposition, Kavanaugh said that after she opened the Kumar report and read that he was supporting McNaughton’s current treatment plan, she immediately spoke to her supervisor, who told her to call MRIoA and have the case sent back to Pabby for review. Kavanaugh said she didn’t save a copy of the Kumar report, nor did she forward it to anyone at United or to officials at Penn State who had been inquiring about the McNaughton case. “I didn’t because it shouldn’t have existed,” she said. “It should have gone back to Dr. Pabby.” When asked if the Kumar report caused her any concerns given his warning that McNaughton risked cancer or hospitalization if his regimen were changed, Kavanaugh said she didn’t read his full report. “I saw that it was not the correct doctor, I saw the initial outcome and I was asked to send it back,” she said. Kavanaugh added, “I have a lot of empathy for this member, but it needed to go back to the peer-to-peer reviewer.” In a court filing, United said Kavanaugh was correct in insisting that Pabby conduct the review and that MRIoA confirmed that Pabby should have been the one doing the review. The Kumar report was not provided to McNaughton when his lawyer, Jonathan Gesk, first asked United and MRIoA for any reviews of the case. Gesk discovered it by accident when he was listening to a recorded telephone call produced by United in which Kavanaugh mentioned a report number Gesk had not heard before. He then called MRIoA, which confirmed the report existed and eventually provided it to him. Pabby asked ProPublica to direct any questions about his involvement in the matter to MRIoA. The company did not respond to questions from ProPublica about the case. A Sense of Hopelessness McNaughton on the Penn State campus (Nate Smallwood, special to ProPublica) When McNaughton enrolled at Penn State in 2020, it brought a sense of normalcy that he had lost when he was first diagnosed with colitis. He still needed monthly hours-long infusions and suffered occasional flare-ups and symptoms, but he was attending classes in person and living a life similar to the one he had before his diagnosis. It was a striking contrast to the previous six years, which he had spent largely confined to his parents’ house in State College. The frequent bouts of diarrhea made it difficult to go out. He didn’t talk much to friends and spent as much time as he could studying potential treatments and reviewing ongoing clinical trials. He tried to keep up with the occasional online course, but his disease made it difficult to make any real progress toward a degree. United, in correspondence with McNaughton, noted that its review of his care was “not a treatment decision. Treatment decisions are made between you and your physician.” But by threatening not to pay for his medications, or only to pay for a different regimen, McNaughton said, United was in fact attempting to dictate his treatment. From his perspective, the insurer was playing doctor, making decisions without ever examining him or even speaking to him. The idea of changing his treatment or stopping it altogether caused constant worry for McNaughton, exacerbating his colitis and triggering physical symptoms, according to his doctors. Those included a large ulcer on his leg and welts under his skin on his thighs and shin that made his leg muscles stiff and painful to the point where he couldn’t bend his leg or walk properly. There were daily migraines and severe stomach pain. “I was consumed with this situation,” McNaughton said. “My path was unconventional, but I was proud of myself for fighting back and finishing school and getting my life back on track. I thought they were singling me out. My biggest fear was going back to the hell.” McNaughton said he contemplated suicide on several occasions, dreading a return to a life where he was housebound or hospitalized. If you or someone you know needs help, here are a few resources: Call the National Suicide Prevention Lifeline: 988 Text the Crisis Text Line from anywhere in the U.S. to reach a crisis counselor: 741741 McNaughton and his parents talked about him possibly moving to Canada where his grandmother lived and seeking treatment there under the nation’s government health plan. Loftus connected McNaughton with a psychologist who specializes in helping patients with chronic digestive diseases. The psychologist, Tiffany Taft, said McNaughton was not an unusual case. About 1 in 3 patients with diseases like colitis suffer from medical trauma or PTSD related to it, she said, often the result of issues related to getting appropriate treatment approved by insurers. “You get into hopelessness,” she said of the depression that accompanies fighting with insurance companies over care. “They feel like ‘I can’t fix that. I am screwed.’ When you can’t control things with what an insurance company is doing, anxiety, PTSD and depression get mixed together.” In the case of McNaughton, Taft said, he was being treated by one of the best gastroenterologists in the world, was doing well with his treatment and then was suddenly notified he might be on the hook for nearly a million dollars in medical charges without access to his medications. “It sends you immediately into panic about all these horrific things that could happen,” Taft said. The physical and mental symptoms McNaughton suffered after his care was threatened were “triggered” by the stress he experienced, she said. In early June 2021, United informed McNaughton in a letter that it would not cover the cost of his treatment regimen in the next academic year, starting in August. The insurer said it would only pay for a treatment plan that called for a significant reduction in the doses of the drugs he took. United wrote that the decision came after his “records have been reviewed three times and the medical reviewers have concluded that the medication as prescribed does not meet the Medical Necessity requirement of the plan.” In August 2021, McNaughton filed a federal lawsuit accusing United of acting in bad faith and unreasonably making treatment decisions based on financial concerns and not what was the best and most effective treatment. It claims United had a duty to find information that supported McNaughton’s claim for treatment rather than looking for ways to deny coverage. United, in a court filing, said it did not breach any duty it owed to McNaughton and acted in good faith. On Sept. 20, 2021, a month after filing the lawsuit, and with United again balking at paying for his treatment, McNaughton asked a judge to grant a temporary restraining order requiring United to pay for his care. With the looming threat of a court hearing on the motion, United quickly agreed to cover the cost of McNaughton’s treatment through the end of the 2021-2022 academic year. It also dropped a demand requiring McNaughton to settle the matter as a condition of the insurer paying for his treatment as prescribed by Loftus, according to an email sent by United’s lawyer. The Cost of Treatment An order form for medications given to McNaughton (Nate Smallwood, special to ProPublica) It is not surprising that insurers are carefully scrutinizing the care of patients treated with biologics, which are among the most expensive medications on the market. Biologics are considered specialty drugs, a class that includes the best-selling Humira, used to treat arthritis. Specialty drug spending in the U.S. is expected to reach $505 billion in 2023, according to an estimate from Optum, United’s health services division. The Institute for Clinical and Economic Review, a nonprofit that analyzes the value of drugs, found in 2020 that the biologic drugs used to treat patients like McNaughton are often effective but overpriced for their therapeutic benefit. To be judged cost-effective by ICER, the biologics should sell at a steep discount to their current market price, the panel found. A panel convened by ICER to review its analysis cautioned that insurance coverage “should be structured to prevent situations in which patients are forced to choose a treatment approach on the basis of cost.” ICER also found examples where insurance company policies failed to keep pace with updates to clinical practice guidelines based on emerging research. United officials did not make the cost of treatment an issue when discussing McNaughton’s care with Penn State administrators or the family. Bill Truxal, the president of UnitedHealthcare StudentResources, the company’s student health plan division, told a Penn State official that the insurer wanted the “best for the student” and it had “nothing to do with cost,” according to notes the official took of the conversation. Behind the scenes, however, the price of McNaughton’s care was front and center at United. In one email, Opperman asked about the cost difference if the insurer insisted on only paying for greatly reduced doses of the biologic drugs. Kavanaugh responded that the insurer had paid $1.1 million in claims for McNaughton’s care as of the middle of May 2021. If the reduced doses had been in place, the amount would have been cut to $260,218, she wrote. United was keeping close tabs on McNaughton at the highest levels of the company. On Aug. 2, 2021, Opperman notified Truxal and a United lawyer that McNaughton “has just purchased the plan again for the 21-22 school year.” A month later, Kavanaugh shared another calculation with United executives showing that the insurer spent over $1.7 million on McNaughton in the prior plan year. United officials strategized about how to best explain why it was reviewing McNaughton’s drug regimen, according to an internal email. They pointed to a justification often used by health insurers when denying claims. “As the cost of healthcare continues to climb to soaring heights, it has been determined that a judicious review of these drugs should be included” in order to “make healthcare more affordable for our members,” Kavanaugh offered as a potential talking point in an April 23, 2021, email. Three days later, UnitedHealth Group filed an annual statement with the U.S. Securities and Exchange Commission disclosing its pay for top executives in the prior year. Then-CEO David Wichmann was paid $17.9 million in salary and other compensation in 2020. Wichmann retired early the following year, and his total compensation that year exceeded $140 million, according to calculations in a compensation database maintained by the Star Tribune in Minneapolis. The newspaper said the amount was the most paid to an executive in the state since it started tracking pay more than two decades ago. About $110 million of that total came from Wichmann exercising stock options accumulated during his stewardship. The McNaughtons were well aware of the financial situation at United. They looked at publicly available financial results and annual reports. Last year, United reported a profit of $20.1 billion on revenues of $324.2 billion. When discussing the case with Penn State, Light said, she told university administrators that United could pay for a year of her son’s treatment using just minutes’ worth of profit. “Betrayed” McNaughton looks out a window at his home in State College. (Nate Smallwood, special to ProPublica) McNaughton has been able to continue receiving his infusions for now, anyway. In October, United notified him it was once again reviewing his care, although the insurer quickly reversed course when his lawyer intervened. United, in a court filing, said the review was a mistake and that it had erred in putting McNaughton’s claims into pending status. McNaughton said he is fortunate his parents were employed at the same school he was attending, which was critical in getting the attention of administrators there. But that help had its limits. In June 2021, just a week after United told McNaughton it would not cover his treatment plan in the upcoming plan year, Penn State essentially walked away from the matter. In an email to the McNaughtons and United, Penn State Associate Vice President for Student Affairs Andrea Dowhower wrote that administrators “have observed an unfortunate breakdown in communication” between McNaughton and his family and the university health insurance plan, “which appears from our perspective to have resulted in a standstill between the two parties.” While she proposed some potential steps to help settle the matter, she wrote that “Penn State’s role in this process is as a resource for students like Chris who, for whatever reason, have experienced difficulty navigating the complex world of health insurance.” The university’s role “is limited,” she wrote, and the school “simply must leave” the issue of the best treatment for McNaughton to “the appropriate health care professionals.” In a statement, a Penn State spokesperson wrote that “as a third party in this arrangement, the University’s role is limited and Penn State officials can only help a student manage an issue based on information that a student/family, medical personnel, and/or insurance provider give — with the hope that all information is accurate and that the lines of communication remain open between the insured and the insurer.” Penn State declined to provide financial information about the plan. However, the university and United share at least one tie that they have not publicly disclosed. When the McNaughtons first reached out to the university for help, they were referred to the school’s student health insurance coordinator. The official, Heather Klinger, wrote in an email to the family in February 2021 that “I appreciate your trusting me to resolve this for you.” In April 2022, United began paying Klinger’s salary, an arrangement which is not noted on the university website. Klinger appears in the online staff directory on the Penn State University Health Services webpage, and has a university phone number, a university address and a Penn State email listed as her contact. The school said she has maintained a part-time status with the university to allow her to access relevant data systems at both the university and United. The university said students “benefit” from having a United employee to handle questions about insurance coverage and that the arrangement is “not uncommon” for student health plans. The family was dismayed to learn that Klinger was now a full-time employee of United. “We did feel betrayed,” Light said. Klinger did not respond to an email seeking comment. McNaughton’s fight to maintain his treatment regimen has come at a cost of time, debilitating stress and depression. “My biggest fear is realizing I might have to do this every year of my life,” he said. McNaughton said one motivation for his lawsuit was to expose how insurers like United make decisions about what care they will pay for and what they will not. The case remains pending, a court docket shows. He has been accepted to Penn State’s law school. He hopes to become a health care lawyer working for patients who find themselves in situations similar to his. He plans to reenroll in the United health care plan when he starts school next fall. Do You Have Insights Into Health Insurance Denials? Help Us Report on the System. Doris Burke and Lexi Churchill contributed research.
[*] [+] [-] [x] [A+] [a-]  
[l] at 2/2/23 3:00am
by David Armstrong, Patrick Rucker and Maya Miller ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive our biggest stories as soon as they’re published. In May 2021, a nurse at UnitedHealthcare called a colleague to share some welcome news about a problem the two had been grappling with for weeks. United provided the health insurance plan for students at Penn State University. It was a large and potentially lucrative account: lots of young, healthy students paying premiums in, not too many huge medical reimbursements going out. But one student was costing United a lot of money. Christopher McNaughton suffered from a crippling case of ulcerative colitis — an ailment that caused him to develop severe arthritis, debilitating diarrhea, numbing fatigue and life-threatening blood clots. His medical bills were running nearly $2 million a year. United had flagged McNaughton’s case as a “high dollar account,” and the company was reviewing whether it needed to keep paying for the expensive cocktail of drugs crafted by a Mayo Clinic specialist that had brought McNaughton’s disease under control after he’d been through years of misery. On the 2021 phone call, which was recorded by the company, nurse Victoria Kavanaugh told her colleague that a doctor contracted by United to review the case had concluded that McNaughton’s treatment was “not medically necessary.” Her colleague, Dave Opperman, reacted to the news with a long laugh. “I knew that was coming,” said Opperman, who heads up a United subsidiary that brokered the health insurance contract between United and Penn State. “I did too,” Kavanaugh replied. UnitedHealthcare Employees Discuss the Denial of Chris McNaughton’s Claim David Opperman is an insurance broker who works for UnitedHealthcare. Victoria Kavanaugh is a nurse for United. In this recorded phone call from 2021, the two express relief that a doctor has turned down Penn State student Chris McNaughton’s claim as “not medically necessary.” Opperman then complained about McNaughton’s mother, whom he referred to as “this woman,” for “screaming and yelling” and “throwing tantrums” during calls with United. The pair agreed that any appeal of the United doctor’s denial of the treatment would be a waste of the family’s time and money. “We’re still gonna say no,” Opperman said. More than 200 million Americans are covered by private health insurance. But data from state and federal regulators shows that insurers reject about 1 in 7 claims for treatment. Many people, faced with fighting insurance companies, simply give up: One study found that Americans file formal appeals on only 0.1% of claims denied by insurers under the Affordable Care Act. Insurers have wide discretion in crafting what is covered by their policies, beyond some basic services mandated by federal and state law. They often deny claims for services that they deem not “medically necessary.” When United refused to pay for McNaughton's treatment for that reason, his family did something unusual. They fought back with a lawsuit, which uncovered a trove of materials, including internal emails and tape-recorded exchanges among company employees. Those records offer an extraordinary behind-the-scenes look at how one of America's leading health care insurers relentlessly fought to reduce spending on care, even as its profits rose to record levels. As United reviewed McNaughton’s treatment, he and his family were often in the dark about what was happening or their rights. Meanwhile, United employees misrepresented critical findings and ignored warnings from doctors about the risks of altering McNaughton’s drug plan. At one point, court records show, United inaccurately reported to Penn State and the family that McNaughton’s doctor had agreed to lower the doses of his medication. Another time, a doctor paid by United concluded that denying payments for McNaughton’s treatment could put his health at risk, but the company buried his report and did not consider its findings. The insurer did, however, consider a report submitted by a company doctor who rubber-stamped the recommendation of a United nurse to reject paying for the treatment. United declined to answer specific questions about the case, even after McNaughton signed a release provided by the insurer to allow it to discuss details of his interactions with the company. United noted that it ultimately paid for all of McNaughton’s treatments. In a written response, United spokesperson Maria Gordon Shydlo wrote that the company’s guiding concern was McNaughton’s well-being. “Mr. McNaughton’s treatment involves medication dosages that far exceed FDA guidelines,” the statement said. “In cases like this, we review treatment plans based on current clinical guidelines to help ensure patient safety.” But the records reviewed by ProPublica show that United had another, equally urgent goal in dealing with McNaughton. In emails, officials calculated what McNaughton was costing them to keep his crippling disease at bay and how much they would save if they forced him to undergo a cheaper treatment that had already failed him. As the family pressed the company to back down, first through Penn State and then through a lawsuit, the United officials handling the case bristled. “This is just unbelievable,” Kavanaugh said of McNaughton’s family in one call to discuss his case. ”They’re just really pushing the envelope, and I’m surprised, like I don’t even know what to say.” The Same Meal Every Day McNaughton on the Penn State campus, where he first enrolled in 2020 (Nate Smallwood, special to ProPublica) Now 31, McNaughton grew up in State College, Pennsylvania, just blocks from the Penn State campus. Both of his parents are faculty members at the university. In the winter of 2014, McNaughton was halfway through his junior year at Bard College in New York. At 6 feet, 4 inches tall, he was a guard on the basketball team and had started most of the team’s games since the start of his sophomore year. He was majoring in psychology. When McNaughton returned to school after the winter holiday break, he started to experience frequent bouts of bloody diarrhea. After just a few days on campus, he went home to State College, where doctors diagnosed him with a severe case of ulcerative colitis. A chronic inflammatory bowel disease that causes swelling and ulcers in the digestive tract, ulcerative colitis has no cure, and ongoing treatment is needed to alleviate symptoms and prevent serious health complications. The majority of cases produce mild to moderate symptoms. McNaughton’s case was severe. Treatments for ulcerative colitis include steroids and special drugs known as biologics that work to reduce inflammation in the large intestine. McNaughton, however, failed to get meaningful relief from the drugs his doctors initially prescribed. He was experiencing bloody diarrhea up to 20 times a day, with such severe stomach pain that he spent much of his day curled up on a couch. He had little appetite and lost 50 pounds. Severe anemia left him fatigued. He suffered from other conditions related to his colitis, including crippling arthritis. He was hospitalized several times to treat dangerous blood clots. For two years, in an effort to help alleviate his symptoms, he ate the same meals every day: Rice Chex cereal and scrambled eggs for breakfast, a cup of white rice with plain chicken breast for lunch and a similar meal for dinner, occasionally swapping in tilapia. McNaughton at his home in State College, Pennsylvania. When he fell ill with ulcerative colitis he was forced to stop playing college basketball. (Nate Smallwood, special to ProPublica) His hometown doctors referred him to a specialist at the University of Pittsburgh, who tried unsuccessfully to bring his disease under control. That doctor ended up referring McNaughton to Dr. Edward Loftus Jr. at the Mayo Clinic in Minnesota, which has been ranked as the best gastroenterology hospital in the country every year since 1990 by U.S. News & World Report. For his first visit with Loftus in May 2015, McNaughton and his mother, Janice Light, charted hospitals along the 900-mile drive from Pennsylvania to Minnesota in case they needed medical help along the way. Mornings were the hardest. McNaughton often spent several hours in the bathroom at the start of the day. To prepare for his meeting with Loftus, he set his alarm for 3:30 a.m. so he could be ready for the 7:30 a.m. appointment. Even with that preparation, he had to stop twice to use a bathroom on the five-minute walk from the hotel to the clinic. When they met, Loftus looked at McNaughton and told him that he appeared incapacitated. It was, he told the student, as if McNaughton were chained to the bathroom, with no outside life. He had not been able to return to school and spent most days indoors, managing his symptoms as best he could. McNaughton had tried a number of medications by this point, none of which worked. This pattern would repeat itself during the first couple of years that Loftus treated him. In addition to trying to find a treatment that would bring McNaughton’s colitis into remission, Loftus wanted to wean him off the steroid prednisone, which he had been taking since his initial diagnosis in 2014. The drug is commonly prescribed to colitis patients to control inflammation, but prolonged use can lead to severe side effects including cataracts, osteoporosis, increased risk of infection and fatigue. McNaughton also experienced “moon face,” a side effect caused by the shifting of fat deposits that results in the face becoming puffy and rounder. In 2018, Loftus and McNaughton decided to try an unusual regimen. Many patients with inflammatory bowel diseases like colitis take a single biologic drug as treatment. Whereas traditional drugs are chemically synthesized, biologics are manufactured in living systems, such as plant or animal cells. A year’s supply of an individual biologic drug can cost up to $500,000. They are often given through infusions in a medical facility, which adds to the cost. McNaughton receives an infusion of medication to treat his ulcerative colitis at a medical facility in State College. After initially paying for his treatment, UnitedHealthcare began rejecting his insurance claims. (Nate Smallwood, special to ProPublica.) McNaughton had tried individual biologics, and then two in combination, without much success. He and Loftus then agreed to try two biologic drugs together at doses well above those recommended by the U.S. Food and Drug Administration. Prescribing drugs for purposes other than what they are approved for or at higher doses than those approved by the FDA is a common practice in medicine referred to as off-label prescribing. The federal Agency for Healthcare Research and Quality estimates 1 in 5 prescriptions written today are for off-label uses. There are drawbacks to the practice. Since some uses and doses of particular drugs have not been extensively studied, the risks and efficacy of using them off-label are not well known. Also, some drug manufacturers have improperly pushed off-label usage of their products to boost sales despite little or no evidence to support their use in those situations. Like many leading experts and researchers in his field, Loftus has been paid to do consulting related to the biologic drugs taken by McNaughton. The payments related to those drugs have ranged from a total of $1,440 in 2020 to $51,235 in 2018. Loftus said much of his work with pharmaceutical companies was related to conducting clinical trials on new drugs. In cases of off-label prescribing, patients are depending upon their doctor’s expertise and experience with the drug.