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by Maya Miller and Robin Fields

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This story is part of a partnership with Scripps News.

In North Carolina, lawmakers outraged that breast cancer patients were being denied reconstructive surgeries passed a measure forcing health insurers to pay for them. In Arizona, legislators intervened to protect patients with diabetes, requiring health plans to cover their supplies. Elected officials in more than a dozen states, from Oklahoma to California, wrote laws demanding that insurance companies pay for emergency services.

Over the last four decades, states have enacted hundreds of laws dictating precisely what insurers must cover so that consumers aren’t driven into debt or forced to go without medicines or procedures. But health plans have violated these mandates at least dozens of times in the last five years, ProPublica found.

In the most egregious cases, patients have been denied coverage for lifesaving care. On Wednesday, a ProPublica investigation traced how a Michigan company would not pay for an FDA-approved cancer medication for a patient, Forrest VanPatten, even though a state law requires insurers to cover cancer drugs. That expensive treatment offered VanPatten his only chance for survival. The father of two died at the age 50, still battling the insurer for access to the therapy. Regulators never intervened.

These laws don’t apply to every type of health plan, but they are supposed to provide protections for tens of millions of people. AHIP, a trade group that used to be known as America’s Health Insurance Plans, said new mandates are costly for consumers and states, “tie insurers’ hands and limit plan innovation” by requiring specific benefits. Nevertheless, its members take steps to make sure they are following these mandates, the trade group said.

State insurance departments are responsible for enforcing these laws, but many are ill-equipped to do so, researchers, consumer advocates and even some regulators say. These agencies oversee all types of insurance, including plans covering cars, homes and people’s health. Yet they employed less people last year than they did a decade ago. Their first priority is making sure plans remain solvent; protecting consumers from unlawful denials often takes a backseat.

“They just honestly don’t have the resources to do the type of auditing that we would need,” said Sara McMenamin, an associate professor of public health at the University of California, San Diego, who has been studying the implementation of state mandates.

Agencies often don’t investigate health insurance denials unless policyholders or their families complain. But denials can arrive at the worst moments of people’s lives, when they have little energy to wrangle with bureaucracy. People with plans purchased on HealthCare.gov appealed less than 1% of the time, one study found.

ProPublica surveyed every state’s insurance agency and identified just 45 enforcement actions since 2018 involving denials that have violated coverage mandates. Regulators sometimes treat consumer complaints as one-offs, forcing an insurer to pay for that individual’s treatment without addressing whether a broader group has faced similar wrongful denials.

When regulators have decided to dig deeper, they’ve found that a single complaint is emblematic of a systemic issue impacting thousands of people.

In 2017, a woman complained to Maine’s insurance regulator, saying her carrier, Aetna, broke state law by incorrectly processing claims and overcharging her for services related to the birth of her child. After being contacted by the state, Aetna acknowledged the mistake and issued a refund.

That winter, the woman gave birth to a second child, and Aetna did it again. She filed another complaint. This time, when the state made Aetna pay up, it also demanded broader data on childbirth claims. Regulators discovered that the insurer had miscalculated claims related to more than 1,000 births over a four-year period. Aetna issued refunds totaling $1.6 million and agreed to pay a $150,000 fine if it failed to follow conditions listed in a consent agreement.

It was a rare victory. The potential fine, though, constituted less than .002% of the $6.63 billion in profit recorded by Aetna’s parent company, CVS Health, that year.

Aetna spokesperson Alex Kepnes said the company resolved the matter in 2019 to the state’s satisfaction. Kepnes declined to answer why the insurer failed to fix the issue after the first complaint.

Watch the Scripps News Report “Hope Denied”

Patients often don’t know what care they’re entitled to under state mandates. And one survey found that 86% of people with health insurance don’t know which government agency to call for help. Knowing how to navigate the system can make all the difference to patients socked with giant medical bills.

In December 2022, Samantha Slabyk felt a sudden sharp pain in her lower right abdomen. The San Marcos, Texas, resident took herself to an outpatient emergency clinic, but after a CT scan revealed she had appendicitis, doctors sent her in an ambulance to a nearby hospital. “Everyone indicated that this was an emergency situation that needed to be dealt with promptly,” Slabyk said.

Texas has long had a law requiring insurers to cover medical treatment needed by patients in emergencies. Yet that month, her insurer, Ambetter, wrote in a letter that it would not pay the $93,000 bill because the appendectomy took place at an out-of-network facility.

Slabyk was studying to be a physician’s assistant and had been an EMT. Her fiance’s brother-in-law worked in medical billing and gave her advice on how to push back, as did her mom — whose cancer diagnosis meant she often interacted with health insurers. These connections and experiences gave Slabyk an unusual grasp of her rights and how the system works. Still, every time she reached someone at Ambetter, she felt like she was being stonewalled. Slabyk felt lost.

You can find more information about your state's laws on the Centers for Medicare & Medicaid Services website.

By June, she was so fed up she decided to submit a complaint to the Texas Department of Insurance. Five days later, she received a call from an Ambetter employee apologizing and saying they would process the procedure as an emergency and pay up.

Centene, Ambetter’s parent company, did not respond to emailed questions or a phone call seeking comment. (The state informed Slabyk it closed the complaint.)

“I was around a lot of people who were knowledgeable and giving me very good advice,” Slabyk said. “And so if you’re just like, on your own, not in the health care system whatsoever, I mean, I just, I can totally see giving up.”

California had to pass not one but two laws to compel insurers to pay for infertility treatments. And one lawmaker said insurers are still saying no often enough that he’s considering introducing a third.

After legislators began requiring such coverage in 1990, some health plans took a narrow view. They refused to pay to preserve eggs, sperm or reproductive tissue for patients facing treatments for diseases like cancer that could impair their fertility. Some patients were delaying chemotherapy to try to get pregnant beforehand or going into debt to pay for treatments out-of-pocket. Regulators forced insurers to pay in some cases, but elected officials worried that other patients were being denied this care.

