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ProPublica is an independent, non-profit newsroom that produces investigative journalism in the public interest. Our work focuses exclusively on truly important stories, stories with “moral force.” We do this by producing journalism that shines a light on exploitation of the weak by the strong and on the failures of those with power to vindicate the trust placed in them.
VALE, Ore. — In 2016, Oregon officials freed Anthony Montwheeler from the Oregon State Hospital, accepting his argument that he had faked mental illness for nearly 20 years to avoid prison.
Last week, an Oregon judge ruled that Montwheeler, 50, was not competent to stand trial for an assault and two murders that prosecutors say he committed just weeks after his release. The judge ordered him returned to the hospital for treatment of depression brought on by the charges against him.
The Montwheeler case has raised broader questions about Oregon’s handling of people charged with crimes and judged not guilty by reason of insanity, questions ProPublica and the Malheur Enterprise are examining in a yearlong project.
Records show that Montwheeler was allowed to leave the hospital despite warnings from a psychologist that there was a significant risk he would attack relatives or friends.
On Jan. 9, 2017, prosecutors charge, Montwheeler kidnapped Annita Harmon, one of his ex-wives, and stabbed her to death at a gas station. A clerk who witnessed the attack called the police, who then chased Montwheeler’s pickup truck down Oregon Highway 201. Authorities say Montwheeler swerved into the oncoming lane and collided head-on with an SUV, killing David Bates and seriously injuring his wife, Jessica. Harmon was a mother of two children; Bates was a father of five.
The ruling by Circuit Court Judge Thomas Ryan came after a state doctor who had examined Montwheeler testified that while he continues to exaggerate his condition, he is suffering from sufficiently serious “adjustment disorder” to prevent him from effectively participating in his own defense.
Ryan’s decision angered many in this rural farming community who had hoped to see Montwheeler held criminally accountable for his actions.
“He lied to the state to get out of the hospital, and now he’s lying to get out of murder,” said Susan Harmon, the mother of Montwheeler’s ex-wife Annita. Harmon said she is frustrated with the repeated delays that have pushed a trial to late 2019.
The case drew national attention last year after the Enterprise reported on Montwheeler’s claims of faking his illness, his subsequent release and the alleged attacks in January 2017.
The Oregon Psychiatric Security Review Board, which had supervised Montwheeler for 19 years, sued the newspaper to block the release of public documents regarding his time under state supervision as public pressure built for explanations about why the man was free. Gov. Kate Brown of Oregon stepped in to order the records released and the lawsuit dropped.
The state board has since said it had no information on the recidivism of discharged clients. The five-member panel appointed by the governor supervises about 600 people deemed not guilty because of insanity who are sent for treatment instead of prison.
Under Oregon law, the board is required to balance “the protection of society and the welfare of the (criminally insane) person.”
The recent court hearings on the Montwheeler case cast new light on the complexities of that challenge.
Dr. Octavio Choi, a board-certified forensic psychiatrist and director of the Oregon State Hospital’s Forensic Evaluation Service, prepared a 37-page report on Montwheeler’s mental state and sent it to the court in January 2018. It was kept confidential until last week, when Ryan ordered it disclosed at the request of the Enterprise.
The report concluded that Montwheeler needed hospital care before he could assist in his own defense. Choi wrote that he had based his conclusion on a six-hour interview of Montwheeler in September 2017 and thousands of pages of mental health and legal records.
Choi found that Montwheeler had “attempted to exaggerate impairment for the purpose of a favorable outcome,” presumably so he would be sent to the hospital. He cast doubt on Montwheeler’s claim that he was hearing voices, noting that he told the review board in 2016 that he had lied about having such hallucinations. Montwheeler, Choi wrote, “provided highly inconsistent accounts” of those voices and when they started. When pressed about the voices, Montwheeler “became quite angry at this evaluator,” the report says.
Choi catalogued Montwheeler’s previous diagnoses by state doctors. At present, he wrote, there was no sign of active symptoms of bipolar disorder, post-traumatic stress disorder, delusional disorder or any other psychotic condition.
He testified last Monday that Montwheeler might have those conditions, or had them in the past, but that he couldn’t be certain because of “the unreliability of Mr. Montwheeler’s self-reported history.” Without additional documented symptoms from mental health experts, Choi said, he couldn’t trust Montwheeler’s descriptions “at face value.”
He said Montwheeler did have adjustment disorder with depressed mood, which Choi described in court as “mild to moderate depression.”
That disorder, Choi told the judge, “significantly impaired” his ability to make rational decisions about his defense.
He explained in court that he tested Montwheeler’s ability to learn new concepts and evaluated his capacity to consider the pros and cons of choices, both of which he judged insufficient. Such skills are important for deciding legal strategies in his case, such as weighing a plea bargain against the risks of a trial.
“Usually, there’s no clear, no-brainer path,” Choi said. “One could quibble: When he says he doesn’t know or doesn’t understand, is that reliable or not?”
He said that Montwheeler’s condition is “highly treatable,” and that three to six months at the state hospital could restore his mental competency, allowing the criminal case to move forward.
“He should properly be considered highly dangerous and thus would be inappropriate for community-based restoration,” Choi wrote.
He offered no evaluation of whether the past diagnoses were made in error. Choi did emphasize in the report and in testimony that the events of the last three years led him to give little weight to any symptoms described by Montwheeler.
