ProPublica

by Irena Hwang and Al Shaw

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[For more technical details, view this story on our website.]

This year at ProPublica, we’ve paired computer modeling with traditional reporting to explore questions around viral outbreaks: What causes them and what can be done to prevent the next big one?

One of the most feared diseases is Ebola, which kills about half the people it infects and has shown that it can pop up in unexpected countries such as Guinea. The virus jumped from a wild animal to a human there in 2013, leading to an epidemic that ultimately left 11,000 dead around the globe.

Researchers studying how outbreaks begin have learned that deforestation can increase the chances for pathogens to leap from wildlife to humans. Jesús Olivero, a professor in the department of animal biology at the University of Malaga, Spain, found that seven Ebola outbreaks, including the one that started in Meliandou, Guinea, were significantly linked to forest loss. We found that, around five of those outbreak locations, forests had been cleared in a telltale pattern, increasing the chances that humans could share space with animals that might harbor the disease.

We wondered: Could we use what we learned about these locations to find places that had not yet experienced outbreaks but could be at risk for one? Were there places where Ebola could emerge that look a lot like Meliandou did in 2013?

With the help of epidemiologists and forest-loss experts, along with one of ProPublica’s data science advisers, Heather Lynch, professor of ecology and evolution at Stony Brook University, we developed a machine-learning model designed to detect locations that bore striking similarity to places that had experienced outbreaks.

The result? Out of a random sample of nearly 1,000 locations across 17 countries, ProPublica’s model identified 51 areas that, in 2021 (the most recent year that satellite image data on forest loss was available at the time of our analysis), looked a lot like places that had experienced outbreaks driven by forest changes.

These locations fell within forested zones in Africa that have wildlife believed to be carrying Ebola; that had recently experienced extensive forest fragmentation (that is, clearing of forests in many small, disconnected patches); and that have a population baseline that could sustain an outbreak if one emerged. To our surprise, 27 of the locations were in Nigeria, where an Ebola outbreak has never started.

After reviewing our findings, one of the researchers we consulted, Christina Faust, a research fellow at the University of Glasgow, Scotland, called the analysis a “best estimate of risk,” in light of the many outstanding questions about how Ebola arises.

“You’ve clearly identified ecological features that are consistent across the spillover locations,” Faust said. “And these ecological conditions and human conditions are cropping up in other places. And given that we don’t know so much about the reservoirs, I think this is our kind of best ability to do a risk analysis.”

Why Random Forests

This model was developed out of an earlier analysis we published in February. We used satellite imagery and epidemiological modeling to show that villages where five previous Ebola outbreaks occurred are at a greater risk of spillover happening today, including Meliandou, Guinea, the site of the worst Ebola outbreak in history.

In five locations where outbreaks had occurred, we found a distinctive pattern in how forests erode over time. At the highest level of fragmentation, the areas where humans and virus-carrying animals might interact, or “mixing zones,” are largest, and risk is at its peak. But after the forest becomes so eroded by human activity that it can’t sustain wildlife anymore, risk decreases.

That analysis focused on the research led by Olivero and an epidemiological model created by Faust and her colleagues that tracked how spillover risk changes as forests become increasingly fragmented. But there was also other intriguing research on the link between land use and Ebola spillover that caught our attention.

One paper, by a team led by Maria Rulli at the Politecnico di Milano, Italy, found a relationship between increased forest fragmentation over time and Ebola outbreaks. We came across a couple other papers that mapped out where Ebola is likely to exist in wild animals, including one by Olivero himself.

As part of the first project, we created a data set of ecological characteristics from satellite imagery. We were curious if some of the factors, like the number of forest patches or proportion of mixing zones around those patches, could shed additional light on how susceptible a location could be to disease spillover.

Months in, we asked ourselves, could we combine the 23 environmental and population characteristics and what we learned from work by Olivero, Faust and Rulli into a single model? Could such a model reveal new insights into the conditions related to forest change that make it possible for Ebola to jump from animals to humans?

On the advice of Lynch, our science adviser, we started by looking for any clear patterns or clusters among the characteristics.

But after squinting at lots of tiny scatter plots, nothing jumped out. This wasn’t entirely unexpected, because we had only seven outbreaks to compare. When the number of characteristics far outnumbers the events you’re interested in, it can be hard to tease out clear relationships. So Lynch suggested something straight from her own research playbook: decision trees and random forests.

Decision trees, Lynch explained, are machine learning algorithms that create chains of binary decisions to help distinguish groups from one another. We hoped they could help us find places that looked a lot like locations where Ebola outbreaks had occurred. These trees — not to be confused with the leafy trees in our forest data — are useful because they can sort and cluster data based on combinations of characteristics that might not be obvious when considering each individually, and flag potential matches.

Decision trees helped us figure out which population and forest characteristics best explain the differences between locations we’re interested in, and all others.

Here’s an example of one decision tree generated by our model.

Most importantly, they’re easy to understand. Unlike many machine learning models, it’s easy to pop the hood on a decision tree and examine the choices made at each step. But easy doesn’t mean unsophisticated. Many decision trees, each with random, slight differences, can be combined into something called a random forest, which aggregates the results of multiple decision trees. Random forests are a popular and versatile technique that has been used widely in academia and journalism.

Computers can generate many decision trees, each with slight differences. Together, they make up a random forest.

Any single location that is flagged by a majority of trees in a random forest is considered a location of interest.

We created a random forest made up of 1,000 trees. If a location was flagged by the random forest, then it was classified as similar to locations where Ebola outbreaks had been linked to forest loss, and reviewed by us.

Choosing Data

Our ultimate goal was a model that could figure out which characteristics were distinctive in places that had experienced Ebola outbreaks. So we created three buckets of data: outbreaks linked to forest loss, outbreaks that had other origins and random places where outbreaks never happened.

Collecting the first two buckets was easy: the seven Ebola outbreaks previously linked to forest loss by Olivero and his collaborators went into one. The rest of the outbreaks since 2000 (the earliest year for which forest loss data from Hansen/Global Forest Watch is available) went into the other.

For the third bucket, we had lots of options. We started with a database of villages and hamlets in 28 countries. Then, we found which of them overlapped with Olivero’s data that maps where conditions are favorable for wild animals to harbor Ebola. In all, we had 11 million locations to examine.

It was unfeasible to query all 11 million, so we collected a random sample of 50,000 and collected population statistics for each. We then determined which of the 50,000 locations were at least 100 kilometers, about 62 miles, away from the outbreaks already in our two buckets. Finally, we narrowed the sample to villages and hamlets where the human population was within the range of populations in our outbreak buckets, because they might interact with the forest in similar ways; for example, for firewood or hunting. The populations couldn’t be too small, either — spillover events require, by definition, human hosts to jump into.

Our last step was to filter for locations similar to those in our second bucket. In other words, these locations had characteristics that could sustain an Ebola outbreak, maybe even due to a spillover event, but for reasons unrelated to forest loss. We selected 21 of those random locations for our third bucket of data.

For all 35 locations, which we refer to as our training data, we calculated 23 different characteristics about forest change and population using a variety of data sources.

Seven locations used as training data were outbreaks tied to forest loss.

The other locations fell into two buckets: outbreaks not tied to forest loss, or locations where outbreaks were never recorded.

Training and Validating the Model

With training data in hand, we set about trying to get the model to find insightful patterns. It’s a real possibility, especially when the input data is limited, that machine learning models will find patterns where there actually are none. This is called overfitting; think of it as a computer interpreting polka dots as a connect-the-dots game.

To avoid overfitting, we trained multiple random forest models, each time withholding some of the data. This is a common strategy in ecology, where data can be scarce and it’s important to make sure that a model is not overly influenced by the idiosyncrasies of any one data point. In our case, Ebola is such a rare disease that excluding one of seven outbreaks in each training round allowed us to see if any of them were disproportionately affecting the models.

The results from each training round also gave us a better idea about which of the 23 characteristics were most important. Only four characteristics were ranked as important across all training rounds: the number of patches the forest is divided into, the forest area at two points in time and changes in forest fragmentation.

This set of characteristics was exciting, because it confirmed that key concepts from the work by Olivero, Faust and Rulli could be combined into a single model.

Before we ran with these results, though, we wanted to gut-check one last possibility: that whatever pattern our model had found was too general. Sure, maybe we’d built something that identified a handful of shared traits among seven outbreaks, but perhaps our approach would always find key characteristics among a small number of data points.

To test this hypothesis, Lynch proposed something called, intriguingly, a “garbage model.”

Think of an English-Spanish dictionary, except the word pairs are all shuffled — “cat” is linked with “perro,” instead of “gato.” Using the dictionary to translate an English sentence would result in a totally nonsensical Spanish sentence.

Shuffling our data, Lynch said, should result in similarly nonsensical classifications of the data withheld from training. If not, then our approach was likely too general. But if the garbage model generated garbage classifications for the withheld data, then we could have some reassurance that whatever patterns our actual model found were genuine.

We tried it and — out came basura, as expected. It was time to create the final model.

Testing the Model

Our final model only used the four most important characteristics of the nearly two dozen we’d started out with: how much patchier the forest had become in the two years leading up to an outbreak, how much bigger the mixing zones had gotten in that time, the amount of total forest in the year the outbreak happened and the amount of forest two years before that.

Finally, it was time to test the model by showing it completely new places and then asking which of them look like the set of outbreaks in the first bucket.

We took another random sample of approximately 1,000 places from the 50,000 previously sampled random set of settlements. Calculating fragmentation statistics in Google Earth Engine is time consuming — it took us about a week to process 1,000 locations. Collecting data for more locations would not have been feasible.

Out of nearly 1,000 test locations, we found that 51 were consistently flagged. About half of the locations were in southwest Nigeria. Sixteen were in the Democratic Republic of Congo, and the remaining handful were in Ghana, Burundi and Benin.

Given that a spillover-induced outbreak of Ebola has never been recorded in Nigeria, we were surprised by the results. But a literature review revealed other papers that warned of the potential for Ebola spillover events in Nigeria. These papers, plus the locations flagged in the Democratic Republic of Congo — the site of the most recent Ebola outbreak with confirmed links to a spillover event — gave us the confidence to hit pause on all the coding and modeling to do some reporting.

You can read about it in our story.

Caroline Chen contributed reporting.

by Caroline Chen, Al Shaw and Irena Hwang

ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive our biggest stories as soon as they’re published.

We’re investigating the cause of viruses spilling over from animals to humans — and what can be done to stop it. Read more in the series.

The bright spots on the map struck us like a lightning bolt.

We had spent months teaching a computer about the Ebola virus –– feeding it information about the landscapes and populations in places where the disease had previously emerged, showing it how to analyze those outbreaks for patterns, and then instructing it to flag other areas that looked similarly perilous.

Some of the highlighted spots were predictable; the virus had repeatedly ravaged one of those countries.

But we didn’t expect our model to light up Nigeria, the most populous country in Africa. The West African nation and international travel hub has never seeded an Ebola outbreak, but just a year ago, it served as the springboard for another virus to travel into Europe and the Americas and spread across the globe. However that virus, mpox, originally known as monkeypox, is rarely fatal.

What if it had been Ebola, which kills about half of the people it infects?

We asked Nigerian public health officials whether they were concerned.

“Ebola is not part of our top concerns any more,” said Oyeladun Okunromade, the director of surveillance and epidemiology at the Nigeria Centre for Disease Control.

In the aftermath of the 2014 West African Ebola epidemic, the worst on record, Nigerian officials were on high alert. But last year, they took the virus off the list of the top infectious diseases the country needed to prepare for, downgrading Ebola in relation to threats like mpox, which Nigeria was actively fighting.

The disjoint between how our model sees Nigeria’s risk and how the nation’s health officials view it reveals a weakness in the way that governments and public health experts are preparing for future pandemics. The methods many countries use to rank threats focus mainly on factors that occur after an outbreak has already begun, such as the potential economic impact of an epidemic. Or they rely on past cases, looking at where a pathogen has previously struck.

Neither approach considers the root causes.

We’ve spent more than a year digging into the question of what causes outbreaks and what the world can do to prevent them. And we’ve learned that while science has advanced so we’re starting to understand the complex factors that trigger an outbreak, the world is not doing nearly enough to try to head off the next big one.

Most emerging infectious diseases come from wildlife. Those outbreaks require two essential elements: animals that carry a virus and opportunities for those animals to infect people.

Many of these fateful jumps, known as spillovers, have happened in forested, but populated, areas where trees have been cut down. Researchers have found that when people cut trees in patches, leaving the landscape dotted with holes like Swiss cheese, that creates more pockets and edges where humans and infected animals can collide. That world-shaking Ebola outbreak in 2014, for example, started in a Guinean village surrounded by a ring of forest.

Models that incorporate these environmental drivers could help countries look forward instead of backward as they determine how to allocate resources. Solomon Chieloka Okoli, an epidemiologist who works for Nigeria’s field epidemiology and laboratory training network, said his country, like many others, tends to react to outbreaks after they’ve started instead of trying to prevent them. That isn’t enough, Okoli said. “Being proactive is the best line of defense — if you wait, a lot of people will have died before you can get yourself together.”

Our model, created in consultation with scientists, was able to identify ecological factors that were common to past Ebola spillovers. The resulting risk map should be enough to prompt action, according to Christina Faust, a fellow at the University of Glasgow, Scotland, whose research focuses on how human activities like deforestation affect disease transmission.

Ebola often starts with a fever, so governments should invest in surveillance systems that help health authorities track patients with fevers, she said. “We should be watching these areas.”

Training Computers to Learn How Outbreaks Work

Models are not crystal balls; they can’t say exactly when or even whether a place will be hit with an outbreak. But they are great for understanding risk — where it is growing and where it may be shifting to.

“I love these as advocacy tools, because they’re meant for action,” said Dr. Maria Van Kerkhove, an infectious disease epidemiologist at the World Health Organization. “We just want these types of maps to inform and say: Make sure you’ve considered what might be circulating that you haven’t yet detected.”

We were curious to see where risky deforestation patterns are happening today. So we turned to a machine learning technique called “random forests” (no relation to actual tree-filled forests!) that can be used to spot patterns that might explain how some previous Ebola outbreaks happened. We limited our analysis to the geographic area where wildlife that can transmit Ebola is most likely to be found. This area covers 27 African countries from Guinea to Uganda.

We started with seven locations of past Ebola outbreaks that researchers have linked to forest loss. Then we selected 23 parameters, including demographic characteristics like the change in population from 2019 to 2021 (the most recent available data), as well as forest characteristics like the amount of tree loss and the patchiness of the surrounding forests.

We pulled data from satellite imagery and online population databases, fed it to the model and asked the computer to examine these factors across the seven known Ebola outbreaks. The model digested all this information and determined the relative importance of each parameter.

We also asked it to compare the outbreak sites to a set of places that were in the area where Ebola-carrying animals could live but had not seen an Ebola spillover.

Then we gave it a list of 1,000 candidate villages that had at least the same population size as previous Ebola spillover sites. (The 1,000 candidates were a random sample of all the villages that met our criteria; we weren’t able to run our model on the full set because of the amount of time and computing power that would have been required.) We asked the computer: Are there places that look very similar to past outbreak sites?

The model identified 51 locations with patterns of tree loss very similar to the seven previous Ebola outbreaks. The Democratic Republic of Congo had 16, which made sense; the country has recorded more than 10 Ebola outbreaks since the 1970s. The model highlighted additional spots in Ghana, Burundi and Benin.

More than half of the locations of concern, 27, were concentrated in Nigeria.

(Source: Hansen/UMD/Google/USGS/NASA, OpenStreetMap)

(If you — like us — are a nerd and want to read about our model in more detail, here is a comprehensive methodology.)

Why Nigeria’s Deforestation May Increase Its Risk

We were initially surprised to see the cluster of flagged locations in the southwest region of Nigeria, since the nation has never been the starting point for an Ebola outbreak. (The country has dealt with Ebola patients before, after an infected traveler flew to Lagos from Liberia during the West Africa outbreak in 2014.)

But we came to learn that Nigeria has experienced rapid deforestation over the past two decades. According to Global Forest Watch, the country has lost over 3,800 square miles of forest since 2001, and the rate of that loss has been accelerating. Nigeria has cleared the equivalent of nearly 170,000 football fields every year since 2017.

This is in part because energy prices have risen, making conventional fuel sources like kerosene unaffordable for many families, said NwaJesus Anthony Onyekuru, a professor of resource and environmental economics at the University of Nigeria. “They don’t want to use kerosene to cook, so they use wood,” he said.

Our model showed that this rapid forest clearing has happened in the dangerous, patchy pattern that researchers say leads to more interactions between humans and wildlife, and therefore increases the chances of spillover.

Scientists have found that bats can shed more virus when they’re stressed, such as by losing their habitats. That means that hunters may now encounter wildlife that is more likely to transmit a pathogen. Some Nigerians eat bats. Hunger has driven other residents to hunt for monkeys and rats in the forests, according to the epidemiologist Okoli. He said that consumption of large rats in the country’s southern region may have spurred the recent mpox outbreak.

Local deforestation has contributed to an increase in Lassa fever cases, said Dr. Charles Akataobi Michael, a senior technical officer at the Africa Centres for Disease Control and Prevention. Lassa fever can cause bleeding from the mouth, nose and gastrointestinal tract in severe cases, as well as neurological symptoms like hearing loss. The virus is carried by rodents, and people can be infected when food or household items are contaminated with the rodents’ urine or droppings.

The virus has been circulating in areas where people burn trees to create farmland, said Michael, destroying the rodents’ habitat. “They go to human habitats as a result of bush burning and deforestation to find food,” he said. “As we continue to alter the environment, the risk of disease outbreaks are increasing significantly.”

As the country’s population continues to grow rapidly, residents are chipping away at the forests to make room for farms. This land-use change is another way that risk may be increasing: Many outbreaks around the world have started when a virus jumped first from wildlife to a farm animal and then made another leap to humans. That includes deadly forms of bird flu and the brain-inflaming Nipah virus, which was immortalized in the movie “Contagion.”

Though we were initially surprised, we’ve since learned that Nigeria has appeared in other academic models as a potential Ebola hot spot. A 2019 analysis, published in the journal Nature Communications, identified Nigeria as a country at risk for an Ebola outbreak based on both current conditions and future climate and socioeconomic drivers.

In 2014, a different group of scientists used human and animal data to map locations most at risk of an Ebola outbreak. Among countries that had never reported an Ebola spillover before, Nigeria was at the top of their list. We know that Ebola isn’t constrained to country borders — after all, the worst Ebola outbreak to date started in Guinea, where the virus hadn’t previously been thought to be a threat. And this year, Marburg, Ebola’s cousin, has spread in two countries that had never before recorded an outbreak.

David Pigott, who led the 2014 analysis, said looking at prior cases isn’t the best way to evaluate risk: “The conversation of preparedness should not just be a function of what happened in the past.”

But that, we learned, is exactly what Nigeria is doing.

The Gap Between Knowledge and Action

The Nigerian experts we interviewed all acknowledged the importance of environmental factors in increasing outbreak risk. But many said that not much has been done to try and mitigate dangerous deforestation.

Okunromade, from the Nigeria CDC, helped create its One Health Strategic Plan — a national action plan based on the “one health” principle that the well-being of the environment, animals and humans are deeply interconnected. She said the government has brought together experts on human and animal diseases so that they can share information about pathogens such as mpox, Lassa fever and bird flu.

Yet when we asked what the country was doing to address environmental risks, she wasn’t aware of any initiatives, though she said it may be possible that other agencies were telling the public about the dangers of deforestation.

Okunromade said that experts used a tool developed by the U.S. Centers for Disease Control and Prevention to assess the risks of dozens of diseases that come from animals. The process has local experts select five criteria, commonly including epidemic potential or a country’s diagnostic capacity, and answer questions about different diseases for each criteria. Based on the answers, the diseases get scored as having a higher or lower priority.

When Nigerian officials ran this exercise in 2017, the devastating Ebola epidemic was fresh in their memories, and Ebola made the top five. “Looking at West Africa, at the countries surrounding us, looking at Sierra Leone, looking at Liberia, they were the worst hit. So that was why it made the list,” she said.

Ebola is a disease that would typically rank highly using the U.S. CDC’s tool because it gives more points to pathogens with a higher fatality rate. In 2022, Nigerian officials re-did the ranking exercise and initially, Ebola was still in the top five, but the officials felt it was more important to look at recent cases. Since there hasn’t been an Ebola outbreak in neighboring countries in recent years, the disease fell off their priority list, according to Michael, from the Africa CDC, who participated in the ranking process.

The CDC’s tool, which has been used by more than two dozen countries, does not require consideration of environmental causes like deforestation when ranking threats. Dr. Casey Barton Behravesh, the director of the U.S. CDC’s One Health Office, said that the process does not mandate which criteria should be considered and “it’s up to the country or region to decide on the criteria of greatest importance to them.” In examples she provided, two workshops, conducted in Alaska and the Economic Community of West African States, included a question about whether climate change would impact a disease. Some other countries considered the environmental impact of a potential outbreak, but they did not look at environmental factors that could increase the chance of a spillover. None of the examples included a question about deforestation.

There’s hope that new tools will evolve. The WHO is currently working with Pigott, who is an assistant professor of health metric sciences at the University of Washington, and other academics to develop risk maps for 16 different pathogens. Their model will incorporate data on environmental drivers of outbreaks. They aim to publish their work in a journal in future months, according to Pigott.

Pigott acknowledged that it can be hard for governments to prioritize a rare event like an Ebola outbreak. Still, he said, preparing for a disease like Ebola can be incorporated into plans for other pathogens. A malaria test may be the most logical place to start in a patient with a fever; if that is negative, health workers should be ready to test for Ebola, he said. But that only works if they are aware of the potential threat.

Ultimately, putting a disease on a priority list is only the first step. True prevention will need to address people’s lives, said Okoli, the Nigerian field epidemiologist: “If you say, ‘Don’t cut the bush to make charcoal,’ then you need to provide gas. If people are saying, ‘When I’m hungry, I get wild game,’ then you need to make it easier to get meat from the shops. You need to provide an alternative.”

Preventing the next outbreak from starting, Okoli said, should not be that hard. “It’s just about the political will and the willingness of the government to do something.”

by Megan O’Matz and Mariam Elba

ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up for Dispatches, a newsletter that spotlights wrongdoing around the country, to receive our stories in your inbox every week.

Margaret Rose Bostelmann’s ideals are clear from one glance at her well-kept ranch-style house in central Wisconsin.

A large American flag is mounted near the front door, and a “We Back the Badge” sign on her front lawn announces her support for law enforcement. Bostelmann, a Wisconsin elections commissioner, said she voted for Donald Trump in 2020 and added: “I will always vote Republican. I always have.”

But her fellow Republicans have exiled her and disparaged her, sought to upend her career and, on this day in July, brought the 70-year-old to tears as she discussed what she’s been through over the last several years because she refuses to support false claims that Trump won the state in the 2020 presidential election.

Bostelmann, who goes by Marge, previously served for more than two decades as the county clerk in Green Lake County, overseeing elections without controversy. But two years into her term in a Republican slot on the Wisconsin Elections Commission she became a target, denounced and disowned by the Republican Party of Green Lake County, which claimed she had failed to protect election integrity in the state.

Now a suit filed in June by a Wisconsin man who promotes conspiracy theories about election fraud seeks her removal from the commission. Citing her estrangement from the county party, the suit claims she’s not qualified to fill a position intended for a Republican.

The elections commission, which has an equal number of Republican and Democratic members, has faced an onslaught of discredited claims about election fraud in Wisconsin. The most recent drama involves the commission’s nonpartisan administrator, Meagan Wolfe, whose term is expiring and whose future in the role is in doubt. After the three Republican members of the commission supported Wolfe in a June vote, Republicans in the state legislature made it clear they wanted to find a way to get rid of her.

The Republican clashes in Wisconsin exemplify ongoing discord seen across the country, with elections officials shunned, berated and even driven away by members of their own party over their defense of the integrity of the 2020 election.

In Hood County, Texas — a solid red block in a red state — hard-line Republicans successfully pushed for the resignation of the elections administrator, even though Trump won 81% of the vote in the county. In Surry County, North Carolina, where Trump also won overwhelmingly, the Republican elections administrator was threatened with firing or a pay cut for refusing to give a GOP party leader access to voting equipment to conduct a forensic audit. And in Clare County, Michigan, officials are considering possible charges against a GOP activist accused of kicking the party chair in the groin.

The Wisconsin Elections Commission has been sued by numerous parties, verbally attacked by voters and earmarked for elimination by GOP lawmakers. It has survived only because a Democrat still occupies the governor’s office and wields veto power.

In an April survey of local election officials nationwide, the Brennan Center for Justice, an independent, nonpartisan law and policy organization, found that nearly one in three reported being abused, harassed, or threatened because of their job.

In a rare interview, Bostelmann wept at one point. For the most part, though, she was defiant, insisting the 2020 election was not stolen by Joe Biden.

“I’m a Republican who stands up for the truth and not for a lie,” Bostelmann said. And she predicted the latest legal gambit, which seeks her removal, would fail.

Don Millis, the Republican who chairs the Wisconsin Elections Commission, also has expressed frustration with the election conspiracy theorists. At the commission’s June meeting, he said he considered some of the agitators to be “grifters” who are conning people of goodwill into thinking there is something wrong with the election system.

“It’s not about winning or preventing fraud,” he said of the conspiracy theorists’ motives. “It’s about getting publicity or attention. It’s about grifting, convincing others to donate to their cause.”

In a recent interview with ProPublica, Millis said he was referring to a small set of people he believes are trying to raise money by spreading lies through social media or newsletters. “There are many people who believe them, who don’t know any better,” he said.

From Fraudster to Fraud Investigator

The man who brought the suit against Bostelmann is Peter Bernegger, grandson of the founders of Hillshire Farm, the Wisconsin deli meat and sausage company. Now 60, Bernegger has described himself as a “data analyst” and an “independent journalist.”

He has engaged in relentless — and so far futile — legal efforts to prove fraud in the 2020 election. This mirrors a different kind of legal fight from earlier in his life: trying to overturn his own fraud conviction.

A 2008 indictment accused Bernegger and a business partner in Mississippi of deceiving investors, bilking them of $790,000 in various ventures — including the development of a gelatin, intended for pharmaceutical or cosmetic companies, made from the carcasses of catfish. A federal jury acquitted the partner, who has since died, but convicted Bernegger of mail and bank fraud. He was sentenced to 70 months in prison and ordered to pay nearly $2.2 million in restitution.

Bernegger overwhelmed the courts with claims to clear his name, alleging procedural errors, insufficient evidence, judicial bias, ineffective counsel, violations of his constitutional rights and other misconduct.

“Mr. Bernegger, you file an awful lot,” said U.S. District Court Judge William Griesbach of Wisconsin. “Just let me say that. You file so many things. And in all honesty, I don’t have time to keep up on it all.”

Though most of his claims failed, Bernegger did succeed on one front: He got his restitution reduced to roughly $1.7 million. Ordered in 2019 to get a steady job to make payments on the debt, Bernegger testified that he had limited options.

He said his health was too poor for him to be able to lift heavy objects, drive a truck or operate heavy equipment. “I work odd jobs, a wide variety of them. And it is cash, but it's legal,” he explained.