State Sen. Anthony Portantino worked with colleagues to amend the law in 2019, clarifying that these treatments must be covered. Even so, insurers have been putting up roadblocks.

“Some of the insurers are taking a very strict approach that it has to be chemo,” said Portantino, who is a Democrat. For instance, patients who need cancer surgeries that could leave them infertile have faced denials.

Portantino said he plans to work with California’s largest health insurance regulator to clarify that fertility preservation must be covered more broadly. If that does not work, he said he will turn to legislation once again.

Other regulators are trying to bolster enforcement on the front end. Health insurers submit annual filings to the states where they operate, detailing the treatments and services the company will and won’t cover. Regulators check these policies to figure out whether an insurer is complying with state mandates. In Vermont, the insurance department is using federal grant money to work with an outside company to improve these reviews. Through staff training and education, the department hopes to catch insurers not following state laws before Vermont residents face wrongful denials.

Not all health plans have to follow state mandates. About 65% of employees who get insurance through their jobs work for companies that pay directly for health care. Those companies often hire insurers solely to process claims. Known as self-funded plans, they are regulated by the federal government and exempt from state coverage requirements. Employers increasingly are turning to these types of plans, which tend to be cheaper, partly because they don’t have to cover care that states require. (The federal government also imposes coverage mandates, but state laws can be more robust.)

For patients, this can mean fewer protections from denials.

When 57-year-old Sayeh Peterson, a nonsmoker, was diagnosed with stage 4 lung cancer, her doctors ordered genetic testing to identify the cause. Those tests revealed that a rare gene mutation was, in fact, the culprit for Peterson’s disease and gave doctors the information they needed to create a treatment that targeted the mutation. Her state, Arizona, requires insurers to cover such testing, but Peterson’s UnitedHealthcare plan was self-funded by her husband’s employer, so the law didn’t apply. She and her husband were left with more than $12,000 in bills.

In response to questions, UnitedHealth spokesperson Maria Gordon Shydlo wrote that “there is not enough medical evidence to support use of all those tests.”

As Peterson undergoes a treatment plan tailored to the genetic test results, she is continuing to appeal the denials months later. “We’re told that we have this great insurance,” Peterson said. “But then they deny coverage for the testing that determined what my treatment would be. How do you even get your head around this?”

Do You Have Insights Into Dental and Health Insurance Denials? Help Us Report on the System.

Doris Burke contributed research.

A conversation with Forward Through Ferguson executive director Annissa McCaskill

It's the best of times, it's the worst of times for LGBTQ rights in St. Louis. On Tuesday, the Human Rights Campaign released their annual Municipal Equality Index, which evaluates more than 500 cities across the country on how inclusive their laws, policies, and services are for LGBTQ residents.

A panel of Missouri lawmakers have spent several hours in recent weeks debating whether or not aliens and robots should be banned on marijuana product labels. Humans, animals and fruits are already not allowed — an effort by the state to keep products out of the hands of children. But would robots fall under that […]

The post Missouri legislators criticize regulations targeting cannabis packaging aimed at kids appeared first on Missouri Independent.

WASHINGTON — U.S. Rep. Pramila Jayapal, a Washington state Democrat, joined about 100 tenant advocates at a press event outside the U.S. Capitol on Wednesday to demand action on the housing crisis. Jayapal, who chairs the Congressional Progressive Caucus, called on the Federal Housing Finance Agency to bolster tenant protections and rent regulations. The People’s […]

The post ‘Out of control’: Advocates rally in D.C. calling for action on housing crisis appeared first on Missouri Independent.

Workers at the General Motors plant in Wentzville have voted down what union officials have described as a record contract offer.

A host of bobbleheads, clothing and other swag is up for grabs this upcoming season.

by Samantha Sunne, Dannah Sauer and Lee Zurik, WVUE-TV

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

The village of Fenton, outside the oil and gas town of Lake Charles, covers only about 20 blocks. There’s City Hall. The library. One gas station. A small public housing complex. A Dollar General. A grain elevator. A Baptist church. Drivers headed to east Texas from central Louisiana go right through town, passing it all in under a minute.

In many ways, Fenton is like other small towns in Louisiana. But it is remarkable in one way: This village of 226 people collected more money in a single year through fines and forfeitures, primarily traffic tickets, than almost any other municipality in Louisiana, according to audits.

In the year ending in June 2022, Fenton brought in $1.3 million that way.

The fines were collected through what’s known as a “mayor’s court”: a little-known type of small town court found only in Louisiana and Ohio. In Fenton, its primary function is processing the thousands of traffic tickets written annually by a few police officers. Here, the mayor is also the judge, appointing the prosecutor and, if drivers ask for a trial, deciding their guilt or innocence.

The mayor runs the village with revenue primarily made up of those fines. The bulk of the salaries of the people in the courtroom — everyone from the mayor to the clerk — comes from fines and fees collected by the court.

This arrangement is so ripe for conflict of interest that the fairness of mayor’s courts has been challenged several times. One case resulted in a 1972 U.S. Supreme Court ruling that curtailed the power of mayors who take in a lot of money through their court.

Fenton village attorney Mike Holmes, in an email to WVUE-TV and ProPublica, said the mayor presides over court in a “neutral, impartial manner” consistent with Louisiana law.

But the village’s court records suggest something else about how it handles some tickets: Case summaries include curious notes from village employees and police officers. Some say not to “fix” tickets or reduce charges for drivers who had a “bad attitude.” Others suggest that the police chief and others have had a hand in dismissing charges, although Holmes said tickets are dismissed only at his direction.

Getting clear answers to how Fenton operates its court, and how fairly, has been difficult. Over four visits, journalists from WVUE and ProPublica reviewed court files, town meeting minutes, municipal ordinances and body camera video. We asked for three and a half years of electronic case summaries. We tried, several times, to see the court in action and to meet with the mayor, eventually observing court once and speaking with the mayor for five minutes.

