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by Lisa Song and Lylla Younes, photography by Kathleen Flynn for ProPublica

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One summer night last year, air began flowing into a steel canister across the street from the Little Bo Peep Child Development Center in Calvert City, Kentucky. The pollution monitor hummed into the morning as parents dropped off their toddlers and later into the day as the kids played outside. Within a month, a lab analysis would reveal that the canister had captured a troubling concentration of ethylene dichloride, which has been linked to pancreatic and stomach cancers and leukemia.

No one, however, raced in to warn parents or alert nearby residents that the air they sucked in with every breath was laced with a poisonous chemical. No one took immediate steps to stop the stream or sue the offending polluter into compliance.

In fact, that Calvert City monitor had been running all year, along with two others around town. Each of them had registered more ethylene dichloride than any of the 123 other monitors nationwide designed to detect the chemical. The results had been logged by Kentucky regulators and uploaded to a database managed by the Environmental Protection Agency.

If my child attended that day care, “I would be very concerned and working tremendously to get them into another school,” said Wilma Subra, an environmental health expert who advises the EPA on community concerns, after reviewing a summary of the air-monitoring results at ProPublica’s request.

It’s examples like Calvert City, experts say, that expose an infuriating conundrum with the U.S. systems for protecting citizens from dangerous pollution: Regulators install air monitors to flag hazardous emissions from local companies, then pull their punches in taking action against the offenders.

Meanwhile, the monitors serve as a false promise to residents that the findings will be used to keep them safe. Some people believe the mere existence of monitoring is “protecting them” from harm, said Barbara Morin, an air pollution expert at a nonprofit that advises the environmental regulators of eight Northeastern states. “Unfortunately, sometimes there’s just the monitoring and nothing happens to change the situation.”

ProPublica spent the last year crisscrossing the country to detail the failures of the EPA and state regulators to measure and address the community impacts of industrial toxic air pollution. The series of stories resulted in immediate response, including promises by the EPA to install monitors and track outputs — a move hailed as a victory for local communities. Residents of many of the toxic hot spots had spent years begging regulators to install them.

But an examination of the long history of air monitors in Calvert City shows that even when the monitors capture years’ worth of evidence that a polluter is putting a community in harm’s way, the path to clean, safe air is rocky and filled with well-funded obstacles, misdirection and inaction.

An air monitor maintained by Kentucky environmental regulators has been located behind Calvert City Elementary School for about a decade.

In this remote industrial city of 2,500, where manufacturing has long been king, regulators have had proof for at least three decades that residents are breathing dangerous amounts of air pollution. During that time, the EPA and the state have amassed an extraordinary amount of documentation establishing not just how hazardous the air is in Calvert City, but where the worst pollution is coming from.

They’ve watched in real time as the problem got worse and as the estimated cancer risks of area residents crossed the threshold level that the EPA considered acceptable — in places, reaching 17 times that limit.

Nicole Deziel, a Yale epidemiology professor and environmental health expert, said it could take decades to see the damage. Researchers often find themselves lagging behind, studying emerging cancer clusters and trying to reconstruct the cause, Deziel said. In Calvert City, where there’s already data that pollution levels exceed what’s considered safe, “we have the opportunity to actually intervene,” she said.

State and federal regulators have an arsenal of ways to do so and hold the culprits accountable, including levying millions in fines, requiring pollution controls and launching criminal investigations.

And yet, as the history of Calvert City shows, such action isn’t a given. In the face of a global petrochemical corporation, in a company town where residents are reluctant to criticize their employers, regulators have, again and again, stopped short of using all the tools at their disposal.

“Good Neighbor”

Founded on a railroad stop near the Tennessee River, Calvert City began attracting industrial development after the Kentucky Dam brought cheap electricity to the region in the 1940s. By 2020, more than a quarter of the private-sector jobs in surrounding Marshall County came from chemical plants and other manufacturing, with wages well above those in other fields. Every year, local families gather for a “Good Neighbor Night” hosted by a collection of plants whose employees hand out free swag, such as lawn chairs printed with the companies’ logos, as a turtle mascot named Wally Wise Guy teaches kids how to shelter in place in the event of an industrial accident.

Westlake Chemical moved into town in 1990, expanding over time into three plants — a maze of industrial boilers, tanks and wastewater ponds, with innumerable smokestacks and vents and pipes. The plants make polyvinyl chloride, better known as PVC, and petrochemicals used in construction, packaging and other goods. The company got regulatory permits that authorized it to release thousands of pounds of carcinogens a year, but almost from the start, additional, unauthorized releases accidentally seeped or leaked into the air, according to EPA records. It wasn’t just ethylene dichloride, but vinyl chloride, which is highly flammable and has been associated with brain, liver and lung cancers. (The company did not respond to multiple requests for comment).

A Westlake chemical plant in Calvert City.

While a few plants run by other companies nearby also emitted these chemicals, Westlake’s authorized emissions would come to dwarf theirs. According to the most recent four years of available federal data, Westlake released at least 48,000 pounds of ethylene dichloride per year; the other companies combined released just 1 pound. Westlake’s annual vinyl chloride emissions during that time were at least 28 times that of the others.

Within eight years of Westlake’s opening, state and federal regulators had already been alerted to problems at the sprawling compound. In the decades that followed, news articles and regulatory documents would chart the company’s checkered record with the chemicals. In 1998, for example, Westlake told the EPA that it hadn’t released any ethylene dichloride into the water when it had actually released more than 8,000 pounds, according to an EPA complaint. In 2001, it waited more than an hour before reporting a 2,727-pound leak; the same happened four years later, after a release of 7,700 pounds, the complaint said. The company was supposed to immediately inform a federal center for chemical accidents if it leaked 100 pounds of the potent carcinogen into the air.

Shortly after that leak in 2005, the local emergency response system made thousands of automated calls warning residents to shelter indoors, The Paducah Sun reported. The system had been adopted after 5,000 pounds of leaking vinyl chloride caused a fire and explosion at the plant in 2002. Despite the calls in 2005, a Westlake manager told The Associated Press that air monitors hadn’t detected the carcinogen outside the plant’s boundaries.

In 2010, the EPA took the aggressive step of announcing a consent decree, a settlement that involves complex negotiations with the help of the Department of Justice. Under the terms of the decree, Westlake agreed to pay $800,000 and create a vast leak detection plan. Failure to meet those terms could lead to daily penalties of up to $5,000. The EPA predicted this would force Westlake to cut emissions of vinyl chloride by 2,300 pounds a year and of ethylene dichloride by 1,300 pounds per year.

Less than a year later, more than 11,000 pounds of vinyl chloride and 2,000 pounds of ethylene dichloride streamed out of a hole in a piece of Westlake piping, according to state and federal records. The leak destroyed the EPA’s goal in a single day; the agency later found Westlake hadn’t inspected the piping for mechanical integrity.

“Negligence Loophole”

With that leak in 2011, state regulators believed they had three separate air pollution violations, but Westlake wielded its legal might to fight back.

In the company’s lengthy response to regulators, a Westlake manager interrogated the definitions of basic terms like “equipment leak” or “standard” and argued that none of the violations were valid. In response, Kentucky regulators rescinded one of them, noting that the federal rule only applied to leaks during startups, shutdowns or malfunctions. Then they offered a startling rationale: The leak didn’t count as a “malfunction” because the problem partly stemmed from “poor operations and maintenance.”

“We are left with this loophole,” the regulators wrote.

Experts say such exit ramps from regulation are not uncommon. The system often presents a “laundry list of defenses” to polluters, said Seema Kakade, a former attorney in the EPA’s civil enforcement division who is now a law professor at the University of Maryland. Some provide leeway for unavoidable accidents and some are negotiated end-runs around the rules by corporate or other special interests, she said — with large, wealthy companies poised to take advantage.

Westlake benefited from what was “basically a negligence loophole” that “allows plants to avoid accountability even for releases caused by their own poor operations and maintenance,” Jim Pew, an attorney for the nonprofit group Earthjustice, said in an email. His organization has spent decades advocating for stronger EPA rules.

Left: Calvert City, located in western Kentucky. Right: The Westlake Chemical Corporation facility in Calvert City.

Over the next few years, the EPA unearthed four more leaks caused by faulty inspections or testing. However, none of these incidents broke the terms of the consent decree, as the agency concluded that these leaks concerned “alleged violations” of a different regulation from the one cited in the consent decree, said Tim Carroll, deputy press secretary for the EPA. (Carroll said Westlake has continuously demonstrated compliance with the 2010 settlement.) Despite the continued problems, and additional leaks cited by state regulators, Westlake was able to expand one of its plants — a move with so little pushback from the state that then-Gov. Steve Beshear, a Democrat, attended the ceremony. (Beshear didn’t respond to a request for comment.)

In 2017, two state environmental investigators were on the highway when they spotted a plume of black smoke, which they traced to a flare at a Westlake plant. Flares reduce pollution by burning off toxic gases, and they’re much less effective when there’s visible smoke. When the inspectors parked outside the facility fence to take photos, a Westlake security officer came out “and, after we had introduced ourselves, asked us to leave this location,” an inspector wrote in a report, which they did. Hours later, the plume of smoke was still visible from 10 miles away.

Though this violation and others at the same plant could have entailed millions in penalties, the agency offered Westlake a $350,000 settlement, according to an email from Beth Clemons, a Kentucky environmental enforcement specialist, to Westlake. In the email, obtained through open records requests, Clemons called it “a good deal.”

Westlake flatly disagreed. “$350,000 may be a good deal if there were violations, which we clearly believe there are not,” Kevin Sheridan, a Westlake health, safety and environment manager, wrote in an email.

Clemons responded that state regulators believed “the violations are valid and we are pretty much in total disagreement with what you are saying.”

The parties eventually agreed on a $175,000 penalty and a list of required repairs — a sanction that experts say amounts to a financial hiccup for the corporation that owns Westlake. Last year, Westlake’s parent company, Westlake Corporation, reported $2 billion in net income from dozens of facilities across North America, Europe and Asia.

Such penalties are “like a nuisance to the facility. It doesn’t serve as a significant deterrent,” said Scott Throwe, a former senior staffer in the EPA’s Office of Enforcement and Compliance Assurance. Wealthy corporations see it as “the cost of doing business.”

In response to questions about the effectiveness of its enforcement actions, John Mura, director of communication for the Kentucky regulator, said in a statement that his agency “remains committed to safeguarding the health of all Kentuckians and believes that it has acted appropriately under its regulatory authority.”

Even the better-resourced EPA rarely seeks maximum fines, said George Czerniak, a former enforcement officer in EPA’s Midwest regional office. Doing so involves going to court, and there is no guarantee the judge will rule favorably. The risk, he said, has made the agency skittish about pursuing aggressive sanctions in court. In the 35 years he spent on air pollution enforcement covering six states, Czerniak recalled fewer than 20 cases that ended up before a judge or jury.

If the EPA is going to take a case to court, then it needs to be “assured this is an important case,” Czerniak said — and one that “we can win.”

Limited budgets and EPA leaders’ changing priorities drove a decline in EPA enforcement actions from 2007 to 2018, according to a recent EPA Inspector General report. In 2009, the office that manages Kentucky conducted 2,700 inspections and other related activities to ensure polluters were following the law; that number plummeted more than 50% over the next decade. After Donald Trump became president, his administration deferred more enforcement cases to the states; Throwe said state agencies are more hamstrung by political pressure and less able to act decisively. “That’s why EPA is supposed to be the neutral entity that goes in,” he said.

The EPA wrapped up another investigation of Westlake in 2019, issuing a consent agreement and final order for a series of leaks that occurred more recently. The order, which is less serious than a consent decree, came with a $49,000 penalty. The company also had to buy $183,500 worth of equipment for local emergency responders. Four additional EPA inquiries of Westlake violations over the past decade have resulted in less than $150,000 in penalties.

Throwe said it would have been more effective to require Westlake to install no-leak valves and other devices to reduce leaks.

“This shows how hard it is to actually effect change,” he said.

“You Can’t Use That”

Manufacturers in Calvert City benefited from yet another flaw in oversight: Even when regulators stocked the town with air monitors that logged damning evidence, bureaucratic bungles and missed opportunities rendered them virtually useless.

Alarm bells about dangerously dirty air began going off as far back as 2005. Some of the more than 10,000 air samples collected statewide by Kentucky regulators over the prior 15 years showed “levels of concern” in Calvert City, and officials announced a work group to investigate “elevated levels of hazardous air pollutants,” the Courier-Journal in Louisville, Kentucky, reported.

Between 2005 and 2007, state regulators installed five monitors in town, including the one at Calvert City Elementary School, across the street from the Little Bo Peep day care center.

Air monitors installed between 2005 and 2007.

Once every six days, the monitors took a 24-hour sample that was analyzed for ethylene dichloride, vinyl chloride and other hazardous pollutants. “What they’ve done here is way more air monitoring than what’s required by any EPA program,” said Morin, the Northeastern air pollution expert. “So the state clearly recognized there was some issue they wanted to deal with.”

By 2015, a quarter of the samples from the monitor closest to Westlake’s vinyls plant had levels of ethylene dichloride that violated EPA’s long-term cancer risk guidelines.

But an EPA audit that year found a critical flaw in the data; the state had never created a quality-assurance plan for the monitors, detailing the procedures to ensure that the collected data was reliable and accurate. Neglecting to do so, Throwe said, “gives ammunition to the industry to say, ‘You can’t use that.’”

Kentucky officials say they didn’t break any rules in their failure to implement a quality-assurance plan. But a spokesperson for the EPA regional office in charge of Kentucky said the federal government required such a plan.

The agency ordered the state to develop one in 2015, but two years later Kentucky still didn’t have one. By then, every one of the five monitors had captured elevated cancer risks, with ethylene dichloride and vinyl chloride the chief culprits. The EPA considers a 1 in 10,000 risk as acceptable, meaning that if 10,000 people in an area are exposed to a certain level of hazardous air pollution over a lifetime, at least one person would develop cancer as a result. (These EPA guidelines are used to calculate community cancer risk, and it’s nearly impossible to tie an individual cancer case to emissions from a specific facility.) In Calvert City, at least one sample showed cumulative risk as high as 60 times the limit, according to a 2017 risk screening analysis conducted by the EPA.

“Overall, the weight of evidence indicates that high levels of several VOC air toxics are present in the air in the Calvert City area,” concluded a report from Kentucky regulators and the EPA, while acknowledging that the lack of a quality-assurance plan “may affect the potential legal defensibility of the prior data collected.”

Mura said the state didn’t develop a plan because “no specific data monitoring objective was identified by EPA or Kentucky for the data collected.” Mura said his agency doesn’t know how many residents were exposed to those concentrations or for how long.

The failure to come up with a plan — rendering the results vulnerable to challenge — was baffling to experts and advocates. Monitoring for hazardous air pollutants is a costly, painstaking endeavor; no regulator would operate multiple monitors for years without a good reason, several experts told ProPublica. “You would think you’d want to get data that you can use,” Czerniak said.

And despite its worrisome conclusions, neither the EPA nor state regulators told residents about the cancer analysis. Billy Pitts, public health director of the Marshall County Health Department, said no one has contacted his office.

“We’ll Cross Those Bridges When We Get There”

It wasn’t until 2020 — five years after it was ordered to do so and 15 years after concerns about toxic air pollution were first raised — that Kentucky finally put in place a quality-assurance plan that would make the monitors’ data usable in serious enforcement efforts. It was the seventh straight year that one of Westlake’s plants emitted more ethylene dichloride than any other polluter in the country.

In 2020, the EPA installed new monitors in town after conducting air modeling to find the areas with the highest concentrations of the dangerous chemicals. The agency modeled vinyl chloride and ethylene dichloride emissions from the three Westlake facilities and three other nearby plants. Federal data shows that Westlake releases far more of these compounds than the other companies: Since 2010, only one of the non-Westlake plants has leaked vinyl chloride (a 15-pound leak in 2014), and none has leaked ethylene dichloride, according to state records. In contrast, regulators have cited Westlake at least a dozen times for leaking these and other hazardous compounds.

EPA and state regulators are analyzing data from the new monitors (and the one at the school) that was gathered from October 2020 to September 2021. A cancer risk analysis will be shared with the community once it’s complete.

Air monitors for the October 2020-September 2021 study. The EPA modeled emissions from the six facilities shown in order to determine the monitors’ locations. Two of the monitors were placed to catch the highest concentrations of ethylene dichloride and vinyl chloride; the monitor at the school indicates what people are exposed to near the center of town.

If the results show a cause for concern, then “we’ll cross those bridges when we get there,” said Pitts, the health director, during an interview in his office. After ProPublica described the elevated levels from the past decade, Pitts said he wouldn’t “get too concerned until I see the facts that are presented.”

He later explained his department conducts a community health assessment once every three years, using data from local hospitals, schools and other sources. After ProPublica showed him air-monitoring reports from the EPA and state regulators, Pitts shared the materials with the team developing the health assessment, he said. The next assessment is scheduled for June, and the community would help decide the top public health concerns.

Interim updates from the current study, obtained through public records requests, show higher concentrations than the earlier data. While average ethylene dichloride levels at one monitor near the Westlake plants exceeded the EPA’s cancer risk guideline by 40% in 2017, the newer data showed the levels exceeded the limit by 600%. When ProPublica showed the data to Morin, the concentrations were so high in Calvert City that she initially thought there’d been a mistake.

Czerniak, the former EPA regional enforcement officer, said that if he were in charge, he would assign three of the federal agency’s technical experts and a couple of attorneys to do a deep dive on the Westlake plants and neighboring polluters. Czerniak has conducted similar investigations during his time at EPA, he said. If the agency found that specific air-permit violations at any Calvert City facility are pushing air pollution past acceptable cancer risk, he said, it should require the facilities to fix the root cause. If the excessive risk is caused by the sheer quantity of local facilities, the case could be referred to EPA headquarters with the request that tighter emission limits be put on these types of facilities.

In an email, Carroll, the EPA spokesperson, said the agency “is continuing to take steps to address noncompliance” at Westlake’s plants. In response to questions about the company’s pattern of violations, Carroll cited the ongoing study in Calvert City and said the EPA “will address any noncompliance identified using the appropriate enforcement tools.”

The EPA is also investigating Westlake’s flares at its Calvert City and Lake Charles, Louisiana, facilities, according to the company’s 2021 annual report to the U.S. Securities and Exchange Commission. The EPA has worked on the case since 2014 and “indicated that it is seeking a consent decree that would obligate us to take corrective actions,” the report said. The decree could lead to penalties “in excess of $1 million,” the report continued. “We do not believe that the resolution of these flare matters will have a material adverse effect on our financial condition, results of operations or cash flows.” (An EPA spokesperson said the agency “cannot comment on potential or ongoing investigations.”)

It might be time to raise the stakes by building a criminal case against Westlake, Czerniak said, as even the threat of a criminal investigation could change the facility’s behavior. “I realize that agencies have limited capacity to undertake criminal-type proceedings, but heck, when you have a community that is exposed” to cancer risks up to 60 times the EPA’s acceptable limit, he said, “make no mistake ... there are people who are being impacted.”

The motivation to hold the polluter accountable may need to come from regulators, as most residents ProPublica encountered in Calvert City were unaware of Westlake’s environmental record or the pattern of alarming air-monitoring data. When a reporter and photographer visited community leaders in March, we found that no one had heard of ethylene dichloride, and most did not know there was an air monitor at the school. Some expressed concern after learning about elevated levels of carcinogens.

“We know the EPA monitors the area,” said Tammy Blackwell, director of the county library system. “I would hope that if anything was significant enough that we needed to be made aware of it, the EPA would let us know.”

Tammy Blackwell, Director of the Marshall County Public Library.

Marshall County Schools Superintendent Steve Miracle was even blunter: “You can’t just record it. ... You would think if they’re the EPA, they can actually go in and help those companies come up with a solution for correcting that.”

Others did not want to talk about the companies that support the tax base and employ their friends and family.

Mayor Gene Colburn didn’t respond to multiple inquiries for this story, including messages left in person. (The mayor and three of the six City Council members work for local chemical plants, but not for Westlake.) The principal of Calvert City Elementary School, Kendra Glenn, declined through a representative to listen to a single question when ProPublica reporters visited in March.

Connie Monroe, who owns the Little Bo Peep day care across the street, said that she’d want to learn more about the pollution if it’s harming the kids she cares for, but that her husband recently retired from a local chemical plant. “It’s made our living,” she said, “so I’m not going to say anything critical.”

Chemical plants “do a lot for the community,” retired nurse Sherry Todd said on a recent spring day while watching her grandson’s soccer practice. The plants pay taxes that go toward “making Calvert City nice.” She had no qualms about air pollution or the plants hurting the town. “I can’t believe they’d do something intentionally,” she said.

Sherry Todd, right, watches her grandson's soccer practice.

About the Story

Last year, ProPublica conducted an analysis of data from the EPA’s Risk Screening Environmental Indicators model to identify hot spots of cancer-causing industrial air pollution across the United States. We then compared the results of our analysis to data from the EPA’s Air Quality System (AQS), which is a database of state, local and federally collected ambient air-monitoring samples. Because the EPA does not require states to set up air monitors near most major sources of toxic air pollution, we were unable to make comparisons in many of the hot spots that we identified. We filtered and sorted the data to understand which air monitors in the AQS network were picking up high concentrations of cancer-causing chemicals. Calvert City stood out, particularly for its concentrations of ethylene dichloride, a potent human carcinogen. Our analysis of the RSEI model indicated that Westlake was the dominant driver of cancer risk in Calvert City, so we began investigating the enforcement history of the facility and the reason the monitoring program was established there in the first place. We obtained documents through public records requests and correspondence with the EPA and Kentucky Division for Air Quality.

Do You Live Near an Industrial Facility? Help Us Investigate.

Mariam Elba contributed research.

Update, May 19, 2022: This story has been updated to reflect that information about the air-monitoring data could end up in the upcoming Marshall County Community Health Assessment.

by Charles Ornstein

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Twelve years ago, ProPublica set out to build a first-of-its-kind tool that would allow users, with a single search, to see whether their doctors were receiving money from an array of pharmaceutical companies.

Dollars for Docs generated a huge rush of interest. Readers searched the database tens of millions of times to see if their doctors had financial ties to the companies that made the drugs they prescribed. Law enforcement officials used it to investigate drug company marketing, drug companies looked up their competitors and doctors searched for themselves.

A trove of recently released documents offers the public an unvarnished look inside those relationships from the perspective of drug companies themselves. The material shows company officials worked to deflect the media scrutiny even as they sought to take advantage of relationships that they had built with doctors they were paying significant sums of money.

The documents were published online by the University of California San Francisco and Johns Hopkins University and became available as a result of drugmakers settling lawsuits against them for their role in the opioid crisis. These are exactly the kinds of documents we wanted to see when we started working on the Dollars for Docs series in 2010, but of course, no one was willing to show them to us.

Reading them should give patients even more pause about the financial entanglements their doctors have with the drug industry and spur them to ask questions (we have some ideas about specifics below).

The Washington Post mined the records and found that more than a quarter of the 239 medical professionals ranked as top prescribers by opioid maker Mallinckrodt Pharmaceuticals in 2013 “were later convicted of crimes related to their medical practices, had their medical licenses suspended or revoked, or paid state or federal fines after being accused of wrongdoing.” The article was replete with examples of doctors whose problems were well known but who were targeted anyway by sales representatives.

This was a familiar finding. Back in 2010, we found that hundreds of doctors paid by drug companies to promote their drugs had been accused of professional misconduct, were disciplined by state boards or lacked credentials as researchers or specialists.

The document trove included some mentions of our earlier work.

Among them: a 2010 email from a senior director of global compliance at Cephalon Inc., a small drug company that was subsequently acquired by Teva Pharmaceuticals.

In the message, the director notes that what ProPublica found — Cephalon had paid doctors who had been sanctioned by their states to deliver promotional talks on its behalf — was, indeed, true, and that the company was undertaking a review of all of its doctors in light of our findings.

(Screenshot by ProPublica)

Another document included a list of those doctors.

And there’s a 2017 presentation from an official at Mallinckrodt about the state of transparency around payments to doctors. It called ProPublica the “most thorough and vocal media source re: Open Payments data. Their analyses and searchable database are likely the go-to place for anyone wanting to do a comparison of companies and physicians.”

(Screenshot by ProPublica)

Our Dollars for Docs data often was picked up by news outlets across the country, including WNBC-TV in New York City. In one document, a spokesperson for the company Covidien was happy that the reporter had not asked about Exalgo, a new opioid made by the company. “Based on our conversation, I do not believe that the reporter is aware of Exalgo — and I am certainly not planning to make him aware,” she wrote in 2013.

