How water use affects the Spokane River

We attended the Spokane River Forum Conference last week and learned tons about the unique watershed we work so hard to protect.  One talk stood out for me though and I wanted to share it with you.  John Covert of the Washington State Department of Ecology presented on the relationship between our summertime water use and the flow of the Spokane River.

Slide4
The Spokane Valley – Rathdrum Prairie Aquifer (SVRP) provides drinking water to much of the greater Spokane area via wells drilled throughout the area.

In the Spokane area we get our water from the massive 10 trillion gallon Spokane Valley-Rathdrum Prairie (SVRP) Aquifer which extends from Lake Coeur d’Alene north to Lake Pend Oreille and west to Spokane.  What’s interesting about this is that the river also receives water from the aquifer starting from downstream of the Sullivan Road Bridge.  This cold influx from the SVRP aquifer to the river is what makes our river a great place for our native Redband Trout and  to cool off in the heat of summer. The drought of 2015 allowed scientists to explore the relationship between our water use from the SVRP aquifer and River levels.

This summer was the hottest and driest on record in Spokane.  Summertime river flows were the lowest on record for much of the summer.  It was so dry that the Post Falls dam (yellow dot on map), which usually begins to draw down Lake Coeur d’Alene after Labor Day instead continued to discharge a relative trickle (500 cfs, red line on graph below) into the river throughout September and October.  This had never happened before and allowed us to see a fascinating pattern (see graph below).  Amazingly although the flow over Post Falls dam remained steady, the river began to rise at the gage in downtown Spokane (pink square on map above).  Where is the extra water in the river coming from?

The explanation of this lies in the graph below.  As the City of Spokane (dark blue) decreased their pumping rate the river (green) began to rise.  Near the end of August the City of Spokane began to decrease their pumping rate, eventually reducing it about 70 cubic feet per second (cfs).  The river began to respond in early September, eventually gaining about 90 cfs!  This is approximately 13% of the river flow.  Aquifer wide pumping decreased about 166 cfs during this period.  Due to this reduction in pumping, the aquifer levels actually rose 0.5 ft (6 inches), resulting in more aquifer water discharging to the river.  Comparing the maximum air temp (light blue) with the city pumping rate (dark blue), shows that during hot periods pumping increases.

covert graph

These data show that decreases in water use increase the flow of the Spokane River.  I suspect the variations in pumping rate are due to the typical summertime uses, such as lawn watering, which does not return water to the river.  Most importantly, we have never seen such clear data on how personal water use choices affect our Spokane River.  As summertime river levels continue to drop due to decreasing snow pack (another amazing and scary talk at the conference) and municipal water use continues to grow, our choices regarding water use will have even larger impacts to our river.

Fair Chance Hiring

By Julie Schaffer

March 2016

“Fair Chance Hiring,” also known as “Ban the Box,” is finally getting some much deserved airtime in Spokane. This is welcome news to the 1 in 4 individuals who have a criminal record and who desperately want to tell potential employers why they are the best pick for the job, an opportunity many of them do not get because of the box on the application that asks about criminal history.  Research shows that people who check the box rarely move forward in the hiring process, regardless of whether or not they qualify for the job, how long ago their conviction was, what it was for, or what they’ve done since that time.  To prevent this arbitrary rejection, and to ensure that employers are not missing out on undiscovered talent, 21 states and over 100 jurisdictions have mandated that employers delay asking about criminal history until later in the hiring process – ideally until after the applicant pool has been narrowed based on qualifications and after face-to-face interviews.  Under such policies, employers can still do background checks, they can still ask applicants about their criminal history, and they can still hire the best fit for the job.

Most policies apply to public employers (like City of Spokane’s current policy), but more and more jurisdictions are mandating that private employers comply as well. Why?  Because it’s the right thing to do (we used to allow businesses to disqualify people of color and women), it increases public safety by dramatically reducing the chance that someone will commit another crime, reduces reliance on public benefits, increases the tax base and helps the local economy, ensures that employers aren’t missing out on highly qualified employees, reduces costs related to incarceration, reduces racial disparity in hiring (people of color are disproportionately represented in the criminal justice system and therefore suffer more from “the box,” and it allows people who have served their time to return to our community and help us make it thrive.