Village officials offered conflicting and confusing explanations for the mayor’s role, how and why tickets are reduced or dismissed, why the town asks the state to suspend so many drivers’ licenses and how often trials are held. Their description of how the town runs its court didn’t align with state Judicial College guidance or that U.S. Supreme Court ruling.

Such irregularities demonstrate the problems inherent in this unique court system in place across Louisiana, said Joel Friedman, an emeritus professor at Tulane University in New Orleans who has taught procedural law for 46 years.

“The mayor who’s trying to raise money for the city is in charge of prosecuting these minor criminal offenses and getting fines brought back to the city,” he said. “There’s no accountability,” he added. “They can do whatever they want.”

A few people well-versed in mayor’s courts, including an attorney who was intrigued enough to write a book about them, said Fenton shouldn’t allow the mayor to preside over court.

Small Town, Big Budget

Fenton has just 226 residents, but it collected about as much money through fines and forfeitures in a single year as Louisiana’s third-largest city, Shreveport, which has a population of 187,000. (Jon Turnipseed/WVUE)

Watch video ➜

Fenton is not unusual among small towns in Louisiana in administering justice through its mayor’s court.

Courts like this, which likely have been around since before Louisiana was a state, were carried over into the state’s modern judicial system when its constitution was updated in the 1970s, according to attorney Floyd Buras, who wrote that book on mayor’s courts. Now, they function as an informal way to handle minor offenses in about 250 municipalities, mostly small towns and villages.

Mayor’s courts operate in a gray area of Louisiana law. Like municipal courts, they handle violations of local ordinances. Municipal judges must hold a law degree and pass the bar; a mayor can preside over court without meeting any qualifications. Yet, like a municipal judge, a mayor can impose fines or sentence people to jail.

Mayor’s courts must ensure defendants have fair trials. But unlike other courts in the state, they aren’t subject to rules like the Code of Criminal Procedure that are supposed to ensure courts are run fairly and properly.

“They sort of operate in the shadow of the law,” said Eric Foley, an attorney with the MacArthur Justice Center, a law firm that litigates for civil rights in criminal justice.

Fenton’s court is the main reason the town’s revenue for the year ending in June 2022 was about five times as high as the average Louisiana municipality its size. This tiny village collected about as much through fines and forfeitures as Shreveport, the state’s third-largest city, with a population of 187,000. (The state provides no official definition of “fines and forfeitures,” but it generally refers to penalties for breaking the law and associated fees.)

The average municipality in the U.S. gets 1.7% of its revenue from fines and forfeitures, according to the Urban Institute, a Washington, D.C.-based think tank that promotes equity. In Fenton, it’s 92.5%.

That’s the highest percentage of any municipality in Louisiana, according to a survey by WVUE and ProPublica of audits on file with the state.

It’s also one of the highest percentages in the whole country. In a frequently cited review of local government data by the news outlet Governing in 2019, Fenton ranked second-highest for its share of revenue that came from fines and forfeitures.

Governing said nearly 600 jurisdictions in the U.S., including 70 in Louisiana, collected at least 10% of general fund revenue through fines and forfeitures.

Advocates for the poor say a reliance on fines, which they call “taxation by citation,” distorts the role of police departments. “It’s almost impossible to generate that much of your revenue without doing pretty abusive things,” said Joanna Weiss, co-executive director of the Fines and Fees Justice Center, which promotes what it calls equitable fines and the elimination of fees in the justice system.

Holmes, the attorney for Fenton, said fines make up an outsized share of its revenue because, like many other small towns, it doesn’t bring in much money from sales or property taxes. “While revenues fluctuate from year to year, Village of Fenton Police Department has long had an active traffic enforcement policy,” he wrote.

That enforcement is particularly active on the north side of town, where U.S. Route 165 shifts from a divided highway to a five-lane road. Just before drivers reach a welcome sign, the speed limit drops from 65 mph to 50. Police cruisers often wait nearby, in a stand of trees across from a small roadside cemetery.

That’s where Nikki Cross got her ticket last year. She was returning to Bridge City, Texas, about 70 miles away, to pick up her son after meeting a client north of Lake Charles for her sales job.

Cross said she braked when she saw the speed limit drop. She was ticketed for driving 61 mph in a 50 mph zone. “I told them I was slowing down at the time; I just didn’t slam on my brakes to get to the speed I needed to be at,” Cross said in a text message to WVUE and ProPublica.

Her fine: $210.00.

Mayor, Judge and Jury

The Supreme Court has ruled that a mayor can’t be impartial as a judge if he oversees the town’s finances and if its court brings in a substantial share of the town’s revenue, like Fenton’s does. Mayor Eddie Alfred Jr. initially told WVUE and ProPublica he doesn’t preside over court, but village attorney Mike Holmes later confirmed Alfred does after we saw the mayor sitting at the bench in September. (Jon Turnipseed/WVUE)

Watch video ➜

Legally, there’s nothing improper about a town like Fenton collecting so much of its revenue through its mayor’s court. But when it does, court rulings say, the mayor shouldn’t both hold the town’s gavel and sign its paychecks.

In a 1972 case, a driver contesting two $50 traffic tickets in Monroeville, Ohio, argued that he had been denied a fair trial because the mayor who ruled against him was responsible for law enforcement and for producing revenue for the town. At the time, Monroeville generated 37% to 51% of its annual revenue from its mayor’s court, much less than Fenton.

The case, Ward v. Monroeville, went to the U.S. Supreme Court. In a 7-2 decision, Justice William Brennan Jr. wrote that the issue turned on “whether the Mayor can be regarded as an impartial judge.” He can’t, Brennan wrote, if he presides over court and also manages the town’s finances, and if the court generates a substantial part of the town’s revenue.

A week later, the Louisiana attorney general’s office followed up with an opinion instructing Louisiana towns with mayor's courts to assess whether they were in a similar situation as Monroeville.