In court, Choi said psychiatrists “are not mind readers” and cautioned against using his current opinion to question the original insanity finding in 1997 and Montwheeler’s 2016 discharge from the state hospital.
Montwheeler’s odyssey with the state’s criminal-insanity system began in 1996 when he was accused of the kidnapping of his then-wife and 3-year-old son, and threatening to kill them and himself. In jail for the crime, he attempted to kill himself and talked about demons. He pleaded not guilty by reason of insanity.
From the beginning, opinions differed about whether he met the criteria.
A state psychiatrist concluded that Montwheeler was depressed because of his circumstances, but that he did not have any other mental illness and did not qualify for the insanity defense.
A private psychologist disagreed. He said Montwheeler had told him he heard voices: his mother, who was killed by his father, and a man he saw die during his military service. He also described other symptoms that the psychologist said meant he suffered from bipolar disorder. The judge sided with the defense witness, deemed Montwheeler criminally insane and placed him into the review board’s custody for up to 70 years.
At a 2016 hearing before state officials, Montwheeler said his lawyer in the kidnapping case gave him a copy of a psychiatrist’s diagnostic manual that he used to feign insanity. His lawyer did not reply to a request for comment.
Montwheeler lived at the state hospital four times over the next 19 years, but he was otherwise allowed to live in the community while being overseen by the Psychiatric Security Review Board. During that time, he was convicted of several crimes, including felony aggravated theft. He last returned to the state hospital in 2014 after two years in prison.
In the years before he was released, state officials once again wanted to move Montwheeler out of the hospital, but only to a secure location away from “his family or active crime victims.” A state psychologist had warned the board that family members would be likely targets should he become violent again. Montwheeler objected and asserted for the first time that he had been fooling doctors for almost 20 years.
“I’ve been using the system, and I’m done,” he told the review board in December 2016. “I basically made that up to make myself sound crazy. I didn’t hear anything, I was just saying that’s what I was hearing.”
The Psychiatric Security Review Board is required to discharge anyone who no longer medically qualifies for its jurisdiction, regardless of the danger to the public. The board freed him.
Officials at the state hospital and the state board have refused to discuss their handling of Montwheeler, citing patient confidentiality, and haven’t undertaken any review of their actions. Relatives of the victims have notified the state they intend to sue for negligence in releasing Montwheeler.
Alison Bort, the Psychiatric Security Review Board’s director since June, said the audio recording of Montwheeler’s appearance before the board nearly two years ago is revealing.
“He lied about it. He malingered. That’s his testimony: that he didn’t actually have a mental disorder,” she said. “I think it was devastating to everybody in that that was the decision that had to be made. … I think if there was anyway the board could’ve held unto him, they would have.
“He was dangerous, but not because of a qualifying mental disorder,” she said.
That was the conclusion of Dr. Mukesh Mittal, who recommended Montwheeler be released from the state hospital. The psychiatrist spoke publicly for the first time last week about why he concluded Montwheeler was telling the truth when he said he had faked mental illness.
Mittal testified in court on Tuesday that he cared for Montwheeler in a controlled setting from 2014 to 2016.
“There was never any indication he was experiencing active symptoms, and he revealed to me that he was taking the medication just to keep up the reasonable deception,” Mittal said, noting the man didn’t take any psychiatric medications for the last year of his hospitalization. “It would be very difficult to hide (a serious illness) for two years.”
One of Montwheeler’s attorneys, Nicolas Ortiz, challenged past diagnoses. He asked if his client’s post-traumatic stress disorder might have just been in remission.
Mittal conceded that the disorder can be inactive for years, but he questioned the validity of that previous diagnosis, noting the Department of Veterans Affairs made no mention of it when he was honorably discharged from the Marines.
“I’m not limiting my diagnosis to the two years he spent under my care,” he said. “I am considering the 20 years he spent under the PSRB’s jurisdiction.”
Under questioning, Mittal said his opinion from two years ago wouldn’t be of value in determining Montwheeler’s fitness for trial. He didn’t dispute Choi’s conclusions.
At times through the hearing, Ryan knotted his hands and pressed his chin into them as he thought.
“This is a close case. I have serious concerns about the defendant’s potential for malingering,” he said. “But on balance I don’t believe I have a basis to contest. And I do agree with Dr. Choi’s report, and I am going to find the defendant unable to aid and assist. And I will be sending him to the hospital for treatment.”
At the back of the courtroom, the audience stirred. The mother of Annita Harmon sat near relatives of David Bates. The group had regularly exchanged hugs and shed tears during breaks in the proceedings. At Ryan’s announcement, the group shifted and some softly cursed. They told the prosecutor that it was unfair they had to wait so long for a court to weigh Montwheeler’s guilt. Malheur County District Attorney Dave Goldthorpe assured them that justice would come.
“The legal system is going to work as it’s designed to work,” he later told a reporter. “I believe he’s competent to stand trial now based on my reading of the report, but it’s the judge’s ultimate decision to make. And that’s what he did.”
The prosecutors, defense attorneys and judge consulted their calendars to decide when to meet to consider next steps in the criminal case. They settled on Jan. 4, 2019.
Susan Harmon leaned over in the wooden pew and spoke with quiet force: “That will be almost exactly two years since he killed her.”
In June, the North Carolina General Assembly passed legislation mandating that all early voting sites in the state remain open for uniform hours on weekdays from 7 a.m. to 7 p.m., a move supporters argued would reduce confusion and ultimately make early voting easier and more accessible.