We are pleased that our city councilmembers are currently exploring whether to require private employers in Spokane to delay background checks until after the initial application stage, something the City has been doing (without incident) for the past year. City Council hosted a Fair Chance Hiring Forum on March 8 to educate themselves and the community more about this issue.  Councilmembers Stuckart and Beggs organized the forum, along with Smart Justice Spokane member orgs CFJ, PJALs and I Did the Time.  District Court Judge Richard Leland graciously moderated with humor and a genuine interest in how this relates to the cycle of crime he sees every day on the bench.  Approximately 100 people showed up (during the Gonzaga WCC championship game!), and it played live on City Cable 5 (Forum Video).  A WSU PhD student presented research showing that employment dramatically reduces crime, CFJ presented the common elements of fair chance hiring laws, and formerly incarcerated individuals courageously shared their personal stories of healing, change, education, and then heartbreaking rejection by ‘the box.”  The evening ended with a diverse panel of business people who have voluntarily removed the box with great results, the City’s Chief Civil Service Examiner who is implementing the City’s Fair Chance Hiring policy, GSI’s new CEO Todd Mielke, and the leader of I Did the Time Layne Pavey.  The discussion was rich and honest, and I believe it demonstrated that there is enough common ground and shared love for this community to create fair hiring in Spokane.

To learn more, visit www.nelp.org/campaign/ensuring-fair-chance-to-work, and watch the Forum Video.  And please spread the word and tell council members what you think (their emails are below).  Our leaders need to hear that the people in this community support Fair Chance Hiring!

Ben Stuckart [email protected]

Amber Waldref [email protected]

Mike Fagan  [email protected]

Candace Mumm [email protected]

Karen Stratton   [email protected]

Lori Kinnear   [email protected]

Breean Beggs   [email protected]

Hurt lingers 10 years after Zehm’s death

By Jeffry Finer / Special to The Spokesman-Review

I remember Otto Zehm.

Working downtown, I would see him from time to time walking, loping really – he walked fast and bounced from step to step – but I never so much as said hello. I did not know he was a musician, or that he had mental illness, that he sometimes heard things the rest of us didn’t. I knew he had the longest golden hair of anyone on the Spokane street scene. And he sang quietly to himself. He smiled but did not seem to want attention. He moved along in his own world. He’d be surprised what his name has come to mean. And how often city leaders and media cite his life and death.

For Spokane, his name evokes strong reactions.

Some see Otto’s death on a personal level. He was beloved by his family (mother, sister and cousins were closest). He was respected and liked at work (at the nonprofit Skils’kin, where he was a janitor). Friends said he was careless with generosity and would give you his only coat if he saw you were cold. Everyone knew him to be gentle.

Most of Spokane, of course, knows about his death in 2006 after two days on life support. We watched local media play and replay his videotaped beating and restraint by a half-dozen local police officers. We know about the City Hall cover-up, the federal criminal case and Officer Karl Thompson’s conviction.

For some of us, the “system worked.” For others, the aftermath of Otto’s death was a system failure that ruined a good cop.

If you voted in February 2013 for Proposition 1, and 70 percent of Spokane voters did, you remember Otto as the poster child for passage of a strongly worded demand for an independent police ombudsman. And unless you’ve been living under a rock, you know the office of the ombudsman is in tatters.

Spokane tries to move on.

Officer Thompson has served his time and just this month has been released. The Use of Force Commission met for a year, issued two dozen specific recommendations and dissolved. Some recommendations have taken hold; others, such as changes to Spokane’s “police culture,” have not.

Local civil rights advocates press on – working hard to see that we get the independent ombudsman we overwhelmingly voted for, moving “smart justice” reforms ahead to fix our broken criminal justice system, and pushing the city to hire a new chief of police who is committed to implement the changes our community needs. Other law enforcement issues have come under scrutiny, such as the understaffed jail, its lack of nurses and timely medical services. Just more budget-driven problems facing us and every city and county in America.

Overall? We have yet to heal our relationship with our own peace officers. They have yet to heal their relationship with us.

On the day Officer Thompson was taken into custody, the Friday after the verdict finding him guilty of excessive force and lying in a federal investigation, I sat in the gallery behind Assistant Chief Craig Meidl. He and some four dozen men and women – off-duty police officers sworn to uphold the law – snapped to salute as federal marshals led Officer Thompson away. Otto’s middle-age cousins seated with me were stunned into silence. We looked for help but the court had left and its staff seemed powerless.