The document trove also shows firsthand how drug companies targeted doctors and used information purchased from data brokers to rank them and gain insight on how many of their drugs each doctor prescribed each week.

When we first started working on our stories, we were very eager to see what pharma drug reps knew about the prescribing practices of doctors. So we asked a company then called IMS Health, which purchased data from pharmacies on which drugs each doctor prescribed and then sold it to the drug companies, if it would sell that data to us. IMS, now known as IQVIA, told us we could not buy the data at any cost.

The document trove includes a number of samples of what that data looks like and makes clear why the industry was so reluctant to have it come into public view.

The following chart was put together for Covidien about Exalgo. For every doctor in the Las Vegas region, it shows their prescribing, by week, of the drug and notes whether they are a “target.”

(Screenshot by ProPublica)

Documents then show how such information was used when meeting with doctors. In this email, a Covidien drug rep brags about how she was able to turn a doctor’s office staff into allies who would feed her information and talk up the company’s drugs to the doctor. “The nurse got very excited ... and wanted to know all about the product, the coverage, how to use it, etc. She even took the liberty of detailing the doctor when he walked into to (sic) lunch as well.”

(Screenshot by ProPublica)

The documents also showed how closely Covidien measured the performance of drug reps in getting doctors to prescribe their drugs.

(Screenshot by ProPublica)

Covidien spun off Mallinckrodt in 2013 as a specialty pharmaceutical company, managing drugs such as Exalgo. (Mallinckrodt stopped promoting Exalgo in 2015 and no longer sells it.) Covidien focused on medical devices and was acquired by Medtronic.

In 2020, Mallinckrodt agreed to pay $1.6 billion to settle with states and the federal government for its role in the opioid crisis. That figure has since grown to $1.725 billion. In response to a request for comment, a spokesperson for the company sent a statement identical to one it had sent to the Post: “While Mallinckrodt does not agree with the allegations regarding decade-old issues, it has spent the past three years negotiating a comprehensive, complete and final settlement that resolves the opioid litigation against it, provides $1.725 billion to a trust serving affected communities, and allows Mallinckrodt to continue to serve patients with critical health needs under an independently monitored compliance program.”

This year, Mallinckrodt also agreed to pay $260 million to resolve allegations that it underpaid rebates to the Medicaid program and paid illegal kickbacks related to another of its drugs, H.P. Acthar Gel. As it happens, ProPublica has also written about that drug, raising questions about the public spending on it in light of questions about its efficacy.

We stopped updating our Dollars for Docs tool in 2019 because the government’s Open Payments database is robust and refreshed annually and has gotten better with time.

Still, searching through these documents reinforced my view of how important it is for patients to know about their doctors’ relationships with drug companies and talk directly to their doctors about the drugs they are prescribed.

Here are some of the questions you may want to ask:

• What type of work do you do with these companies?
• Have you prescribed me any drugs that are manufactured by companies you’ve taken payments from?
• Are there non-drug alternatives that I may want to consider first?
• Are there less expensive generic alternatives to the drugs you have prescribed?
• What devices have you used in my care that are manufactured by companies you’ve taken payments from?

Have you used Dollars for Docs or Open Payments? What have you found? I’d love to hear your story.

by Sarah Smith

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When it comes to reproductive care, Mississippi has a dual distinction. The state spawned the law that likely will lead to the Supreme Court striking down Roe v. Wade. It is also unique among Deep South states for doing the least to provide health care coverage to low-income people who have given birth.

Mississippians on Medicaid, the government health insurance program for the poor, lose coverage a mere 60 days after childbirth. That’s often well before the onset of postpartum depression or life-threatening, birth-related infections: A 2020 study found that people racked up 81% of their postpartum expenses between 60 days and a year after delivery. And Mississippi’s own Maternal Mortality Review Committee found that 37% of pregnancy-related deaths between 2013 and 2016 occurred more than six weeks postpartum.

Every other state in the Deep South has extended or is in the process of extending Medicaid coverage to 12 months postpartum. Wyoming and South Dakota are the only other states where trigger laws will outlaw nearly all abortions if Roe falls and where lawmakers haven’t expanded Medicaid or extended postpartum coverage.

“It’s hypocrisy to say that we are pro-life on one end, that we want to protect the baby, but yet you don’t want to pass this kind of legislation that will protect that mom who has to bear the responsibility of that child,” said Cassandra Welchlin, executive director of the MS Black Women’s Roundtable, a nonprofit that works at the intersection of race, gender and economic justice.

Efforts to extend coverage past 60 days have repeatedly failed in Mississippi — where 60% of births are covered by Medicaid — despite support from major medical associations and legislators on both sides of the aisle.

Mississippi House Speaker Philip Gunn, a Republican, said shortly after he killed the most recent bill that would’ve extended postpartum coverage that he’s against expanding any form of Medicaid. “We need to look for ways to keep people off, not put them on,” he told The Associated Press in March. When asked about the issue during a May 8 interview on CNN, Mississippi Gov. Tate Reeves said, “When you talk about these young ladies, the best thing we can do for them is to provide and improve educational opportunities for them.” (Neither Gunn nor Reeves responded to requests for comment.)

During the pandemic, a change in federal rules prevented states from cutting off Medicaid recipients, which has allowed people in Mississippi and elsewhere to retain postpartum coverage beyond 60 days. But at the end of the federal public health emergency declaration — which is set to expire in July 2022 — states will revert to their prior policies. “What we are afraid of is that when that does end, it will go back to what we knew was pre-pandemic health care,” Welchlin said.

We discussed the implications of Mississippi’s post-Roe reality with Welchlin and two other experts in the field: Alina Salganicoff, the Kaiser Family Foundation’s director for women’s health policy, and Andrea Miller, president of the National Institute for Reproductive Health. Their answers have been lightly edited for length and clarity.

What services does Medicaid provide postpartum?

Salganicoff: Typically, everything from assistance if the person is having problems breastfeeding to screening for depression services.

Welchlin: We know the struggles of so many who have had life threatening illnesses such as heart conditions and hypertension. We know of course that Medicaid helps in that.

What have you seen in terms of postpartum needs in Mississippi?

Welchlin: One of the stories that really touched me over the course of this pandemic was that of a mom who already had a child, and she needed access to child care so she could get back and forth to the doctor. During this particular pregnancy she had a severe heart disorder where she couldn’t breathe, and she had to get rushed to the hospital. Because she was so connected to doulas and a supportive care organization like us, she was able to get admitted and sure enough that’s when they diagnosed her with that heart condition. And she was a mom on Medicaid.

What happens when mothers lose Medicaid coverage postpartum?

Miller: Only giving someone two months postpartum doesn’t allow for the kind of continuation of care that you need. If there are indications of problems in the postpartum period, they don’t all necessarily show up within the first two months. And we certainly know that the ability to have a healthy infant and keep an infant healthy is also related to whether you have coverage. The extension to 12 months really allows for that kind of continuum of care.

Welchlin: We know in the state of Mississippi, women die at higher rates, and of course it’s higher for Black women. And so, when women don’t have that coverage, what happens is they die.

What does it mean to not extend postpartum Medicaid coverage if Roe falls?

Miller: These bans on abortion are going to be layered on top of an already-unconscionable maternal and infant health crisis that most particularly impacts those who are struggling to make ends meet. It particularly impacts Black women and other communities of color. ... A state like Mississippi that is so clearly wanting to ban abortions — the fact that they refuse to extend basic health care benefits that will help during pregnancy and postpartum just clearly indicates that they are not interested in the health and well-being of women and families and children, that they are purely on an ideological crusade.

Anything else that you wanted to add?

Salganicoff: We’re very focused on that first year of life. But if you’re speaking about a woman who is not going to be able to get an abortion that she seeks and ends up carrying the pregnancy, the supports that she’s going to need and her child is going to need go far beyond the first year of life.

Miller: You can’t have a conversation about legality or soon-to-be illegality of abortion in these states and not have a conversation simultaneously about the existing crisis around maternal and infant health. These things are all interconnected, and that’s why it is so deeply disturbing that the states trying to ban abortion are the same states that are refusing to expand Medicaid under the ACA, that are failing to take advantage of the ability to extend postpartum [coverage] by 12 months, that don’t invest in child care, that don’t invest in education — these are all part of the same conversation.

Welchlin: Audre Lorde said, “There is no such thing as a single-issue struggle because we do not live single-issue lives.” So, abortion access, reproductive justice, voting rights, racial justice, gender equity — these are not separate issues, they are intersecting issues that collectively determine the quality of our lives.

by Anjeanette Damon

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

This article was co-published with The Nevada Independent and Block Club Chicago.

Last winter’s sports season had just begun, and the epidemiology staff at Nevada’s second-largest health district were busy calling the parents of high school athletes who’d tested positive for COVID-19.

A state mandate required unvaccinated or traveling athletes to get tested weekly. A nasal swab for an on-site antigen test produced rapid results in 15 minutes; a second swab was sent to an out-of-state laboratory for a more sensitive PCR test. Parents of students who tested positive on the rapid tests would get phone calls from the health district.

Because families already knew about positive rapid results, the phone calls should have been a routine follow-up to start tracking anyone who had had contact with the infected person. But for some reason, parents were repeatedly disputing that their children had the virus.

“These parents were pretty adamant that their kid was not a case and that they could play,” said Heather Kerwin, epidemiology program manager for the Washoe County Health District.

Heather Kerwin, epidemiology program manager for the Washoe County Health District (Emily Najera for ProPublica)

A pattern emerged. Athletes would test positive on the rapid test. But before a contact tracer could call, parents would learn from the testing company that their children’s PCR tests, typically the gold standard of COVID-19 testing, were negative, even for students with symptoms. Kerwin investigated and learned the University of Nevada Reno campus was seeing similarly conflicting results.

The university and school district had something in common. Both had recently hired the same company to conduct their testing: Northshore Clinical Labs.

The Chicago-based company was aggressively pursuing government customers in Nevada. In fact, as Kerwin was learning about the inconsistent results, Washoe County Assistant Manager David Solaro was negotiating with Northshore to provide testing for public employees and local residents. Kerwin thought county officials should know there might be a problem with the company’s tests, and encouraged her contact at the school district and her boss, COVID-19 Regional Operations Chief Jim English, to alert Solaro before an agreement was finalized.

Solaro signed the agreement anyway.

“Why did this go through without a discussion of their discordant results? This is going to cause absolute mayhem,” Kerwin wrote English when she learned the agreement had been signed.

English wrote back: “I tried. No one listens to me sorry.”

(Screenshot highlighted and redacted by ProPublica)

Kerwin’s instincts were right. As state scientists would later verify, something “catastrophic” was wrong with Northshore’s PCR tests.

A ProPublica investigation into the company’s operations in Nevada, including a review of more than 3,000 pages of internal emails obtained through public records requests, shows the Chicago laboratory’s testing was unreliable from the start. As evidence mounted that Northshore was telling infected people that they had tested negative for the virus, government managers in Nevada ignored their own scientists’ warnings and expanded the lab’s testing beyond schools to the general public.

Ultimately, state public health officials found that Northshore’s PCR tests missed 96% of the positive cases from the university campus — errors that sent people infected with COVID-19 back into the community. But to date, neither state nor county health officials have alerted the public to the inaccurate tests.

ProPublica’s investigation also found that Northshore used political connections, including contracting with the sons of a close friend to the governor, to fast-track its state laboratory license application and secure testing agreements with five government entities in the state. Those agreements not only gave Northshore the exclusive right to test and bill for thousands of people a week, they also gave its lab a legitimacy lacking among upstart testing companies that had set up shop in strip malls and parking lots across the country.

In mid-January, when state regulators finally launched an investigation into Northshore, they found the company had been operating unlicensed sites across Nevada. They allowed the company to continue its rapid antigen testing anyway.

Northshore, which said it had operations in more than 20 states, pitched free COVID-19 testing, telling local officials the tests would be paid for by individual insurance plans or a federal government program for the uninsured. But emails reviewed by ProPublica raised serious questions about the company’s billing practices.

In its pitch emails, Northshore told multiple government agencies it planned to bill the federal program for the uninsured even for those who might have insurance but declined to provide the information. In one case, a Washoe County School District official said in an email the company recommended insured individuals withhold their insurance information so the company could bill the government instead.

As of May 5, the company had collected nearly $165 million from the federal government, 11th most among more than 28,000 companies nationwide seeking reimbursement for testing uninsured individuals.

Northshore, through the public relations firm Weber Shandwick, repeatedly declined requests for interviews. After ProPublica provided the company with a summary of its findings, a spokesperson asked for additional time to address them, then responded: “Northshore declines to comment.”

Although demand for COVID-19 tests waned after the initial omicron surge passed, testing remains a key component of President Joe Biden’s pandemic mitigation strategy. What happened in Nevada offers a cautionary tale as local governments search for ways to provide testing through a system that relies on massive government spending to attract companies to meet the demand.

“It’s still a profit-hungry model,” said Alex Greninger, assistant director of the University of Washington’s virology lab. The guarantee of large payouts prompts companies to take on too many clients too quickly, he added: “Most groups get overwhelmed and exceed clinical capacity. Your operations fall apart.”

“I Do Not Understand Why This Lab Gets Preferential Treatment”

Northshore Clinical Labs has been in business for nearly three decades, but its leadership changed in July 2020. It is now run by three men with no apparent clinical laboratory experience and a history of fraud allegations: brothers Hirsh and Gaurav Mohindra and their associate Omar Hussain.

The Mohindra brothers have been involved in a variety of business pursuits unrelated to the medical field. Hirsh Mohindra was a real estate developer and Gaurav Mohindra lists himself on his LinkedIn page as an intellectual property lawyer.

Together they ran a debt collection business until 2016, when the Federal Trade Commission accused them of operating a scheme in which they bullied people into paying off debt they didn’t owe. As part of a settlement agreement, the brothers and a partner surrendered $9 million in assets and were banned from the debt collection business.

Hirsh Mohindra later served time in prison for an unrelated mortgage fraud case. He was released in February 2020, just as the pandemic was beginning and five months before his mother, Meena Mohindra, was listed as the new president of Northshore in Illinois Secretary of State filings.

In 2019, the FTC accused Hussain of participating in a phantom-debt collection ring with ties to the Mohindras’ case. He also agreed to a lifetime ban on debt collection activities and to surrender assets. The Illinois Secretary of State’s Office currently lists Hussain as Northshore’s president, replacing Meena Mohindra.

The Mohindras did not respond to requests for comment. Hussain declined an interview through a spokesperson.

Last year, the company began a dramatic national expansion. In Nevada, it contracted with Greg and Angelo Palivos, brothers with deep ties to both Chicago and Las Vegas, to build clientele and manage operations. Their father, Peter Palivos, is a prolific contributor to Nevada political campaigns and close enough with Gov. Steve Sisolak that the two met regularly in the early days of the governor’s administration. (Peter Palivos also served time in prison on an obstruction of justice charge related to a fraud case in Chicago, though he maintained he was set up by the U.S. Attorney’s Office for not helping prosecutors build a case against former Illinois Gov. George Ryan.)

The Palivoses’ first task was to get the lab licensed in Nevada. They turned to an influential ally for help: Mike Willden, a former director of the Nevada Department of Health and Human Services, who now works for The Perkins Company lobbying firm, run by former Assembly Speaker Richard Perkins. Willden had worked with Peter Palivos on a past health care venture that didn’t pan out.

Willden said he talked with the manager of the state’s licensing office, who explained to Northshore how to submit its application. But when the Palivos brothers thought it was taking too long, Willden called and emailed his contacts in the governor’s office and laboratory licensing bureau — an agency he had overseen as head of DHHS.

Willden told ProPublica he helped the Palivos brothers as a favor and because he thought the company could help address a dearth of testing capacity in Nevada.

“My understanding was there was a license pending, and in this world of testing where it would take three to five days to get results and everybody was calling me frustrated,” Willden said. “I said, ‘Look, here’s someone who can help you with testing.’”

(Screenshot redacted by ProPublica)

At Willden’s urging, Sisolak’s chief of staff, Yvanna Cancela, nudged the director of the state’s pandemic response, who nudged the head of the state’s licensing bureau, Cody Phinney. She in turn encouraged the agency to move up its inspection of Northshore’s Nevada headquarters in Las Vegas — much to the dismay of the supervising inspector.

Inspector Bradley Waples would let Northshore skip to the head of the line, but not before complaining to Phinney.

“I want to let you know how frustrating it is to have my staff schedule their inspections only to have labs use previous directors to influence or pressure us into having businesses that they represent, jump ahead of others that are patiently waiting for their inspections,” he wrote.

Waples also noted in his email to Phinney that Northshore would be processing specimens in Illinois, which would delay results. “There are a number of places in Nevada that people can go to get COVID tests in which their results will be available the same day or sooner,” he wrote. “This is why I do not understand why this lab gets preferential treatment while other labs are required to patiently wait.”

(Screenshot highlighted by ProPublica)

Three months later, Waples would lead the investigation into Northshore’s testing operations.

In an interview with ProPublica, Phinney said she understood Waples’ frustrations but didn’t view Willden’s request as an attempt to influence the process.

“I didn’t perceive that there was fast-tracking,” she said. “There were questions about when we could get an inspector out there. Certainly, we have staff who are trying to work as fast as they can, and they were being asked to work faster, that’s frustrating.”

Through the agency’s spokesperson, Waples declined to comment.

Willden also downplayed his influence, saying the state was “getting broad pressure to help speed up testing and results. I seriously doubt my inquiries carry that much weight.”

Willden said that he wasn’t paid by the Palivos brothers but that they sent him caramel popcorn and four steaks at Christmas as a gesture of appreciation.

Sisolak spokesperson, Meghin Delaney, said in a written statement the governor has not had conversations with the Palivos family about Northshore’s operations. She said the state’s pandemic response coordinator helped with Northshore’s licensing to avoid a gap in testing service.

“Throughout the pandemic, the State of Nevada has worked to remove barriers and make services available to Nevadans while working through existing regulatory and licensing processes to move expeditiously without cutting corners,” Delaney said. “State employees continue to work tirelessly on behalf of Nevadans, and the State will use lessons learned from across the pandemic to make investments and strengthen Nevada’s public health systems moving forward.”

The Palivos brothers, in a written statement from their spokesperson, Elizabeth Trosper, said they were unaware of the Northshore owners’ history of fraud allegations when they agreed to do work for the company. In addition to generating sales leads for Northshore, Trosper said, their role in Nevada was to manage the local workforce of testers and the collection of specimens.

“They relied on Northshore for standard operating procedures, licensing, compliance, test supplies, molecular lab work, reporting of test results, and billing,” she said.

She said neither the brothers nor their father spoke with Sisolak about Northshore.

“Greg and Angelo Palivos’ involvement with testing was driven by their desire to assist during the COVID-19 crisis,” Trosper said.

“They Make It Sound Almost Too Good to Be True”

When Northshore got its Nevada license in November, it was for a single location in Las Vegas. The company did not complete the paperwork and site inspections required to operate statewide. Still, Northshore began an aggressive push to woo local government agencies across the state. The climate was ripe for what they were offering: free tests.

The delta wave was subsiding and omicron hadn’t yet emerged. But that didn’t mean the need for testing was starting to wane. Quite the opposite.

An OSHA rule mandating large employers to regularly test unvaccinated workers was about to take effect. Universities in Nevada were looking to increase surveillance testing in order to resume in-person learning. School districts were adopting the CDC’s “test-to-stay” recommendation to allow K-12 students who had contact with a COVID-19 case to remain in class if they could produce a negative test. And the governor’s coronavirus plan required regular tests for student-athletes, coaches and others participating in school activities.

That all meant thousands of people would need weekly testing even without a surge of infections. And for each person, Northshore could collect between $165 and $260 for administering the two tests.

At the same time, the Washoe County Health District, a reliable provider of community COVID-19 testing since the start of the pandemic, wanted to focus its testing on communities with less access to health care, such as people without health insurance or a primary care doctor, rather than being the go-to source for the community at large.

Northshore’s pitch was difficult for pandemic-weary government managers to refuse: We can test everyone who needs it on site, we can turn around results in 24 to 48 hours, and it won’t cost you a dime.

“They are very good salespeople,” Kerwin said. “They make it sound almost too good to be true. They hire all the folks. They do it very quickly for you. You don’t have to staff it.”

English, Washoe County’s COVID-19 operations manager, said he was inundated with pitches from labs offering testing. He ignored most of them. But Northshore came recommended by a high-profile doctor who had worked with the district on its COVID-19 vaccination program. English and Kerwin met with Northshore officials and verified they had a state license and could report results through the state’s contact-tracing system.

Then they began referring Northshore to other local governments in the region that were scrambling to find testing resources.

“We didn’t recommend, we referred,” English said. “We told them they had to do their own due diligence.”

(Screenshot redacted by ProPublica)

Government managers interviewed by ProPublica acknowledged they did only a cursory vetting of Northshore, verifying their license and relying on referrals from people they trusted. They also were swayed by the company’s claims of successful testing operations in other states.

By November, Northshore had agreements with the University of Nevada Reno and the Washoe County School District. By December, Washoe County itself had signed on. In Southern Nevada, the city of Las Vegas signed an agreement for testing in multiple locations, and the city of Henderson allowed the lab to use a parking lot at one of its recreation centers.

Had officials done more research, they would have found Northshore didn’t have the proper licensing to operate statewide.

But government rules that might have ensured a more thorough vetting are suspended during emergencies, such as a pandemic, to allow a more nimble response. More than two years into this pandemic, Washoe County continues to operate under emergency response orders.

Still, Greninger, the University of Washington virology lab’s assistant director, said government managers can take measures to both avoid burdensome bureaucracy and avoid being taken advantage of. For example, they can expand local labs with a documented track record instead of handing out contracts for huge numbers of tests to a single new provider.

“Go to the people with the track record. And try to distribute your risk a little bit,” he said.

“That’s Fraudulent”

Although an attractive sales pitch, Northshore’s promise of free tests was problematic.

The federal government had mandated that insurance plans cover diagnostic testing for COVID-19 ordered by a health care provider and created a fund to reimburse testing of uninsured patients. The law didn’t require insurance plans to cover testing for nonmedical reasons, such as employment requirements, screening for student-athletes and dorm residents or travel. Most major insurance plans do not cover such screening tests, according to Krutika Amin, a policy expert at the Kaiser Family Foundation, a health policy think tank.

(Screenshot highlighted and redacted by ProPublica)

Northshore, however, indicated it did not differentiate between the two types of testing in its billing, according to a Nov. 16 email exchange between Northshore’s business development director Razi Khan and University of Nevada Reno officials. The company was relying on a pandemic-specific federal guideline instructing health care providers treating patients to bill for COVID-19 tests as diagnostic tests whether or not the patient had symptoms or could pinpoint an exposure.

“In short, our interpretation” of that guideline “constitutes all COVID-19 testing as clinically necessary and therefore allows for full coverage,” Khan wrote to university officials. He also said Nevada’s positivity rate of 11% justified this billing approach.

Through a spokesperson, Khan declined to be interviewed.

On its registration forms, including for student-athlete screening, Northshore required individuals to sign a statement that they “may have been exposed to someone infected with COVID-19 during my routine daily activities” to be tested.

ProPublica also found an example of Northshore billing an insurance company for a screening test required for a mother and daughter to travel to a high school choir performance. The Reno mother emailed the district after her family’s insurance plan denied the two claims — totaling $470 — because Northshore was an out-of-network provider.

Laura Rich, the executive officer of the Nevada Public Employees’ Benefits Program, which insures most state of Nevada employees, emailed higher education officials after she had been briefed by Northshore on its plans. In the email, she called the practice of billing screening tests as diagnostic “fraudulent."

(Screenshot highlighted and redacted by ProPublica)

The Nevada System of Higher Education was considering hiring Northshore to test unvaccinated employees and to provide testing on Southern Nevada college campuses. Rich worried the state employee health plan would be deluged with claims for surveillance tests that it hadn’t budgeted for and was under no obligation to pay. But when she tried to alert decision-makers, Northshore again asked Willden to intervene.

“So I got a call from a certain lobbyist who got a call from Northshore and now I am roped into a meeting with Northshore next week,” Rich wrote in an email to the head of NSHE’s COVID-19 task force.

(Screenshot redacted by ProPublica)

Rich confirmed that the lobbyist was Willden. She said he didn’t apply pressure, he simply wanted to understand her agency’s concerns with Northshore’s billing practices. But she took from the conversation that Northshore thought her agency was trying to block the company from getting the contract with NSHE.

Ultimately, Rich prevailed in her opposition to Northshore billing the state employee insurance plan for what she believed was surveillance testing. University officials viewed it as unethical, according to the emails, and did not sign a contract with Northshore for the Las Vegas campuses.

Laura Rich, executive officer of the Nevada Public Employees’ Benefits Program (Emily Najera for ProPublica)

Northshore had a backup if insurance wasn’t available: the federal government’s fund for the uninsured.