When ProPublica reached Bernegger by phone for this story, he immediately hung up. He did not respond to letters and emails seeking comment.

Much of his energy, it appears, is now devoted to stoking doubt about election integrity. In his social media posts and podcast appearances, he has railed against Wolfe, the Wisconsin elections commission administrator, while repeating sweeping, unsubstantiated claims about problems in voting systems across the country. Along the way, he has made alliances with like-minded individuals beyond his home state.

Bernegger has ties to Omega4America, a website promoting a super-fast computing method to identify fraud by matching voter data with property tax records and other large databases. The site solicits donations to a nonprofit called Election Watch Inc.; Bernegger founded a tax-exempt organization with that same name in 2022.

The Texas Tribune has reported that the Omega4America project was initially funded by MyPillow CEO Mike Lindell, a conspiracy theorist close to Trump. Omega4America makes glowing claims about programming marketed by Texan Jay Valentine as a powerful tool that could replace the Electronic Registration Information Center, or ERIC, a multistate consortium that ferrets out duplicate voter registrations across states. ERIC has been the subject of heavy criticism from conservatives who believe its work identifying unregistered voters for states bolsters the rolls for Democrats.

In a podcast, Bernegger mentioned that he has access to the “Valentine fractal programming system” as he seeks to uncover voter fraud. Valentine, who is listed on the Omega4America website as the site contact, declined to discuss his work or Bernegger, telling a ProPublica reporter: “I have nothing to say to you.”

In an April episode of a podcast called The AlphaWarrior Show, Bernegger said he’s now part of a team of 10 scouring federal campaign data for oddities. He named James O’Keefe as a member of that team. O’Keefeis the former head of Project Veritas, a conservative group known for secretly recording liberal organizations, and has a new media company that encourages “citizen journalists” to investigate election fraud. ProPublica’s attempts to reach O’Keefe for comment were unsuccessful.

Toward the end of the AlphaWarrior podcast, the host urged viewers to “smash” the blue donate button on an Election Watch website to show support for Bernegger and his team.

“It means we sacrifice a movie or a fancy dinner and we throw a couple dollars their way,” he said.

Peter Bernegger, right, on The AlphaWarrior Show (via Rumble) “I Don’t Know That I’d Be Welcome”

Marge Bostelmann still doesn’t fully understand how it got to this point, how she became such a target of Bernegger and others, including people she once thought held similar values.

But she does know that things in Green Lake began to change in 2020, during Trump’s reelection bid. Bostelmann said she stopped paying membership dues to the county party after the party chair became critical of her and of the way the 2020 election had been run in Green Lake County by her successor.

By November 2021, as conservatives carried out investigations into voting accommodations made in Wisconsin during the pandemic — including the use of drop boxes and allowing unsupervised absentee voting in nursing homes — Bostelmann and others on the elections commission came under attack for their votes shaping those procedures.

Kent McKelvey, the Green Lake County GOP chair at the time, issued a press release saying Bostelmann’s actions on the Wisconsin Elections Commission “do not reflect the principles, values and beliefs of the Green Lake County Republicans, in this case, supporting the proper enforcement of the law and of election integrity.”

The press release said flat-out that “Ms. Bostelmann is no longer a member of the Republican Party of Green Lake County.” McKelvey did not respond to requests for comment.

The snub hurt. Bostelmann, a former foster parent who knows many local Republicans through her activities with her church and the Rotary Club, said she stopped attending many local GOP events. “I don’t know that I’d be welcome,” she said.

Even as efforts to prove fraud in Wisconsin fizzled, the pressure on the commission remained intense. Powerful Republicans in the state Senate called for Wolfe’s ouster, blaming her for what they saw as regulatory overreach by the commission, though in her role she carries out the orders of the six voting members.

Prior to the commission’s key June vote on Wolfe, Bostelmann said, she received a disturbing phone call from an acquaintance who had been critical of Wolfe. “The patriots would not be happy” with her, she was told, if she backed Wolfe. Bostelmann took that as a threat.

Still, she and the panel’s two other Republicans voted to reappoint Wolfe. Bostelmann defended Wolfe publicly at the June meeting, saying the administrator had been unfairly targeted “as the scapegoat” by people dissatisfied with the commission and the outcome of the 2020 election.

In a tactical move, Democrats abstained from voting, leading to a final tally of three yes votes. That appeared to mean that the panel did not have the requisite four votes to send the matter to the state Senate for final consideration, and it was widely thought Wolfe would continue in her post because of the impasse.

But the Senate, surprisingly, decided the three affirmative votes were enough for it to take up her nomination. Wolfe’s reappointment is now pending before the Senate elections committee. No public hearing or vote has been scheduled.

Lawsuits are expected, though for now she remains on the job.

“Some judge will tell us who our administrator is. That’s my guess,” said the commission chair, Millis, a tax attorney who favored retaining Wolfe.

Like Bostelmann, Millis has been the target of Bernegger, who on Twitter has ranted about Millis ignoring election system problems, referring to him as “Blind Don.”

Robert Spindell, the third Republican member of the commission, said he hasn’t been chastised for his renomination of Wolfe. He said he thought it best that the Senate take up the matter. “I haven’t had anybody call or criticize me,” he said, noting: “Most of the people I know on this election stuff are not shy.”

Through a spokesperson, Wolfe declined a request for an interview.

Bernegger’s suit against Bostelmann demands that the circuit court remove her from her seat on the commission, citing the disavowal from Green Lake County Republican Party. “She cannot prove she is a member of the Green Lake County Republican Party and is otherwise qualified to hold the designated Republican seat,” he wrote.

The statute that governs commission appointees does not specifically require them to be dues-paying party members.

Records show Bernegger has bombarded the Wisconsin Elections Commission with official complaints and demands for data, often accompanied by threats of legal action and accusations of criminal conduct. In one email he referred to a commission staffer as a “prick.”

“Please note that I am becoming increasingly uncomfortable with this individual’s erratic behavior that is directed at myself, our staff and local election officials,” Wolfe wrote to the commission in October 2022. In May of this year, Wolfe told the commission Bernegger made her feel “incredibly unsafe” when he noted her home address in bold in an email to the commission and called her a “pathological liar.”

The commission fined Bernegger $2,403 in March 2022 for filing frivolous complaints. Records show commission staff have, at times, forwarded his correspondence to the Wisconsin Department of Justice.

On July 7, the Wisconsin Department of Justice’s Criminal Investigation Division served Bernegger with a letter at his home in New London, stating that his actions could reasonably have made Wolfe and others at the commission feel “harassed, tormented or intimidated.” It warned that he could be arrested for stalking if he continued his behavior.

Excerpt of a Wisconsin Department of Justice’s Criminal Investigation Division letter served to Peter Bernegger on July 7 (Obtained by ProPublica)

One of Bernegger’s lawsuits over records against the commission is still ongoing.

He has also sued officials in Dane, Door, Grant, Marathon, Milwaukee and Ozaukee counties, the town of Hudson, the city of Hudson, the city of Milwaukee and the town of Richmond in Walworth County. The suits are related to broad public record requests he made for absentee ballot applications, images of ballots, router logs and other materials and involve disputes over costs and access. While many of those have been dismissed, four are still pending.

“We’re all trying to do our jobs to the very best of our abilities. It makes it difficult when we are constantly being undermined and questioned,” said Marathon County Clerk Kim Trueblood. Her office provided Bernegger with some information when he inquired but denied him certain documentation that Trueblood said was exempt from release. He sued, but a judge dismissed the case.

Another clerk, Vickie Shaw of the town of Hudson, said she had to go to court three times to deal with a Bernegger suit over records. A judge threw out the case, Bernegger appealed, and it was tossed again.

Before Bernegger’s suit, Shaw had quit in 2021, finding the job too burdensome and confrontational. But she returned the following year because, she said, the town “didn't have anybody to run the April election.”

Bostelmann expressed dismay with Bernegger’s tactics against her and the other election clerks.

“It’s bullying is what it is. It’s truly bullying,” she said. “It’s almost like they are trying to get people who are knowledgeable, and do a good job, to quit to have people who don't know how to do the job to come in.”

by Logan Jaffe

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Illinois Gov. J.B. Pritzker signed into law Friday sweeping reforms that for the first time will give tribal nations — not state agencies, universities or museums — final say over how and when the remains of their ancestors and sacred items are returned to them.

“With the Governor signing these bills into law, Illinois is proving that a government is capable of reflecting on its past injustices and planning for a future that respects and celebrates our interconnectedness,” Prairie Band Potawatomi Nation Chairperson Joseph “Zeke” Rupnick said.

The newly signed Human Remains Protection Act was shaped by tribal nations over more than two years of consultations with the Illinois State Museum and the state Department of Natural Resources. The legislation unanimously passed the state House and Senate this spring and follows publication of ProPublica’s “The Repatriation Project,” an ongoing investigation into the delayed return of Native American ancestral remains by universities, museums and government agencies.

“Here in Illinois we believe in justice, and we won’t hide from the truth,” Pritzker said. “It’s up to us to right the wrongs of the past and to chart a new course.”

The law makes it the state’s responsibility to help return ancestral remains, funerary objects and other important cultural items to tribal nations, and it compels the state to follow the lead of tribal nations throughout the repatriation process. It also establishes a state Repatriation and Reinterment Fund to help with the costs of reburial, tribal consultation and the repair of any damage to burial sites, remains or sacred items.

Existing law to protect unmarked cemeteries in Illinois failed to create a pathway for tribal nations to rebury ancestral remains that had been disinterred. That law, passed in 1989, deemed most Native American remains to be property of the state.

The new law increases criminal penalties for the looting and desecration of gravesites, while adding a ban on profiteering from human remains and funerary objects through their sale, purchase or exhibition. Moreover, it mandates tribal nations be consulted as soon as possible when Indigenous gravesites are unintentionally disturbed or unearthed — such as during construction projects.

The measure follows decades of Indigenous activism, new leadership within the Illinois State Museum and IDNR, and ProPublica reporting that revealed widespread delays in institutions’ compliance with a 1990 federal repatriation law. ProPublica found that more than 30 years after passage of the Native American Graves Protection and Repatriation Act, museums and other institutions nationwide still hold more than 100,000 Native American human remains.

The failure to repatriate expeditiously, as required by NAGPRA, is rife in Illinois, where more than 15,461 Native Americans have been excavated — more than from any other state, the ProPublica investigation found. The vast majority of those ancestors are still held by Illinois institutions. Previous policies at the Illinois State Museum, which holds the remains of at least 7,000 ancestors, favored the scientific study of remains over their return to tribes for reburial.

Sunshine Thomas-Bear, the cultural preservation director for the Winnebago Tribe of Nebraska, said, “It has been a rough road in trying to get the protection and rights that non-Natives have in protecting our ancestral burial sites and homelands.” She added that many Illinois gravesites have been desecrated and destroyed.

“This bill cannot remedy the damage that has been caused thus far, but perhaps it will protect the sites that remain in our homelands,” Thomas-Bear said, though she emphasized that the law is “a step in the right direction” for rebuilding relationships.

Significantly, the law empowers IDNR to set aside and maintain land solely for the reburial of repatriated Native American ancestors and their belongings. Tribal nations have pointed to the lack of protected places for reburial in Illinois as among the highest barriers to repatriation.

For example, in 1999 the Sac & Fox Tribe of the Mississippi in Iowa, the Sac and Fox Nation of Missouri in Kansas and Nebraska and the Sac and Fox Nation, Oklahoma, repatriated the remains of 34 of their ancestors held by the University of Illinois Urbana-Champaign, records show. The tribes wanted to rebury their ancestors at or near the site where they were originally interred: a former Sauk and Meskwaki village in Rock Island County along the Mississippi River. But the state wouldn’t allow the tribes to use the land, said Johnathan Buffalo, the tribal historic preservation director of the Sac & Fox Tribe of the Mississippi in Iowa. They had to rebury the ancestors in Iowa — west of the Mississippi River, the same borderline used by the U.S. government when it expelled all Native American tribes from the state during the 1830s.

“That old wound opened when Illinois did that to us,” Buffalo said.

More than 30 tribal nations are recognized by the state museum as having cultural and historic ties to Illinois. The consultations, which are ongoing, began with discussing the repatriation of more than 230 ancestors unearthed from what today is known as Dickson Mounds.

“The need to rebury and to think about a different way of being in relationship with land from the state side was reiterated to us from just about every tribal nation,” said Heather Miller, the director of tribal relations and historic preservation for the Illinois State Museum. Miller is also an enrolled citizen of the Wyandotte Nation.

The new law is part of a broader effort to recenter Native voices in Illinois and within state institutions, a commitment brought to the Illinois State Museum in part by its former director, Cinnamon Catlin-Legutko, before her death this year. It was signed in tandem with two other laws; one requires the history of Native Americans in the Midwest be taught in Illinois public schools and another that bans school boards from prohibiting students from wearing cultural or tribal clothing and regalia in schools and at graduation ceremonies.

Interim Director Jennifer Edginton said the museum and IDNR, which oversees the institution, have “been looking very inward” to address the previous absence of Indigenous worldviews in their programs, collections and exhibits.

“We don’t want to continue that erasure, or stereotypes, or things that the museum field in general, unfortunately, has done since the inception of museums,” Edginton said.

The Legacy of Forced Removal

Today, no federally recognized tribes reside in Illinois, though Chicago is home to one of the largest urban communities of Indigenous people in the country. The absence of an organized political presence and tribal government has in part led to the state having among the worst repatriation track records in the nation.

“Forced removal affects everything,” said Miller, referring to the expulsion of Native American tribes from Illinois throughout the 1800s. “There was the physical removal, but that also removed [tribal nations] from being able to have a say in law, to have a say in voting, and from participating in all the ways the state operates and functions.”

That legacy has also contributed to Illinois museums designating many of the ancestral remains in their collections as “culturally unidentifiable” under the federal repatriation law. That designation has been misused by some institutions to avoid repatriating remains under NAGPRA, giving museums outsize power in consultations with tribal nations.

With passage of the new Illinois law, that balance of power will for the first time tip toward tribal nations whose ancestral lands became the state of Illinois.

“We have the ability to now bring those communities that were forcibly removed in violent ways back here,” Miller said. “Rather than being a ‘removal state,’ Illinois could be known as a ‘new relations’ state instead.”

The Future of Funerary Items

Another significant aspect of the new law is that it prohibits institutions from charging admission to view human remains that are Native American and any items that were originally buried with those individuals. Although the public display of Native American ancestral remains by museums fell out of practice after the passage of NAGPRA in the early 1990s, the public display of their funerary items has not.

After Dickson Mounds Museum in the early 1990s closed a burial exhibit that displayed the remains of more than 230 Native Americans, the institution still maintained a permanent exhibit that featured items taken from Indigenous gravesites across the state. As ProPublica reported this year, in September 2021, curators dismantled much of the exhibit at the request of tribal partners, who wished to see the items reunited with the ancestors they were buried with before their repatriation. Those funerary items made up about 40% of the exhibit.

State museum officials told ProPublica they’re not sure how many museums in Illinois still display funerary items. The law applies to every museum, university and historical society in the state — far more than the 15 institutions in Illinois that have reported their Native American holdings under the NAGPRA.

When asked about what he would say to museums that may push back against the law, Illinois State Rep. Mark L. Walker said: “Too bad.”

Walker, a Democrat who represents part of Chicago’s northwest suburbs, sponsored the legislation. He said he’s already received interest from other states looking to adopt similar laws.

“I think we can be a model for other states,” Walker said. “Whether we can change [Illinois’] image to such an extent that these communities actually trust us? I don’t know. That may take 30 years.”

by Sharon Lerner

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The Environmental Protection Agency approved a component of boat fuel made from discarded plastic that the agency’s own risk formula determined was so hazardous, everyone exposed to the substance continually over a lifetime would be expected to develop cancer. Current and former EPA scientists said that threat level is unheard of. It is a million times higher than what the agency usually considers acceptable for new chemicals and six times worse than the risk of lung cancer from a lifetime of smoking.

Federal law requires the EPA to conduct safety reviews before allowing new chemical products onto the market. If the agency finds that a substance causes unreasonable risk to health or the environment, the EPA is not allowed to approve it without first finding ways to reduce that risk.

But the agency did not do that in this case. Instead, the EPA decided its scientists were overstating the risks and gave Chevron the go-ahead to make the new boat fuel ingredient at its refinery in Pascagoula, Mississippi. Though the substance can poison air and contaminate water, EPA officials mandated no remedies other than requiring workers to wear gloves, records show.

ProPublica and the Guardian in February reported on the risks of other new plastic-based Chevron fuels that were also approved under an EPA program that the agency had touted as a “climate-friendly” way to boost alternatives to petroleum-based fuels. That story was based on an EPA consent order, a legally binding document the agency issues to address risks to health or the environment. In the Chevron consent order, the highest noted risk came from a jet fuel that was expected to create air pollution so toxic that 1 out of 4 people exposed to it over a lifetime could get cancer.

In February, ProPublica and the Guardian asked the EPA for its scientists’ risk assessment, which underpinned the consent order. The agency declined to provide it, so ProPublica requested it under the Freedom of Information Act. The 203-page risk assessment revealed that, for the boat fuel ingredient, there was a far higher risk that was not in the consent order. EPA scientists included figures that made it possible for ProPublica to calculate the lifetime cancer risk from breathing air pollution that comes from a boat engine burning the fuel. That calculation, which was confirmed by the EPA, came out to 1.3 in 1, meaning every person exposed to it over the course of a full lifetime would be expected to get cancer.

Such risks are exceedingly unusual, according to Maria Doa, a scientist who worked at EPA for 30 years and once directed the division that managed the risks posed by chemicals. The EPA division that approves new chemicals usually limits lifetime cancer risk from an air pollutant to 1 additional case of cancer in a million people. That means that if a million people are continuously exposed over a presumed lifetime of 70 years, there would likely be at least one case of cancer on top of those from other risks people already face.

When Doa first saw the 1-in-4 cancer risk for the jet fuel, she thought it must have been a typo. The even higher cancer risk for the boat fuel component left her struggling for words. “I had never seen a 1-in-4 risk before this, let alone a 1.3-in-1,” said Doa. “This is ridiculously high.”

Another serious cancer risk associated with the boat fuel ingredient that was documented in the risk assessment was also missing from the consent order. For every 100 people who ate fish raised in water contaminated with that same product over a lifetime, seven would be expected to develop cancer — a risk that’s 70,000 times what the agency usually considers acceptable.

When asked why it didn’t include those sky-high risks in the consent order, the EPA acknowledged having made a mistake. This information “was inadvertently not included in the consent order,” an agency spokesperson said in an email.

Nevertheless, in response to questions, the agency wrote, “EPA considered the full range of values described in the risk assessment to develop its risk management approach for these” fuels. The statement said that the cancer risk estimates were “extremely unlikely and reported with high uncertainty.” Because it used conservative assumptions when modeling, the EPA said, it had significantly overestimated the cancer risks posed by both the jet fuel and the component of marine fuel. The agency assumed, for instance, that every plane at an airport would be idling on a runway burning an entire tank of fuel, that the cancer-causing components would be present in the exhaust and that residents nearby would breathe that exhaust every day over their lifetime.

In addition, the EPA also said that it determined the risks from the new chemicals were similar to those from fuels that have been made for years, so the agency relied on existing laws rather than calling for additional protections. But the Toxic Substances Control Act requires the EPA to review every new chemical — no matter how similar to existing ones. Most petroleum-based fuels were never assessed under the law because existing chemicals were exempted from review when it passed in 1976. Studies show people living near refineries have elevated cancer rates.

“EPA recognizes that the model it used in its risk assessments was not designed in a way that led to realistic risk estimates for some of the transportation fuel uses,” an agency spokesperson wrote. For weeks, ProPublica asked what a realistic cancer risk estimate for the fuels would be, but the agency did not provide one by the time of publication.

New chemicals are treated differently under federal law than ones that are already being sold. If the agency is unsure of the dangers posed by a new chemical, the law allows the EPA to order tests to clarify the potential health and environmental harms. The agency can also require that companies monitor the air for emissions or reduce the release of pollutants. It can also restrict the use of new products or bar their production altogether. But in this case, the agency didn’t do any of those things.

Six environmental organizations concerned about the risks from the fuels — the Sierra Club, Natural Resources Defense Council, Moms Clean Air Force, Toxic-Free Future, Environmental Defense Fund and Beyond Plastics — are challenging the agency’s characterization of the cancer risks. “EPA’s assertion that the assumptions in the risk assessment are overly conservative is not supported,” the groups wrote in a letter sent Wednesday to EPA administrator Michael Regan. The groups accused the agency of failing to protect people from dangers posed by the fuels and urged the EPA to withdraw the consent order approving them.

Chevron has not started making the new fuels, the EPA said.

Separately, the EPA acknowledged that it had mislabeled critical information about the harmful emissions. The consent order said the 1-in-4 lifetime cancer risk referred to “stack air” — a term for pollution released through a smokestack. The cancer burden from smokestack pollution would fall on residents who live near the refinery. And indeed a community group in Pascagoula sued the EPA, asking the U.S. Court of Appeals in Washington, D.C., to invalidate the agency’s approval of the chemicals.

But the agency now says that those numbers in the consent order do not reflect the cancer risk posed by air from refinery smokestacks. When the consent order said stack emissions, the EPA says, it really meant pollution released from the exhaust of the jets and boats powered by these fuels.

“We understand that this may have caused a misunderstanding,” the EPA wrote in its response to ProPublica.

Based on that explanation, the extraordinary cancer burden would fall on people near boats or idling airplanes that use the fuels — not those living near the Chevron refinery in Pascagoula.

Each of the two cancer-causing products is expected to be used at 100 sites, the EPA confirmed. ProPublica asked for the exact locations where the public might encounter them, but Chevron declined to say. The EPA said it didn’t know the locations and didn’t even know whether the marine fuel would be used for a Navy vessel, a cruise ship or a motorboat.

In an email, a Chevron spokesperson referred questions to the EPA and added: “The safety of our employees, contractors and communities are our first priority. We place the highest priority on the health and safety of our workforce and protection of our assets, communities and the environment.”

Doa, the former EPA scientist who worked at the agency for three decades, said she had never known the EPA to misidentify a source of pollution in a consent order. “When I was there, if we said something was stack emissions, we meant that they were stack emissions,” she said.

During multiple email exchanges with ProPublica and the Guardian leading up to the February story, the EPA never said that cancer risks listed as coming from stack emissions were actually from boat and airplane exhaust. The agency did not explain why it initially chose not to tell ProPublica and the Guardian that the EPA had mislabeled the emissions.

The agency faced scrutiny after the February story in ProPublica and the Guardian. In an April letter to EPA administrator Michael Regan, Sen. Jeff Merkley, the Oregon Democrat who chairs the Senate’s subcommittee on environmental justice and chemical safety, said he was troubled by the high cancer risks and the fact that the EPA approved the new chemicals using a program meant to address the climate crisis.

Sen. Jeff Merkley (Graeme Sloan/Sipa via AP Images)

EPA assistant administrator Michal Freedhoff told Merkley in a letter earlier this year that the 1-in-4 cancer risk stemmed from exposure to the exhaust of idling airplanes and the real risk to the residents who live near the Pascagoula refinery was “on the order of one in a hundred thousand,” meaning it would cause one case of cancer in 100,000 people exposed over a lifetime.

Told about the even higher cancer risk from the boat fuel ingredient, Merkley said in an email, “It remains deeply concerning that fossil fuel companies are spinning what is a complicated method of burning plastics, that is actually poisoning communities, as beneficial to the climate. We don’t understand the cancer risks associated with creating or using fuels derived from plastics.”

Merkley said he is “leaving no stone unturned while digging into the full scope of the problem, including looking into EPA’s program.”

He added, “Thanks to the dogged reporting from ProPublica we are getting a better sense of the scale and magnitude of this program that has raised so many concerns.”

The risk assessment makes it clear that cancer is not the only problem. Some of the new fuels pose additional risks to infants, the document said, but the EPA didn’t quantify the effects or do anything to limit those harms, and the agency wouldn’t answer questions about them.

Some of these newly approved toxic chemicals are expected to persist in nature and accumulate in living things, the risk assessment said. That combination is supposed to trigger additional restrictions under EPA policy, including prohibitions on releasing the chemicals into water. Yet the agency lists the risk from eating fish contaminated with several of the compounds, suggesting they are expected to get into water. When asked about this, an EPA spokesperson wrote that the agency’s testing protocols for persistence, bioaccumulation and toxicity are “unsuitable for complex mixtures” and contended that these substances are similar to existing petroleum-based fuels.

The EPA has taken one major step in response to concerns about the plastic-based chemicals. In June, it proposed a rule that would require companies to contact the agency before making any of 18 fuels and related compounds listed in the Chevron consent order. The EPA would then have the option of requiring tests to ensure that the oil used to create the new fuels doesn’t contain unsafe contaminants often found in plastic, including certain flame retardants, heavy metals, dioxins and PFAS. If approved, the rule will require Chevron to undergo such a review before producing the fuels, according to the EPA.

But environmental advocates say that the new information about the plastic-based chemicals has left them convinced that, even without additional contamination, the fuels will pose a grave risk.

“This new information just raises more questions about why they didn’t do this the right way,” said Daniel Rosenberg, director of federal toxics policy at NRDC. “The more that comes out about this, the worse it looks.”

by Jessica Miller, The Salt Lake Tribune

This article was produced for ProPublica’s Local Reporting Network in partnership with The Salt Lake Tribune. Sign up for Dispatches to get stories like this one as soon as they are published.

This story discusses sexual assault.

Andrew was feeling crushed by the cultural expectation to get married.

Twenty-two years old, he had just returned from a mission for The Church of Jesus Christ of Latter-day Saints and was attending a singles’ ward in Provo, Utah — a local congregation of unmarried college students.

But Andrew is gay. And marriage between a man and a woman is a central tenet of the Latter-day Saint faith, which teaches that the highest level of heaven is reserved only for married, heterosexual couples. Same-sex marriage is not an option in the church.

So in the fall of 2015, he did as many Latter-day Saints do when they are having a crisis: He went to his bishop.

The lay leader suggested trying therapy, Andrew remembered. In fact, the bishop said he had just gotten a referral that same day for a local therapist named Scott Owen who worked well with gay men who were members of their faith. Owen co-owned a Provo therapy business called Canyon Counseling and, at that time, was also a regional leader in a Provo-area stake, a cluster of congregations that is similar to a Catholic diocese.

The coincidental timing — that his bishop learned of Owen on the same day Andrew disclosed his internal struggles — felt miraculous.

“It was like, God has a plan,” Andrew said. “This is going to work out. Everything seems dark and depressing. But this therapist is going to fix everything.”

But that’s not what happened. For five months beginning in October 2015, Andrew said, the clinical mental health counselor groped him, encouraged him to undress and kissed him during sessions. Andrew said Owen told him that the touching was a therapeutic way to learn how to accept love and intimacy.

Andrew, now 30, is being identified by a pseudonym to protect his privacy.

Sexual touching in a therapy session is considered unethical by all major mental health professional organizations, and it is defined in Utah rules as “unprofessional conduct” that could lead to a mental health worker losing their license or other discipline. It’s also illegal in Utah.

