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Oversight of Jail Inmate Health Care Away Might Be Yanked From LA Sheriff’s Department…& Will the Supes Reconsider the High Ticket Jail Building Plan? – UPDATED

June 9th, 2015 by Celeste Fremon



PROBABLE NEW MANAGEMENT FOR LA JAILS’ MEDICAL AND MENTAL HEALTH CARE

Los Angeles County is the only county in the state of California that lets its sheriff’s department run the health care system for its county jails.

At Tuesday’s Board of Supervisor’s meeting, all that may change.

Tuesday is the day when the board will entertain a motion—proposed by supervisors Mark Ridley-Thomas and Mike Antonovich—to take away responsibility for inmate medical care from the sheriff’s department, and to also to snatch the oversight of inmate mental health care from the Department of Mental Health. The two functions are then to be consolidated under the Department of Health Services (DHS), and overseen by the newly created position of “Correctional Health Director” within the DHS.

This new configuration for how LA County looks after the medical and mental health needs of its jail inmates is part of a larger plan that will be officially presented by Interim CEO Sachi Hamai. The plan was created in response to a request from the board back in early March, which asked the CEO and representatives of other county officials to take a look at “the status of jail health services in Los Angeles County,” and to make recommendations about how “the overall quality and delivery of the care provided in the County jails..” could be improved.

In other words, the supes had been aware for a while that the medical and mental health care in the jails sucked, but they wanted to know how much it sucked, and what to do about getting it not to suck.

The conclusion reached by the CEO and her fellow evaluators (which included representatives from the LASD) was that both functions needed to be removed post haste from those who’d been running them in the past. (Although the report said this far more politely.)

We have known for some time that the LA County Department of Mental Health (DMH), along with the sheriff’s department, has been doing a frighteningly lousy job of running the mental health part of the medical system inside our county lock-ups.

(For an idea of how lousy, see the federal investigation that resulted in scathing reports and a still looming federal consent decree.)

But while the mental health situation inside the jails—and the need for mental health diversion—has received a lot of public attention, plain old medical services have not.

And, yet, anecdotal information strongly indicates that matters are not healthy on the medical care side of things either.

For instance, a pattern of problems has shown up in the complaints filed with the ACLU, and in accounts by sources who work inside the jail system and who are troubled by what they see. At WLA we’ve also been getting harrowing calls from inmates inside the jail who describe fairly convincingly how they cannot get basic care and/or medication for very real and often serious medical conditions. So they call us in the hope that somehow we can help them get their needs met.

As legal director of the Southern California ACLU, Peter Eliasberg, put it, “We have every reason to believe that the quality of medical care in the jails is abysmal.”

Yet, it turns out that what reportedly amounts to inadequate medical care (or worse) does not come cheap: A budget of $238 million and over 1,700 budgeted personnel are allocated yearly to the Sheriff’s Medical Services Bureau (MSB).

“There are numerous reasons why these changes make sense including a) the obvious unsuitability of a law enforcement agency for the provision of medical care, b) the well-documented and long-standing failures of DMH to provide appropriate care to inmates with mental illness…” Eliasberg wrote on Monday in a letter to the board.

Time for a change. Good for the supes for calling for it. Lets hope they and the DHS and the LASD follow through and insist on—as they say in the movie script business— a Page 1 rewrite.

More on the jail medical care issue as it unfolds.


UPDATE: After lots of commentary from the audience, including people who won Tuesday the motion passed unanimously.



AND WHILE THEY’RE TALKING ABOUT JAILS, HOW MUCH WILL THE LA COUNTY SUPES CONSIDER SCALING DOWN THE MEGA BUCKS JAIL BUILDING PLAN ON TUESDAY?

Likely the presentation that will make the biggest splash at Tuesday’s LA County Board of Supes meeting will be the powerpoint of the retooled jail building proposal that scales down the nearly $2 billion plus Vanir building plan that was approved in May of 2014, before we had a new sheriff.

Among those presenting the plan will be Sheriff Jim McDonnell, Assistant Sheriff Terri McDonald, Dr. Marvin Southard, of the (possibly soon to be ousted from the jails) Dept. of Mental Health and more.

The group has done some admirable scaling back and rethinking of the number of new beds, (See P. 19 of the report) but will the changes be enough?

Since both Supervisors Hilda Solis and Sheila Kuehl talked about their opposition to the existing plan in their campaigns for office, and Supervisor Mark Ridley-Thomas abstained during the Vanir vote, one presumes there will be some hard and lively questions asked.


UPDATE: Rather than accept the new plan put forth by the Sheriff, et al, a three member majority of the board decided to delay the go-ahead on the revised building plan in order to take a long hard look at how large the new jail really needs to be.

Stay tuned.

Posted in Department of Justice, jail, LA County Board of Supervisors, LA County Jail, LASD, mental health, The Feds, U.S. Attorney | 9 Comments »

Bills to Curb Drugging of Foster Kids Clear CA Senate…Veteran’s Court Makes Vets Feel at Home…LA FBI Agent Indicted…and More

June 5th, 2015 by Taylor Walker

PACKAGE OF BILLS TARGETING OVER-DRUGGING OF CA’S FOSTER KIDS MOVES ON TO STATE ASSEMBLY

On Wednesday, the California Senate approved a package of four California reform bills addressing over-drugging in California foster care system. The bills have bipartisan support, and have a good chance of making it through the Assembly and onto Governor Jerry Brown’s desk. But a price tag of between $8-$22 million may be a tough sell for the governor.

Among other changes, the bills, authored by Sens. Holly Mitchell (D-Los Angeles), Jim Beall (D-San Jose), and Bill Monning (D-Carmel), would require state-wide data-tracking on the prescribing of psychotropic drugs and other potentially harmful drugs to foster kids, as well as restrict how juvenile courts authorize such medication, set up a system of nurses to monitor the kids who are medicated, and push doctors to choose non-medical treatments before psychiatric drugs.

Karen de Sá, who has been doing some powerful investigative reporting on the excessive use of psychotropic medications to treat California kids in the foster care system, has more on the issue for the San Jose Mercury News. Here’s a clip:

The newspaper’s investigation found the powerful medications, which can cause debilitating side effects, are often prescribed to control troubled children’s behavior. But the bills, approved unanimously in the state Senate on Thursday, would improve how the state’s juvenile courts approve prescriptions; create new training programs; expand the ranks of public health nurses; and require ongoing reporting of how often foster children are being medicated.

Social workers would be alerted when kids receive multiple medications or high dosages and when psychiatric drugs are prescribed to very young children. And residential group homes, where prescribing is typically the highest, would be more closely monitored and subject to corrective action.

“The Senate has sent a clear message: The system must never permit powerful psychotropic drugs to replace other effective and necessary treatments,” said Sen. Jim Beall, D-San Jose, who authored the bills along with Sens. Holly Mitchell, D-Los Angeles, and Bill Monning, D-Carmel.

While the legislation faces no formal opposition, some child psychiatrists have expressed concerns that too many new rules could hinder care when access to medication is vital. The bills also carry a multimillion dollar price tag that could threaten their passage if they reach the governor’s desk.


VETERANS COURT BRINGS COMFORT AND FAMILIARITY TO PARTICIPANTS BY ADOPTING MILITARY-INSPIRED PRACTICES

A court in Orange County aims to help, rather than punish, veterans who are often suffering from PTSD, other mental illnesses, substance abuse, or a combination of those issues. The veterans court is modeled after drug courts and offers low-level offenders an alternative to incarceration.

To make the veterans feel more comfortable, the court does certain things military-style, like addressing participants by their rank. Participants receive a mentor (who is also a combat veteran), intensive therapy, substance abuse treatment, and other services they must take advantage of to make it through the program.

The veterans court, one of many cropping up across the nation, believes it has saved $2 million so far in jail and prison expenses since its inception five years ago.

Alisa Roth has more on the program for the Marketplace Morning Report. Here’s a clip:

Castro ended up in the veterans court in Orange County, California, after he got drunk and beat up a worker in a Subway restaurant. He says he doesn’t remember much of what happened, but he woke up the next morning in jail facing a bunch of felony charges.

The veterans court wasn’t his first choice, he says, but it seemed better than prison. And when he started the program, he was pleasantly surprised to find that it felt familiar.

“It was like being in the Marine Corps again,” he says. “They’re watching you … they’re on you.”

The program is modeled on drug courts, so the emphasis is on treatment and recovery rather than punishment. In this case, the court connects clients to existing services, mostly through the Department of Veterans Affairs, and then forces the vets to make use of them or go back to jail. It’s intense: there’s substance abuse treatment, group therapy and individual therapy, plus regular check-ins with the judge and probation officer at court.

“They make you get those demons out,” Castro says. “They make you work, work, work.”

But it’s also supportive.

“What makes this unique,” says Joe Perez, the presiding judge, “is we’re all getting together, trying to figure out what’s the best way to keep this person from coming back.”

In Orange County, one of the ways they try to keep people from coming back is to make court feel like the military. The judge makes references to the military, sometimes addressing clients by their rank.


LA-AREA FBI AGENT ALLEGEDLY GOES ON SHOPPING SPREE WITH $100,000 IN STOLEN DRUG RAID MONEY

A former FBI agent, Scott Bowman, was indicted Wednesday for allegedly stealing more than $100,000 in confiscated drug raid money, and for obstructing justice by falsifying FBI reports to hide his ill-gotten gains. As part of the Gang Impact Team “GIT” in San Bernardino, Bowman carried out state and federal search warrants throughout the Central District of California, seizing and documenting evidence from drug raids.

Bowman allegedly spent the money on two cars plus upgraded equipment, plastic surgery for his wife, and a weekend in Las Vegas at a luxury hotel with his girlfriend.

As an explanation for his increased spending, Bowman allegedly told his fellow agents that he had received an advance inheritance of $97,000 from his sick father.