Documents obtained by ProPublica indicate Northshore planned to bill that fund even for individuals who had insurance. According to Khan’s pitch emails to multiple government agencies, Northshore said it would seek reimbursement from the fund for those who “choose not to provide their health insurance.” Northshore also told the school district it would bill the federal fund if an insurance claim for the test was rejected and recommended the district instruct its employees to withhold their insurance information to avoid claims to its self-funded plan, according to emails from Leslie Allfree, who manages the district’s medical emergency response program.

That contradicts the rules of the program for uninsured patients run by the Health Resources & Services Administration. A spokesperson for the agency said it has safeguards to block testing companies from receiving reimbursement for insured clients, including a database where it can check clients’ insurance status. ProPublica was unable to determine if any Northshore claims were rejected for this reason. As of May 5, the company had been paid nearly $165 million from the fund.

Still, some government managers in Washoe County considered following Northshore’s advice to withhold insurance information on the testing forms.

(Screenshot redacted by ProPublica)

“The vendor recommends that those who are insured by self-insured plans, such as ours, not provide their insurance information and allow the vendor to submit for HRSA reimbursement as if they are not insured,” Allfree wrote. “I foresee messaging around this could be problematic.”

In an interview, Paul LaMarca, the district’s chief strategies officer, said the district did not end up instructing its employees to withhold their insurance information.

Trosper said the Palivos brothers had no responsibility over billing procedures.

“It Is Something Catastrophic”

As officials were debating who to bill for Northshore’s tests, a far larger problem was coming into focus.

The discordant antigen and PCR results at the school district were causing confusion about which students should be kept out of the classroom and which could return.

On Dec. 28, Laura Gingerich, assistant principal at North Valleys High School in Reno, wrote district administrators pleading for them to shut down testing because of the inconsistent results. She had personally tested positive on two rapid tests before receiving negative PCR results from Northshore despite having “every symptom on the checklist,” she wrote.

“I know for a fact this has happened to at least two other student-athletes,” she told administrators. “It is time to stop and question this process. It is not consistent. It is not reliable. We can do better.”

Gingerich did not respond to a request for an interview.

In response, Allfree confirmed the district was “seeing an unusually high number of inconsistent, or what we call discordant results” and was working with health officials to figure out the problem.

The next day, the Centers for Medicare and Medicaid Services cited the Northshore lab in Chicago for deficiencies that put the public in “immediate jeopardy,” including problems with shipping and labeling of patient specimens and inadequate employee training. The problems had affected 1.7 million tests, according to the CMS report.

But word of that investigation did not immediately reach Nevada officials, and Northshore continued signing agreements with local governments. Washoe County could see that the spreading omicron variant was going to require increased capacity. Despite the warnings from Kerwin and the school district about Northshore’s test results, Solaro, the county’s emergency manager, inked an agreement with Northshore to provide drive-up community testing starting Jan. 5.

Solaro said in an interview that the county had to have testing in place for the OSHA mandate, which ended up being struck down by the U.S. Supreme Court, and there were no other options.

“Northshore was in town. They were doing testing for the university and the school district. It seemed like a good move to get them on contract. They needed time to ramp up and hire people. It just seemed like all the right things to do,” Solaro said.

At the time, the concerns about Northshore’s testing were still “anecdotal,” Kerwin later told ProPublica. “I didn’t have any data.”

Data would soon arrive, thanks to a decision by Dr. Cheryl Hug-English, director of the University of Nevada Reno’s student health center. She had noticed contradictory results in the first weeks of testing and contacted Northshore several times looking for an explanation and a solution that never came.

With problematic test results piling up, Hug-English began running an experiment in December. She quietly sent patient specimens to both the lab in Chicago and the Nevada State Public Health Laboratory, which had done PCR testing for the campus prior to Northshore’s arrival. After a month, the results were clear: Northshore’s PCR process wasn’t working. More than 96% of the PCR results that came back positive from the state lab came back negative from Chicago.

(Screenshot highlighted and redacted by ProPublica)

Kerwin and Hug-English again tried to get answers from Northshore. Kerwin asked if the company was seeing similar problems at any of its other testing sites across the country.

“Oh, no, this is just a weird thing going on in Washoe,” Kerwin said she was told.

“I’m like, science says that’s probably not true. But they weren’t going to be any kind of transparent with us about the real reasons,” she said.

Kerwin asked the state lab to investigate why Northshore’s testing was so unreliable. State scientists exchanged emails with Northshore representatives, and, while they never arrived at a clear explanation, they came away determined that PCR testing from Chicago should stop.

“Without physically being in their laboratory, I can only guess at what is going wrong. But it is something catastrophic,” the state lab’s molecular supervisor, Andrew Gorzalski, wrote on Jan. 10. “My personal recommendation would be to stop using Northshore for SC2 PCR testing immediately.”

(Screenshot highlighted and redacted by ProPublica)

By that time, however, the mayhem that Kerwin had predicted was erupting. The omicron surge completely overwhelmed Northshore’s operations. Community testing sites had lines so long they snarled traffic. Schools that offered Northshore testing to symptomatic students, families and staff had sick people wandering hallways. So many people needed testing that Northshore testers couldn’t keep up. Angry parents took their frustrations out on school staff.

“This is the second week in a row and tensions are getting to the boiling point with the people we have to turn away,” wrote one high school administrator.

Then Northshore’s employees began to get sick. The company was not providing N95 masks and gowns or requiring staff to wear them, according to emails from the school district and a state investigation. Some testers wore less-effective cloth or surgical masks. Some didn’t wear gloves. So many employees became ill, the company had to suspend operations at two county sites, according to emails from the Palivoses.

(Screenshot highlighted and redacted by ProPublica)

In response to concerns from Kerwin and school officials, the company purchased better personal protective equipment.

“We have also bought face shields, N-95 masks, and gowns for our techs to use at their discretion. Effective: 1/17,” Greg Palivos wrote to the school district on Jan. 16.

Trosper said the Palivos brothers stopped PCR testing in January, when the state notified them of the inaccurate results. An email exchange provided by Trosper shows Angelo Palivos had pushed Northshore to fix its problems before it even got to that point.

“This casts more doubt on the efficacy of Northshore lab, in what is already a very fragile situation with plenty of doubt already cast,” Angelo Palivos wrote to Hussain on Dec. 16. “This is very concerning to everyone in Washoe County, and us as well.”

Hussain responded in reference to patients with contradictory results: “They need to be retested.”

Kerwin was fed up with her concerns going unheeded by local officials. On Jan. 14, after the state lab documented the 96% false negative rate, Kerwin emailed state health officials: “I am asking for Northshore’s license for PCR testing in Nevada be revoked immediately.”

(Screenshot highlighted and redacted by ProPublica)

Even then, state inspectors were slow to act. Worried the school district and community would be left in the lurch if Northshore halted operations, the deputy administrator of the state Division of Public and Behavioral Health, Julia Peek, asked for a backup plan. But there wasn’t one. Peek and Kerwin agreed Northshore should continue using rapid tests while ceasing PCR testing. The rapid tests were accurately “coming up positive,” Kerwin said.

A text message exchange between Northshore’s Angelo Palivos and Washoe County Assistant Manager David Solaro (Screenshot obtained by ProPublica)

When it became clear the state would investigate Kerwin’s complaint, Angelo Palivos texted Solaro, at the county, to try to put a stop to it: “If they can rescind the complaint we would appreciate it. It’s caused a major problem for us.” Solaro said he was “digging in with my mole now” to find out who had filed the complaint.

Trosper said Angelo Palivos challenged the complaint because the brothers had already told the testing sites to stop PCR testing.

Solaro told ProPublica he did not uncover who filed the complaint or take any action to have it rescinded. He said Angelo Palivos was frustrated. “In his mind, we needed their help, and here we are filing a complaint,” Solaro said.

At this point, Phinney’s agency, which was responsible for licensing and inspecting the lab, learned about the discordant results and discovered that Northshore was testing at locations across the state despite only being licensed for a single location. Waples immediately sent out an investigator, who came back with a list of deficiencies in Northshore’s operations, including not properly training all of its workers, not following the test manufacturers’ instructions and not properly performing quality control measures.

Waples was reluctant to shut down Northshore’s operations and instead said he wanted to bring them “into compliance.” In an interview, Phinney said that’s common practice for the bureau. “When we have a facility or provider that appears to be working with us, we do our darndest to work with them.”

By February, demand for testing had dropped. Although Northshore provided investigators with 600 pages of documentation to support its claim that it had fixed the problems, regulators continued to find deficiencies. In the end, Northshore decided to abandon its operations in Nevada and asked for the agency to close its license.

At this point the Palivos brothers also ended their relationship with Northshore. Trosper said Northshore still owes the brothers “hundreds of thousands of dollars” for employee salaries, subcontractors and vendors.

Ultimately, the state of Nevada rescinded the license and closed its investigation, but not before detailing its findings in a letter to the company. The director of the state Department of Health and Human Services, Richard Whitley, wanted the issues to be documented.

“It’s like staff who do harm and we let quit rather than be fired and then there is no record of the performance and they can reinvent themselves after a period of time and come back,” he wrote to Phinney. “We shouldn’t let this happen in health care.”

(Screenshot highlighted by ProPublica)

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Alex Mierjeski and Agnel Philip contributed research.

by Michael Grabell

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As hundreds of meatpacking workers fell sick from the coronavirus that was spreading through their plants and into their communities in April 2020, the CEO of Tyson Foods reached out to the head of another major meatpacker, Smithfield Foods, with a proposal.

Smithfield’s pork plant in Sioux Falls, South Dakota, had been hit particularly hard, and state and local officials were pressuring the company to shut it down.

“Anything we can do to help?” Tyson CEO Noel White asked in an email.

Smithfield’s CEO Ken Sullivan replied that he wished there was.

But White had an idea. Would Sullivan like to discuss the possibility of getting President Donald Trump to sign an executive order to keep meatpacking plants open?

So began a high-pressure lobbying campaign by the meat industry, according to a report released Thursday by congressional investigators, leading to one of the most consequential moments in the nation’s COVID-19 response: a presidential order that effectively thwarted efforts by local health officials to shut plants down and slow the spread of COVID-19.

In 2020, ProPublica obtained thousands of emails and other documents showing that the meatpacking industry had ignored years of pandemic warnings, tried to overrule public health officials and exposed vulnerable workers and their communities to COVID-19.

But the new report from the House Select Subcommittee on the Coronavirus Crisis, along with revelations in a wrongful death lawsuit, make clear that the callousness of meatpacking executives and the level of industry influence over the Trump administration were far greater than previously known.

For example, ProPublica had reported that the meat industry’s trade group shared a draft executive order with the Trump administration that bore striking similarities to the one the president signed days later.

Emails released by the subcommittee now show that the proposed order was drafted by Tyson’s legal department. The goal, according to Tyson’s vice president of government relations, was to shield the company from legal liability.

ProPublica also reported that the meat industry dismissed government warnings to prepare for a pandemic by stockpiling masks and developing plans to space out workers on processing lines.

But documents uncovered in a wrongful death lawsuit filed this week in Iowa show that while Tyson was slow to adopt safety measures to protect U.S. workers, it moved swiftly to do so at its plants in China, with extensive protocols, including a mask requirement and reduced production, in place by mid-February 2020 — more than a month before cases showed up in U.S. plants.

The effect that the meatpacking plant outbreaks had on the early spread of COVID-19 is staggering. ProPublica and other news outlets tracked cases and deaths involving meatpacking workers. But academic researchers have found that by July 2020, about 6% to 8% of all coronavirus cases in the U.S. were tied to packing plant outbreaks, and that by October 2020, community spread from the plants had generated 334,000 illnesses and 18,000 COVID-19-related deaths.

Within the cache of new documents are allegations that meatpacking companies tried to hide cases. As workers began calling in sick at a Tyson pork plant in Waterloo, Iowa, the company’s workplace health managers instructed plant nurses not to record the absences as “COVID-19,” but instead as “flu-like symptoms,” families of deceased workers said in their lawsuit. ProPublica reported extensively on how COVID cases at the plant spread through the community.

Similarly, when local health officials in California investigated an outbreak at a Foster Farms chicken plant, they discovered five additional deaths that had been marked not as fatalities, but instead as “resolved cases” or “resolutions.” Health officials told the subcommittee that during a conference call with the U.S. Department of Agriculture, someone from either Foster Farms or the USDA jokingly called them “toe tag resolutions,” referring to the toe tags that are often put on corpses at morgues.

The new emails demonstrate that the primary goal of some meatpacking leaders was not to protect their employees as they had professed, but to get them to show up to work so they could keep producing meat.

“As an industry we’re doing everything we can to provide as sanitized an environment as possible,” Sullivan wrote to other industry executives in early April. “But, we’re not asking for N-95 masks or anything like that. The ask is for the President, as well as all levels of government, to make more explicitly clear that food and agriculture workers are front line workers fighting the pandemic. The industry needs help, straight from the bully pulpit, to reinforce our patriotic duty to produce food for the country.”

Even after it was clear that dozens of workers were dying, an executive from Koch Foods said in late May 2020 that he thought the only safety measure the chicken industry should be using was to take temperatures. Ashley Peterson, a lobbyist for the National Chicken Council, said she agreed.

“Now to get rid of those pesky health departments!” she replied.

Despite the toll, meatpacking companies have faced little consequence. Several key executives, including Sullivan and White, have either retired or remain in key leadership roles. The companies faced only small workplace safety fines and have used Trump’s executive order to fight lawsuits from workers’ families. The profit margins of four of the largest meatpackers have grown more than 300% since the start of the pandemic, according to the Biden administration.

“The meatpacking industry’s efforts — aided extensively by Trump’s USDA and White House officials — led to policies, guidance, and an executive order that, individually and altogether, forced meatpacking workers to continue working despite health risks and allowed companies to avoid taking precautions to protect workers from the coronavirus,” the subcommittee concluded.

The meatpacking industry on Thursday pushed back on the subcommittee’s findings, saying it distorted the record and ignored the billions of dollars that meatpackers spent on safety measures.

“The Committee could have tried to learn what the industry did to stop the spread of COVID among meat and poultry workers,” Julie Anna Potts, president of the North American Meat Institute, said in a statement. “Instead, the Committee uses 20/20 hindsight and cherry picks data to support a narrative that is completely unrepresentative of the early days of an unprecedented national emergency.”

The National Chicken Council did not address lobbyist Peterson’s comments but said in a statement that processors “did everything they could to keep their workers safe.” Tyson and Smithfield emphasized that the unique challenges of the pandemic necessitated that they work closely with top government officials.

“This collaboration is crucial to ensuring the essential work of the U.S. food supply chain and our continued efforts to keep team members safe,” Tyson spokesperson Gary Mickelson said, noting that the Biden administration supported the company’s effort last year to have one of the first fully vaccinated workforces in the U.S. Mickelson did not address the lawsuit allegations.

Said Smithfield spokesperson Jim Monroe, “Did we make every effort to share with government officials our perspective on the pandemic and how it was impacting the food production system? Absolutely.”

Foster Farms did not respond to a request for comment.

While most of the previous reporting on the meatpacking industry’s response to COVID-19 relied on documents obtained under public records laws, the subcommittee’s report is based on 151,000 pages of documents that include an extensive trove of internal company emails.

From the beginning, those records show, meatpacking executives used their clout with the USDA to influence health decisions made at the highest levels of the Trump administration.

In March 2020, the industry pushed for the USDA to be involved in the White House Coronavirus Task Force and to help ensure that meatpacking workers were classified as “critical infrastructure” workers so they would be exempted from governors’ stay-at-home orders.

The industry was fortunate to have the USDA as its “primary regulator,” Potts wrote in an email to colleagues. “Officials at USDA are moving more quickly than other agencies and representing our industry’s interests in every important interagency decision,” she said.

Within weeks, Trump’s agriculture secretary, Sonny Perdue, set up a call between the CEOs of Tyson, Smithfield and other meatpackers and Vice President Mike Pence. That same day, during a White House press briefing, Pence heeded the industry’s request to address recent worker absences, telling meatpacking workers to “show up and do your job.”

A spokesperson for the University System of Georgia, where Perdue is now chancellor, declined to comment on his behalf, saying Perdue was now “focused on his new position serving the students of Georgia.”

After Smithfield’s Sioux Falls plant was shut down in April 2020, the emails show, Sullivan took a uniquely aggressive stance, one that even some of his colleagues in the meat industry bristled at.

When the Centers for Disease Control and Prevention issued draft recommendations to reduce COVID-19 at the plant, Sullivan marked up a copy, starring in the margins strategies that he deemed “problematic” for the aging plant. In response, the CDC added multiple qualifiers saying Smithfield should implement the recommendations only “if feasible.”

“It really muddies the guidance when we start putting these waffle words into it,” Dr. Henry Walke, then-director of CDC’s Division of Preparedness and Emerging Infections told the subcommittee, according to excerpts from an interview transcript. “I felt that was watering down our guidance.”

Sullivan and others in the industry meanwhile misled the public about an impending meat shortage that they said would result if plants closed temporarily, the subcommittee said. After the Smithfield plant suspended operations, Sullivan said the closures were “pushing our country perilously close to the edge in terms of our meat supply.” Days later, however, Smithfield urged the North American Meat Institute to issue a statement to reassure international customers that “there was plenty of meat” for export.

In emails, the trade group’s leaders said Sullivan was “directing the panic” and “intentionally scaring people,” creating a “mess” that they’d have to clean up.

Smithfield spokesperson Monroe said, “The concerns we expressed were very real and we are thankful that a food crisis was averted.”

As the coronavirus spiraled through meatpacking towns, Potts of the North American Meat Institute began to fret, noting in an email that “plants are being closed” and “health departments are showing up unannounced at plants.”

She wrote, “It seems to be cascading and our friends at USDA and the VP’s office are not able to stop it.”

But at almost the exact same moment, Tyson’s CEO was emailing the head of Smithfield about his idea for an executive order.

Within two days, Tyson’s vice president and associate general counsel circulated a draft order that would invoke the president’s powers under a Korean War-era law called the Defense Production Act. And meatpacking executives agreed they should send it to the White House.

Tyson’s vice president of government relations called it a “long shot,” but said, “I think we have a good momentum for a Hail Mary!”

When some in the industry expressed concern that such an ask could come across as “production at any cost,” Potts once again leaned on the industry’s connections with the USDA, sending the draft to top agency officials who passed on the request to the White House.

In the days leading up to the executive order, meatpacking industry representatives were in constant communication with the White House and USDA, the subcommittee records show. Sullivan and White held calls with Trump’s chief of staff, Mark Meadows, which were followed by a request from Meadows for White to meet directly with Trump. And the president held a call with meatpacking executives on the morning he issued the executive order.

The order had immediate effect, as health officials in Virginia backed off a recommendation to close a plant and officials in Utah cited the order as the reason they couldn’t shut a plant down.

Thousands of meatpacking workers would continue to crowd into processing plants, risking contracting the virus and bringing it home to their families.

A few months later, when the Trump administration issued plans to reopen schools, executives at the North American Meat Institute privately struck a different tone. They questioned whether bringing students back together without a vaccine — what they had done with meatpacking workers — was a good idea for kids in their area.

“This is just astounding,” wrote Bill Westman, a senior vice president for the trade group. “How can anyone guarantee that schools can ‘safely reopen’ under the circumstances as cases are surging across the USA? Why put students and extended families at risk?

“This administration is living in an alternative and dangerous reality.”

by Jodi S. Cohen, ProPublica, and Jennifer Smith Richards, Chicago Tribune

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.

This story was co-published with the Chicago Tribune.

Illinois’ top financial official has banned local governments from using a state program to collect debt from students who have been ticketed for truancy, eliminating a burden for families struggling to pay steep fines.

A number of school districts around the state, meanwhile, have begun to scale back and reevaluate when to involve law enforcement in student discipline, among them a suburban Chicago high school where Black students have been disproportionately ticketed. That school, Bloom Trail High School in Steger, said Thursday that it will stop asking police to ticket students and move to other methods of discipline.

The moves come after an investigation by the Chicago Tribune and ProPublica, “The Price Kids Pay,” found that school officials and police were working together to ticket students for misbehavior at school, resulting in fines that could cost hundreds of dollars per ticket. When students or their families failed to pay, local governments sometimes turned to the state for help collecting the money.

Bloom Trail High School in Steger, Illinois (Armando L. Sanchez/Chicago Tribune)

The state told municipalities that beginning June 11 they no longer may submit truancy ticket debt for collections, according to an email from the Illinois comptroller’s office to municipalities that participate in the state’s Local Debt Recovery Program. Through that program, the state helps local governments collect on unpaid penalties for ordinance violations, unpaid water and sewer bills and other municipal debts by withholding money from people’s tax refunds, their lottery winnings or even their paychecks if they are state employees.

School and police officials have also responded to the investigation. Among those districts is Elgin-based U-46, the second largest in the state, which has stopped working with police to fine students for truancy and is reviewing whether police should be involved in fewer situations overall.

The U-46 superintendent, Tony Sanders, said he thinks the widespread school-related ticketing revealed by the Tribune and ProPublica should prompt “school leaders across Illinois, and across the nation, to reflect on our current systems related to student behavior” and find alternatives that keep students in school and don’t punish families financially.

The investigation found that punishing students with tickets violates the intent of a state law that bans schools from issuing fines as discipline. While not fining students directly, schools have been involving police so students can be ticketed and, in most cases, fined.

Another state law prohibits schools from notifying police about truant students so officers can ticket them. The investigation found dozens of school districts where students received tickets for truancy since the law went into effect in 2019.

A spokesperson for Illinois Comptroller Susana Mendoza said her office decided to prohibit collections on truancy ticket debt because state law is clear that schools aren’t allowed to seek fines for truant students. At this point the comptroller’s office has not stopped collecting other types of student ticket debt, the spokesperson said.

Illinois Comptroller Susana Mendoza (Antonio Perez/pool/Chicago Tribune)

Officials at Bloom Trail High School in Chicago’s south suburbs, featured in “The Price Kids Pay” for its racial disparities in ticketing, said they will work with students to resolve differences when they get in trouble instead of calling the police to request that tickets be written.

The school “is committed to no longer seeing students receive police citations,” according to an emailed response on behalf of the district. “In order to prevent this, we are developing alternative approaches that will reduce the number of circumstances in which we will involve the local police.”

Police had issued 178 tickets to Bloom Trail students from the start of the 2018-19 school year through March. Almost all of the tickets were for fighting, and almost all went to Black students.

The police chief in the village of Steger said that if the school asks for help with a more serious matter, officers with juvenile training will work with students and try alternatives such as requiring community service. Until now, students who have gotten tickets have been required to attend municipal hearings, and they typically got fined.

“They are going to try to do more in-house with the kids, which is good for us because we are there all the time,” Steger Police Chief Greg Smith said. He also said that after receiving the comptroller’s directive, Steger will not submit to the state collections program any unpaid debt from truancy tickets.

“We will stop doing that,” Smith said.

The investigation documented at least 11,800 tickets issued over the last three school years to students in public schools across the state. Most of the tickets identified were for violating local ordinances against fighting, tobacco or vape possession or use, having small amounts of cannabis or truancy.

The Tribune-ProPublica investigation documented 1,830 truancy tickets issued during the past three school years across about 50 school districts. Police continued to ticket students for truancy in more than 40 districts after the 2019 law went into effect.

For instance, at Dundee-Crown High School in Carpentersville, police issued 649 tickets for truancy from January 2019 through Dec. 7, 2021, the largest number of truancy tickets that reporters documented. At $75 each, the tickets totaled nearly $50,000, police records show.

Some police records of tickets issued this school year at Dundee-Crown High School in Carpentersville (Records provided by Carpentersville)

A spokesperson for Community Unit School District 300, which includes Dundee-Crown, did not respond to repeated requests for comment.

At nearby Wauconda High School, almost all of the nearly two dozen truancy tickets issued to students came after the state banned schools from referring truant students to police. One student got a ticket after leaving “to go to McDonald’s and go home,” according to the ticket. Another was ticketed for missing the first three class periods, and a group of boys were ticketed after they “left and tried to return to school for lunch,” the tickets stated. Each ticket came with a $50 fine that doubled if not paid within a couple of weeks. District officials did not respond to requests for comment.

Local governments can try to collect debt from unpaid student tickets through private collection agencies or the state collections program. Municipalities that use the state program send debt information to the comptroller’s office without indicating the reason for the fine or the age of the debtor. Since the state does not know if it is pursuing debt from a young person or whether it was related to truancy, the onus is on local governments to follow the comptroller’s directive.

The ban on truancy debt collections applies to tickets issued by police to students or to their parents or guardians.