In 30 years, I’ve never felt such repressed tension in a courtroom. The marshals, wisely I think, took Thompson away uncuffed and the officers gradually left the courtroom. My apology to the Zehm cousins for the salute brought a cold stare from two officers. At the elevator, another officer blamed the sole reporter present for causing Thompson’s conviction.

It is said that no one should be judged solely by their worst day; and in that sense Officer Thompson’s supporters may have been feeling a conflicted affinity for him. But it remains troubling that the department has failed to account to the public for the embrace by 50 of its officers of a convicted felon. Troubling that there has been no apology and no consequences.

A lot needs doing to restore our faith and trust in our police. Their work requires such trust as surely as we require faithful police. The Center for Justice, where I work with a team of lawyers and community activists, coordinates with citizens, police and local officials to make our city safer and fairer for everyone.

Sometimes the struggle goes on quietly in meetings, or noisily in the media. But a certain spirit of gentleness inspires us at times to keep a memory of Otto Zehm alive. Not only as saber-rattling social change warriors but as neighbors, colleagues, friends and people who remember Otto Zehm.

Legal Financial Obligations: “Modern-Day Debtors’ Prisons”

Publication1555

A huge thanks to intern Jerusha Dressel for researching and writing this blog post.

In 2003, Washington resident David Ramirez was convicted of residential burglary. Currently, the father of four still struggles to make his $30 Legal Financial Obligation (LFO) payment each month. Ramirez cannot go back to his former employment due to medical issues and consequently, the family relies on $400 a month in public aid as well as food stamps for their income. The constant threat of arrest if a payment is missed lingers over him. He is forced to decide between jail and meeting his family’s basic needs: “The message the courts have sent to me over and over again is that if I don’t pay in full every month, I’ll go to jail and I’ll lose everything. I’ve had judges tell me that they don’t care what my other obligations are, LFOs come first. First before food and shelter. It doesn’t matter what my family suffers, so long as the court gets paid.”[1]

In February 2014, the ACLU published a report entitled “Modern-Day Debtors’ Prisons: The Ways Court-Imposed Debts Punish People for Being Poor.” The report specifically focused on LFOs in the State of Washington and their effects on offenders and law enforcement efficacy. The report found that 80 to 90 percent of individuals facing felony charges are deemed “indigent” and over half of persons in prison have not obtained a high school diploma.[2] Almost everyone convicted of a crime in the state of Washington must pay LFOs.

Given that a significant portion of the convicted criminal population falls into such a low income bracket and are poorly educated, it is not a stretch to imagine how this could have adverse effects. Many individuals simply want to leave prison and move on with their lives, but LFOs represent a constant reminder of their past. The average LFO for a convicted felon is $2,540 and LFOs for felonies accrue interest at a rate of 12 percent in Washington, which includes the time that the offender is in prison. In light of the high fraction of convicted felons who are labeled indigent, this is an enormous amount and can take years to pay off. LFOs often create a lose-lose situation for offenders and the government. Many individuals are sent back to prison due to an inability to make payments on their LFOs. This may interrupt employment and pull children apart from their parents. According to the ACLU, this “court imposed debt presents a formidable barrier, pushing people deeper into poverty and prolonging their involvement with the criminal justice system.”[3] The criminal justice system is required to process additional paperwork and hunt down and jail persons who fail to keep up on their LFO fees.

Although state statute allows a court to take into account an individual’s financial situation when imposing optional LFOs, that often does not happen. In many cases, persons making payments on LFOs are also dependent on public aid programs such as Social Security Disability Insurance (SSDI). These programs are giving these individuals/families funds just so they can sustain an elemental standard of living. However, recipients can be obligated by a court to reroute the money away from necessities such as food and housing in order to pay off LFOs.[4]

In response to the “debtors’ prison” problem in Washington, the ACLU has made seven recommendations. Among these, it encouraged creating “clear statewide criteria for determining a person’s ability to pay LFOs.”[5] The ACLU maintained that taking into account an individual’s financial situation when determining LFOs should be mandatory. There are currently no standards set for the examination of an individual’s financial situation. Clear guidelines need to be established for determining whether a person is fiscally capable of handling LFO payments. The ACLU also recommends that Washington “[e]liminate the current 12% interest rate on non-restitution LFOs, and suspend all interest during incarceration.”[6] Additional proposals include ensuring that defendants understand their rights and are allowed council throughout the court process.[7]

The Center for Justice provides services to aid those struggling under the burden of LFOs:

  • We can ask the courts to waive the interest that has accrued on non-restitution LFOs, either while an individual was incarcerated or after he or she was released.
  • We can ask the courts to reduce interest that has accrued on restitution.
  • We can help determine if LFOs will ever expire.
  • We can help create a realistic, long-term budgeting strategy that allows the individual to make payments on their LFOs and avoid sanctions for nonpayment.