But with the start of early voting only weeks away, county election officials across the state — who previously had control over setting polling hours in their jurisdictions — say the new law has hamstrung their ability to best serve voters. Some officials in rural counties say they’ve had to shrink the number of early voting locations to accommodate the law’s longer hour requirements and stay within their budgets.
A ProPublica analysis of polling locations shows that North Carolina’s 2018 midterm election will have nearly 20 percent fewer early voting locations than there were in 2014. Nearly half of North Carolina’s 100 counties are shutting down polling places, in part because of the new law. Poorer rural counties, often strapped for resources to begin with, are having a particularly difficult time adjusting to the new requirement.
The closure of polling locations increases the time it takes for voters to travel to the polls, and it could result in lower turnout, making matters worse for a state already dealing with Hurricane Florence. Early voting in North Carolina begins on Oct. 17.
We interviewed more than two dozen county election officials across North Carolina. None said they were in favor of the new law, and none said they were contacted by state lawmakers for counsel on the legislation. Some referred to the policy as “overkill,” a waste of resources and an “unfunded mandate,” particularly burdensome for cash-strapped counties.
“We know our county. We know when most people go to vote early. The 12-hour, 7-a.m.-to-7-p.m. requirement just ties our hands when coming up with a catered approach that fits our county best,” said Steve Stone, the Republican chair of the Robeson County Board of Elections.
Republican state lawmakers, who championed the new law, argue that the consistency it provides will eliminate uncertainty among voters and expand early voting by increasing hours and allowing those who work full-time jobs to vote before or after work.
“The purpose of the uniformity is to make it easier and more convenient and more accessible for the voter to participate,” said David Lewis, a state representative who supported the bill. “I think that access to the polls, access to the ballots in a uniform fashion, is more important than poll worker or election worker convenience.”
Lewis says the law has led to an increase in the number of aggregate polling hours across the state. Indeed, polls for early voting will be open 49,696 hours in 2018, a substantial jump from the 25,887 hours offered in 2014, according to a preliminary analysis from the North Carolina State Board of Elections & Ethics Enforcement.
But according to Robert Stein, a professor of political science at Rice University, aggregate hours are not nearly as important a factor to voter access as the number of early voting locations offered by a county.
“There is a lot of good research to suggest that when it comes to having a positive effect on early voting turnout, the important things are not the hours of operation but the location of the polling place and the distance and travel time it takes a voter to get there,” Stein said.
For many counties, the trade-off for more polling hours is fewer early voting locations. Take Gaston County, near Charlotte. In 2014, the county opened one main polling place at 8 a.m. and three additional ones at 10 a.m. According to Adam Ragan, the county’s nonpartisan director of elections, there are very few voters in the county eager to cast ballots early in the morning. The county, therefore, typically maximizes its resources by staggering voting hours across multiple locations.
“In elections administration, we have what we consider ‘non-usable hours,’” Ragan explained. “There are some locations where people won’t come at 7 a.m. or 8 a.m. That’s why we’ve always opened our auxiliary sites at 10 a.m.”
The county originally planned to open five early voting locations, but with the new policy it can now only afford to operate three.
While county election officials from both parties have expressed near uniform discontent over the new requirements, state lawmakers were split along partisan lines on the measure, with support coming exclusively from GOP lawmakers.
“It will put a strain on local boards,” Democratic Rep. Marcia Morey said on the floor of the North Carolina House of Representatives. “We need local flexibility, not the strong arm of the state for political purposes to suppress the vote.”
North Carolina’s Democratic Gov. Roy Cooper originally vetoed the bill, writing in a statement that “we should be making it easier for people to vote, not harder,” but GOP state lawmakers have veto-proof majorities in both chambers of the General Assembly and handily overrode the veto.
In addition to setting uniform polling hours, the original legislation also eliminated the final Saturday of early voting, a day that historically attracts a large number of black voters, opening legislators up to further charges of voter suppression.
Republican lawmakers subsequently backed off on this and restored the popular voting day. Lewis acknowledged the move was a mistake, though he said it had been proposed to give counties more time prepare for Election Day. Still, given the sordid history of voting rights violations in North Carolina, many Democrats remain skeptical of GOP lawmakers’ dedication to expanding access to early voting.
“I do not see it as an isolated event, but rather a part of a larger voter suppression effort,” said Al Daniels, a Democratic member of the Bladen County Board of Elections, of the uniform-hours law. “I see it as anti-voter, period.”
In 2013, the GOP-led General Assembly passed far-reaching legislation in the name of combating voter fraud that cut back on early voting, established a photo ID requirement and did away with pre-registration of high school students, same-day registration and out-of-precinct voting. A federal appeals court struck down the law, labeling it an unconstitutional attempt to “target African Americans with almost surgical precision.”
The 2013 law was passed in the wake of the Supreme Court decision in Shelby County v. Holder, which weakened a provision of the Voting Rights Act that had required a handful of jurisdictions — including parts of North Carolina — to submit voting law changes to the federal government to determine whether those changes had a discriminatory effect or purpose. Now, laws like North Carolina’s uniform-voting legislation don’t need to be given preclearance from the federal government before they can take effect.
“Given the context of the GOP legislature, it makes you want to raise your eyebrows that this just wasn’t some neutral requirement to have consistent voting hours around the state,” said Philip Lehman, the Democratic vice chair of Durham County’s Board of Elections and a former member of the state’s General Assembly.
