# cache

url: http://feeds.propublica.org/propublica/main
title: ProPublica
created_at: 2024-03-19 00:09:31
entries:
{"entries": [{"title": "An Oregon Bill to Cut Millions in Timber Taxes Is Dead, Despite Backing by the Industry, the Governor and a Top Lawmaker", "title_detail": {"type": "text/plain", "language": null, "base": "https://www.propublica.org/feeds/propublica/main", "value": "An Oregon Bill to Cut Millions in Timber Taxes Is Dead, Despite Backing by the Industry, the Governor and a Top Lawmaker"}, "links": [{"rel": "alternate", "type": "text/html", "href": "https://www.propublica.org/article/oregon-bill-to-cut-millions-in-timber-taxes-is-dead"}], "link": "https://www.propublica.org/article/oregon-bill-to-cut-millions-in-timber-taxes-is-dead", "published": "Mon, 18 Mar 2024 06:00:00 -0400", "published_parsed": [2024, 3, 18, 10, 0, 0, 0, 78, 0], "id": "https://www.propublica.org/article/oregon-bill-to-cut-millions-in-timber-taxes-is-dead", "guidislink": false, "summary": "<p class=\"byline\">\n                by <a class=\"name\" href=\"https://www.propublica.org/people/rob-davis-2\">Rob Davis</a>                </p>\n                                             \n\n                                                                    \n            \n                <p>ProPublica is a nonprofit newsroom that investigates abuses of power. <a href=\"https://www.propublica.org/newsletters/dispatches?source=54G&amp;placement=top-note&amp;region=local\">Sign up for Dispatches</a>, a newsletter that spotlights wrongdoing around the country, to receive our stories in your inbox every week.</p>\n\n            \n\n                \n\n      \n  \n\n\n\n                    \n<p>Oregon state Sen. Elizabeth Steiner seemed to have a lot of power and momentum behind her effort that would have shifted the costs of wildland firefighting further onto taxpayers this year.</p>\n\n<p>The influential timber industry, which stood to save millions and is a major source of campaign cash in the state, worked behind closed doors to help craft Steiner\u2019s proposal. Republican leaders threw their support behind it. Gov. Tina Kotek, whose staff assisted in the bill\u2019s development, also came out in favor.</p>\n\n<p>But there was fallout from the effort. <a href=\"https://oregoncapitalchronicle.com/2024/01/10/timber-industry-tied-to-proposal-shifting-wildfire-protection-costs-from-landowners-to-public/\">Media reports noted</a> the <a href=\"https://www.propublica.org/article/oregon-timber-industry-tax-cuts-legislature\">industry\u2019s central role</a> in shaping the bill. Steiner, a Democrat running for state treasurer, drew a primary challenge from another Democratic state senator, Jeff Golden, who had offered a competing bill to fund wildfire preparedness and other services by raising taxes on logging. His entry into the race had the potential to turn their divergence on the industry into a campaign issue.</p>\n\n<p>And then, in the Legislature\u2019s waning moments, Steiner\u2019s bill died. In an email to ProPublica, she blamed \u201ctechnical difficulties\u201d without specifying what they were.</p>\n\n<p>\u201cI recognize it is not perfect,\u201d Steiner told Golden in a hearing on Feb. 28, when her bill was still moving forward. \u201cI think it\u2019s damn good, excuse my language, because it\u2019s more progress than we\u2019ve made in a really long time.\u201d</p>\n        \n    \n                    \n<p>The bill\u2019s failure leaves unresolved a debate over how much the timber industry pays for services like fire protection in Oregon, decades after <a href=\"https://www.propublica.org/series/the-cutting\">a series of massive tax cuts</a> whose harms Oregon Public Broadcasting, The Oregonian/OregonLive and ProPublica documented in a 2020 investigation. Those cuts have saved the industry more than $3 billion since the 1990s, the news organizations found, allowing timber companies to profit at the expense of rural communities.</p>\n\n<p>Today, logging companies pay less to cut down trees than they do in neighboring Washington, state analyses have shown.</p>\n\n<p>After catastrophic fires burned thousands of homes in 2020, lawmakers invested $195 million into readiness, including outfitting local fire departments and developing home hardening programs. But with costs rising and the acreage burned by fires doubling over the last decade, lawmakers are still looking for a stable source of money to prepare for and fight wildfires.</p>\n\n<p>Steiner defended her ideas for raising money from taxpayers and homeowners throughout the monthlong 2024 legislative session, saying wildfires had become a statewide problem that demanded funding from all Oregonians, who already subsidize the state\u2019s firefighting capabilities.</p>\n\n<p>A lobbyist for Weyerhaeuser, Oregon\u2019s largest private forestland owner and a participant in the drafting of Steiner\u2019s bill, announced the initial proposal would save the company $500,000 a year. Steiner later committed to reducing the cost shift to taxpayers from $7 million to $3.5 million. When Golden proposed an amendment to ensure big timberland owners didn\u2019t pay any less than they do now, Steiner rejected it.</p>\n\n<p>A Weyerhaeuser spokesperson declined to comment about whether the company expects to pay less in future wildfire funding proposals.</p>\n\n<p>\u201cWildfires are a shared responsibility that threatens every Oregonian,\u201d the spokesperson said, \u201cand moving forward we\u2019re committed to partnering with Oregon legislators and community members on the complex issue of wildfire funding.\u201d</p>\n\n<p>One of Steiner\u2019s fellow Democrats, state Rep. Mark Gamba, told ProPublica that Steiner\u2019s bill would have reduced what the timber industry pays without solving a real problem that Oregon faces.</p>\n\n<p>\u201cFires are doubling decade over decade, and our coffers to fight those fires are not doubling,\u201d Gamba said. \u201cI was shocked that this was even brought to us.\u201d</p>\n\n<p>Golden said Oregon needs tens of millions of dollars annually to prepare for increasing wildfire risks. Giving a tax cut to the industry, then turning to the public for more money, would be \u201ca nonstarter,\u201d he said.</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            Oregon state Sen. Jeff Golden offered a competing bill to fund wildfire response and other services by raising taxes on logging.\n    \n            (Kristyna Wentz-Graff/Oregon Public Broadcasting)\n    \n    \n    \n\n    \n\n        \n    \n                    \n<p>In a departure from Steiner, Golden during the session sought voter approval to reinstate logging taxes eliminated in the 1990s. He introduced a bill that he said could have raised as much as $110 million annually for wildfire fighting, drinking water protection and the county services the logging taxes once funded. That bill stalled, was subsequently weakened to solely seek a study of those taxes, then died in committee.</p>\n\n<p>As Golden and Steiner\u2019s dueling visions for timber taxation and wildfire funding played out, Golden announced he would challenge her in the May Democratic primary for state treasurer. But he withdrew less than two weeks later, saying he realized he didn\u2019t actually want the job.</p>\n\n<p>Kotek, a Democrat, acknowledged in a Feb. 28 letter to lawmakers that differences remain about whether the timber industry is paying its fair share of wildfire costs. How much the industry contributes, she wrote, is a legitimate issue for discussion \u201cas we work to create a comprehensive, long-term fix to our wildfire funding policies.\u201d</p>\n\n<p>Steiner, in an email to ProPublica, said her bill was always intended to be \u201can intermediate step toward a more equitable, sustainable solution for funding this system. We expect that the next iteration of this proposal will have more nuance.\u201d</p>\n\n<p>Golden said he will continue introducing legislation to tax the industry to pay for wildfire readiness.</p>\n\n<p>\u201cIt\u2019s going to come up in some form again,\u201d he said, \u201cas long as I\u2019m in the Legislature.\u201d</p>\n        \n    \n                    \n    \n        <p>\n            <strong><a href=\"https://www.propublica.org/getinvolved/send-propublica-story-tips\">Do You Have a Tip for ProPublica? Help Us Do Journalism.</a></strong>\n        </p>", "summary_detail": {"type": "text/html", "language": null, "base": "https://www.propublica.org/feeds/propublica/main", "value": "<p class=\"byline\">\n                by <a class=\"name\" href=\"https://www.propublica.org/people/rob-davis-2\">Rob Davis</a>                </p>\n                                             \n\n                                                                    \n            \n                <p>ProPublica is a nonprofit newsroom that investigates abuses of power. <a href=\"https://www.propublica.org/newsletters/dispatches?source=54G&amp;placement=top-note&amp;region=local\">Sign up for Dispatches</a>, a newsletter that spotlights wrongdoing around the country, to receive our stories in your inbox every week.</p>\n\n            \n\n                \n\n      \n  \n\n\n\n                    \n<p>Oregon state Sen. Elizabeth Steiner seemed to have a lot of power and momentum behind her effort that would have shifted the costs of wildland firefighting further onto taxpayers this year.</p>\n\n<p>The influential timber industry, which stood to save millions and is a major source of campaign cash in the state, worked behind closed doors to help craft Steiner\u2019s proposal. Republican leaders threw their support behind it. Gov. Tina Kotek, whose staff assisted in the bill\u2019s development, also came out in favor.</p>\n\n<p>But there was fallout from the effort. <a href=\"https://oregoncapitalchronicle.com/2024/01/10/timber-industry-tied-to-proposal-shifting-wildfire-protection-costs-from-landowners-to-public/\">Media reports noted</a> the <a href=\"https://www.propublica.org/article/oregon-timber-industry-tax-cuts-legislature\">industry\u2019s central role</a> in shaping the bill. Steiner, a Democrat running for state treasurer, drew a primary challenge from another Democratic state senator, Jeff Golden, who had offered a competing bill to fund wildfire preparedness and other services by raising taxes on logging. His entry into the race had the potential to turn their divergence on the industry into a campaign issue.</p>\n\n<p>And then, in the Legislature\u2019s waning moments, Steiner\u2019s bill died. In an email to ProPublica, she blamed \u201ctechnical difficulties\u201d without specifying what they were.</p>\n\n<p>\u201cI recognize it is not perfect,\u201d Steiner told Golden in a hearing on Feb. 28, when her bill was still moving forward. \u201cI think it\u2019s damn good, excuse my language, because it\u2019s more progress than we\u2019ve made in a really long time.\u201d</p>\n        \n    \n                    \n<p>The bill\u2019s failure leaves unresolved a debate over how much the timber industry pays for services like fire protection in Oregon, decades after <a href=\"https://www.propublica.org/series/the-cutting\">a series of massive tax cuts</a> whose harms Oregon Public Broadcasting, The Oregonian/OregonLive and ProPublica documented in a 2020 investigation. Those cuts have saved the industry more than $3 billion since the 1990s, the news organizations found, allowing timber companies to profit at the expense of rural communities.</p>\n\n<p>Today, logging companies pay less to cut down trees than they do in neighboring Washington, state analyses have shown.</p>\n\n<p>After catastrophic fires burned thousands of homes in 2020, lawmakers invested $195 million into readiness, including outfitting local fire departments and developing home hardening programs. But with costs rising and the acreage burned by fires doubling over the last decade, lawmakers are still looking for a stable source of money to prepare for and fight wildfires.</p>\n\n<p>Steiner defended her ideas for raising money from taxpayers and homeowners throughout the monthlong 2024 legislative session, saying wildfires had become a statewide problem that demanded funding from all Oregonians, who already subsidize the state\u2019s firefighting capabilities.</p>\n\n<p>A lobbyist for Weyerhaeuser, Oregon\u2019s largest private forestland owner and a participant in the drafting of Steiner\u2019s bill, announced the initial proposal would save the company $500,000 a year. Steiner later committed to reducing the cost shift to taxpayers from $7 million to $3.5 million. When Golden proposed an amendment to ensure big timberland owners didn\u2019t pay any less than they do now, Steiner rejected it.</p>\n\n<p>A Weyerhaeuser spokesperson declined to comment about whether the company expects to pay less in future wildfire funding proposals.</p>\n\n<p>\u201cWildfires are a shared responsibility that threatens every Oregonian,\u201d the spokesperson said, \u201cand moving forward we\u2019re committed to partnering with Oregon legislators and community members on the complex issue of wildfire funding.\u201d</p>\n\n<p>One of Steiner\u2019s fellow Democrats, state Rep. Mark Gamba, told ProPublica that Steiner\u2019s bill would have reduced what the timber industry pays without solving a real problem that Oregon faces.</p>\n\n<p>\u201cFires are doubling decade over decade, and our coffers to fight those fires are not doubling,\u201d Gamba said. \u201cI was shocked that this was even brought to us.\u201d</p>\n\n<p>Golden said Oregon needs tens of millions of dollars annually to prepare for increasing wildfire risks. Giving a tax cut to the industry, then turning to the public for more money, would be \u201ca nonstarter,\u201d he said.</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            Oregon state Sen. Jeff Golden offered a competing bill to fund wildfire response and other services by raising taxes on logging.\n    \n            (Kristyna Wentz-Graff/Oregon Public Broadcasting)\n    \n    \n    \n\n    \n\n        \n    \n                    \n<p>In a departure from Steiner, Golden during the session sought voter approval to reinstate logging taxes eliminated in the 1990s. He introduced a bill that he said could have raised as much as $110 million annually for wildfire fighting, drinking water protection and the county services the logging taxes once funded. That bill stalled, was subsequently weakened to solely seek a study of those taxes, then died in committee.</p>\n\n<p>As Golden and Steiner\u2019s dueling visions for timber taxation and wildfire funding played out, Golden announced he would challenge her in the May Democratic primary for state treasurer. But he withdrew less than two weeks later, saying he realized he didn\u2019t actually want the job.</p>\n\n<p>Kotek, a Democrat, acknowledged in a Feb. 28 letter to lawmakers that differences remain about whether the timber industry is paying its fair share of wildfire costs. How much the industry contributes, she wrote, is a legitimate issue for discussion \u201cas we work to create a comprehensive, long-term fix to our wildfire funding policies.\u201d</p>\n\n<p>Steiner, in an email to ProPublica, said her bill was always intended to be \u201can intermediate step toward a more equitable, sustainable solution for funding this system. We expect that the next iteration of this proposal will have more nuance.\u201d</p>\n\n<p>Golden said he will continue introducing legislation to tax the industry to pay for wildfire readiness.</p>\n\n<p>\u201cIt\u2019s going to come up in some form again,\u201d he said, \u201cas long as I\u2019m in the Legislature.\u201d</p>\n        \n    \n                    \n    \n        <p>\n            <strong><a href=\"https://www.propublica.org/getinvolved/send-propublica-story-tips\">Do You Have a Tip for ProPublica? Help Us Do Journalism.</a></strong>\n        </p>"}, "tags": [{"term": "Politics, The Cutting", "scheme": null, "label": null}], "updated": "2024-03-18T06:00:00-04:00", "updated_parsed": [2024, 3, 18, 10, 0, 0, 0, 78, 0], "authors": [{"name": "by Rob Davis"}], "author": "by Rob Davis", "author_detail": {"name": "by Rob Davis"}}, {"title": "An Expert Who Has Testified in Foster Care Cases Across Colorado Admits Her Evaluations Are Unscientific", "title_detail": {"type": "text/plain", "language": null, "base": "https://www.propublica.org/feeds/propublica/main", "value": "An Expert Who Has Testified in Foster Care Cases Across Colorado Admits Her Evaluations Are Unscientific"}, "links": [{"rel": "alternate", "type": "text/html", "href": "https://www.propublica.org/article/expert-in-foster-care-cases-admits-her-method-is-unscientific"}], "link": "https://www.propublica.org/article/expert-in-foster-care-cases-admits-her-method-is-unscientific", "published": "Mon, 18 Mar 2024 05:00:00 -0400", "published_parsed": [2024, 3, 18, 9, 0, 0, 0, 78, 0], "id": "https://www.propublica.org/article/expert-in-foster-care-cases-admits-her-method-is-unscientific", "guidislink": false, "summary": "<p class=\"byline\">\n                by <a class=\"name\" href=\"https://www.propublica.org/people/eli-hager\">Eli Hager</a>                </p>\n                                             \n\n                                                                    \n            \n                <p>ProPublica is a nonprofit newsroom that investigates abuses of power. <a href=\"https://www.propublica.org/newsletters/dispatches?source=54G&amp;placement=top-note&amp;region=local\">Sign up for Dispatches</a>, a newsletter that spotlights wrongdoing around the country, to receive our stories in your inbox every week.</p>\n\n            \n\n                \n\n      \n  \n\n\n\n                    \n<p>Diane Baird had spent four decades evaluating the relationships of poor families with their children. But last May, in a downtown Denver conference room, with lawyers surrounding her and a court reporter transcribing, she was the one under the microscope.</p>\n\n<p>Baird, a social worker and professional expert witness, has routinely advocated in juvenile court cases across Colorado that foster children be adopted by or remain in the custody of their foster parents rather than being reunified with their typically lower-income birth parents or other family members.</p>\n\n<p>In the conference room, Baird was questioned for nine hours by a lawyer representing a birth family in a case out of rural Huerfano County, according to a recently released transcript of the deposition obtained by ProPublica.</p>\n\n<p>Was Baird\u2019s method for evaluating these foster and birth families empirically tested? No, Baird answered: Her method is unpublished and unstandardized, and has remained \u201cpretty much unchanged\u201d since the 1980s. It doesn\u2019t have those \u201cstandard validity and reliability things,\u201d she admitted. \u201cIt\u2019s not a scientific instrument.\u201d</p>\n\n<p>Who hired and was paying her in the case that she was being deposed about? The foster parents, she answered. They wanted to adopt, she said, and had heard about her from other foster parents. </p>\n\n<p>Had she considered or was she even aware of the cultural background of the birth family and child whom she was recommending permanently separating? (The case involved a baby girl of multiracial heritage.) Baird answered that babies have \u201cnever possessed\u201d a cultural identity, and therefore are \u201cnot losing anything,\u201d at their age, by being adopted. Although when such children grow up, she acknowledged, they might say to their now-adoptive parents, \u201cOh, I didn\u2019t know we were related to the, you know, Pima tribe in northern California, or whatever the circumstances are.\u201d </p>\n\n<p>The Pima tribe is located in the Phoenix metropolitan area.</p>\n\n<p>It went on and on like this. Baird acknowledged that her entire basis for recommending that the foster parents keep the baby girl was a single less-than-two-hour observation and interview that she\u2019d conducted with them \u2014 her clients. She\u2019d never met the baby girl\u2019s biological grandmother, whom the county child services department had been actively planning for the girl to be placed with, according to internal department emails. Nor had she even read any case documents.</p>\n\n<p>A fundamental goal of foster care, under federal law, is for it to be temporary: to reunify children with their birth parents if it is safe to do so or, second best, to place them with other kin. Extensive social science research has found that <a href=\"https://publications.aap.org/pediatrics/article/146/6/e2020034629/33590/Pediatrician-Guidance-in-Supporting-Families-of\">kids who grow up with their own families experience less long-term separation trauma</a>, fewer mental health and behavioral problems as adolescents and more of an ultimate sense of belonging to their culture of origin.</p>\n\n<p>But a ProPublica investigation co-published with The New Yorker in October revealed that there is <a href=\"https://www.newyorker.com/magazine/2023/10/23/foster-family-biological-parents-adoption-intervenors\">a growing national trend of foster parents undermining </a><a href=\"https://www.newyorker.com/magazine/2023/10/23/foster-family-biological-parents-adoption-intervenors\">the foster system</a><a href=\"https://www.newyorker.com/magazine/2023/10/23/foster-family-biological-parents-adoption-intervenors\">\u2019s premise by \u201cintervening\u201d in family court cases as a way to adopt children</a>. As intervenors, they can file motions and call witnesses to argue that they\u2019ve become too attached to a child for the child to be reunited with their birth family, even if officials have identified a biological family member who is suitable for a safe placement.</p>\n\n<p>A key element of the intervenor strategy, ProPublica found, is hiring an attachment expert like Baird to argue that rupturing the child\u2019s current attachment with his or her foster parents could cause lifelong psychological damage \u2014 even though Baird admitted in her deposition that attachment is a nearly inevitable aspect of the foster care model. (Transitions of children back to their birth families are not just possible, they happen every day in the child welfare system.)</p>\n\n<p>As part of our reporting, we reviewed hundreds of pages of Baird\u2019s reports and testimony from cases over the past decade. We also interviewed more than two dozen attorneys, officials, caseworkers, experts and members of foster and birth families who\u2019ve worked with Baird or observed how she implements her methodology, which she has long called the \u201cKempe Protocol for Interactional Evaluation,\u201d after the Kempe Center at the University of Colorado, the nation\u2019s leading academic institute focused on child welfare. We found that \u2014 leaving aside the question of whether attachment theory should even be used as an argument in these cases \u2014 Baird\u2019s assessments of foster children\u2019s relationships aren\u2019t just unscientific. They barely touch the surface of a child\u2019s life.</p>\n\n<p>\u201cI don\u2019t know these children,\u201d she testified in one 2017 case, adding, \u201cI have not met anybody.\u201d Still, she said, she \u201cstrongly\u201d recommended that those children\u2019s birth parents\u2019 rights be permanently terminated and that the kids be adopted.</p>\n\n<p>Baird is so consistent in this view that she sometimes copies and pastes from her own past evaluations. In the Huerfano County case, she filed a report saying that the baby girl\u2019s life with her foster parents was \u201cpredictable, safe, and filled with love\u201d; that removing her from them and placing her with her biological grandma \u2014 with whom the girl had been having regular, joyful visits \u2014 would \u201cderail her healthy development and create lifelong risk\u201d; and that her \u201chealthy development and mental health will be best protected if her current caregiving environment does not change.\u201d </p>\n\n<p>That same month, Baird filed a report in a Weld County case saying that a baby boy\u2019s life with his foster parents was \u201cpredictable, safe, and filled with love\u201d; that removing him from them and placing him with his biological grandmother \u2014 who too was regularly visiting him with the support of the county child services department, but whom Baird had never met \u2014 would \u201cderail his healthy development and create lifelong risk\u201d; and that his \u201chealthy development and mental health will be best protected if his current caregiving environment does not change.\u201d</p>\n        \n    \n                    \n\n    \n            Documents Show Baird Repeated Language in Reports on Different Children\n                <p>Identical, or nearly identical, text in Diane Baird\u2019s reports in two separate cases is highlighted below. Corresponding colors show where text was repurposed. <em>Names and identifying details have been redacted.</em></p>\n\n    \n\n                        \n                    \n                \n\n    \n            (Anna Donlan/ProPublica)\n    \n    \n    \n\n    \n\n        \n    \n                    \n<p>Baird, in an interview with ProPublica, admitted that \u201cI do sometimes use the same verbiage in one report as I did in others.\u201d But, she added in an email, \u201cMy consistency is not a boiler-plate approach, but rather reflects developmental science which applies to all children.\u201d</p>\n\n<p>She emphasized, \u201cIn all cases I advocate for what I am convinced is the child\u2019s best interest.\u201d</p>\n\n<p>Baird also noted that in many cases she is hired by county officials, rather than directly by foster parents, although ProPublica\u2019s interviews and review of records show that this typically happens when officials are in agreement with the foster parents that they should get continuing or permanent custody.</p>\n\n<p>Baird, despite not being a child psychologist, achieves credibility with these officials \u2014 and with judges \u2014 in part via the impressive label that she uses for her methodology: the Kempe Protocol.</p>\n\n\u201cDon\u2019t Believe It Is Our Place to Get Involved\u201d\n<p>The University of Colorado\u2019s Kempe Center, widely considered the birthplace of the modern U.S. child welfare system, is where this all began.</p>\n\n<p>Baird developed the Kempe Protocol, alongside colleagues, while working at Kempe in the 1980s and \u201990s. She continually used the method both as an employee of the center and after entering private practice in 2017.</p>\n\n<p>Founded in the 1970s, the Kempe Center is best known for getting laws passed across the country requiring <a href=\"https://www.propublica.org/article/mandatory-reporting-strains-systems-punishes-poor-families\">\u201cmandated reporters\u201d</a> like teachers and police officers to call in any suspicion of child abuse or neglect to a state hotline \u2014 after which kids were to be removed from their families, into foster care, if there was evidence of maltreatment. \u201cNo organization,\u201d said Marty Guggenheim, the founder of the nation\u2019s indigent family defense movement, \u201cplayed a more direct role in shaping the modern system of surveillance, over-reporting, and under-emphasizing of the harms associated with state intervention.\u201d</p>\n\n<p>But in recent years, Kempe has taken a more critical look at its past, accepting some institutional responsibility for what it has called the <a href=\"https://www.truthtellingforjustice.org/kempe-center-truth-telling\">\u201cmyth of benevolence\u201d</a>: the idea that certain kids should be redistributed from their families to (often better-off) foster and adoptive parents. The center recently released a statement saying that it had participated in ignoring poverty by placing sole responsibility for poor children\u2019s health and well-being on their families\u2019 alleged maltreatment of them. The statement acknowledged the center\u2019s \u201ccomplicity\u201d in its \u201cgeneration-spanning impacts.\u201d</p>\n\n<p>The center even invited Dorothy Roberts, a law professor and sociologist at the University of Pennsylvania who is a leader of the movement to abolish the child welfare system because of its widespread surveillance and separation of Black families in particular, to be a keynote speaker at a recent conference.</p>\n\n<p>Yet when attorneys for poor birth families wrote to Kempe in late 2022 saying that Baird and experts she has trained \u201care doing real damage to families, and they are doing damage in the name of the Kempe Center,\u201d a University of Colorado lawyer responded by declining the advocates\u2019 request that the center \u201cpublicly disavow this protocol and correct the record.\u201d The reason, the lawyer said, was that the judge or jury on a particular case \u201cis in the best position to evaluate arguments raised by involved parties\u201d as to the scientific efficacy of the method. The lawyer added that the center has \u201cworked with hundreds of individuals in its 50-year history in the child welfare arena and we have little ability to control testimony of each individual.\u201d</p>\n\n<p>This response was far from satisfying to some of the Kempe Center\u2019s own faculty, according to interviews with people who work there and internal emails obtained through a Colorado Open Records Act request. \u201cWhen the Kempe Center was given the opportunity to do the right thing,\u201d wrote one pediatrics professor who has been at Kempe for more than a decade, \u201cit hid behind its legal counsel.\u201d</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            Alicia Johansen and Fred Thornton with their son Carter, at their home in Colorado. As ProPublica and The New Yorker reported, Baird spent years opposing this birth family\u2019s reunification. But Carter is now back home, bonding with his mom and dad and doing well at school.\n    \n            (Rachel Woolf for ProPublica)\n    \n    \n    \n\n    \n\n        \n    \n                    \n<p>After ProPublica published the article with The New Yorker documenting Baird\u2019s role in the trend of foster parents \u201cintervening\u201d in family court cases, faculty at Kempe started organizing a discussion around our reporting and sought an organizationwide reckoning with our findings. \u201cIt was a gut punch to read this,\u201d wrote another professor. \u201cThis is likely the most widely distributed reference to the Kempe Center that we\u2019ve seen in the past decade or more.\u201d The tragedy, the professor said, \u201cis that it diminishes all of the good work we have and continue to do for kids and families.\u201d (ProPublica is not naming the Kempe faculty and staff who wrote these emails because several asked not to be named, saying that they were fearful of retaliation by leadership or a negative effect on their academic standing.)</p>\n\n<p>Still another staffer wrote that past cases of hers similar to the one we wrote about \u201ccontinue to haunt me.\u201d</p>\n\n<p>More emails called Baird\u2019s method a \u201cbogus Kempe protocol\u201d and \u201cjunk science\u201d used \u201cto rip apart families.\u201d She is \u201cleveraging the Kempe name to bolster her opinion.\u201d </p>\n\n<p>Even amid this outcry, Dr. Kathryn Wells, the Kempe Center\u2019s executive director, gave a lawyerly explanation to her staff. \u201cYes,\u201d she wrote in an emailed response to them, \u201ca former employee of the Center has used an approach based on attachment theory and named it after the Center, even though there is no such protocol.\u201d The protocol, she said, was named after Baird\u2019s longtime place of employment \u2014 Kempe \u2014 but \u201cnot trademarked nor listed anywhere in the work that the Center provides.\u201d</p>\n\n<p>In a previous email, Wells, who has national influence on child welfare policy and practice, had explained her reasoning for not taking further action, such as sending Baird a cease-and-desist letter. \u201cIf the claims in court are not supported in the literature, that is not ours to get involved with as Diane is not an employee and it is a legal issue for the attorneys to battle in court,\u201d Wells wrote. She added, \u201cDon\u2019t believe it is our place to get involved.\u201d</p>\n\nWhat Is the Kempe Protocol?\n<p>One of Baird\u2019s first steps upon taking a new case, according to ProPublica\u2019s review of records and interviews that we conducted, including with Baird herself, is to meet with the foster parents. She observes the bond that they have with their foster child, which she generally compliments, and then talks to them about the child\u2019s birth family. She asks them about the circumstances of the child\u2019s birth and alleged neglect \u2014 neither of which foster parents likely would have been present for \u2014 and also about how visits with the birth parents or other relatives have been going.</p>\n\n<p>Drawing from the foster parents\u2019 version of events, Baird routinely reports to the county or testifies in court that visits with the birth family have been detrimental to the child, and, accordingly, she recommends that the foster parents keep the child indefinitely or permanently, on the basis of attachment theory. She has called just this amount of evaluation \u201cthe Kempe Protocol\u201d in several cases we reviewed.</p>\n\n<p>In some cases, though, Baird does observe a birth family visit. During these evaluations, she often asks the birth parents or family members a litany of personal questions that can be stressful to answer in a formal visitation setting, including, sometimes, ones about their marital history and why they\u2019re attracted to their significant other. All the while, she judges how they\u2019re interacting with their child, looking for \u201cthe little nuances\u201d of how babies communicate, she told me. She calls this, too, the Kempe Protocol.</p>\n\n<p>In Baird\u2019s reports and testimony summarizing her observations from such sessions, she has said, for instance, that a little boy and his birth father seeming to be happy around each other (they were playing catch and saying \u201cI love you!\u201d \u201cI love you more!\u201d; the boy \u201cexpressed no negative emotion during their time together\u201d) just showed that the dad was too rigidly setting the emotional tone of the relationship. </p>\n\n<p>She also regularly uses terms like \u201cmirror neurons,\u201d \u201cneurotoxins,\u201d \u201csynapses,\u201d \u201chormones,\u201d and \u201cencoded trauma in the central nervous system\u201d to justify her conclusions about children\u2019s family relationships. (Baird is not a neuroscientist.)</p>\n\n<p>In interviews and emails with ProPublica, Baird said that she is simply opposed, in almost all cases, to rupturing the current healthy attachment of any child under 3 with that child\u2019s foster parents, even if a birth family member is available and family and cultural heritage stand to be lost forever. She said that this is the age when kids are developing their capacity to form healthy relationships, and that they may experience being removed from their foster parents as a rejection, causing a loss of trust going forward. She also said that kids who have a history of caregiver changes and trauma, which is true of many little ones in foster care, need a sense of \u201cpermanency,\u201d often meaning adoption.</p>\n\nBaird\u2019s \u2014 and Kempe\u2019s \u2014 Legacy\n</p>\n        \n    \n                        \n\n    \n        \n\n                            \n                                                        \n                                                        \n                                \n\n            Baird in her office\n    \n            (Trent Davis Bailey for ProPublica)\n    \n    \n    \n\n            \n                    \n    \n                    \n<p>Baird says that she is likely retiring soon, in part as a result of the increasing scrutiny of her practices that she has been facing. In an email to ProPublica, she wrote, \u201cYou have been the catalyst for a good bit of self examination,\u201d adding, \u201cDeep soul searching has followed and your process has helped me as I have worked to be honest with myself.\u201d</p>\n\n<p>Yet Baird still shares thoughts and advice about ongoing cases with a coterie of mostly younger experts \u2014 what she called in her deposition a \u201cpeer supervision and support\u201d group.</p>\n\n<p>\u201cDo you think it\u2019s maybe advisable that others don\u2019t continue to use that protocol given its controversy and the lack of evidence?\u201d she was asked in the deposition.</p>\n\n<p>\u201cI\u2019ll leave that up to them,\u201d she answered.</p>\n\n<p>Several of these experts, according to their resumes, have trained at Kempe, or they have testified or told ProPublica that they\u2019ve learned directly from Baird either at Kempe or in their continuing practice.</p>\n\n<p>\u201cKempe is such a weighty voice that no judge is going to be like, \u2018Oh, Kempe is wrong,\u2019\u201d said Melissa Michaelis Thompson, executive director of the Office of Respondent Parents\u2019 Counsel, Colorado\u2019s public defender agency for indigent birth parents. Thompson said that her attorneys around the state keep seeing versions of the Kempe Protocol being used in their cases.</p>\n\n<p>Wells, the Kempe Center\u2019s executive director, told ProPublica in a statement earlier this month that the use of attachment theory and parent-child interactional assessments, the procedure that Baird conducts with birth families, \u201cin isolation\u201d and \u201cparticularly in non-therapeutic settings and without attention to bias,\u201d is \u201cnot consistent with current best practices and can be abused by experts.\u201d Wells added that Kempe does not itself currently provide such evaluations for court proceedings or endorse the methodology for that purpose. \u201cEquity is at the heart of our mission,\u201d she said.</p>\n\n<p>Even if the Kempe Center did fully disavow Baird and her cohort\u2019s use of this protocol and practices like it, there would be no clear recourse for all of the birth families who\u2019ve lost their children in the past because of Baird\u2019s work. Still, those families might better know the truth of what happened to them, many of them say.</p>\n\n<p>Stephanie Riggs, the biological grandmother in the Huerfano County case \u2014 \u201chuerfano,\u201d ironically, means \u201corphan\u201d in Spanish \u2014 had been doing everything she could to bring her granddaughter back from foster care. She was working nights to be able to travel to visit the baby girl during the day. She\u2019d dug into her limited budget to get a crib, a dresser and baby clothes, bookshelves and baby books, and a play carpet and a toy box. She successfully completed a safety check of her home, case records show. \u201cThe grandmother Mrs. Riggs has been committed\u201d to the child \u201cand loves her very much,\u201d the county said in a report.</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            A crib, toys and other items in the room Stephanie Riggs prepared for her granddaughter\n    \n            (Courtesy of Stephanie Riggs)\n    \n    \n    \n\n    \n\n        \n    \n                    \n<p>But then \u201cDiane Baird turned everything upside down,\u201d Riggs said. \u201cI didn\u2019t see how she could be unbiased,\u201d Riggs said of Baird, because the foster parent intervenors were \u201cgiving her her paycheck.\u201d </p>\n\n<p>Baird told ProPublica that \u201cwho pays me is not a factor in any recommendation in any case.\u201d She also noted that she was found credible as an expert by the judge in this case.</p>\n\n<p>The foster father, when reached by phone, declined to comment, citing his family\u2019s desire for privacy and the fact that the case had been emotionally difficult for all parties.</p>\n\n<p>This past fall, with Baird\u2019s help, the foster parents were granted full custody of the baby girl through her 18th birthday. Some visits may still be allowed in the future, at least by video, but Riggs is unsure if her granddaughter will ever meet her aunts, uncles and cousins, or go to their family reunions, or know their family traditions. Only the crib remains, and it is empty.</p>\n        \n             \n\n                                    \n        \n                        <p><a href=\"https://www.propublica.org/people/mollie-simon\">Mollie Simon</a> contributed research.</p>", "summary_detail": {"type": "text/html", "language": null, "base": "https://www.propublica.org/feeds/propublica/main", "value": "<p class=\"byline\">\n                by <a class=\"name\" href=\"https://www.propublica.org/people/eli-hager\">Eli Hager</a>                </p>\n                                             \n\n                                                                    \n            \n                <p>ProPublica is a nonprofit newsroom that investigates abuses of power. <a href=\"https://www.propublica.org/newsletters/dispatches?source=54G&amp;placement=top-note&amp;region=local\">Sign up for Dispatches</a>, a newsletter that spotlights wrongdoing around the country, to receive our stories in your inbox every week.</p>\n\n            \n\n                \n\n      \n  \n\n\n\n                    \n<p>Diane Baird had spent four decades evaluating the relationships of poor families with their children. But last May, in a downtown Denver conference room, with lawyers surrounding her and a court reporter transcribing, she was the one under the microscope.</p>\n\n<p>Baird, a social worker and professional expert witness, has routinely advocated in juvenile court cases across Colorado that foster children be adopted by or remain in the custody of their foster parents rather than being reunified with their typically lower-income birth parents or other family members.</p>\n\n<p>In the conference room, Baird was questioned for nine hours by a lawyer representing a birth family in a case out of rural Huerfano County, according to a recently released transcript of the deposition obtained by ProPublica.</p>\n\n<p>Was Baird\u2019s method for evaluating these foster and birth families empirically tested? No, Baird answered: Her method is unpublished and unstandardized, and has remained \u201cpretty much unchanged\u201d since the 1980s. It doesn\u2019t have those \u201cstandard validity and reliability things,\u201d she admitted. \u201cIt\u2019s not a scientific instrument.\u201d</p>\n\n<p>Who hired and was paying her in the case that she was being deposed about? The foster parents, she answered. They wanted to adopt, she said, and had heard about her from other foster parents. </p>\n\n<p>Had she considered or was she even aware of the cultural background of the birth family and child whom she was recommending permanently separating? (The case involved a baby girl of multiracial heritage.) Baird answered that babies have \u201cnever possessed\u201d a cultural identity, and therefore are \u201cnot losing anything,\u201d at their age, by being adopted. Although when such children grow up, she acknowledged, they might say to their now-adoptive parents, \u201cOh, I didn\u2019t know we were related to the, you know, Pima tribe in northern California, or whatever the circumstances are.\u201d </p>\n\n<p>The Pima tribe is located in the Phoenix metropolitan area.</p>\n\n<p>It went on and on like this. Baird acknowledged that her entire basis for recommending that the foster parents keep the baby girl was a single less-than-two-hour observation and interview that she\u2019d conducted with them \u2014 her clients. She\u2019d never met the baby girl\u2019s biological grandmother, whom the county child services department had been actively planning for the girl to be placed with, according to internal department emails. Nor had she even read any case documents.</p>\n\n<p>A fundamental goal of foster care, under federal law, is for it to be temporary: to reunify children with their birth parents if it is safe to do so or, second best, to place them with other kin. Extensive social science research has found that <a href=\"https://publications.aap.org/pediatrics/article/146/6/e2020034629/33590/Pediatrician-Guidance-in-Supporting-Families-of\">kids who grow up with their own families experience less long-term separation trauma</a>, fewer mental health and behavioral problems as adolescents and more of an ultimate sense of belonging to their culture of origin.</p>\n\n<p>But a ProPublica investigation co-published with The New Yorker in October revealed that there is <a href=\"https://www.newyorker.com/magazine/2023/10/23/foster-family-biological-parents-adoption-intervenors\">a growing national trend of foster parents undermining </a><a href=\"https://www.newyorker.com/magazine/2023/10/23/foster-family-biological-parents-adoption-intervenors\">the foster system</a><a href=\"https://www.newyorker.com/magazine/2023/10/23/foster-family-biological-parents-adoption-intervenors\">\u2019s premise by \u201cintervening\u201d in family court cases as a way to adopt children</a>. As intervenors, they can file motions and call witnesses to argue that they\u2019ve become too attached to a child for the child to be reunited with their birth family, even if officials have identified a biological family member who is suitable for a safe placement.</p>\n\n<p>A key element of the intervenor strategy, ProPublica found, is hiring an attachment expert like Baird to argue that rupturing the child\u2019s current attachment with his or her foster parents could cause lifelong psychological damage \u2014 even though Baird admitted in her deposition that attachment is a nearly inevitable aspect of the foster care model. (Transitions of children back to their birth families are not just possible, they happen every day in the child welfare system.)</p>\n\n<p>As part of our reporting, we reviewed hundreds of pages of Baird\u2019s reports and testimony from cases over the past decade. We also interviewed more than two dozen attorneys, officials, caseworkers, experts and members of foster and birth families who\u2019ve worked with Baird or observed how she implements her methodology, which she has long called the \u201cKempe Protocol for Interactional Evaluation,\u201d after the Kempe Center at the University of Colorado, the nation\u2019s leading academic institute focused on child welfare. We found that \u2014 leaving aside the question of whether attachment theory should even be used as an argument in these cases \u2014 Baird\u2019s assessments of foster children\u2019s relationships aren\u2019t just unscientific. They barely touch the surface of a child\u2019s life.</p>\n\n<p>\u201cI don\u2019t know these children,\u201d she testified in one 2017 case, adding, \u201cI have not met anybody.\u201d Still, she said, she \u201cstrongly\u201d recommended that those children\u2019s birth parents\u2019 rights be permanently terminated and that the kids be adopted.</p>\n\n<p>Baird is so consistent in this view that she sometimes copies and pastes from her own past evaluations. In the Huerfano County case, she filed a report saying that the baby girl\u2019s life with her foster parents was \u201cpredictable, safe, and filled with love\u201d; that removing her from them and placing her with her biological grandma \u2014 with whom the girl had been having regular, joyful visits \u2014 would \u201cderail her healthy development and create lifelong risk\u201d; and that her \u201chealthy development and mental health will be best protected if her current caregiving environment does not change.\u201d </p>\n\n<p>That same month, Baird filed a report in a Weld County case saying that a baby boy\u2019s life with his foster parents was \u201cpredictable, safe, and filled with love\u201d; that removing him from them and placing him with his biological grandmother \u2014 who too was regularly visiting him with the support of the county child services department, but whom Baird had never met \u2014 would \u201cderail his healthy development and create lifelong risk\u201d; and that his \u201chealthy development and mental health will be best protected if his current caregiving environment does not change.\u201d</p>\n        \n    \n                    \n\n    \n            Documents Show Baird Repeated Language in Reports on Different Children\n                <p>Identical, or nearly identical, text in Diane Baird\u2019s reports in two separate cases is highlighted below. Corresponding colors show where text was repurposed. <em>Names and identifying details have been redacted.</em></p>\n\n    \n\n                        \n                    \n                \n\n    \n            (Anna Donlan/ProPublica)\n    \n    \n    \n\n    \n\n        \n    \n                    \n<p>Baird, in an interview with ProPublica, admitted that \u201cI do sometimes use the same verbiage in one report as I did in others.\u201d But, she added in an email, \u201cMy consistency is not a boiler-plate approach, but rather reflects developmental science which applies to all children.\u201d</p>\n\n<p>She emphasized, \u201cIn all cases I advocate for what I am convinced is the child\u2019s best interest.\u201d</p>\n\n<p>Baird also noted that in many cases she is hired by county officials, rather than directly by foster parents, although ProPublica\u2019s interviews and review of records show that this typically happens when officials are in agreement with the foster parents that they should get continuing or permanent custody.</p>\n\n<p>Baird, despite not being a child psychologist, achieves credibility with these officials \u2014 and with judges \u2014 in part via the impressive label that she uses for her methodology: the Kempe Protocol.</p>\n\n\u201cDon\u2019t Believe It Is Our Place to Get Involved\u201d\n<p>The University of Colorado\u2019s Kempe Center, widely considered the birthplace of the modern U.S. child welfare system, is where this all began.</p>\n\n<p>Baird developed the Kempe Protocol, alongside colleagues, while working at Kempe in the 1980s and \u201990s. She continually used the method both as an employee of the center and after entering private practice in 2017.</p>\n\n<p>Founded in the 1970s, the Kempe Center is best known for getting laws passed across the country requiring <a href=\"https://www.propublica.org/article/mandatory-reporting-strains-systems-punishes-poor-families\">\u201cmandated reporters\u201d</a> like teachers and police officers to call in any suspicion of child abuse or neglect to a state hotline \u2014 after which kids were to be removed from their families, into foster care, if there was evidence of maltreatment. \u201cNo organization,\u201d said Marty Guggenheim, the founder of the nation\u2019s indigent family defense movement, \u201cplayed a more direct role in shaping the modern system of surveillance, over-reporting, and under-emphasizing of the harms associated with state intervention.\u201d</p>\n\n<p>But in recent years, Kempe has taken a more critical look at its past, accepting some institutional responsibility for what it has called the <a href=\"https://www.truthtellingforjustice.org/kempe-center-truth-telling\">\u201cmyth of benevolence\u201d</a>: the idea that certain kids should be redistributed from their families to (often better-off) foster and adoptive parents. The center recently released a statement saying that it had participated in ignoring poverty by placing sole responsibility for poor children\u2019s health and well-being on their families\u2019 alleged maltreatment of them. The statement acknowledged the center\u2019s \u201ccomplicity\u201d in its \u201cgeneration-spanning impacts.\u201d</p>\n\n<p>The center even invited Dorothy Roberts, a law professor and sociologist at the University of Pennsylvania who is a leader of the movement to abolish the child welfare system because of its widespread surveillance and separation of Black families in particular, to be a keynote speaker at a recent conference.</p>\n\n<p>Yet when attorneys for poor birth families wrote to Kempe in late 2022 saying that Baird and experts she has trained \u201care doing real damage to families, and they are doing damage in the name of the Kempe Center,\u201d a University of Colorado lawyer responded by declining the advocates\u2019 request that the center \u201cpublicly disavow this protocol and correct the record.\u201d The reason, the lawyer said, was that the judge or jury on a particular case \u201cis in the best position to evaluate arguments raised by involved parties\u201d as to the scientific efficacy of the method. The lawyer added that the center has \u201cworked with hundreds of individuals in its 50-year history in the child welfare arena and we have little ability to control testimony of each individual.\u201d</p>\n\n<p>This response was far from satisfying to some of the Kempe Center\u2019s own faculty, according to interviews with people who work there and internal emails obtained through a Colorado Open Records Act request. \u201cWhen the Kempe Center was given the opportunity to do the right thing,\u201d wrote one pediatrics professor who has been at Kempe for more than a decade, \u201cit hid behind its legal counsel.\u201d</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            Alicia Johansen and Fred Thornton with their son Carter, at their home in Colorado. As ProPublica and The New Yorker reported, Baird spent years opposing this birth family\u2019s reunification. But Carter is now back home, bonding with his mom and dad and doing well at school.\n    \n            (Rachel Woolf for ProPublica)\n    \n    \n    \n\n    \n\n        \n    \n                    \n<p>After ProPublica published the article with The New Yorker documenting Baird\u2019s role in the trend of foster parents \u201cintervening\u201d in family court cases, faculty at Kempe started organizing a discussion around our reporting and sought an organizationwide reckoning with our findings. \u201cIt was a gut punch to read this,\u201d wrote another professor. \u201cThis is likely the most widely distributed reference to the Kempe Center that we\u2019ve seen in the past decade or more.\u201d The tragedy, the professor said, \u201cis that it diminishes all of the good work we have and continue to do for kids and families.\u201d (ProPublica is not naming the Kempe faculty and staff who wrote these emails because several asked not to be named, saying that they were fearful of retaliation by leadership or a negative effect on their academic standing.)</p>\n\n<p>Still another staffer wrote that past cases of hers similar to the one we wrote about \u201ccontinue to haunt me.\u201d</p>\n\n<p>More emails called Baird\u2019s method a \u201cbogus Kempe protocol\u201d and \u201cjunk science\u201d used \u201cto rip apart families.\u201d She is \u201cleveraging the Kempe name to bolster her opinion.\u201d </p>\n\n<p>Even amid this outcry, Dr. Kathryn Wells, the Kempe Center\u2019s executive director, gave a lawyerly explanation to her staff. \u201cYes,\u201d she wrote in an emailed response to them, \u201ca former employee of the Center has used an approach based on attachment theory and named it after the Center, even though there is no such protocol.\u201d The protocol, she said, was named after Baird\u2019s longtime place of employment \u2014 Kempe \u2014 but \u201cnot trademarked nor listed anywhere in the work that the Center provides.\u201d</p>\n\n<p>In a previous email, Wells, who has national influence on child welfare policy and practice, had explained her reasoning for not taking further action, such as sending Baird a cease-and-desist letter. \u201cIf the claims in court are not supported in the literature, that is not ours to get involved with as Diane is not an employee and it is a legal issue for the attorneys to battle in court,\u201d Wells wrote. She added, \u201cDon\u2019t believe it is our place to get involved.\u201d</p>\n\nWhat Is the Kempe Protocol?\n<p>One of Baird\u2019s first steps upon taking a new case, according to ProPublica\u2019s review of records and interviews that we conducted, including with Baird herself, is to meet with the foster parents. She observes the bond that they have with their foster child, which she generally compliments, and then talks to them about the child\u2019s birth family. She asks them about the circumstances of the child\u2019s birth and alleged neglect \u2014 neither of which foster parents likely would have been present for \u2014 and also about how visits with the birth parents or other relatives have been going.</p>\n\n<p>Drawing from the foster parents\u2019 version of events, Baird routinely reports to the county or testifies in court that visits with the birth family have been detrimental to the child, and, accordingly, she recommends that the foster parents keep the child indefinitely or permanently, on the basis of attachment theory. She has called just this amount of evaluation \u201cthe Kempe Protocol\u201d in several cases we reviewed.</p>\n\n<p>In some cases, though, Baird does observe a birth family visit. During these evaluations, she often asks the birth parents or family members a litany of personal questions that can be stressful to answer in a formal visitation setting, including, sometimes, ones about their marital history and why they\u2019re attracted to their significant other. All the while, she judges how they\u2019re interacting with their child, looking for \u201cthe little nuances\u201d of how babies communicate, she told me. She calls this, too, the Kempe Protocol.</p>\n\n<p>In Baird\u2019s reports and testimony summarizing her observations from such sessions, she has said, for instance, that a little boy and his birth father seeming to be happy around each other (they were playing catch and saying \u201cI love you!\u201d \u201cI love you more!\u201d; the boy \u201cexpressed no negative emotion during their time together\u201d) just showed that the dad was too rigidly setting the emotional tone of the relationship. </p>\n\n<p>She also regularly uses terms like \u201cmirror neurons,\u201d \u201cneurotoxins,\u201d \u201csynapses,\u201d \u201chormones,\u201d and \u201cencoded trauma in the central nervous system\u201d to justify her conclusions about children\u2019s family relationships. (Baird is not a neuroscientist.)</p>\n\n<p>In interviews and emails with ProPublica, Baird said that she is simply opposed, in almost all cases, to rupturing the current healthy attachment of any child under 3 with that child\u2019s foster parents, even if a birth family member is available and family and cultural heritage stand to be lost forever. She said that this is the age when kids are developing their capacity to form healthy relationships, and that they may experience being removed from their foster parents as a rejection, causing a loss of trust going forward. She also said that kids who have a history of caregiver changes and trauma, which is true of many little ones in foster care, need a sense of \u201cpermanency,\u201d often meaning adoption.</p>\n\nBaird\u2019s \u2014 and Kempe\u2019s \u2014 Legacy\n</p>\n        \n    \n                        \n\n    \n        \n\n                            \n                                                        \n                                                        \n                                \n\n            Baird in her office\n    \n            (Trent Davis Bailey for ProPublica)\n    \n    \n    \n\n            \n                    \n    \n                    \n<p>Baird says that she is likely retiring soon, in part as a result of the increasing scrutiny of her practices that she has been facing. In an email to ProPublica, she wrote, \u201cYou have been the catalyst for a good bit of self examination,\u201d adding, \u201cDeep soul searching has followed and your process has helped me as I have worked to be honest with myself.\u201d</p>\n\n<p>Yet Baird still shares thoughts and advice about ongoing cases with a coterie of mostly younger experts \u2014 what she called in her deposition a \u201cpeer supervision and support\u201d group.</p>\n\n<p>\u201cDo you think it\u2019s maybe advisable that others don\u2019t continue to use that protocol given its controversy and the lack of evidence?\u201d she was asked in the deposition.</p>\n\n<p>\u201cI\u2019ll leave that up to them,\u201d she answered.</p>\n\n<p>Several of these experts, according to their resumes, have trained at Kempe, or they have testified or told ProPublica that they\u2019ve learned directly from Baird either at Kempe or in their continuing practice.</p>\n\n<p>\u201cKempe is such a weighty voice that no judge is going to be like, \u2018Oh, Kempe is wrong,\u2019\u201d said Melissa Michaelis Thompson, executive director of the Office of Respondent Parents\u2019 Counsel, Colorado\u2019s public defender agency for indigent birth parents. Thompson said that her attorneys around the state keep seeing versions of the Kempe Protocol being used in their cases.</p>\n\n<p>Wells, the Kempe Center\u2019s executive director, told ProPublica in a statement earlier this month that the use of attachment theory and parent-child interactional assessments, the procedure that Baird conducts with birth families, \u201cin isolation\u201d and \u201cparticularly in non-therapeutic settings and without attention to bias,\u201d is \u201cnot consistent with current best practices and can be abused by experts.\u201d Wells added that Kempe does not itself currently provide such evaluations for court proceedings or endorse the methodology for that purpose. \u201cEquity is at the heart of our mission,\u201d she said.</p>\n\n<p>Even if the Kempe Center did fully disavow Baird and her cohort\u2019s use of this protocol and practices like it, there would be no clear recourse for all of the birth families who\u2019ve lost their children in the past because of Baird\u2019s work. Still, those families might better know the truth of what happened to them, many of them say.</p>\n\n<p>Stephanie Riggs, the biological grandmother in the Huerfano County case \u2014 \u201chuerfano,\u201d ironically, means \u201corphan\u201d in Spanish \u2014 had been doing everything she could to bring her granddaughter back from foster care. She was working nights to be able to travel to visit the baby girl during the day. She\u2019d dug into her limited budget to get a crib, a dresser and baby clothes, bookshelves and baby books, and a play carpet and a toy box. She successfully completed a safety check of her home, case records show. \u201cThe grandmother Mrs. Riggs has been committed\u201d to the child \u201cand loves her very much,\u201d the county said in a report.</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            A crib, toys and other items in the room Stephanie Riggs prepared for her granddaughter\n    \n            (Courtesy of Stephanie Riggs)\n    \n    \n    \n\n    \n\n        \n    \n                    \n<p>But then \u201cDiane Baird turned everything upside down,\u201d Riggs said. \u201cI didn\u2019t see how she could be unbiased,\u201d Riggs said of Baird, because the foster parent intervenors were \u201cgiving her her paycheck.\u201d </p>\n\n<p>Baird told ProPublica that \u201cwho pays me is not a factor in any recommendation in any case.\u201d She also noted that she was found credible as an expert by the judge in this case.</p>\n\n<p>The foster father, when reached by phone, declined to comment, citing his family\u2019s desire for privacy and the fact that the case had been emotionally difficult for all parties.</p>\n\n<p>This past fall, with Baird\u2019s help, the foster parents were granted full custody of the baby girl through her 18th birthday. Some visits may still be allowed in the future, at least by video, but Riggs is unsure if her granddaughter will ever meet her aunts, uncles and cousins, or go to their family reunions, or know their family traditions. Only the crib remains, and it is empty.</p>\n        \n             \n\n                                    \n        \n                        <p><a href=\"https://www.propublica.org/people/mollie-simon\">Mollie Simon</a> contributed research.</p>"}, "tags": [], "updated": "2024-03-18T05:00:00-04:00", "updated_parsed": [2024, 3, 18, 9, 0, 0, 0, 78, 0], "authors": [{"name": "by Eli Hager"}], "author": "by Eli Hager", "author_detail": {"name": "by Eli Hager"}}, {"title": "\u201cIt Feels Impossible to Stay\u201d: The U.S. Needs Wildland Firefighters More Than Ever, but the Federal Government Is Losing Them", "title_detail": {"type": "text/plain", "language": null, "base": "https://www.propublica.org/feeds/propublica/main", "value": "\u201cIt Feels Impossible to Stay\u201d: The U.S. Needs Wildland Firefighters More Than Ever, but the Federal Government Is Losing Them"}, "links": [{"rel": "alternate", "type": "text/html", "href": "https://www.propublica.org/article/wildland-firefighters"}], "link": "https://www.propublica.org/article/wildland-firefighters", "published": "Sat, 16 Mar 2024 05:00:00 -0400", "published_parsed": [2024, 3, 16, 9, 0, 0, 5, 76, 0], "id": "https://www.propublica.org/article/wildland-firefighters", "guidislink": false, "summary": "<p class=\"byline\">\n                by <span class=\"name\">Abe Streep</span> for <a href=\"https://www.propublica.org\">ProPublica</a>, illustrations by <span class=\"name\">Hokyoung Kim</span>, special to <a href=\"https://www.propublica.org\">ProPublica</a>                </p>\n                                             \n\n                                                                    \n            \n                <p>ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive <a href=\"https://www.propublica.org/newsletters/the-big-story?source=54G&amp;placement=top-note&amp;region=national\">our biggest stories</a> as soon as they\u2019re published.</p>\n\n            \n\n                \n\n\n\n        \n                        <p>Join us March 26 to <a href=\"https://www.propublica.org/events/the-big-burnout-wildland-firefighters-and-the-west?utm_source=website&amp;utm_medium=story&amp;utm_campaign=storypage\">discuss the exodus of wildland firefighters</a>.</p>\n\n        \n\n    \n      \n  \n\n\n\n                    \n<p>Black Butte is an inactive volcano that rises from the high desert in eastern Oregon. In May 2022, a turboprop plane approached its pine-blanketed slopes, carrying about 10 men wearing bulky Kevlar outfits. They were smokejumpers with the United States Forest Service, the agency that directs the majority of the nation\u2019s efforts to manage wildfires. Within the vast and hierarchical fire service, smokejumpers occupy a singular niche, parachuting into remote areas to fight early-stage wildfires. There are only about 450 nationwide, and the physical requirements are rigorous.</p>\n\n<p>One of the smokejumpers on board was Ben Elkind. Thirty-seven years old with a long, athletic build and restless energy, he had been fighting wildfires for 14 years and jumping for the last eight of them. Despite his elite status, Elkind earned about $43,000 in 2021 over the course of the seven-month fire season. His base paycheck, though, was less than half of that. Like most wildland firefighters, he relied on overtime and hazard pay, which can be accumulated on two- or three-week shifts away from home. Many firefighters exceed 1,000 hours of overtime in a season. Elkind chose to be with his wife and two young children more that year and worked a relatively modest 700 hours of overtime, the equivalent of 17 additional weeks.</p>\n\n<p>Still, the beginning of the season usually rekindled the parts of the job that Elkind loved \u2014 especially the adrenalized clarity that arrived when his crew\u2019s spotter tapped him on the back, indicating that it was time to jump. In recent years, the Forest Service has switched from round parachutes to rectangular ones, which allow for greater maneuverability. During training exercises that spring, Elkind was still getting accustomed to the new chute. After he slid out of the plane\u2019s open door, a tailwind picked up. He did not descend quickly enough to the landing zone, sailing slightly past it. He saw ponderosa pines rushing toward him and tried to slow his chute. Its canopy collapsed, and he free fell. When he landed, his left leg crashed through his pelvis. Colleagues rushed to him, cutting his suit away. An ambulance sped him to a hospital, where doctors would eventually insert three plates and 12 screws into his hip. He was sent home on painkillers.</p>\n\n<p>Doctors told him he would be on crutches for at least two months, possibly three. When I spoke with Elkind soon after the injury, he said, \u201cI got a lot of pills going, but it\u2019s all right.\u201d Then his tone shifted. \u201cI need to \u2014 I would like to \u2014 get back jumping,\u201d he said. \u201cThat would mean I\u2019ve recovered, but I also know that you don\u2019t always recover from these things.\u201d</p>\n\n<p>He had more immediate worries, though. He could file for workers\u2019 compensation benefits through the Department of Labor, but wildland firefighters have historically struggled to receive those, since federal caseworkers are often unfamiliar with the job\u2019s geographically diffuse nature. (A firefighter based in Idaho might get injured in Arizona, adding a layer of complexity to an already burdensome and bureaucratic process.) A recent survey found that nearly half of Forest Service employees who had suffered an on-the-job injury chose not to report it, assuming that they would receive little or no help. Even if Elkind recovered quickly enough to do office work, he would not be eligible for hazard pay or likely earn overtime, meaning he\u2019d be making around $20,000. His wife, Amber, a physician\u2019s assistant, would be contributing most of the family\u2019s income. \u201cIt\u2019s not a great situation,\u201d Elkind told me. \u201cMy base check doesn\u2019t cover rent alone.\u201d</p>\n\n<p>Knowing that the government couldn\u2019t offer a swift remedy, his colleagues started a GoFundMe campaign, which quickly raised $50,000. Elkind called it a lifesaver. It was, he said, what wildland fighters did when a colleague was seriously injured. It was, he told me, \u201cstandard operating procedure.\u201d</p>\n\n\n<p>For communities throughout the American West, wildland firefighters represent the last line of defense, but that line is fraying because the government decided long ago that they\u2019re not worth very much. The highly trained men and women protecting communities from immolation earn the same base pay as a fast-food server while taking severe risks with their physical and mental health. Despite the mounting public concern over the increasing severity of wildfires, the federal government has not seen fit to meaningfully address these issues. The effects of this chronic neglect have now become strikingly clear as the fire service is finding it difficult to fill its ranks, prefiguring what advocates are calling a national security crisis.</p>\n\n<p>Fighting wildfires has always been a dangerous occupation, but in the last decade it has become staggering in its demands. Accelerating climate change, coupled with a century of suppression of wildfire, has created <a href=\"https://projects.propublica.org/california-fire-weather/\">thick stands of trees primed to burn across much of the American West</a>. In certain parts of the country, <a href=\"https://www.propublica.org/article/the-southwests-drought-and-fires-are-a-window-to-our-climate-change-future\">fire seasons that once lasted a few months now span much of the year</a>. In 1993, the federal government fought wildfires on 1,797,574 acres; by 2021, that figure had more than quadrupled. Each spring brings a game of geographic roulette. In 2017, Montana set a state record for wildfires. The next year, California followed suit, with nearly 2 million burned acres, a figure that stood briefly before it was topped twice in the next three years. Experts have been forced to coin a new term for fires exceeding 1 million acres: gigafire.</p>\n        \n    \n                    \n<p>In many places, wildfire is an essential part of the ecosystem: It clears out dead underbrush and aging foliage, spreads new seeds and enables biodiversity. Extinguishing it, as federal and state governments have done for 100 years, just creates a larger and more dangerous fuel load. Great swaths of the country are now in what scientists call a fire deficit \u2014 they haven\u2019t burned for a long time, and they need to, or fires will only get bigger and more destructive. The only way out of such a deficit is to let a wildfire go or to manage it by setting a prescribed burn to reduce the amount of fuel. But in drought-stressed and densely populous places, that is difficult. In 2022 in New Mexico, two prescribed burns got out of control, merged and scorched an area larger than Los Angeles. It can be all but impossible to suppress a megafire, but the government must try, unless it wishes to write off, say, Mora, New Mexico, or Malibu, California. There is no technology up to the task; most of the work is still done by unseen, underpaid people with chainsaws and hand tools.</p>\n\n<p>But at exactly the time when the country needs wildland firefighters more than ever, the federal government is losing them. In the past three years, according to the Forest Service\u2019s own assessments, it has suffered an attrition rate of 45% among its permanent employees. Many people inside and outside the fire service believe this represents one of the worst crises in its history. Last spring, as the 2023 fire season was getting started, I asked Grant Beebe, a former smokejumper who now heads the Bureau of Land Management\u2019s fire program, if there had been an exodus of wildland firefighters. He initially hesitated. \u201c\u2018Exodus\u2019 is a pretty strong word,\u201d he said. But then he reconsidered. \u201cI\u2019ll say yeah. Yeah.\u201d</p>\n\n<p>\u201cThe ship is sinking,\u201d Abel Martinez, a Forest Service engine captain in California and the national fire chair for the National Federation of Federal Employees, the union that represents wildland firefighters, told me. (For this story, almost every wildland firefighter who agreed to use their full name has an official role with the union; the one firefighter identified by their middle name does not.)</p>\n\n<p>Although nobody could provide precise numbers, leaders like Beebe are especially concerned that the attrition has been particularly acute among those with extensive experience \u2014 those like Elkind. It takes years and hundreds of thousands of dollars to train a wildland firefighter capable of overseeing the numerous resources \u2014 engines, helicopters, smokejumpers \u2014 that are deployed on large fires. As Beebe put it, \u201cYou can\u2019t just hire some person off the street into one of our higher-level management jobs.\u201d</p>\n\n<p>The reasons for the exodus are many, but fundamentally it reflects an inattentive bureaucracy and a culture that suppresses internal criticism. Only in 2022 did the fire service acknowledge an explicit link between cancer and wildland firefighters, even though officials have long expressed concern about the connection. And it was only last year that the fire service held its first conference on mental health, even though officials have been aware for decades of the high incidence of substance abuse and divorce among wildland firefighters.</p>\n\n<p>But more than anything, wildland firefighters are leaving because they\u2019re compensated so poorly, the result of a byzantine civil service structure that makes it extremely hard to sustain a career. The federal fire service is responsible for managing blazes on nearly 730 million acres of land \u2014 an area almost the size of India. Among the five agencies, one dominates in terms of influence and size: the Forest Service, which employs more than 11,000 wildland firefighters, most of whom work from roughly April to October. The hiring system dates to the early years of the agency, when it often recruited from bars and relied on volunteers to suppress wildfires by 10 a.m.</p>\n\n<p>About one third of the workforce is temporary \u2014 firefighters who are automatically laid off at the end of each season. Even those who are permanent receive compensation starting at $15 per hour until they accumulate overtime and hazard pay. Because of the way the government classifies their work, it\u2019s extremely difficult for wildland firefighters to increase their base salaries unless they frequently move around the country. Altogether, it\u2019s a pay structure that incentivizes risk taking and a nomadic existence.</p>\n\n<p>For more than a century, the Forest Service was able to call on a ready workforce, one made up largely of rural men. (It is estimated that 84% of wildland firefighters are male.) Because of the reliable flow of applicants, the agency did not need to advocate for increased pay. But the changing nature of fire seasons, combined with the skyrocketing cost of living in the mountain West, has made firefighting less alluring than it once was.</p>\n\n<p>A Forest Service spokesperson wrote that since 2021 the agency has acknowledged the attrition among its workforce: \u201cIt is why agency and department leadership have been doing everything possible in coordination with the administration and Congress to provide a permanent, competitive increase in wildland firefighter pay, as well as staffing capacity and mental health programs.\u201d The spokesperson pointed to a raise \u2014 from $13 to $15 an hour \u2014 created by the Biden administration in 2021. The spokesperson also wrote, \"With the increasing duration and intensity of wildfires the agency understands the need to do much more.\u201d</p>\n\n<p>Last fall, the Forest Service processed its applicants for 2024. An official who has been involved in hiring for the agency for more than a decade characterized the returns as \u201cabysmal\u201d \u2014 \u201cIt\u2019s the smallest list I\u2019ve ever seen,\u201d he told me. A severe dearth of applicants for temporary seasonal jobs \u2014 the entry point for the next generation of wildland firefighters \u2014 forced the agency to extend its hiring period. For permanent positions, the returns were not much better.</p>\n\n\n<p>Talk to enough wildland firefighters, and you\u2019ll eventually hear about freedom. Not liberty, necessarily, but the thrill of a job that requires walking around woods with a chainsaw. Hannah Coolidge joined the Forest Service when she was 25, eventually becoming a hotshot, part of an elect crew that tromps far into forests to cut breaks around the largest wildfires to rob them of fuel. For a decade, Coolidge never attended a wedding or a funeral during fire season, but she loved the life \u2014 living outside, working with a tight-knit group, having winters for herself, being in phenomenal shape. (Researchers at the University of Montana have found that, during fire season, hotshots can expend about as much energy as cyclists in the Tour de France.) Taylor Hess also came for the time off but found that a Montana fire crew brought communal purpose, something that had been missing in the Midwestern town where she was raised. She liked huddling with colleagues at the end of the day, frying Spam over a wildfire\u2019s dying embers and pouring an electrolyte mix on top. \u201cIt\u2019s kind of gross,\u201d she said, but she cherished those moments: \u201cWe get so close.\u201d</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n    \n\n        \n    \n                    \n<p>A lot of the job is grueling and dirty: mopping up the end of a wildfire in a sea of ash; constructing line around piles of downed limbs in advance of lighting a prescribed burn; unrolling a sleeping pad in the woods or an ad-hoc camp, then awakening to the boot of a superintendent or water from the sprinklers on a high school football field. It\u2019s slow until it\u2019s not. Then it becomes vertiginous and hallucinatory. \u201cIt is a landscape of extremes,\u201d Eric Franta, a wildland firefighter based in Oregon, told me. During Bobbie Scopa\u2019s first fire, she was walking on a hill above a burning canyon when a chief bellowed for her to cover her head. An air tanker dropped chemical retardant, a great red squall that shook the ground. \u201cI thought, \u2018This is the coolest fucking job!\u2019\u201d she said. </p>\n\n<p>In many communities, it\u2019s also the best available employment option. Jake Kennedy, now an engine driver in California, was recruited by a former wrestling coach in a tiny Oregon town where the Forest Service was one of two reliable employers. Morgan Thomsen grew up in a remote part of Idaho where his parents were fire lookouts, so he was raised thinking that fighting fire was a good way to earn a living. Kristina \u2014 her middle name \u2014 enlisted in part to honor her family. Her grandfather had been a smokejumper, and her parents had both worked as wildland firefighters. \u201cWe have this loyalty in my family to the Forest Service,\u201d she said.</p>\n\n<p>Among his peers, Elkind is seen as fortunate. He didn\u2019t join the Forest Service to escape rural poverty \u2014 he has a bachelor\u2019s degree in economics from Lewis &amp; Clark College \u2014 but rather to seek adventure. He was also a smokejumper, with the status that the job entails. (A fire service joke goes like this: A group of wildland firefighters walk into a bar. How do you know which is the smokejumper? They\u2019ll tell you.) Still, Elkind, like so many of the firefighters I talked to, seemed almost trapped by the freedom he had once sought. \u201cI like my job,\u201d he said. \u201cIt\u2019s just hard to see the effects when you\u2019re starting out a career.\u201d</p>\n        \n    \n                            \n    \n                    \n<p>Those effects weren\u2019t just his busted pelvis. It was being away from his family for long stretches. (\u201cIt\u2019s a Catch-22,\u201d a firefighter told me. \u201cFor us to be able to provide for our families, it requires us to basically detach from our families.\u201d) And it was how difficult the Forest Service made it for someone to rise and earn a decent living. To earn a promotion and reach higher pay grades, firefighters usually have to move among the agency\u2019s nine regions or earn a master\u2019s degree in forestry and leave the fire line.  </p>\n\n<p>Elkind didn\u2019t want to do either of those things. He\u2019d grown up in Oregon, and his family was rooted there. In early 2022, he and Amber moved to Redmond, a town of 35,000 in the central part of the state, where the Forest Service has one of its seven smokejumper bases. Compared with nearby Bend \u2014 a bacchanalia of Gore-Tex and microbreweries where the median home price hovers above $700,000 \u2014 Redmond is middle class. But, as Elkind told me, \u201cThis place is blowing up.\u201d</p>\n\n<p>Redmond, like many towns where wildland firefighters live, has experienced an influx of remote workers since the onset of COVID-19, which has driven up housing costs. The rent on the Elkinds\u2019 modest house is $2,300. Even before his accident, he was nervous about making ends meet. In November 2021, the government offered some relief when Congress passed the Bipartisan Infrastructure Law, which created a temporary pay raise for wildland firefighters of either $20,000 or 50% of their regular check.</p>\n\n<p>When I visited Elkind at his home, toys were scattered across the floor, an elk mount lay on a couch and bills were piled on the dining room table. He wore shorts and a tank top, and his hair was long. Save for the flecks of gray in his beard, he looked boyish. Three months after his accident, he still walked with a limp and needed a cane but was able to drive his kids to school. He had considered filing for worker\u2019s compensation but decided against it, because it was hard to reach his caseworker and because the Forest Service offered him an office job, which allowed him to benefit from the temporary pay raise.</p>\n\n<p>Until the move, Elkind had been living a split existence, with his family in Portland and his job in Redmond, where he camped out on a colleague\u2019s property during fire season. In the summer of 2020, lightning started a fire on the Warm Springs Reservation in Oregon. It soon spread onto land managed by the Forest Service, and Elkind was dispatched. Upon arriving at a fire camp, he was alarmed by a lack of veteran firefighters. \u201cIt was like a ghost town,\u201d he said. He found himself training people from municipal departments who had been hired on temporary contracts to fill vacancies. Over Labor Day weekend, wind carried embers for miles, causing the fire, which became known as the Lionshead, to jump and merge with others. The blazes burned more than 400,000 acres, killing at least five people.</p>\n\n<p>At the same time, his mother\u2019s home near Hagg Lake was under evacuation orders brought on by another fire. Amber was in Portland with the couple\u2019s 2-year-old son, in a house without air conditioning. She was also pregnant. Elkind told her to duct-tape paper towels over a box fan to create a makeshift air filter as smoke from the fires suffused the city. \u201cI think I had a little bit of a mental breakdown,\u201d he told me. \u201cHomes are burning down. People are dying.\u201d Entire forests in western Oregon were disappearing. He couldn\u2019t stop what was happening to the only place he\u2019d ever called his own.</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n    \n\n        \n    \n                    \n<p>The decision to relocate to Redmond was so Elkind would not be away from his family throughout fire season. Still, he worried about the choice. Amber had been able to find work with a clinic in Redmond. But for him to reach a higher hourly wage would likely require the family to move again. \u201cWhat\u2019s she supposed to do? Quit her career every year and a half so I can get a dollar-fifty an hour raise?\u201d he asked.</p>\n\n<p>During our discussions, Elkind often edited his sentences so as to not sound as though he was blaming the Forest Service, even though as a union representative he had protection. His affection for his work became a refrain that he repeated to the point of awkwardness: \u201cI like my job. It\u2019s just difficult to justify it with a family.\u201d \u201cI do love my job, but that doesn\u2019t mean that I think it\u2019s worth it for a young person.\u201d \u201cI would almost do it for free,\u201d he <a href=\"https://www.oregonlive.com/opinion/2021/04/opinion-more-fires-less-staffing-and-low-pay-are-taking-a-steep-toll-on-wildland-firefighters.html\">wrote</a> in an op-ed that appeared in The Oregonian in 2021 that was critical of the Forest Service\u2019s refusal \u201cto rise to the challenge of climate change and the growing demand that increased fires, short-staffing and low pay presents for our workforce.\u201d</p>\n\n<p>That rhetorical hesitancy was a reflection of Elkind\u2019s torn feelings, but it was also an acknowledgment of something else: The Forest Service is known to function as a company town in rural America, deterring discussions that could result in negative attention. When I spoke with Jaelith Hall-Rivera, the Forest Service deputy chief for state, private and tribal forestry, she acknowledged that the agency has a reputation for discouraging employees from speaking out. \u201cWe have tried for a long time to change that culture,\u201d she said. \u201cEspecially in fire, you have to be able to speak up when something doesn\u2019t feel right to you.\u201d</p>\n\n<p>The National Federation of Federal Employees says it does not track instances of workplace intimidation or retaliation among wildland firefighters, so it\u2019s impossible to ascertain how often this occurs. But fear of reprisal was a common thread in many of my conversations. At a gathering of wildland firefighters and agency supervisors that I attended last spring, a member of a Forest Service rappel crew approached me eager to discuss the changes she wanted to see in the agency \u2014 especially the need for more women in leadership positions. An older colleague quickly pulled her aside; when she returned, she asked if she could see the article before it was published. When I asked if a superior had told her not to speak to me, she said, \u201cI don\u2019t feel comfortable answering that.\u201d </p>\n\n\n<p>Every year, returning federal wildland firefighters take a refresher course covering safety practices. Firefighters get to choose from a number of videos. One, titled <a href=\"https://www.youtube.com/watch?v=hD8OD2l09ds\">\u201cSmoke: Knowing The Risks,\u201d</a> is led by George Broyles, a former wildland firefighter and public information officer. From 2008 to 2014, he spearheaded the Forest Service\u2019s research into the physiological impacts of wildfire smoke. \u201cExposure to carbon monoxide and some of these other chemicals is going to impact the way we think,\u201d Broyles says in the video, which emphasizes wildfire smoke\u2019s effect on performance and decision-making. But when it comes to the long-term health effects of working in smoke, the video is circumspect. \u201cThat\u2019s an issue that\u2019s still understudied,\u201d Broyles says. The video, which was produced in 2018, never mentions the possibility of cancer, nor does a more recent preparedness guide for new recruits.  </p>\n\n<p>It is now widely accepted that all firefighters \u2014 structure as well as wildland \u2014 are far more susceptible to cancer than the rest of society. In 2022, the International Agency for Research on Cancer <a href=\"https://www.iarc.who.int/news-events/iarc-monographs-evaluate-the-carcinogenicity-of-occupational-exposure-as-a-firefighter/\">declared</a> that the job is carcinogenic to humans. But still the Forest Service and the other federal agencies that employ wildland firefighters have been slow to acknowledge the obvious. Part of the problem is a lack of epidemiological research into the distinct risks that wildland firefighters face. Dr. Jeff Burgess, the director of the Center for Firefighter Health Collaborative Research at the University of Arizona Mel and Enid Zuckerman College of Public Health, is working to fill that void by conducting long-term epidemiological studies on wildland firefighters. \u201cWe just don\u2019t have the same degree of information on cancer risk in wildland firefighting that we do in structure firefighting,\u201d he said.</p>\n\n<p>Last February, I attended an event at the University of Miami called the International Firefighter Cancer Symposium, which brought together firefighters from as far away as Australia and researchers from institutions like the American Cancer Society and the University of Toronto\u2019s Dalla Lana School of Public Health. It was a gathering for those who study cancer and those who develop it while fighting fires. Many of the researchers were looking into the dangers of per- and polyfluoroalkyl substances, or PFAS, commonly known as \u201cforever chemicals.\u201d Synthetic compounds, PFAS are ubiquitous in municipal fire- and water-resistant gear and have long been used in firefighting foam. (The Forest Service says it does not know whether its protective gear for wildland firefighters contains PFAS but that it has sent samples to the National Institute for Occupational Safety and Health for testing.)  </p>\n\n<p>The conference\u2019s emphasis on PFAS reflected a huge gap in research. Structure firefighters encounter smoke that is often more toxic than wildfire smoke, but they also use powerful respirators. Wildland firefighters eschew respirators since most are bulky and can be operated for only about 30 minutes at a time. Of the numerous studies presented, only one explicitly focused on wildland firefighters. In that project, which hasn\u2019t yet been published by a peer-reviewed journal, researchers from the University of Miami examined exposure to polycyclic aromatic hydrocarbons, or PAHs, produced during prescribed burning. They found that wildland firefighters had elevated exposures to the compounds, which have been associated in the general population with lung and bladder cancer and cardiovascular dysfunction.</p>\n\n<p>That smoke contains such material is not news to the Forest Service. In 1989, the agency convened its first gathering to discuss the physical effects of smoke and allotted some money for research. Attendees recommended that the agency conduct an epidemiological cohort study to examine long-term health risks. Funding for the study was never appropriated, though. </p>\n\n<p>Eleven years later, researchers employed by the Forest Service published a paper that found that smoke from prescribed burns contained elevated levels of carbon monoxide and particulate matter, including benzene and formaldehyde, both of which are carcinogenic. It noted that, during high winds, the levels were up to three times above what workplace safety organizations recommend. Despite this, it concluded that \u201cthe adverse health effects of smoke exposure at prescribed fires seem to be manageable.\u201d</p>\n\n<p>At a summit in 1997, researchers again suggested that the Forest Service undertake a cohort study to look at the effect of wildfire smoke among the workforce, using markers like blood and urine samples. It, too, was never done. </p>\n\n<p>Starting in 2008, Broyles, with the support of the Forest Service, traveled the country and to test fire crews\u2019 smoke exposures. It wasn\u2019t an epidemiological study, but it led to a 2019 peer-reviewed paper that modeled wildland firefighter cancer rates based on what is understood about smoke\u2019s impact on the general population. It projected that wildland firefighters\u2019 incidences of lung cancer would be elevated by between 8% and 43%.</p>\n\n<p>The <a href=\"https://www.fs.usda.gov/pnw/pubs/journals/pnw_2019_navarro001.pdf\">study</a> was posted on the agency\u2019s website, but, according to Broyles, its findings have led to little change. He said he was brushed off when he proposed an updated version of the smoke video to address the risk of cancer.  (When asked about Broyles\u2019 assertion, an agency spokesperson wrote, \u201cThe Forest Service is deeply committed to not only understanding occupational risks to employees but mitigating these risks.\u201d They added, \u201cRecruitment materials for wildland fire positions often describe the job as difficult and dangerous.\u201d)</p>\n\n<p>In 2022, the National Wildfire Coordinating Group, which is made up of leaders from the five federal agencies that oversee wildland firefighting, released a new preparedness guide for recruits that made no mention of cancer. \u201cIt confounds me,\u201d Broyles told me. \u201cQuite frankly, it breaks my heart.\u201d As of last year, his 2018 smoke video was still being shown to federal firefighters. (When asked why the materials did not refer to cancer, the Forest Service and the Department of the Interior said they were developed before the agencies were provided legal language recognizing a link between the disease and wildland firefighting.)</p>\n\n<p>The firefighters union and an advocacy group called Grassroots Wildland Firefighters used the 2019 paper to lobby the Department of Labor, and in April 2022, the department announced that it would recognize numerous cancers, including lung, testicular and thyroid, as an occupational hazard. (Notably, cancers distinctive to women, such as ovarian, were excluded.) Eight months later, Congress passed a law that called cancer a presumptive sickness for federal firefighters and mandated that the five agencies that make up the fire service file a report on illnesses, including cancer, in the profession. \u201cWe\u2019re just starting that,\u201d said Hall-Rivera, the Forest Service deputy chief.</p>\n\n<p>Some advocates have expressed hope that a deeper understanding of wildland firefighter cancer rates might evolve after the launch of the National Firefighter Registry for Cancer, a voluntary database managed by the National Institute for Occupational Safety and Health. Congress allocated funding for the registry in 2018, but it went online only last spring. According to current and former employees of the Centers for Disease Control and Prevention, NIOSH\u2019s information technology department caused unnecessary delay. \u201cFrom my perspective this is gross mismanagement,\u201d said one person with direct knowledge of the project. Another official supported that assessment. (In a statement, a NIOSH spokesperson wrote that since 2021, the agency \u201chas designed, built, tested, and deployed a robust enrollment system that incorporates industry best practices for information security and sensitive data management.\u201d)</p>\n\n<p>Immediately after the registry launched, Elkind decided to enter his name. When he arrived at the hospital after his training accident, he underwent a full-body CT scan, which revealed a mass in his thyroid. It proved to be cancerous. He had no family history of thyroid cancer, so he assumes his illness came from smoke inhalation, but he\u2019ll never know. \u201cNot everybody\u2019s as lucky as me to break their pelvis at work and get scanned at the hospital,\u201d he said with deadpan sarcasm. The next time we spoke, three months after the accident, he said, \u201cI\u2019m not upset at the Forest Service. I\u2019m just like \u2014 I\u2019ve never heard them say, \u2018Hey, this smoke is cancerous.