By March 2016, Andrew had reported Owen to both his bishop and to state licensing officials. A new investigation from The Salt Lake Tribune and ProPublica shows how Utah licensers allowed Owen to continue practicing and church leaders repeatedly heard concerns but took several years to take official action. For nearly two years after Andrew’s report, Owen provided therapy to clients, some of whom were men referred for “same-sex attraction” counseling. During that time, at least three more patients allege they were sexually abused by Owen, including two who reported him to the state licensing body in 2018. Those reports ultimately led Owen to agree to surrender his license.

Owen’s case is indicative of a flawed and misleading system: Officials within Utah’s Division of Professional Licensing encourage the public to look to the agency’s disciplinary records to vet a professional, yet those records rarely offer a full picture of misconduct. Despite Owen’s pattern of alleged inappropriate behavior, his publicly available disciplinary records reference touching but never disclose that the accusations against him were sexual in nature. This is one of a number of shortcomings identified by The Tribune and ProPublica while reporting on how Utah officials fail to supervise medical professionals and to adequately address patient reports of sexual assault.

Scott Owen (Obtained by The Salt Lake Tribune)

Owen, a large-framed bald man with dark blue eyes who speaks with a drawl, built a reputation over his 20-year career as a therapist with Christian values who could help Latter-day Saint men with same-gender attraction. He gave public lectures so often about pornography and masturbation, Owen told a crowd of LGBTQ+ church members in 2016, that he had earned the nickname “The Porn King.”

Although Owen, now 64, responded to an initial email from a reporter, he did not answer detailed questions sent to him via certified mail.

Officials with DOPL say that, given the evidence they had from Andrew’s complaint, they believe they responded appropriately. But, communications between Andrew and an investigator suggest that the agency’s actions rested largely on Owen’s denial that anything improper had happened and a failed polygraph test officials asked Andrew to take — a tool that experts say is known to be specifically unreliable with victims of sexual abuse, and that some states ban for that reason.

Church spokesperson Sam Penrod said the faith made an annotation on Owen’s personal church record in spring of 2019 — three years after Andrew’s initial report to his bishop. An annotation is a confidential marking intended to alert a bishop to someone whose conduct has threatened the well-being of other people or the church. It can affect what roles members are asked to fill within their congregation.

Penrod said in an email: “The Church takes all matters of sexual misconduct very seriously. This case was no exception.”

Both the church and the licensing division declined to comment on whether they reported the therapist to the police. Provo police officials said they had no record of ever receiving any report of sexual abuse against Owen.

Owen co-founded Canyon Counseling in Provo, Utah, in 1998. (Leah Hogsten/The Salt Lake Tribune) Touching in Therapy

Owen pushed physical boundaries from the very start, Andrew said. After their first session, Owen ended their meeting with a quick hug. At his second appointment, Andrew said, Owen held him in a longer embrace.

“I’m doing this because I know you’re uncomfortable with love,” Andrew remembered Owen telling him as they hugged. “I want you to get used to it.” Such touching, he recalled Owen saying, would be “a key step in my therapy.”

Andrew did feel uncomfortable. But he remembered Owen seemed genuine and truthful in their therapy sessions — even “Christ-like” in his caring.

Growing up in the Latter-day Saint faith, Andrew was taught to trust men in positions of authority. There was also the expectation to talk with his bishop about deeply personal sexual details during one-on-one interviews. These annual closed-door discussions generally start when members become teenagers and typically explore whether they are following the faith’s rules; they have been criticized by some parents and therapists as being “inappropriate” and “intrusive.”

These interviews, Andrew said, left him with a skewed view of what was appropriate in a mentoring relationship.

“I felt like a lot of the times I didn’t understand what normal boundaries to have around sexuality,” he said, in part because of how he was instructed to relate to religious leaders. “You have to air it all to these particular people in your life — and then you hide it desperately from everyone else.”

In the late 1960s, church leaders took a hard stance against even identifying as gay, including “homosexuality” in a list of behaviors that could result in excommunication. Bishops and church leaders in subsequent years were taught that being gay was a reversible condition, and church leaders would send gay men to conversion therapy or advise they could be fixed by marrying a woman.

By the time Andrew began seeing Owen in 2015, the church had publicly acknowledged that its members do not have a choice in being attracted to the same sex; today, church policy says a gay member can remain in good standing if they remain celibate and never marry someone of their same gender.

“At the time, I knew it might not be possible for me to get married, and that would still be OK in the church framework,” Andrew recalled. But, he added, “so much of the LDS dream is based on marriage that that was crushing and really depressing to me.”

So Andrew kept going to therapy, even as he said Owen began touching him more, at times rubbing his back or his bottom during hugs. Owen encouraged him to undress during some therapy sessions, Andrew said, which evolved into what he describes as “makeout sessions.” Looking back now, it’s clear to Andrew that this was inappropriate — but in the moment, he felt desperate and confused.

Andrew reasoned with himself that he was not physically attracted to Owen when they touched, which would be similar if he married a woman. Maybe it was a way for him to learn how to express romantic feelings he didn’t have or to fake it until those feelings came.

“I couldn’t accept that I was being taken advantage of,” Andrew said. “That’s a hard thing to be like, ‘Oh, I’ve been sexually abused this whole time.’”

“This was supposed to be my miracle,” he added.

Decorations in Andrew’s room (Leah Hogsten/The Salt Lake Tribune) A Reprimand

Andrew decided to stop therapy in February 2016, as he wrestled with whether what had happened had been abusive. He confided in a friend during late-night study sessions on Brigham Young University’s campus a few days later. In an interview corroborating Andrew’s account, she recalled urging him to tell someone.

Within a week of stopping therapy, Andrew again found himself confiding in his bishop.

Andrew recalled feeling like his church leader, who works as a livestock and pasture insurance agent, seemed confused about how to help a gay member of the church — and whether this type of touching in therapy was supposed to be helpful. He referred Andrew to another therapist who, Andrew said, told him Owen’s alleged conduct was a “gross violation” of patient boundaries.

Andrew went back to his bishop with this information, but the lay leader never reported that information to church authorities. The church’s general handbook for members makes it clear that if a bishop or stake president “learns of abuse of a spouse or another adult,” they are supposed to call a confidential hotline for guidance from lawyers and clinical professionals.

The bishop, whom The Tribune and ProPublica are not identifying to protect Andrew’s identity, said that he struggled to process what Andrew told him, and that he felt it was sufficient that he had encouraged Andrew to report Owen to state licensing officials at DOPL. The division is responsible for licensing Utah professionals, from medical doctors to armed security guards to massage therapists. It is also charged with investigating misconduct and can revoke a license or put someone on administrative probation.

By then, Andrew had stopped seeing Owen. Andrew’s bishop questions now whether he should have said something to a higher church leader, but he said he felt the faith’s guidance for when bishops should report alleged abuse to church authorities pertained more to “something happening that needs to be stopped, like when there’s abuse in the home.” The bishop added that he didn’t feel he knew how he should help members who were struggling with their sexual identity and their faith.

“A bishop is supposed to be a spiritual guide. Not a psychologist, not a family therapist. So I felt equipped to listen and love them, absolutely,” he said. “But as far as to help them process what it means and how to be a part of this religion and be gay — I never figured that out.”

Andrew followed his bishop’s guidance and went to licensers in early March 2016. In a statement Andrew wrote for investigators — which he shared with The Tribune and ProPublica — Andrew described the escalating touching and accused Owen of touching parts of his genital area at their last appointment.

“I left feeling disgusted in what had happened,” Andrew wrote about their last appointment, “and vowed to never return.”

To conduct their investigation, licensing officials offered the therapist a polygraph test. He refused, according to DOPL. They also asked Andrew if he would wear a recording device, he said, and go to Owen’s office to ask him about the touching. Andrew said he didn’t feel like he could go through with that.

That’s when the investigator asked Andrew if he would take a lie detector test.

Andrew said the investigator reasoned to him that if he could pass one, it could bolster what essentially was a case of one person’s word against the other.

The polygraph did not go well, Andrew said — the results suggested he was being deceptive.

“I had so much trauma,” Andrew said. “And so, certainly, when they asked me questions about the particular things that happened in therapy, it’s going to elicit a very strong emotional response.”

Researchers say this is a common response for trauma victims, and many recommend that sexual abuse victims not undergo polygraph exams. Half of states have laws explicitly prohibiting law enforcement from conducting a polygraph test with someone reporting a sexual assault, with some barring any government employee from requiring an alleged sexual assault victim to take one. There is no law in Utah that puts limits on the use of polygraph tests on victims.

Melanie Hall, the spokesperson for DOPL, acknowledged that an investigator did “offer the option” of a polygraph test to both Owen and Andrew. She said that it is “extremely rare” for a polygraph to be used as part of an investigation, but that the agency doesn’t track how often.

Andrew’s failed polygraph sent his own mental health spiraling. He wrote in an email in October 2016 that he no longer wanted to participate in the investigation unless someone else came forward.

A month later, Owen was given a public reprimand from licensers for the one inappropriate action he admitted to: that he gave Andrew hugs. Owen admitted in licensing documents that he “inappropriately touched a client in a non-sexual manner.”

Hall said the “overwhelming majority” of DOPL’s disciplinary actions are negotiated settlements — where a licensed professional admits to lesser conduct than what is alleged by those who say they’ve been harmed.

Owen later told the Clinical Mental Health Counselor Licensing Board, in a hearing in Salt Lake City at which he received an official reprimand, that his client had been struggling with a family issue, and that it was “not uncommon” for him to hug his patients.

But he denied Andrew’s allegations to the board, calling it “quite a story he concocted.”

“I readily agreed and admitted to giving him hugs at the end of the session and that sort of stuff,” Owen said during the meeting, adding that someone at DOPL told him that he should “know better” than to hug someone who was seeking therapy for same-sex attraction.

Owen said that he had changed his practices.

“I don’t do that anymore,” he said. “I have just been a little bit stunned and burned by this. I’ll shake hands, and I don’t even like to shake hands until my office door’s open and completely out in the reception area with my receptionist there.”

Owen left the meeting that day with a reprimand but no other limitations on his license — and no need to tell his other patients.

“I Felt Betrayed”

At precisely the time DOPL was investigating Owen, and then publicly reprimanded him, another man living in Provo and attending the same religious university as Andrew was questioning whether the way the therapist touched him during sessions had crossed the line.

Jonathan Scott had been seeing Owen for three years — and he would continue to see him for nine months more after the reprimand. His allegations bear a striking resemblance to Andrew’s, but he was not aware of the licensing reprimand — and it would be years before he realized that his experience was not unique.

Jonathan Scott began therapy sessions with Scott Owen in 2013 as an effort to heal from childhood sexual abuse. Scott said that the therapist touched him inappropriately but that he did not initially recognize Owen’s alleged actions as abuse. (Leah Hogsten/The Salt Lake Tribune)

Jonathan Scott, a reserved 32-year-old with curly ash brown hair, first started seeing Owen in 2013 as a lanky BYU student struggling to deal with childhood trauma from being sexually abused by his Boy Scout leader in Illinois. His parents found Owen online and met with him first; Jonathan Scott’s father recalls Owen saying that he could help their son have safe relationships with adult men.

Jonathan Scott said his new therapist reminded him of the man who sexually abused him when he was a kid. They had similar nervous tics, and the way each man had looked at him felt the same. They were both middle aged and had the large frame and roundness of a teddy bear.

“That was kind of the point,” Jonathan Scott remembers. Unlike his abuser, Owen was supposed to be “a safe, good man who is supposed to help me reestablish trust with men.”

But Jonathan Scott said Owen frequently touched him under his clothing while hugging him during sessions.

Like Andrew, he said this touching gradually escalated. Eventually, he said, his sessions felt like nothing more than 40 minutes of cuddling. Also like Andrew, he told himself that to heal he needed to learn to accept touch. And because he was raised in the church, he added, he wasn’t going to question a religious leader.

“You justify things. You let things slide. But did it feel comfortable? No, it didn’t feel comfortable. It didn’t feel safe,” he said. “But I was told I needed to work through that.”

Jonathan Scott ended therapy in 2017 when he moved. He never contacted DOPL, or the police, himself. It was only two years later that his partner — upset with the thought that Owen had never faced consequences — was searching online and found the reprimand. She corroborated details of his account in an interview with The Tribune.

It felt like a betrayal, Jonathan Scott said, to learn that Owen had denied touching Andrew around the same time he says the therapist had been groping him.

“When I found out that there were others, I felt not alone,” he said. “I felt justified in my anger of what I thought had happened to me. I felt even less trust in authority.”

Hall said that DOPL may, in some cases, require a disciplined licensee to inform their patients of unprofessional conduct, though that didn’t happen in Owen’s case. Utah has no law requiring this type of disclosure, and there are only three states that do require medical professionals disciplined for sexual misconduct to disclose that to their patients.

“DOPL and/or the licensing board may decide to implement this requirement,” Hall said, “if there is strong concern about an individual treating others without first informing them and receiving consent from the patient.”

But a search of more than 3,200 filings obtained from DOPL’s website, some from as early as 2010, shows the state has rarely required disclosure of unprofessional conduct to individual patients.

A Surrendered License

Owen continued to practice for nearly two years after the reprimand. It would take two more people coming forward before the licensing process was able to take meaningful action.

One of those was Sam, a 43-year-old man who now lives in Arizona. As a Latter-day Saint who was attracted to other men, Sam struggled to feel accepted, his brother Jason recalled. One fall day in 2017, Sam called Jason sobbing to tell him about a therapist he had been going to: how Owen had made him feel loved; how the therapist told him that he could help him learn to accept intimacy; how the sessions had become sexual.

Sam later detailed his experiences in a written timeline, an account that a friend later also shared in a letter to the church: It started in January 2017 with a hug and by August had escalated to mutual masturbation.

He declined an interview request relayed through his brother. Sam and his brother are identified by pseudonyms for this article, and information about Sam’s experience was gleaned from interviews and records provided by his brother and Troy Flake, a friend Sam confided in at the time.

In February 2018, DOPL received another report alleging Owen engaged in sexual misconduct. Details of the complaint were redacted in response to a public records request. And in April, Sam himself spoke to a DOPL investigator.

“Just got off the phone with the investigator,” Sam wrote in a text message to his brother. “It was pretty rough to explain to him all of what happened, but I’m glad I got through it and started this process.”

He wrote that the investigator had “accumulated accounts from several of Scott’s clients.”

Within weeks of Sam speaking to the investigator, Owen surrendered his license as part of an agreement with Utah’s licensing division. According to the DOPL order, investigators believed that Owen inappropriately touched “a number” of clients in a five-year period beginning in 2013. There was no reference to the sexual nature of those contacts. And when Owen surrendered his license, he was able to give it up while neither agreeing with nor denying licensers’ findings.

Reports to Church Leaders

Utah’s licensing division wasn’t the only entity that had knowledge of Owen’s activities for years before he was censured. There was also the church.

Andrew had gone to his bishop back in 2016, but church officials say their legal department did not learn of any alleged inappropriate conduct involving Owen until two years later, after DOPL had already begun to investigate.

As with Andrew, Sam first relayed his concerns to a trusted church leader. In the timeline Sam created, which he had shared with Flake, he wrote that Owen at times had told him that he “didn’t need to run off and talk to my bishop about” their counseling sessions.

If he wanted help processing what was happening, Sam wrote in that document, Owen suggested he talk with Alan Hansen, a psychologist who was also Owen’s business partner at Canyon Counseling. Hansen’s role as Sam’s stake president at that time meant he was also in charge of overseeing thousands of church members who make up local congregations in their area.

A patient of Owen’s twice raised concerns with Alan Hansen, co-owner of Canyon Counseling, about inappropriate touching during therapy. (Leah Hogsten/The Salt Lake Tribune)

In August 2017, Sam went to Hansen’s church office on BYU’s campus, where he disclosed that Owen had been “physical” with him during sessions.

He wrote in his timeline that Hansen encouraged him to keep attending therapy and gave him a priesthood blessing — a prayer of healing and encouragement given by adult men in their church. The blessing made Sam feel better, he wrote, and he continued seeing Owen for therapy for two months. But then, he added, he became too uncomfortable with the sexual touching he said happened inside the Canyon Counseling office.

In December, according to the timeline, he told Hansen again about Owen’s touching. This time, though, he was more explicit — telling the church leader that Owen had kissed him and had engaged in heavy petting and other types of sexual touching.

“Alan acknowledged that some of Scott’s actions clearly crossed some boundaries and that was likely due to Scott’s own weaknesses,” Sam wrote. “He also stated that Scott had done something like this before — and that there were others. I don’t remember his exact language, but that was the effect of what he said.”

Hansen did not respond to a list of questions sent to him, and he referred a reporter to the church’s legal department. A church spokesperson did not address questions about Hansen.

Sam continued to tell other church leaders about Owen’s behavior — and Hansen’s dismissal of it. He also went to his previous bishop in Provo. Sam wrote in text messages to his brother that this church leader confronted Hansen about “essentially doing nothing about my situation with my previous therapist.”

“He thinks it’s possible that it’s a releasable offense for the stake president,” Sam wrote to his brother about the chance that church authorities would strip Hansen of his official role in their faith. But that didn’t happen.

Penrod, the church spokesperson, did not respond to a question asking whether Hansen ever received disciplinary action for not reporting his business partner to church authorities.

He added that “local leaders who are themselves professional therapists should not refer members to affiliated therapists or practices in which they have a financial interest.”

But concerns over Owen’s behavior didn’t end when he surrendered his license. Flake, Sam’s friend, was worried that Owen could still be teaching in a church setting and was frustrated that he believed Hansen had known what was going on and took no action. More than a year later, in December 2019, he sent an email to church lawyers urging them to investigate.

A church attorney responded to his email later that same day, according to correspondence shared with The Tribune and ProPublica, telling Flake the firm would provide the information “to Owen’s current leaders and let you know if we need additional information.” The attorney made no mention of Hansen. Flake says he never heard from the church lawyers again.

The Tribune asked church officials in an email whether Hansen had ever been disciplined in connection to his business partner’s actions, but the church did not respond to that question. Hansen’s psychologist license is in good standing with the state, and no disciplinary action has been taken against him.

“There’s Been Zero Justice”

Years after they say they were sexually assaulted, several of Owen’s former patients are connected now through one more person who says the ex-therapist sexually abused him nearly 40 years ago: Owen’s own cousin, a Boise, Idaho, man named James Cooper.

Cooper wrote to his family in June 2020, telling them that Owen molested him in a shared bed during a trip to Colorado in the 1980s. The email describes how Cooper had learned that past winter that Owen had surrendered his license.

He also sent a separate email to Owen, who denied the allegation and replied: “I don’t see this the same, but I am so sorry for your pain and hurt.”

Cooper wrote in the email to his family that up until then “my strategy has been to forget and avoid Scott [Owen] as much as possible, and admittedly that means I was content to keep my head in the sand in this regard.”

But after he read about Owen surrendering his license, Cooper wrote, it forced him to think about those who allege his cousin later hurt them. The 48-year-old man scoured the internet, searching for any potential victims and posting anonymously on Google reviews asking others to reach out to him.

Owen’s cousin, James Cooper, alleged Owen molested him in the 1980s. More recently, Cooper sought out and connected former patients of Owen’s who allege they were abused in therapy. (Sarah A. Miller for ProPublica)

That’s how he connected with Andrew, Jonathan Scott and Sam’s friend Flake; together, the men grappled with what to do next. All of them described long-term effects of Owen’s alleged conduct and also a sense that there had been no meaningful consequences for him.

Both Andrew and Jonathan Scott have left the church, in part because of the alleged abuse. Sam has been devastated after realizing he had been taken advantage of, according to Flake, which has destroyed his ability to trust his own perception. And Jonathan Scott has thought about reporting Owen to the police, but he continues to struggle to trust authority figures.

“There’s been zero justice, as far as I can see,” Jonathan Scott said.

Owen today is listed as the registered agent for Canyon Counseling in public business records. It’s not clear what his role in the business is, but in 2019, Flake called the police to report seeing Owen’s truck in the Canyon Counseling parking lot, though he did not have a license to practice therapy.

An officer contacted Owen, who said he owns the business — but is not a therapist any more.

The Mental Health Profession Violations

Scott Owen is one of at least 197 mental health professionals who have been disciplined by Utah licensers since 2012, according to a data analysis by The Salt Lake Tribune and ProPublica of available disciplinary documents on the state Division of Professional Licensing’s website as of April 20, 2023. This database is not exhaustive, as older filings may no longer appear on the website.

Of those, 73 — or 37% — had been disciplined for sexual misconduct. Searches of DOPL’s disciplinary records suggest that mental health professionals are more often disciplined for sexual-related misconduct than doctors or nurses. The Tribune and ProPublica also identified 28 other misconduct cases where a therapist had an inappropriate “dual relationship” with a client — such as a client sleeping over at a therapist’s home or cleaning horse stalls together — that did not appear on paper to be explicitly sexual in nature.

Owen is one of five Utah mental health professionals identified by The Tribune and ProPublica who have been disciplined more than once for sexual conduct. Several of them continue to work in the therapy business in some capacity. Two others among the five were put on probation and allowed to continue working as therapists, according to disciplinary filings, while a third opened a life coaching business marketing himself as a “one of the few Ph.D.-level coaches” in southern Utah.

Utah licensers consider any sexual contact with a current patient to be misconduct, and sexual relationships with a former patient are not allowed within two years after they stop seeing a therapist.

When asked if the licensing division knew whether therapists were at higher risk for sexual misconduct, spokesperson Melanie Hall said DOPL is aware that certain license types “have a tendency towards certain types of violations.” She didn’t specifically address mental health professionals, but she gave certified public accountants as an example of professionals who have increased access to bank accounts and are more likely to commit financial fraud than other professionals who do not have that access.

The agency, she said, “takes these factors into account when investigating complaints, and takes appropriate disciplinary action when necessary.”

The news organizations also asked Hall about whether DOPL reports cases to law enforcement. Under Utah law, it is illegal for a health professional to engage in sexual contact with their patient under the guise of providing treatment.

The licensing division, Hall said, is not legally required to forward information to law enforcement — just as the police are also not mandated to share information about a licensed professional they are investigating. The only exception to this, she said, is a requirement that drug thefts be reported to police.

Hall said that licensers do collaborate and report crimes to police agencies “often,” though she did not explain under what circumstances they would do so. She said that licensers may encourage a patient to reach out to the police or decide that the case does not require a criminal investigation. She would not say whether anyone at DOPL ever reported Owen to the police.

Help ProPublica and The Salt Lake Tribune Investigate Sexual Assault in Utah

Editor’s Note: Three sources for this story — Andrew, Sam and Jason — are identified only by pseudonyms because they requested anonymity. Two are alleged victims of sexual assault, and the third is the brother of one of those men. We have granted this request because of the risk to their standing in their communities if they were publicly identified. The Salt Lake Tribune and ProPublica typically use sources’ full names in stories. But sometimes that isn’t possible, and we consider other approaches. That often takes the form of initials or middle names. In this case, we felt that we couldn’t fully protect our sources by those means. Their full names are known to a reporter and editors, and their accounts have been corroborated by documents and interviews with others.

This story was supported in part by a grant from the Fund for Investigative Journalism.

Jeff Kao and Haru Coryne, ProPublica, and Will Craft, special to The Salt Lake Tribune, contributed data reporting. Mollie Simon, ProPublica, contributed research.

by Melissa Sanchez and Maryam Jameel

ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up for Dispatches, a newsletter that spotlights wrongdoing around the country, to receive our stories in your inbox every week.

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Central Wisconsin’s Clark County is home to more dairy farms than any other county in the state, which bills itself as America’s Dairyland. Its identity is so tied to the dairy industry that a 16-foot-tall, black-and-white talking Holstein stands outside downtown Neillsville, the county seat.

To corral the cows, milk them and clear their manure at these dairy farms — the dirty, dangerous work that makes this multibillion-dollar industry go — farm owners here and across Wisconsin rely on a labor force that they know is largely undocumented.

But the state makes it almost impossible for workers to have lives outside the farm without breaking the law. In Wisconsin, undocumented immigrants can own and register their cars and trucks, but they aren’t allowed to drive them. Those who drive anyway are pulled over again and again and again, and issued tickets that eat away at their wages.

The law banning undocumented immigrants from obtaining driver’s licenses has cascading effects across the state. Law enforcement officials say the roads are less safe because undocumented immigrants aren’t trained and tested on basic driving rules but they drive anyway — and often without insurance. Court officials say tickets for driving without a license overwhelm their dockets and drain their limited resources. Farmers say they have to build or find employee housing to help their workers avoid getting ticketed.

The workers, many from remote, impoverished communities in Latin America, are grateful for the jobs. And yet they feel trapped.

They are people like a 33-year-old Nicaraguan who came to Wisconsin two years ago after hearing from friends that it was easy to find work on “los ranchos,” as dairy farms here are known by Spanish-speaking workers. He lives with three other Central American men in a small, white house owned by their boss that sits a few miles down a county road from the farm.

One afternoon in March, as the worker drove a roommate’s Jeep to the grocery store, a Neillsville police officer ran a random check of the license plates. The officer learned that the Jeep’s registered owner didn’t have a driver’s license and pulled him over.

The worker told the officer he didn’t have a license, records show, and the officer issued him a $200.50 citation.

“A day’s worth of work, lost. It hurts,” said the man, who routinely works 14-hour days.

Over the past year, ProPublica has interviewed more than 100 undocumented current and former dairy workers — in farm breakrooms, in the trailers and apartments where they live, in the shops where they wire money home, and at courthouse cashier’s windows where they pay their tickets. They said they are isolated and stuck on the farms where they work and often live. They struggle to get to grocery stores, to their children’s schools and to immigration court hearings. They delay medical care.

So they either rely on others who, for a price, drive them where they need to go, or they break the law and take their chances.

“You can’t call Uber because there isn’t any. You can’t take the bus because there aren’t any,” said John Rosenow, a dairy farmer in western Wisconsin who has become one of the most prominent advocates for immigrant workers in the state. “The closest barber shop is 15 miles away. The closest grocery store is 25 miles away.”

Making matters worse, the punishments for repeat offenses can escalate in severity, exposing workers to stiffer financial penalties, criminal cases and jail time. In counties that have formal agreements with federal immigration authorities, the threat of deportation hangs over every police stop.

What’s happening in Clark County and across Wisconsin is the result of Congress’ failure to figure out what to do about the millions of undocumented immigrants who live here and work in industries that, like dairy, unabashedly depend on them. That leaves state lawmakers to craft legislation to try to address the consequences — or to ignore what’s happening, punishing immigrants in the process.

Wisconsin is home to about 70,000 undocumented immigrants, mostly from Latin America, according to estimates from the nonprofit Migration Policy Institute. These are the people who hang drywall, clean hotel rooms, wash dishes in restaurant kitchens and package the nation’s cheese.

Determining how many of Wisconsin’s dairy workers are undocumented is almost impossible. Workers use fake papers to get jobs, farmers accept those papers without question, and the state and federal governments make little effort to get an accurate count. But a conservative estimate from a recent University of Wisconsin at Madison study puts the number of undocumented Hispanic workers on medium-to-large farms at roughly 6,200. That figure excludes the many immigrant workers on smaller farms, those with fewer than 500 cows.