This is all part of an effort to reduce the number of individuals trapped in a cycle of poverty. Before making payments on their LFOs, persons should be permitted to ensure that basic needs such as food and housing are being met. Moreover, by aiding in the development of long-term budget strategies, the Center helps the individual become an active participant in his or her success.

Across Washington, there are situations similar to that of David Ramirez. Individuals committed a crime years ago and really just want to move on with their lives cannot because they are still living with the burden of LFOs. These are ordinary, everyday people with families to provide for and dreams for the future. Despite his situation, Ramirez expresses optimism about the future, “I believe in America, you know? I love this country. I want to start a business and provide for my family. My kids are straight A students, and I want them to go to college. But right now, I feel like the fines keep me from getting up and breathing and being the person I want to be.”[8]

[1] “MODERN-DAY DEBTORS’ PRISONS: The Ways Court-Imposed Debts Punish People for Being Poor,” ACLU, February 2014, accessed February 29, 2016, http://cforjustice.org/legal-services/legal-financial-obligations-lfos/.
[2] Ibid.
[3] Ibid.
[4] Ibid.
[5] Ibid.
[6] Ibid.
[7] Ibid.
[8] “MODERN-DAY DEBTORS’ PRISONS: The Ways Court-Imposed Debts Punish People for Being Poor,” ACLU.

Driver Relicensing: Encouraging Individuals to Take Responsibility for Their Futures

A huge thanks to intern Jerusha Dressel for researching and writing this blog post.

Under current statutes in the State of Washington, an individual’s driver’s license can be “suspended indefinitely” if he or she fails to appear in court or pay a ticket.[1] In contrast, the suspension period is one year for a vehicular assault conviction, two years for a vehicular homicide conviction, and 30 days for a reckless driving conviction.[2] An increasing percentage of driver’s license suspensions are not for offenses where the individual is deemed to pose a threat to society. A 2013 study done by the American Association of Motor Vehicle Administrators (AAMVA) found that driver’s license suspensions for “social non-conformance reasons” represented 39 percent of suspended driver’s licenses, up from 29 percent in 2002: “Drivers are now commonly suspended for reasons such as bounced checks, fuel theft, truancy, vandalism and many more.”[3] Nevertheless, it was also found by the AAMVA that driver’s license suspensions for crimes unrelated to traffic safety are largely ineffective. Because the punishment is not closely tied to the original offense, the offender, the court and the police do not give it as much weight.

A driver’s license suspension can be debilitating for an individual. Grocery shopping, picking up a child from daycare and getting to work all become much more difficult tasks. Unpaid fines accumulate interest and often result in more fines. The Lawyers’ Committee for Civil Rights of the San Francisco Bay Area looked at individuals whose licenses had been suspended as a result of violations unrelated to driver’s safety. They found that many of these individuals were unable to keep their jobs due to a lack of transportation and eventually just gave up on paying back their fines, resulting in perpetual suspensions of their licenses. A cycle of poverty has been created by this system in which individuals become weighed down by fines they cannot pay. Jim Gramling, a former municipal court judge in Milwaukee, described the frequently occurring situation: “Often they’re living lives where they can’t afford to leave a job early, or at all, to go to court. They can’t hire a lawyer, can’t afford a lawyer. So they often let the cases go by default and don’t challenge tickets that maybe should be challenged.”[4]

The relicensing program at the Center for Justice exists to help individuals who have had their licenses suspended re-obtain their licenses and pay off their fines. Clients are responsible for the $150 payment that goes along with relicensing and are required to pay additional fees including Department of Licensing and Court fees. The process generally takes two to four weeks. The purpose of the driver’s relicensing program is to empower “people to take the first steps towards gaining responsibility and independence.”[5] In 2015, the Center for Justice aided in the relicensing of more than 400 persons,[6] indirectly benefiting the Spokane community by combatting poverty, increasing the efficiency of law enforcement officers and allowing clients to take ownership in their future.