“In this case, I was comfortable that the potential benefits to Chris outweighed the risks,” Loftus said. There was evidence that the treatment plan for McNaughton might work, including studies that had found dual biologic therapy to be efficacious and safe. The two drugs he takes, Entyvio and Remicade, have the same purpose — to reduce inflammation in the large intestine — but each works differently in the body. Remicade, marketed by Janssen Biotech, targets a protein that causes inflammation. Entyvio, made by Takeda Pharmaceuticals, works by preventing an excess of white blood cells from entering into the gastrointestinal tract. As for any suggestion by United doctors that his treatment plan for McNaughton was out of bounds or dangerous, Loftus said “my treatment of Chris was not clinically inappropriate — as was shown by Chris’ positive outcome.” The unusual high-dose combination of two biologic drugs produced a remarkable change in McNaughton. He no longer had blood in his stool, and his trips to the bathroom were cut from 20 times a day to three or four. He was able to eat different foods and put on weight. He had more energy. He tapered off prednisone. “If you told me in 2015 that I would be living like this, I would have asked where do I sign up,” McNaughton said of the change he experienced with the new drug regimen. When he first started the new treatment, McNaughton was covered under his family’s plan, and all his bills were paid. McNaughton enrolled at the university in 2020. Before switching to United’s plan for students, McNaughton and his parents consulted with a health advocacy service offered to faculty members. A benefits specialist assured them the drugs taken by McNaughton would be covered by United. McNaughton receiving infusions of medicine used to treat his ulcerative colitis (Nate Smallwood, special to ProPublica) McNaughton joined the student plan in July 2020, and his infusions that month and the following month were paid for by United. In September, the insurer indicated payment on his claims was “pending,” something it did for his other claims that came in during the rest of the year. McNaughton and his family were worried. They called United to make sure there wasn’t a problem; the insurer told them, they said, that it only needed to check his medical records. When the family called again, United told them it had the documentation needed, they said. United, in a court filing last year, said it received two calls from the family and each time indicated that all of the necessary medical records had not yet been received. In January 2021, McNaughton received a new explanation of benefits for the prior months. All of the claims for his care, beginning in September, were no longer “pending.” They were stamped “DENIED.” The total outstanding bill for his treatment was $807,086. When McNaughton’s mother reached a United customer service representative the next day to ask why bills that had been paid in the summer were being denied for the fall, the representative told her the account was being reviewed because of “a high dollar amount on the claims,” according to a recording of the call. Misrepresentations McNaughton, center, at his home in State College with parents David McNaughton, left, and Janice Light, right. (Nate Smallwood, special to ProPublica) With United refusing to pay, the family was terrified of being stuck with medical bills that would bankrupt them and deprive McNaugton of treatment that they considered miraculous. They turned to Penn State for help. Light and McNaughton’s father, David, hoped their position as faculty members would make the school more willing to intervene on their behalf. “After more than 30 years on faculty, my husband and I know that this is not how Penn State would want its students to be treated,” Light wrote to a school official in February 2021. In response to questions from ProPublica, Penn State spokesperson Lisa Powers wrote that “supporting the health and well-being of our students is always of primary importance” and that “our hearts go out to any student and family impacted by a serious medical condition.” The university, she wrote, does “not comment on students’ individual circumstances or disclose information from their records.” McNaughton offered to grant Penn State whatever permissions it needed to speak about his case with ProPublica. The school, however, wrote that it would not comment “even if confidentiality has been waived.” The family appealed to school administrators. Because the effectiveness of biologics wanes in some patients if doses are skipped, McNaughton and his parents were worried about even a delay in treatment. His doctor wrote that if he missed scheduled infusions of the drugs, there was “a high likelihood they would no longer be effective.” During a conference call arranged by Penn State officials on March 5, 2021, United agreed to pay for McNaughton’s care through the end of the plan year that August. Penn State immediately notified the family of the “wonderful news” while also apologizing for “the stress this has caused Chris and your family.” Behind the scenes, McNaughton’s review had “gone all the way to the top” at United’s student health plan division, Kavanaugh, the nurse, said in a recorded conversation. Victoria Kavanaugh Complains to a United Contractor That McNaughton’s Coverage Request Is “Insane” McNaughton had been on the treatment for three years and it had put his disease in remission with no side effects. The family’s relief was short-lived. A month later, United started another review of McNaughton’s care, overseen by Kavanaugh, to determine if it would pay for the treatment in the upcoming plan year. The nurse sent the McNaughton case to a company called Medical Review Institute of America. Insurers often turn to companies like MRIoA to review coverage decisions involving expensive treatments or specialized care. Kavanaugh, who was assigned to a special investigations unit at United, let her feelings about the matter be known in a recorded telephone call with a representative of MRIoA. “This school apparently is a big client of ours,” she said. She then shared her opinion of McNaughton’s treatment. “Really this is a case of a kid who’s getting a drug way too much, like too much of a dose,” Kavanaugh said. She said it was “insane that they would even think that this is reasonable” and “to be honest with you, they’re awfully pushy considering that we are paying through the end of this school year.” Victoria Kavanaugh Describes Penn State as a “Big Account for Us” On a call with an outside contractor, the United nurse claimed McNaughton was on a higher dose of medication than the FDA approved, which is a common practice known as “off-label prescribing.” MRIoA sent the case to Dr. Vikas Pabby, a gastroenterologist at UCLA Health and a professor at the university’s medical school. His May 2021 review of McNaughton’s case was just one of more than 300 Pabby did for MRIoA that month, for which he was paid $23,000 in total, according to a log of his work produced in the lawsuit. In a May 4, 2021 report, Pabby concluded McNaughton’s treatment was not medically necessary, because United’s policies for the two drugs taken by McNaughton did not support using them in combination. Insurers spell out what services they cover in plan policies, lengthy documents that can be confusing and difficult to understand. Many policies, such as McNaughton’s, contain a provision that treatments and procedures must be “medically necessary” in order to be covered. The definition of medically necessary differs by plan. Some don’t even define the term. McNaughton’s policy contains a five-part definition, including that the treatment must be “in accordance with the standards of good medical policy” and “the most appropriate supply or level of service which can be safely provided.” Behind the scenes at United, Opperman and Kavanaugh agreed that if McNaughton were to appeal Pabby’s decision, the insurer would simply rule against him. “I just think it’s a waste of money and time to appeal and send it to another one when we know we’re gonna get the same answer,” Opperman said, according to a recording in court files. At Opperman’s urging, United decided to skip the usual appeals process and arrange for Pabby to have a so-called “peer-to-peer” discussion with Loftus, the Mayo physician treating McNaughton. Such a conversation, in which a patient’s doctor talks with an insurance company’s doctor to advocate for the prescribed treatment, usually only occurs after a customer has appealed a denial and the appeal has been rejected. When Kavanaugh called Loftus’ office to set up a conversation with Pabby, she explained it was an urgent matter and had been requested by McNaughton. “You know I’ve just gotten to know Christopher,” she explained, although she had never spoken with him. “We’re trying to advocate and help and get this peer-to-peer set up.” McNaughton, meanwhile, had no idea at the time that a United doctor had decided his treatment was unnecessary and that the insurer was trying to set up a phone call with his physician. In the peer-to-peer conversation, Loftus told Pabby that McNaughton had “a very complicated case” and that lower doses had not worked for him, according to an internal MRIoA memo. Following his conversation with Loftus, Pabby created a second report for United. He recommended the insurer pay for both drugs, but at reduced doses. He added new language saying that the safety of using both drugs at the higher levels “is not established.” When Kavanaugh shared the May 12 decision from Pabby with others at United, her boss responded with an email calling it “great news.” Then Opperman sent an email that puzzled the McNaughtons. In it, Opperman claimed that Loftus and Pabby had agreed that McNaughton should be on significantly lower doses of both drugs. He said Loftus “will work with the patient to start titrating them down” — or reducing the dosage — “to a normal dose range.” Opperman wrote that United would cover McNaughton’s treatment in the coming year, but only at the reduced doses. Opperman did not respond to emails and phone messages seeking comment. McNaughton didn’t believe a word of it. He had already tried and failed treatment with those drugs at lower doses, and it was Loftus who had upped the doses, leading to his remission from severe colitis. The only thing that made sense to McNaughton was that the treatment United said it would now pay for was dramatically cheaper — saving the company at least hundreds of thousands of dollars a year — than his prescribed treatment because it sliced the size of the doses by more than half. When the family contacted Loftus for an explanation, they were outraged by what they heard. Loftus told them that he had never recommended lowering the dosage. In a letter, Loftus wrote that changing McNaughton’s treatment “would have serious detrimental effects on both his short term and long term health and could potentially involve life threatening complications. This would ultimately incur far greater medical costs. Chris was on the doses suggested by United Healthcare before, and they were not at all effective.” It would not be until the lawsuit that it would become clear how Loftus’ conversations had been so seriously misrepresented. Under questioning by McNaughton’s lawyers, Kavanaugh acknowledged that she was the source of the incorrect claim that McNaughton’s doctor had agreed to a change in treatment. “I incorrectly made an assumption that they had come to some sort of agreement,” she said in a deposition last August. “It was my first peer-to-peer. I did not realize that that simply does not occur.” Kavanaugh did not respond to emails and telephone messages seeking comment. When the McNaughtons first learned of Opperman’s inaccurate report of the phone call with Loftus, it unnerved them. They started to question if their case would be fairly reviewed. “When we got the denial and they lied about what Dr. Loftus said, it just hit me that none of this matters,” McNaughton said. “They will just say or do anything to get rid of me. It delegitimized the entire review process. When I got that denial, I was crushed.” A Buried Report While the family tried to sort out the inaccurate report, United continued putting the McNaughton case in front of more company doctors. On May 21, 2021, United sent the case to one of its own doctors, Dr. Nady Cates, for an additional review. The review was marked “escalated issue.” Cates is a United medical director, a title used by many insurers for physicians who review cases. It is work he has been doing as an employee of health insurers since 1989 and at United since 2010. He has not practiced medicine since the early 1990s. Cates, in a deposition, said he stopped seeing patients because of the long hours involved and because “AIDS was coming around then. I was seeing a lot of military folks who had venereal diseases, and I guess I was concerned about being exposed.” He transitioned to reviewing paperwork for the insurance industry, he said, because “I guess I was a chicken.” When he had practiced, Cates said, he hadn’t treated patients with ulcerative colitis and had referred those cases to a gastroenterologist. He said his review of McNaughton’s case primarily involved reading a United nurse’s recommendation to deny his care and making sure “that there wasn't a decimal place that was out of line.” He said he copied and pasted the nurse’s recommendation and typed “agree” on his review of McNaughton’s case. Dr. Nady Cates, a United Medical Director, Explains That He Copied and Pasted the Text of His Decision to Deny McNaughton’s Care In the deposition, Cates tells McNaughton’s lawyer that he copied the recommendation of Pamela Banister, a nurse for United, rather than writing his own decision. Watch video ➜ Cates said that he does about a hundred reviews a week. He said that in his reviews he typically checks to see if any medications are prescribed in accordance with the insurer’s guidelines, and if not, he denies it. United’s policies, he said, prevented him from considering that McNaughton had failed other treatments or that Loftus was a leading expert in his field. “You are giving zero weight to the treating doctor’s opinion on the necessity of the treatment regimen?” a lawyer asked Cates in his deposition. He responded, “Yeah.” Attempts to contact Cates for comment were unsuccessful. At the same time Cates was looking at McNaughton’s case, yet another review was underway at MRIoA. United said it sent the case back to MRIoA after the insurer received the letter from Loftus warning of the life-threatening complications that might occur if the dosages were reduced. On May 24, 2021, the new report requested by MRIoA arrived. It came to a completely different conclusion than all of the previous reviews. Dr. Nitin Kumar, a gastroenterologist in Illinois, concluded that McNaughton’s established treatment plan was not only medically necessary and appropriate but that lowering his doses “can result in a lack of effective therapy of Ulcerative Colitis, with complications of uncontrolled disease (including dysplasia leading to colorectal cancer), flare, hospitalization, need for surgery, and toxic megacolon.” Unlike other doctors who produced reports for United, Kumar discussed the harm that McNaughton might suffer if United required him to change his treatment. “His disease is significantly severe, with diagnosis at a young age,” Kumar wrote. “He has failed every biologic medication class recommended by guidelines. Therefore, guidelines can no longer be applied in this case.” He cited six studies of patients using two biologic drugs together and wrote that they revealed no significant safety issues and found the therapy to be “broadly successful.” When Kavanaugh learned of Kumar’s report, she quickly moved to quash it and get the case returned to Pabby, according to her deposition. In a recorded telephone call, Kavanaugh told an MRIoA representative that “I had asked that this go back through Dr. Pabby, and it went through a different doctor and they had a much different result.” After further discussion, the MRIoA representative agreed to send the case back to Pabby. “I appreciate that,” Kavanaugh replied. “I just want to make sure, because, I mean, it’s obviously a very different result than what we’ve been getting on this case.” MRIoA case notes show that at 7:04 a.m. on May 25, 2021, Pabby was assigned to take a look at the case for the third time. At 7:27 a.m., the notes indicate, Pabby again rejected McNaughton’s treatment plan. While noting it was “difficult to control” McNaughton’s ulcerative colitis, Pabby added that his doses “far exceed what is approved by literature” and that the “safety of the requested doses is not supported by literature.” In a deposition, Kavanaugh said that after she opened the Kumar report and read that he was supporting McNaughton’s current treatment plan, she immediately spoke to her supervisor, who told her to call MRIoA and have the case sent back to Pabby for review. Kavanaugh said she didn’t save a copy of the Kumar report, nor did she forward it to anyone at United or to officials at Penn State who had been inquiring about the McNaughton case. “I didn’t because it shouldn’t have existed,” she said. “It should have gone back to Dr. Pabby.” When asked if the Kumar report caused her any concerns given his warning that McNaughton risked cancer or hospitalization if his regimen were changed, Kavanaugh said she didn’t read his full report. “I saw that it was not the correct doctor, I saw the initial outcome and I was asked to send it back,” she said. Kavanaugh added, “I have a lot of empathy for this member, but it needed to go back to the peer-to-peer reviewer.” In a court filing, United said Kavanaugh was correct in insisting that Pabby conduct the review and that MRIoA confirmed that Pabby should have been the one doing the review. The Kumar report was not provided to McNaughton when his lawyer, Jonathan Gesk, first asked United and MRIoA for any reviews of the case. Gesk discovered it by accident when he was listening to a recorded telephone call produced by United in which Kavanaugh mentioned a report number Gesk had not heard before. He then called MRIoA, which confirmed the report existed and eventually provided it to him. Pabby asked ProPublica to direct any questions about his involvement in the matter to MRIoA. The company did not respond to questions from ProPublica about the case. A Sense of Hopelessness McNaughton on the Penn State campus (Nate Smallwood, special to ProPublica) When McNaughton enrolled at Penn State in 2020, it brought a sense of normalcy that he had lost when he was first diagnosed with colitis. He still needed monthly hours-long infusions and suffered occasional flare-ups and symptoms, but he was attending classes in person and living a life similar to the one he had before his diagnosis. It was a striking contrast to the previous six years, which he had spent largely confined to his parents’ house in State College. The frequent bouts of diarrhea made it difficult to go out. He didn’t talk much to friends and spent as much time as he could studying potential treatments and reviewing ongoing clinical trials. He tried to keep up with the occasional online course, but his disease made it difficult to make any real progress toward a degree. United, in correspondence with McNaughton, noted that its review of his care was “not a treatment decision. Treatment decisions are made between you and your physician.” But by threatening not to pay for his medications, or only to pay for a different regimen, McNaughton said, United was in fact attempting to dictate his treatment. From his perspective, the insurer was playing doctor, making decisions without ever examining him or even speaking to him. The idea of changing his treatment or stopping it altogether caused constant worry for McNaughton, exacerbating his colitis and triggering physical symptoms, according to his doctors. Those included a large ulcer on his leg and welts under his skin on his thighs and shin that made his leg muscles stiff and painful to the point where he couldn’t bend his leg or walk properly. There were daily migraines and severe stomach pain. “I was consumed with this situation,” McNaughton said. “My path was unconventional, but I was proud of myself for fighting back and finishing school and getting my life back on track. I thought they were singling me out. My biggest fear was going back to the hell.” McNaughton said he contemplated suicide on several occasions, dreading a return to a life where he was housebound or hospitalized. If you or someone you know needs help, here are a few resources: Call the National Suicide Prevention Lifeline: 988 Text the Crisis Text Line from anywhere in the U.S. to reach a crisis counselor: 741741 McNaughton and his parents talked about him possibly moving to Canada where his grandmother lived and seeking treatment there under the nation’s government health plan. Loftus connected McNaughton with a psychologist who specializes in helping patients with chronic digestive diseases. The psychologist, Tiffany Taft, said McNaughton was not an unusual case. About 1 in 3 patients with diseases like colitis suffer from medical trauma or PTSD related to it, she said, often the result of issues related to getting appropriate treatment approved by insurers. “You get into hopelessness,” she said of the depression that accompanies fighting with insurance companies over care. “They feel like ‘I can’t fix that. I am screwed.’ When you can’t control things with what an insurance company is doing, anxiety, PTSD and depression get mixed together.” In the case of McNaughton, Taft said, he was being treated by one of the best gastroenterologists in the world, was doing well with his treatment and then was suddenly notified he might be on the hook for nearly a million dollars in medical charges without access to his medications. “It sends you immediately into panic about all these horrific things that could happen,” Taft said. The physical and mental symptoms McNaughton suffered after his care was threatened were “triggered” by the stress he experienced, she said. In early June 2021, United informed McNaughton in a letter that it would not cover the cost of his treatment regimen in the next academic year, starting in August. The insurer said it would only pay for a treatment plan that called for a significant reduction in the doses of the drugs he took. United wrote that the decision came after his “records have been reviewed three times and the medical reviewers have concluded that the medication as prescribed does not meet the Medical Necessity requirement of the plan.” In August 2021, McNaughton filed a federal lawsuit accusing United of acting in bad faith and unreasonably making treatment decisions based on financial concerns and not what was the best and most effective treatment. It claims United had a duty to find information that supported McNaughton’s claim for treatment rather than looking for ways to deny coverage. United, in a court filing, said it did not breach any duty it owed to McNaughton and acted in good faith. On Sept. 20, 2021, a month after filing the lawsuit, and with United again balking at paying for his treatment, McNaughton asked a judge to grant a temporary restraining order requiring United to pay for his care. With the looming threat of a court hearing on the motion, United quickly agreed to cover the cost of McNaughton’s treatment through the end of the 2021-2022 academic year. It also dropped a demand requiring McNaughton to settle the matter as a condition of the insurer paying for his treatment as prescribed by Loftus, according to an email sent by United’s lawyer. The Cost of Treatment An order form for medications given to McNaughton (Nate Smallwood, special to ProPublica) It is not surprising that insurers are carefully scrutinizing the care of patients treated with biologics, which are among the most expensive medications on the market. Biologics are considered specialty drugs, a class that includes the best-selling Humira, used to treat arthritis. Specialty drug spending in the U.S. is expected to reach $505 billion in 2023, according to an estimate from Optum, United’s health services division. The Institute for Clinical and Economic Review, a nonprofit that analyzes the value of drugs, found in 2020 that the biologic drugs used to treat patients like McNaughton are often effective but overpriced for their therapeutic benefit. To be judged cost-effective by ICER, the biologics should sell at a steep discount to their current market price, the panel found. A panel convened by ICER to review its analysis cautioned that insurance coverage “should be structured to prevent situations in which patients are forced to choose a treatment approach on the basis of cost.” ICER also found examples where insurance company policies failed to keep pace with updates to clinical practice guidelines based on emerging research. United officials did not make the cost of treatment an issue when discussing McNaughton’s care with Penn State administrators or the family. Bill Truxal, the president of UnitedHealthcare StudentResources, the company’s student health plan division, told a Penn State official that the insurer wanted the “best for the student” and it had “nothing to do with cost,” according to notes the official took of the conversation. Behind the scenes, however, the price of McNaughton’s care was front and center at United. In one email, Opperman asked about the cost difference if the insurer insisted on only paying for greatly reduced doses of the biologic drugs. Kavanaugh responded that the insurer had paid $1.1 million in claims for McNaughton’s care as of the middle of May 2021. If the reduced doses had been in place, the amount would have been cut to $260,218, she wrote. United was keeping close tabs on McNaughton at the highest levels of the company. On Aug. 2, 2021, Opperman notified Truxal and a United lawyer that McNaughton “has just purchased the plan again for the 21-22 school year.” A month later, Kavanaugh shared another calculation with United executives showing that the insurer spent over $1.7 million on McNaughton in the prior plan year. United officials strategized about how to best explain why it was reviewing McNaughton’s drug regimen, according to an internal email. They pointed to a justification often used by health insurers when denying claims. “As the cost of healthcare continues to climb to soaring heights, it has been determined that a judicious review of these drugs should be included” in order to “make healthcare more affordable for our members,” Kavanaugh offered as a potential talking point in an April 23, 2021, email. Three days later, UnitedHealth Group filed an annual statement with the U.S. Securities and Exchange Commission disclosing its pay for top executives in the prior year. Then-CEO David Wichmann was paid $17.9 million in salary and other compensation in 2020. Wichmann retired early the following year, and his total compensation that year exceeded $140 million, according to calculations in a compensation database maintained by the Star Tribune in Minneapolis. The newspaper said the amount was the most paid to an executive in the state since it started tracking pay more than two decades ago. About $110 million of that total came from Wichmann exercising stock options accumulated during his stewardship. The McNaughtons were well aware of the financial situation at United. They looked at publicly available financial results and annual reports. Last year, United reported a profit of $20.1 billion on revenues of $324.2 billion. When discussing the case with Penn State, Light said, she told university administrators that United could pay for a year of her son’s treatment using just minutes’ worth of profit. “Betrayed” McNaughton looks out a window at his home in State College. (Nate Smallwood, special to ProPublica) McNaughton has been able to continue receiving his infusions for now, anyway. In October, United notified him it was once again reviewing his care, although the insurer quickly reversed course when his lawyer intervened. United, in a court filing, said the review was a mistake and that it had erred in putting McNaughton’s claims into pending status. McNaughton said he is fortunate his parents were employed at the same school he was attending, which was critical in getting the attention of administrators there. But that help had its limits. In June 2021, just a week after United told McNaughton it would not cover his treatment plan in the upcoming plan year, Penn State essentially walked away from the matter. In an email to the McNaughtons and United, Penn State Associate Vice President for Student Affairs Andrea Dowhower wrote that administrators “have observed an unfortunate breakdown in communication” between McNaughton and his family and the university health insurance plan, “which appears from our perspective to have resulted in a standstill between the two parties.” While she proposed some potential steps to help settle the matter, she wrote that “Penn State’s role in this process is as a resource for students like Chris who, for whatever reason, have experienced difficulty navigating the complex world of health insurance.” The university’s role “is limited,” she wrote, and the school “simply must leave” the issue of the best treatment for McNaughton to “the appropriate health care professionals.” In a statement, a Penn State spokesperson wrote that “as a third party in this arrangement, the University’s role is limited and Penn State officials can only help a student manage an issue based on information that a student/family, medical personnel, and/or insurance provider give — with the hope that all information is accurate and that the lines of communication remain open between the insured and the insurer.” Penn State declined to provide financial information about the plan. However, the university and United share at least one tie that they have not publicly disclosed. When the McNaughtons first reached out to the university for help, they were referred to the school’s student health insurance coordinator. The official, Heather Klinger, wrote in an email to the family in February 2021 that “I appreciate your trusting me to resolve this for you.” In April 2022, United began paying Klinger’s salary, an arrangement which is not noted on the university website. Klinger appears in the online staff directory on the Penn State University Health Services webpage, and has a university phone number, a university address and a Penn State email listed as her contact. The school said she has maintained a part-time status with the university to allow her to access relevant data systems at both the university and United. The university said students “benefit” from having a United employee to handle questions about insurance coverage and that the arrangement is “not uncommon” for student health plans. The family was dismayed to learn that Klinger was now a full-time employee of United. “We did feel betrayed,” Light said. Klinger did not respond to an email seeking comment. McNaughton’s fight to maintain his treatment regimen has come at a cost of time, debilitating stress and depression. “My biggest fear is realizing I might have to do this every year of my life,” he said. McNaughton said one motivation for his lawsuit was to expose how insurers like United make decisions about what care they will pay for and what they will not. The case remains pending, a court docket shows. He has been accepted to Penn State’s law school. He hopes to become a health care lawyer working for patients who find themselves in situations similar to his. He plans to reenroll in the United health care plan when he starts school next fall. Do You Have Insights Into Health Insurance Denials? Help Us Report on the System. Doris Burke and Lexi Churchill contributed research.