“The General Assembly has made clear its intention that schools not fine students for misbehavior, though they did leave the door open for schools to let police fine their parents for some activity,” comptroller’s office spokesperson Abdon Pallasch wrote in an emailed statement. “But the legislators put serious restrictions on schools’ ability to let law enforcement fine students’ parents for truancy. We agree with that policy.”

A truancy ticket issued to a Wauconda High School student who left school to go to McDonald’s (Obtained from the Wauconda Police Department by ProPublica)

Samantha Corzine had about $800 withheld from her state tax refund in 2020 because of debt owed by her daughters for tickets — including for truancy — that they received while students at Bradley-Bourbonnais Community High School in Bradley. She said the comptroller’s decision to stop collecting on some student debts is a step in the right direction.

“I’m glad they actually did that,” she said. “The state should not be able to take any money from parents.”

A clerk at the village said debt from students’ truancy tickets would not be pursued through the state program. The Bradley-Bourbonnais high school principal has said that it’s school administrators’ responsibility to alert police if students violate local ordinances.

Just hours after the investigation was published last month, Illinois’ top education official, Superintendent Carmen Ayala, told school leaders to “immediately stop” working with police to ticket students, saying that “the only consequences of the tickets are to impose a financial burden on already struggling families and to make students feel even less cared for, less welcome, and less included at school.” Gov. J.B. Pritzker, meanwhile, said conversations were already underway with legislators “to make sure that this doesn’t happen anywhere in the state of Illinois.”

One district superintendent contacted by reporters, however, said that he would continue to support involving police to either arrest or ticket students when their behavior is violent or extremely disruptive. Without police intervention, “schools will become the most violent, drug-filled places students attend,” said Jacksonville School District 117 Superintendent Steve Ptacek. “We owe it to our communities to keep schools safe, free from drugs, and focused on our academic atmosphere.” Officers wrote about 20 tickets at Jacksonville High School, west of Springfield, in the past three school years, according to Jacksonville Police Department records. Most were for student fights, though some were for truancy. None was for drugs.

But several school districts have begun to make changes in response to the investigation and Ayala’s plea.

In Harvard Community Unit School District 50, northwest of Chicago in McHenry County, Superintendent Corey Tafoya wrote in an email that an internal review of practices was underway. The deputy police chief in Harvard also said officers would immediately stop ticketing students for truancy.

Police had ticketed students at the high school and junior high at least 231 times over the past three school years, according to police records. At least 67 of the tickets were for truancy, and most of those had been issued since the state banned schools from referring truant students to police for fines.

“In light of the article being written, we decided we are not going to issue truancy tickets anymore. The school can handle it,” said Harvard Deputy Chief Tyson Bauman. He said school resource officers — police stationed at the schools — will still write citations for other local ordinance violations, including possession of tobacco or vaping materials and fighting.

Superintendent Jesse Brandt of Hall High School District 502, a one-school district of about 400 students in rural Bureau County, said school employees will no longer refer truant students to police. At least 10 truancy tickets were written to students there after the state truancy law was enacted.

Jennifer Smith Richards has been a reporter at the Chicago Tribune since 2015. Jennifer’s data-driven investigative work often focuses on schools and disability. She is a member of the ProPublica Distinguished Fellows program.

by Richard A. Webster, The Advocate | The Times-Picayune, and David Hammer, WWL-TV

This article was produced for ProPublica’s Local Reporting Network in partnership with The Advocate | The Times-Picayune, and it was also co-published with WWL-TV. Sign up for Dispatches to get stories like this one as soon as they are published.

As natural disasters become more expensive, ProPublica and The Advocate | The Times-Picayune are investigating how relief programs unintentionally punish poor people. Do you have a story to tell? Fill out this form.

Celeste Matthews spent last summer’s 16th anniversary of Hurricane Katrina in a panic at her cousin’s house in Uptown New Orleans as another monster storm, Hurricane Ida, roared through the city. With every gust, she was terrified the windows would shatter.

The next day, she returned to her home in the Gert Town neighborhood to find part of the roof torn off. With the electricity out, she had to sleep with the windows open. Mosquitoes swarmed around her bed.

“It was horrible,” said Matthews, 67.

After three days without power, Matthews had her daughter drive her to Houston. A week later she returned home, closed the curtains and sank into a depression, spending the next several days in bed.

One morning, she awoke to a knock on the door. An Orleans Parish sheriff’s deputy was holding a stack of court papers. Matthews, her hands shaking, read the first page:

“State of Louisiana, Division of Administration, Office of Community Development - Disaster Recovery Unit Versus Matthews, Celeste.”

Below that: “YOU HAVE BEEN SUED.”

Watch the Report

WWL-TV reports on Louisiana’s elevation grant lawsuits.

When the levees broke during Katrina in 2005, Matthews’ home was engulfed in 5 feet of water. She lost everything. Like most poor New Orleanians, she struggled to cobble together enough money to rebuild.

In 2008, the state of Louisiana offered Matthews $30,000 through the federally funded Road Home program to elevate her house to reduce the risk of future flooding. But her home was still unlivable, and she desperately needed the cash for repairs. To her relief, she said, a Road Home representative told her she could use the elevation grant to instead pay for repairs. So she did.

Now, more than a decade later, the state wanted the money back.

Louisiana has sued about 3,500 people — about one in every nine people who received an elevation grant — for failing to use the grants to raise their homes after hurricanes Katrina and Rita struck in 2005.

The real problem, however, wasn’t that people ignored the rules, according to an investigation by The Advocate | The Times-Picayune, WWL-TV and ProPublica. It’s that the state Office of Community Development and a contractor it hired in 2006, ICF Emergency Management Services, mismanaged the program. For more than a decade since, the U.S. Department of Housing and Urban Development has insisted that the state recoup the money from people who are noncompliant.

Court documents at Matthews’ home, including the notice that she was being sued by the state (Sophia Germer/The Advocate | The Times-Picayune)

Louisiana gave money to 32,000 homeowners starting in 2008. The state was in such a rush to distribute grants that no one verified they were eligible, according to the testimony of a top state official in one of the lawsuits. Some homeowners, like Matthews, said Road Home representatives told them they could use the money for repairs, even though that would violate their grant agreements.

Twice between 2013 and 2015, the state tried to fix the problem, changing the rules to allow spending on repairs and other expenses. But by then, so much time had passed that many homeowners couldn’t prove how they had used the money.

Some homeowners said they originally planned to elevate, but found that $30,000, the typical elevation grant, was less than a third of what it typically costs to lift a house and put it onto raised footings.

In 2017, under pressure from the federal government to recoup the funds, Louisiana started filing lawsuits against residents.

For many low-income homeowners, the suits could threaten financial ruin. Several pre-emptively declared bankruptcy, according to their attorneys. Others failed to defend themselves in court, resulting in the state placing liens on their properties. Some fear their homes will be taken away.

“We worked our asses off to get where we are now,” said Michelle Williams, 54, who is being sued along with her husband, Patrick Williams. “And for this to happen? You’re not helping the people of Louisiana. You’re knocking us farther and farther back.”

If they lose the lawsuit, she said, “I will crumble.”

The failures of Louisiana’s elevation grant program are part of a tapestry of dysfunction in how America prepares for disasters and helps victims in their wake. ProPublica and The Advocate | The Times-Picayune are exploring how a range of policies unintentionally punish working-class Americans and people of color, contributing to the disproportionate harm they suffer in catastrophes.

Louisiana’s Broken Disaster Aid

American disaster planning and relief programs are flawed in many ways, some of which have been brought into especially clear focus in Louisiana:

• HUD and the state of Louisiana paid $62 million to settle a lawsuit claiming that the Road Home, the signature post-Katrina rebuilding program, disproportionately hurt poor communities and people of color by basing grants in part on pre-storm values rather than the cost of rebuilding, leaving some homeowners unable to complete renovations. That policy’s effects are still reverberating in the form of neighborhood blight and depressed home values.
• As the National Flood Insurance Program reconfigures itself in an effort to better account for risk, premiums will rise drastically in many working-class communities in coastal Louisiana and elsewhere. The changes could make those homes difficult if not impossible to sell and could lead some people to drop their insurance, leaving them vulnerable to future storms.
• Even HUD has acknowledged that federal aid is distributed unpredictably and unevenly after devastating storms. The blue-collar town of Lake Charles has had a hard time getting help after Hurricane Laura in 2020, though wealthier, more influential areas struck by other major storms have gotten more aid more quickly.
• The federal government won’t build levees to protect an area from flooding until a critical mass of property is threatened. St. John the Baptist Parish, outside New Orleans, became a haven for working-class Black people due to plentiful and affordable housing. Though a hurricane levee has been planned for more than 30 years, it’s only now being built — after two punishing floods in the last decade.

The problem is particularly urgent in Louisiana. Not only is it one of the poorest states in the union, it’s the most flood-prone, and it has been struck by some of the costliest natural disasters ever to hit the U.S. Thanks to global warming, the severity of such events is increasing, and their monetary toll is skyrocketing: Adjusted for inflation, the cost of U.S. natural disasters has increased by 600% since 1980.

The lawsuits over elevation grants, which have left thousands of Louisiana homeowners facing the prospect of cripping liens or payment plans, are part of the broader pattern of poor disaster planning.

The majority of elevation grants were in lower-income neighborhoods and communities of color, as were the lawsuits that followed, according to an analysis by ProPublica and The Advocate | The Times-Picayune. For the roughly 3,000 lawsuits that could be mapped, more than half of properties were located in census tracts with median incomes below the surrounding areas.

Roughly two-thirds of the properties were in neighborhoods that were disproportionately Black compared to their parishes.

The state is seeking $103 million in the elevation lawsuits. So far it has recovered nearly 5% of that from 425 families through the suits, said Pat Forbes, executive director of the Office of Community Development.

The agency tried to avoid taking such an aggressive approach, he said. But the state is required by the federal government to claw back money from people who didn’t follow the grant requirements.

“We’ve gone to great lengths to try to not have to take money back from people,” Forbes said, adding that the state will not foreclose on anyone’s home to collect.

Matthews points out storm windows she installed after Hurricane Katrina. “I never completely recovered, emotionally,” she said. (Sophia Germer/The Advocate | The Times-Picayune)

A HUD spokesperson said the state could have used its own funds to repay any misspent grants rather than going after homeowners.

Suing them years later runs counter to the goal of helping the devastated communities of Louisiana rebuild, said U.S. Rep. Troy Carter, D-La.

Carter said he and other officials have talked to the Biden administration and Gov. John Bel Edwards about wiping the slate clean.

“These are not people that defrauded the government,” Carter said. “These are people that used the money to repair their homes. And they should not be put in a position where now those homes are being threatened.”

“I Wish I Never Signed That Paper”

Donnie Small’s family has deep ties to Jefferson Parish, which borders New Orleans. His father was the first Black sheriff’s deputy in the parish. Small drove a public bus there for 37 years.

After Katrina, Small volunteered to shuttle first responders between a small town upriver and New Orleans, 29 miles every morning and night. He did so when his own family was suffering, like so many others.

The one-story house in Kenner that he shared with his wife and two daughters sat in 2 feet of water for days after the storm. Everything had to be replaced: furniture, flooring, appliances, wiring.

Small, 69, received about $60,000 from his insurance company, but that covered only immediate needs, such as remediating mold and removing damaged trees. Unable to afford other accommodations, his family slept on air mattresses in the gutted structure, wearing masks to keep out the dust.

Small didn’t know how he was going to come up with more money, but he refused to give up. “I’ve never had any intentions of moving anywhere else,” he said. “This is my home. I’m going to be here.”

The Road Home program, created in 2006 to help people rebuild, often gave people less money than they needed to complete repairs because of how awards were calculated.

So in 2008, when the state sent 40,000 letters to homeowners telling them they were eligible for elevation grants, plenty of them were interested.

A letter to a homeowner announces that grants are available to help homeowners elevate their homes to reduce future flooding damage. (Obtained by ProPublica, The Advocate | The Times-Picayune and WWL-TV)

“The State of Louisiana is pleased to announce that funds are now available to assist you with the cost of elevating your home,” the letters read. To get the money, homeowners had to agree to raise their homes within three years of receiving grants.

Yet when Small met with a Road Home representative, he said, he was told he could put his $30,000 grant toward repairs. The money was a godsend, Small said.

Donnie Small looks for photos from after Katrina on his computer at his home in Kenner, Louisiana. Everything in the home had to be replaced in the storm’s aftermath. (Sophia Germer/The Advocate | The Times-Picayune)

Once the state Office of Community Development received an application, it sent the money to homeowners, Jeff Haley, who helped administer the elevation grant program as an official with ICF from 2006 to 2009, said in testimony during one of the elevation lawsuits.

No one double-checked before the money went out that homeowners were eligible or that their homes needed to be elevated, said Haley, who is now with the state Division of Administration. The state simply “didn’t have time,” he said. There was pressure to “get the funds out into the community as fast as possible.”

The state told the news organizations that it selected people whose homes were in flood-prone areas and who had already received another Road Home grant. It was up to homeowners to determine how much they needed to elevate their homes, officials said, and if they learned they were already at the correct height, they should have returned the money.

But when homeowners informed Road Home representatives, sometimes in writing, that they didn’t plan to elevate their homes, they were verbally told that they could use the money for repairs, according to eight families and eight attorneys representing more than 200 homeowners.

State officials told the news organizations no homeowners have identified who told them they could use the money for repairs. They suggested this didn’t happen until years later, after the state changed the rules to allow people who hadn’t raised their homes to use elevation grants for repairs.

Small said he never would’ve accepted the money if he hadn’t been told he could use it to fix his home.

“Back then it seemed they were really trying to help people,” said Small, who is the subject of a pending lawsuit. “We thought it was something that was a plus for us, that we can get our home back to the position that it was before the storm. Now, I wish I never signed that paper.”

The agreement that Small signed to receive his Road Home grant required that his home be raised within three years. He said a program representative told him he could instead put the grant toward repairs. The state contends that homeowners are bound by their agreements. (Obtained by ProPublica, The Advocate | The Times-Picayune and WWL-TV) Road Home Representative “Talked Me Into this Mess”

At least five appeals court rulings support homeowners’ contention that they were told they could use the grants for repairs.

Wallace and Kristy Styron received a $30,000 elevation grant even though their home was already above the required height. Wallace Styron testified that he repeatedly told a Road Home representative that he didn’t need to raise it, and even said he had submitted paperwork to prove it. But the person insisted he accept the grant, he said, telling him he could use it for repairs.

The representative “made me apply for this,” Styron testified in court after the state sued him in 2019 for failing to elevate his two-story home in southwestern Louisiana’s Cameron Parish. “She filled it out for me,” he said. “She talked me into this mess."

None of that mattered, the state argued. The Styrons had signed a contract in which he agreed to raise his home, and he was bound by it.

A document outlining the benefits Styron qualified for, dated Dec. 2, 2006, says he was not eligible for an elevation grant. Forms for two other homeowners reviewed by the news organizations said the same. Another three homeowners indicated on forms they didn’t want the elevation money. Yet all those homeowners subsequently received grants, and all have been sued.

The state’s Third Circuit Court of Appeal ruled for Styron, finding that “the Road Home representatives maintained” that he “did not have to use the funds for elevation purposes.”

The court noted that the state made no effort to dispute the Styrons’ claim by, for instance, putting a caseworker on the stand.

The state’s caseworkers were employees or subcontractors of ICF, ​​a subsidiary of a Virginia-based disaster management firm that won a contract for hundreds of millions of dollars in 2006 to manage the massive Road Home program, including processing grant applications and distributing funds to Louisiana homeowners.

State officials were highly critical of ICF’s performance throughout its three-year tenure. At first, they were unhappy with the slow pace at which the company awarded grants. Then, ICF said on its website in 2007, it sped up its work when “the need to move even faster than we believed possible quickly became clear.”

Cameron Parish attorney Jennifer Jones said ICF disseminated false information to families. She has won four lawsuits in which her clients testified that ICF caseworkers told them they could use the grants to fix their homes.

“All they wanted to do was get the money out, get the money out,” Jones said.

ICF spokesperson Lauren Dyke said the firm “worked within the policies put in place by the state.” She referred further questions to the state.

A worker for a shoring company shows temporary support beams at a New Orleans home being elevated in 2006. (Eliot Kamenitz/The Advocate | The Times-Picayune)

Even if families wanted to elevate, $30,000 was only a fraction of what most of them needed. The state estimated it would typically cost about $110,000 to raise a 1,500-square-foot home 3 feet — a complex process in which the home is lifted by a temporary network of support beams and jacks while a higher foundation is constructed below.

The state later offered more money, but there wasn’t enough to go around to everyone who needed more to elevate their homes.

By the time Cherylyn Davis got her elevation grant three years after Katrina, she said, she had been scammed out of $20,000 by three different contractors — a common complaint in the years after the storm.

Davis said she called a shoring company and learned it would cost more than $100,000 to raise her New Orleans East home.

“So I had no other choice but to finish my home” with the elevation grant, Davis wrote when the state demanded repayment in 2014. “I’m sorry that I did not inform you before this.” Considering she was missing some of her receipts, she asked, where “do we go from here”? She noted that she only earned $720 a month.

Haley, the former ICF official, testified in the Styrons’ case that the state and ICF were hearing from a lot of people that they didn’t have enough money to elevate and so they used the funds to repair their homes.

The state has asked a judge to enter a $28,263.57 default judgment against Davis because she hasn’t responded to the suit. She has neither the money nor the strength to fight the state, she said.

“I’ve been through a lot with this house,” she said. “I can’t worry about this, because I have a bad heart. I was sick for a long time worrying about things. I learned how to pray more and stress less.”

Cherylyn Davis, outside her home, holds a photo taken after Katrina and a 2014 letter she wrote to the state explaining that her grant would not cover the cost of elevating her home, so she used it for repairs. (Sophia Germer/The Advocate | The Times-Picayune) “These People Are Not Suspected of Fraud”

Thanks in part to the confusion around the program, 53% of grantees who had hit the three-year deadline to spend the money had not elevated their homes as of 2012, according to a 2013 report by HUD’s Office of Inspector General.

Most of the people who hadn’t followed the rules were “lower income or senior citizens who did not have sufficient resources to either rehabilitate their homes or to elevate them,” HUD said in a news release.

“These people are not suspected of fraud,” Forbes, the Office of Community Development executive director, said. “It’s just that they can’t demonstrate that the funds were spent for the purpose for which they were granted.”

While HUD seemed to sympathize with those who hadn’t fulfilled their grants, the federal agency for years has pressured the state to recoup money from noncompliant homeowners. With HUD’s approval, the state changed its rules several times to give people more ways to justify their spending.

The first time, in 2013, the state decided to allow grant recipients to count the cost of repairs, living expenses while rebuilding and other costs — but only if they could produce receipts. The original agreement hadn’t required people to save receipts, so few did, attorneys and homeowners said.

Photos show Davis’ home after Katrina. She told the state she had no choice but to make repairs, but she didn’t keep all of her receipts. (Sophia Germer/The Advocate | The Times-Picayune)

In 2015, the state tried a new approach: an inspection program to verify grantees had used the money for repairs.

That effort fell short too. So many hurricanes had struck Louisiana that inspectors couldn't determine whether the repairs they saw were from Katrina or subsequent storms, Haley testified. The inspections were halted after two years.

According to the state, more than 5,000 families benefited from its remedies. Others, however, were left in an impossible position, said attorney Keren Gesund, who represents several families being sued by the state.

“Nobody has receipts, and they’re not sending out inspectors anymore. And they don’t trust your word. So then that means that a person has no real avenue of relief at that point,” Gesund said. “After a certain amount of time, there’s no way to prove anything.”

In 2015, HUD issued its sternest warning yet, telling Louisiana that if it didn’t commit to “vigorous enforcement against fraud, waste and abuse,” the federal agency would look at all its options. HUD guidelines say failure to repay misspent funds can result in a reduction in current or future grants, including disaster assistance.

Forbes said penalties could range from the state being forced to repay unaccounted-for Road Home grants “all the way down to not having to pay back anything.”

In 2016, Louisiana sued ICF, claiming it had committed “numerous breaches” of its contract through errors in its “handling of files, determinations of eligibility, the calculation of the grant award, and the distribution of funds.”

ICF denies it breached the contract, according to court records.

The state’s lawsuit, now six years old, is still pending.

Too Tired to Fight

Matthews, the homeowner who was served with her lawsuit shortly after Ida, moved to Baton Rouge after Katrina. She would drop her daughter off at school and walk to a nearby park, where she would sit on a bench and cry.

About 80% of New Orleans flooded after the federal levees failed. About 1,800 people died; hundreds of thousands were displaced. Matthews counted family and friends among both groups.

“I never completely recovered, emotionally,” she said.

It took eight years for Matthews to return to her beloved New Orleans home. At first she planned to use her grant to elevate it, but she decided not to when others said their houses had been damaged in the process.

Then she began to receive letters warning she might have to return the money.

Matthews at her home with court documents, received in the days after her home was damaged again by Ida. (Sophia Germer/The Advocate | The Times-Picayune)

Matthews didn’t know what to do. She hadn’t saved receipts. Several years later, she tried to get an inspector to assess the value of her repairs, but by then the state had discontinued inspections.

Between Ida and the lawsuit, she’s been dragged into the abyss of a debilitating depression that has been with her since Katrina. At this point, she said, she’s too worn down to fight the state.

Roughly half of the lawsuits target New Orleanians. For those suits that could be mapped, over two-thirds were filed over properties in high-poverty neighborhoods and nearly 80% in tracts with a higher proportion of Black residents than the city as a whole, according to an analysis by ProPublica, The Advocate | The Times-Picayune and WWL-TV .

The news organizations reviewed a sample of 200 of the more than 1,600 elevation grant lawsuits filed over properties in the city. Just 30% of the defendants in the reviewed cases have legal representation.

Judges can issue default judgments against homeowners who don’t respond. About 150 have been issued or are pending, according to the state’s list of lawsuits. The state can place a lien on each home, which will have to be paid off when the house is sold or passed on — greatly reducing what these homeowners can bequeath to heirs.

“The state is relying on people to not fight back,” said attorney Shermin Khan, who represents more than 50 homeowners. “They’re having their wealth stolen from them. Their only equity.”

Meanwhile, the state has paid Baton Rouge law firm Shows, Cali & Walsh $11.1 million since 2009 to litigate claims of fraud and waste for all Road Home programs, including the elevation lawsuits.

There are essentially two ways homeowners can win these cases, attorneys said: Provide receipts, or prove that the homeowner wasn’t eligible and the state knew it when the contract was signed.

Mark and Donna Leger were able to pull that off. When they filled out a Road Home application, they provided a certificate showing their house in Cameron Parish was above the required height. On a printout of their Road Home application, next to the question “Is home required to be elevated?” the “No” box is checked.

And yet the state still awarded the Legers a $30,000 elevation grant. According to a court ruling, Mark Leger testified that a Road Home representative told him he could use the money to elevate his air-conditioning units or the utility meter, or to repair his house.

Eleven years later, the state sued them. The Third Circuit Court of Appeal ruled for the Legers.

Valerie Labat of Marrero, across the river from New Orleans, produced receipts and an affidavit showing she spent more than $31,000 between her contractor and various purchases at home improvement stores. Lawyers for the state want her to show how she spent a $12,300 insurance settlement so they know she’s not double-counting any expenses.

Labat, a 28-year Army veteran who struggles with PTSD, broke down several times as she discussed the pending lawsuit.

“The whole thing was supposed to be Road Home!” she said. “You are providing me a road to get home. A path to get in my house. But now that I’m home, you’re gonna pull the road from under me? What the hell you name it Road Home for?”

About the Data

To analyze the distribution of elevation lawsuits, ProPublica, The Advocate | The Times-Picayune and WWL-TV combined a list of lawsuit defendants sued by Louisiana’s Office of Community Development with a list of elevation grant recipients that included property addresses, excluding cases where the defendant could not be clearly matched to a grant recipient, or where the address in the grant data could not be mapped accurately. Nearly 98% of the 32,200 grants were geocoded successfully. The news organizations then matched roughly 3,000 of about 3,500 lawsuits related to elevation grants to census tracts and analyzed their characteristics. The news organizations evaluated tracts based on their demographics around the time period that the elevation grants were distributed, using 2010 census data to determine the racial composition of tracts and 2011 5-year American Community Survey data to measure poverty and income levels. The organizations defined “high-poverty neighborhoods” as census tracts with poverty rates of 20% or higher.

Did You Get the Help You Needed After a Hurricane or Tropical Storm? We’re Investigating Disaster Relief.

Sophie Chou and Joel Jacobs, ProPublica, and Jeff Adelson, The Advocate | The Times-Picayune, contributed data analysis.

by Mark Olalde

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.