Advocates for immigrants have worked for years to persuade lawmakers to give undocumented immigrants driving privileges, as 19 states — most of them blue — have done. But those efforts have been unsuccessful in Wisconsin, where legislative districts have been drawn to favor Republicans. Few GOP lawmakers have been willing to support any such efforts; political observers say the lawmakers don’t want to look soft on immigration.

So local communities are left to look for their own solutions.

In one county, officials have been quietly conducting a pilot driver’s education program aimed largely at undocumented immigrants who were caught driving without a license. They are reluctant to speak publicly about it out of fear that any attention will lead to conservative backlash.

Elected district attorneys in several counties have stopped bringing criminal charges against people caught driving without a license; both Democrat and Republican prosecutors say they want to dedicate their limited resources to crimes with victims.

And in four counties in southwestern Wisconsin, community advocates worked with local law enforcement agencies and dairy farmers a few years ago to create identification cards that workers could show officers during traffic stops to prove that they worked in the area and, potentially, keep those encounters from escalating.

“It did not prevent them from getting a ticket, but it prevented them from being handcuffed and hauled off to jail,” said Shirley Barnes, the recently retired co-director of the MultiCultural Outreach Program in Dodgeville. “The fact is, all the police officers in all of these counties know exactly where these people work. They know it is local farmers who are employing these people.”

A dairy farm in south-central Wisconsin (Caleb Santiago Alvarado for ProPublica)

One morning in May, a former dairy worker from Honduras slid into a courtroom bench in the Clark County Circuit Court in downtown Neillsville and waited for his name to be called. His 16-year-old son sat next to him, missing school to serve as his father’s interpreter. ProPublica is identifying the man only by his first name, José. Like other workers in this story, he asked not to be fully identified because he is undocumented and fears being deported.

A month earlier, a state trooper had pulled José over for driving 15 mph over the speed limit on U.S. Highway 10. In addition to issuing a speeding ticket, the trooper had cited him for driving without a valid license.

“We just enforce the law,” Sgt. Brandon Gray, a spokesperson for the Eau Claire post of the Wisconsin State Patrol, said in an interview. “If they don’t have a valid license, then obviously they receive a citation.”

José said he regrets speeding. But he said it’s impossible for him to comply with the license requirement.

“It makes me so damn sad I could cry,” said José, who said he came to the U.S. two years ago to better provide for his son. “I have to drive. Nobody else is going to come to support my son. Nobody else is going to pay my rent.”

José left court with his son after paying $200.50 for driving without a license and another $175.30 for speeding. José drove home, still licenseless.

Of the 35,000 people who live in Clark County, just 6% are Hispanic, according to census estimates.

Yet last year, 187 of the 245 cases that were brought in this court for operating a vehicle without a valid license — or more than 75% — involved Hispanic drivers, according to data compiled for ProPublica by Court Data Technologies, a Madison company.

A similar trend is playing out in circuit and municipal courts across the state, ProPublica found. (Citations for this charge can go to either type of court if it’s a first-time offense; circuit courts also handle repeat offenses, which can become criminal cases.)

Roughly half of the 16,000 circuit court convictions for driving without a valid license involved Hispanic drivers, according to the information provided by Court Data Technologies from cases filed in 2022.

The actual percentage is likely higher, since Latin American immigrants are often marked as “Caucasian” in court records; José, for example, is listed this way.

Hispanic residents make up less than 8% of the population.

“Those numbers are alarming,” said Primitivo Torres Martinez, deputy director for statewide civic engagement for Voces de la Frontera, the state’s largest immigrant rights advocacy group, who learned of the statistics from ProPublica. “The thing is, farmers need [immigrant workers] to drive, so it’s a Catch-22 for a lot of folks.”

Police and the courts don’t track the immigration status of drivers. But across the state, people involved in nearly every step of the traffic enforcement process — police, judges, prosecutors, defense attorneys, interpreters and other circuit and municipal court officials — agreed that most Hispanic drivers who get ticketed for not having a license are undocumented immigrants.

Records from these cases routinely describe drivers who show Mexican or Nicaraguan identification cards to police, don’t speak English and need an interpreter, or tell officers they can’t get a license because of their immigration status. You can see them in courthouse lobbies, glancing hopefully around for an interpreter when the clerk offers to use Google Translate on her phone, or sitting anxiously on courtroom benches, wondering whether they will end up being deported.

Thousands more tickets for driving without a valid license were processed last year in the state’s roughly 230 municipal courts. These courts operate independently from each other and, as a result, there is no one single place to get case information that would allow a statewide analysis of those courts.

But ProPublica obtained data from about a dozen municipal courts and found that, over and over, Hispanic drivers received a substantial share of these citations.

In Milwaukee, the state’s largest city, they accounted for nearly 40% of the tickets. In Waukesha, a Milwaukee suburb, 49%. In Manitowoc, along Lake Michigan, 58%. In each of these places, Hispanics account for 20% or less of the population.

The numbers appear to be starker in municipal courts farther from metropolitan areas. At the Marshfield Area Municipal Court in central Wisconsin, for example, 69% of these tickets issued by the Marshfield Police Department went to Hispanic drivers, records show. Less than 3% of Marshfield residents are Hispanic.

It’s a similar story in Sparta, a small town surrounded by dairy farms in western Wisconsin. Sparta’s municipal court does not track defendants’ race or ethnicity, but ProPublica found that 91 of the 131 tickets issued last year for driving without a valid license — or about 70% — involved defendants with common Hispanic surnames like Cruz, Cortez and Gonzalez. (The U.S. Census Bureau says that more than 85% of people with those last names are Hispanic.) Fewer than 6% of residents in Sparta are Hispanic.

Immigrant dairy workers from around Sparta, Wisconsin, regularly visit Supermercado Guerrero to buy groceries and painkillers, cash their checks and wire money to relatives in Mexico and Central America. (Caleb Santiago Alvarado for ProPublica)

Mention the subject of tickets in a tiny Mexican grocery store there and the tired dairy workers in line will nod their heads with familiarity and indignation.

“I’ve been pulled over probably 15 times,” said one man, a longtime dairy worker from Mexico. Sometimes, he said, it’s the same police officer who pulls him over. “They recognize me immediately and call me by name, saying, ‘I told you not to drive,’” the worker added. “But I have to drive to get to work.”

Most Hispanic immigrant drivers don’t bother to contest the tickets, they simply pay in cash, said Andrea Ziegler, Sparta’s municipal court clerk. Altogether, Hispanic drivers in Sparta paid more than $8,400 in tickets issued last year for not having a license, records show.

“I don’t think it’s right. If you’re going to ticket them, then you need to provide a path for them to get a license so they can work, so they can continue to contribute to our society,” Ziegler said.

“Our farms would not be able to survive without them.”

When we asked farmers about their employees’ immigration status, they told us they merely accept the paperwork that applicants hand them.

“I don’t think it’s right. If you’re going to ticket them, then you need to provide a path for them to get a license so they can work, so they can continue to contribute to our society.”

—Andrea Ziegler, Sparta, Wisconsin’s municipal court clerk

But over the years, the dairy industry has tacitly acknowledged its reliance on an undocumented workforce. At the federal level, it has tried unsuccessfully to gain access to an immigrant guest worker program. Closer to home, dairy farmers have become powerful allies of Voces de la Frontera in its campaign to allow undocumented immigrants to get driver’s licenses.

Almost a dozen dairy farmers across Wisconsin told ProPublica they wish their workers could get licenses.

In one sense, their motivation is economic. Many farmers say they would like to ensure their employees can get to and from work without police stopping and ticketing them. Several described the calls they’ve received in the middle of the night from workers who needed a ride after they got locked up. “If they throw them in jail, they’re no good to us,” said one farmer in western Wisconsin.

Farmers said they are also motivated by empathy.

“It’s basically a human need issue,” said Randy Roecker, a third-generation dairy farmer who runs a 275-cow operation in Sauk County, in central Wisconsin. “They need to be able to drive to go get groceries, the bank, the doctor, but yet they feel they can’t because they’re afraid they’re gonna get picked up all the time.”

Randy Roecker watches as his dairy cows are taken to the milking parlor. (Caleb Santiago Alvarado for ProPublica)

Like many other farmers, Roecker and his family decided to build employee housing when they expanded their operation and hired their first immigrant workers in 2006.

That was the year Wisconsin lawmakers banned access to driver’s licenses for undocumented immigrants. Some dairy workers who were in the state at the time still keep their expired licenses in their wallets in the hope that the old documents may help them avoid tickets in traffic stops.

The change in the law was a response to the federal REAL ID Act — a post-9/11 law sponsored by then-U.S. Rep. James Sensenbrenner, a Wisconsin Republican — which standardized the type of identification that could be used to board planes and enter federal buildings. To comply, Wisconsin and other states began to require proof of U.S. citizenship or other legal status to obtain licenses.

From the beginning it was clear the law would hurt undocumented immigrants living in states that let them drive. For some lawmakers, like Sensenbrenner, this was a good thing; he told reporters at the time that Wisconsin had become a “mecca for illegal aliens” seeking driver’s licenses.

Latino lawmakers and advocates said banning these immigrants from driving would cause more problems than it would solve. Bernard Trujillo, then a law professor at the University of Wisconsin at Madison, told The Capital Times that if Wisconsin denied immigrants driver’s licenses, “they will just drive without it.”

“This is the ‘If I close my eyes, I’ll make them go away’ approach to treating the undocumented, which is ineffective as a policy matter,” he added.

(Caleb Santiago Alvarado for ProPublica)

On a frigid evening in February 2021, John Rosenow stood outside his dairy farm in Cochrane, in western Wisconsin, and watched as a longtime employee got pulled over on his way into work.

A Buffalo County sheriff’s deputy had been parked in front of the farm observing traffic on a stretch of county road where the speed limit is 35 mph. The deputy noted later that he saw a car moving at a “slow rate of speed,” then ran the license plate. The records check showed that the car’s owner didn’t have a license, so the deputy pulled it over.

Despite a language barrier, the worker was able to tell the deputy he didn’t have a driver’s license but showed his Mexican identification card. The deputy told him that he’d be getting a ticket in the mail and warned him not to drive without a license.

Because it was the worker’s second citation in three years, he was charged with a misdemeanor in Buffalo County Circuit Court.

To Rosenow, the traffic stop looked like racial profiling. He wrote a letter to the judge in the case.

“Certainly, the court can understand how important Juan and other Mexicans are to the agricultural and food processing industries in our area,” Rosenow wrote. “Harassment by the Sheriff’s department does not help make our community any safer.”

That argument didn’t sway the judge. The worker, who has since returned to Mexico to be with his family, pleaded guilty and paid $443 for the ticket and mandatory court costs — including a DNA test, a requirement in criminal cases. The total amount was equivalent to about five days’ take-home pay.

In a statement, Buffalo County Sheriff Mike Osmond declined to comment on the traffic stop but said he understood the concerns about potential racial profiling. But he said that his deputies “enforce traffic laws impartially, without discrimination based on race or ethnicity” and that his office is “committed to upholding the constitutional rights of all individuals, regardless of their immigration status.”

Across Wisconsin, dozens of undocumented immigrants who have been stopped and ticketed solely for not having a license told ProPublica they believed they were the victims of racial profiling.

Among them: the 33-year-old Nicaraguan man who was pulled over after a random plate check as he drove to the grocery store in Neillsville this spring. “How did he know I didn’t have a license?” he wondered. “I hadn’t committed any infraction but got pulled over.”

In an interview, Neillsville Police Chief Jim Mankowski said he would support letting undocumented immigrants get licenses as a way to make the roads safer and to help officers more quickly and accurately identify people they encounter.

“How did he know I didn’t have a license? I hadn’t committed any infraction but got pulled over.”

—A Nicaraguan man who was pulled over after a random plate check

But he said random plate checks can help officers discover violations that are tied to the registered owner of a vehicle, from suspended or revoked licenses to outstanding arrest warrants. He said officers should have a reasonable suspicion that the person driving a vehicle is its owner; for example, if a plate check determines the owner is a man who doesn’t have a license, it wouldn’t make sense to pull the vehicle over if a woman is driving.

He added, “If it’s a tool that can help my cops do their job better, that’s something that we have to embrace.”

Records from law enforcement and court cases across the state show that, in many communities, sheriff’s deputies and police officers routinely run the license plates of passing vehicles — regardless of the racial or ethnic background of the driver — and pull people over if they discover a violation. But the issue of not having a license hits Hispanic drivers the most.

One of the underlying factors is the contradiction in state policy that allows undocumented immigrants to register their cars but not drive them.

“They put a bullseye on them,” said Tony Gonzalez, an immigration rights advocate in north-central Wisconsin. “The state collects the money on registration and there is no benefit for that registrant. It’s like taxation without representation.”

A spokesperson for the state transportation department said the agency “implements the laws as written.” The spokesperson could not say how many vehicles are registered to people who do not have driver’s licenses.

Getting pulled over after a random license plate check by police is so common that many undocumented immigrants have turned to a black market for protection: Several people who spoke with ProPublica described paying someone with a license to register a vehicle under their name to help avoid getting pulled over. One man, a home construction contractor in a Milwaukee suburb, said that once he started registering his car under his company’s name instead of his own, he stopped getting pulled over and ticketed for not having a license.

Similarly, a dairy worker in Jefferson County, in southern Wisconsin, said he felt “like an ATM” for police after paying thousands of dollars over the past few years in fines and court costs resulting from not having a license. Then, he said, he heard of someone in another community who, for a price, would register his car under their name.

It has been worth the money, the worker said. He hasn’t been pulled over since.

Help ProPublica Journalists Investigate the Dairy Industry

Alex Mierjeski and Jeff Frankl contributed research.

by Anjeanette Damon and Byard Duncan

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As soon as Lisa Casteel learned her 78-year-old mother had agreed to sell her Kansas City home to a “We Buy Ugly Houses” franchise for far below its market value, she contacted the buyer to halt the deal.

In her letter to the company, she invoked a Kansas state law that grants three days to cancel certain sales agreements. She believed it would protect her mother and any other vulnerable homeowners entangled by questionable real estate deals. Her mother had no other place to live and had recently been showing signs of dementia, she said.

But the representative of the franchise, Red Rock REI, refused.

The experience more than three years ago revealed a glaring hole in regulations meant to protect people from unfair and deceptive practices. Even though HomeVestors franchises are in the business of buying properties, they use many of the same methods found in high pressure sales. In Kansas and many other states, laws that require a grace period for getting out of such sales contracts don’t apply to real estate transactions. Neither does a federal law aimed at protecting people from predatory sales practices.

Only after the Kansas Attorney General’s Office intervened at Casteel’s request was her mom able to keep her home. The attorney general ultimately demanded that Red Rock REI release Casteel’s mother from the contract by relying on state laws that protect the elderly from deceptive practices. And while Casteel succeeded in saving her mother’s house, no other action was taken against the franchise.

“I feel bad for others out there who are getting taken advantage of,” Casteel said. “They’ve got no help. And they feel like there’s no place to turn but to go ahead and sell to Red Rock and Ugly Houses and people like that.”

Adam Hays, who owned Red Rock before selling the franchise in 2021, said his sales representative did not observe that Casteel’s mother had any cognitive issues. He said HomeVestors demanded its franchises maintain a “strict standard of integrity and honesty.”

He said his company did not easily release homeowners from contracts because that would make it difficult to stay in business. His practice was to conduct “due diligence” into a homeowner’s reason for backing out of a deal to ensure another party wasn’t interfering with the homeowner’s decision. He said when he received the letters from the attorney general’s office about Casteel’s mother, he realized she had a legitimate reason for canceling the contract.

A corporate spokesperson for HomeVestors said the company was unaware of Red Rock’s dealing with Casteel’s mother and that it is no longer a franchise. HomeVestors recently prohibited some of the tactics Red Rock used to tie homeowners to contracts.

An investigation this year by ProPublica found some HomeVestors of America franchises used deception and aggressive sales tactics to persuade homeowners in vulnerable situations to sell their homes for far below market prices. The investigation also found few jurisdictions have laws or regulations to protect homeowners from aggressive tactics that fall short of outright fraud or elder abuse.

There have, however, been a few attempts by policymakers to protect vulnerable homeowners. A first-of-its-kind law in Philadelphia regulates real estate investors that participate in wholesaling properties — meaning they buy houses and resell them without making improvements or sell purchase contracts signed by the homeowner to another investor.

“A high pressure sales technique isn’t new, and we’ve been trying to protect people against it in all sorts of areas for years,” said Kate Dugan, staff attorney at Community Legal Services in Philadelphia, which worked on the law.

The law attempts to address a flaw in most consumer protection laws: Because homeowners are being pressured to sell rather than to buy something, the laws don’t cover them as consumers.

“The harm is the same, though: Parties with unequal bargaining power are engaging in a transaction, and the less sophisticated party loses,” Dugan said.

Oklahoma recently became one of a few jurisdictions to require licenses for residential real estate wholesalers. Unethical behavior can put wholesalers’ licenses at risk.

“When you don’t have reasonable guidelines, or restrictions or regulations in place to protect very minimum standards of abuse, then you’re going to open up the door for rampant abuse, like we’re seeing right now,” said Grant Cody, executive director of the Oklahoma Real Estate Commission.

ProPublica spoke to experts, including advocates for homeowners, real estate lawyers, a regulator and an individual in the business of flipping houses, about policies that could better protect homeowners. Here are their suggestions for regulations policymakers could consider.

A Cooling-Off Period

Casteel was quick to answer when asked what policymakers could do to help people like her mother.

“There should be at least a cooling-off period,” she said. “And I don’t think three days is enough. Because for seniors who fall victim to this, they may not mention it to a family member within the first couple of days.”

Advocates for stronger homeowner protections agree the law should provide an efficient way to cancel a signed real estate contract within a set period under certain circumstances. Or, as an alternative, policymakers could adopt something similar to Philadelphia’s requirement that wholesalers give a homeowner three days to consider a contract before it’s signed.

Cooling-off periods are common in other transactions that involve high pressure sales or large assets. Many states, for example, have a right of rescission in timeshare sales, and a cooling-off period is built into many annuity purchases.

In particular, homeowners who have never publicly listed their houses for sale should be allowed a quick way out of a contract, said Sarah Bolling Mancini, co-director of advocacy at the National Consumer Law Center. Public listings attract competing offers and can better determine fair market value. Such a regulation would also protect homeowners from cash buyers who solicit sales.

Casteel said she’d also require that cash house buyers leave a copy of the contract with the homeowner along with the paperwork necessary to cancel it.

Asked by ProPublica whether HomeVestors would support such a regulation, a corporate spokesperson said the company is implementing a 72-hour cooling-off period requirement for its franchises.

“We require our franchisees to comply with our Systems and Standards, which generally go above and beyond state regulations, and we regularly update our standards to ensure our franchisees do the right thing and act to protect consumers,” she said.

Penalties for Persistent Solicitation

HomeVestors and its franchises spend heavily on advertising — peppering neighborhoods with billboards and sending postcards to thousands of addresses at a time, promising quick cash and a painless sale process. Other homebuyers call and text endlessly.

Many homeowners view these aggressive, ground-level marketing strategies as a nuisance. And in some cities, policymakers have taken steps to curb them.

In Houston, residents can report illegally placed “bandit signs” to the city’s Department of Neighborhoods. Violators there can face up to $500 in fines, lawsuits and even arrest. Following reporting from WABE, the Atlanta City Council in 2020 prohibited real estate investors from “repeated and unsolicited attempts” to contact a homeowner after being asked to stop. Such overtures now amount to a form of “commercial harassment.” Violators can face fines or up to six months in jail.

And Philadelphia’s “do-not-solicit” list, launched last year, allows residents to opt out of in-person sales pitches, emails, phone calls and mailers. Offenders face up to $2,000 in fines. The city can ask a judge to assess larger fines on repeat offenders.

Restrictions on Recording Claims on a Property Title

ProPublica’s investigation found some HomeVestors franchises routinely recorded documents against a homeowner’s title to trap them in a deal — a predatory practice known as “title clouding.” In response to ProPublica’s reporting, HomeVestors prohibited its franchises from clouding titles. But other cash homebuyers still do it.

Dugan said policymakers should consider restrictions on title clouding, including a waiting period between signing a contract and recording it and an easy way for a homeowner to contest the recording.

Many jurisdictions, including Philadelphia, allow homeowners to sign up to be notified when any document has been recorded against their title.

In many cases, months pass before homeowners learn that a contract had been recorded against the title. Sometimes the homeowner has died and their family must pay the house flipper to release the claim.

For example, six months passed before Casteel learned that Red Rock REI had recorded the sales contract against her mother’s title. When the Kansas Attorney General’s Office pressed Red Rock to remove the recording, the franchise owner tried to justify the action.

In an email to the attorney general’s office, the franchise owner said he recorded the contract to protect his interest in the property in the event Casteel’s mother “was being dishonest” and tried to sell the house to someone else.

Red Rock didn’t remove the recording until the attorney general’s office issued multiple warnings.

“It might discourage this predatory behavior if the bad actor knows that the homeowner will get notice immediately,” Dugan said.

Requiring a License

A professional license, such as those required for real estate agents, isn’t a guarantee against unethical behavior. But experts said licensing could require a basic education so that wholesalers know such things as real estate laws, what should be included in a contract and what disclosures homeowners are entitled to. A licensing board could investigate homeowner complaints.

Philadelphia’s licensing of residential real estate wholesalers has provided transparency into who is wholesaling, Dugan said. The law also allows homeowners to cancel contracts at any time before closing if they’ve sold to an unlicensed wholesaler, which is a strong incentive for wholesalers to become licensed.

Kevin Link, a former Financial Industry Regulatory Authority investigator who co-owns a house-flipping business in Maryland, said he would welcome more regulation of the industry to weed out bad actors and ensure that those in the business have a minimum level of real estate education.

“Right now, the only regulations in place are those that govern white-collar crime,” he said.

HomeVestors’ corporate spokesperson said the company isn’t opposed to requiring wholesaler licenses.

“We look forward to exploring this, as well as other constructive ideas, on how we can best protect consumers within our industry,” she said.

A Need for Federal Regulations?

Real estate regulation is largely the domain of cities, counties and states, creating a patchwork of policies and varying degrees of oversight and transparency. Because many regulatory bodies can only investigate licensed real estate activity, wholesalers often operate without the same guardrails as real estate agents.

Federal regulations to standardize local oversight, similar to the Secure and Fair Enforcement for Mortgage Licensing Act passed 15 years ago in the wake of the financial crisis, could help. The SAFE Act, which passed in 2008 after the explosion in predatory mortgage practices helped inflate a housing bubble and spark that year’s financial crisis, requires minimum local licensing standards for mortgage originators.

“I think a federal statute could be very helpful and meaningful,” Mancini said.

Rather than leaving it to states to enact a regulatory model, however, Mancini said federal rules could be applied to “we buy houses” transactions, such as by allowing a homeowner to cancel a sale if they have never publicly listed the home or obtained an appraisal, didn’t have a real estate agent or were directly solicited to sell the house.

She said states could also follow Maryland’s lead and ensure their unfair and deceptive acts and practices laws explicitly apply to real estate purchases in which high pressure sales tactics are used or a homeowner has been misled about the value or marketability of their house.

Mollie Simon contributed research.

by Cassandra Jaramillo

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Update, Aug. 9, 2023: Ohio voters rejected Issue 1 in a special election on Aug. 8, according to The Associated Press. The proposal would have raised the threshold to pass constitutional amendments in Ohio, including the upcoming abortion rights measure on the ballot in November.

In her eight years as a pediatrician, Dr. Lauren Beene had always stayed out of politics. What happened at the Statehouse had little to do with the children she treated in her Cleveland practice. But after the Supreme Court struck down abortion protections, that all changed.

The first Monday after the Dobbs v. Jackson Women’s Health Organization ruling was emotional. Beene fielded a call from the mother of a 13-year-old patient. The mother was worried her child might need birth control in case she was the victim of a sexual assault. Beene also talked to a 16-year-old patient unsure about whether to continue her pregnancy. Time wasn’t on her side, Beene told the girl.

“What if it were too late to get her an abortion? What would they do? And I just, I felt sick to my stomach,” Beene said. “Nobody had ever asked me a question like that before.”

Beene felt she had to do something. She drafted a letter to a state lawmaker about the dangers of abortion bans, then another doctor reached out with an idea to get dozens of doctors to sign on. The effort took off. About 1,000 doctors signed that letter, and they later published it as a full-page ad in The Columbus Dispatch.

Beene felt momentum building within the medical community and decided to help use that energy to form the Ohio Physicians for Reproductive Rights coalition. Now, Beene and the coalition are working to pass a citizen-led amendment to enshrine reproductive rights into the state constitution. The state’s six-week ban on abortion was blocked by a judge in October 2022.

The group is a part of an emerging political force: doctors on the front lines of the reproductive rights debate. In many states, the fight to protect reproductive rights is heating up as 14 states have outlawed abortion. Doctors who previously never mixed work with politics are jumping into the abortion debate by lobbying state lawmakers, campaigning, forming political action committees and trying to get reproductive rights protected by state law.

In Texas, at a two-day court hearing earlier this month , women who were denied abortion care testified they were harmed by the state’s abortion ban. Two Texas doctors, who are plaintiffs, took the stand to testify about the chilling effect they say the laws have had on them. Dr. Damla Karsan, a Houston obstetrician, said she had never testified in a court case before but felt compelled to participate in this one to advocate for her patients and colleagues.

“I feel like I’m being handicapped,” Karsan said, referring to the Texas abortion law. “I’m looking for clarity, a promise that I will not be persecuted for providing care with informed consent from patients that someone interprets is not worthy of the medical exception” that would permit a legal abortion.

Although doctors’ groups have formed on both sides of the issue, most of these groups oppose abortion bans, largely because doctors worry that abortion bans could put their patients’ health at risk. Doctors now find themselves risking criminal and civil penalties in some states if they act to help patients who are suffering.

The Ohio coalition, along with its partners, gathered signatures for months in order to put the proposed constitutional amendment on the November ballot. The group filed more than 700,000 signatures on its petition, nearly twice the minimum number needed. The amendment’s language would protect several aspects of reproductive medical care, not just abortion: misscarriage care, contraception and in vitro fertilization.

“We see all those areas being negatively impacted by the Dobbs decision,” Beene said. “So we felt that by establishing that fundamental right to reproductive freedom, we would be able to protect all of those issues.”

In Nebraska, doctors formed the Campaign for a Healthy Nebraska PAC, which raised money to target key races, according to the Flatwater Free Press. The group also worked to get the Nebraska Medical Association to publicly oppose abortion restrictions, the news organization reported.

The Good Trouble Coalition in Indiana also mobilized medical professionals to work with legislators on abortion laws.

States including Michigan and Vermont have also used citizen-led ballot initiatives to get reproductive protections included in their constitutions, efforts that were supported by voters. In Michigan, doctors created a committee to help campaign for the proposal. Beene said the Ohio coalition modeled its strategy on Michigan’s approach.