Here’s a clip from the Dept. of Justice:

The indictment alleges that Bowman used the stolen money for his own purposes, including spending $43,850 in cash to purchase a 2012 Dodge Challenger coupe, $27,500 in cash to purchase a 2013 Toyota Scion FR-S coupe and approximately $26,612 in cash to outfit these vehicles with new equipment including speakers, rims and tires. According to the allegations in the indictment, the defendant also used approximately $15,000 of the misappropriated cash to pay for cosmetic surgery for his spouse, and opened a checking account into which he deposited approximately $10,665 of the stolen funds, a portion of which he used to pay for a weekend stay at a luxury hotel, casino and resort in Las Vegas, Nevada.

According to the indictment, to conceal his misappropriation of the drug proceeds, Bowman allegedly falsified official FBI reports and other records. Specifically, in connection with one of the seizures, Bowman allegedly endorsed an evidence receipt knowing that it did not accurately reflect the amount of cash seized and altered the same receipt by forging the signature of a police detective next to his own.

The indictment further alleges that Bowman made false representations to his colleagues regarding the disposition of certain seized drug proceeds. In addition, Bowman allegedly sent an email to the detective whose signature Bowman had forged setting forth a detailed cover story that the detective should offer if asked about Bowman’s activities with respect to the seized drug proceeds. According to the indictment, Bowman also allegedly provided the detective with a copy of the forged receipt so that the detective falsely could claim the forged signature as his own, if asked.

The Department of Justice Office of Inspector General has investigated this case, and now it is in the hands of prosecutors from the Criminal Division’s Public Integrity Section.


DISCUSSING BLACK-ON-BLACK CRIME

Fusion’s Collier Meyerson has a worthwhile guide to black-on-black crime for those sometimes generality-ridden discussions about crime in predominantly black communities.

Meyerson excerpts articles, research, and statistics to help move the public dialogue away from common myths toward more fact-driven context. Here are some examples:

2. Gun violence in black communities is a matter of public health, and it depends on a variety of structural inequalities.

Jonah Birch and Paul Heideman break it down in Jacobin:

“Research suggests that violent crime rates are driven by a variety of social factors which tend to make American cities particularly prone to gun violence against black residents. Among the most of these factors are very high levels of neighborhood segregation, concentrated un- and underemployment, poverty and a dearth of adequate social services or institutional resources. Fundamentally, gun violence has to be treated like other kinds of public health problems — not as the basis for continuous, empty calls for an introspective discussion about ‘black on black violence.’ And like other kinds of public health disparities, tackling high rates of inter-personal violence requires confronting the social context in which it occurs.”

[SNIP]

5. Crime in black communities and crime committed against black people by the state are not created equal.

Michael Eric Dyson gives a compelling reason: “Black people who kill black people go to jail. White people who are policemen who kill black people do not go to jail.”

“Focusing on black-on-black crime distracts from the current news (the murder case against Slanger, in this instance) that is worthy of discussion and analysis. Worse, it randomly zooms in on one phenomenon — that sometimes black people kill people who are also black — while ignoring the issues that go hand in hand with it. And that’s a lot to ignore. As Ta-Nehesi Coates wrote at the Atlantic in 2014, “The policy of America has been, for most of its history, white supremacy. The high rates of violence in black neighborhoods do not exist outside of these facts — they evidence them.”

Posted in Edmund G. Brown, Jr. (Jerry), FBI, Foster Care, mental health | 6 Comments »

CA Counties “Step Up” for Mental Health Diversion…Jazz Therapy in Jail…and Preschool Savings

May 8th, 2015 by Taylor Walker

LA, OC, OTHER COUNTIES JOIN UNIQUE MENTAL HEALTH DIVERSION INITIATIVE

A new national initiative to divert people with mental illness from jails will connect counties with resources to create concrete action plans and track results.

On Tuesday, the National Association of Counties (NACo), the Council of State Governments (CSG) Justice Center, and the American Psychiatric Foundation (APF) launched the initiative, which will use money from Department of Justice’s Bureau
of Justice Assistance (BJA).

Sheriff’s departments in California counties and across the nation are signing up to participate in the “Stepping Up” initiative, which is intended to be “a long-term, national movement—not a moment in time,” according to organizers.

Here are a few of the areas sheriff’s departments participating in the initiative will focus on:

- Learning from a group of criminal justice, mental health, and substance abuse experts, as well as people with mental illnesses and their families

- Collecting data and using it to assess needs of (and to better serve) people who are both mentally ill and justice system-involved

- Developing, implementing, and thoroughly tracking the progress of a diversion plan involving research-based approaches

Counties that see progress over the next year will be eligible to attend a national summit in the Spring of 2016, after which certain counties with the best diversion results will be selected to receive grant money to expand their efforts.

The LA Times’ Abby Sewell has more on the initiative, and what the LA and OC sheriffs have to say about it. Here’s a clip:

“You will not find a sheriff in this state or this nation who is not struggling with the growing number of people who are mentally ill in our jails,” Orange County Sheriff Sandra Hutchens said at a kickoff event for the initiative in Sacramento….

Los Angeles County Sheriff Jim McDonnell was not present Thursday at the Sacramento event, but said in a previous interview, “Absolutely, we want to be a participant.”

“Jails were not built as treatment facilities with long-term treatment in mind,” McDonnell said. “When you think about a jail environment, it’s probably the worst possible place to house or attempt to treat the mentally ill.”

LA County District Attorney Jackie Lacey has been researching and working on a comprehensive mental health diversion program, and is expected to present the full plan to the Board of Supervisors next month.


A JAZZ SINGER’S MUSIC THERAPY CLASS LIFTS SPIRITS OF WOMEN LOCKED IN SAN FRANCISCO JAIL

After singing three songs to an extremely appreciative crowd of women housed in the San Francisco County Jail last year, cultural anthropologist and jazz singer, Naima Shalhoub, formed a weekly music therapy class to bring a little happiness and hope to the inmates.

The SF Chronicle’s Carolyne Zinko has the story. It’s behind a paywall, but here are some clips:

You don’t need a master’s degree to know that jail inmates are lonely, but during the past year, cultural anthropologist Naima Shalhoub has seen it doesn’t take much, or cost much, to make them feel less isolated and sad.

The difference between happy and unhappy just might be eight minutes. That’s the time it took for Shalhoub, also a jazz artist, to sing three songs on her first visit to a women’s unit at the San Francisco County Jail a year ago, right around Mother’s Day.

“One woman said, ‘I’ve been here two years and this is the happiest I’ve felt,’” she recalled during a visit to the women’s unit on Tuesday. With feedback so powerful, she had to come back, and has taught music therapy classes almost every Friday since.

For this Mother’s Day, Shalhoub went further: She and a four-piece band performed a 45-minute concert in the jail’s E pod on Tuesday, and recorded it before a captive audience of 50 female inmates, a first in the jail’s history.

[SNIP]

“Even though it’s not much to bring music on the inside, it’s a way to learn the day-in, day-out on the inside in the lives of women, and to intervene in their isolation and confinement,” Shalhoub said. “Dreaming about other systems that are restorative is what fuels my passion for this work.”


HOW MUCH COULD CALIFORNIA SAVE BY EXPANDING ACCESS TO PRE-K?

There are 31,500 4-year-olds from low-income households in California that don’t have access to public preschool.

Providing preschool to 31,500 kids—which was included in Governor Jerry Brown’s 2014-15 Budget Act—could save California $820 million per year (at $26,000 per child), according to a new report by ReadyNation.

Heres a clip from ReadyNation:

Long-term savings are substantial. An independent cost-benefit analysis of more than 20 different studies of high-quality state and local preschool programs by the Washington State Institute for Public Policy found that providing high-quality early childhood education can have, on average, a net return of over $26,000 for every child served.

These savings result from fewer placements in special education, less grade repetition, increased lifetime earnings thanks to higher graduation rates, more income taxes collected from those earnings, reduced health care costs, and decreased crime.

In keeping with the promise in the 2014-15 Budget Act, an estimated additional 31,500 preschool slots are needed in order to provide early learning for all low-income 4-year-olds in California. Applying the estimated $26,000 in lifetime net savings per child served by preschool means that serving these children in California would result in savings to our state of close to $820 million for each graduating preschool class.

“When it comes to early education for at-risk youth, the research is clear: investing in our youngest learners now will pay big dividends in the future,” said Moreen Lane, Deputy Director of READYNATION California. “Hopefully, our state legislators and the Governor will agree and fulfill the promise of least year’s Budget Act to make early education available for all low-income 4-year-olds. Smart investments in preschool would be a solid step for our state economy.”

Posted in District Attorney, Edmund G. Brown, Jr. (Jerry), Education, Innocence, LA County Board of Supervisors, LAPD, LASD, mental health, racial justice | 5 Comments »

Support for Aging-out Foster Kids with Their Own Children…Former WA Justice Resigns Over Death Penalty….CA Mental Health Courts….from Drug Dealing to QuickBooks

May 1st, 2015 by Taylor Walker

LA SUPES MOVE FORWARD ON CREATING SUPPORT SYSTEMS FOR YOUNG PARENTS WHO ARE AGING OUT OF THE FOSTER CARE SYSTEM

On Tuesday, the LA County Board of Supervisors formally approved a two-year pilot program to prevent intergenerational abuse among foster children who become parents. Now the Department of Children and Family Services can move forward on a contract with Imagine LA, the non-profit that will be providing the services to foster kids who have young children and are aging out of the foster care system.

Specifically, Imagine LA will pair the young parents with a group of volunteer mentors to help with every day parenting activities, creating a support system that new parents outside the child welfare system often receive from their own parents and extended families.

The program, which may be renewed for one additional year at the end of the first two years, will be evaluated by the USC School of Social Work.

In LA County where 38% of California’s foster kids reside, 50% of foster kids who age out of the system end up homeless or incarcerated, according to Alliance for Children’s Rights. And, girls in foster care in LA are 2.5 times more likely to be pregnant by age 19 than girls not involved in the child welfare system. Fifty percent of 21-year-old young men aging out say they have gotten someone pregnant, compared to 19% of 21-year-old males not in foster care.