The concentration of carbon dioxide in Earth’s atmosphere has reached its highest level in recorded human history. Again.

In April, the level of CO2 was 27% higher than it was 50 years ago, according to the latest data from the National Oceanic and Atmospheric Administration and the Scripps Institution of Oceanography. (Methane, a gas with about 85 times the near-term warming effect of CO2, has risen more than 16% since 1984, the first full year that NOAA collected data.)

Each spring, going back decades, we have surpassed the previous year’s CO2 record, as humans continue burning hydrocarbons at breathtaking rates, releasing greenhouse gasses. That impacts temperatures, precipitation, the intensity of storms and other weather patterns.

Across the American Southwest, this has amplified record droughts and fires.

Climate change is exposing where the bodies are buried, literally. Boaters and paddle boarders discovered two corpses in early May in Lake Mead, as water levels fell to their lowest point since the reservoir was filled in the 1930s. Lake Powell has also dropped to its lowest point since being filled. The ongoing drought appears to be the worst in 1,200 years, according to research recently published in the journal Nature Climate Change. Around the region, there have been hotter temperatures, smaller snowpack and an earlier start to the fire season. Wildfires have already torched more than 300,000 acres near Santa Fe in northern New Mexico this year.

This new reality threatens the Southwest, the fastest-growing region in the U.S., and the 40 million people who rely on the Colorado River, while offering a glimpse at what climate change will bring there and elsewhere.

“This happens to be one of those years when we can look out the window and look at the future as the smoke pall floats overhead,” said David Gutzler, a professor emeritus who researches climatology and meteorology at the University of New Mexico’s Earth and Planetary Sciences department.

To better understand how climate change is and will continue to affect the Southwest, ProPublica spoke to three experts: Gutzler; Mikhail Chester, a professor in Arizona State University’s engineering school and the director of the Metis Center for Infrastructure and Sustainable Engineering; and Gregg Garfin, a climatologist at the University of Arizona and co-lead author of the Southwest chapter in the Fourth National Climate Assessment.

The conversations have been edited for length and clarity.

Wildfires are burning near Santa Fe, while the Boulder, Colorado, area is still reeling from a fire that burned a developed area in the dead of winter. What are the connections between a changing climate and wildfires?

Gutzler: We make the extremes worse. That’s a bit different than saying a wildfire is caused by climate change. As temperatures rise, hot temperature-related extreme events are likely to become more frequent and more severe, and that’s exactly what we’re seeing across the West right now.

Garfin: There are also parts of the region where there’s a link between fire severity and climate change. The way that plays out is that climate change affects the hydrology, so it leads to a shorter snow-cover season, less snow-covered area, soils that are desiccated, and then temperature also puts stress on trees that dries out the fuels.

Research also suggests the Colorado River’s flow is down about 20% this century. How might the region’s river systems be shaped by climate change?

Gutzler: We should plan for diminished flows, particularly out of snow-fed rivers. ... What snow there is melts earlier and melts faster. That’s exactly what we saw this year. In the Rio Grande Basin, snowpack was pretty close to what most people would consider average right around the time of peak snow, a month and a half ago. But it has just melted really fast in this hot weather, so the effect of that on streamflow is we get less flow in the river for the same amount of snow that fell last winter.

Garfin: We’re seeing less snow-covered area, less water content in the snowpack, early runoff in the late winter and early spring at elevations lower than around 7,000 feet, an increased fraction in the precipitation that we get coming as rain rather than snow and reduced soil moisture. All of these things combine to reduce the efficiency of runoff. ...

We’re already seeing an increasing water supply coming from treated effluent that’s primarily being used to irrigate parks or golf courses. Probably we’ll be seeing more of our potable water supply coming from treated effluent. Another thing — we saw this in Arizona in the State of the State address from Gov. (Doug) Ducey — he said let’s put billions of dollars into developing desalinated water supplies, and there have been plenty of feasibility studies. It’s expensive and it takes a lot of energy, but we could end up with some technological breakthroughs. ... Water managers throughout the Colorado River Basin have been creative in finding ways to keep more water in the reservoirs. Obviously that’s not enough, but I think there will be water marketing and trading maneuvers — because some tribes have large amounts of water — to create the legal mechanisms for the cities to buy more water from tribes.

What about the impact of climate change on living things in the region? What do we know about changes to ecosystems and biodiversity?

Gutzler: The change in the climate is happening at the same time as humans affect ecosystems in other ways that aren’t connected to climate change, just by habitat destruction and all the other things that people do to change the environment. I view climate change as an added stress to wild ecosystems that are already stressed by large numbers of people moving into the Southwest.

One way for mobile species to adapt to climate change is to move north. ... If people have built fences or, at the U.S.-Mexico border, a wall, then the combined effect of a changing climate and barriers to migration can jeopardize the health of species and ecosystems.

In addition to biodiversity, how does a changing climate interact with the Southwest’s rapid population growth?

Garfin: We’ve got a lot of people who have built their homes or expanded towns into the so-called wildland-urban interface, and that puts infrastructure at risk (to wildfires). Also, if we have severe fire, eventually there’s going to be rain — it doesn’t even have to be record rainfall — and all that stuff that has burned is going to find its way into watercourses. We end up with debris flows that can take out infrastructure, that can take out roads or that can end up in reservoirs and increasing the sediment load and decreasing water quality.

Chester: We are figuring out already how to deal with extremes in terms of heat, in terms of monsoons, in terms of drought that are beyond the forecasts of most other places in the United States. The worst of the worst in a particular place in Illinois, let’s say, is probably not close to what you get in Phoenix, so we’re already living with these extremes. ... For the most part, things aren’t breaking right now. ...

Now, you’re running into the reality that the conditions that we’re designing for are not necessarily what we will live with in the future. So, if we designed for 120 degrees Fahrenheit maximum temperatures, is that what’s going to be the max 20 years from now, 30 years from now, or is it going to be greater?

If the Phoenix metro area is doing pretty well overall, are there any examples of infrastructure that’s already nearing the breaking point?

Chester: You get a lot more blackouts and brownouts in the power system when you have these heat waves. That’s the case anywhere in the U.S., but you certainly have that here. You get inundation of the stormwater system. ... Everything breaks more frequently when you have hotter temperatures. That’s the simpler way of looking at it.

The Southwest is a very ethnically diverse region. How does that affect the calculus as society pursues solutions?

Garfin: If we don’t deal with equity in climate solutions, then we’re going to shoot ourselves in the foot. Through the impacts to vulnerable communities and less economically well-off communities, it’ll end up being more costly anyway. ... Previous failures were that housing developments in less affluent parts of our cities have typically lacked the kinds of landscaping that would reduce the heat-island effect and that would absorb more stormwater, so we know that now and we know that we haven’t done well by those communities.

The Intergovernmental Panel on Climate Change published reports this year that came with a warning — we’re likely to miss the Paris Agreement’s goal of limiting warming to 2.7 degrees Fahrenheit. What does that mean for the Southwest?

Gutzler: We’re living it this year. ... You can take an extreme drought of the sort that we’re experiencing now and the way that it has impacted the environment, the water supply across the board, and say that is the direction the Southwest is headed unless we do something about climate change.

Garfin: We already have amplified heat in our cities from the urban heat-island effect, from just changing from natural vegetation to the built environment. Also, as you increase the background temperature, the effects that we see in our large cities — Phoenix, Tucson, Las Vegas — more people are exposed to the public health effects of extreme heat. ... In places like Tucson or Las Cruces, our future might look like Phoenix, and Phoenix’s future might look like Middle Eastern cities. ... Then, what’s projected is continued decreases in snowpack, perhaps more extreme high flows, but more days with very low flows. That leads to a much less reliable surface water supply.

Are there examples of steps being taken in the region to address climate change through mitigation or adaptation?

Garfin: If we look to some of the more progressive climate change plans like Flagstaff’s Climate Action and Adaptation Plan, they’re doing a couple things in terms of wildfire. One is insisting through their public policy that there’s more defensible space around houses and other structures that are in the wildland-urban interface. Then, they also had a bond in 2012 where city residents overwhelmingly voted to tax themselves to pay for forest treatments on public, federal lands in their watershed to reduce the risk of really severe fires.

Chester: There’s got to be a readjustment of how we utilize ecological infrastructure. ... You’re going to have a lot of small-scale failures, and at times it might make sense to allow those failures to happen.

I’m not suggesting we allow loss of life. I’m not suggesting we allow major economic damages. So, a great example here of safe-to-fail infrastructure is Indian Bend Wash in Scottsdale. We’ve basically said, when the monsoon rains come, we are going to allow a giant river to move through the wash, and it might take out the golf courses, the bike paths, the Frisbee golf, the dog park. ... The cost of replacing it is pretty low, but the benefit we get is enormous. The benefit is social in terms of all this space. The benefit is ecological; there’s a lot of green infrastructure in there. There’s also the benefit of stormwater attenuation.

With all this in mind, what does the future hold for the Southwest?

Chester: The problem — from my perspective as an engineer who studies infrastructure — is the rigidity of everything we’ve built out. ... For the past century we’ve gotten away with these design assumptions that things can be rigid, can be based on a future that is largely predictable. Here we are in the future saying that doesn’t seem to be the case. We need a lot of flexibility.

Gutzler: Ultimately, carbon energy will be replaced on purely economic grounds by renewables, so there’s hope there. But the Southwest is inevitably going to become a hotter and drier place than it is now with huge stresses on human societies and wild ecosystems. That’s what’s in store for us, so we better adapt to it as intelligently as we can.

by Molly Parker, The Southern Illinoisan

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

Two Southern Illinois lawmakers are calling on Gov. J.B. Pritzker to improve access to mental health and substance abuse treatment and other services to ensure that families repeatedly investigated by the state’s child welfare agency can access the help they need.

“It’s time for the governor to be a leader and figure out how to solve this problem in Southern Illinois,” said State Sen. Terri Bryant, a Murphysboro Republican who sits on a subcommittee focused on family and child welfare issues.

The calls to action come on the heels of reporting by The Southern Illinoisan and ProPublica about the large number of parents who are investigated by the Illinois Department of Children and Family Services time and again for allegations of child abuse or neglect.

The reporting involved an analysis of departmental investigative case data by ProPublica and The Southern Illinoisan and found that parents and caregivers in Southern Illinois were more likely to face repeat DCFS investigations compared with those in other parts of the state. Numerous parents cycling through DCFS investigations told reporters they were having difficulty accessing the services they needed in order to keep or reunite with their children after an abuse or neglect allegation was reported to the department.

State Rep. Patrick Windhorst, a Republican from Metropolis, at the state’s southern border with Kentucky, also called on the governor and other state policymakers to take swift action to improve the lives of children and families involved with DCFS in Southern Illinois. The agency, he said, “is deeply in need of reform.”

Statewide, Illinois is experiencing escalating rates of “recurrence,” which measures the percentage of child abuse and neglect victims who are the subject of a subsequent substantiated DFCS investigation within a year of an earlier substantiated investigation. Illinois’ recurrence rate reached a 10-year high in fiscal year 2020 and was among the nation’s worst.

The analysis also found that most parents facing repeated investigations have not physically abused their children but instead face numerous allegations of neglect. Neglect is broadly defined as a failure to provide for basic needs such as food, clothing, shelter and supervision.

Bryant said that she called DCFS Director Marc Smith late last month, on the day the story was published, demanding answers about his agency’s plans for Southern Illinois families. She also expressed frustration that Smith, a Pritzker appointee, was quoted in the article blaming problems on the state’s budget woes, particularly during the administration of former Republican Gov. Bruce Rauner. Pritzker, a Democrat, ousted Rauner in the 2018 election and faces reelection this November. In recent months, Prtizker’s DCFS has faced intense scrutiny from child welfare officials and lawmakers from both parties.

Still, Bryant described her conversation with Smith as productive. He acknowledged to her the need to expand services in Southern Illinois, she said. He also told her — according to Bryant, and echoing his prior comments to reporters — that solving this issue can’t be the work of DCFS alone. The state’s other social service agencies, especially the Department of Human Services and the Department of Healthcare and Family Services, also play a role, he told her. They are responsible for ensuring that there’s a robust menu of drug treatment and mental health services available across the state, and that they’re accessible to low-income Illinoisans, including to the families involved with child welfare services. (A spokesman for DCFS confirmed that Bryant and Smith spoke about the need for a multi-agency response to these challenges.)

“The gist of it was that all three of those agencies have responsibilities when it comes to certain things for youth in care and their parents, and as he said that to me, it made sense.”

Still, Bryant questioned why the governor, who oversees all of those departments, isn’t doing more to bring them together to solve these issues. The 27 Southern Illinois counties served by DCFS’ Marion office and its satellite offices have collectively experienced a 120% spike in the number of children in foster care in a decade. “The time for DCFS, HFS and DHS to point fingers at each other is long past over,” she said.

While those agencies have acknowledged difficulties providing services in the region, officials emphasized recent efforts to solve those issues. In a statement, Alex Gough, Pritzker’s senior deputy press secretary, reiterated the administration’s claim that the service deserts and the worsening child welfare trends are attributable to Rauner’s budget policies.

“After social service programs were hollowed out over four years under the previous administration, Governor Pritzker has worked tirelessly to restore reliable services in every corner of the state,” Gough said. Numerous attempts to reach Rauner were unsuccessful.

Pritzker has “invested hundreds of millions of dollars in programs that help families build better lives,” Gough added. That has included increasing funding for mental health and substance abuse treatment, and expanding access to housing, child care and food programs for low-income families. Further, he said, the governor tapped two experienced executives in March to lead an overhaul of the state’s behavioral health support systems for adults and children, and to oversee the expansion of services into areas where they are lacking.

DHS spokesperson Patrick Laughlin said the governor has committed more resources for substance abuse prevention and recovery, as well as for family support services, “than ever before.”

Jamie Munks, spokesperson for HFS, acknowledged that accessing specialty and behavioral health services “has long proven challenging in certain parts of the state.” But in this administration, she said, the department is working under a mandate to increase equitable access to health care services. The department launched a program last year aimed at improving health care access in rural and underserved areas.

In recent years, Windhorst said the General Assembly has considered several proposals to make child welfare services more responsive locally. One proposal called for fracturing DCFS’ statewide authority and placing regional branches under the control of the chief judge of each circuit. Another proposal called for expanding court involvement for parents in substantiated cases of abuse or neglect but whose circumstances do not necessitate immediate removal of their children. But before any reform efforts can be implemented, they “require the needed services to be available,” he said.

“That has long been an issue in southernmost Illinois and will require DCFS to focus on how it uses resources that are sometimes scarce in our region and are often more readily available out of state,” Windhorst said.

by Eli Hager and Asia Fields

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.

Reporters at ProPublica and NBC News are conducting research on Arizona’s child protective services agency (the Department of Child Safety, or DCS) and how it investigates Black families in the Phoenix area at a higher rate than white families. We would like to hear directly from people who have been affected by this issue.

We’re especially interested in speaking with Black families who have had any interaction with DCS, which used to be called Child Protective Services, or CPS. We’d also like to hear from others who know about this topic, such as educators and community organizers.

We know this can be difficult to talk about. We appreciate you sharing your story, and we take your privacy seriously. It is important to us. We are gathering these stories for the purposes of our reporting, and we will contact you if we wish to publish any part.

Filling out the short questionnaire below will help us shine a light on the important issue of racial disparities in Arizona’s child protective services system.

by Adriana Gallardo

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The original version of this story, which was co-published with NPR, is available here. The version below contains updated links and statistics and has been condensed for clarity.

In 2017, ProPublica and NPR launched a project shedding light on maternal deaths and near-deaths in the U.S. We explored better ways to track and understand preventable deaths, and the intergenerational trauma caused by childbirth complications and chronic racial disparities in who suffers from them. We heard from more than 5,000 people who endured, or watched a loved one endure, life-threatening pregnancy and childbirth complications, often resulting in long-lasting physical and emotional effects.

These people who sent us their stories frequently told us they knew little to nothing beforehand about the potentially fatal complications that they or their loved ones faced. They wanted to help others. So we decided to publish some of their wisdom.

They told us what they wish they had known ahead of their severe complications: How do I get medical professionals to listen? When are changes in my body normal, and when are they a warning? How do I navigate the postpartum period? In the years since, other readers have told us this advice was critical.

Recent data shows maternal deaths, including deaths in the first six weeks after childbirth, rose in the first year of the pandemic. The increase puts the nation’s maternal mortality rate at 23.8 deaths per 100,000 live births in 2020, up from 20.1 deaths in 2019.

If the U.S. Supreme Court strikes down Roe v. Wade, they’ll do so in a country where pregnancy and childbirth continue to become more dangerous. We’re republishing this advice today, in a shortened and easier-to-navigate format, because self-advocacy and community knowledge are important when systems fail.

Choosing a Provider

“A lot of data on specific doctors and hospitals can be found publicly. Knowing how your physician and hospital rates as compared to others (cesarean rates, infection rates, readmission rates) can give you valuable insight into how they perform. ‘Liking’ your doctor as a person is nice, but not nearly as important as their and their facility’s culture and track record.”

— Kristen Terlizzi, survivor of a 2014 placenta accreta spectrum (a disorder in which the placenta grows into or through the uterine wall) and cofounder of the National Accreta Foundation

“Key pieces of information every woman should know before choosing a hospital are: What are their safety protocols for adverse maternal events? No one likes to think about this while pregnant, and providers will probably tell you that it’s unlikely to happen. But it does happen and it’s good to know that the hospital and providers have practiced for such scenarios and have proper protocols in place.”

— Marianne Drexler, survived a hemorrhage and emergency hysterectomy in 2014

“If a birthing center is your choice, discuss what happens in an emergency — how far away is the closest hospital with an ICU? Because a lot of hospitals don’t have them. Another thing many women don’t realize is that not every hospital has an obstetrician there 24/7. Ask your doctors: If they’re not able to be there the whole time you’re in labor, will there be another ob/gyn on site 24 hours a day if something goes wrong?”

— Miranda Klassen, survivor of amniotic fluid embolism in 2008 and founder/executive director of the Amniotic Fluid Embolism Foundation

Preparing for an Emergency

“A conversation about possible things that could go wrong is prudent to have with your doctor or in one of these childbirth classes. I don’t think that it needs to be done in a way to terrify the new parents, but as a way to provide knowledge. The pregnant woman should be taught warning signs, and know when to speak up so that she can be treated as quickly and accurately as possible.”

— Susan Lewis, survived disseminated Intravascular Coagulation (DIC) in 2016

“Always have somebody with you in a medical setting to ask the questions you might not think of and to advocate on your behalf if your ability to communicate is compromised by being in poor health. ... And get emotional support to steel you against the naysayers. It may feel really unnatural or difficult to push back [against doctors and nurses]. Online forums and Facebook groups can be helpful to ensure you’re not losing your mind.”

— Eleni Tsigas, survivor of preeclampsia in 1998 and 1999 and chief executive officer of the Preeclampsia Foundation

“In case you ever are unable to respond, someone needs to step in and be your voice! Know as much thorough medical history as possible, and let your spouse or support person know [in depth] your history as well.”

— Kristina Landrus, survived a hemorrhage in 2013

“Also be sure your spouse and your other family members, like your parents or siblings, are on the same page about your care. And if you aren’t married, who will be making the decisions on your behalf? You should put things in order, designate the person who will be the decision maker, and give that person power of attorney. Other important things to have are a medical directive or a living will — be sure to bring a copy with you to the hospital. I also recommend packing a journal to record everything that happens.”

— Miranda Klassen

“Make a list of your questions and make sure you get the full answer. I went to every appointment the second time around with a notebook. I would apologize for being ‘that patient,’ but I had been through this before and I wasn’t going to be confused again. I wanted to know everything. Honestly, it was as harmful as it was helpful. I knew what I was getting into, which made it much scarier. The first time, my ignorance was bliss. I didn’t realize I almost died until two weeks after I had left the hospital. I didn’t even start researching what had happened to me until months later. The second time I was an advocate for myself. Medical journals and support groups were a part of every single visit. And thankfully, I was in good hands.”

— Carrie Anthony, survived placenta accreta and hemorrhage in 2008 and 2015 as well as placenta previa in the second pregnancy

“Write down what each specialty says to you. ... They paraded in on a schedule, checked up on me, asked if I had any questions. I always did, but I regret not writing down what each said each time (along with names!). I got so many different answers regarding how I would be anesthetized, and on the day it all had to happen in an emergency, there were disagreements above me in the OR between the specialists. It was like children arguing on a playground and my life was in danger. Had I kept a more vigilant record of what each specialty reported to me, perhaps prior to the day I could have confronted each with the details that weren’t matching up.”

— Megan Moody, survived placenta percreta (when the placenta penetrates through the uterine wall) in 2016

“People should know that they have a right to ask for more time with the doctor or more follow-up if they feel something is not right. The OB-GYNs (at least in Pennsylvania) are so busy and sometimes appointments are quite quick and rushed. Make the doctors slow down and take the time with you.”

— Dani Leiman, survived HELLP syndrome (a particularly dangerous variant of preeclampsia) in 2011

“You have a legal right to your medical records throughout pregnancy and anytime afterwards. Get a copy of your lab results each time blood is drawn, and a copy of your prenatal and hospital reports. Ask about concerning or unclear results.”

— Eleni Tsigas

Getting Your Provider to Listen

“Understand the system. Ask a nurse or a trusted loved one in the ‘industry’ how it all works. I’ve found that medical professionals are more likely to listen to you if you demonstrate an understanding of their roles and the kind of questions they can/cannot answer. Know your ‘silos.’ Don’t ask an anesthesiologist how they plan on stitching up your cervix. Specialists are often incredibly impatient. You need to get the details out of them regarding their very specific roles.”

— Megan Moody

“If your provider tells you, ‘You are pregnant. What you’re experiencing is normal,’ remember — that may be true. [But it’s also true] that preeclampsia can mimic many normal symptoms of pregnancy. Ask, ‘What else could this be?’ Expect a thoughtful answer that includes consideration of ‘differential diagnoses’ — in other words, other conditions that could be causing the same symptoms.”

— Eleni Tsigas

“They only listen if the pain is a 10 or higher. Most of us don’t understand what a 10 is. I’d always imagined a 10 would feel like having a limb blown off in combat. When asked to evaluate your pain on a scale of 1 to 10, when you are in your most vulnerable moment, it is very hard to assess this logically, for you and for your partner witnessing your pain. I later saw a pain chart with pictures. A 10 was demonstrated with an illustration of a crying face. You may not actually be shedding tears, but you are most likely crying on the inside in pain, so I suggest to always say a 10. My pain from the brain hemorrhage was probably a 100, but I’m not sure if I even said 10 at the time.”

— Emily McLaughlin, survived a postpartum stroke in 2015

“So many women do speak up about the strange pain they have, and a nurse may brush it off as normal without consulting a doctor and running any tests. Be annoying if you must, this is your life. ... Thankfully, I never had to be so assertive. I owe my life to the team of doctors and nurses who acted swiftly and accurately, and I am eternally grateful.”

— Susan Lewis

“If you have a hemorrhage, don’t clean up after yourself! Make sure the doctor is fully aware of how much blood you are losing. I had a very nice nurse who was helping to keep me clean and helping to change my (rapidly filling) pads. If the doctor had seen the pools of blood himself, rather than just being told about them, he might not have been so quick to dismiss me.”

— Valerie Bradford, survived a hemorrhage in 2016

Paying Attention to Your Symptoms

“I had heard of preeclampsia but I was naïve. [I believed] that it was something women developed who didn’t watch what they ate and didn’t focus on good health prior and/or during pregnancy. I was in great health and shape prior to getting pregnant, during my pregnancy I continued to make good food choices and worked out up until 36 hours before the baby had to be taken. I gained healthy weight and kept my BMI at an optimum number. I thought due to my good health, I was not susceptible to anything and my labor would be easy. So although I had felt bad for 1 1/2 weeks, I chalked it up to the fact that I was almost 8 months into this pregnancy, so you’re not supposed to feel great. … I walked into my doctor’s office that Friday and not one hour later I was in an emergency C-section delivering a baby. I had to fully be put under due to the severity of the HELLP, so I didn’t wake up until the next day.”

— Kelli Davis, survived HELLP syndrome in 2016

“Understand that severe, sustained pain is not normal. So many people told me that the final trimester of pregnancy is sooo uncomfortable. It was my first pregnancy, I have a generally high threshold for pain, and my son was breech so I thought his head was causing bad pain under my ribs [when it was really epigastric pain from the HELLP syndrome]. I kept thinking it was normal to be in pain and I let it go until it was almost too late.”

— Dani Leiman

“Know the way your blood pressure should be taken. And ask for the results. Politely challenge the technician or nurse if it’s not being done correctly or if they suggest ‘changing positions to get a lower reading.’ Very high blood pressure (anything over 160/110) is a ‘hypertensive crisis’ and requires immediate intervention.”