In at least one state, doctors have rallied for a measure that would have limited abortion access.

In Kansas, a coalition of 200 physicians, nurses and pharmacists publicly supported an amendment to remove the right to an abortion from the state constitution, according to the Kansas Reflector. Voters ultimately rejected the amendment, with 59% voting against the initiative.

Mary Ziegler, an abortion historian and a law professor at the University of California, Davis, said medical associations have been involved in the abortion debate before, but the organizing efforts are broader this time, with several doctors’ groups throwing their support behind ballot initiatives that protect reproductive rights and draw widespread public support.

“It’s not a trivial thing that it’s a ballot initiative, because one of the other things we’ve seen is that voters are with them,” Ziegler said. “Doctors who are afraid of alienating potential patients or colleagues are realizing that bans are not popular with most people. So the risk may be lower than people thought of taking a stand.”

Beene prepared for backlash when she and other Ohio physicians came out against abortion bans. But she didn’t expect that lawmakers would try to change the rules needed to pass a citizen-led amendment just months after the coalition started to collect signatures.

Lawmakers in May passed a controversial resolution to raise the threshold needed for an amendment to pass from a simple majority to 60%. Voters will decide whether to adopt the proposal, known as Issue 1, in an Aug. 8 special election.

The Republican-controlled Ohio legislature passed a law last year banning special elections, citing their low turnout and high costs, but state lawmakers scheduled this August’s election despite the ban. Republicans have signaled that this vote on Issue 1 was aimed at blocking the reproductive rights amendment.

Jen Miller, executive director of the League of Women Voters of Ohio, a nonpartisan voting rights organization, said the group is against Issue 1 because it would overturn more than 100 years of precedent in the state for how citizen-initiated amendments are passed.

“What they’re trying to do is to trick voters into voting our own rights away in a low-turnout August election,” Miller said. “Even voters who never miss an election are unaware that there is an August special election.”

It’s possible that only a single-digit sliver of the population will vote —  records from the Ohio secretary of state’s office show the 2022 August primary election had 8% voter turnout.

If Issue 1 is adopted, the reproductive-rights amendment would require approval from 60% of voters to pass in November, which Beene said she believes is what lawmakers want.

“They’ve sunk to tremendous lows and they’re doing everything they can to try to stop us,” Beene said.

Are You in a State That Banned Abortion? Tell Us How Changes in Medical Care Impact You.

by Jennifer Berry Hawes, photography by Gavin McIntyre for ProPublica

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In his younger days as a carriage driver, Tony Youmans would strike a rapport with customers, nearly all of them white, as he prepared to show them around downtown Charleston, South Carolina. Youmans knew that long-whitewashed racial history lurked everywhere — beneath every cobblestone, every courtyard garden, the hooves of every draft horse he steered past the finely preserved antebellum structures.

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But if he mentioned slavery or pointed out enslaved people’s quarters, “a couple would cringe and roll their eyes, so you quickly went back to the moonlight and magnolias.”

Today, he is part of a movement to tell a more complete story of the city. After 40 years in its booming tourism industry, he is seeing a huge shift in visitors’ reactions, from denialism to curiosity.

“African American tourism right now is red hot, especially in the South,” Youmans said. He sees this up close as manager of the Old Slave Mart Museum and director of the Old Exchange and Provost Dungeon, two key historic sites. “People are hungry for this information,” he said, “and they come to Charleston specifically looking for it.”

Elijah Green, a formerly enslaved man, sits in front of the Old Slave Mart in Charleston, South Carolina. Green once told an interviewer that the mart’s owner was “very cruel” and that “seldom one of his slaves survive a whipping.” (The Photography Collections, University of Maryland, Baltimore County)

For generations, Charleston has been better known for its wartime history and physical beauty than the horrific institution that built it. But new interest from visitors, historians and armchair detectives alike is helping to unearth details of the painful past of this coastal city where about 40% of captive Africans arrived into American chattel slavery. Just last month, ProPublica reported how a graduate student discovered an 1835 newspaper advertisement for an auction of 600 people at the Exchange — marking the largest known slave sale in U.S. history. It had gone unrecognized as such for nearly two centuries.

Multiple companies now offer tours of Charleston emphasizing Black history and culture. Plantations that once described enslaved laborers as “servants” and “workers” hold Juneteenth commemorations. The City Council apologized for the city’s role in slavery. And an expansive new museum opened in June to tell the African American story at a wharf where thousands of captives once arrived to be sold.

Yet, as that redress gains potency, tensions are flaring. Republicans increasingly frame demands for a frank accounting of slave history as the exploitation of a bygone past to push “woke” agendas.

South Carolina’s GOP-controlled legislature enacted a measure similar to hundreds nationwide, concentrated in former slave states, that restrict teaching related to race. Since 2021, a budget provision has forbidden state education funds from being used to teach that any student “bears responsibility for actions committed in the past by other members of the same race” or that someone should feel “discomfort, guilt or anguish” due to race.

As a result, one school district near the state capital faced a lawsuit, and a student in a nearby district challenged a lesson about systemic racism. But it remains to be seen how the restrictions will impact racial reckoning in Charleston, an old city where buildings stand atop slave burial grounds and countless stories remain hidden.

The Concrete Story

Tonya Matthews is ushering this once-ignored history out onto an enormous stage.

After 23 years of plowing through the indifference and denial that once permeated Charleston, the International African American Museum opened in late June. It stands at a downtown wharf where ships delivered an estimated 30,000 captives to sell.

It is hard to overstate the mammoth feat of raising $125 million to build a museum to share the African American experience in a city that a generation ago scarcely acknowledged the realities of slavery at all. Matthews, the museum’s president and CEO, often hears: “I never thought this would happen.”

The International African American Museum opened in late June. It sits on the former site of Gadsden’s Wharf, where all Charleston-bound slave ships were received during the final 22 months of the legal transatlantic slave trade in the United States. (Sean Rayford/Getty Images)

Fresh off huge buzz around the museum’s opening, Matthews said she was more focused on telling that story than tracking the state’s political headwinds, which she called “a lot of noise at the top.” She doesn’t expect it to affect what the private museum teaches, nor does she hear much about it from people on the ground — the teachers and other visitors she called the “curious folks.”

But it’s impossible to ignore for both white and Black Americans trying to grapple with the country’s original sin, whether they are descendants of enslaved people or those who enslaved them.

“It’s all a very, very personal journey, which is why the noise is so threatening and striking and discouraging to everyone,” she said. “Because when we hear it, we take it in personally.”

Along with nine galleries and various traveling exhibitions, the museum also offers the Center for Family History to bridge gulfs in African American genealogy. That requires help from white families whose records often are the only ones that exist about Black people’s enslaved ancestors. The museum aims to provide a safe space for that exchange.

“One side is simply asking for the authentic story,” Matthews said. “And the other side is asking not to be judged.”

Old Story, New Audience

Christine King Mitchell is pushing Charleston’s slave history from obscurity to prominence at a small, city-owned museum tucked off a cobblestone road.

On a recent morning, she stood with her back to a row of windows that look out over what once was a four-story brick fortress, a barracoon called the “jail” where enslaved people for sale were housed. The complex included a “dead house,” a morgue. Today, the site is a private parking lot.

Mitchell works at the Old Slave Mart Museum, where many auctions moved after the city banned them at the Exchange and surrounding streets in 1856. From the dimly lit second floor, she tells an unvarnished story of slavery here and across Charleston. Record numbers of people are coming to hear it.

Christine King Mitchell shares the history of South Carolina’s slave trade with students and other visitors at the Old Slave Mart Museum in Charleston.

She began working at the Slave Mart a decade ago — and annual visitors have skyrocketed since, from about 30,000 to more than 80,000 last year. They now narrowly surpass visitors to the Exchange, one of the most historic colonial public buildings in the country.

Mitchell’s first audience of the day was a class from a private school in Greenville, a city three hours away in upper South Carolina. They listened with quiet intensity as she explained how slavery infused every vein of the city’s economy.

“You’re talking insurance companies making money, the shipbuilding industry making money…”

A big screen beside her projected an 1856 document titled: SLAVE POLICY. In it, Aetna Life Insurance Co. had insured a 24-year-old enslaved woman named Sebina for $600. “This city was built on the backs of Black people,” Mitchell said. “You can start to understand the tentacles.”

Mitchell informs visitors about the business of slavery during a presentation at the Old Slave Mart Museum. First image: Visitors stop to examine panels containing historical information on slavery at the Old Slave Mart Museum. Second image: Shackles used to bind enslaved people during transport are on display at the museum.

When she first read the policy about five years ago, she cried. For white people, slavery might seem distant. But to her, it feels very near. She remembers her first freeborn grandfather, “and I’m not 100 years old yet.” Now 67, she grew up in the 1960s picking cotton with her mother.

This history plays forward today. Mitchell, who wrote a new book, “The Business of Slavery,” noted the generational wealth gap that persists between Black and white people. The education disparities. The Black women paid 52 cents for every $1 a white man is paid in South Carolina.

After the class left, while waiting for the next one to file in, she explained the importance of her work. “If you understand the past, you understand the present.” She pointed an index finger and moved it in a circular motion toward the museum’s display panels, the chains under glass, the bricks in the walls with enslaved people’s fingerprints still pressed into them.

“It’s all of this.”

Unearthing Buried Stories

Lauren Davila is using archival research to unearth lost stories in what once was the heart of the local slave-trading district — although you’d hardly know it traversing the streetscape today.

Davila was a College of Charleston graduate history student when she began compiling a digital map of businesses connected to the slave trade around Broad Street, one of the city’s most iconic stretches. Rows of mostly two- and three-story buildings, many of them predating the Civil War, line the street. Wrought iron and columns adorn the structures, which today house law firms, restaurants and banks — with little indication of what they were once used for.

Lauren Davila, photographed behind the Old Exchange and Provost Dungeon, discovered a newspaper ad that promoted the sale of 600 people while conducting research as a graduate student at the College of Charleston.

Only two buildings overtly acknowledge their histories despite the concentration of horrors that happened in the vicinity. “Charleston is really doing a disservice to locals, tourists and Black people as a whole by not acknowledging it,” said Davila, now an adjunct at the College of Charleston.

While searching Charleson newspaper archives last year for an especially prolific slave-trading firm, Davila paused at one of its advertisements. Published in 1835, the ad informed readers of the upcoming sale of 600 enslaved people. She had discovered the largest known slave auction in American history, a finding first reported by ProPublica in June.

The sale was held at the Exchange, a grand 1771 structure at the head of Broad Street. One of the two historical markers on the street that mention slavery stands outside the building, where city leaders once entertained George Washington. Installed in 2016, the marker describes how public auctions of enslaved people were held there.

The other marker, added in 2021, hangs on a bank building a block down that once housed a slave trader’s office. Margaret Seidler was researching her family tree when she discovered a notorious slave trader among her ancestors and then hired a deeds researcher who pinpointed the building as his former office.

Seidler, a white Charlestonian who funded some of Davila’s research training, has since been tracking down descendents of slave traders. Many she approached have cried when she presented evidence of their ancestors’ actions. Some privately thanked her.

Fewer are willing to publicly acknowledge it. Others won’t at all. They don’t see the point. One white descendant told her that slavery was unfortunate but is getting too much emphasis today. All the discussion did, he added, was give people ideas about reparations.

But another recently agreed to publicly acknowledge a prominent trader among her ancestors as a way to “recognize the importance of this truth being known and told as part of the history of Charleston.”

And soon, there could be a third marker a few doors down from the office of Seidler’s ancestor. Davila traced the building that once housed the firm that organized the sale of 600 people to 24 Broad St.

Since 1989, Stephen Schmutz has owned the building, an elegant salmon-colored structure where he has spent a long career practicing law. A large framed portrait of Martin Luther King Jr. hangs near his desk, a gift from the Racial Justice Network for his work. He also represented three families whose loved ones were among nine Black people murdered by a white supremacist in 2015 inside Emanuel AME Church, just a mile away.

Schmutz’s building stands close enough to the Exchange that someone standing outside might have heard wailing from enslaved families torn apart. When ProPublica told him that his building once housed a notorious slave-trading firm, he was stunned.

“It has been a lot of things,” he said. “But I didn’t know it had been one of those things.”

Davila has asked him to meet and discuss putting a marker outside his building; he told ProPublica he wouldn’t object.

Changing the Narrative

Harold Singletary joined thousands of others celebrating the International African American Museum’s opening last month. Shortly after, he read ProPublica’s story about the sale of 600 people — and learned that several of his ancestors were among those sold.

They included the mother and grandparents of a woman Singletary so reveres that he named his business, BrightMa Farms, after her. It operates in part on the same 10-acre plot she farmed after the Civil War freed her.

He quickly realized that the farm’s corporate office sits barely a four-minute stroll from the Exchange, where his ancestors stood before potential buyers. He used to work for a developer on Broad Street near the building that housed the firm that sold them. It all felt very surreal.

Harold Singletary recently discovered that some of his ancestors were sold as part of the 600-person sale in Charleston, which took place not far from the corporate office of his business, BrightMa Farms.

He supports efforts by Davila and Seidler to put a marker outside so that others who walk by learn the story. “It’s connecting dots. It’s these conversations that never were had,” he said. “We are still in a position of changing the narrative.”

For him, teaching history isn’t an esoteric examination of dates and events. Everywhere he goes in Charleston, the past feels very near. As white lawmakers work to protect students from feeling discomfort while learning about their state’s racial legacy, Singletary wants them to consider how he experiences it. He wants them to know the pain he, and his children, feel walking past the place where their ancestors were sold or the building where the white men who orchestrated it grew rich.

Correction

July 31, 2023: This story originally misstated a street number. Several residents want to put an historical marker at 24 Broad St. There already is one at 34 Broad St.

by Jeremy Schwartz

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This article is co-published with The Texas Tribune, a nonprofit, nonpartisan local newsroom that informs and engages with Texans. Sign up for The Brief Weekly to get up to speed on their essential coverage of Texas issues.

Two months after Texas lawmakers stripped millions of dollars from a company that supplies child identification kits, a bill to fund a similar program in Pennsylvania is facing key opposition.

In March, two Pennsylvania senators filed legislation that called for purchasing and distributing child identification kits for all of the state’s first graders. The kits, which would cost the state about $350,000, needed to use “inkless” fingerprinting technology, according to the bill.

Such a provision would provide an advantage to one vendor: the National Child Identification Program, a Waco, Texas, company run by former NFL player Kenny Hansmire, who has a track record of failed businesses and has been disciplined by Connecticut banking regulators.

On May 2, the bill sailed through the Senate Education Committee on a unanimous vote, a key step that was celebrated by the company’s representatives and the legislation’s authors. During a press conference that day, Hansmire turned to a common phrase he uses to promote the kits, calling the bill a “gift of safety” and urging the lawmakers to support the measure.

“We’re asking the state of Pennsylvania to step up, the Senate and the House to step up,” he said.

A week later, ProPublica and The Texas Tribune published an investigation that found no evidence that the kits had ever been used to find a missing child and that the company had used exaggerated statistics as it sought to secure government dollars across the country.

After the investigation was published, Texas lawmakers — who had approved legislation in 2021 that delivered nearly $6 million to the company — zeroed out future funding for the effort.

Pennsylvania lawmakers also began taking a closer look at the company. The bill’s authors removed the requirement that kits be “inkless,” and the measure passed the full Senate last month with a 34-15 vote. Now the bill is awaiting a hearing in the House Education Committee. But the chair of that committee told the news organizations that he has no plans to bring the legislation forward for a vote.

Jason Thompson, a spokesperson for bill sponsors Sens. Scott Martin and Camera Bartolotta, both Republicans, said the removal of the provision that required the kits to be “inkless” would allow a wider pool of potential vendors to seek a state contract. Hansmire has claimed that his company’s inkless technology makes its kits superior.

“Understanding the clear value of providing these kits to young people, Senator Bartolotta and Senator Martin amended their bill to provide additional flexibility to ensure whatever kits are distributed to students meet the needs of Pennsylvania families, law enforcement and taxpayers,” Thompson said.

But that change was not enough to persuade multiple state lawmakers who questioned the use of taxpayer funding to pay for the kits, including Rep. Peter Schweyer, chair of the House Education Committee.

“This just never seemed like it was all that well thought out,” Schweyer, a Democrat, said, adding that addressing school violence and mental health are more urgent priorities. “I’d rather hire a couple more cops or spend money on a couple more psychologists in our most at-risk schools.”

Two Democratic senators offered similar concerns.

Sen. Maria Collett said she was worried that the legislation, as originally proposed, appeared to benefit a single vendor. She noted that several nonprofits in the state already provide child ID kits for free to parents who want them.

“To ask the taxpayers of Pennsylvania to invest hundreds of thousands of dollars, year over year, to a private vendor for a product that we have no data showing the efficacy of is unconscionable, in my opinion,” she said.

Sen. Nikil Saval said the news organizations’ investigation raised concerns among lawmakers.

“A number of us, initially, were supportive of the effort,” Saval said. “Frankly, the reporting gave a number of us pause.”

Beyond questions of the kits’ effectiveness, the news outlets’ investigation found Hansmire had a string of failed businesses, had millions of dollars in outstanding federal tax liens and had previously been barred from some finance-related business in Connecticut by banking regulators because of his role in an alleged scheme to defraud or mislead investors.

Hansmire, who did not respond to emailed questions for this article, has said the kits help law enforcement find missing children and save time during the early stages of a search. But none of the law enforcement agencies contacted by the news outlets could recall the kits having assisted in finding a missing child.

Hansmire also previously said that his legal disputes, including his sanction in Connecticut, had been “properly resolved, closed and are completely unrelated to the National Child ID Program.” He claimed to have “paid debts entirely” but did not provide details.

The Pennsylvania House Education Committee is scheduled to reconvene in late September, following the Legislature’s summer break.

If the committee takes no action, another legislative avenue called a “code bill” could potentially provide funding for the kits, but Schweyer said he isn’t aware of a push for such a move.

“It doesn’t feel like there’s a lot of momentum for it here,” he said. Schweyer added: “For now, it’s a dead issue in Pennsylvania.”

by Duaa Eldeib

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Members of Congress on Thursday introduced sweeping legislation that aims to reduce the country’s stillbirth rate, tackling gaps in research, data and awareness as well as authorizing tens of millions of dollars in new funding.

If passed, the Stillbirth Health Improvement and Education (SHINE) for Autumn Act of 2023 would be the most comprehensive federal stillbirth law on record. Rep. Young Kim, R-Calif., who introduced the bill in the House, called it “the first step in the right direction” to help prevent stillbirths and ensure healthy pregnancies.

As a mother, grandmother and co-chair of the Maternity Care Caucus, Kim said she understands the challenges firsthand. She said that when one of her daughters lost a baby a few years ago, the doctor’s response was, “It happens.”

“These experiences have made me want to be a part of the solution,” she said. “I want us to have more information and make sure things are better for my grandkids. We should be able to prevent the preventable.”

Every year in the U.S., more than 20,000 pregnancies end in stillbirth, the death of an expected child at 20 weeks or more. Research shows as many as 1 in 4 stillbirths may be preventable, a figure that jumps to nearly half as the due date nears. But for years, the U.S. stillbirth crisis has been overlooked.

ProPublica has reported extensively on the devastating effects of stillbirth on families and the country’s failure to prevent, prioritize and raise awareness around stillbirth. Stark racial disparities underscore the crisis, as Black women are more than twice as likely to have a stillbirth as white women. But government officials, doctors and researchers often cite the dearth of research, data and autopsies as barriers to change.

Kim and other lawmakers lauded ProPublica’s reporting for bringing the stillbirth crisis to the forefront and revealing shortcomings in how the nation’s health care system was combating stillbirths.

“ProPublica’s work has been so important for shedding light on the challenges related to stillbirth, amplifying the stories of mothers and women whose voices have not been heard, and highlighting the gaps in our stillbirth-related data and where the United States stands compared to other countries,” said Kim, who was not involved in last session’s legislation.

Sen. Cory Booker, D-N.J., introduced legislation in the Senate last year with Sen. Marco Rubio, R-Fla., but it did not pass. They joined forces again to reintroduce a measure on Thursday. Booker said the growing list of bipartisan cosponsors and the relentless work of advocates makes him optimistic that it will pass this session.

“Sadly, despite staggering statistics, stillbirth remains one of the most underfunded and understudied public health issues in the United States. This legislation would provide long-overdue resources towards research and data collection,” said Booker, adding that he was “incredibly grateful” to ProPublica for raising awareness and giving a human face to the ongoing crisis, which has been “critical” to garnering support for the legislation.

The SHINE for Autumn Act is named after the daughter of New Jersey maternal health advocate Debbie Haine Vijayvergiya. Autumn Joy was stillborn 12 years ago this month.

The SHINE for Autumn Act is named for the stillborn daughter of Debbie Haine Vijayvergiya, a maternal health advocate. Her daughter, Autumn Joy, was stillborn in 2011. (Liz Moughon/ProPublica)

“This is life-saving, historic, monumental legislation,” Haine Vijayvergiya said. “I’ve been waiting and working so hard all these years, knocking on doors and screaming from rooftops trying to get someone’s attention, trying to find anyone who can help to elevate the sense of urgency around this issue.”

She teared up as she expressed gratitude to the lawmakers who listened and signed on to the legislation. She’s now turning her attention to getting the bill passed, which means a steady stream of meetings and calls.

“ProPublica has helped to shine the very brightest light,” she said. “I don't think we’d be where we are today without the help of ProPublica.”

The bill marks the second time this month that federal lawmakers have introduced stillbirth legislation. The Maternal and Child Health Stillbirth Prevention Act specifically adds stillbirth prevention to the list of federal funding programs earmarked for mothers and children.

The SHINE for Autumn Act would authorize a total of $45 million in federal funding over the next five years for the various programs. That includes building a partnership between federal and state agencies to focus on collecting better data on stillbirths and risk factors, as well as building capacity at the local level to assess and standardize that data. It also seeks to develop and make educational awareness materials publicly available. Many women interviewed by ProPublica said they didn’t know they were at risk until they delivered their stillborn baby.

In addition, the bill paves the way for a perinatal pathology fellowship program to help provide additional training for fetal autopsies. In 2020, autopsies were conducted or planned in less than 20% of stillbirths, according to data from Centers for Disease Control and Prevention, which also shows that the cause of death is not determined in about one-third of stillbirths.

Rep. Dave Joyce, R-Ohio, Rep. Kathy Castor, D-Fla., and Rep. Robin Kelly, D-Ill., are all cosponsors in the House. Kelly, who co-chairs the Maternity Care Caucus with Kim, said the federal government has a major responsibility when it comes to ensuring maternal and newborn care, and part of that includes addressing the alarming racial disparities in maternal mortality and stillbirth.

“Stillbirth is a deeply painful experience for many mothers, and another area (of) health care where Black women feel a disproportionate burden,” she said. “By shedding light on this issue and directing more resources and more awareness to supporting moms and babies, we can improve outcomes across the board.”

Key medical organizations, including the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine, have also backed the legislation. Dr. Tony Sciscione, president of the Society for Maternal-Fetal Medicine, said preventing stillbirths is crucial.

“One of the most difficult things that maternal-fetal medicine subspecialists do is comfort families as they try to understand why their baby was stillborn,” he said. “For patients and clinicians, there are far too many questions and far too few answers.”

by Isabelle Taft, Mississippi Today, and Mollie Simon, ProPublica

This article contains descriptions of threats of violence and mental illness.

This article was produced for ProPublica’s Local Reporting Network in partnership with Mississippi Today. It was also co-published with Sun Herald and Northeast Mississippi Daily Journal. Sign up for Dispatches to get stories like this one as soon as they are published.

If you or someone you know needs help:

• Call the National Suicide Prevention Lifeline: 988
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Nearly 40 years ago, a federal appeals court ruled that Alabama officials could not jail people in mental health crisis who were sent to the state for help. Jailing people going through the state’s civil commitment process, the court decided, amounted to punishment. And about 30 years ago, after Kentucky was labeled the worst state in the nation for jailing mentally ill people without charges, legislators there banned it.

But a new survey of counties and an analysis of jail dockets in Mississippi, which has no such law, has found that people going through the civil commitment process for mental illness are regularly jailed as they await evaluation and treatment, even when they haven’t been charged with a crime. Some counties routinely hold such people in jail — people awaiting treatment for mental illness or substance abuse were held in jail without charges at least 2,000 times from 2019 to 2022 in 19 counties alone, sometimes for days or weeks.

Nationally, Mississippi is a stark outlier. Mississippi Today and ProPublica conducted a nationwide survey of disability advocacy organizations and state agencies that oversee behavioral health. None described anything close to the scale of what’s happening in Mississippi.

Civil commitment laws are meant to ensure people get treatment even when they don’t recognize that they need it, said James Tucker, an attorney and the director of the Alabama Disabilities Advocacy Program. Locking them up as they wait for a treatment bed doesn’t fulfill that goal.

“The bargain for your lack of freedom is that the state has decided you need treatment,” he said. “The minute that order is entered, the state has a constitutional duty to deliver treatment.”

At least 12 states plus the District of Columbia prohibit jailing people undergoing commitment proceedings for mental illness unless they have been charged with a crime.

Mississippi law, however, allows people going through the civil commitment process to be sent to jail if there is “no reasonable alternative.” If there are no publicly funded beds in appropriate facilities, local officials sometimes decide they have no other option.

“We Forbid the Use of Jails”

In the 1970s, a federal class-action lawsuit against Alabama officials alleged that it was unconstitutional to jail people going through the commitment process for mental illness while they awaited hearings. It was common at the time: Probate judges in three-quarters of the state’s counties had jailed people, according to discovery findings cited in a court ruling.

Lawyers for the plaintiffs — everyone in the state who had been committed or would be in the future — cited previous lawsuits that had uncovered fire hazards, overcrowding and a dearth of mental health and routine medical care in Alabama’s county jails.

The district court ruled against the plaintiffs’ constitutional claims, reasoning that if the local jail was the only option in a county, it was the least restrictive facility that would also protect society.

"The bargain for your lack of freedom is that the state has decided you need treatment. The minute that order is entered, the state has a constitutional duty to deliver treatment." – James Tucker, director of the Alabama Disabilities Advocacy Program

But in 1984, a panel of judges on the 11th U.S. Circuit Court of Appeals rejected that reasoning. Circuit Judge Thomas Alonzo Clark wrote in his opinion that nothing prevented counties from placing people in a public facility in another county or in a local private facility that was equipped to handle mentally ill patients.

Clark cited a doctor’s testimony that jail often worsened psychosis, made it harder to treat people and increased suicidal tendencies.

“We forbid the use of jails for the purpose of detaining persons awaiting involuntary civil commitment proceedings, finding that to do so violates those persons’ substantive and procedural due process rights,” the judge wrote.

The reasons that Alabama officials provided for placing people in jail were similar to Mississippi officials’ arguments today. But Mississippi is in a different federal circuit, and the practice there has not been tested with a class-action lawsuit.

A sister of one woman who had died in a Mississippi jail in 1987 tried and failed to convince a federal judge that the woman’s rights had been violated when she was incarcerated without treatment.