\u2019\u201d</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n    \n\n        \n    \n                    \n\n<p>In the fall of 2020, after Oregon\u2019s fire season ended, Elkind went for a run in Portland\u2019s Peninsula Park. He had recently been laid off for the winter. For many wildland firefighters, this period of sudden transition is brutal: When you\u2019ve been operating on intensity for six months, taking out the trash and folding laundry can feel empty. In the past, Elkind had managed the annual pivot by doing construction work and house projects or by traveling with friends. But he was still experiencing the acute pressure he\u2019d felt since the peak of fire season when so much of Oregon burned. Amber had just given birth to the couple\u2019s second son, and he wasn\u2019t sure how to responsibly move forward in his career. \u201cI was so stressed out,\u201d he told me.</p>\n\n<p>Elkind thought he\u2019d try to contact a therapist \u2014 something he\u2019d never done. During his run, he called the Employee Assistance Program, a service set up by the federal government that provides workers from any agency as many as six sessions per condition with a mental health professional. Elkind hoped to arrange an appointment in person but was informed that the session was only available right then on the phone. That wasn\u2019t the worst of it: When he shared his employment information, he was told that he would not be eligible to receive help until he returned to work during the next fire season. \u201cI was like, \u2018Maybe I\u2019ll drink a few more beers and forget about this,\u2019\u201d Elkind said.  </p>\n\n<p>The Forest Service revised its EAP policy a year later and now offers consultations to firefighters for up to six months after their layoff. (\u201cThe agency has been proactive in addressing known challenges with past EAP services,\u201d wrote a spokesperson.) However, because the EAP serves a vast federal bureaucracy, multiple wildland firefighters told me that they did not trust its counselors; the people on the other end of the phone, they said, knew little about what their job entailed.</p>\n\n<p>The fire service does offer wildland firefighters access to a crisis intervention program after the death of a colleague, say, but it provides little aid for those facing the daily burdens of the job \u2014 and those can be extreme: Trees falling next to where you\u2019re standing. Helicopters flying in to remove the injured. Mopping up for days, surrounded by smoke. Many wildland firefighters, who operate in a culture that prides itself on stoicism, respond to those pressures in ways that aren\u2019t surprising. Some chase more adrenaline: kayaking, skiing, mountain biking. \u201cThere\u2019s a lot of dealing with it through drinking and drugs \u2014 at best,\u201d Hannah Coolidge, the Washington hotshot, said. In January, researchers with NIOSH and the CDC released a <a href=\"https://academic.oup.com/annweh/article/68/2/122/7504841?rss=1\">peer-reviewed study</a> that confirmed what Coolidge and others told me. It found that among six federal wildland crews, 78% of the firefighters reported binge drinking. </p>\n\n<p>\u201cWe\u2019re so unhealthy in such a ubiquitous way that it\u2019s almost hard to pinpoint,\u201d a Forest Service firefighter in Oregon said. He had returned home from combatting a fire to find his house burned to the ground. Since then, he had endured symptoms consistent with post-traumatic stress disorder. A firefighter in Wyoming who recently left the service told me that, like many of his colleagues, he couldn\u2019t maintain a relationship: \u201cI wouldn\u2019t date me either. I\u2019m not emotionally available. I\u2019m gone.\u201d A recent survey of the spouses of wildland firefighters found that almost half had considered leaving their relationships because of the job.</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n    \n\n        \n    \n                    \n<p>\u201cWildland firefighting is similar to other high-risk occupations and also similar to the Western American culture around how to manage difficulty,\u201d psychologist Patricia O\u2019Brien, a former hotshot who now oversees the Bureau of Land Management\u2019s mental health program, told me. \u201cThere\u2019s been a tradition of not talking about it, of keeping your personal life boxed up and separate and prioritizing work. And a sense that, as long as you\u2019re able to show up and work, you keep your personal problems at home. We know that people may be able to do that for a period of time, but it\u2019s not sustainable, and it\u2019s harmful to people.\u201d</p>\n\n<p>In 2018, O\u2019Brien, who at the time was a doctoral student, conducted a survey of 2,600 wildland firefighters, finding that one-fifth had experienced suicidal thoughts, while nearly 14% of respondents screened positive for probable PTSD \u2014 a rate about four times that found in the general population. Six years later, that data remains the most reliable on the mental health of wildland firefighters.</p>\n\n<p>The Forest Service has responded to the mental health struggles of its workforce much the way it has responded to cancer: For years, officials have raised concerns about the issue, and for years, the agency has either ignored or minimized them. In a statement, the agency acknowledged it \u201chas not conducted or funded a study into the mental-health effects of wildland firefighting.\u201d Tom Harbour, a former national director of fire and aviation management at the Forest Service, told me that the agency began discussing the pressures on its workforce in the 1990s. \u201cWe started asking ourselves about the cost of the system we had built,\u201d he said, referring to the agency\u2019s emphasis on overtime and hazard pay. \u201cDivorces, heavy drinking \u2014 those were just things that were kind of a byproduct of the system.\u201d He added, \u201cWhy in the world should it take 30 years to make some of these changes?\u201d</p>\n\n<p>\u201cThat\u2019s a fair question,\u201d the Forest Service\u2019s Hall-Rivera said. \u201cWe did have to build our awareness. It is hard to get people to talk about it, and we had to shift our focus and start asking for resources, start investing resources.\u201d </p>\n\n<p>In 2021, the Bipartisan Infrastructure Law allotted $20 million to the agencies overseeing the fire service to establish year-round mental health programs. The Bureau of Land Management had already been taking steps in that direction; five years ago, it launched a pilot program offering pre- and postseason mental health trainings for firefighters to help them transition in and out of the season. </p>\n\n<p>But the Forest Service has lagged behind. Last year, for the first time, the agency announced a wildland firefighter mental health support program; with $1.5 million allotted over two years, it\u2019s still in the planning stage. (The Forest Service\u2019s budget for the fiscal year was $10 billion.) Individual districts have begun contracting at least one mental health provider, Dani Shedden, a former wildland firefighter who in 2022 quit to start a counseling business. Shedden told me that much of her work with the Forest Service is focused on post-season sessions, in which she shows firefighters how to use the EAP and find what she called \u201cculturally competent clinicians\u201d in rural areas. Shedden has conducted 10 such sessions.</p>\n\n<p>Last April, many of the fire service\u2019s leaders \u2014 including Hall-Rivera and Beebe \u2014 gathered in Boise, Idaho, for what was billed as a first-of-its-kind seminar on mental health. Long the nerve center for the federal fire service, Boise has become a boomtown, pricing out wildland firefighters, with a median home price of $513,000. After the event, attendees gathered at a downtown food court, where Kelly Martin, a co-founder of Grassroots Wildland Firefighters, approached Jeff Arnberger, at the time a Bureau of Land Management official who also served on the executive board of the National Wildfire Coordinating Group. They began discussing their hopes for the service \u2014 subsidized housing, fair pay, presumptive coverage for PTSD, a more tolerant fire service. \u201cIf you ran our model at Nikon or Google or McDonald\u2019s, those places would be out of business in five minutes,\u201d Arnberger said. \u201cWe pay our people like shit. We don\u2019t offer them any help when they have a problem.\u201d</p>\n\n\n<p>By January 2023, doctors had removed the cancer in Elkind\u2019s thyroid, and he had been cleared to return to smokejumping. Amber asked him not to tell her about his first practice jump, so he didn\u2019t. He spent almost the entire summer away from Redmond. In early July, he jumped a fire in Washington and felt his old confidence returning. He then had a long stint learning to be a medical unit leader. When we spoke in September, he was working on a handcrew in western Washington as its assistant \u2014 in effect, the second in command. \u201cIt feels like I\u2019m almost giving back, helping to train people, which is kind of nice,\u201d he said.</p>\n\n<p>With Elkind away so much, Amber left her job as a physician\u2019s assistant. \u201cI didn\u2019t feel like I could do the summer with me taking care of the children and doing primary care,\u201d she said. Compared with previous years, 2023 was a light fire season. Fewer than 3 million acres had burned \u2014 the lowest figure in more than 20 years. That was particularly fortunate for residents of California, where, according to the union, 12% of Forest Service engines went unstaffed and had to be effectively shut down and six hotshot crews did not have enough firefighters to operate. In September \u2014 often the height of California\u2019s fire season \u2014 the agency\u2019s statewide wildland firefighting force had a vacancy rate of 35%. In one forest, the Modoc, 68% of positions were empty. </p>\n\n<p>The temporary pay raise from the Bipartisan Infrastructure Law was set to expire in the fall. Kyrsten Sinema, the independent senator from Arizona, introduced a bill in August that would largely protect the increase, which had Republican and Democratic cosponsors. Then, over Labor Day weekend, the Forest Service sent an email to thousands of firefighters, informing them that they would be receiving a 50% pay increase \u2014 which turned out to be erroneous. The Forest Service explained that the notification was the result of a clerical mistake. \u201cPlease know that this error was not made deliberately,\u201d the Forest Service\u2019s human resources department wrote in a mass email two weeks later.</p>\n\n<p>Elkind was on a fire when this occurred and said his attention was elsewhere. But for other wildland firefighters I spoke with, the email was indicative not just of the agency\u2019s incompetence but of an obliviousness that bordered on cruelty. Congress has since voted to preserve the raise until Sept. 30, 2024, but its future remains uncertain. \u201cI know that some of you are living paycheck to paycheck and do not have the means to save for a rainy day,\u201d Hall-Rivera wrote on the Forest Service\u2019s website. \u201cRest assured that we remain committed to securing the permanent solution that our wildland firefighters deserve.\u201d</p>\n\n<p>In the fall, when the Forest Service began to assess the state of its workforce for the 2024 fire season, the results were shocking, according to an official. Undesirable applicants were appearing frequently for crucial positions. \u201cThis list really stinks,\u201d he said. In Rapid City, South Dakota \u2014 typically a popular work location \u2014 there was only one applicant for an engine captain position by mid-November. In California, union officials were anticipating a mass departure of engine captains and hotshot superintendents. \u201cWe used to have the depth,\u201d Abel Martinez, the California engine captain, said. \u201cWe\u2019d just promote everybody up. Now you go to the cupboard, and there\u2019s no food. There\u2019s nobody there.\u201d</p>\n\n<p>When asked about the continuing attrition, an agency spokesperson wrote, \u201cIt is accurate to say that the Forest Service has lost firefighters to better paying jobs,\u201d adding that the dynamic \u201cis more pronounced in specific regions and states.\u201d</p>\n\n<p>In January, Elkind resigned from his position as a smokejumper to become an assistant captain on a handcrew. \u201cIt feels impossible to stay,\u201d he told me shortly before he made the decision. \u201cIt feels irresponsible to stay \u2014 with a family.\u201d Then he started, once again, to talk about what he prized about his job: chainsaws, doing something that almost no one else can do, sliding out of the door of a moving plane into the open sky. He would miss that, but he wanted to continue fighting wildfire. It is an incredible force \u2014 writhing, leaping, kicking off embers that dart toward other living things. It can be regenerative, but it can also devour.</p>\n        \n             \n\n                                    \n        \n                        <p><strong>Clarification, March 18, 2024:</strong> After publication, the reporter and ProPublica learned that the smokejumper prominently featured in the story, Ben Elkind, is a nephew of staff reporter Peter Elkind. Peter Elkind had no involvement in the reporting, editing or preparation of the article.</p>", "summary_detail": {"type": "text/html", "language": null, "base": "https://www.propublica.org/feeds/propublica/main", "value": "<p class=\"byline\">\n                by <span class=\"name\">Abe Streep</span> for <a href=\"https://www.propublica.org\">ProPublica</a>, illustrations by <span class=\"name\">Hokyoung Kim</span>, special to <a href=\"https://www.propublica.org\">ProPublica</a>                </p>\n                                             \n\n                                                                    \n            \n                <p>ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive <a href=\"https://www.propublica.org/newsletters/the-big-story?source=54G&amp;placement=top-note&amp;region=national\">our biggest stories</a> as soon as they\u2019re published.</p>\n\n            \n\n                \n\n\n\n        \n                        <p>Join us March 26 to <a href=\"https://www.propublica.org/events/the-big-burnout-wildland-firefighters-and-the-west?utm_source=website&amp;utm_medium=story&amp;utm_campaign=storypage\">discuss the exodus of wildland firefighters</a>.</p>\n\n        \n\n    \n      \n  \n\n\n\n                    \n<p>Black Butte is an inactive volcano that rises from the high desert in eastern Oregon. In May 2022, a turboprop plane approached its pine-blanketed slopes, carrying about 10 men wearing bulky Kevlar outfits. They were smokejumpers with the United States Forest Service, the agency that directs the majority of the nation\u2019s efforts to manage wildfires. Within the vast and hierarchical fire service, smokejumpers occupy a singular niche, parachuting into remote areas to fight early-stage wildfires. There are only about 450 nationwide, and the physical requirements are rigorous.</p>\n\n<p>One of the smokejumpers on board was Ben Elkind. Thirty-seven years old with a long, athletic build and restless energy, he had been fighting wildfires for 14 years and jumping for the last eight of them. Despite his elite status, Elkind earned about $43,000 in 2021 over the course of the seven-month fire season. His base paycheck, though, was less than half of that. Like most wildland firefighters, he relied on overtime and hazard pay, which can be accumulated on two- or three-week shifts away from home. Many firefighters exceed 1,000 hours of overtime in a season. Elkind chose to be with his wife and two young children more that year and worked a relatively modest 700 hours of overtime, the equivalent of 17 additional weeks.</p>\n\n<p>Still, the beginning of the season usually rekindled the parts of the job that Elkind loved \u2014 especially the adrenalized clarity that arrived when his crew\u2019s spotter tapped him on the back, indicating that it was time to jump. In recent years, the Forest Service has switched from round parachutes to rectangular ones, which allow for greater maneuverability. During training exercises that spring, Elkind was still getting accustomed to the new chute. After he slid out of the plane\u2019s open door, a tailwind picked up. He did not descend quickly enough to the landing zone, sailing slightly past it. He saw ponderosa pines rushing toward him and tried to slow his chute. Its canopy collapsed, and he free fell. When he landed, his left leg crashed through his pelvis. Colleagues rushed to him, cutting his suit away. An ambulance sped him to a hospital, where doctors would eventually insert three plates and 12 screws into his hip. He was sent home on painkillers.</p>\n\n<p>Doctors told him he would be on crutches for at least two months, possibly three. When I spoke with Elkind soon after the injury, he said, \u201cI got a lot of pills going, but it\u2019s all right.\u201d Then his tone shifted. \u201cI need to \u2014 I would like to \u2014 get back jumping,\u201d he said. \u201cThat would mean I\u2019ve recovered, but I also know that you don\u2019t always recover from these things.\u201d</p>\n\n<p>He had more immediate worries, though. He could file for workers\u2019 compensation benefits through the Department of Labor, but wildland firefighters have historically struggled to receive those, since federal caseworkers are often unfamiliar with the job\u2019s geographically diffuse nature. (A firefighter based in Idaho might get injured in Arizona, adding a layer of complexity to an already burdensome and bureaucratic process.) A recent survey found that nearly half of Forest Service employees who had suffered an on-the-job injury chose not to report it, assuming that they would receive little or no help. Even if Elkind recovered quickly enough to do office work, he would not be eligible for hazard pay or likely earn overtime, meaning he\u2019d be making around $20,000. His wife, Amber, a physician\u2019s assistant, would be contributing most of the family\u2019s income. \u201cIt\u2019s not a great situation,\u201d Elkind told me. \u201cMy base check doesn\u2019t cover rent alone.\u201d</p>\n\n<p>Knowing that the government couldn\u2019t offer a swift remedy, his colleagues started a GoFundMe campaign, which quickly raised $50,000. Elkind called it a lifesaver. It was, he said, what wildland fighters did when a colleague was seriously injured. It was, he told me, \u201cstandard operating procedure.\u201d</p>\n\n\n<p>For communities throughout the American West, wildland firefighters represent the last line of defense, but that line is fraying because the government decided long ago that they\u2019re not worth very much. The highly trained men and women protecting communities from immolation earn the same base pay as a fast-food server while taking severe risks with their physical and mental health. Despite the mounting public concern over the increasing severity of wildfires, the federal government has not seen fit to meaningfully address these issues. The effects of this chronic neglect have now become strikingly clear as the fire service is finding it difficult to fill its ranks, prefiguring what advocates are calling a national security crisis.</p>\n\n<p>Fighting wildfires has always been a dangerous occupation, but in the last decade it has become staggering in its demands. Accelerating climate change, coupled with a century of suppression of wildfire, has created <a href=\"https://projects.propublica.org/california-fire-weather/\">thick stands of trees primed to burn across much of the American West</a>. In certain parts of the country, <a href=\"https://www.propublica.org/article/the-southwests-drought-and-fires-are-a-window-to-our-climate-change-future\">fire seasons that once lasted a few months now span much of the year</a>. In 1993, the federal government fought wildfires on 1,797,574 acres; by 2021, that figure had more than quadrupled. Each spring brings a game of geographic roulette. In 2017, Montana set a state record for wildfires. The next year, California followed suit, with nearly 2 million burned acres, a figure that stood briefly before it was topped twice in the next three years. Experts have been forced to coin a new term for fires exceeding 1 million acres: gigafire.</p>\n        \n    \n                    \n<p>In many places, wildfire is an essential part of the ecosystem: It clears out dead underbrush and aging foliage, spreads new seeds and enables biodiversity. Extinguishing it, as federal and state governments have done for 100 years, just creates a larger and more dangerous fuel load. Great swaths of the country are now in what scientists call a fire deficit \u2014 they haven\u2019t burned for a long time, and they need to, or fires will only get bigger and more destructive. The only way out of such a deficit is to let a wildfire go or to manage it by setting a prescribed burn to reduce the amount of fuel. But in drought-stressed and densely populous places, that is difficult. In 2022 in New Mexico, two prescribed burns got out of control, merged and scorched an area larger than Los Angeles. It can be all but impossible to suppress a megafire, but the government must try, unless it wishes to write off, say, Mora, New Mexico, or Malibu, California. There is no technology up to the task; most of the work is still done by unseen, underpaid people with chainsaws and hand tools.</p>\n\n<p>But at exactly the time when the country needs wildland firefighters more than ever, the federal government is losing them. In the past three years, according to the Forest Service\u2019s own assessments, it has suffered an attrition rate of 45% among its permanent employees. Many people inside and outside the fire service believe this represents one of the worst crises in its history. Last spring, as the 2023 fire season was getting started, I asked Grant Beebe, a former smokejumper who now heads the Bureau of Land Management\u2019s fire program, if there had been an exodus of wildland firefighters. He initially hesitated. \u201c\u2018Exodus\u2019 is a pretty strong word,\u201d he said. But then he reconsidered. \u201cI\u2019ll say yeah. Yeah.\u201d</p>\n\n<p>\u201cThe ship is sinking,\u201d Abel Martinez, a Forest Service engine captain in California and the national fire chair for the National Federation of Federal Employees, the union that represents wildland firefighters, told me. (For this story, almost every wildland firefighter who agreed to use their full name has an official role with the union; the one firefighter identified by their middle name does not.)</p>\n\n<p>Although nobody could provide precise numbers, leaders like Beebe are especially concerned that the attrition has been particularly acute among those with extensive experience \u2014 those like Elkind. It takes years and hundreds of thousands of dollars to train a wildland firefighter capable of overseeing the numerous resources \u2014 engines, helicopters, smokejumpers \u2014 that are deployed on large fires. As Beebe put it, \u201cYou can\u2019t just hire some person off the street into one of our higher-level management jobs.\u201d</p>\n\n<p>The reasons for the exodus are many, but fundamentally it reflects an inattentive bureaucracy and a culture that suppresses internal criticism. Only in 2022 did the fire service acknowledge an explicit link between cancer and wildland firefighters, even though officials have long expressed concern about the connection. And it was only last year that the fire service held its first conference on mental health, even though officials have been aware for decades of the high incidence of substance abuse and divorce among wildland firefighters.</p>\n\n<p>But more than anything, wildland firefighters are leaving because they\u2019re compensated so poorly, the result of a byzantine civil service structure that makes it extremely hard to sustain a career. The federal fire service is responsible for managing blazes on nearly 730 million acres of land \u2014 an area almost the size of India. Among the five agencies, one dominates in terms of influence and size: the Forest Service, which employs more than 11,000 wildland firefighters, most of whom work from roughly April to October. The hiring system dates to the early years of the agency, when it often recruited from bars and relied on volunteers to suppress wildfires by 10 a.m.</p>\n\n<p>About one third of the workforce is temporary \u2014 firefighters who are automatically laid off at the end of each season. Even those who are permanent receive compensation starting at $15 per hour until they accumulate overtime and hazard pay. Because of the way the government classifies their work, it\u2019s extremely difficult for wildland firefighters to increase their base salaries unless they frequently move around the country. Altogether, it\u2019s a pay structure that incentivizes risk taking and a nomadic existence.</p>\n\n<p>For more than a century, the Forest Service was able to call on a ready workforce, one made up largely of rural men. (It is estimated that 84% of wildland firefighters are male.) Because of the reliable flow of applicants, the agency did not need to advocate for increased pay. But the changing nature of fire seasons, combined with the skyrocketing cost of living in the mountain West, has made firefighting less alluring than it once was.</p>\n\n<p>A Forest Service spokesperson wrote that since 2021 the agency has acknowledged the attrition among its workforce: \u201cIt is why agency and department leadership have been doing everything possible in coordination with the administration and Congress to provide a permanent, competitive increase in wildland firefighter pay, as well as staffing capacity and mental health programs.\u201d The spokesperson pointed to a raise \u2014 from $13 to $15 an hour \u2014 created by the Biden administration in 2021. The spokesperson also wrote, \"With the increasing duration and intensity of wildfires the agency understands the need to do much more.\u201d</p>\n\n<p>Last fall, the Forest Service processed its applicants for 2024. An official who has been involved in hiring for the agency for more than a decade characterized the returns as \u201cabysmal\u201d \u2014 \u201cIt\u2019s the smallest list I\u2019ve ever seen,\u201d he told me. A severe dearth of applicants for temporary seasonal jobs \u2014 the entry point for the next generation of wildland firefighters \u2014 forced the agency to extend its hiring period. For permanent positions, the returns were not much better.</p>\n\n\n<p>Talk to enough wildland firefighters, and you\u2019ll eventually hear about freedom. Not liberty, necessarily, but the thrill of a job that requires walking around woods with a chainsaw. Hannah Coolidge joined the Forest Service when she was 25, eventually becoming a hotshot, part of an elect crew that tromps far into forests to cut breaks around the largest wildfires to rob them of fuel. For a decade, Coolidge never attended a wedding or a funeral during fire season, but she loved the life \u2014 living outside, working with a tight-knit group, having winters for herself, being in phenomenal shape. (Researchers at the University of Montana have found that, during fire season, hotshots can expend about as much energy as cyclists in the Tour de France.) Taylor Hess also came for the time off but found that a Montana fire crew brought communal purpose, something that had been missing in the Midwestern town where she was raised. She liked huddling with colleagues at the end of the day, frying Spam over a wildfire\u2019s dying embers and pouring an electrolyte mix on top. \u201cIt\u2019s kind of gross,\u201d she said, but she cherished those moments: \u201cWe get so close.\u201d</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n    \n\n        \n    \n                    \n<p>A lot of the job is grueling and dirty: mopping up the end of a wildfire in a sea of ash; constructing line around piles of downed limbs in advance of lighting a prescribed burn; unrolling a sleeping pad in the woods or an ad-hoc camp, then awakening to the boot of a superintendent or water from the sprinklers on a high school football field. It\u2019s slow until it\u2019s not. Then it becomes vertiginous and hallucinatory. \u201cIt is a landscape of extremes,\u201d Eric Franta, a wildland firefighter based in Oregon, told me. During Bobbie Scopa\u2019s first fire, she was walking on a hill above a burning canyon when a chief bellowed for her to cover her head. An air tanker dropped chemical retardant, a great red squall that shook the ground. \u201cI thought, \u2018This is the coolest fucking job!\u2019\u201d she said. </p>\n\n<p>In many communities, it\u2019s also the best available employment option. Jake Kennedy, now an engine driver in California, was recruited by a former wrestling coach in a tiny Oregon town where the Forest Service was one of two reliable employers. Morgan Thomsen grew up in a remote part of Idaho where his parents were fire lookouts, so he was raised thinking that fighting fire was a good way to earn a living. Kristina \u2014 her middle name \u2014 enlisted in part to honor her family. Her grandfather had been a smokejumper, and her parents had both worked as wildland firefighters. \u201cWe have this loyalty in my family to the Forest Service,\u201d she said.</p>\n\n<p>Among his peers, Elkind is seen as fortunate. He didn\u2019t join the Forest Service to escape rural poverty \u2014 he has a bachelor\u2019s degree in economics from Lewis &amp; Clark College \u2014 but rather to seek adventure. He was also a smokejumper, with the status that the job entails. (A fire service joke goes like this: A group of wildland firefighters walk into a bar. How do you know which is the smokejumper? They\u2019ll tell you.) Still, Elkind, like so many of the firefighters I talked to, seemed almost trapped by the freedom he had once sought. \u201cI like my job,\u201d he said. \u201cIt\u2019s just hard to see the effects when you\u2019re starting out a career.\u201d</p>\n        \n    \n                            \n    \n                    \n<p>Those effects weren\u2019t just his busted pelvis. It was being away from his family for long stretches. (\u201cIt\u2019s a Catch-22,\u201d a firefighter told me. \u201cFor us to be able to provide for our families, it requires us to basically detach from our families.\u201d) And it was how difficult the Forest Service made it for someone to rise and earn a decent living. To earn a promotion and reach higher pay grades, firefighters usually have to move among the agency\u2019s nine regions or earn a master\u2019s degree in forestry and leave the fire line.  </p>\n\n<p>Elkind didn\u2019t want to do either of those things. He\u2019d grown up in Oregon, and his family was rooted there. In early 2022, he and Amber moved to Redmond, a town of 35,000 in the central part of the state, where the Forest Service has one of its seven smokejumper bases. Compared with nearby Bend \u2014 a bacchanalia of Gore-Tex and microbreweries where the median home price hovers above $700,000 \u2014 Redmond is middle class. But, as Elkind told me, \u201cThis place is blowing up.\u201d</p>\n\n<p>Redmond, like many towns where wildland firefighters live, has experienced an influx of remote workers since the onset of COVID-19, which has driven up housing costs. The rent on the Elkinds\u2019 modest house is $2,300. Even before his accident, he was nervous about making ends meet. In November 2021, the government offered some relief when Congress passed the Bipartisan Infrastructure Law, which created a temporary pay raise for wildland firefighters of either $20,000 or 50% of their regular check.</p>\n\n<p>When I visited Elkind at his home, toys were scattered across the floor, an elk mount lay on a couch and bills were piled on the dining room table. He wore shorts and a tank top, and his hair was long. Save for the flecks of gray in his beard, he looked boyish. Three months after his accident, he still walked with a limp and needed a cane but was able to drive his kids to school. He had considered filing for worker\u2019s compensation but decided against it, because it was hard to reach his caseworker and because the Forest Service offered him an office job, which allowed him to benefit from the temporary pay raise.</p>\n\n<p>Until the move, Elkind had been living a split existence, with his family in Portland and his job in Redmond, where he camped out on a colleague\u2019s property during fire season. In the summer of 2020, lightning started a fire on the Warm Springs Reservation in Oregon. It soon spread onto land managed by the Forest Service, and Elkind was dispatched. Upon arriving at a fire camp, he was alarmed by a lack of veteran firefighters. \u201cIt was like a ghost town,\u201d he said. He found himself training people from municipal departments who had been hired on temporary contracts to fill vacancies. Over Labor Day weekend, wind carried embers for miles, causing the fire, which became known as the Lionshead, to jump and merge with others. The blazes burned more than 400,000 acres, killing at least five people.</p>\n\n<p>At the same time, his mother\u2019s home near Hagg Lake was under evacuation orders brought on by another fire. Amber was in Portland with the couple\u2019s 2-year-old son, in a house without air conditioning. She was also pregnant. Elkind told her to duct-tape paper towels over a box fan to create a makeshift air filter as smoke from the fires suffused the city. \u201cI think I had a little bit of a mental breakdown,\u201d he told me. \u201cHomes are burning down. People are dying.\u201d Entire forests in western Oregon were disappearing. He couldn\u2019t stop what was happening to the only place he\u2019d ever called his own.</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n    \n\n        \n    \n                    \n<p>The decision to relocate to Redmond was so Elkind would not be away from his family throughout fire season. Still, he worried about the choice. Amber had been able to find work with a clinic in Redmond. But for him to reach a higher hourly wage would likely require the family to move again. \u201cWhat\u2019s she supposed to do? Quit her career every year and a half so I can get a dollar-fifty an hour raise?\u201d he asked.</p>\n\n<p>During our discussions, Elkind often edited his sentences so as to not sound as though he was blaming the Forest Service, even though as a union representative he had protection. His affection for his work became a refrain that he repeated to the point of awkwardness: \u201cI like my job. It\u2019s just difficult to justify it with a family.\u201d \u201cI do love my job, but that doesn\u2019t mean that I think it\u2019s worth it for a young person.\u201d \u201cI would almost do it for free,\u201d he <a href=\"https://www.oregonlive.com/opinion/2021/04/opinion-more-fires-less-staffing-and-low-pay-are-taking-a-steep-toll-on-wildland-firefighters.html\">wrote</a> in an op-ed that appeared in The Oregonian in 2021 that was critical of the Forest Service\u2019s refusal \u201cto rise to the challenge of climate change and the growing demand that increased fires, short-staffing and low pay presents for our workforce.\u201d</p>\n\n<p>That rhetorical hesitancy was a reflection of Elkind\u2019s torn feelings, but it was also an acknowledgment of something else: The Forest Service is known to function as a company town in rural America, deterring discussions that could result in negative attention. When I spoke with Jaelith Hall-Rivera, the Forest Service deputy chief for state, private and tribal forestry, she acknowledged that the agency has a reputation for discouraging employees from speaking out. \u201cWe have tried for a long time to change that culture,\u201d she said. \u201cEspecially in fire, you have to be able to speak up when something doesn\u2019t feel right to you.\u201d</p>\n\n<p>The National Federation of Federal Employees says it does not track instances of workplace intimidation or retaliation among wildland firefighters, so it\u2019s impossible to ascertain how often this occurs. But fear of reprisal was a common thread in many of my conversations. At a gathering of wildland firefighters and agency supervisors that I attended last spring, a member of a Forest Service rappel crew approached me eager to discuss the changes she wanted to see in the agency \u2014 especially the need for more women in leadership positions. An older colleague quickly pulled her aside; when she returned, she asked if she could see the article before it was published. When I asked if a superior had told her not to speak to me, she said, \u201cI don\u2019t feel comfortable answering that.\u201d </p>\n\n\n<p>Every year, returning federal wildland firefighters take a refresher course covering safety practices. Firefighters get to choose from a number of videos. One, titled <a href=\"https://www.youtube.com/watch?v=hD8OD2l09ds\">\u201cSmoke: Knowing The Risks,\u201d</a> is led by George Broyles, a former wildland firefighter and public information officer. From 2008 to 2014, he spearheaded the Forest Service\u2019s research into the physiological impacts of wildfire smoke. \u201cExposure to carbon monoxide and some of these other chemicals is going to impact the way we think,\u201d Broyles says in the video, which emphasizes wildfire smoke\u2019s effect on performance and decision-making. But when it comes to the long-term health effects of working in smoke, the video is circumspect. \u201cThat\u2019s an issue that\u2019s still understudied,\u201d Broyles says. The video, which was produced in 2018, never mentions the possibility of cancer, nor does a more recent preparedness guide for new recruits.  </p>\n\n<p>It is now widely accepted that all firefighters \u2014 structure as well as wildland \u2014 are far more susceptible to cancer than the rest of society. In 2022, the International Agency for Research on Cancer <a href=\"https://www.iarc.who.int/news-events/iarc-monographs-evaluate-the-carcinogenicity-of-occupational-exposure-as-a-firefighter/\">declared</a> that the job is carcinogenic to humans. But still the Forest Service and the other federal agencies that employ wildland firefighters have been slow to acknowledge the obvious. Part of the problem is a lack of epidemiological research into the distinct risks that wildland firefighters face. Dr. Jeff Burgess, the director of the Center for Firefighter Health Collaborative Research at the University of Arizona Mel and Enid Zuckerman College of Public Health, is working to fill that void by conducting long-term epidemiological studies on wildland firefighters. \u201cWe just don\u2019t have the same degree of information on cancer risk in wildland firefighting that we do in structure firefighting,\u201d he said.</p>\n\n<p>Last February, I attended an event at the University of Miami called the International Firefighter Cancer Symposium, which brought together firefighters from as far away as Australia and researchers from institutions like the American Cancer Society and the University of Toronto\u2019s Dalla Lana School of Public Health. It was a gathering for those who study cancer and those who develop it while fighting fires. Many of the researchers were looking into the dangers of per- and polyfluoroalkyl substances, or PFAS, commonly known as \u201cforever chemicals.\u201d Synthetic compounds, PFAS are ubiquitous in municipal fire- and water-resistant gear and have long been used in firefighting foam. (The Forest Service says it does not know whether its protective gear for wildland firefighters contains PFAS but that it has sent samples to the National Institute for Occupational Safety and Health for testing.)  </p>\n\n<p>The conference\u2019s emphasis on PFAS reflected a huge gap in research. Structure firefighters encounter smoke that is often more toxic than wildfire smoke, but they also use powerful respirators. Wildland firefighters eschew respirators since most are bulky and can be operated for only about 30 minutes at a time. Of the numerous studies presented, only one explicitly focused on wildland firefighters. In that project, which hasn\u2019t yet been published by a peer-reviewed journal, researchers from the University of Miami examined exposure to polycyclic aromatic hydrocarbons, or PAHs, produced during prescribed burning. They found that wildland firefighters had elevated exposures to the compounds, which have been associated in the general population with lung and bladder cancer and cardiovascular dysfunction.</p>\n\n<p>That smoke contains such material is not news to the Forest Service. In 1989, the agency convened its first gathering to discuss the physical effects of smoke and allotted some money for research. Attendees recommended that the agency conduct an epidemiological cohort study to examine long-term health risks. Funding for the study was never appropriated, though. </p>\n\n<p>Eleven years later, researchers employed by the Forest Service published a paper that found that smoke from prescribed burns contained elevated levels of carbon monoxide and particulate matter, including benzene and formaldehyde, both of which are carcinogenic. It noted that, during high winds, the levels were up to three times above what workplace safety organizations recommend. Despite this, it concluded that \u201cthe adverse health effects of smoke exposure at prescribed fires seem to be manageable.\u201d</p>\n\n<p>At a summit in 1997, researchers again suggested that the Forest Service undertake a cohort study to look at the effect of wildfire smoke among the workforce, using markers like blood and urine samples. It, too, was never done. </p>\n\n<p>Starting in 2008, Broyles, with the support of the Forest Service, traveled the country and to test fire crews\u2019 smoke exposures. It wasn\u2019t an epidemiological study, but it led to a 2019 peer-reviewed paper that modeled wildland firefighter cancer rates based on what is understood about smoke\u2019s impact on the general population. It projected that wildland firefighters\u2019 incidences of lung cancer would be elevated by between 8% and 43%.</p>\n\n<p>The <a href=\"https://www.fs.usda.gov/pnw/pubs/journals/pnw_2019_navarro001.pdf\">study</a> was posted on the agency\u2019s website, but, according to Broyles, its findings have led to little change. He said he was brushed off when he proposed an updated version of the smoke video to address the risk of cancer.  (When asked about Broyles\u2019 assertion, an agency spokesperson wrote, \u201cThe Forest Service is deeply committed to not only understanding occupational risks to employees but mitigating these risks.\u201d They added, \u201cRecruitment materials for wildland fire positions often describe the job as difficult and dangerous.\u201d)</p>\n\n<p>In 2022, the National Wildfire Coordinating Group, which is made up of leaders from the five federal agencies that oversee wildland firefighting, released a new preparedness guide for recruits that made no mention of cancer. \u201cIt confounds me,\u201d Broyles told me. \u201cQuite frankly, it breaks my heart.\u201d As of last year, his 2018 smoke video was still being shown to federal firefighters. (When asked why the materials did not refer to cancer, the Forest Service and the Department of the Interior said they were developed before the agencies were provided legal language recognizing a link between the disease and wildland firefighting.)</p>\n\n<p>The firefighters union and an advocacy group called Grassroots Wildland Firefighters used the 2019 paper to lobby the Department of Labor, and in April 2022, the department announced that it would recognize numerous cancers, including lung, testicular and thyroid, as an occupational hazard. (Notably, cancers distinctive to women, such as ovarian, were excluded.) Eight months later, Congress passed a law that called cancer a presumptive sickness for federal firefighters and mandated that the five agencies that make up the fire service file a report on illnesses, including cancer, in the profession. \u201cWe\u2019re just starting that,\u201d said Hall-Rivera, the Forest Service deputy chief.</p>\n\n<p>Some advocates have expressed hope that a deeper understanding of wildland firefighter cancer rates might evolve after the launch of the National Firefighter Registry for Cancer, a voluntary database managed by the National Institute for Occupational Safety and Health. Congress allocated funding for the registry in 2018, but it went online only last spring. According to current and former employees of the Centers for Disease Control and Prevention, NIOSH\u2019s information technology department caused unnecessary delay. \u201cFrom my perspective this is gross mismanagement,\u201d said one person with direct knowledge of the project. Another official supported that assessment. (In a statement, a NIOSH spokesperson wrote that since 2021, the agency \u201chas designed, built, tested, and deployed a robust enrollment system that incorporates industry best practices for information security and sensitive data management.\u201d)</p>\n\n<p>Immediately after the registry launched, Elkind decided to enter his name. When he arrived at the hospital after his training accident, he underwent a full-body CT scan, which revealed a mass in his thyroid. It proved to be cancerous. He had no family history of thyroid cancer, so he assumes his illness came from smoke inhalation, but he\u2019ll never know. \u201cNot everybody\u2019s as lucky as me to break their pelvis at work and get scanned at the hospital,\u201d he said with deadpan sarcasm. The next time we spoke, three months after the accident, he said, \u201cI\u2019m not upset at the Forest Service. I\u2019m just like \u2014 I\u2019ve never heard them say, \u2018Hey, this smoke is cancerous.\u2019\u201d</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n    \n\n        \n    \n                    \n\n<p>In the fall of 2020, after Oregon\u2019s fire season ended, Elkind went for a run in Portland\u2019s Peninsula Park. He had recently been laid off for the winter. For many wildland firefighters, this period of sudden transition is brutal: When you\u2019ve been operating on intensity for six months, taking out the trash and folding laundry can feel empty. In the past, Elkind had managed the annual pivot by doing construction work and house projects or by traveling with friends. But he was still experiencing the acute pressure he\u2019d felt since the peak of fire season when so much of Oregon burned. Amber had just given birth to the couple\u2019s second son, and he wasn\u2019t sure how to responsibly move forward in his career. \u201cI was so stressed out,\u201d he told me.</p>\n\n<p>Elkind thought he\u2019d try to contact a therapist \u2014 something he\u2019d never done. During his run, he called the Employee Assistance Program, a service set up by the federal government that provides workers from any agency as many as six sessions per condition with a mental health professional. Elkind hoped to arrange an appointment in person but was informed that the session was only available right then on the phone. That wasn\u2019t the worst of it: When he shared his employment information, he was told that he would not be eligible to receive help until he returned to work during the next fire season. \u201cI was like, \u2018Maybe I\u2019ll drink a few more beers and forget about this,\u2019\u201d Elkind said.  </p>\n\n<p>The Forest Service revised its EAP policy a year later and now offers consultations to firefighters for up to six months after their layoff. (\u201cThe agency has been proactive in addressing known challenges with past EAP services,\u201d wrote a spokesperson.) However, because the EAP serves a vast federal bureaucracy, multiple wildland firefighters told me that they did not trust its counselors; the people on the other end of the phone, they said, knew little about what their job entailed.</p>\n\n<p>The fire service does offer wildland firefighters access to a crisis intervention program after the death of a colleague, say, but it provides little aid for those facing the daily burdens of the job \u2014 and those can be extreme: Trees falling next to where you\u2019re standing. Helicopters flying in to remove the injured. Mopping up for days, surrounded by smoke. Many wildland firefighters, who operate in a culture that prides itself on stoicism, respond to those pressures in ways that aren\u2019t surprising. Some chase more adrenaline: kayaking, skiing, mountain biking. \u201cThere\u2019s a lot of dealing with it through drinking and drugs \u2014 at best,\u201d Hannah Coolidge, the Washington hotshot, said. In January, researchers with NIOSH and the CDC released a <a href=\"https://academic.oup.com/annweh/article/68/2/122/7504841?rss=1\">peer-reviewed study</a> that confirmed what Coolidge and others told me. It found that among six federal wildland crews, 78% of the firefighters reported binge drinking. </p>\n\n<p>\u201cWe\u2019re so unhealthy in such a ubiquitous way that it\u2019s almost hard to pinpoint,\u201d a Forest Service firefighter in Oregon said. He had returned home from combatting a fire to find his house burned to the ground. Since then, he had endured symptoms consistent with post-traumatic stress disorder. A firefighter in Wyoming who recently left the service told me that, like many of his colleagues, he couldn\u2019t maintain a relationship: \u201cI wouldn\u2019t date me either. I\u2019m not emotionally available. I\u2019m gone.\u201d A recent survey of the spouses of wildland firefighters found that almost half had considered leaving their relationships because of the job.</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n    \n\n        \n    \n                    \n<p>\u201cWildland firefighting is similar to other high-risk occupations and also similar to the Western American culture around how to manage difficulty,\u201d psychologist Patricia O\u2019Brien, a former hotshot who now oversees the Bureau of Land Management\u2019s mental health program, told me. \u201cThere\u2019s been a tradition of not talking about it, of keeping your personal life boxed up and separate and prioritizing work. And a sense that, as long as you\u2019re able to show up and work, you keep your personal problems at home. We know that people may be able to do that for a period of time, but it\u2019s not sustainable, and it\u2019s harmful to people.\u201d</p>\n\n<p>In 2018, O\u2019Brien, who at the time was a doctoral student, conducted a survey of 2,600 wildland firefighters, finding that one-fifth had experienced suicidal thoughts, while nearly 14% of respondents screened positive for probable PTSD \u2014 a rate about four times that found in the general population. Six years later, that data remains the most reliable on the mental health of wildland firefighters.</p>\n\n<p>The Forest Service has responded to the mental health struggles of its workforce much the way it has responded to cancer: For years, officials have raised concerns about the issue, and for years, the agency has either ignored or minimized them. In a statement, the agency acknowledged it \u201chas not conducted or funded a study into the mental-health effects of wildland firefighting.\u201d Tom Harbour, a former national director of fire and aviation management at the Forest Service, told me that the agency began discussing the pressures on its workforce in the 1990s. \u201cWe started asking ourselves about the cost of the system we had built,\u201d he said, referring to the agency\u2019s emphasis on overtime and hazard pay. \u201cDivorces, heavy drinking \u2014 those were just things that were kind of a byproduct of the system.\u201d He added, \u201cWhy in the world should it take 30 years to make some of these changes?\u201d</p>\n\n<p>\u201cThat\u2019s a fair question,\u201d the Forest Service\u2019s Hall-Rivera said. \u201cWe did have to build our awareness. It is hard to get people to talk about it, and we had to shift our focus and start asking for resources, start investing resources.\u201d </p>\n\n<p>In 2021, the Bipartisan Infrastructure Law allotted $20 million to the agencies overseeing the fire service to establish year-round mental health programs. The Bureau of Land Management had already been taking steps in that direction; five years ago, it launched a pilot program offering pre- and postseason mental health trainings for firefighters to help them transition in and out of the season. </p>\n\n<p>But the Forest Service has lagged behind. Last year, for the first time, the agency announced a wildland firefighter mental health support program; with $1.5 million allotted over two years, it\u2019s still in the planning stage. (The Forest Service\u2019s budget for the fiscal year was $10 billion.) Individual districts have begun contracting at least one mental health provider, Dani Shedden, a former wildland firefighter who in 2022 quit to start a counseling business. Shedden told me that much of her work with the Forest Service is focused on post-season sessions, in which she shows firefighters how to use the EAP and find what she called \u201cculturally competent clinicians\u201d in rural areas. Shedden has conducted 10 such sessions.</p>\n\n<p>Last April, many of the fire service\u2019s leaders \u2014 including Hall-Rivera and Beebe \u2014 gathered in Boise, Idaho, for what was billed as a first-of-its-kind seminar on mental health. Long the nerve center for the federal fire service, Boise has become a boomtown, pricing out wildland firefighters, with a median home price of $513,000. After the event, attendees gathered at a downtown food court, where Kelly Martin, a co-founder of Grassroots Wildland Firefighters, approached Jeff Arnberger, at the time a Bureau of Land Management official who also served on the executive board of the National Wildfire Coordinating Group. They began discussing their hopes for the service \u2014 subsidized housing, fair pay, presumptive coverage for PTSD, a more tolerant fire service. \u201cIf you ran our model at Nikon or Google or McDonald\u2019s, those places would be out of business in five minutes,\u201d Arnberger said. \u201cWe pay our people like shit. We don\u2019t offer them any help when they have a problem.\u201d</p>\n\n\n<p>By January 2023, doctors had removed the cancer in Elkind\u2019s thyroid, and he had been cleared to return to smokejumping. Amber asked him not to tell her about his first practice jump, so he didn\u2019t. He spent almost the entire summer away from Redmond. In early July, he jumped a fire in Washington and felt his old confidence returning. He then had a long stint learning to be a medical unit leader. When we spoke in September, he was working on a handcrew in western Washington as its assistant \u2014 in effect, the second in command. \u201cIt feels like I\u2019m almost giving back, helping to train people, which is kind of nice,\u201d he said.</p>\n\n<p>With Elkind away so much, Amber left her job as a physician\u2019s assistant. \u201cI didn\u2019t feel like I could do the summer with me taking care of the children and doing primary care,\u201d she said. Compared with previous years, 2023 was a light fire season. Fewer than 3 million acres had burned \u2014 the lowest figure in more than 20 years. That was particularly fortunate for residents of California, where, according to the union, 12% of Forest Service engines went unstaffed and had to be effectively shut down and six hotshot crews did not have enough firefighters to operate. In September \u2014 often the height of California\u2019s fire season \u2014 the agency\u2019s statewide wildland firefighting force had a vacancy rate of 35%. In one forest, the Modoc, 68% of positions were empty. </p>\n\n<p>The temporary pay raise from the Bipartisan Infrastructure Law was set to expire in the fall. Kyrsten Sinema, the independent senator from Arizona, introduced a bill in August that would largely protect the increase, which had Republican and Democratic cosponsors. Then, over Labor Day weekend, the Forest Service sent an email to thousands of firefighters, informing them that they would be receiving a 50% pay increase \u2014 which turned out to be erroneous. The Forest Service explained that the notification was the result of a clerical mistake. \u201cPlease know that this error was not made deliberately,\u201d the Forest Service\u2019s human resources department wrote in a mass email two weeks later.</p>\n\n<p>Elkind was on a fire when this occurred and said his attention was elsewhere. But for other wildland firefighters I spoke with, the email was indicative not just of the agency\u2019s incompetence but of an obliviousness that bordered on cruelty. Congress has since voted to preserve the raise until Sept. 30, 2024, but its future remains uncertain. \u201cI know that some of you are living paycheck to paycheck and do not have the means to save for a rainy day,\u201d Hall-Rivera wrote on the Forest Service\u2019s website. \u201cRest assured that we remain committed to securing the permanent solution that our wildland firefighters deserve.\u201d</p>\n\n<p>In the fall, when the Forest Service began to assess the state of its workforce for the 2024 fire season, the results were shocking, according to an official. Undesirable applicants were appearing frequently for crucial positions. \u201cThis list really stinks,\u201d he said. In Rapid City, South Dakota \u2014 typically a popular work location \u2014 there was only one applicant for an engine captain position by mid-November. In California, union officials were anticipating a mass departure of engine captains and hotshot superintendents. \u201cWe used to have the depth,\u201d Abel Martinez, the California engine captain, said. \u201cWe\u2019d just promote everybody up. Now you go to the cupboard, and there\u2019s no food. There\u2019s nobody there.\u201d</p>\n\n<p>When asked about the continuing attrition, an agency spokesperson wrote, \u201cIt is accurate to say that the Forest Service has lost firefighters to better paying jobs,\u201d adding that the dynamic \u201cis more pronounced in specific regions and states.\u201d</p>\n\n<p>In January, Elkind resigned from his position as a smokejumper to become an assistant captain on a handcrew. \u201cIt feels impossible to stay,\u201d he told me shortly before he made the decision. \u201cIt feels irresponsible to stay \u2014 with a family.\u201d Then he started, once again, to talk about what he prized about his job: chainsaws, doing something that almost no one else can do, sliding out of the door of a moving plane into the open sky. He would miss that, but he wanted to continue fighting wildfire. It is an incredible force \u2014 writhing, leaping, kicking off embers that dart toward other living things. It can be regenerative, but it can also devour.</p>\n        \n             \n\n                                    \n        \n                        <p><strong>Clarification, March 18, 2024:</strong> After publication, the reporter and ProPublica learned that the smokejumper prominently featured in the story, Ben Elkind, is a nephew of staff reporter Peter Elkind. Peter Elkind had no involvement in the reporting, editing or preparation of the article.</p>"}, "tags": [{"term": "Environment", "scheme": null, "label": null}], "updated": "2024-03-16T05:00:00-04:00", "updated_parsed": [2024, 3, 16, 9, 0, 0, 5, 76, 0], "authors": [{"name": "by Abe Streep for ProPublica, illustrations by Hokyoung Kim, special to ProPublica"}], "author": "by Abe Streep for ProPublica, illustrations by Hokyoung Kim, special to ProPublica", "author_detail": {"name": "by Abe Streep for ProPublica, illustrations by Hokyoung Kim, special to ProPublica"}}, {"title": "New EPA Rule to Slash Cancer-Causing Emissions From Sterilization Facilities", "title_detail": {"type": "text/plain", "language": null, "base": "https://www.propublica.org/feeds/propublica/main", "value": "New EPA Rule to Slash Cancer-Causing Emissions From Sterilization Facilities"}, "links": [{"rel": "alternate", "type": "text/html", "href": "https://www.propublica.org/article/epa-rule-ethylene-oxide-sterilization-facilities"}], "link": "https://www.propublica.org/article/epa-rule-ethylene-oxide-sterilization-facilities", "published": "Fri, 15 Mar 2024 14:35:00 -0400", "published_parsed": [2024, 3, 15, 18, 35, 0, 4, 75, 0], "id": "https://www.propublica.org/article/epa-rule-ethylene-oxide-sterilization-facilities", "guidislink": false, "summary": "<p class=\"byline\">\n                by <span class=\"name\">Alejandra Martinez</span>, <a href=\"https://www.texastribune.org/\">The Texas Tribune</a>                </p>\n                                             \n\n                                                                    \n            \n                <p>ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive <a href=\"https://www.propublica.org/newsletters/the-big-story?source=54G&amp;placement=top-note&amp;region=texas\">our biggest stories</a> as soon as they\u2019re published.</p>\n\n            \n\n                \n\n\n\n                                                                    \n            \n                <p>This article is co-published with The Texas Tribune, a nonprofit, nonpartisan local newsroom that informs and engages with Texans. Sign up for <a href=\"https://www.texastribune.org/newsletters/briefweekly/\">The Brief Weekly</a> to get up to speed on their essential coverage of Texas issues.</p>\n\n            \n\n                \n\n      \n  \n\n\n\n                    \n<p>The U.S. Environmental Protection Agency on Thursday issued a rule to slash toxic emissions from commercial sterilization facilities that have posed an increased lifetime cancer risk to residents who live near them. These facilities release fumes of ethylene oxide, labeled by the agency as \u201cone of the most potent cancer-causing chemicals.\u201d</p>\n\n<p>Ethylene oxide, a flammable, colorless gas, is used to sanitize medical and dental equipment to reduce the risk of infection, and fumigate certain food products. <a href=\"https://www.epa.gov/sites/default/files/2016-09/documents/ethylene-oxide.pdf\">Long-term exposure to ethylene oxide</a> can cause irritation of the eyes, skin, nose and throat as well as damage to the brain and reproductive system.</p>\n\n<p>The new rule will place stricter limits on how much ethylene oxide commercial sterilizers can release into the outside air, eventually eliminating about 90% of emissions of the gas nationwide, according to the EPA. <a href=\"https://www.ucsusa.org/about/news/new-analysis-shows-stark-and-disproportionate-harm-ethylene-oxide-pollution\">An analysis</a> by the environmental group Union of Concerned Scientists found about 13 million people live near these facilities, and these emissions pose a disproportionate risk to poor and minority communities. In Texas, residents say a plant in Laredo, Midwest Sterilization Corporation, has contributed to the <a href=\"https://www.dshs.texas.gov/sites/default/files/CHI-ESTB/CSum%2022002_Full%20Report_Final.pdf\">city\u2019s elevated rates of cancer</a>.</p>\n\n<p>Facilities would be required to install pollution-control equipment, conduct continuous emissions monitoring and file quarterly reports to the EPA. A spokesperson with Midwest Sterilization told ProPublica the company is evaluating the new rule and learning about its requirements. \u201cOur top priority is ensuring we can continue to keep communities safe while helping to save patient\u2019s lives,\u201d the spokesperson wrote, referring to the corporation\u2019s work on sterilizing surgical kits for hospitals.</p>\n\n<p>Reducing cancer in communities exposed to toxic air pollution has been a prime focus of the Biden administration\u2019s environmental agenda. The new rule will address emissions at nearly 90 commercial sterilization facilities, including some in Texas, that are owned and operated by approximately 50 companies.</p>\n        \n    \n                    \n<p>Prior regulations on commercial sterilizers that use <a href=\"https://iris.epa.gov/ChemicalLanding/&amp;substance_nmbr=1025\">ethylene oxide</a> did not account for the EPA\u2019s latest research. In 2016, the agency concluded that ethylene oxide was 30 times more carcinogenic for adults than previously thought and 50 times more carcinogenic for those who are exposed since birth.</p>\n\n<p>\u201cWe have followed the science and listened to communities,\u201d EPA Administrator Michael Regan said in a press release. \u201cWe\u2019ve arrived at a historically strong rule that will protect the most exposed communities from toxic air pollution while also ensuring that there will be a process that safeguards our nation\u2019s critical supply of sterilized medical equipment.\u201d</p>\n\n<p>A 2021 investigation by <a href=\"https://www.propublica.org/article/a-plant-that-sterilizes-medical-equipment-spews-cancer-causing-pollution-on-tens-of-thousands-of-schoolchildren\">ProPublica and The Texas Tribune</a> revealed the EPA\u2019s yearslong failure to inform communities, including Laredo, a city of more than 250,000 on the Texas-Mexico border, of the risks they faced from the cancer-causing chemical. The Texas Department of State Health Services conducted two assessments in 2022 examining cancer rates from 2006 to 2019 in Laredo and found a higher rate of acute lymphocytic leukemia, breast cancer and non-Hodgkin lymphoma compared with cancer rates elsewhere in the state.</p>\n\n<p>\u201cWe were completely unaware. And to this day, I think many still are not fully aware of what\u2019s right there and how dangerous this chemical is,\u201d said Tricia Cortez, a Laredo resident and executive director of the environmental nonprofit Rio Grande International Study Center, on Thursday.</p>\n\n<p>\u201cThe ones who suffer most are our everyday people who live and work right next to these facilities.\u201d</p>\n\n<p>Cortez said that her community has been waiting a long time for EPA\u2019s new rule and that the decision to reduce emissions means a lot.</p>\n\n<p>In 2022, <a href=\"https://earthjustice.org/press/2023/environmental-groups-sue-epa-to-limit-cancerous-air-pollution-from-chemical-manufacturing-plants\">Earthjustice sued the EPA</a> on behalf of environment and community groups including the Rio Grande International Study Center for not updating the rules in nearly a decade and leaving communities unaware of the risks. (The lawsuit is still ongoing.)</p>\n\n<p>Following news reports, the EPA <a href=\"https://www.propublica.org/article/air-pollution-epa-sacrifice-zones\">published proposed requirements last year to reduce ethylene oxide at these medical sterilizers</a>. The agency conducted public hearings, webinars and meetings to hear from communities and their health concerns. It also published an analysis of the industry\u2019s self-reported emissions data that showed about <a href=\"https://www.texastribune.org/2022/08/04/epa-laredo-toxic-air-pollution/\">a quarter of the nearly 100 commercial sterilizers</a>, including the one in Laredo, were exposing nearby residents to unacceptable cancer risks from ethylene oxide. The agency also published <a href=\"https://www.epa.gov/hazardous-air-pollutants-ethylene-oxide/forms/ethylene-oxide-risk-commercial-sterilizers\">risk maps and other information online</a> for each of the high-risk facilities.</p>\n\n<p>\u201cOverall, I am pleased this rule will protect the health of communities while still considering the importance of medical sterilization devices to hospitals, doctors, and patients,\u201d said U.S. Rep. <a href=\"https://www.texastribune.org/directory/henry-cuellar/\">Henry Cuellar</a>, D-Laredo, in a press release.</p>\n\n<p>Scott Whitaker, president and CEO of the Advanced Medical Technology Association, a group that lobbies for the interests of medical device manufacturers, said in an email on Thursday the group is still examining the new rule\u2019s full impact, but he warned that new regulations could cause problems for patients by creating treatment and surgical delays.</p>\n\n<p>\u201cThere are three broad areas we have emphasized throughout the rulemaking: adequate time to implement, flexibility in technologies to remove emissions, and the ability to achieve EPA targets that would not force resubmission of medical devices for FDA approval,\u201d Whitaker wrote.</p>\n\n<p>EPA is assuring the medical industry that these new rules will not impact access to sterilized medical equipment. Harold Wimmer, president and CEO at the American Lung Association, praised the federal agency for striking a balance between new measures for limiting pollution and the need for safe and clean medical supplies.</p>\n\n<p>\u201cNo one should have to live with elevated cancer risk because of air pollution in their community,\u201d Wimmer said in a press release.</p>\n\n<p>The new rule will evaluate if facilities are complying based on their cap or allowable amount of emissions they can release into the air per pollutant as listed in their state permits.</p>\n\n<p>\u201cWhat we know is that these facilities are often releasing more than what they are stating. [The EPA] revised its risk assessment to look at how much a facility is allowed to emit and as a result is more stringent standards, which we think is a major positive,\u201d said Marvin C. Brown IV, a senior attorney at the nonprofit Earthjustice.</p>\n\n<p>In response to questions from ProPublica, Brown said that the news organizations\u2019 joint investigation into industrial emissions and cancer risk played a role in the final rules. \u201cI think it has led to people commenting, participating in the process, pushing EPA to do this and to regulate this industry in a way that will hopefully save a lot of lives in the future,\u201d he said.</p>\n\n<p>While Brown sees the EPA\u2019s new rules as a great first step, he said he was disappointed to see that the agency did not end up requiring commercial sterilization facilities to obtain Title V permits. The agency had included this stipulation in its proposed rule last year, which would have mandated that facilities undergo a permit approval process that includes a review from federal regulators in addition to state regulators, and federal requirements for public participation.</p>\n\n<p>The rules go into effect shortly after they are published in the Federal Register. Facilities will have two years to install monitoring and pollution controls and an additional 180 days to demonstrate compliance. If facilities need more time, they can petition states and the EPA for an extension.</p>\n\n<p>In the past, the state\u2019s environmental regulator, Texas Commission on Environmental Quality, has disagreed with the EPA\u2019s science assessment of ethylene oxide\u2019s dangers to health and the environment. The TCEQ launched its own review of the chemical in 2020, which ruled that it was significantly less toxic than the federal agency had found. The TCEQ attempted to enact a new standard that could allow plants to emit more of the chemical, but the EPA rejected it in 2022.</p>\n\n<p>Richard Richter, a spokesperson for the TCEQ, said the agency will implement the new standard and facilities will be required to comply with the new rule.</p>\n        \n             \n\n                                    \n        \n                        <p><a href=\"https://www.propublica.org/people/lisa-song\">Lisa Song</a> and <a href=\"https://www.propublica.org/people/maya-miller\">Maya Miller</a> contributed reporting.</p>", "summary_detail": {"type": "text/html", "language": null, "base": "https://www.propublica.org/feeds/propublica/main", "value": "<p class=\"byline\">\n                by <span class=\"name\">Alejandra Martinez</span>, <a href=\"https://www.texastribune.org/\">The Texas Tribune</a>                </p>\n                                             \n\n                                                                    \n            \n                <p>ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive <a href=\"https://www.propublica.org/newsletters/the-big-story?source=54G&amp;placement=top-note&amp;region=texas\">our biggest stories</a> as soon as they\u2019re published.</p>\n\n            \n\n                \n\n\n\n                                                                    \n            \n                <p>This article is co-published with The Texas Tribune, a nonprofit, nonpartisan local newsroom that informs and engages with Texans. Sign up for <a href=\"https://www.texastribune.org/newsletters/briefweekly/\">The Brief Weekly</a> to get up to speed on their essential coverage of Texas issues.</p>\n\n            \n\n                \n\n      \n  \n\n\n\n                    \n<p>The U.S. Environmental Protection Agency on Thursday issued a rule to slash toxic emissions from commercial sterilization facilities that have posed an increased lifetime cancer risk to residents who live near them. These facilities release fumes of ethylene oxide, labeled by the agency as \u201cone of the most potent cancer-causing chemicals.\u201d</p>\n\n<p>Ethylene oxide, a flammable, colorless gas, is used to sanitize medical and dental equipment to reduce the risk of infection, and fumigate certain food products. <a href=\"https://www.epa.gov/sites/default/files/2016-09/documents/ethylene-oxide.pdf\">Long-term exposure to ethylene oxide</a> can cause irritation of the eyes, skin, nose and throat as well as damage to the brain and reproductive system.</p>\n\n<p>The new rule will place stricter limits on how much ethylene oxide commercial sterilizers can release into the outside air, eventually eliminating about 90% of emissions of the gas nationwide, according to the EPA. <a href=\"https://www.ucsusa.org/about/news/new-analysis-shows-stark-and-disproportionate-harm-ethylene-oxide-pollution\">An analysis</a> by the environmental group Union of Concerned Scientists found about 13 million people live near these facilities, and these emissions pose a disproportionate risk to poor and minority communities. In Texas, residents say a plant in Laredo, Midwest Sterilization Corporation, has contributed to the <a href=\"https://www.dshs.texas.gov/sites/default/files/CHI-ESTB/CSum%2022002_Full%20Report_Final.pdf\">city\u2019s elevated rates of cancer</a>.</p>\n\n<p>Facilities would be required to install pollution-control equipment, conduct continuous emissions monitoring and file quarterly reports to the EPA. A spokesperson with Midwest Sterilization told ProPublica the company is evaluating the new rule and learning about its requirements. \u201cOur top priority is ensuring we can continue to keep communities safe while helping to save patient\u2019s lives,\u201d the spokesperson wrote, referring to the corporation\u2019s work on sterilizing surgical kits for hospitals.</p>\n\n<p>Reducing cancer in communities exposed to toxic air pollution has been a prime focus of the Biden administration\u2019s environmental agenda. The new rule will address emissions at nearly 90 commercial sterilization facilities, including some in Texas, that are owned and operated by approximately 50 companies.</p>\n        \n    \n                    \n<p>Prior regulations on commercial sterilizers that use <a href=\"https://iris.epa.gov/ChemicalLanding/&amp;substance_nmbr=1025\">ethylene oxide</a> did not account for the EPA\u2019s latest research. In 2016, the agency concluded that ethylene oxide was 30 times more carcinogenic for adults than previously thought and 50 times more carcinogenic for those who are exposed since birth.</p>\n\n<p>\u201cWe have followed the science and listened to communities,\u201d EPA Administrator Michael Regan said in a press release. \u201cWe\u2019ve arrived at a historically strong rule that will protect the most exposed communities from toxic air pollution while also ensuring that there will be a process that safeguards our nation\u2019s critical supply of sterilized medical equipment.\u201d</p>\n\n<p>A 2021 investigation by <a href=\"https://www.propublica.org/article/a-plant-that-sterilizes-medical-equipment-spews-cancer-causing-pollution-on-tens-of-thousands-of-schoolchildren\">ProPublica and The Texas Tribune</a> revealed the EPA\u2019s yearslong failure to inform communities, including Laredo, a city of more than 250,000 on the Texas-Mexico border, of the risks they faced from the cancer-causing chemical. The Texas Department of State Health Services conducted two assessments in 2022 examining cancer rates from 2006 to 2019 in Laredo and found a higher rate of acute lymphocytic leukemia, breast cancer and non-Hodgkin lymphoma compared with cancer rates elsewhere in the state.</p>\n\n<p>\u201cWe were completely unaware. And to this day, I think many still are not fully aware of what\u2019s right there and how dangerous this chemical is,\u201d said Tricia Cortez, a Laredo resident and executive director of the environmental nonprofit Rio Grande International Study Center, on Thursday.</p>\n\n<p>\u201cThe ones who suffer most are our everyday people who live and work right next to these facilities.\u201d</p>\n\n<p>Cortez said that her community has been waiting a long time for EPA\u2019s new rule and that the decision to reduce emissions means a lot.</p>\n\n<p>In 2022, <a href=\"https://earthjustice.org/press/2023/environmental-groups-sue-epa-to-limit-cancerous-air-pollution-from-chemical-manufacturing-plants\">Earthjustice sued the EPA</a> on behalf of environment and community groups including the Rio Grande International Study Center for not updating the rules in nearly a decade and leaving communities unaware of the risks. (The lawsuit is still ongoing.)</p>\n\n<p>Following news reports, the EPA <a href=\"https://www.propublica.org/article/air-pollution-epa-sacrifice-zones\">published proposed requirements last year to reduce ethylene oxide at these medical sterilizers</a>. The agency conducted public hearings, webinars and meetings to hear from communities and their health concerns. It also published an analysis of the industry\u2019s self-reported emissions data that showed about <a href=\"https://www.texastribune.org/2022/08/04/epa-laredo-toxic-air-pollution/\">a quarter of the nearly 100 commercial sterilizers</a>, including the one in Laredo, were exposing nearby residents to unacceptable cancer risks from ethylene oxide. The agency also published <a href=\"https://www.epa.gov/hazardous-air-pollutants-ethylene-oxide/forms/ethylene-oxide-risk-commercial-sterilizers\">risk maps and other information online</a> for each of the high-risk facilities.</p>\n\n<p>\u201cOverall, I am pleased this rule will protect the health of communities while still considering the importance of medical sterilization devices to hospitals, doctors, and patients,\u201d said U.S. Rep. <a href=\"https://www.texastribune.org/directory/henry-cuellar/\">Henry Cuellar</a>, D-Laredo, in a press release.</p>\n\n<p>Scott Whitaker, president and CEO of the Advanced Medical Technology Association, a group that lobbies for the interests of medical device manufacturers, said in an email on Thursday the group is still examining the new rule\u2019s full impact, but he warned that new regulations could cause problems for patients by creating treatment and surgical delays.</p>\n\n<p>\u201cThere are three broad areas we have emphasized throughout the rulemaking: adequate time to implement, flexibility in technologies to remove emissions, and the ability to achieve EPA targets that would not force resubmission of medical devices for FDA approval,\u201d Whitaker wrote.</p>\n\n<p>EPA is assuring the medical industry that these new rules will not impact access to sterilized medical equipment. Harold Wimmer, president and CEO at the American Lung Association, praised the federal agency for striking a balance between new measures for limiting pollution and the need for safe and clean medical supplies.</p>\n\n<p>\u201cNo one should have to live with elevated cancer risk because of air pollution in their community,\u201d Wimmer said in a press release.</p>\n\n<p>The new rule will evaluate if facilities are complying based on their cap or allowable amount of emissions they can release into the air per pollutant as listed in their state permits.</p>\n\n<p>\u201cWhat we know is that these facilities are often releasing more than what they are stating. [The EPA] revised its risk assessment to look at how much a facility is allowed to emit and as a result is more stringent standards, which we think is a major positive,\u201d said Marvin C. Brown IV, a senior attorney at the nonprofit Earthjustice.</p>\n\n<p>In response to questions from ProPublica, Brown said that the news organizations\u2019 joint investigation into industrial emissions and cancer risk played a role in the final rules. \u201cI think it has led to people commenting, participating in the process, pushing EPA to do this and to regulate this industry in a way that will hopefully save a lot of lives in the future,\u201d he said.</p>\n\n<p>While Brown sees the EPA\u2019s new rules as a great first step, he said he was disappointed to see that the agency did not end up requiring commercial sterilization facilities to obtain Title V permits. The agency had included this stipulation in its proposed rule last year, which would have mandated that facilities undergo a permit approval process that includes a review from federal regulators in addition to state regulators, and federal requirements for public participation.</p>\n\n<p>The rules go into effect shortly after they are published in the Federal Register. Facilities will have two years to install monitoring and pollution controls and an additional 180 days to demonstrate compliance. If facilities need more time, they can petition states and the EPA for an extension.</p>\n\n<p>In the past, the state\u2019s environmental regulator, Texas Commission on Environmental Quality, has disagreed with the EPA\u2019s science assessment of ethylene oxide\u2019s dangers to health and the environment. The TCEQ launched its own review of the chemical in 2020, which ruled that it was significantly less toxic than the federal agency had found. The TCEQ attempted to enact a new standard that could allow plants to emit more of the chemical, but the EPA rejected it in 2022.</p>\n\n<p>Richard Richter, a spokesperson for the TCEQ, said the agency will implement the new standard and facilities will be required to comply with the new rule.</p>\n        \n             \n\n                                    \n        \n                        <p><a href=\"https://www.propublica.org/people/lisa-song\">Lisa Song</a> and <a href=\"https://www.propublica.org/people/maya-miller\">Maya Miller</a> contributed reporting.</p>"}, "tags": [{"term": "Environment, Sacrifice Zones", "scheme": null, "label": null}], "updated": "2024-03-15T14:35:00-04:00", "updated_parsed": [2024, 3, 15, 18, 35, 0, 4, 75, 0], "authors": [{"name": "by Alejandra Martinez, The Texas Tribune"}], "author": "by Alejandra Martinez, The Texas Tribune", "author_detail": {"name": "by Alejandra Martinez, The Texas Tribune"}}, {"title": "Indiana Enacts Law to Allow State Child Services to Investigate More Abuse Claims at Youth Centers", "title_detail": {"type": "text/plain", "language": null, "base": "https://www.propublica.org/feeds/propublica/main", "value": "Indiana Enacts Law to Allow State Child Services to Investigate More Abuse Claims at Youth Centers"}, "links": [{"rel": "alternate", "type": "text/html", "href": "https://www.propublica.org/article/indiana-law-abuse-youth-treatment-centers"}], "link": "https://www.propublica.org/article/indiana-law-abuse-youth-treatment-centers", "published": "Fri, 15 Mar 2024 05:00:00 -0400", "published_parsed": [2024, 3, 15, 9, 0, 0, 4, 75, 0], "id": "https://www.propublica.org/article/indiana-law-abuse-youth-treatment-centers", "guidislink": false, "summary": "<p class=\"byline\">\n                by <span class=\"name\">Tony Cook</span>, <a href=\"https://www.indystar.com/\">IndyStar</a>                </p>\n                                             \n\n                                                                    \n            \n                <p>ProPublica is a nonprofit newsroom that investigates abuses of power. <a href=\"https://www.propublica.org/newsletters/dispatches?source=54G&amp;placement=top-note&amp;region=local\">Sign up for Dispatches</a>, a newsletter that spotlights wrongdoing around the country, to receive our stories in your inbox every week.</p>\n\n            \n\n                \n\n      \n  \n\n\n\n                    \n<p>Amid ongoing concerns about abuse at Indiana\u2019s residential youth centers, Gov. Eric Holcomb signed into law on Wednesday a measure intended to increase scrutiny of care and curb abuse.</p>\n\n<p>The new law authorizes the Indiana Department of Child Services to investigate claims of abuse at residential facilities involving youth ages 18 to 21. DCS previously screened out such complaints without investigating.</p>\n\n<p>The legislation is a response to an IndyStar-ProPublica investigation that uncovered more than two dozen allegations of sexual abuse or inappropriate behavior by employees at Pierceton Woods Academy, a northern Indiana residential treatment center for boys with substance use disorders and sexually harmful behaviors.</p>\n        \n    \n                    \n<p>In a story published in November, the news organizations found that <a href=\"https://www.indystar.com/restricted/?return=https%3A%2F%2Fwww.indystar.com%2Fstory%2Fnews%2Finvestigations%2F2023%2F11%2F28%2Fpierceton-woods-indiana-youth-center-dcs-failed-to-protect-teens-from-sexual-abuse%2F70606680007%2F\">DCS failed to investigate </a>some of the allegations. In at least one case, <a href=\"https://www.propublica.org/article/indiana-pierceton-woods-academy-abuse-allegations-teens\">records indicated DCS declined to look into claims against a staffer</a> because the alleged victim had turned 18 and was no longer considered a child. The accused staffer went on to sexually abuse a different resident two years later during a walk near the facility\u2019s soccer field, according to a subsequent DCS investigation.</p>\n\n<p>DCS also found that Pierceton Woods knew about sexual abuse claims but did not report them to the state\u2019s child abuse hotline. Indiana\u2019s mandatory reporting law requires suspected abuse to be reported to DCS or law enforcement immediately.</p>\n\n<p>In <a href=\"https://www.indystar.com/story/news/investigations/2024/03/05/why-dcs-revoked-wernle-youth-family-treatment-center-license-sexual-abuse-runaways-reporting/72736720007/\">another story published this month</a>, IndyStar found similar problems at Wernle Youth &amp; Family Treatment Center in Richmond. State records show the facility failed to report allegations of physical or sexual abuse on multiple occasions, including after a 21-year-old counselor engaged in a sexual act with a 14-year-old resident behind a trash receptacle in 2019.</p>\n\n<p>Such revelations stirred concern among lawmakers, especially because Pierceton Woods\u2019 parent organization, Lasting Change Inc., lobbied last year for legislation that would have given residential treatment centers immunity from the most common civil lawsuits filed by abuse victims. Lawmakers were poised to grant the request, but they scrapped the proposal at the last minute after <a href=\"https://www.indystar.com/story/news/2023/04/25/after-sexual-abuse-claims-youth-treatment-center-wants-immunity/70147775007/\">an IndyStar story</a> detailing abuse allegations at Pierceton Woods.</p>\n\n<p>Rep. Victoria Garcia Wilburn, a Democrat, worked across the aisle to get the new provision amended into a bill sponsored by two Republicans, Sen. Greg Walker and Rep. Chris Judy. The bill also codifies qualifications for case managers and others who work in residential facilities.</p>\n\n<p>In <a href=\"https://indianahousedemocrats.org/news-media/garcia-wilburn-language-to-resolve-dcs-residential-care-facility-reporting-issue-headed-to-governors-desk\">a statement</a>, Garcia Wilburn called the measure \u201can important step forward in empowering residential care facility employees to report suspected abuse, especially as more accounts of abuse at residential facilities have come to light.\u201d</p>\n\n<p>\u201cThe children who reside at residential care facilities often have experienced sexual abuse prior to their time at the facility, and it horrifies and saddens me that anyone would take advantage of a child in such a vulnerable state,\u201d she said. \u201cI believe that this will make progress in ensuring that all children at residential care facilities are kept safe and treated with the care, concern and respect they deserve.\u201d</p>\n\n<p>Her statement credited investigative reporting for prompting the legislation.</p>\n\n<p>\u201cThe law always comes before any facility \u2018policy,\u2019 and we\u2019ve made this crystal clear for employees and administrators alike,\u201d she said. \u201cThis code clarification has been a year in the making ever since the Indianapolis Star published an investigation about several employees\u2019 abuse of residents at Pierceton Woods Academy.\u201d</p>\n\n<p>Pierceton Woods, a faith-based nonprofit whose CEO, Tim Smith, is running for Congress, has previously denied failing to protect minors from sexual abuse. In an email on Thursday, company spokesperson Curtis Smith, who is not related to Tim Smith, said, \u201cThe reason we supported this bill from the beginning is that we serve, support, and treat all our residents with unconditional respect, and always have.\u201d</p>\n\n<p>Neither DCS nor the governor\u2019s office immediately responded to messages seeking comment.</p>\n\n<p>Garcia Wilburn and other lawmakers say there is still more work to do.</p>\n\n<p>Several related proposals failed to advance during this year\u2019s legislative session, including a measure from Rep. Becky Cash that would have increased criminal penalties for failing to report abuse.</p>\n\n<p>\u201cMy hope is that we can get a much larger piece of legislation to protect children and young adults in residential facilities next year,\u201d Cash, a Republican, said. \u201cI am also committed to getting legislation regarding abuses in youth sports and failure to report those abuses passed. We have a lot of work to do to protect children.\u201d</p>", "summary_detail": {"type": "text/html", "language": null, "base": "https://www.propublica.org/feeds/propublica/main", "value": "<p class=\"byline\">\n                by <span class=\"name\">Tony Cook</span>, <a href=\"https://www.indystar.com/\">IndyStar</a>                </p>\n                                             \n\n                                                                    \n            \n                <p>ProPublica is a nonprofit newsroom that investigates abuses of power. <a href=\"https://www.propublica.org/newsletters/dispatches?source=54G&amp;placement=top-note&amp;region=local\">Sign up for Dispatches</a>, a newsletter that spotlights wrongdoing around the country, to receive our stories in your inbox every week.</p>\n\n            \n\n                \n\n      \n  \n\n\n\n                    \n<p>Amid ongoing concerns about abuse at Indiana\u2019s residential youth centers, Gov. Eric Holcomb signed into law on Wednesday a measure intended to increase scrutiny of care and curb abuse.</p>\n\n<p>The new law authorizes the Indiana Department of Child Services to investigate claims of abuse at residential facilities involving youth ages 18 to 21. DCS previously screened out such complaints without investigating.</p>\n\n<p>The legislation is a response to an IndyStar-ProPublica investigation that uncovered more than two dozen allegations of sexual abuse or inappropriate behavior by employees at Pierceton Woods Academy, a northern Indiana residential treatment center for boys with substance use disorders and sexually harmful behaviors.</p>\n        \n    \n                    \n<p>In a story published in November, the news organizations found that <a href=\"https://www.indystar.com/restricted/?return=https%3A%2F%2Fwww.indystar.com%2Fstory%2Fnews%2Finvestigations%2F2023%2F11%2F28%2Fpierceton-woods-indiana-youth-center-dcs-failed-to-protect-teens-from-sexual-abuse%2F70606680007%2F\">DCS failed to investigate </a>some of the allegations. In at least one case, <a href=\"https://www.propublica.org/article/indiana-pierceton-woods-academy-abuse-allegations-teens\">records indicated DCS declined to look into claims against a staffer</a> because the alleged victim had turned 18 and was no longer considered a child. The accused staffer went on to sexually abuse a different resident two years later during a walk near the facility\u2019s soccer field, according to a subsequent DCS investigation.</p>\n\n<p>DCS also found that Pierceton Woods knew about sexual abuse claims but did not report them to the state\u2019s child abuse hotline. Indiana\u2019s mandatory reporting law requires suspected abuse to be reported to DCS or law enforcement immediately.</p>\n\n<p>In <a href=\"https://www.indystar.com/story/news/investigations/2024/03/05/why-dcs-revoked-wernle-youth-family-treatment-center-license-sexual-abuse-runaways-reporting/72736720007/\">another story published this month</a>, IndyStar found similar problems at Wernle Youth &amp; Family Treatment Center in Richmond. State records show the facility failed to report allegations of physical or sexual abuse on multiple occasions, including after a 21-year-old counselor engaged in a sexual act with a 14-year-old resident behind a trash receptacle in 2019.</p>\n\n<p>Such revelations stirred concern among lawmakers, especially because Pierceton Woods\u2019 parent organization, Lasting Change Inc., lobbied last year for legislation that would have given residential treatment centers immunity from the most common civil lawsuits filed by abuse victims. Lawmakers were poised to grant the request, but they scrapped the proposal at the last minute after <a href=\"https://www.indystar.com/story/news/2023/04/25/after-sexual-abuse-claims-youth-treatment-center-wants-immunity/70147775007/\">an IndyStar story</a> detailing abuse allegations at Pierceton Woods.</p>\n\n<p>Rep. Victoria Garcia Wilburn, a Democrat, worked across the aisle to get the new provision amended into a bill sponsored by two Republicans, Sen. Greg Walker and Rep. Chris Judy. The bill also codifies qualifications for case managers and others who work in residential facilities.</p>\n\n<p>In <a href=\"https://indianahousedemocrats.org/news-media/garcia-wilburn-language-to-resolve-dcs-residential-care-facility-reporting-issue-headed-to-governors-desk\">a statement</a>, Garcia Wilburn called the measure \u201can important step forward in empowering residential care facility employees to report suspected abuse, especially as more accounts of abuse at residential facilities have come to light.\u201d</p>\n\n<p>\u201cThe children who reside at residential care facilities often have experienced sexual abuse prior to their time at the facility, and it horrifies and saddens me that anyone would take advantage of a child in such a vulnerable state,\u201d she said. \u201cI believe that this will make progress in ensuring that all children at residential care facilities are kept safe and treated with the care, concern and respect they deserve.\u201d</p>\n\n<p>Her statement credited investigative reporting for prompting the legislation.</p>\n\n<p>\u201cThe law always comes before any facility \u2018policy,\u2019 and we\u2019ve made this crystal clear for employees and administrators alike,\u201d she said. \u201cThis code clarification has been a year in the making ever since the Indianapolis Star published an investigation about several employees\u2019 abuse of residents at Pierceton Woods Academy.\u201d</p>\n\n<p>Pierceton Woods, a faith-based nonprofit whose CEO, Tim Smith, is running for Congress, has previously denied failing to protect minors from sexual abuse. In an email on Thursday, company spokesperson Curtis Smith, who is not related to Tim Smith, said, \u201cThe reason we supported this bill from the beginning is that we serve, support, and treat all our residents with unconditional respect, and always have.\u201d</p>\n\n<p>Neither DCS nor the governor\u2019s office immediately responded to messages seeking comment.</p>\n\n<p>Garcia Wilburn and other lawmakers say there is still more work to do.</p>\n\n<p>Several related proposals failed to advance during this year\u2019s legislative session, including a measure from Rep. Becky Cash that would have increased criminal penalties for failing to report abuse.</p>\n\n<p>\u201cMy hope is that we can get a much larger piece of legislation to protect children and young adults in residential facilities next year,\u201d Cash, a Republican, said. \u201cI am also committed to getting legislation regarding abuses in youth sports and failure to report those abuses passed. We have a lot of work to do to protect children.