According to Imagine LA, since launching it’s first family mentorship team in 2008, the non-profit has worked with 68 families with whom they have had positive outcomes:

* 100% of families maintained their housing

* 100% of children achieved ASQ (under 5 year developmental standards) or grade level school proficiency with the majority excelling

* 100% of high school-aged youth graduated and pursued higher education

* 100% of participants (adults and children) received annual medical and dental exams

* 75% of families increased their household earned income, on average an increase of 67%

According to Imagine LA’s CEO and President, Jill Bauman, a participating family gets paired with a custom mentor team and a Team Manager who work together to “make sure all the resources, skills and habits the family needs stick. They are in it for the long haul,” Bauman says. “The young people in this program will get help with everything from finding and keeping employment, to learning how to budget, cook, parent, and utilize healthcare, to getting a ‘mom’ break when they need it most. And the children will have other caring resourceful adults also nurturing their development.”

For more information on the specific roles and responsibilities of mentor team members, visit Imagine LA’s website.

Note: the above video shares the stories of Imagine LA’s participating parents who have struggled with homelessness. The new program approved by the LA Supes will be specifically tailored to aging-out foster kids.


THE WASHINGTON STATE JUSTICE WHO LEFT THE BENCH BECAUSE HE COULD NO LONGER UPHOLD CAPITAL PUNISHMENT

On Wednesday, while the US Supreme Court debated lethal injection protocol, specifically, the use of the sedative midazolam. That same day, on the other side of the country, the Washington State Supreme Court held a memorial service for former justice Robert Utter, who died in October.

the fact that the two things happened on the same day had a significance

Utter resigned from the state’s high court in 1995—after 23 years on the bench—in protest of the death penalty. In his resignation letter, Utter wrote, “We continue to demonstrate no human is wise enough to decide who should die.”

The Marshall Project’s Ken Armstrong has Robert Utter’s story, including what convinced him to leave the high court. Here are some clips:

Utter’s resignation was part of a string of judicial condemnations of the death penalty in the mid- and late 1990s. The most famous of these came from the U.S. Supreme Court, when Justice Harry Blackmun wrote in a 1994 dissent: “From this day forward, I no longer shall tinker with the machinery of death.” But justices on state courts also joined in, with Utter’s resignation followed by Illinois Supreme Court Justice Moses Harrison II warning of the inevitability of an innocent person being executed. “When that day comes, as it must, my colleagues will see what they have allowed to happen, and they will feel ashamed,” Harrison wrote in a 1998 dissent.

[SNIP]

On the state Supreme Court, Utter dissented two dozen times in cases where his colleagues upheld a death sentence. (Often, those sentences were thereafter reversed in the federal courts.) His chief criticism was the unequal application of the law. He would write time and again of how one defendant had received a death sentence while others, whose crimes were worse and whose circumstances were less forgivable, had not. In the 1990s, two events helped convince him to walk away. One was the 1993 execution of Westley Allan Dodd, the state’s first execution since 1963 and the country’s first hanging since 1965. The second was reading “Hitler’s Justice,” a book by Ingo Müller, a German lawyer. In a law review article published in 1997, Utter wrote that Müller “chronicles how the entire legal system, including judges, lawyers, and lawmakers, were co-opted to serve a lawless regime with the corresponding death of the rule of law and its legal institutions. … In fact, he told of only two non-Jewish judges who actively protested the actions of the Nazi government by resigning.”

In a long interview conducted as part of the Washington Secretary of State’s Legacy Project, Utter explained how the book made his choice clear.

“Nobody stood up,” he said. “I had to.”

There’s more, so read the rest.


CALIFORNIA’S CHIEF JUSTICE SEZ ALL CA COUNTIES SHOULD HAVE MENTAL HEALTH COURTS

While sitting in on Sacramento Superior Court’s Mental Health Court, California Chief Justice Tani Cantil-Sakauye, a Republican, pointed out that only 27 of the state’s 58 counties have mental health diversion courts despite their proven ability to reduce recidivism.

Chief Justice Cantil-Sakauye said that although the state appropriated $15 million in one-time funds for diversion courts, many counties may not be able to afford them when the start-up money runs out.

Capital Public Radio’s Bob Moffitt has the story. Here’s how it opens:

In Sacramento Superior Court’s Mental Health Court, there are plenty of congratulations and plenty of cupcakes for people who used to be known as defendants but who are now known as participants. They stand before Judge Larry Brown. An attorney updates the judge on the status of a participant.

“I am happy to report his drug test was negative.” Brown responds, “Great! That’s terrific. Good job.”

Judge Larry Brown gently reminds one of the participants in the County’s mental health program that progress involves a little work, “None of this punishment. It’s all about having part of a structured program, right?”

On this day, Chief Justice Tani Cantil-Sakauye sits in the jury box as an observer. She says only 27 of the 58 counties have a mental health court.

“When you give people treatment and they get on some kind of service-provider program, they tend to re-offend less -hence the reduction in recidivism, hence less of a cost to the community -law enforcement, jails and institutions.”

For 18 months, the MacArthur researchers followed 447 participants from mental health courts in San Francisco County and Santa Clara County as well as Hennepin County, MN, and Marion County, IN, as well as 600 people receiving “treatment as usual.”

According to the MacArthur Foundation Mental Health Court Study, the mental health court graduates had lower recidivism rates than mentally ill offenders who were not enrolled in (or who did not finish) the diversion court program.


THE NOT-SO-FAR-FETCHED JUMP FROM DRUG DEALER TO ACCOUNTANT

RadioDiaries’ Joe Richmond talked with Kamari Ridgle, a young, former drug dealer from Richmond, CA who discovered his passion for accounting, after 22 bullets pierced his body, leaving him paralyzed from the waist-down at 15-years-old. According to Kamari, “Every drug dealer is a businessman.”

“Last fall, in my accounting class,” Kamari continues, “the teacher was like, ‘This is what you really need to know: you’ve got expenses, you’ve got revenues.’ That’s when I was just like, ‘Oh, I did this before. I get this…”

(Joe Richmond is also in the middle of a series for This American Life about the city of Richmond where the Office of Neighborhood Safety pays former offenders to stay out of trouble.)

Posted in California Supreme Court, Courts, DCFS, Death Penalty, Foster Care, Homelessness, juvenile justice, mental health | No Comments »

LA County’s Proposed Budget…Feds Investigate SF Jail Abuse Allegations…CA Bill to Reduce Drivers License Suspensions…and Criminal Justice Questions for Presidential Candidates

April 14th, 2015 by Taylor Walker

LA COUNTY’S REFORM-MINDED BUDGET PROPOSAL ALLOCATES MORE $$ TO MENTAL HEALTH DIVERSION, JAIL SERVICES, FOSTER CARE

In a press conference Monday morning, the office of LA County interim CEO Sachi Hamai released the 2015-16 budget proposal.

A spokesman for the CEO emphasized that the new budget is focused on “major programatic reforms, with new positions and funding” going toward “improvements in the criminal justice system, child protection, and improvements in health care delivery.”

Out of $26,923 billion, only an additional 10.2 million is going to mental health diversion, but it’s a big step in the right direction. In June, LA County District Attorney Jackie Lacey is expected to present to the Board of Supervisors her task force’s report on creating a comprehensive mental health diversion plan for the county.

An even larger step is the $66.9 million to fund 542 additional child protection positions, in order to lighten social workers’ cases loads, a crucial move in the name of child safety. Over-stressed social workers are more likely to miss things.

Los Angeles Sheriff Jim McDonnell said in a statement that the proposed budget “provides critically needed resources to support ongoing efforts by the Los Angeles Sheriff’s Department (LASD) to ensure the compassionate treatment of inmates in the nation’s largest jail system, while also continuing to develop smarter justice system approaches to those in our community suffering from mental illness.”

Public budget hearings are slated to begin in mid-May.

The LA County Supervisors are also scheduled to vote today on a motion to institute some additional oversight for probation in the form of an audit.


FBI JOINS THE GROUP OF AGENCIES PROBING REPORTS OF SF DEPUTIES FORCING INMATES TO FIGHT AND BETTING ON THEM

The FBI has initiated an investigation into allegations that four San Francisco deputies forced jail inmates to brawl in gladiator-style fights and placed bets on them. SF District Attorney George Gascon, the SF Police Department, and the sheriff’s department have also launched investigations into the matter. (WLA will continue to track this story.)

KQED’s Alex Emslie has the updated story. Here are some clips:

The four deputies named at the center of an independent investigation initiated by [San Francisco Public Defender] Jeff Adachi remain on paid leave, [SF Sheriff Ross] Mirkarimi said. Their names are Scott Neu, Eugene Jones, Clifford Chiba and Evan Staehely. The law firm representing the deputies did not return a call seeking comment.

The federal inquiry officially started April 3. Special Agent Greg Wuthrich said the FBI investigation is at a very early stage.

“Civil rights allegations are definitely huge for the bureau,” Wuthrich said. “These kind of things, we take very seriously.”

[SNIP]

Adachi said in a statement that he is pleased with the FBI’s involvement and commended Mirkarimi for taking the unusual step of inviting the federal probe.

“Eliminating this sort of brutal and sadistic conduct starts by leading an investigation that isn’t tainted by conflict of interest or misplaced loyalty,” Adachi said. “I look forward to a thorough and fair investigation that includes determining whether additional deputies were aware of the abuse and complicit in their silence. To ensure this never happens again, there must be accountability — not only for the perpetrators, but for those who fail to speak up.”


CA BILL WOULD CUT DOWN ON ALL-TOO-COMMON LICENSE SUSPENSIONS FOR NON-VIOLENT TRAFFIC VIOLATIONS

A new bill by CA Sen. Bob Hertzberg (D-Van Nuys) aims to reduce the number of drivers whose licenses are suspended after failing to pay (often exorbitant) fines for non-violent traffic offenses.

SB 405 follows closely behind a report condemning California’s policing-for-profit system as not unlike the situation in Ferguson, MO. In both places, fines pile on top of fines when a driver is unable to pay a ticket, burying the person (often poor to begin with) under a mountain of debt. And often failure to pay these fines results in a suspended license, which prevents the person from driving to a job to earn money to pay the fines. One in six California drivers have had their licenses suspended, and according to a separate report, nearly half of people whose licenses are suspended lose their jobs.

The bill would reinstate drivers licenses lost due to non-violent traffic infractions, as long as the licensee then paid back the debt through the state’s proposed Traffic Amnesty program.