[*] [-] [-] [x] [A+] [a-]  
[l] at 2/1/23 9:30am
by Megan Rose ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive our biggest stories as soon as they’re published. In 2016, Congress passed a law that was supposed to make the military justice system more transparent, instructing the U.S. military’s six branches to give the public broader access to court records. Seven years later, the Department of Defense has finally issued guidelines for how the services should comply with the law, but they fall far short of the transparency lawmakers intended. Caroline Krass, general counsel for the Defense Department, told officials from the Army, Navy, Air Force, Marines, Coast Guard and Space Force in a memorandum last month that they could mostly continue doing what they have been for years: keep many court records secret from the public. In their 2016 law, lawmakers had envisioned a military justice system that operated much like federal courts, where the public has real-time electronic access to dockets, records and filings. Concerned about fairness and secrecy in the military system, Congress wanted the public to have similar access to records for courts-martial to allow for more scrutiny of how the military handles criminal cases, particularly sexual assault. The law calls for the “timely” release of court records “at all stages of the military justice system ... including pretrial, trial, post-trial, and appellate processes.” The newly released Pentagon guidance, however, does little to make the system more open. The guidance tells the services they do not have to make any records public until after a trial ends. It gives the military the discretion to suppress key trial information. And in cases where the defendant is found not guilty, the directive appears to be even more sweeping: The military services will be allowed to keep the entire record secret permanently. The Pentagon did not respond to ProPublica’s questions about the new guidance. A Navy prosecutor argued in a court filing last year that the military cannot act like its counterparts in federal court because the military system doesn’t have a clerk of court and needs to be “fluid and mobile.” Despite the 2016 law, which required consistent standards across the military, the Pentagon for years let the individual services decide how to comply with the law, and public access to court-martial records remained extremely limited. Frank Rosenblatt, vice president of the National Institute of Military Justice, said even before the new guidance was issued, the spirit of the law wasn’t met. Leaving access decisions “to the discretion of military officials really is a default towards secrecy,” he said. In September, ProPublica sued the Navy for refusing to provide nearly all of the court records in a high-profile arson case. The Navy prosecuted a sailor for allegedly setting the USS Bonhomme Richard on fire. In 2020, the amphibious assault ship burned for more than four days and was destroyed, a more than $1 billion loss. A ProPublica investigation showed there was little evidence of the sailor’s guilt, and Seaman Recruit Ryan Mays was found not guilty at his court-martial. ProPublica’s lawsuit was successful in getting the Navy to release hundreds of pages of court-martial documents in the Mays case. The suit also challenges the Navy’s overall policy for withholding records and is ongoing. The lawsuit could end up questioning Krass’ new directive as well for not following the 2016 law or abiding by the First Amendment and judicial rulings that grant timely access to court records. ProPublica’s lawsuit appears to have spurred the new Pentagon guidance. ProPublica, along with the Reporters Committee for Freedom of the Press and other media organizations, also wrote a letter to Krass requesting she outline standards for the military to follow. The National Institute of Military Justice supported ProPublica’s lawsuit and wrote a separate letter to Krass. However, nothing in the new policy would force the Navy or the other services to release similar court records in the future. The guidance allows the military to withhold records when public access and scrutiny is often most important: leading up to and during a court-martial. Under the new policy, the military doesn’t have to make records public until after a verdict is reached and the trial record is certified. The guidance says the services can take up to 45 days after certification to release any documents. That arbitrary time frame is out of step with how every other court is run, Rosenblatt said. After a trial is over, “the newsworthiness is gone,” he said. Even then, only a limited part of the trial record has to be produced. The services do not have to provide transcripts or recordings of court sessions or any evidence entered as exhibits, according to the Pentagon guidance. And the Pentagon does not consider any preliminary hearing documents to be part of the trial record. In the military, there is a proceeding called an Article 32 hearing to decide whether there is enough evidence for a trial. Under the new guidance, the military won’t have to put these hearings on the docket, so the public won’t even know they are happening. Records from Article 32 and other preliminary hearings tell the public a lot about whether the system is just. That’s where citizens can review and assess what cases the military are deciding to prosecute, Rosenblatt said. In Mays’ case, for example, the judge who presided over the Article 32 hearing recommended that the Navy drop its case against him for lack of evidence. The Navy ignored that recommendation and moved forward with the prosecution. The service then refused to make that recommendation public. The new Pentagon guidance also allows the military to permanently seal the trial record if the defendant is found not guilty. This could also prevent an assessment of fairness. For example, if a general is accused of sexual assault and found not guilty, the military doesn’t have to release any court records about the case, and the public would not be able to scrutinize how the case of a high-ranking officer was handled. The new guidelines make one change in favor of transparency. The military will no longer use Freedom of Information Act exemptions to justify redacting information from court records. FOIA law is not used to withhold or redact court records in any other court in the country, and it was inappropriately applied in military courts, Rosenblatt said. For example, in the Mays case, the Navy cited FOIA to redact the names of witnesses who testified in open court at trial. Krass’ new guidance says that the 2016 law makes access to courts-martial records “distinct from the right” to federal records granted under FOIA. Instead the federal Privacy Act, which regulates how the government can collect and release information about private individuals, should guide “which information and documents from the military justice system are to be made accessible to the public.” Although Rosenblatt said eliminating FOIA from the military judicial process was progress, the Privacy Act also doesn’t belong in the equation. The guidance also leaves how to interpret the Privacy Act and release of documents up to the services. “The Privacy Act,” Rosenblatt said, “is increasingly being weaponized to shield what’s going on in the military justice system from the public.”
[*] [+] [-] [x] [A+] [a-]  
[l] at 2/1/23 4:00am
by Logan Jaffe ProPublica is a nonprofit newsroom that investigates abuses of power. This story was first published as part of ProPublica’s Repatriation Project newsletter, which follows our ongoing investigation into whether U.S. institutions are returning Native American ancestral remains. Sign up to get updates as they publish and learn more about our reporting. When William Dickson moved to Fulton County, Illinois, from Kentucky in 1833, he purchased a beautiful piece of land overlooking the confluence of the Spoon and Illinois rivers. The federal Indian Removal Act of 1830 had exiled most Native American tribes from the state under the threat of genocide, and Illinois would soon have no tribally held land. The people of Fulton County, as described an 1879 history of the area, were proud of what they saw as accomplishments of the “Anglo Saxon” race: “They transformed the wigwams into cities; dotted the knolls with school-houses and churches; replaced the buffalo, deer, elk, and wolf, which had been driven further westward, with domestic animals; erected factories, built railroads, and reared a refined, enlightened and cultured people.” Still buried throughout much of Fulton County, according to archaeologists’ estimates, were at least 3,000 grave mounds and remnants of villages that belonged to Indigenous people and their ancestors. So when Dickson prepared his property to plant an orchard in the 1860s, he inadvertently unearthed human remains. His grandson, Thomas, later unearthed more human remains and objects while building his house nearby. Years later, in 1927, Thomas’ son, Don, turned the burial mounds into a public spectacle — and his livelihood. “I grew up with this knowledge,” Don F. Dickson told an audience of Illinois State Academy of Science members in May 1947. “The burials were in my backyard. I liked those people.” Dickson, a chiropractor, and his family excavated at least 234 burials and opened the site to the public. While most amateurs, archaeologists and anthropologists of the time fully disinterred and disarticulated human remains during excavations, Dickson chose to leave the burials as he found them in the ground. The novelty of seeing the dead in situ helped make the site a popular Illinois tourist attraction billed as Dickson’s Mound Builders Tomb, or what’s known today as Dickson Mounds Museum. Inside a canvas tent lay the remains of what Dickson and newspaper reporters believed was an extinct race of people. A 1927 article from one local paper promoted the exhibit under the headline “Excavations in Illinois Reveal Race That Lived and Died Before Indians.” Dickson benefited from the promotion; tens of thousands of people visited the private museum in the late 1920s. By charging 50 cents for admission, the Dickson family made their living. What visitors learned from the “museum” was the story that the Dicksons wanted to tell. In the remains of two adults placed side by side, their faces turned to face a baby that lay between them, Don Dickson saw a primitive, but loving, family. He speculated about relationships, social hierarchies and the purposes of various possessions. He and his family members served as the tour guides and public interpreters of the site. He rearranged objects to make the burials more dramatic; he removed the mandibles of some people to display them alongside the mandibles of various animals. Many bones and belongings were broken; some were stolen. The state of Illinois purchased the site from Dickson in 1945 and then hired the Dicksons to run it; Don Dickson continued to interpret the site for the public until his death in 1964. Don Dickson (Illinois Digital Archive, Illinois State Library) A few years later, the state built a large, new museum and adopted Dickson’s open-air exhibit as a permanent wing of the facility. Over the years, the burial exhibit saw various interpretations by museum staff, including the addition of audio and multicolored spotlights. Viewmaster reels and postcards were sold in the gift shop. I learned of the exhibit when I started investigating why the state museum held so many human remains, and I quickly realized that memories of it are not uncommon among a generation of Illinoisans slightly older than I am. An archivist assisting me with research in the Illinois State Archives told me that he was among many Illinois students in the 1970s who had visited the museum on field trips, and he remembered it, simply, as “spooky.” In 1990, a long movement for Native American rights led to the passage of the Native American Graves Protection and Repatriation Act, a federal law intended to enable tribal nations to reclaim their ancestors, funerary objects and sacred items from institutions. Staff at the Dickson Mounds Museum and its parent institution, the Illinois State Museum, had been monitoring the bill and others like it for years and had anticipated changes in public sentiment around the display of open graves. To try to head off controversy, museum leaders decided to close the burial exhibit. Illinois Gov. James R. Thompson had agreed with the museum’s decision. But when news of the exhibit’s planned closure broke, the public outcry and political pressure that ensued forced Thompson to reconsider his decision. At the heart of his dilemma was the question of whether the exhibit was educational or entertainment, and whether the offense it caused to Native Americans outweighed the potential benefits of public education and tourism. Ultimately, Thompson reversed course. “This never has been treated as a carnival sideshow,” Thompson said. “It is an educational exhibit that respects the lives of people who made a civilization here hundreds of years ago. It will remain so.” Among Thompson’s most vocal opponents was Michael Haney, an activist of Seminole and Sioux heritage. Haney had helped gather crowds of protestors at the museum and had responded to the governor’s decision to keep the exhibit open by calling it racist. But in addition to making many pointed public comments, which included referring to Fulton County residents as “country bumpkins,” he expressed the deep hurt caused by the Dicksons and those who supported keeping the exhibit open in a way that continues to resonate: “If you want to know about Indians, ask living Indians,” Haney said at a public hearing in 1990. “Don’t desecrate our graves.” A protest against the museum’s exposed burial sites in the early 1990s (Illinois Digital Archive, Illinois State Library) For perhaps the first time, some local residents and others paying attention to the issue were forced to confront the notion that, by advocating to keep the exhibit open, they were complicit in the erasure of Indigenous people from the story the museum was telling about them. The controversy lasted for more than two years. The exhibit eventually closed in 1992. Contractors installed cedar flooring over the open graves to shield them from public view. Museum officials today say that no one has seen the graves in 30 years. At ProPublica, my colleagues and I have spent the last 18 months trying to understand why so many of the nation’s top museums and universities still have thousands of human remains in their collections even though the law to push for repatriation passed more than 30 years ago. The Illinois State Museum and Dickson Mounds Museum, for example, together hold the remains of more than 7,000 Native Americans. But a new generation of museum leadership sees an opportunity to rewrite the story the Dicksons wanted visitors to learn, and returning remains to tribal nations is part of that. Dickson Mounds Museum is now led by a citizen of the Peoria Tribe of Indians of Oklahoma, whose members are descendents of more than a dozen tribes that were forcibly removed from the state in the 1700s and 1800s. “My ancestors put me here,” said Logan Pappenfort, interim director of Dickson Mounds Museum. “They came from Illinois, and it’s my responsibility to do everything I can to get them where they’re supposed to be again.”
[*] [+] [-] [x] [A+] [a-]  
[l] at 1/31/23 3:00am
by Sophia Kovatch, Pamela Colloff and Brett Murphy ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive our biggest stories as soon as they’re published. It’s been decades since the intersection of forensic science and criminal justice first became a pop culture phenomenon, popularized by countless TV shows, movies and books. But the public’s growing awareness of forensic techniques obscures a far more complex field that’s chock full of bogus science — and the people who champion it, often for profit. For years, ProPublica has reported on these dubious techniques as they’ve wormed their way into every corner of our real-life criminal justice system. So, what’s legitimate forensic science and what’s junk? Let’s start with the basics. What Is Junk Science? Junk science refers to any theory or method presented as scientific fact without sufficient research or evidence to support it. Some types of junk science have virtually no supporting evidence, while others are oversimplifications of real but complex science findings. Adding to the risk they pose to the justice system, many forms of junk science are very subjective and depend highly on individual interpretation. How to Spot Junk Science in Forensics When ProPublica has reported on junk science, we’ve found many common traits. They could include: It has limited or no scientific evidence or research supporting it. It is presented as absolutely certain or conclusive, with no mention of error rates. It relies on subjective criteria or interpretation. It oversimplifies a complex science. It takes just a few days to become an “expert.” Examples of Junk Science in Forensics and Law Enforcement Tracing the spread of junk science through the criminal justice system can be difficult. But ProPublica has followed forensic junk science in various forms for years. 911 Call Analysis Police and prosecutors trained in 911 call analysis are taught they can spot a murderer on the phone by analyzing speech patterns, tone, pauses, word choice and even the grammar used during emergency calls. These are known as “guilty indicators,” according to the tenets of the program. A misplaced word, too long of a pause or a phrase of politeness could reveal a killer. Analysis of 911 calls appears in the criminal justice system in lots of different ways. Some detectives say it’s a tool to help build a case or prepare to interrogate a suspect. They have used it to help extract confessions. Others present their analyses to prosecutors or enlist Tracy Harpster, the program’s creator and a retired deputy police chief from Ohio, to consult on cases. Never miss the most important reporting from ProPublica’s newsroom. Subscribe to the Big Story newsletter. During Harpster’s career, he had almost no homicide investigation experience or scientific background. He developed the 911 call analysis technique based on a small study for his master’s thesis in 2006. After teaming up with the FBI to promote his findings nationwide, there was enough demand from law enforcement to create a full-fledged training curriculum. Since the technique’s development, 911 call analysis has been used in investigations across the country. ProPublica documented more than 100 cases in 26 states where Harpster’s methods played a role in arrests, prosecutions and convictions — likely a fraction of the actual figure. In addition, Harpster says he has personally consulted in more than 1,500 homicide investigations nationwide. Despite the seeming pervasiveness of the technique, researchers who have studied 911 calls have not been able to corroborate Harpster’s claims. A 2020 study from the FBI warned against using 911 call analysis to bring actual cases. A separate FBI study in 2022 said applying 911 analysis may actually increase bias. And academic studies from researchers at Villanova and James Madison universities came to similar conclusions. Ultimately, five studies have not been able to find scientific evidence that 911 call analysis works. In a 2022 interview, Harpster defended his program and noted that he has also helped defense attorneys argue for suspects’ innocence. He maintained that critics don’t understand the research or how to appropriately use it, a position he has repeated in correspondence with law enforcement officials for years. “The research is designed to find the truth wherever it goes,” Harpster said. Example: ProPublica chronicled how 911 call analysis was used in the case of Jessica Logan, who was convicted of killing her baby after a detective trained by Harpster analyzed her call and then testified about it during trial. Bloodstain-Pattern Analysis Bloodstain-pattern analysis is a forensic discipline whose practitioners regard the drops, spatters and trails of blood at a crime scene as clues that can sometimes be used to reconstruct and even reverse-engineer the crime itself. The reliability of bloodstain-pattern analysis has never been definitively proven or quantified, but largely due to the testimony of criminalist Herbert MacDonell, it was steadily admitted in court after court around the country in the 1970s and ’80s. MacDonell spent his career teaching weeklong “institutes” in bloodstain-pattern analysis at police departments around the country, training hundreds of officers who, in turn, trained hundreds more. While there is no index that lists cases in which bloodstain-pattern analysis played a role, state appellate court rulings show that the technique has played a factor in felony cases across the country. Additionally, it has helped send innocent people to prison. From Oregon to Texas to New York, convictions that hinged on the testimony of a bloodstain-pattern analyst have been overturned and the defendants acquitted or the charges dropped. In 2009, a watershed report commissioned by the National Academy of Sciences cast doubt on the discipline, finding that “the uncertainties associated with bloodstain-pattern analysis are enormous,” and that experts’ opinions were generally “more subjective than scientific.” More than a decade later, few peer-reviewed studies exist, and research that might determine the accuracy of analysts’ findings is close to nonexistent. When MacDonell, who died in 2019, was asked whether he ever considered changing his course structure or certification process after seeing students give faulty testimony, MacDonell answered in the negative. “You can’t control someone else’s thinking,” he said. “The only thing you can do is go in and testify to the contrary.” Example: ProPublica has also reported on how bloodstain-pattern analysis was used to convict Joe Bryan of killing his wife, Mickey. Other Junk Science Examples ProPublica’s reporting on junk science in forensics goes beyond bloodstain-pattern analysis and 911 call analysis. We’ve also covered: The pervasiveness of Scientific Content Analysis, or SCAN, a means of dissecting written suspect statements while looking for markers of deception. How the FBI used unproven photo analysis in its investigations for years. Why police and prosecutors kept using roadside drug tests with known high rates of false positives. How Does Junk Science Spread in Forensics? Junk science can spread a lot of different ways, but there are some common patterns in how it spreads across forensics and law enforcement. Often, junk science originates when an individual devises a forensic technique based on minimal or narrow experience and data. For example, the original 911 call analysis training curriculum was based on a study of just 100 emergency calls, most of which came from a single state. The creators of these techniques then put together curriculums and workshops targeting law enforcement at every level around the country. As more police officers take these courses, these techniques are employed more often in investigating crimes and interrogating suspects. When officers testify in court, the impact of junk forensic techniques makes its way into the justice system. Other times, prosecutors call the creators and trainees of these forensic methods as expert witnesses, as was common with bloodstain-pattern analysis. In the courtroom, it’s up to the judge to decide whether certain evidence is admissible. While judges are experts in the law, they aren’t necessarily experts in the scientific disciplines that make up forensics. Once a type of junk science is admitted in a case, other prosecutors and judges can use that as precedent to allow it in future cases too. In this way, new junk science methods like 911 call analysis can spread quickly through the justice system. How Long Has Junk Science Been a Problem in Criminal Justice? Forensic science has had a junk science problem for decades. In the 1980s and ’90s, the FBI and other law enforcement agencies used faulty microscopic hair comparison in hundreds of cases, only formally acknowledging the problematic science in 2015. Since at least the 1990s, law enforcement has used a written content analysis tool with no scientific backing to interpret witness and suspect statements. The 2009 report from the National Academy of Sciences, which reviewed the state of forensic science in the United States, found that a lot of forensic evidence “was admitted into criminal trials without any meaningful scientific validation, determination of error rates, or reliability testing to explain the limits of the discipline.” A 2016 report from the President’s Council of Advisors on Science and Technology found that despite efforts to fund forensic science research, there was still a major gap in understanding the scientific validity of many forensic methods. In 2017, the Trump administration allowed the charter for the National Commission on Forensic Science to expire, further limiting the progress on validating forensic science methods. Since then, many forensic professionals have critiqued the junk science problems rampant in forensics and criminal justice.
[*] [+] [-] [x] [A+] [a-]  
[l] at 1/30/23 4:00am
by Alec MacGillis ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive our biggest stories as soon as they’re published. This story is exempt from ProPublica’s Creative Commons license until March 31, 2023. Corey Winfield was 10 when he saw someone get shot for the first time. He and a friend were marching around with a drum in the Park Heights section of Northwest Baltimore, and a few older guys asked if they could use it; while they were doing so, someone came up and shot one of them in the back, paralyzing him. At 11, Corey found his first gun, in an alley near his school. He sold it to a friend’s older brother for $45 and used the money to buy lots of penny candy. At 13, he saw someone get killed for the first time — a friend, who was 14 — and that year he started selling drugs. After he was robbed a few times, he bought another gun. When he was 17, he was buying some drugs to sell when the dealers tried to rob him, so he shot one of them, killing him. Winfield went to prison for nearly 20 years. Two weeks after his release, in 2006, his younger brother, Jujuan, who was 21, was shot to death outside the family’s house. For days, Winfield stalked the man he suspected of the murder; he might have killed him, but a police cruiser appeared as he was about to shoot. He went home, where he found his aunt Ruth, who had brought him up, sitting alone in the dark. She told him that she knew what he was up to. “Please stop, I don’t want to lose another baby,” she said to him. “I broke down and we cried on the sofa,” Winfield told me. Winfield promised to give up guns, and soon he committed to getting others to stop shooting, too. Baltimore was building a “violence interrupter” program, modeled on one launched in Chicago, in which people who have criminal records and a history of street violence use their contacts and credibility to defuse tensions before anyone is shot. Winfield became one of the first outreach workers in the new program, Safe Streets, citing his willingness to eschew vengeance as proof that peace was possible. Jujuan’s death “opened my eyes up to the pain I was causing and had been causing for half my life,” he told me. “I was part of the mayhem and the destruction.” Soon after he joined, he helped a 19-year-old who wanted to stop selling drugs procure a copy of his birth certificate, so that he could get regular work. When the young man finally got the document, he started crying. “All my life, they told me my father didn’t know who I was,” he said. “But he signed my birth certificate, and that’s gotta mean he loved me.” Many other cities also began adopting the interrupter model. It had intuitive appeal as a complement to policing: why not deploy people with neighborhood know-how and the motivation to redeem themselves? “There’s so many things that we could do and should be doing, outside of law enforcement, before things get to the point of needing to utilize the criminal justice system,” Monique Williams, a public health researcher who until recently led Louisville, Kentucky’s Office for Safe and Healthy Neighborhoods, said. There was resistance from police departments: The interrupters generally avoided cooperating with the cops, and some officers were wary of men whom they had arrested not so long ago. Some interrupters lapsed into drug dealing or other illegal activity. In Louisville, the Metro Council stopped funding the city’s three interrupter teams in 2019 after an interrupter was arrested for dealing methamphetamine (the charges were later dropped) and another worker was charged with raping a woman. (He was convicted of a related felony.) “There was not a lot of believing in the product from the Metro Council,” the leader of one team, Eddie Woods, told me. “So any excuse is a good excuse to pull the plug on it.” In 2020, everything changed. Violence spiked across the country, with homicides rising by 30%, wiping out two decades of progress. Criminologists attributed the rise to a combination of the social disruption caused by the pandemic and the deterioration of police-community relations after the murder of George Floyd in Minneapolis, which led to less proactive policing and less cooperation from residents. After the presidential election, Joe Biden’s administration looked for ways to stem the violence without relying solely on traditional law enforcement, which had come under intense scrutiny on the left. In 2021, Congress passed the American Rescue Plan Act, or ARPA, which included funding that many cities are spending on “community violence intervention,” the catchall term for non-police approaches to reducing violent crime. In addition to interrupters, these measures include programs that detach young men from gangs, those which meet with shooting victims in hospitals to deter retaliation and those which offer young men employment and counseling in cognitive-behavioral therapy. For years, these programs competed with one another for whatever scarce funding was available, passing from one short-lived pilot project to another. Now they are being showered with unprecedented resources: Louisville is getting $24 million; Baltimore will receive $50 million. The funding has created an opportunity for community violence intervention to become a significant feature of the public safety landscape. But the challenges are still immense. The programs have only a few years to prove that they deserve lasting support after the federal money runs out. Public safety agencies that until recently consisted of a handful of people are having to expand rapidly to oversee millions in spending, building a new civic infrastructure in a matter of months. And the evidence for how well some of the programs work is mixed and sometimes elusive, not least because it’s hard to measure crimes that never happen. “The money creates a problem,” Eddie Woods said. “Everybody’s an intervention specialist now.” Gary Slutkin, an epidemiologist, spent seven years in the late 1980s and early ’90s at the World Health Organization, working to contain the HIV-AIDS epidemic in Central and East Africa. He had previously fought cholera in Somalia and a tuberculosis outbreak in San Francisco. When he returned to the United States in 1995, he went to Chicago to be near his parents. Deciding which cause to take on next, he settled on one of the leading drivers of mortality in the city: violence. Gary Slutkin, the founder of Cure Violence (Jon Lowenstein/NOOR/Redux) Chicago had about 900 homicides per year, and Slutkin found the debates about causes and solutions deeply unsatisfying. “I just began to ask people what they were doing about it, and nothing made sense to me,” he said. “It made no scientific sense. It had no logic. There was no theory other than ‘bad people.’” As he saw it, gun violence was an epidemic not unlike the diseases he had spent his career fighting. “It qualifies as a contagious disease, as it has characteristic signs and symptoms causing morbidity and mortality, and it’s contagious, as one event leads to another,” he told me. Slutkin believed that it needed to be treated as an epidemic by using public health workers to reach those who were most infectious and susceptible. Those workers should be people who “have credibility and access to the population that you need to talk to,” he said. In Chicago, that entailed recruiting men with criminal histories to serve as outreach workers in neighborhoods experiencing high rates of violence. In 2000, with the University of Illinois Chicago as his institutional base and initial funding from the Centers for Disease Control and Prevention and the Robert Wood Johnson Foundation, Slutkin deployed a team of eight workers in West Garfield Park, one of the most violent neighborhoods in the city. Shootings there declined by 68%. Slutkin added teams in six more areas in the next couple of years, and within a year shootings in those areas decreased an average of 30%. It was an impressive result, but homicide rates were