The AAMVA found that individuals who have their driver’s licenses have a higher probability of a steady job. Enabling an individual to maintain steady employment is integral to fighting poverty. Additionally, decreasing the number of individuals with their license suspended frees up police resources. The amount of time and money currently being expended by law enforcement officers in citing and appearing in court for individuals whose licenses were revoked for violations unrelated to driver’s safety is enormous. The broad application of the driver’s license suspension punishment is draining funds from numerous areas of the criminal justice system. The AAMVA report concluded that, “In addition to the cost of the law enforcement officer’s time – jailers, corrections officers, judges, judicial clerks, bailiffs, prosecutors, support staff, and defense attorneys are all potentially involved in the process and could potentially benefit from the elimination of social non-conformance suspensions.”[7]

The structure of the relicensing program at the Center for Justice encourages individuals to take responsibility for their future. The program seeks to help clients gain their independence, but requires participants to take an active role in the process. In addition to the fee due to the center, the client is responsible for filling out paperwork related to their relicensing. Each client is required to sign a conduct pledge agreeing to treat employees at the Center for Justice with “respect, dignity, and fairness” and they are held accountable to this pledge throughout their relicensing process. In addition, as part of this pledge, clients agree to bring in required documents in a prompt manner. If a client fails to hold up his or her end of the bargain, he or she may be removed from the program. By placing a substantial amount of responsibility on the individual, the Center hopes that the individual will feel more ownership and pride in the process.

 

[1] “Why does the Center for Justice have this program?” Center for Justice, accessed February 26, 2016, http://cforjustice.org/legal-services/getting-my-license-back/.
[2] “Reckless driving,” Washington State Department of Licensing, accessed February 26, 2016, http://www.dol.wa.gov/driverslicense/suspendrecklessdriving.html. “Vehicular assault,” Washington State Department of Licensing, accessed February 26, 2016, http://www.dol.wa.gov/driverslicense/suspendvassault.html.
“Vehicular homicide,” Washington State Department of Licensing, accessed February 26, 2016, http://www.dol.wa.gov/driverslicense/suspendvhomicide.html.
[3] “Best Practices Guide to Reducing Suspended Drivers,” American Association of Motor Vehicle Administrators, February 2013, PDF, accessed February 26, 2016.
[4] Joseph Shapiro, “Can’t Pay Your Fines? Your License Could Be Taken,” NPR, December 29, 2014,  http://www.npr.org/2014/12/29/372691960/cant-pay-your-fines-your-license-could-be-taken.
[5] CFJ Driver’s Relicensing Program Conduct Pledge.
[6] “CFJ Top 15 of 2015,” Center for Justice, accessed February 26, 2016, http://cforjustice.org/top-15-of-2015/.
[7] “Best Practices Guide to Reducing Suspended Drivers,” American Association of Motor Vehicle Administrators.

Smart Justice: Recommendations for Reform

Western and many fellow prison-policy scholars have observed that American criminal-justice policy is built on the rheA huge thanks to intern Jerusha Dressel for researching and writing this blog post .

Although the U.S. contains only five percent of the globe’s population, the country houses 20 percent of its prisoners. Numerous individuals are let out of prison every day, but over two-thirds of these individuals will be detained again by police in the next three years and about half will be sent back to prison. Since 1978, the number of individuals in American prisons has increased by 408 percent. In Spokane, 70 percent of the budget goes towards funding the criminal justice system and half of the individuals in prison have not yet had a trial. Additionally, around 80 percent of prisoners have “substance abuse and/or mental health issues.”[1] Something is clearly wrong with these numbers. Instead of reforming the individual and aiding them in becoming functional members of society, the American prison system has become overcrowded and inefficient.