Other arguments in favor of the law have only advanced suspicion of lawmakers’ motives. State Sen. Ralph Hise, one of a dozen Republican sponsors of the bill, said in an interview with ProPublica that the law was meant, in part, to rein in partisan maneuvering on county election boards. He said that, in previous elections, certain counties would strategically leave specific early voting sites open for longer to “impact the election.” When asked to provide an example of such conduct, during the interview and subsequently, however, Hise did not do so.
The new law came as a surprise to many local election officials who had already finalized their budgets. Elections in North Carolina, unlike some other states, are funded entirely at the county level, leaving some administrators scrambling to figure out how to work within the confines of their budgets while accommodating the new law.
“I’m a full-fledged Republican and a Republican supporter, and I’m just disappointed in the General Assembly for not reaching out to election officials in the state and asking, ‘What do you think would work well for this early voting law?’” said Stone, the chair of the Robeson County Board of Elections.
The law appears to have exacerbated the divide between urban and rural counties, putting a greater strain on poorer, less populous counties, which often have smaller budgets, fewer full-time employees and an older voting population that is less willing to volunteer for what could be a 12-hour poll worker shift.
Take Bladen County. When it approved its operating budget this year, election officials set aside funds for four early voting sites. Though sparsely populated, Bladen County is large — the state’s fourth biggest by area — and local election administrators wanted to provide ample access to voters across the region.
Their plan had precedent. In every statewide election over the past decade, Bladen voters could cast their ballots at one of four early voting locations spread out across the county. Now, with the strict hours requirement, Bladen County can only afford to staff and operate one early voting site.
“We’re a small county and the law has affected us pretty badly,” said Bobby Ludlum, the GOP chair of Bladen County’s Board of Elections.
Wealthier, more populous counties appear to be doing better at weathering the changes. Still, election officials acknowledged that the law may adversely affect their rural counterparts.
“One size does not necessarily fit all,” said Michael Dickerson, the nonpartisan director of elections in Mecklenburg County, North Carolina’s most populous. “I’m very fortunate in this county. I’ve got over a million people living here, so we can find poll workers.”
The legislation has contributed to an already chaotic and uncertain year for election administrators in North Carolina. In addition to the difficulties they will encounter getting elections up and running in a state dealing with a major natural disaster, election officials are still scrambling to deal with man-made crises. A federal court in late August ruled that the state’s congressional maps were unconstitutionally gerrymandered and ordered they be redrawn immediately, sparking widespread confusion among election officials on whether the general election would move forward as planned. The court later clarified that the current maps should be used for the coming election.
A separate series of court battles over ballot language delayed the preparation and printing of election ballots, and the reduced timeline has left little flexibility in case ballots need to be reprinted. Adding to all of this, federal prosecutors in early September issued subpoenas to 44 county election boards asking that millions of voter records be handed over to immigration authorities by the end of the month.
While North Carolina has a handful of consequential congressional races in this fall’s election — the Cook Political Report rates four as competitive — most officials who spoke to ProPublica worry about how the early-voting changes and other laws might affect 2020, when the swing state will vote for president, governor and senator.
“It seems that every time we have an election, the rules are different,” said Jake Quinn, a Democratic member of the Buncombe County Board of Elections.
“We’re looking at different district boundaries, or we have to have voter IDs, or you can’t vote out of precinct, or the hours have to be changed. This is a problem. When you change the rules for voting every single election, some people are going to get discouraged by that,” he said. “All of this is very destabilizing.”
Arizona health officials threatened on Wednesday to revoke the licenses of 13 federally funded immigrant children shelters, accusing the facilities’ operator, Southwest Key, of displaying an “astonishingly flippant attitude” toward complying with the state’s child protection laws.
But a day after the state sent its blistering letter to Southwest Key CEO Juan Sanchez, it became clear that any shutdown would create a tumultuous chain of events for federal and state regulators, who lack options for housing tens of thousands of unaccompanied children who cross the border every year.
“Shutting down the shelters would create a crisis for the federal Office of Refugee Resettlement, which is charged with housing children caught at the border,” said Maria Cancian, deputy assistant secretary for policy at the U.S. Department of Health and Human Services’ Administration for Children and Families from 2015 to 2016.
Southwest Key is the country’s largest operator of immigrant youth shelters, housing more than 5,000 children in Arizona, Texas and California. As many as 1,600 children currently reside in its Arizona facilities.
The Texas-based nonprofit has become an increasingly critical asset for the federal government as the number of children in its custody has reached record numbers — even as the Trump administration has ended the practice of separating children from their parents. Southwest Key has received more than $1.3 billion in federal grants and contracts for the shelters and other services in the past five years.
Arizona’s investigation showing the company has been lax in protecting children in its care highlights the government’s fraught reliance on shelter operators — and the power those operators have, even in the face of failures. The federal government desperately needs every shelter as tougher immigration policies have put the system near capacity, housing five times as many children as last summer. Former HHS officials said closing 13 shelters in Arizona at once would throw the system into chaos.
It would create a “humanitarian crisis,” said one former official, forcing federal officials to scramble to find safe, licensed housing with trained and vetted staff for 1,600 children.
Arizona launched its investigation of Southwest Key’s shelters after news reports raised questions about background checks and other issues. A ProPublica story in August detailed the charges against Levian Pacheco, a former Southwest Key employee who is accused of molesting eight boys at a Mesa shelter over an 11-month period. Pacheco, who is HIV-positive, went without a background check for nearly four months. He was convicted earlier this month of 10 sex offenses connected to the molestation.