falling all over the country, and other models of violence reduction were also seeing success. One was the “focused deterrence” model, pioneered by David Kennedy in Boston, which included group interventions, wherein teams of prosecutors, police officers and respected community figures met with young men deemed most likely to commit violent crimes and offered them social services, coupled with the threat of consequences if they engaged in further violence. But Slutkin’s model — eventually called Cure Violence — got enough credit for reduced shootings that other cities began deploying interrupters, often hiring Cure Violence to train and guide them. Many city governments were leery of hiring people with serious criminal records, and the programs were often run by nonprofit groups that had looser restrictions. When Baltimore launched Safe Streets, in 2007, its homicide rate was among the highest in the country. Dante Barksdale, a charismatic native of East Baltimore in his early 30s, helped lead the effort almost from the start. “I was tired of getting locked up, of getting robbed by police, of having to keep an eye out at all times,” Barksdale later wrote of his attraction to the program. “I wanted a regular job. And it seemed the universe had one in mind for me. My reputation as a hustler would help the Safe Streets mission, more than any amount of training could.” Safe Streets put its first team in McElderry Park, on the east side. Barksdale, who was better known by his nickname, Tater, became a champion for the program as it expanded into three more neighborhoods in the next few years, a period during which homicides began falling sharply in Baltimore for the first time in decades. He joined Cure Violence staff from Chicago for training sessions around the country. Cobe Williams, Cure Violence’s training director, would drive around the Chicago housing projects with Barksdale. “That’s my guy,” Williams told people. “He is so committed to stopping the violence.” Like many interrupters, Corey Winfield found it hard to avoid sliding back into illegal activity. By 2011, he was selling drugs on the side to supplement his Safe Streets wage, $13 an hour, with which he was supporting two daughters. His aunt Ruth chided him. Winfield told me, “She said: ‘Listen, you’re doing God’s work. You can’t do God’s work and still do the Devil’s work. God’s going to punish you.’” Two months later, he was arrested after giving a ride to a friend who was on the way to a robbery and sentenced to five years’ probation. Winfield found it challenging to strike the balance demanded of a “credible messenger” — using the reputation gained from past brushes with the law to earn the trust of those who were still entrenched in the streets while avoiding such behavior himself. Sometimes, he told me, he was ostracized by friends who saw him wearing an orange Safe Streets T-shirt. “When I first put this shirt on, the whole city knew, and it was hard, but I didn’t take it off,” he said. “I would go up, like, ‘Yo, what’s up,’ and you walk away. I’m usually in, but now you all walk away, you leave. It’s hard on me.” Winfield left the program for a few years and worked with an organization that served runaway youths. Then, in April 2015, a 25-year-old man from West Baltimore named Freddie Gray died from injuries sustained while in police custody. Protests and rioting ensued, and gun violence in the city increased dramatically. The circumstances foreshadowed those in 2020: a surge in homicides that followed a death at police hands and a collapse in police-­community trust, which led to changes in police behavior, and calls for non-police approaches to public safety. Amid the spike in violence, Corey Winfield decided to rejoin Safe Streets. Winfield, center, is flanked by Safe Streets workers outside the organization’s office in the Brooklyn section of South Baltimore. (Rahim Fortune for The New Yorker) In his absence, Safe Streets had continued to struggle with the problem of workers falling back into crime: A site in West Baltimore had been suspended in 2013 after two of its workers were arrested, and in July 2015, an East Baltimore office closed after police found drugs and seven guns there and arrested two workers. But the program retained enough support that, in 2018, the mayor at the time, Catherine Pugh, who had moved control of the program from the Health Department to City Hall’s public ­safety office, expanded it from four sites to 10. On Martin Luther King Jr. Day in 2018, I was in an East Baltimore church as Winfield told an audience drawn from several local congregations how violence interruption worked. Big Corey, as he is known, is 6 feet, 3 inches tall and weighs 280 pounds, and his size is matched by a bright-eyed, magnetic charm. He sketched out a typical scenario: “Anita calls me and says: ‘Corey, my brother, I heard him talking, and they’re going to kill Lisa’s brother. Him and his buddies. ’Cause Lisa’s brother gets out of work at 3 in the morning and they’re going to get him.’ So I say, ‘OK,’ so I’m gonna get up at 2:30 and I’m gonna be out there so that when Anita’s brother jumps out on Lisa’s brother they’re going to see me. ‘Oh, it’s 3 in the morning. We ain’t doing this, right?’” Winfield continued, “Now, we know for a fact that 3 o’clock in the morning the police ain’t around. The police don’t mean a damn thing when somebody is coming to get killed. But somebody coming with guns, if they see me, that level of respect is high. “But once that respect leaves,” he added, alluding to his perceived independence from the police, “I’ll be lying beside Lisa’s brother. We cannot lose that, because that’s all we have. That makes us, the effectiveness we have.” That year, a different model of community violence intervention was emerging. In Massachusetts, an organization called Roca, which had worked for years with high-risk young adults in gritty places like Chelsea, Lynn and Springfield, was trying a new approach, using behavioral-theory techniques to help participants control their emotions. The approach tapped into a new neuro­scientific understanding of how trauma and harsh circumstances can keep people operating in survival mode — in their “bottom brain.” Roca believed that participants needed to acquire basic emotional self-regulation before they could advance to job training and other forms of support. “What we know changes behavior is people feeling safe, being able to manage their emotions and begin to heal their trauma,” Molly Baldwin, Roca’s founder, said. Instead of mediating conflicts, as Cure Violence does, Roca was seeking to make young people less likely to be drawn into conflict in the first place. The approach gained traction in Chicago, under the leadership of Eddie Bocanegra. Like Corey Winfield, Bocanegra had committed a murder; in 1994, at the age of 18, he had avenged the shooting of two members of a gang he belonged to. He served nearly 15 years in prison; after his release, he joined Cure Violence. In 2011, he was among a handful of workers featured in “The Interrupters,” a documentary film about the organization. Bocanegra, a slightly built man with a goatee, stands out in the film for his soft-spoken, cerebral bearing. One scene shows him doing good deeds, like delivering flowers, on the anniversary of the murder he’d committed. “I’ve thought of hopefully one day going to my victim’s family and really just expressing to them how deeply sorry I am,” he says. “It’s just that, right now, I don’t think it’s still right.” Soon after the documentary was released, Bocanegra quit Cure Violence. He was becoming increasingly aware of what the focus on intervention was leaving out. “How can I expect someone to put their guns down when their basic needs aren’t being addressed?” he said to me. “How can I expect someone to put their guns down when their basic needs aren’t being addressed?” said Eddie Bocanegra, who served nearly 15 years in prison before getting involved in violence-prevention programs. (Sebastián Hidalgo for ProPublica) He became an organizer with the Community Renewal Society, a social ­justice organization, while pursuing a master’s degree in social work at the University of Chicago. By 2013, the YMCA of Metro Chicago had hired him as its co-director of youth safety and violence prevention, working with some 400 teenagers, many of whom were involved in gangs. It was fulfilling work, but he was disturbed by the contrast between the investment that was made in the teenagers and the paltry efforts made on their behalf after they turned 18. Homicide rates remained well below their historic highs in Chicago, as they did nationally — in 2015, the city registered only 468 murders. But, late that year, the city released a video of a police officer firing 16 shots at Laquan McDonald, a 17-year-old armed with a knife, killing him. As in previous episodes of excessive police force, in Ferguson, Missouri, and Baltimore, the video gave rise to protests, an erosion of police-community trust and a sharp rise in deadly violence. In 2016, there were 764 homicides in Chicago. The city’s civic and business leaders committed $75 million for violence-prevention efforts. Much of the funding went to a new initiative called READI Chicago, which took a different approach from that of Cure Violence. READI identified several hundred men, mostly in their 20s, who were recruited by outreach workers and referrals upon release from incarceration. The men had, on average, between four and five felony arrests each, and 80% of them had been the victims of violence. The program provided them with 12 months of paid job training and employment plus cognitive-behavioral techniques. It was, by the standards of violence-prevention programs, an expensive undertaking — eventually, $25,000 per participant. Eight years after Eddie Bocanegra completed his prison sentence for first-­degree murder, he was chosen to lead the initiative. In Baltimore, the expansion of Safe Streets faced challenges. The city had to find nonprofit organizations to manage the sites and people to staff them. Cure Violence had stopped leading training sessions some years earlier, after the city grew lax about paying its bills. Meanwhile, the leadership of City Hall’s public ­safety office changed four times between 2017 and 2020. Amid the disorder, several Safe Streets staff members left for jobs at a new anti-­violence effort in the city: Roca. In 2018, the Massachusetts organization had opened a branch in Baltimore, the hometown of its leader, Molly Baldwin. Instead of targeting certain areas — even after its expansion, Safe Streets still covered only 2.6 of the city’s 92 square miles — Roca focussed on some of the hardest-to-reach young men between the ages of 16 and 24, drawn from across the city. They were generally referred to Roca by the police or by juvenile services; Roca came into contact with some through making regular visits to the homes of victims of nonfatal shootings. Within several years, the organization was working with about 200 young men — applying cognitive-behavioral theory, putting some on job crews and simply maintaining contact with them through the organization’s practice of “relentless outreach.” “It’s the more long-term approach, the more meaningful, sustained behavior change that we’re looking for,” James “J.T.” Timpson, who left Safe Streets to join Roca in 2018, said. “While I believe that the intervention is extremely important, even intervention requires some type of follow-up. You can intervene today, but what happens tomorrow?” A member of a Roca work crew picks up trash in Baltimore. (Rahim Fortune for The New Yorker) In late December 2020, Baltimore’s new mayor, Brandon Scott, named as director of the public safety office his longtime friend Shantay Jackson, a former information technology manager who had embraced anti-violence activism after Freddie Gray’s death and after her stepson was gravely injured in a 2018 shooting. She had led a nonprofit group that got the contract to oversee one of the new Safe Streets sites — a site that then experienced serious troubles despite being in the least dangerous of the 10 locations. It shut down only a few months after opening, in 2019, a closure that Jackson attributed to concerns about the safety of the workers. (It was later reopened.) A month after Jackson took over the public safety office, Dante Barksdale, the champion of Safe Streets, was paying a visit to the Douglass Homes, a public ­housing project in East Baltimore, on a Sunday morning. A gunman shot him in the head and body nine times, killing him. Even in a city that had experienced more than 300 homicides for six years in a row, the killing of the admired leader of the best-known violence-prevention program — its “heart and soul,” according to Scott — was a big blow. “My heart is broken with the loss of my friend Dante Barksdale, a beloved leader in our community who committed his life to saving lives in Baltimore,” Scott said. Six months later, another Safe Streets worker, Kenyell “Benny” Wilson, was shot in the South Baltimore neighborhood of Cherry Hill while driving to lunch and died after making his way to the hospital. Two people familiar with the case told me that Wilson, who was 44, had reprimanded a teenager for being rude to an elderly woman, and his colleagues suspected that this had prompted the shooting. “Tonight, our brother Kenyell Wilson became a victim of the gun violence he worked every day to prevent,” Scott said. Six months after that, in January 2022, DaShawn McGrier, a newly hired Safe Streets worker in McElderry Park, the program’s first site, was on duty just after 7 p.m., standing with several other men, when a gunman drove up and started shooting, killing McGrier, who was 29, and two others and injuring a fourth man. Scott called the shooting a “horrific tragedy.” Three deaths, in 13 months, in a program with fewer than 100 workers. It was exactly the dark scenario that Corey Winfield had sketched out four years earlier: The orange T-shirt no longer provided enough protection. At what point did a program’s administrators need to decide that the work was simply too dangerous? “Three people lost their lives,” Joseph Richardson Jr., a University of Maryland ethnographer specializing in gun violence, said. “That’s not normal. To have three Safe Streets workers killed, we need to assess what’s going on.” Roca underscored the safety of its workers, who were paid at least $60,000 a year, compared with the $45,000 that Safe Streets workers typically make. Roca was cautious about sending its staffers into areas when tensions were high, and, unlike Safe Streets, it maintained direct lines of communication with the police. “Are we really supposed to send another human being, not the police department, no equipment, in this day and age, when people are loaded up with automatic weapons?” Baldwin said. “To assume someone is going to listen to someone is to assume that they can access the thinking part of their brain.” Roca’s offices in Baltimore include a space for people studying for their GED certification. (Rahim Fortune for The New Yorker) Slutkin, the founder of Cure Violence, defended his approach. If violence interruption went awry, as it had in Baltimore, that was a sign that an individual program wasn’t following the model correctly, he said. “The difference is always whether they’re really doing it,” he went on. “Let’s say, in any given city, there’s three places that are getting results and four aren’t getting results. You can’t just keep not getting results for the whole year.” There are protocols for running an interrupter site, he said — from hiring the right people to reaching the right people on the street and keeping close track of outcomes. Slutkin, who stepped down as the head of Cure Violence last year, referred to positive results in other cities, including Chicago and Philadelphia. But some experts have interpreted the results in these cities, and in others, as being more mixed. Jeff Butts, a sociologist at John Jay College who led a study in New York, told me that interrupter programs are fundamentally difficult to assess — it’s hard to know whether a decline in shootings in an area is due to the interrupters or to all the other factors at play. The assessments typically tally only the shootings within the narrow boundaries of interrupter zones, even though the interrupters’ work inevitably ranges farther afield. Further complicating the research is that the approach varies so much from one site to another. “They live under the same banner, the same T-shirts, the same brand name, the same philosophy,” Butts said. “But they all insist on doing things their own way.” To better gauge interrupters’ effectiveness, researchers at Johns Hopkins University and the University of Maryland were in talks with Baltimore’s public ­safety office last year to conduct a comprehensive study of Safe Streets that would include field observations and interviews with workers and participants for nine months. But the qualitative component of the study fell through after city officials, citing costs, insisted that it run for fewer months. Richardson, of the University of Maryland, who would have led the field work, said that he plans to do a similar study in Washington, D.C., instead. “You can have all the numbers in the world,” he said, “but if you don’t understand how it plays out on the ground, without having that context you can’t really capture the effectiveness of the program.” Programs such as Roca and READI Chicago are easier to assess because they work with a defined group of men whose outcomes can be tracked. A randomized controlled study of READI Chicago released last year found that men who had participated in its 18-month program were nearly two-thirds less likely to be arrested for a shooting and nearly one-fifth less likely to be shot than men with similar backgrounds who had not been offered a place. Cure Violence leaders were quick to put READI Chicago’s results into context. Such programs help those who are fortunate enough to be enrolled, but what about all the other young men in the neighborhood? “You have programs like READI that maybe get 50 or 100 guys, and that’s what they’re working with,” Charlie Ransford, Cure Violence’s director of science and policy, said. “But what if some guys get released from prison and they’re not with them? What if a group of kids a few blocks over start getting into stuff and they’re not helping them? We’re community-based, they’re looking at individuals. We’re looking at the mass on a daily basis.” Helping some young men get on track was essential, he said, but insufficient. “You need Cure Violence as the head of the spear.” Last winter, the competition suddenly took on broader ramifications. The Biden administration created a position within the Department of Justice to oversee the distribution of $250 million for community-violence-­intervention efforts, part of legislation passed in response to the mass shootings in Uvalde, Texas and Buffalo, New York. Three decades after Eddie Bocanegra’s murder conviction, and a decade after he left Cure Violence in search of a different approach, he was tasked with helping lead the federal government’s response to the biggest surge of violence since the early-’90s wave that he had been part of. Many cities are using some of their new funding to start or expand teams founded on the Cure Violence model, among them Atlanta; Charlotte, North Carolina; Columbus, Ohio; Memphis, Tennessee; Philadelphia; St. Louis; Peoria, Illinois; Winston-Salem, North Carolina; Nashville, Tennessee; and Wichita, Kansas. In Louisville, the launch of five new Cure Violence teams is being led by a city agency that did not exist until less than a decade ago. After a high-­profile triple homicide in 2012, Mayor Greg Fischer created the Office for Safe and Healthy Neighborhoods, which started out as essentially a one-man shop run by Anthony Smith, a community organizer. It now has 50 employees. Unlike many of its counterparts in other cities, in recent years the agency has been led by people with deep expertise in violence prevention: Monique Williams, who stepped down in October, is a public health researcher, and her successor, Paul Callanan, has worked as a probation officer and later led a gang-reduction initiative in Denver. In collaboration with city and community leaders, they came up with a plan for the $15 million the office was getting, which included hiring case managers and funding two hospital-visitation programs and three of the five new interrupter teams. Separately, the city launched an effort based on David Kennedy’s focused deterrence, which, unlike Cure Violence, includes a major role for police and prosecutors. Louisville was adopting a hybrid approach, bringing together focused deterrence, interrupters and long-term case management into a single ecosystem for violence reduction. Compared with Baltimore, where the city’s public ­safety office has presided over a falloff in cooperation between Safe Streets and Roca, Louisville has maintained a unified, citywide approach, with biweekly meetings to discuss specific incidents and individuals. The sense of urgency is high in Louisville, where homicides nearly doubled in 2020, to 173, the most ever recorded. But Callanan told me that he is wary of the demand for quick action, fretting that federal deadlines for spending ARPA money — it must be committed by the end of 2024 — wouldn’t give cities time to build intervention efforts strong enough to justify continued local or state taxpayer support once the federal funding runs out in 2026. “We’re laying this expectation across the country that you can take a Cure Violence program and you can get it up and running in three months and you’re going to have these dramatic results,” he said. “The reality, historically, is it takes a long time to build these programs.” The interrupter model, Callanan noted, had been created during the Chicago gang wars of the ’90s, before large gangs fractured into smaller crews and before social media upended communication. “We have the challenge today of taking these concepts and putting them into play in our communities where the dynamics have completely changed,” he told me. This meant rethinking the profile of the ideal violence interrupter. Perhaps, he said, it was no longer necessarily the forty- or fiftysomething former gang member — “OG” — who would have commanded respect a couple of decades ago. Now, with social media, youths could find notoriety much more quickly. “You may have a 22-year-old with more clout than the 40-year-old guy who started a gang there,” Callanan said. “You may be hiring individuals based on a gang background or a historical background that is no longer relevant today to the groups that you’re dealing with.” “It’s not about gang warfare anymore,” a former administrator of Safe Streets told me. “The problem is more impulsive crazy shit.” At a YMCA in Louisville, I met Demetrius McDowell, who had been hired by a new interrupter site in the Smoketown neighborhood run by the nonprofit group YouthBuild. McDowell had spent years selling heroin before shifting his focus to real estate, which drug proceeds had helped him accumulate, and to efforts to help boys and young men stay off the path he had taken. Despite his age — 43 — McDowell was attuned to the swirl of online antagonism in the city. He described one of the most prevalent forms of social ­media provocation: Someone would livestream a video of himself supposedly on rival territory, and a rival would challenge him to reveal his location — to “drop a pin” — or otherwise be deemed a coward. “If you’re not tracking these things on their social network, you’ll never know what’s going on in the street,” McDowell told me. “That’s where I get all my information.” McDowell lasted less than two months on the YouthBuild team. He clashed with its leaders over a wish to continue building his own youth group, which had a contract with the YMCA. He also bristled at the adherence to protocols that Cure Violence trainers and one of the team’s supervisors, a college graduate, demanded. “You need individuals who can relate to the community,” he said, “but you got college guys coming in telling you how he thinks you should do it. A college fellow is telling me that you ought to do it this way because studies say this or that. It has to be a feel thing. ... This educated guy has no type of experience. I’ll take experience over data anywhere that could be manipulated.” With the new funding came ex­pectations that the programs institute standardized training, conform to established guidelines and collect copious data. But some of the interrupters viewed these demands as top-down cluelessness that undermined the organic nature of their work. “We’ve had a couple that didn’t work out,” Lynn Rippy, YouthBuild’s director, said. “We got them in for a little bit and realized that, in terms of the intake of information and the way we want to do business, that wasn’t going to work for them. So it didn’t work for us.” Last September, Eddie Bocanegra came to Baltimore to announce the distribution of the first $100 million of the Department of Justice funds he oversees. He made the announcement not at City Hall or at Safe Streets but at Roca, which was receiving $2 million. Of some 50 other recipients nationwide, relatively few were interrupter programs. A month later, Bocanegra was back in the city for the annual conference of Cities United, a national violence-prevention network founded in 2011 by, among others, the former Philadelphia Mayor Michael Nutter and the former New Orleans Mayor Mitch Landrieu and now led by Anthony Smith, the first director of Louisville’s public safety office. The two-day event drew hundreds of people from around the country, an indication that, thanks to the surge in federal funding, community violence intervention was experiencing a moment of arrival. But, in a closed-door session with mayors and other top city officials, Bocanegra offered a cautionary note. The field, he said, “is so grossly underdeveloped. We continue to use two or three models from the 1990s and early 2000s. This field has evolved, social media and technology have evolved, gangs have evolved. There are pockets of promising evidence and good models, but, because of a lack of investment, we’re not seeing that return. If this was a board of directors running a Fortune 500 company, we’d ask ourselves some very serious questions about our investment.” There was an unjust element to the pressure to produce results: police departments had, after all, received exponentially more resources for decades, even as violence remained high in many cities. “There’s a lot of pressure to hurry up and reduce the violence,” Shani Buggs, an assistant professor of public health at UC Davis who briefly worked for the Baltimore city government, said. Community violence intervention, she told me, “should be seen as a core city function, as police are seen as a core city function. There’s never a question about whether they should get rid of the police department because violence hasn’t gone down.” In Bocanegra’s remarks, he stressed that the field wasn’t doing enough to develop the workforce tasked with the actual intervention. Workers were not getting adequate support for the frequent traumas of the job and rarely gained the skills to advance from street work. “We’ve overlooked so much talent and potential,” he said. “We’re not building the field.” The “credible messenger” approach meant shifting enormous emotional and physical risk onto people who had already been through a tremendous amount. The messengers were, in a sense, both the best and the worst people to do interrupter work. To address these concerns, some cities, including Baltimore, allocated part of their ARPA funds to provide counseling for their interrupters. Shantay Jackson, the head of Baltimore’s public safety office, said that the workers “are dealing with their own level of trauma, given their lived experiences, but also dealing with vicarious trauma as they do the work of interrupting violence every single day.” In Baltimore, the new funding was increasing the pressure. “We need to learn as much as we can from the things that we’re rolling out, because in a ­couple of years we won’t have $50 million to throw at the problem,” Councilman Mark Conway, the chairman of the public safety committee, told me. “And when we make a decision about where we pare back, we’re going to need to look back at our data, we’re going to need to look back at our systems, and make some tough decisions about where we get the best bang for the buck.” Facing demands from the City Council to show how the public safety office was spending the money, Jackson released a breakdown — some was being given to nonprofit groups, some to the city’s launch of a focused-deterrence initiative and some to new staff positions, expanding the office from 15 to about 40. A view of Baltimore’s Brooklyn neighborhood, from the Safe Streets office led by Winfield (Rahim Fortune for The New Yorker) At the same time, the public safety office was losing two of its main liaisons to Safe Streets, raising the risk of further drift. And, as reported by the Baltimore Banner, the office was delaying Roca’s contract to deliver services to young men involved in the focused-­deterrence initiative. The effort to build a unified violence-reduction ecosystem was foundering on turf battles and personal conflicts, though Jackson downplayed the tensions, saying that her office and Roca “continue to have conversations that I think have been very productive.” One evening in early December, I was on my way to meet Corey Winfield when he told me that he would have to postpone: in the Baltimore neighborhood of Brooklyn, where he was now the Safe Streets site director, a gang member had stolen a car from a member of another gang, and Winfield and his team were trying to get the car returned before anyone tried to avenge the theft. It had been a tumultuous stretch for the Brooklyn site, which, like several others in the city, was now administered by Catholic Charities. In November, a former worker at the site had pleaded guilty to dealing fentanyl while he was employed by Safe Streets. The site, which was supposed to have seven workers, had only five. But Winfield was pleased about the progress of an interrupter he had recruited for another site, a 38-year-old man he had met in prison who had survived three shootings. Winfield also took pride in the food distribution that his site had undertaken during the pandemic and in his idea to begin distributing used purses and handbags filled with hygiene products to the many sex workers in the area. A week later, I stopped by the Brooklyn Safe Streets office to see Winfield, but it appeared to be closed. I called him, and he told me that his aunt Ruth had just died of cancer. I went to the wake, at a church in West Baltimore, where I found Winfield in the lobby, being consoled by several Safe Streets workers wearing orange sweatshirts. He told me that he had been there for an hour and a half and hadn’t been able to go in to see her. “I can face a firing squad and my heart will still be strong,” he said. “But I’ve not been in there yet. It’s the hardest thing I’ve ever had to do.” He also told me about another recent intervention. Three months earlier, a sex video involving high school students had surfaced online, angering a rival group of teenagers, who had beat up one participant, stealing his designer bag and sunglasses, then fired shots at a car belonging to another participant’s mother. This was not in Winfield’s Safe Streets zone, but he went to help. He reached out to the mother of a member of the retaliating group, fearing that she might be a target, and, for several days, he accompanied her on the bus to work. “It’s how kids think now,” he said. “If they can’t get who they’re targeting, they’re going to get you.” He also reached out to the father of one of the students in the video; the man was known to Winfield as a “shot caller,” someone who had the ability to arrange a killing or to defuse a conflict, and he had been making provocative comments about the episode online. At a 2 a.m. meeting on an abandoned block, arranged by the superiors in the crew that the father belonged to, Winfield urged him to de-escalate. “We were able to resolve it. That’s what we do out here,” Winfield said. “We squashed it. But nobody knows about those kinds of stories.” Two weeks after the wake, a couple of miles west of the church, five high school students were shot outside a Popeyes across from their school at lunch. One of them, a 16-year-old, died. For Roca’s staff, it was a delicate situation — the murder victim was the younger brother of a Roca participant, and Roca leaders wanted to proceed strategically with their outreach to the other victims. Corey Winfield, in contrast, wanted to get involved immediately. He knew that retaliation was likely, and he wanted Safe Streets on the scene, figuring out who might seek vengeance. But the shooting was several miles from his site. Winfield called me to voice his frustration. “We need to get on top of that now,” he said. “This is the real shit, right here. This needs to be handled right now. We don’t have a week or two. More kids are going to die.