Subsequent rulings have cited that Supreme Court opinion. In 1995, a federal judge in Ohio ruled that a mayor could be considered biased on the bench if just 10% of the town’s revenue came from its mayor’s court. In 2019, the 5th Circuit Court of Appeals ruled that a judge in Orleans Parish Criminal District Court had a conflict of interest when setting bail bonds because the court collected a fee based on the amount of each bond.

A training video on mayor’s courts released this year by the Louisiana Judicial College, the educational arm of the state Supreme Court, addresses this conflict of interest. It advises mayors to appoint an attorney to preside over their court if it brings in more than 10% of the town’s revenue. Some towns, including many in the New Orleans area, have done that.

But we found at least nine other municipalities in the state where staff confirmed that the mayor presides over court even though collections make up anywhere from 18% to 79% of the town’s annual revenue.

Bobby King, the prosecutor for the mayor’s court in Walker, near Baton Rouge, led that Louisiana Judicial College video training. In an interview, he said he would advise Fenton, or any municipality in its position, to appoint a magistrate. “You can’t be fair and impartial,” he said, “if you’re wanting to spend money on a park and a big part of that money comes from fines and fees.”

Yet it was not easy to determine who presides over court in Fenton. In a phone call in June, Eddie Alfred Jr., who has been the village’s mayor since 2009, was eager to talk about its traffic ticketing system. But he said he doesn’t preside over court.

Instead, Alfred said, defendants talk to Holmes, the prosecutor. If someone pleads not guilty, Holmes shows the driver a video of their violation. After that, Alfred claimed, “not one person” has maintained their innocence since he has been mayor. If they did, he said, they would go to the district court in Jennings, the seat of Jefferson Davis Parish.

When we visited Fenton in September to observe court, “Judge Alfred,” as he is referred to in court records, donned a black judge’s robe, walked down the hall from the mayor’s office and sat at the bench. No one was waiting to have their cases heard. After Holmes noted for the record that several people had missed their court date, Alfred said, “Court is now adjourned.” Afterward, he refused to speak with us and went back to his office.

Watch WVUE’s Report

Holmes later confirmed that Alfred does preside over court; when asked about the mayor’s statement to the contrary, Holmes said it “must have resulted from misunderstanding or miscommunication.” Asked why the mayor serves as judge when the village collects so much money from the court, Holmes said, “He is authorized to do so by law.”

Four lawyers who spoke with us — the law professor, the author of the book on mayor’s courts, the civil rights attorney and the prosecutor who led the Judicial College training — said they believe Fenton is violating the Supreme Court ruling.

“Our Main Income Is Traffic Tickets” (Anna Donlan/ProPublica)

Watch video ➜

“Even if you can’t point to the mayor actually being on the record saying, ‘I have to keep up these prosecutions to maintain this funding,’ the fact that the average person put in that mayor’s shoes might feel that temptation — that’s kind of enough,” Foley said.

Actually, Fenton’s mayor has said something quite similar.

In a recording made in September and obtained by WVUE and ProPublica, Alfred can be heard telling village employees that there could be layoffs due to financial problems.

“Our main income is traffic tickets, and they ain’t getting written,” he said, according to one person who was in the meeting and another village employee who identified the voice on the recording as the mayor’s. They asked not to be named for fear of retribution. “We need to write more traffic tickets.”

Holmes, who handled our inquiries, did not respond to our request for comment on that statement.

The Cost of Being Rude

On the north side of Fenton, just before a welcome sign, the speed limit drops from 65 mph to 50. Police cruisers often wait here to catch speeders. Officers write, on average, about 16 tickets per day. (Jon Turnipseed/WVUE)

Watch video ➜

Fenton’s court records paint a picture of a justice system in which some people are punished for how they act while others are rewarded for who they know.

We found a dozen court records that include notations from officers and village employees saying not to “help” people or “fix” their tickets because drivers were rude. On a ticket for driving 71 mph in a 50: “Refused phone number, driver was very disrespectful no help.” Fine: $305.

A ticket for 81 in a 50: “Very bad attitude. Do not fix.” Fine: $490.

Video from an officer’s body camera during one traffic stop shows a woman, stopped for driving 62 mph, asking the officer to show her the radar reading and to let her go with a warning.

“What else do you guys do around this town?” she asked the officer after he handed her a ticket.

“Protect and serve,” he responded.

Her file reads, “Bad attitude.” She was fined $215.

Some tickets bear officers’ handwritten notes saying drivers had a “bad attitude.” We found a dozen court records with notations saying not to “help” people or “fix” their tickets because of their behavior. Holmes said such notes do not affect how cases are decided. (Obtained by WVUE and ProPublica. Redacted and highlighted by ProPublica.)

Holmes said notes about drivers’ behavior have nothing to do with how cases are decided. “A defendant is not punished for rude behavior during a traffic stop, but rather for objective, provable violations of law,” he told WVUE and ProPublica. Besides, he said, the vast majority of drivers decide to pay their tickets. (We spoke to several drivers with such notations in their files. Of those three, two said they didn’t contest their charges; the third said he couldn’t remember.)

Fourteen court files include notations saying a charge was dismissed after someone, often in law enforcement, had intervened. “Dismissed per Chief Alfred,” said the record for a ticket issued to someone who, according to the notation, knew a village employee.

Luther Alfred, the chief, said he sometimes gets requests to dismiss tickets and passes them on to the judge or prosecutor. Though he acknowledged that he has written “Dismiss” on paperwork and signed his name, he said he doesn’t dismiss charges himself and doesn’t have that authority.

Phillip Hattaway’s file for a speeding ticket he received in 2022 says, “Ivy Woods asked to dismiss per O’Quinn.” Woods is the sheriff of Jefferson Davis Parish, and Sgt. Vernon O’Quinn is Fenton’s police sergeant. In an interview, Hattaway said he contacted people he knew in law enforcement, asking for help. His ticket was dismissed. “It was short and sweet,” Hattaway said. “They just got it taken care of.”

O’Quinn said the department was “asked if we could provide any assistance,” and he “advised he didn’t have a problem with it and recommended to the prosecutor for dismissal.”