In response to media attention and complaints, Arizona health officials reviewed records on background checks at every Southwest Key facility across the state. Of the 13 shelters, the state found two additional facilities also had problems with background checks. In mid-August the company agreed it would verify that all employees had complete background checks by mid-September.
Arizona health officials also found that Southwest Key hadn’t vetted all employees by interviewing their previous employers and hadn’t ensured all employee files contained proof of tuberculosis testing. At some facilities, officials discovered bedroom and bathroom doors missing and problems with the size of residents’ rooms.
In Wednesday’s letter, Dr. Cara Christ, the director of the Arizona Department of Health Services, told Sanchez that his organization had failed to comply with the mid-August agreement.
“Southwest Key’s lack of ability to deliver a simple report on the critical protections these children have against dangerous felons demonstrates an utter disregard for Arizona law,” Christ wrote.
Jeff Eller, a Southwest Key spokesman, said the nonprofit has requested a meeting with state health officials to discuss the matter. “We have apologized to DHS for missing the reporting deadline and are serious about ensuring that never happens again,” he said in a statement. Eller declined to comment on the substantive issues raised in Arizona’s investigation. The state’s move to revoke the licenses was first reported by Arizona media outlets.
Gov. Doug Ducey’s office said in an email on Thursday he expects licensed facilities to comply with the law or his administration will hold them accountable.
Federal HHS spokesman Kenneth Wolfe said in an email Thursday that the agency was reviewing the letter and working with the shelters and Ducey’s office “to get all of the facts regarding the Arizona Department of Health Services audit to determine the next step.”
Former federal officials said they anticipate HHS will step in to help negotiate an outcome between Southwest Key and Arizona that will allow the children to remain in the facilities. Even Arizona officials acknowledged that the letter represents the beginning of what would be a long process.
In Texas, which has 16 Southwest Key facilities housing about 3,700 children, state health officials say they are not aware of similar issues with Southwest Key.
The Texas’ Health and Human Services Commission said its “monitoring inspections have not produced evidence of a pattern of background check deficiencies within any SWK [Southwest Key] operation, nor any patterns of failure to comply with minimum standard training requirements.”
An official with California’s Department of Social Services said in June the agency re-inspected all known facilities used by the US Office of Refugee Resettlement — including those operated by Southwest Key — and found no licensing concerns. The dust-up comes as the number of immigrant youth in federal custody has continued to grow. Immigrant advocates and former health officials say the record population doesn’t appear to be due to an influx of children at the border, but to the fact that children are staying in the shelters nearly twice as long as in the past.
They attributed that to a Trump administration policy that requires health officials to share information with Immigration and Customs Enforcement to vet potential sponsors for children in the shelters. As a result, they said, many parents and relatives who have traditionally served as sponsors worry they’ll be turned over to ICE if they come forward.
Matthew Albence, who heads ICE’s Enforcement and Removal Operations, gave credence to that fear at a Senate hearing on Tuesday when he testified that ICE had arrested 41 people who either came forward as sponsors or lived with them.
“Close to 80 percent of the individuals that are either sponsors or household members of sponsors are here in the country illegally,” Albence said. “So we are continuing to pursue those individuals.”
Arizona’s move against Southwest Key is just the latest in a series of bad headlines for the nonprofit.
In addition to ProPublica’s reporting on Pacheco, two other cases involving abuse at other Southwest Key shelters in Arizona surfaced in July. An employee at a Southwest Key facility in Phoenix was arrested on allegations that he sexually abused a 14-year-old girl by kissing her and rubbing her breast and crotch, according to Phoenix news outlets. And The Nation reported in July that a 6-year-old girl, who had been separated from her mother, was allegedly fondled by a boy at a Southwest Key facility in Glendale in June.
At other Southwest Key facilities, police reports and call logs from the last five years detail dozens of runaways, inappropriate relationships with staff, sexual contact among kids, and allegations of molestation by employees, ProPublica found. In one case, a 46-year-old youth care worker in Tucson was convicted of groping a 15-year-old boy who had arrived in the United States five days earlier.
In response to each of these reports, a Southwest Key spokesman said the organization immediately reports any abuse claim to police, that it cooperates fully with all investigations and that it educates children in its care of their right to be free of abuse.
And in August, UnidosUS, formerly known as the National Council of La Raza, the nation’s largest Hispanic civil rights and advocacy organization, suspended its affiliation with Southwest Key.
Both UnidosUS and Arizona officials highlighted similar concerns about the Southwest Key officials’ attitude toward the scrutiny it is receiving. UnidosUS said the organization “failed to convey that it understands the gravity and magnitude of the situation” and had failed to apologize to the victims in its care.
In response to UnidosUs, Eller told the Austin American-Statesman in August that the company was disappointed in the group’s decision and said any insinuation that Southwest Key didn’t take allegations seriously was grossly incorrect.
A former HHS official with knowledge of how the refugee resettlement agency operates said the recent developments with Southwest Key raise serious questions about the organization’s ability to meet the government’s needs.
“It sounds like, based on their inability to respond or even communicate in a timely fashion that they have really significant internal operating challenges and that may or may not be indicative of the quality of care the children are receiving,” the former official said.
Nonetheless, other former officials said shuttering the facilities might not be in the best interest of the children. The state might have more effective options, such as increasing unannounced visits to shelters.