— Eleni Tsigas

“Please ask for a heart monitor for yourself while in labor, not just for the baby. I think if I had one on, seconds or minutes could have been erased from reaction time by the nurses. They were alerted to an issue because the baby’s heart stopped during labor, and while the nurse was checking that machine, my husband noticed I was also non-responsive. That’s when everything happened.”

— Kristy Kummer-Pred, survived amniotic fluid embolism and cardiac arrest in 2012

After the Delivery

“My swelling in my hands and feet never went away. My uterus hadn’t shrunk. I wasn’t bleeding that bad, but there was a strange odor to it. My breasts were swollen and my milk wasn’t coming in. I was misdiagnosed with mastitis [a painful inflammation of the breast tissue that sometimes occurs when milk ducts become plugged and engorged]. The real problem was that I still had pieces of placenta inside my uterus. Know that your placenta should not come out in multiple pieces. It should come out in one piece. If it is broken apart, demand an ultrasound to ensure the doctors got it all. If you have flu-like symptoms, demand to be seen by a doctor. If you don’t like your doctor, demand another one.”

— Brandi Miller, survived placenta accreta and hemorrhage in 2015

“There is a period in the days and weeks after delivery where your blood pressure can escalate and you can have a seizure, stroke, or heart attack, even well after a healthy birth. You should take your own blood pressure at home if your doctor doesn’t tell you to. ... Unfortunately, I went home from [all my postpartum] appointments with my blood pressure so high that I started having a brain hemorrhage. Not one single person ever thought of taking my blood pressure when I was complaining about my discomfort and showing telltale warning signs of [preeclampsia].”

— Emily McLaughlin

“The postpartum period is when a lot of pregnancy-related heart problems like cardiomyopathy emerge. If there is still difficulty breathing, fluid buildup in ankles, shortness of breath and you are unable to lie flat on your back, go see a cardiologist ASAP. If you have to go to an emergency room, request to have the following tests performed: echocardiogram (echo) test, ejection fraction test, B-type natriuretic peptides (BNP), EKG test and chest X-ray test. These tests will determine if your heart is failing and will save your life.”

— Anner Porter, survivor of peripartum cardiomyopathy in 1992

“Rest as much as possible — for as long as possible. Being in too big a rush to get ‘back to normal’ can exacerbate postpartum health risks. Things that are not normal: heavy bleeding longer than 6 weeks, or bleeding that stops and starts again, not producing milk, fevers, severe pain (especially around incision sites), excessive fatigue, and anxiety/depression. If you don’t feel like yourself, get help.”

— Amy Barron Smolinski, a survivor of preeclampsia, postpartum hemorrhage and other complications in three pregnancies in 2006, 2011 and 2012 and executive director of Mom2Mom Global, a breastfeeding support group

“Know that your preexisting health conditions may be impacted by having a baby (hormone changes, sleep deprivation, stress). Record your health and your baby’s in a journal or app to track any changes. Reach out to the nurse or doctor when there are noticeable changes that you have tracked.”

— Noelle Garcia, survived placental abruption (placenta separating from the uterine wall during pregnancy) in 2007

“If your hospital discharges you on tons of Motrin or pain killers, be aware that this can mask the warning signs of headache, which is sometimes the only warning sign of preeclampsia coming on postpartum.”

— Emily McLaughlin

Grappling With the Emotional Fallout

“I wish I had known that postpartum PTSD was possible. Most people associate PTSD with the effects of war, but I was diagnosed with PTSD after my traumatic birth and near-death experience. Almost 6 years later, I still experience symptoms sporadically.”

— Meagan Raymer, survived severe preeclampsia and HELLP syndrome in 2011

“I recommend therapy with a female therapist specializing in trauma. Honestly, I avoided it for 8 months. I was then in therapy for 12 months. I still have ongoing anxiety ... but I would be in a very bad place (potentially depression and self-harm due to self-blame) were it not for therapy. It was so hard to admit [what was happening]. I started to get a suspicion when I heard an NPR story about a veteran with PTSD. I thought ... that sounds like me. And I started Googling.”

— Jessica Rae Hoffman, survived severe sepsis and other complications in 2015

“The emotional constructs our society puts around pregnancy and childbirth make the ideas of severe injury and death taboo. Childbirth is a messy, traumatic experience. ... Many women don’t seek care even when they instinctively believe something is wrong because they’re supposed to ‘be happy.’ Awareness and transparency are so important.”

— Leah Soule, survived a hemorrhage in 2015

“I wish I had understood how significant the impact was on my husband. Emotionally, the experience was much more difficult and long-lasting for him than for me, and it continued to affect his relationship with both me and our baby for quite a while, at a time when I didn’t think it was a thing at all.”

— Elizabeth Venstra, survived HELLP syndrome in 2014

“I would suggest establishing yourself ahead of time with a doula or midwife that can make postpartum visits to your home, which can promote health even if everything goes smoothly. Many communities have those services available if you can’t afford them. [A doula] wasn’t covered through our insurance, but the social worker at the hospital arranged for someone paid for by [San Diego County] to come and do several checks on me and my son, which was very reassuring to both my husband and me.”

— Miranda Klassen

Other Resources

• The Leapfrog Group provides performance data on more than 1,800 hospitals and publishes an annual Maternity Care Report.

• Consumer Reports offers C-section data from more than 1,300 hospitals by ZIP code.

• The California Maternal Quality Care Collaborative’s toolkits of protocols for treating life-threatening obstetric complications include infographics, checklists and extensive backup materials. Register on the site for free access. The Alliance for Innovation on Maternal Health’s offers bundles of similar information in a condensed, downloadable form.

• The Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN)’s Health4Mom site has a “Save Your Life” campaign, including a one-page checklist, to help new parents recognize post-birth warning signs. The Institute for Perinatal Quality Improvement offers resources for medical professionals.

• Childbirth Connection provides evidence-based information on maternity care.

• The Preeclampsia Foundation’s “Wonder Woman” posts put the U.S. maternal mortality numbers in context and suggest more strategies for self-advocacy.

• Postpartum Support International offers many resources for people suffering from pregnancy-related depression, anxiety and mood disorders. They also have resources for dads.

• Facebook is a gathering place for thousands of people who have experienced life-threatening complications. Many groups are condition-specific or closed to nonsurvivors. One open group worth checking out: The Unexpected Project.

• Some social justice groups advocate to reduce childbirth-related deaths and near-deaths. Many focus on why Black people are disproportionately affected. Those groups include theBlack Mamas Matter Alliance, Moms Rising and the National Birth Equity Collective.

• For more context, check out “Killing the Black Body: Race, Reproduction, and the Meaning of Liberty” by Dorothy Roberts, which was reissued a few years ago in celebration of its 20th anniversary. The new edition includes reflections on its publication and findings, and on the continued escalation of abortion bans across the country.

• For those dealing with complicated medical bills, former ProPublica reporter Marshall Allen offers advice in his book “Never Pay the First Bill: And Other Ways to Fight the Health Care System and Win.”

Help us continue reporting on pregnancy and childbirth. Have you had an experience with prenatal genetic testing? Tell us here. We want to understand more about your interactions with genetic screening providers.

by Ken Armstrong

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

When U.S. Supreme Court Justice Samuel Alito, in a draft opinion obtained and published this week by Politico, detailed his justifications for overturning Roe v. Wade, he invoked a surprising name given the case’s subject. In writing about abortion, a matter inextricably tied to a woman’s control over her body, Alito chose to quote from Sir Matthew Hale, a 17th-century English jurist whose writings and reasonings have caused enduring damage to women for hundreds of years.

The so-called marital rape exemption — the legal notion that a married woman cannot be raped by her husband — traces to Hale. So does a long-used instruction to jurors to be skeptical of reports of rape. So, in a way, do the infamous Salem witch trials, in which women (and some men) were hanged on or near Gallows Hill.

Hale’s influence in the United States has been on the wane since the 1970s, with one state after another abandoning his legal principles on rape. But Alito’s opinion resurrects Hale, a judge who was considered misogynistic even by his era’s notably low standards. Hale once wrote a long letter to his grandchildren, dispensing life advice, in which he veered into a screed against women, describing them as “chargeable unprofitable people” who “know the ready way to consume an estate, and to ruin a family quickly.” Hale particularly despaired of the changes he saw in young women, writing, “And now the world is altered: young gentlewomen learn to be bold” and “talk loud.”

An excerpt from Hale’s “Letter of Advice.” (Via Google Books)

Hale became Lord Chief Justice of England in 1671. In his time (Hale’s contemporaries included Oliver Cromwell and Charles II), Hale was a respected, perhaps even venerated, jurist known for piety and sober judgment. He wrote a two-volume legal treatise, “The History of the Pleas of the Crown,” that has proved influential ever since.

Alito, in his draft opinion, invokes “eminent common-law authorities,” including Hale, to show how abortion was viewed historically not as a right, but as a criminal act. “Two treatises by Sir Matthew Hale likewise described abortion of a quick child who died in the womb as a ‘great crime’ and a ‘great misprision,’” Alito wrote.

Even before “quickening” — defined by Alito as “the first felt movement of the fetus in the womb, which usually occurs between the 16th and 18th week of pregnancy” — Hale believed an abortion could qualify as homicide. “Hale wrote that if a physician gave a woman ‘with child’ a ‘potion’ to cause an abortion, and the woman died, it was ‘murder’ because the potion was given ‘unlawfully to destroy her child within her,’” Alito wrote.

Courts have long leaned on precedents established by old cases and the scholarship of legal authorities from centuries gone by. But what happens when you trace citations back to their ancient source? In Hale’s case, you sometimes find a man conceiving precepts out of thin air. Other times it was the opposite, as he clung to notions that were already becoming anachronistic in the last half of the 17th century.

Consider the marital rape exemption. In “Pleas of the Crown,” Hale wrote, “The husband cannot be guilty of a rape committed by himself upon his lawful wife for by their mutual matrimonial consent and contract the wife hath given up herself in this kind unto her husband which she cannot retract.” So, according to Hale, marriage, for a woman, amounts to contractual forfeit, in which she loses legal protection or recourse should her husband sexually assault her.

Hale’s pronouncement became the accepted common law and served as foundation in the United States for immunizing a husband accused of raping his wife. And where did Hale’s pronouncement come from? What did he base it upon? Who knows? “Hale appears to have been the first to articulate what later would become an accepted legal principle, that a husband cannot be charged with raping his wife,” according to a footnote in one law review article. Another law review article, titled “The Marital Rape Exemption: Evolution to Extinction,” called Hale’s pronouncement “an unsupported, extrajudicial statement” lacking in authority.

Starting in the 1970s, states began to abandon the marital rape exemption, in whole or in part. In 1981, the Supreme Court of New Jersey wrote that it could find no support for Hale’s proposition among earlier writers. Hale’s declaration, the court found, “cannot itself be considered a definitive and binding statement of the common law, although legal commentators have often restated the rule since the time of Hale without evaluating its merits.” In 1984, the Supreme Court of Virginia wrote: “Hale's statement was not law, common or otherwise. At best it was Hale's pronouncement of what he observed to be a custom in 17th century England.” The Virginia court went on to note, “Moreover, Hale cites no authority for his view nor was it subsequently adopted, in its entirety, by the English courts.”

Like the marital rape exemption, the so-called Hale Warning to jurors caused centuries of misfortune in the American courts.

In “Pleas of the Crown,” Hale called rape a “most detestable crime.” Then, in words quoted many times since, he wrote, “It must be remembered, that it is an accusation easy to be made and hard to be proved, and harder to be defended by the party accused, tho never so innocent.”

Hale evoked the fear of the false accuser — and made for that fear a legal frame, which lasted for more than 300 years. In weighing the evidence in cases of alleged rape, jurors (all men, in Hale’s time and for long after) needed to consider a series of factors, Hale wrote. Did the woman cry out? Did she try to flee? Was she of “good fame” or “evil fame”? Was she supported by others? Did she make immediate complaint afterward?

Hale’s words and formulation became a standard feature of criminal trials in the United States, with jurors instructed by judges to be especially wary of allegations of rape. The effect was predictable: Charges of rape were frequently rejected. In the United States, one early example was chronicled by historian John Wood Sweet in his soon-to-be-published book, “The Sewing Girl’s Tale.” (I was allowed to read an advance copy.)

In 1793, in New York City, an aristocrat, Henry Bedlow, was accused of raping a 17-year-old seamstress, Lanah Sawyer. Bedlow hired six lawyers, including a future U.S. Supreme Court justice, who used Hale’s framework to destroy Sawyer. Sawyer said she screamed. But, one attorney asked the jury, did she also stamp her feet? Witnesses spoke of Sawyer’s good fame, according to the trial record. But “she may have had the art to carry a fair outside, while all was foul within,” the same attorney argued. “Ultimately, the defense team’s dizzying effort to dispute and distort reality had been part of a relentless effort to transform a young woman who mattered into one who didn’t,” Sweet wrote. The jury took 15 minutes to acquit.

Starting in the 1970s and 1980s, courts in the United States began moving away from instructing juries with Hale’s admonition to be particularly skeptical of rape claims. The repudiation of Hale became so complete that when a Maryland lawmaker, in 2007, invoked Hale’s words in a state legislative hearing, it was met with “outrage,” according to the Washington Post.

Despite those legal changes, the fear of the false rape accuser still persists in the justice system, at times leading to horrendous outcomes. I began researching Hale when writing, with T. Christian Miller, “An Unbelievable Story of Rape,” published by ProPublica and the Marshall Project. The story reconstructs what happened when a young woman in Lynnwood, Washington, reported being raped. We later expanded the story into a book, “Unbelievable,” in which we described Hale’s influence in rape cases at greater length. (The story also became a Netflix series.)

Then there was Hale’s role in what today is synonymous with the perversion of justice: witch trials.

In 1662, Hale presided at a jury trial in Bury St. Edmunds in which two women, Amy Denny and Rose Cullender, were accused of being witches. In a book on this case, “A Trial of Witches,” authors Ivan Bunn and Gilbert Geis wrote that by 1662, “belief in witches was in retreat in England.” Hale, however, was not part of that retreat. He believed witches were real. “Hale represented not a mainstream position but rather one rapidly becoming anachronistic,” Bunn and Geis wrote.

What’s more, Hale instructed the jurors that witches were real. A written record of the trial recounts what Hale told them: “That there were such creatures as witches he made no doubt at all; for first, the scriptures had affirmed so much. Secondly, the wisdom of all nations had provided laws against such persons, which is an argument of their confidence of such a crime.”

The jury convicted Denny and Cullender, after which Hale sentenced both women to hang. (Four years before, Hale had also sentenced to death another woman convicted of being a witch.)

Hale’s influence, once again, extended beyond the immediate case and his time. Thirty years later, his handling of the trial in Bury St. Edmunds, preserved in written record, served as a model in Salem, Massachusetts, in the infamous witch trials in 1692. “Indeed, the Salem witch-hunts might not have taken place if there had not been a trial at Bury St. Edmunds: the events at Salem notoriously imitated those at Bury,” Bunn and Geis wrote.

Hale is known mostly for his legal treatises. But his views toward women are perhaps best revealed in a letter he wrote to his grandchildren, titled “Letter of Advice.” (In a twitter thread this week I said Hale’s letter was 182 pages long. I may have understated it. I’ve since found a version online that goes on for 206 pages.)

The title page of Hale’s letter. (Via Google Books)

In this letter, Hale prescribes individualized counsel for three granddaughters.

Mary, he wrote, possessed great wit and spirit, and “if she can temper the latter, will make an excellent woman, and a great housewife; but if she cannot govern the greatness of her spirit, it will make her proud, imperious, and revengeful.”

Frances, he wrote, possessed great confidence: “If she be kept in some awe, especially in relation to lying and deceiving, she will make a good woman and a good housewife.”

Ann, he wrote, possessed a “soft nature.” “She must not see plays, read comedies, or love books or romances, nor hear nor learn ballads or idle songs, especially such as are wanton or concerning love-matters, for they will make too deep an impression upon her mind.”

Hale complained in his letter that young women “make it their business to paint or patch their faces, to curl their locks, and to find out the newest and costliest fashions.” And with that, he was just getting started. Hale followed with a 160-word sentence that is a marvel in its depth of disdain.

“If they rise in the morning before ten of the clock, the morning is spent between the comb, and the glass, and the box of patches; though they know not how to make provision for it themselves, they must have choice diet provided for them, and when they are ready, the next business is to come down, and sit in a rubbed parlour till dinner come in; and, after dinner, either to cards, or to the exchange, or to the play, or to Hyde Park, or to an impertinent visit; and after supper, either to a ball or to cards; and at this rate they spend their time, from one end of the year to the other; and at the same rate they spend their parent’s or husband’s money or estates in costly clothes, new fashions, chargeable entertainments: their home is their prison, and they are never at rest in it, unless they have gallants and splendid company to entertain.”

Some observers have been taken aback that Alito referenced Hale. But not everyone was surprised. Eileen Hunt, a Notre Dame political science professor who has written extensively about Mary Wollstonecraft, author of the path-breaking 1792 treatise “A Vindication of the Rights of Woman,” tweeted:

“It is a truth universally acknowledged that a conservative Supreme Court justice will cherry-pick an Enlightenment-era man as a timeless authority on reproductive rights but ignore #Wollstonecraft’s pivotal philosophical views on women, mothering, and the sexual double standard.”

by Rob Perez, Honolulu Star-Advertiser

This article was produced for ProPublica’s Local Reporting Network in partnership with the Honolulu Star-Advertiser. Sign up for Dispatches to get stories like this one as soon as they are published.

The Hawaii Legislature on Thursday unanimously passed landmark legislation appropriating $600 million for the state’s Native Hawaiian homesteading program, a chronically underfunded initiative that has long fallen short of its promise to return Native people to their ancestral land.

The amount represents the largest one-time infusion of money in the program’s 101-year history, and it’s more than seven times the record amount that state lawmakers approved last year. The majority of the funds will go toward the development of nearly 3,000 lots, most of them residential, on Hawaii’s main islands.

Under the program, people who are at least 50% Hawaiian are entitled to lease land for $1 a year and, upon getting the lease, to buy or build a home on the parcel. The homes cost roughly half the market price because the program’s beneficiaries are not paying for the land.

But, as the Honolulu Star-Advertiser and ProPublica have reported, the state Department of Hawaiian Home Lands, the agency that manages Hawaii’s 203,000-acre land trust, has failed to meet a crushing demand for housing. Today, more than 28,700 Native Hawaiians sit on an ever-growing waitlist. More than 2,000 people have died while waiting, according to the news organizations’ first-of-its-kind analysis.

In 2020, an investigation by the Star-Advertiser and ProPublica revealed a number of structural shortcomings that contributed to the problem. For example, the department has focused on building large subdivision housing, which proved too expensive for many low-income waitlisters, including those who are homeless. The analysis also showed that at the rate DHHL had been developing lots for the previous quarter century, it would need 182 more years to get everyone off the waitlist as it stood in 2020.

In response to the coverage, DHHL officials acknowledged that bold action was needed to deliver on the department’s main mission, and they pressed for more funding. In turn, legislative leaders prioritized the homesteading program this year. It was a top issue for House Speaker Scott Saiki, who cited the news organizations’ reporting as a major factor in the $600 million legislation.

“I never thought I would see the day that something like this would happen,” said Sen. Maile Shimabukuro, who heads the Senate’s Hawaiian Affairs Committee, as the bill was positioned for passage.

Rep. Patrick Branco, a Native Hawaiian lawmaker, called the legislative action great news. “When Native Hawaiians benefit, all of Hawaii benefits,” he said.

Legislators on the floor at the Capitol. (Jamm Aquino/Honolulu Star-Advertiser)

Timing also helped the push succeed. As Native Hawaiians and others have become more politically active in recent years about issues affecting Native culture, lawmakers this session faced the rare situation of deciding how to spend a huge budget surplus — about $2 billion — in a year in which all legislative seats are up for grabs in the coming election.

Given all that, the newsrooms’ revelations about the failures of the homesteading program boosted public awareness and prodded legislators to consider big initiatives, according to beneficiaries, advocates and others.

“No doubt about it,” said former Gov. John Waihee, the only Native Hawaiian to serve in the state’s top political post. “It’s like everything came to a head, and all of a sudden you’ve got money.”

The state’s flush fiscal position also paved the way for the proposed settlement of a class-action lawsuit filed in 1999 by more than 2,700 beneficiaries, mostly over the long waits for homesteads. Even though the court in 2009 found that the state breached its trust obligation and was liable for damages, the litigation has dragged on for years, and more than one-third of the original plaintiffs, many of them elderly, died without seeing a resolution. Lawmakers on Tuesday approved a separate $328 million appropriation to settle the case.

Both bills — totaling nearly $1 billion — now go to Gov. David Ige for his signature. He previously told the Star-Advertiser and ProPublica that fulfilling the state’s obligations to the Hawaiian homesteading program is a priority for his administration.

“This has been a historic legislative session for providing additional support to Native Hawaiian beneficiaries,” Ige said in a statement. “Collectively, we have appropriated more funds this session than ever in the history of the state of Hawaii to advance the ideas and priorities of the Hawaiian homesteading program.”

As the $600 million homesteading bill worked its way through the legislative process, lawmakers received hundreds of pages of written testimony, many from waitlisters who applied decades ago and still don’t have homesteads. Some lamented the missed opportunities that being homeowners would have given them and said they watched as beneficiaries left Hawaii because they couldn’t afford the high housing costs.

One who applied in 2008 and is still more than 7,000 names deep on the Oahu residential waitlist shared a common fear: “I don’t want to be like many of my relatives who died on the waitlist without being awarded a lease,” he wrote.

A high school teacher told legislators about one of her students who wrote of his family’s gratitude after getting a new home in a homestead subdivision. But the student’s grandfather, a Vietnam War veteran who had a separate entry on the waitlist, slipped in and out of homelessness and died while waiting.

The majority of the $600 million is expected to be used by DHHL for developing homestead lots and acquiring land — an effort that will be further boosted by a record $22.3 million that Congress approved earlier this year for Native Hawaiian housing. The agency is planning to tackle 17 projects totaling over 2,900 lots statewide. Eight of the developments, totaling nearly 1,700 lots, are on Oahu — the island with the greatest demand for beneficiary housing.

But, because those developments will still only help a fraction of the people on the waitlist, the bill also authorizes DHHL to spend some of the money to help waitlisters in other ways, including offering down-payment assistance to those seeking to purchase homes on the private market, off trust land. The agency could also provide mortgage or rent subsidies to waitlisters who already have housing. The rent relief is aimed at those who cannot afford to purchase their own homes. If the legislation becomes law, the department would have to develop rules and procedures for how the various forms of housing assistance would work. The measure allows DHHL to use a waitlister’s income level, among other factors, to set priorities for who gets assistance and in what amounts.

A department official said the agency was grateful for the one-time infusion but noted it would need up to $6 billion to clear the entire waitlist. Acknowledging that need, Ige, at a news conference Thursday, floated the idea of dedicating a portion of the state’s hotel tax to the homesteading program on an annual basis.

For now, though, DHHL’s plans are welcome news for beneficiaries like Mauna Kekua, a 50-year-old Oahu public school custodian who has been on the waitlist for nearly two decades. She inherited her spot in line from her mother, Sarah Hauoli Larinaga, who died in 2003 after waiting a quarter century for a homestead.

Kekua said she and her husband, a maintenance worker, have struggled to pay the $2,500 in monthly rent for a West Oahu home for their family of nine, including two sons, a son’s girlfriend and four grandchildren. But now they are hopeful they’ll land a spot in a new, 280-lot development that DHHL plans to build in Maili, a Waianae Coast town not far from where Kekua now lives. The first homes in that project are expected to be completed before the end of the decade. Kekua is No. 114 on the area waitlist — a position high enough to make her optimistic about her chances of getting a parcel.

“I’m praying on it,” she said. “I’m leaving this in God’s hands.”

by Byard Duncan

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by Jennifer Smith Richards, Chicago Tribune, and Jodi S. Cohen, photography by Armando L. Sanchez, Chicago Tribune, illustrations by Laila Milevski

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At Bloom Trail High School in Chicago’s south suburbs, the student body is diverse: About 60% of the 1,100 students are Black or multiracial. Another 27% are Latino. And 12% are white.

But when you look at the group of students who get ticketed for misbehavior at school, the diversity vanishes.

Police, in cooperation with school officials, have written 178 tickets at the school in Steger since the start of the 2018-19 school year. School district records show that six went to Latino students. Five went to white students. And 167 went to Black or multiracial students — 94% of the total.