Colett Boston, left, and Everlean Boston hold a photograph of their mother, Mae Evelyn Boston, in Oxford, Mississippi. When the sisters were young, their mother died in jail as she went through the civil commitment process. (Eric J. Shelton/Mississippi Today)

Mae Evelyn Boston, an Oxford woman who had dealt with paranoid schizophrenia for most of her adult life, had a psychotic episode shortly after giving birth. Her older daughter, Everlean, was 12 years old; she remembers her mother saying she was going to kill the baby because the girl “had a demon in her.”

One of Boston’s sisters initiated commitment proceedings — making Boston one of more than 100 people jailed for that reason from 1984 to 1988 in Lafayette County, according to a deposition cited in a 1990 ruling by U.S. District Judge Neal Biggers. When deputies arrived to take her mother into custody for evaluation, Everlean recalled, it took six of them to get her onto the ground before handcuffing her and placing her in the back of a cop car.

Once Boston was in jail, guards did not complete a medical screening required by department policy and didn’t know Boston had given birth via cesarean section 12 days before, Biggers wrote. She died two days later from heart failure caused by blood clots.

Everlean Boston remembers her mother smoking cigarettes and listening to the blues on quiet Sundays at home. The day deputies took her mother away was the last time she saw her. “I never got to say goodbye,” she recalled. “I never got to say I loved her. It hurts.”

“I never got to say goodbye. I never got to say I loved her. It hurts.” – Everlean Boston, whose mother, Mae Evelyn Boston, died in jail as she went through the civil commitment process

Biggers concluded that the “medical care customarily provided by the county for mentally ill detainees does not fall below constitutional standards” and that what happened with Boston represented a “scheduling error” and an “isolated instance.” The county, which argued it had provided adequate care for Boston, had the right to detain people like her “in the interest of societal safety,” he found, and those people were not entitled to placement in the “least restrictive alternative” such as a hospital. Biggers considered the Alabama appeals court ruling from a few years earlier, but concluded it didn’t apply because it was based on specific facts about that state’s jails.

“The court declines to hold that use of jails for temporary detention of persons awaiting civil commitment proceedings is unconstitutional per se,” Biggers ruled.

Since then, at least nine lawsuits have been filed over the deaths of Mississippians incarcerated during civil commitment proceedings. None of those lawsuits directly challenged the constitutionality of being jailed during the commitment process. The U.S. Supreme Court has not ruled on the matter, academics and attorneys with expertise in civil commitment said.

In the years after Boston’s death, Mississippi continued to stand out.

The chancery courthouse in Lafayette County, at the site that previously housed the county jail where Mae Evelyn Boston died (Eric J. Shelton/Mississippi Today)

In 1992, the National Alliance for the Mentally Ill and Public Citizen’s Health Research Group conducted a national survey about the practice of jailing mentally ill people.

Almost a third of city and county jails in Mississippi responded. About 76% of respondents said they detained people who had not been charged with a crime and were awaiting an evaluation, treatment or hospitalization for mental illness. That was the second-highest percentage of any state in the country and far higher than the national average of 29%.

An unnamed Mississippi jail official said in the organizations’ report that jails were a “dumping ground for what nobody else wants.”

The report gave its “Worst State Award” to Kentucky, where 81% of responding jails reported holding people without criminal charges for mental evaluations.

Two years later, Kentucky’s legislature voted unanimously to ban the practice. The state health agency and its federally designated disability rights organization told Mississippi Today and ProPublica that Kentucky jails today are not used to hold people without charges awaiting mental health evaluations.

Few States Compare to Mississippi

Officials with the Mississippi Department of Mental Health emphasize that they do not support the practice of jailing people during the commitment process. But a spokesperson said they “have heard anecdotally from other states regarding challenges of individuals waiting in jail.”

Nationally, even basic data like the number of people committed each year is elusive. After reviewing some of Mississippi Today and ProPublica’s findings, the Treatment Advocacy Center, a national nonprofit that advocates making it easier for people with mental illness to get treatment, started planning a project to understand how often people are jailed without charges during the commitment process across the U.S.

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Mississippi Today and ProPublica contacted agencies overseeing mental health and disability advocacy organizations in every state to find out whether Mississippi is an outlier. It is.

Respondents in 42 states and the District of Columbia said they were not aware of people being regularly held in jail without charges during the psychiatric civil commitment process. In a handful of those states, respondents said they had seen it once or twice over the years.

In two states, people can be sent from state psychiatric hospitals to mental health units inside prisons. In a few others, respondents said they had seen people jailed for noncompliance with court-ordered treatment for mental illness or substance abuse.

Respondents in three other states — Alaska, South Dakota and Wyoming — reported that people sometimes are sent to jail to await psychiatric evaluations, but the information they provided suggested that it happens to fewer people, and for a shorter period, than in Mississippi.

In 2018, staffing shortages at the Alaska Psychiatric Institute caused people to be held at the Anchorage Correctional Complex until they could be evaluated. The next year, an Anchorage judge ordered an end to the practice except in the “rarest circumstances,” finding that it had caused “irreparable harm.”

A subsequent settlement declared that jails shouldn’t be used unless no other option was available and that such detentions should be as short as possible.

But detentions do still occasionally happen in the state when people in rural areas await transportation to an evaluation center, said Mark Regan, legal director at the Disability Law Center of Alaska. According to the Alaska Department of Family and Community Services, people awaiting evaluation were held in jail 555 times from mid-2018 through late February 2023.

Across South Dakota, people without charges sometimes have been held in jail during the commitment process, according to law enforcement agencies and Disability Rights South Dakota, but such holds are limited by law to 24 hours; in Mississippi, the vast majority of cases analyzed were for more than 24 hours. The South Dakota Department of Social Services said it doesn’t track how often it happens and declined to answer questions.

And in Wyoming, a person can be held in jail for up to 72 hours on an emergency basis before a hearing, but they must have a mental examination within 24 hours. Such holds in jail have occurred “in very rare circumstances,” according to the state.

Attempts to constrain the use of jails date back at least to 1950, when the federal government sent governors model legislation that limited the incarceration of people for mental illness to “extreme emergency” situations. The National Institute of Mental Health called incarcerating such people “among the worst of current practices.”

Some states adopted the legislation. Mississippi did not.

Agnel Philip contributed reporting.

by Isabelle Taft, Mississippi Today, with data analysis by Agnel Philip, ProPublica, reporting by Mollie Simon, ProPublica

This article contains detailed descriptions of mental illness and suicide.

This article was produced for ProPublica’s Local Reporting Network in partnership with Mississippi Today. It was also co-published with Sun Herald, Northeast Mississippi Daily Journal and The Guardian. Sign up for Dispatches to get stories like this one as soon as they are published.

*** If you or someone you know needs help:

• Call the National Suicide Prevention Lifeline: 988
• Text the Crisis Text Line from anywhere in the U.S. to reach a crisis counselor: 741741

When sheriff’s department staff in Mississippi’s Benton County took Jimmy Sons into custody several years ago, they followed their standard protocol for people charged with a crime: They took his mug shot, fingerprinted him, had him change into an orange jumpsuit and locked him up.

But Sons, who was then 20 years old, had not been charged with a crime. Earlier that day, his father, James Sons, had gone to a county office to ask that his youngest son be taken in for a mental evaluation and treatment. Jimmy Sons had threatened to hurt family members and himself, and his father had come across him sitting on his bed with a loaded shotgun.

On Sons’ booking form, in the spot where jailers usually record criminal charges, was a single word: “LUNACY.”

The booking form for Jimmy Sons, identifying his “offense” as “lunacy” (Obtained by Mississippi Today)

In every state, people who present a threat to themselves or others can be ordered to receive mental health treatment. Most states allow people with substance abuse problems to be ordered into treatment, too. The process is called civil commitment.

But Mississippi Today and ProPublica could not find any state other than Mississippi where people are routinely jailed without charges for days or weeks during that process.

What happened to Sons has occurred hundreds of times a year in the state.

The news organizations examined jail dockets from 19 Mississippi counties — about a quarter of the state’s 82 — that clearly marked bookings related to civil commitments. All told, people in those counties were jailed at least 2,000 times for civil commitments alone from 2019 to 2022. None had been charged with a crime.

Most were deemed to need psychiatric treatment; others were sent to substance abuse programs, according to county officials.

Since 2006, at least 13 people have died in Mississippi county jails as they awaited treatment for mental illness or substance abuse, Mississippi Today and ProPublica found. Nine of the 13 killed themselves. At least 10 hadn’t been charged with a crime.

A woman going through the civil commitment process, wearing a shirt labeling her a “convict,” is transported from her commitment hearing back to a county jail to await transportation to a state hospital in north Mississippi this spring. (Eric J. Shelton/Mississippi Today)

We shared our findings with disability rights advocates, mental health officials in other states and 10 national experts on civil commitment or mental health care in jails. They used words such as “horrifying,” “breaks my heart” and “speechless” when they learned how many people are jailed in Mississippi as they go through the civil commitment process.

Some said they didn’t see how it could be constitutional.

“If an ER is full, you don’t send people to jail,” said Megan Schuller, legal director of the Bazelon Center for Mental Health Law, a Washington, D.C.-based organization. “This is just outright discriminatory treatment in my view.”

Mississippi Today and ProPublica also interviewed 10 individuals who had been committed and jailed, as well as 20 family members.

Many of those people said they or their family members had been housed alongside criminal defendants. Nobody knew how long they would be there. They were often shackled when they left their cells. Some of them said they couldn’t access prescribed psychiatric medications or had minimal medical care as they experienced withdrawal from illegal drugs.

“It felt more criminal than, like, they were trying to help me,” said Richard Millwood, who was booked into the DeSoto County jail in 2020 following an attempted suicide. “I got the exact same treatment in there as I did when I was in jail facing charges. In fact worse, in my opinion, because at least when I was facing charges I could bond out.”

"I got the exact same treatment in there as I did when I was in jail facing charges. In fact worse, in my opinion, because at least when I was facing charges I could bond out." — Richard Millwood, who was booked into jail following an attempted suicide

DeSoto County leadership, informed of Millwood’s statement, did not respond.

Millwood spent 35 days in jail before being admitted to a publicly funded rehab program 90 miles away.

Jimmy Sons didn’t receive a mental evaluation when he was booked into the Benton County jail in September 2015, according to documents in a lawsuit his father later filed. Less than 24 hours later, he was dead. Left alone in a cell without regular visits by jail staff, he had hanged himself.

He had been back in Mississippi for just a few days, planning to join his dad in electrical work, said his mother, Juli Murray. He had set out from her home in Bradenton, Florida, so early in the morning that he didn’t say goodbye.

Murray remembers the phone call from Jimmy’s half-brother in which she learned her son was in jail. She didn’t understand why.

“If you do something wrong, that’s why you’re in jail,” she said. “Not if you’re not mentally well. Why would they put them in there?”

The Lesser Sin

When James Sons went to the clerk’s office in the tiny town of Ashland to file commitment paperwork for his son, he took the first step in Mississippi’s peculiar, antiquated system for mandating treatment for people with serious mental health problems.

Jimmy Sons at age 18 at his father’s home in Mississippi (Courtesy of John Sons)

It starts when someone — usually a family member, but it could be almost anyone — signs a form alleging that the person in question is “in need of treatment because the person is mentally ill under law and poses a likelihood of physical harm to themselves or others.”

James Sons filled out that form, listing why he was concerned: Jimmy’s guns, his threats, his talk of suicide.

Then a special master — an attorney appointed by a chancery judge to make commitment decisions — issued a “Writ to Take Custody.” It instructed sheriff’s deputies in Benton County, just south of the Tennessee border, to hold Jimmy Sons at the jail until he could be evaluated.

The sheriff’s office asked Sons to come in on an unrelated matter. When he showed up, Chief Deputy Joe Batts told him he needed a mental health evaluation. Batts tried to reassure Sons that the process would be as quick as possible and would end with him back home, according to Batts’ testimony in the lawsuit Sons’ father filed over his death.

Then Batts told Sons, “What we’re going to have to do now is take you back and book you.”

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What he never told Sons, he later acknowledged in a deposition, was that the young man would have to wait in jail for days before he would see a mental health provider. The first screening required by law was four days away. If it concluded he needed further examination, he would be evaluated by two more medical professionals. Then the special master would decide whether to order him into treatment at a state psychiatric hospital.

The whole process should take seven to 10 days, according to the state Department of Mental Health. But sometimes it takes longer, the news organizations found. And if someone is ordered into treatment at their hearing, they generally have to wait for a bed, though the department says average wait times for state hospital beds after hearings have dropped dramatically in the last year.

While waiting for their hearing, people like Sons are supposed to receive treatment at a hospital or a short-term public mental health facility called a crisis stabilization unit. But state law does allow people to be jailed before their commitment hearing if there is “no reasonable alternative.” (The law is less clear about what’s allowed following a hearing.)

The Benton County Sheriff’s Department formerly housed the county jail where Jimmy Sons died, in Ashland, Mississippi. (Eric J. Shelton/Mississippi Today)

Mississippi Today and ProPublica spoke to dozens of officials across Mississippi involved in the commitment process: clerks who handle the paperwork, chancery judges and special masters who sign commitment orders, sheriffs who run the jails, deputies who drive people from jails to state hospitals, and the head of the state Department of Mental Health.

None of them thinks jail is the right place for people awaiting treatment for mental illness.

“We’re not a mental health hospital,” said Greg Pollan, president of the Mississippi Sheriffs’ Association and the sheriff of rural Calhoun County in the north of the state. “We’re not even a mental health Band-Aid station. That’s not what we do. So they should never, ever see the inside of my jail.”

Batts himself, who took Sons into custody in Benton County, said law enforcement officers across Mississippi “hate to detain people like that. But we’re told we have to do it.” He acknowledged that the facility “was substandard to begin with, not having the space and the adequate facilities to hold and monitor someone in that mental state — it just puts everybody in a bad situation.” And he said he thought the state could provide alternatives to jail.

Some counties jail most people going through the commitment process for mental illness, Mississippi Today and ProPublica found. Other counties reserve jail for people who are deemed violent or likely to hurt themselves. And at least a handful sometimes jail people committed for substance abuse — even though a 2021 opinion by the state’s attorney general says that isn’t allowed under state law.

This happens because until people are admitted to a state hospital, counties are responsible for covering the costs of the commitment process unless the state provides funding. If a crisis stabilization unit is full or turns someone away, the county must find an alternative, and it must foot the bill.

Counties can place patients in an ER or contract with a psychiatric hospital — and some do — but many officials balk at the cost. Many officials, particularly those in poor, rural counties, see jail as the only option.

“You have to put them somewhere to monitor them,” said Cindy Austin, chancery clerk in rural Smith County, located in central Mississippi. Chancery clerks are responsible for finding beds for people going through the commitment process. “It’s not that anybody wants to hold them in jail, it’s just we have no hospital here to hold them in.”

Timothy Gowan, an attorney who adjudicated commitments in Noxubee County from 1999 to late 2020, said people going through the commitment process there generally were jailed if they were determined to be violent and their family didn’t want them at home.

According to the Noxubee County jail docket, people going through the civil commitment process with no criminal charges were booked into the jail about 50 times from 2019 to 2022. Ten stays lasted at least 30 days. The longest was 82 days.

“Putting a sick person in a jail is a sin,” Gowan said. “But it’s the lesser of somebody getting killed.”

Some counties rarely hold people in jail — sometimes because a sheriff, chancery judge or other official has taken a stand against it. Rural Neshoba County in central Mississippi pays Alliance, a psychiatric hospital in Meridian, to house patients.

"We’re not a mental health hospital. We’re not even a mental health Band-Aid station. That’s not what we do. So they should never, ever see the inside of my jail." — Greg Pollan, president of the Mississippi Sheriffs’ Association and sheriff of Calhoun County

The practice isn’t confined to poor, rural counties. DeSoto County, a populous, relatively wealthy county near Memphis, jailed people without charges about 500 times over four years, the most of any of the counties analyzed by Mississippi Today and ProPublica. The median jail stay there was about nine days; the longest was 106.

The state and county recently set aside money to build a crisis stabilization unit — currently, the nearest one is about 40 miles away — but the county and the local community mental health center haven’t decided on a location, said County Supervisor Mark Gardner.

Some county officials say that keeping people out of jail during the process requires the state to step up. State Rep. Jansen Owen, a Republican from Pearl River County in southern Mississippi who represents people during the commitment process, said he believes counties that spend “millions of dollars on fairgrounds and ballparks” could find alternatives to jail. But he also sees a need for more state-funded facilities.

“You can’t just throw it on the counties,” he said. “It’s a state prerogative. And them being held in the jail, I think, is a result of the state kicking the can down the road to the counties.”

Wendy Bailey, head of the state Department of Mental Health, said it’s “unacceptable” to jail people simply because they may need behavioral health treatment. Department staff have met with chancery clerks around the state to urge them to steer families away from commitment proceedings and toward outpatient services offered by community mental health centers whenever possible.

The Department of Mental Health says it prioritizes people waiting in jail when making admissions to state hospitals. The state has expanded the number of crisis unit beds from 128 in 2018 to 180 today, with plans to add more. And it has increased funding for local services in recent years in an effort to reduce commitments.

But Bailey said the department has no authority to force counties to change course, nor legal responsibility for people going through the commitment process until a judge orders them into treatment at a state psychiatric hospital.

Locked in the “Lunacy Zone”

Willie McNeese’s problems started after he came home to Shuqualak, Mississippi, a town of about 400 people and a lumber mill, in 2007. He had spent a decade in prison starting at age 17.

He found the changes that had taken place — bigger highways, cellphones — overwhelming, said his sister, Cassandra McNeese. He was eventually diagnosed with bipolar disorder.

“It’s like a switch — highs and lows,” said Willie McNeese, now 43. “I might have a whole lot of laughter going on, trying to make the next person laugh. Then my day going down, I be depressed and worried about situations that nobody can change but God.”

McNeese has been involuntarily committed in Noxubee County 10 times since 2008 and has been jailed during at least eight of them, one for more than a month in 2019 according to court records and the jail docket. During his most recent commitment starting in March 2022, McNeese was held in jail for a total of 58 days in two stints before eventually going to a state psychiatric hospital.

Cassandra McNeese, left, and her mother, Yvonne A. McNeese, in Shuqualak, Mississippi. Cassandra’s brother, Willie McNeese, has been held in jail during civil commitment proceedings at least eight times since 2008. Cassandra McNeese said Noxubee County officials told her jail was the only place they had for him to wait. ”This is who you trust to take care of things,” she said. ”That’s all you have to rely on.” (Eric J. Shelton/Mississippi Today)

From 2019 to 2022, about 1,200 civil commitment jail stays in the 19 counties analyzed by Mississippi Today and ProPublica lasted longer than three days. That’s about how long it can take for people to start to experience withdrawal from a lack of psychiatric medications, which jails don’t always provide. About 130 stays lasted more than 30 days.

McNeese said he spent much of his time in jail last year standing near the door of his cell, what jail staff called the “Lunacy Zone,” screaming to be allowed to take a shower. A jailer tased him to quiet him down, and his clothes were taken from him. For a period, his mattress was taken, too.

“It’s a way of punishment,” he said. “They don’t handle it like the hospital. If you have a problem in the hospital they’ll come with a shot or something, but they don’t take your clothes or take your mattress or lock your door on you or nothing like that.”

McNeese said he had inconsistent access to medication and received none during his first stay in 2022, which lasted 25 days.

The Noxubee County Sheriff’s Department did not respond to questions about McNeese’s allegations.

Staff from Community Counseling, the community mental health center where McNeese had regular appointments, could have provided him with medication, but McNeese said no one from the center came to visit him in jail. A therapist at Community Counseling said staff go to the jail only when they’re called, usually when there’s a problem jail staff can’t handle. Rayfield Evins Jr., the organization’s executive director, said when he recently worked in Noxubee, deputies brought people from the jail to his facility for medication and treatment.

"If you have a problem in the hospital they’ll come with a shot or something, but they don’t take your clothes or take your mattress or lock your door on you or nothing like that." — Willie B. McNeese, jailed multiple times following a diagnosis for bipolar disorder

Mental health advocates in Mississippi and other people who have been jailed during the commitment process said the limited mental health treatment McNeese received is common.

Mental health care varies widely from jail to jail, and no state agency sets requirements for what care must be provided. Jails can refuse to distribute medications that are controlled substances, which includes anti-anxiety medications like Xanax. The state Department of Mental Health says counties should work with community mental health centers to provide treatment to people waiting in jail as they go through the commitment process.

But those facilities generally don't have the resources to provide services in jails, said Greta Martin, litigation director for Disability Rights Mississippi.

Martin’s organization, one of those charged by Congress with advocating for people with disabilities in each state, investigates county jails when it receives complaints. “We are not seeing any indication that these individuals are getting any mental health treatment while they are being held in these county facilities,” she said.

Willie McNeese was incarcerated at the old jail in Noxubee County multiple times during civil commitment processes, including his first commitment in 2008. (Eric J. Shelton/Mississippi Today)

McNeese said those jail stays added physical discomfort and pain to the delusions that got him committed in the first place. “Then you get to the mental hospital — they have to straighten you all the way back over again,” he said.

Since being released from the state hospital last year, McNeese said, he has been doing well. He is now living in Cincinnati with his wife.

Scott Willoughby, the program director at South Mississippi State Hospital in Purvis, said it can be hard to earn patients’ trust when they arrive at the psychiatric hospital from jail.

At his facility, patients sleep two to a room in a hall decorated with photographs of nature scenes. Group counseling sessions are often held outside under a gazebo. In between, patients draw and paint during recreational therapy.

Willoughby has spoken with patients who had attempted suicide and were shocked to find themselves in jail as a result.

“People tend to associate jail with punishment, which is exactly the opposite of what a person needs when they’re in a mental health crisis,” he said. “Jail can be traumatic and stigmatizing.”

“I’m More Scared of Myself”

When Sons learned that he was going to be booked, he became anxious about being locked in a cell, Batts testified. So he was assigned to an area of the jail reserved for trusties — inmates who are allowed to work, sometimes outside the jail, while they serve their sentences.

On the afternoon of his first day in jail, Sons was sitting on his bed when a trusty named Donnie Richmond returned from work. Richmond said in a deposition that he asked a deputy who the new guy was.

“You better watch him,” Richmond recalled the deputy telling him. “He kind of off a little bit.”

Richmond offered Sons a cigarette and cookies and asked him why he was there. Sons took a cigarette and told Richmond the deputies had said he would hurt someone.

“He was like, ‘Man, I’m going to be honest with you,’” Richmond testified. “‘I ain’t going to hurt no one. I’m more scared of myself, of hurting myself.’”

Sons was not placed on suicide watch. The jail’s suicide prevention policy applied only to those who had attempted suicide in the jail, although attorneys for the jail officials in the lawsuit over his death said there was an unwritten policy to closely monitor people going through the commitment process.

An excerpt of the Benton County Sheriff’s Department’s suicide prevention policy at the time of Sons’ death (Obtained by Mississippi Today)

That evening, Sons told a jailer he was feeling anxious around the other men. He asked to be moved to a cell by himself.

A guard took him to a cinder block cell with no windows. There was no television and nothing to read. He was given a blanket.

A security camera in Sons’ cell was supposed to allow jail staff to watch him at all times. But jail officials said in depositions that no one noticed anything unusual the next morning.

At 11:28 a.m., Sons rose from his bunk bed, walked to the door and placed his ear near it. He went back to his bunk, fashioned a noose and tied it around his neck. He sat there for three minutes before hanging himself, according to a narrative of the video in court records.

He stopped moving just before 11:38 a.m. A trusty serving lunch peeked through a tray opening in the door 48 minutes later and saw his body.

The door of the Benton County Jail cell where Sons was held (Obtained by Mississippi Today)

Sons’ father sued Benton County, the sheriff and several of his employees over his death. The defendants denied in court filings that they were responsible, but the county’s insurance company eventually settled the case for an undisclosed sum. (All that’s publicly known is that the county paid a $25,000 policy deductible toward defense costs.)

Sheriff’s department staff said in depositions they had kept an eye on Sons, but they couldn’t watch the video feed constantly. Lawyers for the defendants said there was no evidence sheriff’s department employees knew someone could kill himself in the way Sons did.

Sheriff A. A. McMullen, who is no longer in office, acknowledged in a deposition that “any mental commitment is a suicide risk,” but he said he wasn’t sure it would have made a difference if Sons had been placed on suicide watch.

“You could write up the biggest policy in the world and you couldn’t prevent it. There’s no way. God knows, you know, it hurts us,” he said. “If they’re going to do it, they’re going to do it.”

McMullen couldn’t be reached for comment for this story.

In an interview, jail administrator Kristy O’Dell, who joined the department after Sons died, said the jail still holds two or three people going through the commitment process each month.

John S. Farese, an attorney for Benton County, told Mississippi Today and ProPublica that the county, like others, “does the best they can do with the resources they have to abide by the laws” regarding commitments. He said the sheriff and the county will try to adapt to any changes in the law “while still being mindful of our limited personnel and financial resources.” He declined to comment on the specifics of the Sons case, which he didn’t work on.

Murray, Sons’ mother, was at a grocery store around noon the day her son died. As she picked out a watermelon, she thought about him, a fitness buff who loved fruits and vegetables. A strange thought crossed her mind: “Jimmy’s never going to eat watermelon again.”

When she got home, she got the call that he was gone.

John Sons, Jimmy’s half-brother, wrote in a text to Mississippi Today and ProPublica that the family is left with “complete and total guilt for putting him in the prison and always the wonder if we would not have done that move, if he would be with us today.”

But Richmond, the trusty who briefly shared a cell with Sons, testified that it was jail staff who “messed up.”

“He hung himself,” Richmond said. “I say this. God forgive me if I’m wrong. We couldn’t have saved that man from killing himself, but we could have saved that man from hanging himself in that jail.”

How We Reported This Story

No one in Mississippi has ever comprehensively tracked the number of people jailed at any point during the civil commitment process, according to interviews with dozens of state and county officials.

Last year, the state Department of Mental Health released, for the first time, a tally of people who were admitted to a state hospital directly from jail following civil commitment proceedings. The department tracked 734 placements in fiscal year 2022. (Under a law that takes effect this year, every county must regularly report to the department data regarding how often people are held in jail both before and after their commitment hearings.)

But that figure understates the scope of commitments. It doesn’t include people who were sent places other than a state hospital for treatment or who were released without being treated, and it counts only the time people spent in jail after their hearings. People can be jailed for 12 days before a commitment hearing, or longer if a county doesn’t follow the law.

County jail dockets can provide a more comprehensive picture, so Mississippi Today and ProPublica requested them from 80 of Mississippi’s 82 counties. Seventeen counties provided dockets that clearly marked bookings related to civil commitments — with notes including “writ to take custody,” “mental writ” and “lunacy.” In two more counties, we reviewed dockets in person.

Many counties didn’t respond, said their records were available only on paper or declined to provide records. Some cited a 2007 opinion by the state attorney general that sheriffs may choose not to enter the names of people detained during civil commitment proceedings onto their jail dockets.

After cleaning and standardizing the data from the dockets, we counted the number of jail stays involving civil commitments in which the person was not booked for a criminal charge on the same day. (We ended up excluding about 750 civil commitments for that reason.) If the dockets provided booking and release dates, we calculated the duration of jail stays.