Asked why his name appears on court records, Woods said many people ask if he can get tickets reduced to nonmoving violations. “You’d be surprised how many tickets Fenton writes,” he said. “They’re pretty tough — they like their money.”

But he didn’t acknowledge calling in any favors, saying that the village “might be covering their butts, saying the sheriff asked.” Although he offered to elaborate later, he didn’t respond to subsequent phone calls.

In response to questions for this article, Holmes said, “Requests for consideration to amend or dismiss charges are received from myriad sources.” He didn’t answer a question about how the village decides which requests to act on.

We reached out to more than 100 drivers, including about 40 whose files said something about their behavior or why a ticket had been dismissed, and interviewed about 35. Several said they felt like they had been caught in a speed trap or said they had heard from others about Fenton’s reputation for traffic enforcement.

Fenton “most certainly does NOT operate a ‘speed trap,’” Holmes wrote to WVUE and ProPublica. Speed limits are well marked, police officers are stationed in the open, and tickets are rarely issued unless drivers are going more than 11 mph over the limit, he said.

Several drivers said they had been threatened with license suspensions or even arrest, both of which are allowed under state law.

When April Dugas called to ask for leniency on a ticket for driving 65 in a 50 mph zone, she said she was told Fenton issues warrants for unpaid tickets. “I was living in Texas in my car with no money for gas to go back,” said Dugas, who now lives in the central Louisiana city of Alexandria. “My grandma had to pay the ticket, so I wouldn’t have warrants out for my arrest.”

Holmes didn’t respond to a question about whether village employees threaten drivers with arrest if they don’t pay. He did say the village sometimes issues an arrest warrant to compel someone’s appearance in court, typically when they don’t show up for trial, but it’s “fairly rare.”

For those who miss court and don’t pay, the consequences can be severe. Fenton sent the Louisiana Office of Motor Vehicles about 750 requests to suspend driver’s licenses between 2018 and June, a number on par with much larger municipalities in the state.

Asked why Fenton does this, Holmes at first said state law requires municipalities to notify the state when someone doesn’t show up for court. He later acknowledged that’s not true and cited a two-year deadline under state law to request a suspension.

The village has asked the state to suspend some drivers’ licenses over a single unpaid speeding ticket, records show.

That’s what happened to Santina Griffin, a hairdresser in New Orleans who was stopped for driving 74 mph in a 50 mph zone on her way back from a funeral. She said she meant to ask the judge for leniency because she was lost at the time. But as a student and a single mom, she couldn’t make it back to Fenton for her court appearance.

She was surprised to hear the judge was also the mayor: “Sounds like a monopoly to me.”

Court Is In Session

Drivers who want to contest their speeding tickets must show up at Fenton’s City Hall, where mayor’s court meets once a month. (Jon Turnipseed/WVUE)

Watch video ➜

In a town the size of Fenton, visitors are conspicuous. We were especially so — four journalists toting notebooks and a video camera, driving around town, flying a drone overhead, watching police officers wait for speeders.

After checking out the town, we went to its small City Hall, where we encountered Luther Alfred, the police chief and uncle of the mayor, and O’Quinn, who came up to us to chat. We had been driving around recording video for a couple of hours by then, and they mentioned some places we had been. O’Quinn chuckled about a man who had warned us to keep our drone away from his house about 15 minutes earlier.

The people of Fenton care about three things, O’Quinn said: “Christ, family and the Fenton Police Department.”

We wanted to see how the court handled tickets written by that police department, but we saw the mayor handle cases just once in the four times we went to court.

Over the summer, Alfred had promised to talk to us when we came for the August court session. That was the first time we made the three-hour trek from New Orleans. But the mayor skipped our interview and canceled court without notice, surprising us and a few defendants waiting at City Hall.

When we went back in September, no defendants showed up. A court staffer later told us that few people come to court. Before the October hearing, we called ahead to arrange a time to review some files. A few days beforehand, court was canceled without explanation.

Last week, we gave it one last shot. This time, as our reporter pulled up to City Hall, she was surprised to see cars parked along the road. She took the only open spot, a patch of grass outside a utility building.

As a dozen defendants filtered in, Holmes, the prosecutor, fetched some chairs from the kitchen to accommodate them. He described what would happen. Tonight, he said, they were in what’s called a mayor’s court. This was an arraignment, where they would each enter a plea. He spent about 20 minutes describing their rights: You have the right to appeal to district court. You have the right not to incriminate yourself.

Holmes had told us that he offers plea deals to many drivers, and he did just that, telling them to meet him in the kitchen if they were interested.

Then he called the judge in. Alfred, wearing his judge’s robe, sat at a large wooden desk emblazoned with the village seal. Holmes called up each driver to answer to their charges before the judge. Most pleaded no contest, which means they didn’t admit guilt but accepted punishment.

When a driver wants to contest a ticket, Holmes had told us, the driver or a lawyer shows up in court, pleads not guilty and is told to return later. “A trial is conducted with all care to ensure each defendant receives due process and is treated fairly before the court,” he said.

That’s not what happened with one case that night. One man, facing a charge of failing to use his turn signal, insisted he was innocent. The mayor told him to wait so O’Quinn could find video of the stop and play it in court. The video was inconclusive, however, and the driver maintained his innocence. Holmes said if the officer were called to testify, he likely would say the driver had broken the law. But he suggested the charge be dropped, and the mayor agreed.

Under state law, mayor’s courts are required to keep a record of all trials, but we had been told there was none and that there hadn’t been a trial since at least 2018. Holmes had told us the mayor “is rarely called upon to pass judgment at trial.”

Afterward, our reporter went up to ask Holmes more questions. The mayor called her into the kitchen. He wanted to make sure she had noticed how lenient the court had been with defendants.

“We’re not without compassion,” Holmes said.

Alfred said he believes he’s a fair judge, despite all the money he collects through court. But, he said, we’d been asking a lot of questions. “Now,” he said, “we have to hire someone.”