\u201d</p>"}, "tags": [], "updated": "2024-03-15T05:00:00-04:00", "updated_parsed": [2024, 3, 15, 9, 0, 0, 4, 75, 0], "authors": [{"name": "by Tony Cook, IndyStar"}], "author": "by Tony Cook, IndyStar", "author_detail": {"name": "by Tony Cook, IndyStar"}}, {"title": "Customer Service Company That Worked With Disney, Comcast Will Pay $2M to Workers to Settle Lawsuit Over Pay Practices", "title_detail": {"type": "text/plain", "language": null, "base": "https://www.propublica.org/feeds/propublica/main", "value": "Customer Service Company That Worked With Disney, Comcast Will Pay $2M to Workers to Settle Lawsuit Over Pay Practices"}, "links": [{"rel": "alternate", "type": "text/html", "href": "https://www.propublica.org/article/arise-work-at-home-customer-service-settle-lawsuit"}], "link": "https://www.propublica.org/article/arise-work-at-home-customer-service-settle-lawsuit", "published": "Thu, 14 Mar 2024 07:00:00 -0400", "published_parsed": [2024, 3, 14, 11, 0, 0, 3, 74, 0], "id": "https://www.propublica.org/article/arise-work-at-home-customer-service-settle-lawsuit", "guidislink": false, "summary": "<p class=\"byline\">\n                by <a class=\"name\" href=\"https://www.propublica.org/people/justin-elliott\">Justin Elliott</a> and <a class=\"name\" href=\"https://www.propublica.org/people/ken-armstrong\">Ken Armstrong</a>                </p>\n                                             \n\n                                                                    \n            \n                <p>ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive <a href=\"https://www.propublica.org/newsletters/the-big-story?source=54G&amp;placement=top-note&amp;region=national\">our biggest stories</a> as soon as they\u2019re published.</p>\n\n            \n\n                \n\n      \n  \n\n\n\n                    \n<p>Arise Virtual Solutions, a work-at-home customer service company, will pay $2 million to workers in the District of Columbia to settle a lawsuit alleging the company failed to pay minimum wage and overtime.</p>\n\n<p>The company, which did not admit wrongdoing, <a href=\"https://oag.dc.gov/release/attorney-general-schwalb-secures-3-million-workers\">will pay an additional $940,000</a> to the District of Columbia in civil penalties and stop operating there.</p>\n\n<p>The lawsuit by the D.C. attorney general <a href=\"https://twitter.com/sarahmakesmaps/status/1767686108135948444\">was sparked by</a> a 2020 ProPublica <a href=\"https://www.propublica.org/article/meet-the-customer-service-reps-for-disney-and-airbnb-who-have-to-pay-to-talk-to-you\">investigation that revealed</a> how Arise required workers to pay for the company\u2019s training as well as monthly fees in order to take customer service calls on its \u201cplatform.\u201d The workers, who are mostly women and work from home, answer customer calls for major corporations such as Comcast and Disney, which contract with Arise.</p>\n        \n    \n                    \n<p>The company classifies the workers as \u201cindependent contractors,\u201d like Uber drivers. Such classification allows the company not to pay minimum wage or offer other labor protections. Customer service representatives told ProPublica, however, that the idea that they were independent was largely a fiction. Arise and the large corporations for whom they answered calls maintained a high level of control over their jobs.</p>\n\n<p>\u201cThis settlement puts more than $2 million into the pockets of workers Arise took advantage of in a misclassification scheme \u2014 an illegal practice that is, unfortunately, all too common in the District,\u201d D.C. Attorney General Brian Schwalb said.</p>\n\n<p>That money will be distributed among more than 250 workers in the district. Specific payouts will depend on several factors, including how much unpaid time each person worked.</p>\n\n<p><a href=\"https://www.arise.com/\">Arise</a>, which is based in Miramar, Florida, is owned by private equity giant <a href=\"https://warburgpincus.com/investments/vivtera-holdings/\">Warburg Pincus</a>. In a statement, an Arise spokesperson said: \u201cWhile we disagree with the office of the Attorney General\u2019s allegations, and their efforts to deprive business owners in the District of the economic opportunities that the Arise Platform provides, we are pleased to have resolved this matter and we will continue to move our business forward outside of the District.\u201d</p>\n\n<p>The company is facing a separate lawsuit filed by the U.S. Department of Labor in federal court in Florida last year. The government accused Arise of misclassifying more than 22,000 employees as independent contractors. The Labor Department\u2019s lawsuit, which asks the court to force Arise to pay those workers back wages and damages, \u201cmay be the largest misclassification case in its history,\u201d an agency <a href=\"https://www.dol.gov/newsroom/releases/WHD/WHD20230629-1\">news release</a> says.</p>\n\n<p>A Labor Department spokesperson said the agency had no comment on the case, saying it\u2019s still in litigation.</p>\n\n<p>In its complaint, the Labor Department recounts much of the litigation history against Arise that ProPublica reported on in its initial story, noting, for example, that two separate arbitrators have found that the company treated employees as independent contractors. One agent in the Arise network who won in arbitration, Tami Pendergraft, paid about $1,500 for home office equipment, paid for a background check and training, devoted 44 unpaid days to passing a certification course, and then worked three weeks fielding telephone calls from AT&amp;T customers. After all that, she got a single paycheck for $96.12.</p>\n\n<p>Arise, in court records, denied the Labor Department\u2019s allegation that it misclassifies workers. Referring to the agents as \u201cservice partners,\u201d Arise says they are independent contractors who \u201ccontrol their service schedules and have flexibility to provide customer support services to clients whenever and wherever they want to service.\u201d</p>\n\n<p>\u201cThis independent contractor model,\u201d Arise writes in court records, \u201chas benefitted many groups who have been poorly served by a regimented employment model, including disabled individuals, veterans, caregivers, and others who particularly benefit from such flexibility.\u201d</p>\n\n<p>The Arise spokesperson said the company disagrees \u201cwith the Department of Labor\u2019s efforts to take away the opportunities that the Arise Platform provides. We have and will continue working with the Department of Labor to answer questions and illustrate how we appropriately use the independent contractor relationship to protect flexibility and increase economic opportunity.\u201d</p>", "summary_detail": {"type": "text/html", "language": null, "base": "https://www.propublica.org/feeds/propublica/main", "value": "<p class=\"byline\">\n                by <a class=\"name\" href=\"https://www.propublica.org/people/justin-elliott\">Justin Elliott</a> and <a class=\"name\" href=\"https://www.propublica.org/people/ken-armstrong\">Ken Armstrong</a>                </p>\n                                             \n\n                                                                    \n            \n                <p>ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive <a href=\"https://www.propublica.org/newsletters/the-big-story?source=54G&amp;placement=top-note&amp;region=national\">our biggest stories</a> as soon as they\u2019re published.</p>\n\n            \n\n                \n\n      \n  \n\n\n\n                    \n<p>Arise Virtual Solutions, a work-at-home customer service company, will pay $2 million to workers in the District of Columbia to settle a lawsuit alleging the company failed to pay minimum wage and overtime.</p>\n\n<p>The company, which did not admit wrongdoing, <a href=\"https://oag.dc.gov/release/attorney-general-schwalb-secures-3-million-workers\">will pay an additional $940,000</a> to the District of Columbia in civil penalties and stop operating there.</p>\n\n<p>The lawsuit by the D.C. attorney general <a href=\"https://twitter.com/sarahmakesmaps/status/1767686108135948444\">was sparked by</a> a 2020 ProPublica <a href=\"https://www.propublica.org/article/meet-the-customer-service-reps-for-disney-and-airbnb-who-have-to-pay-to-talk-to-you\">investigation that revealed</a> how Arise required workers to pay for the company\u2019s training as well as monthly fees in order to take customer service calls on its \u201cplatform.\u201d The workers, who are mostly women and work from home, answer customer calls for major corporations such as Comcast and Disney, which contract with Arise.</p>\n        \n    \n                    \n<p>The company classifies the workers as \u201cindependent contractors,\u201d like Uber drivers. Such classification allows the company not to pay minimum wage or offer other labor protections. Customer service representatives told ProPublica, however, that the idea that they were independent was largely a fiction. Arise and the large corporations for whom they answered calls maintained a high level of control over their jobs.</p>\n\n<p>\u201cThis settlement puts more than $2 million into the pockets of workers Arise took advantage of in a misclassification scheme \u2014 an illegal practice that is, unfortunately, all too common in the District,\u201d D.C. Attorney General Brian Schwalb said.</p>\n\n<p>That money will be distributed among more than 250 workers in the district. Specific payouts will depend on several factors, including how much unpaid time each person worked.</p>\n\n<p><a href=\"https://www.arise.com/\">Arise</a>, which is based in Miramar, Florida, is owned by private equity giant <a href=\"https://warburgpincus.com/investments/vivtera-holdings/\">Warburg Pincus</a>. In a statement, an Arise spokesperson said: \u201cWhile we disagree with the office of the Attorney General\u2019s allegations, and their efforts to deprive business owners in the District of the economic opportunities that the Arise Platform provides, we are pleased to have resolved this matter and we will continue to move our business forward outside of the District.\u201d</p>\n\n<p>The company is facing a separate lawsuit filed by the U.S. Department of Labor in federal court in Florida last year. The government accused Arise of misclassifying more than 22,000 employees as independent contractors. The Labor Department\u2019s lawsuit, which asks the court to force Arise to pay those workers back wages and damages, \u201cmay be the largest misclassification case in its history,\u201d an agency <a href=\"https://www.dol.gov/newsroom/releases/WHD/WHD20230629-1\">news release</a> says.</p>\n\n<p>A Labor Department spokesperson said the agency had no comment on the case, saying it\u2019s still in litigation.</p>\n\n<p>In its complaint, the Labor Department recounts much of the litigation history against Arise that ProPublica reported on in its initial story, noting, for example, that two separate arbitrators have found that the company treated employees as independent contractors. One agent in the Arise network who won in arbitration, Tami Pendergraft, paid about $1,500 for home office equipment, paid for a background check and training, devoted 44 unpaid days to passing a certification course, and then worked three weeks fielding telephone calls from AT&amp;T customers. After all that, she got a single paycheck for $96.12.</p>\n\n<p>Arise, in court records, denied the Labor Department\u2019s allegation that it misclassifies workers. Referring to the agents as \u201cservice partners,\u201d Arise says they are independent contractors who \u201ccontrol their service schedules and have flexibility to provide customer support services to clients whenever and wherever they want to service.\u201d</p>\n\n<p>\u201cThis independent contractor model,\u201d Arise writes in court records, \u201chas benefitted many groups who have been poorly served by a regimented employment model, including disabled individuals, veterans, caregivers, and others who particularly benefit from such flexibility.\u201d</p>\n\n<p>The Arise spokesperson said the company disagrees \u201cwith the Department of Labor\u2019s efforts to take away the opportunities that the Arise Platform provides. We have and will continue working with the Department of Labor to answer questions and illustrate how we appropriately use the independent contractor relationship to protect flexibility and increase economic opportunity.\u201d</p>"}, "tags": [{"term": "Labor, The New Sweatshop", "scheme": null, "label": null}], "updated": "2024-03-14T07:00:00-04:00", "updated_parsed": [2024, 3, 14, 11, 0, 0, 3, 74, 0], "authors": [{"name": "by Justin Elliott and Ken Armstrong"}], "author": "by Justin Elliott and Ken Armstrong", "author_detail": {"name": "by Justin Elliott and Ken Armstrong"}}, {"title": "Virginia Lawmakers Approve Commission to Examine Universities\u2019 Displacement of Black Communities", "title_detail": {"type": "text/plain", "language": null, "base": "https://www.propublica.org/feeds/propublica/main", "value": "Virginia Lawmakers Approve Commission to Examine Universities\u2019 Displacement of Black Communities"}, "links": [{"rel": "alternate", "type": "text/html", "href": "https://www.propublica.org/article/virginia-commission-investigate-black-community-displacement-universities"}], "link": "https://www.propublica.org/article/virginia-commission-investigate-black-community-displacement-universities", "published": "Thu, 14 Mar 2024 06:00:00 -0400", "published_parsed": [2024, 3, 14, 10, 0, 0, 3, 74, 0], "id": "https://www.propublica.org/article/virginia-commission-investigate-black-community-displacement-universities", "guidislink": false, "summary": "<p class=\"byline\">\n                by <span class=\"name\">Brandi Kellam</span>                </p>\n                                             \n\n        \n                        <p>This article was produced for ProPublica\u2019s Local Reporting Network in partnership with the <a href=\"https://vcij.org/\">Virginia Center for Investigative Reporting at WHRO</a>. <a href=\"https://www.propublica.org/newsletters/dispatches\">Sign up for Dispatches</a> to get stories like this one as soon as they are published.</p>\n\n        \n\n    \n      \n  \n\n\n\n                    \n<p>The Virginia legislature has approved creating a statewide commission to investigate the role of public colleges and universities in displacing Black communities.</p>\n\n<p>The legislature\u2019s action represents a milestone for the budding national movement to seek compensation for families dispossessed by university expansion. It follows a 2023 series by ProPublica and the Virginia Center for Investigative Journalism at WHRO, which showed that <a href=\"https://www.propublica.org/series/uprooted\">universities nationwide have uprooted tens of thousands of families of color</a>, contributing to Black land loss and lagging rates of Black home ownership. The series, which detailed how the creation and expansion of <a href=\"https://cnu.edu\">Christopher Newport University</a> in Newport News, Virginia, swallowed up a Black neighborhood, spurred city and university leaders there to create a similar task force in January.</p>\n\n<p>The state budget passed by the legislature Saturday would establish a commission to determine whether any public institution of higher education in Virginia \u201chas purchased, expropriated, or otherwise taken possession\u201d of properties in Black neighborhoods to establish or expand a campus, and whether compensation would be \u201cappropriate\u201d for the property owners or their descendants, according to the bill. The commission will also research similar acquisitions in other states to provide context. The panel would report its findings annually to the legislature and submit final recommendations by July 2027. National higher education groups said they are unaware of any other statewide commissions studying the issue. </p>\n\n<p>The Virginia commission would include 10 legislators, the state\u2019s two top education officials and seven members of the public. Gov. Glenn Youngkin has until April 17 to sign the budget; he could also veto specific line items such as the commission\u2019s funding, which consists of $28,760 per year for members\u2019 expenses. Commission staff will be paid separately by the state Division of Legislative Services.</p>\n        \n    \n                    \n<p>\u201cMy country has gone from uprooting Black communities violently to legally doing it,\u201d the Rev. Robin D. Mines, a Richmond minister, testified at a legislative hearing last month in support of the provision. \u201cIt is far past due time to do something about this and bringing hope to our communities.\u201d</p>\n\n<p>By documenting the confiscation and destruction of Black neighborhoods for higher-education facilities, the ProPublica-VCIJ series added to the debate over how universities address the legacy of racial injustice \u2014 both on their campuses and in the country as a whole. Numerous universities are grappling with their racial histories, even as red states are restricting classroom discussion of critical race theory, which holds that racism is ingrained in America\u2019s laws and power structures.</p>\n\n<p>Del. Delores McQuinn, a Richmond Democrat, <a href=\"https://vcij.org/stories/lawmaker-seeks-study-relief-for-black-communities-uprooted-by-virginia-universities\">introduced legislation in January to create the commission</a>. McQuinn originally proposed allocating $150,000 a year, which was reduced in the conference committee process after her bill was inserted into the budget. She said she would request more funding if needed.</p>\n\n<p>McQuinn, who will be a member of the commission, said she will seek input from other legislators, historians and families affected by university expansion. She said the commission would address \u201chow we repair some of the damage that has been done, whether it is through actual dollars, or scholarships or other kinds of ways.\u201d</p>\n\n<p>She declined to speculate on whether the governor would veto the commission. Youngkin, a Republican, issued an executive order in 2022 to end the use in K-12 schools of what he called \u201cinherently divisive concepts,\u201d including critical race theory, which is more commonly taught in colleges and graduate schools. In a statement Saturday after the legislative session ended, Youngkin said that the legislature \u201csent me more than a thousand bills plus backward budgets that need a lot of work,\u201d and that he would review and decide on them in the next 30 days.</p>\n\n<p>In the past two decades, prominent universities including <a href=\"https://news.harvard.edu/gazette/story/2022/04/slavery-probe-harvards-ties-inseparable-from-rise/\">Harvard</a>, <a href=\"https://yaleandslavery.0yale.edu/university-statement\">Yale</a>, <a href=\"https://slaveryandjustice.brown.edu/report\">Brown</a> and the <a href=\"https://slavery.virginia.edu/\">University of Virginia</a> have issued extensive mea culpas describing their historical involvement with the slave trade and slave owners. In Virginia, a 2021 law required UVA and four other universities that were established before the Civil War and used enslaved laborers to search for descendants and <a href=\"https://news.virginia.edu/content/new-law-signed-uva-focuses-reparations-descendants-enslaved-workers\">make reparations through scholarships</a> or community-based economic development and memorial programs.</p>\n\n<p>The 2020 protests over the murder of George Floyd prompted more institutions to reexamine their history of racial injustice. Still, only a few universities have reckoned with the impact of their growth on communities of color. In 2022, Colorado lawmakers allocated $2 million in scholarships for families and descendants of the Auraria community in Denver. The establishment of the University of Colorado at Denver campus in the early 1970s and its subsequent growth displaced 350 families and reduced the predominantly Hispanic neighborhood to just 13 cottages and a grocery store. The scholarship program eliminates fees and tuition for students and families who lived in the community between 1955 and 1973.</p>\n\n<p>In Athens, Georgia, former residents of the Linnentown neighborhood have sought redress for the taking of their community by eminent domain to develop dormitories for the University of Georgia in the early 1960s. Researchers estimated the property seizures cost Black families $5 million in current dollars, mostly due to underpayment for the land.</p>\n\n<p>Commissioners in Athens-Clarke County, where that university is located, passed a resolution in 2021 urging the state to compensate the roughly 50 displaced families and their descendants. They set aside $2.5 million to build affordable housing and a community center. The University of Georgia, citing a state constitutional ban on voluntary public funding for third parties, has rejected the concept of reparations.</p>\n\n<p>Virginia legislators began discussing redress for uprooted families in response to the ProPublica-VCIJ series and <a href=\"https://www.youtube.com/watch?v=o80ENCqNFAc\">an accompanying documentary film</a>, which both explored how Newport News\u2019 all-white city council seized the core of a thriving Black community in and around Shoe Lane by eminent domain in the early 1960s to build Christopher Newport\u2019s campus. City leaders wanted to \u201c<a href=\"https://www.propublica.org/article/how-virginia-college-expanded-by-uprooting-black-neighborhood\">erase the Black spot</a>\u201d near a segregated country club. In the ensuing decades, the school acquired almost all of the remaining homes.</p>\n\n<p>Following the first article in the series, Christopher Newport University President William Kelly acknowledged in a message to faculty and staff that the university\u2019s progress \u201chas come at a human cost, and we must continue to learn about and understand our complicated history.\u201d Kelly, who became president last year, has also said that incoming freshmen will be taught at orientation about the college\u2019s origins and evolution. In January, the city of Newport News and CNU announced a task force to review decades of property acquisitions and consider possible redress for displaced families.</p>\n\n<p>Christopher Newport University has declined to comment to ProPublica or VCIJ on the joint local task force or the possible state commission.</p>\n\n<p>Other Virginia state universities that absorbed Black communities have tried to make amends for their history. Old Dominion University\u2019s expansion since the early 1960s diminished a once-thriving Black community in Norfolk called Lamberts Point. In the 1990s, the university established scholarships and a jobs program for current neighborhood residents.</p>\n\n<p>A memorial on UVA\u2019s campus acknowledges its centuries of mistreatment of Black people both during and after slavery, including employees and local residents. In 2020, UVA President Jim Ryan announced a goal to build as many as 1,500 affordable homes and apartments on property owned by the school and its affiliates. The housing would be open to residents outside the university community.</p>\n\n<p>While the Virginia measure focuses on public universities because they were established by the state, private institutions have their own fraught history. The University of Richmond, for example, acknowledged in 2019 that part of the campus was built on top of a cemetery for enslaved persons. The university is planning a memorial to honor the people buried there.</p>\n\n<p>McQuinn, the legislation\u2019s sponsor, said that she has long been aware of the displacement of Black neighborhoods by universities, but that the ProPublica-VCIJ series spurred her to act. Several supporters of the proposal, including the heads of the statewide and Richmond chapters of the NAACP, attended the Feb. 9 subcommittee hearing in person or online.</p>\n\n<p>Others submitted comments via the General Assembly\u2019s portal. \u201cI see an opportunity to right the wrongs of the past,\u201d wrote a Richmond resident identifying himself only as Antoine. He added that the \u201cpushback\u201d against studying the history of racial injustice, like the university expansions themselves, is \u201creminiscent once again of the erasure of a culture.\u201d</p>\n        \n             \n\n                                    \n        \n                        <p>Louis Hansen contributed reporting.</p>", "summary_detail": {"type": "text/html", "language": null, "base": "https://www.propublica.org/feeds/propublica/main", "value": "<p class=\"byline\">\n                by <span class=\"name\">Brandi Kellam</span>                </p>\n                                             \n\n        \n                        <p>This article was produced for ProPublica\u2019s Local Reporting Network in partnership with the <a href=\"https://vcij.org/\">Virginia Center for Investigative Reporting at WHRO</a>. <a href=\"https://www.propublica.org/newsletters/dispatches\">Sign up for Dispatches</a> to get stories like this one as soon as they are published.</p>\n\n        \n\n    \n      \n  \n\n\n\n                    \n<p>The Virginia legislature has approved creating a statewide commission to investigate the role of public colleges and universities in displacing Black communities.</p>\n\n<p>The legislature\u2019s action represents a milestone for the budding national movement to seek compensation for families dispossessed by university expansion. It follows a 2023 series by ProPublica and the Virginia Center for Investigative Journalism at WHRO, which showed that <a href=\"https://www.propublica.org/series/uprooted\">universities nationwide have uprooted tens of thousands of families of color</a>, contributing to Black land loss and lagging rates of Black home ownership. The series, which detailed how the creation and expansion of <a href=\"https://cnu.edu\">Christopher Newport University</a> in Newport News, Virginia, swallowed up a Black neighborhood, spurred city and university leaders there to create a similar task force in January.</p>\n\n<p>The state budget passed by the legislature Saturday would establish a commission to determine whether any public institution of higher education in Virginia \u201chas purchased, expropriated, or otherwise taken possession\u201d of properties in Black neighborhoods to establish or expand a campus, and whether compensation would be \u201cappropriate\u201d for the property owners or their descendants, according to the bill. The commission will also research similar acquisitions in other states to provide context. The panel would report its findings annually to the legislature and submit final recommendations by July 2027. National higher education groups said they are unaware of any other statewide commissions studying the issue. </p>\n\n<p>The Virginia commission would include 10 legislators, the state\u2019s two top education officials and seven members of the public. Gov. Glenn Youngkin has until April 17 to sign the budget; he could also veto specific line items such as the commission\u2019s funding, which consists of $28,760 per year for members\u2019 expenses. Commission staff will be paid separately by the state Division of Legislative Services.</p>\n        \n    \n                    \n<p>\u201cMy country has gone from uprooting Black communities violently to legally doing it,\u201d the Rev. Robin D. Mines, a Richmond minister, testified at a legislative hearing last month in support of the provision. \u201cIt is far past due time to do something about this and bringing hope to our communities.\u201d</p>\n\n<p>By documenting the confiscation and destruction of Black neighborhoods for higher-education facilities, the ProPublica-VCIJ series added to the debate over how universities address the legacy of racial injustice \u2014 both on their campuses and in the country as a whole. Numerous universities are grappling with their racial histories, even as red states are restricting classroom discussion of critical race theory, which holds that racism is ingrained in America\u2019s laws and power structures.</p>\n\n<p>Del. Delores McQuinn, a Richmond Democrat, <a href=\"https://vcij.org/stories/lawmaker-seeks-study-relief-for-black-communities-uprooted-by-virginia-universities\">introduced legislation in January to create the commission</a>. McQuinn originally proposed allocating $150,000 a year, which was reduced in the conference committee process after her bill was inserted into the budget. She said she would request more funding if needed.</p>\n\n<p>McQuinn, who will be a member of the commission, said she will seek input from other legislators, historians and families affected by university expansion. She said the commission would address \u201chow we repair some of the damage that has been done, whether it is through actual dollars, or scholarships or other kinds of ways.\u201d</p>\n\n<p>She declined to speculate on whether the governor would veto the commission. Youngkin, a Republican, issued an executive order in 2022 to end the use in K-12 schools of what he called \u201cinherently divisive concepts,\u201d including critical race theory, which is more commonly taught in colleges and graduate schools. In a statement Saturday after the legislative session ended, Youngkin said that the legislature \u201csent me more than a thousand bills plus backward budgets that need a lot of work,\u201d and that he would review and decide on them in the next 30 days.</p>\n\n<p>In the past two decades, prominent universities including <a href=\"https://news.harvard.edu/gazette/story/2022/04/slavery-probe-harvards-ties-inseparable-from-rise/\">Harvard</a>, <a href=\"https://yaleandslavery.0yale.edu/university-statement\">Yale</a>, <a href=\"https://slaveryandjustice.brown.edu/report\">Brown</a> and the <a href=\"https://slavery.virginia.edu/\">University of Virginia</a> have issued extensive mea culpas describing their historical involvement with the slave trade and slave owners. In Virginia, a 2021 law required UVA and four other universities that were established before the Civil War and used enslaved laborers to search for descendants and <a href=\"https://news.virginia.edu/content/new-law-signed-uva-focuses-reparations-descendants-enslaved-workers\">make reparations through scholarships</a> or community-based economic development and memorial programs.</p>\n\n<p>The 2020 protests over the murder of George Floyd prompted more institutions to reexamine their history of racial injustice. Still, only a few universities have reckoned with the impact of their growth on communities of color. In 2022, Colorado lawmakers allocated $2 million in scholarships for families and descendants of the Auraria community in Denver. The establishment of the University of Colorado at Denver campus in the early 1970s and its subsequent growth displaced 350 families and reduced the predominantly Hispanic neighborhood to just 13 cottages and a grocery store. The scholarship program eliminates fees and tuition for students and families who lived in the community between 1955 and 1973.</p>\n\n<p>In Athens, Georgia, former residents of the Linnentown neighborhood have sought redress for the taking of their community by eminent domain to develop dormitories for the University of Georgia in the early 1960s. Researchers estimated the property seizures cost Black families $5 million in current dollars, mostly due to underpayment for the land.</p>\n\n<p>Commissioners in Athens-Clarke County, where that university is located, passed a resolution in 2021 urging the state to compensate the roughly 50 displaced families and their descendants. They set aside $2.5 million to build affordable housing and a community center. The University of Georgia, citing a state constitutional ban on voluntary public funding for third parties, has rejected the concept of reparations.</p>\n\n<p>Virginia legislators began discussing redress for uprooted families in response to the ProPublica-VCIJ series and <a href=\"https://www.youtube.com/watch?v=o80ENCqNFAc\">an accompanying documentary film</a>, which both explored how Newport News\u2019 all-white city council seized the core of a thriving Black community in and around Shoe Lane by eminent domain in the early 1960s to build Christopher Newport\u2019s campus. City leaders wanted to \u201c<a href=\"https://www.propublica.org/article/how-virginia-college-expanded-by-uprooting-black-neighborhood\">erase the Black spot</a>\u201d near a segregated country club. In the ensuing decades, the school acquired almost all of the remaining homes.</p>\n\n<p>Following the first article in the series, Christopher Newport University President William Kelly acknowledged in a message to faculty and staff that the university\u2019s progress \u201chas come at a human cost, and we must continue to learn about and understand our complicated history.\u201d Kelly, who became president last year, has also said that incoming freshmen will be taught at orientation about the college\u2019s origins and evolution. In January, the city of Newport News and CNU announced a task force to review decades of property acquisitions and consider possible redress for displaced families.</p>\n\n<p>Christopher Newport University has declined to comment to ProPublica or VCIJ on the joint local task force or the possible state commission.</p>\n\n<p>Other Virginia state universities that absorbed Black communities have tried to make amends for their history. Old Dominion University\u2019s expansion since the early 1960s diminished a once-thriving Black community in Norfolk called Lamberts Point. In the 1990s, the university established scholarships and a jobs program for current neighborhood residents.</p>\n\n<p>A memorial on UVA\u2019s campus acknowledges its centuries of mistreatment of Black people both during and after slavery, including employees and local residents. In 2020, UVA President Jim Ryan announced a goal to build as many as 1,500 affordable homes and apartments on property owned by the school and its affiliates. The housing would be open to residents outside the university community.</p>\n\n<p>While the Virginia measure focuses on public universities because they were established by the state, private institutions have their own fraught history. The University of Richmond, for example, acknowledged in 2019 that part of the campus was built on top of a cemetery for enslaved persons. The university is planning a memorial to honor the people buried there.</p>\n\n<p>McQuinn, the legislation\u2019s sponsor, said that she has long been aware of the displacement of Black neighborhoods by universities, but that the ProPublica-VCIJ series spurred her to act. Several supporters of the proposal, including the heads of the statewide and Richmond chapters of the NAACP, attended the Feb. 9 subcommittee hearing in person or online.</p>\n\n<p>Others submitted comments via the General Assembly\u2019s portal. \u201cI see an opportunity to right the wrongs of the past,\u201d wrote a Richmond resident identifying himself only as Antoine. He added that the \u201cpushback\u201d against studying the history of racial injustice, like the university expansions themselves, is \u201creminiscent once again of the erasure of a culture.\u201d</p>\n        \n             \n\n                                    \n        \n                        <p>Louis Hansen contributed reporting.</p>"}, "tags": [{"term": "Racial Justice, Uprooted", "scheme": null, "label": null}], "updated": "2024-03-14T06:00:00-04:00", "updated_parsed": [2024, 3, 14, 10, 0, 0, 3, 74, 0], "authors": [{"name": "by Brandi Kellam"}], "author": "by Brandi Kellam", "author_detail": {"name": "by Brandi Kellam"}}, {"title": "Gangsters, Money and Murder: How Chinese Organized Crime Is Dominating America\u2019s Illegal Marijuana Market", "title_detail": {"type": "text/plain", "language": null, "base": "https://www.propublica.org/feeds/propublica/main", "value": "Gangsters, Money and Murder: How Chinese Organized Crime Is Dominating America\u2019s Illegal Marijuana Market"}, "links": [{"rel": "alternate", "type": "text/html", "href": "https://www.propublica.org/article/chinese-organized-crime-us-marijuana-market"}], "link": "https://www.propublica.org/article/chinese-organized-crime-us-marijuana-market", "published": "Thu, 14 Mar 2024 05:00:00 -0400", "published_parsed": [2024, 3, 14, 9, 0, 0, 3, 74, 0], "id": "https://www.propublica.org/article/chinese-organized-crime-us-marijuana-market", "guidislink": false, "summary": "<p class=\"byline\">\n                by <a class=\"name\" href=\"https://www.propublica.org/people/sebastian-rotella\">Sebastian Rotella</a> and <a class=\"name\" href=\"https://www.propublica.org/people/kirsten-berg\">Kirsten Berg</a>, ProPublica, and <a class=\"name\" href=\"https://www.readfrontier.org/author/garrett/\">Garrett Yalch</a> and <a class=\"name\" href=\"https://www.readfrontier.org/author/clifton-adcock/\">Clifton Adcock</a>, The Frontier                </p>\n                                             \n\n        \n                        <p>ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive <a href=\"https://www.propublica.org/newsletters/the-big-story?source=www.propublica.org&amp;placement=top-note&amp;region=national\">our biggest stories</a> as soon as they\u2019re published. This article was produced in partnership with <a href=\"https://www.readfrontier.org/\">The Frontier</a>. Additional funding for this story was provided by The Pulitzer Center.</p>\n\n        \n\n    \n      \n  \n\n\n\n                    \n<p>It seemed an unlikely spot for a showdown between Chinese gangsters: a marijuana farm on the prairie in Kingfisher County, Oklahoma. </p>\n\n<p>On a Sunday evening in late November 2022, a blue Toyota Corolla sped down a dirt-and-gravel road in the twilight, passing hay meadows and columns of giant wind turbines spinning on the horizon. The Corolla braked and turned, headlights sweeping across prairie grass, and entered the driveway of a 10-acre compound filled with circular huts and row after row of greenhouses. Past a ranch house, the sedan stopped outside a large detached garage.</p>\n\n<p>The driver, Chen Wu, burst out of the car with a 9 mm pistol in his hand. Balding and muscular, he had worked at the farm and invested in the illegal marijuana operation. </p>\n\n<p>Charging into the garage, Wu confronted the five men and one woman working inside. Like him, they were immigrants from China. Piles of marijuana leaves cluttered the brightly lit room, covering a table and stuffed into plastic bins and cardboard boxes.</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            Stacks and boxes of marijuana fill the garage where four people were shot to death on a farm, shown in a still image from a sheriff\u2019s deputy\u2019s bodycam video.\n    \n            (Kingfisher County Sheriff\u2019s Department)\n    \n    \n    \n\n    \n\n        \n    \n                    \n<p>Wu aimed his gun at He Qiang Chen, a 56-year-old ex-convict known at the farm as \u201cthe Boss.\u201d Chen had a temper; he was awaiting trial in the beating and shooting of a man two years earlier at a Chinese community center in Oklahoma City. </p>\n\n<p>Before Chen could make a move, Wu shot him in the right knee. The boss fell to the floor, writhing in pain. </p>\n\n<p>Wu held the others at gunpoint. He said Chen owed him $300,000 and told his hostages they had half an hour to get him the money. </p>\n\n<p>If they didn\u2019t, he said, he would kill them all.</p>\n        \n    \n                    \n<p>Both the shooter and his victim were from Fujian, a coastal province known for mafias, immigration and corruption. They had come to America and joined a wave of new players rushing into the nation\u2019s billion-dollar marijuana boom: Chinese mobsters who roam from state to state, harvesting drugs and cash and overwhelming law enforcement with their resources and elusiveness. </p>\n\n<p>Now, their itinerant odysseys had collided in this remote outpost in the heartland. The clash left four people dead and unveiled an international underworld of dangerous dimensions.  </p>\n\nWild West\n<p>The bloodshed in Kingfisher County made national headlines, highlighting  Oklahoma\u2019s role as the latest and wildest frontier in the marijuana underworld.</p>\n\n<p>From California to Maine, Chinese organized crime has come to dominate much of the nation\u2019s illicit marijuana trade, an investigation by ProPublica and The Frontier has found. Along with the explosive growth of this criminal industry, the gangsters have unleashed lawlessness: violence, drug trafficking, money laundering, gambling, bribery, document fraud, bank fraud, environmental damage and theft of water and electricity. </p>\n\n<p>Chinese organized crime \u201chas taken over marijuana in Oklahoma and the United States,\u201d said Donnie Anderson, the director of the Oklahoma Bureau of Narcotics and Dangerous Drugs, in an interview. </p>\n\n<p>Among the victims are thousands of Chinese immigrants, many of them smuggled across the Mexican border to toil in often abusive conditions at farms ringed by fences, surveillance cameras and guards with guns and machetes. A grim offshoot of this indentured servitude: Traffickers force Chinese immigrant women into prostitution for the bosses of the agricultural workforce. </p>\n\n<p>The mobsters operate in a loose but disciplined confederation overseen from New York by mafias rooted in southern China, according to state and federal officials. Known as \u201ctriads\u201d because of an emblem used long ago by secret societies, these criminal groups wield power at home and throughout the diaspora and allegedly maintain an alliance with the Chinese state.</p>\n\n<p>In 2018, the mafias set their sights on Oklahoma when the state\u2019s voters approved a ballot measure that legalized the cultivation and sale of marijuana for medicinal purposes. The law did not limit the number of dispensaries or growing operations \u2013 known in the industry simply as \u201cgrows.\u201d It requires marijuana businesses to have majority owners who have lived in the state for two years, and it bars <a href=\"https://www.oscn.net/applications/oscn/DeliverDocument.asp?CiteID=486029\">shipping</a> the product <a href=\"https://law.justia.com/codes/oklahoma/2022/title-63/section-63-423v1/\">across state lines</a>. But limited enforcement enabled out-of-state investors to recruit illegal \u201cstraw owners\u201d and to traffic weed clandestinely across the country. And land was cheap. In this wide-open atmosphere, the industry grew at breakneck speed and, regulators say, is now second only to the oil and gas industry in the state. </p>\n\n<p>Since Colorado became the first state to legalize marijuana for personal use in 2012, a patchwork of marijuana-related legislation has developed across the country. State authorities generally require licenses and put limits on cultivation, and federal law prohibits interstate sales. But steep taxes on legal products and gaps and differences in laws across states have created the conditions for a massive black market to thrive.</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            A body-camera image shows a law enforcement officer responding to the murders at the marijuana farm.\n    \n            (Kingfisher County Sheriff\u2019s Department)\n    \n    \n    \n\n    \n\n        \n    \n                    \n<p>Oklahoma has quickly become a top supplier of illicit weed. Although street prices fluctuate and calculating the value of a black market is complex, officials estimate the value of the illegal marijuana grown in the state at somewhere between $18 billion and $44 billion a year. State investigators have found links between foreign mafias and over 3,000 illegal grows \u2014 and they say that more than 80% of the criminal groups are of Chinese origin. </p>\n\n<p>The federal response, however, has been muted. With the spread of legalization and decriminalization, enforcement has become a low priority for the U.S. Department of Justice, anti-drug veterans say. </p>\n\n<p>\u201cThe challenge we are having is a lack of interest by federal prosecutors to charge illicit marijuana cases,\u201d said Ray Donovan, the former chief of operations of the Drug Enforcement Administration. \u201cThey don\u2019t realize all the implications. Marijuana causes so much crime at the local level, gun violence in particular. The same groups selling thousands of pounds of marijuana are also laundering millions of dollars of fentanyl money. It\u2019s not just one-dimensional.\u201d</p>\n\n<p>The expansion into the cannabis market is propelling the rise of Chinese organized crime as a global powerhouse, current and former national security officials say. During the past decade, <a href=\"https://www.propublica.org/article/china-cartels-xizhi-li-money-laundering\">Chinese mafias became the dominant money launderers</a> for Latin American cartels dealing narcotics including fentanyl, which has killed hundreds of thousands of Americans. The huge revenue stream from marijuana fuels that laundering apparatus, which is \u201cthe most extensive network of underground banking in the world,\u201d said a former senior DEA official, Donald Im. </p>\n\n<p>\u201cThe profits from the marijuana trade allow the Chinese organized criminal networks to expand their underground global banking system for cartels and other criminal organizations,\u201d said Im, who was an architect of the DEA\u2019s fight against Chinese organized crime.</p>\n        \n    \n                            \n    \n                    \n<p>U.S. law enforcement struggles to respond to this multifaceted threat. State and federal agencies suffer from a lack of personnel who know Chinese language and culture well enough to investigate complex cases, infiltrate networks or translate intercepts, current and former officials say. A federal shift of priorities to counterterrorism after 2001 meant resources dedicated to Chinese organized crime dwindled \u2014 while the power of the underworld grew. </p>\n\n<p>And the shadow of the Chinese state hovers over it all. <a href=\"https://www.propublica.org/article/how-beijing-chinese-mafia-europe-protect-interests\">As ProPublica has reported</a>, the authoritarian regime and the mafias allegedly maintain an alliance that benefits both sides. In exchange for government protection, Chinese mobsters <a href=\"https://www.smh.com.au/national/illegal-malign-china-s-state-sponsored-crime-stretches-across-pacific-20230517-p5d8xe.html\">deliver services</a> such as illegally moving money overseas for the Communist Party elite and helping to spy on and intimidate Chinese immigrant communities, according to Western national security officials, case files, Chinese dissidents and human rights groups. </p>\n\n<p>Because China has emerged as the top geopolitical rival of the United States, carrying out brazen espionage and influence activities in this country, the spread of Chinese mafias in Oklahoma and elsewhere also poses a potential national security threat, state and federal officials say. </p>\n\n<p>Leaders of Chinese cultural associations in Oklahoma and other states are allegedly connected to both the illegal marijuana trade and to Chinese government officials, ProPublica and The Frontier have found. A number of influential leaders have been charged with or convicted of crimes ranging from drug offenses to witness intimidation. (A second part of this series further explores that issue.)</p>\n\n<p>\u201cYou\u2019d be very naive to sit and say the Chinese state doesn\u2019t know what Chinese organized crime is doing in the U.S.,\u201d Anderson said, \u201cor that there is not a connection between the Chinese state and organized crime.\u201d</p>\n\n<p>In February, <a href=\"https://www.ernst.senate.gov/imo/media/doc/ernst_works_to_shut_down_ccp-linked_marijuana_farms.pdf\">50 U.S. legislators wrote to Attorney General Merrick Garland</a> expressing concern that Chinese nationals, \u201cincluding those with potential ties to the Chinese Communist Party,\u201d are \u201creportedly operating thousands of illicit marijuana farms across the country.\u201d  </p>\n\n<p>The bipartisan group of lawmakers, who included all but two members of Oklahoma\u2019s congressional delegation, asked whether federal authorities are investigating CCP connections to the marijuana underworld and how much illicit revenue returns to China.  </p>\n\n<p>The Department of Justice plans to respond to the questions raised by the legislators, a department spokesperson said in an emailed statement.</p>\n\n<p>\u201cThe Department is working on developing a marijuana enforcement policy that will be consistent\u201d with federal guidance related to state legalization initiatives, said the spokesperson, Peter Carr. \u201cAmong the federal enforcement priorities under that policy is preventing the revenue from the illegal distribution of marijuana from going to criminal enterprises, gangs, and cartels.\u201d </p>\n\n<p>The department declined to comment about other issues raised in this story.</p>\n\n<p>In response to a list of questions, a spokesperson for the Chinese embassy in Washington, D.C., said in an emailed statement that he was \u201cnot aware of the specifics\u201d related to Chinese organized crime in the marijuana industry. But the spokesperson, Liu Pengyu, said China wages a determined fight against drugs, the \u201ccommon enemy of mankind.\u201d</p>\n\n<p>\u201cWe always ask our fellow citizens to observe local laws and regulations and refrain from engaging in any illegal or criminal activities while they are abroad,\u201d Liu said in the written statement. \u201cThe Chinese government is steadfast on fighting drug crimes, playing an active part in international anti-drug cooperation, and resolving the drug issue with other countries including the US in an active and responsible attitude.\u201d</p>\n\n<p>ProPublica and The Frontier interviewed more than three dozen current and former law enforcement officials in the United States and overseas, as well as academic experts, defense lawyers, farmworkers, Chinese dissidents, Chinese-American leaders, human rights advocates and others. Some sources were granted anonymity to protect their safety or because they were not authorized to speak to the media. Reporters reviewed thousands of pages of court files, government reports, news reports and social media posts in English, Chinese and other languages.</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n    \n            (Stefano Summo for ProPublica)\n    \n    \n    \n\n    \n\n        \n    \n                    \nCalifornia Dreams\n<p>He Qiang Chen came to New York about 30 years ago from the Changle district outside Fuzhou, the capital of Fujian. </p>\n\n<p>Chen and his older brother opened a restaurant and a laundry in the Bronx and became legal U.S. residents. By the early 2000s, they had moved to North Carolina, where they also ran restaurants, according to public records and law enforcement officials. They shuttled back and forth to New York, buying properties in and around Flushing, which has a vibrant Chinese business district. The area has also developed a reputation as a bastion of Chinese crime bosses with nationwide reach, leading to a refrain in law enforcement: \u201cAll roads lead to Flushing.\u201d</p>\n\n<p>Until about five years ago, public records indicate that Chen\u2019s encounters with the justice system consisted of repeated tickets for speeding and reckless driving.</p>\n\n<p>In 2017, though, the brothers launched into the marijuana racket at a level that would make investigators think they\u2019d been involved in crime for a while. They went to California, where Chen paid $825,000 for a four-bedroom house behind a wrought-iron gate in the San Joaquin Valley about 35 miles from Sacramento.</p>\n\n<p>The semirural lot was near a winery and an equestrian center. But Chen wasn't interested in genteel pastimes. Along with his romantic companion, a 43-year-old woman from San Francisco named Fang Hui Lee, Chen and his brother got to work converting the spacious barn into a cannabis plantation.</p>\n\n<p>Several associates also established themselves in the Sacramento area. A 39-year-old fellow transplant from North Carolina, Yifei Lin, bought a suburban house and set up a clandestine indoor grow, court records show.  </p>\n\n<p>The cross-country move was part of a migration of criminal groups into the marijuana industry. Other destinations included Colorado and the Pacific Northwest. California law limited cannabis for personal use to six plants and required commercial growers to get a license. With criminal penalties diminishing, the goals of legalization were to establish regulation, generate tax revenue and eliminate organized crime from the picture. </p>\n\n<p>Instead, the low risk and fast money set off a feeding frenzy. The players who established clandestine grows included Mexican cartels, Cuban immigrant gangs and longtime locals. But the <a href=\"https://www.politico.com/news/2023/03/21/illicit-cannabis-china-00086125\">Chinese crews were the biggest and best organized</a>. They smuggled their product by car, truck and plane to the East Coast, where profit margins were stratospheric.  </p>\n\n<p>In this rapacious subculture, mobsters went into subdivisions and snapped up a half dozen homes at a time. In San Bernardino County, east of Los Angeles, a federal court <a href=\"https://www.justice.gov/usao-cdca/pr/chino-real-estate-agent-pleads-guilty-charge-coordinating-multi-million-dollar-scheme\">convicted a real estate agent</a> in 2020 for a typical tactic: paying \u201cghost owners\u201d to fly in from China posing as buyers, sign paperwork and go home, according to case files and interviews. </p>\n\n<p>The bosses brought in recent Chinese immigrants to tend indoor crops, often stealing industrial quantities of water and power from public utility systems for their operations. Grow houses created a nefarious mix of risks: toxic fumes from banned pesticides, <a href=\"https://www.sgvtribune.com/2023/10/27/butane-honey-oil-lab-in-irwindale-where-4-were-killed-operated-under-the-radar/\">deadly fires</a> from makeshift electrical bypasses, volatile chemicals and flammable equipment. The presence of drugs, cash and weapons was a magnet for crime, and the blighted homes hurt property values.</p>\n\n<p>In November 2018, Sgt. George Negrete, a detective for the San Joaquin County Sheriff\u2019s Office, got a tip about Chen\u2019s illegal grow. </p>\n\n<p>Doing surveillance on foot from an adjacent water treatment facility, Negrete saw telltale signs, such as spray foam filling the seams of the barn walls to mask heat, light and odor. Utility records showed that the electric bill had spiked from $170 a month to more than $2,000 per month after Chen bought the property, indicating sustained use of air conditioning and high-intensity lights.</p>\n\n<p>On Dec. 13, deputies served a search warrant. They found 3,835 plants and arrested the Chen brothers, Lee and two other men, court documents say. Chen claimed he didn\u2019t speak English. But he admitted he was in charge. He told Negrete that someone had advised him marijuana was a good business. </p>\n\n<p>\u201cThey weren\u2019t scared or afraid,\u201d Negrete said in an interview. \u201cIt was like regular business for them.\u201d</p>\n\n<p>The crew had slept on mattresses on the floor. Lee apparently supervised the day-to-day work. And deputies found two .40-caliber pistols, court documents say. Firearms were unusual at Chinese-run grows that Negrete had raided.</p>\n\n<p>\u201cIt made me think they were at a higher scale in an organization,\u201d the detective said.</p>\n\nCash and Discipline\n<p>The arrests of the Chens and their associates happened during a state-federal crackdown in the Sacramento area known as <a href=\"https://www.justice.gov/usao-edca/pr/sweeping-two-day-operation-targets-international-organized-crime-sacramento-area\">Operation Lights Out</a>.</p>\n\n<p>On the day of the raid on Chen\u2019s house, federal prosecutors <a href=\"https://www.justice.gov/usao-edca/pr/sacramento-real-estate-broker-indicted-international-money-laundering-conspiracy\">indicted a Sacramento real estate broker</a>, accusing her and other suspects of teaming with financiers in Fujian who wired millions of dollars to acquire houses for indoor grows through fraudulent maneuvers, according to a criminal complaint. Authorities also seized more than 100 houses.</p>\n\n<p>The elaborate and brazen nature of the alleged conspiracy led investigators to believe it involved the triads, according to three former federal officials who declined to be named because they were not authorized to discuss the case.</p>\n\n<p>Suspects used banks in China to wire money to the U.S. defendants in suspicious and obvious increments, according to the criminal complaint and former federal officials. Yet there was no interference from the most powerful police state in the world. Although hard proof was elusive, two former senior U.S. officials told ProPublica they suspected Chinese officials protected the scheme and may have benefited from it financially. </p>\n\n<p>\u201cThere was no question in my mind that there was at least Chinese government awareness of this,\u201d a former senior Department of Justice official said. \u201cThere was no way they didn\u2019t see the movement of the money going to the same people in the United States. But could we prove it? We suspected Chinese officials were complicit.\u201d</p>\n\n<p>Although the prosecution had a big impact by combining the might of the FBI, DEA, IRS and Homeland Security Investigations, it was one of the few federal offensives against Chinese networks involved in marijuana.</p>\n\n<p>Still, DEA financial investigations around the country revealed that the emerging marijuana empire intersected with the networks laundering billions of dollars for Latin American drug lords. Some of the funds from the laundering returned to China, but a lot was reinvested into new U.S. marijuana ventures, current and former officials said. </p>\n\n<p>The marijuana proceeds were \u201canother massive bucket of money\u201d with which high-level Chinese crime bosses funded interconnected rackets such as the money laundering and migrant smuggling, said former senior DEA official Christopher Urben, who is now a managing partner at the global investigations firm Nardello &amp; Co. </p>\n\n<p>Agents marveled at the scope of the enterprise and the lack of turf wars. Around 2019, the DEA learned that triad bosses had traveled from China to sit-downs in New York, where they issued directives and kept the peace nationwide, according to Urben and other current and former officials. New York had become the command hub for marijuana as well as money laundering. </p>\n\n<p>\u201cThe discipline involved is incredible,\u201d Urben said. \u201cHow are we having thousands of workers moved into the country and among states? How are all these groups doing this without more conflict or violence? How do you ensure that all these mid-level managers get along, with all this money, all this marijuana? The only way you can do it is with an organized crime apparatus.\u201d</p>\n\n<p>In the federal prosecution in Sacramento, a defendant pleaded guilty this Feb. 27. The real estate broker and two others are still awaiting trial.</p>\n\n<p>Meanwhile, Chen and his associates pleaded no contest to misdemeanors in state courts, which sentenced them to probation. Wasting no time, the crew headed for Oklahoma in 2020. </p>\n\n<p>In contrast to California, Oklahoma did not limit the size of grows. As long as the operations had a nominal local owner and a medical marijuana license, they could spread dozens of greenhouses capable of holding tens of thousands of plants over a cheap parcel of farmland.</p>\n\n<p>Some Chinese groups redeployed by air, according to officials and case files. Federal agents began detecting flights of private planes from California to rural airfields in Oklahoma. Couriers aboard the aircraft carried hundreds of thousands of dollars in cash to buy farmland, sometimes for twice or three times its value. To dodge federal interdiction teams, some pilots filed flight plans for one airstrip, then diverted to another.</p>\n\n<p>And money poured in from China. Around 2020, one group crowdfunded Oklahoma marijuana ventures through an invitation to investors on WeChat, the popular Chinese social media platform, said Mark Woodward, spokesperson of the Oklahoma Bureau of Narcotics. U.S. investigations show that WeChat, although heavily monitored by Chinese security forces, is often a forum for discussions of criminal activity.</p>\n\n<p>Oklahoma\u2019s marijuana industry surged to \u201can astronomical level,\u201d said Ray Padilla, a Denver-based DEA agent. He estimated that 90% of Colorado\u2019s illicit producers moved to the neighboring state. </p>\n\n<p>Oklahoma was the new frontier, Padilla said. And it was \u201cabsolute insanity.\u201d </p>\n\nGunplay at the Association\n<p>A statue of a panda bear sits like a chunky sentry atop a pillar on Classen Boulevard in Oklahoma City\u2019s Asian District.</p>\n\n<p>Mixing a longtime Vietnamese community with a more recent Chinese one, the boulevard is lined with stores, restaurants, massage parlors, nail salons and, block after block, marijuana dispensaries. </p>\n\n<p>Behind the panda, a ground-floor suite in a corner mini-mall houses the local chapter of the American Fujian Association. </p>\n\n<p>Shortly before dusk on Dec. 8, 2020, a black Mercedes SUV carrying Chen and Lin pulled up at the mini-mall accompanied by two other cars. The crew had driven an hour from their new farm in Kingfisher County. They were looking for Jintao Liu, who had also relocated from Sacramento after his marijuana site got busted, court documents show. Liu and Chen had been feuding since Chen had failed to pay him for organizing a delivery from California. </p>\n\n<p>When Liu had asked him to pay the $2,000 debt, Chen had become infuriated and began to terrorize Liu and his wife with threatening phone calls and texts showing photos of guns. Chen squared off with Liu at a gathering and punched him in the jaw. Later, Chen threatened to kill his wife and three children, court records say.</p>\n\n<p>The reasons for the rage remain somewhat murky. Asked during a court hearing why Chen was so angry if he owed the money, not the other way around, Liu answered, \u201cHe did not want to pay. He was this kind of a person.\u201d  </p>\n\n<p>On the afternoon that Chen and his crew appeared outside the Fujianese association, Liu was inside watching a friend play cards, according to court testimony. Liu and several other men came out. A brawl ensued. </p>\n\n<p>\u201cShoot him,\u201d Chen told Lin, according to witnesses.</p>\n\n<p>Lin pulled a gun and fired, the bullet fracturing Liu\u2019s hipbone, according to court documents. </p>\n\n<p>Police soon arrested Chen and Lin. A search of Chen\u2019s house in suburban Edmond turned up three pistols, 27.5 pounds of marijuana, $97,000 in cash and eight vials of ketamine, the party drug of choice in the Chinese underworld, court records say.</p>\n\n<p>Prosecutors charged Chen and Lin with assault and battery with a deadly weapon and drug offenses. The men made bail and went right back to the grow. (Lin has pleaded not guilty. His lawyer declined to comment.)</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            An Oklahoma Bureau of Narcotics agent searches for witnesses and survivors at the Kingfisher County farm where four people were shot to death.\n    \n            (Kingfisher County Sheriff\u2019s Department)\n    \n    \n    \n\n    \n\n        \n    \n                    \n<p>Their farm was about 13 miles from Hennessey, population 2,000. Lin had bought the 10-acre spread for $280,000, court documents say. To evade a state residency law, he paid cash to a local man named Richard Ignacio to pose as the 75% owner of the medical marijuana business and obtain a license, court documents allege. Ignacio had allegedly been drafted as a straw owner by an Oklahoma City accountant, a 20-time felon named Kevin Pham, who has been charged in connection with the Kingfisher farm and other grows, court documents say. Ignacio told investigators that he \u201cearned significant income\u201d acting as a hired front man. </p>\n\n<p>Ignacio pleaded guilty last year to being a straw owner for the Kingfisher farm. He and Pham have pleaded not guilty to other charges and are awaiting trial. They could not be reached for comment.</p>\n\n<p>Lin lived at and managed the place for Chen, according to court records and interviews. For equipment, three companies in China shipped about 440,000 pounds of greenhouse parts. Even among the vast marijuana farms in Oklahoma, the spread was unusually large: it contained over 100 greenhouses and several indoor grow houses, interviews and satellite images show. </p>\n\n<p>The closest neighbor, Gary Hawk, lived about a mile away. He had grown up at the place next door when it was a dairy farm owned by his parents. There was tension with the newcomers from the start. After a neighboring farmer used a plane for crop dusting, men at Chen\u2019s farm threatened to shoot it out of the sky, Hawk said in an interview. </p>\n\n<p>\u201cThe mail carrier would go by and she would stop to deliver mail there,\u201d he said. \u201cThey would come out of the house and one guy would come out with a machete and one guy would come out with an AR-15. That was just to pick up the mail. \u201d</p>\n\n<p>The farm employed an armed security officer stationed in a guard hut and as many as two dozen laborers, according to law enforcement officials and others who spent time there. Workers slept in trailers, the garage or the cluttered main house, where meals were prepared throughout the day and there was only one bathroom. During an inspection by fire marshals that found multiple safety violations in 2021, most of the employees presented Chinese identification and U.S. immigration documents.</p>\n\n<p>Neighbors complained about uncollected trash blowing into nearby pastures and endangering cattle, said Sgt. Michael Shults of the Kingfisher County Sheriff\u2019s Department. </p>\n\n<p>\u201cWe\u2019ve been out there several times explaining to them you need to put trash up,\u201d Shults said in an interview. \u201cCattle get into plastics that are blowing around, you know, cattle will eat almost anything.\u201d</p>\n\n<p>Deputies soon became convinced that Chen\u2019s crew, like many others, was trafficking its product on the black market in other states. In April 2021, Shults and other deputies intercepted a vehicle carrying 46.8 pounds of marijuana and arrested the driver, who was from Texas and did not have an Oklahoma cannabis transport license. Surveillance showed that she was one of two suspected couriers who had picked up bales at the farm that day, according to Shults and court documents.</p>\n\nAwash in Weed\n<p>By 2021, a mysterious investor had joined the crew at the Kingfisher farm. </p>\n\n<p>Chen Wu (also known as Wu Chen, but not related to the brothers) was in his mid-40s and from Fujian, according to officials and Chinese media reports. There are gaps in his past that investigators are still trying to fill. What they do know suggests he was a heavyweight: He had ties to Chinese criminal networks involved in money laundering, drug trafficking and migrant smuggling across the country and overseas, according to officials and court records. </p>\n\n<p>As a young man, Wu lived illegally in Spain, whose Chinese population has grown rapidly in the past two decades. In 2000, police on the resort island of Mallorca arrested him for entering the country illegally, Spanish law enforcement officials said.  </p>\n\n<p>As often happens, though, he managed to stay. He sought work authorization in 2003 and gave an address in a gritty neighborhood of Madrid. Five years later, he got in trouble for using someone else\u2019s identity, officials said, and Spanish police issued an arrest warrant for him in 2010. </p>\n\n<p>But he had already moved on. Wu spent time in the Caribbean, including Cuba. Arriving in the United States around 2016, he bounced around the country pursuing illicit schemes, officials said. In Minnesota, he married the owner of a restaurant and got legal status. During his divorce in 2020, Wu claimed in legal filings to have only about $18,000 to his name, records show.</p>\n\n<p>Yet he moved to Oklahoma and invested in Chen\u2019s farm. After months working there, he argued with his partners over money and left. </p>\n\n<p>By then, the state was awash in weed.</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            Oklahoma Bureau of Narcotics agents and Kingfisher County deputies search through buildings on the 10-acre marijuana farm.\n    \n            (Kingfisher County Sheriff\u2019s Department)\n    \n    \n    \n\n    \n\n        \n    \n                    \n<p>The number of licensed marijuana grows in Oklahoma peaked at nearly 10,000 at the end of 2021. Authorities suspected most of them of trafficking on the black market. One Chinese criminal group oversaw at least 400 grows. Another outfit smuggled truckloads to the East Coast every week, <a href=\"https://www.readfrontier.org/stories/with-cheap-land-and-low-fees-oklahoma-grown-marijuana-fuels-the-black-market-in-other-states/\">selling each for over $20 million</a>, before investigators dismantled it. </p>\n\n<p>Whether bosses or grunts, most of the newcomers were from New York, where a mob hierarchy oversees the illicit marijuana trade in Oklahoma and swoops in to collect the profits, according to law enforcement officials and court files.</p>\n\n<p>\u201cYou have many different levels,\u201d said Anderson, the state anti-drug director. \u201cSome overseeing grows. Then another upper echelon that controls money. \u2026 They\u2019re never around except to collect money.\u201d</p>\n\n<p>The boom caused prices to crater, hurting the legal industry. And it brought a generalized surge of crime. At airports, wary-looking Chinese immigrant laborers with backpacks became a familiar sight to law enforcement officers. So did human traffickers accompanying flashily dressed prostitutes to <a href=\"https://www.oklahoman.com/story/news/2023/10/26/one-arrested-in-human-trafficking-scheme-tied-to-oklahoma-medical-marijuana-farms/71317992007/\">brothels set up for overseers of the marijuana farms</a>. Illegal casinos appeared, seizures of ketamine soared, and robberies and violence plagued grows, dispensaries and stash houses, according to court cases and law enforcement officials.</p>\n\n<p>There was complex criminality as well. In <a href=\"https://www.justice.gov/usao-sdny/pr/three-men-arrested-complex-bank-fraud-and-cryptocurrency-laundering-scheme\">a case</a> investigated by the FBI, a Chinese ring based in New York and Oklahoma\u00a0allegedly used a cryptocurrency scheme to steal over $10 million from banks and other financial institutions. One defendant, who is now awaiting trial, was involved in a marijuana grow with an associate of Chen\u2019s Kingfisher County crew, according to law enforcement officials and public records.</p>\n\n<p>The victims of another scam were law-abiding Asian Americans. Cybercriminals manipulated the computer system of the Texas Department of Public Safety to obtain thousands of driver\u2019s licenses destined for Asian Americans, tricking authorities into <a href=\"https://cw39.com/news/texas/affidavit-texas-drivers-licenses-were-sent-to-oklahoma-addresses-in-organized-fraud-scheme/\">mailing the licenses to marijuana farms in neighboring Oklahoma</a>. The suspects used the licenses for fraudulent purchases or sold them on the underground market. Police arrested the accused mastermind in New York and extradited him to Texas last April to stand trial. </p>\n\n<p>Before marijuana legalization, Oklahoma was \u201ca pretty quiet state,\u201d said Tony Lie, president of the Oklahoma Chinese Association. \u201cWe didn\u2019t have any Chinese criminal gangs coming here.\u201d</p>\n\n<p>Lie has lived in Oklahoma for more than 30 years. Members of his longtime organization come from several regions in mainland China as well as Hong Kong and Taiwan. In contrast, most of the newcomers are Fujianese. Lie said the ills of the marijuana industry have hurt the image of Chinese Americans in the state.</p>\n\n<p>\u201cWe don\u2019t want people to come to Oklahoma to do something bad for the Chinese community,\u201d Lie said.</p>\n\n<p>The shooting at the Fujianese association in 2020 had opened a window into a fast-evolving underworld. </p>\n\n<p>But it turned out to be just a prelude. </p>\n\nPitch-Black Night\n<p>Shortly before 8 p.m. on Nov. 20, 2022, Kingfisher County Sheriff Dennis Banther alerted his deputies to a hostage incident at a farm near Hennessey. </p>\n\n<p>\u201cEverybody go 10-8,\u201d the text message said: Go in service and rush to the scene.</p>\n\n<p>Shults was the third to arrive. Four gunshot victims lay dead in the garage, and the shooter was on the loose. Deputies feared he was hiding in the sprawl of agricultural buildings known as hoop-houses. </p>\n\n<p>\u201cIt was pitch black,\u201d Shults said. \u201cWhen you\u2019re out there in the pitch dark, in the black night, and you\u2019ve got four people down, been executed, and you don\u2019t know if the shooter\u2019s still on scene or not \u2026 it\u2019s find the shooter. Survival.\u201d</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            Kingfisher County deputies discovered the bodies of four victims among stacks of marijuana in the garage.\n    \n            (Kingfisher County Sheriff\u2019s Department)\n    \n    \n    \n\n    \n\n        \n    \n                    \n<p>The sergeant came upon a wounded man lying in a black Ford F-150 pickup truck. It was Lin, the farm manager who had been the accused gunman at the Fujianese association, according to court documents. </p>\n\n<p>A second survivor emerged from the darkness. A deputy struggled to ask the farmworker urgent questions using Google Translate on his phone. Deputies found another worker who had recorded part of the incident on a cellphone, leaving it near the garage with the camera on before fleeing, according to court documents and interviews.  </p>\n\n<p>The survivors said the killer was Wu, who had worked at the farm until about a year earlier. He had arrived in his Toyota Corolla and shot Chen and a dog that was in the garage. Wu then told his hostages he would kill them if they didn\u2019t hand over $300,000 in half an hour.</p>\n\n<p>\u201cThe Boss told his girlfriend, who was inside the garage at the time, to call her brother to get the money,\u201d a witness told police. </p>\n\n<p>As minutes passed, Wu became increasingly agitated. The hostages tried to stop Chen\u2019s bleeding by wrapping a long-sleeved shirt around his knee as a makeshift tourniquet. </p>\n\n<p>But Chen \u201cwas not doing very well,\u201d the witness said. In a grim exchange, the wounded boss told the gunman \u201cto finish him off.\u201d</p>\n\n<p>Wu pumped two bullets into Chen\u2019s chest. Then, two hostages rushed at the gunman, who let loose a barrage that killed Chen\u2019s brother, Chen\u2019s girlfriend Lee and a newly hired employee. The wounded Lin ran outside and took refuge in the truck.</p>\n\n<p>Although the phone video didn\u2019t capture the actual shooting, it recorded the sound of gunshots and showed the gunman leaving the garage. </p>\n\n<p>Emergency personnel swarmed the scene. A helicopter evacuated the wounded man. Deputies spent all night doing a sweep of the grounds, finding another terrified worker hiding in a barn. </p>\n\n<p>At one point, a sedan with New York plates pulled up to the farm. An Asian man rolled down the window, startling deputies, and said he \u201cwas sent\u201d to pick up the workers remaining onsite, a deputy said.</p>\n\n<p>\u201cYou need to back him off,\u201d a sheriff\u2019s lieutenant yelled to his deputies. Afterward, they would wonder who had sent him so quickly.</p>\n\n<p>In one area of the dark compound, deputies thought they were trudging through mud. After sunrise, they realized it was human excrement \u2014 a sign of the conditions in which the farmworkers lived.</p>\n\n<p>Meanwhile, the gunman sped east toward Florida. From the road, he called people in Florida, including a Chinese organized crime figure suspected of involvement in drugs and human trafficking, according to court records and law enforcement officials familiar with the case. </p>\n\n<p>Investigators believe Wu wanted help from smugglers to flee the country, possibly to Cuba, which doesn\u2019t have an extradition treaty with the U.S., court records say. One affidavit for search warrants for Wu\u2019s phones and online accounts seeks evidence \u201crelating to the planning, preparation and actions taken to facilitate human smuggling.\u201d </p>\n\n<p>Soon after Wu got to Miami Beach, however, a license plate reader detected his car. Police arrested him two days after the murders. During an extradition hearing, Wu told the judge his life was in danger.</p>\n\n<p>\u201cIf I go back to Oklahoma, I\u2019ll be killed in the prison or jail,\u201d he said through an interpreter. \u201cI\u2019m afraid I will be killed because these people are mafiosos.\u201d</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n    \n            (Stefano Summo for ProPublica)\n    \n    \n    \n\n    \n\n        \n    \n                    \nAftermath\n<p>It seemed ironic: a mass murderer begging the court for protection. But a strange story told by a deputy who brought him back suggests that his fears may have been well founded.</p>\n\n<p>Kingfisher County sheriff\u2019s Lt. Ken Thompson had 25 years of experience transporting prisoners. He and another deputy drove nonstop to Florida in a marked Chevrolet Tahoe. In Miami, they checked into a motel near the airport in the evening, planning to sleep a few hours before picking up Wu from the Miami-Dade County jail, Thompson said in an interview.</p>\n\n<p>They changed their minds, Thompson said, because \u201ca weird deal happened.\u201d</p>\n\n<p>Looking out of the window of his motel room, Thompson said, he saw a car pull up next to his marked police vehicle in the parking lot. Another car appeared, then a third. The three cars drove around the motel as if doing surveillance, he said.</p>\n\n<p>The deputies concluded that they \u201cdidn\u2019t really feel comfortable sitting in this place,\u201d Thompson said. They decided to take custody of Wu and hit the road. </p>\n\n<p>After the deputies left the jail with Wu in the back seat, the three cars from the motel reappeared, Thompson said, and shadowed the Tahoe on the highway. </p>\n\n<p>Thompson said he did evasive maneuvers to lose them, exiting abruptly and returning to the highway miles later. </p>\n\n<p>\u201cIt's just a feeling, a gut feeling that you get, and the fact that they all just kind of just paced right around us,\u201d he said. \u201cI mean, they flew right up on us, but then they just locked down to our speed. So it was a weird deal.\u201d</p>\n\n<p>Thompson suspects that people in organized crime somehow located the deputies in Miami. He said he did not know if their goal was to harm Wu, to free him or simply to monitor a case that was causing a commotion.</p>\n\n<p>The prisoner was polite and obedient during the cross-country ride, getting out for bathroom breaks and accepting a McDonald\u2019s breakfast burrito that the deputies offered him. After they crossed the Oklahoma state line, though, his demeanor changed, the lieutenant said. </p>\n\n<p>\u201cYou couldn\u2019t pry him out of that car,\u201d Thompson said. \u201cOnce he reached Oklahoma, he wouldn\u2019t get out of the car.\u201d</p>\n\n<p>On Feb. 9, Wu pleaded guilty to the four murders and assault and battery. The judge sentenced him to life without possibility of parole. (He declined an interview request.)</p>\n\n<p>The quadruple murder made international headlines and set off a flurry of investigative activity and <a href=\"https://www.kjrh.com/news/local-news/ok-attorney-general-creates-task-force-to-target-illegal-cannabis-grow-operations\">political attention</a>. A state crackdown has reduced the number of growing operations by almost half, officials say.</p>\n\n<p>Chinese immigrants involved in the marijuana industry say law enforcement has been excessively harsh on them since late 2022. Qiu (Tina) He, who operated a marijuana-related consulting firm that is under investigation, said in an interview that many Asian investors have become disillusioned by what she called discriminatory treatment and the risks of the business. She denied wrongdoing in her case and predicted the state will suffer from the loss of tax revenue if Asian investors leave.</p>\n\n<p>\u201cWe are funding Oklahoma,\u201d she said. \u201cOklahoma City will be like a ghost town if we leave.\u201d</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            Law enforcement officers search dozens of metal and plastic marijuana grow houses at the Kingfisher farm the day after the quadruple homicide.\n    \n            (Kingfisher County Sheriff\u2019s Department)\n    \n    \n    \n\n    \n\n        \n    \n                    \n<p>The crime in Kingfisher County was a relatively unusual eruption of violence in the Chinese underworld. Law enforcement experts say the frontier atmosphere in Oklahoma is likely a result of the sheer amount of money generated by the cannabis trade and the number of criminals it has attracted. The growing wealth and power of Chinese organized crime is causing clashes elsewhere in the country as well, experts said.</p>\n\n<p>\u201cMaybe it\u2019s more like the Wild West as these groups keep spreading,\u201d said Urben, the former DEA official. \u201cYou are going to have violence even if someone is controlling from above. I think there would be even more conflict if the triads were not so involved.\u201d</p>", "summary_detail": {"type": "text/html", "language": null, "base": "https://www.propublica.org/feeds/propublica/main", "value": "<p class=\"byline\">\n                by <a class=\"name\" href=\"https://www.propublica.org/people/sebastian-rotella\">Sebastian Rotella</a> and <a class=\"name\" href=\"https://www.propublica.org/people/kirsten-berg\">Kirsten Berg</a>, ProPublica, and <a class=\"name\" href=\"https://www.readfrontier.org/author/garrett/\">Garrett Yalch</a> and <a class=\"name\" href=\"https://www.readfrontier.org/author/clifton-adcock/\">Clifton Adcock</a>, The Frontier                </p>\n                                             \n\n        \n                        <p>ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive <a href=\"https://www.propublica.org/newsletters/the-big-story?source=www.propublica.org&amp;placement=top-note&amp;region=national\">our biggest stories</a> as soon as they\u2019re published. This article was produced in partnership with <a href=\"https://www.readfrontier.org/\">The Frontier</a>. Additional funding for this story was provided by The Pulitzer Center.</p>\n\n        \n\n    \n      \n  \n\n\n\n                    \n<p>It seemed an unlikely spot for a showdown between Chinese gangsters: a marijuana farm on the prairie in Kingfisher County, Oklahoma. </p>\n\n<p>On a Sunday evening in late November 2022, a blue Toyota Corolla sped down a dirt-and-gravel road in the twilight, passing hay meadows and columns of giant wind turbines spinning on the horizon. The Corolla braked and turned, headlights sweeping across prairie grass, and entered the driveway of a 10-acre compound filled with circular huts and row after row of greenhouses. Past a ranch house, the sedan stopped outside a large detached garage.</p>\n\n<p>The driver, Chen Wu, burst out of the car with a 9 mm pistol in his hand. Balding and muscular, he had worked at the farm and invested in the illegal marijuana operation. </p>\n\n<p>Charging into the garage, Wu confronted the five men and one woman working inside. Like him, they were immigrants from China. Piles of marijuana leaves cluttered the brightly lit room, covering a table and stuffed into plastic bins and cardboard boxes.</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            Stacks and boxes of marijuana fill the garage where four people were shot to death on a farm, shown in a still image from a sheriff\u2019s deputy\u2019s bodycam video.\n    \n            (Kingfisher County Sheriff\u2019s Department)\n    \n    \n    \n\n    \n\n        \n    \n                    \n<p>Wu aimed his gun at He Qiang Chen, a 56-year-old ex-convict known at the farm as \u201cthe Boss.\u201d Chen had a temper; he was awaiting trial in the beating and shooting of a man two years earlier at a Chinese community center in Oklahoma City. </p>\n\n<p>Before Chen could make a move, Wu shot him in the right knee. The boss fell to the floor, writhing in pain. </p>\n\n<p>Wu held the others at gunpoint. He said Chen owed him $300,000 and told his hostages they had half an hour to get him the money. </p>\n\n<p>If they didn\u2019t, he said, he would kill them all.</p>\n        \n    \n                    \n<p>Both the shooter and his victim were from Fujian, a coastal province known for mafias, immigration and corruption. They had come to America and joined a wave of new players rushing into the nation\u2019s billion-dollar marijuana boom: Chinese mobsters who roam from state to state, harvesting drugs and cash and overwhelming law enforcement with their resources and elusiveness. </p>\n\n<p>Now, their itinerant odysseys had collided in this remote outpost in the heartland. The clash left four people dead and unveiled an international underworld of dangerous dimensions.  </p>\n\nWild West\n<p>The bloodshed in Kingfisher County made national headlines, highlighting  Oklahoma\u2019s role as the latest and wildest frontier in the marijuana underworld.</p>\n\n<p>From California to Maine, Chinese organized crime has come to dominate much of the nation\u2019s illicit marijuana trade, an investigation by ProPublica and The Frontier has found. Along with the explosive growth of this criminal industry, the gangsters have unleashed lawlessness: violence, drug trafficking, money laundering, gambling, bribery, document fraud, bank fraud, environmental damage and theft of water and electricity. </p>\n\n<p>Chinese organized crime \u201chas taken over marijuana in Oklahoma and the United States,\u201d said Donnie Anderson, the director of the Oklahoma Bureau of Narcotics and Dangerous Drugs, in an interview. </p>\n\n<p>Among the victims are thousands of Chinese immigrants, many of them smuggled across the Mexican border to toil in often abusive conditions at farms ringed by fences, surveillance cameras and guards with guns and machetes. A grim offshoot of this indentured servitude: Traffickers force Chinese immigrant women into prostitution for the bosses of the agricultural workforce. </p>\n\n<p>The mobsters operate in a loose but disciplined confederation overseen from New York by mafias rooted in southern China, according to state and federal officials. Known as \u201ctriads\u201d because of an emblem used long ago by secret societies, these criminal groups wield power at home and throughout the diaspora and allegedly maintain an alliance with the Chinese state.</p>\n\n<p>In 2018, the mafias set their sights on Oklahoma when the state\u2019s voters approved a ballot measure that legalized the cultivation and sale of marijuana for medicinal purposes. The law did not limit the number of dispensaries or growing operations \u2013 known in the industry simply as \u201cgrows.\u201d It requires marijuana businesses to have majority owners who have lived in the state for two years, and it bars <a href=\"https://www.oscn.net/applications/oscn/DeliverDocument.asp?CiteID=486029\">shipping</a> the product <a href=\"https://law.justia.com/codes/oklahoma/2022/title-63/section-63-423v1/\">across state lines</a>. But limited enforcement enabled out-of-state investors to recruit illegal \u201cstraw owners\u201d and to traffic weed clandestinely across the country. And land was cheap. In this wide-open atmosphere, the industry grew at breakneck speed and, regulators say, is now second only to the oil and gas industry in the state. </p>\n\n<p>Since Colorado became the first state to legalize marijuana for personal use in 2012, a patchwork of marijuana-related legislation has developed across the country. State authorities generally require licenses and put limits on cultivation, and federal law prohibits interstate sales. But steep taxes on legal products and gaps and differences in laws across states have created the conditions for a massive black market to thrive.</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            A body-camera image shows a law enforcement officer responding to the murders at the marijuana farm.\n    \n            (Kingfisher County Sheriff\u2019s Department)\n    \n    \n    \n\n    \n\n        \n    \n                    \n<p>Oklahoma has quickly become a top supplier of illicit weed. Although street prices fluctuate and calculating the value of a black market is complex, officials estimate the value of the illegal marijuana grown in the state at somewhere between $18 billion and $44 billion a year. State investigators have found links between foreign mafias and over 3,000 illegal grows \u2014 and they say that more than 80% of the criminal groups are of Chinese origin. </p>\n\n<p>The federal response, however, has been muted. With the spread of legalization and decriminalization, enforcement has become a low priority for the U.S. Department of Justice, anti-drug veterans say. </p>\n\n<p>\u201cThe challenge we are having is a lack of interest by federal prosecutors to charge illicit marijuana cases,\u201d said Ray Donovan, the former chief of operations of the Drug Enforcement Administration. \u201cThey don\u2019t realize all the implications. Marijuana causes so much crime at the local level, gun violence in particular. The same groups selling thousands of pounds of marijuana are also laundering millions of dollars of fentanyl money. It\u2019s not just one-dimensional.\u201d</p>\n\n<p>The expansion into the cannabis market is propelling the rise of Chinese organized crime as a global powerhouse, current and former national security officials say. During the past decade, <a href=\"https://www.propublica.org/article/china-cartels-xizhi-li-money-laundering\">Chinese mafias became the dominant money launderers</a> for Latin American cartels dealing narcotics including fentanyl, which has killed hundreds of thousands of Americans. The huge revenue stream from marijuana fuels that laundering apparatus, which is \u201cthe most extensive network of underground banking in the world,\u201d said a former senior DEA official, Donald Im. </p>\n\n<p>\u201cThe profits from the marijuana trade allow the Chinese organized criminal networks to expand their underground global banking system for cartels and other criminal organizations,\u201d said Im, who was an architect of the DEA\u2019s fight against Chinese organized crime.</p>\n        \n    \n                            \n    \n                    \n<p>U.S. law enforcement struggles to respond to this multifaceted threat. State and federal agencies suffer from a lack of personnel who know Chinese language and culture well enough to investigate complex cases, infiltrate networks or translate intercepts, current and former officials say. A federal shift of priorities to counterterrorism after 2001 meant resources dedicated to Chinese organized crime dwindled \u2014 while the power of the underworld grew. </p>\n\n<p>And the shadow of the Chinese state hovers over it all. <a href=\"https://www.propublica.org/article/how-beijing-chinese-mafia-europe-protect-interests\">As ProPublica has reported</a>, the authoritarian regime and the mafias allegedly maintain an alliance that benefits both sides. In exchange for government protection, Chinese mobsters <a href=\"https://www.smh.com.au/national/illegal-malign-china-s-state-sponsored-crime-stretches-across-pacific-20230517-p5d8xe.html\">deliver services</a> such as illegally moving money overseas for the Communist Party elite and helping to spy on and intimidate Chinese immigrant communities, according to Western national security officials, case files, Chinese dissidents and human rights groups. </p>\n\n<p>Because China has emerged as the top geopolitical rival of the United States, carrying out brazen espionage and influence activities in this country, the spread of Chinese mafias in Oklahoma and elsewhere also poses a potential national security threat, state and federal officials say. </p>\n\n<p>Leaders of Chinese cultural associations in Oklahoma and other states are allegedly connected to both the illegal marijuana trade and to Chinese government officials, ProPublica and The Frontier have found. A number of influential leaders have been charged with or convicted of crimes ranging from drug offenses to witness intimidation. (A second part of this series further explores that issue.)</p>\n\n<p>\u201cYou\u2019d be very naive to sit and say the Chinese state doesn\u2019t know what Chinese organized crime is doing in the U.S.,\u201d Anderson said, \u201cor that there is not a connection between the Chinese state and organized crime.\u201d</p>\n\n<p>In February, <a href=\"https://www.ernst.senate.gov/imo/media/doc/ernst_works_to_shut_down_ccp-linked_marijuana_farms.pdf\">50 U.S. legislators wrote to Attorney General Merrick Garland</a> expressing concern that Chinese nationals, \u201cincluding those with potential ties to the Chinese Communist Party,\u201d are \u201creportedly operating thousands of illicit marijuana farms across the country.\u201d  </p>\n\n<p>The bipartisan group of lawmakers, who included all but two members of Oklahoma\u2019s congressional delegation, asked whether federal authorities are investigating CCP connections to the marijuana underworld and how much illicit revenue returns to China.  </p>\n\n<p>The Department of Justice plans to respond to the questions raised by the legislators, a department spokesperson said in an emailed statement.</p>\n\n<p>\u201cThe Department is working on developing a marijuana enforcement policy that will be consistent\u201d with federal guidance related to state legalization initiatives, said the spokesperson, Peter Carr. \u201cAmong the federal enforcement priorities under that policy is preventing the revenue from the illegal distribution of marijuana from going to criminal enterprises, gangs, and cartels.\u201d </p>\n\n<p>The department declined to comment about other issues raised in this story.</p>\n\n<p>In response to a list of questions, a spokesperson for the Chinese embassy in Washington, D.C., said in an emailed statement that he was \u201cnot aware of the specifics\u201d related to Chinese organized crime in the marijuana industry. But the spokesperson, Liu Pengyu, said China wages a determined fight against drugs, the \u201ccommon enemy of mankind.\u201d</p>\n\n<p>\u201cWe always ask our fellow citizens to observe local laws and regulations and refrain from engaging in any illegal or criminal activities while they are abroad,\u201d Liu said in the written statement. \u201cThe Chinese government is steadfast on fighting drug crimes, playing an active part in international anti-drug cooperation, and resolving the drug issue with other countries including the US in an active and responsible attitude.\u201d</p>\n\n<p>ProPublica and The Frontier interviewed more than three dozen current and former law enforcement officials in the United States and overseas, as well as academic experts, defense lawyers, farmworkers, Chinese dissidents, Chinese-American leaders, human rights advocates and others. Some sources were granted anonymity to protect their safety or because they were not authorized to speak to the media. Reporters reviewed thousands of pages of court files, government reports, news reports and social media posts in English, Chinese and other languages.</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n    \n            (Stefano Summo for ProPublica)\n    \n    \n    \n\n    \n\n        \n    \n                    \nCalifornia Dreams\n<p>He Qiang Chen came to New York about 30 years ago from the Changle district outside Fuzhou, the capital of Fujian. </p>\n\n<p>Chen and his older brother opened a restaurant and a laundry in the Bronx and became legal U.S. residents. By the early 2000s, they had moved to North Carolina, where they also ran restaurants, according to public records and law enforcement officials. They shuttled back and forth to New York, buying properties in and around Flushing, which has a vibrant Chinese business district. The area has also developed a reputation as a bastion of Chinese crime bosses with nationwide reach, leading to a refrain in law enforcement: \u201cAll roads lead to Flushing.\u201d</p>\n\n<p>Until about five years ago, public records indicate that Chen\u2019s encounters with the justice system consisted of repeated tickets for speeding and reckless driving.</p>\n\n<p>In 2017, though, the brothers launched into the marijuana racket at a level that would make investigators think they\u2019d been involved in crime for a while. They went to California, where Chen paid $825,000 for a four-bedroom house behind a wrought-iron gate in the San Joaquin Valley about 35 miles from Sacramento.