Our count of commitments includes those for both mental illness and substance abuse. None of the jail dockets specified which commitment process people were going through, although some county officials said they don’t jail people committed for substance abuse and haven’t for years.

State laws regarding commitment for mental illness and substance abuse are different, but in many counties they were handled similarly until late 2021. That’s when the Mississippi attorney general’s office said state law didn’t allow people going through the drug and alcohol commitment process to be jailed.

To identify deaths of individuals held in jail during the civil commitment process, we reviewed news articles and federal court records. We also reviewed nearly 90 investigations of jail deaths from the Mississippi Bureau of Investigation. Most of the deaths had not previously been publicly reported.

For our survey of practices in other states, we contacted agencies overseeing mental health and disability advocacy organizations in every state and Washington, D.C. We received responses from one or the other in every location, and we received responses from both in 33. We also searched for news reports of similar cases in other states.

Do you have a story to share about someone who went through the civil commitment process in Mississippi? Contact Isabelle Taft at itaft@mississippitoday.org or call her at 601-691-4756.

by Kavitha Surana

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Since the Supreme Court overturned Roe v. Wade last year, doctors have warned that limiting abortion care will make pregnancy more dangerous in a country that already has the highest maternal mortality rate among industrialized nations.

The case of Mylissa Farmer, a Missouri woman, is one example. Last August, her water broke less than 18 weeks into her pregnancy, when her fetus was not viable. She was at risk for developing a life-threatening infection if she continued the pregnancy. Yet during three separate visits to emergency rooms, she was denied abortion care because her fetus still had a heartbeat. Doctors specifically cited the state’s new abortion law in her medical records and said they could not intervene until her condition worsened. She eventually traveled to Illinois for care.

Even for people who don’t develop sudden life-threatening complications, doctors note that carrying a pregnancy to term is inherently risky because rapid physical and hormonal changes can exacerbate chronic health conditions and trigger new complications. If more people are forced to continue unwanted pregnancies, there are bound to be more pregnancy-related deaths: A study by the University of Colorado estimates a 24% increase in maternal deaths if the United States bans abortion federally. They predicted the increase would be even higher for Black patients, at 39%. Currently, 14 states have total abortion bans.

Additionally, when abortion is illegal, it makes the procedure more dangerous for those who still try to terminate their pregnancies. The World Health Organization found that unsafe or illegal abortions account for up to 10% of maternal deaths worldwide.

As the United States enters its second post-Roe year, advocates say it’s important to gather data on the impact abortion bans are having on the health of pregnant people to help both policy makers and voters understand the life-or-death consequences of the restrictions. Without such accounting, they say, the public may remain ignorant of the toll. Maternal mortality rates would be a crucial gauge of impact.

Despite the stakes, experts say, at least in the short term, it may be difficult or impossible to track the number of lives lost due to limits on abortion access.

ProPublica spoke to four members of state maternal mortality review committees. Here are some of the challenges they see to drawing any clear conclusions from maternal mortality data in the near future.

The Data Can Be Inconsistent

Each state has its own system for compiling the data maternal mortality researchers work with. The quality of the data varies vastly by state. It can involve comparing birth and fetal death records, scanning through obituaries, and sometimes begging coroner’s offices to send death records. Many states are still working toward a complete system.

“It really depends on the rigor of the contributing entities,” said Dr. Michelle Owens, a maternal-fetal medicine specialist and the clinical chair for Mississippi’s maternal mortality review committee. “We rely so heavily upon the information we glean from these sources, and if that information is not as reliable … it will definitely have a negative impact on our work and understanding of what the contributing things may have been and what the gaps are.”

All the maternal mortality experts that ProPublica spoke with noted issues with the “pregnancy check box” used in death certificates to denote whether a patient was pregnant at the time of death or within the previous year. In Florida, Dr. Karen Harris, an OB-GYN and a member of Florida’s maternal mortality review committee, has observed the check box “overselect some patients who were never pregnant, or not pregnant in the last year, and it underselects patients who were pregnant.”

Sometimes the check box is wrong because of clerical errors, the researchers said. Other times, it’s simply not filled out because no autopsy was performed to verify whether the person was pregnant. That information could be important in measuring deaths that happen early in pregnancy — including murders. Homicide is a leading cause of death for pregnant or recently pregnant Americans, and researchers also would like to measure how abortion bans, which could force people in abusive relationships to carry unwanted pregnancies, affect those numbers.

Studying pregnancy-associated deaths within a year of pregnancy helps researchers account for any additional factors like substance abuse, unstable housing, suicide or mental health problems. These could be important in identifying deaths connected to continuing an undesired pregnancy.

The data can also be slow — some states, like Florida, provide data to the committee for the past year right away. But others are years behind. Currently, many states have only released data through 2019.

Records May Not Address Abortion Access

One of the thorniest questions facing maternal mortality experts: How can they determine if abortion access was a factor?

Dr. Lynlee Wolfe, an assistant professor at the University of Tennessee Medical Center and a member of the state’s maternal mortality review committee, wishes maternal mortality review reports could include a check box for the question, “Did inability to get an abortion play a role?”

“But you often can’t dig that out of notes,” she said. “I think what we’re asking is kind of an untrackable number.”

The experts said they could look into causes of death that may be linked to a patient’s inability to get an abortion when they’re having an emergency pregnancy complication: Sepsis, hemorrhage and heart issues, for example, are all worth studying to see if medical records might indicate if doctors delayed ending the pregnancy because the fetus still had a heartbeat.

But beyond that, when the pregnancy was unwanted or exacerbated broader health concerns, it could prove very difficult to determine if abortion access was a factor in the patient’s decision-making.

For example, if a patient had a heart condition that carried a 50% chance of death in pregnancy, researchers would like to see whether the patient was counseled about the risk and offered a termination.

But in a state that had criminalized abortion, “no one’s going to write that down,” said Harris, the Florida doctor. “So we won’t be able to know in the in-depth review if this was a patient choice — or if it was something that was forced upon her.”

Researchers might be able to learn more about the patient’s state of mind and whether the pregnancy was desired or not from interviews with family members and social service records, Owens, the Mississippi doctor, said. But there’s no guarantee they would have discussed their feelings about the pregnancy with family members either.

“With stigma and controversy surrounding conversations and considerations around abortions, people are hesitant to share those thoughts and feelings outside a very small circle of trust,” she said.

Risk of Political Interference

Maternal mortality review committees are funded by their states, and some are overseen by state legislatures.

The maternal mortality review members ProPublica spoke with said they did not anticipate interference with their report findings, even if they found examples where abortion access was a factor in a maternal death.

But some maternal care advocates worry such committees are vulnerable to political interference and manipulation. Last year, the Texas Department of State Health Services announced it was delaying its 2019 maternal mortality review report, originally scheduled for September 2022, until mid 2023.

Some saw the delay as a way to keep negative numbers out of the public eye during election season and postpone their release until after the 2023 legislative session had ended. A member of the review committee said she believed there was no legitimate need for the delay and that it was “dishonorably burying these women.” ProPublica reached out to the committee and the Texas health agency to ask about these concerns, but did not receive any response.

After pushback, the report was partially released in December 2022. It found persistent disparities affecting Black mothers and showed that the childbirth complication rate had risen 28% since 2018.

In July, Idaho disbanded its maternal mortality review committee, making it the only state without one. Lawmakers cited the costs of operating the committee — though members said operating costs were about $15,000 a year and covered by a federal grant. The decision came after a lobbying group argued that the committee was a “vehicle to promote more government intervention in health care” and opposed its recommendation to extend Medicaid coverage to mothers for 12 months postpartum.

The Sample Size Is Small

Maternal mortality rates in the U.S. are higher than in other wealthy countries and have been rising in recent years, so many resources are devoted to studying root causes of the trend and possible strategies for reversing it. But the actual number of deaths is statistically small: In 2021, the U.S. saw an estimated 32.9 deaths per 100,000 births, or 1,205 total pregnancy-related deaths, according to the Centers for Disease Control and Prevention.

This makes it difficult to draw conclusions that are rigorous by epidemiological standards, said Dr. Elliot Main, a Stanford professor and the former medical director for the California Maternal Quality Care Collaborative.

While researchers may learn of individual cases where it’s clear that abortion access was an issue in the patient’s outcome, it could take years to have a data set large enough to reveal a clear picture.

Main also pointed out that many other factors influence maternal mortality rates, which muddles the picture. “Maternal deaths are so rare and often complicated in their underlying causes,” he said. “If you see a trend over time, we have to break it down to see what’s really causing that.”

Before the Supreme Court’s decision in Dobbs v. Jackson Women's Health Organization struck down federal protections for abortion rights, U.S. maternal mortality rates were already rising. Influences include COVID-19, the opioid crisis and people having children at older ages, when they are at higher risk for complications. The U.S. also has long-standing racial and socioeconomic health care disparities affecting quality prenatal care — more than half of Georgia’s counties have no OB-GYN, for example. That can mean more patients go into pregnancy with undiagnosed health conditions and may be at higher risk for life-threatening complications.

Main and other researchers suggested that studying data on childbirth complications may provide more avenues for understanding the effects of abortion bans, because those are more common and would provide a larger data set to study.

Bans Don’t Prevent All Abortions

One reason the impact of Dobbs on maternal mortality rates could remain limited even in states that have banned abortion is that some people who want to terminate their pregnancy are still able to do so, either by traveling or by ordering abortion medication in the mail.

It’s impossible to know the full picture of how many are able to jump through the hoops and obtain abortions even when there are no legal options nearby. But WeCount, a research project led by the Society of Family Planning that has been collecting data from abortion providers, estimates that in the six months following Dobbs, about 35,000 people in abortion-ban states were able to get abortions in other states — just over half of the people estimated to have sought abortions in those states, based on numbers from the same time period the previous year. It’s unclear what happened to the other half. Some may have continued their pregnancies, others may have ordered abortion pills in the mail, which could be sent by organizations based in Europe and Mexico and not be recorded in any database.

Still, having to travel out of state to a limited number of abortion providers meant more patients were forced to wait until their second trimester, researchers said, when an abortion can be more complicated.

And while abortion pills are considered an exceedingly safe method of terminating a pregnancy through the first 10 weeks, according to the Food and Drug Administration and leading medical organizations, patients should still have the option to take them with the instruction and care of a medical provider, advocates say.

by James Bandler

ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive our biggest stories as soon as they’re published.

Reflecting rising concerns that Big Tech’s infatuation with artificial intelligence threatens privacy and economic competition, Sen. Elizabeth Warren has begun investigating Google’s efforts to swoop up medical information derived from biopsy specimens of millions of military service members.

Warren, a Massachusetts Democrat and the chair of the Senate Armed Services Subcommittee on Personnel, wrote on Tuesday to Google and the Department of Defense, seeking information and records related to the company’s pursuit of a vast trove of medical data overseen by the military’s Joint Pathology Center. The archive represents a largely untapped gold mine for AI and health care companies, because computers can use the data to develop algorithms that detect patterns, like telltale signs of tumors, faster and often better than humans can.

In her letters, Warren accused Google of “aggressive attempts” to gain service members’ medical information and Defense Department officials of “favoritism” toward the tech giant. “I am alarmed by reports that Google tried to privately broker a deal to secure exclusive access to JPC data,” Warren wrote to Sundar Pichai, CEO of both Google and its parent company, Alphabet.

Warren was referring to a ProPublica report published last December, which revealed that at least a dozen Defense Department staff members pushed back against Google’s campaign for the medical data. ProPublica found that Google began in late 2015 to gather medical information at military installations and hospitals around the country, which it planned to use to build AI tools. Such software, the company hoped, would give it an edge in the race to develop algorithms that could help pathologists diagnose illnesses more quickly and accurately, predict prognoses and, eventually, Google scientists hoped, find new treatments for diseases, including cancers.

Google’s allies in the Defense Department and on the staff of the House Armed Services Committee tried to help the company, ProPublica reported. In exchange for exclusive access to the archive, the company offered to digitize the collection of pathology slides that are stored at a sprawling warehouse in Silver Spring, Maryland. But staff at the JPC and elsewhere expressed dismay about risks to the privacy of service members’ tissue specimens and about the use of a sensitive government resource by a corporation to develop unproven AI tools. In 2021, Google was not selected for a pilot project to begin digitizing the collection.

“The public deserves a full accounting of DoD’s secretive interactions with Google regarding private health data contained at the JPC and complete transparency surrounding DoD’s blatant favoritism towards Google,” Warren wrote to Defense Secretary Lloyd Austin III. She has asked both Google and the Defense Department to respond by Aug. 8.

A Warren spokesperson characterized the letters as a “prelude to inform a potential Senate investigation and potential future legislation.” The senator said in a statement on Tuesday that the JPC “has millions of tissue samples from servicemembers and veterans that are meant to support the public good — but Google came dangerously close to landing an exclusive monopoly on these samples and the right to charge DoD for access to this data.”

A Google spokesperson declined to comment but referred ProPublica to statements and a blog post that the company published in response to the December story. “We had hoped to enable the JPC to digitize its data and, with its permission, develop computer models that would enable researchers and clinicians to improve diagnosis for cancers and other illnesses,” the company said then. “Despite efforts from Google and many at the Department of Defense, our work with JPC unfortunately never got off the ground, and the physical repository of pathology slides continues to deteriorate.”

A Defense Department spokesperson declined to comment, saying the agency doesn’t discuss communications with members of Congress. The JPC has said that its highest priority is to ensure that any medical information shared with outside parties is “used ethically and in a manner that protects patient privacy and military security.”

Since the Civil War, the U.S. military has been collecting and studying human tissue of armed service members in an effort to reduce the toll of injuries, diseases and fatalities suffered in wartime and peace. The collection has spurred numerous advances in medicine and science, including the first genetic sequencing of the 1918 flu virus. Today, the repository holds more than 31 million matchbook-sized blocks of human tissue and 55 million pathology slides.

Pathology is ripe for the AI revolution. A single pathology slide, which can be scanned and digitized, holds vast amounts of visual information. In 2021, Google told the military that the JPC collection of veterans’ skin samples, tumor biopsies and slices of organs holds the “raw materials” for the most significant biotechnology breakthroughs of this decade — “on par with the Human Genome Project in its potential for strategic, clinical, and economic impact.”

But lawmakers, regulators and ethicists have struggled to keep pace with developments in AI. Some models can process information now at a scale that’s beyond human comprehension.

The corporate use of the JPC collection is particularly delicate. Most of the specimens come from military service members who did not consent to the use of their tissue for research. In addition, there are national security ramifications. China has already collected huge health care data sets from the U.S., both legally and illegally, as it seeks to develop its own AI capabilities, according to the National Counterintelligence and Security Center.

Warren has emerged as one of Google and Big Tech’s most vocal critics on Capitol Hill. In 2019, she assailed the company’s efforts to amass millions of patient records in a partnership with the Catholic health care system Ascension, dubbed “Project Nightingale.”

Doris Burke contributed research.

by Jeff Ernsthausen

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Once a week, a little past noon on Wednesdays, a line of cars forms outside the wrought-iron gates of the Carolands mansion, 20 miles south of downtown San Francisco. From the entrance, you can see the southeast facade of the 98-room Beaux Arts chateau, which was built a century ago by an heiress to the Pullman railroad-car fortune. Not visible from that vantage point is the stately reflecting pool, or the gardens, whose original designer took inspiration from Versailles.

I was sitting just outside this splendor, idling in my rented Toyota Corolla, on a clear day last winter. Like the other people in the line of cars, I was about to enjoy a rare treat. Carolands is an architectural landmark, but it’s open only two hours a week. Would-be visitors apply a month in advance, hoping to win a lottery for tickets. Like most lotteries, this one has long odds. I had applied unsuccessfully for the three tours scheduled for February. Finally, I resorted to my journalist’s privilege: I emailed and called the director of the foundation that owns the estate, explaining that I was a reporter planning to be in the area for a few days. Could she help? Eventually, she called back and offered me a place on a tour.

It wasn’t supposed to be this difficult. When billionaire Charles Johnson sought a tax break in 2013 for donating his mansion to his private foundation, the organization assured the Internal Revenue Service and state officials that the public would be welcome. “The Foundation will fulfill its charitable and educational purpose by opening the Carolands Estate to the public,” it stated in its application for tax-exempt status, which included a pamphlet for a self-guided tour. The foundation later told a California tax regulator that the estate was open to the public every weekday from 9-5.

The Carolands Estate (San Francisco Chronicle/AP Images)

There was a lot of money at stake. Johnson, a Republican megadonor and part owner of the San Francisco Giants, had gotten an appraisal valuing the property at $130 million, a price higher than any publicly reported home sale in the U.S. up to that time, and five times the $26 million he and his wife, Ann, had reportedly paid 14 years earlier to buy and restore what then was a dilapidated property.

The plan worked. The IRS granted the foundation tax-exempt status. That allowed the Johnsons to collect more than $38 million in tax savings from the estate over five years, confidential tax records show.

But the Johnsons never opened Carolands to the public for 40 hours a week. Instead, the foundation bestows tickets on a few dozen lottery winners, who receive two-hour tours, led by docents, most Wednesdays at 1 p.m. Self-guided tours, like the ones described in the attachments to Johnson’s IRS application, are not offered. “It sounds like a vanity project with little to no public benefit,” said Roger Colinvaux, a professor of law at The Catholic University of America who specializes in the tax law of nonprofit organizations. (Experts also questioned Carolands’ $130 million valuation — which turbocharged the Johnsons’ deduction — while acknowledging that as long as it’s based on a qualified appraisal, which it was, the IRS is unlikely to challenge the size of the deduction.)

Charles Johnson and his wife, Ann, collected more than $38 million in tax deductions as a result of donating their estate. (Mike Coppola/Getty Images for the New York Philharmonic)

For the ultrawealthy, donating valuables like artwork, real estate and stocks to their own charitable foundation is an alluring way to cut their tax bills. In exchange for generous tax breaks, they are supposed to use the assets to serve the public: Art might be put on display where people can see it, or stock sold to fund programs to fight child poverty. Across the U.S., such foundations hold over $1 trillion in assets.

But a ProPublica investigation reveals that some foundation donors have obtained millions of dollars in tax deductions without holding up their end of the bargain, and sometimes they personally benefit from donations that are supposed to be a boon to the public. A tech billionaire used his charitable foundation to buy his girlfriend’s house, then stayed there with her while he was going through a divorce. A real estate mogul keeps his nonprofit art museum in his guesthouse and told ProPublica that he hadn’t shown it to a member of the public since before the pandemic. And a venture capitalist couple’s foundation bought the multimillion dollar house next to their own without ever opening the property to the public.

Unlike public charities, private foundations are typically funded by a single donor or family, who retain a high degree of control long after receiving a tax break for ostensibly giving their possessions away. “This is the classic problem with private foundations: Substantial contributors can see it as their thing,” said Philip Hackney, a law professor at the University of Pittsburgh and former IRS attorney. “There’s generally not a coalition who cares, other than the family, so there’s nothing to ensure that the assets are used for a particular purpose,” he added.

In theory, it’s illegal to fail to provide a public benefit or to make personal use of foundation assets. But the rules defining what’s in the public interest are vague, according to tax experts; for example, Congress has never defined how many hours a museum would need to be open to be considered accessible to the public. And with the IRS depleted by a decade of budget cuts, enforcement has been lax. The agency examines an average of 225 returns among the 100,000 filed by private foundations each year, according to agency statistics.

Peter Kanter, an attorney representing the Carolands Foundation, told ProPublica that “we believe pretty strongly that the foundation is serving its purpose of preserving and showcasing this historic and unique property to the public.” He said that tours are limited because the foundation has only a few volunteer docents who are knowledgeable about the home, and because significantly higher traffic might compromise the foundation’s ability to preserve its unique architecture. Kanter also emphasized the public value of free charitable events that the foundation occasionally hosts for other nonprofits at the estate.

At the Carolands, guides didn’t emphasize benefits to the public — just the opposite. A docent told my tour group that the foundation prefers lotteries to holding regular hours and charging admission. This, he explained, preserves the home for those who “really want to see it.” Indeed, exclusivity and rarefied taste were a theme of the tour, which included tales of the exacting specifications of Harriett Carolan, the Pullman heiress, a Francophile who imported an entire salon that had been built in France on the eve of the revolution. (For their parts, when Ann and Charles Johnson unveiled the restored chateau at a costume party, they dressed as Marie Antoinette and Louis XVI.)

Before the tour, one of the docents asked how many of us had ever visited a nearby historical mansion, called the Filoli estate, built in the same era as the Carolands. Many hands shot up among the tour group. When he asked if any of us had visited the Carolands before, no one raised their hand.

Curious, I popped by Filoli the following afternoon. It is run by a public charity and is open from 10 to 5 every day. In contrast to the Carolands, I was able to simply show up, pay admission and enter. Inside, I encountered dozens of employees who provided helpful information and watched over the manor and its gardens while more than a hundred visitors wandered about. Photography, which had been prohibited inside the Carolands, was permitted at Filoli.

Congress and the IRS have never clearly defined what qualifies as a “public benefit.” By contrast, identifying a private benefit is much simpler. Decades ago Congress prohibited what it called self-dealing by insiders. The laws are designed to keep them from using or profiting from foundation assets. Among other things, the rules bar leases between a donor and their foundation. Violations can incur a penalty known as an excise tax.

At least one billionaire appears to have run afoul of those real estate rules, according to tax experts. Since 2009, Ken Xie, CEO of a cybersecurity company called Fortinet, has gotten more than $30 million in income tax deductions for contributing shares of his business to a private foundation that he started to support various charitable causes.

In 2017, Xie’s foundation (whose sole officers are Xie and his brother) spent $3 million to purchase a home in Cupertino, California, from his new girlfriend while he was going through an acrimonious divorce. After the foundation purchased the home, Xie allowed his girlfriend to continue living there; he also stayed there for a time. These details emerged in a lawsuit filed by the now-ex-girlfriend, who was permitted to file the suit anonymously, in county court. (The suit is ongoing.) According to leases filed in the case, the foundation charged her rent, but Xie agreed to pay half of it.

Xie himself appears to have been aware that he risked violating the rules. In a December 2019 text message to his girlfriend that was included in the court case, Xie wrote, “I covered some house part but also try not creat issue related to foundation and tax, believe will make some progress next few months by transfer house out of foundation, may need 2 step by first transfer to other entity.” The next month, his foundation transferred the property to an LLC.

Ken Xie, CEO of cybersecurity company Fortinet, has earned more than $30 million worth of tax deductions by donating shares to a private foundation. (K.Y. Cheng/South China Morning Post/Getty Images)

In an email to ProPublica, Gordon Finwall, a lawyer for Xie, said the foundation is “fully committed to complying with all applicable rules and regulations.” He acknowledged that Xie “spent some time at the Cupertino property in 2017 and 2018,” but asserted that the sublease was never in effect and Xie never paid his ex-girlfriend any rent.

Two days after I emailed Finwall in April inquiring about the Xie Foundation’s purchase of the house, the foundation filed records with the California attorney general’s office, stating that it had “discovered a self-dealing event” and including a federal tax return with the word “amended” handwritten at the top. In his email to ProPublica, Finwall said that, after amending its returns, the foundation “paid some excise taxes related to Mr. Xie’s stay at the property.” Finwall also said that Xie had planned to file the amended returns months earlier but didn’t do so because his accountant mailed the IRS forms to Xie at an outdated address.

Despite the blurriness of many rules relating to foundations, the issue of public access has given rise to controversy in the past. After a New York Times article in 2015 exposed the limited hours of many private museums, the Senate Finance Committee, under then-chairman Orrin Hatch, launched an investigation. Hatch expressed concerns about museums that require advance reservations and maintain limited public hours. He questioned instances where “founding donors continue to play an active role in management and operations of the museum” and “museum buildings are adjacent to the donor’s private residence.”

But no meaningful rule changes followed the investigation. And absent new laws, cracking down on abusive foundations would require the IRS to put scarce resources into an area that many experts said simply isn’t a priority, particularly after the agency’s previous attempt to police abuse by political nonprofits a decade ago caused a conservative firestorm.

The agency doesn’t appear likely to increase oversight any time soon. A recently published budget blueprint outlining IRS priorities for the $80 billion in new funding it received from the Inflation Reduction Act made no mention of increasing audits of private foundations.

“The IRS protects the public interest by applying the tax law with integrity and fairness to all,” the agency wrote in a statement to ProPublica. The statement cited a compliance program that “focuses on high-risk issues” among tax-exempt organizations, and it asserted that the program “deploys the right resources to address noncompliance issues.” The IRS also pointed to a recent tax court case that it won against a foundation that, among other things, kept a collection of African artifacts in a basement with no public access. And an agency spokesperson highlighted a rule stating that foundations can lose their exempt status if they operate in a manner “materially different” than what they claimed they would do in their initial application.

Despite the attention spurred by the Hatch investigation, some foundations seem to have continued undeterred. Consider the Lijin Gouhua Foundation. Collecting Chinese paintings and sharing them with the public was the stated mission of the organization, which was launched by Bay Area venture capitalists J. Sanford “Sandy” Miller and his then-wife, Vinie Zhang Miller, in 2006. Since then, the couple generated $5.6 million worth of income tax write-offs largely from donating shares of tech companies like Twitter and Snapchat to their private foundation.

When the couple cashed in the foundation’s stock to buy a potential museum space for the art in 2017, they opted against a high-traffic location where lots of people could easily access it. Instead, they chose the $3.1 million house adjacent to their own estate in Woodside, an exclusive enclave outside of San Francisco.

“A private museum is usually by appointment only,” Vinie Miller said when asked about the out-of-the-way location. “We wouldn’t hold long showing hours. It’s usually people we have a relationship with.” She said that the main way for the public to access the collection was through loans of artwork the foundation has made to universities, other museums and galleries. (In an email, Sandy Miller wrote: “Please be advised that I am not married to Vinie and that I have no involvement with the Lijin Gouhua Foundation.” Public records show Vinie filed for divorce from him in 2019; Sandy ceased to be listed as president of the foundation on IRS filings that year as well.)

The museum that was purchased with the foundation’s tax-exempt funds never actually opened. Vinie Miller said the plan was “hypothetical” and that the foundation held the home as an investment instead. That’s at odds with the foundation’s publicly available tax returns, which have listed the property as being used for charitable purposes. (Miller did not respond to a follow-up question asking about the discrepancy between her statements and the foundation’s tax returns.) As Colinvaux, the specialist in nonprofits, put it, “If it’s an investment asset, then it’s not a charitable use asset, and they shouldn’t be counting it as such” on their IRS filings.

In one similar instance involving another foundation, the IRS expressed hesitation about the organization’s plans, then backed off. In 2006, San Diego real estate magnate Matthew Strauss sought a $4 million write-off for the guesthouse that held part of his contemporary art collection. An IRS employee wrote that it appeared Strauss and his wife “are using the assets of the Foundation (the guest house gallery) as a facility for housing and displaying a large portion of their personal art collection for their enjoyment and benefit as well as the enjoyment and benefit of invited guests.” The employee wanted to know when actual art would be donated, what kind of access the public would have to the gallery, and how the couple planned to inform people that they could visit, among other things.