[*] [+] [-] [x] [A+] [a-]  
[l] at 1/27/23 7:00am
by Lulu Ramadan, The Seattle Times This article was produced for ProPublica’s Local Reporting Network in partnership with The Seattle Times. Sign up for Dispatches to get stories like this one as soon as they are published. A King County judge ruled last week that a private special education school that has been the subject of a recent Seattle Times and ProPublica investigation has to comply with public information laws and release records to the Times. The ruling has the potential to shed light on an obscure part of Washington’s special education system, in which school districts send students with disabilities to private programs at taxpayer expense. Few other legal rulings have defined how the state’s public records laws apply to private organizations that assume the functions of government agencies. The special education schools operate with little state oversight and aren’t required to disclose key data, like discipline rates or test scores, as traditional public schools are. The investigative series, published late last year, found significant problems at the Northwest School of Innovative Learning, the largest program in the system, including allegations of abuse by staff, a lack of basic resources and unqualified aides instead of certified special education teachers leading classrooms. While researching the story, in December 2021, Times reporter Mike Reicher sent a request to Northwest SOIL seeking records related to restraint and isolation of students, staff training materials, complaints against the school, government inspection reports and other documents. These documents would be available at any public school under the state’s Public Records Act, which requires government agencies to make documents available for public review to ensure transparency but typically does not apply to private entities. Northwest SOIL is owned by Fairfax Hospital, the largest private psychiatric hospital in Washington and a subsidiary of the Universal Health Services hospital chain. UHS denied the Times’ request, noting the school was not a government agency. The Times sued Fairfax in February, arguing that Northwest SOIL should be subject to state transparency laws because it was a “functional equivalent” of a public agency — all its students were placed by public school districts, and their tuition was paid entirely using tax dollars. In a Jan. 18 order, King County Superior Judge Annette Messitt agreed with the Times, granting its motion for summary judgment. Messitt wrote that Northwest SOIL “has essentially stepped into the shoes of the school districts to carry out the state’s duty to provide special education to children with disabilities.” Fairfax and its attorneys did not respond to requests for comment and haven’t indicated whether they plan to appeal. Previously, Fairfax denied that it understaffed its schools and said restraint and isolation were only used as a last resort. “They are paid with public tax dollars, and they are charged with educating and nurturing public school students — and only public school students,” Seattle Times Executive Editor Michele Matassa Flores said. “They should be held accountable, which starts with parents and the taxpaying public being able to see what’s happening there. This disclosure is a step toward transparency and ultimately better outcomes for the students.” The Times and ProPublica pieced together details about Northwest SOIL by sifting through more than 17,000 pages of documents obtained under public records laws from more than 40 schools districts, three police departments and the state education department. The series prompted a sweeping reform bill in the Washington State Legislature and an investigation by the state Office of Superintendent of Public Instruction. OSPI noted that some allegations were “previously unknown” to the education office and other government agencies. The ruling has potential implications for parents of children who have attended private programs that have operated for years with little accountability or oversight. Emily Ragan, whose son attended Northwest SOIL last school year, said the school needed to be more transparent. In a declaration in support of the Times’ lawsuit, Ragan described how her son, then 9 years old, came home from school with bruises at least seven times. When she asked Northwest SOIL for video footage that might explain how her son was injured, the school similarly denied her request. Ragan supported the Times’ lawsuit because “I believe that would help parents like me find out what really goes on at Northwest SOIL,” she wrote in her declaration. Messitt’s ruling last week compels Fairfax and Northwest SOIL to provide the Times with all documents and information that the newspaper requested, with the exception of those that are exempt under state law, in February and March, absent an appeal. The ruling also awarded the Times attorney fees and potential penalties, to be determined later, for the withholding of the records. “This important ruling will shine a light on how a large for-profit corporation carries out the state’s educational duties at enormous public expense,” said Katherine George, the Times’ attorney. “It will help the public assess whether vulnerable students are getting the services and humane treatment they deserve.” Messitt used a four-pronged legal assessment, known as the Telford test, to judge whether the private school was subject to public records. The judge wrote that three of the four factors applied to Northwest SOIL to some degree: the school performs a government function, it receives significant government funding and it is subject to government involvement or control. The fourth factor — whether an entity was created by the government — does not apply, Messitt wrote. In 2017, the state Supreme Court applied the test in a public records case involving an animal rights activist who requested records from the private nonprofit group that ran the Woodland Park Zoo. In that case, the court ruled in favor of the zoo and against public disclosure, but it found the Telford test was an appropriate way to decide whether a private entity must comply with the Public Records Act. Mike Reicher of The Seattle Times contributed reporting.
[*] [+] [-] [x] [A+] [a-]  
[l] at 1/27/23 4:00am
by Richard A. Webster, Verite This article was produced for Verite by Richard A. Webster, who covered the Jefferson Parish Sheriff’s Office as part of ProPublica’s Local Reporting Network in 2021-22. Sign up for Dispatches to get stories like this one as soon as they are published. Nearly half of Louisiana sheriffs are in violation of a state law regulating the preservation and destruction of public records, according to documents provided by state officials. The disclosure follows an article this month by Verite, also published by ProPublica, on accusations that the Jefferson Parish Sheriff’s Office illegally destroyed documents in a lawsuit involving an autistic boy who died in custody. It also comes on the heels of increased scrutiny on the outsize power wielded by Louisiana sheriffs. The new reporting found that the lack of a records retention policy extends far beyond Jefferson Parish. Of the 64 sheriffs statewide, 23 have never secured state approval for their policy, three allowed their policies to expire (one as far back as 1980) and the policies of an additional four are so limited they only address a small fraction of the records in their possession. State law requires all public agencies to submit a records retention policy for approval to the State Archives, a division of the Secretary of State’s Office. Further, in the past decade, nearly two-thirds of all Louisiana sheriffs failed to file a request with the state for permission to dispose of public records, as required by the same law. The State Archives, the agency responsible for overseeing and approving the handling of records, keeps disposal requests on file for 10 years. The lack of governmental oversight of elected sheriffs — despite years of complaints and allegations of civil rights abuses — has made it difficult for alleged victims of police abuse to prove misconduct. It has also led to impunity for bad actors, according to civil rights attorneys, community activists and criminal justice experts. And the lack of state approval for the disposal of public records means sheriffs offices are not fully accounting for information about alleged deputy misconduct, which can be crucial in investigations and litigation over claims of civil rights violations. These records can include internal affairs investigations into the use of excessive force and in-custody deaths, as well as more mundane documents such as payroll records. Verite requested the records retention policies and disposal requests filed by every sheriff from the State Archives, the agency responsible for overseeing and approving the handling of records. Some of the largest sheriff’s offices are among those that didn’t follow the public records law. The Orleans Parish Sheriff’s Office under former Sheriff Marlin Gusman never sought approval for a records retention policy during his 17 years in office, according to the State Archives. In addition, Gusman did not obtain permission to destroy records for at least 10 years. The parish jail overseen by the sheriff has been under a federal consent decree since 2013 following evidence of rampant violence — at the hands of both the guards and of those jailed — and unsafe living conditions. The consent decree is concerned with federal, not state, law and does not require the OPSO to get a state-approved records retention schedule. As part of the federal consent judgment, Emily Washington and Elizabeth Cumming, attorneys with the MacArthur Justice Center in New Orleans, represent the men and women held in the Orleans Justice Center. They said they have been forced to request court assistance in accessing records related to in-custody deaths and uses of force by jail deputies. This highlights the need for records retention policies, Cumming said, not just for public accountability and transparency, but also for ensuring that jails are being operated in accordance with the Constitution. “Comprehensive and accurate records are critical if patterns and causes of harm are going to be identified and corrected, for example when looking at staff deployment or employee discipline,” Cumming said. “Without a robust practice of record generation, maintenance, review and assessment, our clients will continue to experience preventable violations of their rights.” Sheriff Susan Hutson, who defeated Gusman in the 2021 election, completed and signed a new records retention policy draft on Jan. 24, which will be submitted to the state for approval. Improving the agency’s handling of public records is a priority, she said. “One of the things I told our communities is that this is going to be a well-run department, and that includes following the law,” Hutson said. “These are the community’s records. It’s their information. And we should be making sure it’s collected, preserved and available.” The problems with the Jefferson Parish Sheriff’s Office came to light in a federal civil rights lawsuit filed by the family of a 16-year-old autistic boy who died in January of 2021 while being restrained by JPSO deputies. Attorneys for the family of Eric Parsa accused the sheriff of illegally destroying the disciplinary records of the accused deputies. U.S. Magistrate Judge Donna Phillips Currault in a November ruling found that JPSO should have known to preserve the disciplinary and training records of deputies involved in the case. However, she denied the family’s request to place sanctions against the sheriff, stating that the family failed to prove JPSO destroyed evidence in “bad faith” or with a “desire to suppress the truth.” According to its written policy, the sheriff’s office destroys its deputies’ disciplinary records after three years. Yet, as previously reported, it has not secured approval for that policy, nor has it submitted requests to dispose of public records in at least a decade, according to the State Archives. This month, JPSO attorney Danny Martiny said the office doesn’t comment on pending litigation. Jefferson Parish Sheriff Joe Lopinto, who did not respond to requests for comment, denied all wrongdoing in court filings. Attempts to reach Gusman were unsuccessful. Record retention policies, or schedules, determine how long public records are preserved, and they provide guidelines on how they should be destroyed. Every public agency is required by law to submit one for approval with the State Archives. State law instructs the secretary of state to notify the head of any agency of the “impending, or threatening unlawful removal, defacing, alteration, or destruction of records … and initiate action through the attorney general for the recovery of such records.” Destroying, damaging, altering or removing public records “required to be preserved in any public office or by any person or public officer” is punishable by up to a year in prison, a fine of up to $1,000 or both. State Archivist Catherine Newsome said aside from “ongoing outreach” to agencies throughout the state, there is little more State Archives can do since it is not a “law enforcement or compliance agency.” Michael Ranatza, executive director of the Louisiana Sheriffs’ Association, in an email said that the group’s interpretation of the law allows sheriffs to retain public records for at least three years in the absence of a “more detailed records retention schedule.” “We believe that Sheriffs utilizing the statutory alternative of a three year minimum retention period in the absence of a more formal retention policy are not acting unlawfully,” Ranatza said. He did not address why 42 sheriffs do not have any disposal requests on file for at least 10 years. Guidance from the secretary of state’s office says, “State agencies are required under La. R.S. 44:411 to submit a records retention schedule” to the State Archives for approval. Asked if every agency is required by law to submit a records retention schedule to the secretary of state for approval, Newsome said, “Yes.”
[*] [+] [-] [x] [A+] [a-]  
[l] at 1/27/23 3:00am
by Logan Jaffe ProPublica is a nonprofit newsroom that investigates abuses of power. This story is part of an ongoing series investigating the return of Native American ancestral remains. Sign up for ProPublica’s Repatriation Project newsletter to get updates as they publish and learn more about our reporting. Every day when Logan Pappenfort is at work, he tries not to dwell on what’s under his feet. Beneath the south wing of the museum where he’s interim director are the remains of at least 234 of his ancestors. For more than 800 years, they laid undisturbed, carefully buried inside a mound of earth overlooking a quiet valley and a slow river. Then in the 1920s, a chiropractor named Don Dickson dug open the mound, eventually exposing the remains of hundreds of Native Americans. He left them in place, and his family turned the excavation into a roadside attraction they called Dickson Mounds. They charged visitors 50 cents for admission. In 1945, the state of Illinois purchased the site and later expanded it into a museum. The exposed human remains were used for decades to teach schoolchildren, visitors and local residents about what the museum presented as a long-gone culture of Illinois Indians. .repat-intro-block .repat-tag h2{ color: var(--black); text-align: left; font-family: var(--fonts-sans); } .repat-intro-block{ background-color: #E1DCD0; padding: 1em; border-radius: 5px; } p a.intro-block-link{ text-decoration: none; color: var(--color-accent-70); font-weight: 700; } p a.intro-block-link:hover{ text-decoration: underline; } .repat-intro-block p{ font-size:var(--scale-1); font-family:var(--fonts-sans); line-height:var(--line-height-1); padding-top: 1em; } .repat-intro-block h6{ font-size: var(--scale-2); font-family: var(--fonts-sans); line-height: var(--line-height-1); color: var(--warm-60); padding-top: 1em; } .repat-tag{ display: block; position: relative; } .repat-tag h2{ font-size: var(--scale-1); text-align: center; padding-bottom: 1em; color: var(--warm-10); font-family: var(--fonts-sans); font-weight: 700; } The Repatriation Project A series investigating the return of Native American ancestral remains. View the Full Series The exhibit closed in the early 1990s, after Congress passed legislation requiring museums to begin returning Native American human remains and funerary objects to their rightful owners. Contractors installed cedar floorboards over the pit. They left no doorway, no hatch. The remains at the Dickson Mounds Museum, which is a branch of the Illinois State Museum, account for a sliver of all the Native American human remains still in the hands of the state of Illinois. Federal records show the Illinois State Museum has reported that it holds the remains of at least 7,000 Native Americans. In three decades, it has returned only 2% of them — 156 individuals — to tribal nations who could claim them under the Native American Graves Protection and Repatriation Act. That is among the lowest return rates in the country. ProPublica found that the museum avoided repatriating any remains dating to before 1673, when European records of the area begin, which marks the start of what archeologists call the “historic era.” Museum leaders believed anything older than that could not be traced to living people and therefore could not be repatriated. Those decisions were based solely on geographic, scientific and historical evidence — including the maps and journals recorded by Europeans during their travels down the Mississippi River in 1673 — despite the law requiring institutions to also weigh linguistics, folklore and oral history. NAGPRA does not require absolute certainty in order to repatriate. In its initial inventory, the museum declared 98.4% of the Native American remains in its collections “culturally unidentifiable,” and after completing required tribal consultations in the mid-1990s, it did close to nothing to advance repatriations for more than 20 years. Instead, ProPublica found, the museum prioritized the scientific study of Native American human remains over their return. “The Repatriation Project,” an ongoing investigation by ProPublica and NBC News, has found that some of the nation’s most renowned museums have exploited loopholes in the law to hold on to Native American human remains and related items. D. Rae Gould, executive director of the Native American and Indigenous Studies Initiative at Brown University and a member of the Hassanamisco Band of Nipmucs of Massachusetts, said it’s common for institutions to say they can’t figure out who they should return remains and items to. Gould said such institutions often “use arbitrary analysis they call science to say there’s no cultural affiliation with modern day tribes.” Cinnamon Catlin-Legutko, who until her death earlier this month was the director of the Illinois State Museum, said that using the year 1673 to decide whether tribes have connections to the human remains and can reclaim them is “not OK.” Many museums, including ISM, “have been superb at avoiding the spirit of the law,” she said. A new generation of leadership at the museum aims to reverse its abysmal repatriation record. Curator of Anthropology Brooke Morgan said the institution no longer privileges archaeological and historical evidence over tribal knowledge. She and Pappenfort hope to set a new precedent for how the museum handles repatriations — one that relies less on finding a scientific link to prove a tribe’s cultural connections to ancestral remains. “Cultural affiliation is kind of a moot point,” said Pappenfort, who joined Dickson Mounds Museum as a curator of anthropology in 2021 and now serves as its interim director. “The reality is many tribes can lay claim to affiliation.” Logan Pappenfort, a member of the Peoria Tribe of Indians of Oklahoma and interim director at the Dickson Mounds Museum, is part of a group of people who have started to confront the history of the museum, including its lack of repatriations. (Sky Hopinka for ProPublica) Pappenfort is the first tribal citizen on the museum’s payroll and a member of the Peoria Tribe of Indians of Oklahoma, which includes descendants of more than a dozen tribes that collectively were known as the Illinois. Growing up in Kansas City, Kansas, Pappenfort said kids teased him when he would tell them he was Native American. He could not be an Indian, they would say, because Indians are extinct. In college, he came across a photograph in a textbook of the exposed burials at Dickson Mounds Museum. He realized the kids who taunted him in grade school had something in common with the Dicksons: “They weren’t actually looking at my ancestors as people.” That was on his mind as he drove across the state line into Illinois. “My ancestors put me here,” Pappenfort said. “They came from Illinois, and it’s my responsibility to do everything I can to get them where they’re supposed to be again.” A tent covers remains at a site excavated by Don Dickson in 1927. (Illinois Digital Archive, Illinois State Library) The Land and Its History High on a limestone bluff overlooking the Mississippi River, two painted monsters stared down at the Frenchmen below. Jesuit priest Jacques Marquette described them in his journal as having men’s faces, with horns on their heads, scales on their bodies and long tails that ended in fins. “These two monsters are so well painted that we cannot believe that any savage is their author; for good painters in France would find it difficult to paint so well,” Marquette wrote upon arriving in what he called the Illinois Country in 1673. Marquette and fur trader Louis Jolliet had entered a land that Indigenous people had inhabited for more than 12,000 years. More than 30 federally recognized tribes can trace their ancestry or cultural connections to the land that is now the state of Illinois. At the time of the Frenchmen’s arrival, though, most of that land was under the control of nearly a dozen tribes — including the Kaskaskia, Cahokia, Michigamea, Peoria and Tamaroa — who lived along the Mississippi and Illinois Rivers. Tribes With Ties to Illinois Absentee Shawnee Tribe of Indians of Oklahoma • Citizen Potawatomi Nation, Oklahoma • Delaware Nation, Oklahoma • Eastern Shawnee Tribe of Oklahoma • Forest County Potawatomi Community, Wisconsin • Hannahville Indian Community, Michigan • Ho-Chunk Nation, Wisconsin • Iowa Tribe of Kansas and Nebraska • Iowa Tribe of Oklahoma • Kaw Nation, Oklahoma • Kickapoo Traditional Tribe of Texas • Kickapoo Tribe of Indians of the Kickapoo Reservation in Kansas • Kickapoo Tribe of Oklahoma • Little Traverse Bay Bands of Odawa Indians, Michigan • Match-E-Be-Nash-She-Wish Band of Pottawatomi Indians of Michigan • Menominee Indian Tribe of Wisconsin • Miami Tribe of Oklahoma • Nottawaseppi Huron Band Potawatomi, Michigan • Osage Nation • Omaha Tribe of Nebraska • Otoe-Missouria Tribe • Peoria Tribe of Indians of Oklahoma • Pokagon Band of Potawatomi • Ponca Tribe of Indians of Oklahoma • Ponca Tribe of Nebraska • Prairie Band Potawatomi Nation • Quapaw Nation, Oklahoma • Sac and Fox Nation of Missouri in Kansas and Nebraska • Sac and Fox Nation, Oklahoma • Sac & Fox Tribe of the Mississippi in Iowa • Santee Sioux Nation, Nebraska • Seneca-Cayuga Nation • Shawnee Tribe, Oklahoma • Winnebago Tribe of Nebraska Some of these tribes accommodated Marquette and Jolliet as the pair traveled through the Mississippi and Illinois River valleys in the summer of 1673 aiming to introduce Indigenous people to Catholicism and expand the French trading empire. Marquette and Jolliet would have passed what today is called Dickson Mounds. There, a winding little tributary called the Spoon River floods into the slow waters of the Illinois and transforms the prairie into a Midwestern Everglades, teeming with life. Marquette and Jolliet left no records of people who may have lived or camped at that spot in 1673, but archaeological research indicates that between 1100 and 1350, thousands of people lived in the Central Illinois River Valley — many in a large town near Dickson Mounds and others in smaller communities nearby. The burial mounds that remain are testament to their lives, explained Pappenfort. A massive network of Indigenous communities stretched from Florida to Michigan’s upper peninsula. They shared similar ways of life, such as trading and farming, and traditions that included burying the dead in large earthen platforms. The mounds were built by moving thousands of pounds of dirt, basket by basket, often over many generations, said Pappenfort. The Dickson Mounds Museum (Sky Hopinka for ProPublica) Between 1350 and 1450, something changed. Groups began to move out of centralized communities, including the area around Dickson Mounds. About 150 miles to the south, Cahokia, a multicultural metropolis that’s sometimes called America’s first city, also experienced relatively fast population loss. Archaeologists have estimated that at its peak, around the year 1200, more than 20,000 people lived in Cahokia and its outskirts. Recent research suggests a changing climate that made growing maize difficult might have forced people to leave Cahokia. But there’s no widely accepted explanation for why they left or where they went. In the 1800s, a racist myth that the mounds were too sophisticated to have been built by the local Indigenous people led some to theorize that an extinct race of “mound-builders” had once inhabited the area. Though it was disproved as early as 1884, the remnants of that myth, in tandem with the unexplained depopulation of Cahokia, gave rise to an oft-repeated story that the people responsible for the mounds throughout Illinois had “vanished” or that their culture “ceased to exist.” Then Marquette and Jolliet showed up in 1673. That summer, Marquette chronicled the locations and customs of various tribal groups, including the Peoria and Kaskaskia. Archaeologists and anthropologists rely on the information in Marquette’s journals, but the missionary didn’t record the histories of any tribe he encountered. More than 300 years later, in 1995, some tribes would tell the Illinois State Museum curators that their oral histories describe their ancestors as mound-building people. But because that history wasn’t written down, the museum dismissed it. The year 1673 also marked the beginning of the end of tribally held lands in what is now the state of Illinois. By the 1830s, after Indigenous people were devastated by warfare and disease brought by Europeans — and after some tribes resisted ceding the land of their ancestors — the U.S. government gave Native people in Illinois two options: move or perish. Illinois Was Built on Native Land Maps of the land acquired through treaties show the rapid takeover of tribal land in the early 1800s. (Source: “Indian Land Cessions in the United States” via the U.S. Department of Agriculture, Illinois Geospatial Clearinghouse, Natural Earth. Map by Shane Loeffler.) Watch video ➜ White settlers soon arrived in larger numbers. Some, like the Dicksons, dug up burial mounds and speculated about who had built them. Amateurs were later joined by professional archaeologists and anthropologists. In the 1920s and 1930s, Fay-Cooper Cole and Thorne Deuel of the University of Chicago set up a field school just north of Dickson Mounds on land owned by Joy Morton, the founder of Morton Salt. Cole and Deuel lamented that many mounds had been leveled and looted in Fulton County. “Nearly every village had its local collection from the ‘Mound Builders,’” they wrote. “Mounds were looted and valuable data relating to the prehistory of the state were destroyed.” They still surveyed roughly 900 archaeological sites in the area, prompting their development of a cultural classification system that archaeologists still use today. “Their field school at the Morton site is often referred to as the ‘Birthplace of American Archaeology,’” wrote a former Dickson Mounds Museum curator, Alan D. Harn, in a 2010 paper. The Dickson family burial mound exhibit in the 1940s (Illinois Digital Archive, Illinois State Library) Federal records show that the remains of at least 15,461 Native Americans were excavated in Illinois, more than in any other state. Most are still in the state, and many are property of the Illinois State Museum. When the Illinois State Museum opened its Dickson Mounds branch in 1972, an elevated pathway guided guests around Don Dickson’s excavation. Below, exposed and broken, were the remains of a fetus with a shell pendant on her chest; two men in their mid-40s lay beside her. A woman, about 20 years old, rested with her left hand on her pelvis. She once wore a necklace of shells, but at some point it was stolen. Someone misplaced her mandible. A man lay with two fishing hooks made of bone, and another had five arrows between his knees. A 2-year-old child was buried with a rattle made of mussel shells, but that, too, was lost. Pappenfort stops at the Ogden-Fettie Mound, a burial site near the museum. (Sky Hopinka for ProPublica) Inviting Tribes Back to Illinois In the fall of 1995, the Illinois State Museum invited tribes from across the Midwest to discuss the remains in its possession. The Native American Graves Protection and Repatriation Act required institutions receiving federal funds to inventory their Native American holdings by the end of that year; they were then to consult with tribes about how to return the material to the appropriate groups. Leaders of tribes in Oklahoma, Wisconsin, Michigan, Kansas, Nebraska and Iowa were invited to Dickson Mounds Museum. Some tribal members were returning to Illinois for the first time since their ancestors had been forcibly relocated. Archaeologist Duane Esarey, who retired from the museum in 2021, said he remembers many on staff felt nervous before the meeting because it would be their first time speaking with the tribes. Johnathon Buffalo, historic preservation director of the Sac & Fox Tribe of the Mississippi in Iowa, was skeptical that the museum actually wanted to return anything to the tribes. Images of the Dickson Mounds burial exhibit and the controversy over its recent closure were fresh in his mind. A protest against the museum’s open burials in the early 1990s (Illinois Digital Archive, Illinois State Library) In early 1990, the museum’s leadership had recommended that the exhibit close, acknowledging changing norms and anticipating the passage of NAGPRA later that year. Illinois Gov. James Thompson agreed, then reversed his decision, claiming the closure would harm tourism while arguing that Native American tribes had no special say in the matter because they weren’t related to the ancient people who built Dickson Mounds. Protesters swarmed the museum, and some jumped into the pit with shovels to rebury the ancestors. The debacle, which drew the attention of national news outlets, ended in 1992, when a new