Claudia Flores, director of the International Human Rights Clinic at the University of Chicago Law School who has studied the conditions faced by immigrant youth at the border, highlighted the difficult position the federal government and Arizona are in with Southwest Key.
“It’s not a response to say we can’t shut down the facilities when there are reports of abuse taking place,” she said. “It’s really not the kids in these facilities that should be suffering.”
The Trump administration this week proposed eliminating a decade-old regulation that puts hospitals at risk of losing their Medicare funding if too many of their patients die or suffer organ failure after receiving transplants.
The rule the government is proposing to scrap is the same one that led the Centers for Medicare and Medicaid Services to cut off funding last month for heart transplants at Baylor St. Luke’s Medical Center in Houston after an investigation by ProPublica and the Houston Chronicle revealed an outsized number of patient deaths and complications in recent years.
The proposal was unveiled Monday as part of the White House’s push to “cut the red tape” and do away with “burdensome regulation” that officials said put paperwork ahead of patients. In a speech announcing the proposed changes, CMS Administrator Seema Verma said the agency’s existing policies have “put lives in danger.”
“We are proposing to remove those inefficiencies to reduce the amount of time patients have to wait, so that they can begin healing,” Verma said.
The proposal, now subject to public comment and revision before it is finalized, surprised many transplant physicians who have long called for relaxed federal oversight. They’ve argued that the rules requiring that hospitals meet certain survival thresholds for transplants discourage them from taking on risky patients or accepting less-than-perfect organs, lengthening the time patients spend on the waiting list.
Some experts, however, said the proposal would not help patients because it would weaken the government’s authority to hold transplant programs accountable if they fail to provide safe patient care. The regulation was put in place in 2007 after a series of scandals at transplant programs revealed lax federal oversight. Several transplant programs had compiled abysmal patient survival statistics for years while continuing to receive Medicare funding.
Even though it has the authority to do so, Medicare rarely terminates programs for poor outcomes. It is far more common for the government to force underperforming programs into systems improvement agreements, in which hospitals agree to make certain changes and be subject to stepped-up oversight.
Medicare bypassed that process and cut off funding for heart transplants at St. Luke’s in August after the hospital’s one-year patient survival rate fell below national norms from 2014 to mid-2016. A few St. Luke’s cardiologists grew so concerned that they started sending some of their patients to other hospitals for transplants.
St. Luke’s has appealed its Medicare termination, saying, “we do not believe CMS’ recent decisions reflect our ongoing progress and accomplishments to improve the quality of our care.” A spokeswoman said officials are still reviewing the Medicare proposal and declined to comment.
In a statement to reporters Friday, CMS said it would continue monitoring transplant programs and is strengthening its process for inspecting transplant programs to ensure they are providing safe, quality care.
“CMS will continue to collect the data on each transplant program’s performance with regards to patient and graft survival,” the agency said in the statement. “These data, rather than being a stand-alone measure, will be used as a component of the survey process to further inform and direct the survey.”
If the proposed regulatory change had been in place previously, it’s not clear whether St. Luke’s would have faced punitive action from Medicare.
“I am probably in the minority in the transplant community, but I think, based on what is proposed, this is a bad idea,” said Laura Aguiar, an Arizona-based transplant consultant who has spent years helping programs improve their outcomes to stave off Medicare penalties. “I have been around long enough to remember that there were very valid reasons why CMS, in the George W. Bush administration, took the steps they took in implementing all of this.”
Since the rules were put in place 11 years ago, the percentage of patients who survive at least one year after receiving heart, kidney, lung and other organ transplants has increased nationally. But some experts say those gains have come at a cost.
Jesse Schold, a researcher at the Cleveland Clinic, has spent years chronicling what he calls the “unintended consequences” of holding transplant programs accountable for poor outcomes. Even though CMS relies on data that has been adjusted to ensure that programs aren’t punished for treating sicker patients or accepting riskier donor organs, Schold said the rules have created a perception that programs need to turn away some ailing patients and reject less-than-ideal organs in order to meet outcome targets.
As a result, Schold said, some potentially viable donor organs are discarded while thousands of patients die on waiting lists each year. Schold said he was surprised to learn a study he co-authored was among the research cited by CMS as justification for the policy change, which he said would be a “significant net positive” for patients.
“I don’t want anything to in any way imply that I’m a fan of the current administration,” Schold said, referencing the Trump administration’s aggressive and often controversial efforts to slash regulations. “However, in this case, I think it is something that is beneficial.”
Dr. Joel Adler, a liver surgeon at the University of Wisconsin School of Medicine and Public Health whose research also was cited by CMS, said a major weakness of the current regulation is that it focuses only on the survival of patients fortunate enough to have received a transplant. Medicare, he said, does not take into account the percentage of patients who die awaiting a transplant. That can discourage programs from accepting organs for patients who might be less likely to survive afterward.
Despite identifying problems with the current rules, Adler and his co-author did not propose eliminating Medicare’s standards, but they instead suggested ways to improve outcome measures and create incentives for programs to perform more, not fewer, transplants.
“Should we get rid of (the regulation) entirely?” Alder said. “I don’t know. I suspect we’ll swing back to somewhere in the middle, because there has to be some mechanism of capturing things when they are really, really bad. That has to exist.”
Medicare isn’t the only organization that oversees transplant centers. The United Network for Organ Sharing, a federal contractor that operates the national waiting list for organs, can put programs on probation or even revoke their good standing for continued poor results, though it rarely takes such actions. Similarly, another federal contractor, the Scientific Registry of Transplant Recipients, analyzes transplant outcomes and publicly reports which centers have mortality rates that are higher than expected based on the characteristics of their patients.