A New Way of Life Reentry Project, the East Bay Community Law Center, the Lawyers’ Committee for Civil Rights, and Legal Services for Prisoners with Children cosponsored the bill.

Here’s a clip from Sen. Hertzberg’s website:

Hertzberg said suspended licenses can trap the working poor in an impossible situation: unable to reinstate their license without gainful employment and unable to access employment without a license.

“This is a Catch 22 that traps people in a cycle of poverty,” Hertzberg said, pointing to a recent New Jersey study that found that when a license was suspended, 42 percent of drivers lost their jobs. Of those, 45 percent were unable to find a new job. Even accounting for those that kept their job, 88 percent of people with suspended licenses reported a reduction in their income.

In California, the number of licenses suspended during an 8-year period from 2006 to 2013 exceeded 4.2 million. In that same timespan, only 71,000 driver licenses were reinstated.

Under existing law, it is virtually impossible for the driver’s license to be restored until all the unpaid fees, fines and assessments are completely paid. This jeopardizes economic stability in the state, limits the available workforce, and forces employers to bear the cost of replacing workers and finding qualified replacement workers with valid licenses.

In addition to trapping many Californians in a cycle of poverty, the sheer number of suspended licenses poses a threat to public safety. Evidence suggests that when people lose a license for reasons unrelated to safety, they take the suspensions less seriously. According to the National Highway Traffic Safety Administration, at least 75 percent of people who have had their licenses suspended just keep driving – often without insurance.


RADLEY BALKO: CRUCIAL CRIMINAL JUSTICE QUESTIONS WE SHOULD ASK ALL PRESIDENTIAL CANDIDATES

The Washington Post’s Radley Balko has a “quick and dirty” list of important criminal justice reform questions for all presidential candidates.

If you are wondering who has thrown their hat in, thus far, the NY Times has a nice little chart (updated as of yesterday, April 13).

Here are four from Balko’s list, but there are … more where these came from:

The Obama administration has made heavy use of the Justice Department’s Civil Rights Division to investigate patterns of abuse and civil rights violations by local police departments. Would you continue this policy in your administration? To what extent is the federal government obligated to step in when local police and prosecutors are either habitually violating or failing to protect the constitutional rights of citizens in their jurisdiction?

[SNIP]

Several media reports, advocacy groups and judicial opinions (including a recent opinion by Judge Alex Kozinski of the U.S. Court of Appeals for the 9th Circuit) have described an epidemic of prosecutor misconduct across the country. Do you believe there is a widespread problem of prosecutor misconduct in America? Do you believe the federal government has a responsibility to address it?

[SNIP]

Do you believe the criminal justice system is infected with institutional racism? I’m not asking you to assess whether individual cops, judges, or prosecutors are racist; I’m asking if you believe there is inherent bias built into the system.

[SNIP]

Do you believe the criminal justice system is infected with institutional racism? I’m not asking you to assess whether individual cops, judges, or prosecutors are racist; I’m asking if you believe there is inherent bias built into the system.


Posted in Board of Supervisors, DCFS, District Attorney, FBI, Foster Care, jail, Jim McDonnell, Juvenile Probation, LA County Board of Supervisors, mental health, Public Defender | No Comments »

LA Officials to (Belatedly) Crack Down on Over-Drugging LA Kids….A Juvie Lifer Artist…and the Shooting of Walter Scott

April 8th, 2015 by Celeste Fremon



MENTAL HEALTH OFFICIALS TO CRACK DOWN ON OVER-DRUGGING OF KIDS IN COUNTY CARE (UM…THAT WOULD BE NICE.)

In the past year, it has come to light that kids are being over-drugged in many of California’s various foster care and juvenile systems, LA County’s included. Then more recently, we learned that powerful medications are unnecessarily being jammed down the throats of poor kids via the Medicare system. (See here and here and here for some of the latest stories.)

Tuesday, however, there was a piece of good news when the LA Times’ Garrett Therolf reported that Los Angeles County Department of Mental Health officials plan to crack down on doctors who appear to be inappropriately prescribing powerful and dangerous antipsychotic drugs to kids in LA County’s foster care and juvenile justice systems.

The question is, however, knowing the serious dangers posed by overprescribing or wrongly prescribing antipsychotics for children or teenagers, why weren’t the county’s mental health officials paying better attention?

Here’s a clip from Therolf’s story:

Social workers and child welfare advocates have long alleged that the widespread use of the drugs is fueled in part by some caretakers’ desire to make the children in their care more docile. On May 1, the county Department of Mental Health is scheduled to launch a program to use computer programs to identify doctors who have a pattern of overprescribing the medications or prescribing unsafe combinations of the drugs.

Once problematic doctors are identified, the department will recommend that judges no longer approve their prescriptions for youth under court supervision.

Additionally, Los Angeles County mental health workers will fan out across the county to randomly interview children, caregivers and doctors about the reasons behind the prescriptions and how they are working.

The hope is that the in-person reviews will allow the county to go beyond the information doctors submit in their paperwork, offering a more complete picture of the youth’s mental health and whether less-intrusive interventions were used before turning to drugs.

“We know there is really a need to do this,” said Fesia Davenport who was recently named interim director of the county Office of Child Protection, a new agency charged with coordinating services across county departments for abused and neglected children. “Once we start to look at the data I think we’ll identify patterns and really understand why the use of the drugs seems to be high.”

In February, Therolf, writing for the LA Times, noted that “51% of California’s foster youth who are prescribed mental health-related drugs took the most powerful class of the medications — antipsychotics.” (And, of course, Karen de Sá, of the San Jose Mercury News, reported extensively on the over-drugging of foster kids in her multi-part series.)

That 51% figure is deeply concerning..

The risks of using antipsychotics on kids are considerable—except in certain very closely monitored situations. (For further details, read last week’s WLA story by Taylor Walker about the most recent study released showing the disturbing overuse of antipsychotics on Medicaid kids, with California one of the five states studied.)

The crack-down Therolf reports is a very welcome step, albeit distressingly belated. Yet, another underlying issue still calls out to be discussed, namely that, every study we have on the matter shows that most kids who land in foster care or the juvenile justice system, or both, are suffering from high degrees of childhood and adolescent trauma. This kind of toxic stress almost inevitably results in some kind of emotional and/or behavioral symptoms—which are crucial to address. But, in most cases, powerful drugs are neither an appropriate nor safe way to ameliorate and heal these issues.

Of course, real healing of trauma-harmed kids is labor intensive— and cannot be done from the remove at which one can prescribe drugs.

But that’s a discussion for another day.


A JUVENILE LIFER WHO MAKES MEANING WITH ART COULD BE AMONG THOSE GETTING NEW SENTENCE IF SCOTUS AGREES

In 1999, when Kenneth Crawford was fifteen, he was the getaway driver for a brutal murder of strangers. He did not himself beat, rob and shoot Diana Lynn Algar, 39, and her friend Jose Julian Molina, 33, at a campground in Pennsylvania. The admitted killer was an 18-year-old fellow drifter and carnival worker, David Lee Hanley. Nevertheless, Crawford was tried as an adult, and given a sentence of life without parole in a plea bargain to avoid the death penalty, which was still legal for juveniles as the time.

Although nearly all of his upbringing was horrific, Crawford makes no excuses for his involvement in the crime for which he was convicted.

“I was too drunk and full of pills and have only myself to blame,” he wrote to a couple who have befriended him during his time in prison.

The victims “were good people and their families did not deserve the pain and suffering they endured. I have begged the Lord for forgiveness and I believe I have been forgiven. But I will never forgive myself.”

One of the primary ways Crawford, now 31, finds meaning and solace in his life behind bars is painting miniature scenes on fallen leaves he collects. The results are remarkably beautiful.

Crawford is also one of the 2100 inmates given life sentences as teenagers, whose prison terms could possibly be affected when the U.S. Supreme Court deliberates the question, likely in September of this year, of whether their historic ruling of Miller v. Alabama should be applied retroactively. Miller, if you remember, which was presented by civil rights attorney and author, Bryan Stevenson, ruled that mandatory sentences of juvenile life without parole were unconstitutional.

Gary Gately has delved further into Crawford’s story for the Juvenile Justice Information Exchange.

Here are some clips:

Five years ago, Kenneth Carl Crawford III returned to that woods behind his childhood home in Oklahoma, but only in his mind — the only way he can go back now, perhaps the only way he’ll ever go there again in his time on this Earth.

After a storm, he had been gazing at a thick forest about 100 yards away when he noticed a bunch of leaves had blown over the high electric fences topped by razor wire and landed in the prison yard at the State Correctional Institution-Greene, here in the southwest corner of Pennsylvania.

Crawford picked up one of the leaves. “It had been a long time since I had touched a part of a tree, let alone held a piece of it in my hands,” he would write in his journal.

He kept looking at the leaf, mesmerized, nostalgic for so much of a bit of boyhood paradise lost.

Then he took the leaf back to his 8-by-12-foot cell and decided to recapture some of what he missed so dearly — and ultimately painted on it a scene right out of the woods he remembered.

He’s been painting wildlife scenes — and painting them superbly — on leaves ever since.

Crawford, 31, has plenty of time to create his miniature masterpieces. He’s serving a mandatory life-without-parole sentence for his involvement in a double murder at age 15 in 1999.

[SNIP]

Crawford, a lean man with the beginnings of a mustache and beard, calls the Sanfords “Mudder” and “Peepaw.” [The Sanfords are a couple who ran across his art and have gradually befriended him.]

“I’ve had ‘mothers’ and ‘fathers,’ and none of them turned out too well,” he says.

Indeed, his alcoholic father beat him, his brother and his two sisters with extension cords and switches in drunken rages and often left them home alone in their ramshackle trailer with no electricity or heat and little food. And he forced them to tend to his marijuana plants behind the trailer.

Crawford’s mother ran off with one of her boyfriends to work the carnival circuit when Ken was 5…..

When he was 9, Child Welfare Services came to remove Ken and his siblings from their father’s custody — and promised the children their lives would be much better with foster parents.

They weren’t.

Crawford recalls one 400-pound foster father who forced the children to scratch and bathe his legs because he could not reach down to them.

Another foster father showed off Ken’s ability to play football — until he outshone the man’s biological son, at which point the foster father made Ken quit the team.