governor, Jim Edgar, allowed the exhibit to close. In his office at the tribe’s headquarters in Tama, Iowa, last summer, Buffalo flipped through a packet of information that the Illinois State Museum had given to tribal members during the 1995 consultations. He read off the names that the museum uses to divide up thousands of years of history — the archaic period, woodland period, Mississippian, prehistoric — and arrived at the number of human remains in the museum collection that it said were from the historic era, beginning in 1673. There were 88. The museum had preemptively designated the rest of the remains — at least 5,450 ancestors excavated from at least 55 counties in Illinois — as culturally unidentifiable. All of them were dated to before 1673. Bruce McMillan, director of the Illinois State Museum from 1977 to 2005, told ProPublica the museum did that because “it’s very difficult — regardless of what the NAGPRA regulations say — to trace things prehistorically,” meaning before there are written records. He said that during the prehistoric era, between roughly 1450 and 1673, many Native groups in the Illinois region were “fissioning, coalescing, and migrating” because of war and disease, and that they were constantly reorganizing. “We wanted to make sure that if remains and associated objects prior to the time [were going to be repatriated], that we had some kind of written records,” McMillan said. “We wanted to make sure that they were going to the correct group or tribe.” At least two tribes claimed during the 1995 consultations that oral histories traced their ancestry in Illinois to mound-building cultures. And Robert Warren, the museum’s curator of anthropology at the time, wrote in a report to the National Park Service that the museum was open to evidence that might counter its previous conclusions. But when the museum finished its four months of consultations with six tribal nations, curators did not change a single determination of cultural affiliation. No tribe formally requested the return of remains that dated to before 1673. Many of the tribes invited to the museum viewed the ancestors as their collective responsibility. Connecting the remains to a specific tribe mattered less than ensuring they were reburied in the areas they’d been taken from. Every tribal leader told the museum that their ancestors should be reburied in Illinois. Johnathon Buffalo holds a photograph of a group invited to the museum’s 1995 consultations with tribes. (Sky Hopinka for ProPublica) The conversations did lead to the Illinois State Museum returning the remains of at least 117 ancestors to the Peoria Tribe of Indians of Oklahoma. The museum also transferred ownership of more than 32,000 funerary objects to the tribe, though the museum continues to hold the objects on the tribe’s behalf. (At the time of the repatriation in 1997, the tribe lacked the resources to appropriately store the objects.) Those human remains and funerary objects had been excavated from several sites throughout the state, not including Dickson Mounds, and all dated to after 1673. The Illinois State Museum submitted reports to the National Park Service and, with that, it had complied with the law. (The museum later submitted a grant proposal to the park service to help fund a reburial facility, but funding was denied.) And even though every tribe had said during the 1995 consultations that they believed the human remains in the museum’s collections should be reburied in Illinois, the reburial has yet to take place. “They show us their stuff — our stuff — but it’s a ‘look at it but don’t touch it’ kind of thing,” Buffalo recalled of those early consultations. “And then that’s it. When they close, we leave and we never hear from them again.” Buffalo points to binders containing information on museums whose inventories he believes include ancestors of the Meskwaki Nation, also known as the Sac & Fox Tribe of the Mississippi in Iowa. (Sky Hopinka for ProPublica) Research Instead of Repatriation In the late 1960s, the state excavated more human remains from Dickson Mounds to make way for the museum. Archaeologists found at least 10 burial mounds and two cemeteries, unearthing the remains of more than 800 people. All of them were sent to Massachusetts. George Armelagos, a new assistant professor recruited by the University of Massachusetts, Amherst to help start its anthropology Ph.D. program, had requested them for research. Anthropologists hoped that the remains, which were on loan from the Illinois State Museum, would offer a window into how people who lived for hundreds of years in roughly the same spot adapted to the expansion of agriculture and population growth. George Armelagos, second from left, accepts a teaching award at the University of Massachusetts, Amherst in 1973. (Robert S. Cox Special Collections and University Archives Research Center, UMass Amherst Libraries) Over the next 20 years, Armelagos published at least 15 papers based on his research using the remains, and his students produced even more. Their work on the Dickson Mounds ancestors helped convince the field that Native American remains had scientific value (before then, many were kept in storage but not examined), and by 1990, the collection was dubbed by prominent anthropologists as “one of the most intensively studied skeletal samples in North America.” “Unfortunately, in retrospect, I think there just weren’t many conversations about who were the likely descendant communities of these individuals,” said Alan Goodman, one of Armelagos’ students who now teaches biological anthropology at Hampshire College and previously served as president of the American Anthropological Association. After the passage of NAGPRA, the museum continued to allow scientific research on human remains it had deemed culturally unidentifiable. The law does not prohibit it, nor does it require that tribes consent. ProPublica obtained records showing the museum approved almost every request to research its Dickson Mounds collections from 1990 to 2018. Museum leaders hoped studies would lead to groundbreaking findings and bring prestige to the institutions. So, when the museum received a request in 1991 from Anne C. Stone, a Ph.D. student at Pennsylvania State University, the institution’s leadership was interested. Stone wanted to extract DNA from the ribs of 43 people excavated from Dickson Mounds and compare it to another group buried nearby. The process, according to her proposal, would require freezing bone samples to -112 degrees Fahrenheit, crushing them and soaking the powdered bone in an enzyme. The museum approved Stone’s request. Never miss the most important reporting from ProPublica’s newsroom. Subscribe to the Big Story newsletter. Former Illinois State Museum Anthropology Curator Michael Wiant told ProPublica that at the time he believed DNA might answer big questions about migration and genetic continuity. Wiant said he hoped it also “would give tribal people a better sense of their history” and add to conversations about who may be culturally connected to people who lived near Dickson Mounds 1,000 years ago. Wiant said that, in hindsight, tribal leaders should have been involved in conversations about using the remains for research. Stone kept the remains for seven years. The museum approved her requests to experiment with different DNA extraction methods, and even to travel abroad with the samples. But none of the methods she tried were successful. In an interview, Stone, who now runs an anthropological genetics lab at Arizona State University and is a member of the National Academy of Sciences, explained that at the time, methods of extracting ancient DNA, or aDNA, were fairly new and far more destructive than current methods. Today, she said, any of her research that involves destructive analysis is done in consultation with descendant communities. In 2010, a new rule was added to the federal repatriation law that created a pathway for tribes to bring their ancestors home without establishing a cultural affiliation. It also required institutions to consult with tribes about “culturally unidentifiable” remains. Professional organizations, including the Society for American Archaeology, opposed the rule, as did the Illinois State Museum. A sign at the Ogden-Fettie Mound warns that visitors are banned from digging and collecting artifacts. (Sky Hopinka for ProPublica) “The Rule would deprive the entire world of valuable scientific knowledge and historical information on biological and cultural heritage, diversity, and change,” wrote Bonnie Styles, then-director of the Illinois State Museum, in public comments. Under Styles’ leadership, from 2005 to 2015, records show that the Illinois State Museum repatriated the remains of only seven Native Americans. Records show she allowed Dickson Mounds remains to be loaned to various institutions and approved destructive analysis requests from her own staff until as recently as 2014. In a written statement, Styles said that during her tenure “these actions were not disallowed by NAGPRA and its associated rules” and that the museum followed its board-approved policies on collection management, the treatment and disposition of human remains, and destructive analysis. “The Illinois State Museum did not willfully ignore NAGPRA and associated rules in order to hold onto collections of culturally unidentified human remains,” said Styles. “Home No Matter What” In a wooden crate from Piggly Wiggly, Pappenfort keeps letters written by his great-great-great-grandfather George Washington Finley. Finley was Piankashaw, an Illinois people with roots in the Miami tribe that merged with the Wea, Peoria and Kaskaskia in the 1850s. Finley’s first language was his native one, Pappenfort said, and he was one of the few survivors of removal to record some of the Miami-Illinois language and oral histories his parents and elders shared with him. As Pappenfort deliberated in the summer of 2021 whether to accept the job as curator of Dickson Mounds Museum, he thought about what Finley would want him to do. He read the letters to help him decide. Accepting the job would mean moving to a place where the scars of forced removal are still visible on the land: dozens of burial mounds, many of them excavated or disturbed, surround the museum. But leaving Oklahoma would also mean reconnecting with a place he felt he’d lost. “Two hundred years,” said Pappenfort from his desk at Dickson Mounds Museum, “that’s how long it took to have more of an active voice in Illinois.” For the first time in more than 25 years, the museum has again entered formal consultations with tribes about repatriation. This time, the museum is asking different questions. Instead of trying to answer who, exactly, is the right tribe to repatriate to, the museum is asking tribes to lead in deciding what’s the best way to right a wrong. “Our institutional will is to get the ancestors home no matter what,” Pappenfort said. So far, conversations with tribes have led to reuniting many ancestors’ remains with the belongings they were buried with — a task that required a recall of all loans and a moratorium on new research and imaging. Then Dickson Mounds began cleaning up its own house. An exhibit at the Dickson Mounds Museum shows spaces where some objects have been removed from view. (Sky Hopinka for ProPublica) In September 2021, the museum closed its most popular archaeology exhibit. For weeks, Pappenfort worked with the museum’s then-director Esarey and anthropology curator Morgan to disassemble each display case and remove funerary objects that tribes had requested not be displayed. When they were finished, about 40% of the exhibit was gone. Pappenfort and Morgan found solace in the work. To Esarey, who earlier in his career had excavated some of the human remains and pulled out funerary objects to put on display, it was the bittersweet dismantling of a world he helped build. The objects from 75 years of Illinois excavations had guided visitors through a categorized chronology as archaeologists understand it: from the archaic period, to the woodland, the Mississippian, the prehistoric and, following the arrival of Europeans in 1673, the historic. Archaeologists can spend decades seeking to connect the past and the present, Esarey realized, but they’ll always find more questions than answers. Doing the work of repatriation required a willingness to let go: Finding the “right” answer mattered less than doing what is right by tribal nations. “There’s nothing special about 1673,” said Esarey. “It’s all history.” The museum intends to repatriate about 1,100 ancestors from Dickson Mounds, including those excavated in the 1920s whose gravesites are still covered by cedar planks in the south wing. If the effort is successful, the remains will be reclaimed by a coalition of more than two dozen tribes with ancestral lands in Illinois. It would be the largest repatriation in the state’s history. Until then the door to the south wing is locked. An emptied display case at the Dickson Mounds Museum (Sky Hopinka for ProPublica) Ash Ngu contributed data analysis.
[*] [+] [-] [x] [A+] [a-]  
[l] at 1/26/23 3:00am
by Sophia Kovatch ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive our biggest stories as soon as they’re published. Under the Free File agreement, Americans who make less than $73,000 per year should be able to file their taxes for free with one of the tax preparation companies that partners with the IRS. But this program has been historically underutilized, with just 4% of eligible Americans filing for free in 2021. The story of the Free File program is long and twisting, and it can seem more like a fight against free tax filing than a fight for it. One of the biggest players is Intuit, the maker of TurboTax, one of the largest tax preparation software companies in the country. ProPublica has reported on Intuit and the Free File program since 2013. Here’s what we’ve found. The Truth About TurboTax In 2002, Intuit, H&R Block and other tax prep companies signed a deal with the IRS to provide free tax filing services to millions of Americans. In return, the IRS agreed it would not create its own tax filing system that could compete with the tax prep companies. A government-run tax filing system, often known as return-free filing, is already a reality in many countries around the world. With a return-free filing system, the government fills out the tax forms with the information it already has, and taxpayers simply have to review the forms for accuracy. This is not the case in the U.S. Switching to such a system would devastate tax prep company profits. That’s why Intuit and other members of the industry spent millions through the years lobbying to preserve the Free File agreement, particularly the part that restricts the IRS from creating its own free filing system. That’s not all Intuit did to limit the scope of Free File. Intuit purposefully suppressed its own Free File product. It added website code to block its Free File page from showing up in search engines and used manipulative marketing patterns to trick customers into paying for TurboTax even when they qualified for Free File. It later removed the code. Internal documents previously obtained by ProPublica show these strategies were intentional on the part of Intuit and H&R Block. In previous statements, Intuit and H&R Block maintained that they support and encourage free tax filing options through Free File and other avenues within their businesses. ProPublica’s Reporting Impact As ProPublica reported on Intuit and the Free File program, government officials took note. When ProPublica pointed out that codifying the existing Free File agreement into law would permanently bar the IRS from creating its own free filing system, the bill got new scrutiny in Congress and the restriction on an IRS-created filing system was scrapped. Senior IRS leadership and a New York state regulator began investigating Intuit and the Free File program. The Federal Trade Commission started investigating Intuit too, looking into the company’s allegedly deceptive marketing practices. Ultimately, Intuit was found to have tricked millions of Americans into paying to file their taxes when they should have been able to do so for free. The company reached a $141 million dollar settlement in May 2022 in a case led by New York Attorney General Letitia James and covering all 50 states and the District of Columbia. (Intuit did not admit any wrongdoing in the settlement.) More than 4 million people are expected to receive money as part of the settlement. It’s not clear when the payments will be made. The Current State of Free File Following ProPublica’s reporting in 2019, the IRS reformed the Free File program. It barred companies from using deceptive practices to deter taxpayers from using Free File and removed the prohibition on the IRS creating its own tax filing system. Intuit left the Free File program in October 2021, citing a desire to innovate beyond what the agreement would allow. In March 2022, during the first tax season in which TurboTax did not participate in the Free File program, the FTC sued Intuit over deceptive ads for its so-called “Free” edition. Intuit disputed the FTC’s arguments but agreed to pull the ads in question for the remainder of tax season. After both Intuit and H&R Block left the Free File program, the future of the program was unclear. It’s still difficult to find truly free tax filing options. The IRS created a tool to help you find this year’s Free File options. More changes may be on the horizon for Free File. In August 2022, IRS received a mandate to look into creating a public filing system, with $15 million allocated to the study. Justin Elliot and Paul Kiel contributed reporting.
[*] [+] [-] [x] [A+] [a-]  
[l] at 1/25/23 3:00am
by Anjeanette Damon ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up for Dispatches, a newsletter that spotlights wrongdoing around the country, to receive our stories in your inbox every week. During his contentious campaign to become Nevada governor, Joe Lombardo accused the Democratic incumbent of catering to the family of a donor and their lobbyist who helped an error-prone COVID-19 testing lab get licensed in the state. Shortly after he won the race, Lombardo, a Republican, quietly turned to that same lobbyist for help building the state budget, giving him access to confidential documents and putting him in a position that allowed him to advocate for state funding sought by his clients. Lobbyist Mike Willden’s name doesn’t appear on the list of people Lombardo appointed to his transition team as he takes the reins from former Gov. Steve Sisolak. But emails and budget documents obtained by ProPublica show Willden was invited to budget meetings with each of Lombardo’s department directors, provided advice on health care spending and was involved in discussions on changes to the spending plan worth nearly $30 million a year to his clients — though not all of those changes were ultimately approved. He also was involved in discussions on an effort to extend a nearly $600 million contract for one of his clients to continue administering Nevada’s Medicaid program. Willden has expertise in state government, including the complex Medicaid budget. He served as chief of staff to the last Republican governor, after decades working for the Department of Health and Human Services, including 13 years as director. The owner of the lobbying firm that employs Willden said in a statement that he volunteered hundreds of hours to help Lombardo’s transition team with the budget and that none of his clients “materially benefited from Mike’s involvement.” “He has been involved in five gubernatorial transitions and has played a vital role in the preparation of more than 20 budgets,” said Richard Perkins, owner of The Perkins Company and a former state assemblyman. “He has unique expertise, experience and integrity. His involvement is especially critical, in the incredibly compressed time frame” a new governor has to prepare a budget. “I know that cynicism and skepticism dominate our political and governing environment these days, however, it’s a shame that a long time, trusted public servant, like Mike Wilden, is criticized, and not truly appreciated,” Perkins added. Willden played a central role in a controversy that rocked the final year of Sisolak’s administration. In late 2021, Willden leaned on his relationships with state regulators and Sisolak’s office to speed the licensing of COVID-19 testing laboratory Northshore Clinical. Last year, ProPublica detailed serious problems with the lab’s operations in Nevada, including questionable billing practices and a high rate of false negative results. At the time, Willden said he was trying to help the state address a critical shortage in testing by assisting Northshore’s two Nevada representatives, who were family friends of Sisolak’s. Willden said he wasn’t paid by the company or its representatives and was unaware of problems with the lab’s services. During the gubernatorial race, Lombardo and Republicans spent heavily on advertising that used the Northshore debacle to portray Sisolak as corrupt and accuse him of jeopardizing the safety of Nevadans to enrich his friends. Lombardo described it as the “biggest scandal in our history” on Twitter, and his campaign dubbed Sisolak “Northshore Steve.” Sisolak denied showing favoritism toward the company and said his administration had acted quickly once problems with Northshore’s tests became known. Lombardo’s chief of staff, Ben Kieckhefer, said the campaign attacks weren’t on his mind when Willden was asked to help prepare the $11.4 billion, two-year budget, which the governor recommended to the Legislature this week. Under state law, Lombardo had three weeks from the time he took office to complete a proposed spending plan. “My thought was we needed to get a budget built. That was my focus,” Kieckhefer said. He dismissed the idea that Willden’s involvement could open Lombardo to the same criticisms the Republican leveled against Sisolak. “You’d be hard-pressed to find someone who knows more about the Medicaid budget than Mike,” Kieckhefer said. “Coping with potential conflicts? That’s on me, not on Mike.” Documents show Willden worked with Kieckhefer, as well as the incoming deputy chief of staff and two members of the transition team: state Senate Minority Leader Heidi Gansert and Jeremy Aguero, an economic analyst with clients who do business with state and local governments in Nevada. The group held budget meetings with each of the state’s department directors to review funding requests, raise issues and decide what changes should be made to the draft budget from the previous administration. Kieckhefer said Willden was already part of the transition team’s budget subcommittee when Kieckhefer was named chief of staff and took over management of the budget process. The documents obtained by ProPublica include an “open issues list” drawn up by the working group in late December. It shows that issues affecting three of Willden’s clients featured heavily in the budget discussion. For example, Willden lobbies for the Nevada Health Care Association and Center for Assisted Living, an industry group for nursing homes and assisted living facilities. That industry stands to lose $24 million a year in extra Medicaid funding related to the pandemic that’s expected to expire when the public health emergency ends. The document states it’s the industry’s “desire not to experience payment reductions.” The document also highlights a requested rate increase worth $4.5 million a year to providers of early childhood intervention services. Willden is a paid lobbyist for the Early Intervention Community Providers Association. The largest issue, and perhaps the thorniest, is a lucrative contract to administer the state’s Medicaid program, which provides health insurance for more than 900,000 lower-income Nevadans. Gainwell Technologies, which holds the $558 million contract, is one of Willden’s clients. The contract expires in June, and efforts to renew it have stalled. “Immediate action needs to be taken to negotiate a contract extension with Gainwell or there will be no contracted vendor in place as of July 1, 2023,” the document says. Kieckhefer said he did not include the request for additional money for nursing homes in the recommended budget but did include the rate increase for early intervention providers. That increase was listed as a top priority of the department director before Willden’s involvement, Kieckhefer said. The Gainwell contract has no bearing on the state budget but was flagged as a serious issue that needs attention, he added. Kieckhefer said Willden was “always forthcoming about who he represented” during his work with the transition team. He said he wasn’t too concerned that Willden’s participation may give his clients an advantage. “My job is to weigh all the considerations and then act in the way I think is in the best interest of Gov. Lombardo and his priorities,” Kieckhefer said. “I rely on my previous experience and taking counsel from people who also may have experience one way or another. Ultimately, it’s me and the governor making decisions about what’s included in the budget.”
[*] [+] [-] [x] [A+] [a-]  
[l] at 1/24/23 4:00am
by Will Fitzgibbon, International Consortium of Investigative Journalists ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive our biggest stories as soon as they’re published. Three more countries have announced reviews of honorary consuls after an investigation by the International Consortium of Investigative Journalists and ProPublica revealed widespread wrongdoing by members of the little-known system of volunteer diplomats. Jordan, Latvia and Israel have either terminated the status of honorary consuls operating within their borders or ordered reviews of those currently serving. Meanwhile, reporters at ICIJ media partner El Periódico obtained an exclusive police report with new details about a money laundering probe of honorary consuls in Spain. Last year, ICIJ and ProPublica, in collaboration with 60 media partners, published “Shadow Diplomats,” an investigation revealing that honorary consuls have repeatedly exploited diplomatic status to threaten international security and the rule of law. The investigation found at least 500 current and former honorary consuls who have been accused of crimes or embroiled in controversy — the majority while they held their posts. Under international treaty, honorary consuls receive legal protections and privileges that can include immunity from lawsuits and the ability to move consular bags across borders without inspection. So far, the investigation has prompted action in nine countries. Shortly before publication of our first story and after questions from reporters, Germany and Austria announced the dismissal of one honorary consul in Brazil. After publication, Finland, Brazil and Paraguay promptly announced reforms to their systems of appointing and vetting the volunteer diplomats. More recently, government ministers in Jordan approved the termination of its honorary consul in Honduras, millionaire businessman Schucry Kafie, according to a Jordanian official. Kafie had served as honorary consul for Jordan in Honduras for more than three decades. In 2016, a judge cited Kafie’s diplomatic status as honorary consul in allowing the millionaire to avoid detention after an arrest for fraud, the “Shadow Diplomats” investigation found. Jordan’s council of ministers approved the termination of six honorary consuls, including Kafie, as part of a broader reassessment, according to the official. The Honduran Foreign Ministry told ICIJ media partner Contra Corriente Honduras that it has not received official notification of the decision. Kafie could not be reached for comment. Previously, Kafie has denied wrongdoing and told ICIJ and ProPublica that the criminal charges, which were dismissed, were politically motivated. In Latvia, the Foreign Ministry announced an investigation after the project revealed the honorary consul representing Indonesia had once tried to claim diplomatic immunity when facing charges of assaulting his wife. The honorary consul, Valdis Tilgalis, received a fine, records show. “In light of the information received, the ministry shall look into the matter in depth,” said a spokesperson for the Ministry of Foreign Affairs, adding that it became aware of the assault charges only after receiving questions from reporters. “The ministry is currently vetting the matter in collaboration with law enforcement authorities.” Tilgalis told ICIJ and ProPublica that the charges against him were untrue and that his attorney told him the case would soon be forgotten. Tilgalis told ICIJ that his lawyer had suggested that he mention his honorary consul status, which could give him immunity from administrative proceedings. “Unfortunately, when the case was already in process, the status of honorary consul did not help,” Tilgalis said. In Israel, the Ministry of Foreign Affairs launched a review after reporters identified consuls facing corruption allegations and other criminal probes. ICIJ media partner Shomrim obtained public records showing that Israel requires honorary consuls representing foreign countries inside its borders to be “free from any blemish of moral purity.” Honorary consuls appointed by Israel overseas, records show, may be dismissed if they are found to have “behaved in a manner that is not appropriate.” Despite the policy governing representatives in foreign countries, the “Shadow Diplomats” investigation found Israel has recognized and appointed one honorary consul to represent it who had previously been convicted of fraud and others who have faced charges of corruption, money laundering, diamond trafficking and rape. The Foreign Ministry announced it would examine the status of two current honorary consuls, one who was a key witness in a vast corruption case in Africa and another who recently used his honorary consul status to prevent police in Italy from searching his home as part of an illegal political financing probe. In Spain, the police report obtained by El Periódico detailed links between honorary consuls and Simón Montero Jodorovich, a member of a prominent Barcelona family who is suspected of trafficking drugs. Barcelona police believe honorary consuls helped move money for him. “We can conclude that Mr. Simón Montero Jodorovich, directly or indirectly, paid an amount of more than 20,200 euros in cash to obtain favors from honorary consuls,” police wrote in the latest report. “Payments would be in consideration for managing contacts with representatives of public administrations, since their position as honorary consuls allowed them direct access to high civil or political positions.” The consuls — who have represented countries in Africa and Europe — deny wrongdoing and have not been charged. An attorney for Jodorovich previously told ICIJ and ProPublica that his client is innocent and “has never manipulated any consul.”