Even if the proposal is approved, it would not mean CMS would stop regulating transplant programs. Last year, for example, CMS cut off funding to Medical University Hospital in Charleston, South Carolina, after the program failed to perform the minimum number of heart transplants required by CMS to maintain certification. That provision, also added during the reforms of 2007, would not be affected by the changes proposed this week.
The Charleston hospital, the only heart transplant program in South Carolina, made necessary changes and regained Medicare certification this year.
Alexander Aussi, a San Antonio-based consultant who specializes in helping transplant programs satisfy regulatory requirements, said he understands the desire to reduce the number of rules and regulations that transplant centers must follow. But he said he fears that the CMS proposal would return the transplant field to an earlier era when “some programs were cowboyish about their outcomes.”
“I cannot tell you in good conscience that if you remove those guidelines and metrics … that you’re going to have better outcomes,” Aussi said. “On the contrary, I believe you’re going to have a lot of transplant programs reversing course.”
Aguiar, the Arizona-based consultant, shares those concerns. Even without strict CMS oversight, she said, many transplant programs will continue providing high-quality care, but some won’t.
“There will be others that will take the removal of these requirements as a blessing to go back to the bad old days,” she said, “and it is patients who will end up paying the price for it.”
El pasado martes, el inspector general del Departamento de Justicia anunció que su oficina investigaría un programa de la Administración para el Control de las Drogas vinculado con ataques de carteles de narcotraficantes en México que dejaron docenas, o hasta cientos, de personas muertas o desaparecidas.
En un oficio dirigido a congresistas demócratas, el Inspector General Michael E. Horowitz dijo que una revisión interna resaltó al programa de Unidades Investigadoras de Información Confidencial (SIU, Sensitive Investigative Units) de la DEA, como “área de alto riesgo". También mencionó que su oficina evaluaría la administración del programa por parte de esa Agencia y si existen controles internos para garantizar que las “operaciones, la información y el personal de la DEA estén protegidos contra algún compromiso".
Bajo el programa, la DEA autoriza y adiestra equipos de policías federales mexicanos, conocidos como SIU encargados de llevar a cabo operaciones dirigidas por la DEA en México. El año pasado, ProPublica y National Geographic informaron que por lo menos dos de esas operaciones habían quedado comprometidas, además de activar espasmos terribles de violencia que incluyeron un incidente a menos de una hora de la frontera entre México y Texas. Un reportaje de junio de 2017 reveló que, en 2011, se disparó un ataque en la ranchería pequeña de Allende, Coahuila, después de que información confidencial obtenida durante una operación de la DEA acabara en manos de los jefes de ciertos carteles. Estos, a su vez, ordenaron posteriormente una oleada de represalias en contra de los traidores sospechados.
Un segundo reportaje en diciembre investigó el ataque de un cartel en el Holiday Inn de Monterrey, México, descubriendo también que se vinculaba con una operación de vigilancia de la DEA. En ese suceso fueron secuestrados cuatro huéspedes y un empleado del hotel sin que tuvieran nada que ver con el narcotráfico. Estas personas no han vuelto a aparecer.
En ambos operativos se vio involucrada la SIU de la DEA en México. Los reportajes de ProPublica detallaron que la SIU mexicana tenía antecedentes documentados a lo largo de un año indicando que esta revelaba información a narcotraficantes violentos y poderosos. Desde el año 2000, por lo menos dos supervisores fueron asesinados después de que miembros de la SIU revelaran a narcotraficantes tanto sus identidades como su ubicación, según lo que han dicho agentes actuales y previos de la DEA quienes trabajaron en México.
El año pasado, Iván Reyes Árzate, otro supervisor de la SIU, voló a Chicago y se rindió ante las autoridades estadounidenses quienes le impusieron cargos de colaborar con narcotraficantes. En mayo Árzate se declaró sin disputa ante los cargos y actualmente se enfrenta a 25 años de cárcel, con el dictamen de la sentencia programado para este año.
ProPublica encontró que la DEA tuvo conocimiento de la corrupción durante un largo tiempo sin haber actuado al respecto y aun cuando se perdieron vidas inocentes. En un mensaje de correo electrónico, Katherine M. Pfaff, Vocera de la DEA, indicó que la agencia no giraba comentario alguno sobre el tema de la investigación del inspector general. La DEA considera que el programa de SIU es un “programa internacional eficaz”, escribió.
La agencia tiene unidades similares en unos doce países más.
La decisión tomada por el Departamento de Justicia para investigar las SIU resalta la culminación de la campaña iniciada por varios congresistas demócratas después de publicarse los reportajes de ProPublica. En una serie de oficios, los altos miembros de tres comités poderosos, judicial, asignaciones y relaciones exteriores, comenzaron a exigir que tanto el Departamento de Justicia, como la DEA, investigaran la situación. “Estas operaciones hacen que surja un cuestionamiento serio acerca de las prácticas de las SIU adiestradas y sufragadas por la DEA”, redactaron los legisladores en febrero, “y apuntan hacia la necesidad de que dichas unidades aprobadas rindan cuentas en forma más amplia".