Such racial disparities in ticketing are part of a pattern at schools across the state, an investigation by ProPublica and the Chicago Tribune has found. In the schools and districts examined, an analysis indicated that Black students were twice as likely to be ticketed as their white peers.

Reporters set out to analyze police ticketing in nearly 200 districts throughout Illinois, which together enroll most of the state’s high school students. Most local officials either did not specify race on tickets or refused to provide the information, but the news organizations obtained documentation of the race of students for about 4,000 tickets issued at schools in 68 districts.

After excluding places where ticketing was rare, schools in 42 districts remained, representing more than one-fifth of the state’s high school students. The analysis found that about 9% of those students are Black but nearly 20% of tickets went to Black students.

Analyzing tickets received by members of other racial or ethnic groups is more difficult, in part because the Tribune and ProPublica identified anomalies in the way school districts and police recorded information about white and Latino students. But students in those groups don’t appear to have been ticketed at high rates compared to their share of school enrollment.

Student ticketing in Illinois, or any other state, has never been examined on this scale. In fact, while Illinois officials have focused on whether schools are suspending or expelling Black students in unequal ways, they have not monitored police ticketing at schools. Neither has the division of the U.S. Department of Education that oversees civil rights issues.

The first installment of the Tribune-ProPublica investigation “The Price Kids Pay” detailed how student ticketing flouts a state law meant to prevent schools from using fines to discipline students. The investigation, which was based on school and municipal records from across the state, documented at least 11,800 tickets during the past three school years. It found that schools often involve police in minor incidents, resulting in harsh fines, debt for students and families and records that can follow children into adulthood. (Use our interactive database to look up how many and what kinds of tickets have been issued in an Illinois public school or district.)

In response, Illinois’ top education official told school leaders to “immediately stop and consider both the cost and the consequences of these fines,” and Gov. J.B. Pritzker said conversations already were underway with legislators “to make sure that this doesn’t happen anywhere in the state of Illinois.”

Illinois lawmakers tried in the past to pass legislation that would require school districts to collect and share student race and ethnicity data compiled by police when they intervene at schools for all types of disciplinary reasons, including such minor offenses as tobacco possession, tardiness or insubordination. But those efforts have stalled.

House Speaker Emanuel “Chris” Welch, a Democrat, said the legislature should take action if school ticketing is harming students.

“If these tickets are being issued disproportionately to people of color, we need to address that. That can create larger problems for students of color, problems that we’ve become accustomed to for far too long,” Welch said in an interview.

The U.S. Department of Education collects data nationally in alternate years about the race of students referred to and arrested by police. But it didn’t do so during the 2019-20 school year, when in-person learning was interrupted by the pandemic. In 2017-18, the most recent year data was collected, Illinois stood out for the gap between the percentage of students who are Black and the percentage of students referred to the police who are Black. No other state had a bigger disparity.

In response to similar data on expulsions and suspensions, the state last fall put a group of districts including Bloom Township High School District 206 on notice to reform how they handle discipline.

In an emailed response to reporters’ questions, district officials said they were concerned about the racial disparities in ticketing identified at Bloom Trail. The district’s response asserted that Black students and white students receive the same consequences for the same offenses and that the school has been affected by “a rise in violent crime and gang activity” in the communities the school serves.

Officials at Bloom Trail, which employs security guards to work inside the school, call Steger police when there is a fight that school officials think warrants a citation. Police bring the students’ tickets to the school, and officials give them to the students or their parents.

Greg Horak, Bloom Township’s director of climate, described the citations as a supplement to school discipline. “Dealing with the police, we hope this shows parents that this is a very serious situation,” Horak said in an interview.

Rodney and Elizabeth Posley, whose sons Josiah and Jeremiah attend Bloom Trail, didn’t realize students could get ticketed by police until it happened to their children in the fall. They said the boys were treated too harshly after they were part of a school fight that got out of hand.

The brothers were suspended and ticketed for disorderly conduct, and one was threatened with expulsion — extreme measures, Elizabeth Posley said, for teenage mistakes. The Posleys enlisted the help of a lawyer, their church and school employees to advocate for their sons, noting that neither boy had been in trouble at school before and the younger of the two receives special education services.

Josiah and Jeremiah, at left and right-center, play basketball at a church near their home with their parents, Rodney and Elizabeth Posley.

“They’re young Black men. They stereotyped them,” said Elizabeth Posley, who works as a pretrial officer at the Cook County Circuit Court. “They’re not into gangs, where they’re tough and they’re bad. We pray as a family.”

Last fall, during his freshman year at Bradley-Bourbonnais Community High School, southwest of Chicago, a 14-year-old Black student named Isaiah felt like school employees were closely watching him. Then an administrator reported him to Bradley village police after catching a glimpse of another student handing Isaiah a vaping device in a bathroom.

At the high school, which is patrolled by 10 security guards and a police officer, 10% of students are Black. But Black students received 21% of the 137 tickets written there from the start of the 2018-19 school year through the end of October. White students, who make up more than 68% of enrollment, got 60% of the tickets.

In Bradley, as in many other Illinois communities, students ticketed in schools are funneled into quasi-judicial hearings designed for adults and overseen by the local municipality. At the hearing for Isaiah’s ticket at Bradley’s village hall in November, the hearing officer asked Isaiah to “admit” or “deny” that he had a vaping device at school. Isaiah’s mom encouraged him to say “deny” so the hearing officer would allow him to describe what led to the ticket.

Isaiah explained that he had immediately handed the vaping device back to his friend. He said he had been searched by administrators — including being made to remove his socks and shoes — and no device was found.

The hearing officer found Isaiah not liable for possession of an electronic vaping device — a rare vindication in a ticketing case. But the village imposes a $50 fee for attending the hearing, which Isaiah still had to pay.

Isaiah’s mother, Catherine Hilgeman, said in an interview that she was upset school officials had questioned and searched her son without contacting her. She said she told her son he had learned a lesson: “You are a young Black male. You already have something against you. You shouldn’t, but you do — it’s the color of your skin. When somebody looks at you they automatically think, ‘They’re up to no good.’”

Christian, a multiracial student ticketed in the fall, described a strikingly similar incident. Another student, who saw in a mirror that a school administrator was walking into the bathroom, quickly handed his vape pen to Christian, who put it in his pocket, the family said.

Christian, 16, was required to appear at a ticket hearing in Bradley on a January afternoon. Most of the people ordered to attend that day were high school students, and most of them, including Christian, had been ticketed for possession of vaping devices. The hearing officer ordered Christian to pay $175 — a $125 fine plus a $50 hearing fee — and then asked if he would pay that day or if he needed time.

“Take some time,” Christian said. He is paying the fine off with money he earned at his job at Little Caesars. By early May, he had paid $113, his mother said.

If students don’t pay their fines quickly, Bradley is one of many Illinois municipalities that have sent the debt to collection agencies or to a program run by the state comptroller’s office that deducts money from tax refunds or payroll checks.

At DeKalb High School, west of Chicago, nearly half the tickets issued during the past three years went to Black students, even though only about 20% of the students are Black. Between the start of the school year and mid-November, police wrote about 30 tickets to students, and Black students received 22 of them, or 73%. Most of the tickets were for fighting, followed by cannabis possession.

Tickets were also written at the two middle schools in DeKalb Community Unit School District 428, to students as young as 11, city records show. Black students make up about a quarter of the enrollment at each school, but at Huntley Middle School at least 63% of tickets went to Black students during the last three school years. At Clinton Rosette Middle School, tickets did not always specify race, but at least 40% went to Black students.

At four DeKalb hearings that reporters attended in the fall and winter, nearly all of the students were Black or Latino. All of the adults involved in the hearing process — the prosecutor, the clerk, the bailiff, the hearing officer — were white.

Records from the last three school years show that DeKalb students were most commonly cited for fighting, a violation that comes with a minimum $300 fine. The city gives students a choice: Pay within 21 days of getting the ticket, or attend a hearing. At the hearing, students can contest the ticket or plead liable, which usually results in an order to do community service. Hearings are held twice a month at 9 a.m. at the police station, and students have to miss school to be there.

If the students don’t pay and don’t show up on their hearing date, the fine increases to the maximum allowed by state law: $750, plus a $100 administrative fee. If the fines and fees are not paid, the debt can be sent to collections.

After 16-year-old Christian, center, was ticketed for possession of an electronic smoking device at school in Bradley, Illinois, he and his mother, Ashlee Dennison, far right, were called to a hearing where they faced a police lieutenant and two adjudication officials.

Terri Jackson, whose 14-year-old daughter agreed to perform 25 hours of community service after being ticketed for fighting, said she thinks the reason more tickets are written to Black children is simple: “They’re paying attention to what the Black kids do.”

At a hearing in November, a 15-year-old boy who had been caught with cannabis vape cartridges at the high school received 15 hours of community service; he would be fined $250 if he didn’t complete it. After he went before the hearing officer, he told reporters he thought white students were disciplined less harshly at his school.

“There’s differences. There are situations when they get caught and not punished like we do,” said the sophomore, who identifies as Black and Latino.

Brian Wright, principal at Bradley-Bourbonnais Community High School, called his school’s ticketing disparity disturbing and perhaps a reflection of racial bias.

“We have to assume that there is a population of our white students doing the same things that our Black students are, but why are they not getting ticketed but our Black students are?” Wright asked. “It is bothersome to me, but it is good information to take back to our assistant principals to see.”

Brian Wright, principal at Bradley-Bourbonnais Community High School.

Wright said the school already is concerned about disproportionate suspensions. He also said the school has been working to address racial equity and inclusivity during the past few years by diversifying the books in the curriculum and including more students of color in Advanced Placement courses.

Administrators at other schools who were interviewed for this story said the disparities in ticketing at their schools are not the result of racial bias.

“The police are just being responsive to the actions of the students,” DeKalb High School Principal James Horne said. “Where you see in the data the disproportionate numbers, the unfortunate part is there is disproportionate trauma that is affecting certain parts of the community.” He added: “We’re just being responsive to the challenge of our students.”

Horne said his high school doesn’t only respond to student misbehavior by involving police; it also uses restorative justice practices that bring students together to resolve conflicts with discussion and problem-solving. The school tries to avoid discipline that causes students to miss class time, Horne said.

Reporters sent DeKalb district officials questions about disparities at the two middle schools. They did not address those questions but wrote in a statement that they have been taking actions to better support their students and are developing a new districtwide code of conduct.

Disproportionate ticketing also occurs at schools with relatively few Black students, the analysis found. East Peoria Community High School, for example, has about 25 Black students in an average year. But Black students received 11 of the tickets police wrote during the past three school years. That’s 10% of all police tickets, even though Black students represent just 2% of the school’s enrollment. This school year, records show Black students received six of the 34 tickets police issued through mid-January, or about 18%. These totals don’t include truancy tickets, as those were issued by a school employee.

Marjorie Greuter, the East Peoria Community High School superintendent, disputed any suggestion that students are ticketed unfairly at her school.

“We’re consistent in our referral for city ordinance violations. If a kid is vaping, it doesn’t matter — male, female, white, Black, low-income, high-income — they’re going to get referred” to the school police officer, Greuter said.

“If it’s disproportionate, it’s because the offense is disproportionate or the offender is disproportionate.”

Bloom Township High School District 206 has two schools: Bloom Trail in Steger and Bloom in Chicago Heights. The Chicago Heights police department does not ticket students at Bloom, but Steger police have agreed to ticket students at Bloom Trail when contacted by school officials.

“They call us and we ticket them,” said Steger Police Chief Greg Smith, who acknowledged that when he got into a fight at school as a teenager in the mid-1980s, his dean and football coach took care of it.

“I think the world has changed. What happened in the past, it wouldn’t be unheard of for a dean to smack a kid upside the head — that, they just don’t do anymore.”

Now, he said, “it is the police officer’s problem, and it’s unfortunate, but everything has come down to ‘We need the police.’ We are handling a lot more issues than police used to.”

In Chicago Heights, Deputy Police Chief Mikal Elamin said officers will arrest a student if necessary — if the school or a victim signs a complaint — but the department doesn’t think ticketing is appropriate. Police have not ticketed students at Bloom High School in at least the last three years, records show.

“I can’t tell you that we have never ticketed, but I can say that it is not our policy to target or focus on our high school students. We wouldn’t do that,” Elamin said. He said issuing tickets would be “punishing the parent” because students typically aren’t capable of paying.

Christian is using part of his paychecks from a job at Little Caesars to pay off a ticket he received at school.

In an emailed response to reporters’ questions, Bloom Township district officials said administrators call the police when someone is injured or at risk of physical harm, when there is “severe and potentially dangerous” school disruption or when a student’s behavior has “willfully interrupted the learning process” beyond what school workers can handle.

“Overall, we work to communicate that the school is not the place to handle your disagreements physically,” according to the email. “We are intentional about addressing these situations fairly and equitably, regardless of students’ race or gender.”

After reviewing the district’s own data and in response to the findings of the Tribune-ProPublica investigation, the Bloom Township superintendent scheduled a meeting with the Steger police chief to revisit their approach to police involvement in discipline.

“We want to be on the right side of things and do what is best for children,” said Latunja Williams, the district’s assistant superintendent for human resources.

Decades of research on school discipline has shown that when a judgment call is involved — such as whether to ticket someone for disorderly conduct for being disruptive or profane — students of color are disciplined more severely.

The Tribune and ProPublica were able to analyze both the race of students and the alleged violations for about 3,000 tickets that police wrote in 34 districts. While Black students made up about 11% of the enrollment in schools in these districts, they received nearly 29% of the tickets related to student behavior, including disorderly conduct, disturbing the peace, insubordination, “activity constituting a public nuisance” and “prohibited conduct on school property.” White students represented about 45% of enrollment and 44% of the tickets related to student behavior. Black students also were disproportionately ticketed for fighting, assault and other offenses related to physical aggression.

Other types of violations, such as possession of drug paraphernalia, were more in proportion to Black students’ enrollment. For several other racial groups, including Asian students and Native American students, there were too few tickets to draw meaningful conclusions.

Russ Skiba, a professor emeritus at Indiana University and a leading researcher on educational inequity, said U.S. schools began suspending Black students disproportionately for behavioral offenses in the 1970s, after districts were forced to fully desegregate. In the 1990s, he added, police became a more common presence in schools, exacerbating inequalities in discipline.

“There is an abundance of research that shows that Black students are not engaging in more severe behavior, that they receive punishments that are harsher for the same behavior,” Skiba said. “Black and brown kids understand, and it doesn’t go unnoticed, that they are being punished more often, suspended more often and, in your case, ticketed more often.”

Few studies have examined ticketing of students, including how race may play a role. But an analysis published this year by the American Civil Liberties Union found police cited Black students in the Erie City School District in Pennsylvania for minor infractions at four times the rate of white students.

And in Texas, the Texas Appleseed advocacy group uncovered disparities in police ticketing in multiple school districts, leading state lawmakers to pass legislation in 2013 that prohibits officers from issuing tickets for disrupting class and other misbehavior at school. In the state’s Bryan Independent School District, police had issued 53% of tickets for “disruption of class” to Black students during the 2011-2012 school year, even though that group made up about 21% of the district’s enrollment. U.S. Department of Education investigators looking into the Bryan district found at least 10 incidents where Black students received harsher punishment than white students for similar conduct.

Federal data tracks how often schools involve police in a school incident, which is called a police referral, and whether an arrest was made, as well as the race of the students involved. The data does not track ticketing or other possible outcomes. In Illinois, Black students accounted for about 17% of enrollment but 42% of the students referred to police in the 2017-18 school year, according to the federal data.

The gap is similar with suspensions and expulsions. State data shows that in the 2019-20 school year about 44% of the students suspended or expelled from Illinois public schools were Black.

Citing the federal and state data, Illinois state education and justice officials in March urged schools to evaluate their punitive discipline policies, including suspensions and expulsions, and the impact of police in their schools. They said the expanding role of police officers at school raises concerns about a disparate impact on students of color, particularly Black students.

It was the first guidance the state has issued to school districts with the intent of ensuring that disciplinary practices do not violate civil rights law. Illinois State Board of Education spokesperson Jackie Matthews said punishing students for behaviors perceived as defiance or misconduct does nothing to address the reasons the students are behaving that way.

“These tactics disproportionately impact students of color and increase the odds of students dropping out and experiencing involvement with the criminal justice system,” Matthews wrote in an email.

The recent state guidance did not mention tickets, which the Tribune-ProPublica investigation found to be the most common outcome when police get involved in school incidents.

Amy Meek, chief of the Civil Rights Bureau in the Illinois attorney general’s office, said schools can be in violation of civil rights laws if their policies and practices have a disparate impact on certain groups of people — even if it is not intentional.

Ticketing students “falls within the umbrella of concerns” related to disparate impact and is “something that we definitely look forward to looking at in more depth,” Meek said.

“School districts have an ongoing obligation to annually revisit their discipline policies,” she said. “This is a prime opportunity for them to look at their data and take a look at practices that they may be employing that impose an unjustified disparate impact because of race.”

Harold Jordan, nationwide education equity coordinator at the ACLU, said the U.S. Department of Education should be specifically tracking police ticketing at schools as part of its Civil Rights Data Collection, which is used to monitor whether schools provide equal opportunities to all students. The education department did not respond to a request for comment.

“I think it’s significant because it’s an indicator of the extent to which there’s a growing amount of collaboration between schools and police that’s outright harmful,” Jordan said.

He said that while some incidents at school are serious, most discipline is for minor infractions. “Two kids can do essentially the same thing and be treated quite differently in how they are disciplined, and especially whether police are involved,” Jordan said. “Too often, race and ethnicity are factors.”

Bloom Township High School District 206 is on an Illinois State Board of Education list of districts that, for three consecutive years, suspended or expelled students of color disproportionately. In the 2019-20 school year, 88.5% of students suspended at Bloom Trail High School were Black, though Black students make up only about 54% of the student body.

Concerned about those numbers, district officials have focused this year on alternative ways to correct student behavior, they wrote in an email. The district is one of six in the state participating in training sessions focused on improving equity in student discipline, funded by the Illinois State Board of Education with pandemic relief funds.

Bloom Township school administrators are working with Loyola University Chicago school discipline experts to get certified in restorative justice practices. In February, all school employees were trained on positive behavior interventions. The district also has partnered with the University of Illinois at Springfield to learn about “empathetic instruction,” a way of handling student misbehavior in less punitive ways.

“Our ultimate goal is to ensure a safe learning environment for all students and the school community, while proactively addressing the challenging behaviors of some of our neediest students,” district officials wrote in an emailed response.

But ticketing remains a central part of Bloom Trail’s disciplinary process, and by mid-April of this school year, all but six of the 54 tickets police wrote at the school went to Black students. No white students were ticketed.

Two of the tickets written to Black students went to the Posleys’ sons, Josiah and Jeremiah, who were 16 and 14 at the time.

Josiah, right, shows his brother Jeremiah a photo he took while they shopped for outfits for prom.

Josiah said he made a bad decision to meet another student in the bathroom after a disagreement. Once there, he said, he got jumped by several boys and defended himself. “I didn’t instigate it. I didn’t cause it,” said Josiah, who excels in algebra and literature and wants to be an engineer. “I’m not like that.”

Jeremiah said he followed Josiah into the bathroom out of concern for his brother. He didn’t hit anyone, he said, but one of the boys punched him in the face. At least five boys were involved in the fight, and a security guard who tried to break it up needed four stitches after a student — not one of the brothers — pushed him into a window, according to the district.

After the fight, school officials suspended the brothers and threatened to expel Josiah, a junior, for “mob action.” A meeting also was called to review the special education plan for Jeremiah, a freshman who has autism, and his parents feared the school would try to transfer him.

The family was shocked by the severity of the punishment for two boys who had not had previous discipline issues and were good students. They decided to find a lawyer and challenge the school’s actions. Bloom Trail later withdrew the threat of expulsion and told both boys to come back to school.

But by then, the school had already asked Steger police to write tickets. Both boys, as well as three other students who were in the bathroom, were cited for disorderly conduct.

The Posleys said involving police added a layer of unnecessary punishment and worry for the family. The police department sent letters to their home notifying the boys that they had to appear at a hearing in November at the police station.

Jackie Ross, an attorney at Loyola University Chicago’s ChildLaw Clinic who specializes in school discipline and special education, said she took on Josiah and Jeremiah’s case because she felt the boys were being treated unfairly. The same goes for many others, she said.

“There is this gross secret practice going on of fining families of color who are largely unrepresented and making a lot of money from it,” Ross said.

The school district said officials couldn’t talk about the discipline of individual students.

As the brothers’ November hearing date neared, Elizabeth Posley worried that Josiah’s longer hair wouldn’t be considered “presentable.” Her husband agreed, even though Josiah thought it was unfair that he would have to change the way he looked to avoid being stereotyped.

“In my mind, because you look a certain way as an African American child, you’re going to be judged a certain way,” Elizabeth Posley said. Rodney Posley used his clippers to cut Josiah’s hair.

Both boys wore suits to the hearing, Jeremiah’s from his eighth-grade graduation. The family lined up several character references, including one from a church leader. Three Bloom Trail employees — a guidance counselor, a social worker and a teacher — signed a letter praising Jeremiah and his parents for their positive involvement in school.

“Jeremiah is a hard worker, compassionate and respectful of others,” they wrote.

Josiah said he expected the hearing would be in a courtroom, like the one on the TV show “Judge Mathis.” Instead, it took place in a Steger police conference room with rows of stackable chairs.

According to a recording of the hearing, Ross told the hearing officer that Illinois law specifically prohibits schools from fining students for disciplinary reasons. She said Jeremiah has difficulty reading social cues because of his autism and went into the bathroom not knowing he was walking into a fight. Jeremiah has protections under federal disabilities law, she argued, and the consequences he faced for his actions, including the ticket, were inappropriate.

The family said at the hearing that school officials had scaled back some of the school-based punishment and that the family expected the ticket would be thrown out, too.

“It doesn’t matter if the school disciplined the children or didn’t discipline them,” hearing officer Brian Driscoll said in response. At the hearing, he said, “it is just different rules.”

Under Steger’s municipal code, the hearing officer has discretion in setting the amount of a fine or can decide to give a warning instead.

Driscoll found both boys liable and said he would fine Josiah $75 and Jeremiah $25. A third boy involved in the fight also received a $75 fine. Two others didn’t show up for the hearing and were fined $150 each.

The five boys ticketed for the Bloom Trail fight, all students of color, collectively owed the village $475.

“I didn’t find what he did helpful,” Elizabeth Posley said of the hearing officer. “He didn’t tell the kids to apologize or make up. He just fined them and kicked them out. He fined kids all night. Every kid who got in there got a fine.”

The Posleys didn’t pay the fines that night. They thought about appealing. But a few days later, concerned that they had a short window before the village could impose further financial consequences, Rodney Posley went to the police station to pay.

When he got there, he found out Steger accepts only cash or checks for ticket payments, and he didn’t have $100 on him. He drove to a nearby Jewel-Osco supermarket and bought a Snickers bar with his debit card so he could get cash back, then drove back and handed over the money.

Josiah’s suspension prevented him from playing drums at the high school’s homecoming concert in the fall. Now that it’s prom season, he’s glad he can participate in school activities again. Wanting his younger brother to experience a typical high school rite of passage, Josiah decided to take Jeremiah to the prom with him.

On Friday, surrounded by 20 family members, the brothers slipped on sunglasses and posed in the driveway by an arch of red and black balloons to match their red and black suits. As the boys left for the dance, the whole family cheered.

Elizabeth and Rodney Posley, center, pose for a family photo with sons Jeremiah, left, and Josiah outside their Sauk Village home before the brothers leave for their school’s prom.

How We Reported the Story

Neither the state of Illinois nor the federal government tracks how often police give tickets to students in public schools for violations of municipal ordinances.

To understand more about police ticketing of students, including the race of students who had been ticketed, reporters from the Chicago Tribune and ProPublica filed more than 500 requests for public records with schools and law enforcement agencies under the Illinois Freedom of Information Act.

The requests were sent to 199 school districts: high-school-only districts and large K-12 districts. Those districts encompass roughly 86% of the state’s high school students. The requests sought records that would show how many times police were involved in student incidents during the school years that ended in 2019, 2020 and 2021; how often students were arrested; and how often tickets were issued in those incidents. Reporters also asked for the race of students who had been referred to police.

Some school districts said they did not track whether police issued tickets to students, so reporters then filed requests with the hundreds of law enforcement agencies that have jurisdiction over high schools in those districts. The requests sought information on where each ticket was issued, the age of the ticketed person or an indication whether they were a juvenile, the race of the person ticketed, the alleged violation and the amount of the fine.

From those records, reporters built a database documenting more than 11,800 tickets issued by police in 141 school districts during the three school years examined. For records obtained from police, the database included tickets issued at a school address to persons younger than 18, while excluding tickets issued for traffic, parking or curfew violations. Records obtained from school officials may have included tickets issued to students 18 or older.