</p>\n\n<p>The semirural lot was near a winery and an equestrian center. But Chen wasn't interested in genteel pastimes. Along with his romantic companion, a 43-year-old woman from San Francisco named Fang Hui Lee, Chen and his brother got to work converting the spacious barn into a cannabis plantation.</p>\n\n<p>Several associates also established themselves in the Sacramento area. A 39-year-old fellow transplant from North Carolina, Yifei Lin, bought a suburban house and set up a clandestine indoor grow, court records show.  </p>\n\n<p>The cross-country move was part of a migration of criminal groups into the marijuana industry. Other destinations included Colorado and the Pacific Northwest. California law limited cannabis for personal use to six plants and required commercial growers to get a license. With criminal penalties diminishing, the goals of legalization were to establish regulation, generate tax revenue and eliminate organized crime from the picture. </p>\n\n<p>Instead, the low risk and fast money set off a feeding frenzy. The players who established clandestine grows included Mexican cartels, Cuban immigrant gangs and longtime locals. But the <a href=\"https://www.politico.com/news/2023/03/21/illicit-cannabis-china-00086125\">Chinese crews were the biggest and best organized</a>. They smuggled their product by car, truck and plane to the East Coast, where profit margins were stratospheric.  </p>\n\n<p>In this rapacious subculture, mobsters went into subdivisions and snapped up a half dozen homes at a time. In San Bernardino County, east of Los Angeles, a federal court <a href=\"https://www.justice.gov/usao-cdca/pr/chino-real-estate-agent-pleads-guilty-charge-coordinating-multi-million-dollar-scheme\">convicted a real estate agent</a> in 2020 for a typical tactic: paying \u201cghost owners\u201d to fly in from China posing as buyers, sign paperwork and go home, according to case files and interviews. </p>\n\n<p>The bosses brought in recent Chinese immigrants to tend indoor crops, often stealing industrial quantities of water and power from public utility systems for their operations. Grow houses created a nefarious mix of risks: toxic fumes from banned pesticides, <a href=\"https://www.sgvtribune.com/2023/10/27/butane-honey-oil-lab-in-irwindale-where-4-were-killed-operated-under-the-radar/\">deadly fires</a> from makeshift electrical bypasses, volatile chemicals and flammable equipment. The presence of drugs, cash and weapons was a magnet for crime, and the blighted homes hurt property values.</p>\n\n<p>In November 2018, Sgt. George Negrete, a detective for the San Joaquin County Sheriff\u2019s Office, got a tip about Chen\u2019s illegal grow. </p>\n\n<p>Doing surveillance on foot from an adjacent water treatment facility, Negrete saw telltale signs, such as spray foam filling the seams of the barn walls to mask heat, light and odor. Utility records showed that the electric bill had spiked from $170 a month to more than $2,000 per month after Chen bought the property, indicating sustained use of air conditioning and high-intensity lights.</p>\n\n<p>On Dec. 13, deputies served a search warrant. They found 3,835 plants and arrested the Chen brothers, Lee and two other men, court documents say. Chen claimed he didn\u2019t speak English. But he admitted he was in charge. He told Negrete that someone had advised him marijuana was a good business. </p>\n\n<p>\u201cThey weren\u2019t scared or afraid,\u201d Negrete said in an interview. \u201cIt was like regular business for them.\u201d</p>\n\n<p>The crew had slept on mattresses on the floor. Lee apparently supervised the day-to-day work. And deputies found two .40-caliber pistols, court documents say. Firearms were unusual at Chinese-run grows that Negrete had raided.</p>\n\n<p>\u201cIt made me think they were at a higher scale in an organization,\u201d the detective said.</p>\n\nCash and Discipline\n<p>The arrests of the Chens and their associates happened during a state-federal crackdown in the Sacramento area known as <a href=\"https://www.justice.gov/usao-edca/pr/sweeping-two-day-operation-targets-international-organized-crime-sacramento-area\">Operation Lights Out</a>.</p>\n\n<p>On the day of the raid on Chen\u2019s house, federal prosecutors <a href=\"https://www.justice.gov/usao-edca/pr/sacramento-real-estate-broker-indicted-international-money-laundering-conspiracy\">indicted a Sacramento real estate broker</a>, accusing her and other suspects of teaming with financiers in Fujian who wired millions of dollars to acquire houses for indoor grows through fraudulent maneuvers, according to a criminal complaint. Authorities also seized more than 100 houses.</p>\n\n<p>The elaborate and brazen nature of the alleged conspiracy led investigators to believe it involved the triads, according to three former federal officials who declined to be named because they were not authorized to discuss the case.</p>\n\n<p>Suspects used banks in China to wire money to the U.S. defendants in suspicious and obvious increments, according to the criminal complaint and former federal officials. Yet there was no interference from the most powerful police state in the world. Although hard proof was elusive, two former senior U.S. officials told ProPublica they suspected Chinese officials protected the scheme and may have benefited from it financially. </p>\n\n<p>\u201cThere was no question in my mind that there was at least Chinese government awareness of this,\u201d a former senior Department of Justice official said. \u201cThere was no way they didn\u2019t see the movement of the money going to the same people in the United States. But could we prove it? We suspected Chinese officials were complicit.\u201d</p>\n\n<p>Although the prosecution had a big impact by combining the might of the FBI, DEA, IRS and Homeland Security Investigations, it was one of the few federal offensives against Chinese networks involved in marijuana.</p>\n\n<p>Still, DEA financial investigations around the country revealed that the emerging marijuana empire intersected with the networks laundering billions of dollars for Latin American drug lords. Some of the funds from the laundering returned to China, but a lot was reinvested into new U.S. marijuana ventures, current and former officials said. </p>\n\n<p>The marijuana proceeds were \u201canother massive bucket of money\u201d with which high-level Chinese crime bosses funded interconnected rackets such as the money laundering and migrant smuggling, said former senior DEA official Christopher Urben, who is now a managing partner at the global investigations firm Nardello &amp; Co. </p>\n\n<p>Agents marveled at the scope of the enterprise and the lack of turf wars. Around 2019, the DEA learned that triad bosses had traveled from China to sit-downs in New York, where they issued directives and kept the peace nationwide, according to Urben and other current and former officials. New York had become the command hub for marijuana as well as money laundering. </p>\n\n<p>\u201cThe discipline involved is incredible,\u201d Urben said. \u201cHow are we having thousands of workers moved into the country and among states? How are all these groups doing this without more conflict or violence? How do you ensure that all these mid-level managers get along, with all this money, all this marijuana? The only way you can do it is with an organized crime apparatus.\u201d</p>\n\n<p>In the federal prosecution in Sacramento, a defendant pleaded guilty this Feb. 27. The real estate broker and two others are still awaiting trial.</p>\n\n<p>Meanwhile, Chen and his associates pleaded no contest to misdemeanors in state courts, which sentenced them to probation. Wasting no time, the crew headed for Oklahoma in 2020. </p>\n\n<p>In contrast to California, Oklahoma did not limit the size of grows. As long as the operations had a nominal local owner and a medical marijuana license, they could spread dozens of greenhouses capable of holding tens of thousands of plants over a cheap parcel of farmland.</p>\n\n<p>Some Chinese groups redeployed by air, according to officials and case files. Federal agents began detecting flights of private planes from California to rural airfields in Oklahoma. Couriers aboard the aircraft carried hundreds of thousands of dollars in cash to buy farmland, sometimes for twice or three times its value. To dodge federal interdiction teams, some pilots filed flight plans for one airstrip, then diverted to another.</p>\n\n<p>And money poured in from China. Around 2020, one group crowdfunded Oklahoma marijuana ventures through an invitation to investors on WeChat, the popular Chinese social media platform, said Mark Woodward, spokesperson of the Oklahoma Bureau of Narcotics. U.S. investigations show that WeChat, although heavily monitored by Chinese security forces, is often a forum for discussions of criminal activity.</p>\n\n<p>Oklahoma\u2019s marijuana industry surged to \u201can astronomical level,\u201d said Ray Padilla, a Denver-based DEA agent. He estimated that 90% of Colorado\u2019s illicit producers moved to the neighboring state. </p>\n\n<p>Oklahoma was the new frontier, Padilla said. And it was \u201cabsolute insanity.\u201d </p>\n\nGunplay at the Association\n<p>A statue of a panda bear sits like a chunky sentry atop a pillar on Classen Boulevard in Oklahoma City\u2019s Asian District.</p>\n\n<p>Mixing a longtime Vietnamese community with a more recent Chinese one, the boulevard is lined with stores, restaurants, massage parlors, nail salons and, block after block, marijuana dispensaries. </p>\n\n<p>Behind the panda, a ground-floor suite in a corner mini-mall houses the local chapter of the American Fujian Association. </p>\n\n<p>Shortly before dusk on Dec. 8, 2020, a black Mercedes SUV carrying Chen and Lin pulled up at the mini-mall accompanied by two other cars. The crew had driven an hour from their new farm in Kingfisher County. They were looking for Jintao Liu, who had also relocated from Sacramento after his marijuana site got busted, court documents show. Liu and Chen had been feuding since Chen had failed to pay him for organizing a delivery from California. </p>\n\n<p>When Liu had asked him to pay the $2,000 debt, Chen had become infuriated and began to terrorize Liu and his wife with threatening phone calls and texts showing photos of guns. Chen squared off with Liu at a gathering and punched him in the jaw. Later, Chen threatened to kill his wife and three children, court records say.</p>\n\n<p>The reasons for the rage remain somewhat murky. Asked during a court hearing why Chen was so angry if he owed the money, not the other way around, Liu answered, \u201cHe did not want to pay. He was this kind of a person.\u201d  </p>\n\n<p>On the afternoon that Chen and his crew appeared outside the Fujianese association, Liu was inside watching a friend play cards, according to court testimony. Liu and several other men came out. A brawl ensued. </p>\n\n<p>\u201cShoot him,\u201d Chen told Lin, according to witnesses.</p>\n\n<p>Lin pulled a gun and fired, the bullet fracturing Liu\u2019s hipbone, according to court documents. </p>\n\n<p>Police soon arrested Chen and Lin. A search of Chen\u2019s house in suburban Edmond turned up three pistols, 27.5 pounds of marijuana, $97,000 in cash and eight vials of ketamine, the party drug of choice in the Chinese underworld, court records say.</p>\n\n<p>Prosecutors charged Chen and Lin with assault and battery with a deadly weapon and drug offenses. The men made bail and went right back to the grow. (Lin has pleaded not guilty. His lawyer declined to comment.)</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            An Oklahoma Bureau of Narcotics agent searches for witnesses and survivors at the Kingfisher County farm where four people were shot to death.\n    \n            (Kingfisher County Sheriff\u2019s Department)\n    \n    \n    \n\n    \n\n        \n    \n                    \n<p>Their farm was about 13 miles from Hennessey, population 2,000. Lin had bought the 10-acre spread for $280,000, court documents say. To evade a state residency law, he paid cash to a local man named Richard Ignacio to pose as the 75% owner of the medical marijuana business and obtain a license, court documents allege. Ignacio had allegedly been drafted as a straw owner by an Oklahoma City accountant, a 20-time felon named Kevin Pham, who has been charged in connection with the Kingfisher farm and other grows, court documents say. Ignacio told investigators that he \u201cearned significant income\u201d acting as a hired front man. </p>\n\n<p>Ignacio pleaded guilty last year to being a straw owner for the Kingfisher farm. He and Pham have pleaded not guilty to other charges and are awaiting trial. They could not be reached for comment.</p>\n\n<p>Lin lived at and managed the place for Chen, according to court records and interviews. For equipment, three companies in China shipped about 440,000 pounds of greenhouse parts. Even among the vast marijuana farms in Oklahoma, the spread was unusually large: it contained over 100 greenhouses and several indoor grow houses, interviews and satellite images show. </p>\n\n<p>The closest neighbor, Gary Hawk, lived about a mile away. He had grown up at the place next door when it was a dairy farm owned by his parents. There was tension with the newcomers from the start. After a neighboring farmer used a plane for crop dusting, men at Chen\u2019s farm threatened to shoot it out of the sky, Hawk said in an interview. </p>\n\n<p>\u201cThe mail carrier would go by and she would stop to deliver mail there,\u201d he said. \u201cThey would come out of the house and one guy would come out with a machete and one guy would come out with an AR-15. That was just to pick up the mail. \u201d</p>\n\n<p>The farm employed an armed security officer stationed in a guard hut and as many as two dozen laborers, according to law enforcement officials and others who spent time there. Workers slept in trailers, the garage or the cluttered main house, where meals were prepared throughout the day and there was only one bathroom. During an inspection by fire marshals that found multiple safety violations in 2021, most of the employees presented Chinese identification and U.S. immigration documents.</p>\n\n<p>Neighbors complained about uncollected trash blowing into nearby pastures and endangering cattle, said Sgt. Michael Shults of the Kingfisher County Sheriff\u2019s Department. </p>\n\n<p>\u201cWe\u2019ve been out there several times explaining to them you need to put trash up,\u201d Shults said in an interview. \u201cCattle get into plastics that are blowing around, you know, cattle will eat almost anything.\u201d</p>\n\n<p>Deputies soon became convinced that Chen\u2019s crew, like many others, was trafficking its product on the black market in other states. In April 2021, Shults and other deputies intercepted a vehicle carrying 46.8 pounds of marijuana and arrested the driver, who was from Texas and did not have an Oklahoma cannabis transport license. Surveillance showed that she was one of two suspected couriers who had picked up bales at the farm that day, according to Shults and court documents.</p>\n\nAwash in Weed\n<p>By 2021, a mysterious investor had joined the crew at the Kingfisher farm. </p>\n\n<p>Chen Wu (also known as Wu Chen, but not related to the brothers) was in his mid-40s and from Fujian, according to officials and Chinese media reports. There are gaps in his past that investigators are still trying to fill. What they do know suggests he was a heavyweight: He had ties to Chinese criminal networks involved in money laundering, drug trafficking and migrant smuggling across the country and overseas, according to officials and court records. </p>\n\n<p>As a young man, Wu lived illegally in Spain, whose Chinese population has grown rapidly in the past two decades. In 2000, police on the resort island of Mallorca arrested him for entering the country illegally, Spanish law enforcement officials said.  </p>\n\n<p>As often happens, though, he managed to stay. He sought work authorization in 2003 and gave an address in a gritty neighborhood of Madrid. Five years later, he got in trouble for using someone else\u2019s identity, officials said, and Spanish police issued an arrest warrant for him in 2010. </p>\n\n<p>But he had already moved on. Wu spent time in the Caribbean, including Cuba. Arriving in the United States around 2016, he bounced around the country pursuing illicit schemes, officials said. In Minnesota, he married the owner of a restaurant and got legal status. During his divorce in 2020, Wu claimed in legal filings to have only about $18,000 to his name, records show.</p>\n\n<p>Yet he moved to Oklahoma and invested in Chen\u2019s farm. After months working there, he argued with his partners over money and left. </p>\n\n<p>By then, the state was awash in weed.</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            Oklahoma Bureau of Narcotics agents and Kingfisher County deputies search through buildings on the 10-acre marijuana farm.\n    \n            (Kingfisher County Sheriff\u2019s Department)\n    \n    \n    \n\n    \n\n        \n    \n                    \n<p>The number of licensed marijuana grows in Oklahoma peaked at nearly 10,000 at the end of 2021. Authorities suspected most of them of trafficking on the black market. One Chinese criminal group oversaw at least 400 grows. Another outfit smuggled truckloads to the East Coast every week, <a href=\"https://www.readfrontier.org/stories/with-cheap-land-and-low-fees-oklahoma-grown-marijuana-fuels-the-black-market-in-other-states/\">selling each for over $20 million</a>, before investigators dismantled it. </p>\n\n<p>Whether bosses or grunts, most of the newcomers were from New York, where a mob hierarchy oversees the illicit marijuana trade in Oklahoma and swoops in to collect the profits, according to law enforcement officials and court files.</p>\n\n<p>\u201cYou have many different levels,\u201d said Anderson, the state anti-drug director. \u201cSome overseeing grows. Then another upper echelon that controls money. \u2026 They\u2019re never around except to collect money.\u201d</p>\n\n<p>The boom caused prices to crater, hurting the legal industry. And it brought a generalized surge of crime. At airports, wary-looking Chinese immigrant laborers with backpacks became a familiar sight to law enforcement officers. So did human traffickers accompanying flashily dressed prostitutes to <a href=\"https://www.oklahoman.com/story/news/2023/10/26/one-arrested-in-human-trafficking-scheme-tied-to-oklahoma-medical-marijuana-farms/71317992007/\">brothels set up for overseers of the marijuana farms</a>. Illegal casinos appeared, seizures of ketamine soared, and robberies and violence plagued grows, dispensaries and stash houses, according to court cases and law enforcement officials.</p>\n\n<p>There was complex criminality as well. In <a href=\"https://www.justice.gov/usao-sdny/pr/three-men-arrested-complex-bank-fraud-and-cryptocurrency-laundering-scheme\">a case</a> investigated by the FBI, a Chinese ring based in New York and Oklahoma\u00a0allegedly used a cryptocurrency scheme to steal over $10 million from banks and other financial institutions. One defendant, who is now awaiting trial, was involved in a marijuana grow with an associate of Chen\u2019s Kingfisher County crew, according to law enforcement officials and public records.</p>\n\n<p>The victims of another scam were law-abiding Asian Americans. Cybercriminals manipulated the computer system of the Texas Department of Public Safety to obtain thousands of driver\u2019s licenses destined for Asian Americans, tricking authorities into <a href=\"https://cw39.com/news/texas/affidavit-texas-drivers-licenses-were-sent-to-oklahoma-addresses-in-organized-fraud-scheme/\">mailing the licenses to marijuana farms in neighboring Oklahoma</a>. The suspects used the licenses for fraudulent purchases or sold them on the underground market. Police arrested the accused mastermind in New York and extradited him to Texas last April to stand trial. </p>\n\n<p>Before marijuana legalization, Oklahoma was \u201ca pretty quiet state,\u201d said Tony Lie, president of the Oklahoma Chinese Association. \u201cWe didn\u2019t have any Chinese criminal gangs coming here.\u201d</p>\n\n<p>Lie has lived in Oklahoma for more than 30 years. Members of his longtime organization come from several regions in mainland China as well as Hong Kong and Taiwan. In contrast, most of the newcomers are Fujianese. Lie said the ills of the marijuana industry have hurt the image of Chinese Americans in the state.</p>\n\n<p>\u201cWe don\u2019t want people to come to Oklahoma to do something bad for the Chinese community,\u201d Lie said.</p>\n\n<p>The shooting at the Fujianese association in 2020 had opened a window into a fast-evolving underworld. </p>\n\n<p>But it turned out to be just a prelude. </p>\n\nPitch-Black Night\n<p>Shortly before 8 p.m. on Nov. 20, 2022, Kingfisher County Sheriff Dennis Banther alerted his deputies to a hostage incident at a farm near Hennessey. </p>\n\n<p>\u201cEverybody go 10-8,\u201d the text message said: Go in service and rush to the scene.</p>\n\n<p>Shults was the third to arrive. Four gunshot victims lay dead in the garage, and the shooter was on the loose. Deputies feared he was hiding in the sprawl of agricultural buildings known as hoop-houses. </p>\n\n<p>\u201cIt was pitch black,\u201d Shults said. \u201cWhen you\u2019re out there in the pitch dark, in the black night, and you\u2019ve got four people down, been executed, and you don\u2019t know if the shooter\u2019s still on scene or not \u2026 it\u2019s find the shooter. Survival.\u201d</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            Kingfisher County deputies discovered the bodies of four victims among stacks of marijuana in the garage.\n    \n            (Kingfisher County Sheriff\u2019s Department)\n    \n    \n    \n\n    \n\n        \n    \n                    \n<p>The sergeant came upon a wounded man lying in a black Ford F-150 pickup truck. It was Lin, the farm manager who had been the accused gunman at the Fujianese association, according to court documents. </p>\n\n<p>A second survivor emerged from the darkness. A deputy struggled to ask the farmworker urgent questions using Google Translate on his phone. Deputies found another worker who had recorded part of the incident on a cellphone, leaving it near the garage with the camera on before fleeing, according to court documents and interviews.  </p>\n\n<p>The survivors said the killer was Wu, who had worked at the farm until about a year earlier. He had arrived in his Toyota Corolla and shot Chen and a dog that was in the garage. Wu then told his hostages he would kill them if they didn\u2019t hand over $300,000 in half an hour.</p>\n\n<p>\u201cThe Boss told his girlfriend, who was inside the garage at the time, to call her brother to get the money,\u201d a witness told police. </p>\n\n<p>As minutes passed, Wu became increasingly agitated. The hostages tried to stop Chen\u2019s bleeding by wrapping a long-sleeved shirt around his knee as a makeshift tourniquet. </p>\n\n<p>But Chen \u201cwas not doing very well,\u201d the witness said. In a grim exchange, the wounded boss told the gunman \u201cto finish him off.\u201d</p>\n\n<p>Wu pumped two bullets into Chen\u2019s chest. Then, two hostages rushed at the gunman, who let loose a barrage that killed Chen\u2019s brother, Chen\u2019s girlfriend Lee and a newly hired employee. The wounded Lin ran outside and took refuge in the truck.</p>\n\n<p>Although the phone video didn\u2019t capture the actual shooting, it recorded the sound of gunshots and showed the gunman leaving the garage. </p>\n\n<p>Emergency personnel swarmed the scene. A helicopter evacuated the wounded man. Deputies spent all night doing a sweep of the grounds, finding another terrified worker hiding in a barn. </p>\n\n<p>At one point, a sedan with New York plates pulled up to the farm. An Asian man rolled down the window, startling deputies, and said he \u201cwas sent\u201d to pick up the workers remaining onsite, a deputy said.</p>\n\n<p>\u201cYou need to back him off,\u201d a sheriff\u2019s lieutenant yelled to his deputies. Afterward, they would wonder who had sent him so quickly.</p>\n\n<p>In one area of the dark compound, deputies thought they were trudging through mud. After sunrise, they realized it was human excrement \u2014 a sign of the conditions in which the farmworkers lived.</p>\n\n<p>Meanwhile, the gunman sped east toward Florida. From the road, he called people in Florida, including a Chinese organized crime figure suspected of involvement in drugs and human trafficking, according to court records and law enforcement officials familiar with the case. </p>\n\n<p>Investigators believe Wu wanted help from smugglers to flee the country, possibly to Cuba, which doesn\u2019t have an extradition treaty with the U.S., court records say. One affidavit for search warrants for Wu\u2019s phones and online accounts seeks evidence \u201crelating to the planning, preparation and actions taken to facilitate human smuggling.\u201d </p>\n\n<p>Soon after Wu got to Miami Beach, however, a license plate reader detected his car. Police arrested him two days after the murders. During an extradition hearing, Wu told the judge his life was in danger.</p>\n\n<p>\u201cIf I go back to Oklahoma, I\u2019ll be killed in the prison or jail,\u201d he said through an interpreter. \u201cI\u2019m afraid I will be killed because these people are mafiosos.\u201d</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n    \n            (Stefano Summo for ProPublica)\n    \n    \n    \n\n    \n\n        \n    \n                    \nAftermath\n<p>It seemed ironic: a mass murderer begging the court for protection. But a strange story told by a deputy who brought him back suggests that his fears may have been well founded.</p>\n\n<p>Kingfisher County sheriff\u2019s Lt. Ken Thompson had 25 years of experience transporting prisoners. He and another deputy drove nonstop to Florida in a marked Chevrolet Tahoe. In Miami, they checked into a motel near the airport in the evening, planning to sleep a few hours before picking up Wu from the Miami-Dade County jail, Thompson said in an interview.</p>\n\n<p>They changed their minds, Thompson said, because \u201ca weird deal happened.\u201d</p>\n\n<p>Looking out of the window of his motel room, Thompson said, he saw a car pull up next to his marked police vehicle in the parking lot. Another car appeared, then a third. The three cars drove around the motel as if doing surveillance, he said.</p>\n\n<p>The deputies concluded that they \u201cdidn\u2019t really feel comfortable sitting in this place,\u201d Thompson said. They decided to take custody of Wu and hit the road. </p>\n\n<p>After the deputies left the jail with Wu in the back seat, the three cars from the motel reappeared, Thompson said, and shadowed the Tahoe on the highway. </p>\n\n<p>Thompson said he did evasive maneuvers to lose them, exiting abruptly and returning to the highway miles later. </p>\n\n<p>\u201cIt's just a feeling, a gut feeling that you get, and the fact that they all just kind of just paced right around us,\u201d he said. \u201cI mean, they flew right up on us, but then they just locked down to our speed. So it was a weird deal.\u201d</p>\n\n<p>Thompson suspects that people in organized crime somehow located the deputies in Miami. He said he did not know if their goal was to harm Wu, to free him or simply to monitor a case that was causing a commotion.</p>\n\n<p>The prisoner was polite and obedient during the cross-country ride, getting out for bathroom breaks and accepting a McDonald\u2019s breakfast burrito that the deputies offered him. After they crossed the Oklahoma state line, though, his demeanor changed, the lieutenant said. </p>\n\n<p>\u201cYou couldn\u2019t pry him out of that car,\u201d Thompson said. \u201cOnce he reached Oklahoma, he wouldn\u2019t get out of the car.\u201d</p>\n\n<p>On Feb. 9, Wu pleaded guilty to the four murders and assault and battery. The judge sentenced him to life without possibility of parole. (He declined an interview request.)</p>\n\n<p>The quadruple murder made international headlines and set off a flurry of investigative activity and <a href=\"https://www.kjrh.com/news/local-news/ok-attorney-general-creates-task-force-to-target-illegal-cannabis-grow-operations\">political attention</a>. A state crackdown has reduced the number of growing operations by almost half, officials say.</p>\n\n<p>Chinese immigrants involved in the marijuana industry say law enforcement has been excessively harsh on them since late 2022. Qiu (Tina) He, who operated a marijuana-related consulting firm that is under investigation, said in an interview that many Asian investors have become disillusioned by what she called discriminatory treatment and the risks of the business. She denied wrongdoing in her case and predicted the state will suffer from the loss of tax revenue if Asian investors leave.</p>\n\n<p>\u201cWe are funding Oklahoma,\u201d she said. \u201cOklahoma City will be like a ghost town if we leave.\u201d</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            Law enforcement officers search dozens of metal and plastic marijuana grow houses at the Kingfisher farm the day after the quadruple homicide.\n    \n            (Kingfisher County Sheriff\u2019s Department)\n    \n    \n    \n\n    \n\n        \n    \n                    \n<p>The crime in Kingfisher County was a relatively unusual eruption of violence in the Chinese underworld. Law enforcement experts say the frontier atmosphere in Oklahoma is likely a result of the sheer amount of money generated by the cannabis trade and the number of criminals it has attracted. The growing wealth and power of Chinese organized crime is causing clashes elsewhere in the country as well, experts said.</p>\n\n<p>\u201cMaybe it\u2019s more like the Wild West as these groups keep spreading,\u201d said Urben, the former DEA official. \u201cYou are going to have violence even if someone is controlling from above. I think there would be even more conflict if the triads were not so involved.\u201d</p>"}, "tags": [{"term": "Criminal Justice", "scheme": null, "label": null}], "updated": "2024-03-14T05:00:00-04:00", "updated_parsed": [2024, 3, 14, 9, 0, 0, 3, 74, 0], "authors": [{"name": "by Sebastian Rotella and Kirsten Berg, ProPublica, and Garrett Yalch and Clifton Adcock, The Frontier"}], "author": "by Sebastian Rotella and Kirsten Berg, ProPublica, and Garrett Yalch and Clifton Adcock, The Frontier", "author_detail": {"name": "by Sebastian Rotella and Kirsten Berg, ProPublica, and Garrett Yalch and Clifton Adcock, The Frontier"}}, {"title": "Listen to the \u201cTimber Wars Season 2: Salmon Wars\u201d Podcast", "title_detail": {"type": "text/plain", "language": null, "base": "https://www.propublica.org/feeds/propublica/main", "value": "Listen to the \u201cTimber Wars Season 2: Salmon Wars\u201d Podcast"}, "links": [{"rel": "alternate", "type": "text/html", "href": "https://www.propublica.org/article/salmon-wars-podcast-episodes"}], "link": "https://www.propublica.org/article/salmon-wars-podcast-episodes", "published": "Wed, 13 Mar 2024 07:00:00 -0400", "published_parsed": [2024, 3, 13, 11, 0, 0, 2, 73, 0], "id": "https://www.propublica.org/article/salmon-wars-podcast-episodes", "guidislink": false, "summary": "<p class=\"byline\">\n                by <a class=\"name\" href=\"https://www.propublica.org/people/propublica\">ProPublica</a> and <a href=\"https://www.opb.org/\">Oregon Public Broadcasting</a>                </p>\n                                             \n\n        \n                        <p>This podcast was produced for ProPublica\u2019s Local Reporting Network in partnership with <a href=\"https://www.opb.org/homepage\">Oregon Public Broadcasting</a>. <a href=\"https://www.propublica.org/newsletters/dispatches\">Sign up for Dispatches</a> to get stories like this one as soon as they are published.</p>\n\n        \n\n    \n      \n  \n\n\n\n                    \n<p>Salmon are essential to Columbia River tribal people. These fish represent not only a food source but a way of life. As a white kid growing up in the Pacific Northwest, Tony Schick heard a lot about salmon \u2014 how important they are to this region, and how much trouble they\u2019re in now. But the history he learned was not the whole story. As an investigative reporter for Oregon Public Broadcasting and ProPublica, he\u2019s been working to uncover and understand a more sinister version of events. And along the way, he connected with a guy named Randy Settler and his family.</p>\n\n<p>Our new podcast \u201cSalmon Wars\u201d tells the story of salmon in the Northwest in a way you haven\u2019t heard before \u2014 through the voices of <a href=\"https://www.propublica.org/article/the-fight-of-the-salmon-people\">one Yakama Nation family who have been fighting for salmon for generations</a>. We\u2019ll dive into hidden history. We\u2019ll investigate who\u2019s to blame for the salmon vanishing and what can be done before it\u2019s too late.</p>\n        \n    \n                    \n<p>\u201cSalmon Wars\u201d is listed as Season Two of the \u201cTimber Wars\u201d podcast series. You can listen to the new season in the audio player below, or follow the link to your favorite podcast app.</p>\n\n<ul>\n<li><a href=\"https://podcasts.apple.com/us/podcast/timber-wars-season-2-salmon-wars/id1528060427\">Apple Podcasts</a></li>\n<li><a href=\"https://open.spotify.com/show/066UfmOs4ig1jBlPQqdRjt\">Spotify</a></li>\n</ul>\n</p>\n        \n    \n                    \nEpisode 1: The Family\n<p>Host Tony Schick introduces us to Randy Settler and his family. The Settlers, members of the Yakama Nation, have been deeply affected by the Northwest\u2019s salmon policies for generations. They lost their home, their primary food source, their ancestral fishing grounds. Randy and his parents went to jail for exercising their fishing rights, and they won some important victories along the way. Now, he\u2019s passing the fight on to the younger people in the tribe. </p>\n\nEpisode 2: The Treaties\n<p>To understand the war over salmon, we have to go back to 1855. That\u2019s when chiefs from the Yakama Nation and other Pacific Northwest tribes signed treaties that are still used as the basis for laws and policies governing salmon fishing. Some tribal members believe the Yakama signed a treaty under duress. In some ways, this document represents the first in a multigenerational series of promises that the U.S. government made and broke. It also created a powerful legal framework the Yakama still use to advocate for fishing rights.</p>", "summary_detail": {"type": "text/html", "language": null, "base": "https://www.propublica.org/feeds/propublica/main", "value": "<p class=\"byline\">\n                by <a class=\"name\" href=\"https://www.propublica.org/people/propublica\">ProPublica</a> and <a href=\"https://www.opb.org/\">Oregon Public Broadcasting</a>                </p>\n                                             \n\n        \n                        <p>This podcast was produced for ProPublica\u2019s Local Reporting Network in partnership with <a href=\"https://www.opb.org/homepage\">Oregon Public Broadcasting</a>. <a href=\"https://www.propublica.org/newsletters/dispatches\">Sign up for Dispatches</a> to get stories like this one as soon as they are published.</p>\n\n        \n\n    \n      \n  \n\n\n\n                    \n<p>Salmon are essential to Columbia River tribal people. These fish represent not only a food source but a way of life. As a white kid growing up in the Pacific Northwest, Tony Schick heard a lot about salmon \u2014 how important they are to this region, and how much trouble they\u2019re in now. But the history he learned was not the whole story. As an investigative reporter for Oregon Public Broadcasting and ProPublica, he\u2019s been working to uncover and understand a more sinister version of events. And along the way, he connected with a guy named Randy Settler and his family.</p>\n\n<p>Our new podcast \u201cSalmon Wars\u201d tells the story of salmon in the Northwest in a way you haven\u2019t heard before \u2014 through the voices of <a href=\"https://www.propublica.org/article/the-fight-of-the-salmon-people\">one Yakama Nation family who have been fighting for salmon for generations</a>. We\u2019ll dive into hidden history. We\u2019ll investigate who\u2019s to blame for the salmon vanishing and what can be done before it\u2019s too late.</p>\n        \n    \n                    \n<p>\u201cSalmon Wars\u201d is listed as Season Two of the \u201cTimber Wars\u201d podcast series. You can listen to the new season in the audio player below, or follow the link to your favorite podcast app.</p>\n\n<ul>\n<li><a href=\"https://podcasts.apple.com/us/podcast/timber-wars-season-2-salmon-wars/id1528060427\">Apple Podcasts</a></li>\n<li><a href=\"https://open.spotify.com/show/066UfmOs4ig1jBlPQqdRjt\">Spotify</a></li>\n</ul>\n</p>\n        \n    \n                    \nEpisode 1: The Family\n<p>Host Tony Schick introduces us to Randy Settler and his family. The Settlers, members of the Yakama Nation, have been deeply affected by the Northwest\u2019s salmon policies for generations. They lost their home, their primary food source, their ancestral fishing grounds. Randy and his parents went to jail for exercising their fishing rights, and they won some important victories along the way. Now, he\u2019s passing the fight on to the younger people in the tribe. </p>\n\nEpisode 2: The Treaties\n<p>To understand the war over salmon, we have to go back to 1855. That\u2019s when chiefs from the Yakama Nation and other Pacific Northwest tribes signed treaties that are still used as the basis for laws and policies governing salmon fishing. Some tribal members believe the Yakama signed a treaty under duress. In some ways, this document represents the first in a multigenerational series of promises that the U.S. government made and broke. It also created a powerful legal framework the Yakama still use to advocate for fishing rights.</p>"}, "tags": [{"term": "Environment, Broken Promises", "scheme": null, "label": null}], "updated": "2024-03-13T07:00:00-04:00", "updated_parsed": [2024, 3, 13, 11, 0, 0, 2, 73, 0], "authors": [{"name": "by ProPublica and Oregon Public Broadcasting"}], "author": "by ProPublica and Oregon Public Broadcasting", "author_detail": {"name": "by ProPublica and Oregon Public Broadcasting"}}, {"title": "What\u2019s Missing From Railroad Safety Data? Dead Workers and Severed Limbs.", "title_detail": {"type": "text/plain", "language": null, "base": "https://www.propublica.org/feeds/propublica/main", "value": "What\u2019s Missing From Railroad Safety Data? Dead Workers and Severed Limbs."}, "links": [{"rel": "alternate", "type": "text/html", "href": "https://www.propublica.org/article/railroad-safety-data-missing-dead-workers-severed-limbs"}], "link": "https://www.propublica.org/article/railroad-safety-data-missing-dead-workers-severed-limbs", "published": "Wed, 13 Mar 2024 05:00:00 -0400", "published_parsed": [2024, 3, 13, 9, 0, 0, 2, 73, 0], "id": "https://www.propublica.org/article/railroad-safety-data-missing-dead-workers-severed-limbs", "guidislink": false, "summary": "<p class=\"byline\">\n                by <a class=\"name\" href=\"https://www.propublica.org/people/topher-sanders\">Topher Sanders</a>, <a class=\"name\" href=\"https://www.propublica.org/people/dan-schwartz\">Dan Schwartz</a>, <a class=\"name\" href=\"https://www.propublica.org/people/danelle-morton\">Danelle Morton</a> and <a class=\"name\" href=\"https://www.propublica.org/people/gabriel-sandoval\">Gabriel Sandoval</a>                </p>\n                                             \n\n                                                                    \n            \n                <p>ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive <a href=\"https://www.propublica.org/newsletters/the-big-story?source=54G&amp;placement=top-note&amp;region=national\">our biggest stories</a> as soon as they\u2019re published.</p>\n\n            \n\n                \n\n      \n  \n\n\n\n                    \n<p>On a hot July afternoon in 2018, Gregory West found himself trudging through the mountains of northern Tennessee on what would be the last walk of his life.</p>\n\n<p>The engineer and his conductor had been stuck behind a stalled train that had not budged by the end of their shift, and rail company officials told them to walk out to a road where a vehicle could meet them. It would be an hour\u2019s journey up and down steep hills in 88-degree heat. And West, 57, had to lug two large bags of his belongings the entire way. Just as he reached the rendezvous point, he collapsed. The Campbell County medical examiner said West had pneumonia and hypertension, which decreased his oxygen supply before he died. His sister sued the railroad company, CSX, which settled with her for an undisclosed amount. </p>\n\n<p>But none of that is reflected in CSX\u2019s worker injury statistics. ProPublica only found out about it while reviewing lawsuits levied against the nation\u2019s largest freight carriers in the past 15 years. West\u2019s was one of at least 130 worker deaths and other injuries that were alleged to have happened on the job but that railroad companies never reported to regulators. </p>\n\n<p>Among the others, according to the lawsuits, were a CSX conductor who suffered a fatal heart attack after doing physical labor on a subfreezing overnight shift and a contractor who lost three fingers rigging equipment in a Norfolk Southern rail yard. </p>\n\n<p>The Federal Railroad Administration requires companies to report such incidents because knowing about them allows officials to spot broader lapses and hazardous working conditions. The agency\u2019s statistics are the main way the public can view the businesses\u2019 safety records, for which they must answer to their employees\u2019 unions and their shareholders. </p>\n\n<p>But, as ProPublica has previously reported, railroad companies go to extreme lengths to portray themselves as safer than they really are \u2014 <a href=\"https://www.propublica.org/article/railroad-safety-union-pacific-csx-bnsf-trains-freight?token=MdNELE4bvc-hjCgYiaEGN-QXxZSCJFgK\">retaliating against workers</a> who <a href=\"https://www.propublica.org/article/union-pacific-railroad-dangerous-conditions-warnings-fired-employee\">report defects</a> and <a href=\"https://www.propublica.org/article/railroad-worker-injuries-union-pacific-csx-cn-norfolk-southern\">silencing those who get injured</a>. Officials with the FRA have said there is not much they can do about the forces \u2014 like the financial implications of appearing to admit liability and a culture that faults managers when employees get hurt on their watch \u2014 that can drive companies to quash injury reporting. </p>\n\n<p>This tranche of missing injuries and deaths, however, exposes the clearest failure by regulators to hold companies accountable.</p>\n\n<p>Much of the problem stems from the FRA\u2019s porous reporting policies, which ProPublica found provide opportunities for companies to hide work-related injuries and deaths. Officials say they have spent the past five years working on revisions, which they plan to unveil this year. They said disclosing the details now would be a breach of the rulemaking process, but they mentioned that their changes could address issues raised by ProPublica\u2019s reporting.</p>\n\n<p>ProPublica's findings show the powerful rail companies have long benefitted from loopholes.</p>\n\n<p>Though agency officials say they are aware of conflicts of interest that steer railroad companies toward keeping worker injuries quiet, FRA policies give the businesses broad latitude to determine whether injuries and even on-the-job deaths are work-related \u2014 and, thus, whether they need to be reported. </p>\n\n<p>One reason companies give for opting out of reporting: Rail company officials believe a worker is lying, an argument the companies have made in court, and one juries and judges have sometimes rejected.</p>\n\n<p>The agency also doesn\u2019t require railroad companies to report certain injuries and deaths of contractors who are crushed or maimed by trains. Those incidents are supposed to be reported to a different agency by the contractor\u2019s employer, which doesn\u2019t tie them to the railroad\u2019s record or allow them to be easily studied for possible safety reforms. </p>\n\n<p>Empowered to levy fines up to $10,000 against companies that willfully fail to report injuries, and even to disqualify managers who do so, FRA officials say they will not be investigating the scores of unreported cases ProPublica provided them in a database \u2014 cases they confirmed were nowhere to be found in their records.</p>\n\n<p>The bulk of the cases ProPublica found, including the deaths, happened more than five years ago. The FRA says it does not have the power to punish railroads for unreported injuries after that much time or even edit the safety record to reflect them. It attributes that to a law that applies to all federal regulators.</p>\n\n<p>And though 11 of the alleged injuries ProPublica raised are newer \u2014 in two unreported cases, workers said they were fired after being hurt \u2014 officials said those won\u2019t be reviewed either. They view lawsuits, which ProPublica used to find the cases, as \u201cunreliable\u201d sources of information. </p>\n\n<p>The FRA is satisfied with its standard process for unearthing hidden injuries, an audit done of each rail company every two years. As part of these four-month deep dives, regulators say they pore through internal company documents to find injuries that were deemed unreportable, then review medical records and interview employees to determine whether the injury should, in fact, have been reported.</p>\n\n<p>Officials didn\u2019t have an explanation for how audits missed the two deaths ProPublica found and said they should have been submitted to the FRA based on the information reporters provided. \u201cDespite our best efforts, regrettably there are cases of failures to report or to accurately capture all covered events,\u201d the agency said in a statement, adding that \u201cany gaps or voids in reporting are of concern and will prompt us to redouble our efforts,\u201d that it expects companies to \u201cfaithfully abide\u201d by the requirements and that it strives to continuously improve its data collection and validation.</p>\n\n<p>Each of the <a href=\"https://www.documentcloud.org/documents/24462119-railroad-statements-3-6-24\">railroads denied that they failed to report injuries</a>, largely claiming that the cases either didn\u2019t meet the reporting guidelines, as CSX argued about West\u2019s death, or that the company didn\u2019t believe the worker\u2019s injury happened at work. \u201cThose cases where CSX determined the events were not reportable are fully supported by the facts and evidence gathered by CSX through its thorough investigations of each incident,\u201d the company said in a statement, adding that it was proud of its \u201cbest in class\u201d reporting process and that it complies with FRA\u2019s audits. </p>\n\n<p>The Association of American Railroads, the industry\u2019s lobbying arm, denied that underreporting is widespread and called ProPublica\u2019s findings isolated incidents. The association pointed to the <a href=\"https://www.aar.org/news/fra-2023-data-affirms-rails-strong-sustained-safety-record/\">most recent injury statistics</a> \u2014 the ones ProPublica has found are incomplete \u2014 to show the rails are the safest they have ever been.</p>\n\n<p>But union leader Jared Cassity said ProPublica\u2019s findings are further evidence that companies\u2019 safety records do not capture the full range of dangers allowed to persist on the rails. \u201cThe system is rigged, especially when it comes to injuries,\u201d said Cassity, the alternate national legislative director for the International Association of Sheet Metal, Air, Rail and Transportation Workers, or SMART.</p>\n\n<p>\u201cYou see what they want you to see,\u201d he said. </p>\n\n\n<p>To find unreported injuries and deaths, ProPublica reviewed more than 5,000 federal lawsuits levied against the nation\u2019s six largest freight railroad companies, the so-called Class 1s, from 2009 to 2022. For each complaint that mentioned a worker injury or death and had a detailed enough description of what happened, ProPublica consulted a 300-page FRA guidebook to determine which cases appeared to fit reporting requirements. Then, journalists combed through the agency\u2019s online railroad injury database to see whether the incidents had been reported and, if not, asked the agency to double check its files.</p>\n\n<p>Clear patterns emerged in cases that weren\u2019t reported. </p>\n\n<p>Unlike trauma deaths or amputations, the vast majority of unreported injuries were open to easier arguments that they were not work-related \u2014 sprained ankles, torn rotator cuffs, tweaked backs, strained tendons. One man said he had been in a port-a-potty when a track hoe struck it; another said he was hurt when the railroad\u2019s transport vehicle crashed. One said he slipped along the ballast, the gravel that surrounds train tracks; another said he jumped from a train to avoid a collision.</p>\n\n<p>Broadly speaking, railroads must tell the government about any on-the-job injury that requires medical care beyond diagnostic procedures like X-rays, that requires an employee to miss a day of work, or that lands an employee on light duty.</p>\n\n<p>But rail officials have long found ways to argue that these less-visible soft-tissue injuries, unlike gaping wounds, could have happened off duty or for reasons not related to the work employees were doing. </p>\n\n<p>\u201cThe guide gives us the right to make our best guess on a case, and then [the FRA has] to prove us otherwise,\u201d said Tuesdi Sweatt, CSX\u2019s then-senior manager of accident reporting and compliance, in a legal deposition in 2018.</p>\n\n<p>BNSF engineer Scotty Bragg was operating a train near Hardy, Arkansas, on Nov. 17, 2021, when he said he encountered rough track and \u201cexperienced significant jostling\u201d in a cab that didn\u2019t have seatbelts. He said he injured his neck, back and spine, requiring surgery. A company official said in a deposition that a review of locomotive footage led officials to decide that Bragg hadn\u2019t encountered rough track and wasn\u2019t injured at work.</p>\n\n<p>It was a familiar argument used against hurt workers. ProPublica has reported on cases in which <a href=\"https://www.propublica.org/article/trains-railroad-kcs-kansas-city-southern-injuries-lawsuit\">companies presented video evidence that did not hold up to scrutiny</a> in court, failing to convince juries that an employee was wrong or lying. At least two of these cases resulted in multimillion-dollar payouts to the workers. Despite the company\u2019s denial of Bragg\u2019s injuries, it did agree to settle his case. BNSF\u2019s response did not address any of the unreported cases ProPublica sent the company in a spreadsheet along with an interview request.In a statement, BNSF said it takes its reporting obligations seriously and touted its safety record, which over the last decade, \u201cproduced the lowest number of injuries in our railroad\u2019s history.\u201d </p>\n\n<p>The FRA allows companies to decide whether an injury was job-related or not, even when an employee dies at work.</p>\n\n<p>In the case of West, the engineer who died in the mountains, the company said that because he suffered from a \u201cpersonal condition,\u201d his death didn\u2019t have to be reported. In court, the company said West \u201csuffered from multiple maladies and physical conditions, and as a result, it was not foreseeable\u201d that a \u201cone-half mile walk would cause or contribute to his death.\u201d </p>\n\n<p>The FRA said that even if companies don\u2019t file reports, they must phone in all on-the-job deaths to the U.S. Coast Guard\u2019s National Response Center, no matter the cause. But it is unclear what happens once the agency is contacted; these calls don\u2019t become a part of an official injury record and it\u2019s unclear what trend analysis, if any, is done with them. </p>\n\n<p>CSX conductor Danny Byrom, 37, was working an overnight shift in an Illinois yard on Jan. 27, 2019, while the temperature was around 20 degrees. He bent over to remove a heavy piece of equipment. Afterward, he collapsed and died of cardiac arrest.</p>\n\n<p>When asked about the case, FRA officials said it should have been reported because there was \u201cprobably a causal connection\u201d between his work-related exertion and his death. CSX told ProPublica the company believes Byrom\u2019s death wasn\u2019t reportable because he suffered from a \u201cpersonal condition.\u201d His family\u2019s lawsuit against the company is ongoing.</p>\n\n<p>Agency officials said nontrauma deaths that appear to be natural aren\u2019t likely to immediately spur a full investigation. </p>\n\n<p>The omissions of these kinds of deaths from companies\u2019 safety records \u2014 and the lack of any kind of investigation by the FRA \u2014 troubles Cassity, the union leader, because the deaths appeared to be related to work tasks. \u201cYou\u2019re being forced to do it, and you die in the performance of it. \u2026 The fact they don\u2019t consider that is \u2026 it\u2019s unconscionable.\u201d</p>\n\n<p>The FRA should investigate all on-the-job deaths, he said, and determine itself whether they were work-related.</p>\n\n<p>Such reporting would help the agency identify and eliminate hazards for workers, said David Michaels, former head of the Occupational Safety and Health Administration, which oversees injury and death investigations in most industries outside the rails. </p>\n\n<p>\u201cYou certainly want events that occur at work to be reported for the agency to consider whether or not they deserve further investigation, and that will include heart attacks and asthma,\u201d said Michaels, who is now a professor at George Washington University. \u201cAnd by aggregating information from these investigations, it allows researchers to go in and use the data to better understand what\u2019s going on in these workplaces.\u201d</p>\n\n<p>Had West and Byrom worked at a bank, or a restaurant, or some other American workplace, OSHA would have considered their deaths reportable, Michaels said.</p>\n\n<p>But ProPublica found the plight of workers who are injured by trains \u2014 but who are not staff members of rail companies \u2014 may be even worse.</p>\n\n\n<p>Kenneth Ivy was working for Riceland Foods at the company\u2019s Jonesboro, Arkansas, rail yard in November 2013 when he said he noticed a Union Pacific freight car had been placed on a slope without its brakes applied. He said he attempted to apply the brakes and they wouldn\u2019t work. The freight car rolled over Ivy, crushing part of his left arm and both his legs, which had to be amputated. </p>\n\n<p>Because Ivy didn\u2019t work for the railroad and the accident didn\u2019t happen on Union Pacific land, government policies dictated that Union Pacific didn\u2019t have to report it to the FRA. Instead, Riceland Foods reported it to OSHA. So now Union Pacific\u2019s safety record doesn\u2019t reflect the fact that its freight car grievously injured someone, nor did the regulator with expertise in rail safety investigate whether the brakes were faulty, nor could the agency use the incident to track similar injuries or learn whether there are any systemic hazards. </p>\n\n<p>Union Pacific, which denied in court that the brakes were defective, said the worker tripped when he attempted to apply them to the moving freight car. The company noted to ProPublica that it was Riceland Foods that moved the rail car and Riceland Foods that was responsible for the switch operations. While that company settled with the injured worker, so did Union Pacific.  </p>\n\n<p>Though rail companies must report when contractors are hurt on their land, ProPublica found they have dodged that reporting requirement, too. </p>\n\n<p>Contractor James Wheeler was rigging down a boom of heavy equipment in Norfolk Southern\u2019s rail yard when a fellow contractor\u2019s mistake resulted in Wheeler having three fingers on his right hand amputated. Norfolk never reported it, despite the fact that the incident happened on its land. The company did not comment on the case, but said it reviewed all of the unreported cases found by ProPublica and wound up reporting one of them to the FRA, \u201cwhich was based on information added to a case months after the initial report was made internally. That update was made immediately.\u201d</p>\n\n<p>FRA officials said they believed the incident should have been reported, but because the injury happened in 2016, they told ProPublica that nothing further had to be done. The FRA said the five-year limit was a reasonable time frame.</p>\n\n<p>The agency says it focuses its efforts on newer injuries and that its audits are rigorous and successful. Last year, the process caught Union Pacific managers hiding nearly 100 injuries that should have been reported. </p>\n\n<p>\u201cUP documentation clearly showed these incidents were reportable injuries,\u201d the agency said. The company disciplined those involved, the FRA said, but the agency\u2019s investigation is still open because a key witness in the case has filed an OSHA complaint against Union Pacific and won\u2019t speak to the FRA until given clearance by his attorney. An agency spokesperson said the FRA expects to issue violations but as of now no fines have been levied. \u201cAllegations that managers are incentivized to hide or ignore injured employees are false,\u201d UP told ProPublica in a statement. The company also told ProPublica that its own audit process had found the \u201cincorrectly classified\u201d injuries and that the company had corrected them. </p>\n\n<p>Agency officials said that most of the time, when they catch unreported injuries, they simply ask officials to reconcile the matter. The agency doesn\u2019t separately track fines it gives for injury reporting violations, instead lumping together all the fines it levies against railroads for all kinds of reporting failures. ProPublica added up these kinds of fines levied against all Class 1 companies in 2022, the most recent year of data available. For the companies, which had $108 billion in combined revenue that year, the penalties added up to $30,011.</p>\n\n<p>The agency told ProPublica it knows the penalties are too paltry to prevent the companies or their officials from attempting to hide injuries. Only Congress could increase the fines, a spokesperson said. \u201cThe proposed <a href=\"https://www.congress.gov/bill/118th-congress/senate-bill/576\">Railway Safety Act</a> would allow for a substantial increase in the maximum civil penalty amount,\u201d the spokesperson said. That bill, which received bipartisan support when it was introduced on the heels of last year\u2019s catastrophic derailment that unleashed hazardous chemicals on East Palestine, Ohio, has since <a href=\"https://www.levernews.com/the-koch-network-is-killing-rail-safety/\">stalled in Congress</a>.</p>\n\n<p>Cassity said the FRA\u2019s audit process allows railroads too much notice before the government arrives on site to check records. \u201cIt just just doesn\u2019t go far enough,\u201d he said, adding that he believes companies purposefully don\u2019t fill out certain paperwork so they can hide injuries from the FRA and that there is little the agency can do to combat the practice.</p>\n\n<p>He suggested that one way to get the fullest accounting of injuries would be for the FRA to devise a system where the reports come directly from employees. \u201cRight now, the only way to get the facts is through a carrier that, quite frankly, is not playing fairly,\u201d he said. \u201cAnd so you've got to get it from the source.\u201d</p>\n\n<p>Such a system would require significant procedural and operational changes, FRA officials said, and there is no guarantee all employees would abide by them. </p>\n\n<p>But agency officials said they can entertain these and other big changes during the upcoming public comment period for their proposed rules, which have not been updated since 2010. During this period, railroad companies and labor groups are expected to provide their perspectives and could mount legal efforts to change the proposals. According to the agency, any new rules will receive final approval from its chief safety officer.</p>\n        \n             \n\n                                    \n        \n                        <p>Research was contributed by <a href=\"https://www.propublica.org/people/jeff-kao\">Jeff Kao</a>, <a href=\"https://www.propublica.org/people/Mollie-Simon\">Mollie Simon</a>, <a href=\"https://www.propublica.org/people/Mariam-Elba\">Mariam Elba</a>, and <a href=\"https://www.propublica.org/people/Ruth-Baron\">Ruth Baron</a> of ProPublica, and Carolyn Edds and Miriam Pensack.</p>", "summary_detail": {"type": "text/html", "language": null, "base": "https://www.propublica.org/feeds/propublica/main", "value": "<p class=\"byline\">\n                by <a class=\"name\" href=\"https://www.propublica.org/people/topher-sanders\">Topher Sanders</a>, <a class=\"name\" href=\"https://www.propublica.org/people/dan-schwartz\">Dan Schwartz</a>, <a class=\"name\" href=\"https://www.propublica.org/people/danelle-morton\">Danelle Morton</a> and <a class=\"name\" href=\"https://www.propublica.org/people/gabriel-sandoval\">Gabriel Sandoval</a>                </p>\n                                             \n\n                                                                    \n            \n                <p>ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive <a href=\"https://www.propublica.org/newsletters/the-big-story?source=54G&amp;placement=top-note&amp;region=national\">our biggest stories</a> as soon as they\u2019re published.</p>\n\n            \n\n                \n\n      \n  \n\n\n\n                    \n<p>On a hot July afternoon in 2018, Gregory West found himself trudging through the mountains of northern Tennessee on what would be the last walk of his life.</p>\n\n<p>The engineer and his conductor had been stuck behind a stalled train that had not budged by the end of their shift, and rail company officials told them to walk out to a road where a vehicle could meet them. It would be an hour\u2019s journey up and down steep hills in 88-degree heat. And West, 57, had to lug two large bags of his belongings the entire way. Just as he reached the rendezvous point, he collapsed. The Campbell County medical examiner said West had pneumonia and hypertension, which decreased his oxygen supply before he died. His sister sued the railroad company, CSX, which settled with her for an undisclosed amount. </p>\n\n<p>But none of that is reflected in CSX\u2019s worker injury statistics. ProPublica only found out about it while reviewing lawsuits levied against the nation\u2019s largest freight carriers in the past 15 years. West\u2019s was one of at least 130 worker deaths and other injuries that were alleged to have happened on the job but that railroad companies never reported to regulators. </p>\n\n<p>Among the others, according to the lawsuits, were a CSX conductor who suffered a fatal heart attack after doing physical labor on a subfreezing overnight shift and a contractor who lost three fingers rigging equipment in a Norfolk Southern rail yard. </p>\n\n<p>The Federal Railroad Administration requires companies to report such incidents because knowing about them allows officials to spot broader lapses and hazardous working conditions. The agency\u2019s statistics are the main way the public can view the businesses\u2019 safety records, for which they must answer to their employees\u2019 unions and their shareholders. </p>\n\n<p>But, as ProPublica has previously reported, railroad companies go to extreme lengths to portray themselves as safer than they really are \u2014 <a href=\"https://www.propublica.org/article/railroad-safety-union-pacific-csx-bnsf-trains-freight?token=MdNELE4bvc-hjCgYiaEGN-QXxZSCJFgK\">retaliating against workers</a> who <a href=\"https://www.propublica.org/article/union-pacific-railroad-dangerous-conditions-warnings-fired-employee\">report defects</a> and <a href=\"https://www.propublica.org/article/railroad-worker-injuries-union-pacific-csx-cn-norfolk-southern\">silencing those who get injured</a>. Officials with the FRA have said there is not much they can do about the forces \u2014 like the financial implications of appearing to admit liability and a culture that faults managers when employees get hurt on their watch \u2014 that can drive companies to quash injury reporting. </p>\n\n<p>This tranche of missing injuries and deaths, however, exposes the clearest failure by regulators to hold companies accountable.</p>\n\n<p>Much of the problem stems from the FRA\u2019s porous reporting policies, which ProPublica found provide opportunities for companies to hide work-related injuries and deaths. Officials say they have spent the past five years working on revisions, which they plan to unveil this year. They said disclosing the details now would be a breach of the rulemaking process, but they mentioned that their changes could address issues raised by ProPublica\u2019s reporting.</p>\n\n<p>ProPublica's findings show the powerful rail companies have long benefitted from loopholes.</p>\n\n<p>Though agency officials say they are aware of conflicts of interest that steer railroad companies toward keeping worker injuries quiet, FRA policies give the businesses broad latitude to determine whether injuries and even on-the-job deaths are work-related \u2014 and, thus, whether they need to be reported. </p>\n\n<p>One reason companies give for opting out of reporting: Rail company officials believe a worker is lying, an argument the companies have made in court, and one juries and judges have sometimes rejected.</p>\n\n<p>The agency also doesn\u2019t require railroad companies to report certain injuries and deaths of contractors who are crushed or maimed by trains. Those incidents are supposed to be reported to a different agency by the contractor\u2019s employer, which doesn\u2019t tie them to the railroad\u2019s record or allow them to be easily studied for possible safety reforms. </p>\n\n<p>Empowered to levy fines up to $10,000 against companies that willfully fail to report injuries, and even to disqualify managers who do so, FRA officials say they will not be investigating the scores of unreported cases ProPublica provided them in a database \u2014 cases they confirmed were nowhere to be found in their records.</p>\n\n<p>The bulk of the cases ProPublica found, including the deaths, happened more than five years ago. The FRA says it does not have the power to punish railroads for unreported injuries after that much time or even edit the safety record to reflect them. It attributes that to a law that applies to all federal regulators.</p>\n\n<p>And though 11 of the alleged injuries ProPublica raised are newer \u2014 in two unreported cases, workers said they were fired after being hurt \u2014 officials said those won\u2019t be reviewed either. They view lawsuits, which ProPublica used to find the cases, as \u201cunreliable\u201d sources of information. </p>\n\n<p>The FRA is satisfied with its standard process for unearthing hidden injuries, an audit done of each rail company every two years. As part of these four-month deep dives, regulators say they pore through internal company documents to find injuries that were deemed unreportable, then review medical records and interview employees to determine whether the injury should, in fact, have been reported.</p>\n\n<p>Officials didn\u2019t have an explanation for how audits missed the two deaths ProPublica found and said they should have been submitted to the FRA based on the information reporters provided. \u201cDespite our best efforts, regrettably there are cases of failures to report or to accurately capture all covered events,\u201d the agency said in a statement, adding that \u201cany gaps or voids in reporting are of concern and will prompt us to redouble our efforts,\u201d that it expects companies to \u201cfaithfully abide\u201d by the requirements and that it strives to continuously improve its data collection and validation.</p>\n\n<p>Each of the <a href=\"https://www.documentcloud.org/documents/24462119-railroad-statements-3-6-24\">railroads denied that they failed to report injuries</a>, largely claiming that the cases either didn\u2019t meet the reporting guidelines, as CSX argued about West\u2019s death, or that the company didn\u2019t believe the worker\u2019s injury happened at work. \u201cThose cases where CSX determined the events were not reportable are fully supported by the facts and evidence gathered by CSX through its thorough investigations of each incident,\u201d the company said in a statement, adding that it was proud of its \u201cbest in class\u201d reporting process and that it complies with FRA\u2019s audits. </p>\n\n<p>The Association of American Railroads, the industry\u2019s lobbying arm, denied that underreporting is widespread and called ProPublica\u2019s findings isolated incidents. The association pointed to the <a href=\"https://www.aar.org/news/fra-2023-data-affirms-rails-strong-sustained-safety-record/\">most recent injury statistics</a> \u2014 the ones ProPublica has found are incomplete \u2014 to show the rails are the safest they have ever been.</p>\n\n<p>But union leader Jared Cassity said ProPublica\u2019s findings are further evidence that companies\u2019 safety records do not capture the full range of dangers allowed to persist on the rails. \u201cThe system is rigged, especially when it comes to injuries,\u201d said Cassity, the alternate national legislative director for the International Association of Sheet Metal, Air, Rail and Transportation Workers, or SMART.</p>\n\n<p>\u201cYou see what they want you to see,\u201d he said. </p>\n\n\n<p>To find unreported injuries and deaths, ProPublica reviewed more than 5,000 federal lawsuits levied against the nation\u2019s six largest freight railroad companies, the so-called Class 1s, from 2009 to 2022. For each complaint that mentioned a worker injury or death and had a detailed enough description of what happened, ProPublica consulted a 300-page FRA guidebook to determine which cases appeared to fit reporting requirements. Then, journalists combed through the agency\u2019s online railroad injury database to see whether the incidents had been reported and, if not, asked the agency to double check its files.</p>\n\n<p>Clear patterns emerged in cases that weren\u2019t reported. </p>\n\n<p>Unlike trauma deaths or amputations, the vast majority of unreported injuries were open to easier arguments that they were not work-related \u2014 sprained ankles, torn rotator cuffs, tweaked backs, strained tendons. One man said he had been in a port-a-potty when a track hoe struck it; another said he was hurt when the railroad\u2019s transport vehicle crashed. One said he slipped along the ballast, the gravel that surrounds train tracks; another said he jumped from a train to avoid a collision.</p>\n\n<p>Broadly speaking, railroads must tell the government about any on-the-job injury that requires medical care beyond diagnostic procedures like X-rays, that requires an employee to miss a day of work, or that lands an employee on light duty.</p>\n\n<p>But rail officials have long found ways to argue that these less-visible soft-tissue injuries, unlike gaping wounds, could have happened off duty or for reasons not related to the work employees were doing. </p>\n\n<p>\u201cThe guide gives us the right to make our best guess on a case, and then [the FRA has] to prove us otherwise,\u201d said Tuesdi Sweatt, CSX\u2019s then-senior manager of accident reporting and compliance, in a legal deposition in 2018.</p>\n\n<p>BNSF engineer Scotty Bragg was operating a train near Hardy, Arkansas, on Nov. 17, 2021, when he said he encountered rough track and \u201cexperienced significant jostling\u201d in a cab that didn\u2019t have seatbelts. He said he injured his neck, back and spine, requiring surgery. A company official said in a deposition that a review of locomotive footage led officials to decide that Bragg hadn\u2019t encountered rough track and wasn\u2019t injured at work.</p>\n\n<p>It was a familiar argument used against hurt workers. ProPublica has reported on cases in which <a href=\"https://www.propublica.org/article/trains-railroad-kcs-kansas-city-southern-injuries-lawsuit\">companies presented video evidence that did not hold up to scrutiny</a> in court, failing to convince juries that an employee was wrong or lying. At least two of these cases resulted in multimillion-dollar payouts to the workers. Despite the company\u2019s denial of Bragg\u2019s injuries, it did agree to settle his case. BNSF\u2019s response did not address any of the unreported cases ProPublica sent the company in a spreadsheet along with an interview request.In a statement, BNSF said it takes its reporting obligations seriously and touted its safety record, which over the last decade, \u201cproduced the lowest number of injuries in our railroad\u2019s history.\u201d </p>\n\n<p>The FRA allows companies to decide whether an injury was job-related or not, even when an employee dies at work.</p>\n\n<p>In the case of West, the engineer who died in the mountains, the company said that because he suffered from a \u201cpersonal condition,\u201d his death didn\u2019t have to be reported. In court, the company said West \u201csuffered from multiple maladies and physical conditions, and as a result, it was not foreseeable\u201d that a \u201cone-half mile walk would cause or contribute to his death.\u201d </p>\n\n<p>The FRA said that even if companies don\u2019t file reports, they must phone in all on-the-job deaths to the U.S. Coast Guard\u2019s National Response Center, no matter the cause. But it is unclear what happens once the agency is contacted; these calls don\u2019t become a part of an official injury record and it\u2019s unclear what trend analysis, if any, is done with them. </p>\n\n<p>CSX conductor Danny Byrom, 37, was working an overnight shift in an Illinois yard on Jan. 27, 2019, while the temperature was around 20 degrees. He bent over to remove a heavy piece of equipment. Afterward, he collapsed and died of cardiac arrest.</p>\n\n<p>When asked about the case, FRA officials said it should have been reported because there was \u201cprobably a causal connection\u201d between his work-related exertion and his death. CSX told ProPublica the company believes Byrom\u2019s death wasn\u2019t reportable because he suffered from a \u201cpersonal condition.\u201d His family\u2019s lawsuit against the company is ongoing.</p>\n\n<p>Agency officials said nontrauma deaths that appear to be natural aren\u2019t likely to immediately spur a full investigation. </p>\n\n<p>The omissions of these kinds of deaths from companies\u2019 safety records \u2014 and the lack of any kind of investigation by the FRA \u2014 troubles Cassity, the union leader, because the deaths appeared to be related to work tasks. \u201cYou\u2019re being forced to do it, and you die in the performance of it. \u2026 The fact they don\u2019t consider that is \u2026 it\u2019s unconscionable.\u201d</p>\n\n<p>The FRA should investigate all on-the-job deaths, he said, and determine itself whether they were work-related.</p>\n\n<p>Such reporting would help the agency identify and eliminate hazards for workers, said David Michaels, former head of the Occupational Safety and Health Administration, which oversees injury and death investigations in most industries outside the rails. </p>\n\n<p>\u201cYou certainly want events that occur at work to be reported for the agency to consider whether or not they deserve further investigation, and that will include heart attacks and asthma,\u201d said Michaels, who is now a professor at George Washington University. \u201cAnd by aggregating information from these investigations, it allows researchers to go in and use the data to better understand what\u2019s going on in these workplaces.\u201d</p>\n\n<p>Had West and Byrom worked at a bank, or a restaurant, or some other American workplace, OSHA would have considered their deaths reportable, Michaels said.</p>\n\n<p>But ProPublica found the plight of workers who are injured by trains \u2014 but who are not staff members of rail companies \u2014 may be even worse.</p>\n\n\n<p>Kenneth Ivy was working for Riceland Foods at the company\u2019s Jonesboro, Arkansas, rail yard in November 2013 when he said he noticed a Union Pacific freight car had been placed on a slope without its brakes applied. He said he attempted to apply the brakes and they wouldn\u2019t work. The freight car rolled over Ivy, crushing part of his left arm and both his legs, which had to be amputated. </p>\n\n<p>Because Ivy didn\u2019t work for the railroad and the accident didn\u2019t happen on Union Pacific land, government policies dictated that Union Pacific didn\u2019t have to report it to the FRA. Instead, Riceland Foods reported it to OSHA. So now Union Pacific\u2019s safety record doesn\u2019t reflect the fact that its freight car grievously injured someone, nor did the regulator with expertise in rail safety investigate whether the brakes were faulty, nor could the agency use the incident to track similar injuries or learn whether there are any systemic hazards. </p>\n\n<p>Union Pacific, which denied in court that the brakes were defective, said the worker tripped when he attempted to apply them to the moving freight car. The company noted to ProPublica that it was Riceland Foods that moved the rail car and Riceland Foods that was responsible for the switch operations. While that company settled with the injured worker, so did Union Pacific.  </p>\n\n<p>Though rail companies must report when contractors are hurt on their land, ProPublica found they have dodged that reporting requirement, too. </p>\n\n<p>Contractor James Wheeler was rigging down a boom of heavy equipment in Norfolk Southern\u2019s rail yard when a fellow contractor\u2019s mistake resulted in Wheeler having three fingers on his right hand amputated. Norfolk never reported it, despite the fact that the incident happened on its land. The company did not comment on the case, but said it reviewed all of the unreported cases found by ProPublica and wound up reporting one of them to the FRA, \u201cwhich was based on information added to a case months after the initial report was made internally. That update was made immediately.\u201d</p>\n\n<p>FRA officials said they believed the incident should have been reported, but because the injury happened in 2016, they told ProPublica that nothing further had to be done. The FRA said the five-year limit was a reasonable time frame.</p>\n\n<p>The agency says it focuses its efforts on newer injuries and that its audits are rigorous and successful. Last year, the process caught Union Pacific managers hiding nearly 100 injuries that should have been reported. </p>\n\n<p>\u201cUP documentation clearly showed these incidents were reportable injuries,\u201d the agency said. The company disciplined those involved, the FRA said, but the agency\u2019s investigation is still open because a key witness in the case has filed an OSHA complaint against Union Pacific and won\u2019t speak to the FRA until given clearance by his attorney. An agency spokesperson said the FRA expects to issue violations but as of now no fines have been levied. \u201cAllegations that managers are incentivized to hide or ignore injured employees are false,\u201d UP told ProPublica in a statement. The company also told ProPublica that its own audit process had found the \u201cincorrectly classified\u201d injuries and that the company had corrected them. </p>\n\n<p>Agency officials said that most of the time, when they catch unreported injuries, they simply ask officials to reconcile the matter. The agency doesn\u2019t separately track fines it gives for injury reporting violations, instead lumping together all the fines it levies against railroads for all kinds of reporting failures. ProPublica added up these kinds of fines levied against all Class 1 companies in 2022, the most recent year of data available. For the companies, which had $108 billion in combined revenue that year, the penalties added up to $30,011.</p>\n\n<p>The agency told ProPublica it knows the penalties are too paltry to prevent the companies or their officials from attempting to hide injuries. Only Congress could increase the fines, a spokesperson said. \u201cThe proposed <a href=\"https://www.congress.gov/bill/118th-congress/senate-bill/576\">Railway Safety Act</a> would allow for a substantial increase in the maximum civil penalty amount,\u201d the spokesperson said. That bill, which received bipartisan support when it was introduced on the heels of last year\u2019s catastrophic derailment that unleashed hazardous chemicals on East Palestine, Ohio, has since <a href=\"https://www.levernews.com/the-koch-network-is-killing-rail-safety/\">stalled in Congress</a>.</p>\n\n<p>Cassity said the FRA\u2019s audit process allows railroads too much notice before the government arrives on site to check records. \u201cIt just just doesn\u2019t go far enough,\u201d he said, adding that he believes companies purposefully don\u2019t fill out certain paperwork so they can hide injuries from the FRA and that there is little the agency can do to combat the practice.</p>\n\n<p>He suggested that one way to get the fullest accounting of injuries would be for the FRA to devise a system where the reports come directly from employees. \u201cRight now, the only way to get the facts is through a carrier that, quite frankly, is not playing fairly,\u201d he said. \u201cAnd so you've got to get it from the source.\u201d</p>\n\n<p>Such a system would require significant procedural and operational changes, FRA officials said, and there is no guarantee all employees would abide by them. </p>\n\n<p>But agency officials said they can entertain these and other big changes during the upcoming public comment period for their proposed rules, which have not been updated since 2010. During this period, railroad companies and labor groups are expected to provide their perspectives and could mount legal efforts to change the proposals. According to the agency, any new rules will receive final approval from its chief safety officer.</p>\n        \n             \n\n                                    \n        \n                        <p>Research was contributed by <a href=\"https://www.propublica.org/people/jeff-kao\">Jeff Kao</a>, <a href=\"https://www.propublica.org/people/Mollie-Simon\">Mollie Simon</a>, <a href=\"https://www.propublica.org/people/Mariam-Elba\">Mariam Elba</a>, and <a href=\"https://www.propublica.org/people/Ruth-Baron\">Ruth Baron</a> of ProPublica, and Carolyn Edds and Miriam Pensack.</p>"}, "tags": [{"term": "Regulation, Train Country", "scheme": null, "label": null}], "updated": "2024-03-13T05:00:00-04:00", "updated_parsed": [2024, 3, 13, 9, 0, 0, 2, 73, 0], "authors": [{"name": "by Topher Sanders, Dan Schwartz, Danelle Morton and Gabriel Sandoval"}], "author": "by Topher Sanders, Dan Schwartz, Danelle Morton and Gabriel Sandoval", "author_detail": {"name": "by Topher Sanders, Dan Schwartz, Danelle Morton and Gabriel Sandoval"}}, {"title": "New York Trusted This Company to Care for the Sick and Elderly. Instead, It Left People Confused and Alone.", "title_detail": {"type": "text/plain", "language": null, "base": "https://www.propublica.org/feeds/propublica/main", "value": "New York Trusted This Company to Care for the Sick and Elderly. Instead, It Left People Confused and Alone."}, "links": [{"rel": "alternate", "type": "text/html", "href": "https://www.propublica.org/article/new-york-guardianship-services-care-sick-elderly-confused-alone"}], "link": "https://www.propublica.org/article/new-york-guardianship-services-care-sick-elderly-confused-alone", "published": "Tue, 12 Mar 2024 06:00:00 -0400", "published_parsed": [2024, 3, 12, 10, 0, 0, 1, 72, 0], "id": "https://www.propublica.org/article/new-york-guardianship-services-care-sick-elderly-confused-alone", "guidislink": false, "summary": "<p class=\"byline\">\n                by <a class=\"name\" href=\"https://www.propublica.org/people/jake-pearson\">Jake Pearson</a>, illustrations by <span class=\"name\">Dominic Bodden</span>, special to <a href=\"https://www.propublica.org\">ProPublica</a>                </p>\n                                             \n\n                                                                    \n            \n                <p>ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive <a href=\"https://www.propublica.org/newsletters/the-big-story?source=54G&amp;placement=top-note&amp;region=national\">our biggest stories</a> as soon as they\u2019re published.</p>\n\n            \n\n                \n\n      \n  \n\n\n\n                    \n<p>Across New York City, hundreds of vulnerable people have been entrusted to New York Guardianship Services, one of roughly a dozen companies the courts rely on to care for \u201cthe unbefriended,\u201d those without family or friends to help them.</p>\n\n<p>The state\u2019s guardianship law is supposed to prevent these guardians from abusing, neglecting and defrauding those under their care. But, as ProPublica reported last week, the measure is <a href=\"https://www.propublica.org/article/how-one-woman-endured-decade-neglect-new-york-guardianship\">failing to safeguard those who need protection the most</a>.</p>\n\n<p>Our reporting told the story of Judith Zbiegniewicz, who suffers from depression and anxiety and spent a decade under the care of NYGS. The company placed her in a dilapidated Queens apartment where she lived among rats and bedbugs, sometimes with no heat or electricity. She complained to the company regularly but said it did little to fix the problems. Instead, NYGS repeatedly told court-appointed examiners that her housing was adequate \u2014 a claim these authorities never challenged.</p>\n\n<p>ProPublica has now identified more than a dozen cases like Zbiegniewicz\u2019s in which NYGS \u2014 and the court officials charged with oversight of the cases \u2014 failed to meet the needs of those entrusted to its care.</p>\n\n<p>The stories provide a stark portrait of New York\u2019s overtaxed guardianship system, which experts say is straining to care for more than 28,600 people statewide \u2014 60% of whom live in New York City. Across the five boroughs, there are only 157 examiners to monitor how guardians care for wards. And just over a dozen judges review their work. Such thin ranks can render oversight almost meaningless, with annual assessments often taking years to complete.</p>\n\n<p>NYGS executives Sam and David Blau declined to be interviewed for this story and didn\u2019t answer written questions about the cases identified by ProPublica or the company\u2019s broader business practices. Sam Blau, the company\u2019s chief financial officer, said in a statement that as a fiduciary he was barred from answering questions \u201cabout any specific client.\u201d However, he noted, \u201cwe are accountable to the Court and our annual accounts and reports are scrutinized by Court appointed examiners and any issues would be addressed.\u201d </p>\n\n<p>In his statement, Blau called ProPublica\u2019s reporting \u201cmisguided, without full and proper context, filled with omissions and less than accurate information.\u201d But when asked to specify his concerns, he did not respond.</p>\n\n<p>These stories of NYGS\u2019s wards represent the range of harms that can befall New Yorkers whose needs are great and bank accounts are small. </p>\n\n\n</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            Renea Richardson\n    \n    \n    \n    \n\n    \n\n        \n    \n                    \n<p>Renea Richardson became a ward of NYGS in March 2018, two years after suffering two strokes and undergoing surgery to relieve swelling in her brain. The health crisis left the former Port Authority of New York and New Jersey worker with brain damage and trouble walking. </p>\n\n<p>But her time in rehabilitation facilities didn\u2019t help her recover, and her goddaughter, Erin Samples, said NYGS wasn\u2019t responding to her many calls. So by the fall of 2021, Samples took her concerns directly to the judge overseeing the guardianship. She was particularly concerned about the conditions in the Brooklyn nursing home where NYGS had placed Richardson.</p>\n\n<p>Richardson was \u201cnot receiving regular diaper changing, not being properly dressed when I have visited her and not receiving physical therapy services,\u201d Samples wrote. \u201cSimply put, many people including Ms. Richardson\u2019s guardian has dropped the ball when it comes to her care.\u201d</p>\n\n<p>The judge discharged NYGS four months later, replacing it with Integral Guardianship Services \u2014 a nonprofit guardian firm where Blau had also worked. Richardson and her family, however, were unaware that the group had its own problems. During Blau\u2019s tenure, the state attorney general had investigated Integral, ultimately accusing it in 2015 of improperly loaning its executives hundreds of thousands of dollars while wards sat unnecessarily in nursing homes. Blau was not named in the probe, and Integral executives repaid the loans and pledged widespread reforms. </p>\n\n<p>But Samples said the group was just as unresponsive as NYGS when she complained about Richardson\u2019s care, according to emails she provided to ProPublica.  </p>\n\n<p>Samples now plans to become Richardson\u2019s guardian herself. </p>\n\n<p>\u201cI never thought I\u2019d be like this,\u201d Richardson said in an interview last summer from her hospital bed in the Bedford Stuyvesant nursing home. Asked what she does all day, she said: \u201cI lay in this bed and get fat and watch TV.\u201d </p>\n\n<p>Integral shut down last spring, and the courts reassigned its wards to other guardians. In a statement, John Ousley, Integral\u2019s former CEO, acknowledged the delays in Richardson\u2019s case, saying that more than half of the firm\u2019s cases were pro bono and that due to limited resources and crushing needs, his staff had to \u201cprioritize the most urgent requests in a given moment.\u201d While he recognized Richardson and Samples\u2019 frustrations, he said, he hoped they understood that \u201cwe were doing the best we could under very difficult circumstances.\u201d</p>\n\n\n</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            Sigifredo Morante\n    \n    \n    \n    \n\n    \n\n        \n    \n                    \n<p>Another NYGS ward, Sigifredo Morante, appears to have slipped through the cracks entirely. </p>\n\n<p>The former accountant and his wife, whose memories were fading, were appointed a guardian in the spring of 2017. The couple was living in a Queens nursing home, though they wanted to return to their native Colombia, where they had family and property. As it turned out, they had given a nephew, Francisco Arango, power of attorney, and he\u2019d petitioned the court to send them back to their home country that fall. A Queens judge allowed the dual citizens to return under Arango\u2019s care.</p>\n\n<p>In an October 2017 hearing, the judge ordered NYGS to relinquish the guardianship altogether after the couple relocated and to reimburse Arango for fees associated with the move, which was completed before the end of that year. That never happened. </p>\n\n<p>For reasons that are unclear, NYGS instead stayed on as Morante\u2019s guardian \u2014 at least on paper \u2014 and took $450 in compensation from his Social Security check each month. In annual reports, the guardianship disclosed that Morante had moved to Colombia but provided no explanation for its fees. Reviews of those reports, court records show, were delayed in part because of NYGS\u2019 own delinquency in responding to the examiner. Pandemic-era courthouse closures further prolonged his examination. By the time the examiner had enough information to flag the apparent no-show guardianship, Morante had been dead for more than two years. </p>\n\n<p>Arango had no idea the company had continued to take compensation even after Morante died in March 2021, just shy of his 83rd birthday. He has since hired an attorney in Colombia, but it\u2019s unclear whether Arango will be able to claw back the thousands of dollars NYGS took while Morante lived \u2014 and died \u2014 overseas.</p>\n\n<p>After Arango\u2019s lawyer notified NYGS of Morante\u2019s death last summer, David Blau, the chief operating officer of NYGS, told him that the company could \u201cconclude this matter I think fairly simple\u201d once Arango provided a death certificate, an email shows. Arango has since done so, but Blau hasn\u2019t responded to his lawyer\u2019s subsequent inquiries, according to emails Arango\u2019s lawyer provided to ProPublica. </p>\n\n<p>Arango said law enforcement should investigate how NYGS was able to maintain the guardianship and take a cut of Morante\u2019s government benefits, even as Arango spent thousands of his own dollars caring for him. \u201cIn my opinion they did what they could to take money\u201d from vulnerable elderly people, he said of NYGS.</p>\n\n\n<p>Even in cases where the company did know about dire conditions, it was slow to act, former employees said.</p>\n\n<p>That was the case for William Bell, who was in his mid-80s and being looked after by his stepdaughter when the city sought a guardianship for him in 2017 to help stop an eviction from his apartment. Widowed and fiercely independent, he refused for years to move into a nursing home, even as his health deteriorated and his needs exceeded what his stepdaughter could provide.</p>\n\n<p>In February 2019, a Brooklyn judge granted NYGS\u2019s motion to permanently move Bell into a rehabilitation center, where he was eventually diagnosed with dementia.</p>\n\n<p>Last June, Bell, then 90, was rushed to NewYork-Presbyterian Brooklyn Methodist Hospital, where hospital records show he presented with \u201cagonal breathing\u201d \u2014 gasps or moans that a person near death utters. Doctors told the guardianship that they could not save him and advised ending life support, according to a person familiar with Bell\u2019s case who spoke on condition of anonymity to discuss his medical records. </p>\n\n<p>But it took NYGS nearly a month to request a formal ethics assessment from the hospital to facilitate that process, that person said. The report, completed just after the July Fourth holiday, unambiguously argued that Bell\u2019s care should be withdrawn since he\u2019d lost \u201cmental status\u201d and couldn\u2019t be weaned from a ventilator. \u201cThe prognosis is extremely grave without any hope of recovery,\u201d it read. </p>\n\n<p>Bell died the following day, on July 7, before any action could be taken.</p>\n        \n    \n                    \n    \n        <p>\n            <strong><a href=\"https://www.propublica.org/getinvolved/send-propublica-story-tips\">Do You Have a Tip for ProPublica? Help Us Do Journalism.</a></strong>\n        </p>", "summary_detail": {"type": "text/html", "language": null, "base": "https://www.propublica.org/feeds/propublica/main", "value": "<p class=\"byline\">\n                by <a class=\"name\" href=\"https://www.propublica.org/people/jake-pearson\">Jake Pearson</a>, illustrations by <span class=\"name\">Dominic Bodden</span>, special to <a href=\"https://www.propublica.org\">ProPublica</a>                </p>\n                                             \n\n                                                                    \n            \n                <p>ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive <a href=\"https://www.propublica.org/newsletters/the-big-story?source=54G&amp;placement=top-note&amp;region=national\">our biggest stories</a> as soon as they\u2019re published.</p>\n\n            \n\n                \n\n      \n  \n\n\n\n                    \n<p>Across New York City, hundreds of vulnerable people have been entrusted to New York Guardianship Services, one of roughly a dozen companies the courts rely on to care for \u201cthe unbefriended,\u201d those without family or friends to help them.</p>\n\n<p>The state\u2019s guardianship law is supposed to prevent these guardians from abusing, neglecting and defrauding those under their care. But, as ProPublica reported last week, the measure is <a href=\"https://www.propublica.org/article/how-one-woman-endured-decade-neglect-new-york-guardianship\">failing to safeguard those who need protection the most</a>.