Smart Justice recognizes that there are groups, including ethnic minorities, the impoverished, and the disabled, that are disproportionately negatively affected by the criminal justice system in Spokane and it seeks to remedy this inequality. Its mission is “to implement comprehensive, cost-effective, and research-based smart justice reforms in the Spokane criminal justice system by conducting research, educating, mobilizing impacted voices, advocating and collaborating for a just, strong, and healthy community, which fosters racial equity and opportunities for recovery and integration.”[2] Smart Justice recognizes that hundreds of thousands of taxpayer dollars are being spent on a system that is largely ineffective. The coalition has put forward a list of six recommendations for improvement of the current criminal justice system:

  1. View the problem through a “Smart Justice Lens.”[3] That is, keep in mind the ultimate goal of reforming the system when making judgments and policy changes.
  2. Involve community input in solutions, especially voices from groups that are unduly negatively affected by the current system.
  3. Data on race and ethnicity should be used to improve current systems, rules and regulations.
  4. Reducing the number of individuals in prison through means including jail substitutes and alternate processes for rehabilitation should be explored, especially for “non-violent, low-risk” persons.[4]
  5. Analyze programs with the goal of understanding what is and is not working.
  6. Delay investing resources in increasing the size of the jail.[5]

The third point is referring to data that has demonstrated that certain ethnic groups are disparately impacted by the current justice system. In 2014, the demographics of the Spokane jails and Spokane County were as follows:

sj11There is a definite contrast between these two sets of statistics in the chart above. Although Caucasians make up 86 percent of the Spokane County population, they constitute only 67 percent of the jail population. Moreover, African-Americans compose two percent of the Spokane County population but 12 percent of the jail population and American Indians/Alaska Natives accounted for one percent of the general population but seven percent of the jail population.[6]

Additionally, Smart Justice has expounded upon its fourth recommendation. This policy change included a program that reminded persons of their court dates so that fewer individuals are jailed as a result of a simple “failure to appear.”[7] This point also involves the redirection of funds from financing jail time to paying for programs that aid the offender in overcoming personal problems such as addiction or mental health issues. Additionally, this policy recommendation pushes for an initial assessment of prisoners that helps “ensure that release conditions, plea negotiations and sanctions are matched to the individual’s risks and need.”[8] These evaluations would allow decisions about the offenders punishment and post-prison accountability program be catered to the individual’s requirements. The fourth point also recommends working with individuals once they leave prison, helping them with processes such as finding employment and housing.[9]

A Harvard Magazine article critiquing the American criminal justice system noted: “Western and many fellow prison-policy scholars have observed that American criminal-justice policy is built on the rhetoric of personal responsibility—paying for one’s bad decision—to the exclusion of asking why minority and low-income groups are so much more likely to make bad decisions, or how society fails them.”[10] In a democratic society, there is a tendency towards an individualistic, “pull yourself up by your bootstraps” mindset. This mentality is reflected in the American criminal justice system. However, there are individuals who do not even have bootstraps to pull themselves up by. Smart Justice aims to give individuals bootstraps. Instead of simply locking up someone every time they commit a crime, it invites a justice system that looks at offenders on a more individual basis. It allows for a structure that asks what is best for the improvement of the specific person.

 

Chart accessed February 22, 2016 from http://www.spokanecounty.org/data/scljc/subcommittees/racialequity/Data%20Slides%20Final.pdf.
[1] “Vision,” Smart Justice Spokane, accessed February 22, 2016, http://smartjusticewashington.org/vision/.
[2]“About Us,” Smart Justice Spokane, accessed February 22, 2016,  http://smartjusticewashington.org/about-us/.
[3] “Smart Justice Policy Recommendations,” Smart Justice Spokane, January 22, 2013, http://web.archive.org/web/20141225223703/http:/smartjusticewashington.org/media/blogs/spokane/Smart%20Justice%20Policy%20Recommendations.pdf?mtime=1364885768.
[4] Ibid.
[5] Ibid.
[6] “Spokane Regional Criminal Justice System Data Slides,” Spokane County, accessed February 22, 2016, http://www.spokanecounty.org/data/scljc/subcommittees/racialequity/Data%20Slides%20Final.pdf.
[7] “Smart Justice Policy Recommendations,” Smart Justice Spokane.
[8] Ibid.
[9] Ibid.
[10] Elizabeth Gudrais, “The Prison Problem,” Harvard Magazine, March-April 2013, http://harvardmagazine.com/2013/03/the-prison-problem.

Medical-Legal Partnerships: A Comprehensive Problem Requiring a Comprehensive Solution

MLP Image copy for blog

A huge thanks to our intern, Jerusha Dressel of Whitworth University, for researching and writing this blog post about one of our newest program areas, the Health & Justice Initiative.