That was the topic of discussion a week later, when the three members of the board of aldermen held their monthly meeting in the same kitchen where Holmes had arranged plea deals. “The mayor can’t be the judge,” Alfred said, “which to me does not make sense.“ A man named Hugh Cunningham, who presides over mayor’s court in a nearby town, stood up and described how he would run the court if hired.

Board members objected. “We have to pay somebody to be the judge when he was judging for nothing,” said one board member about Alfred.

For about 15 minutes, Holmes laid out why the town should appoint a magistrate: the Supreme Court ruling, attorney general’s opinions, the possible appearance of bias.

Under the law, Holmes said, it’s up to the mayor to appoint a magistrate; the board votes on that decision. It didn't take long for Alfred to make up his mind: “I think we should put it off because I think this court is fair.”

How We Reported This Story

Louisiana law requires municipalities to turn in yearly financial reports to the state auditor. Over several months, we reviewed the most recent available annual audits for all 301 municipalities and two combined city-parish governments required to file audits with the state. We compared revenue from fines and forfeitures to overall governmental revenue.

There is no official government definition of fines and forfeitures in those audits, but the terms generally cover penalties for breaking the law and associated fees. In some places, they could include collections outside court, such as library fines and traffic camera tickets. Fenton’s attorney confirmed that its total is made up of fines and fees collected through mayor’s court for violations of municipal ordinance. A small number of municipalities’ audits did not include a line item for fines and forfeitures.

We compared all municipalities, regardless of whether they had a mayor’s court. (There is no official list of municipalities in Louisiana with mayor’s courts, but the state Supreme Court said there are about 250.) Of all the municipalities we reviewed, Fenton’s share of total revenue from fines and forfeitures was the highest.

Do you have a story to share about a mayor’s court in Louisiana? Contact Lee Zurik at lee.zurik@gray.tv or 504-483-1544.

Joel Jacobs of ProPublica reviewed the data analysis.

Correction

Nov. 22, 2023: This story originally contained an inaccurate description of what the Fines and Fees Justice Center advocates for. The organization promotes equitable fines and the elimination of fees in the justice system, not equitable fees.

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by Paige Pfleger, WPLN/Nashville Public Radio

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With a glint in his eye, Richard L. Bean reminisces about the days when children in his detention center could be paddled.

“We didn’t have any problems then,” Bean says. “I’d whip about six or eight a year and it run pretty smooth. They’d say, ‘You don’t want him to get hold of you.’” Once, he chuckles, a kid had to be held down by four guards to be spanked.

Bean took the helm of this East Tennessee detention center — now named the Richard L. Bean Juvenile Service Center — in 1972. The laws and the science on how to treat children in detention have changed a bit since then.

Yet Bean has held on to an old-fashioned approach to his work. These days, he’s reliant on a different tool for keeping kids in line: locking them alone in cells for hours — sometimes even days — at a time.

“What we do is treat everybody like they’re in here for murder,” he says. “You don’t have a problem if you do that.”

Most of the children in the Bean Center are not in for murder — in fact, most have only been charged with a crime, but are awaiting court dates.

Listen to Richard L. Bean describe paddling kids as punishment. “Had a lot of problems since” the state made him stop, he says. (Paige Pfleger/Nashville Public Radio and ProPublica)

At 83, superintendent Bean uses a bamboo cane to give a tour of the 120-bed facility. It’s connected to the juvenile court by a maze of windowless corridors; kids are passed between the two buildings in uniforms and shackles.

It’s difficult to know how children have been treated inside the walls of institutions like this one because policies designed to protect the privacy of kids can also obscure what goes on in facilities that break the law.

That was the case at a juvenile court about 150 miles west in Rutherford County, where reporting from ProPublica and WPLN revealed that kids were being illegally detained — at rates far higher than anywhere else in the state — for the most minor crimes, or even, in at least one instance, crimes that didn’t exist. The proof was right there, being collected by the state and laid out, for years, in an annual report. Yet no one flagged that kids were being jailed at a staggering rate, and no one seemed to try to stop it.

Here at the Bean Center, records reveal different violations of the law.

What we do is treat everybody like they’re in here for murder. You don’t have a problem if you do that.”

—Richard L. Bean, superintendent of the Richard L. Bean Juvenile Service Center

Kids have been locked alone in a cell here more often than other facilities in the state, sometimes as punishment, and sometimes for an indeterminate length of time. And even as the state has implemented reforms that would have made seclusion less common, the Bean Center remained reliant on the practice.

Here too, these violations are not a secret: The facility’s licensing agency, Tennessee’s Department of Children’s Services, has been documenting this improper use of seclusion for years at Bean’s center and elsewhere. The Richard L. Bean Center has repeatedly been put on corrective action plans. Yet DCS continues to approve the center’s license to operate without the facility changing its ways.

The Rules of Seclusion

In 2016, a suit in Rutherford County challenged the use of solitary confinement in the juvenile detention center after a child was kept in solitary for days for disrupting class. Around the same time, research emerged showing that isolating children doesn’t actually improve their behavior — if anything, it could worsen it. Solitary confinement can cause psychological impacts like depression, anxiety or psychosis, and young people are especially vulnerable to those effects. The majority of suicides inside juvenile correction facilities in the United States happen when a child is isolated.

So in 2017, DCS mandated that juvenile detention centers throughout the state change the way they use seclusion, adding guidelines and a reporting requirement.

The new standards said that children kept in seclusion inside Tennessee’s juvenile detention centers could be locked into cells that are 50 square feet — about the size of a U-Haul cargo van — usually with a concrete slab for a bed and a metal toilet affixed to the wall.

A cell at the Richard L. Bean Juvenile Service Center where kids are sometimes kept in isolation (William DeShazer for ProPublica)

Importantly, the standards made clear that seclusion was meant to be a last resort and should not be used as punishment.

“Seclusion shall only be used when necessary to prevent imminent harm to themselves, another person, prevent damage to property, or prevent the youth from escaping,” the standards dictate. “Staff shall never use seclusion for discipline, punishment, administrative convenience, retaliation, staffing shortages, or reasons other than a temporary response to behavior that threatens immediate harm to a youth or others.”