</p>\n\n<p>Our reporting told the story of Judith Zbiegniewicz, who suffers from depression and anxiety and spent a decade under the care of NYGS. The company placed her in a dilapidated Queens apartment where she lived among rats and bedbugs, sometimes with no heat or electricity. She complained to the company regularly but said it did little to fix the problems. Instead, NYGS repeatedly told court-appointed examiners that her housing was adequate \u2014 a claim these authorities never challenged.</p>\n\n<p>ProPublica has now identified more than a dozen cases like Zbiegniewicz\u2019s in which NYGS \u2014 and the court officials charged with oversight of the cases \u2014 failed to meet the needs of those entrusted to its care.</p>\n\n<p>The stories provide a stark portrait of New York\u2019s overtaxed guardianship system, which experts say is straining to care for more than 28,600 people statewide \u2014 60% of whom live in New York City. Across the five boroughs, there are only 157 examiners to monitor how guardians care for wards. And just over a dozen judges review their work. Such thin ranks can render oversight almost meaningless, with annual assessments often taking years to complete.</p>\n\n<p>NYGS executives Sam and David Blau declined to be interviewed for this story and didn\u2019t answer written questions about the cases identified by ProPublica or the company\u2019s broader business practices. Sam Blau, the company\u2019s chief financial officer, said in a statement that as a fiduciary he was barred from answering questions \u201cabout any specific client.\u201d However, he noted, \u201cwe are accountable to the Court and our annual accounts and reports are scrutinized by Court appointed examiners and any issues would be addressed.\u201d </p>\n\n<p>In his statement, Blau called ProPublica\u2019s reporting \u201cmisguided, without full and proper context, filled with omissions and less than accurate information.\u201d But when asked to specify his concerns, he did not respond.</p>\n\n<p>These stories of NYGS\u2019s wards represent the range of harms that can befall New Yorkers whose needs are great and bank accounts are small. </p>\n\n\n</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            Renea Richardson\n    \n    \n    \n    \n\n    \n\n        \n    \n                    \n<p>Renea Richardson became a ward of NYGS in March 2018, two years after suffering two strokes and undergoing surgery to relieve swelling in her brain. The health crisis left the former Port Authority of New York and New Jersey worker with brain damage and trouble walking. </p>\n\n<p>But her time in rehabilitation facilities didn\u2019t help her recover, and her goddaughter, Erin Samples, said NYGS wasn\u2019t responding to her many calls. So by the fall of 2021, Samples took her concerns directly to the judge overseeing the guardianship. She was particularly concerned about the conditions in the Brooklyn nursing home where NYGS had placed Richardson.</p>\n\n<p>Richardson was \u201cnot receiving regular diaper changing, not being properly dressed when I have visited her and not receiving physical therapy services,\u201d Samples wrote. \u201cSimply put, many people including Ms. Richardson\u2019s guardian has dropped the ball when it comes to her care.\u201d</p>\n\n<p>The judge discharged NYGS four months later, replacing it with Integral Guardianship Services \u2014 a nonprofit guardian firm where Blau had also worked. Richardson and her family, however, were unaware that the group had its own problems. During Blau\u2019s tenure, the state attorney general had investigated Integral, ultimately accusing it in 2015 of improperly loaning its executives hundreds of thousands of dollars while wards sat unnecessarily in nursing homes. Blau was not named in the probe, and Integral executives repaid the loans and pledged widespread reforms. </p>\n\n<p>But Samples said the group was just as unresponsive as NYGS when she complained about Richardson\u2019s care, according to emails she provided to ProPublica.  </p>\n\n<p>Samples now plans to become Richardson\u2019s guardian herself. </p>\n\n<p>\u201cI never thought I\u2019d be like this,\u201d Richardson said in an interview last summer from her hospital bed in the Bedford Stuyvesant nursing home. Asked what she does all day, she said: \u201cI lay in this bed and get fat and watch TV.\u201d </p>\n\n<p>Integral shut down last spring, and the courts reassigned its wards to other guardians. In a statement, John Ousley, Integral\u2019s former CEO, acknowledged the delays in Richardson\u2019s case, saying that more than half of the firm\u2019s cases were pro bono and that due to limited resources and crushing needs, his staff had to \u201cprioritize the most urgent requests in a given moment.\u201d While he recognized Richardson and Samples\u2019 frustrations, he said, he hoped they understood that \u201cwe were doing the best we could under very difficult circumstances.\u201d</p>\n\n\n</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            Sigifredo Morante\n    \n    \n    \n    \n\n    \n\n        \n    \n                    \n<p>Another NYGS ward, Sigifredo Morante, appears to have slipped through the cracks entirely. </p>\n\n<p>The former accountant and his wife, whose memories were fading, were appointed a guardian in the spring of 2017. The couple was living in a Queens nursing home, though they wanted to return to their native Colombia, where they had family and property. As it turned out, they had given a nephew, Francisco Arango, power of attorney, and he\u2019d petitioned the court to send them back to their home country that fall. A Queens judge allowed the dual citizens to return under Arango\u2019s care.</p>\n\n<p>In an October 2017 hearing, the judge ordered NYGS to relinquish the guardianship altogether after the couple relocated and to reimburse Arango for fees associated with the move, which was completed before the end of that year. That never happened. </p>\n\n<p>For reasons that are unclear, NYGS instead stayed on as Morante\u2019s guardian \u2014 at least on paper \u2014 and took $450 in compensation from his Social Security check each month. In annual reports, the guardianship disclosed that Morante had moved to Colombia but provided no explanation for its fees. Reviews of those reports, court records show, were delayed in part because of NYGS\u2019 own delinquency in responding to the examiner. Pandemic-era courthouse closures further prolonged his examination. By the time the examiner had enough information to flag the apparent no-show guardianship, Morante had been dead for more than two years. </p>\n\n<p>Arango had no idea the company had continued to take compensation even after Morante died in March 2021, just shy of his 83rd birthday. He has since hired an attorney in Colombia, but it\u2019s unclear whether Arango will be able to claw back the thousands of dollars NYGS took while Morante lived \u2014 and died \u2014 overseas.</p>\n\n<p>After Arango\u2019s lawyer notified NYGS of Morante\u2019s death last summer, David Blau, the chief operating officer of NYGS, told him that the company could \u201cconclude this matter I think fairly simple\u201d once Arango provided a death certificate, an email shows. Arango has since done so, but Blau hasn\u2019t responded to his lawyer\u2019s subsequent inquiries, according to emails Arango\u2019s lawyer provided to ProPublica. </p>\n\n<p>Arango said law enforcement should investigate how NYGS was able to maintain the guardianship and take a cut of Morante\u2019s government benefits, even as Arango spent thousands of his own dollars caring for him. \u201cIn my opinion they did what they could to take money\u201d from vulnerable elderly people, he said of NYGS.</p>\n\n\n<p>Even in cases where the company did know about dire conditions, it was slow to act, former employees said.</p>\n\n<p>That was the case for William Bell, who was in his mid-80s and being looked after by his stepdaughter when the city sought a guardianship for him in 2017 to help stop an eviction from his apartment. Widowed and fiercely independent, he refused for years to move into a nursing home, even as his health deteriorated and his needs exceeded what his stepdaughter could provide.</p>\n\n<p>In February 2019, a Brooklyn judge granted NYGS\u2019s motion to permanently move Bell into a rehabilitation center, where he was eventually diagnosed with dementia.</p>\n\n<p>Last June, Bell, then 90, was rushed to NewYork-Presbyterian Brooklyn Methodist Hospital, where hospital records show he presented with \u201cagonal breathing\u201d \u2014 gasps or moans that a person near death utters. Doctors told the guardianship that they could not save him and advised ending life support, according to a person familiar with Bell\u2019s case who spoke on condition of anonymity to discuss his medical records. </p>\n\n<p>But it took NYGS nearly a month to request a formal ethics assessment from the hospital to facilitate that process, that person said. The report, completed just after the July Fourth holiday, unambiguously argued that Bell\u2019s care should be withdrawn since he\u2019d lost \u201cmental status\u201d and couldn\u2019t be weaned from a ventilator. \u201cThe prognosis is extremely grave without any hope of recovery,\u201d it read. </p>\n\n<p>Bell died the following day, on July 7, before any action could be taken.</p>\n        \n    \n                    \n    \n        <p>\n            <strong><a href=\"https://www.propublica.org/getinvolved/send-propublica-story-tips\">Do You Have a Tip for ProPublica? Help Us Do Journalism.</a></strong>\n        </p>"}, "tags": [], "updated": "2024-03-12T06:00:00-04:00", "updated_parsed": [2024, 3, 12, 10, 0, 0, 1, 72, 0], "authors": [{"name": "by Jake Pearson, illustrations by Dominic Bodden, special to ProPublica"}], "author": "by Jake Pearson, illustrations by Dominic Bodden, special to ProPublica", "author_detail": {"name": "by Jake Pearson, illustrations by Dominic Bodden, special to ProPublica"}}, {"title": "Walmart Bought a Finance App and Reduced Fraud Protections. Guess What Happened Next?", "title_detail": {"type": "text/plain", "language": null, "base": "https://www.propublica.org/feeds/propublica/main", "value": "Walmart Bought a Finance App and Reduced Fraud Protections. Guess What Happened Next?"}, "links": [{"rel": "alternate", "type": "text/html", "href": "https://www.propublica.org/article/after-walmart-bought-finance-app-one-complaints-soared"}], "link": "https://www.propublica.org/article/after-walmart-bought-finance-app-one-complaints-soared", "published": "Mon, 11 Mar 2024 05:00:00 -0400", "published_parsed": [2024, 3, 11, 9, 0, 0, 0, 71, 0], "id": "https://www.propublica.org/article/after-walmart-bought-finance-app-one-complaints-soared", "guidislink": false, "summary": "<p class=\"byline\">\n                by <a class=\"name\" href=\"https://www.propublica.org/people/craig-silverman\">Craig Silverman</a> and <a class=\"name\" href=\"https://www.propublica.org/people/peter-elkind\">Peter Elkind</a>                </p>\n                                             \n\n                                                                    \n            \n                <p>ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive <a href=\"https://www.propublica.org/newsletters/the-big-story?source=54G&amp;placement=top-note&amp;region=national\">our biggest stories</a> as soon as they\u2019re published.</p>\n\n            \n\n                \n\n      \n  \n\n\n\n                    \n<p>Only a few hours elapsed between the time that Carl\u2019s pay landed in his checking account and when online thieves pilfered it. \u201cThey took all of it but like 67 cents,\u201d he said. Months before, Carl had signed up for One Finance, a banking app. It\u2019s owned and promoted by Walmart, where Carl works in a grocery department. </p>\n\n<p>He was enticed by features like cash back on purchases at Walmart and the chance to receive his pay two days early, as well as by low fees and high interest rates. Everything was fine until Carl used his One debit card \u2014 for the very first time \u2014 to buy a video game at Walmart last fall. The next time he checked the app, he saw a series of unauthorized transactions that had drained his account. To get by, he tapped his savings, which he said was \u201cjust enough to cover everything.\u201d Carl asked to be identified by first name only out of concern for his job security. </p>\n\n<p>Carl\u2019s experience has been distressingly common. \nOne Finance was plagued by fraud and customer dissatisfaction after a Walmart-controlled partnership acquired it in 2022. As Walmart began touting One to employees and others, the \u201cneobank\u201d \u2014 as such ultraconvenient, lightly regulated apps are called \u2014 weakened user security and outsourced customer support. Con artists took advantage, spurring a litany of customer complaints to regulators and the Better Business Bureau and across social media platforms. One froze some accounts and blocked access to its app and website from several countries, according to current and former customers and employees.</p>\n\n<p>Frustrated users tanked One\u2019s rating on Google Play from 4.6 to <a href=\"https://web.archive.org/web/20221221135626/https://play.google.com/store/apps/details?id=com.onefinance.one\">2.8 stars</a>. So many complaints inundated a Reddit community for One users that moderators made the page private \u201cdue to ONE fraud issue and their lack of customer support.\u201d One\u2019s Better Business Bureau page warns that scammers are <a href=\"https://www.bbb.org/us/ca/sacramento/profile/banking-services/one-finance-inc-1156-90061871\">using the One name and logo to steal money</a> via \u201cloan and impersonation scams.\u201d </p>\n\n<p>One\u2019s problems echo the <a href=\"https://www.propublica.org/article/walmart-financial-services-became-fraud-magnet-gift-cards-money-laundering\">fraud and compliance issues revealed in </a><a href=\"https://www.propublica.org/article/walmart-financial-services-became-fraud-magnet-gift-cards-money-laundering\">a recent ProPublica investigation</a> of Walmart\u2019s financial services business. That article found that the company resisted calls to rein in fraud and skimped on employee training as more than $1 billion in consumer fraud losses were routed through Walmart\u2019s financial systems over the past decade.</p>\n\n<p>One had a higher rate of complaints lodged against it at the federal Consumer Financial Protection Bureau in 2023, its first full year under Walmart control, than most other large neobanks for which data is publicly available. The CFPB received 89 complaints about One, which has 1.6 million customers, according to a recent internal company presentation. That was six more complaints than Dave, a neobank with 9.9 million customers. One also has more complaints per customer than both Current and MoneyLion, two large neobanks. <a href=\"https://www.propublica.org/article/chime\">Chime, the largest neobank</a> in the U.S., has by far the highest rate of complaints. (These comparisons are imperfect because neobanks don\u2019t always use the same definitions of \u201ccustomer.\u201d) </p>\n\n<p>To Carla Sanchez-Adams, a senior attorney with the National Consumer Law Center, the rate of complaints about One shows that \u201cthey don\u2019t have the proper amount of resources dedicated to resolving customer disputes and complaints.\u201d</p>\n\n<p>The CFPB received 13 complaints about One in December, almost double the neobank\u2019s monthly average for 2023. Five drivers for Spark, Walmart\u2019s delivery service, have complained in the past two months that hackers stole their personal information, set up fake One accounts in their names, and then diverted their paychecks into those accounts. One was \u201ctelling me that they were going to escalate this issue, and weeks would go by and I\u2019d never hear anything from them,\u201d said one driver who requested anonymity to protect his job. Walmart eventually reimbursed his lost pay, he said. </p>\n\n<p>There are signs that the peak of the One-related fraud may have passed. The Reddit page was made public again at the end of January, and the app\u2019s Google Play rating has rebounded to 4.6 stars. </p>\n\n<p>In a statement to ProPublica, One acknowledged blocking access in unspecified countries, due to \u201csignificant occurrences or patterns of fraud or cybersecurity risk.\u201d But the neobank denied that problems with fraud, customer support or customer accounts were ever unusually frequent or have increased since the acquisition. When customer growth is factored in, One said, the rate of complaints has fallen \u201csignificantly.\u201d The company declined to provide comparative data. </p>\n\n<p>The company said it has taken \u201can industry-leading approach to protecting its customers and platform from bad actors\u201d and added that it has enhanced its customer support, fraud and security operations. \u201cWe take our customers' feedback seriously and take pride in the investments we have made in our product and the ways in which we serve our customer base, which has grown substantially since we acquired the platform less than two years ago,\u201d a One spokesperson said.</p>\n\n<p>For its part, Walmart said in a statement that it works hard to protect customers and that it has \u201clong been committed to bringing much-needed access and affordability to unbanked and underbanked consumers who have been locked out of traditional financial services, and our partnership with One to help develop and offer modern, innovative, and affordable financial solutions is no different.\u201d </p>\n\n\n<p>One\u2019s issues threaten to undermine Walmart\u2019s biggest opportunity to enter consumer banking. Starting in 1999, Walmart made four bids to go into the banking business. All failed in the face of what a 2007 New York Times article called a \u201c<a href=\"https://www.nytimes.com/2007/03/17/business/17bank.html#:~:text=Yesterday%2C%20Wal%2DMart%20Stores%20abruptly,industry%20officials%20and%20watchdog%20groups.\">firestorm of criticism</a> from lawmakers, banking industry officials and watchdog groups.\u201d </p>\n\n<p>Many feared that Walmart would use its power as the biggest retailer on the planet to become a financial behemoth that would wipe out small banks and suck up the profits of the big ones. In the face of stiff opposition, the company seemed to give up. The Times article quoted Walmart\u2019s president for financial services saying, \u201cWe don\u2019t plan to do this again. The bank is behind us. We will use our partners to roll out new products.\u201d</p>\n\n<p>Since then, Walmart has steadily expanded its financial services. The company now provides check cashing, money transfers, prepaid debit cards, gift cards and bill payment services in thousands of U.S. stores, typically at lower prices than those offered by competitors. Walmart managed to do that without becoming a government-approved bank, thus allowing it to avoid most regulatory oversight.</p>\n\n<p>The rise of online-only neobanks provided a new opportunity: Essentially any company could offer checking and savings accounts, as long as it partnered with a traditional regulated bank, which would handle the underlying functions of holding deposits and insuring money. One launched as an independent operation in 2020 and sold itself with a brash anti-bank message. It created stickers with the slogan \u201cUn*uck Your Money\u201d and said it wouldn\u2019t use customer deposits to invest in fossil fuel, tobacco or firearms companies. </p>\n\n<p>In January 2022, Walmart announced that a partnership it majority owned was <a href=\"https://corporate.walmart.com/news/2022/01/26/hazel-announces-definitive-merger-agreements-with-even-and-one-to-build-a-business-that-empowers-consumers-to-improve-their-financial-lives\">acquiring One and another company</a>, Even, and merging them under the One brand. When the deal closed on March 31 of that year, Walmart valued the merged business at $3.67 billion, according to internal documents obtained by ProPublica. </p>\n\n<p>Under Walmart, One expanded beyond its <a href=\"https://techcrunch.com/2021/08/18/one-banks-40m-to-offer-all-in-one-financial-services-to-the-middle-class/?tpcc=ECTW2020\">previous target market of middle-class users</a> to focus on signing up Walmart\u2019s 1.6 million employees and getting them to deposit their paychecks into One accounts. The goal was to keep associates\u2019 pay in the Walmart ecosystem and induce them to spend it with the retailer, according to former One managers. \u201cThe idea that \u2018Hey, how crazy is it that they\u2019re going to be spending the money we give them with us? How perfect of a situation is that?\u2019\u201d a former senior manager said. A former One exec said she came to think of their company as \u201cno longer One, but instead the Bank of Walmart.\u201d</p>\n\n<p>Walmart doesn\u2019t require associates to use One. But the service has been overhauled to emphasize features that benefit Walmart employees and shoppers, such as free ATM withdrawals and cash back on purchases at Walmart stores. Walmart also incentivized the hundreds of thousands of contract drivers on its Spark platform, the company\u2019s answer to delivery apps like Instacart, to use the app. Drivers get paid the same day if they use One as their deposit option, weekly if they don\u2019t.</p>\n\n<p>Soon after the acquisition, One eliminated some popular features, such as customer credit lines with low interest rates. It eliminated account overdraft coverage for some customers and reduced it to $200 for others. It also restricted the functionality of account \u201cpockets,\u201d a signature feature for budgeting, sharing and spending money. In a conversation with moderators of the One Reddit community, company reps said the restrictions were necessary to fight fraud.</p>\n\n<p>But the company simultaneously made it easier for scammers to log in to and compromise accounts of Walmart employees and other customers. Previously, One users needed a username and password and a verification code sent by text message. After the acquisition, One removed the username and password requirement for mobile users. Instead, customers entered their phone number and received a login code via text. Nowadays, fewer companies require a password. They typically rely on a username, such as an email address, and a second form of authentication. But One uses the same telephone number both for the username and to deliver the login code, which makes it less secure, said Allison Nixon, the chief research officer of <a href=\"https://unit221b.com/\">Unit 221B</a>, a security research and consulting firm.</p>\n\n<p>One also asks users to set up a PIN. But if you forget your PIN, you can reset it with the last four digits of your Social Security number, which Nixon said is easy for criminals to obtain. \u201cIt doesn't feel safe and it doesn't seem like the way we should protect people's entire bank accounts,\u201d said Nixon, who tested One\u2019s login flow at ProPublica\u2019s request. \u201cWhen the criminal underground realizes that there's a weakness, a lot of different parties jump on that.\u201d </p>\n\n<p>In its statement to ProPublica, One said that its accounts \u201crequire two-factor authentication.\u201d Nixon disagreed. \"Possession of a phone number plus a PIN that isn't really required because you can just reset it is one-factor authentication,\" she said.</p>\n\n<p>Without a password barrier, fraudsters were able to impersonate company representatives in calls and messages to gain access to customer accounts, according to interviews and online reports. Natasha Tabachnikoff, a One account holder who works in local government in Pennsylvania, said she received two calls from someone falsely claiming to work for One. The caller said her account, which she\u2019d had for years, had unauthorized charges and asked her to confirm her identity by sharing the authentication code sent to her phone. </p>\n\n<p>Tabachnikoff almost shared the code but instead hung up and contacted One. \u201cI told them, \u2018You have a very insecure system here.\u2019 And they were basically like, \u2018Well, we'll never call you and ask you to give us your code,\u2019\u201d said Tabachnikoff. She said she moved her savings out of One \u201cto a more reputable bank.\u201d </p>\n\n\n<p>As fraud mounted, One took steps that weakened the human side of its defenses. Last May, it laid off nearly all of its U.S. customer support agents and replaced them with outsourced workers in India and El Salvador. Although many of the new workers weren\u2019t fully trained, they were assigned to provide frontline support via chat and phone. </p>\n\n<p>\u201cThey were trained to only handle the lowest intake questions that do not require advanced knowledge or support,\u201d said a former One employee with knowledge of support operations. Every One user interviewed by ProPublica who had contacted customer service after being defrauded said that the outsourced agents could answer only basic questions. \u201cThese folks were really gatekeepers, they weren\u2019t there to resolve your problem,\u201d said James Scherber, an Oregon-based entrepreneur who had convinced several members of his family to join One.</p>\n\n<p>Separately, One hired outsourced agents to assist with reviewing reports of fraud. This delayed the resolution of problems and has caused One to reject valid reports of fraud, according to the former employee and to transcripts of customer support chats provided by One users. One did not comment specifically on these criticisms, but it said it has \u201csubstantially grown its investment\u201d and personnel in both customer support and fraud review.</p>\n\n<p>Jae Bleiberg contends that One brushed off legitimate claims of fraud. Bleiberg, who has run customer service and operations for other neobanks for eight years, used One as their primary bank since 2021. (Bleiberg uses they/them pronouns.) Early in 2023, Bleiberg was unable to use their One debit card in Brazil, forcing them to cut their vacation short. A One support rep told Bleiberg that \u201call transactions in and out of Brazil were blocked due to \u2018security concerns,\u2019\u201d Bleiberg said. When Bleiberg returned to New York, the card remained inactive and wasn\u2019t replaced for another month. \u201cTheir response was \u2018You can go to Walmart and get cash with your virtual One card,\u2019 Bleiberg said. But, they added, \u201cthere are <a href=\"https://www.youtube.com/watch?v=Z1vUTQsTtKo\">no Walmarts in New York City</a>.\u201d</p>\n\n<p>Worse, multiple fraudulent transactions had been made using Bleiberg\u2019s account. One reimbursed Bleiberg for those transactions, but rejected a subsequent claim. After weeks of back and forth, One eventually issued a $250 credit after Bleiberg threatened to complain to the CFPB and other agencies. Beliberg provided a screenshot of their bank statement showing the credit. \u201cThis clearly came with the understanding I would not seek regulatory action,\u201d Bleiberg said. One said it\u2019s \u201ccategorically false\u201d to say that it pays customers to not file complaints. As their dispute with One escalated, Bleiberg filed complaints last month with several federal agencies. When Bleiberg asked for copies of their chat-support transcripts and call logs, screenshots show, One said it would provide the materials only if served with a subpoena. \u201cI have spent the last year trying to obtain the records\u201d of their interactions with One, Bleiberg wrote to the Federal Reserve Board. \u201cMy account was closed without consent a few days ago by a spiteful support agent.\u201d </p>\n\n<p>Scherber, the customer from Oregon who got his family to join One, said the company\u2019s ineffective fraud response cost him thousands of dollars last fall. The company froze all of his money and stonewalled him after he reported a series of unauthorized charges. \u201cThey have a firehose of fraud and you have to wait for a response back from the relevant team,\u201d Scherber said.</p>\n\n<p>The account lockup meant his scheduled payments to American Express didn\u2019t go through, he said. That lowered Scherber\u2019s credit rating, causing a lender to raise the interest rate on a planned mortgage refinancing. \u201cI had to postpone my refinancing,\u201d he said. \u201cNow it\u2019s not going to happen.\u201d Scherber and his family ditched One last year.</p>\n\n<p>One said the rate at which it freezes or otherwise restricts customer accounts due to fraud \u201cis down by more than 50% since the acquisition of One.\u201d It declined to share the data or time frame used to calculate that statistic or to address specific customer accounts of fraud or poor service.</p>\n\n<p>Carl, the Walmart employee whose paycheck was stolen by fraudsters, eventually got his money back. But he\u2019s done with One. Now he gets his Walmart pay deposited in a traditional bank. As he put it, \u201cAfter losing the whole check I wasn't going to risk losing it again.\u201d</p>\n        \n    \n                    \n    \n        <p>\n            <strong><a href=\"https://www.propublica.org/getinvolved/send-propublica-story-tips\">Do You Have a Tip for ProPublica? Help Us Do Journalism.</a></strong>\n        </p>\n\n            \n             \n\n                                    \n        \n                        <p><a href=\"https://www.propublica.org/people/doris-burke\">Doris Burke</a> contributed research.</p>", "summary_detail": {"type": "text/html", "language": null, "base": "https://www.propublica.org/feeds/propublica/main", "value": "<p class=\"byline\">\n                by <a class=\"name\" href=\"https://www.propublica.org/people/craig-silverman\">Craig Silverman</a> and <a class=\"name\" href=\"https://www.propublica.org/people/peter-elkind\">Peter Elkind</a>                </p>\n                                             \n\n                                                                    \n            \n                <p>ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive <a href=\"https://www.propublica.org/newsletters/the-big-story?source=54G&amp;placement=top-note&amp;region=national\">our biggest stories</a> as soon as they\u2019re published.</p>\n\n            \n\n                \n\n      \n  \n\n\n\n                    \n<p>Only a few hours elapsed between the time that Carl\u2019s pay landed in his checking account and when online thieves pilfered it. \u201cThey took all of it but like 67 cents,\u201d he said. Months before, Carl had signed up for One Finance, a banking app. It\u2019s owned and promoted by Walmart, where Carl works in a grocery department. </p>\n\n<p>He was enticed by features like cash back on purchases at Walmart and the chance to receive his pay two days early, as well as by low fees and high interest rates. Everything was fine until Carl used his One debit card \u2014 for the very first time \u2014 to buy a video game at Walmart last fall. The next time he checked the app, he saw a series of unauthorized transactions that had drained his account. To get by, he tapped his savings, which he said was \u201cjust enough to cover everything.\u201d Carl asked to be identified by first name only out of concern for his job security. </p>\n\n<p>Carl\u2019s experience has been distressingly common. \nOne Finance was plagued by fraud and customer dissatisfaction after a Walmart-controlled partnership acquired it in 2022. As Walmart began touting One to employees and others, the \u201cneobank\u201d \u2014 as such ultraconvenient, lightly regulated apps are called \u2014 weakened user security and outsourced customer support. Con artists took advantage, spurring a litany of customer complaints to regulators and the Better Business Bureau and across social media platforms. One froze some accounts and blocked access to its app and website from several countries, according to current and former customers and employees.</p>\n\n<p>Frustrated users tanked One\u2019s rating on Google Play from 4.6 to <a href=\"https://web.archive.org/web/20221221135626/https://play.google.com/store/apps/details?id=com.onefinance.one\">2.8 stars</a>. So many complaints inundated a Reddit community for One users that moderators made the page private \u201cdue to ONE fraud issue and their lack of customer support.\u201d One\u2019s Better Business Bureau page warns that scammers are <a href=\"https://www.bbb.org/us/ca/sacramento/profile/banking-services/one-finance-inc-1156-90061871\">using the One name and logo to steal money</a> via \u201cloan and impersonation scams.\u201d </p>\n\n<p>One\u2019s problems echo the <a href=\"https://www.propublica.org/article/walmart-financial-services-became-fraud-magnet-gift-cards-money-laundering\">fraud and compliance issues revealed in </a><a href=\"https://www.propublica.org/article/walmart-financial-services-became-fraud-magnet-gift-cards-money-laundering\">a recent ProPublica investigation</a> of Walmart\u2019s financial services business. That article found that the company resisted calls to rein in fraud and skimped on employee training as more than $1 billion in consumer fraud losses were routed through Walmart\u2019s financial systems over the past decade.</p>\n\n<p>One had a higher rate of complaints lodged against it at the federal Consumer Financial Protection Bureau in 2023, its first full year under Walmart control, than most other large neobanks for which data is publicly available. The CFPB received 89 complaints about One, which has 1.6 million customers, according to a recent internal company presentation. That was six more complaints than Dave, a neobank with 9.9 million customers. One also has more complaints per customer than both Current and MoneyLion, two large neobanks. <a href=\"https://www.propublica.org/article/chime\">Chime, the largest neobank</a> in the U.S., has by far the highest rate of complaints. (These comparisons are imperfect because neobanks don\u2019t always use the same definitions of \u201ccustomer.\u201d) </p>\n\n<p>To Carla Sanchez-Adams, a senior attorney with the National Consumer Law Center, the rate of complaints about One shows that \u201cthey don\u2019t have the proper amount of resources dedicated to resolving customer disputes and complaints.\u201d</p>\n\n<p>The CFPB received 13 complaints about One in December, almost double the neobank\u2019s monthly average for 2023. Five drivers for Spark, Walmart\u2019s delivery service, have complained in the past two months that hackers stole their personal information, set up fake One accounts in their names, and then diverted their paychecks into those accounts. One was \u201ctelling me that they were going to escalate this issue, and weeks would go by and I\u2019d never hear anything from them,\u201d said one driver who requested anonymity to protect his job. Walmart eventually reimbursed his lost pay, he said. </p>\n\n<p>There are signs that the peak of the One-related fraud may have passed. The Reddit page was made public again at the end of January, and the app\u2019s Google Play rating has rebounded to 4.6 stars. </p>\n\n<p>In a statement to ProPublica, One acknowledged blocking access in unspecified countries, due to \u201csignificant occurrences or patterns of fraud or cybersecurity risk.\u201d But the neobank denied that problems with fraud, customer support or customer accounts were ever unusually frequent or have increased since the acquisition. When customer growth is factored in, One said, the rate of complaints has fallen \u201csignificantly.\u201d The company declined to provide comparative data. </p>\n\n<p>The company said it has taken \u201can industry-leading approach to protecting its customers and platform from bad actors\u201d and added that it has enhanced its customer support, fraud and security operations. \u201cWe take our customers' feedback seriously and take pride in the investments we have made in our product and the ways in which we serve our customer base, which has grown substantially since we acquired the platform less than two years ago,\u201d a One spokesperson said.</p>\n\n<p>For its part, Walmart said in a statement that it works hard to protect customers and that it has \u201clong been committed to bringing much-needed access and affordability to unbanked and underbanked consumers who have been locked out of traditional financial services, and our partnership with One to help develop and offer modern, innovative, and affordable financial solutions is no different.\u201d </p>\n\n\n<p>One\u2019s issues threaten to undermine Walmart\u2019s biggest opportunity to enter consumer banking. Starting in 1999, Walmart made four bids to go into the banking business. All failed in the face of what a 2007 New York Times article called a \u201c<a href=\"https://www.nytimes.com/2007/03/17/business/17bank.html#:~:text=Yesterday%2C%20Wal%2DMart%20Stores%20abruptly,industry%20officials%20and%20watchdog%20groups.\">firestorm of criticism</a> from lawmakers, banking industry officials and watchdog groups.\u201d </p>\n\n<p>Many feared that Walmart would use its power as the biggest retailer on the planet to become a financial behemoth that would wipe out small banks and suck up the profits of the big ones. In the face of stiff opposition, the company seemed to give up. The Times article quoted Walmart\u2019s president for financial services saying, \u201cWe don\u2019t plan to do this again. The bank is behind us. We will use our partners to roll out new products.\u201d</p>\n\n<p>Since then, Walmart has steadily expanded its financial services. The company now provides check cashing, money transfers, prepaid debit cards, gift cards and bill payment services in thousands of U.S. stores, typically at lower prices than those offered by competitors. Walmart managed to do that without becoming a government-approved bank, thus allowing it to avoid most regulatory oversight.</p>\n\n<p>The rise of online-only neobanks provided a new opportunity: Essentially any company could offer checking and savings accounts, as long as it partnered with a traditional regulated bank, which would handle the underlying functions of holding deposits and insuring money. One launched as an independent operation in 2020 and sold itself with a brash anti-bank message. It created stickers with the slogan \u201cUn*uck Your Money\u201d and said it wouldn\u2019t use customer deposits to invest in fossil fuel, tobacco or firearms companies. </p>\n\n<p>In January 2022, Walmart announced that a partnership it majority owned was <a href=\"https://corporate.walmart.com/news/2022/01/26/hazel-announces-definitive-merger-agreements-with-even-and-one-to-build-a-business-that-empowers-consumers-to-improve-their-financial-lives\">acquiring One and another company</a>, Even, and merging them under the One brand. When the deal closed on March 31 of that year, Walmart valued the merged business at $3.67 billion, according to internal documents obtained by ProPublica. </p>\n\n<p>Under Walmart, One expanded beyond its <a href=\"https://techcrunch.com/2021/08/18/one-banks-40m-to-offer-all-in-one-financial-services-to-the-middle-class/?tpcc=ECTW2020\">previous target market of middle-class users</a> to focus on signing up Walmart\u2019s 1.6 million employees and getting them to deposit their paychecks into One accounts. The goal was to keep associates\u2019 pay in the Walmart ecosystem and induce them to spend it with the retailer, according to former One managers. \u201cThe idea that \u2018Hey, how crazy is it that they\u2019re going to be spending the money we give them with us? How perfect of a situation is that?\u2019\u201d a former senior manager said. A former One exec said she came to think of their company as \u201cno longer One, but instead the Bank of Walmart.\u201d</p>\n\n<p>Walmart doesn\u2019t require associates to use One. But the service has been overhauled to emphasize features that benefit Walmart employees and shoppers, such as free ATM withdrawals and cash back on purchases at Walmart stores. Walmart also incentivized the hundreds of thousands of contract drivers on its Spark platform, the company\u2019s answer to delivery apps like Instacart, to use the app. Drivers get paid the same day if they use One as their deposit option, weekly if they don\u2019t.</p>\n\n<p>Soon after the acquisition, One eliminated some popular features, such as customer credit lines with low interest rates. It eliminated account overdraft coverage for some customers and reduced it to $200 for others. It also restricted the functionality of account \u201cpockets,\u201d a signature feature for budgeting, sharing and spending money. In a conversation with moderators of the One Reddit community, company reps said the restrictions were necessary to fight fraud.</p>\n\n<p>But the company simultaneously made it easier for scammers to log in to and compromise accounts of Walmart employees and other customers. Previously, One users needed a username and password and a verification code sent by text message. After the acquisition, One removed the username and password requirement for mobile users. Instead, customers entered their phone number and received a login code via text. Nowadays, fewer companies require a password. They typically rely on a username, such as an email address, and a second form of authentication. But One uses the same telephone number both for the username and to deliver the login code, which makes it less secure, said Allison Nixon, the chief research officer of <a href=\"https://unit221b.com/\">Unit 221B</a>, a security research and consulting firm.</p>\n\n<p>One also asks users to set up a PIN. But if you forget your PIN, you can reset it with the last four digits of your Social Security number, which Nixon said is easy for criminals to obtain. \u201cIt doesn't feel safe and it doesn't seem like the way we should protect people's entire bank accounts,\u201d said Nixon, who tested One\u2019s login flow at ProPublica\u2019s request. \u201cWhen the criminal underground realizes that there's a weakness, a lot of different parties jump on that.\u201d </p>\n\n<p>In its statement to ProPublica, One said that its accounts \u201crequire two-factor authentication.\u201d Nixon disagreed. \"Possession of a phone number plus a PIN that isn't really required because you can just reset it is one-factor authentication,\" she said.</p>\n\n<p>Without a password barrier, fraudsters were able to impersonate company representatives in calls and messages to gain access to customer accounts, according to interviews and online reports. Natasha Tabachnikoff, a One account holder who works in local government in Pennsylvania, said she received two calls from someone falsely claiming to work for One. The caller said her account, which she\u2019d had for years, had unauthorized charges and asked her to confirm her identity by sharing the authentication code sent to her phone. </p>\n\n<p>Tabachnikoff almost shared the code but instead hung up and contacted One. \u201cI told them, \u2018You have a very insecure system here.\u2019 And they were basically like, \u2018Well, we'll never call you and ask you to give us your code,\u2019\u201d said Tabachnikoff. She said she moved her savings out of One \u201cto a more reputable bank.\u201d </p>\n\n\n<p>As fraud mounted, One took steps that weakened the human side of its defenses. Last May, it laid off nearly all of its U.S. customer support agents and replaced them with outsourced workers in India and El Salvador. Although many of the new workers weren\u2019t fully trained, they were assigned to provide frontline support via chat and phone. </p>\n\n<p>\u201cThey were trained to only handle the lowest intake questions that do not require advanced knowledge or support,\u201d said a former One employee with knowledge of support operations. Every One user interviewed by ProPublica who had contacted customer service after being defrauded said that the outsourced agents could answer only basic questions. \u201cThese folks were really gatekeepers, they weren\u2019t there to resolve your problem,\u201d said James Scherber, an Oregon-based entrepreneur who had convinced several members of his family to join One.</p>\n\n<p>Separately, One hired outsourced agents to assist with reviewing reports of fraud. This delayed the resolution of problems and has caused One to reject valid reports of fraud, according to the former employee and to transcripts of customer support chats provided by One users. One did not comment specifically on these criticisms, but it said it has \u201csubstantially grown its investment\u201d and personnel in both customer support and fraud review.</p>\n\n<p>Jae Bleiberg contends that One brushed off legitimate claims of fraud. Bleiberg, who has run customer service and operations for other neobanks for eight years, used One as their primary bank since 2021. (Bleiberg uses they/them pronouns.) Early in 2023, Bleiberg was unable to use their One debit card in Brazil, forcing them to cut their vacation short. A One support rep told Bleiberg that \u201call transactions in and out of Brazil were blocked due to \u2018security concerns,\u2019\u201d Bleiberg said. When Bleiberg returned to New York, the card remained inactive and wasn\u2019t replaced for another month. \u201cTheir response was \u2018You can go to Walmart and get cash with your virtual One card,\u2019 Bleiberg said. But, they added, \u201cthere are <a href=\"https://www.youtube.com/watch?v=Z1vUTQsTtKo\">no Walmarts in New York City</a>.\u201d</p>\n\n<p>Worse, multiple fraudulent transactions had been made using Bleiberg\u2019s account. One reimbursed Bleiberg for those transactions, but rejected a subsequent claim. After weeks of back and forth, One eventually issued a $250 credit after Bleiberg threatened to complain to the CFPB and other agencies. Beliberg provided a screenshot of their bank statement showing the credit. \u201cThis clearly came with the understanding I would not seek regulatory action,\u201d Bleiberg said. One said it\u2019s \u201ccategorically false\u201d to say that it pays customers to not file complaints. As their dispute with One escalated, Bleiberg filed complaints last month with several federal agencies. When Bleiberg asked for copies of their chat-support transcripts and call logs, screenshots show, One said it would provide the materials only if served with a subpoena. \u201cI have spent the last year trying to obtain the records\u201d of their interactions with One, Bleiberg wrote to the Federal Reserve Board. \u201cMy account was closed without consent a few days ago by a spiteful support agent.\u201d </p>\n\n<p>Scherber, the customer from Oregon who got his family to join One, said the company\u2019s ineffective fraud response cost him thousands of dollars last fall. The company froze all of his money and stonewalled him after he reported a series of unauthorized charges. \u201cThey have a firehose of fraud and you have to wait for a response back from the relevant team,\u201d Scherber said.</p>\n\n<p>The account lockup meant his scheduled payments to American Express didn\u2019t go through, he said. That lowered Scherber\u2019s credit rating, causing a lender to raise the interest rate on a planned mortgage refinancing. \u201cI had to postpone my refinancing,\u201d he said. \u201cNow it\u2019s not going to happen.\u201d Scherber and his family ditched One last year.</p>\n\n<p>One said the rate at which it freezes or otherwise restricts customer accounts due to fraud \u201cis down by more than 50% since the acquisition of One.\u201d It declined to share the data or time frame used to calculate that statistic or to address specific customer accounts of fraud or poor service.</p>\n\n<p>Carl, the Walmart employee whose paycheck was stolen by fraudsters, eventually got his money back. But he\u2019s done with One. Now he gets his Walmart pay deposited in a traditional bank. As he put it, \u201cAfter losing the whole check I wasn't going to risk losing it again.\u201d</p>\n        \n    \n                    \n    \n        <p>\n            <strong><a href=\"https://www.propublica.org/getinvolved/send-propublica-story-tips\">Do You Have a Tip for ProPublica? Help Us Do Journalism.</a></strong>\n        </p>\n\n            \n             \n\n                                    \n        \n                        <p><a href=\"https://www.propublica.org/people/doris-burke\">Doris Burke</a> contributed research.</p>"}, "tags": [], "updated": "2024-03-11T05:00:00-04:00", "updated_parsed": [2024, 3, 11, 9, 0, 0, 0, 71, 0], "authors": [{"name": "by Craig Silverman and Peter Elkind"}], "author": "by Craig Silverman and Peter Elkind", "author_detail": {"name": "by Craig Silverman and Peter Elkind"}}, {"title": "At Seattle\u2019s Boeing Field, Real-Time Video Offers a Rare Glimpse of America\u2019s Troubled Deportation Flights", "title_detail": {"type": "text/plain", "language": null, "base": "https://www.propublica.org/feeds/propublica/main", "value": "At Seattle\u2019s Boeing Field, Real-Time Video Offers a Rare Glimpse of America\u2019s Troubled Deportation Flights"}, "links": [{"rel": "alternate", "type": "text/html", "href": "https://www.propublica.org/article/seattle-boeing-field-ice-deportation-flights"}], "link": "https://www.propublica.org/article/seattle-boeing-field-ice-deportation-flights", "published": "Fri, 08 Mar 2024 05:00:00 -0500", "published_parsed": [2024, 3, 8, 10, 0, 0, 4, 68, 0], "id": "https://www.propublica.org/article/seattle-boeing-field-ice-deportation-flights", "guidislink": false, "summary": "<p class=\"byline\">\n                by <a class=\"name\" href=\"https://www.propublica.org/people/mac-funk\">McKenzie Funk</a>                </p>\n                                             \n\n                                                                    \n            \n                <p>ProPublica is a nonprofit newsroom that investigates abuses of power. <a href=\"https://www.propublica.org/newsletters/dispatches?source=54G&amp;placement=top-note&amp;region=local\">Sign up for Dispatches</a>, a newsletter that spotlights wrongdoing around the country, to receive our stories in your inbox every week.</p>\n\n            \n\n                \n\n      \n  \n\n\n\n                    \n<p>A closed-circuit video camera zoomed in on the tarmac of Seattle's Boeing Field one recent afternoon, buffeted by 30-mile-an-hour gusts as it captured the arrival of a charter jet. The jet rolled to a stop alongside two buses. Behind their tinted windows, still invisible to the camera, were people waiting to be deported from the United States.</p>\n\n<p>\"Windy,\" muttered a woman watching the video feed on a projector screen. Struggling to make out the plane\u2019s tail number from the shaky image, she stood up for a closer look.</p>\n\n<p>On the screen, a stairway was wheeled over, and a cluster of men in bright yellow jackets descended from the plane. Another man stepped out of an SUV that partly blocked the foot of the stairs from view. Soon the group lugged over black bags, opened them, and laid out something that looked like chains.</p>\n\n<p>When detainees began emerging from the camera\u2019s blind spot, their ankles, waists and wrists appeared to be shackled together, and they seemed unable to hold the handrails as they shuffled up the wet stairs in the wind.</p>\n\n<p>\"So dangerous,\" said another woman watching the video feed. People kept coming, and she and her partner kept count: \"Seven ... eight ... nine ... ten ... eleven ... twelve.\" One by one, the hunched figures disappeared into the plane. After an hour, it was gone.</p>\n        \n    \n                    \n\n    \n        \n\n    \n        \n            \n            \n            \n\n            People board a deportation flight at King County International Airport. The original video image has been zoomed in on for greater clarity.\n    \n            (Obtained by ProPublica)\n    \n    \n    \n\n            <p><strong><a href=\"https://assets-d.propublica.org/v5/video/01092024_ICE_Recording-zoomed-desktop_2024-03-07-181456_uyiu.mp4\">Watch video \u279c</a></strong></p>\n        \n    \n    \n        \n    \n                    \n<p>The observation room at Boeing Field offers what is arguably America\u2019s best real-time window into our vast network of privately run deportation flights, a system that has generated troubling reports of passenger mistreatment and in-flight emergencies.</p>\n\n<p>In 2017, passengers on a deportation flight to Somalia said they were left bound and shackled in their seats for 23 hours during a stopover, some forced to soil themselves because they were denied bathroom visits. A year later, the right landing gear collapsed as a plane carrying detainees touched down at an airport in Louisiana, sparking a fire on its wing, filling the cabin with the smell of burning rubber and sending shackled passengers racing toward the three functioning evacuation slides after another slide failed to deploy. The next year, a detainee at the same Louisiana airport tumbled from the top of the boarding stairs and was rushed to the hospital.</p>\n\n<p>While news organizations have reported on <a href=\"https://capitalandmain.com/a-drunk-mechanic-shackled-immigrants-a-crash-landing-the-dangers-of-ice-flights\">some of </a><a href=\"https://capitalandmain.com/a-drunk-mechanic-shackled-immigrants-a-crash-landing-the-dangers-of-ice-flights\">these incidents</a> aboard what the government calls ICE Air, key details about how the system works would still be hidden were it not for a group of researchers who are now part of the work inside the observation room.</p>\n\n<p>The University of Washington Center for Human Rights has spent the past six years trying to shed light on deportation operations, even as U.S. Immigration and Customs Enforcement and its contractors and subcontractors have taken steps that shield their activities from view. (ICE declined ProPublica\u2019s requests for comment.) Now the human rights center is in close contact with the observers at Boeing Field, hoping their weekly vigil will yield new clues and drive further research. </p>\n\n<p>Every scrap of information is hard won.</p>\n\n<p>As the recent dramatic influx of immigrants has prompted a push among political leaders to accelerate expulsions, what Seattle's single shaky tarmac camera really shows is how little the public is allowed to know about the nation\u2019s hidden deportation infrastructure.</p>\n\n\n<p>The Washington human rights center\u2019s investigation of ICE Air began in 2018 with a modest goal: to prove that deportation operations took place at King County International Airport, as Boeing Field is officially known. Liberal local officials had enacted various \u201csanctuary\u201d policies to insulate their residents from then-President Donald Trump\u2019s crackdown on immigrants, but they were unaware (or could at least claim to be unaware) of ICE flights at the county-owned airport. \u201cThey all played dumb,\u201d said Maru Mora Villalpando of the immigrant rights group La Resistencia. \u201cAll of them were like, \u2018Wait, what, there are deportations happening here?\u2019\u201d</p>\n\n<p>The center began gathering documents that proved it, and also hinted at the worldwide breadth of ICE Air's network. Their investigation grew. Through records requests to ICE, and after interventions by Washington's congressional delegation, researchers obtained an ICE Air database spanning eight years of global operations: 1.73 million passenger records from nearly 15,000 flights to and from 88 U.S. airports \u2014 Boeing Field indeed among them \u2014 and to 134 international airports in 119 countries around the world.</p>\n\n<p>In April 2019, the center published this trove of raw data and a pair of reports cataloging a history of in-flight abuses and potential due process violations. </p>\n\n<p>The Washington human rights center reports also mapped the layers of contractors and subcontractors that provide ICE with planes, security guards, in-flight nurses and access to local airports. \u201cOver the past decade, the institutional infrastructure behind these flights has shifted from a government operation run by the US Marshals Service on government planes,\u201d <a href=\"https://jsis.washington.edu/humanrights/2019/04/23/ice-air/\">the researchers wrote</a>, \u201cto a sprawling, semi-secret network of flights on privately-owned aircraft.\u201d Their reports identified the charter companies by name.</p>\n\n<p>A great majority of the deportation flights leaving Boeing Field were bound not for destinations overseas but for domestic ICE Air hubs closer to America\u2019s southern border, over 1,000 miles away, where detainees could be placed on connecting flights to countries of origin. The Washington researchers showed that Boeing Field was a busy part of the network, having hosted close to 500 ICE Air flights since 2010, collecting landing fees as the government shipped off at least 34,400 people for deportation.</p>\n\n<p>Confronted with these findings, King County Executive Dow Constantine issued an order designed to eventually make it impossible for ICE Air to get any ground support, such as refueling, at Boeing Field. The company providing these ground services to ICE, which had also been named in the center\u2019s reports, decided to stop rather than wait until its contract came up for renewal. The flights suddenly ended. (The company, Clay Lacy Aviation, and its successor in Seattle, Modern Aviation, did not respond to requests for comment.)</p>\n\n<p>A game of cat and mouse had begun, pitting the Trump administration \u2014 and later the Biden administration \u2014 against local sanctuary advocates.</p>\n\n<p>First, ICE switched locations. It began charter operations out of a municipal airport in the small city of Yakima, located in the farming region about three hours east of Seattle.</p>\n\n<p>But activists began showing up at the Yakima airfield, recording tail numbers and keeping count of people being deported.</p>\n\n<p>Second, ICE changed its flight numbering system. The human rights center had disclosed in its 2019 report that it used the federally assigned prefix \u201cRPN-\u201d for \u201crepatriate\u201d to plug information into free flight-tracking websites and obtain a plane\u2019s tail number and ownership. So ICE dropped the \u201cRPN-\u201d and adopted the call signs of its various charter companies.</p>\n\n<p>Activists became more sophisticated. Thomas Cartwright, a retired financial executive in Ohio turned refugee advocate, figured out how to identify ICE Air missions by analyzing flight patterns, operators and airport pairs. He began to track charter planes by the dozens, enabling the human rights center to issue a 2022 report linking specific deportation flights to the sports teams and musical acts that chartered the same planes.</p>\n\n<p>\u201cI'm retired, and I really do need to retire,\" Cartwright said. \"I don't know who's going to do it after me.\u201d</p>\n\n<p>Meanwhile, the U.S. Department of Justice proceeded with a lawsuit against Constantine, the King County executive, to restart ICE flights at Boeing Field. Announcing the suit in February 2020, then-Attorney General William Barr had called it \u201ca significant escalation in the federal government\u2019s efforts to confront the resistance of 'sanctuary cities.'\" </p>\n\n<p>A judge ruled against the county in March 2023, and ICE made preparations to return.</p>\n\n<p>Signature Aviation, a ground-support company at Boeing Field with an $11.5 million new terminal building for its executive clients, agreed to service ICE Air out on a hard-to-see part of the tarmac. Two charter companies, iAero Airways and GlobalX, would do the flying. (None of the companies responded to ProPublica\u2019s requests for comment.)</p>\n\n<p>La Resistencia, the local immigrant rights group, responded by pressuring King County officials to set up a viewing area. The county hastily opened a conference room and closed-circuit video feed for observers.</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            Students from the University of Washington protest Signature Aviation at King County International Airport. Signature services ICE deportation flights at the airfield.\n    \n            (Jovelle Tamayo, special to ProPublica)\n    \n    \n    \n\n    \n\n        \n    \n                    \n<p>On May 2, according to a spreadsheet kept by the observers, a white Boeing 737 with the tail number N802TJ arrived from Phoenix. The plane was known as the Straight Talk Express when used on Sen. John McCain's 2008 presidential campaign, photos and news reports from the time show. On this day iAero was using it for a deportation flight. ICE Air was back.</p>\n\n\n<p>Volunteers now observe deportation flights every week at Boeing Field, usually on Tuesday mornings.</p>\n\n<p>Coordinating their efforts along with La Resistencia\u2019s Maru Mora Villalpando is Stan Shikuma, a 70-year-old retired nurse and the co-president of the civil liberties group Tsuru for Solidarity.</p>\n\n<p>\u201cTsuru\u201d means \u201ccrane\u201d in Japanese. The group consists of Japanese American survivors of U.S. incarceration camps during World War II and their descendants. They first organized to protest what they saw as similar mass camps for immigrant families during the Trump administration. One, in Dilley, Texas, was just 45 minutes down the road from Crystal City, Texas, the site of an infamous camp that housed Japanese American families. In 2019, the group that would become Tsuru led a large rally outside the Dilley detention center, giving speeches and playing taiko drums and stringing tens of thousands of origami paper cranes along the fence. The cranes became their symbol. They rallied under the cry \u201cStop Repeating History!\u201d</p>\n\n<p>At Boeing Field, the volunteers record tail numbers and keep a count of how many people get on and off each plane. The observations can serve as \u201ca check on ICE in case they do put out numbers,\u201d Shikuma says. \u201cIf they say, \u2018We\u2019ve only deported 25 people in the last two months,\u2019 we can say, \u2018Well, we counted 85 in the last two weeks.\u2019\u201d</p>\n        \n    \n                        \n\n    \n        \n\n                            \n                                                        \n                                                        \n                                \n\n            First image: Maru Mora Villalpando, leader of La Resistencia, views a deportation flight on a live feed. Second image: Stan Shikuma, left, and Margaret Sekijima observe a departure, recording the number of people they see board the plane.\n    \n            (Jovelle Tamayo, special to ProPublica)\n    \n    \n    \n\n            \n                    \n    \n                    \n<p>The second goal, Shikuma says, is to \"let the people on the plane know that we're out here and that someone cares.\" In this effort, the groups, hidden away as they are in the observation room, have been less successful.</p>\n\n<p>When Shikuma is on duty, he sits with one or two other observers in the conference room and stares intently at the closed-circuit video screen on the wall. He sips coffee and checks FlightAware, a popular plane tracking app, on his phone. He watches the buses roll in from the 1,575-bed Northwest ICE Processing Center in nearby Tacoma, run by private-prison contractor The Geo Group.</p>\n\n<p>After the ICE Air flight arrives, usually from Phoenix but sometimes Las Vegas, San Antonio or El Paso, Shikuma marks in his notebook the time, the plane\u2019s tail number, how many detainees exit and how many board.</p>\n\n<p>Planes meet buses behind a large hangar, almost entirely out of view from a perimeter road. There are often three buses, but only two of them, Shikuma said, ever unload passengers. The third parks along a fence line, blocking any remaining view from the road. While the county's closed-circuit camera can still capture the boarding process, the positioning of the SUV and two passenger buses means that detainees are generally visible on the camera only for the seconds it takes them to ascend the stairs.</p>\n\n<p>Twice in recent months volunteers witnessed what they considered unusual activity during boardings on the tarmac, prompting the human rights center to request records of internal ICE documentation on those two flights under the Freedom of Information Act.</p>\n\n<p>Activists say that King County, despite its left-leaning reputation, has been a more reluctant partner in keeping tabs on deportation flights than was Yakima, which had regularly shared passenger tallies.</p>\n\n<p>But Cameron Satterfield, a county spokesperson, said officials are doing what they can within a limited set of options. \u201cWe have a federal judge saying, \u2018No, this is a public airport,\u2019\u201d he told ProPublica.</p>\n\n<p>The county logs ICE Air\u2019s arrivals and departures on its website, though the page was missing for weeks this winter after an update. Local officials have been unable to obtain passenger data from ICE, not even a head count. \u201cThey have told us: You can send a FOIA request,\u201d Satterfield said.</p>\n\n<p>This means that the only practical way to get numbers is the volunteers\u2019 flight-by-flight paper tally. In 2022, ICE's average processing time for what it deems \"complex\" requests hit a record high: 186 days. At the end of that year, it had a backlog of 16,902 unresolved cases, a fourfold jump from 2021.</p>\n\n\n<p>ProPublica\u2019s review of <a href=\"https://www.dvidshub.net/video/885548/ice-conducts-removal-flights-june-2-guatemala\">deportation videos posted online by ICE</a> shows what a difference the unvarnished view from Boeing Field can make. The agency began routinely posting the productions in May.</p>\n\n<p>The 97 videos ProPublica examined, ranging in length from 22 seconds to almost 3 minutes, show signs of careful framing and editing. While detainees are commonly shown climbing the steps in handcuffs and the waist chains that secure them, the videos often cut to a new shot before leg shackles can make an appearance. When leg shackles are visible, they are typically out of focus, discernible only if you know to look for them. </p>\n\n<p>It is common on ICE Air to place passengers in five-point restraints \u2014 wrists, ankles, and waists in chains \u2014 even as the agency\u2019s own statistics show that <a href=\"https://www.ice.gov/spotlight/statistics\">less than half of the people deported in 2023 had any kind of criminal conviction</a>, let alone for serious felonies that could suggest a possible risk to others on board. </p>\n\n<p>Carrier names and tail numbers are blurred or absent in the videos, consistent with tail-number redactions in documents the Washington human rights center has gradually received from ICE in the years after its 2019 reports. The agency cites an exemption to the Freedom of Information Act protecting records that would reveal \"techniques and procedures for law enforcement investigations or prosecutions\" or \"could reasonably be expected to risk circumvention of the law.\"</p>\n        \n    \n                    \n\n    \n        \n\n    \n        \n            \n            \n            \n\n            In this outtake from a June 2023 video released by ICE of a deportation flight from Alexandria, Louisiana, to Guatemala, people are filmed out of focus, making it difficult to see any leg shackles.\n    \n            (U.S. Immigration and Customs Enforcement)\n    \n    \n    \n\n            <p><strong><a href=\"https://assets-d.propublica.org/v5/video/DOD_109677459-cinemagraph-shortened-5.mp4\">Watch video \u279c</a></strong></p>\n        \n    \n    \n        \n    \n                    \n<p>The agency did not respond when asked by ProPublica how disclosing tail numbers could pose such risks, nor when asked to explain the use of five-point restraints. When the California news organization Capital &amp; Main wrote in 2021 about ICE flights that went badly, it quoted a spokesperson saying the agency required safety reports from flight brokers and that \u201cICE retains the ability to hold the vendor accountable if there are performance issues.\u201d</p>\n\n<p>The spokesperson also told Capital &amp; Main that the agency \u201cutilizes restraints only when necessary for the safety and security of the detainee passengers, flight crew, and the aircraft.\u201d</p>\n\n<p>What ICE\u2019s online videos don't show is revealing in its own right. In spring 2023, the center obtained a series of ICE Air incident reports detailing various accidents during charter operations, including the one in which a detainee in Alexandria, Louisiana, tumbled down the boarding stairs. Agency investigators recommended that contractors and subcontractors avoid such accidents in the future by placing a guard midway up the stairs to help detainees board and to catch any who lose their balance.</p>\n\n<p>Yet in most of the ICE Air videos, including 32 of the 33 shot over the last year at the Louisiana airport where the man fell, ICE's contractors did not heed the investigators\u2019 suggestion.</p>\n\n<p>At Boeing Field, observers have documented the same practices. Week after week, rain or shine, including the recent gusty day when the tarmac camera shook in 30-mile-an-hour winds, chained detainees continue to climb aboard the planes alone.</p>\n\n\n<p>On a calmer day this winter, Shikuma shared the observation room with Mora Villalpando and with fellow Tsuru volunteer Margaret Sekijima. FlightAware showed an inbound Airbus A320 operated by the ICE Air subcontractor GlobalX. Buses from the detention center, which normally arrive well in advance, had yet to appear on the screen. \u201cVery unusual,\u201d Shikuma said. \u201cI wonder if they've changed up the protocol.\"</p>\n\n<p>A few weeks prior, Mora Villalpando had led a group of protestors who intercepted the buses outside the gates of the airport, waving at the detainees inside and unfurling a banner that read \"You are not alone\" in three languages spoken by recent groups of Northwest detainees: English, Spanish and Punjabi.</p>\n\n<p>Minutes later, two buses traversed the video frame from left to right. A young woman burst into the room. \u201cThey changed the entrance and came from the north!\u201d she said. She was a student from the University of Washington, there to lead a demonstration in front of Signature Aviation\u2019s gleaming terminal building. \u201cI\u2019m going to go round up the troops.\u201d</p>\n\n<p>The Airbus landed. The observers took down its tail number. They counted 29 detainees getting on, zero getting off. </p>\n\n<p>Shikuma and Mora Villalpando went outside to join the protesters. Sekijima stayed in the conference room, her expression tight, her eyes on the screen until the plane left for El Paso, its next destination in ICE Air\u2019s endless loop of deportation flights.</p>\n        \n    \n                    \n    \n        <p>\n            <strong><a href=\"https://www.propublica.org/getinvolved/help-propublica-reporters-investigate-the-immigration-system\">Help ProPublica Reporters Investigate the Immigration System</a></strong>\n        </p>", "summary_detail": {"type": "text/html", "language": null, "base": "https://www.propublica.org/feeds/propublica/main", "value": "<p class=\"byline\">\n                by <a class=\"name\" href=\"https://www.propublica.org/people/mac-funk\">McKenzie Funk</a>                </p>\n                                             \n\n                                                                    \n            \n                <p>ProPublica is a nonprofit newsroom that investigates abuses of power. <a href=\"https://www.propublica.org/newsletters/dispatches?source=54G&amp;placement=top-note&amp;region=local\">Sign up for Dispatches</a>, a newsletter that spotlights wrongdoing around the country, to receive our stories in your inbox every week.</p>\n\n            \n\n                \n\n      \n  \n\n\n\n                    \n<p>A closed-circuit video camera zoomed in on the tarmac of Seattle's Boeing Field one recent afternoon, buffeted by 30-mile-an-hour gusts as it captured the arrival of a charter jet. The jet rolled to a stop alongside two buses. Behind their tinted windows, still invisible to the camera, were people waiting to be deported from the United States.</p>\n\n<p>\"Windy,\" muttered a woman watching the video feed on a projector screen. Struggling to make out the plane\u2019s tail number from the shaky image, she stood up for a closer look.</p>\n\n<p>On the screen, a stairway was wheeled over, and a cluster of men in bright yellow jackets descended from the plane. Another man stepped out of an SUV that partly blocked the foot of the stairs from view. Soon the group lugged over black bags, opened them, and laid out something that looked like chains.</p>\n\n<p>When detainees began emerging from the camera\u2019s blind spot, their ankles, waists and wrists appeared to be shackled together, and they seemed unable to hold the handrails as they shuffled up the wet stairs in the wind.</p>\n\n<p>\"So dangerous,\" said another woman watching the video feed. People kept coming, and she and her partner kept count: \"Seven ... eight ... nine ... ten ... eleven ... twelve.\" One by one, the hunched figures disappeared into the plane. After an hour, it was gone.</p>\n        \n    \n                    \n\n    \n        \n\n    \n        \n            \n            \n            \n\n            People board a deportation flight at King County International Airport. The original video image has been zoomed in on for greater clarity.\n    \n            (Obtained by ProPublica)\n    \n    \n    \n\n            <p><strong><a href=\"https://assets-d.propublica.org/v5/video/01092024_ICE_Recording-zoomed-desktop_2024-03-07-181456_uyiu.mp4\">Watch video \u279c</a></strong></p>\n        \n    \n    \n        \n    \n                    \n<p>The observation room at Boeing Field offers what is arguably America\u2019s best real-time window into our vast network of privately run deportation flights, a system that has generated troubling reports of passenger mistreatment and in-flight emergencies.</p>\n\n<p>In 2017, passengers on a deportation flight to Somalia said they were left bound and shackled in their seats for 23 hours during a stopover, some forced to soil themselves because they were denied bathroom visits. A year later, the right landing gear collapsed as a plane carrying detainees touched down at an airport in Louisiana, sparking a fire on its wing, filling the cabin with the smell of burning rubber and sending shackled passengers racing toward the three functioning evacuation slides after another slide failed to deploy. The next year, a detainee at the same Louisiana airport tumbled from the top of the boarding stairs and was rushed to the hospital.</p>\n\n<p>While news organizations have reported on <a href=\"https://capitalandmain.com/a-drunk-mechanic-shackled-immigrants-a-crash-landing-the-dangers-of-ice-flights\">some of </a><a href=\"https://capitalandmain.com/a-drunk-mechanic-shackled-immigrants-a-crash-landing-the-dangers-of-ice-flights\">these incidents</a> aboard what the government calls ICE Air, key details about how the system works would still be hidden were it not for a group of researchers who are now part of the work inside the observation room.</p>\n\n<p>The University of Washington Center for Human Rights has spent the past six years trying to shed light on deportation operations, even as U.S. Immigration and Customs Enforcement and its contractors and subcontractors have taken steps that shield their activities from view. (ICE declined ProPublica\u2019s requests for comment.) Now the human rights center is in close contact with the observers at Boeing Field, hoping their weekly vigil will yield new clues and drive further research. </p>\n\n<p>Every scrap of information is hard won.</p>\n\n<p>As the recent dramatic influx of immigrants has prompted a push among political leaders to accelerate expulsions, what Seattle's single shaky tarmac camera really shows is how little the public is allowed to know about the nation\u2019s hidden deportation infrastructure.</p>\n\n\n<p>The Washington human rights center\u2019s investigation of ICE Air began in 2018 with a modest goal: to prove that deportation operations took place at King County International Airport, as Boeing Field is officially known. Liberal local officials had enacted various \u201csanctuary\u201d policies to insulate their residents from then-President Donald Trump\u2019s crackdown on immigrants, but they were unaware (or could at least claim to be unaware) of ICE flights at the county-owned airport. \u201cThey all played dumb,\u201d said Maru Mora Villalpando of the immigrant rights group La Resistencia. \u201cAll of them were like, \u2018Wait, what, there are deportations happening here?\u2019\u201d</p>\n\n<p>The center began gathering documents that proved it, and also hinted at the worldwide breadth of ICE Air's network. Their investigation grew. Through records requests to ICE, and after interventions by Washington's congressional delegation, researchers obtained an ICE Air database spanning eight years of global operations: 1.73 million passenger records from nearly 15,000 flights to and from 88 U.S. airports \u2014 Boeing Field indeed among them \u2014 and to 134 international airports in 119 countries around the world.</p>\n\n<p>In April 2019, the center published this trove of raw data and a pair of reports cataloging a history of in-flight abuses and potential due process violations. </p>\n\n<p>The Washington human rights center reports also mapped the layers of contractors and subcontractors that provide ICE with planes, security guards, in-flight nurses and access to local airports. \u201cOver the past decade, the institutional infrastructure behind these flights has shifted from a government operation run by the US Marshals Service on government planes,\u201d <a href=\"https://jsis.washington.edu/humanrights/2019/04/23/ice-air/\">the researchers wrote</a>, \u201cto a sprawling, semi-secret network of flights on privately-owned aircraft.\u201d Their reports identified the charter companies by name.</p>\n\n<p>A great majority of the deportation flights leaving Boeing Field were bound not for destinations overseas but for domestic ICE Air hubs closer to America\u2019s southern border, over 1,000 miles away, where detainees could be placed on connecting flights to countries of origin. The Washington researchers showed that Boeing Field was a busy part of the network, having hosted close to 500 ICE Air flights since 2010, collecting landing fees as the government shipped off at least 34,400 people for deportation.</p>\n\n<p>Confronted with these findings, King County Executive Dow Constantine issued an order designed to eventually make it impossible for ICE Air to get any ground support, such as refueling, at Boeing Field. The company providing these ground services to ICE, which had also been named in the center\u2019s reports, decided to stop rather than wait until its contract came up for renewal. The flights suddenly ended. (The company, Clay Lacy Aviation, and its successor in Seattle, Modern Aviation, did not respond to requests for comment.)</p>\n\n<p>A game of cat and mouse had begun, pitting the Trump administration \u2014 and later the Biden administration \u2014 against local sanctuary advocates.</p>\n\n<p>First, ICE switched locations. It began charter operations out of a municipal airport in the small city of Yakima, located in the farming region about three hours east of Seattle.</p>\n\n<p>But activists began showing up at the Yakima airfield, recording tail numbers and keeping count of people being deported.</p>\n\n<p>Second, ICE changed its flight numbering system. The human rights center had disclosed in its 2019 report that it used the federally assigned prefix \u201cRPN-\u201d for \u201crepatriate\u201d to plug information into free flight-tracking websites and obtain a plane\u2019s tail number and ownership. So ICE dropped the \u201cRPN-\u201d and adopted the call signs of its various charter companies.</p>\n\n<p>Activists became more sophisticated. Thomas Cartwright, a retired financial executive in Ohio turned refugee advocate, figured out how to identify ICE Air missions by analyzing flight patterns, operators and airport pairs. He began to track charter planes by the dozens, enabling the human rights center to issue a 2022 report linking specific deportation flights to the sports teams and musical acts that chartered the same planes.</p>\n\n<p>\u201cI'm retired, and I really do need to retire,\" Cartwright said. \"I don't know who's going to do it after me.\u201d</p>\n\n<p>Meanwhile, the U.S. Department of Justice proceeded with a lawsuit against Constantine, the King County executive, to restart ICE flights at Boeing Field. Announcing the suit in February 2020, then-Attorney General William Barr had called it \u201ca significant escalation in the federal government\u2019s efforts to confront the resistance of 'sanctuary cities.'\" </p>\n\n<p>A judge ruled against the county in March 2023, and ICE made preparations to return.</p>\n\n<p>Signature Aviation, a ground-support company at Boeing Field with an $11.5 million new terminal building for its executive clients, agreed to service ICE Air out on a hard-to-see part of the tarmac. Two charter companies, iAero Airways and GlobalX, would do the flying. (None of the companies responded to ProPublica\u2019s requests for comment.)</p>\n\n<p>La Resistencia, the local immigrant rights group, responded by pressuring King County officials to set up a viewing area. The county hastily opened a conference room and closed-circuit video feed for observers.</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            Students from the University of Washington protest Signature Aviation at King County International Airport. Signature services ICE deportation flights at the airfield.\n    \n            (Jovelle Tamayo, special to ProPublica)\n    \n    \n    \n\n    \n\n        \n    \n                    \n<p>On May 2, according to a spreadsheet kept by the observers, a white Boeing 737 with the tail number N802TJ arrived from Phoenix. The plane was known as the Straight Talk Express when used on Sen. John McCain's 2008 presidential campaign, photos and news reports from the time show. On this day iAero was using it for a deportation flight. ICE Air was back.</p>\n\n\n<p>Volunteers now observe deportation flights every week at Boeing Field, usually on Tuesday mornings.</p>\n\n<p>Coordinating their efforts along with La Resistencia\u2019s Maru Mora Villalpando is Stan Shikuma, a 70-year-old retired nurse and the co-president of the civil liberties group Tsuru for Solidarity.</p>\n\n<p>\u201cTsuru\u201d means \u201ccrane\u201d in Japanese. The group consists of Japanese American survivors of U.S. incarceration camps during World War II and their descendants. They first organized to protest what they saw as similar mass camps for immigrant families during the Trump administration. One, in Dilley, Texas, was just 45 minutes down the road from Crystal City, Texas, the site of an infamous camp that housed Japanese American families. In 2019, the group that would become Tsuru led a large rally outside the Dilley detention center, giving speeches and playing taiko drums and stringing tens of thousands of origami paper cranes along the fence. The cranes became their symbol. They rallied under the cry \u201cStop Repeating History!\u201d</p>\n\n<p>At Boeing Field, the volunteers record tail numbers and keep a count of how many people get on and off each plane. The observations can serve as \u201ca check on ICE in case they do put out numbers,\u201d Shikuma says. \u201cIf they say, \u2018We\u2019ve only deported 25 people in the last two months,\u2019 we can say, \u2018Well, we counted 85 in the last two weeks.\u2019\u201d</p>\n        \n    \n                        \n\n    \n        \n\n                            \n                                                        \n                                                        \n                                \n\n            First image: Maru Mora Villalpando, leader of La Resistencia, views a deportation flight on a live feed. Second image: Stan Shikuma, left, and Margaret Sekijima observe a departure, recording the number of people they see board the plane.\n    \n            (Jovelle Tamayo, special to ProPublica)\n    \n    \n    \n\n            \n                    \n    \n                    \n<p>The second goal, Shikuma says, is to \"let the people on the plane know that we're out here and that someone cares.\" In this effort, the groups, hidden away as they are in the observation room, have been less successful.</p>\n\n<p>When Shikuma is on duty, he sits with one or two other observers in the conference room and stares intently at the closed-circuit video screen on the wall. He sips coffee and checks FlightAware, a popular plane tracking app, on his phone. He watches the buses roll in from the 1,575-bed Northwest ICE Processing Center in nearby Tacoma, run by private-prison contractor The Geo Group.</p>\n\n<p>After the ICE Air flight arrives, usually from Phoenix but sometimes Las Vegas, San Antonio or El Paso, Shikuma marks in his notebook the time, the plane\u2019s tail number, how many detainees exit and how many board.</p>\n\n<p>Planes meet buses behind a large hangar, almost entirely out of view from a perimeter road. There are often three buses, but only two of them, Shikuma said, ever unload passengers. The third parks along a fence line, blocking any remaining view from the road. While the county's closed-circuit camera can still capture the boarding process, the positioning of the SUV and two passenger buses means that detainees are generally visible on the camera only for the seconds it takes them to ascend the stairs.</p>\n\n<p>Twice in recent months volunteers witnessed what they considered unusual activity during boardings on the tarmac, prompting the human rights center to request records of internal ICE documentation on those two flights under the Freedom of Information Act.</p>\n\n<p>Activists say that King County, despite its left-leaning reputation, has been a more reluctant partner in keeping tabs on deportation flights than was Yakima, which had regularly shared passenger tallies.</p>\n\n<p>But Cameron Satterfield, a county spokesperson, said officials are doing what they can within a limited set of options. \u201cWe have a federal judge saying, \u2018No, this is a public airport,\u2019\u201d he told ProPublica.</p>\n\n<p>The county logs ICE Air\u2019s arrivals and departures on its website, though the page was missing for weeks this winter after an update. Local officials have been unable to obtain passenger data from ICE, not even a head count. \u201cThey have told us: You can send a FOIA request,\u201d Satterfield said.</p>\n\n<p>This means that the only practical way to get numbers is the volunteers\u2019 flight-by-flight paper tally. In 2022, ICE's average processing time for what it deems \"complex\" requests hit a record high: 186 days. At the end of that year, it had a backlog of 16,902 unresolved cases, a fourfold jump from 2021.</p>\n\n\n<p>ProPublica\u2019s review of <a href=\"https://www.dvidshub.net/video/885548/ice-conducts-removal-flights-june-2-guatemala\">deportation videos posted online by ICE</a> shows what a difference the unvarnished view from Boeing Field can make. The agency began routinely posting the productions in May.</p>\n\n<p>The 97 videos ProPublica examined, ranging in length from 22 seconds to almost 3 minutes, show signs of careful framing and editing. While detainees are commonly shown climbing the steps in handcuffs and the waist chains that secure them, the videos often cut to a new shot before leg shackles can make an appearance. When leg shackles are visible, they are typically out of focus, discernible only if you know to look for them. </p>\n\n<p>It is common on ICE Air to place passengers in five-point restraints \u2014 wrists, ankles, and waists in chains \u2014 even as the agency\u2019s own statistics show that <a href=\"https://www.ice.gov/spotlight/statistics\">less than half of the people deported in 2023 had any kind of criminal conviction</a>, let alone for serious felonies that could suggest a possible risk to others on board. </p>\n\n<p>Carrier names and tail numbers are blurred or absent in the videos, consistent with tail-number redactions in documents the Washington human rights center has gradually received from ICE in the years after its 2019 reports. The agency cites an exemption to the Freedom of Information Act protecting records that would reveal \"techniques and procedures for law enforcement investigations or prosecutions\" or \"could reasonably be expected to risk circumvention of the law.\"</p>\n        \n    \n                    \n\n    \n        \n\n    \n        \n            \n            \n            \n\n            In this outtake from a June 2023 video released by ICE of a deportation flight from Alexandria, Louisiana, to Guatemala, people are filmed out of focus, making it difficult to see any leg shackles.\n    \n            (U.S. Immigration and Customs Enforcement)\n    \n    \n    \n\n            <p><strong><a href=\"https://assets-d.propublica.org/v5/video/DOD_109677459-cinemagraph-shortened-5.mp4\">Watch video \u279c</a></strong></p>\n        \n    \n    \n        \n    \n                    \n<p>The agency did not respond when asked by ProPublica how disclosing tail numbers could pose such risks, nor when asked to explain the use of five-point restraints. When the California news organization Capital &amp; Main wrote in 2021 about ICE flights that went badly, it quoted a spokesperson saying the agency required safety reports from flight brokers and that \u201cICE retains the ability to hold the vendor accountable if there are performance issues.\u201d</p>\n\n<p>The spokesperson also told Capital &amp; Main that the agency \u201cutilizes restraints only when necessary for the safety and security of the detainee passengers, flight crew, and the aircraft.\u201d</p>\n\n<p>What ICE\u2019s online videos don't show is revealing in its own right. In spring 2023, the center obtained a series of ICE Air incident reports detailing various accidents during charter operations, including the one in which a detainee in Alexandria, Louisiana, tumbled down the boarding stairs. Agency investigators recommended that contractors and subcontractors avoid such accidents in the future by placing a guard midway up the stairs to help detainees board and to catch any who lose their balance.</p>\n\n<p>Yet in most of the ICE Air videos, including 32 of the 33 shot over the last year at the Louisiana airport where the man fell, ICE's contractors did not heed the investigators\u2019 suggestion.</p>\n\n<p>At Boeing Field, observers have documented the same practices. Week after week, rain or shine, including the recent gusty day when the tarmac camera shook in 30-mile-an-hour winds, chained detainees continue to climb aboard the planes alone.</p>\n\n\n<p>On a calmer day this winter, Shikuma shared the observation room with Mora Villalpando and with fellow Tsuru volunteer Margaret Sekijima. FlightAware showed an inbound Airbus A320 operated by the ICE Air subcontractor GlobalX. Buses from the detention center, which normally arrive well in advance, had yet to appear on the screen. \u201cVery unusual,\u201d Shikuma said. \u201cI wonder if they've changed up the protocol.\"</p>\n\n<p>A few weeks prior, Mora Villalpando had led a group of protestors who intercepted the buses outside the gates of the airport, waving at the detainees inside and unfurling a banner that read \"You are not alone\" in three languages spoken by recent groups of Northwest detainees: English, Spanish and Punjabi.</p>\n\n<p>Minutes later, two buses traversed the video frame from left to right. A young woman burst into the room. \u201cThey changed the entrance and came from the north!\u201d she said. She was a student from the University of Washington, there to lead a demonstration in front of Signature Aviation\u2019s gleaming terminal building. \u201cI\u2019m going to go round up the troops.\u201d</p>\n\n<p>The Airbus landed. The observers took down its tail number. They counted 29 detainees getting on, zero getting off. </p>\n\n<p>Shikuma and Mora Villalpando went outside to join the protesters. Sekijima stayed in the conference room, her expression tight, her eyes on the screen until the plane left for El Paso, its next destination in ICE Air\u2019s endless loop of deportation flights.</p>\n        \n    \n                    \n    \n        <p>\n            <strong><a href=\"https://www.propublica.org/getinvolved/help-propublica-reporters-investigate-the-immigration-system\">Help ProPublica Reporters Investigate the Immigration System</a></strong>\n        </p>"}, "tags": [{"term": "Immigration", "scheme": null, "label": null}], "updated": "2024-03-08T05:00:00-05:00", "updated_parsed": [2024, 3, 8, 10, 0, 0, 4, 68, 0], "authors": [{"name": "by McKenzie Funk"}], "author": "by McKenzie Funk", "author_detail": {"name": "by McKenzie Funk"}}, {"title": "Bedbugs, Rats and No Heat: How One Woman Endured a Decade of Neglect in New York\u2019s Guardianship System", "title_detail": {"type": "text/plain", "language": null, "base": "https://www.propublica.org/feeds/propublica/main", "value": "Bedbugs, Rats and No Heat: How One Woman Endured a Decade of Neglect in New York\u2019s Guardianship System"}, "links": [{"rel": "alternate", "type": "text/html", "href": "https://www.propublica.org/article/how-one-woman-endured-decade-neglect-new-york-guardianship"}], "link": "https://www.propublica.org/article/how-one-woman-endured-decade-neglect-new-york-guardianship", "published": "Thu, 07 Mar 2024 06:00:00 -0500", "published_parsed": [2024, 3, 7, 11, 0, 0, 3, 67, 0], "id": "https://www.propublica.org/article/how-one-woman-endured-decade-neglect-new-york-guardianship", "guidislink": false, "summary": "<p class=\"byline\">\n                by <span class=\"name\">Jake Pearson</span>, illustrations by <span class=\"name\">Dominic Bodden</span>, special to <a href=\"https://www.propublica.org\">ProPublica</a>                </p>\n                                             \n\n                                                                    \n            \n                <p>ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive <a href=\"https://www.propublica.org/newsletters/the-big-story?source=54G&amp;placement=top-note&amp;region=national\">our biggest stories</a> as soon as they\u2019re published.</p>\n\n            \n\n                \n\n      \n  \n\n\n\n                    \n<p>The temperature was plummeting on Thanksgiving eve when Judith Zbiegniewicz wrapped herself in a blanket, picked up her phone and tapped out yet another plea for help to New York Guardianship Services. It was 2018, and for the previous five years the company, whose slogan is \u201ccaring that makes a difference,\u201d had overseen nearly every major decision in her life, as it did for hundreds of New Yorkers deemed incapable by the courts of looking after themselves. </p>\n\n<p>The organization had repeatedly maintained in court filings that Zbiegniewicz, who was 65 and suffered from depression and anxiety, was doing well under its supervision and that the Queens apartment it had placed her in was the \u201cbest and only place for her.\u201d Each year, court examiners reviewed the reports and a judge signed off on their assessments. </p>\n\n<p>In truth, though, Zbiegniewicz lived in squalor on the second floor of a dilapidated home whose roof had partially collapsed. She\u2019d complained when her mattress teemed with bedbugs and when rats gnawed the legs of her kitchen chairs. Yet every month, her legally appointed guardian had taken $450 in compensation from her bank account as her living conditions deteriorated.</p>\n\n<p>Now, with no heat and a cold front barreling down on the city, she stuffed bath towels under a door to block the draft and again appealed to NYGS.</p>\n\n<p>\u201cWhile you and every one at the guardianship are home in a warm house and having Thanksgiving dinner think of me. In a apartment without heat and can\u2019t,cook. And rats in the kitchen,\u201d she wrote on the evening of Nov. 21, 2018. \u201cSo much for where caring makes a difference.\u201d</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n    \n\n        \n    \n                    \n<p>Three decades ago, New York was at the vanguard of a national movement to prevent such exploitation. State lawmakers passed progressive legislation to codify wards\u2019 civil rights and maximize their independence. Under the law, guardianships were supposed to be tailored to the needs of the individual, with regular court examination to safeguard their welfare. </p>\n\n<p>But today, the system is in shambles, leaving thousands of vulnerable New Yorkers sequestered, voiceless and forgotten while the officials who oversee their care struggle to ensure it, according to a ProPublica investigation. In New York City, there are just over a dozen judges to handle the 17,411 people in guardianships, data provided by the courts show. With that load, cases can sit for years without any kind of meaningful oversight. The hardest hit are poor New Yorkers like Zbiegniewicz, whom the state has entrusted to a network of loosely regulated nonprofits. The outcomes for some of these individuals \u2014 known in industry parlance as the \u201cunbefriended,\u201d because they have no family or anyone else to help them \u2014 have been dire.