A third foster father told him he’d be in prison by the time he was 18.

When Ken was 10 and wetting the bed, his foster mother screamed at him and ordered him to strip naked and lie on a towel on the living room floor. As other children in the home laughed, she put a diaper on him and made him wear it to school the next day.

He wet the bed again that night, and she forced him to sleep in the bathtub.

If he could change two things in his life, Crawford says now, he would have never have hung out with David Lee Hanley, and, if it were somehow possible, he would have eluded Child Welfare Services workers.

“If I could go back in time, I would have hid from Child Welfare Services. I should have hid. I shouldn’t have let them find us,” he says.

Speaking of his father’s abuse and neglect, he says: “That’s what we knew. It was nothing out of the ordinary for us. We still had something, and the physical abuse we grew up with I was used to.

“In foster care, it was mental abuse, and the mental abuse was much worse.”

Still, he’s quick to add that he doesn’t blame anybody for the circumstances that led to the double homicides. “I made the choices,” he says.


THE SHOOTING OF WALTER SCOTT

As most of you probably know by now, a 50-year-old black man named Walter Scott was fatally shot on Saturday in North Charleston, S.C., after being stopped for a broken tail light by a white Charleston police officer, Michael T. Slager, 33.

On Tuesday, Officer Slager was charged with murder.

Initially, Officer Slager reported that he made a traffic stop and was in foot pursuit after the subject. Next Slager reported shots fired and that the subject was down. “He took my Taser,” Slager said on the radio. Later, in the police report, Slager stated he had feared for his life because the suspect, Scott, had taken his taser in a scuffle.

However when a video taken by a bystander surfaced, and it told a very different story.

Here’s how the South Charleston Post and Courier describes what is on the video:

The three-minute clip of Saturday morning’s shooting starts [shakily], but it steadies as Slager and Scott appear to be grabbing at each other’s hands.

Slager has said through his attorney that Scott had wrested his Taser from him during a struggle.

The video appears to show Scott slapping at the officer’s hands as several objects fall to the ground. It’s not clear what the objects are.

Scott starts running away. Wires from Slager’s Taser stretch from Scott’s clothing to the officer’s hands.

With Scott more than 10 feet from Slager, the officer draws his pistol and fires seven times in rapid succession. After a brief pause, the officer fires one last time. Scott’s back bows, and he falls face first to the ground near a tree.

After the gunfire, Slager glances at the person taking the video, then talks into his radio.

The cameraman curses, and Slager yells at Scott as sirens wail.

“Put your hands behind your back,” the officer shouts before he handcuffs Scott as another lawman runs to Scott’s side.

Scott died there. [Actually, in the beginning Scott appears to be alive.]

Slager soon jogs back to where he fired his gun and picks up something from the ground. He walks back to Scott’s body and drops the object.

At no time, does Slager or the next officer on the scene, attempt to help the dying Scott, although one of the officers searches him and then eventually feels for a pulse.

According to the Post & Courier, Mr. Scott “had a history of arrests related to contempt of court charges for failing to pay child support. The only accusation of violence against Scott during his lifetime came through an assault and battery charge in 1987″—in other words, 27 years ago, when Scott was 23.

A family member told reporters that Scott likely ran because he didn’t want to be arrested for back child support.

In a statement released Tuesday night, South Carolina Governor Nikki Haley (R) said, “What happened in this case is not acceptable in South Carolina.” Senator Tim Scott (R) said “The senseless shooting and taking of Walter Scott’s life was absolutely unnecessary and avoidable.” Senator Scott said that he would be watching the case closely.

Posted in DCFS, Foster Care, juvenile justice, law enforcement, Los Angeles County, LWOP Kids, mental health, Youth | 7 Comments »

Feds Investigate Rampant Drugging of Poor Children with Antipsychotics

April 1st, 2015 by Taylor Walker

ALARMING NEW FEDERAL REPORT ON DOCS OVER-PRESCRIBING POWERFUL ANTIPSYCHOTIC DRUGS TO CHILDREN ON MEDICAID

A new report from the US Department of Health and Human Services’ Office of Inspector General shines some light on the excessive use of antipsychotic drugs to treat poor children (many of them in foster care) on Medicaid.

Researchers requested records from 2011 on 687 claims in five states: California, Florida, Illinois, New York, and Texas. They received information on 485 of the requests (many of the other records were incomplete or nonexistent). These particular states were chosen because they comprised 39% of all Medicaid payments for antipsychotics.

These “second-generation antipsychotics” (SGAs) are often used to treat schizophrenia, bipolar disorder, and autism-related irritability. Because minimal clinical research has been completed on how the SGAs affect kids, and there are very specific age-ranges approved for use of the antipsychotics, many doctors prescribe these medications for conditions that are not considered medically accepted.

Thus, kids often receive the wrong treatment, are given a dangerous cocktail of psychotropic drugs, and experience severe side-effects (like suicidal thoughts, paranoia, and hallucinations) and other potentially problematic effects like weight gain, none of which are properly monitored.

In 67% of the claims, the researchers found what they call quality-of-care concerns. Just under half of claims showed two or more of these particular concerns.

A whopping 53% of cases were poorly monitored. Kids vital signs and blood pressure were not regularly tracked, they were not checked for involuntary movements, height and weight were not monitored, and doctors did not run lab work to check for liver and blood issues.

In 41% of kids’ records, there was either no explanation as to why the antipsychotics were prescribed, or they were prescribed for an inappropriate reason. In over one-third of cases, these drugs were prescribed to treat conditions listed on the medication’s FDA boxed warning. (An example of this would be prescribing an antipsychotic medication to a child with major depressive disorder, despite an FDA warning label that says the drug may cause suicidal thoughts in children with major depressive disorders).

Other distressing patterns included prescribing kids too many drugs at once (37%), keeping kids on the antipsychotics for too long (34%), giving the wrong dose (23%), prescribing to kids too young (17%), and negative side-effects (7%).

In one particular case, a child diagnosed with bipolar disorder was prescribed six psychotropic drugs at once. Three were antipsychotics. A vague mention of hallucinations was the only explanation for the heavy drugging. The 16-year-old suffered through insomnia, “paranoia, hostility, unstable mood, hallucinations, and suicidal thoughts” as well as significant weight gain, and swelling of the hands and feet. When the teen was taken off these drugs, the originally reported hallucinations vanished.

Only in 8% of the cases were kids’ prescribed these drugs for any of the medically accepted reasons. And of the five states, only New York restricted Medicaid coverage for these drugs outside of medically accepted reasons (unfortunately, 3,366 prescriptions were covered in violation of New York’s policy).

According to the report’s lead investigator, Michala Walker, antipsychotics “should only be used for a medically appropriate reason and, when they’re used, they must be very carefully managed to ensure safety and quality care.”

The report urges the Centers for Medicare and Medicaid Services (CMS) to partner with state medicaid programs to review how antipsychotics are prescribed to children, and to conduct regular reviews of the medical records of medicaid-covered kids prescribed the drugs, and to work with states to come up with ways to boost oversight. CMS has agreed with these three recommendations.

Karen de Sa, who has been doing some powerful investigative reporting on how and why California’s foster kids are so heavily medicated, also reported on this new data.

Posted in children and adolescents, Foster Care, health care, mental health, The Feds | 1 Comment »

DOJ Picks Stockton for Community Policing Pilot, Dorsey Nunn, Pasadena Police Misconduct Audit, and Fullerton’s Homeless Liaison Unit

March 16th, 2015 by Taylor Walker

STOCKTON, CA ONE OF SIX CITIES TO PILOT DOJ’S COMMUNITY POLICING INITIATIVE

Hours after the shooting of two Ferguson officers late last week, the Department of Justice announced the first six pilot cities to take part in the National Initiative for Building Community Trust and Justice, a program meant to help build better relationships between cops and the communities they serve.

The pilot cities included Stockton, California, as well as Minneapolis, MN, Birmingham, AL, Fort Worth, TX, Gary, IN, and Pittsburgh, PA.

Each city will assess their current police-community relations, and apply strategies focusing on implicit bias, procedural justice, and racial reconciliation.

The process will be guided by a panel of criminal justice professionals, experts, and faith-based groups, and advocates, and includes a three-year grant to the John Jay College of Criminal Justice, as well as Yale Law School, UCLA’s Center for Policing Equity, and the Urban Institute.

The Stockton Record’s Jason Anderson has more on the initiative as it relates to Stockton. Here’s a clip:

“The Stockton Police Department is excited that we have been selected as one of six cities to be part of this national initiative,” Stockton Police Chief Eric Jones said. “The men and women of the Stockton Police Department are very committed to building police/community trust within our community.”

City Manager Kurt Wilson lauded Stockton’s selection as a pilot site and praised Jones, who has created a number of community outreach initiatives aimed at easing tensions following a rash of officer-involved shootings in recent years.

“Chief Eric Jones is one of the most respected law enforcement leaders in the country,” Wilson said. “He has been fully engaged locally, statewide and nationally. We are thankful for his leadership, and by his team joining this initiative, we feel it will boost these leading-edge efforts, because some of his evidence-based strategies that are already under way fit into this model.”

[SNIP]

…the program will highlight three areas that hold great promise for concrete, rapid progress: racial reconciliation, procedural justice and implicit bias.

The racial reconciliation component is described as the facilitation of frank conversations between minority communities and law enforcement that allow them to address historic tensions, grievances and misconceptions between them.

The procedural justice element will focus on how the characteristics of law enforcement interactions with the public shape the public’s views of the police, their willingness to obey the law and actual crime rates.

The implicit bias aspect of the initiative will focus on how largely unconscious psychological processes can shape authorities’ actions and lead to racially disparate outcomes even where actual racism is not present.

Pilot sites were chosen based on a list of factors such as geographic diversity, jurisdiction size, ethnic and religious composition, and population density. Also considered were each site’s history of social tensions, level of violence, economic conditions, police department size and historical strategies for addressing procedural justice, implicit bias and racial reconciliation at the local level.