Shortly after, those standards were codified into state law.

In order to have their licenses renewed, which happens annually, juvenile detention centers are supposed to abide by DCS’ standards. Every few months, a DCS inspector drops into facilities unannounced to take a tour, review documentation of the use of tools like chemical sprays, and interview a few kids. The resulting inspection reports are written almost like a journal entry and provide a glimpse of life inside juvenile detention centers.

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WPLN and ProPublica reviewed eight years of those inspection reports, covering 2016 to 2023, and found multiple instances of children being locked up in seclusion — sometimes for days or more than a week — for minor rule infractions like laughing during meals or talking during class. One facility put a child in seclusion for eight days for simply having head lice, which the inspector called “a little extreme.”

And while many facilities were documented using seclusion improperly, the Richard L. Bean Center emerged as particularly prolific in its use of seclusion as a means of punishment, even years after the state standards were imposed.

Tyshon Booker was 16 years old when he says he was secluded in the Richard L. Bean Center. Now he’s 24 and incarcerated at a nearby prison, serving a 51-year sentence for homicide — a sentence the state Supreme Court recently ruled amounted to cruel and unusual punishment for juveniles like Tyshon.

But even though it was years ago, he remembers his two-year stay at the Bean Center like it was yesterday. During his 2015-2017 detention there, he says he was kept in seclusion twice for several days on end, without reprieve. He was stripped to his boxers, a T-shirt and socks before being placed in a cell alone.

Boys at the Bean Center wear orange clothing and sandals. (William DeShazer for ProPublica)

He says he had to get creative to keep his mind from spinning out.

“I learned how to make dice out of bread,” Booker says. “I made dice, roll the dice for hours. And then you’ve got to remember, we’re in solitary confinement, so I’d get hungry and I’d eat the dice. So, like, just imagine, the savage life in solitary confinement — rolling dice on a dirty floor for hours,” he recalled. “It was horrible.”

He says he would also lay on the ground of his cell with his face pressed against the cold floor, trying to yell to another kid who was locked in a solitary cell nearby.

He says it was worse than anything he’s experienced in adult prison. He thinks prison conditions are better because there’s more oversight. At the Bean Center, on the other hand? “They think, ‘Oh, they’re kids. Nobody is going to do this to kids, nobody would treat kids like this.’ So I don’t think it’s as much eyes as the penitentiary.”

In 2018 reports from visits to the Bean Center, one child said he was secluded after he forgot to bring his books to class. “Staff will put you in seclusion if they don’t like you,” he told the inspector. Another child said he was secluded but he didn’t really understand why.

They think, ‘Oh, they’re kids. Nobody is going to do this to kids, nobody would treat kids like this.’ So I don’t think it’s as much eyes as the penitentiary.”

—Tyshon Booker, former detainee at the Richard L. Bean Juvenile Service Center

The same inspector visited the facility twice in October of 2018. On Oct. 16 she wrote that the facility “continues to be in good standing with the DCS licensing” and that the facility had corrected all its problems and could have its license renewed for the year. But when she returned the next day, Oct. 17, documents show the facility was put on a corrective action plan for a list of problems, including using seclusion as punishment.

Then in 2019, an inspector returned and found that the Bean Center’s reliance on seclusion as punishment had escalated. Seclusions at the facility that year were about double what they had been the year before. In just a few months, it reported more than 160 instances of locking up children alone.

On that visit, the inspector talked to five kids. Each one of them had seen youth placed in seclusion for fighting or not following the rules. One child said he was secluded for talking back. That would break not only DCS’ standards but also the new state law. Despite documenting evidence that the Bean Center’s problem with seclusion had only gotten worse, the facility was taken off its corrective action plan and had its license approved for another year.

In an email to WPLN and ProPublica, DCS says it has multiple levers it can pull if a facility isn’t in compliance, including freezing or slowing admissions, decreasing capacity, or even refusing to approve a license. But DCS says it has never used any of those options at the Bean Center.

Inside the Bean Machine

From the outside, the one-story brick Bean Center looks more like an elementary school than a junior jail. It’s situated just a few miles from downtown Knoxville, next to an ill-kempt sports field where kids play peewee football.

Inside, colorful stripes on the walls help kids navigate the hallways, an eerie counterpart to their neon orange prison outfits and the handcuffs they sometimes wear.

Color coding in the Bean Center’s hallways helps kids know where to go. (William DeShazer for ProPublica) The facility sometimes uses handcuffs and leg shackles on the children. (William DeShazer for ProPublica. Names blurred by ProPublica.)

Bean can be found sitting behind a massive desk in his office. Where the rest of the detention center is sparse, his office is stuffed. His walls are covered in photos of himself through the years with visitors to the facility. His tenure has lasted so long that he’s run out of wall space — the photos spill out of his office and into the hallway.

The room is cluttered with memorabilia — a can of pinto beans from his family’s renowned meals with local politicians, dubbed Bean dinners; bumper stickers for the current juvenile court judge; figurines of elephants; and political tchotchkes.

He says he thinks the politicians making the rules around juvenile detention centers and seclusion don’t know what it’s like inside these facilities.

“Most people think we’re running a kindergarten,” Bean says. “We’re running the juvenile junior jail for Knox County. And there’s some tough kids — tougher than the ones in the jail, I guarantee.”

Bean doesn’t see reform laws as the state trying to do right by these kids; instead he sees it as the state making his job more difficult. He compares his relationship with the state and DCS to his marriage of 55 years.

“You have to do a lot of kissing,” he says, laughing. “A lot of, ‘Yes, ma’am.’ You can’t always have it your way in this business.”

Bean’s office (William DeShazer for ProPublica)

In 2021, when the state ruled that kids could not be secluded for longer than six hours because of the damaging effects isolation had on them, Bean didn’t shy away from telling inspectors his thoughts.