</p>\n\n<p>In one case, a guardian didn\u2019t notice his ward had died and continued to collect payments for the man\u2019s care even after his death. In another, a guardian told the court in a report that they didn\u2019t know where their ward was for a year. Case managers had visited her apartment but never went in. Eventually a utility worker discovered the woman\u2019s corpse, covered in maggots, decomposing in her own bed.</p>\n\n<p>That the 1990s reforms have failed has been an open secret for years among advocates, lawyers and judges, who have repeatedly called for an overhaul. But the state lawmakers and judicial leaders who have the power to improve it have not done so \u2014 even as <a href=\"https://www.propublica.org/article/the-investigative-reporting-behind-americas-obsession-with-britney-spears-conservatorship\">cases like that of Britney Spears</a> have brought national attention to the issue of guardianships. </p>\n\n<p>ProPublica reviewed hundreds of pages of court records, interviewed dozens of lawyers and experts and talked to the wards who are least equipped to advocate for themselves. What we found is that some of the remedies that policymakers introduced 30 years ago to bolster care and curb abuse, like minimum qualifications for guardians and court examination of their reports, are in dire need of an upgrade. </p>\n\n<p>Today, for example, it is far easier in New York to become a guardian than a nail technician. Parties need only complete a day-long course \u2014 far less training than is required in <a href=\"https://guardianshipcert.org/become-certified/state-specific-information/\">some other states</a>, including California, Texas and Florida. And oversight of their work is similarly threadbare, consisting primarily of a court-appointed examiner who focuses almost exclusively on financial paperwork and a judge who signs off on the examination. But with thin ranks of reviewers, annual assessments can take years to complete. And officials rarely, if ever, see the wards in person.</p>\n\n<p>The easy entry and lack of oversight, critics say, has helped attract unscrupulous nonprofits that take advantage of the wards they are supposed to protect.</p>\n\n<p>In 2015, the chief financial officer of one nonprofit was convicted for stealing more than $50,000 from a ward\u2019s accounts, government documents show. That same year, state regulators found that another nonprofit improperly loaned its top officials more than $250,000 while wards were unnecessarily kept in nursing homes.</p>\n\n<p>Today, even those who helped write the state\u2019s main guardianship statute, known as Article 81 of the Mental Hygiene Law, concede the yawning gap between its promise and its practice has rendered it, in the words of one, \u201cbasically pointless.\u201d</p>\n\n<p>\u201cKeeping people out of guardianship in the first place is the single most important thing to do, because once you\u2019re in it, it\u2019s the toilet you get flushed down,\u201d said Kristin Booth Glen, a former judge who helped craft the law and has called for reform for years. New York\u2019s oversight of guardianships has been \u201ca total and utter disaster,\u201d she said. </p>\n\n<p>Few groups illustrate the consequences of that failure better than NYGS, the organization that was supposed to care for Zbiegniewicz. Over the past decade, the company has grown to become one of the largest providers in the business, drawing $450 in monthly compensation each from hundreds of wards\u2019 accounts while providing as few services as possible, according to court documents and six people familiar with the company\u2019s operations, including former employees. </p>\n\n<p>\u201cEverybody is shirking responsibility,\u201d said Carla Billini, the former director of case management for NYGS. She resigned last April after a decade in the job, saying she was fearful that the company\u2019s practices would result in harm to wards. \u201cHow is there nobody above the guardian who watches all the guardians?\u201d </p>\n\n<p>A spokesperson for the Office of Court Administration, which runs New York\u2019s court system, said that judges face \u201cextremely challenging circumstances\u201d but do the best they can under the law. \u201cThe caseloads are extremely high and individual cases can persist for decades,\u201d he said. \u201cYet, the courts never give up in searching for solutions to ensure the well-being of some of society\u2019s most underserved populations.\u201d</p>\n\n<p>NYGS executives declined to be interviewed for this story. In a statement, Sam Blau, the company\u2019s chief financial officer, said that as a fiduciary he was barred from answering questions \u201cabout any specific client.\u201d However, he noted, \u201cwe are accountable to the Court and our annual accounts and reports are scrutinized by Court appointed examiners and any issues would be addressed.\u201d NYGS did not answer written questions about the company\u2019s broader business practices.</p>\n\n<p>In his statement, Blau called ProPublica\u2019s reporting \u201cmisguided, without full and proper context, filled with omissions and less than accurate information.\u201d But when asked to specify his concerns, he did not respond.</p>\n\n<p>Zbiegniewicz\u2019s decadelong experience as a NYGS ward serves as a road map to how Article 81 fails New Yorkers who are least able to protect themselves.</p>\n\n\u201cSomebody\u2019s Going to Come Help Me\u201d\n<p>Zbiegniewicz\u2019s introduction to guardianship came as it does for thousands of others in the city each year: through a call to the city Adult Protective Services program by someone concerned about her well-being.</p>\n\n<p>It was November 2008, and Zbiegniewicz was struggling financially and emotionally. Her father had died suddenly from a heart attack a year and a half earlier, leaving her the family\u2019s Maspeth, Queens, home \u2014 and, to her surprise, a reverse mortgage. The outstanding debt was $266,532.95.</p>\n\n<p>Zbiegniewicz had no job and no way to pay. She had been dependent on her father all of her adult life, the result of an early trauma: At 18, she was raped leaving the subway on her way to work at Queens\u2019 Welbilt Stove plant. Her world became small, as her devastated parents shielded her. She never sought therapy, never returned to work and rarely ventured beyond the comfort of her block. </p>\n\n<p>Now, with the house in foreclosure, someone called the city to check on her. Adult Protective Services soon sent a psychiatric nurse practitioner, who diagnosed Zbiegniewicz with depression, anxiety and a dependent personality disorder. In a court petition, the city noted that she relied on food stamps and public assistance. With bills piling up, she had just $459.88 in her bank account. </p>\n\n<p>So on a January day in 2010, to help Zbiegniewicz stave off eviction, a city lawyer walked into a wood-paneled courtroom in the state Supreme Court building in Queens and asked a judge to declare her an \u201cincapacitated person\u201d in need of a guardian to manage her finances and housing.</p>\n\n<p>Zbiegniewicz, who declined to attend the hearing, initially welcomed the move. \u201cI was in no condition right then and there,\u201d she said. \u201cI was all alone, no direction, no nothing. I thought, \u2018OK, somebody\u2019s going to come help me get focused and leave.\u2019\u201d</p>\n\n<p>The judge granted the city\u2019s request, setting in motion Zbiegniewicz\u2019s spiraling journey into New York\u2019s overloaded guardianship system, which now contains 28,619 people statewide, more than 60% of whom live in New York City. In most cases, a judge selects either a so-called lay guardian \u2014 family or friends who volunteer \u2014 or a professional guardian, usually a lawyer, which can be pricey. For the thousands of New Yorkers like Zbiegniewicz, who have no family and too little money to be worth a professional guardian\u2019s time, a judge will choose from just under a dozen nonprofit groups, depending on the circumstances. In cases where Adult Protective Services is involved, that means one of three publicly-funded organizations.</p>\n\n<p>In Zbiegniewicz\u2019s case, the judge initially appointed the Jewish Association for Services for the Aged. Its mandate was narrow: stopping her eviction.</p>\n\n<p>The guardian negotiated the sale of Zbiegniewicz\u2019s family home, paid off the reverse mortgage and secured $92,000 for her in the deal. Once the money was placed in a special needs trust, JASA\u2019s mission was complete. The judge then turned to the list of professional guardians to help Zbiegniewicz find new housing.</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n    \n\n        \n    \n                    \n<p>But the task was a challenge. Zbiegniewicz insisted on keeping her five beloved schnauzers and living with four longtime friends who\u2019d supported her after her father\u2019s death. The arrangement made her a tough tenant to place, and by July 2013 she\u2019d faced eviction from two separate apartments where she had withheld rent until repairs were made. </p>\n\n<p>Before long, Zbiegniewicz\u2019s professional guardian wanted out. </p>\n\n<p>Like many private attorneys in the system, she was working the case pro bono, and her petition to be replaced reflected a larger strain in New York\u2019s system, which has long relied on such goodwill to handle guardianships of the indigent.</p>\n\n<p>Private lawyers have \u201cstopped taking cases in droves because they don\u2019t want to spend the time,\u201d Arthur Diamond, the former supervising guardianship judge in Nassau County, told state lawmakers in 2018. \u201cAnd it can be an immense amount of time being a guardian for somebody who has Alzheimer\u2019s and dementia, which many of our wards do.\u201d</p>\n\n<p>NYGS pitched itself explicitly to the courts as a solution to this problem. A lawyer for the group once wrote to a Queens judge in a letter obtained by ProPublica that the company \u201chopes to fill a need in the court system\u201d by taking those cases in which a judge would otherwise have \u201ca difficult time finding a suitable guardian willing to act.\u201d </p>\n\n<p>In a July 2013 hearing, Zbiegniewicz\u2019s private guardian suggested NYGS take over her case because \u201cthey seem to have a significant amount of resources.\u201d</p>\n\n<p>Supreme Court Justice Lee Mayersohn OKed the switch, making NYGS the third guardian to handle Zbiegniewicz\u2019s case in three and a half years.</p>\n\nExploding Caseloads, Little Vetting\n<p>The guardianship bill state lawmakers passed in the early 1990s established the first training requirements for guardians before they can serve \u2014 generally a daylong class meant to ensure they have a baseline familiarity with Article 81\u2019s requirements. That\u2019s less stringent than what the state requires of prospective nail technicians, who must complete a 250-hour course and pass tests. This low barrier to entry can allow a family member who steps up to help a loved one in crisis quickly get in place. But advocates say that New York\u2019s permissiveness also enables exploitative actors to enter the guardianship business. </p>\n\n<p>At the time of NYGS\u2019 founding, Blau was working as the director of judicial compliance at another guardianship firm, according to his LinkedIn profile. The state attorney general\u2019s office investigated that group, Integral Guardianship Services, during Blau\u2019s tenure, and eventually accused it of abandoning its most basic duties, including filing annual reports detailing wards\u2019 finances. (Blau wasn\u2019t named in the probe, which the group settled. The firm shuttered its operations last spring.)</p>\n\n<p>NYGS\u2019 chief operating officer \u2014 Blau\u2019s older brother David \u2014 had been running an unrelated e-commerce business, selling discounted travel coupons, according to former employees.</p>\n\n<p>Once certified, private guardians are required to attest that they haven\u2019t been found to have violated any criminal, civil or professional rules. Nonprofits, however, undergo no such vetting. In fact, they are not even required to provide proof of their charitable status.</p>\n\n<p>Had there been such a requirement, the courts would have seen that NYGS is not registered as a charity with the state attorney general\u2019s office nor does it have tax-exempt status from the Internal Revenue Service, both agencies confirmed. Nevertheless, the company repeatedly represented itself as a nonprofit in its court filings and promotional material as it took on more and more cases, including Zbiegniewicz\u2019s.</p>\n\n<p>The distinction is significant. Nonprofits are exempt from court rules that cap the number of cases and the amount of compensation guardians can receive annually. Such operations can be lucrative. One estimate commissioned by the state attorney general in 2016 projected that a nonprofit guardian serving 400 low-and-no-fee wards could generate $1.2 million per year.</p>\n\n<p>Sam Blau declined to answer questions about the company\u2019s tax status, but said in a statement that \u201ca large percentage of our cases are done completely Pro Bono,\u201d which \u201cis certainly in line with our mission to help people of minimal financial means.\u201d</p>\n\n<p>In pitching the firm to the court, NYGS\u2019 lawyer painted a picture of an organization with a \u201ccadre of knowledgeable and caring individuals\u201d experienced in guardianships who used \u201cstate of the art records management technology.\u201d</p>\n\n<p>In reality, the Blau brothers operated out of a cramped second-floor office on Avenue J in Midwood, Brooklyn, that was strewn with stacks of government forms, old checkbooks and financial statements. For years, employee chats show, the cremated remains of a ward sat in a plastic bag on the shelf of a hallway closet, nestled in a plain white container the size of a shoe box. The \u201cstate of the art\u201d technology it used to manage its caseload were actually Dropbox and Google Docs, former employees said.</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            David Blau\n    \n    \n    \n    \n\n    \n\n        \n    \n                    \n<p>NYGS\u2019s business grew rapidly by taking on dozens of new cases annually \u2014 a strategy that former employees said was intended to maximize profit on the $450 per month apiece it earned from most of its wards. But staffing didn\u2019t keep pace with volume, and workers realized that in order to do the job well, the firm needed to take fewer cases and throw significant resources at the ones it already had.</p>\n\n<p>That didn\u2019t happen.</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            Sam Blau\n    \n    \n    \n    \n\n    \n\n        \n    \n                    \n<p>In 2016, when the company had 167 clients, it employed two full-time case managers, internal records show. That was true the following year when the total caseload jumped to 248 and remained the case the year after that, when NYGS was responsible for nearly 300 wards. Two more employees were hired in 2018 to handle wards\u2019 finances. Several studies, as well as states including Virginia and Colorado, <a href=\"https://www2.stetson.edu/law-review/article/wards-of-the-state-a-national-study-of-public-guardianship/\">recommend a 20-client limit</a> to ensure proper care. New York, however, has no equivalent guidance, and at one point NYGS had 83 wards per staffer, according to internal records.</p>\n\n<p>More recently, former employees said, the company outsourced key jobs to workers in the Philippines who were expected to address the complicated insurance, banking and health care needs of vulnerable wards from 8,500 miles away. One worker told ProPublica that she was so troubled by the lack of resources and ceaseless calls \u2014 she was responsible for dozens of wards every day \u2014 that she quit after six months.</p>\n\n<p>For years, unless judges specifically asked, they had no way to know whether nonprofits they assigned actually had the bandwidth to take on new cases. It wasn\u2019t until last fall that the state court system, using a federal grant, <a href=\"https://acl.gov/news-and-events/announcements/new-elder-justice-grants-address-aps-training-guardianship-aps\">created a database</a> so that judges and court staff can \u201cbetter oversee the flow and nature and structure of guardianship cases,\u201d the courts\u2019 spokesperson said. </p>\n\n<p>Within NYGS, complaints about the conditions, the lack of resources or a ward\u2019s specific problems were usually met with silence, said Billini, the former director of case management. Sam Blau would just \u201cstare into his computer when you\u2019d tell him something he didn\u2019t want to hear,\u201d she said. \u201cWe called it the passive-aggressive stare.\u201d</p>\n\n<p>The former case manager, as well as other workers, said this dynamic would play out time and again after NYGS moved Zbiegniewicz into the upstairs apartment of 150-15 Yates Road, a two-family home in a dangerous section of Jamaica, Queens. It was seven miles and a world away from the spacious Maspeth house where she\u2019d lived most of her life.</p>\n\n<p>Blau did not respond to questions about Billini\u2019s account. In a general statement, he disputed ProPublica\u2019s reporting, which he claimed was based on \u201cdisgruntled former employees who have a clear biased agenda.\u201d</p>\n\nBedbugs, Rats \u2014 No Questions Asked\n<p>Zbiegniewicz suspected something was amiss with her guardian from the start. </p>\n\n<p>Shortly after moving into the Yates Road apartment, she discovered bedbugs. She said she complained to NYGS immediately, but it took three months before the company sent pest control. The disruption caused her therapist to cancel weekly sessions until an exterminator certified the insects were gone, Zbiegniewicz said. </p>\n\n<p>\u201cI was tore up from the floor up,\u201d she recalled of the bites.</p>\n\n<p>In its filings to the court, however, NYGS presented Zbiegniewicz as thriving. In language that would repeat year after year, a company social worker who visited the home wrote that \u201cMs. Zbiegniewicz is oriented to person, place, and time,\u201d described the frequency of her therapy sessions and the medications she took, adding that she \u201cenjoys gardening and taking care of her dogs and roommates.\u201d </p>\n\n<p>To ensure the integrity of such reports, the system includes a layer of protection for wards in the form of court-appointed examiners. By law, these individuals \u2014 typically lawyers or accountants \u2014 are tasked with reviewing guardians\u2019 reports to \u201cdetermine the condition and care\u201d and finances of the ward, as well as \u201cthe manner in which the guardian has carried out his or her duties and exercised his or her powers.\u201d In practice, the scrutiny can be far from robust.</p>\n\n<p>Today, there are just 157 examiners responsible for reviewing the reports of 17,411 New York City wards, according to data from the court system. And their training can be minimal. In Brooklyn, Queens and Staten Island, this includes viewing a set of instructional DVDs that were recorded 12 years ago. </p>\n\n<p>Like the cost of the guardianship itself, the price for these examinations is borne by the ward.</p>\n\n<p>Zbiegniewicz paid a few hundred dollars each year for an examiner\u2019s reviews. But her records show these examiners did not interrogate spending that indicated potential housing problems.</p>\n\n<p>In 2014, for example, Zbiegniewicz\u2019s account listed four separate disbursements \u2014 totaling $1,251 \u2014 for extermination, laundry and cleaning services, all explicitly labeled as bedbug remedies. Yet when the examiner asked whether the housing was \u201cbest suited\u201d to Zbiegniewicz\u2019s needs, NYGS said it was \u201cappropriate.\u201d There\u2019s no indication in the file that the examiner at the time, Paul Guttenberg, pressed any further or followed up on the extermination expenses. Guttenberg, who declined to be interviewed and didn\u2019t respond to emailed questions, approved NYGS\u2019 report.</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n    \n\n        \n    \n                    \n<p>The subsequent examiner of Zbiegniewicz\u2019s case, Janet Brown, was similarly uncritical. Court data show she carried a significant caseload. Zbiegniewicz was just one of 44 new cases Brown picked up in 2015 alone \u2014 a pace that would continue throughout the guardianship. Each year, after reconciling the financials, she signed off on NYGS\u2019 reports, including those that showed Zbiegniewicz paying to address more problems a landlord would typically be expected to cover: $180 for electrical work in January 2018, then $30 more for an electric stove that May and $50 for a heater in December. </p>\n\n<p>That year, when Brown asked whether Zbiegniewicz\u2019s apartment was \u201cbest suited to her current needs,\u201d an NYGS employee responded, \u201cIt is not the ideal placement, but currently it is the best &amp; <em>only</em> placement\u201d for her.</p>\n\n<p>The employee provided no further explanation in the filing, and there is no indication in the court record that Brown asked for one.</p>\n\n<p>Meanwhile, the conditions in the apartment steadily worsened, according to emails, court filings and interviews with four other people who spent time there.</p>\n\n<p>\u201cNow the rats are eating the kitchen chairs,\u201d Zbiegniewicz wrote to NYGS in a March 2019 email. \u201cBy the time I leave I will not have anything to take.\u201d</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n    \n\n        \n    \n                    \n<p>That year, the guardianship reported spending $280 of Zbiegniewicz\u2019s money for \u201cstorage containers and pest Control,\u201d as well as \u201creimbursement for Extermination and Bathroom Repair.\u201d </p>\n\n<p>There is no indication in the court records that Brown even examined these 2019 expenses. While Article 81 requires guardians to file wards\u2019 annual accounts by May of the following year, there is no such deadline for examiners. Zbiegniewicz\u2019s file is still missing reviews for four years of her guardianship.</p>\n\n<p>In an interview, Brown said that her job was to \u201cmake sure the dollar amounts balance out\u201d and that funds were not \u201cbeing misused.\u201d By those standards, there were no disbursements in the annual reports that \u201craised an eyebrow,\u201d she said. She said she wasn\u2019t aware of the chronic heating problems, the collapsed roof or the pest infestations in the Yates Road apartment, despite the expenditures for extermination and various capital improvements in the reports she reviewed.</p>\n\n<p>\u201cI would have had no way of knowing that unless someone directly reached out to me and said, \u2018Hey, this is a problem,\u2019\u201d she said. </p>\n\n<p>Brown didn\u2019t respond when asked why she didn\u2019t file her reviews for 2019 through 2022.  </p>\n\n<p>Zbiegniewicz said that for years she had no idea that she could take her complaints to the examiner. When she finally did phone, she said, Brown conferenced in a NYGS employee and left the call.</p>\n\n<p>Brown, who is no longer an examiner, said she didn\u2019t recall that conversation, but that she remembered Zbiegniewicz was vocal about her desire to be released from the guardianship. Brown said that she believed she discussed that with someone at NYGS but she couldn\u2019t recall with whom or what was said.</p>\n\n<p>\u201cI do genuinely care,\u201d she said, \u201ceven if you don\u2019t think so.\u201d</p>\n\n<p>Experts said the failure to conduct face-to-face check-ins could hide horrific situations. Judicial leaders, they said, can and should bolster examinations with home visits. For example, in Davidson County, Tennessee, which includes Nashville, social services workers visit wards, review their medical records and interview guardians and their doctors.</p>\n\n<p>\u201cYou\u2019ve got to visit the person,\u201d said Booth Glen, the former judge who helped write Article 81. \u201cPaper is not enough when human lives are at stake.\u201d</p>\n\nWith Judges, \u201cThings Just Get Locked In\u201d\n<p>Examiners are the main check on guardians, but judges also review examiners\u2019 reports before signing off. </p>\n\n<p>Zbiegniewicz believed that if Mayersohn understood how dire her living conditions were, he would require NYGS to fix the situation. The son of a state assemblymember, he started his career as a legislative aide and practiced law for nearly two decades, focusing on trusts and estates, among other civil matters, before being elected to the bench in 2004.</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            Judge Lee Mayersohn\n    \n    \n    \n    \n\n    \n\n        \n    \n                    \n<p>What Zbiegniewicz didn\u2019t know was how long it could take for information to get to the judge \u2014 and how long it could take him to review it. She is just one of 1,566 open guardianship cases currently on the judge\u2019s docket, according to court data. Such a robust caseload, coupled with too few examiners, can add years to the oversight process, creating dangerous gaps in information in cases like Zbiegniewicz\u2019s. </p>\n\n<p>For example, in the spring of 2018, NYGS submitted its guardianship report for the prior year, as required by law. The paperwork contained numerous indications that something was wrong at Yates Road. Notably, no rent payments were listed for the apartment and the company acknowledged for the first time that the house was \u201cnot the ideal placement\u201d for Zbiegniewicz. </p>\n\n<p>But a full year passed before the examiner filed her review with the court, where it was eventually checked by clerks and then passed to Mayersohn for approval. In all, the entire process took more than two years. None of the parties raised alarms over, or even noted, the missing rent payments.</p>\n\n<p>Had they dug deeper, they would have found that Yates Road had gone through a foreclosure and been sold to a bank that was moving to evict Zbiegniewicz and her friends. It\u2019s unclear who actually owned the house when NYGS moved her there; the deed had changed hands multiple times in quick succession. During Zbiegniewicz\u2019s first two years in the house, the guardian had sent $32,000 of its ward\u2019s money to a firm run by a Queens entrepreneur who was later convicted of real estate fraud in an unrelated case. When the eviction notice arrived, NYGS stopped paying the rent but appeared to do little else.</p>\n\n<p>\u201cPhone calls to the guardian in an attempt to work out some sort of reasonable solution have failed since the guardian has refused to respond to any call,\u201d an attorney for the new landlord wrote in a December 2017 court filing. The company eventually hired a lawyer to respond to the landlord-tenant action.</p>\n\n<p>For more than two years, while the official reports on Zbiegniewicz\u2019s welfare crawled through the court system, NYGS kept her in the home. </p>\n\n<p>During that time, she endured all manner of horrendous living conditions. According to her emails to NYGS, she went long stretches without heat and rats ate holes through her clothes. When the apartment lost power, she and her roommates had to jury-rig the breaker box with a popsicle stick to feed electricity upstairs. </p>\n\n<p>\u201cYou have to get in contact with someone,\u201d she wrote to NYGS on Jan. 20, 2018, when her refrigerator lost power. \u201cWe are running extension cord from the basement to up stairs. We are hungry did not eat yesterday.\u201d</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n    \n\n        \n    \n                    \n<p>When NYGS failed to act, Zbiegniewicz and her roommates complained to the city, triggering visits from building inspectors, who documented no running hot water and failure to supply adequate heat. That prompted the Department of Housing Preservation and Development to sue the new owner, who agreed to pay fines to settle the lawsuit.</p>\n\n<p>It\u2019s not clear just how much Mayersohn knew about these cases. The siloed nature of New York\u2019s sprawling courts can leave guardianship judges in the dark about significant developments elsewhere in the legal system. That makes the guardian's report \u2014 and the examiner's review \u2014 even more critical for guardianship judges. But neither NYGS nor Zbiegniewicz\u2019s examiner mentioned the escalating legal actions in their reports. </p>\n\n<p>Mayersohn declined to be interviewed, saying judicial ethics opinions barred him from commenting on \u201cany pending case in any jurisdiction,\u201d and he didn't respond to detailed written questions about his handling of Zbiegniewicz\u2019s case.</p>\n\n<p>Within NYGS, staffers were growing increasingly concerned for Zbiegniewicz\u2019s well-being and passed complaints along to David and Sam Blau, said Billini, the firm\u2019s former case manager. A nurse practitioner for the company confirmed the deplorable conditions on her quarterly visits to the house and reported back to NYGS.</p>\n\n<p>\u201cClient remains angry and frustrated over her living conditions \u2014 roaches, mice and rats,\u201d the nurse wrote in notes submitted to the guardianship in February 2019. \u201cThere is mold \u2014 breathing unhealthy. Would like things to move along.\u201d </p>\n\n<p>And yet, nothing changed, Zbiegniewicz said. (The Blaus did not respond to requests for comment on these claims.)</p>\n\n<p>So in 2019, she started calling Mayersohn\u2019s chambers. She phoned so frequently, she said, that the judge\u2019s secretary knew her case number by heart. But the judge never talked to her when she called, she said. Like the examiner, the secretary sent Zbiegniewicz\u2019s complaints back to the guardianship. </p>\n\n<p>\"Once a guardian is appointed, the court\u2019s tendency is to just work with the guardian,\u201d said Joe Rosenberg, who co-directs the CUNY School of Law\u2019s Disability and Aging Justice Clinic. \u201cI think it\u2019s tough to get out of that cycle. And perhaps that\u2019s in part because it\u2019s hard to find another guardian. Things just get locked in.\u201d</p>\n\n<p>The demand for guardians is particularly great among elderly New Yorkers \u201cwho are alone, with no one to help, and few or no resources,\u201d the Vera Institute of Justice, a legal reform nonprofit, <a href=\"https://www.vera.org/downloads/publications/incapacitated-indigent-and-alone-guardianship-new-york.pdf\">reported in 2018</a>. And so groups like NYGS fulfill the court\u2019s \u201cgreatest need,\u201d said acting state Supreme Court Justice Charles Troia during a panel discussion on guardianships in 2021. \u201cWe need agencies that are willing to help those that truly have nothing.\u201d</p>\n\n<p>Other judges, the courts\u2019 spokesperson said, have advocated for structural changes, including replacing nonprofits with \u201ca statewide, state-supported public guardian program for indigent persons.\u201d </p>\n\n<p>But for now, without such an agency to serve poor wards with considerable needs, judges have few other options.</p>\n\n<p>Zbiegniewicz was better able to advocate for herself than wards who have severe health problems, but even she worried that her persistent complaints may have hurt her cause. She said she got the feeling that the judge and lawyers and court staff believed she was unstable and therefore easy to dismiss. \u201cIt used to drive me up a wall,\u201d she said of the Article 81 designation attached to her name. \u201cThat is a badge saying that I'm cuckoo.\u201d</p>\n\n\u201cThis Is My Life and I Want It Back\u201d\n<p>After years of turmoil, David Blau notified the court in May 2019 that he had negotiated a resolution to Zbiegniewicz\u2019s five-year-plus housing crisis: The bank would pay her $5,000 to leave Yates Road and NYGS would, in turn, place her in an assisted living facility.</p>\n\n<p>Zbiegniewicz \u201csuffers from a debilitating anxiety disorder and requires assistance with her finances,\u201d Blau asserted in a court petition. The conditions, he argued, necessitated a higher level of care. Billini and other staffers inside NYGS disagreed. Zbiegniewicz and her court-appointed attorney did too.  </p>\n\n<p>In a June 2019 filing opposing David Blau\u2019s petition, the attorney informed the court that Zbiegniewcz had already moved out of Yates Road on her own. That month she\u2019d married her longtime friend Leonard Hubbard, and the couple were living together in a city shelter.</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n    \n\n        \n    \n                    \n<p>Nevertheless, Mayersohn ordered Zbiegniewicz to find proper housing and ordered NYGS to \u201csupport\u201d her in that endeavor. But again, Zbiegniewicz said, the company failed her. She needed her financial records to apply for subsidized housing, but she said NYGS responded slowly to her requests or not at all. She managed to get the records on her own and worked with a social worker at the shelter to secure a new home, she said.</p>\n\n<p>\u201cI need to be in control of my own life and I can\u2019t wait on you to do something, to give me paperwork, to give me this, or anything,\u201d she told David Blau in an Oct. 29, 2020, voicemail. \u201cThis is my life and I want it back. Thank you.\u201d</p>\n        \n    \n                        \n\n        \n            Listen to Zbiegniewicz\u2019s Voice Message\n                <p>On Oct. 29, 2020, Zbiegniewicz left this voicemail begging David Blau to release her from her guardianship.</p>\n\n    \n\n        \n        \n        \n\n\n    \n        \n    \n                    \n<p>Zbiegniewicz said she never heard back after leaving that message. And because the pandemic shuttered the courts, there were no appearances in her case for more than two years. She was in legal limbo, without any kind of oversight. </p>\n\n<p>\u201cThese people do not care about you,\u201d Zbiegniewicz said.</p>\n\n<p>Eventually, she secured a one-bedroom apartment for herself, Hubbard and their new dog, Bogart, in a Long Island City building overlooking the East River for $905 a month. With a housing voucher and public benefits covering two-thirds of the rent, it\u2019s far cheaper than the $1,350 she shelled out each month to live on Yates Road. Ironically, because of an oversight by NYGS, she was able to access her bank account to help pay rent.</p>\n\n<p>Mayersohn finally released Zbiegniewicz from the guardianship in February 2022. In NYGS\u2019 final report, the company disclosed taking $12,551 to cover \u201cunpaid monthly compensation\u201d for the nearly two and a half years she had effectively lived outside the guardianship. The lump sum payment brought the balance of Zbiegniewicz\u2019s accounts to zero.</p>\n\n<p>To date, nobody involved in her case \u2014 from NYGS to the examiners who approved the company\u2019s reports \u2014 has been held to account. But there is still time for the judge to consider their actions. </p>\n\n<p>Because NYGS failed to file the required paperwork to settle Zbiegniewicz\u2019s account, her case technically remains open. A lawyer for NYGS finally filed that motion in January \u2014 two days after ProPublica first contacted the organization for comment on this story. The paperwork now awaits Mayersohn\u2019s signature. </p>\n\n<p>In January, Zbiegniewicz sent a letter to Mayersohn, describing the \u201cinjustice and mistreatment\u201d she said she\u2019d endured.</p>\n\n<p>\u201cAll I would like is to be heard and for New York Guardianship Services to be held accountable for what they did and did not do for me,\u201d she wrote.</p>\n\n<p>Mayersohn\u2019s secretary confirmed receipt on Jan. 31 but cautioned that, due to a significant backlog, it would take time to resolve her guardianship.</p>", "summary_detail": {"type": "text/html", "language": null, "base": "https://www.propublica.org/feeds/propublica/main", "value": "<p class=\"byline\">\n                by <span class=\"name\">Jake Pearson</span>, illustrations by <span class=\"name\">Dominic Bodden</span>, special to <a href=\"https://www.propublica.org\">ProPublica</a>                </p>\n                                             \n\n                                                                    \n            \n                <p>ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive <a href=\"https://www.propublica.org/newsletters/the-big-story?source=54G&amp;placement=top-note&amp;region=national\">our biggest stories</a> as soon as they\u2019re published.</p>\n\n            \n\n                \n\n      \n  \n\n\n\n                    \n<p>The temperature was plummeting on Thanksgiving eve when Judith Zbiegniewicz wrapped herself in a blanket, picked up her phone and tapped out yet another plea for help to New York Guardianship Services. It was 2018, and for the previous five years the company, whose slogan is \u201ccaring that makes a difference,\u201d had overseen nearly every major decision in her life, as it did for hundreds of New Yorkers deemed incapable by the courts of looking after themselves. </p>\n\n<p>The organization had repeatedly maintained in court filings that Zbiegniewicz, who was 65 and suffered from depression and anxiety, was doing well under its supervision and that the Queens apartment it had placed her in was the \u201cbest and only place for her.\u201d Each year, court examiners reviewed the reports and a judge signed off on their assessments. </p>\n\n<p>In truth, though, Zbiegniewicz lived in squalor on the second floor of a dilapidated home whose roof had partially collapsed. She\u2019d complained when her mattress teemed with bedbugs and when rats gnawed the legs of her kitchen chairs. Yet every month, her legally appointed guardian had taken $450 in compensation from her bank account as her living conditions deteriorated.</p>\n\n<p>Now, with no heat and a cold front barreling down on the city, she stuffed bath towels under a door to block the draft and again appealed to NYGS.</p>\n\n<p>\u201cWhile you and every one at the guardianship are home in a warm house and having Thanksgiving dinner think of me. In a apartment without heat and can\u2019t,cook. And rats in the kitchen,\u201d she wrote on the evening of Nov. 21, 2018. \u201cSo much for where caring makes a difference.\u201d</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n    \n\n        \n    \n                    \n<p>Three decades ago, New York was at the vanguard of a national movement to prevent such exploitation. State lawmakers passed progressive legislation to codify wards\u2019 civil rights and maximize their independence. Under the law, guardianships were supposed to be tailored to the needs of the individual, with regular court examination to safeguard their welfare. </p>\n\n<p>But today, the system is in shambles, leaving thousands of vulnerable New Yorkers sequestered, voiceless and forgotten while the officials who oversee their care struggle to ensure it, according to a ProPublica investigation. In New York City, there are just over a dozen judges to handle the 17,411 people in guardianships, data provided by the courts show. With that load, cases can sit for years without any kind of meaningful oversight. The hardest hit are poor New Yorkers like Zbiegniewicz, whom the state has entrusted to a network of loosely regulated nonprofits. The outcomes for some of these individuals \u2014 known in industry parlance as the \u201cunbefriended,\u201d because they have no family or anyone else to help them \u2014 have been dire.</p>\n\n<p>In one case, a guardian didn\u2019t notice his ward had died and continued to collect payments for the man\u2019s care even after his death. In another, a guardian told the court in a report that they didn\u2019t know where their ward was for a year. Case managers had visited her apartment but never went in. Eventually a utility worker discovered the woman\u2019s corpse, covered in maggots, decomposing in her own bed.</p>\n\n<p>That the 1990s reforms have failed has been an open secret for years among advocates, lawyers and judges, who have repeatedly called for an overhaul. But the state lawmakers and judicial leaders who have the power to improve it have not done so \u2014 even as <a href=\"https://www.propublica.org/article/the-investigative-reporting-behind-americas-obsession-with-britney-spears-conservatorship\">cases like that of Britney Spears</a> have brought national attention to the issue of guardianships. </p>\n\n<p>ProPublica reviewed hundreds of pages of court records, interviewed dozens of lawyers and experts and talked to the wards who are least equipped to advocate for themselves. What we found is that some of the remedies that policymakers introduced 30 years ago to bolster care and curb abuse, like minimum qualifications for guardians and court examination of their reports, are in dire need of an upgrade. </p>\n\n<p>Today, for example, it is far easier in New York to become a guardian than a nail technician. Parties need only complete a day-long course \u2014 far less training than is required in <a href=\"https://guardianshipcert.org/become-certified/state-specific-information/\">some other states</a>, including California, Texas and Florida. And oversight of their work is similarly threadbare, consisting primarily of a court-appointed examiner who focuses almost exclusively on financial paperwork and a judge who signs off on the examination. But with thin ranks of reviewers, annual assessments can take years to complete. And officials rarely, if ever, see the wards in person.</p>\n\n<p>The easy entry and lack of oversight, critics say, has helped attract unscrupulous nonprofits that take advantage of the wards they are supposed to protect.</p>\n\n<p>In 2015, the chief financial officer of one nonprofit was convicted for stealing more than $50,000 from a ward\u2019s accounts, government documents show. That same year, state regulators found that another nonprofit improperly loaned its top officials more than $250,000 while wards were unnecessarily kept in nursing homes.</p>\n\n<p>Today, even those who helped write the state\u2019s main guardianship statute, known as Article 81 of the Mental Hygiene Law, concede the yawning gap between its promise and its practice has rendered it, in the words of one, \u201cbasically pointless.\u201d</p>\n\n<p>\u201cKeeping people out of guardianship in the first place is the single most important thing to do, because once you\u2019re in it, it\u2019s the toilet you get flushed down,\u201d said Kristin Booth Glen, a former judge who helped craft the law and has called for reform for years. New York\u2019s oversight of guardianships has been \u201ca total and utter disaster,\u201d she said. </p>\n\n<p>Few groups illustrate the consequences of that failure better than NYGS, the organization that was supposed to care for Zbiegniewicz. Over the past decade, the company has grown to become one of the largest providers in the business, drawing $450 in monthly compensation each from hundreds of wards\u2019 accounts while providing as few services as possible, according to court documents and six people familiar with the company\u2019s operations, including former employees. </p>\n\n<p>\u201cEverybody is shirking responsibility,\u201d said Carla Billini, the former director of case management for NYGS. She resigned last April after a decade in the job, saying she was fearful that the company\u2019s practices would result in harm to wards. \u201cHow is there nobody above the guardian who watches all the guardians?\u201d </p>\n\n<p>A spokesperson for the Office of Court Administration, which runs New York\u2019s court system, said that judges face \u201cextremely challenging circumstances\u201d but do the best they can under the law. \u201cThe caseloads are extremely high and individual cases can persist for decades,\u201d he said. \u201cYet, the courts never give up in searching for solutions to ensure the well-being of some of society\u2019s most underserved populations.\u201d</p>\n\n<p>NYGS executives declined to be interviewed for this story. In a statement, Sam Blau, the company\u2019s chief financial officer, said that as a fiduciary he was barred from answering questions \u201cabout any specific client.\u201d However, he noted, \u201cwe are accountable to the Court and our annual accounts and reports are scrutinized by Court appointed examiners and any issues would be addressed.\u201d NYGS did not answer written questions about the company\u2019s broader business practices.</p>\n\n<p>In his statement, Blau called ProPublica\u2019s reporting \u201cmisguided, without full and proper context, filled with omissions and less than accurate information.\u201d But when asked to specify his concerns, he did not respond.</p>\n\n<p>Zbiegniewicz\u2019s decadelong experience as a NYGS ward serves as a road map to how Article 81 fails New Yorkers who are least able to protect themselves.</p>\n\n\u201cSomebody\u2019s Going to Come Help Me\u201d\n<p>Zbiegniewicz\u2019s introduction to guardianship came as it does for thousands of others in the city each year: through a call to the city Adult Protective Services program by someone concerned about her well-being.</p>\n\n<p>It was November 2008, and Zbiegniewicz was struggling financially and emotionally. Her father had died suddenly from a heart attack a year and a half earlier, leaving her the family\u2019s Maspeth, Queens, home \u2014 and, to her surprise, a reverse mortgage. The outstanding debt was $266,532.95.</p>\n\n<p>Zbiegniewicz had no job and no way to pay. She had been dependent on her father all of her adult life, the result of an early trauma: At 18, she was raped leaving the subway on her way to work at Queens\u2019 Welbilt Stove plant. Her world became small, as her devastated parents shielded her. She never sought therapy, never returned to work and rarely ventured beyond the comfort of her block. </p>\n\n<p>Now, with the house in foreclosure, someone called the city to check on her. Adult Protective Services soon sent a psychiatric nurse practitioner, who diagnosed Zbiegniewicz with depression, anxiety and a dependent personality disorder. In a court petition, the city noted that she relied on food stamps and public assistance. With bills piling up, she had just $459.88 in her bank account. </p>\n\n<p>So on a January day in 2010, to help Zbiegniewicz stave off eviction, a city lawyer walked into a wood-paneled courtroom in the state Supreme Court building in Queens and asked a judge to declare her an \u201cincapacitated person\u201d in need of a guardian to manage her finances and housing.</p>\n\n<p>Zbiegniewicz, who declined to attend the hearing, initially welcomed the move. \u201cI was in no condition right then and there,\u201d she said. \u201cI was all alone, no direction, no nothing. I thought, \u2018OK, somebody\u2019s going to come help me get focused and leave.\u2019\u201d</p>\n\n<p>The judge granted the city\u2019s request, setting in motion Zbiegniewicz\u2019s spiraling journey into New York\u2019s overloaded guardianship system, which now contains 28,619 people statewide, more than 60% of whom live in New York City. In most cases, a judge selects either a so-called lay guardian \u2014 family or friends who volunteer \u2014 or a professional guardian, usually a lawyer, which can be pricey. For the thousands of New Yorkers like Zbiegniewicz, who have no family and too little money to be worth a professional guardian\u2019s time, a judge will choose from just under a dozen nonprofit groups, depending on the circumstances. In cases where Adult Protective Services is involved, that means one of three publicly-funded organizations.</p>\n\n<p>In Zbiegniewicz\u2019s case, the judge initially appointed the Jewish Association for Services for the Aged. Its mandate was narrow: stopping her eviction.</p>\n\n<p>The guardian negotiated the sale of Zbiegniewicz\u2019s family home, paid off the reverse mortgage and secured $92,000 for her in the deal. Once the money was placed in a special needs trust, JASA\u2019s mission was complete. The judge then turned to the list of professional guardians to help Zbiegniewicz find new housing.</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n    \n\n        \n    \n                    \n<p>But the task was a challenge. Zbiegniewicz insisted on keeping her five beloved schnauzers and living with four longtime friends who\u2019d supported her after her father\u2019s death. The arrangement made her a tough tenant to place, and by July 2013 she\u2019d faced eviction from two separate apartments where she had withheld rent until repairs were made. </p>\n\n<p>Before long, Zbiegniewicz\u2019s professional guardian wanted out. </p>\n\n<p>Like many private attorneys in the system, she was working the case pro bono, and her petition to be replaced reflected a larger strain in New York\u2019s system, which has long relied on such goodwill to handle guardianships of the indigent.</p>\n\n<p>Private lawyers have \u201cstopped taking cases in droves because they don\u2019t want to spend the time,\u201d Arthur Diamond, the former supervising guardianship judge in Nassau County, told state lawmakers in 2018. \u201cAnd it can be an immense amount of time being a guardian for somebody who has Alzheimer\u2019s and dementia, which many of our wards do.\u201d</p>\n\n<p>NYGS pitched itself explicitly to the courts as a solution to this problem. A lawyer for the group once wrote to a Queens judge in a letter obtained by ProPublica that the company \u201chopes to fill a need in the court system\u201d by taking those cases in which a judge would otherwise have \u201ca difficult time finding a suitable guardian willing to act.\u201d </p>\n\n<p>In a July 2013 hearing, Zbiegniewicz\u2019s private guardian suggested NYGS take over her case because \u201cthey seem to have a significant amount of resources.\u201d</p>\n\n<p>Supreme Court Justice Lee Mayersohn OKed the switch, making NYGS the third guardian to handle Zbiegniewicz\u2019s case in three and a half years.</p>\n\nExploding Caseloads, Little Vetting\n<p>The guardianship bill state lawmakers passed in the early 1990s established the first training requirements for guardians before they can serve \u2014 generally a daylong class meant to ensure they have a baseline familiarity with Article 81\u2019s requirements. That\u2019s less stringent than what the state requires of prospective nail technicians, who must complete a 250-hour course and pass tests. This low barrier to entry can allow a family member who steps up to help a loved one in crisis quickly get in place. But advocates say that New York\u2019s permissiveness also enables exploitative actors to enter the guardianship business. </p>\n\n<p>At the time of NYGS\u2019 founding, Blau was working as the director of judicial compliance at another guardianship firm, according to his LinkedIn profile. The state attorney general\u2019s office investigated that group, Integral Guardianship Services, during Blau\u2019s tenure, and eventually accused it of abandoning its most basic duties, including filing annual reports detailing wards\u2019 finances. (Blau wasn\u2019t named in the probe, which the group settled. The firm shuttered its operations last spring.)</p>\n\n<p>NYGS\u2019 chief operating officer \u2014 Blau\u2019s older brother David \u2014 had been running an unrelated e-commerce business, selling discounted travel coupons, according to former employees.</p>\n\n<p>Once certified, private guardians are required to attest that they haven\u2019t been found to have violated any criminal, civil or professional rules. Nonprofits, however, undergo no such vetting. In fact, they are not even required to provide proof of their charitable status.</p>\n\n<p>Had there been such a requirement, the courts would have seen that NYGS is not registered as a charity with the state attorney general\u2019s office nor does it have tax-exempt status from the Internal Revenue Service, both agencies confirmed. Nevertheless, the company repeatedly represented itself as a nonprofit in its court filings and promotional material as it took on more and more cases, including Zbiegniewicz\u2019s.</p>\n\n<p>The distinction is significant. Nonprofits are exempt from court rules that cap the number of cases and the amount of compensation guardians can receive annually. Such operations can be lucrative. One estimate commissioned by the state attorney general in 2016 projected that a nonprofit guardian serving 400 low-and-no-fee wards could generate $1.2 million per year.</p>\n\n<p>Sam Blau declined to answer questions about the company\u2019s tax status, but said in a statement that \u201ca large percentage of our cases are done completely Pro Bono,\u201d which \u201cis certainly in line with our mission to help people of minimal financial means.\u201d</p>\n\n<p>In pitching the firm to the court, NYGS\u2019 lawyer painted a picture of an organization with a \u201ccadre of knowledgeable and caring individuals\u201d experienced in guardianships who used \u201cstate of the art records management technology.\u201d</p>\n\n<p>In reality, the Blau brothers operated out of a cramped second-floor office on Avenue J in Midwood, Brooklyn, that was strewn with stacks of government forms, old checkbooks and financial statements. For years, employee chats show, the cremated remains of a ward sat in a plastic bag on the shelf of a hallway closet, nestled in a plain white container the size of a shoe box. The \u201cstate of the art\u201d technology it used to manage its caseload were actually Dropbox and Google Docs, former employees said.</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            David Blau\n    \n    \n    \n    \n\n    \n\n        \n    \n                    \n<p>NYGS\u2019s business grew rapidly by taking on dozens of new cases annually \u2014 a strategy that former employees said was intended to maximize profit on the $450 per month apiece it earned from most of its wards. But staffing didn\u2019t keep pace with volume, and workers realized that in order to do the job well, the firm needed to take fewer cases and throw significant resources at the ones it already had.</p>\n\n<p>That didn\u2019t happen.</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            Sam Blau\n    \n    \n    \n    \n\n    \n\n        \n    \n                    \n<p>In 2016, when the company had 167 clients, it employed two full-time case managers, internal records show. That was true the following year when the total caseload jumped to 248 and remained the case the year after that, when NYGS was responsible for nearly 300 wards. Two more employees were hired in 2018 to handle wards\u2019 finances. Several studies, as well as states including Virginia and Colorado, <a href=\"https://www2.stetson.edu/law-review/article/wards-of-the-state-a-national-study-of-public-guardianship/\">recommend a 20-client limit</a> to ensure proper care. New York, however, has no equivalent guidance, and at one point NYGS had 83 wards per staffer, according to internal records.</p>\n\n<p>More recently, former employees said, the company outsourced key jobs to workers in the Philippines who were expected to address the complicated insurance, banking and health care needs of vulnerable wards from 8,500 miles away. One worker told ProPublica that she was so troubled by the lack of resources and ceaseless calls \u2014 she was responsible for dozens of wards every day \u2014 that she quit after six months.</p>\n\n<p>For years, unless judges specifically asked, they had no way to know whether nonprofits they assigned actually had the bandwidth to take on new cases. It wasn\u2019t until last fall that the state court system, using a federal grant, <a href=\"https://acl.gov/news-and-events/announcements/new-elder-justice-grants-address-aps-training-guardianship-aps\">created a database</a> so that judges and court staff can \u201cbetter oversee the flow and nature and structure of guardianship cases,\u201d the courts\u2019 spokesperson said. </p>\n\n<p>Within NYGS, complaints about the conditions, the lack of resources or a ward\u2019s specific problems were usually met with silence, said Billini, the former director of case management. Sam Blau would just \u201cstare into his computer when you\u2019d tell him something he didn\u2019t want to hear,\u201d she said. \u201cWe called it the passive-aggressive stare.\u201d</p>\n\n<p>The former case manager, as well as other workers, said this dynamic would play out time and again after NYGS moved Zbiegniewicz into the upstairs apartment of 150-15 Yates Road, a two-family home in a dangerous section of Jamaica, Queens. It was seven miles and a world away from the spacious Maspeth house where she\u2019d lived most of her life.</p>\n\n<p>Blau did not respond to questions about Billini\u2019s account. In a general statement, he disputed ProPublica\u2019s reporting, which he claimed was based on \u201cdisgruntled former employees who have a clear biased agenda.\u201d</p>\n\nBedbugs, Rats \u2014 No Questions Asked\n<p>Zbiegniewicz suspected something was amiss with her guardian from the start. </p>\n\n<p>Shortly after moving into the Yates Road apartment, she discovered bedbugs. She said she complained to NYGS immediately, but it took three months before the company sent pest control. The disruption caused her therapist to cancel weekly sessions until an exterminator certified the insects were gone, Zbiegniewicz said. </p>\n\n<p>\u201cI was tore up from the floor up,\u201d she recalled of the bites.</p>\n\n<p>In its filings to the court, however, NYGS presented Zbiegniewicz as thriving. In language that would repeat year after year, a company social worker who visited the home wrote that \u201cMs. Zbiegniewicz is oriented to person, place, and time,\u201d described the frequency of her therapy sessions and the medications she took, adding that she \u201cenjoys gardening and taking care of her dogs and roommates.\u201d </p>\n\n<p>To ensure the integrity of such reports, the system includes a layer of protection for wards in the form of court-appointed examiners. By law, these individuals \u2014 typically lawyers or accountants \u2014 are tasked with reviewing guardians\u2019 reports to \u201cdetermine the condition and care\u201d and finances of the ward, as well as \u201cthe manner in which the guardian has carried out his or her duties and exercised his or her powers.\u201d In practice, the scrutiny can be far from robust.</p>\n\n<p>Today, there are just 157 examiners responsible for reviewing the reports of 17,411 New York City wards, according to data from the court system. And their training can be minimal. In Brooklyn, Queens and Staten Island, this includes viewing a set of instructional DVDs that were recorded 12 years ago. </p>\n\n<p>Like the cost of the guardianship itself, the price for these examinations is borne by the ward.</p>\n\n<p>Zbiegniewicz paid a few hundred dollars each year for an examiner\u2019s reviews. But her records show these examiners did not interrogate spending that indicated potential housing problems.</p>\n\n<p>In 2014, for example, Zbiegniewicz\u2019s account listed four separate disbursements \u2014 totaling $1,251 \u2014 for extermination, laundry and cleaning services, all explicitly labeled as bedbug remedies. Yet when the examiner asked whether the housing was \u201cbest suited\u201d to Zbiegniewicz\u2019s needs, NYGS said it was \u201cappropriate.\u201d There\u2019s no indication in the file that the examiner at the time, Paul Guttenberg, pressed any further or followed up on the extermination expenses. Guttenberg, who declined to be interviewed and didn\u2019t respond to emailed questions, approved NYGS\u2019 report.</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n    \n\n        \n    \n                    \n<p>The subsequent examiner of Zbiegniewicz\u2019s case, Janet Brown, was similarly uncritical. Court data show she carried a significant caseload. Zbiegniewicz was just one of 44 new cases Brown picked up in 2015 alone \u2014 a pace that would continue throughout the guardianship. Each year, after reconciling the financials, she signed off on NYGS\u2019 reports, including those that showed Zbiegniewicz paying to address more problems a landlord would typically be expected to cover: $180 for electrical work in January 2018, then $30 more for an electric stove that May and $50 for a heater in December. </p>\n\n<p>That year, when Brown asked whether Zbiegniewicz\u2019s apartment was \u201cbest suited to her current needs,\u201d an NYGS employee responded, \u201cIt is not the ideal placement, but currently it is the best &amp; <em>only</em> placement\u201d for her.</p>\n\n<p>The employee provided no further explanation in the filing, and there is no indication in the court record that Brown asked for one.</p>\n\n<p>Meanwhile, the conditions in the apartment steadily worsened, according to emails, court filings and interviews with four other people who spent time there.</p>\n\n<p>\u201cNow the rats are eating the kitchen chairs,\u201d Zbiegniewicz wrote to NYGS in a March 2019 email. \u201cBy the time I leave I will not have anything to take.\u201d</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n    \n\n        \n    \n                    \n<p>That year, the guardianship reported spending $280 of Zbiegniewicz\u2019s money for \u201cstorage containers and pest Control,\u201d as well as \u201creimbursement for Extermination and Bathroom Repair.\u201d </p>\n\n<p>There is no indication in the court records that Brown even examined these 2019 expenses. While Article 81 requires guardians to file wards\u2019 annual accounts by May of the following year, there is no such deadline for examiners. Zbiegniewicz\u2019s file is still missing reviews for four years of her guardianship.</p>\n\n<p>In an interview, Brown said that her job was to \u201cmake sure the dollar amounts balance out\u201d and that funds were not \u201cbeing misused.\u201d By those standards, there were no disbursements in the annual reports that \u201craised an eyebrow,\u201d she said. She said she wasn\u2019t aware of the chronic heating problems, the collapsed roof or the pest infestations in the Yates Road apartment, despite the expenditures for extermination and various capital improvements in the reports she reviewed.</p>\n\n<p>\u201cI would have had no way of knowing that unless someone directly reached out to me and said, \u2018Hey, this is a problem,\u2019\u201d she said. </p>\n\n<p>Brown didn\u2019t respond when asked why she didn\u2019t file her reviews for 2019 through 2022.  </p>\n\n<p>Zbiegniewicz said that for years she had no idea that she could take her complaints to the examiner. When she finally did phone, she said, Brown conferenced in a NYGS employee and left the call.</p>\n\n<p>Brown, who is no longer an examiner, said she didn\u2019t recall that conversation, but that she remembered Zbiegniewicz was vocal about her desire to be released from the guardianship. Brown said that she believed she discussed that with someone at NYGS but she couldn\u2019t recall with whom or what was said.</p>\n\n<p>\u201cI do genuinely care,\u201d she said, \u201ceven if you don\u2019t think so.\u201d</p>\n\n<p>Experts said the failure to conduct face-to-face check-ins could hide horrific situations. Judicial leaders, they said, can and should bolster examinations with home visits. For example, in Davidson County, Tennessee, which includes Nashville, social services workers visit wards, review their medical records and interview guardians and their doctors.</p>\n\n<p>\u201cYou\u2019ve got to visit the person,\u201d said Booth Glen, the former judge who helped write Article 81. \u201cPaper is not enough when human lives are at stake.\u201d</p>\n\nWith Judges, \u201cThings Just Get Locked In\u201d\n<p>Examiners are the main check on guardians, but judges also review examiners\u2019 reports before signing off. </p>\n\n<p>Zbiegniewicz believed that if Mayersohn understood how dire her living conditions were, he would require NYGS to fix the situation. The son of a state assemblymember, he started his career as a legislative aide and practiced law for nearly two decades, focusing on trusts and estates, among other civil matters, before being elected to the bench in 2004.</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            Judge Lee Mayersohn\n    \n    \n    \n    \n\n    \n\n        \n    \n                    \n<p>What Zbiegniewicz didn\u2019t know was how long it could take for information to get to the judge \u2014 and how long it could take him to review it. She is just one of 1,566 open guardianship cases currently on the judge\u2019s docket, according to court data. Such a robust caseload, coupled with too few examiners, can add years to the oversight process, creating dangerous gaps in information in cases like Zbiegniewicz\u2019s. </p>\n\n<p>For example, in the spring of 2018, NYGS submitted its guardianship report for the prior year, as required by law. The paperwork contained numerous indications that something was wrong at Yates Road. Notably, no rent payments were listed for the apartment and the company acknowledged for the first time that the house was \u201cnot the ideal placement\u201d for Zbiegniewicz. </p>\n\n<p>But a full year passed before the examiner filed her review with the court, where it was eventually checked by clerks and then passed to Mayersohn for approval. In all, the entire process took more than two years. None of the parties raised alarms over, or even noted, the missing rent payments.</p>\n\n<p>Had they dug deeper, they would have found that Yates Road had gone through a foreclosure and been sold to a bank that was moving to evict Zbiegniewicz and her friends. It\u2019s unclear who actually owned the house when NYGS moved her there; the deed had changed hands multiple times in quick succession. During Zbiegniewicz\u2019s first two years in the house, the guardian had sent $32,000 of its ward\u2019s money to a firm run by a Queens entrepreneur who was later convicted of real estate fraud in an unrelated case. When the eviction notice arrived, NYGS stopped paying the rent but appeared to do little else.</p>\n\n<p>\u201cPhone calls to the guardian in an attempt to work out some sort of reasonable solution have failed since the guardian has refused to respond to any call,\u201d an attorney for the new landlord wrote in a December 2017 court filing. The company eventually hired a lawyer to respond to the landlord-tenant action.</p>\n\n<p>For more than two years, while the official reports on Zbiegniewicz\u2019s welfare crawled through the court system, NYGS kept her in the home. </p>\n\n<p>During that time, she endured all manner of horrendous living conditions. According to her emails to NYGS, she went long stretches without heat and rats ate holes through her clothes. When the apartment lost power, she and her roommates had to jury-rig the breaker box with a popsicle stick to feed electricity upstairs. </p>\n\n<p>\u201cYou have to get in contact with someone,\u201d she wrote to NYGS on Jan. 20, 2018, when her refrigerator lost power. \u201cWe are running extension cord from the basement to up stairs. We are hungry did not eat yesterday.\u201d</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n    \n\n        \n    \n                    \n<p>When NYGS failed to act, Zbiegniewicz and her roommates complained to the city, triggering visits from building inspectors, who documented no running hot water and failure to supply adequate heat. That prompted the Department of Housing Preservation and Development to sue the new owner, who agreed to pay fines to settle the lawsuit.</p>\n\n<p>It\u2019s not clear just how much Mayersohn knew about these cases. The siloed nature of New York\u2019s sprawling courts can leave guardianship judges in the dark about significant developments elsewhere in the legal system. That makes the guardian's report \u2014 and the examiner's review \u2014 even more critical for guardianship judges. But neither NYGS nor Zbiegniewicz\u2019s examiner mentioned the escalating legal actions in their reports. </p>\n\n<p>Mayersohn declined to be interviewed, saying judicial ethics opinions barred him from commenting on \u201cany pending case in any jurisdiction,\u201d and he didn't respond to detailed written questions about his handling of Zbiegniewicz\u2019s case.</p>\n\n<p>Within NYGS, staffers were growing increasingly concerned for Zbiegniewicz\u2019s well-being and passed complaints along to David and Sam Blau, said Billini, the firm\u2019s former case manager. A nurse practitioner for the company confirmed the deplorable conditions on her quarterly visits to the house and reported back to NYGS.</p>\n\n<p>\u201cClient remains angry and frustrated over her living conditions \u2014 roaches, mice and rats,\u201d the nurse wrote in notes submitted to the guardianship in February 2019. \u201cThere is mold \u2014 breathing unhealthy. Would like things to move along.\u201d </p>\n\n<p>And yet, nothing changed, Zbiegniewicz said. (The Blaus did not respond to requests for comment on these claims.)</p>\n\n<p>So in 2019, she started calling Mayersohn\u2019s chambers. She phoned so frequently, she said, that the judge\u2019s secretary knew her case number by heart. But the judge never talked to her when she called, she said. Like the examiner, the secretary sent Zbiegniewicz\u2019s complaints back to the guardianship. </p>\n\n<p>\"Once a guardian is appointed, the court\u2019s tendency is to just work with the guardian,\u201d said Joe Rosenberg, who co-directs the CUNY School of Law\u2019s Disability and Aging Justice Clinic. \u201cI think it\u2019s tough to get out of that cycle. And perhaps that\u2019s in part because it\u2019s hard to find another guardian. Things just get locked in.\u201d</p>\n\n<p>The demand for guardians is particularly great among elderly New Yorkers \u201cwho are alone, with no one to help, and few or no resources,\u201d the Vera Institute of Justice, a legal reform nonprofit, <a href=\"https://www.vera.org/downloads/publications/incapacitated-indigent-and-alone-guardianship-new-york.pdf\">reported in 2018</a>. And so groups like NYGS fulfill the court\u2019s \u201cgreatest need,\u201d said acting state Supreme Court Justice Charles Troia during a panel discussion on guardianships in 2021. \u201cWe need agencies that are willing to help those that truly have nothing.\u201d</p>\n\n<p>Other judges, the courts\u2019 spokesperson said, have advocated for structural changes, including replacing nonprofits with \u201ca statewide, state-supported public guardian program for indigent persons.\u201d </p>\n\n<p>But for now, without such an agency to serve poor wards with considerable needs, judges have few other options.</p>\n\n<p>Zbiegniewicz was better able to advocate for herself than wards who have severe health problems, but even she worried that her persistent complaints may have hurt her cause. She said she got the feeling that the judge and lawyers and court staff believed she was unstable and therefore easy to dismiss. \u201cIt used to drive me up a wall,\u201d she said of the Article 81 designation attached to her name. \u201cThat is a badge saying that I'm cuckoo.\u201d</p>\n\n\u201cThis Is My Life and I Want It Back\u201d\n<p>After years of turmoil, David Blau notified the court in May 2019 that he had negotiated a resolution to Zbiegniewicz\u2019s five-year-plus housing crisis: The bank would pay her $5,000 to leave Yates Road and NYGS would, in turn, place her in an assisted living facility.</p>\n\n<p>Zbiegniewicz \u201csuffers from a debilitating anxiety disorder and requires assistance with her finances,\u201d Blau asserted in a court petition. The conditions, he argued, necessitated a higher level of care. Billini and other staffers inside NYGS disagreed. Zbiegniewicz and her court-appointed attorney did too.  </p>\n\n<p>In a June 2019 filing opposing David Blau\u2019s petition, the attorney informed the court that Zbiegniewcz had already moved out of Yates Road on her own. That month she\u2019d married her longtime friend Leonard Hubbard, and the couple were living together in a city shelter.</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n    \n\n        \n    \n                    \n<p>Nevertheless, Mayersohn ordered Zbiegniewicz to find proper housing and ordered NYGS to \u201csupport\u201d her in that endeavor. But again, Zbiegniewicz said, the company failed her. She needed her financial records to apply for subsidized housing, but she said NYGS responded slowly to her requests or not at all. She managed to get the records on her own and worked with a social worker at the shelter to secure a new home, she said.</p>\n\n<p>\u201cI need to be in control of my own life and I can\u2019t wait on you to do something, to give me paperwork, to give me this, or anything,\u201d she told David Blau in an Oct. 29, 2020, voicemail. \u201cThis is my life and I want it back. Thank you.\u201d</p>\n        \n    \n                        \n\n        \n            Listen to Zbiegniewicz\u2019s Voice Message\n                <p>On Oct. 29, 2020, Zbiegniewicz left this voicemail begging David Blau to release her from her guardianship.</p>\n\n    \n\n        \n        \n        \n\n\n    \n        \n    \n                    \n<p>Zbiegniewicz said she never heard back after leaving that message. And because the pandemic shuttered the courts, there were no appearances in her case for more than two years. She was in legal limbo, without any kind of oversight. </p>\n\n<p>\u201cThese people do not care about you,\u201d Zbiegniewicz said.</p>\n\n<p>Eventually, she secured a one-bedroom apartment for herself, Hubbard and their new dog, Bogart, in a Long Island City building overlooking the East River for $905 a month. With a housing voucher and public benefits covering two-thirds of the rent, it\u2019s far cheaper than the $1,350 she shelled out each month to live on Yates Road. Ironically, because of an oversight by NYGS, she was able to access her bank account to help pay rent.</p>\n\n<p>Mayersohn finally released Zbiegniewicz from the guardianship in February 2022. In NYGS\u2019 final report, the company disclosed taking $12,551 to cover \u201cunpaid monthly compensation\u201d for the nearly two and a half years she had effectively lived outside the guardianship. The lump sum payment brought the balance of Zbiegniewicz\u2019s accounts to zero.</p>\n\n<p>To date, nobody involved in her case \u2014 from NYGS to the examiners who approved the company\u2019s reports \u2014 has been held to account. But there is still time for the judge to consider their actions. </p>\n\n<p>Because NYGS failed to file the required paperwork to settle Zbiegniewicz\u2019s account, her case technically remains open. A lawyer for NYGS finally filed that motion in January \u2014 two days after ProPublica first contacted the organization for comment on this story. The paperwork now awaits Mayersohn\u2019s signature. </p>\n\n<p>In January, Zbiegniewicz sent a letter to Mayersohn, describing the \u201cinjustice and mistreatment\u201d she said she\u2019d endured.</p>\n\n<p>\u201cAll I would like is to be heard and for New York Guardianship Services to be held accountable for what they did and did not do for me,\u201d she wrote.</p>\n\n<p>Mayersohn\u2019s secretary confirmed receipt on Jan. 31 but cautioned that, due to a significant backlog, it would take time to resolve her guardianship.</p>"}, "tags": [], "updated": "2024-03-07T06:00:00-05:00", "updated_parsed": [2024, 3, 7, 11, 0, 0, 3, 67, 0], "authors": [{"name": "by Jake Pearson, illustrations by Dominic Bodden, special to ProPublica"}], "author": "by Jake Pearson, illustrations by Dominic Bodden, special to ProPublica", "author_detail": {"name": "by Jake Pearson, illustrations by Dominic Bodden, special to ProPublica"}}, {"title": "Massachusetts\u2019 Highly Touted Push to \u201cSignificantly Reduce\u201d Affordable Housing Vacancies Barely Made a Dent", "title_detail": {"type": "text/plain", "language": null, "base": "https://www.propublica.org/feeds/propublica/main", "value": "Massachusetts\u2019 Highly Touted Push to \u201cSignificantly Reduce\u201d Affordable Housing Vacancies Barely Made a Dent"}, "links": [{"rel": "alternate", "type": "text/html", "href": "https://www.propublica.org/article/massachusetts-affordable-housing-vacancies"}], "link": "https://www.propublica.org/article/massachusetts-affordable-housing-vacancies", "published": "Thu, 07 Mar 2024 05:00:00 -0500", "published_parsed": [2024, 3, 7, 10, 0, 0, 3, 67, 0], "id": "https://www.propublica.org/article/massachusetts-affordable-housing-vacancies", "guidislink": false, "summary": "<p class=\"byline\">\n                by <span class=\"name\">Todd Wallack</span>, <a href=\"https://www.wbur.org\">WBUR</a>                </p>\n                                             \n\n        \n                        <p>ProPublica is a nonprofit newsroom that investigates abuses of power. <a href=\"https://www.propublica.org/newsletters/dispatches\">Sign up for Dispatches</a>, a newsletter that spotlights wrongdoing around the country, to receive our stories in your inbox every week. This story was co-published with <a href=\"https://www.wbur.org/\">WBUR</a>.</p>\n\n        \n\n    \n      \n  \n\n\n\n                    \n<p>Every night, Graciella Carter puts her 5-year-old son to bed with the same routine. She tucks Oscar under some blankets, kisses and hugs him, and stays with him until he drifts off to sleep, no matter how long it takes.</p>\n\n<p>But nothing else is routine. They stay in a different place almost every night. The bed may be a sofa in a friend\u2019s or relative\u2019s living room anywhere in western Massachusetts. Carter usually has to sleep sitting up, at the end of the couch or on a nearby chair, leaning on her fist like a pillow. </p>\n\n<p>Carter and Oscar have been couch surfing since being evicted from their Holyoke apartment in October. She said she fell behind on the rent because she\u2019d been injured in a car accident and couldn\u2019t work for several months. Oscar had to give away his beloved dog, a poodle-Chihuahua mix named Luna. When friends didn\u2019t have room for both Carter and Oscar, she would sit by his side until he fell asleep and then spend the night in her car \u2014 until it was repossessed a month ago. Now she gets rides from friends or takes buses, hauling around a pair of laundry bags with their clothes and other necessities. </p>\n\n<p>\u201cIt\u2019s hard,\u201d she said recently while playing with Oscar in a small park in downtown Northampton, 20 miles north of Springfield. \u201cIt\u2019s just bouncing around.\u201d</p>\n\n<p>The 28-year-old, a high school graduate who has worked off and on as a certified nursing assistant, has been waiting for a state-subsidized apartment for nearly five years, since Oscar was a few months old. She has applied for state-funded housing in 11 cities and towns without getting a single placement, even though some of those communities have vacant family units.</p>\n        \n    \n                    \n<p>To the disappointment of the Carters and other families desperate for refuge from the winter cold, the state failed to achieve its goal, proclaimed last September, to <a href=\"https://www.propublica.org/article/massachusetts-push-fill-vacant-state-funded-apartments\">\u201csignificantly reduce\u201d vacancies in state-subsidized public housing</a> by Jan. 1. The \u201c90-day push\u201d followed an investigation by WBUR and ProPublica, which revealed that <a href=\"https://www.propublica.org/article/massachusetts-public-housing-units-vacant-despite-waitlists\">almost 2,300 state-funded units were vacant</a>, despite a waitlist of more than 180,000 people. The findings came as the number of homeless families increased sharply, prompting Gov. Maura Healey to declare a state of emergency, which remains in effect. </p>\n\n<p>Yet the 90-day initiative barely made a dent in the vacancy totals. According to the latest data available, the number of vacancies has dropped by only 72 since July. As of March 1, the figure stood at 2,219, with most of the decline occurring in the past two months after WBUR asked why the state hadn\u2019t made more progress. More than three-quarters of the vacant units have been unoccupied for at least 60 days, the deadline that the state gives local authorities to fill a unit. Apartments that remain empty beyond that time limit need a state waiver or the <a href=\"https://www.wbur.org/news/2023/12/28/massachusetts-public-housing-fines-waivers-empty-fees\">local authority may face fines</a>.</p>\n        \n            \n    \n    \n    \n                            \n\n    \n            Vacancies in Massachusetts\u2019 Public Housing Decreased by Only 72 Units Over Seven Months\n                <p>The state had pushed to \u201csignificantly reduce\u201d vacancies last fall, but it made little progress.</p>\n\n    \n\n                        \n                    \n                \n\n            Source: The Massachusetts Executive Office of Housing and Livable Communities\n    \n    \n    \n    \n\n    \n\n            \n        \n    \n                    \n<p>The state also has not fixed key problems that contribute to vacancies, WBUR and ProPublica found. It still doesn\u2019t screen applicants for eligibility when they first apply for housing, and it allows people to sign up in as many as 230 places, including towns too far away for them to realistically relocate to. Almost 13,300 candidates for priority status, which is largely reserved for people in dire need of housing due to situations like fires, domestic violence or a condo conversion, are still waiting for a vendor hired by the state to determine if they are eligible and potentially bump them up the list.</p>\n\n<p>In most states, low-income residents seeking affordable apartments rely on federal public housing or vouchers for private housing. Massachusetts has those options, but it\u2019s one of four states \u2014 the others are New York, Connecticut and Hawaii \u2014 that also offer state-funded public housing. The state\u2019s 41,500 subsidized apartments are in high demand because Massachusetts has some of the highest housing prices in the country. </p>\n\n<p>Until 2019, local housing agencies in Massachusetts were responsible for maintaining their own waitlists for the subsidized units. That year, the state created a central list with the aim of making it easier for people to find public housing. Instead, the system has become a bureaucratic quagmire.</p>\n\n<p>The waitlist \u201cis not going to get fixed with iterative steps,\u201d said John LaBella, president of HousingWorks, a Boston company that helps people find affordable housing. \u201cIt needs a fundamental redesign.\u201d </p>\n\n<p>All the communities where Carter has applied for state-subsidized apartments are in western Massachusetts, and she would be glad to live in any of them. Agawam, a Springfield suburb, has a pair of three-bedroom units that have been vacant since 2021, along with seven empty two-bedrooms that would be suitable for the Carters. But the waitlist functions so ineffectively that the Carters and many other families have yet to receive offers.</p>\n\n<p>When applicants reach the top of the list, Agawam\u2019s housing authority notifies them, then spends hours verifying their information and reviewing their criminal backgrounds, income and references. Ultimately, most of them don\u2019t respond, don\u2019t qualify, or decline to move to Agawam. On average, Agawam vets hundreds of applicants to fill one vacancy, said Maureen Cayer, director of the housing authority there. </p>\n\n<p>The continuing abundance of vacancies \u201cis a failure,\u201d Cayer said. \u201cIt\u2019s a failure for the state. It\u2019s a failure for the system. It\u2019s a failure for the housing authority.\u201d</p>\n        \n    \n                    \n<p>Kevin Sbardella, director of the Fall River housing authority, similarly blamed the state\u2019s centralized waitlist for the nearly two dozen empty units there. He said he wishes agencies could go back to using their own lists. \u201cIf I could just go local, I\u2019d fill my vacancies up in a week,\u201d he said. </p>\n\n<p>After WBUR asked in February about the failure to fill more vacancies, state officials made a new set of promises to local housing directors. Ben Stone, director of the state division of public housing and rental assistance, pledged to track vacancies better and provide extra funding to help agencies reduce high vacancy rates. In an email to local housing directors, Stone said the state aims to cut the vacancy rate almost in half, to 3%. That would mean reducing the number of vacant apartments by nearly 1,000. </p>\n\n<p>State housing officials didn\u2019t set a deadline to achieve the 3% mark. They told WBUR that it is a \u201clong-term\u201d objective, and that the medium-term goal is getting under 2,000 vacant units. They said they have been tracking the number of vacancies since 2016, and 2023 was the first year that it declined. \u201cI think we made a little bit of headway,\u201d Housing Secretary Ed Augustus said in an interview. </p>\n\n<p>Augustus said he was surprised to hear that local housing officials were complaining about the waitlist. He said they have told him the system has been working much better since the state hired an outside vendor last year to help screen applicants who requested priority to move up the waitlist.</p>\n\n<p>\u201cThey\u2019ve all told me they\u2019ve seen improvements,\u201d Augustus said. \u201cNot perfection. Not every bug has been taken out of the system, but marked improvements.\u201d</p>\n\n<p>The contractor handling the priority review has screened out far more applicants than it has approved. As part of a three-year, $3.3 million contract, Archipelago Strategies Group, a Boston marketing firm, is working its way through a backlog of 45,000 requests to move up the waitlist. So far, it has approved 640 completed applications and denied another 1,435, according to state housing officials. They said the firm has discarded more than 30,000 other applicants because they withdrew, did not respond to requests for more information, or were deceased or otherwise no longer eligible. Most of the applicants approved by Archipelago for priority are still waiting for housing offers, according to the state. </p>\n\n<p>Archipelago has sifted through more than two-thirds of the priority requests, and it is \u201chelping the most vulnerable applicants move forward as quickly and fairly as possible,\u201d said Josiane Martinez, the company\u2019s chief executive officer. \u201cOur centralized screening is saving housing authorities thousands of screening hours, which they can now use to finalize housing placements.\u201d </p>\n\n<p>One priority applicant Archipelago rejected was Carter, the homeless mother in western Massachusetts. One reason she gave for seeking priority was that her injuries made it difficult for her to climb the stairs to the second-floor apartment where she and Oscar had been living. \u201cYour documents show that the Primary Residence was not the impediment to your health,\u201d Archipelago wrote her on Oct. 12. Once she was evicted, she remained ineligible because nonpayment of rent is typically considered the tenant\u2019s fault. To receive priority, applicants must show they lost their housing through no fault of their own.</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            Carter has been waiting for a state-subsidized apartment since Oscar was just a few months old.\n    \n            (Jesse Costa/WBUR)\n    \n    \n    \n\n    \n\n        \n    \n                    \n<p>\u201cI have a 5-year-old, it\u2019s winter, how does that not make someone a priority?\u201d Carter said. \u201cI don\u2019t care about anything other than finding somewhere to stay.\u201d</p>\n\n<p>Waitlist woes aren\u2019t the only reason for vacancies. More than 100 apartments have been repurposed for uses such as offices, storage or laundry. Hundreds more need major renovation. Augustus said he\u2019s asked his team to make sure there are good reasons for taking such units offline. </p>\n\n<p>Last fall, Healey proposed a bond bill that includes $1.6 billion in funding for capital expenditures in public housing, more than double the previous allocation. The funds would help renovate hundreds of uninhabitable or rundown apartments. But the Legislature has yet to approve it. Augustus estimated that the state has \u201cover $1 billion worth of requests in the pipeline\u201d for public and private development from local housing authorities.</p>\n\n<p>One stalled project is in Fall River, where the state approved an $8 million grant in 2020 to rehab 40 apartments, about half of which are vacant. But the state has yet to sign off on final plans, so the authority can\u2019t seek bids or start construction. One unit has been empty for almost eight years. </p>\n\n<p>\u201cThat\u2019s been just moving at a snail\u2019s pace,\u201d said Sbardella, who runs the Fall River housing authority. </p>\n\n<p>A spokesperson for the state housing agency said it agreed to reimburse local housing authorities for $1.5 million in minor repairs and staff overtime during the state\u2019s push to fill vacancies last fall. But some local housing directors said the 90-day window for funding was too short for them to learn about the program, line up workers and win approval from their boards. </p>\n\n<p>\u201cI need a solid four to six months at least,\u201d said Paula Mountain, executive director of the housing authority in Wenham, 25 miles north of Boston. She was only able to take advantage of the offer for two months, she said.</p>\n\n<p>Cayer, in Agawam, said she didn\u2019t tap the money because her state liaison couldn\u2019t explain where it was coming from and what strings, if any, were attached. Stone told housing directors in February that the state plans to extend portions of the aid beyond 90 days.</p>\n        \n    \n                            \n    \n                    \n<p>Meanwhile, Carter and her son are still waiting and hoping to find a place to live. Although Carter has largely recovered from her car accident, she said she had to quit a recent job as a medical assistant because she didn\u2019t have reliable child care or a home to invite a sitter to. She\u2019s separated from Oscar\u2019s father, who is not currently providing any financial help, she said.</p>\n\n<p>In the Northampton park, she watched Oscar leap over a stump, then chased him across the wet grass and spun him around on a carousel.</p>\n\n<p>\u201cYou want to spin?\u201d she asked him. \u201cAre you sure? OK, tell me when you have a good grip. You ready?\u201d</p>\n\n<p>Oscar can\u2019t ride his bike or play with his toys at the park; his mother had to put them in storage. Instead, after playing with her and riding the carousel, he entertains himself by collecting sticks.</p>", "summary_detail": {"type": "text/html", "language": null, "base": "https://www.propublica.org/feeds/propublica/main", "value": "<p class=\"byline\">\n                by <span class=\"name\">Todd Wallack</span>, <a href=\"https://www.wbur.org\">WBUR</a>                </p>\n                                             \n\n        \n                        <p>ProPublica is a nonprofit newsroom that investigates abuses of power. <a href=\"https://www.propublica.org/newsletters/dispatches\">Sign up for Dispatches</a>, a newsletter that spotlights wrongdoing around the country, to receive our stories in your inbox every week. This story was co-published with <a href=\"https://www.wbur.org/\">WBUR</a>.</p>\n\n        \n\n    \n      \n  \n\n\n\n                    \n<p>Every night, Graciella Carter puts her 5-year-old son to bed with the same routine. She tucks Oscar under some blankets, kisses and hugs him, and stays with him until he drifts off to sleep, no matter how long it takes.</p>\n\n<p>But nothing else is routine. They stay in a different place almost every night. The bed may be a sofa in a friend\u2019s or relative\u2019s living room anywhere in western Massachusetts. Carter usually has to sleep sitting up, at the end of the couch or on a nearby chair, leaning on her fist like a pillow. </p>\n\n<p>Carter and Oscar have been couch surfing since being evicted from their Holyoke apartment in October. She said she fell behind on the rent because she\u2019d been injured in a car accident and couldn\u2019t work for several months. Oscar had to give away his beloved dog, a poodle-Chihuahua mix named Luna. When friends didn\u2019t have room for both Carter and Oscar, she would sit by his side until he fell asleep and then spend the night in her car \u2014 until it was repossessed a month ago. Now she gets rides from friends or takes buses, hauling around a pair of laundry bags with their clothes and other necessities. </p>\n\n<p>\u201cIt\u2019s hard,\u201d she said recently while playing with Oscar in a small park in downtown Northampton, 20 miles north of Springfield. \u201cIt\u2019s just bouncing around.\u201d</p>\n\n<p>The 28-year-old, a high school graduate who has worked off and on as a certified nursing assistant, has been waiting for a state-subsidized apartment for nearly five years, since Oscar was a few months old. She has applied for state-funded housing in 11 cities and towns without getting a single placement, even though some of those communities have vacant family units.</p>\n        \n    \n                    \n<p>To the disappointment of the Carters and other families desperate for refuge from the winter cold, the state failed to achieve its goal, proclaimed last September, to <a href=\"https://www.propublica.org/article/massachusetts-push-fill-vacant-state-funded-apartments\">\u201csignificantly reduce\u201d vacancies in state-subsidized public housing</a> by Jan. 1. The \u201c90-day push\u201d followed an investigation by WBUR and ProPublica, which revealed that <a href=\"https://www.propublica.org/article/massachusetts-public-housing-units-vacant-despite-waitlists\">almost 2,300 state-funded units were vacant</a>, despite a waitlist of more than 180,000 people. The findings came as the number of homeless families increased sharply, prompting Gov. Maura Healey to declare a state of emergency, which remains in effect. </p>\n\n<p>Yet the 90-day initiative barely made a dent in the vacancy totals. According to the latest data available, the number of vacancies has dropped by only 72 since July. As of March 1, the figure stood at 2,219, with most of the decline occurring in the past two months after WBUR asked why the state hadn\u2019t made more progress. More than three-quarters of the vacant units have been unoccupied for at least 60 days, the deadline that the state gives local authorities to fill a unit. Apartments that remain empty beyond that time limit need a state waiver or the <a href=\"https://www.wbur.org/news/2023/12/28/massachusetts-public-housing-fines-waivers-empty-fees\">local authority may face fines</a>.</p>\n        \n            \n    \n    \n    \n                            \n\n    \n            Vacancies in Massachusetts\u2019 Public Housing Decreased by Only 72 Units Over Seven Months\n                <p>The state had pushed to \u201csignificantly reduce\u201d vacancies last fall, but it made little progress.</p>\n\n    \n\n                        \n                    \n                \n\n            Source: The Massachusetts Executive Office of Housing and Livable Communities\n    \n    \n    \n    \n\n    \n\n            \n        \n    \n                    \n<p>The state also has not fixed key problems that contribute to vacancies, WBUR and ProPublica found. It still doesn\u2019t screen applicants for eligibility when they first apply for housing, and it allows people to sign up in as many as 230 places, including towns too far away for them to realistically relocate to. Almost 13,300 candidates for priority status, which is largely reserved for people in dire need of housing due to situations like fires, domestic violence or a condo conversion, are still waiting for a vendor hired by the state to determine if they are eligible and potentially bump them up the list.</p>\n\n<p>In most states, low-income residents seeking affordable apartments rely on federal public housing or vouchers for private housing. Massachusetts has those options, but it\u2019s one of four states \u2014 the others are New York, Connecticut and Hawaii \u2014 that also offer state-funded public housing. The state\u2019s 41,500 subsidized apartments are in high demand because Massachusetts has some of the highest housing prices in the country. </p>\n\n<p>Until 2019, local housing agencies in Massachusetts were responsible for maintaining their own waitlists for the subsidized units. That year, the state created a central list with the aim of making it easier for people to find public housing. Instead, the system has become a bureaucratic quagmire.</p>\n\n<p>The waitlist \u201cis not going to get fixed with iterative steps,\u201d said John LaBella, president of HousingWorks, a Boston company that helps people find affordable housing. \u201cIt needs a fundamental redesign.