The couple’s lawyer assured the IRS representative that she’d gotten the wrong impression. The Strausses would host no personal events there and the public would have access to view the collection “upon request.” The couple anticipated donating “substantially all” of their $50 million collection to the foundation. They couldn’t say when, but the couple planned to make donations “in a fashion that minimizes income taxes.”

As 2006 turned into 2007 with no sign that the IRS would bless its museum tax deduction, the couple sought political help. In January, the head of the IRS’ tax-exempt division received a letter from the office of Sen. Dianne Feinstein (D.-Calif.), inquiring about the delay in approving the application from the couple, who’d given her more than $15,000 over the past few election cycles. That June, their application was approved. (“The senator was not advocating in support of the constituent’s application, but instead requested clarification on the case after nine months of an inability to resolve the case,” a spokesperson for Feinstein said, noting that her office frequently sends such letters on behalf of constituents).

As of 2021, 15 years after the Strausses’ lawyer told the IRS they would donate $50 million in art, the foundation holds $6 million worth. The rest remained in a private trust.

To learn more about Strausses’ gallery, I tried to schedule a visit earlier this year. As with Carolands, I was able to get in, but it took some effort. The foundation’s website doesn’t list an address or hours of operation. A contact form available for visitors to inquire about tours wasn’t working when I tried it repeatedly. I ultimately had to pester employees of Strauss’ real estate company for a couple of weeks before someone responded and asked me to submit a biography for their boss to review. (My bio described me as a reporter with ProPublica, with the first coverage area listed as “tax policy.”)

Soon after I sent in my biography, I received a call from Matthew Strauss himself. After a brief conversation, he declared me “worthy” of the first tour he said he’d given in three years and sent along directions to the museum.

I didn’t see any signs outside the couple’s estate, nicknamed Rancho Del Arte, that indicated a museum could be found anywhere on the premises. From the outside, their guesthouse seemed relatively unassuming, its multimillion-dollar value betrayed only by the horse stables and privacy hedges of the nearby mansions I passed on the way in. A path wide enough for a golf cart wound its way through a grove of palm trees, past oversized sculptures and a private tennis court, to the Strausses’ own sprawling abode a hundred yards or so away.

The inside was more remarkable. The Strausses remodeled the building in the early 2000s with custom fixtures to illuminate works from their collection of contemporary art. Sounds and music from dueling audiovisual works on the main floor flooded the space, while the click-clack of a never-ending ping pong game echoed up from a conceptual piece in the basement. These noisier forms shared space with paintings on canvas and metal and with textured mixed-media compositions.

Dressed in sweats and sporting a Bentley baseball cap, Strauss personally led my solo tour, meandering from one prized possession to the next. He exhibited an uncanny memory for how he obtained each piece, likening the acquisition process to the thrill of a hunt. (“Once you get the fox, it’s not as much fun.”) He spoke of one painting as “my poor man’s ‘Mona Lisa’” and another as “my victory piece.”

Matthew Strauss in front of “Sunshine and Snow,” by Kenneth Noland, at his foundation’s museum. (Jeff Ernsthausen/ProPublica)

Halfway through my visit, we stopped to take in the view from the museum’s balcony. “At this point, you can see why I had to buy this property,” he told me, explaining that he’d bought the guesthouse from his neighbor in the late 1990s to keep anyone else from moving in. “Anybody here, they would have knocked it down, and you know, really ruined our privacy.”

As the tour continued from room to room, Strauss leaned into his persona as a friendly professor. He asked probing questions about each modern piece before delving into centuries of art history. “I really show [people] how to look at art, I don’t just tell them ‘This is So-and-So,’” he said, recalling the tours he used to give to college students.

Before the pandemic, the foundation would conduct a dozen or two dozen tours each year, drawing a total of about 400 visitors to the gallery, according to the foundation’s website. But even as California’s other museums welcomed guests back in the spring of 2021, the foundation remained dormant.

Strauss acknowledges the tax benefits of having the foundation and maintained that he had made efforts to make his art available to the public. “I feel like I have an obligation to show it, but it’s got to be under favorable conditions,” he said. He’d told me he’d like to get tours going again, but only when schools and universities stop requiring masks and start treating COVID-19 “like normal.”

Strauss said he gets requests from individuals to see the collection “all the time.” But, he added, “to show one or two, it’s not worthy. It’ll wear me out.” Letting people come on their own was out of the question (they might damage the art), as was having regular public hours (it’s a zoning issue, he said, and the neighbors would never go for it). Strauss declined to respond to a list of follow-up questions that I sent after the tour.

A couple months from turning 90, Strauss was more focused on the big picture. Sooner or later, he said, he plans to give away most of the collection, which he estimates to be worth hundreds of millions of dollars. Most of his personal collection will go to the Museum of Contemporary Art San Diego, while the foundation’s assets will go to the University of California, San Diego under a deal that is in the process of being finalized.

As we made our way through the gallery, Strauss paused before a reproduction of a Life magazine cover featuring the 1964 World’s Fair in New York. Did anything catch my eye about it, he asked.

I stared for a moment.

“Why don’t you knock on it,” he suggested. “Maybe that’ll help you.”

Strauss sensed my hesitation to touch the art — he wanted me to see it was made of metal — and tried to put me at ease.

“You’re not supposed to,” he chuckled. “But this is my museum!”

For this story, ProPublica reviewed a nationwide database of parcels provided by the real estate data analytics firm Regrid to find homes owned by private foundations.

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Paul Kiel and Andrea Suozzo contributed data analysis.

by Robin Urevich, Capital & Main, with additional reporting by Gabriel Sandoval, ProPublica, photography by Barbara Davidson for ProPublica

This article was produced for ProPublica’s Local Reporting Network in partnership with Capital & Main. Sign up for Dispatches to get stories like this one as soon as they are published.

On her first day in office last December, Los Angeles Mayor Karen Bass declared a state of emergency over housing and homelessness, promising to provide shelter for people living on the streets and make it easier for developers to build affordable housing.

At the time, I was a few weeks into my fellowship with ProPublica’s Local Reporting Network. I had previously worked on a two-year series of stories on housing for Capital & Main and found that while the city struggled to create affordable housing, some low-income residents were losing homes they’d lived in for years, especially in areas where property values were rising.

The Bass administration clearly aimed to create more affordable housing. But I wondered whether the city was effectively using its enforcement mechanisms to preserve the dwindling supply of low-cost housing that already existed.

With Gabriel Sandoval, a research reporter at ProPublica, I found that in 2008, the LA City Council had passed a law aimed at reserving more than 300 residential hotels as low-cost housing. We decided to see if it was working.

An excerpt from an LA ordinance regulating the demolition and conversion of residential hotel units

Residential hotels provide small, basic rooms, sometimes with shared bathrooms. They often house low-income workers and elderly and disabled people who can’t afford other apartments. City officials determined the hotels were residential by using the state’s legal definition: buildings of six or more units that served as permanent housing for their residents.

Gabriel and I searched hotel webpages and online travel sites and found that some places, like the H Hotel in Koreatown, which are supposed to remain available to local residents, had instead morphed into tourist accommodations.

Once a Residence, Now a Tourist Hotel The H Hotel’s website has a gallery of interior and exterior photos. The building, formerly known as the East West Hotel, in April 2011. It was designated as a residential hotel in 2008 and again in 2011. (Via Google Maps)

El Patio Inn in Van Nuys bills itself as “an inexpensive hotel near Universal Studios Hollywood.”

“Experience the effervescent spirit of Los Angeles with a stay at El Patio Inn, your gateway to the city’s most notable attractions,” the hotel’s website says. “Whether you’re looking to be mesmerized by the magic of Universal Studios Hollywood, enchanted by the art treasures of The Getty Center, or drawn into the allure of Hollywood’s star-studded Walk of Fame, El Patio Inn provides a convenient base for your LA adventures.”

City officials had designated El Patio as residential in 2008. The owner appealed, and in 2013, a Housing Department hearing officer affirmed its residential status, according to the agency’s records. El Patio’s general manager didn’t return phone calls seeking comment.

Eventually we identified 21 residential hotels with more than 800 rooms in total advertising to tourists, in apparent violation of city law.

Promoting Local Attractions El Patio Inn was designated as a residential hotel in 2008, and that decision was affirmed in 2013. (Screenshot by ProPublica)

With their own websites, ads on booking sites and Yelp and Google reviews, these hotels didn’t hide their efforts to draw business and leisure travelers. For example, the Hometel Suites website describes the hotel as “modern,” “boutique” and “the perfect central base to explore all the great restaurants, shops and tourist attractions that Los Angeles has to offer.”

Points of Interest Hometel Suites, designated a residential hotel, advertises rooms to tourists. (Screenshots by ProPublica)

Visitors can book rooms for up to $235 per night and even a “party hall” for $450.

Hometel Suites general manager Becky Hong had previously said the hotel has no plan to offer residential rentals but didn’t respond to a question about whether its tourist accommodations violate the law.

Travelers on a budget can find a “family room” for $175 per night at the Lincoln Park Motel, whose website advertises the property’s proximity to “Downtown Los Angeles, Dodgers Stadium and many other attractions.”

A Budget Honeymoon Suite The Lincoln Park Motel offers rooms near Los Angeles attractions as well as a honeymoon suite with a hot tub. (Screenshots by ProPublica)

Lincoln Park owner Jeffrey Xiao didn’t return calls and declined to answer questions about his property’s short-term rental ads. “No, thank you for reaching out to me,” Xiao texted.

We wondered, if we were able to find what seemed like violations so easily, why city leaders weren’t doing more to enforce the ordinance.

We asked officials if any of the 21 hotels were exempt from the law or had received city clearance to convert to tourist use. (The law allows owners to apply for exemptions from the residential hotel law if they can prove they have not historically operated as long-term housing. It also allows hotel owners to convert their properties to other uses if they either replace the affordable housing or pay into a city housing fund.)

While we waited for answers, we visited some of the hotels to see for ourselves how they were being used.

A map outside Hometel Suites illustrates attractions in California. Outside the American Hotel this summer (Capital & Main)

Some hotels had undergone seemingly obvious transformations. The H Hotel, formerly known as the East West Hotel, replaced its old sign on the building’s brick exterior with a big neon H. The property now includes a bar and a cafe with sidewalk seating.

The H Hotel’s operations manager, Nojan Haddadi, didn’t respond to an email requesting comment. He previously said the hotel offers only short-term rentals and has asked the city to remove its residential designation. The hotel’s owner previously declined to answer questions, citing advice from his attorney.

At other hotels, we found tourists outside.

El Patio Inn advertises its proximity to Universal Studios Hollywood.

These guests who were in town for a Dodgers baseball game were staying at the Knights Inn.

The Knights Inn is within walking distance of Dodger Stadium.

Knights Inn owner Charles Wang said the inn has always operated as a hotel and blamed the previous owner for failing to respond to the city when it put the building on the residential hotel list. The hotel’s franchise agreement requires it to be used for short-term rentals, he said.

The Housing Department told us that low staffing made it difficult to enforce the residential hotel law and that sometimes hotels barred its inspectors from coming in without an administrative warrant. Inspectors didn’t obtain warrants to enter the hotels, a process that would have entailed a day’s work, Housing Department code enforcement director Robert Galardi said.

After our story, the department said it would immediately investigate the 21 hotels and review its enforcement practices. Department spokesperson Sharon Sandow wrote in an email that the agency is “aggressively reviewing and investigating all the leads you provided and additional information as well. We are pursuing all avenues under the Code.”

Through our reporting, we obtained more than 10,000 pages of Housing Department records in response to California Public Records Act requests.

Housing Department correspondence and other documents showed all 21 hotels had been deemed residential and were subject to the city’s residential hotel law. For example, this 2013 letter from the Housing Department to an attorney representing the American Hotel confirmed its status.

This letter was sent to the American Hotel owner’s attorney, confirming that it is designated as a residential hotel. (Obtained by ProPublica)

But nearly all of the American’s rooms are currently offered to tourists, not residents.

Mark Verge, the American’s owner, said he didn’t recall the letter between his attorney and the Housing Department and has always operated the American as a hotel: “I have a hotel license. I pay bed tax.”

This Housing Department document shows the American Hotel was deemed residential in 2008.

When housing inspectors visited the American and other hotels, they appeared to miss what seemed like clear signs that the hotels offered short-term rentals.

At Hollywood’s Las Palmas Hotel, an inspector snapped this 2019 photo to show windows had been replaced without a permit. (You might recognize this hotel from the final scene of “Pretty Woman.”)

A portion of a 2019 inspection report showing the city cited the Las Palmas Hotel for replacing windows without a permit. There’s no indication the inspector asked about the sign. (Obtained by ProPublica)

The inspector cited Las Palmas for an illegal construction violation, but there is no record that he inquired about the sign that advertises “daily” and “weekly” rentals. Until recently, we found, the hotel was booking nightly rentals through its website. One of the hotel’s owners, Ashok Vanmali, declined to comment.

Last year at the H Hotel, a Housing Department inspector noted that a manager told him directly that the hotel was a “transient hotel,” using the legal term for hotels that rent rooms to travelers, and not a residential one.

But the inspector didn’t cite the H Hotel for violations of the residential hotel ordinance.

After we published our initial story, the mayor’s office asked the Housing Department to account for how some residential hotels had apparently turned into tourist lodging and how it could prevent these transformations from happening in the future. The Housing Department said that it would report back by the end of August.

Many hotels continue to advertise online.

by Alec MacGillis

ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive our biggest stories as soon as they’re published.

For the nation’s schoolchildren, the data on pandemic learning loss is relentlessly bleak, with education researchers and economists warning that, unless dramatic action is taken, students will suffer a lifelong drop in income as a result of lagging achievement. “This cohort of students is going to be punished throughout their lifetime,” noted Eric Hanushek, the Stanford economist who did the income study, in ProPublica’s recent examination of the struggle to make up for what students missed out on during the era of remote learning.

For the burgeoning education technology sector, however, the crisis has proven a glimmering business opportunity, as a visit to the industry’s annual convention revealed. The federal government has committed $190 billion in pandemic recovery funds to school districts since 2020, and education technology sales people have been eagerly making the case that their products are just what students and teachers need to make up lost ground.

“We’re huge in learning loss,” said Dan DiDesiderio, a Pittsburgh-area account manager for Renaissance Learning, a top seller of educational software and assessments. He was talking up his company’s offerings in the giant exposition hall of the Philadelphia Convention Center, where dozens of other vendors and thousands of educators gathered for three days late last month at the confab of the International Society for Technology in Education. For DiDesiderio, who was a school administrator before joining Renaissance, this meant explaining how schools have been relying on Renaissance products to help students get back on track. “During COVID, we did see an increase across the board,” he said.

Renaissance is far from the only player in the ed tech industry that is benefiting from the surge in federal funding, and the industry enjoyed a huge wave of private funding as the federal tap opened: The annual total of venture capital investments in ed tech companies rose from $5.4 billion to $16.8 billion between 2019 and 2021 before tailing off.

The largest chunk of the federal largess, $122 billion that was included in the American Rescue Plan signed by President Joe Biden in March 2021, requires that schools put at least 20% toward battling learning loss, and companies are making the case that schools should spend the money on their products, in addition to intensive tutoring, extended-day programs and other remedies. “The pandemic has created a once-in-a-lifetime economic opportunity for early stage companies to reach an eager customer base,” declared Anne Lee Skates, a partner at venture capital firm Andreessen Horowitz, in a recent article. (Her firm has invested in ed tech companies.) The federal funds “are the largest one-time infusion of funds in education from the federal government with almost no strings attached.”

Five days before the convention, the National Center for Education Statistics had released the latest devastating numbers: The decline in math scores for 13-year-olds between the 2019-20 and 2022-23 school years was the largest on record, and for the lowest-performing students, reading scores were lower than they were the first time data was collected in 1971.

But the mood was festive in Philadelphia. The educators in attendance, whose conference costs are generally covered by their district’s professional development funds, were excited to try out the new wave of nifty gadgets made possible by the advances in artificial intelligence and virtual reality. “For a lot of us, it’s like coming to Disneyland,” said one teacher from Alabama.

One could also detect the slightly urgent giddiness of a big bash in its final stages. Schools need to spend most of their recovery funds by 2024, and many have already allocated much of that money, meaning that this golden opportunity would soon close. And summer is the main buying season, with the fiscal year starting July 1 and with educators wanting their new tools delivered in time for school to start in the fall.

Hanging over the proceedings was an undeniable irony: The extent of learning loss was closely correlated to the amount of time that students had spent doing remote learning, on a screen, rather than receiving direct instruction, and here companies were offering more screen-based instruction as the remedy. Few of the companies on hand were proposing to replace the classroom experience entirely with virtual instruction, but to the degree that their offerings recalled the year-plus of Zoom school, it could be a bit awkward. “A lot of people don’t like us, because we can do remote-school stuff,” said Michael Linacre, a salesperson for StarBoard Solution, before demonstrating one of the cool things a StarBoard whiteboard could do: He jotted 1+2= with his finger and up popped 3. “There’s a mixed feeling about that now.”

Most of the vendors were not about to let that awkwardness get in their way, though, as they cajoled teachers to listen to their pitch, often with the lure of free swag.

“I love the shirt — I’m a huge ’N Sync fan,” said a library technology specialist from a New Jersey elementary school at the booth for BrainPOP, a group of educational animation websites whose display included a T-shirt that nodded to the 1990s boy band. The vendor praised the teacher for getting the reference — the union guys setting up the expo had totally missed it, he said — and told her that all one had to do to get one of the shirts was attend one of several pitch sessions during the day. “Students who use BrainPOP two or more times a month show measurable gains toward grade-level proficiency,” asserted a large poster listing the various sessions.

Nearby, a Microsoft salesperson named Mike had a full audience sitting on white settees arrayed in his zone as he launched into his demonstration of the company’s new AI tools for helping kids learn to read aloud. He showed how a program called Reading Coach captured video of a student reading a passage aloud and flagged mispronunciations, with an automated voice declaring, “These words were the most challenging for you.” There were even more features in the offing, Mike said; the program would soon produce comprehension questions to ask about whatever passage the teacher gave the students to read, and it would soon be able to gauge students’ level of expressiveness, too.

One might wonder what all this would leave to the actual teacher, but Mike assured the audience that Reading Coach would simply allow educators to focus on other tasks. “It’s a time saver,” he said.

In fact, education technology is replacing teachers in another sense: A large share of the vendors on hand were themselves former educators who had left the classroom for jobs with tech companies, where they could still feel like they were involved in education, but without the stresses of the classroom and often with higher pay. One former first grade teacher who had made this transition herself two years ago said she had seen the trend accelerate among her colleagues during the pandemic, when the challenges of juggling hybrid online and in-person instruction and managing students who were struggling with learning loss and delayed socialization had made jobs in ed tech seem especially alluring.

Remote learning “flipped the field on its head,” she said. “We were getting a lot more responsibilities than before, a lot more hours, a lot more stress.” At the first of the two ed tech companies she has worked for, she said, “almost everyone was an ex-teacher hired the past couple years. Ed tech is a good space for teachers to go to: It’s a corporate job, but they respect the skills that teachers have.”

Knowing that the ed tech sector was not only seeking a large share of federal recovery funds for schools but also playing a role in the teacher shortage gave the proceedings an extra edge. The profusion of inventively named vendors was overwhelming: Beanstack, Impero, Bluum, Archangel, Teq, Ozobot, Nuiteq, Vivacity, Figma. Kami and Hāpara sounded more like Ikea furniture, but no, they were here, too.

Among the rookie attendees wandering the hall was Joseph Tey, a Stanford computer science major. He was there with a classmate to ask teachers how they felt about the rise of AI. Were they worried about students cheating? Were they going to incorporate AI into their instruction? “Tech adoption in education is tough,” Tey said. “Do you adopt something only when the fire is under your ass? COVID was one fire. This is another fire.”

The COVID-19 fire had been great for one vendor, Wakelet, a website that allows users to pull together videos, images and text files into a single webpage, for use by individuals who want to to promote a resume or body of work or by teachers seeking to present information on a given subject. Its use by teachers had boomed during remote learning, said co-founder Rick Butterworth. “The pandemic was really a benefit for us because we had so many users who came on board,” he said. “2020 was an interesting year for us.” The site has been free to use, with the company funded for several years by angel investors, he said, but it was now about to start offering tiered paid plans for schools, ranging up to $6,000 per year. Among the features available to paying customers: “bespoke professional development.”

Across the aisle, a vendor named Whitney, a former elementary school librarian, was corralling passersby for her next pitch session for MackinMaker. “Have a seat! We’re about to have a demo. It’s really fun. Just fill out the card for the giveaway.” The giveaways were T-shirts that were waiting on each chair.

“It’s all about the giveaway,” said one teacher, with gentle sarcasm, as she took her seat.

Whitney gave her pitch for MackinMaker’s online e-book marketplace. After she was done, her colleague Ethan told the teachers, “If you need a different size T-shirt, let us know.”

Luring teachers into pitches was easiest at the various sellers of virtual reality headsets, some of which had long lines of educators waiting their turn. I tried a headset from ClassVR that was playing virtual reality programs from Eduverse. The first scene was a pastoral landscape of fields and stone walls whose context was unclear until the vendor explained that it was a scene from the Civil War. She clicked over to another of Eduverse’s 500-odd options, this one featuring men building railroads in the 19th century, where I accidentally got myself hit in the head, virtually, by a sledgehammer.

Schools could buy eight of the headsets for $4,299, or 30 for $16,999, the vendor said. Sales in recent years had been “amazing, in terms of rapid growth.”

The afternoon of the convention’s opening day was wearing on, and the conference tote bags were already getting overstuffed with all the free swag. Conveniently, Kahoot (an Oslo-based operation with the slogan “Make learning awesome”) was giving out tote bags as prizes for those who won in demonstrations of its AI-generated quiz games. I participated in a game with questions about the Fourth of July and was frustrated to accidentally input the wrong answer on my smartphone in response to a question about the size of the U.S. population in 1776. (The correct answer was 2.5 million.)

The Kahoot vendor handed out the three tote bags to the victorious educators, who would have two more days of conventioneering to fill them up. “Did you learn something about Independence Day?” she said.

A few weeks later came a reminder that the stakes for the ed tech sector went far beyond tote bags and T-shirts: Kahoot announced that a group led by Goldman Sachs’ private equity division was buying it for $1.7 billion.

by Ava Kofman

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Last week, regulators rolled out enhanced oversight for new hospices in Arizona, California, Nevada and Texas. The Centers for Medicare and Medicaid Services, which pays for most of American hospice care, announced that this change was spurred by “numerous reports of hospice fraud, waste, and abuse” and “serious concerns about market oversaturation.”

In November, ProPublica and The New Yorker highlighted that the four states were overrun with for-profit hospices, many of them sharing the same addresses and owners. Some of these hospices obtained licenses only to sell them to other entrepreneurs. Others appeared to be billing Medicare for “phantom” — that is, nonexistent — patients. Some did both. The government’s own data revealed a pattern of rapid hospice growth in the four states, far outstripping the demand for services.

Rapid Rise in Hospices Concentrated in West and Southwest

A ProPublica analysis of Medicare data reveals a sharp uptick in providers since 2018.

(Source: CMS data set of Medicare-certified hospices. Chart by Lena Groeger.)

During the new oversight period, which can last up to a year, Medicare and its contractors will now scrutinize the claims submitted by new hospices in these states before they pay them. This process — often known as “medical review” or “pre-pay review” — will make it more difficult for a hospice to bill the government for inappropriate patients or medically unnecessary services. Theresa Forster, vice president for end-of-life care policy at the National Association for Home Care & Hospice, praised this action, which all four industry trade groups had recommended. “This gives new hospices an opportunity to start off on the right foot and identify any problem areas from the start,” she said.

The change is part of a larger effort by CMS this year to address fraud, waste and abuse in its hospice program. In January, CMS overhauled its inspections of hospices, with the changes going into effect immediately. In March, the agency released a proposed rule that would require further analysis of the number of patients leaving hospice alive, the diagnoses provided on hospice claims and Medicare hospice spending. And in April, the agency made hospice ownership data public for the first time. The data will allow patients and families to better discern whether their hospice is for-profit or not-for-profit — a distinction that, as researchers have shown, can significantly affect the quality of care. “It’s plain and simple: families deserve transparency when making decisions about hospice and home health care for their loved ones,” Department of Health and Human Services Secretary Xavier Becerra said in a statement. “Shining a light on ownership data is good for families, good for researchers, and good for enforcement agencies.”

These reforms were prompted not just by the ProPublica-New Yorker story but by the continued pressure from lobbyists and lawmakers in its wake. This spring, during hearings held by the Senate Finance and House Ways and Means committees, members cited the investigation as they questioned Becerra on the agency’s next steps for tackling hospice profiteering. In one exchange, Becerra testified that his inspectors had “conducted some unannounced site visits of the hospices identified by that article” and that an audit of suspicious providers was underway. Legislators have sent a series of public letters to HHS, requesting urgent briefings and actions on hospice fraud, including two this summer. The most recent letter, released last week and signed by 26 representatives from both parties, applauded CMS’ commitment to addressing hospice abuse while also requesting further reforms, including targeted moratoriums in high-growth areas and standards to rein in deceptive marketing practices.

“This is an area that escapes partisan gridlock,” Rep. Earl Blumenauer, D-Ore., one of the letter’s signatories and coordinators, told me. “No one sympathizes with people who are cheating this system, particularly when you are involving some of America’s most vulnerable populations.”

Palliative care physicians have also been pushing for stricter guidelines. In April, the Journal of Palliative Medicine published a statement of “Core Roles and Responsibilities” signed by 325 doctors in the field. The group was motivated to issue the statement, it wrote, “out of concern for physician colleagues who may be asked to participate in hospice programs that are staffed, structured, and operated in ways that put patients and families at risk of poor care, and concomitantly expose physicians to violations of clinical and ethical standards.” Among other improvements, it called for hospices to strengthen their staffing, training and frequency of visits.

Ira Byock, the lead author and the former president of the American Academy of Hospice and Palliative Medicine, said that the condition of hospice care in the United States represented a “true public health crisis.”

This year has also seen a spate of further reporting, commentary and research on the profit motive in hospice, including a detailed report on private equity’s role in hospice care from the Center for Economic and Policy Research. Eileen Appelbaum, the center’s co-director and one of the co-authors of the report, “Preying on the Dying,” said that she has long been concerned about how investors can harm vulnerable patients and families. “Problems of asymmetric information — most patients and their caregivers have no prior experience with hospice care — further increase the difficulty of overseeing private hospice agencies,” the report notes.

Ben Marcantonio, the interim CEO at the National Hospice and Palliative Care Organization, the industry’s largest trade group, said that “in my experience, whether hospices are gaming the system is not a direct reflection of tax status. What we need is the right stewardship of taxpayer dollars, so the right delivery of care is provided at the right time with the right amount of resources.”

Blumenauer told me that he and other legislators were committed to checking in with CMS and trade groups like NAHC and NHPCO about ongoing, collaborative efforts to reform the hospice program. “Your article struck a chord on a series of levels,” he said. “We are going to continue pounding away on this issue.”