El oficio llevó la firma del Sen. Patrick Leahy de Vermont, Subdirector del Comité de Asignaciones del Senado, quien lleva buen tiempo tratando de que se contabilice la responsabilidad de las operaciones de la DEA en el exterior. Otra signataria fue la Sen. Dianne Feinstein de California, alta funcionaria del Comité Judicial del Senado, y una de las autoridades principales del país en materia de seguridad nacional. También firmaron el Rep. Eliot L. Engel, alto miembro del Comité de Relaciones Exteriores de la Cámara de Representantes y el Rep. Jerrold Nadler, demócrata principal del Comité Judicial de la Cámara de Representantes. Ambos son representantes de Nueva York y sus comités supervisan al Departamento de Estado y el Departamento de Justicia.
“En vista de los incidentes”, redactaron los legisladores refiriéndose a Allende y Monterrey, “creemos que es esencial que se lleve a cabo una investigación minuciosa de las prácticas de las unidades aprobadas por la DEA”.
A few weeks ago, Melissa Sanchez and I presented our team’s reporting on parking tickets at Chi Hack Night, a weekly gathering that welcomes anyone who is curious about data and civic technology. Most Chi Hack Night events include a presentation followed by hands-on working groups. During the question-and-answer period of our presentation, someone in the audience asked us if we hope to create a “layered map” combining all kinds of disparities to show the plight of African-American communities in Chicago.
This is a common question for anyone who reports on systemic issues with data and code. My first response is to be somewhat dismissive because a single reporter at a tiny organization simply can’t cover that many data sources with enough rigor to have impact. Instead of being dismissive, we need to be creative by working with others outside of journalism.
That’s why it’s so exciting that our readers have downloaded the Chicago parking ticket data and Chicago gang database so often that they have become two of the most popular recent additions to the ProPublica Data Store, our collection of free and commercial datasets. A small newsroom can only do so much. But together we can amplify the impact of work like our reporting on tickets and ticket debt with open data and open-source software.
A way to start analyzing the data with a low barrier to entry is to use a tool called Jupyter. This makes it easy to combine text, code and visualization in a “notebook.” These notebooks are accessible to folks without coding knowledge and are easy for novices to use. We’ve used such notebooks in the past to share our methodology. The more notebooks we build with the ticket data, the more anyone who wants to analyze the data will be able to draw on the work of others.
We’re digging into how patterns in tickets may mirror patterns in policing, the issuing of tickets for technicalities like a cracked windshield or other minor violations, variations in contested tickets and the outcomes, if certain types of tickets and trends have a relationship with gentrification, and more.
We’ve been working with civic data hacker Matt Chapman to give everyone access to accurate geographic data for every ticket in the database. Data scientist Matt Triano and senior software developer Ishmael Rufus have stepped up and provided leadership and significant contributions.
Know how to work with data? We can use your help. Want to learn? We’ll show you. We are meeting every Tuesday at Chi Hack Night to build a collection of examples showing how to analyze Chicago’s ticket data. Even if you aren’t able to join us in person, you can participate via GitHub. If you’re interested in working with the data yourself, get it at the Data Store.
We’ll release another 10 years of ticketing data in the coming weeks.
It’s no surprise that hundreds of staffers on 2016 presidential and congressional campaigns parlayed their work into political jobs in the Trump administration. But you wouldn’t always know about those roles from reading their financial disclosures, which sometimes reveal them and sometimes don’t.
Details about the past jobs and work histories of these staffers — from on-the-ground field work for Donald Trump’s presidential campaign to fundraising for super PACs supporting Republican congressional candidates — can be found in the place where people tend to exhaustively list their credentials: their resumes.
The Washington-based transparency group Property of the People took information from ProPublica’s Trump Town database and submitted Freedom of Information Act requests seeking the resumes of more than 2,700 political appointees in the Trump administration.
We’ve added the documents the group collected to the Trump Town app and created a separate page so that you can examine them yourself. We’ll update the page as we get more.
Think of the resulting information as the equivalent of batting statistics on baseball cards, in this case for staffers in the Trump administration: It’s data viewed as fascinating by some, and as minutiae by others. The resumes received so far largely cover staffers with midlevel and junior positions, and many in this initial batch come from the departments of Agriculture, Interior and Transportation.
They reveal a wide range of roles played by some of them in propelling Trump into the White House — and also their sometimes quirky employment histories.
Consider, for example, the resume for Kevin Jayne, now at the Department of Energy as a special adviser for renewable energy. It claimed that, as a “site specialist” for the campaign, Jayne was “entrusted with the security of President-elect Donald J. Trump and the Trump family” and others, as well as managing the flight manifest for Trump’s plane and making sure members of the media were “secured in assigned area to provide best possible coverage.” Jayne’s CV also indicates that he is a former Chicago-area utility worker and bouncer.
Jason Funes, a special assistant in the Department of the Interior, wrote in his resume that he worked for the Trump campaign in South Florida, targeting Hispanic voters. The document also indicates that he worked as a sales representative for a motorized scooter company in South Florida.
And David Matthews, now a confidential assistant at the Farm Service Agency, oversaw the campaign in 32 pivotal counties in western Pennsylvania. According to his resume, he used to be a legal receptionist and once sold his own line of custom-scented candles in Alabama.
(Jayne, Funes and Matthews did not respond to requests for comment.)
Does knowing that one staffer used to make scented candles provide any valuable insight into the Trump administration? Perhaps not. But between the original Trump Town database and this new information, readers can glean ever-more-detailed portraits of the individuals who do the nitty-gritty work of running the federal government.