Reporters also collected information about ticketing in the ongoing 2021-22 school year in select districts, but this data was not included in statewide analyses or in our interactive database. This story includes information about more recent tickets issued at Bloom Trail High School, DeKalb schools, East Peoria Community High School and Bradley-Bourbonnais Community High School.

If a school district or police department provided the race of the young people who were ticketed, that information was documented in a separate database. In all, reporters were able to compile racial data for tickets issued at schools in 68 districts.

Reporters then excluded from the analysis schools where tickets were rare — those where fewer than 20 citations had been issued over the three school years — and schools where race information was missing for more than 25% of tickets. That left about 4,000 tickets that had been issued at schools in 42 districts. In total, those schools enroll more than one-fifth of Illinois’ high-school students. For districts and some individual schools, reporters estimated total enrollment and enrollment by race by averaging the actual enrollment figures reported to the Illinois State Board of Education for the three school years being examined.

To identify potential racial disparities in ticketing, reporters first calculated the total enrollment for the schools in the database, as well as the total enrollment for various racial groups. They then calculated how many tickets were issued for each racial group and compared those rates to those groups’ share of total enrollment. In a few cases, race information was omitted from the ticket or marked as unknown. These cases were included in the ticket totals to ensure that the resulting racial disparity calculations were conservative.

In some cases, the race of the student ticketed was indicated but the ethnicity was not, meaning that it wasn’t possible to tell the true number of Hispanic or Latino students ticketed. For example, some police departments indicated clearly if a person ticketed was Black or white but left blank the part of the record that indicates whether someone is Hispanic or Latino. That incomplete documentation meant some Latino students who received tickets likely were classified only as white.

Some police departments and school districts provided detailed records for each ticket, including the reason the ticket was written and the race of the student. That allowed reporters to check whether racial disparities differed by type of violation, based on a set of roughly 3,000 tickets issued to students in 33 districts across the state.

To conduct that analysis, reporters standardized the ways different police departments and schools had documented students’ race, then placed each ticket into a category based on the alleged violation. For example, tickets involving disorderly conduct, disturbing the peace, “activity constituting a public nuisance” and “prohibited conduct on school property” were labeled as conduct-related tickets. Tickets involving tobacco, drugs or paraphernalia were labeled as substance-related tickets.

Reporters calculated how many tickets in each category went to students in different racial groups, then compared those rates to the groups’ share of overall enrollment.

To understand how tickets are handled after they’re issued, reporters attended more than 50 hearings across Illinois, observing hundreds of cases. They spoke with dozens of families affected by the process; with school, police and municipal officials; with attorneys and hearing officers; and with juvenile advocates. Reporters consulted with families about how to identify family members in the story and, as a result, did not include full names of all of the young people.

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Editing by Kaarin Tisue, George Papajohn and Steve Mills; additional data analysis by Ruth Talbot and Agnel Philip; additional research by Alex Mierjeski; visual presentation by Laila Milevski, Alex Bandoni, Ellen Przepasniak, Maya Eliahou, Steve Rosenberg, Todd Panagopoulos and Raquel Zaldivar; engagement reporting by Adriana Gallardo and Ariana Tobin; copy editing by Neil deMause and Jeff Carlson.

Jennifer Smith Richards has been a reporter at the Chicago Tribune since 2015. Jennifer’s data-driven investigative work often focuses on schools and disability. She is a member of the ProPublica Distinguished Fellows program.

Armando L. Sanchez joined the Chicago Tribune as a photojournalist in 2014. He was born and raised in Austin, Texas, and graduated from Western Kentucky University in 2012.

by Marek Mazurek, South Bend Tribune

This article was produced by the South Bend Tribune, a former member of ProPublica’s Local Reporting Network. Sign up for Dispatches to get stories like this one as soon as they are published.

A man who spent more than eight years in prison after being wrongfully convicted of an armed robbery in Elkhart, Indiana, will receive $7.5 million in a settlement with the city and with former police officers involved in the investigation, his attorney has announced.

The city’s settlement with Keith Cooper is the largest amount paid to a plaintiff in a wrongful conviction lawsuit in Indiana, according to the University of Michigan’s Exoneration Registry, and marks the end of his legal saga, which was chronicled by the South Bend Tribune and ProPublica.

Cooper, now 54, was pardoned in 2017 by Gov. Eric Holcomb.

The record-breaking settlement follows a series of other wrongful conviction proceedings and lawsuits in Elkhart.

Cooper’s co-defendant in the 1996 robbery, Christopher Parish, was exonerated and awarded nearly $5 million in a 2014 settlement. In March, Andrew Royer filed a lawsuit saying police and prosecutors coerced him into a false confession. A handful of other cases against the Elkhart Police Department are pending.

“It’s been a long uphill battle. I’ve been waiting 14 years for this day and now it’s here,” Cooper said during a press conference Wednesday afternoon in Chicago. “There’s no amount of money that can get me back the time I lost. But it helps build a better tomorrow for me and my family.”

Photos of Cooper and his wife. Cooper is the first Indiana man to win a pardon based on actual innocence. (Robert Franklin/South Bend Tribune)

In a separate press conference, Elkhart city spokesperson Corinne Straight read a prepared statement in which the city apologized for its handling of Cooper’s case.

“We hope this settlement brings to a conclusion the obvious injustice that has been rendered to Mr. Cooper,” the statement read in part. “The current administration and current leadership in the Elkhart Police Department have set upon a path of accountability in the hopes that this kind of case will never happen again.

“To Mr. Cooper and his family, we regret the suffering you experienced.”

Elliot Slosar, an attorney who represented Cooper throughout the civil litigation, said he appreciates the city’s apology, but he called on Elkhart’s mayor to bring in a special prosecutor to review every case investigated by the officers named in Cooper’s lawsuit.

(Christian Sheckler, the Tribune reporter who worked with ProPublica’s Ken Armstrong on a series of stories published in 2018 and 2019 about the criminal justice system in Elkhart, began working this year as an investigator for the Notre Dame Law School Exoneration Justice Clinic. Slosar is also affiliated with the clinic.)

The Case

On Oct. 29, 1996, police were called to a housing project in Elkhart where 17-year-old Michael Kershner had been shot and nearly killed. Friends and family of Kershner’s said two Black men — one short and one tall — had forced their way into his apartment, and the tall suspect shot the teenager during a struggle.

Cooper and Parish were charged in the crime after witnesses identified them as the suspects from photo arrays. Cooper was identified as the taller of the suspects and the alleged shooter. Both men were convicted: Cooper in 1997, of robbery, and Parish in 1998, of robbery and attempted murder. Cooper was sentenced to 40 years, Parish to 30.

(Nadia Sussman/ProPublica)

Cooper’s suit claimed that Elkhart police officials, including detective Steve Rezutko, framed the men through false witness statements and unduly suggestive photo lineups.

Eyewitnesses who testified at Cooper’s trial later recanted and said they had been manipulated by Rezutko into implicating Cooper.

Additionally, an investigation done in the years after Cooper’s trial concluded that DNA obtained from the shooter’s hat matched a man who had been convicted of a 2002 murder in Benton Harbor, Michigan, and then sent to prison.

In 2005, a state appeals court threw out Parish’s conviction. Afterward, a judge offered Cooper a choice. The judge could overturn Cooper’s conviction, allowing for a possible retrial, or modify Cooper’s sentence, allowing Cooper to be released immediately. Cooper chose the sentence modification and was freed in April 2006.

Though he was no longer in prison, Cooper was not exonerated of the robbery. So, in 2009, he filed a petition for a pardon. In 2014, the Indiana Parole Board voted unanimously in Cooper’s favor and forwarded its recommendation to then-Gov. Mike Pence. But for nearly three years, Pence allowed the recommendation to sit, taking no action. Pence’s successor, Holcomb, issued the pardon in 2017, one month after taking office.

Cooper is the first Indiana man to win a pardon based on actual innocence.

Through the discovery process in the case, Cooper and his attorneys also learned that Rezutko had been forced to resign from the Elkhart Police Department in 2001 because of sexual misconduct with an informant.

The department did not disclose until January 2019 that the detective had been accused of paying an informant for oral sex.

Rezutko died by suicide a month after those records were disclosed.

by Justin Elliott

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

Millions of Americans will receive money from Intuit, the maker of TurboTax, as part of a $141 million settlement between the Silicon Valley company and all 50 states and the District of Columbia.

The company will send up to $90 apiece to more than 4 million people who paid for TurboTax software even though they were eligible to receive it for free.

The investigation by state attorneys general, led by Letitia James of New York, was sparked by ProPublica stories in 2019 that revealed how Intuit had systematically tricked millions of people into paying for tax prep.

“For years, Intuit misled the most vulnerable among us to make a profit,” James said in a statement. “Today, every state in the nation is holding Intuit accountable for scamming millions of taxpayers, and we’re putting millions of dollars back into the pockets of impacted Americans.”

The company, which has long defended its marketing practices, did not admit wrongdoing. In a statement, Intuit said it “agreed to pay $141 million to put this matter behind it.”

The deal covers those who paid to file with TurboTax for the tax years 2016 to 2018, even though they were eligible for a no-fee version of the software offered through the Free File program, launched by the industry in partnership with the IRS in 2003. Filers making below a certain threshold — $34,000 for the 2018 tax year — were eligible for TurboTax’s product offered through the program, as were those eligible for the federal Earned Income Tax Credit, as well as active duty military service members with low incomes.

The vast majority of the settlement will go directly to victims. For each year a person paid Intuit even though they were eligible to file for free, the company will send them approximately $30. The company is not facing any fines in addition to the restitution to be paid to TurboTax users.

The settlement follows three years of investigation and negotiations with Intuit involving attorneys for New York, Tennessee, Pennsylvania and other states.

Intuit’s deceptive practices predate 2016. ProPublica reported that they go back more than a decade. A person familiar with the state officials’ investigation said that the settlement did not cover tax years before 2016 because of some states’ statutes of limitations. TurboTax is a major profit driver for the company. Intuit generated around $3 billion in net income over the 2016 to 2018 time period.

The details of when and how the payments will be made are not immediately clear. The process will be overseen by a third party that will handle the logistics of distributing the money, according to the settlement, which says payments will be made by check or electronic services such as PayPal and Venmo. In Texas alone, more than 465,000 consumers are expected to receive restitution payments from Intuit, according to the settlement. More than 371,000 purchasers in California and more than 176,000 in New York are also expected to receive payments.

Under the terms of the settlement, Intuit will also have to take several steps to improve disclosure in its products and cease marketing TurboTax under its yearslong “free free free” ad campaign. The company said in its statement that it “already adheres to most of these advertising practices and expects minimal impact to its business from implementing the remaining changes going forward.”

ProPublica’s stories in recent years reported on how Intuit routinely charged Americans who were eligible to file their taxes for free, sometimes luring them in with deceptive marketing. ProPublica reported that Intuit had even added code to its website to hide its free tax filing program from search engines such as Google. The company later removed the code.

Intuit still faces several other legal fights stemming from its “free” marketing.

The Federal Trade Commission is still pursuing legal action against Intuit over similar issues after suing the company in March under the federal law that prohibits unfair or deceptive business practices.

The agency’s suit asked the court to issue an emergency order forcing Intuit to stop its marketing of its products as “free” before the tax filing deadline on April 18. The judge ruled for Intuit in the lawsuit. But an internal FTC proceeding over the issues is continuing, with a hearing set for September.

Intuit said in its statement today that it believes “this settlement with the state attorneys general and the District of Columbia also addresses the issues at the core of the FTC litigation, making that lawsuit entirely unnecessary. Nevertheless, we are fully prepared to litigate with the FTC to prove the merits of our case.”

As ProPublica previously reported, more than 150,000 individual arbitration claims were also filed against the company by people seeking money back after they paid for software that, they said, should have been free. In a recent securities filing, Intuit said that on Feb. 23 it entered into a settlement agreement with consumers to resolve “a majority” of the pending arbitration claims without any admission of wrongdoing. The company hasn’t disclosed the terms of the settlement.

by Robin Fields and Adriana Gallardo

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

If the U.S. Supreme Court does as its leaked draft opinion says and strikes down Roe v. Wade, researchers expect that in the following year, roughly 75,000 people who want, but can’t get, abortions will give birth instead.

They’ll do so in a country where pregnancy and childbirth continue to become more dangerous.

Government data released this year shows that U.S. maternal deaths increased significantly in the first year of the pandemic, going from 754 in 2019 to 861 in 2020, a 14% jump. The death rate for Black women was almost three times higher than that for white women.

The stats for 2020 were no surprise. As ProPublica detailed in 2017, the U.S. has fallen behind other wealthy nations and many less affluent ones where deaths linked to pregnancy and childbirth have plummeted over the past two decades. Deaths are only one yardstick for measuring maternal health. For every U.S. woman who dies as a result of pregnancy or childbirth, up to 70 suffer dangerous and sometimes life-threatening complications.

The landscape for maternal health post-Roe would change swiftly, and not for the better, many public health officials and experts say. Some 25 states would likely move to ban abortion, according to the Center for Reproductive Rights. A brief submitted in the case on which the court is ruling, signed by about 550 public-health and reproductive-health researchers, draws a straight line between lack of abortion access and increased risk of maternal death.

“Put simply,” the brief says, “women living in states with the most restrictive abortion policies — and thus the least abortion access — were found to be more likely to die while pregnant or shortly thereafter than women living in states with less restrictive abortion policies, regardless of state-to-state differences in poverty, race/ethnicity, and education.”

Middlebury College economics professor Caitlin Knowles Myers, whose work focuses the effects of limits on abortion access, said her research shows that in the year after the ruling, about 100,000 women seeking abortions won’t be able to get them from providers. Some may be able to obtain pills for self-managed abortions, but about three-quarters will give birth.

Those women are likely to be disproportionately poor, young, of color and concentrated in the Deep South, parts of the Midwest and some Western states, often in places where social safety nets are weakest, she said. “Overwhelmingly, it is the poorest and most vulnerable women who are the most affected.”

Dr. Katy Kozhimannil, a health policy professor who directs the University of Minnesota’s Rural Health Research Center, said the loss of abortion access will be a compounding factor in rural communities where contraceptives are hard to get and hospitals have closed or no longer have obstetrics departments.

“I think we’re going to see a lot more emergency obstetric needs in rural communities that are not at all equipped to handle them,” she said.

Many of the states with trigger laws that will outlaw abortion once the Supreme Court has ruled have larger rural populations and a higher percentage of Black and Indigenous residents in those areas, Kozhimannil added.

by Brittany Freeman, Rocky Mountain PBS

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

Colorado lawmakers passed a bill Monday aimed at protecting residents in disputes with their homeowners associations.

House Bill 22-1137 limits HOAs from seeking foreclosure against homeowners who accumulate fines for violating community rules known as covenants. The bill also stops HOAs from assessing those penalties on a daily basis and limits them to $500. The legislation now heads to Gov. Jared Polis, whose office said he plans to sign it into law.

“As it currently stands, Coloradans have little recourse and almost no protections when facing down the endless resources held by associations and the lawyers they may hire,” bill cosponsor Sen. James Coleman, D-Denver, told his colleagues at a committee hearing Friday.

The bill went through numerous changes after its first House committee hearing. Supporters said lawmakers removed a provision that would have limited the amount of legal fees that HOAs can charge residents in court cases, but added provisions that specifically prohibited foreclosure on liens that only contain fines or the costs of collecting them.

Coleman said the changes were driven by hours of meetings with representatives of HOAs and their advocates. “We really took our time,” he said, “so that we ultimately make it so that our communities continue to be safe and beautiful, but at the same time folks aren’t losing their homes because they had weeds in their grass.”

Coleman represents Green Valley Ranch, a community that has become the subject of months of publicity after one of the HOAs there filed dozens of foreclosure cases against residents in the past year. Rep. Naquetta Ricks, D-Aurora, was the bill’s initial sponsor.

An analysis of court case data by Rocky Mountain PBS and ProPublica found that Colorado HOAs have filed at least 2,400 foreclosure cases against residents since 2018. HOAs in the state have the legal right to seek foreclosure against homeowners who are at the equivalent of six months behind on their routine dues, but that total can also include fees, fines and collection costs, such as legal fees.

Many homeowners who faced foreclosure have told Rocky Mountain PBS and ProPublica that they ultimately ended up paying thousands of dollars more than their original debts to save their homes because the HOA billed them legal fees after they fell behind. Residents of one HOA community in Aurora, the Timbers Homeowners Association I, told the news organizations that they were surprised to learn their HOA has filed 41 foreclosure cases since 2018.

The newly passed legislation contains several measures that supporters said would give homeowners due process before delinquencies end up in court. It requires several notifications to residents about delinquencies and fines, requires those notices to be provided in the native language designated by homeowners and allows them the opportunity to seek longer payment plans of 18 months to repay debts to the HOA.

Representatives from the HOA industry told lawmakers they opposed the legislation. They said it would make it harder to enforce their rules, especially when homeowners are defiant, and would push more costs onto others who are compliant.

“This bill is going to harm the people who keep their promises and cause expenses for those people. It’s been through so many different amendments and variations, and it’s still so messy,” testified Lindsay Smith, an HOA attorney who heads Colorado’s legislative action committee for the Community Associations Institute.

The bill’s supporters said a provision that opens up small claims court as a venue for disputes could also make a big difference for homeowners who cannot afford to hire an attorney to fight their HOA.

“The disputes that are creating all of the heat within HOAs finally have a place to go,” said Andrew Mowery, an HOA homeowner advocate whose group helped craft the original legislation.

by Alexandra Zayas

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As all eyes were on the U.S. Supreme Court on Tuesday after a leaked draft majority opinion indicated it is planning to overturn Roe v. Wade, ProPublica spoke with journalist Joshua Prager, who spent 11 years dissecting the landmark case that guaranteed abortion rights for women across the country. For his acclaimed book “The Family Roe: An American Story,” Prager interviewed upwards of 500 people including key figures on both sides of the case, most notably its plaintiff, Norma McCorvey, who was better known as Jane Roe. In delving into the untold story behind her life, those of the children she gave birth to and the monumental case, Prager unfurled the decadeslong history of the American war over abortion.

Prager said indicators of the justices’ leanings were clear while observing arguments in Dobbs v. Jackson Women’s Health Organization, a case challenging a 2018 Mississippi law prohibiting most abortions after 15 weeks’ gestational age, which is the subject of the Supreme Court’s draft opinion. Though the Court confirmed the authenticity of the document published this week by Politico, the final vote and decision are still pending. Prager discussed why he believed the road to this week’s revelation was paved, in part, by decades of mistakes and missed opportunities made by the pro-choice movement. (In his book, Prager refers to those who support the right to abortion the way they refer to themselves, “pro-choice,” and those opposing abortion the way they refer to themselves, “pro-life.” We adhered to these conventions during our interview. The interview has been edited for brevity and clarity.)

Did you expect this day would come?

I absolutely did. Anyone who was a close follower of the issue could see that this was happening when we listened to the oral arguments in Dobbs. We knew where all of the justices stood pretty much, but there were two who we thought might go either way, Justice (Amy Coney) Barrett, Justice (Brett) Kavanaugh — two of Trump’s three appointments. And to listen to them speak and question during oral arguments in Dobbs, we could see where they were going.

Kavanaugh, over and again, was speaking about precedents that the Supreme Court had previously overturned. Justice Barrett, meantime, was speaking about the fact that adoption is, as she put it, a viable alternative to abortion.

What was so fascinating about this and tragic, if you’re a person who believes that Roe ought not to be overturned, was that the Supreme Court did not need Justice (John) Roberts, the chief justice anymore; the conservative bloc now doesn’t need him. They have the votes that they need 5 to 4 without him. He is an incrementalist. He is a person who respects precedent. He really cares about the image of the court, does not want it to be seen as simply a political body. And he was desperate to not actually have the headline that we had last night. He wanted to see Roe maintained, but sort of gutted. But he lost.

So this was not a surprise. If you step back further, when Roe was ruled upon in 1973, it galvanized those opposed to it. And it gave (the pro-life movement) a very simple, clear target, a new raison d’etre: We want to overturn Roe. This is the culmination of 49 1/2 years of efforts and different approaches, novel approaches. And unfortunately, again, if you are a person who believes in reproductive choice, the pro-choice did not take a lot of that seriously for many years, and they are as much to, sort of, blame for this day as the pro-life will (take) credit for.

Tell me a little more about the blame the pro-choice movement shares.

(The pro-choice movement) did not foresee a war here. NARAL’s executive director in 1973, when Roe was ruled upon, told her board after the ruling, “The court has spoken and the case is closed.” They saw this as, basically: It’s over. We’ve won.

The very, very opposite is true of the pro-life, who said: OK, now we have to think about this strategically, how will we go about overturning Roe? As a result of that imbalance, the pro-choice were playing catch up really for 49 1/2 years, as the pro-life (movement has) over and over again come up with many different ways to chip away at Roe and has been remarkably successful. Just to give you a few examples:

• 1976, the Hyde Amendment, which said that you can no longer pay for abortion with Medicaid.
• 1989, the case of Webster, that was a ruling against the use of public resources for abortion.
• 2007, Gonzales v. Carhart banned a specific type of abortion procedure.
• And then of course, just this year in Texas with SB-8, it was a very novel approach coming up with a way to have an end run around the enforcement of abortion by deputizing private citizens to sue anyone who was helping someone have an abortion in any way.

The pro-life also used technology in a way that had never been used before by showing fetal photography. They used language that had never been used before, for example, coining the phrase “partial-birth abortion.”

They also used pseudoscience in a remarkable way. They came up with this very novel approach called “post-abortion syndrome,” saying that if a woman had an abortion, an enormous percentage of the time, she would suffer psychologically as a result of that. That’s not true. In fact, the opposite is true. The majority of women who have abortions express relief as opposed to regret. If there is something that causes women grief, the studies show, it is relinquishing their child to adoption. These were all pro-life weapons in attacking Roe, and over and over again, you had the pro-choice movement outfoxed.

In the early 2000s, one of the attacks on Roe was led by lawyer Allan Parker, who had represented Norma for a time. (The suit) said that Roe needed to become null and void because conditions had changed in the years since it had been filed. And the only way to file this suit was to have the original plaintiff file it. So he came to represent Norma and he filed this suit.

What ended up happening was that the pro-choice basically ignored the suit. They said that it was a sad publicity stunt, and they did not file a single brief defending Roe in this case. And it ended up introducing into the judicial system these affidavits filed by women who said that abortion harmed them. And that idea ended up going right up to the Supreme Court. Justice (Anthony) Kennedy ended up citing them in 2007 in Gonzales v. Carhart. It was evident that Parker’s lawsuit had been incredibly effective and powerful.

It shows all of the different ways in which the pro-choice have failed to meet the pro-life, have failed to repel their arguments and their strategies. And it speaks to a simple human reality that it’s much easier to try to knock something down than to defend it. What we’re going to see now is the very same problem that the pro-choice had, the pro-life now are going to have, because now you are going to see that this is going to galvanize the tens of millions of people who are horrified about what’s happening now. They now will have as simple a marching order as the pro-life used to have to reinstate Roe or to come up with another way to ensure that abortion will be legal for women across the country.

Roe was 1 day old in 1973 when Bella Abzug, who was a House representative from New York, urged Congress to codify Roe. She basically foresaw exactly where we are today, that there was the potential legislation to erode Roe. She introduced an act: The Abortion Rights Act, H.R. 254, to bar states from creating new (laws) on abortion. Congress ignored her bill, and anyway, it was doomed to failure because Roe allowed for future legislation. It gave states the right to oppose regulations from the second trimester onward, but here we are now and people want to go back and do exactly what Bella Abzug was saying that we ought to do.

Is there any more evidence that pro-choice leaders made mistakes that allowed this to happen? Where does the pro-choice movement go from here?

It’s not only true, but something that, case in point, was embodied by Justice (Ruth Bader) Ginsburg’s decision to not step down from the court in her 80s, during Obama’s presidency. We would not be here had she done that. That is a simple fact. And that is a very painful fact, for she’s obviously the greatest hero over the course of 50 years to the pro-choice movement, but whether it was hubris or it was an inability to see that Trump might be elected or just a very human, understandable desire to hold onto a job she loved, it was nonetheless a mistake with catastrophic consequences. And that, you can say, was the final nail in the coffin for Roe, but it was also the latest in a long line of missteps by the pro-choice of failing to properly address the situation in which they found themselves.

And here we are, but again, it’s now going to flip. If you’re a person who cares about choice, that is the silver lining of this very dark, dark cloud that it is now going to galvanize in a way we have not seen in our lifetimes, those who believe in a right to choose.