\u201d </p>\n\n<p>All the communities where Carter has applied for state-subsidized apartments are in western Massachusetts, and she would be glad to live in any of them. Agawam, a Springfield suburb, has a pair of three-bedroom units that have been vacant since 2021, along with seven empty two-bedrooms that would be suitable for the Carters. But the waitlist functions so ineffectively that the Carters and many other families have yet to receive offers.</p>\n\n<p>When applicants reach the top of the list, Agawam\u2019s housing authority notifies them, then spends hours verifying their information and reviewing their criminal backgrounds, income and references. Ultimately, most of them don\u2019t respond, don\u2019t qualify, or decline to move to Agawam. On average, Agawam vets hundreds of applicants to fill one vacancy, said Maureen Cayer, director of the housing authority there. </p>\n\n<p>The continuing abundance of vacancies \u201cis a failure,\u201d Cayer said. \u201cIt\u2019s a failure for the state. It\u2019s a failure for the system. It\u2019s a failure for the housing authority.\u201d</p>\n        \n    \n                    \n<p>Kevin Sbardella, director of the Fall River housing authority, similarly blamed the state\u2019s centralized waitlist for the nearly two dozen empty units there. He said he wishes agencies could go back to using their own lists. \u201cIf I could just go local, I\u2019d fill my vacancies up in a week,\u201d he said. </p>\n\n<p>After WBUR asked in February about the failure to fill more vacancies, state officials made a new set of promises to local housing directors. Ben Stone, director of the state division of public housing and rental assistance, pledged to track vacancies better and provide extra funding to help agencies reduce high vacancy rates. In an email to local housing directors, Stone said the state aims to cut the vacancy rate almost in half, to 3%. That would mean reducing the number of vacant apartments by nearly 1,000. </p>\n\n<p>State housing officials didn\u2019t set a deadline to achieve the 3% mark. They told WBUR that it is a \u201clong-term\u201d objective, and that the medium-term goal is getting under 2,000 vacant units. They said they have been tracking the number of vacancies since 2016, and 2023 was the first year that it declined. \u201cI think we made a little bit of headway,\u201d Housing Secretary Ed Augustus said in an interview. </p>\n\n<p>Augustus said he was surprised to hear that local housing officials were complaining about the waitlist. He said they have told him the system has been working much better since the state hired an outside vendor last year to help screen applicants who requested priority to move up the waitlist.</p>\n\n<p>\u201cThey\u2019ve all told me they\u2019ve seen improvements,\u201d Augustus said. \u201cNot perfection. Not every bug has been taken out of the system, but marked improvements.\u201d</p>\n\n<p>The contractor handling the priority review has screened out far more applicants than it has approved. As part of a three-year, $3.3 million contract, Archipelago Strategies Group, a Boston marketing firm, is working its way through a backlog of 45,000 requests to move up the waitlist. So far, it has approved 640 completed applications and denied another 1,435, according to state housing officials. They said the firm has discarded more than 30,000 other applicants because they withdrew, did not respond to requests for more information, or were deceased or otherwise no longer eligible. Most of the applicants approved by Archipelago for priority are still waiting for housing offers, according to the state. </p>\n\n<p>Archipelago has sifted through more than two-thirds of the priority requests, and it is \u201chelping the most vulnerable applicants move forward as quickly and fairly as possible,\u201d said Josiane Martinez, the company\u2019s chief executive officer. \u201cOur centralized screening is saving housing authorities thousands of screening hours, which they can now use to finalize housing placements.\u201d </p>\n\n<p>One priority applicant Archipelago rejected was Carter, the homeless mother in western Massachusetts. One reason she gave for seeking priority was that her injuries made it difficult for her to climb the stairs to the second-floor apartment where she and Oscar had been living. \u201cYour documents show that the Primary Residence was not the impediment to your health,\u201d Archipelago wrote her on Oct. 12. Once she was evicted, she remained ineligible because nonpayment of rent is typically considered the tenant\u2019s fault. To receive priority, applicants must show they lost their housing through no fault of their own.</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            Carter has been waiting for a state-subsidized apartment since Oscar was just a few months old.\n    \n            (Jesse Costa/WBUR)\n    \n    \n    \n\n    \n\n        \n    \n                    \n<p>\u201cI have a 5-year-old, it\u2019s winter, how does that not make someone a priority?\u201d Carter said. \u201cI don\u2019t care about anything other than finding somewhere to stay.\u201d</p>\n\n<p>Waitlist woes aren\u2019t the only reason for vacancies. More than 100 apartments have been repurposed for uses such as offices, storage or laundry. Hundreds more need major renovation. Augustus said he\u2019s asked his team to make sure there are good reasons for taking such units offline. </p>\n\n<p>Last fall, Healey proposed a bond bill that includes $1.6 billion in funding for capital expenditures in public housing, more than double the previous allocation. The funds would help renovate hundreds of uninhabitable or rundown apartments. But the Legislature has yet to approve it. Augustus estimated that the state has \u201cover $1 billion worth of requests in the pipeline\u201d for public and private development from local housing authorities.</p>\n\n<p>One stalled project is in Fall River, where the state approved an $8 million grant in 2020 to rehab 40 apartments, about half of which are vacant. But the state has yet to sign off on final plans, so the authority can\u2019t seek bids or start construction. One unit has been empty for almost eight years. </p>\n\n<p>\u201cThat\u2019s been just moving at a snail\u2019s pace,\u201d said Sbardella, who runs the Fall River housing authority. </p>\n\n<p>A spokesperson for the state housing agency said it agreed to reimburse local housing authorities for $1.5 million in minor repairs and staff overtime during the state\u2019s push to fill vacancies last fall. But some local housing directors said the 90-day window for funding was too short for them to learn about the program, line up workers and win approval from their boards. </p>\n\n<p>\u201cI need a solid four to six months at least,\u201d said Paula Mountain, executive director of the housing authority in Wenham, 25 miles north of Boston. She was only able to take advantage of the offer for two months, she said.</p>\n\n<p>Cayer, in Agawam, said she didn\u2019t tap the money because her state liaison couldn\u2019t explain where it was coming from and what strings, if any, were attached. Stone told housing directors in February that the state plans to extend portions of the aid beyond 90 days.</p>\n        \n    \n                            \n    \n                    \n<p>Meanwhile, Carter and her son are still waiting and hoping to find a place to live. Although Carter has largely recovered from her car accident, she said she had to quit a recent job as a medical assistant because she didn\u2019t have reliable child care or a home to invite a sitter to. She\u2019s separated from Oscar\u2019s father, who is not currently providing any financial help, she said.</p>\n\n<p>In the Northampton park, she watched Oscar leap over a stump, then chased him across the wet grass and spun him around on a carousel.</p>\n\n<p>\u201cYou want to spin?\u201d she asked him. \u201cAre you sure? OK, tell me when you have a good grip. You ready?\u201d</p>\n\n<p>Oscar can\u2019t ride his bike or play with his toys at the park; his mother had to put them in storage. Instead, after playing with her and riding the carousel, he entertains himself by collecting sticks.</p>"}, "tags": [], "updated": "2024-03-07T05:00:00-05:00", "updated_parsed": [2024, 3, 7, 10, 0, 0, 3, 67, 0], "authors": [{"name": "by Todd Wallack, WBUR"}], "author": "by Todd Wallack, WBUR", "author_detail": {"name": "by Todd Wallack, WBUR"}}, {"title": "Liberty University Hit With Record Fines for Failing to Handle Complaints of Sexual Assault, Other Crimes", "title_detail": {"type": "text/plain", "language": null, "base": "https://www.propublica.org/feeds/propublica/main", "value": "Liberty University Hit With Record Fines for Failing to Handle Complaints of Sexual Assault, Other Crimes"}, "links": [{"rel": "alternate", "type": "text/html", "href": "https://www.propublica.org/article/liberty-university-fined-sexual-assault-safety"}], "link": "https://www.propublica.org/article/liberty-university-fined-sexual-assault-safety", "published": "Wed, 06 Mar 2024 12:35:00 -0500", "published_parsed": [2024, 3, 6, 17, 35, 0, 2, 66, 0], "id": "https://www.propublica.org/article/liberty-university-fined-sexual-assault-safety", "guidislink": false, "summary": "<p class=\"byline\">\n                by <a class=\"name\" href=\"https://www.propublica.org/people/eric-umansky\">Eric Umansky</a>                </p>\n                                             \n\n                                                                    \n            \n                <p>ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive <a href=\"https://www.propublica.org/newsletters/the-big-story?source=54G&amp;placement=top-note&amp;region=national\">our biggest stories</a> as soon as they\u2019re published.</p>\n\n            \n\n                \n\n      \n  \n\n\n\n                    \n<p>The federal Department of Education has announced a historic $14 million fine against Liberty University for failing to properly handle reports of sexual assault and other campus safety issues. </p>\n\n<p>Universities are required by law to support victims of violence. The Education Department found that the Christian evangelical Liberty University had <a href=\"https://www.documentcloud.org/documents/24459024-daf2e931-bc53-43a4-8006-5689f39e91d0\">fundamentally failed to do so</a>. Sexual assault victims were \u201cpunished for violating the student code of conduct,\u201d the report concluded, \u201cwhile their assailants were left unpunished.\u201d </p>\n\n<p>The government found that Liberty\u2019s actions had created a \u201cculture of silence.\u201d </p>\n\n<p>The findings, which the department announced Tuesday, echo a ProPublica investigation that <a href=\"https://www.propublica.org/article/the-liberty-way-how-liberty-university-discourages-and-dismisses-students-reports-of-sexual-assaults\">detailed how officials had discouraged and dismissed</a> women who tried to come forward with accounts of sexual assault. Women who went to school officials to report being raped recalled being threatened with punishment for breaking the university\u2019s strict moral code, known as \u201cThe Liberty Way.\u201d</p>\n\n<p>The coverage prompted widespread outrage, including <a href=\"https://www.propublica.org/article/senators-call-for-federal-investigation-into-liberty-universitys-handling-of-sexual-assaults-school-promises-independent-probe\">demands from senators for a Department of Education investigation</a>. </p>\n\n<p>That investigation culminated in Tuesday\u2019s announcement. The fines against Liberty are more than double the amount of the next-largest fines in Department of Education history \u2014 against Michigan State University for its failures to protect hundreds of women and girls from sexual abuser Larry Nassar.</p>\n\n<p>Liberty will also face two years of federal oversight.</p>\n        \n    \n                    \n<p>Elizabeth Axley, a former Liberty University student who was threatened with punishment when she reported her rape to campus officials, said the government\u2019s findings against Liberty feel \u201cso validating and sort of surreal.\u201d</p>\n\n<p>\u201cFor an official report to say, \u2018Yes, everything you said happened, everything you described was real,\u2019 is more powerful than I can describe,\u201d said Axley, who recalled that when she first wanted to report her rape, a resident adviser told her to pray instead. \u201cAfter I first fought to stand up for myself at Liberty, I was silenced. I didn\u2019t feel hopeful. It took everything for me to stand up to tell my story again and hope it turned out right. This reminds me it was completely worth it.\u201d </p>\n\n<p>In response to the government\u2019s report, Liberty University <a href=\"https://www.liberty.edu/title-ix/clery-act-program-review-response/\">said in a statement</a> that it faced \u201cunfair treatment.\u201d But the school also admitted to mistakes and committed to spending $2 million to improve campus safety.</p>\n        \n    \n                            \n    \n                    \n<p>\u201cWe acknowledge and sincerely regret these errors and have since corrected them in a manner that allows us to maintain compliance in each of these areas,\u201d the school said. \u201cToday is a new day at Liberty University. We remain committed to prioritizing the safety and security of our students and staff without exception.\u201d </p>\n\n<p>Liberty University was co-founded in 1971 by the televangelist Jerry Falwell. His son, Jerry Falwell Jr., took over the university\u2019s helm in 2007 but resigned in 2020 after a <a href=\"https://www.vox.com/2020/8/25/21399954/jerry-falwell-jr-resigns-scandal-liberty\">series of scandals</a>. With more than 90,000 students enrolled on its Virginia campus and online, Liberty remains one of the most influential Christian universities in the country. </p>\n\n<p>S. Daniel Carter, who helped craft the Clery Act, the federal law that requires schools to report sexual assault and other crimes, said the significance of the Department of Education\u2019s actions go beyond the record fines. \u201cIt\u2019s not about a bottom line number,\u201d Carter said. \u201cIt\u2019s about the fact that they are proactively investigating and leading efforts to bring schools into compliance.\u201d</p>\n        \n             \n\n                                    \n        \n                        <p><a href=\"https://www.propublica.org/people/hannah-dreyfus-2\">Hannah Dreyfus</a> contributed reporting.</p>", "summary_detail": {"type": "text/html", "language": null, "base": "https://www.propublica.org/feeds/propublica/main", "value": "<p class=\"byline\">\n                by <a class=\"name\" href=\"https://www.propublica.org/people/eric-umansky\">Eric Umansky</a>                </p>\n                                             \n\n                                                                    \n            \n                <p>ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive <a href=\"https://www.propublica.org/newsletters/the-big-story?source=54G&amp;placement=top-note&amp;region=national\">our biggest stories</a> as soon as they\u2019re published.</p>\n\n            \n\n                \n\n      \n  \n\n\n\n                    \n<p>The federal Department of Education has announced a historic $14 million fine against Liberty University for failing to properly handle reports of sexual assault and other campus safety issues. </p>\n\n<p>Universities are required by law to support victims of violence. The Education Department found that the Christian evangelical Liberty University had <a href=\"https://www.documentcloud.org/documents/24459024-daf2e931-bc53-43a4-8006-5689f39e91d0\">fundamentally failed to do so</a>. Sexual assault victims were \u201cpunished for violating the student code of conduct,\u201d the report concluded, \u201cwhile their assailants were left unpunished.\u201d </p>\n\n<p>The government found that Liberty\u2019s actions had created a \u201cculture of silence.\u201d </p>\n\n<p>The findings, which the department announced Tuesday, echo a ProPublica investigation that <a href=\"https://www.propublica.org/article/the-liberty-way-how-liberty-university-discourages-and-dismisses-students-reports-of-sexual-assaults\">detailed how officials had discouraged and dismissed</a> women who tried to come forward with accounts of sexual assault. Women who went to school officials to report being raped recalled being threatened with punishment for breaking the university\u2019s strict moral code, known as \u201cThe Liberty Way.\u201d</p>\n\n<p>The coverage prompted widespread outrage, including <a href=\"https://www.propublica.org/article/senators-call-for-federal-investigation-into-liberty-universitys-handling-of-sexual-assaults-school-promises-independent-probe\">demands from senators for a Department of Education investigation</a>. </p>\n\n<p>That investigation culminated in Tuesday\u2019s announcement. The fines against Liberty are more than double the amount of the next-largest fines in Department of Education history \u2014 against Michigan State University for its failures to protect hundreds of women and girls from sexual abuser Larry Nassar.</p>\n\n<p>Liberty will also face two years of federal oversight.</p>\n        \n    \n                    \n<p>Elizabeth Axley, a former Liberty University student who was threatened with punishment when she reported her rape to campus officials, said the government\u2019s findings against Liberty feel \u201cso validating and sort of surreal.\u201d</p>\n\n<p>\u201cFor an official report to say, \u2018Yes, everything you said happened, everything you described was real,\u2019 is more powerful than I can describe,\u201d said Axley, who recalled that when she first wanted to report her rape, a resident adviser told her to pray instead. \u201cAfter I first fought to stand up for myself at Liberty, I was silenced. I didn\u2019t feel hopeful. It took everything for me to stand up to tell my story again and hope it turned out right. This reminds me it was completely worth it.\u201d </p>\n\n<p>In response to the government\u2019s report, Liberty University <a href=\"https://www.liberty.edu/title-ix/clery-act-program-review-response/\">said in a statement</a> that it faced \u201cunfair treatment.\u201d But the school also admitted to mistakes and committed to spending $2 million to improve campus safety.</p>\n        \n    \n                            \n    \n                    \n<p>\u201cWe acknowledge and sincerely regret these errors and have since corrected them in a manner that allows us to maintain compliance in each of these areas,\u201d the school said. \u201cToday is a new day at Liberty University. We remain committed to prioritizing the safety and security of our students and staff without exception.\u201d </p>\n\n<p>Liberty University was co-founded in 1971 by the televangelist Jerry Falwell. His son, Jerry Falwell Jr., took over the university\u2019s helm in 2007 but resigned in 2020 after a <a href=\"https://www.vox.com/2020/8/25/21399954/jerry-falwell-jr-resigns-scandal-liberty\">series of scandals</a>. With more than 90,000 students enrolled on its Virginia campus and online, Liberty remains one of the most influential Christian universities in the country. </p>\n\n<p>S. Daniel Carter, who helped craft the Clery Act, the federal law that requires schools to report sexual assault and other crimes, said the significance of the Department of Education\u2019s actions go beyond the record fines. \u201cIt\u2019s not about a bottom line number,\u201d Carter said. \u201cIt\u2019s about the fact that they are proactively investigating and leading efforts to bring schools into compliance.\u201d</p>\n        \n             \n\n                                    \n        \n                        <p><a href=\"https://www.propublica.org/people/hannah-dreyfus-2\">Hannah Dreyfus</a> contributed reporting.</p>"}, "tags": [{"term": "Education", "scheme": null, "label": null}], "updated": "2024-03-06T12:35:00-05:00", "updated_parsed": [2024, 3, 6, 17, 35, 0, 2, 66, 0], "authors": [{"name": "by Eric Umansky"}], "author": "by Eric Umansky", "author_detail": {"name": "by Eric Umansky"}}, {"title": "A Utah Cleft Palate Team Says Its Approach Is Innovative. Others See a Pattern of Unnecessary Surgeries on Children.", "title_detail": {"type": "text/plain", "language": null, "base": "https://www.propublica.org/feeds/propublica/main", "value": "A Utah Cleft Palate Team Says Its Approach Is Innovative. Others See a Pattern of Unnecessary Surgeries on Children."}, "links": [{"rel": "alternate", "type": "text/html", "href": "https://www.propublica.org/article/utah-cleft-palate-team-says-approach-is-innovative-others-disagree"}], "link": "https://www.propublica.org/article/utah-cleft-palate-team-says-approach-is-innovative-others-disagree", "published": "Wed, 06 Mar 2024 05:00:00 -0500", "published_parsed": [2024, 3, 6, 10, 0, 0, 2, 66, 0], "id": "https://www.propublica.org/article/utah-cleft-palate-team-says-approach-is-innovative-others-disagree", "guidislink": false, "summary": "<p class=\"byline\">\n                by <a class=\"name\" href=\"https://www.propublica.org/people/megan-rose\">Megan Rose</a>                </p>\n                                             \n\n                                                                    \n            \n                <p>ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive <a href=\"https://www.propublica.org/newsletters/the-big-story?source=54G&amp;placement=top-note&amp;region=national\">our biggest stories</a> as soon as they\u2019re published.</p>\n\n            \n\n                \n\n      \n  \n\n\n\n                    \n<p>Returning to his home state of Utah, where more babies are born with cleft lip and palate than is typical, Dr. Devan Griner made plans to open his own practice, joining the small cohort of plastic surgeons nationwide who treat the condition.</p>\n\n<p>As he recruited doctors to fill out a team in 2017, Griner had lunch with an orthodontist who\u2019d long worked in the state. He quizzed Griner on his credentials and then turned to bone grafting, a common procedure for cleft patients, who are often missing a piece of their upper jaw. Sitting back, the doctor looked hard at Griner and lobbed a test question: At what age would Griner do bone grafts on patients?</p>\n\n<p>It was a surprising question. There is broad consensus nationwide to time bone grafts to when a patient is getting certain adult teeth, and so Griner, a bit taken aback, replied that of course he does it then. That\u2019s when Griner said the orthodontist relaxed, leaned in over their Neapolitan pizza and declared, \u201cWe have a bone grafting problem here in Utah.\u201d</p>\n\n<p>Almost immediately Griner encountered it for himself. Patients began turning up who\u2019d had treatment that departed from the standard of care in ways Griner found alarming. In many cases, he felt they\u2019d had, or been advised to undergo, grueling, and possibly unnecessary, facial surgeries earlier than his profession advised. And they were all treated at Primary Children\u2019s Hospital in Salt Lake City.</p>\n\n<p>As more former Primary Children\u2019s patients sought out Griner\u2019s team, the doctors started to question among themselves, and then with other cleft doctors in the state, whether they needed to do something. It\u2019s a rare and risky move to call out a fellow doctor\u2019s work, much less a team at a well-known hospital. Most children born with a cleft in the five-state region around Utah are treated at Primary Children\u2019s, some traveling the farthest distance for care in the nation. It\u2019s the largest pediatric hospital in the area, and for many, it had been the only choice.</p>\n        \n    \n                    \n<p>A crucial question emerged: Did the hospital\u2019s patients, and their anxious parents, know that the care they were getting at Primary Children\u2019s was different from what cleft surgeons at top hospitals around the country provided?</p>\n\n<p>The question hit at the heart of a common tension in medicine between the sort of innovation that drives life-enhancing advances and the accepted standard of care, which is informed by peer-reviewed medical studies, broad agreement among specialists and insurance company policies. What information are patients, especially children, owed? And how should regulators respond when doctors want to try something new \u2014 especially when doctors, and their choices, may be geographically or otherwise isolated from their peers?</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            Dr. Devan Griner, a plastic surgeon, at the Cleft and Craniofacial Institute of Utah in Provo\n    \n            (Hannah Yoon, special to ProPublica)\n    \n    \n    \n\n    \n\n        \n    \n                    \n<p>In the case of cleft lip and palate, the future of children\u2019s faces are on the line. The success of some cleft procedures isn't fully known until a child has finished growing. Although there can be signs along the way, not until cleft patients are almost adults will doctors be able to fully assess if a certain treatment done at 2 years old was ultimately beneficial or harmful.</p>\n\n<p>Griner\u2019s team and other doctors who\u2019d worked in Utah eventually felt they had to take collective action. A group of nine doctors decided to file a formal complaint with the state, saying \u201cthis is about protecting children.\u201d Among their allegations: Some doctors on the hospital\u2019s cleft team were performing bone grafts on patients who were too young \u2014 around age 2 \u2014 and using an off-label, controversial bone growth product that many doctors shun. They were performing intensive jaw surgeries \u2014 which require children to wear a large metal device screwed into their heads for months \u2014 so early that they risked some children needing to repeat the operation. And the team was performing surgeries some patients didn\u2019t need.</p>\n\n<p>\u201cThey just over, overoperate,\u201d said Lisa Morris, one of the cleft doctors on the state complaint.</p>\n\n<p>Cleft specialists at seven large pediatric institutions around the country, including Seattle Children\u2019s Hospital and Nationwide Children\u2019s Hospital, told ProPublica that the way doctors performed several procedures sharply departed from their speciality\u2019s most common practices.</p>\n\n<p>Utah\u2019s Division of Professional Licensing is investigating the practices of several doctors on Primary\u2019s cleft team, which is staffed by University of Utah doctors. The state agency originally closed the complaint with little investigation, but after an appeal to the head of Utah\u2019s commerce department, which oversees licensing, the division reopened it in April.</p>\n\n<p>Dr. Dana Johns, director of Primary Children\u2019s cleft team, said the fact that her team\u2019s practices don\u2019t align with those of her colleagues in the field \u201cdoesn\u2019t mean that different is wrong.\u201d She said that intervening earlier helps protect children with visible facial differences from a gamut of bullying in their formative teen years.</p>\n\n<p>In interviews, both Primary Children\u2019s and the University of Utah told ProPublica they stand by their protocol and fully inform their patients during appointments about how and why their care differs. What the team does is \u201cclinically defensible and potentially advantageous,\u201d Kathy Wilets, a University of Utah Health spokesperson, wrote in a statement.</p>\n\n<p>But ProPublica\u2019s questions, the hospital said, prompted the hiring of two independent cleft surgeons to formally review the protocol. Bioethicists have also reviewed the hospital\u2019s informed consent procedures, leading administrators to make changes to its cleft consent policies and consider hospitalwide changes.</p>\n\n<p>Dr. Jay Agarwal, the hospital\u2019s chief of plastic surgery, said the cleft team believes the standard methods of treating cleft lip and palate aren\u2019t good enough and is trying to advance care by fixing children\u2019s mouths at younger ages and in ways that could eliminate the need for surgery when they\u2019re older.</p>\n\n<p>\u201cWe always have to try to do better,\u201d he said.</p>\n\n<p>But parents of some of Primary Children\u2019s patients say their children were unwitting participants in what the hospital calls innovation and what some other cleft experts deemed a potentially risky deviation from evidence-based treatment. Experts said bone grafts done at such an early age could stunt facial growth, resulting in the upper lip looking pushed back and impairing basic tasks such as talking and chewing.</p>\n\n<p>The final results of the early bone grafting won\u2019t be known for years. Patients treated under the new bone-grafting protocol Primary Children\u2019s started around 2017 won\u2019t start seeing full outcomes until around 2029.</p>\n\n<p>Emily Rogers still feels the burden of remorse six years after her son\u2019s bone graft when he was 21 months old. She, like members of several families ProPublica spoke with, said the former head of the program didn\u2019t tell her that bone grafting at that age was unusual, that the hospital was just starting to try it or that doctors weren\u2019t sure how her son\u2019s face would grow after the procedure.</p>\n\n<p>\u201cIt\u2019s sickening to find out later you put your kids in their hands and they lied to you, basically,\u201d she said. \u201cThat\u2019s what it feels like: It was a lie.\u201d</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            Gavin Rogers, 7 sits with his mom, Emily Rogers, at their home in Farmington, Utah.\n    \n            (Hannah Yoon, special to ProPublica)\n    \n    \n    \n\n    \n\n        \n    \n                    \nThe Standard of Care\n<p>From the time a cleft is spotted on a sonogram during pregnancy, parents begin prepping for a series of surgeries to help their child with a noticeable facial difference. Each step of care throughout childhood builds upon the last, slowly marching the face toward the form it failed to take in the womb. A doctor\u2019s misstep can veer the mouth off course or mean more surgery.</p>\n\n<p>People unfamiliar with clefts, besides perhaps what they\u2019ve seen on Operation Smile fundraising commercials, tend to think of the treatment as a one-and-done surgery to repair a small slit in the lip. And while that can be the case, for a lot of babies born with the condition, it\u2019s much more involved. Often, a wide split starts at the nostril, goes down the lip, runs through the upper jaw and continues back through the roof of the mouth toward the throat. Sometimes there are splits on both sides of the mouth.</p>\n\n<p>Cleft lip and palate together affect about <a href=\"https://www.cdc.gov/ncbddd/birthdefects/cleftlip.html\">1 in 1,600 babies</a> in the U.S.; around <a href=\"https://www.nidcr.nih.gov/research/data-statistics/craniofacial-birth-defects/prevalence\">2,500 are born</a> with both each year. It is unclear why Utah has a higher rate. In general, the cause of a cleft is not well understood. According to the Centers for Disease Control and Prevention, there is some evidence that genetics can play a role, and some environmental factors, such as smoking during pregnancy or taking certain medications, can increase the chances of a cleft forming, which happens in the first trimester.</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            With cleft lip and palate, often a split starts at the nostril, goes down the lip and through the upper jaw, and continues back through the roof of the mouth toward the throat. Sometimes the split is on both sides of the mouth.\n    \n            (Illustration by Matt Twombly for ProPublica)\n    \n    \n    \n\n    \n\n        \n    \n                    \n<p>A cleft can affect a child\u2019s teeth, position of the midface and nose, and ability to hear, breathe, swallow and speak. Many cleft patients need care from a range of specialists from their earliest days until adulthood. Successful cleft treatment repairs those issues, leaving patients\u2019 faces with little evidence of their cleft issues by the time they are grown.</p>\n\n<p>Like most well-known conditions, there is a treatment plan for cleft lip and palate that a majority of doctors follow, known generally as the standard of care. ProPublica spoke with more than a dozen cleft specialists nationwide, and all acknowledged the variability, subjectivity and debate in cleft care. Several pointed out there aren\u2019t large randomized trials that have definitively provided answers, and care continues to evolve. Still, they all laid out the same general timeline of cleft treatment and the reasons for it.</p>\n\n<p>Doctors usually repair the lip and nose around 3 to 6 months, close the palate around 9 to 18 months and then wait to do a bone graft until children are about 5 to 11 years old, though there is debate about when in that age range is best. Jaw surgery, if needed, typically waits until the child is done growing. Most patients will need rhinoplasty and years of orthodontia as well and, in some cases, additional surgeries to help with things like speech.</p>\n\n<p>Richard Kirschner, chief of plastic and reconstructive surgery at Nationwide Children\u2019s in Ohio and the editor of a widely used cleft textbook, said this timeline is based on evidence collected over decades in the care of thousands of patients.</p>\n\n<p>To the doctors at Primary Children\u2019s, the skepticism they\u2019re facing is the plight of pioneers.</p>\n\n<p>\u201cI think it\u2019s easy to keep doing things the same way in the way they\u2019ve always been done,\u201d said Agarwal, who noted that he doesn\u2019t think there is a standard of care in cleft. \u201cAnd, you know, that\u2019s the answer for a lot of groups that they feel like they don't want to try new things. And that\u2019s OK. I mean, nothing\u2019s wrong with that.\u201d</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            Dr. Dana Johns in an exam room at Primary Children\u2019s Hospital\n    \n            (Kim Raff, special to ProPublica)\n    \n    \n    \n\n    \n\n        \n    \n                    \n<p>Faizi Siddiqi, who helped start the university\u2019s cleft team in 2003, stopped practicing last year and died from cancer in January at age 58. ProPublica was unable to reach him for comment before his death. Duane Yamashiro, an orthodontist who was the medical director of the cleft program for almost 20 years, declined through a spokesperson to comment. So did the most senior plastic surgeon currently on the team, Barbu Gociman. All three are named on the state complaint. Johns and the rest of cleft team doctors are not named on the complaint, and the hospital and the University of Utah declined to comment on it.</p>\n\n<p>\u201cWe stand firmly behind our surgical approaches and believe they deliver the best outcomes for our patients, although, through an extensive review of our program we realize there are opportunities to improve the way we communicate with our patients and their families,\u201d Wilets said in a written statement. \u201cThe safety and care of our patients is the most important thing to us.\u201d</p>\n\n<p>\u201cWe apologize for any distress to any patient family who feels we didn\u2019t meet their expectations and did not feel comfortable addressing their concerns directly with us,\u201d Wilets wrote.</p>\n\n<p>The hospital has around 700 to 800 cleft patients at any given time, and Wilets said its cleft outcomes are in line with or better than other centers\u2019.</p>\n\n<p>In responding to concerns that patients\u2019 families told ProPublica about, Jess Gomez, a hospital spokesperson, wrote, \u201cWe have no record of prior complaints from the families you\u2019ve identified regarding their care, and we are saddened to learn of the concerns you\u2019re sharing with us.\u201d He added that the patients were cared for by Siddiqi, so the hospital is unable to respond to specifics about treatment discussions.</p>\n\n<p>Innovating in surgery is a gray area. Unlike drug development, which has strict rules, surgeons are allowed wide leeway to try new things. \u201cIt\u2019s a little bit of the Wild West,\u201d said Dr. Jonathan Marron, director of clinical ethics at Harvard, and there isn\u2019t agreement on what the right balance is between supporting innovation and protecting patients.</p>\n\n<p>Doctors have an ethical obligation to make sure their patients are aware of how their protocol differs and what the rationale is for not doing the standard. \u201cInformed consent, in my mind, is an important aspect of this,\u201d he said.</p>\n\n<p>As more and more doctors stick to a standard, the less acceptable a deviation from that standard practice is, Marron said. But figuring out where that line is can be difficult.</p>\n\n<p>Innovating in surgery is not an area that\u2019s robustly regulated. Last year, Utah lawmakers made it easier for doctors to practice outside the standard by loosening the rules that had restricted it, though the law still requires that patients are informed in writing and consent. The hospital and University of Utah didn\u2019t respond to questions about whether patients are informed in writing about any deviations from the standard of care. Since ProPublica began reporting, the hospital has updated its written informed consent form regarding families\u2019 options, Wilets said, and it now \u201cmore explicitly\u201d tells patients that there is no standard protocol for cleft patients and different institutions have different protocols.</p>\n\n<p>In other parts of the world, cleft lip and palate care has undergone changes based on government oversight. For example, in the United Kingdom there used to be many cleft centers with wide variations in success. Then the government audited outcomes, looking at factors such as how well patients were able to speak and how well their jaws aligned. Some centers achieved much better results with fewer surgeries. The government consolidated care among fewer centers to improve results and consistency. There isn\u2019t any similar oversight in the United States.</p>\n\n<p>\u201cI think the important thing to understand here is that there\u2019s not a whole lot of regulation in terms of who is looking after clinical outcomes,\u201d Kirschner said. \u201cAnd so it\u2019s really [left] up to parents to do their research.\u201d</p>\n\nAn Outside Doctor\n<p>When Griner questioned the parents of the former Primary Children\u2019s patients, he said, none of them understood that the treatment their child had received wasn\u2019t the norm. The parents cycled through shock, anger and grief in his office so often that eventually he could tell by their faces what they\u2019d say next, he said. The remorse stage was the hardest to hear, with parents blaming themselves for not asking more questions.</p>\n\n<p>The parents, dogged by inchoate worries, had come to him seeking a second opinion once Griner and his partners opened their practice, he and some patients said.</p>\n\n<p>Griner, who remembers going door to door to fundraise for Primary Children\u2019s as a child, said he\u2019d always believed that the hospital\u2019s general excellence included the cleft team. He had wanted to work there. But Griner says that after he chose a fellowship position in Texas instead of with the University of Utah, relations soured.</p>\n\n<p>Later, after seeing the unit\u2019s handiwork firsthand in his practice, he took his concerns to the hospital\u2019s administration. During 2018 and 2019, he said, he had three conversations with different levels of leadership, including the hospital\u2019s then-CEO, about the poor cleft outcomes he and others were seeing. Each time, he said, his concerns weren\u2019t taken seriously.</p>\n\n<p>A spokesperson for Primary Children\u2019s said the former CEO and another administrator couldn\u2019t recall any such conversations, and the third, a director of surgical services at the time, said he recalled only casual conversations between colleagues. \u201cIf a concern were adequately raised by Dr. Griner, the concern would have been investigated and necessary action would have been taken,\u201d Gomez said in an email.</p>\n\n<p>As Griner\u2019s new cleft team settled in, their worries mounted. Once a month, the cleft team would meet with patients to collectively discuss next steps. After a former Primary Children\u2019s patient would leave one of those meetings for the first time, the doctors said they would look at each other, shaking their heads: \u201cCan you believe that?\u201d</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            Griner checks the teeth of Robbie McFerson, 4, while his mom, Sarah McFerson, holds him at the Cleft and Craniofacial Institute of Utah in Provo.\n    \n            (Hannah Yoon, special to ProPublica)\n    \n    \n    \n\n    \n\n        \n    \n                    \n<p>Primary Children\u2019s undertakes two surgeries to repair the palate instead of one, something most doctors in the United States have stopped doing. The hospital is unusual in that it uses a prosthetic device to cover the palate hole, which requires more time under anesthesia when swapped out for a new one. The hospital also often surgically expands the palate of young patients when a retainer-like device would typically be used instead.</p>\n\n<p>To Griner and his team, the timing of two major procedures \u2014 bone grafting and jaw surgeries \u2014 were worrying enough on their own, but along with other ways Primary Children\u2019s is an outlier, they were concerned that patients were getting aberrant care at many stages.</p>\n\n<p>Finally, in 2022, a group of doctors \u2014 many of whom compete with Primary Children\u2019s \u2014 <a href=\"https://www.documentcloud.org/documents/24451011-dopl-complaint\">raised the issues with the state</a>. Ten doctors\u2019 names appear on the complaint, though one told ProPublica that although he agreed with many of the concerns, he wasn\u2019t aware he\u2019d been included on it.</p>\n\n<p>(One of the plastic surgeons who signed the complaint, Rodney Schmelzer, has a complicated history with Primary Children\u2019s. He lost his privileges there in 2017 and has two ongoing lawsuits against the hospital, one of which also names Yamashiro and Siddiqi. The hospital and the doctors have denied the allegations.) </p>\n\n<p>Utah\u2019s Department of Commerce, which oversees the Division of Professional Licensing, said it could not confirm nor deny an investigation.</p>\n\n<p>The complaint alleges that Primary Children\u2019s doctors \u201croutinely exploit Cleft Patients and their families by \u2026 subjecting [them] to excessive numbers of surgeries outside the standard of care\u201d without being honest about the risks, benefits or alternatives, which the doctors say violates medical ethics and Utah law.</p>\n\nMajor Jaw Surgeries\n<p>Paige Holland started looking for a second opinion when Primary Children\u2019s said her 7-year-old son would next need major jaw surgery to correct the underbite that commonly afflicts cleft patients.</p>\n\n<p>The operation, called <a href=\"https://www.myface.org/surgeries/le-fort-1/\">a LeFort distraction</a>, sounded medieval to Holland: Doctors would cut part of his upper jaw from his skull and screw a rigid metal device, called a halo, to the outside of his head. Wires would attach his upper jaw to the device, and every day for weeks Holland would turn screws to tighten the wires and slowly pull her son\u2019s jaw bone forward and allow more bone to grow. He\u2019d wear the halo for months.</p>\n        \n    \n                    \n\n    \n            The LeFort Halo Procedure\n        \n\n                        \n                    \n                \n\n            <strong>Initial jaw alignment:</strong> Cleft patients often have severe underbites. This can affect how the face looks and can also impact basic functions, such as chewing.\n    \n    \n    \n    \n\n    \n\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            <strong>Surgical procedure:</strong> Doctors make cuts along the upper jaw so it can be repositioned.\n    \n    \n    \n    \n\n    \n\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            <strong>LeFort device attachment:</strong> Doctors screw a rigid metal device, called a halo, to the outside of the head and attach it to the upper jaw. After the surgery, patients tighten the wires daily to pull the jaw forward over the course of a few weeks. New bone grows, lengthening the jaw. The child wears the halo for several months to allow the bone to heal.\n    \n            (Illustrations by Matt Twombly for ProPublica)\n    \n    \n    \n\n    \n\n        \n    \n                    \n<p>Jaw surgeries aren\u2019t unusual for cleft patients, but the age Primary Children\u2019s often does them makes the hospital an outlier. Holland\u2019s son would have been as young as 9 at the time of the surgery, according to his Primary Children\u2019s medical records reviewed by ProPublica.</p>\n\n<p>The American Cleft Palate Craniofacial Association guidelines state that \u201cwhenever possible, [jaw] surgery should be delayed until physical maturation is essentially completed.\u2019\u2019 Cleft doctors at six leading hospitals said they don\u2019t perform jaw surgeries until children stop growing. For girls, that\u2019s about 14 to 16 years old; for boys, it\u2019s closer to 18.</p>\n\n<p>Until recently, Primary Children\u2019s website told families to expect possible jaw surgery between <a href=\"https://web.archive.org/web/20230607075520/https://intermountainhealthcare.org/primary-childrens/programs-specialties/cleft-craniofacial/\">9 and 10 years old</a>. But it has since changed <a href=\"https://intermountainhealthcare.org/primary-childrens/programs-specialties/cleft-craniofacial/\">the age range to between 9 and 15-plus</a>. Some other cleft centers also perform early jaw surgeries, and Kirschner told ProPublica he thinks that surgeries performed before maturity fall within the standard of care, though he personally waits for patients to be grown.</p>\n\n<p>Primary Children\u2019s data from 2020 showed that the average age of LeFort halo surgery there was 11.4 years old, according to a paper published by the hospital\u2019s cleft team that analyzed nearly 60 cleft patients who had halos over a three-year period. The age of the patients ranged from 8 to 16 years old.</p>\n\n<p>Cleft doctors ProPublica spoke with said they perform jaw surgery before maturity in only a tiny proportion of cases, usually only if medically necessary. Dr. Roberto Flores, head of the program at NYU, estimated the number at no more than 5%.</p>\n\n<p>At Seattle Children\u2019s Hospital, even in those extraordinary cases, the surgery would not happen until 12 to 14 years old, when most of the adult teeth are finished coming in, according to the hospital\u2019s former chief of craniofacial surgery, Richard Hopper.</p>\n\n<p>\u201cI\u2019ve been with the cleft team for 20 years, and I can pretty conclusively say we haven\u2019t done a Lefort \u2026 on a patient younger than 12 years old, 11 at the earliest,\u201d Hopper said last year before he took a job with Texas Children\u2019s Hospital.</p>\n\n<p>\u201cThe earlier you do a jaw surgery, the more likely you\u2019re going to have to repeat it later,\u201d a cleft team surgeon at a top-rated pediatric hospital said. \u201cBasically you\u2019re committing kids to having an extra operation.\u201d</p>\n\n<p>The best practice, many doctors said, is to do one definitive jaw surgery close to adulthood.</p>\n\n<p>\u201cIt\u2019s a brutal enough operation. You wouldn\u2019t want to have to do it twice,\u201d a leader in the field said. Both doctors asked not to be identified out of concern it would jeopardize relationships within the small community of doctors who provide cleft care.</p>\n\n<p>Primary\u2019s Johns said such critiques ignore the psychosocial issues children with cleft deal with. Bullying should be given more weight in treatment plans, she said, and repairing a child\u2019s differences before high school has merit. Most of her surgeries wait till at least age 12, she said, and when she does them on younger patients, it\u2019s for either psychosocial or other pronounced medical problems.</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            Dr. Trace Lund checks Robbie\u2019s palate and teeth. Children with cleft lip and palate often have extra or missing teeth, or teeth that emerge in the wrong spot.\n    \n            (Hannah Yoon, special to ProPublica)\n    \n    \n    \n\n    \n\n        \n    \n                    \n<p>Moreover, patients who wait until maturity can sometimes require extensive operations involving both the upper and lower jaws, Johns said. Patients who\u2019ve had the surgery young might require a second jaw surgery, she said, but it would involve only the upper jaw. The trade-off, she said, is worth it.</p>\n\n<p>Rohit Khosla, surgical director of the cleft team at Stanford Medicine Children\u2019s Health who trained Johns during her fellowship, reviewed all of the hospital\u2019s protocols at her request. In general, Khosla told ProPublica that he thought the hospital\u2019s methods were controversial but not problematic. He found several problems with the cleft team\u2019s study designs and conclusions, but overall its \u201cprotocols are conscientiously thought out with [a] goal to provide a high level of care,\u201d he said in a summary of his report. The hospital would not share his full written review and asked Khosla to stop speaking with ProPublica once it was completed. Primary Children\u2019s also set up a double-blinded review \u2014 neither the hospital nor reviewer knew whom the other was \u2014 to further assess its protocols, but the hospital said it would not make the report public when it was completed.</p>\n\n<p>In looking at the hospital\u2019s latest LeFort data, Khosla wrote that in the \u201clast few years\u201d the average age has increased to 14, \u201cwhich I find more acceptable.\u201d</p>\n\n<p>On a Facebook page for Utah parents of children with cleft, numerous posts over the years speak to the hospital\u2019s push to perform LeForts young. Some talk about how their children endured the surgery before 10 years old \u2014 \u201cnot going to lie the Halo is tough!\u201d one mother wrote \u2014 and needed to repeat a jaw surgery as a teenager.</p>\n\n<p>Holland said she thought there had to be another way to fix her son\u2019s underbite and asked about braces. After Primary Children\u2019s said there wasn\u2019t, she said, she sought a second opinion with Griner, who sent him to an orthodontist instead. Holland\u2019s son was one of at least seven former Primary Children\u2019s patients whom Griner said he diverted from having surgery before maturity. None of them, in Griner\u2019s opinion, had any medical necessity for the operation before maturity or reported bullying or other psychosocial issues. Schmelzer, who also signed the complaint against Primary Children\u2019s, said his medical records showed similar numbers.</p>\n\n<p>Griner recalled one startling case last summer in which Primary Children\u2019s had lined up surgery for a 9-year-old child whose jaw was nearly normal. An independent plastic surgeon who specializes in cleft at a large academic institution reviewed the patient\u2019s CT scan for ProPublica and confirmed Griner\u2019s assessment that there was no need for surgery.</p>\n\n<p>Holland\u2019s son, now 13, has only a minor underbite after orthodontics and likely won\u2019t need jaw surgery at all.</p>\n\n<p>\u201cHe\u2019s totally fine,\u201d Holland said. \u201cHe was saved from a major surgery.\u201d</p>\n\nExperimenting With Bone Grafts\n<p>About seven years ago, spurred by what Johns said was a \u201chypothesis we had,\u201d Primary Children\u2019s cleft team began experimenting with how surgeons bone grafted the upper jaw.</p>\n\n<p>Without putting in place the protections of a formal research study, Johns and her colleagues decided the invasive surgeries could be done successfully when children were years younger \u2014 age 2 \u2014 than was standard practice in their field.</p>\n\n<p>The \u201cgold standard\u201d for a bone graft is to use a piece of the child\u2019s own hip. At 2, a patient doesn\u2019t have enough bone to harvest. So over a period of about two years, Primary Children\u2019s tested in its toddler-age patients different combinations of materials that would create a lasting bone graft.</p>\n\n<p>Among the materials was a controversial product called bone morphogenic protein, or BMP, which stimulates bone growth. The BMP is put into the jaw where the child is missing bone and, in theory, spurs the body to naturally make bone, gradually filling the gap.</p>\n\n<p>Some cleft doctors have hailed BMP as a less invasive way to treat patients since it first came to market in 2002 \u2014 but Primary Children\u2019s believed it could be used in children years younger than their peers at other centers. </p>\n\n<p>The parents of several patients told ProPublica they were never informed that their child was undergoing an untested procedure. In some cases the bone graft failed, necessitating a repeat of the painful operation.</p>\n\n<p>In 2017, Gavin Rogers, 21 months old with the wispy blond hair of a baby, had bone graft and hard palate repair. Afterwards, \u201che was screaming all the time. He wasn\u2019t sleeping, wasn\u2019t eating. I had to squirt milk into his mouth,\u201d his mom, Emily Rogers, recalled.</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            Gavin at 21 months, after his bone graft at Primary Children\u2019s Hospital in 2017. His parents said they weren\u2019t told that a bone graft at that age was unusual.\n    \n            (Courtesy of Emily Rogers)\n    \n    \n    \n\n    \n\n        \n    \n                    \n<p>Primary\u2019s decision to use BMP in toddlers was a risky bet. In 2015, the U.S. Food and Drug Administration issued <a href=\"https://wayback.archive-it.org/7993/20170722215727/https://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm430868.htm\">a safety warning</a> about using BMP in children. The warning said that BMP hadn\u2019t been approved for children \u201cbecause their bones may still be growing and using this product may cause serious injuries.\u201d The FDA action followed revelations of injuries, including alleged deaths, related to the use of BMP in spine patients. BMP\u2019s maker was subjected to <a href=\"https://www.finance.senate.gov/chairmans-news/baucus-grassley-investigation-into-medtronic-reveals-manipulated-studies-close-financial-ties-with-researchers\">a congressional investigation</a> and paid hundreds of millions to settle <a href=\"https://www.startribune.com/medtronic-says-it-s-close-to-resolving-infuse-lawsuits/431428693/?refresh=true\">civil suits</a>.</p>\n\n<p>The FDA recommended against routine use in children and told doctors to be sure to inform parents about the risks.</p>\n\n<p>Doctors are allowed to use products like BMP for so-called off-label purposes and commonly do, often to the benefit of their patients. In 2017, Dr. Jeff Hammoudeh, a plastic surgeon at Children\u2019s Hospital Los Angeles, published one of the largest studies of BMP in cleft patients and found that over nine years of use its safety and success was comparable to using bone from the child\u2019s hip. But the average age of his patients was 11 and his youngest patient was 6. He said he wouldn\u2019t use BMP in patients any younger than that because of concerns, shared by other experts, about the long-term growth of a child\u2019s face and questions about the safe amount to use in a child of that size.</p>\n\n<p>Johns, of Primary Children\u2019s, said that Hammoudeh\u2019s study was one of the reasons her team felt confident in using BMP.</p>\n\n<p>Hammoudeh said doctors need to be up-front about what they are doing and build in clear guardrails. When he experimented with performing lip repairs in newborns, he did so through a supervised research study. Parents, he said, were given the choice to have the traditional protocol, just as they were for bone grafting with BMP.</p>\n\n<p>Some doctors may eschew the word \u201cexperiment\u201d when trying out a new protocol, he said, but that\u2019s what it is \u2014 even if they deem it \u201cinnovation.\u201d</p>\n\n<p>\u201cYou can soften the terminology any which way, but if you don\u2019t know what the results will be, you don\u2019t know what the results will be,\u201d he said.</p>\n\n<p>Johns told ProPublica she doesn\u2019t offer parents the choice to have a bone graft at the traditional age because she\u2019s confident that her way is better. Giving them the option, she said, \u201cmeans that we\u2019re telling them, \u2018OK, we\u2019re going to allow you to have subpar results.\u2019\u201d</p>\n\n<p>Johns said that since as early as 2018, the parents of patients have been told that the new protocol is superior to traditional care, a claim she said is supported by observational results from the team\u2019s first patients.</p>\n\n<p>The Rogerses and other parents who spoke with ProPublica said Siddiqi, the lead plastic surgeon at the time, led them to believe that grafting at toddler age was the standard of care.</p>\n\n<p>\u201cOne hundred percent,\u201d said one mom, whose daughter was not yet 18 months at the time of the procedure and had to repeat the surgery later. She said the conversation with a reporter \u201cwas the first I\u2019m hearing this isn\u2019t typical.\u201d</p>\n\n<p>After his surgery, Gavin happened to see a new doctor outside the hospital. Rogers said she stopped breathing when she learned that around the country, many doctors time bone grafts to when certain adult teeth come in. Gavin still didn\u2019t have all his baby teeth.</p>\n\n<p>And the bone graft didn\u2019t work. Gavin faces a second bone graft surgery this summer at 8 years old \u2014 in the age range when most other doctors would have done it the first time.</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            Gavin lies on his bed at his home in Farmington, Utah. He\u2019ll need a second bone graft surgery this summer.\n    \n            (Hannah Yoon, special to ProPublica)\n    \n    \n    \n\n    \n\n        \n    \n                    \n<p>Four years after Primary Children\u2019s started the protocol, the hospital did its first formal study \u2014 a review of 14 patients\u2019 medical records. From around 2017 to mid-2019 \u2014 when Johns was telling patients the protocol was a success \u2014 the cleft team used different surgical techniques and a combination of bone products, including the BMP, that proved unreliable, and some patients needed additional grafts, according to the study and a university spokesperson.</p>\n\n<p>A hospital spokesperson said its bone grafting procedures have advanced since patients such as Gavin had the operation. Khosla, the Stanford doctor who reviewed the protocol, reported in his summary that newer hospital data demonstrates good early results.</p>\n\n<p>Johns and Agarwal said their new protocol was a slow evolution and didn\u2019t need to be overseen by independent reviewers. Performing a bone graft sooner, they said, would solve a common problem in cleft patients in which the arch of their mouth is narrow and collapses inward as they grow. Moving to age 2 was a minor progression, Johns said, noting that the mouths of a 5-year-old, the youngest age most doctors would do a bone graft, and a 2-year-old are similar.</p>\n\n<p>\u201cThere was nothing that felt outlandish about it,\u201d Johns said.</p>\n\n<p>Johns concedes they don\u2019t know yet how their patients\u2019 faces will grow over time. So far, she said the outcomes are trending in the right direction, \u201cbut we recognize that we\u2019ve got eight more years to continue to see if it holds up.\u201d</p>\n\n<p>She\u2019s clear about this uncertainty with her patients, she said, as well as how Primary\u2019s protocols diverge from the standard. She said if parents are uncomfortable, she encourages them to seek a second opinion. (One mother said Johns\u2019 colleague told her that he would no longer treat her son after she sought a second opinion.)</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            Primary Children\u2019s Hospital in Salt Lake City\n    \n            (Kim Raff, special to ProPublica)\n    \n    \n    \n\n    \n\n        \n    \n                    \n<p>Jessica Bernstein, whose 6-year-old son is a cleft patient at Primary Children\u2019s and whom the hospital connected with ProPublica, said she had the utmost confidence in the care received and felt Johns and the other doctors carefully thought out decisions. She said they told her that the hospital\u2019s timeline for care was based on the latest, best research. Although she said she wasn\u2019t informed that aspects of the hospital\u2019s protocol differ from the standard or that BMP was off-label for children, she felt her son was being treated in the right place.</p>\n\n<p>Other cleft doctors said previous attempts to fix the upper jaw line between birth and 2 years old \u2014 known as \u201cprimary bone grafting\u201d \u2014 were abandoned because of poor outcomes.</p>\n\n<p>Dr. Ron Hathaway recalls when he was at the University of Indiana and participated in a study that compared outcomes at five cleft centers. One fared significantly worse. The upper jaws of many of its patients didn\u2019t grow as expected, leaving them with underbites. Hathaway was stunned to learn it was his program.</p>\n\n<p>Indiana, it turned out, was the only one that grafted before age 2. The others waited until patients were school age. Hathaway had been involved in such grafting at Indiana since 1992, and now he faced the humbling data that his patients were three times more likely than the study\u2019s best center to need invasive jaw surgery because of it.</p>\n        \n    \n                            \n    \n                    \n<p>\u201cI had to go home and have a serious conversation with my surgeons,\u201d he said.</p>\n\n<p>Indiana eliminated primary bone grafting, and when the study was repeated 10 years later, Hathaway said, outcomes had drastically improved. While this type of research can\u2019t definitively prove causation, he said, \u201ca thinking person would say primary bone grafting causes [poorer growth] of the upper jaw.\u201d</p>\n\n<p>The original study was published in 2011, joining a body of research over decades that showed such grafting was \u201csignificantly detrimental,\u201d Kirschner, of Nationwide, said.</p>\n\n<p>Nevertheless, in 2016 the cleft team at Primary Children\u2019s began questioning whether operating earlier would be better, said Agarwal, the chief of plastics. He and Johns said what they do is different \u2014 in terms of a slightly older age and specifics of the procedure \u2014 from the primary bone grafting of the past. Khosla, of Stanford, wrote in his review summary that the protocol challenges conventional wisdom, but \u201ctheir rationale and the theoretic benefits are sensible.\u201d</p>\n        \n    \n                    \n<p>For Cindy Anderson, whose daughter\u2019s bone graft echoed Gavin\u2019s in both timing and failure, it wasn\u2019t just that her daughter had to repeat a surgery. Had they been informed of the innovative nature, Anderson said they might have agreed because of their faith in the doctors. But not to be given a chance to consent made them feel duped.</p>\n\n<p>She said they\u2019re left wondering about Primary Children\u2019s: \u201cWhat the heck are they doing?\u201d</p>\n        \n             \n\n                                    \n        \n                        <p><a href=\"https://www.propublica.org/people/mariam-elba\">Mariam Elba</a> contributed research.</p>", "summary_detail": {"type": "text/html", "language": null, "base": "https://www.propublica.org/feeds/propublica/main", "value": "<p class=\"byline\">\n                by <a class=\"name\" href=\"https://www.propublica.org/people/megan-rose\">Megan Rose</a>                </p>\n                                             \n\n                                                                    \n            \n                <p>ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive <a href=\"https://www.propublica.org/newsletters/the-big-story?source=54G&amp;placement=top-note&amp;region=national\">our biggest stories</a> as soon as they\u2019re published.</p>\n\n            \n\n                \n\n      \n  \n\n\n\n                    \n<p>Returning to his home state of Utah, where more babies are born with cleft lip and palate than is typical, Dr. Devan Griner made plans to open his own practice, joining the small cohort of plastic surgeons nationwide who treat the condition.</p>\n\n<p>As he recruited doctors to fill out a team in 2017, Griner had lunch with an orthodontist who\u2019d long worked in the state. He quizzed Griner on his credentials and then turned to bone grafting, a common procedure for cleft patients, who are often missing a piece of their upper jaw. Sitting back, the doctor looked hard at Griner and lobbed a test question: At what age would Griner do bone grafts on patients?</p>\n\n<p>It was a surprising question. There is broad consensus nationwide to time bone grafts to when a patient is getting certain adult teeth, and so Griner, a bit taken aback, replied that of course he does it then. That\u2019s when Griner said the orthodontist relaxed, leaned in over their Neapolitan pizza and declared, \u201cWe have a bone grafting problem here in Utah.\u201d</p>\n\n<p>Almost immediately Griner encountered it for himself. Patients began turning up who\u2019d had treatment that departed from the standard of care in ways Griner found alarming. In many cases, he felt they\u2019d had, or been advised to undergo, grueling, and possibly unnecessary, facial surgeries earlier than his profession advised. And they were all treated at Primary Children\u2019s Hospital in Salt Lake City.</p>\n\n<p>As more former Primary Children\u2019s patients sought out Griner\u2019s team, the doctors started to question among themselves, and then with other cleft doctors in the state, whether they needed to do something. It\u2019s a rare and risky move to call out a fellow doctor\u2019s work, much less a team at a well-known hospital. Most children born with a cleft in the five-state region around Utah are treated at Primary Children\u2019s, some traveling the farthest distance for care in the nation. It\u2019s the largest pediatric hospital in the area, and for many, it had been the only choice.</p>\n        \n    \n                    \n<p>A crucial question emerged: Did the hospital\u2019s patients, and their anxious parents, know that the care they were getting at Primary Children\u2019s was different from what cleft surgeons at top hospitals around the country provided?</p>\n\n<p>The question hit at the heart of a common tension in medicine between the sort of innovation that drives life-enhancing advances and the accepted standard of care, which is informed by peer-reviewed medical studies, broad agreement among specialists and insurance company policies. What information are patients, especially children, owed? And how should regulators respond when doctors want to try something new \u2014 especially when doctors, and their choices, may be geographically or otherwise isolated from their peers?</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            Dr. Devan Griner, a plastic surgeon, at the Cleft and Craniofacial Institute of Utah in Provo\n    \n            (Hannah Yoon, special to ProPublica)\n    \n    \n    \n\n    \n\n        \n    \n                    \n<p>In the case of cleft lip and palate, the future of children\u2019s faces are on the line. The success of some cleft procedures isn't fully known until a child has finished growing. Although there can be signs along the way, not until cleft patients are almost adults will doctors be able to fully assess if a certain treatment done at 2 years old was ultimately beneficial or harmful.</p>\n\n<p>Griner\u2019s team and other doctors who\u2019d worked in Utah eventually felt they had to take collective action. A group of nine doctors decided to file a formal complaint with the state, saying \u201cthis is about protecting children.\u201d Among their allegations: Some doctors on the hospital\u2019s cleft team were performing bone grafts on patients who were too young \u2014 around age 2 \u2014 and using an off-label, controversial bone growth product that many doctors shun. They were performing intensive jaw surgeries \u2014 which require children to wear a large metal device screwed into their heads for months \u2014 so early that they risked some children needing to repeat the operation. And the team was performing surgeries some patients didn\u2019t need.</p>\n\n<p>\u201cThey just over, overoperate,\u201d said Lisa Morris, one of the cleft doctors on the state complaint.</p>\n\n<p>Cleft specialists at seven large pediatric institutions around the country, including Seattle Children\u2019s Hospital and Nationwide Children\u2019s Hospital, told ProPublica that the way doctors performed several procedures sharply departed from their speciality\u2019s most common practices.</p>\n\n<p>Utah\u2019s Division of Professional Licensing is investigating the practices of several doctors on Primary\u2019s cleft team, which is staffed by University of Utah doctors. The state agency originally closed the complaint with little investigation, but after an appeal to the head of Utah\u2019s commerce department, which oversees licensing, the division reopened it in April.</p>\n\n<p>Dr. Dana Johns, director of Primary Children\u2019s cleft team, said the fact that her team\u2019s practices don\u2019t align with those of her colleagues in the field \u201cdoesn\u2019t mean that different is wrong.\u201d She said that intervening earlier helps protect children with visible facial differences from a gamut of bullying in their formative teen years.</p>\n\n<p>In interviews, both Primary Children\u2019s and the University of Utah told ProPublica they stand by their protocol and fully inform their patients during appointments about how and why their care differs. What the team does is \u201cclinically defensible and potentially advantageous,\u201d Kathy Wilets, a University of Utah Health spokesperson, wrote in a statement.</p>\n\n<p>But ProPublica\u2019s questions, the hospital said, prompted the hiring of two independent cleft surgeons to formally review the protocol. Bioethicists have also reviewed the hospital\u2019s informed consent procedures, leading administrators to make changes to its cleft consent policies and consider hospitalwide changes.</p>\n\n<p>Dr. Jay Agarwal, the hospital\u2019s chief of plastic surgery, said the cleft team believes the standard methods of treating cleft lip and palate aren\u2019t good enough and is trying to advance care by fixing children\u2019s mouths at younger ages and in ways that could eliminate the need for surgery when they\u2019re older.</p>\n\n<p>\u201cWe always have to try to do better,\u201d he said.</p>\n\n<p>But parents of some of Primary Children\u2019s patients say their children were unwitting participants in what the hospital calls innovation and what some other cleft experts deemed a potentially risky deviation from evidence-based treatment. Experts said bone grafts done at such an early age could stunt facial growth, resulting in the upper lip looking pushed back and impairing basic tasks such as talking and chewing.</p>\n\n<p>The final results of the early bone grafting won\u2019t be known for years. Patients treated under the new bone-grafting protocol Primary Children\u2019s started around 2017 won\u2019t start seeing full outcomes until around 2029.</p>\n\n<p>Emily Rogers still feels the burden of remorse six years after her son\u2019s bone graft when he was 21 months old. She, like members of several families ProPublica spoke with, said the former head of the program didn\u2019t tell her that bone grafting at that age was unusual, that the hospital was just starting to try it or that doctors weren\u2019t sure how her son\u2019s face would grow after the procedure.</p>\n\n<p>\u201cIt\u2019s sickening to find out later you put your kids in their hands and they lied to you, basically,\u201d she said. \u201cThat\u2019s what it feels like: It was a lie.\u201d</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            Gavin Rogers, 7 sits with his mom, Emily Rogers, at their home in Farmington, Utah.\n    \n            (Hannah Yoon, special to ProPublica)\n    \n    \n    \n\n    \n\n        \n    \n                    \nThe Standard of Care\n<p>From the time a cleft is spotted on a sonogram during pregnancy, parents begin prepping for a series of surgeries to help their child with a noticeable facial difference. Each step of care throughout childhood builds upon the last, slowly marching the face toward the form it failed to take in the womb. A doctor\u2019s misstep can veer the mouth off course or mean more surgery.</p>\n\n<p>People unfamiliar with clefts, besides perhaps what they\u2019ve seen on Operation Smile fundraising commercials, tend to think of the treatment as a one-and-done surgery to repair a small slit in the lip. And while that can be the case, for a lot of babies born with the condition, it\u2019s much more involved. Often, a wide split starts at the nostril, goes down the lip, runs through the upper jaw and continues back through the roof of the mouth toward the throat. Sometimes there are splits on both sides of the mouth.</p>\n\n<p>Cleft lip and palate together affect about <a href=\"https://www.cdc.gov/ncbddd/birthdefects/cleftlip.html\">1 in 1,600 babies</a> in the U.S.; around <a href=\"https://www.nidcr.nih.gov/research/data-statistics/craniofacial-birth-defects/prevalence\">2,500 are born</a> with both each year. It is unclear why Utah has a higher rate. In general, the cause of a cleft is not well understood. According to the Centers for Disease Control and Prevention, there is some evidence that genetics can play a role, and some environmental factors, such as smoking during pregnancy or taking certain medications, can increase the chances of a cleft forming, which happens in the first trimester.</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            With cleft lip and palate, often a split starts at the nostril, goes down the lip and through the upper jaw, and continues back through the roof of the mouth toward the throat. Sometimes the split is on both sides of the mouth.\n    \n            (Illustration by Matt Twombly for ProPublica)\n    \n    \n    \n\n    \n\n        \n    \n                    \n<p>A cleft can affect a child\u2019s teeth, position of the midface and nose, and ability to hear, breathe, swallow and speak. Many cleft patients need care from a range of specialists from their earliest days until adulthood. Successful cleft treatment repairs those issues, leaving patients\u2019 faces with little evidence of their cleft issues by the time they are grown.</p>\n\n<p>Like most well-known conditions, there is a treatment plan for cleft lip and palate that a majority of doctors follow, known generally as the standard of care. ProPublica spoke with more than a dozen cleft specialists nationwide, and all acknowledged the variability, subjectivity and debate in cleft care. Several pointed out there aren\u2019t large randomized trials that have definitively provided answers, and care continues to evolve. Still, they all laid out the same general timeline of cleft treatment and the reasons for it.</p>\n\n<p>Doctors usually repair the lip and nose around 3 to 6 months, close the palate around 9 to 18 months and then wait to do a bone graft until children are about 5 to 11 years old, though there is debate about when in that age range is best. Jaw surgery, if needed, typically waits until the child is done growing. Most patients will need rhinoplasty and years of orthodontia as well and, in some cases, additional surgeries to help with things like speech.</p>\n\n<p>Richard Kirschner, chief of plastic and reconstructive surgery at Nationwide Children\u2019s in Ohio and the editor of a widely used cleft textbook, said this timeline is based on evidence collected over decades in the care of thousands of patients.</p>\n\n<p>To the doctors at Primary Children\u2019s, the skepticism they\u2019re facing is the plight of pioneers.</p>\n\n<p>\u201cI think it\u2019s easy to keep doing things the same way in the way they\u2019ve always been done,\u201d said Agarwal, who noted that he doesn\u2019t think there is a standard of care in cleft. \u201cAnd, you know, that\u2019s the answer for a lot of groups that they feel like they don't want to try new things. And that\u2019s OK. I mean, nothing\u2019s wrong with that.\u201d</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            Dr. Dana Johns in an exam room at Primary Children\u2019s Hospital\n    \n            (Kim Raff, special to ProPublica)\n    \n    \n    \n\n    \n\n        \n    \n                    \n<p>Faizi Siddiqi, who helped start the university\u2019s cleft team in 2003, stopped practicing last year and died from cancer in January at age 58. ProPublica was unable to reach him for comment before his death. Duane Yamashiro, an orthodontist who was the medical director of the cleft program for almost 20 years, declined through a spokesperson to comment. So did the most senior plastic surgeon currently on the team, Barbu Gociman. All three are named on the state complaint. Johns and the rest of cleft team doctors are not named on the complaint, and the hospital and the University of Utah declined to comment on it.</p>\n\n<p>\u201cWe stand firmly behind our surgical approaches and believe they deliver the best outcomes for our patients, although, through an extensive review of our program we realize there are opportunities to improve the way we communicate with our patients and their families,\u201d Wilets said in a written statement. \u201cThe safety and care of our patients is the most important thing to us.\u201d</p>\n\n<p>\u201cWe apologize for any distress to any patient family who feels we didn\u2019t meet their expectations and did not feel comfortable addressing their concerns directly with us,\u201d Wilets wrote.</p>\n\n<p>The hospital has around 700 to 800 cleft patients at any given time, and Wilets said its cleft outcomes are in line with or better than other centers\u2019.</p>\n\n<p>In responding to concerns that patients\u2019 families told ProPublica about, Jess Gomez, a hospital spokesperson, wrote, \u201cWe have no record of prior complaints from the families you\u2019ve identified regarding their care, and we are saddened to learn of the concerns you\u2019re sharing with us.\u201d He added that the patients were cared for by Siddiqi, so the hospital is unable to respond to specifics about treatment discussions.</p>\n\n<p>Innovating in surgery is a gray area. Unlike drug development, which has strict rules, surgeons are allowed wide leeway to try new things. \u201cIt\u2019s a little bit of the Wild West,\u201d said Dr. Jonathan Marron, director of clinical ethics at Harvard, and there isn\u2019t agreement on what the right balance is between supporting innovation and protecting patients.</p>\n\n<p>Doctors have an ethical obligation to make sure their patients are aware of how their protocol differs and what the rationale is for not doing the standard. \u201cInformed consent, in my mind, is an important aspect of this,\u201d he said.</p>\n\n<p>As more and more doctors stick to a standard, the less acceptable a deviation from that standard practice is, Marron said. But figuring out where that line is can be difficult.</p>\n\n<p>Innovating in surgery is not an area that\u2019s robustly regulated. Last year, Utah lawmakers made it easier for doctors to practice outside the standard by loosening the rules that had restricted it, though the law still requires that patients are informed in writing and consent. The hospital and University of Utah didn\u2019t respond to questions about whether patients are informed in writing about any deviations from the standard of care. Since ProPublica began reporting, the hospital has updated its written informed consent form regarding families\u2019 options, Wilets said, and it now \u201cmore explicitly\u201d tells patients that there is no standard protocol for cleft patients and different institutions have different protocols.</p>\n\n<p>In other parts of the world, cleft lip and palate care has undergone changes based on government oversight. For example, in the United Kingdom there used to be many cleft centers with wide variations in success. Then the government audited outcomes, looking at factors such as how well patients were able to speak and how well their jaws aligned. Some centers achieved much better results with fewer surgeries. The government consolidated care among fewer centers to improve results and consistency. There isn\u2019t any similar oversight in the United States.</p>\n\n<p>\u201cI think the important thing to understand here is that there\u2019s not a whole lot of regulation in terms of who is looking after clinical outcomes,\u201d Kirschner said. \u201cAnd so it\u2019s really [left] up to parents to do their research.\u201d</p>\n\nAn Outside Doctor\n<p>When Griner questioned the parents of the former Primary Children\u2019s patients, he said, none of them understood that the treatment their child had received wasn\u2019t the norm. The parents cycled through shock, anger and grief in his office so often that eventually he could tell by their faces what they\u2019d say next, he said. The remorse stage was the hardest to hear, with parents blaming themselves for not asking more questions.</p>\n\n<p>The parents, dogged by inchoate worries, had come to him seeking a second opinion once Griner and his partners opened their practice, he and some patients said.</p>\n\n<p>Griner, who remembers going door to door to fundraise for Primary Children\u2019s as a child, said he\u2019d always believed that the hospital\u2019s general excellence included the cleft team. He had wanted to work there. But Griner says that after he chose a fellowship position in Texas instead of with the University of Utah, relations soured.</p>\n\n<p>Later, after seeing the unit\u2019s handiwork firsthand in his practice, he took his concerns to the hospital\u2019s administration. During 2018 and 2019, he said, he had three conversations with different levels of leadership, including the hospital\u2019s then-CEO, about the poor cleft outcomes he and others were seeing. Each time, he said, his concerns weren\u2019t taken seriously.</p>\n\n<p>A spokesperson for Primary Children\u2019s said the former CEO and another administrator couldn\u2019t recall any such conversations, and the third, a director of surgical services at the time, said he recalled only casual conversations between colleagues. \u201cIf a concern were adequately raised by Dr. Griner, the concern would have been investigated and necessary action would have been taken,\u201d Gomez said in an email.</p>\n\n<p>As Griner\u2019s new cleft team settled in, their worries mounted. Once a month, the cleft team would meet with patients to collectively discuss next steps. After a former Primary Children\u2019s patient would leave one of those meetings for the first time, the doctors said they would look at each other, shaking their heads: \u201cCan you believe that?\u201d</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            Griner checks the teeth of Robbie McFerson, 4, while his mom, Sarah McFerson, holds him at the Cleft and Craniofacial Institute of Utah in Provo.\n    \n            (Hannah Yoon, special to ProPublica)\n    \n    \n    \n\n    \n\n        \n    \n                    \n<p>Primary Children\u2019s undertakes two surgeries to repair the palate instead of one, something most doctors in the United States have stopped doing. The hospital is unusual in that it uses a prosthetic device to cover the palate hole, which requires more time under anesthesia when swapped out for a new one. The hospital also often surgically expands the palate of young patients when a retainer-like device would typically be used instead.</p>\n\n<p>To Griner and his team, the timing of two major procedures \u2014 bone grafting and jaw surgeries \u2014 were worrying enough on their own, but along with other ways Primary Children\u2019s is an outlier, they were concerned that patients were getting aberrant care at many stages.</p>\n\n<p>Finally, in 2022, a group of doctors \u2014 many of whom compete with Primary Children\u2019s \u2014 <a href=\"https://www.documentcloud.org/documents/24451011-dopl-complaint\">raised the issues with the state</a>. Ten doctors\u2019 names appear on the complaint, though one told ProPublica that although he agreed with many of the concerns, he wasn\u2019t aware he\u2019d been included on it.</p>\n\n<p>(One of the plastic surgeons who signed the complaint, Rodney Schmelzer, has a complicated history with Primary Children\u2019s. He lost his privileges there in 2017 and has two ongoing lawsuits against the hospital, one of which also names Yamashiro and Siddiqi. The hospital and the doctors have denied the allegations.) </p>\n\n<p>Utah\u2019s Department of Commerce, which oversees the Division of Professional Licensing, said it could not confirm nor deny an investigation.</p>\n\n<p>The complaint alleges that Primary Children\u2019s doctors \u201croutinely exploit Cleft Patients and their families by \u2026 subjecting [them] to excessive numbers of surgeries outside the standard of care\u201d without being honest about the risks, benefits or alternatives, which the doctors say violates medical ethics and Utah law.</p>\n\nMajor Jaw Surgeries\n<p>Paige Holland started looking for a second opinion when Primary Children\u2019s said her 7-year-old son would next need major jaw surgery to correct the underbite that commonly afflicts cleft patients.</p>\n\n<p>The operation, called <a href=\"https://www.myface.org/surgeries/le-fort-1/\">a LeFort distraction</a>, sounded medieval to Holland: Doctors would cut part of his upper jaw from his skull and screw a rigid metal device, called a halo, to the outside of his head. Wires would attach his upper jaw to the device, and every day for weeks Holland would turn screws to tighten the wires and slowly pull her son\u2019s jaw bone forward and allow more bone to grow. He\u2019d wear the halo for months.</p>\n        \n    \n                    \n\n    \n            The LeFort Halo Procedure\n        \n\n                        \n                    \n                \n\n            <strong>Initial jaw alignment:</strong> Cleft patients often have severe underbites. This can affect how the face looks and can also impact basic functions, such as chewing.\n    \n    \n    \n    \n\n    \n\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            <strong>Surgical procedure:</strong> Doctors make cuts along the upper jaw so it can be repositioned.\n    \n    \n    \n    \n\n    \n\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            <strong>LeFort device attachment:</strong> Doctors screw a rigid metal device, called a halo, to the outside of the head and attach it to the upper jaw. After the surgery, patients tighten the wires daily to pull the jaw forward over the course of a few weeks. New bone grows, lengthening the jaw. The child wears the halo for several months to allow the bone to heal.\n    \n            (Illustrations by Matt Twombly for ProPublica)\n    \n    \n    \n\n    \n\n        \n    \n                    \n<p>Jaw surgeries aren\u2019t unusual for cleft patients, but the age Primary Children\u2019s often does them makes the hospital an outlier. Holland\u2019s son would have been as young as 9 at the time of the surgery, according to his Primary Children\u2019s medical records reviewed by ProPublica.</p>\n\n<p>The American Cleft Palate Craniofacial Association guidelines state that \u201cwhenever possible, [jaw] surgery should be delayed until physical maturation is essentially completed.\u2019\u2019 Cleft doctors at six leading hospitals said they don\u2019t perform jaw surgeries until children stop growing. For girls, that\u2019s about 14 to 16 years old; for boys, it\u2019s closer to 18.</p>\n\n<p>Until recently, Primary Children\u2019s website told families to expect possible jaw surgery between <a href=\"https://web.archive.org/web/20230607075520/https://intermountainhealthcare.org/primary-childrens/programs-specialties/cleft-craniofacial/\">9 and 10 years old</a>. But it has since changed <a href=\"https://intermountainhealthcare.org/primary-childrens/programs-specialties/cleft-craniofacial/\">the age range to between 9 and 15-plus</a>. Some other cleft centers also perform early jaw surgeries, and Kirschner told ProPublica he thinks that surgeries performed before maturity fall within the standard of care, though he personally waits for patients to be grown.</p>\n\n<p>Primary Children\u2019s data from 2020 showed that the average age of LeFort halo surgery there was 11.4 years old, according to a paper published by the hospital\u2019s cleft team that analyzed nearly 60 cleft patients who had halos over a three-year period. The age of the patients ranged from 8 to 16 years old.</p>\n\n<p>Cleft doctors ProPublica spoke with said they perform jaw surgery before maturity in only a tiny proportion of cases, usually only if medically necessary. Dr. Roberto Flores, head of the program at NYU, estimated the number at no more than 5%.</p>\n\n<p>At Seattle Children\u2019s Hospital, even in those extraordinary cases, the surgery would not happen until 12 to 14 years old, when most of the adult teeth are finished coming in, according to the hospital\u2019s former chief of craniofacial surgery, Richard Hopper.</p>\n\n<p>\u201cI\u2019ve been with the cleft team for 20 years, and I can pretty conclusively say we haven\u2019t done a Lefort \u2026 on a patient younger than 12 years old, 11 at the earliest,\u201d Hopper said last year before he took a job with Texas Children\u2019s Hospital.</p>\n\n<p>\u201cThe earlier you do a jaw surgery, the more likely you\u2019re going to have to repeat it later,\u201d a cleft team surgeon at a top-rated pediatric hospital said. \u201cBasically you\u2019re committing kids to having an extra operation.\u201d</p>\n\n<p>The best practice, many doctors said, is to do one definitive jaw surgery close to adulthood.</p>\n\n<p>\u201cIt\u2019s a brutal enough operation. You wouldn\u2019t want to have to do it twice,\u201d a leader in the field said. Both doctors asked not to be identified out of concern it would jeopardize relationships within the small community of doctors who provide cleft care.</p>\n\n<p>Primary\u2019s Johns said such critiques ignore the psychosocial issues children with cleft deal with. Bullying should be given more weight in treatment plans, she said, and repairing a child\u2019s differences before high school has merit. Most of her surgeries wait till at least age 12, she said, and when she does them on younger patients, it\u2019s for either psychosocial or other pronounced medical problems.</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            Dr. Trace Lund checks Robbie\u2019s palate and teeth. Children with cleft lip and palate often have extra or missing teeth, or teeth that emerge in the wrong spot.\n    \n            (Hannah Yoon, special to ProPublica)\n    \n    \n    \n\n    \n\n        \n    \n                    \n<p>Moreover, patients who wait until maturity can sometimes require extensive operations involving both the upper and lower jaws, Johns said. Patients who\u2019ve had the surgery young might require a second jaw surgery, she said, but it would involve only the upper jaw. The trade-off, she said, is worth it.</p>\n\n<p>Rohit Khosla, surgical director of the cleft team at Stanford Medicine Children\u2019s Health who trained Johns during her fellowship, reviewed all of the hospital\u2019s protocols at her request. In general, Khosla told ProPublica that he thought the hospital\u2019s methods were controversial but not problematic. He found several problems with the cleft team\u2019s study designs and conclusions, but overall its \u201cprotocols are conscientiously thought out with [a] goal to provide a high level of care,\u201d he said in a summary of his report. The hospital would not share his full written review and asked Khosla to stop speaking with ProPublica once it was completed. Primary Children\u2019s also set up a double-blinded review \u2014 neither the hospital nor reviewer knew whom the other was \u2014 to further assess its protocols, but the hospital said it would not make the report public when it was completed.</p>\n\n<p>In looking at the hospital\u2019s latest LeFort data, Khosla wrote that in the \u201clast few years\u201d the average age has increased to 14, \u201cwhich I find more acceptable.\u201d</p>\n\n<p>On a Facebook page for Utah parents of children with cleft, numerous posts over the years speak to the hospital\u2019s push to perform LeForts young. Some talk about how their children endured the surgery before 10 years old \u2014 \u201cnot going to lie the Halo is tough!\u201d one mother wrote \u2014 and needed to repeat a jaw surgery as a teenager.</p>\n\n<p>Holland said she thought there had to be another way to fix her son\u2019s underbite and asked about braces. After Primary Children\u2019s said there wasn\u2019t, she said, she sought a second opinion with Griner, who sent him to an orthodontist instead. Holland\u2019s son was one of at least seven former Primary Children\u2019s patients whom Griner said he diverted from having surgery before maturity. None of them, in Griner\u2019s opinion, had any medical necessity for the operation before maturity or reported bullying or other psychosocial issues. Schmelzer, who also signed the complaint against Primary Children\u2019s, said his medical records showed similar numbers.</p>\n\n<p>Griner recalled one startling case last summer in which Primary Children\u2019s had lined up surgery for a 9-year-old child whose jaw was nearly normal. An independent plastic surgeon who specializes in cleft at a large academic institution reviewed the patient\u2019s CT scan for ProPublica and confirmed Griner\u2019s assessment that there was no need for surgery.</p>\n\n<p>Holland\u2019s son, now 13, has only a minor underbite after orthodontics and likely won\u2019t need jaw surgery at all.</p>\n\n<p>\u201cHe\u2019s totally fine,\u201d Holland said. \u201cHe was saved from a major surgery.\u201d</p>\n\nExperimenting With Bone Grafts\n<p>About seven years ago, spurred by what Johns said was a \u201chypothesis we had,\u201d Primary Children\u2019s cleft team began experimenting with how surgeons bone grafted the upper jaw.</p>\n\n<p>Without putting in place the protections of a formal research study, Johns and her colleagues decided the invasive surgeries could be done successfully when children were years younger \u2014 age 2 \u2014 than was standard practice in their field.</p>\n\n<p>The \u201cgold standard\u201d for a bone graft is to use a piece of the child\u2019s own hip. At 2, a patient doesn\u2019t have enough bone to harvest. So over a period of about two years, Primary Children\u2019s tested in its toddler-age patients different combinations of materials that would create a lasting bone graft.</p>\n\n<p>Among the materials was a controversial product called bone morphogenic protein, or BMP, which stimulates bone growth. The BMP is put into the jaw where the child is missing bone and, in theory, spurs the body to naturally make bone, gradually filling the gap.</p>\n\n<p>Some cleft doctors have hailed BMP as a less invasive way to treat patients since it first came to market in 2002 \u2014 but Primary Children\u2019s believed it could be used in children years younger than their peers at other centers. </p>\n\n<p>The parents of several patients told ProPublica they were never informed that their child was undergoing an untested procedure. In some cases the bone graft failed, necessitating a repeat of the painful operation.</p>\n\n<p>In 2017, Gavin Rogers, 21 months old with the wispy blond hair of a baby, had bone graft and hard palate repair. Afterwards, \u201che was screaming all the time. He wasn\u2019t sleeping, wasn\u2019t eating. I had to squirt milk into his mouth,\u201d his mom, Emily Rogers, recalled.</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            Gavin at 21 months, after his bone graft at Primary Children\u2019s Hospital in 2017. His parents said they weren\u2019t told that a bone graft at that age was unusual.