[*] [+] [-] [x] [A+] [a-]  
[l] at 1/24/23 3:00am
by Anna Clark ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive our biggest stories as soon as they’re published. A number of tests used by patients to make major health care decisions have once again escaped regulation by the Food and Drug Administration, following intensive lobbying on behalf of test-makers, professional associations and academic medical centers. For years, experts have warned about the dangers of so-called laboratory-developed tests — including certain cancer screenings and diagnostic tests for everything from Lyme disease to autism — reaching patients without FDA oversight. ProPublica recently published an investigation about popular prenatal screenings that fall into this category, which one expert described as an unregulated “Wild West.” Upwards of half of all pregnant people now receive one of these prenatal screenings. (We also have put together a guide for expecting parents.) Congress was on the cusp of finally creating a pathway for the FDA to scrutinize these tests, as it does for many other common commercial tests. For much of 2022, the VALID Act seemed on track for passage — and then, in the final weeks of the year, legislators backed away. The VALID Act, which had bipartisan support, had been developed after nearly a decade of debate among stakeholders about ways to close a regulatory loophole and clarify the FDA’s role in overseeing the testing industry. The legislation had momentum thanks, in part, to Theranos’ fraudulent blood-testing scandal and the coronavirus pandemic, both of which revealed the possible consequences of unchecked tests reaching patients. But lawmakers left VALID out of a must-pass end-of-year bill that dealt with a range of spending priorities. Opponents argued that VALID would have created burdensome regulations for lab-developed tests, or LDTs, stunting essential innovation and flexibility while limiting patient access to health care. The current approach to lab-developed tests goes back to 1976, when Congress revamped the regulation of medical devices. At the time, the tests were considered low-risk and were not in wide use. Since then, the FDA has effectively exempted this type of lab test from its requirements. Today, the number and complexity of lab-developed tests has grown. A study by the Pew Charitable Trust said there’s no way of knowing how many are used on patients each year because there are no tracking measures. But Pew estimated that 12,000 labs are likely to use LDTs, many of which process thousands of patient samples each day. “The needs were getting bigger and bigger, and also the potential risks get bigger and bigger, too,” said Mark McClellan, who served as the head of both the FDA and the Centers for Medicare and Medicaid Services during President George W. Bush’s administration. He had urged Congress to pass the bill. Several people involved in bill negotiations told ProPublica that concern over how it would affect academic labs is what killed it. “University laboratories and their representatives in Washington put on a full-court press against this,” said Rep. Larry Bucshon, a Republican from Indiana. A former cardiothoracic surgeon, Bucshon co-sponsored VALID in the House, along with Rep. Diana DeGette, Democrat of Colorado. Bucshon pointed to the Association of American Medical Colleges and the Association for Molecular Pathology as particularly influential forces that persuaded his colleagues to leave VALID out of the end-of-year bill. According to disclosure forms, AAMC spent at least $300,000 on lobbying activities that included the VALID Act in 2022, while AMP spent at least $189,000. Since 2018, AMP spent at least $957,000 on lobbying activities that included VALID. AMP had also urged academic lab leaders to reach out to elected officials about this issue. It shared sample letters for them to sign and send, and it organized a “Virtual Advocacy Day,” where AMP scheduled meetings between members and their representatives in Washington, providing them with talking points, background information and best practices. “Here’s the thing,” Bucshon said. “The academic medical centers, and big medical centers, are in every state.” They employ a lot of people and have significant economic impact in every lawmaker’s turf, he said, “and so that gives them a pretty big voice.” Heather Pierce, AAMC’s senior director for science policy and regulatory counsel, said that many academic medical centers make and use a number of lab-developed tests, and they typically don’t have the infrastructure or staff to handle the type of FDA oversight set out by VALID. FDA review, she said, would also add time to the process of developing tests for patients with urgent needs. The makers of prenatal screening tests weighed in on the bill, too. Illumina, for example, spent more than $3 million over two quarters of 2022 on lobbying activities that included provisions of the VALID Act. And since 2019, Invitae paid at least $950,500 on lobbying activities that included VALID. “While we support efforts to make sure that lab-developed testing is high quality, Invitae believes that the VALID Act would increase the cost of testing, slow innovation, and force consolidation in the industry while imposing many requirements that do little to improve patient care,” said a spokesperson in an email. While some proponents of the bill still hold out hope for the VALID Act, others said it’s unlikely to get traction again anytime soon. Several of those involved said they anticipate the FDA, which has long claimed jurisdiction over the tests, will try to use its current powers to take direct action, though that will likely take more time and could face litigation from opponents. “While we stand ready to work with Congress, we are considering all options,” an FDA press officer said in a statement. “One of those options is administrative action, which could include rulemaking.” Speaking at a trade conference in October, FDA Commissioner Robert Califf said that going it alone is “not something we want to do, because having a clear law passed leads to the best situation.” But, he said, if nothing passes, “we also can’t stand by.” Current and former FDA officials have expressed befuddlement at how difficult it has been to regulate these tests. “There’s almost a point of, what do I need to do?” Jeff Shuren, director of the FDA’s Center for Devices and Radiological Health, said to a trade journal in October. “Do I need a pile of dead bodies before somebody says enough is enough?” Some opponents of VALID acknowledge that lab testing reform is needed. But they said it should be done without involving the FDA. AMP’s proposed policy, for example, would update the existing oversight system under the Centers for Medicaid and Medicare, which reviews lab operations. Sen. Rand Paul, a Republican from Kentucky and a former physician, introduced an alternative bill that would do just this, dubbed the VITAL Act. An aide to Paul said the issue came to his attention after AMP approached him about it several years ago. Paul is expected to re-introduce the VITAL Act this year. While the Centers for Medicaid and Medicare monitor the quality standards in labs, no federal agency checks to make sure lab-developed tests work the way they claim to before they reach patients; similarly, no agency vets the marketing before the tests are sold. Companies aren’t required to publicly report so-called adverse events — incidents that happen when the tests get it wrong. And no federal agency has recall authority. The VALID Act would have phased in the FDA review process over time, with the agency evaluating only high-risk tests — ones where an inaccurate result could lead to serious harm. Momentum for VALID began to stall in the summer, with a push for an amendment that would exempt academic medical centers. “I do think that the fact that we couldn’t get it done in July and August really created this opportunity for people to poke holes in the boat, as it were,” said Cara Tenenbaum, a former FDA policy adviser. “This protracted process allowed people who maybe were not otherwise engaged, or fully engaged, to have an outsized effect that I don’t think was in the interest of patients.” Pew declined to comment on the proceedings. Tenenbaum lobbied in support of VALID on behalf of Pew. Bucshon said he understands the concerns of regulatory skeptics. “Include me in that category, if it’s unnecessary and inappropriate regulation that stymies innovation and technology advancements,” Bucshon said. “This isn’t one of those situations, in my opinion.”
[*] [+] [-] [x] [A+] [a-]  
[l] at 1/23/23 5:00am
by Cassandra Jaramillo, ProPublica, and Lauren McGaughy and Allie Morris, The Dallas Morning News ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive our biggest stories as soon as they’re published. This article was published in partnership with The Dallas Morning News. Gregg Phillips and Catherine Engelbrecht are best known as the election deniers behind True the Vote, a Texas-based nonprofit responsible for amplifying conspiracies that the 2020 presidential election was stolen. But soon after Russia invaded Ukraine in early 2022, they shifted some of their focus to the war effort, jumping into the fray with an inspiring idea — to bring a mobile hospital to the region to care for victims of the conflict. They called it The Freedom Hospital. Phillips solicited donations on conservative media platforms, linked up with American veterans working in Ukraine and traveled to the region in March to meet with local officials. The Freedom Hospital’s website announced it was halfway to its goal of raising $25 million. “Our recent project, The Freedom Hospital, in Ukraine helps old folks, women and kids near the fight receive healthcare,” Phillips wrote on the conservative social media site Truth Social on June 5. But that was one of a series of misrepresentations from Phillips and The Freedom Hospital about the operation’s donations and accomplishments, according to a joint investigation by ProPublica and The Dallas Morning News. The Freedom Hospital never got off the ground, and, through their lawyers, Phillips and Engelbrecht now say they never raised significant amounts of money for the project. They never brought the mobile hospital to the region. Both Phillips and Engelbrecht declined to answer questions. According to their lawyers, who spoke to ProPublica and the News, the pair’s Ukraine project was a good-faith effort that was unsuccessful. They said Phillips realized during his March trip to the region that the mission wasn’t feasible because local officials weren’t interested, because potential donors felt the U.S. government was already funneling enough money into the war effort, and because he was worried about the potential for local corruption. “They pretty much abandoned it all as of, like, April,” Cameron Powell, a partner at Gregor, Wynne, Arney who’s one of the pair’s attorneys, said during a December interview. “Pretty much during his trip, he was deciding it’s probably not going to be feasible.” Phillips continued to seek donations for months after that and gave the impression that the project was still in the works. The lawyers now say that is because the pair kept pushing forward “with their due diligence for a while longer” and declined to clarify exactly when the project was abandoned. Asked about Phillips’ statements that The Freedom Hospital had raised half of its $25 million goal, the lawyers said that amount was an in-kind donation from the mobile hospital manufacturer, not cash. The manufacturer's CEO disputed that account, saying it never pledged to make such a donation. The Freedom Hospital’s Twitter account shared a quote from True the Vote’s Gregg Phillips on April 21, 2022. (Screenshot by ProPublica and The Dallas Morning News) Created by Engelbrecht in 2010, True the Vote vaulted to national prominence after its work was featured in the 2022 Dinesh D’Souza movie “2000 Mules,” a film that included voter fraud claims that have been widely discredited. The Ukraine venture is the latest in a string of failed initiatives and misleading statements from Engelbrecht and Phillips. Phillips has been a longtime True the Vote board member, and he and Engelbrecht have raised millions on the promise that they would reveal widespread voter fraud. But they have never supplied any evidence the election was stolen, leaving a trail of disappointed donors and frustrated partners, even as the false election-theft narrative has continued to be a potent force in American politics. An “Awe-Inspiring” Mission A former health and human services official for the states of Texas and Mississippi, Phillips was eager to use his expertise to aid the people of Ukraine when Russia invaded, his lawyers said. The Freedom Hospital’s website, which is now defunct, described the project as “awe-inspiring.” A group of Americans had “banded together” to bring to the region “a state-of-the-art mobile emergency hospital system that can skirt battle zones to treat the wounded,” according to the site’s archive. “Every penny of your donation will be used to save lives,” the website stated, with a link to a PayPal donation site. In March 2022, Phillips traveled to the region and discussed the project with several local governmental and religious officials. The next month, he explained the ongoing effort to a podcaster. Phillips said his team was “ensuring that we could clear supply paths and ensure that the hospitals could remain sort of fully supplied and fully staffed” and that they had secured a warehouse. The hospital’s Twitter account described the facility as a 100,000-square-foot warehouse donated by an unnamed family behind “Europe’s biggest transport company.” The lawyers now say an unnamed citizens’ group offered use of an empty auditorium that was not ultimately needed. A March 20, 2022, Facebook post from Artur Muntyan, a local official in Chernivtsi, Ukraine, shows him with other local government and religious officials as well as Gregg Phillips, who appears in the top left photo on the left side of the back row, and in the bottom middle photo on the right. (Screenshot by ProPublica and The Dallas Morning News) Over the course of the spring, Phillips continued to promote the humanitarian effort, seeking donations and other support. On Twitter, he called it “history in the making.” In early June, he repeatedly discussed the project on Truth Social and said it was responsible for extracting “dozens” of elderly refugees from the region. “My work and my calling is to create a private healthcare and extraction ecosystem for old folks, women and children,” he wrote in a post on June 5. “The Freedom Hospital is my commitment to God come to life.” In the December interview, Powell, one of the pair’s lawyers, said Phillips finished the project’s feasibility study by the time he returned from Ukraine, at which time he told donors he couldn’t ask them to fund the project. But this week, after being sent questions ahead of publication of this article, Powell was vaguer about the project’s timeline. When asked why Phillips continued promoting the hospital into June, he acknowledged his clients began to “harbor doubts” about the project months before without specifying when it was officially shuttered. “The group came to the realization sometime after Gregg returned that the project was ‘probably’ not feasible, but it would be unrealistic to expect that realization occurred during a single, identifiable moment in time. There was no epiphany,” Powell said. The project’s Twitter account still exists but has not tweeted since May 5. Gregg Phillips continued to post about The Freedom Hospital on Truth Social through early June. (Screenshot by ProPublica and The Dallas Morning New) True the Vote was listed as The Freedom Hospital’s fiscal sponsor on the project’s website and Engelbrecht successfully applied for nonprofit status for the hospital from the IRS in March. Phillips and Englebrecht planned to get a medical unit from MED-1 Partners, a mobile hospital manufacturing company based in North Carolina. Phillips’ lawyers said he worked with sales representatives and was told the unit would come at “a substantial reduction in price, which MED-1 spoke of as an in-kind donation to help the effort.” MED-1 Partners CEO Tim Masud told ProPublica and the News this account is not true. MED-1 Partners was selling an older demo unit for a reduced price, the same price that would be offered to anyone interested in purchasing it, he said. Masud added neither he nor his authorized liaison on the deal described this reduced price as a donation or pledged to provide a donation to The Freedom Hospital. In March, Masud said the company drafted a letter of intent for a project called “The Freedom Children’s Hospital” that required a $150,000 deposit. But it was never signed and no money changed hands. “All we did was offer a hospital for sale to a group of people. That’s it,” Masud said. Powell said his clients raised only $268 for the project through PayPal, which the lawyers said was returned “at Mr. Phillips’ direction.” Another of the group’s attorneys, Michael Wynne, said in a December phone call that the project had raised no other funds through other means. The Freedom Hospital’s website, which is now defunct, called for donations and said it was halfway to raising $25 million. (Screenshot of the Wayback Machine by ProPublica and The Dallas Morning News) On April 21, The Freedom Hospital posted a video on its YouTube account with a caption saying that its “team” was “reporting” from Ukraine. But The Freedom Hospital had no role in producing the video. Christopher Loverro, a Los Angeles-based actor and veteran, made the video, which he said was shot in front of a recently bombed Ukrainian preschool. In an interview, Loverro said he has never had any connection to The Freedom Hospital and had not given anyone permission to use his work. After being contacted by ProPublica and the News, Loverro said he reported the video to YouTube and commented on the post, warning: “This is a scam. Do not donate to this organization.” After ProPublica and the News sent the lawyers questions about the video, Loverro said a woman named Catherine, who was associated with the project, contacted him for the first time to discuss The Freedom Hospital. Following that conversation, he said he had no reason to doubt the woman, who told him the project was a legitimate humanitarian effort with “no fraud involved” that simply came to naught. Phillips’ lawyers said he did not post the video and does not have access to The Freedom Hospital’s YouTube account to remove it. It was likely posted by one of “several volunteers working on the Freedom Hospital project at that time,” they added. The video and a donation request still remain up on the project’s YouTube channel. The Freedom Hospital’s YouTube channel has posted one video. An actor and veteran said he produced the video and did not give the project permission to use it. (Screenshot by ProPublica and The Dallas Morning News) Complaints The Freedom Hospital project and other efforts troubled one of True the Vote’s contractors enough that he submitted a complaint in June referencing the hospital and a number of other concerns to the Texas attorney general’s criminal investigation division. “After a series of bizarre calls and communications over several months, Gregg told us he’d raised the money for [The Freedom Hospital]. Several times he told us it was $2.5 million. He also gave us the figures of $10 million. He also marketed that they needed $25 million,” Kyle Reyes, whose company had worked on marketing initiatives for True the Vote, wrote. ProPublica and the News obtained the complaint through a public records request. In the document, Reyes accused True the Vote of a wide range of questionable business practices and said the organization had not paid his marketing firm for the services it performed. Wynne said the complaint is “demonstrably false.” It’s unclear what the status of Reyes’ complaint is; the Texas attorney general’s office did not respond to a request for comment. The questions about The Freedom Hospital come as Engelbrecht and Phillips are facing new scrutiny over continued failed efforts to prove widespread fraud in the American election system. The pair have frequently profited handsomely from their election denial work, according to an investigation by Reveal that found loans issued to Engelbrecht and self-dealing contracts to nonprofit insiders. (Their attorney at the time said that there was nothing inherently wrong about the contracts.) The outgoing attorney general of Arizona, once an ally, now wants the group investigated for potential “financial improprieties” related to this work. In November, the pair spent a week in jail on contempt of court charges for failing to disclose a source behind their election fraud claims. Reyes told ProPublica and the News that he terminated his firm’s contract with True the Vote in June. After Reyes filed his complaint, he said, True the Vote paid his company the outstanding invoices about $25,000. “As conservatives, we need to hold our fellow brothers and sisters to the same standard that we hold everyone in America to — no matter what side of the political aisle you’re on,” he said.
[*] [+] [-] [x] [A+] [a-]  
[l] at 1/23/23 3:00am
by Lisa Song ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive our biggest stories as soon as they’re published. As a climate reporter, I was well aware of the growing concern about the gas stoves in people’s homes leaking dangerous pollutants, like methane, a potent greenhouse gas and explosive hazard; nitrogen dioxide, which worsens asthma; and benzene, which causes cancer. But I was a renter who had no control over my appliances. So I mostly ignored it — until one day last fall when I smelled the rotten-egg odor of leaking natural gas while baking focaccia. I borrowed a $30 gas leak detector from a friend (a fellow climate reporter, of course). When I turned on the oven in my New York City apartment, the lights for a “significant” leak lit up. My kitchen was filling up with methane. According to the user manual, that meant I should “VENTILATE THE AREA IMMEDIATELY and move to a safe location” in case of an explosion. I opened the windows and ignored the evacuation advice (don’t follow my example), too intent on taking a video of the leak as proof for my landlord before turning off the oven. Then I vented my frustration by panic-texting friends and eating too much focaccia — after cutting it into pieces and baking it in my toaster oven. Luckily, my landlord replaced my faulty stove within days. I made sure to check the new stove (still gas, alas) for leaks after it was installed. “People still don’t recognize that there are health downsides to cooking with gas in your home,” said Regina LaRocque, a Harvard Medical School professor who does research on medicine and public health. “This is the 21st century, and we have better ways of cooking than over a fire.” The issue has caught national attention in recent weeks, as the U.S. Consumer Product Safety Commission considers regulating gas stoves. Public health experts and environmentalists have long warned of the risks of gas ranges. One study found that indoor gas stoves were responsible for roughly 13% of childhood asthma cases in the U.S. The American Public Health Association and American Medical Association have urged consumers to transition away from gas. LaRocque uses a traditional electric coil stove at home. But she and other experts advocated for induction stoves, which use electromagnets to heat up food. These stoves are growing in popularity as consumers choose them for climate, health and safety reasons, though they can cost more than twice as much as a gas range. The federal Inflation Reduction Act will provide rebates to upgrade to electric or induction home appliances (here’s a Wirecutter guide on that program). Some states, including Massachusetts, offer their own rebates as well. Induction stoves are much more common in Europe, LaRocque said. That cultural shift has yet to occur in the United States, where more than a third of households use gas stoves. As Mother Jones reported, the gas industry embraced the term “cooking with gas” in the 1930s; an executive even made sure to get it worked into Bob Hope’s comedy routines. More recently, the industry has opposed electrification efforts with lobbying and social media influencers who tout gas as a “super cool way” to cook. I consulted multiple experts on the hazards of gas stovesand what people can do about them. Their advice boiled down to this: homeowners who can afford it should switch to an induction or electric stove. For renters and others who can’t replace their appliances, the experts provided tips on lowering the health risks. What Are the Risks of Gas Appliances? (Illustration by Laila Milevski, special to ProPublica) Methane is a greenhouse gas. The gas that’s piped into your house is virtually all methane. When you burn methane to cook food, it turns into carbon dioxide. But unburned methane trickles out from loose fittings and faulty stovetop igniters. Every pound of methane released into the air is 30 to 86 times more effective at warming the planet than a pound of carbon dioxide. When researchers analyzed 53 homes in California last year, they found methane leaking from almost every stove. More than three-quarters of that methane came from stoves that were turned off. The act of igniting a burner or oven released additional puffs of methane. If these leaks are consistent across the nation, then annual methane emissions from U.S. gas stoves would equal the greenhouse gas emissions of half a million cars. These leaks are “pretty much universal,” said Robert Jackson, a Stanford University professor and a study co-author. Jackson, who’s spent more than a decade studying methane leaks from gas wells, pipelines and other fossil fuel infrastructure, said it can be hard to predict where the leak is coming from. Based on the description of the leak in my kitchen, he told me it likely was caused by ignition problems with the oven. Jackson’s research has inspired him to ditch his gas stove, furnace and hot water heater in favor of induction and electric appliances. “I did not expect to see the high levels of indoor air pollution we saw consistently,” he said. “It strongly motivated me to replace my own stove.” Large methane leaks can cause explosions. If you smell gas in your home, leave the building and call your gas company. The distinctive rotten-egg odor comes from chemicals that gas companies add to the methane to make it easier to detect, since the gas is naturally odorless. Some people are much more sensitive to the smell than others, so it’s not a foolproof warning for explosive risk. Eric Lebel, lead author of the methane study Jackson worked on, recalled smelling gas in some of the homes where he did the testing, even though the homeowners couldn’t smell anything. Lebel is a senior scientist at PSE Healthy Energy, a nonprofit science and policy research institute. Burning natural gas releases nitrogen dioxide, a respiratory irritant. Nitrogen dioxide exacerbates asthma and impairs lung function. The Environmental Protection Agency regulates these emissions from cars and power plants with national air quality standards, but those regulations don’t apply to indoor air. The Lebel and Jackson study measured nitrogen dioxide and a related compound. They found steadily rising emissions after turning on burners and ovens. “Simply having a combustion stove in your home is a health risk,” LaRocque said. In poorly ventilated kitchens, nitrogen dioxide levels could exceed outdoor air standards. “It would be like standing behind an idling car, or standing in a smoke-filled room,” she added. “I think if my child had asthma, I would definitely want to intervene.” Gas stoves leak benzene, a carcinogen that can cause leukemia. In a separate study published last fall, Lebel and his colleagues analyzed gas samples from residential kitchens. Out of 160 samples, all but one contained benzene. “If there’s a leak from that appliance, it likely contains benzene,” Lebel said. “It’s a rather unavoidable cost of owning a gas appliance.” Raw natural gas contains a mix of methane and toxic chemicals like benzene, toluene or formaldehyde. Gas companies strip out the impurities before piping the processed gas to homes, but they don’t eliminate all the toxins. Lebel’s team modeled the benzene concentrations from the leaking stoves and found a handful that failed to meet California’s benzene safety guidelines. They also found traces of other harmful compounds, including toluene, ethyl benzene and xylene, which can cause dizziness, nausea and liver damage. A separate study of gas appliances in the Greater Boston area found benzene in 95% of samples, though at lower levels than Lebel’s study. How Can I Protect Myself? (Illustration by Laila Milevski, special to ProPublica) Turn on the range hood above your stove. Paul Francisco, associate director of building science at the University of Illinois Urbana, Champaign, suggests cooking on the back burners and using the hood whenever you turn on the stove or the oven. The fans improve ventilation and will pull benzene, methane and nitrogen dioxide outdoors. However, this only works if the hood connects to the outside of your house. Follow the piping on the hood: If the top of the device goes through the ceiling or the wall, then it should help with air quality. Another type of range hood, called a “ductless” hood, simply recirculates indoor air. If your hood has grilles or vents on the front, then it’s likely, but not guaranteed, to be ductless, Francisco said. These fans won’t cut down on harmful gases, but they might be able to reduce particulate matter — tiny particles created during cooking, which can cause or exacerbate respiratory illness. A 2014 study found that cooking on induction stoves produced far fewer particles than cooking on gas or electric stoves. Open a window to improve ventilation. At a minimum, an open window will dilute toxic gases. If your kitchen is in the upper half of a building, opening the window should draw the contaminants outside as long as there’s no wind and it’s warmer inside than outside, Francisco said. If you live in the lower half of a building, opening a window in the winter won’t be as effective, he said, though any ventilation is better than none. Get an induction hot plate. If you can’t replace your stove, experts said the next best thing is to buy an induction burner. Here are some consumer guides with reviews of portable hot plates. During last summer’s heat waves, when I couldn’t fathom lighting a fire inside my kitchen, I did almost all my cooking using an induction hot plate, an Instant Pot and an electric toaster oven. Excessive heat is another reason why some chefs advocate for induction burners. What about air purifiers? These devices have become more popular as a way to improve air quality and reduce the risk of COVID-19 infections. Most air purifiers won’t have any effect on toxic gases, though they do remove particulate matter, Francisco said. Some specialty models filter out volatile organic compounds, a class of chemicals that includes benzene. Should I buy a gas detector? There are a number of methane monitors that are designed for consumers, priced from roughly $30 to $200. Some will tell you about the presence of a leak. Others are sensitive enough to detect specific concentrations of methane. You can also find indoor monitors that detect particulate matter for $200 to $300. It’s much harder to monitor for benzene or nitrogen dioxide. The types of instruments used by Lebel and Jackson cost tens of thousands of dollars and require users to undergo extensive training. The South Coast Air Quality Management District, a regulatory agency in California, maintains a list of “low-cost” air quality sensors (less than $2,000) that can be used by citizen scientists and advocacy groups. These sensors can be used to detect particulate matter, nitrogen dioxide and volatile organic compounds. Lebel said it shouldn’t be up to individuals to solve a systemic issue. It seems problematic, he said, “to be asking citizens to be scientists and try and discover if their stove is leaking.”