A FORCE TO BE RECKONED WITH: DORSEY NUNN, FROM INMATE TO A CRIMINAL JUSTICE ADVOCATE

Once drug-addicted and sentenced to life with the possibility of parole for being involved in a fatal armed robbery, Dorsey Nunn, is now the co-founder of All of Us or None and executive director of Legal Services for Prisoners With Children in San Francisco. Through these platforms Dorsey takes on monumental projects like fighting jail expansions, solitary confinement, and (successfully) pushing for “ban-the-box” legislation.

The LA Times’ Lee Romney has Dorsey’s remarkable story. Here are some clips:

A decade ago, All of Us or None scored its first victory when Nunn and dozens of others filled the chambers of the San Francisco Board of Supervisors to demand that the box on city employment applications that asks about felony convictions be removed and the question saved for later in the hiring process.

San Francisco’s successful “ban the box” ordinance was the first in the nation, cementing the city’s ultra-left reputation and changing Nunn’s life.

He now had a voice in a debate upon which public safety and billions of taxpayer dollars hinged — one that ignites emotions over such primal questions as retribution versus redemption.

All we wanted was to have a job, be skilled, be trained and be ethical.

Susan Burton, executive director of A New Way of Life, which provides housing to formerly incarcerated women
The California District Attorneys Assn. was among opponents of statewide ban-the-box legislation in 2013, saying “all this bill will do is ensure that local agencies waste public time and resources” screening applicants who “will almost certainly be rejected” once their criminal histories are known.

But the statewide ban also passed, and Nunn is now regularly consulted by national civil rights groups and policymakers. Ban-the-box legislation has been passed in 96 cities and counties and in 13 states led by Republicans and Democrats alike, according to the National Employment Law Project. (Applications for jobs where criminal history is relevant — such as child care or law enforcement — are exempted.)

The voices of those who know the criminal-justice system from the inside have been “absolutely essential,” said Michelle Rodriguez, a senior staff attorney with the employment law project.

The movement dates to March 2003, when Nunn helped convene a crowd of about 40 formerly incarcerated men and women at Oakland’s Center for Third World Development.

They spoke for many: 70 million Americans have an arrest or conviction record, and 725,000 are released yearly from prison to communities where laws, regulations and private sector practices curtail their access to employment, housing, education and even the vote.

“All we wanted was to have a job, be skilled, be trained and be ethical,” recalled Susan Burton, 63, executive director of Los Angeles-based A New Way of Life, which provides housing to formerly incarcerated women and oversees a Southland All of Us or None chapter.

Priorities were listed on butcher paper: jobs, housing, family reunification. “Ban the box” came first.

The group would take its name from a Bertolt Brecht poem.

Slave, who is it who shall free you?/Those in deepest darkness lying,/Comrade, these alone shall see you,/They alone can hear you crying./Comrade only slaves can free you./Everything or nothing. All of us or none.

Thanks in part to All of Us or None’s amateur lobbyists, bills recently signed into law in Sacramento forbid the shackling of pregnant women, remove the prohibition on food stamps for California recipients with drug felonies, and ban the box from all state and local government applications. San Francisco extended ban-the-box practices to private employers and affordable housing, and efforts are underway to expand the ban in Los Angeles and Long Beach.


AUDIT FINDS MISCONDUCT IN PASADENA POLICE DEPARTMENT, NOT ENOUGH TRAINING, OVERSIGHT

An independent audit of the Pasadena Police Department from 2005-2009 found that homicide detectives at the Pasadena Police Department were undertrained and under-supervised, and used questionable interrogation tactics among other misdeeds.

The city requested the audit after the dismissal of a 2007 homicide case during which detectives allegedly threatened and coerced witnesses and withheld evidence.

The audit will be presented to the City Council’s Public Safety Committee today (Monday).

Pasadena-Star News’ Sarah Favot has more on the audit. Here’s a clip:

“Some officers were allowed to operate extremely close to the line of legality with little or no visible oversight from supervisors who either knew or clearly should have been aware of their subordinates’ actions,” the audit said. “These supervisors had a responsibility to the department, their subordinates and the people of Pasadena to correct theses deficiencies, but they did not. Equally important, their managers did not hold them accountable.”

[SNIP]

The Pasadena Police Department has been under heightened scrutiny since the police shooting of Kendrec McDade, an unarmed black teen who officers shot to death on March 24, 2012.

The slaying resulted in city officials paying a $1 million settlement to Anya Slaughter and Kenneth McDade, the boy’s parents.

Local defense attorneys said the department was dirty and pointed to several instances were officers withheld evidence, beat suspects and threatened witnesses.

One of those attorneys, Andrew Stein, said Friday members of the Pasadena Police Department were no better than the gang members they sought to imprison.

“They shouldn’t have a police department,” Stein said. “It’s a farce. It’s a joke. The sheriff’s department should take over the city of Pasadena. … This conduct is not tolerable. It’s wrong and it’s only going to change when some rich, white person in Pasadena has something bad happen to them by these cowboys and then it’ll matter.”

And here’s a handful of other findings:

• When interrogations weren’t recorded, no reason was given and a supervisor wasn’t involved;

• A lack of consistent training in basic detective skills for both detectives and their supervisors;

• Supervisors weren’t involved before cases were brought before a prosecutor or before a search warrant was filed;

• When juvenile informants were used, there was no evidence the Police Department received court approval;

•The Police Department has no signage explaining to members of the public the process of making a personnel complaint;

• Detectives bargained with informants offering to charge lesser crimes for cooperation without supervisory approval…


COMMUNITY POLICING AT WORK: FULLERTON’S HOMELESS LIAISON UNIT BUILDS BETTER RELATIONS BETWEEN COPS AND HOMELESS

In 2011, Fullerton police officers beat Kelly Thomas, a schizophrenic homeless man, to death while he screamed for his father.

Since then, the Fullerton Police Department have made considerable strides, boosting mental health training for officers and increasing their Homeless Liaison Unit from a one-man-show to a team of four. The unit works with a mental health care professional, connects people they meet on the streets with much-needed services, and meets with advocates and other agencies to discuss issues related to homelessness.

KPCC’s Erika Aguilar has the story. Here’s a clip:

On a warm afternoon at a Fullerton park, a homeless mentally ill man, rolling his head from side to side, carelessly revealed to a pair of officers that he might have a warrant out for his arrest. But he wasn’t sure.

“Can you check for me?” the man asked.

Fullerton police Cpl. Michael McCaskill held back.

“If I check, it might be bad for you,” he warned. “So I’m going to give you a number where you can check.”

This is the type of work four Fullerton police officers assigned to the department’s Homeless Liaison Unit are doing: building relationships with the homeless and mentally ill people in the city and guiding them to services.

Nearly four years after the brutal police beating death of Kelly Thomas — which sparked a national debate on the treatment by police of the homeless and mentally ill — police here have forged partnerships with homeless advocacy groups to connect the people officers meet on the street with service providers. They also participate in regional meetings with other law enforcement and advocacy groups on homelessness.

The reforms came after a series of reviews and reports — both internal and external — about what happened that night in October 2011.

But Fullerton Police Chief Dan Hughes said Thomas’s death isn’t the only reason the agency has increased its focus on the this vulnerable population.

As Orange County has become more urban, its homeless population has swelled. Hughes said the number of calls police get regarding homelessness in Fullerton has increased from about 1,400 in 2010 to more than 4,000 calls last year. That’s something no police agency could ignore.

“Even though, I don’t believe it is necessarily a police issue, it has been put on our shoulders to deal with,” said Hughes. “And so we’re trying to do that as effectively as we possible can.”

Posted in Department of Justice, Homelessness, law enforcement, mental health, race | 1 Comment »

LAPD’s Mental Evaluation Unit a National Model, Oakland Policing Turnaround, Early Trauma-informed Healthcare…and More

March 10th, 2015 by Taylor Walker

LAPD’S MENTAL EVALUATION UNIT A MODEL TO BE REPLICATED IN LAW ENFORCEMENT AGENCIES NATIONWIDE

The Los Angeles Police Department’s nationally celebrated Mental Evaluation Unit pairs police officers with mental health care professionals into “System-wide Mental Assessment Response Teams” (SMART) to respond to people in the midst of a mental health crisis. The goal is to cut down on police use-of-force incidents and to refer people suffering from mental illness to intervention programs and other services instead of just locking them up.

Altogether, there are 61 officers and detectives and 28 clinicians in the MEU.

The “Case Assessment Management Program,” (CAMP) division of the Mental Evaluation Unit takes on the most challenging cases and has likely saved the LA city and county millions of dollars by diverting the mentally ill from lock-up (with just six two-man teams), according to MEU detective Charles Dempsey.

KPCC’s Stephanie O’Neill has more on the program. Here’s a clip:

The unit, which is the largest and among the oldest mental health policing programs in the nation, is highly regarded by law enforcement and by mental health and civil rights advocates. A 2009 report by the LAPD’s independent federal monitor [who oversaw the consent decree] praised the operation, saying the department “now has the recognized best practice in law enforcement for this subject area,” and is “in the national forefront of this important policing issue.”

“They’re setting a great example for other departments to emulate,” says Jerry Murphy, a criminal justice mental health policy specialist at the Council of State Governments Justice Center. In 2010, that nonprofit organization designated the LAPD one of six national training sites for specialized mental health policing. Since then, the unit has shared its approach with nearly 60 law enforcement agencies throughout the U.S. and with 10 agencies in five other countries.

The Burbank Police Department is among those that have sought training here.

“As it evolved, it got more and more comprehensive,” Michael Albanese, captain of Burbank PD’s patrol division, says of the LAPD’s Mental Evaluation Unit. Albanese says he considers the operation to be “on the leading edge as far as how to manage incidents and/or individuals with mental health disorders.”

Newly elected Los Angeles County Sheriff Jim McDonnell says he, too, is open to considering the LAPD program as model for his department, which has a spotty record when it comes to dealing with the mentally ill. Last month, McDonnell told the 21st Century Policing Task Force in Washington D.C. that in 2013, nearly 40 percent of all use of force incidents “involved individuals suffering from mental illness and in too many cases we arrest our way out of these encounters rather than diverting individuals to the community treatment and care they need.”

For more on the how the program works, read the rest.