\n    \n            (Courtesy of Emily Rogers)\n    \n    \n    \n\n    \n\n        \n    \n                    \n<p>Primary\u2019s decision to use BMP in toddlers was a risky bet. In 2015, the U.S. Food and Drug Administration issued <a href=\"https://wayback.archive-it.org/7993/20170722215727/https://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm430868.htm\">a safety warning</a> about using BMP in children. The warning said that BMP hadn\u2019t been approved for children \u201cbecause their bones may still be growing and using this product may cause serious injuries.\u201d The FDA action followed revelations of injuries, including alleged deaths, related to the use of BMP in spine patients. BMP\u2019s maker was subjected to <a href=\"https://www.finance.senate.gov/chairmans-news/baucus-grassley-investigation-into-medtronic-reveals-manipulated-studies-close-financial-ties-with-researchers\">a congressional investigation</a> and paid hundreds of millions to settle <a href=\"https://www.startribune.com/medtronic-says-it-s-close-to-resolving-infuse-lawsuits/431428693/?refresh=true\">civil suits</a>.</p>\n\n<p>The FDA recommended against routine use in children and told doctors to be sure to inform parents about the risks.</p>\n\n<p>Doctors are allowed to use products like BMP for so-called off-label purposes and commonly do, often to the benefit of their patients. In 2017, Dr. Jeff Hammoudeh, a plastic surgeon at Children\u2019s Hospital Los Angeles, published one of the largest studies of BMP in cleft patients and found that over nine years of use its safety and success was comparable to using bone from the child\u2019s hip. But the average age of his patients was 11 and his youngest patient was 6. He said he wouldn\u2019t use BMP in patients any younger than that because of concerns, shared by other experts, about the long-term growth of a child\u2019s face and questions about the safe amount to use in a child of that size.</p>\n\n<p>Johns, of Primary Children\u2019s, said that Hammoudeh\u2019s study was one of the reasons her team felt confident in using BMP.</p>\n\n<p>Hammoudeh said doctors need to be up-front about what they are doing and build in clear guardrails. When he experimented with performing lip repairs in newborns, he did so through a supervised research study. Parents, he said, were given the choice to have the traditional protocol, just as they were for bone grafting with BMP.</p>\n\n<p>Some doctors may eschew the word \u201cexperiment\u201d when trying out a new protocol, he said, but that\u2019s what it is \u2014 even if they deem it \u201cinnovation.\u201d</p>\n\n<p>\u201cYou can soften the terminology any which way, but if you don\u2019t know what the results will be, you don\u2019t know what the results will be,\u201d he said.</p>\n\n<p>Johns told ProPublica she doesn\u2019t offer parents the choice to have a bone graft at the traditional age because she\u2019s confident that her way is better. Giving them the option, she said, \u201cmeans that we\u2019re telling them, \u2018OK, we\u2019re going to allow you to have subpar results.\u2019\u201d</p>\n\n<p>Johns said that since as early as 2018, the parents of patients have been told that the new protocol is superior to traditional care, a claim she said is supported by observational results from the team\u2019s first patients.</p>\n\n<p>The Rogerses and other parents who spoke with ProPublica said Siddiqi, the lead plastic surgeon at the time, led them to believe that grafting at toddler age was the standard of care.</p>\n\n<p>\u201cOne hundred percent,\u201d said one mom, whose daughter was not yet 18 months at the time of the procedure and had to repeat the surgery later. She said the conversation with a reporter \u201cwas the first I\u2019m hearing this isn\u2019t typical.\u201d</p>\n\n<p>After his surgery, Gavin happened to see a new doctor outside the hospital. Rogers said she stopped breathing when she learned that around the country, many doctors time bone grafts to when certain adult teeth come in. Gavin still didn\u2019t have all his baby teeth.</p>\n\n<p>And the bone graft didn\u2019t work. Gavin faces a second bone graft surgery this summer at 8 years old \u2014 in the age range when most other doctors would have done it the first time.</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            Gavin lies on his bed at his home in Farmington, Utah. He\u2019ll need a second bone graft surgery this summer.\n    \n            (Hannah Yoon, special to ProPublica)\n    \n    \n    \n\n    \n\n        \n    \n                    \n<p>Four years after Primary Children\u2019s started the protocol, the hospital did its first formal study \u2014 a review of 14 patients\u2019 medical records. From around 2017 to mid-2019 \u2014 when Johns was telling patients the protocol was a success \u2014 the cleft team used different surgical techniques and a combination of bone products, including the BMP, that proved unreliable, and some patients needed additional grafts, according to the study and a university spokesperson.</p>\n\n<p>A hospital spokesperson said its bone grafting procedures have advanced since patients such as Gavin had the operation. Khosla, the Stanford doctor who reviewed the protocol, reported in his summary that newer hospital data demonstrates good early results.</p>\n\n<p>Johns and Agarwal said their new protocol was a slow evolution and didn\u2019t need to be overseen by independent reviewers. Performing a bone graft sooner, they said, would solve a common problem in cleft patients in which the arch of their mouth is narrow and collapses inward as they grow. Moving to age 2 was a minor progression, Johns said, noting that the mouths of a 5-year-old, the youngest age most doctors would do a bone graft, and a 2-year-old are similar.</p>\n\n<p>\u201cThere was nothing that felt outlandish about it,\u201d Johns said.</p>\n\n<p>Johns concedes they don\u2019t know yet how their patients\u2019 faces will grow over time. So far, she said the outcomes are trending in the right direction, \u201cbut we recognize that we\u2019ve got eight more years to continue to see if it holds up.\u201d</p>\n\n<p>She\u2019s clear about this uncertainty with her patients, she said, as well as how Primary\u2019s protocols diverge from the standard. She said if parents are uncomfortable, she encourages them to seek a second opinion. (One mother said Johns\u2019 colleague told her that he would no longer treat her son after she sought a second opinion.)</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            Primary Children\u2019s Hospital in Salt Lake City\n    \n            (Kim Raff, special to ProPublica)\n    \n    \n    \n\n    \n\n        \n    \n                    \n<p>Jessica Bernstein, whose 6-year-old son is a cleft patient at Primary Children\u2019s and whom the hospital connected with ProPublica, said she had the utmost confidence in the care received and felt Johns and the other doctors carefully thought out decisions. She said they told her that the hospital\u2019s timeline for care was based on the latest, best research. Although she said she wasn\u2019t informed that aspects of the hospital\u2019s protocol differ from the standard or that BMP was off-label for children, she felt her son was being treated in the right place.</p>\n\n<p>Other cleft doctors said previous attempts to fix the upper jaw line between birth and 2 years old \u2014 known as \u201cprimary bone grafting\u201d \u2014 were abandoned because of poor outcomes.</p>\n\n<p>Dr. Ron Hathaway recalls when he was at the University of Indiana and participated in a study that compared outcomes at five cleft centers. One fared significantly worse. The upper jaws of many of its patients didn\u2019t grow as expected, leaving them with underbites. Hathaway was stunned to learn it was his program.</p>\n\n<p>Indiana, it turned out, was the only one that grafted before age 2. The others waited until patients were school age. Hathaway had been involved in such grafting at Indiana since 1992, and now he faced the humbling data that his patients were three times more likely than the study\u2019s best center to need invasive jaw surgery because of it.</p>\n        \n    \n                            \n    \n                    \n<p>\u201cI had to go home and have a serious conversation with my surgeons,\u201d he said.</p>\n\n<p>Indiana eliminated primary bone grafting, and when the study was repeated 10 years later, Hathaway said, outcomes had drastically improved. While this type of research can\u2019t definitively prove causation, he said, \u201ca thinking person would say primary bone grafting causes [poorer growth] of the upper jaw.\u201d</p>\n\n<p>The original study was published in 2011, joining a body of research over decades that showed such grafting was \u201csignificantly detrimental,\u201d Kirschner, of Nationwide, said.</p>\n\n<p>Nevertheless, in 2016 the cleft team at Primary Children\u2019s began questioning whether operating earlier would be better, said Agarwal, the chief of plastics. He and Johns said what they do is different \u2014 in terms of a slightly older age and specifics of the procedure \u2014 from the primary bone grafting of the past. Khosla, of Stanford, wrote in his review summary that the protocol challenges conventional wisdom, but \u201ctheir rationale and the theoretic benefits are sensible.\u201d</p>\n        \n    \n                    \n<p>For Cindy Anderson, whose daughter\u2019s bone graft echoed Gavin\u2019s in both timing and failure, it wasn\u2019t just that her daughter had to repeat a surgery. Had they been informed of the innovative nature, Anderson said they might have agreed because of their faith in the doctors. But not to be given a chance to consent made them feel duped.</p>\n\n<p>She said they\u2019re left wondering about Primary Children\u2019s: \u201cWhat the heck are they doing?\u201d</p>\n        \n             \n\n                                    \n        \n                        <p><a href=\"https://www.propublica.org/people/mariam-elba\">Mariam Elba</a> contributed research.</p>"}, "tags": [{"term": "Health Care", "scheme": null, "label": null}], "updated": "2024-03-06T05:00:00-05:00", "updated_parsed": [2024, 3, 6, 10, 0, 0, 2, 66, 0], "authors": [{"name": "by Megan Rose"}], "author": "by Megan Rose", "author_detail": {"name": "by Megan Rose"}}, {"title": "Michigan Lawmaker Introduces Bill Requiring State Health Plans to Cover Cutting-Edge Cancer Treatments", "title_detail": {"type": "text/plain", "language": null, "base": "https://www.propublica.org/feeds/propublica/main", "value": "Michigan Lawmaker Introduces Bill Requiring State Health Plans to Cover Cutting-Edge Cancer Treatments"}, "links": [{"rel": "alternate", "type": "text/html", "href": "https://www.propublica.org/article/michigan-state-health-plans-cancer-treatments"}], "link": "https://www.propublica.org/article/michigan-state-health-plans-cancer-treatments", "published": "Tue, 05 Mar 2024 10:00:00 -0500", "published_parsed": [2024, 3, 5, 15, 0, 0, 1, 65, 0], "id": "https://www.propublica.org/article/michigan-state-health-plans-cancer-treatments", "guidislink": false, "summary": "<p class=\"byline\">\n                by <a class=\"name\" href=\"https://www.propublica.org/people/robin-fields\">Robin Fields</a> and <a class=\"name\" href=\"https://www.propublica.org/people/maya-miller\">Maya Miller</a>                </p>\n                                             \n\n                                                                    \n            \n                <p>ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive <a href=\"https://www.propublica.org/newsletters/the-big-story?source=54G&amp;placement=top-note&amp;region=national\">our biggest stories</a> as soon as they\u2019re published.</p>\n\n            \n\n                \n\n\n\n        \n                        <p><strong>Update, March 5, 2024:</strong> After this story was published, the <a href=\"https://www.legislature.mi.gov/documents/2023-2024/billintroduced/Senate/pdf/2024-SIB-0738.pdf\">bill was introduced</a>.</p>\n\n        \n\n    \n      \n  \n\n\n\n                    \n<p>Spurred by a ProPublica story about an insurer that <a href=\"https://www.propublica.org/article/priority-health-michigan-cart-insurance-vanpatten-denials\">denied coverage of the only therapy that could have saved the life of a 50-year-old father of two</a>, a Michigan lawmaker plans to introduce a bill Tuesday requiring health plans in the state to cover cutting-edge cancer treatments.</p>\n\n<p>In February 2020, Forrest VanPatten died fighting Priority Health, one of Michigan\u2019s largest health insurers, over its refusal to pay for CAR-T cell therapy, his last-chance treatment. The therapy works by genetically reengineering patients\u2019 own cells, then infusing them back into the body to beat back their disease.</p>\n\n<p>Michigan has long required insurers to cover proven cancer treatments, but according to internal emails, some Priority Health executives argued that CAR-T was a gene therapy, not a drug, and thus not subject to <a href=\"https://www.legislature.mi.gov/(S(fo25nkc4smftag1bd3414u4k))/mileg.aspx?page=getObject&amp;objectName=mcl-500-3406e\">the state\u2019s coverage mandate</a>. </p>\n\n<p>State Sen. Jeff Irwin, D-Ann Arbor, plans to file the new bill to make explicit that Michigan\u2019s cancer treatment coverage mandate includes a new generation of genetic and immunotherapies, including CAR-T. </p>\n\n<p>Earlier this year, <a href=\"https://www.propublica.org/article/michigan-insurance-must-cover-proven-cancer-treatments-priority-health\">Michigan\u2019s top insurance regulator told health plans</a> they had to cover these treatments. Irwin\u2019s measure would codify that guidance, ensuring it\u2019s not dependent on one regulator\u2019s interpretation of the law. He said he wanted the state\u2019s requirements to be abundantly clear to both patients and insurers.</p>\n\n<p>\u201cI feel that the insurance company in this case was painting outside the lines,\u201d Irwin said Monday in an interview. \u201cThis change that we\u2019re making, I think, is going to make it hard to impossible for someone to make that same decision again around these particular treatments.\u201d</p>\n\n<p>The bill\u2019s introduction was bittersweet for the VanPatten family. \u201cIf this helps any other family, any other person, we are all for it,\u201d said Betty VanPatten, Forrest\u2019s widow. \u201cIt just feels like they got one over on everybody.\u201d Betty and her children said they hope Priority Health faces repercussions for the decision to deny coverage for Forrest\u2019s treatment.</p>\n\n<p>Priority Health\u2019s decision not to pay for CAR-T cancer treatments was almost entirely motivated by the medication\u2019s high cost, former employees told ProPublica. \u201cIt was, \u2018This was really expensive, how do we stop payment?\u2019\u201d recalled Dr. John Fox, Priority Health\u2019s associate chief medical officer at the time.</p>\n\n<p>When the Food and Drug Administration approved the first CAR-T therapy in 2017, Fox tried unsuccessfully to persuade executives at Priority Health to cover it, citing Michigan\u2019s law. He left his position with the health plan in 2019, in large part because he was disillusioned with the company\u2019s decision not to pay for life-prolonging cancer therapies.  </p>\n\n<p>In <a href=\"https://www.documentcloud.org/documents/24156051-priority-health-statement\">an earlier statement</a> to ProPublica, Priority Health said that \u201cthere was a lack of consensus in the medical community regarding the treatment\u201d when it was first approved, and that the company began offering coverage after \u201cextensive clinical work improved the treatment.\u201d But well before VanPatten\u2019s doctors requested Priority Health\u2019s approval for the treatment in early 2020, an alliance of leading U.S. cancer treatment centers concluded there was substantial consensus about the treatment\u2019s efficacy.</p>\n\n<p>Asked about Irwin\u2019s bill, Priority Health spokesperson Mark Geary said in a written statement that the company complies with all existing federal and state laws and has been providing coverage for CAR-T cell therapy for several years. \u201cWe also stand ready to continue to work with lawmakers and regulators in Michigan to find ways to offer Michiganders affordable access to effective, evidence-based treatments and procedures,\u201d Geary wrote.</p>\n\n<p>In the aftermath of ProPublica\u2019s story, several Michigan <a href=\"https://www.propublica.org/article/michigan-insurance-must-cover-proven-cancer-treatments-priority-health\">lawmakers called out the state\u2019s insurance department</a> for not investigating Priority Health\u2019s actions in the VanPatten case and failing to enforce the law that requires coverage of cancer drugs. </p>\n\n<p>Regulators acknowledged they hadn\u2019t cited a single Michigan insurer for violating the mandate since it was created in 1989.</p>\n\n<p>Under existing law, the Michigan Department of Insurance and Financial Services can levy fines against insurers that fail to comply and can even suspend or revoke their licenses. </p>\n\n<p>In an emailed statement, Communications Director Laura Hall said the agency anticipated backing Irwin\u2019s proposal. The department, she wrote, \u201csupports efforts to embed protections for cancer patients in state law.\u201d </p>\n\n<p>If Irwin\u2019s proposal passes, not all Michigan health plans will have to follow it. Some employers pay directly for workers\u2019 health care, hiring insurers to process claims. These plans are regulated by the federal government and are exempt from state coverage requirements, though some follow them voluntarily.</p>\n        \n    \n                    \n    \n        <p>\n            <strong><a href=\"https://www.propublica.org/getinvolved/insurance-denial-health-care-investigation\">Do You Have Insights Into Dental and Health Insurance Denials? Help Us Report on the System.</a></strong>\n        </p>", "summary_detail": {"type": "text/html", "language": null, "base": "https://www.propublica.org/feeds/propublica/main", "value": "<p class=\"byline\">\n                by <a class=\"name\" href=\"https://www.propublica.org/people/robin-fields\">Robin Fields</a> and <a class=\"name\" href=\"https://www.propublica.org/people/maya-miller\">Maya Miller</a>                </p>\n                                             \n\n                                                                    \n            \n                <p>ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive <a href=\"https://www.propublica.org/newsletters/the-big-story?source=54G&amp;placement=top-note&amp;region=national\">our biggest stories</a> as soon as they\u2019re published.</p>\n\n            \n\n                \n\n\n\n        \n                        <p><strong>Update, March 5, 2024:</strong> After this story was published, the <a href=\"https://www.legislature.mi.gov/documents/2023-2024/billintroduced/Senate/pdf/2024-SIB-0738.pdf\">bill was introduced</a>.</p>\n\n        \n\n    \n      \n  \n\n\n\n                    \n<p>Spurred by a ProPublica story about an insurer that <a href=\"https://www.propublica.org/article/priority-health-michigan-cart-insurance-vanpatten-denials\">denied coverage of the only therapy that could have saved the life of a 50-year-old father of two</a>, a Michigan lawmaker plans to introduce a bill Tuesday requiring health plans in the state to cover cutting-edge cancer treatments.</p>\n\n<p>In February 2020, Forrest VanPatten died fighting Priority Health, one of Michigan\u2019s largest health insurers, over its refusal to pay for CAR-T cell therapy, his last-chance treatment. The therapy works by genetically reengineering patients\u2019 own cells, then infusing them back into the body to beat back their disease.</p>\n\n<p>Michigan has long required insurers to cover proven cancer treatments, but according to internal emails, some Priority Health executives argued that CAR-T was a gene therapy, not a drug, and thus not subject to <a href=\"https://www.legislature.mi.gov/(S(fo25nkc4smftag1bd3414u4k))/mileg.aspx?page=getObject&amp;objectName=mcl-500-3406e\">the state\u2019s coverage mandate</a>. </p>\n\n<p>State Sen. Jeff Irwin, D-Ann Arbor, plans to file the new bill to make explicit that Michigan\u2019s cancer treatment coverage mandate includes a new generation of genetic and immunotherapies, including CAR-T. </p>\n\n<p>Earlier this year, <a href=\"https://www.propublica.org/article/michigan-insurance-must-cover-proven-cancer-treatments-priority-health\">Michigan\u2019s top insurance regulator told health plans</a> they had to cover these treatments. Irwin\u2019s measure would codify that guidance, ensuring it\u2019s not dependent on one regulator\u2019s interpretation of the law. He said he wanted the state\u2019s requirements to be abundantly clear to both patients and insurers.</p>\n\n<p>\u201cI feel that the insurance company in this case was painting outside the lines,\u201d Irwin said Monday in an interview. \u201cThis change that we\u2019re making, I think, is going to make it hard to impossible for someone to make that same decision again around these particular treatments.\u201d</p>\n\n<p>The bill\u2019s introduction was bittersweet for the VanPatten family. \u201cIf this helps any other family, any other person, we are all for it,\u201d said Betty VanPatten, Forrest\u2019s widow. \u201cIt just feels like they got one over on everybody.\u201d Betty and her children said they hope Priority Health faces repercussions for the decision to deny coverage for Forrest\u2019s treatment.</p>\n\n<p>Priority Health\u2019s decision not to pay for CAR-T cancer treatments was almost entirely motivated by the medication\u2019s high cost, former employees told ProPublica. \u201cIt was, \u2018This was really expensive, how do we stop payment?\u2019\u201d recalled Dr. John Fox, Priority Health\u2019s associate chief medical officer at the time.</p>\n\n<p>When the Food and Drug Administration approved the first CAR-T therapy in 2017, Fox tried unsuccessfully to persuade executives at Priority Health to cover it, citing Michigan\u2019s law. He left his position with the health plan in 2019, in large part because he was disillusioned with the company\u2019s decision not to pay for life-prolonging cancer therapies.  </p>\n\n<p>In <a href=\"https://www.documentcloud.org/documents/24156051-priority-health-statement\">an earlier statement</a> to ProPublica, Priority Health said that \u201cthere was a lack of consensus in the medical community regarding the treatment\u201d when it was first approved, and that the company began offering coverage after \u201cextensive clinical work improved the treatment.\u201d But well before VanPatten\u2019s doctors requested Priority Health\u2019s approval for the treatment in early 2020, an alliance of leading U.S. cancer treatment centers concluded there was substantial consensus about the treatment\u2019s efficacy.</p>\n\n<p>Asked about Irwin\u2019s bill, Priority Health spokesperson Mark Geary said in a written statement that the company complies with all existing federal and state laws and has been providing coverage for CAR-T cell therapy for several years. \u201cWe also stand ready to continue to work with lawmakers and regulators in Michigan to find ways to offer Michiganders affordable access to effective, evidence-based treatments and procedures,\u201d Geary wrote.</p>\n\n<p>In the aftermath of ProPublica\u2019s story, several Michigan <a href=\"https://www.propublica.org/article/michigan-insurance-must-cover-proven-cancer-treatments-priority-health\">lawmakers called out the state\u2019s insurance department</a> for not investigating Priority Health\u2019s actions in the VanPatten case and failing to enforce the law that requires coverage of cancer drugs. </p>\n\n<p>Regulators acknowledged they hadn\u2019t cited a single Michigan insurer for violating the mandate since it was created in 1989.</p>\n\n<p>Under existing law, the Michigan Department of Insurance and Financial Services can levy fines against insurers that fail to comply and can even suspend or revoke their licenses. </p>\n\n<p>In an emailed statement, Communications Director Laura Hall said the agency anticipated backing Irwin\u2019s proposal. The department, she wrote, \u201csupports efforts to embed protections for cancer patients in state law.\u201d </p>\n\n<p>If Irwin\u2019s proposal passes, not all Michigan health plans will have to follow it. Some employers pay directly for workers\u2019 health care, hiring insurers to process claims. These plans are regulated by the federal government and are exempt from state coverage requirements, though some follow them voluntarily.</p>\n        \n    \n                    \n    \n        <p>\n            <strong><a href=\"https://www.propublica.org/getinvolved/insurance-denial-health-care-investigation\">Do You Have Insights Into Dental and Health Insurance Denials? Help Us Report on the System.</a></strong>\n        </p>"}, "tags": [{"term": "Health Care, Uncovered", "scheme": null, "label": null}], "updated": "2024-03-05T10:00:00-05:00", "updated_parsed": [2024, 3, 5, 15, 0, 0, 1, 65, 0], "authors": [{"name": "by Robin Fields and Maya Miller"}], "author": "by Robin Fields and Maya Miller", "author_detail": {"name": "by Robin Fields and Maya Miller"}}, {"title": "Syphilis Is Killing Babies. The U.S. Government Is Failing to Stop the Disease From Spreading.", "title_detail": {"type": "text/plain", "language": null, "base": "https://www.propublica.org/feeds/propublica/main", "value": "Syphilis Is Killing Babies. The U.S. Government Is Failing to Stop the Disease From Spreading."}, "links": [{"rel": "alternate", "type": "text/html", "href": "https://www.propublica.org/article/how-federal-government-fails-stop-syphilis-babies-pregnancy"}], "link": "https://www.propublica.org/article/how-federal-government-fails-stop-syphilis-babies-pregnancy", "published": "Mon, 04 Mar 2024 05:00:00 -0500", "published_parsed": [2024, 3, 4, 10, 0, 0, 0, 64, 0], "id": "https://www.propublica.org/article/how-federal-government-fails-stop-syphilis-babies-pregnancy", "guidislink": false, "summary": "<p class=\"byline\">\n                by <a class=\"name\" href=\"https://www.propublica.org/people/anna-maria-barry-jester\">Anna Maria Barry-Jester</a>                </p>\n                                             \n\n                                                                    \n            \n                <p>ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive <a href=\"https://www.propublica.org/newsletters/the-big-story?source=54G&amp;placement=top-note&amp;region=national\">our biggest stories</a> as soon as they\u2019re published.</p>\n\n            \n\n                \n\n      \n  \n\n\n\n                    \n<p>Karmin Strohfus, the lead nurse at a South Dakota jail, punched numbers into a phone like lives depended on it. She had in her care a pregnant woman with syphilis, a highly contagious, potentially fatal infection that can pass into the womb. A treatment could cure the woman and protect her fetus, but she couldn\u2019t find it in stock at any pharmacy she called \u2014 not in Hughes County, not even anywhere within an hour\u2019s drive.</p>\n\n<p>Most people held at the jail where Strohfus works are released within a few days. \u201cWhat happens if she gets out before I\u2019m able to treat her?\u201d she worried. Exasperated, Strohfus reached out to the state health department, which came through with one dose. The treatment required three. Officials told Strohfus to contact the federal Centers for Disease Control and Prevention for help, she said. The risks of harm to a developing baby from syphilis are so high that experts urge not to delay treatment, even by a day. </p>\n\n<p>Nearly three weeks passed from when Strohfus started calling pharmacies to when she had the full treatment in hand, she said, and it barely arrived in time. The woman was released just days after she got her last shot. </p>\n\n<p>Last June, Pfizer, the lone U.S. manufacturer of the injections, notified the Food and Drug Administration of an \u201cimpending stock out\u201d that it anticipated would last a year. The company blamed \u201can increase in syphilis infection rates as well as competitive shortages.\u201d </p>\n\n<p>Across the country, physicians, clinic staff and public health experts say that the shortage is preventing them from reining in a surge of syphilis and that the federal government is downplaying the crisis. State and local public health authorities, which by law are responsible for controlling the spread of infectious diseases, report delays getting medicine to pregnant people with syphilis. This emergency was predictable: There have been shortages of this drug in eight of the last 20 years.  </p>\n\n<p>Yet federal health authorities have not prevented the drug shortages in the past and aren\u2019t doing much to prevent them in the future. </p>\n\n<p>Syphilis, which is typically spread during sex, can be devastating if it goes untreated in pregnancy: About 40% of babies born to women with untreated syphilis can be stillborn or die as newborns, according to the CDC. Infants that survive can suffer from deformed bones, excruciating pain or brain damage, and some struggle to hear, see or breathe. Since this is entirely preventable, <a href=\"https://www.propublica.org/article/babies-are-dying-of-syphilis-its-100-preventable\">a baby born with syphilis is a shameful sign of a failing public health system. </a></p>\n\n<p>In 2022, the most recent year for which the CDC has data available, more than 3,700 babies were infected with syphilis, including nearly 300 who were stillborn or died as infants. More than 50% of these cases occurred because, even though the pregnant parent was diagnosed with syphilis, they were never properly treated. </p>\n\n<p>That year, there were 200,000 cases identified in the U.S., a 79% increase from five years before. Infection rates among pregnant people and babies increased by <a href=\"https://www.cdc.gov/nchs/products/databriefs/db496.htm\">more than 250%</a> in that time; South Dakota, where Strohfus works, had the highest rates \u2014 including a more than 400% increase among pregnant women. Statewide, the rate of babies born with the disease, a condition known as congenital syphilis, jumped more than 40-fold in just five years. </p>\n\n<p>And that was before the current shortage of shots.</p>\n\n<p>In Mississippi, the state with the second highest rate of syphilis in pregnant women, Dr. Caroline Weinberg started having trouble this summer finding treatments for her clinic\u2019s patients, most of whom are uninsured, live in poverty or lack transportation. She began spending hours each month scouring medicine suppliers\u2019 websites for available doses of the shots, a form of penicillin sold under the brand name Bicillin L-A. </p>\n\n<p>\u201cThe way people do it for Taylor Swift, that\u2019s how I\u2019ve been with the Bicillin shortage,\u201d Weinberg said. \u201cDesperately checking the websites to see what I can snag.\u201d</p>\n\n<p>The shortage is driving up infection rates even further.</p>\n        \n    \n                    \n\n    \n        <p>The way people do it for Taylor Swift, that\u2019s how I\u2019ve been with the Bicillin shortage. Desperately checking the websites to see what I can snag.</p>\n\n    \n        \n        \u2014Dr. Caroline Weinberg\n\n    \n    \n\n        \n    \n                    \n<p>In a November survey by the National Coalition of STD Directors, 68% of health departments that responded said the drug shortage will cause syphilis rates in their area to increase, further crushing the nation\u2019s most disadvantaged populations.</p>\n\n<p>\u201cThis is the most basic medicine,\u201d said Meghan O\u2019Connell, chief public health officer for the Great Plains Tribal Leaders\u2019 Health Board, which represents 18 tribal communities in South Dakota and three other states. \u201cWe allow ourselves to continue to not have enough, and it impacts so many people.\u201d</p>\n\n<p>ProPublica examined what the federal government has done to manage the crisis and the ways in which experts say it has fallen short.</p>\n        \n    \n                        \n    \n        The government could pressure Pfizer to be more transparent.\n    \n        \n    \n                    \n<p>Twenty years ago, there were at least three manufacturers of the syphilis shot. Then Pfizer, one of the manufacturers, purchased the other two companies and became the lone U.S. supplier.</p>\n\n<p>Pfizer\u2019s supply has fallen short since then. In 2016, the company announced a shortage due to a manufacturing issue; it lasted two years. Even during times when Pfizer had not notified the FDA of an official shortage, clinics across the country told ProPublica, the shots were often hard to get. </p>\n\n<p>Several health officials said they would like to see the government use its power as the largest purchaser of the drug to put pressure on Pfizer to produce adequate supplies and to be more transparent about how much of the drug they have on hand, when it will be widely available and how stable the supply will be going forward. </p>\n\n<p>In response to questions, Pfizer said there are two reasons its supply is falling short. One, the company said, was a surge in use of the pediatric form of the drug after a shortage of a different antibiotic last winter. Pfizer also blamed a 70% increase in demand for the adult shots since last February, which it described as unexpected. </p>\n\n<p>Public health experts say the increase in cases and subsequent rise in demand was easy to see coming. Officials have been raising the alarm about skyrocketing syphilis cases for years. \u201cIf Pfizer was truly caught completely off guard, it raises significant questions about the competency of the company to forecast obvious infectious disease trends,\u201d a coalition of organizations wrote to the White House Drug Shortage Task Force in September. </p>\n\n<p>Pfizer said it is consistently communicating with the CDC and FDA about its supply and that it has been transparent with public health groups and policymakers.</p>\n\n<p>The FDA has a group dedicated to addressing drug shortages. But Valerie Jensen, associate director of that staff, said the FDA can\u2019t force manufacturers to make more of a drug. \u201cIt is up to manufacturers to decide how to respond to that increased demand.\u201d she said. \u201cWhat we\u2019re here to do is help with those plans.\u201d</p>\n\n<p>Pfizer said it had a target of increasing production by about 20% in 2023 but faced delays toward the end of the year. The company did not explain the reason for those delays.</p>\n\n<p>The company said it has invested $38 million in the last five years in the Michigan facility where it makes the shots and that it is increasing production capacity. It also said it is adding evening shifts at the facility and actively recruiting and training new workers. Pfizer said it also reduced manufacturing time from 110 to 50 days. By the end of June, the company expects the supply to recover, which it described as having eight weeks of inventory based on its forecast demands with no disruptions in sight.</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            A medical assistant at a California clinic in 2021 holds a syringe used to treat syphilis. Since last June, a shortage has made these shots hard to find.\n    \n            (Talia Herman, special to ProPublica)\n    \n    \n    \n\n    \n\n        \n    \n                        \n    \n        The government could manufacture the drug itself.\n    \n        \n    \n                    \n<p>Having only one supplier for a drug, especially one of public health importance, makes the country vulnerable to shortages. With just one manufacturer, any disruption \u2014 contamination at a plant, a shortage of raw materials, a severe weather event or a flawed prediction of demand \u2014 can put lives at risk. What\u2019s ultimately needed, public health experts say, is another manufacturer. </p>\n\n<p>Congressional Democrats recently introduced a bill that would authorize the U.S. Department of Health and Human Services to manufacture generic drugs in exactly this scenario, when there are few manufacturers and regular shortages. Called the Affordable Drug Manufacturing Act, it would also establish an office of drug manufacturing. </p>\n\n<p>This same bill was introduced in 2018, but it didn\u2019t have bipartisan support and was never taken up for a vote. Sen. Elizabeth Warren, the Massachusetts Democrat who introduced the bill in the Senate, said she\u2019s hopeful this time will be different. Lawmakers from both parties understand the risks created by drug shortages, and COVID-19 helped everyone understand the role the government can play to boost manufacturing.</p>\n\n<p>Still, it\u2019s unlikely to be passed with the current gridlock in Congress.</p>\n        \n    \n                        \n    \n        The government could reserve syphilis drugs for infected patients.\n    \n        \n    \n                    \n<p>Responding to the shortage of shots to treat the disease, the CDC in July asked health care providers nationwide to preserve the scarce remaining doses for people who are pregnant. The shots are considered the gold standard treatment for anyone with syphilis, faster and with fewer side effects than an alternative pill regimen. And for people who are pregnant, the pills are not an option; the shots are the only safe treatment.</p>\n\n<p>Despite that call, the military is giving shots to new recruits who don\u2019t have syphilis, to prevent outbreaks of severe bacterial respiratory infections. The Army has long administered this treatment at boot camps held at Fort Leonard Wood, Fort Moore and Fort Sill. The Army has been unable to obtain the shots several times in the past few years, according to the U.S. Army Center for Initial Military Training. But the Defense Health Agency\u2019s pharmacy operations center has been working with Pfizer to ensure military sites can get them, a spokesperson for the Defense Health Agency said. </p>\n\n<p>\u201cUntil we think about public health the way we think about our military, we\u2019re not going to see a difference,\u201d said Dr. John Vanchiere, chief of pediatric infectious diseases at Louisiana State University Health Shreveport.</p>\n\n<p>Some public health officials, including Alaska\u2019s chief medical officer, Dr. Anne Zink, questioned whether the military should be using scarce shots for prevention.</p>\n\n<p>\u201cWe should ask if that\u2019s the best use,\u201d she said.</p>\n\n<p>Using antibiotics to prevent streptococcal outbreaks is a well-established, evidence-based public health practice that\u2019s also used by other branches of the armed services, said Lt. Col. Randy Ready, a public affairs officer with the Army\u2019s Initial Military Training center. \u201cThe Army continues to work with the CDC and the entire medical community in regards to public health while also taking into account the unique missions and training environments our Soldiers face,\u201d including basic training, Ready said in a written statement.</p>\n        \n    \n                        \n    \n        The government isn\u2019t stockpiling syphilis drugs.\n    \n        \n    \n                    \n<p>In rare instances, the federal government has created stockpiles of drugs considered key to public health. In 2018, confronting shortages of various drugs to treat tuberculosis, the CDC created a small stockpile of them. And the federal Administration for Strategic Preparedness and Response keeps a national stockpile of supplies necessary for public health emergencies, including vaccines, medical supplies and antidotes needed in case of a chemical warfare attack.  </p>\n\n<p>In November, the Biden administration announced it was creating a new syphilis task force. When asked why the federal government doesn\u2019t stockpile syphilis treatments, Adm. Rachel Levine, the HHS official who leads the task force, said officials don\u2019t routinely stockpile drugs, because they have expiration dates. </p>\n\n<p>In a written statement, an HHS spokesperson said that Bicillin has a shelf life of two years and that the Strategic National Stockpile \u201cdoes not deploy products that are commercially available.\u201d In general, the spokesperson wrote, stockpiles are most effective before a national shortage begins and can\u2019t overcome the problems of limited suppliers or fragile supply chains. \u201cThere is also a risk that stockpiles can exacerbate shortages, particularly when supply is already low, by removing drugs from circulation that would have otherwise been available,\u201d the spokesperson wrote. </p>\n\n<p>Stephanie Pang, a senior director with the coalition of STD directors, said that given the critical role of this drug and the severe access concerns, she thinks a stockpile is necessary. \u201cI don\u2019t have another solution that actually gets drugs to patients,\u201d Pang said.</p>\n        \n    \n                        \n    \n        The government could declare a federal emergency.\n    \n        \n    \n                    \n<p>Some public health officials say the federal government needs to treat the syphilis crisis the way it did Ebola or monkeypox.</p>\n\n<p>Declare a federal emergency, said Dr. Michael Dube, an infectious disease specialist for more than 30 years. That would free up money for more public health staff and fund more creative approaches that could lead to a long-term solution to the near-constant shortages, he said. \u201cI\u2019d hate to have to wait for some horrible anecdotes to get out there in order to get the public\u2019s and the policymakers\u2019 minds on it,\u201d said Dube, who oversees medical care for AIDS Healthcare Foundation wellness clinics across the country.</p>\n\n<p>Citing an alarming surge in syphilis cases, the Great Plains Tribes wrote to the HHS secretary last week asking that the agency declare a public health emergency in their areas. In the request, they asked HHS to work globally to find adequate syphilis treatment and send the needed medicine to the Great Plains region.</p>\n\n<p>During the 2014 outbreak of Ebola in West Africa, Congress gave hundreds of millions of dollars to HHS to help develop new rapid tests and vaccines. Facing a global outbreak of monkeypox in 2022, a White House task force deployed more than a million vaccines, regularly briefed the public and sent extra resources to Pride parades and other places where people at risk were gathered.</p>\n        \n    \n                    \n\n    \n        <p>I\u2019d hate to have to wait for some horrible anecdotes to get out there in order to get the public\u2019s and the policymakers\u2019 minds on it.</p>\n\n    \n        \n        \u2014Dr. Michael Dube\n\n    \n    \n\n        \n    \n                    \n<p>Levine, leader of the federal syphilis task force, countered that declaring an emergency wouldn\u2019t make much of a difference. The government, she said, already has a \u201cdramatic and coordinated response\u201d involving several agencies.  </p>\n\n<p>The FDA recently approved an emergency import of a similar syphilis treatment made by a French manufacturer that had plenty on hand. According to the company, Provepharm, the imported shots are enough to cover approximately one or two months of typical use by all people in the U.S. (The FDA would not say how many doses Provepharm sent, and the company said it was not allowed to reveal that number under the federal rules governing such emergency imports.) </p>\n\n<p>Clinics applaud that development. But many of them can\u2019t afford the imported shots.</p>\n        \n    \n                        \n    \n        The government could do more to rein in the cost.\n    \n        \n    \n                    \n<p>Clinics and hospitals that primarily serve low-income patients often qualify for a federal program that allows them to purchase drugs at steeply discounted prices. Pharmaceutical companies that want Medicaid to cover their outpatient drugs must participate in the program.</p>\n\n<p>One factor in determining the discount price is whether a pharmaceutical company has raised the price of a drug by more than the rate of inflation. Because Pfizer has hiked the price of its Bicillin shots significantly over the years, the government requires that it be sold to qualifying clinics for just pennies a dose. Otherwise, a single Pfizer shot can retail for upwards of $500. The French shots are comparable in retail price and not eligible for the discount program.  </p>\n\n<p>Several clinic directors also said they worried that drug distributors were reserving the limited supply of the Pfizer shot for organizations that could pay full price. For several days in January, for example, the website of Henry Schein, a medical supplier, showed doses of the shot available at full price, while doses at the penny pricing were out of stock, according to screenshots shared with ProPublica. When asked whether it was only selling shots at full price, a spokesperson for Henry Schein did not respond to the question.  </p>\n\n<p>Local health departments that qualify for the discount program told ProPublica they\u2019ve had to pay full price at other distributors, because it was the only stock available.  </p>\n\n<p>The Health Resources and Services Administration, the federal agency that regulates the discount program, said that a drug manufacturer is ultimately responsible for ensuring that when supplies are available, they are available at the discounted price. When asked about this, Pfizer said that it has \u201cone inventory that is distributed to our trade partners\u201d and that hospitals and clinics that qualify for the discount program are \u201cresponsible for ensuring compliance with the program and orders through the wholesaler accordingly.\u201d The company added, \u201cPfizer plays no part in this process.\u201d </p>\n\n<p>In October, on Weinberg\u2019s regular search for shots for her Mississippi clinic, she found doses of Bicillin for sale at the discounted price and purchased 40. \u201cThe idea that we\u2019re supposed to be hoarding treatment is a horrific compact,\u201d she said. Word got out that the clinic, called Plan A, has some shots, and other clinics began sending pregnant patients there. </p>\n\n<p>The clinic\u2019s supply is dwindling. Weinberg is happy to get the shots to patients who need them. But she\u2019s not sure how much longer her reserve will last \u2014 or if she\u2019ll be able to find more when they\u2019re gone.</p>", "summary_detail": {"type": "text/html", "language": null, "base": "https://www.propublica.org/feeds/propublica/main", "value": "<p class=\"byline\">\n                by <a class=\"name\" href=\"https://www.propublica.org/people/anna-maria-barry-jester\">Anna Maria Barry-Jester</a>                </p>\n                                             \n\n                                                                    \n            \n                <p>ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive <a href=\"https://www.propublica.org/newsletters/the-big-story?source=54G&amp;placement=top-note&amp;region=national\">our biggest stories</a> as soon as they\u2019re published.</p>\n\n            \n\n                \n\n      \n  \n\n\n\n                    \n<p>Karmin Strohfus, the lead nurse at a South Dakota jail, punched numbers into a phone like lives depended on it. She had in her care a pregnant woman with syphilis, a highly contagious, potentially fatal infection that can pass into the womb. A treatment could cure the woman and protect her fetus, but she couldn\u2019t find it in stock at any pharmacy she called \u2014 not in Hughes County, not even anywhere within an hour\u2019s drive.</p>\n\n<p>Most people held at the jail where Strohfus works are released within a few days. \u201cWhat happens if she gets out before I\u2019m able to treat her?\u201d she worried. Exasperated, Strohfus reached out to the state health department, which came through with one dose. The treatment required three. Officials told Strohfus to contact the federal Centers for Disease Control and Prevention for help, she said. The risks of harm to a developing baby from syphilis are so high that experts urge not to delay treatment, even by a day. </p>\n\n<p>Nearly three weeks passed from when Strohfus started calling pharmacies to when she had the full treatment in hand, she said, and it barely arrived in time. The woman was released just days after she got her last shot. </p>\n\n<p>Last June, Pfizer, the lone U.S. manufacturer of the injections, notified the Food and Drug Administration of an \u201cimpending stock out\u201d that it anticipated would last a year. The company blamed \u201can increase in syphilis infection rates as well as competitive shortages.\u201d </p>\n\n<p>Across the country, physicians, clinic staff and public health experts say that the shortage is preventing them from reining in a surge of syphilis and that the federal government is downplaying the crisis. State and local public health authorities, which by law are responsible for controlling the spread of infectious diseases, report delays getting medicine to pregnant people with syphilis. This emergency was predictable: There have been shortages of this drug in eight of the last 20 years.  </p>\n\n<p>Yet federal health authorities have not prevented the drug shortages in the past and aren\u2019t doing much to prevent them in the future. </p>\n\n<p>Syphilis, which is typically spread during sex, can be devastating if it goes untreated in pregnancy: About 40% of babies born to women with untreated syphilis can be stillborn or die as newborns, according to the CDC. Infants that survive can suffer from deformed bones, excruciating pain or brain damage, and some struggle to hear, see or breathe. Since this is entirely preventable, <a href=\"https://www.propublica.org/article/babies-are-dying-of-syphilis-its-100-preventable\">a baby born with syphilis is a shameful sign of a failing public health system. </a></p>\n\n<p>In 2022, the most recent year for which the CDC has data available, more than 3,700 babies were infected with syphilis, including nearly 300 who were stillborn or died as infants. More than 50% of these cases occurred because, even though the pregnant parent was diagnosed with syphilis, they were never properly treated. </p>\n\n<p>That year, there were 200,000 cases identified in the U.S., a 79% increase from five years before. Infection rates among pregnant people and babies increased by <a href=\"https://www.cdc.gov/nchs/products/databriefs/db496.htm\">more than 250%</a> in that time; South Dakota, where Strohfus works, had the highest rates \u2014 including a more than 400% increase among pregnant women. Statewide, the rate of babies born with the disease, a condition known as congenital syphilis, jumped more than 40-fold in just five years. </p>\n\n<p>And that was before the current shortage of shots.</p>\n\n<p>In Mississippi, the state with the second highest rate of syphilis in pregnant women, Dr. Caroline Weinberg started having trouble this summer finding treatments for her clinic\u2019s patients, most of whom are uninsured, live in poverty or lack transportation. She began spending hours each month scouring medicine suppliers\u2019 websites for available doses of the shots, a form of penicillin sold under the brand name Bicillin L-A. </p>\n\n<p>\u201cThe way people do it for Taylor Swift, that\u2019s how I\u2019ve been with the Bicillin shortage,\u201d Weinberg said. \u201cDesperately checking the websites to see what I can snag.\u201d</p>\n\n<p>The shortage is driving up infection rates even further.</p>\n        \n    \n                    \n\n    \n        <p>The way people do it for Taylor Swift, that\u2019s how I\u2019ve been with the Bicillin shortage. Desperately checking the websites to see what I can snag.</p>\n\n    \n        \n        \u2014Dr. Caroline Weinberg\n\n    \n    \n\n        \n    \n                    \n<p>In a November survey by the National Coalition of STD Directors, 68% of health departments that responded said the drug shortage will cause syphilis rates in their area to increase, further crushing the nation\u2019s most disadvantaged populations.</p>\n\n<p>\u201cThis is the most basic medicine,\u201d said Meghan O\u2019Connell, chief public health officer for the Great Plains Tribal Leaders\u2019 Health Board, which represents 18 tribal communities in South Dakota and three other states. \u201cWe allow ourselves to continue to not have enough, and it impacts so many people.\u201d</p>\n\n<p>ProPublica examined what the federal government has done to manage the crisis and the ways in which experts say it has fallen short.</p>\n        \n    \n                        \n    \n        The government could pressure Pfizer to be more transparent.\n    \n        \n    \n                    \n<p>Twenty years ago, there were at least three manufacturers of the syphilis shot. Then Pfizer, one of the manufacturers, purchased the other two companies and became the lone U.S. supplier.</p>\n\n<p>Pfizer\u2019s supply has fallen short since then. In 2016, the company announced a shortage due to a manufacturing issue; it lasted two years. Even during times when Pfizer had not notified the FDA of an official shortage, clinics across the country told ProPublica, the shots were often hard to get. </p>\n\n<p>Several health officials said they would like to see the government use its power as the largest purchaser of the drug to put pressure on Pfizer to produce adequate supplies and to be more transparent about how much of the drug they have on hand, when it will be widely available and how stable the supply will be going forward. </p>\n\n<p>In response to questions, Pfizer said there are two reasons its supply is falling short. One, the company said, was a surge in use of the pediatric form of the drug after a shortage of a different antibiotic last winter. Pfizer also blamed a 70% increase in demand for the adult shots since last February, which it described as unexpected. </p>\n\n<p>Public health experts say the increase in cases and subsequent rise in demand was easy to see coming. Officials have been raising the alarm about skyrocketing syphilis cases for years. \u201cIf Pfizer was truly caught completely off guard, it raises significant questions about the competency of the company to forecast obvious infectious disease trends,\u201d a coalition of organizations wrote to the White House Drug Shortage Task Force in September. </p>\n\n<p>Pfizer said it is consistently communicating with the CDC and FDA about its supply and that it has been transparent with public health groups and policymakers.</p>\n\n<p>The FDA has a group dedicated to addressing drug shortages. But Valerie Jensen, associate director of that staff, said the FDA can\u2019t force manufacturers to make more of a drug. \u201cIt is up to manufacturers to decide how to respond to that increased demand.\u201d she said. \u201cWhat we\u2019re here to do is help with those plans.\u201d</p>\n\n<p>Pfizer said it had a target of increasing production by about 20% in 2023 but faced delays toward the end of the year. The company did not explain the reason for those delays.</p>\n\n<p>The company said it has invested $38 million in the last five years in the Michigan facility where it makes the shots and that it is increasing production capacity. It also said it is adding evening shifts at the facility and actively recruiting and training new workers. Pfizer said it also reduced manufacturing time from 110 to 50 days. By the end of June, the company expects the supply to recover, which it described as having eight weeks of inventory based on its forecast demands with no disruptions in sight.</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            A medical assistant at a California clinic in 2021 holds a syringe used to treat syphilis. Since last June, a shortage has made these shots hard to find.\n    \n            (Talia Herman, special to ProPublica)\n    \n    \n    \n\n    \n\n        \n    \n                        \n    \n        The government could manufacture the drug itself.\n    \n        \n    \n                    \n<p>Having only one supplier for a drug, especially one of public health importance, makes the country vulnerable to shortages. With just one manufacturer, any disruption \u2014 contamination at a plant, a shortage of raw materials, a severe weather event or a flawed prediction of demand \u2014 can put lives at risk. What\u2019s ultimately needed, public health experts say, is another manufacturer. </p>\n\n<p>Congressional Democrats recently introduced a bill that would authorize the U.S. Department of Health and Human Services to manufacture generic drugs in exactly this scenario, when there are few manufacturers and regular shortages. Called the Affordable Drug Manufacturing Act, it would also establish an office of drug manufacturing. </p>\n\n<p>This same bill was introduced in 2018, but it didn\u2019t have bipartisan support and was never taken up for a vote. Sen. Elizabeth Warren, the Massachusetts Democrat who introduced the bill in the Senate, said she\u2019s hopeful this time will be different. Lawmakers from both parties understand the risks created by drug shortages, and COVID-19 helped everyone understand the role the government can play to boost manufacturing.</p>\n\n<p>Still, it\u2019s unlikely to be passed with the current gridlock in Congress.</p>\n        \n    \n                        \n    \n        The government could reserve syphilis drugs for infected patients.\n    \n        \n    \n                    \n<p>Responding to the shortage of shots to treat the disease, the CDC in July asked health care providers nationwide to preserve the scarce remaining doses for people who are pregnant. The shots are considered the gold standard treatment for anyone with syphilis, faster and with fewer side effects than an alternative pill regimen. And for people who are pregnant, the pills are not an option; the shots are the only safe treatment.</p>\n\n<p>Despite that call, the military is giving shots to new recruits who don\u2019t have syphilis, to prevent outbreaks of severe bacterial respiratory infections. The Army has long administered this treatment at boot camps held at Fort Leonard Wood, Fort Moore and Fort Sill. The Army has been unable to obtain the shots several times in the past few years, according to the U.S. Army Center for Initial Military Training. But the Defense Health Agency\u2019s pharmacy operations center has been working with Pfizer to ensure military sites can get them, a spokesperson for the Defense Health Agency said. </p>\n\n<p>\u201cUntil we think about public health the way we think about our military, we\u2019re not going to see a difference,\u201d said Dr. John Vanchiere, chief of pediatric infectious diseases at Louisiana State University Health Shreveport.</p>\n\n<p>Some public health officials, including Alaska\u2019s chief medical officer, Dr. Anne Zink, questioned whether the military should be using scarce shots for prevention.</p>\n\n<p>\u201cWe should ask if that\u2019s the best use,\u201d she said.</p>\n\n<p>Using antibiotics to prevent streptococcal outbreaks is a well-established, evidence-based public health practice that\u2019s also used by other branches of the armed services, said Lt. Col. Randy Ready, a public affairs officer with the Army\u2019s Initial Military Training center. \u201cThe Army continues to work with the CDC and the entire medical community in regards to public health while also taking into account the unique missions and training environments our Soldiers face,\u201d including basic training, Ready said in a written statement.</p>\n        \n    \n                        \n    \n        The government isn\u2019t stockpiling syphilis drugs.\n    \n        \n    \n                    \n<p>In rare instances, the federal government has created stockpiles of drugs considered key to public health. In 2018, confronting shortages of various drugs to treat tuberculosis, the CDC created a small stockpile of them. And the federal Administration for Strategic Preparedness and Response keeps a national stockpile of supplies necessary for public health emergencies, including vaccines, medical supplies and antidotes needed in case of a chemical warfare attack.  </p>\n\n<p>In November, the Biden administration announced it was creating a new syphilis task force. When asked why the federal government doesn\u2019t stockpile syphilis treatments, Adm. Rachel Levine, the HHS official who leads the task force, said officials don\u2019t routinely stockpile drugs, because they have expiration dates. </p>\n\n<p>In a written statement, an HHS spokesperson said that Bicillin has a shelf life of two years and that the Strategic National Stockpile \u201cdoes not deploy products that are commercially available.\u201d In general, the spokesperson wrote, stockpiles are most effective before a national shortage begins and can\u2019t overcome the problems of limited suppliers or fragile supply chains. \u201cThere is also a risk that stockpiles can exacerbate shortages, particularly when supply is already low, by removing drugs from circulation that would have otherwise been available,\u201d the spokesperson wrote. </p>\n\n<p>Stephanie Pang, a senior director with the coalition of STD directors, said that given the critical role of this drug and the severe access concerns, she thinks a stockpile is necessary. \u201cI don\u2019t have another solution that actually gets drugs to patients,\u201d Pang said.</p>\n        \n    \n                        \n    \n        The government could declare a federal emergency.\n    \n        \n    \n                    \n<p>Some public health officials say the federal government needs to treat the syphilis crisis the way it did Ebola or monkeypox.</p>\n\n<p>Declare a federal emergency, said Dr. Michael Dube, an infectious disease specialist for more than 30 years. That would free up money for more public health staff and fund more creative approaches that could lead to a long-term solution to the near-constant shortages, he said. \u201cI\u2019d hate to have to wait for some horrible anecdotes to get out there in order to get the public\u2019s and the policymakers\u2019 minds on it,\u201d said Dube, who oversees medical care for AIDS Healthcare Foundation wellness clinics across the country.</p>\n\n<p>Citing an alarming surge in syphilis cases, the Great Plains Tribes wrote to the HHS secretary last week asking that the agency declare a public health emergency in their areas. In the request, they asked HHS to work globally to find adequate syphilis treatment and send the needed medicine to the Great Plains region.</p>\n\n<p>During the 2014 outbreak of Ebola in West Africa, Congress gave hundreds of millions of dollars to HHS to help develop new rapid tests and vaccines. Facing a global outbreak of monkeypox in 2022, a White House task force deployed more than a million vaccines, regularly briefed the public and sent extra resources to Pride parades and other places where people at risk were gathered.</p>\n        \n    \n                    \n\n    \n        <p>I\u2019d hate to have to wait for some horrible anecdotes to get out there in order to get the public\u2019s and the policymakers\u2019 minds on it.</p>\n\n    \n        \n        \u2014Dr. Michael Dube\n\n    \n    \n\n        \n    \n                    \n<p>Levine, leader of the federal syphilis task force, countered that declaring an emergency wouldn\u2019t make much of a difference. The government, she said, already has a \u201cdramatic and coordinated response\u201d involving several agencies.  </p>\n\n<p>The FDA recently approved an emergency import of a similar syphilis treatment made by a French manufacturer that had plenty on hand. According to the company, Provepharm, the imported shots are enough to cover approximately one or two months of typical use by all people in the U.S. (The FDA would not say how many doses Provepharm sent, and the company said it was not allowed to reveal that number under the federal rules governing such emergency imports.) </p>\n\n<p>Clinics applaud that development. But many of them can\u2019t afford the imported shots.</p>\n        \n    \n                        \n    \n        The government could do more to rein in the cost.\n    \n        \n    \n                    \n<p>Clinics and hospitals that primarily serve low-income patients often qualify for a federal program that allows them to purchase drugs at steeply discounted prices. Pharmaceutical companies that want Medicaid to cover their outpatient drugs must participate in the program.</p>\n\n<p>One factor in determining the discount price is whether a pharmaceutical company has raised the price of a drug by more than the rate of inflation. Because Pfizer has hiked the price of its Bicillin shots significantly over the years, the government requires that it be sold to qualifying clinics for just pennies a dose. Otherwise, a single Pfizer shot can retail for upwards of $500. The French shots are comparable in retail price and not eligible for the discount program.  </p>\n\n<p>Several clinic directors also said they worried that drug distributors were reserving the limited supply of the Pfizer shot for organizations that could pay full price. For several days in January, for example, the website of Henry Schein, a medical supplier, showed doses of the shot available at full price, while doses at the penny pricing were out of stock, according to screenshots shared with ProPublica. When asked whether it was only selling shots at full price, a spokesperson for Henry Schein did not respond to the question.  </p>\n\n<p>Local health departments that qualify for the discount program told ProPublica they\u2019ve had to pay full price at other distributors, because it was the only stock available.  </p>\n\n<p>The Health Resources and Services Administration, the federal agency that regulates the discount program, said that a drug manufacturer is ultimately responsible for ensuring that when supplies are available, they are available at the discounted price. When asked about this, Pfizer said that it has \u201cone inventory that is distributed to our trade partners\u201d and that hospitals and clinics that qualify for the discount program are \u201cresponsible for ensuring compliance with the program and orders through the wholesaler accordingly.\u201d The company added, \u201cPfizer plays no part in this process.\u201d </p>\n\n<p>In October, on Weinberg\u2019s regular search for shots for her Mississippi clinic, she found doses of Bicillin for sale at the discounted price and purchased 40. \u201cThe idea that we\u2019re supposed to be hoarding treatment is a horrific compact,\u201d she said. Word got out that the clinic, called Plan A, has some shots, and other clinics began sending pregnant patients there. </p>\n\n<p>The clinic\u2019s supply is dwindling. Weinberg is happy to get the shots to patients who need them. But she\u2019s not sure how much longer her reserve will last \u2014 or if she\u2019ll be able to find more when they\u2019re gone.</p>"}, "tags": [{"term": "Health Care", "scheme": null, "label": null}], "updated": "2024-03-04T05:00:00-05:00", "updated_parsed": [2024, 3, 4, 10, 0, 0, 0, 64, 0], "authors": [{"name": "by Anna Maria Barry-Jester"}], "author": "by Anna Maria Barry-Jester", "author_detail": {"name": "by Anna Maria Barry-Jester"}}, {"title": "Lawmakers Could Limit When County Officials in Mississippi Can Jail People Awaiting Psychiatric Treatment", "title_detail": {"type": "text/plain", "language": null, "base": "https://www.propublica.org/feeds/propublica/main", "value": "Lawmakers Could Limit When County Officials in Mississippi Can Jail People Awaiting Psychiatric Treatment"}, "links": [{"rel": "alternate", "type": "text/html", "href": "https://www.propublica.org/article/mississippi-lawmakers-could-limit-when-county-officials-can-jail-people-awaiting-psychiatric-treatment"}], "link": "https://www.propublica.org/article/mississippi-lawmakers-could-limit-when-county-officials-can-jail-people-awaiting-psychiatric-treatment", "published": "Fri, 01 Mar 2024 05:00:00 -0500", "published_parsed": [2024, 3, 1, 10, 0, 0, 4, 61, 0], "id": "https://www.propublica.org/article/mississippi-lawmakers-could-limit-when-county-officials-can-jail-people-awaiting-psychiatric-treatment", "guidislink": false, "summary": "<p class=\"byline\">\n                by <span class=\"name\">Isabelle Taft</span>, <a href=\"https://mississippitoday.org/\">Mississippi Today</a>                </p>\n                                             \n\n        \n                        <p>This article was produced for ProPublica\u2019s Local Reporting Network in partnership with <a href=\"https://mississippitoday.org/\">Mississippi Today</a>. <a href=\"https://www.propublica.org/newsletters/dispatches\">Sign up for Dispatches</a> to get stories like this one as soon as they are published.</p>\n\n        \n\n    \n      \n  \n\n\n\n                    \n<p>Key Mississippi lawmakers have introduced several bills that would drastically limit when people can be jailed without criminal charges as they await court-ordered psychiatric treatment. </p>\n\n<p>The proposals follow an investigation by Mississippi Today and ProPublica finding that hundreds of people in the state are <a href=\"https://www.propublica.org/article/they-needed-mental-health-treatment-mississippi-threw-them-in-jail\">jailed without charges</a> every year as they go through the civil commitment process, in which a judge can force people to undergo treatment if they\u2019re deemed dangerous to themselves or others. People who were jailed said they were treated like criminal defendants and received no mental health care. Since 2006, at least 17 people have died after being jailed during the commitment process, raising questions about <a href=\"https://www.propublica.org/article/mississippi-jail-mental-health-treatment-deaths-substance-abuse\">whether jails can protect people in the midst of a mental health crisis</a>.</p>\n\n<p>Civil rights lawyers contend Mississippi\u2019s practice is unconstitutional because it amounts to punishing people for mental illness, but the state\u2019s civil commitment law allows it. That law spells out the process by which people suffering from severe mental illness can be detained, evaluated and ordered into treatment. Under the law, those people can be held in jail until they\u2019re admitted to a state psychiatric hospital or another mental health facility if <a href=\"https://law.justia.com/codes/mississippi/2019/title-41/chapter-21/persons-in-need-of-mental-treatment/section-41-21-67/#:~:text=However%2C%20the%20respondent%20shall%20not%20be%20held%20in%20a%20hospital%20operated%20directly%20by%20the%20State%20Department%20of%20Mental%20Health%2C%20and%20shall%20not%20be%20held%20in%20jail%20unless%20the%20court%20finds%20that%20there%20is%20no%20reasonable%20alternative.\">there is \u201cno reasonable alternative</a>.\u201d If there isn\u2019t room at a publicly funded facility or open beds are too far away, local officials often conclude that they have no other option besides jail.</p>\n        \n    \n                    \n<p>\u201cPutting a person in jail because they\u2019re hearing voices and you don\u2019t know what to do with them \u2014 that\u2019s not right,\u201d said state Rep. Kevin Felsher, R-Biloxi, one of the lawmakers behind legislation to curtail the practice. The news stories, he said, showed that people are jailed for longer than he thought and that Mississippi is unique in doing so. </p>\n\n<p>The proposals represent the biggest effort to change the state\u2019s civil commitment process since at least 2010, according to a review of legislation and interviews with mental health advocates. That year, lawmakers <a href=\"https://billstatus.ls.state.ms.us/documents/2010/pdf/HB/1500-1599/HB1525SG.pdf\">standardized the commitment process</a> across the state and gave county officials the option to <a href=\"https://billstatus.ls.state.ms.us/documents/2010/pdf/HB/1000-1099/HB1049SG.pdf\">call on crisis teams</a> first. A measure that would have <a href=\"https://www.documentcloud.org/documents/24449544-2010-hb-1525-as-introduced#document/p8/a2431880\">prohibited jail detentions</a> altogether ultimately failed.</p>\n\n<p>A bill proposed by Felsher would allow jail detentions during the commitment process only for \u201cprotective custody purposes and only while awaiting transportation\u201d to a medical facility. It would <a href=\"https://billstatus.ls.state.ms.us/documents/2024/pdf/HB/0400-0499/HB0415IN.pdf\">restrict such detentions</a> to 72 hours. </p>\n\n<p>A bill authored by state Rep. Sam Creekmore, R-New Albany, chair of the House Public Health and Human Services Committee, would <a href=\"https://billstatus.ls.state.ms.us/2024/pdf/history/HB/HB1640.xml\">clamp down on the practice even more</a>, allowing counties to jail people without criminal charges only if they are \u201cactively violent\u201d and for no longer than 24 hours. </p>\n\n<p>The vast majority of the 2,000 jail detentions in 19 counties analyzed by Mississippi Today and ProPublica lasted longer than 24 hours. About 1,200 lasted longer than 72 hours. (Those figures include <a href=\"https://www.propublica.org/article/they-needed-mental-health-treatment-mississippi-threw-them-in-jail\">detentions between 2019 and 2022 for both mental illness and substance abuse</a>; the legislation would address only the commitment process for mental illness.)</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            State Rep. Sam Creekmore, R-New Albany, has proposed a bill that would prohibit jail detentions for people going through the civil commitment process unless they are \u201cactively violent\u201d and would limit such detentions to 24 hours. The vast majority of detentions in 19 counties over four years lasted longer than that, according to an analysis by Mississippi Today and ProPublica.\n    \n            (Eric J. Shelton/Mississippi Today)\n    \n    \n    \n\n    \n\n        \n    \n                    \n<p>Creekmore\u2019s bill, which passed out of committee without opposition Thursday, aims to reduce unnecessary commitments by generally requiring people to be screened for mental illness before paperwork can be filed to have them committed. Those screenings would be conducted in most cases by community mental health centers \u2014 independent organizations, partly funded by state grants, that are supposed to provide mental health care close to home. That bill also would require those organizations to treat people while they\u2019re in jail. </p>\n\n<p>A bill authored by Sen. Nicole Boyd, R-Oxford, to <a href=\"https://billstatus.ls.state.ms.us/documents/2024/pdf/SB/2700-2799/SB2744IN.pdf\">increase state oversight of community mental health centers</a> contains language similar to Creekmore\u2019s proposal restricting jail detentions. Her bill has been referred to the Judiciary A committee, which is chaired by one of its co-authors, Sen. Brice Wiggins, R-Pascagoula.</p>\n\n<p>The bills would bring Mississippi <a href=\"https://www.propublica.org/article/mississippi-outlier-in-jailing-people-during-civil-commitment\">more in line with other states</a> that allow people going through the civil commitment process to be jailed in limited circumstances. South Dakota permits jail detentions without criminal charges but limits them to 24 hours. Wyoming permits them in an \u201cextreme emergency\u201d and only for 72 hours before a hearing. </p>\n\n<p>The Mississippi Department of Mental Health says reforming the commitment process is a priority this legislative session. \u201cWe don\u2019t want someone to have to wait in jail simply because they need mental health treatment,\u201d said Wendy Bailey, director of the agency, at a January conference attended by county officials from all over the state.</p>\n        \n    \n                    \n\n    \n        <p>I think you\u2019ll find all 82 clerks, all 82 sheriffs, all 400 supervisors understand that the jail is not the place they need to be. But there has to be a place. If it\u2019s not the jail, there has to be a place available.</p>\n\n    \n        \n        \u2014Bill Benson, Lee County chancery clerk\n\n    \n    \n\n        \n    \n                    \n<p>But the Mississippi Association of Supervisors, which represents county governments, has raised questions about whether the bills would force county officials to spend more money. Under state law, counties are responsible for housing residents going through the commitment process until they are admitted to a state hospital. Some local officials contend they don\u2019t have any place other than jail to put people. </p>\n\n<p>\u201cI think you\u2019ll find all 82 clerks, all 82 sheriffs, all 400 supervisors understand that the jail is not the place they need to be,\u201d said Bill Benson, who as Lee County\u2019s chancery clerk coordinates the commitment process there. \u201cBut there has to be a place. If it\u2019s not the jail, there has to be a place available.\u201d </p>\n\n<p>Derrick Surrette, executive director of the Mississippi Association of Supervisors, said county leaders are \u201call for\u201d keeping people out of jail while they wait for mental health care. But, he said, they\u2019re concerned that they\u2019ll be forced to pay for treatment in private facilities because there aren\u2019t enough publicly funded beds. None of the proposals would expand publicly funded treatment beds, nor would they provide funding to counties. The association hasn\u2019t taken a position on the bills to limit jail detentions.</p>\n\n<p>\u201cIt\u2019s a whole lot of legislation being proposed telling the county and a regional mental facility what to do,\u201d Surrette said. \u201cIs there very much in there telling what the state shall do?\u201d</p>\n\n<p>The Department of Mental Health advises local officials to direct people who need help to outpatient mental health care when appropriate and to rely on the civil commitment process only when needed. If the commitment process can\u2019t be avoided, the department says officials should work with their local community mental health centers to seek alternatives to jail.</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            A padded cell in the Adams County jail in Natchez, Mississippi, is used to hold people awaiting psychiatric evaluation and court-ordered treatment. Lacey Robinette Handjis, a 37-year-old hospice care consultant and mother of two, was found dead in one of the jail\u2019s two padded cells in late August, less than 24 hours after she was booked with no criminal charges to await mental health treatment.\n    \n            (Eric J. Shelton/Mississippi Today)\n    \n    \n    \n\n    \n\n        \n    \n                    \n<p>The state has expanded the number of beds in crisis stabilization units, which are designed to provide short-term treatment in a less restrictive setting than state hospitals. Chancery clerks and sheriff\u2019s deputies complain that those facilities frequently <a href=\"https://www.documentcloud.org/documents/24449554-cost-reimbursement-metric-report-fy23-end-of-year-3#document/p9/a2431887\">refuse to accept people</a> they deem to be violent or in need of additional medical care, though state data shows those refusals are declining. </p>\n\n<p>An additional bill filed by Felsher would require counties to pay for care at a medical facility if a judge has ordered someone into treatment, no publicly funded bed is available and the person can\u2019t pay for treatment. Although the Mississippi Association of Supervisors hasn\u2019t taken a position on that bill, either, it opposed a similar provision last year because the measure didn\u2019t provide any funding.</p>\n\n<p>At a hearing in November 2022, Felsher asked Benson, the chancery clerk in Lee County, whether he would support his county paying hospitals to treat residents as an alternative to jail. Benson responded that if he did, \u201cMy supervisors would hang me.\u201d</p>\n\n<p>Benson said in an interview that it costs just $40 a day on average to jail someone in Lee County. By contrast, Neshoba County, which is among those that contract with private providers, pays between $625 and $675 a day to Alliance Health Center to treat county residents when no public bed is available. </p>\n\n<p>Felsher said he hopes to expand the availability of public treatment facilities so counties aren\u2019t on the hook except in rare circumstances. But he also said he believes the cost of alternatives can\u2019t justify jailing people who haven\u2019t been charged with crimes.</p>\n\n<p>\u201cWe can\u2019t send people with mental illness to jail because the county doesn\u2019t want to pay for it,\u201d he said. \u201cIf it is a fight, it\u2019s a fight that I will have. We may not win it, but we\u2019ll have it.\u201d</p>\n\n<p>Staffers with Disability Rights Mississippi say the bills don\u2019t go far enough because they don\u2019t ban jail detentions outright. <a href=\"https://www.propublica.org/article/mississippi-outlier-in-jailing-people-during-civil-commitment\">At least a dozen states</a>, including neighboring Alabama, Louisiana and Tennessee, have done so.</p>\n\n<p>Without such a ban, Disability Rights Mississippi staff say they\u2019re planning to sue the state and some counties, alleging the practice is unconstitutional. A federal lawsuit in Alabama led to a <a href=\"https://casetext.com/case/lynch-v-baxley-3\">ruling in 1984 prohibiting the practice</a> there.</p>\n\n<p>\u201cMississippi Today\u2019s reporting has revealed the horrifying scope of this problem, including those who have met an untimely death and data to back it up,\u201d said Polly Tribble, the organization\u2019s director. \u201cI hope that, in light of these dire situations, the Legislature will be motivated to address these issues.\u201d</p>\n\n<p>Bailey, head of the state Department of Mental Health, said she was not aware of the possibility of litigation until Mississippi Today asked about it. She said her agency is working to find ways to make sure people get mental health treatment without going through the civil commitment process, and to restrict the use of jail when they do.</p>\n        \n             \n\n                                    \n        \n                        <p><a href=\"https://www.propublica.org/people/agnel-philip\">Agnel Philip</a> of ProPublica contributed reporting and <a href=\"https://www.propublica.org/people/mollie-simon\">Mollie Simon</a> of ProPublica contributed research.</p>", "summary_detail": {"type": "text/html", "language": null, "base": "https://www.propublica.org/feeds/propublica/main", "value": "<p class=\"byline\">\n                by <span class=\"name\">Isabelle Taft</span>, <a href=\"https://mississippitoday.org/\">Mississippi Today</a>                </p>\n                                             \n\n        \n                        <p>This article was produced for ProPublica\u2019s Local Reporting Network in partnership with <a href=\"https://mississippitoday.org/\">Mississippi Today</a>. <a href=\"https://www.propublica.org/newsletters/dispatches\">Sign up for Dispatches</a> to get stories like this one as soon as they are published.</p>\n\n        \n\n    \n      \n  \n\n\n\n                    \n<p>Key Mississippi lawmakers have introduced several bills that would drastically limit when people can be jailed without criminal charges as they await court-ordered psychiatric treatment. </p>\n\n<p>The proposals follow an investigation by Mississippi Today and ProPublica finding that hundreds of people in the state are <a href=\"https://www.propublica.org/article/they-needed-mental-health-treatment-mississippi-threw-them-in-jail\">jailed without charges</a> every year as they go through the civil commitment process, in which a judge can force people to undergo treatment if they\u2019re deemed dangerous to themselves or others. People who were jailed said they were treated like criminal defendants and received no mental health care. Since 2006, at least 17 people have died after being jailed during the commitment process, raising questions about <a href=\"https://www.propublica.org/article/mississippi-jail-mental-health-treatment-deaths-substance-abuse\">whether jails can protect people in the midst of a mental health crisis</a>.</p>\n\n<p>Civil rights lawyers contend Mississippi\u2019s practice is unconstitutional because it amounts to punishing people for mental illness, but the state\u2019s civil commitment law allows it. That law spells out the process by which people suffering from severe mental illness can be detained, evaluated and ordered into treatment. Under the law, those people can be held in jail until they\u2019re admitted to a state psychiatric hospital or another mental health facility if <a href=\"https://law.justia.com/codes/mississippi/2019/title-41/chapter-21/persons-in-need-of-mental-treatment/section-41-21-67/#:~:text=However%2C%20the%20respondent%20shall%20not%20be%20held%20in%20a%20hospital%20operated%20directly%20by%20the%20State%20Department%20of%20Mental%20Health%2C%20and%20shall%20not%20be%20held%20in%20jail%20unless%20the%20court%20finds%20that%20there%20is%20no%20reasonable%20alternative.\">there is \u201cno reasonable alternative</a>.\u201d If there isn\u2019t room at a publicly funded facility or open beds are too far away, local officials often conclude that they have no other option besides jail.</p>\n        \n    \n                    \n<p>\u201cPutting a person in jail because they\u2019re hearing voices and you don\u2019t know what to do with them \u2014 that\u2019s not right,\u201d said state Rep. Kevin Felsher, R-Biloxi, one of the lawmakers behind legislation to curtail the practice. The news stories, he said, showed that people are jailed for longer than he thought and that Mississippi is unique in doing so. </p>\n\n<p>The proposals represent the biggest effort to change the state\u2019s civil commitment process since at least 2010, according to a review of legislation and interviews with mental health advocates. That year, lawmakers <a href=\"https://billstatus.ls.state.ms.us/documents/2010/pdf/HB/1500-1599/HB1525SG.pdf\">standardized the commitment process</a> across the state and gave county officials the option to <a href=\"https://billstatus.ls.state.ms.us/documents/2010/pdf/HB/1000-1099/HB1049SG.pdf\">call on crisis teams</a> first. A measure that would have <a href=\"https://www.documentcloud.org/documents/24449544-2010-hb-1525-as-introduced#document/p8/a2431880\">prohibited jail detentions</a> altogether ultimately failed.</p>\n\n<p>A bill proposed by Felsher would allow jail detentions during the commitment process only for \u201cprotective custody purposes and only while awaiting transportation\u201d to a medical facility. It would <a href=\"https://billstatus.ls.state.ms.us/documents/2024/pdf/HB/0400-0499/HB0415IN.pdf\">restrict such detentions</a> to 72 hours. </p>\n\n<p>A bill authored by state Rep. Sam Creekmore, R-New Albany, chair of the House Public Health and Human Services Committee, would <a href=\"https://billstatus.ls.state.ms.us/2024/pdf/history/HB/HB1640.xml\">clamp down on the practice even more</a>, allowing counties to jail people without criminal charges only if they are \u201cactively violent\u201d and for no longer than 24 hours. </p>\n\n<p>The vast majority of the 2,000 jail detentions in 19 counties analyzed by Mississippi Today and ProPublica lasted longer than 24 hours. About 1,200 lasted longer than 72 hours. (Those figures include <a href=\"https://www.propublica.org/article/they-needed-mental-health-treatment-mississippi-threw-them-in-jail\">detentions between 2019 and 2022 for both mental illness and substance abuse</a>; the legislation would address only the commitment process for mental illness.)</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            State Rep. Sam Creekmore, R-New Albany, has proposed a bill that would prohibit jail detentions for people going through the civil commitment process unless they are \u201cactively violent\u201d and would limit such detentions to 24 hours. The vast majority of detentions in 19 counties over four years lasted longer than that, according to an analysis by Mississippi Today and ProPublica.\n    \n            (Eric J. Shelton/Mississippi Today)\n    \n    \n    \n\n    \n\n        \n    \n                    \n<p>Creekmore\u2019s bill, which passed out of committee without opposition Thursday, aims to reduce unnecessary commitments by generally requiring people to be screened for mental illness before paperwork can be filed to have them committed. Those screenings would be conducted in most cases by community mental health centers \u2014 independent organizations, partly funded by state grants, that are supposed to provide mental health care close to home. That bill also would require those organizations to treat people while they\u2019re in jail. </p>\n\n<p>A bill authored by Sen. Nicole Boyd, R-Oxford, to <a href=\"https://billstatus.ls.state.ms.us/documents/2024/pdf/SB/2700-2799/SB2744IN.pdf\">increase state oversight of community mental health centers</a> contains language similar to Creekmore\u2019s proposal restricting jail detentions. Her bill has been referred to the Judiciary A committee, which is chaired by one of its co-authors, Sen. Brice Wiggins, R-Pascagoula.</p>\n\n<p>The bills would bring Mississippi <a href=\"https://www.propublica.org/article/mississippi-outlier-in-jailing-people-during-civil-commitment\">more in line with other states</a> that allow people going through the civil commitment process to be jailed in limited circumstances. South Dakota permits jail detentions without criminal charges but limits them to 24 hours. Wyoming permits them in an \u201cextreme emergency\u201d and only for 72 hours before a hearing. </p>\n\n<p>The Mississippi Department of Mental Health says reforming the commitment process is a priority this legislative session. \u201cWe don\u2019t want someone to have to wait in jail simply because they need mental health treatment,\u201d said Wendy Bailey, director of the agency, at a January conference attended by county officials from all over the state.</p>\n        \n    \n                    \n\n    \n        <p>I think you\u2019ll find all 82 clerks, all 82 sheriffs, all 400 supervisors understand that the jail is not the place they need to be. But there has to be a place. If it\u2019s not the jail, there has to be a place available.</p>\n\n    \n        \n        \u2014Bill Benson, Lee County chancery clerk\n\n    \n    \n\n        \n    \n                    \n<p>But the Mississippi Association of Supervisors, which represents county governments, has raised questions about whether the bills would force county officials to spend more money. Under state law, counties are responsible for housing residents going through the commitment process until they are admitted to a state hospital. Some local officials contend they don\u2019t have any place other than jail to put people. </p>\n\n<p>\u201cI think you\u2019ll find all 82 clerks, all 82 sheriffs, all 400 supervisors understand that the jail is not the place they need to be,\u201d said Bill Benson, who as Lee County\u2019s chancery clerk coordinates the commitment process there. \u201cBut there has to be a place. If it\u2019s not the jail, there has to be a place available.\u201d </p>\n\n<p>Derrick Surrette, executive director of the Mississippi Association of Supervisors, said county leaders are \u201call for\u201d keeping people out of jail while they wait for mental health care. But, he said, they\u2019re concerned that they\u2019ll be forced to pay for treatment in private facilities because there aren\u2019t enough publicly funded beds. None of the proposals would expand publicly funded treatment beds, nor would they provide funding to counties. The association hasn\u2019t taken a position on the bills to limit jail detentions.</p>\n\n<p>\u201cIt\u2019s a whole lot of legislation being proposed telling the county and a regional mental facility what to do,\u201d Surrette said. \u201cIs there very much in there telling what the state shall do?\u201d</p>\n\n<p>The Department of Mental Health advises local officials to direct people who need help to outpatient mental health care when appropriate and to rely on the civil commitment process only when needed. If the commitment process can\u2019t be avoided, the department says officials should work with their local community mental health centers to seek alternatives to jail.</p>\n        \n    \n                    \n\n    \n        \n\n                        \n                    \n                \n\n            A padded cell in the Adams County jail in Natchez, Mississippi, is used to hold people awaiting psychiatric evaluation and court-ordered treatment. Lacey Robinette Handjis, a 37-year-old hospice care consultant and mother of two, was found dead in one of the jail\u2019s two padded cells in late August, less than 24 hours after she was booked with no criminal charges to await mental health treatment.\n    \n            (Eric J. Shelton/Mississippi Today)\n    \n    \n    \n\n    \n\n        \n    \n                    \n<p>The state has expanded the number of beds in crisis stabilization units, which are designed to provide short-term treatment in a less restrictive setting than state hospitals. Chancery clerks and sheriff\u2019s deputies complain that those facilities frequently <a href=\"https://www.documentcloud.org/documents/24449554-cost-reimbursement-metric-report-fy23-end-of-year-3#document/p9/a2431887\">refuse to accept people</a> they deem to be violent or in need of additional medical care, though state data shows those refusals are declining. </p>\n\n<p>An additional bill filed by Felsher would require counties to pay for care at a medical facility if a judge has ordered someone into treatment, no publicly funded bed is available and the person can\u2019t pay for treatment. Although the Mississippi Association of Supervisors hasn\u2019t taken a position on that bill, either, it opposed a similar provision last year because the measure didn\u2019t provide any funding.</p>\n\n<p>At a hearing in November 2022, Felsher asked Benson, the chancery clerk in Lee County, whether he would support his county paying hospitals to treat residents as an alternative to jail. Benson responded that if he did, \u201cMy supervisors would hang me.\u201d</p>\n\n<p>Benson said in an interview that it costs just $40 a day on average to jail someone in Lee County. By contrast, Neshoba County, which is among those that contract with private providers, pays between $625 and $675 a day to Alliance Health Center to treat county residents when no public bed is available. </p>\n\n<p>Felsher said he hopes to expand the availability of public treatment facilities so counties aren\u2019t on the hook except in rare circumstances. But he also said he believes the cost of alternatives can\u2019t justify jailing people who haven\u2019t been charged with crimes.</p>\n\n<p>\u201cWe can\u2019t send people with mental illness to jail because the county doesn\u2019t want to pay for it,\u201d he said. \u201cIf it is a fight, it\u2019s a fight that I will have. We may not win it, but we\u2019ll have it.\u201d</p>\n\n<p>Staffers with Disability Rights Mississippi say the bills don\u2019t go far enough because they don\u2019t ban jail detentions outright. <a href=\"https://www.propublica.org/article/mississippi-outlier-in-jailing-people-during-civil-commitment\">At least a dozen states</a>, including neighboring Alabama, Louisiana and Tennessee, have done so.</p>\n\n<p>Without such a ban, Disability Rights Mississippi staff say they\u2019re planning to sue the state and some counties, alleging the practice is unconstitutional. A federal lawsuit in Alabama led to a <a href=\"https://casetext.com/case/lynch-v-baxley-3\">ruling in 1984 prohibiting the practice</a> there.</p>\n\n<p>\u201cMississippi Today\u2019s reporting has revealed the horrifying scope of this problem, including those who have met an untimely death and data to back it up,\u201d said Polly Tribble, the organization\u2019s director. \u201cI hope that, in light of these dire situations, the Legislature will be motivated to address these issues.\u201d</p>\n\n<p>Bailey, head of the state Department of Mental Health, said she was not aware of the possibility of litigation until Mississippi Today asked about it. She said her agency is working to find ways to make sure people get mental health treatment without going through the civil commitment process, and to restrict the use of jail when they do.</p>\n        \n             \n\n                                    \n        \n                        <p><a href=\"https://www.propublica.org/people/agnel-philip\">Agnel Philip</a> of ProPublica contributed reporting and <a href=\"https://www.propublica.org/people/mollie-simon\">Mollie Simon</a> of ProPublica contributed research.</p>"}, "tags": [{"term": "Health Care, Committed to Jail", "scheme": null, "label": null}], "updated": "2024-03-01T05:00:00-05:00", "updated_parsed": [2024, 3, 1, 10, 0, 0, 4, 61, 0], "authors": [{"name": "by Isabelle Taft, Mississippi Today"}], "author": "by Isabelle Taft, Mississippi Today", "author_detail": {"name": "by Isabelle Taft, Mississippi Today"}}]}