An inspector wrote in August 2021 that Bean “stated that he did not feel two to six hours was enough time to lock the youth in their rooms,” a reference to the limits in the new law. “I also asked if the facility’s policy and procedures manual had been updated to reflect the new seclusion bill requirements. … The current policy and procedure manual for the facility was last updated in 1999."

That inspector also noticed a pattern: Instead of writing down the time the child was let out of the cell, as he was supposed to do on forms for the state, Bean would just write his initials, “RLB.”

Despite DCS’ policies and the state law dictating exactly how long kids could be kept in seclusion, Bean decided to use his own discretion. He said writing “RLB” was his way of denoting that it was up to him to decide when the children were ready to be released and rejoin the other kids. He told the inspector that he’d make that decision based on how “remorseful” a child was.

“I asked them how their attitude is,” Bean says. “I can’t let the kids run the place. Sometimes you get a kid, you put him in his room, and he cuss and call you everything in the books. It’s hard to let him out.”

The use of “RLB” instead of a specific time also made it impossible for the state to discern how long kids were being locked up alone.

A Tennessee Department of Children’s Services report from August 2021 noted that records did not always show how long children were held in isolation. (Obtained by WPLN and ProPublica. Highlighting by ProPublica.)

For those seclusion incidents that were documented properly, it was evident that Bean was keeping kids in their cells longer than he was supposed to. Most of the incidents of seclusion were “either definitively over 6 hours, or for an indeterminate amount of time,” the inspector wrote in the same report. One youth told the inspector that he had been placed in seclusion for “several weeks” for fighting.

Then in late 2021, something new happened: Bean’s seclusion numbers started dropping. It was the same year that a new law laid out the option for something called “voluntary time-out,” through which a kid can request to be left alone in their room for a few hours but is allowed to come out whenever they want to.

As the number of seclusions has fallen at the Richard L. Bean Center, the number of what inspectors called “voluntary seclusions” skyrocketed — in August of 2022, the facility reported just 44 seclusions compared with 122 the previous August.

According to the inspections, the facility also reported 344 voluntary seclusions.

“We don’t use it as punishment,” Bean explains. “So all of it’s volunteer.”

But the DCS inspector who visited that year noted that it was uncertain how voluntary the process actually was at the Bean Center.

“It is unclear whether the youth are aware that they can come out of their room by choice,” the inspector wrote. “The previous rule at the facility was that youth had to stay in their room for the remainder of the day if they chose to voluntarily go to their room.”

Bean believes he can “get out of” any trouble he may get into for his disciplinary practices. (Paige Pfleger/Nashville Public Radio and ProPublica)

Recently, Bean said he started a new rule — if a kid requests a voluntary lockup to avoid going to school, he responds by secluding them until the next morning.

“And then next morning, we say, ‘You want to go to school today?’” Bean said. “Most of them say, ‘Yeah, I want to go. I don’t want to be locked up.’”

Bean doesn’t seem to worry too much about getting caught.

“If I got in trouble for it, I believe I could talk to whoever got me in trouble and get out of it.”

Run It Like A Business

When asked what happens to inspection reports after they are filled out, DCS said that evaluation summaries “are distributed to the appropriate administrative parties and filed in the licensing record.” The department also said it provides a list of violations to the facility administrator; the administrator typically has 30 days to submit compliance documentation, which is verified by licensing staff.

DCS confirms that in the time it has been licensing juvenile detention centers in Tennessee, it has never terminated a license. And records from the Bean Center illustrate that corrective action orders can be lifted without the violation being resolved.

The department declined to comment further on why it never did more to crack down on the Bean Center.

“You can write everything into statute and create some really solid legislation, but if it’s not being used or it’s not being enforced, then what’s the next step?” asks Kylie Graves, policy director of the independent state agency Tennessee Commission on Children and Youth.

Graves said that there has been a tendency for the state to look the other way when it comes to juvenile justice in Tennessee.

A statue outside of the Bean Center celebrates “lives saved through caring.” (William DeShazer for ProPublica)

“The idea of this practice ever being used in a foster home or something like that would immediately raise flags and horrify people,” she said.

The Tennessee Commission on Children and Youth is calling for a third-party review of juvenile detention centers and the entire youth justice system. The agency points to Kentucky, which has proposed setting aside money to do just that. Several other organizations are likewise advocating for a review, including Disability Rights Tennessee, an organization that acts as a monitoring agency for juvenile detention facilities and has special access to the kids and documents inside.

“What seems like a good approach starting in January when the legislature reconvenes is to talk about putting in some type of mechanism for enforcing compliance,” says Zoe Jamail of Disability Rights Tennessee.

One proposal, Jamail says, could be a clean-up bill that would take oversight of juvenile detention facilities out of DCS’ purview, though she says she isn’t sure what agency could take that on. An audit last year found that nearly half of new DCS workers quit within their first year. That problem was compounded by an influx of kids entering the foster care system.

And the involvement of a third party could help mitigate a conflict of interest — DCS is invested in keeping county detention centers open and operating. In addition to being the licensing agency for the county detention centers, DCS also has contracts with most of those facilities to hold kids who have been convicted of a crime while they try to find placement for them.

DCS declined to comment on that arrangement.

“Most people think we’re running a kindergarten,” Bean says. “We’re running the juvenile junior jail for Knox County. And there’s some tough kids — tougher than the ones in the jail, I guarantee.” (William DeShazer for ProPublica)

It’s an arrangement that Richard Bean says is mutually beneficial — DCS pays his facility more than $175 per day per kid. He calls those kids paying customers.

Bean says that’s in addition to the $120 per day he gets from detaining kids from surrounding counties that don’t have a juvenile detention center.

Resting his chin on his cane, Bean says he doesn’t intend to slow down. He has big plans to hire more staff and get more bodies in beds — especially kids sent his way by DCS.

“I mean, you’ve got to take care of the kids,” Bean says. “But … you got to kind of run it like a business, too. I could make over one million dollars for the county.”

Meribah Knight contributed reporting.

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