THE OAKLAND POLICE DEPARTMENT’S INCREDIBLE (AND LENGTHY) REFORM JOURNEY

Scott Johnson has a not-to-be-missed essay in the March/April issue of Politico Magazine about the Oakland Police Department’s complete about-face from what many called one of the worst departments in the country, to a complete overhaul resulting in dramatic declines in use-of-force incidents and officer-involved shootings.

It has been a hard-won fight. The department officials and officers (including a group of corrupt officers called the Rough Riders) spent years digging their heels in as lawyers John Burris and James Chanin, costly lawsuits, and a consent decree dragged them slowly toward reform.

Very little progress was made for more than a decade until complete federal oversight was on the horizon. The police union settled with Chanin and Burris, allowing the city to appoint a compliance director with the ability to fire officers and officials, including the chief. The compliance director did just that.

Now, with the help of a new chief and steady pressure from Chanin and Burris and the compliance director4`, the OPD has implemented body cameras and taken up community policing. Officers garnered roughly 40% fewer complaints in 2014 over 2013, and greatly reduced their officer-involved shootings.

Here are some clips:

Before Ferguson, there was Oakland. In the fall of 2011, as the Occupy Wall Street movement spread across the country from New York’s Zuccotti Park, Occupy Oakland quickly became one of the biggest protest sites. By early October, demonstrators had set up an encampment in front of City Hall and named the site after Oscar Grant, a 22-year-old who in 2009 had been shot in the back and killed by an officer for BART, the local rail transit system.

Oakland, with a population of roughly 400,000, may sit just across the bay from increasingly glitzy San Francisco, but it can sometimes seem a world away in poverty and race relations. The city had long been known as a stomping ground for radical activists, matched in their aggression by one of the most brutal police forces in the country…

[SNIP]

Although the situation deteriorated steadily in the 1980s and 1990s, it wasn’t until early in this century that a series of disturbing allegations against the police shocked the system into action. The most serious legal troubles began in 2000, when a 21-year-old named Delphine Allen alleged that police brought him to a remote location and beat him while he was in handcuffs; he described being dragged under a freeway overpass and hit repeatedly on the soles of his feet with police batons. The Rough Riders case, as it came to be known, grew to include at least 119 plaintiffs—the vast majority of whom were people of color—all with similar complaints and stories of abuse.

The Riders case eventually resulted in two extensive trials during which four OPD officers were charged with kidnapping, planting evidence and beating witnesses. Of the four, three were acquitted. A fourth officer, Francisco Vasquez, fled the country and is now believed to be in hiding in Mexico; the FBI is searching for him. The more lasting impact of the Riders case, however, is a legal and judicial marathon now in its 12th year that has required the intervention of a district court judge, two outside monitoring teams, a compliance director, six police chiefs, four mayors and tens of millions of dollars in legal fees. The goal of it all has been to reinvent the police department—to prevent another Rough Riders case from ever happening again.

[SNIP]

Chanin and Burris had had enough. In October 2012, the two lawyers filed the necessary papers to put the police department into full federal receivership with Judge Henderson. But before he had a chance to rule, Chanin and Burris finally reached a compromise with the powerful police union, allowing stronger oversight powers. In the settlement, the lawyers agreed to limit their disciplinary action to the top brass of the police department, and in exchange, the union—which represented the rank and file—agreed not to oppose them. The city could now hire a compliance director with the power to fire the chief and his deputies.

Change finally arrived at the top of the Oakland police in the unexpected form of a baby-faced young internal affairs officer named Sean Whent. In May 2013, Chief Howard Jordan had taken early retirement, and all but one person on his command staff was demoted. Then, in early 2014, the judge overseeing the consent decree fired Thomas Frazier, the compliance director he had hired the year before, and gave monitor Robert Warshaw full control over the department. That set the stage for the new chief, 39-year-old Whent, who quickly made it clear that compliance with the consent decree was going to be a priority.

[SNIP]

The new leadership helped, but Chanin and Burris also finally started playing hardball. The department had owned lapel cameras for years but never used them much. Now Chanin said that unless cops began using them more, and more effectively, he would talk to Henderson about “creating a scenario where if you didn’t use a camera, the presumption was that you did what the complainant said you did.” In other words, the cops would be guilty until proven innocent.

Lapel camera usage quickly shot up—exactly the kind of critical reform that President Barack Obama would mention months later in the wake of the Ferguson shooting. There were other changes, too. New training procedures, both in the academy and on the job, stress de-escalation of potentially violent interactions. There are more frontline supervisors deployed in the field, and many officers have started attending a procedural justice course in which community members and police can interact. “It took a few years to adjust and get everybody doing the right thing,” Whent told me. “Now it’s more of an organizational philosophy, and we’ve made it one of the highest priorities.”

Chanin and Burris now say they’ve seen confidential data indicating that complaints against the police have fallen at least 40 percent in the past year. What’s more, the department went nearly two years without an officer-involved shooting from May 2013 until early in February this year. There were no shootings at all in 2014, whereas from 2000 to 2012, there was an average of eight such shootings a year. Two shootings occurred this February. In one, early on the morning of February 7, two Oakland officers responded to a call about a psychiatric crisis and encountered a man who tried to strike them with two golf clubs; the officers fired at him—but didn’t end up injuring the suspect. He was successfully restrained, the officers’ body cameras were on and functioning correctly, and police leaders quickly released detailed information to the public. It really did seem like a corner had been turned.

Despite major policing breakthroughs, the OPD is not quite out of the woods, yet, still turning up data that is indicative of persistent racial bias with regard to who cops stop and who they arrest:

The intersection of race and policing remains tense—even in a city focused closely on reform. On the long list of compliance tasks, only one now remains, and it concerns racial bias: “test 34,” which refers to the “stop data” that police gather after traffic stops, arrests and detentions. Late last year, a study revealed that African-Americans, who make up roughly 28 percent of Oakland’s population, account for about 62 percent of police stops. But the “yield” from those stops—the amount of contraband—was no higher for African-Americans than any other group. “It means a large number of African-Americans are being stopped and searched without any recovery,” Burris says. “We’re trying to get to the roots of that because the mandate is to reduce racial profiling.”


A PEDIATRICIAN AND A PRENATAL CARE PROGRAM TAKING THEIR PATIENTS’ ACES INTO CONSIDERATION TO PROVIDE TRAUMA-INFORMED CARE

As part of an NPR health series, Laura Starecheski tells of a pediatrician and a community clinic in Philadelphia that are successfully incorporating trauma-informed healthcare into their practices. (We pointed to Starecheski’s previous, related story as well as an ACEs test you can take, here.)

At Cobbs Creek Clinic in West Philly, Dr. Roy Wade measures his young patients’ Adverse Childhood Experiences to see the broader picture, trauma and toxic stress, at home and elsewhere, adversely affecting kids health and well-being.

And the Stephen and Sandra Sheller 11th Street Family Health Services Center in North Philly has expecting parents answer an ACE questionnaire to better help parents end the trauma cycle.

Here are some clips:

Wade is working on his own screening tool, a short list of questions that would give every young patient at the clinic an “adversity score.” The list will include indicators of abuse and neglect (which pediatricians already are on the lookout for) and also check for signs of poverty, racial discrimination or bullying.

Wade wants to take action because research suggests that the stress of a tough childhood can raise the risk for later disease, mental illness and addiction. The American Academy of Pediatrics put out a call in 2011 to doctors to address what the Academy characterizes as “toxic stress” among young patients.

Of course, not every kid with a rough childhood will suffer long-term effects. But asking every patient (or their parents) about adversity in their lives, Wade says, could help identify the kids who are at higher risk.

If a patient has a high adversity score, Wade says, he’s likely to track the child’s development more closely. “That’ll be the kid where I’ll say, ‘Come back to me in three months, or two months,’ ” he says. ” ‘Let’s see how you’re doing. Let’s check in.’ ”

Take 11-year-old Tavestsiar Fullard. When I met Tavestsiar at the Cobbs Creek Clinic last summer, he smiled with shy excitement about starting middle school, and told stories about his new puppy, Midnight. But just a few years ago, he was a very different kid.

“He wouldn’t talk,” says Tavestsiar’s dad, Silvester Fullard. “He didn’t want to be around other kids. If you’d just say something, he’d go into a little shell.”…

[SNIP]

It’s easy from that launching pad to start talking with the adults about their own smoking, or drinking, Wade says. “Instead of looking at the parent, you say, ‘Well, these are the impacts that [your smoking or drinking] could have on your kid.’ It helps you address an array of different problems within a family.”

So how early can you start? At Tavestsiar’s age? Or even earlier — age 5 or 6?

Across town, at a community clinic in North Philly — the Stephen and Sandra Sheller 11th Street Family Health Services Center — the staff is determined to start even earlier than that…


SAN DIEGO #1 IN TEN BIGGEST CITIES FOR FEWEST MURDERS PER CAPITA

In 2014, San Diego had the lowest homicide rate—2.4 murders per 100,000 residents—out of the ten biggest cities in the United States. This is the fourth year San Diego has claimed the title.

(Los Angeles is number four with 6.7 homicides per 100,000, trailing after San Jose and New York with 3.2 and 4.0 respectively.)

The San Diego Police Department’s community policing efforts have been named as having the largest effect on the low murder rate, in addition to better medical care, advanced policing methods, and less gang violence.

U-T San Diego’s Lyndsay Winkley and Michelle Gilchrist have more on the numbers. Here’s a clip:

The department investigated 32 homicides, down from 39, giving San Diego, the eighth largest city in the nation, a murder rate of 2.4 killings per 100,000 residents, according to data compiled by U-T San Diego.

By comparison, Phoenix, which has a slightly larger population than San Diego, had a murder rate of 7.7 per 100,000, while San Antonio, another city of similar size, had a rate of 7.3. Philadelphia had the highest rate of the nation’s ten top cities, with 16 killings for every 100,000 residents.

Those closest to the department’s homicide investigations credit a continued drop in gang violence for fewer slayings, but no factor gets more credit than community policing.

San Diego police homicide Lt. Paul Rorrison said it is contributor No. 1 to the city’s low count.

“It’s directly related to the fact that homicides are down so low,” he said. “… It’s been huge.”