[*] [+] [-] [x] [A+] [a-]  
[l] at 1/22/23 3:00am
by Tim Golden ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive our biggest stories as soon as they’re published. When federal prosecutors walk into the United States Courthouse in Brooklyn on Monday to present their opening statements against Genaro García Luna, the highest-ranking Mexican official ever tried in the United States for drug corruption, they will unveil a complex case that took years to build. But the fuller story of the government’s investigation of García Luna — a former security minister who was arguably the United States’ most important Mexican partner in a long and failed effort to transform his country’s criminal justice system — is hardly a triumph of determined American law enforcement. Investigators from the Drug Enforcement Administration uncovered evidence of García Luna’s secret alliance with violent drug traffickers more than 10 years ago, months before he stepped down from office in 2012. By the next year, they had enough to present their findings to the head of the DEA, who urged them to press ahead to an indictment. But as the investigators continued to build their case over the next few years, federal prosecutors in Houston rejected it repeatedly as insufficient, several current and former officials told ProPublica. Finally, the case stalled. “They wanted more,” said Steven S. Whipple, who supervised the investigation for several years as a deputy chief and then head of the DEA office in Houston. “I thought we had enough to charge the guy, but they said no — and they were the lawyers.” The case did not move forward until early 2019, after a government witness in the trial of the Mexican kingpin Joaquín Guzmán Loera, known as El Chapo, told of paying García Luna more than $6 million in cash on behalf of Guzmán’s so-called Sinaloa Cartel. Soon after that testimony, prosecutors from the Eastern District of New York, based in Brooklyn, began putting together the case on which they arrested García Luna in December of that year. The evidence developed by the Houston agents quickly became a central part of their case, officials familiar with the inquiry said. García Luna has pleaded not guilty. But if he is convicted, his betrayal would point to one of the more extraordinary intelligence failures of the decadeslong U.S. battle against the drug trade in Mexico. The Eastern District prosecutors have also indicted two of García Luna’s closest former aides, Luis Cárdenas Palomino and Ramón Pequeño García, on similar charges and will likely seek their extradition after the trial, officials said. A third former García Luna aide, Iván Reyes Arzate, who for years oversaw elite police units that worked with U.S. agents on sensitive investigations, has already pleaded guilty to U.S. corruption charges. Starting in the late 1990s, when García Luna left Mexico’s civilian intelligence service to help reorganize the federal police, he spent nearly 15 years at the center of the two governments’ joint efforts to build a more effective, less-corrupt criminal justice system in Mexico. For six years, García Luna ran the Federal Investigative Agency, a police force modeled vaguely on the FBI. Starting in late 2006, as President Felipe Calderón sought much wider U.S. help to fight drug mafias and transform the criminal justice system, García Luna served for years as his powerful secretary of public safety. Yet even as he won public praise in Washington, García Luna was the target of repeated accusations of corruption by others in the Mexican security apparatus. Some of those officials said they confided their suspicions to Calderón. Some shared what they knew privately with U.S. Embassy officials. A few spoke out openly. García Luna speaks with then-Secretary of State Hillary Clinton in March 2009. (Luis Acosta/AFP via Getty Images) American officials who served in Mexico City at the time described an environment perpetually clouded with rumors of corruption that were almost always difficult to verify. They said they tried to investigate the most significant allegations but rarely came to satisfying results. Former American diplomats also said that while they had access to U.S. intelligence, they had little or no information that was developed about García Luna and other officials in federal law enforcement investigations. “I never saw any CORROBORATED information of involvement in drug trafficking,” a former U.S. ambassador to Mexico, Roberta S. Jacobson, tweeted following García Luna’s arrest. Yet, given García Luna’s central role in both the fight against organized crime and the longer-term police reform project, the due diligence done by U.S. officials who worked with him is certain to look less compelling against the incriminating information that federal prosecutors will start to reveal in their opening statements on Monday. The Eastern District prosecutors have prepared more than 60 possible witnesses and tens of thousands of pages of documentary evidence, people familiar with the case said. The star witnesses are expected to include the Mexican trafficker who first told his story to DEA agents in Houston in 2012, Sergio Villarreal Barragán, a hulking former police agent known as El Grande. But the case still faces some legal hurdles. The most important may be the five-year statute of limitations that covers drug and corruption crimes. The prosecutors have sought to circumvent this obstacle by charging that García Luna joined the Sinaloa capos in a “continuing criminal enterprise.” Like the more commonly used Racketeer Influenced and Corrupt Organizations, or RICO, Act, the so-called CCE statute is used to impose longer prison sentences on crime bosses, and it specifically targets drug crimes. The CCE charge allows the prosecutors to argue that García Luna and his lieutenants are responsible for criminal actions that continued years after they stopped taking the traffickers’ bribes. The strategy is untested, though, as a way to prosecute a corrupt government official after he apparently ended his criminal ties, and some officials believe it will likely be a focus of García Luna’s defense. Unlike the Eastern District’s abortive effort to prosecute Mexico’s former defense minister, Gen. Salvador Cienfuegos Zepeda, on drug corruption charges in late 2020, the government of Mexican President Andrés Manuel López Obrador has mostly welcomed the U.S. action against García Luna. Officials said his government has cooperated with the U.S. prosecutors in response to some requests for information. Cienfuegos was vigorously defended by the Mexican army, on which López Obrador has depended heavily throughout his administration. In the face of diplomatic protests, then-U.S. Attorney General William P. Barr dropped the charges and sent the general back to Mexico barely a month after he was arrested. Cienfuegos said he was innocent of any wrongdoing. García Luna is closely associated with former Mexican President Felipe Calderón, right. (Alfredo Estrella/AFP via Getty Images) By contrast, García Luna is closely associated with Calderón, a pro-American conservative who defeated López Obrador in a bitterly contested 2006 election and remains his hated rival. The Mexican government has filed its own corruption charges against García Luna and sued him in a Florida court, demanding $250 million that the authorities say he and his associates stole while he was security minister. He has denied those allegations. In hindsight, some of the many American officials who worked closely with García Luna said they had cause to suspect him long before he was charged with working for Guzmán’s Sinaloa Cartel. One former U.S. Embassy official recalled being invited by García Luna to a party at what he described at the country home of his wife’s family in Cuernavaca, a weekend retreat south of the capital favored by wealthy Mexicans. At one point, García Luna escorted some of his American guests to an immaculate, warehouse-like garage where he kept a gleaming array of restored vintage automobiles, one of them recalled. It was impossible to estimate the collection’s value at a glance, but the former official thought it might have been worth hundreds of thousands of dollars — perhaps as much as the home itself. “It was right in front of us,” said the former official, who, like some others, insisted on anonymity to discuss still-secret information about García Luna’s case. “If it wasn’t corrupt, it was suspect. But we didn’t really have a choice about working with him.” The DEA noticed García Luna early on. While still serving in the intelligence service, he and Cárdenas Palomino, his longtime lieutenant, arrived in Tijuana in the mid-1990s to offer to collaborate with U.S. agents working against the Arellano Félix gang, drug-running brothers who had been implicated in the 1993 murder of the Roman Catholic cardinal of Guadalajara. “They gave a beautiful briefing,” one former DEA agent said of the two Mexican intelligence agents. “They had an operational plan, but it was all targeted to the Arellanos. When you talked about anybody else, they didn’t care.” The former agent surmised that García Luna might already have been working for the Sinaloa Cartel, the Arellanos’ rivals. García Luna and Cárdenas Palomino pressed the DEA for information about the Arellanos. But the Mexicans claimed to know little about the Sinaloans, even though they were then operating from nearby Mexicali and pushing violently into Tijuana. In 1998, García Luna joined a former head of the intelligence service to try to reorganize the notoriously corrupt Federal Preventive Police. That effort ended with the former intelligence chief accused of corruption (he was later exonerated), but García Luna prospered. When Mexico’s first opposition president was elected in 2000, he was named to lead the federal police, which was rebranded once more as the Federal Investigative Agency. At the AFI, as it was known by its Spanish initials, García Luna impressed U.S. officials as a can-do technocrat (he had a college degree in mechanical engineering) unburdened by the nationalistic mistrust that had always clouded Mexico’s collaboration with the United States in the drug fight. Members of Mexico’s Federal Investigative Agency, known by its Spanish initials as the AFI, take part in an counterdrug operation in Mexico City in March 2007. García Luna led the agency in the early 2000s. (Daniel Aguilar/Reuters) When García Luna was chosen in late 2006 to run a powerful new public safety ministry under Calderón, the U.S. Embassy fairly rejoiced in a cable to Washington. When Calderón turned to the George W. Bush administration for urgent help in the fight against surging violence, the two governments signed a landmark agreement, the Mérida Initiative, that would lead to a new era of cooperation and more than $3.5 billion in U.S. security aid. “Within a very short time, García Luna became our go-to guy because he was the most effective partner we had,” said John Feeley, a senior American diplomat who worked for years on the Mérida plan’s implementation. “There were a lot of things that we did under the rubric of Mérida that were very successful, and many of them involved García Luna.” At the same time, however, the central Mérida goal of police reform ran into endless difficulties under García Luna’s leadership. When sensitive intelligence information was shared with Mexican police officials, even those trained and vetted by the DEA, it was leaked to the traffickers almost routinely. American-trained police officials in those units were killed one after another, apparently betrayed to the traffickers by others inside the government. García Luna, Cárdenas Palomino and other top security officials refused to submit to the screening and polygraph examinations that were given to the vetted agents, and U.S. officials felt they could not compel them to do so. (Reyes Arzate, a García Luna lieutenant who directed the Mexican police units that worked with U.S. agents, did pass polygraph tests before he was charged in Chicago in 2017 with leaking information to the traffickers, two officials said.) By the time García Luna stepped down in 2012, he had been linked to drug traffickers in several Mexican news articles and implicated publicly and privately by at least three prominent Mexican officials. Two of his accusers, a former police official and an Army general, were themselves jailed on corruption charges, which were later dropped. Then, in May 2012, U.S. allies in the Calderón administration helped secure the extradition of Villarreal, the feared Mexican trafficker called El Grande. Weeks later, U.S. investigators began to question him at length in a federal prison in Texas. Sergio Villarreal Barragán, a former Mexican police agent and trafficker, is expected to be one of the star witnesses in García Luna’s trial. (Alfredo Estrella/AFP via Getty Images) The story he told them was bracing, several former officials said. He described García Luna as having been a paid and trusted protector of both the Sinaloa Cartel and the Beltrán Leyva Organization, a powerful gang headed by brothers who split from Guzmán and his Sinaloa allies in 2008. Arturo Beltrán Leyva, who led the organization until he was killed in a raid by Mexican marines in 2009, felt so strongly that García Luna worked for him that he berated the minister after one of his brothers was arrested, Villarreal said. Cárdenas Palomino and other García Luna lieutenants were described as having been part of the scheme as well. At one point, Villarreal told the DEA investigators, García Luna met with a group of high-level traffickers at an isolated ranch and informed them he could no longer accept their cash, at least for a while. He was taking in so much money that he no longer had the means to launder it, former officials familiar with the account said. Villarreal spoke under oath and laid out specific information that the agents were later able to corroborate. If his accusations against García Luna were true, it suggested that the entire U.S. effort to transform Mexico’s police structure might have been doomed from the start. A small group of DEA agents in Houston, where Villarreal was being prosecuted, began digging into the case. They conducted surveillance of García Luna in Miami, where he had moved with his family to set up a security consulting firm and other businesses. They also discovered his complicated entanglements with a Mexican security executive, Samuel Weinberg, and his son, who were found to be channeling funds to some of García Luna’s enterprises. The Weinbergs have denied wrongdoing. As part of their effort to trace García Luna’s finances, the agents first uncovered records in Panama that showed millions of dollars in suspicious transfers from offshore accounts into others that García Luna appeared to control in Miami, including one for a restaurant that appeared to be laundering the money. Through a front company, the Weinbergs had purportedly facilitated the purchase of a $3.3 million house in Golden Beach, north of Miami, where García Luna was living, but he was the person who had picked it out with a real estate agent, one former official said. In 2013, a senior agent overseeing the case was sent to Washington to brief the DEA administrator, Michele M. Leonhart. She did not hesitate in her assessment of the case, one former official familiar with the meeting recalled. “Get it done,” the official quoted her as saying. “Get him charged.” But while García Luna recruited clients for his security firm, earned a master’s degree in business administration at the University of Miami and enjoyed his new life, the Houston investigators got a less enthusiastic response from federal prosecutors in the Southern District of Texas, headquartered in Houston. The prosecutors were not especially interested in a historical corruption case, three former officials said, and they did not think agents had put together sufficient evidence to convict a high-profile figure like García Luna. “The Southern District felt straight-up that there wasn’t enough information to charge him,” Whipple, the former DEA chief in Houston, said. “We couldn’t get it prosecuted.” Whipple and others overseeing the case pushed the agents to press forward, but they made slow progress. The financial information was complex and complicated by the difficulty of obtaining records overseas. The agents interviewed former Mexican traffickers and lined up other potential witnesses. Despite the additional evidence, prosecutors at the Houston office continued to see their findings as insufficient to go after a target as formidable as García Luna, officials said. A spokesperson for the U.S. attorney’s office, Angela Dodge, declined to comment on how it weighed the Garcia Luna matter, but said, “We consider each case based on the evidence and what can be proven beyond a reasonable doubt in a court of law.” Eventually, though, the DEA investigators began to lose steam, officials said. “When you’ve pursued every lead you can find and the prosecutors say it’s not quite enough, things get stagnant,” Whipple said. “I thought that we had checked all the boxes. But it was on the back burner until something popped — and the Chapo case finally popped.” Early in Guzmán’s trial in the Eastern District, a former Sinaloa lieutenant, Jesús Zambada García, testified that he had twice met with García Luna at a Mexico City restaurant to give him cash-filled briefcases, each one with more than $3 million. That revelation and others prompted the U.S. attorney, Richard P. Donoghue, to instruct his prosecutors to begin making cases against García Luna and other corrupt Mexican officials. Jesús Zambada García, a former cartel lieutenant, testified in another trial that he had twice met with García Luna to give him cash-filled briefcases, each one with more than $3 million. (Alexandre Meneghini/AP) Those prosecutors and the investigators working with them soon found their way to Houston, where one of the DEA agents and a financial crimes analyst eagerly turned over all the work they had done over the previous seven years. García Luna was secretly indicted on drug conspiracy charges by a federal grand jury in Brooklyn, and he was arrested in Dallas on Dec. 9, 2019. Doris Burke contributed research.
[*] [+] [-] [x] [A+] [a-]  
[l] at 1/20/23 9:40am
by Mike Reicher and Lulu Ramadan, The Seattle Times This article was produced for ProPublica’s Local Reporting Network in partnership with The Seattle Times. Sign up for Dispatches to get stories like this one as soon as they are published. Washington education officials have launched an investigation into the state’s largest network of privately run schools for students with disabilities, following a series of stories by The Seattle Times and ProPublica that documented poor conditions at the schools, the state disclosed Thursday. The investigation was revealed in a seven-page letter from the state Office of Superintendent of Public Instruction on the same day lawmakers considered a sweeping reform bill that would give the state greater oversight of the publicly funded system of private special education schools, known as “nonpublic agencies.” “We have to figure out, as a state and as a Legislature, how it is that we protect and make sure our children are getting the services and supports they need,” said Sen. Claire Wilson, D-Auburn, vice chair of the Senate education committee and the bill’s prime sponsor. Both the investigation and the bill came in response to the news organizations’ stories on the Northwest School of Innovative Learning, a program serving students with complex developmental and behavioral disabilities. Owned by Fairfax Hospital, the largest private psychiatric facility in Washington, Northwest SOIL serves the most public school students in the system and only accepts students whose tuition is paid for by taxpayers. The Times and ProPublica investigation found years of complaints by school districts and parents, including allegations of abuse, overuse of isolation rooms to manage student behavior and unqualified aides instead of certified special education teachers leading classrooms. Police investigated allegations that one teacher placed a 13-year-old boy in a chokehold. And former staffers, including the school’s top administrator, said they felt pressured by Fairfax and its parent company, Universal Health Services, to skimp on staffing and basic resources and to enroll more students than the staff could handle. But OSPI routinely approved the schools’ annual application to accept students. It’s rare for the state to investigate the operations at nonpublic agencies, and in the letter, OSPI called out its authority to suspend or revoke a school’s approval. In the case of Northwest SOIL, a revocation could effectively shut down the school. Tania May, assistant superintendent for special education at OSPI, sent Fairfax CEO Christopher West the letter earlier this month requesting detailed information about Northwest SOIL’s three campuses from 2019 to present. She followed up this week, setting deadlines in February and March for responses. “Given the serious nature of the allegations made in the articles, OSPI is examining what, if any, actions need to be taken with respect to Northwest SOIL’s approval to contract with Washington school districts,” May wrote. Northwest SOIL’s three locations in Redmond, Tacoma and Tumwater are among 89 nonpublic agency campuses approved by the state. The programs provide an alternative for school districts that can’t meet the needs of special education students. Roughly 500 Washington students are sent, at public expense, to the nonpublic agency campuses, which include residential schools scattered throughout the country. As part of the wide-ranging inquiry, the state demanded records of allegations of “mistreatment, maltreatment, abuse or neglect” by school staff against students as well as calls to law enforcement and restraint and isolation documents. The inquiry is also seeking documents and data relating to staff qualifications and student-to-teacher ratios. West did not respond to a request for comment Thursday. Fairfax Hospital previously defended the program in a statement to the Times and ProPublica, saying that “use of restraints and seclusion are always used as a last response when a student is at imminent risk of hurting themselves or others.” The company added, “We strongly deny any allegation that we understaff and/or pressure staff to increase admissions in order to maximize profits.” May’s letter said the Times and ProPublica stories described allegations against staff that were “previously unknown” to OSPI and other agencies, including police, Child Protective Services and local school districts. The state told Northwest SOIL to “explain why such allegations were not reported.” Disability rights advocates praised the state’s move. “It is so important that OSPI is taking an urgent and active step to thoroughly investigate the concerns at NWSOIL,” Karen Pillar, director of policy and advocacy at TeamChild, an education rights group, said in an email. “Collecting data is a great first step, but there needs to be simultaneous action to make sure the students attending every day are receiving the support and educational services required by law and designed to keep them safe and learning.” In Olympia on Thursday, state lawmakers took public testimony on a bill, SB 5315, that would require OSPI to publish a wide range of data — from test scores and graduation rates to incidents of restraint or isolation — for Northwest SOIL and other nonpublic agencies. It would also require the state to develop standards for investigating nonpublic agency contracts. Unlike with public schools, the state does not track academic progress, restraint and isolation patterns or disciplinary actions at nonpublic agencies, making it difficult for parents of disabled children to vet the programs. Instead, the schools are overseen piecemeal by individual school districts, who are required to monitor the progress of only their students. “The quality is all over the board and the education information about them is all over the board,” Ramona Hattendorf, director of advocacy for the Arc of King County, a disability rights group, said at the hearing. “I really want to emphasize how critical it is for families to have information about these agencies and faith in their ability to provide the promised and needed support.” The Times and ProPublica stitched together a troubling picture of Northwest SOIL by filing 80 public records requests and speaking with 26 current and former staffers. The proposed legislation would also require OSPI and at least one school district that sends children to the program to visit each nonpublic agency before approving its contract — a significant increase in state oversight. As it stands, state law gives OSPI the option of visiting each school, but it’s not required. Also, every nonpublic agency would be inspected by the state or a school district annually. Current law requires a district inspection once every three years. The legislation would standardize district agreements with nonpublic agencies, including requiring a description of financial safeguards “to ensure that funds are used to provide special education services to students.” But the bill received pushback from representatives of some nonpublic agency schools, who said they were unfairly being lumped together with more troubled programs. Though all nonpublic agencies are approved by OSPI, some are also approved as private schools by the state Board of Education and say they face additional regulations. Others, such as Northwest SOIL, which is run by a hospital, aren’t accredited private schools. “They call themselves schools, but they do not go through the rigorous approval or accreditation process we did,” said Melodee Loshbaugh, the founder of Brock’s Academy in Woodinville. “We feel like it’s overreach to even suggest that we are not doing a good job with our documentation.” Committee members said they were open to modifying the bill to distinguish between different types of nonpublic agencies. “We have some bad actors. We want to go after the bad actors. We don’t want to make life more difficult for the good actors,” said Sen. Mark Mullet, D-Issaquah.

As of 2/5/23 6:28am. Last new 2/3/23 11:58am.

Next feed in category: Raw Story