Community policing hinges on departments forging close relationships with the communities they serve. It took hold in San Diego in the early ’90s, around the time homicides across the nation started to decline…

Posted in ACEs, LAPD, law enforcement, mental health, Trauma | 2 Comments »

The Trauma Files: You Too Can Take the ACEs Test…Now That We’re Finally Having a Serious Conversation About the Effects of Childhood Trauma

March 6th, 2015 by Celeste Fremon



Several times a year, I am asked to speak about juvenile justice issues at classrooms
full of graduate students studying public policy, or some similar subject. These days when I talk about criminal justice–juvenile or otherwise—I always bring up the issue of trauma.

I trot out the results of research showing that kids in the juvenile justice system are 8 times more likely to suffer from post traumatic stress disorder—PTSD—than non-incarcerated kids in the community.

I note that the prevalence of PTSD is higher among girls in the justice system (49%) than among boys in the system (32%).

I explain that for school age kids, PTSD can look a lot like attention-deficit disorder, with the accompanying lack of concentration, resulting poor grades, plus the kind of inability to sit still that often leads to school discipline.

Then I tell the students that there is a newer way to look at the kind of extreme stress and trauma that can cause PTSD in kids—along with related difficulties in school performance, behavior and so on.

It is called Adverse Childhood Experiences—OR ACEs.

(We’ve written about ACEs in the past here and here and here.)


THE ORIGINAL ACEs STUDY

In the late 1990s, Vincent Felitti, founder of the Department of Preventive Medicine for Kaiser Permanente in San Diego, and Robert Anda of the US Centers for Disease Control, conducted a landmark study that examined the effects of what they termed adverse childhood experiences–ACEs—things like abuse, neglect, domestic violence and other forms of family dysfunction and catastrophe.

Felitti and Anda studied around 17,000 people in all, the majority of whom were white, well-educated, and middle class or above. Each subject was asked to answer a series of questions about highly stressful events or conditions in their childhood, along with another basic set of questions about physical and emotional issues in their adulthood.

When the researchers analyzed the resulting data, they found find a powerful connection between the level of adversity faced and the incidence of many health and social problems. The two also discovered that ACEs were more common than they had expected. About 40 percent of Felitti and Anda’s respondents reported two or more ACEs, and 25 percent reported three or more.

Since then, similar studies and surveys have been conducted in several states, with findings that are either consistent, or more dramatic.

It is at around this point in my lecture that I ask the class members if they’d like to take an ACEs test themselves.

It isn’t the full test that Felitti and Anda gave, only a 10-question quiz, but it will still give them a good idea of what we’re talking about.


YOU TOO CAN TAKE THE ACES QUIZ

If you click the link below you can take it yourselves.

ACES 10 Q QUIZ

Of course there are other significant forms of childhood trauma that are not listed in the quiz: having a friend killed, repeated exposure to community violence, surviving and recovering from a severe accident, being the subject of severe bullying or violence by a friend or acquaintance….and so on.

Moreover, the test doesn’t measure traumatic events occurring in young adulthood, or adulthood, which can compound the effects of earlier trauma, or cause it’s own after effects.

Yet it’s a good place to start.


SCORING TRAUMA

After everyone has finished and privately noted their personal scores, we talk further about how trauma is the unacknowledged elephant in the room when it comes to the subjects of school discipline, justice policy, prisoner reentry, etc., and also, as it turns out, when it comes to physical health.

I tell stories about the young men and women I got to know during my first few years of gang reporting in the early 1990′s, and how their ACEs scores were off the charts. And now, 20 years later, many of them are struggling with the physical and emotional issues that the first ACEs study described.

When we talk about criminal justice policy reform, juvenile justice reform, school discipline reform, prisoner reentry, we also have to have the conversation about trauma, I say.

When the class is over, there is inevitably a cluster of students who want to talk more. Once we’ve chatted a little, I ask those who have lingered behind if they’d be willing to reveal their own ACE scores; what they tell me no longer surprises: ….5….6…7….

And in the last class at which I lectured, one obviously bright woman took a breath and said… “10.”

(Her story is an interesting one and I hope to persuade her to write about it for WLA)


BRINGING ACES INTO THE LIGHT

I bring all this up because this week NPR’s Laura Starecheski produced an excellent three part series for All Things Considered about the world of ACEs, which will further explain why this topic is something we should all know more about.

Part 1 is titled Can Family Secrets Make You Sick and it talks about the Felitti/Anda study, and how it was received—when it first came out, and now.

Here a clip.

In the 1980s, Dr. Vincent Felitti, now director of the California Institute of Preventive Medicine in San Diego, discovered something potentially revolutionary about the ripple effects of child sexual abuse. He discovered it while trying to solve a very different health problem: helping severely obese people lose weight.

Felitti, a specialist in preventive medicine, was trying out a new liquid diet treatment among patients at a Kaiser Permanente clinic. And it worked really well. The severely obese patients who stuck to it lost as much as 300 pounds in a year.

“Oh yeah, this was really quite extraordinary,” recalls Felitti.

But then, some of the patients who’d lost the most weight quit the treatment and gained back all the weight — faster than they’d lost it. Felitti couldn’t figure out why. So he started asking questions.

First, one person told him she’d been sexually abused as a kid. Then another.

“You know, I remember thinking, ‘Well, my God, this is the second incest case I’ve seen in [then] 23 years of practice,’ ” Felitti says. “And so I started routinely inquiring about childhood sexual abuse, and I was really floored.”

More than half of the 300 or so patients said yes, they too had been abused.

Felitti wondered if he’d discovered one of the keys to some cases of obesity and all the health problems that go along with it.


THE FIFTEEN YEAR GAP

In Part 2, NPR and Starecheski offered their own interactive ACEs test and what the scores mean.

Part 3 is titled 10 Questions Some Doctors are Afraid to Ask

I met Felitti last fall and he said that when he and Anda first published their results in the late 1990s, they expected an overwhelming response from the medical community.

Instead for the next fifteen years they got….crickets.

Here’s what the CDC’s Anda told Starecheski:

“I thought that people would flock to this information,” Anda says, “and be knocking on our doors, saying, ‘Tell us more. We want to use it.’ And the initial reaction was really — silence.”

In fact, it took a long time to even get the study published. A number of top medical journals rejected the article, Anda says, “because there was intense skepticism.”

Here are some clips from the rest of the story:

For one thing, doctors aren’t taught about ACE scores in medical school. Some physicians wonder what the point would be, as the past can’t be undone. There also is no way to bill for the test, and no standard protocol for what a doctor should do with the results.

But Felitti thinks there’s an even bigger reason why the screening tool largely has been ignored by American medicine: “personal discomfort on the part of physicians.”

Some doctors think the ACE questions are too invasive, Felitti says. They worry that asking such questions will lead to tears and relived trauma … emotions and experiences that are hard to deal with in a typically time-crunched office visit.

[SNIP]

According to Dr. Jeff Brenner, a family doctor and MacArthur Fellows award-winner in Camden, N.J., getting these rough measures of adversity from patients potentially could help the whole health care system understand patients better.

The ACE score, Brenner says, is “still really the best predictor we’ve found for health spending, health utilization; for smoking, alcoholism, substance abuse. It’s a pretty remarkable set of activities that health care talks about all the time.”

Brenner won his MacArthur fellowship in 2013 for his work on how to treat the most complicated, expensive patients in his city — people who often have high ACE scores, he found.

“I can’t imagine, 10, 15 years from now, a health care system that doesn’t routinely use the ACE scores,” he says. “I just can’t imagine that.”

Brenner only learned about ACE scores a few years ago, and says he regrets not integrating the tool into his practice sooner. But like most doctors, he says, he was taught in medical school to not “pull the lid off something you don’t have the training, time or ability to handle.”

In theory, Brenner says, talking to patients about adverse childhood experiences shouldn’t be any different than asking them about domestic violence or their drinking — awkward topics that doctors routinely broach now.


KANSAS CITY TRIES “TRAUMA INFORMED” CARE FOR KIDS

The good news is that there are some promising programs popping up all around the nation, including a number in California, which make use of what we know about the effects of childhood trauma.

For instance, we’ve talked several times about Dr. Nadine Burke Harris, and her remarkable pediatric practice in San Francisco. And there is this pediatric program in Kansas City, profiled by Eric Adler for the Kansas City Star. Here’s a clip:

Never mind the little girl’s name. What’s important is that she was about 10 years old and all the doctors she had seen month after month had failed to ease her pain.

The girl’s stomach wrenched. Her chest tightened. Her skull seared with lightning-bolt headaches.

Then at Children’s Mercy Hospital, pediatrician Lisa Spector decided to probe with a different set of questions. Instead of asking what was wrong physically, Spector asked the girl what had happened to her in her young life. Quickly, the crux of her pain became clear:

Trauma.

“It was impacting her physical and mental health,” Spector said.

At school, she was bullied. At home, she witnessed repeated domestic violence. She talked of her dad belittling and abusing her emotionally. She recently had been a victim of an attempted carjacking; the thief fled after seeing her in the back seat.

Day to day, she was living a tense and unsure existence that was translating itself into hobbling pain.

That the child’s troubles ultimately eased not with medication but with counseling can be credited to a serious effort by Children’s Mercy to focus on “trauma-informed” care.

For a growing number of children across the country, the approach has become the key to their emotional and mental health, “the most important thing we can do for people,” said Marsha Morgan, chief operating officer for behavioral health at Truman Medical Center.

Trauma-informed care focuses on the notion that a traumatic event in childhood, either experienced or witnessed, can alter the biology of the brain. A trauma-informed strategy works on multiple fronts — using counseling and changes to one’s personal interactions and environment — to lessen or bypass those negative associations while forming new and more positive associative pathways in the brain.

“I’ve worked in this field for over 42 years, and this is the most important thing I’ve ever done,” Dr. Morgan told Adler as they talked about the hospital’s trauma work.

We’ll be talking more about trauma, its effects,. and what can be done to prevent and address them, as we profile more of important programs over the coming weeks and months

Posted in ACEs, Community Health, juvenile justice, mental health, prison policy, PTSD, Public Health, School to Prison Pipeline, Trauma, Zero Tolerance and School Discipline | No Comments »

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