 

Medical-Legal Partnerships: A Comprehensive Problem Requiring a Comprehensive Solution

Health care staff at Boston Medical Center, in the winter of 2010, found themselves faced with a problem that appeared to be propagating itself: patients living in sub-standard housing and suffering from chronic diseases would come in to receive treatment only to afterwards return to the same conditions, such as lack of heat, that initially provoked the issue.

It is evident how this could quickly become a self-perpetuating cycle:

  • A patient becomes ill due to asthma complications and consequently cannot go into work.
  • The individual loses income and cannot pay their utilities for the month.
  • The patient’s heat is turned off in their apartment, worsening the asthma issues.

Although regulations in Boston were set up to prevent those suffering from chronic conditions from having utilities turned off, they required paperwork to be filled out by the doctors themselves. Utilizing the resources provided by a medical-legal partnership (MLP), workers at Boston Medical Center were able to ensure that patients were receiving the legal protection they were entitled to under the law. Medical staff, though, found themselves overwhelmed with the paperwork from the massive amounts of individuals in need of a certification to keep their utilities from being turned off. Working as a team, medical and legal professionals were able to encourage regulation changes that lessened the paperwork required to guarantee legal protections for those dealing with certain medical issues. Because of the efforts of this MLP, 10,000 individuals with asthma and 400 with sickle cell are now less likely to need to visit a health care professional as a result of complications from their conditions and the burden on health care providers has been lessened.[1]

Problems similar to those faced by Boston Medical Center occur regularly. Health care and legal professionals employ different perspectives on patient-client issues. Health care professionals concern themselves with the medical side of the problem (e.g. helping the patient recover), whereas legal workers deal with the “justice” side of the issue (e.g. mold in an apartment building in violation of city code).[2] While both are working with aspects of the issue, they have not seen it as one broad issue, or even if they have, they have not been able to find a means to successfully, holistically combat the problem.

The problem facing health care and legal workers is like a puzzle. However, instead of being all together in the same box, the pieces are distributed to different individuals who have no interaction with one another. The lawyer has his or her group of pieces and can assemble a good portion of the puzzle to provide part of a solution, yet the lawyer has no clue as to what the doctor’s portion of the pieces look like and vice-versa. Thus, as much as these individuals may attempt to finish the puzzle and solve the problem, they cannot succeed because they are both lacking critical components. MLPs represent an effort to bring together all of the puzzle pieces.

According to the Journal of Health Care for the Poor and Undeserved: “Medical-legal partnerships (MLPs) seek to eliminate barriers to healthcare and improve the health of vulnerable and underserved populations by integrating legal assistance into the medical setting. These partnerships resolve various legal needs related to health (including medical insurance, Social Security benefits, housing, employment, and family problems) by affording medical patients the benefits and protections of legal services.”[3]

Basically, MLPs represent a partnership of legal and medical professionals. These organizations provide legal aid to patients suffering from chronic diseases. According to the National Center for Medical-Legal Partnership, MLPs have four different avenues through which they further their goal:

  1. They teach health care and legal professionals how to together recognize potential health threats in the patient’s social environment before they become major issues.
  2. MLPs use laws in place to combat these health threats.
  3. The organizations strive to alter the policies of health care providers so that they are more readily equipped to react to potential health threats to the patent.
  4. These institutions make an effort to preclude additional health hazards through the implementation of new rules regarding health issues.[4]

Today there are more than 275 MLPs stretched across thirty-eight states in the U.S., the majority existing in suburban areas. They are legal aid, changes to health and legal organizations and modification of regulations.[5] These groups place “lawyers and paralegals alongside health care teams to detect, address and prevent health-harming social conditions for people and communities.”[6] MLPs increase medical professionals’ awareness of the consequences of the legal structure on the individual’s health care while opening up the eyes of lawyers to the potential benefits of addressing problems before they become major issues

There have been several positive results of this partnership between medical and legal professionals. Among other benefits, the National Center for Medical-Legal Partnership noted that individuals suffering from chronic diseases are “admitted to the hospital less frequently,” patients more regularly ingest prescribed medication and health care costs have been reduced for the patient and the health care provider.[7] The results of a study examining the impacts of rural MLPs revealed an over three hundred percent return on investment of the Medical-Legal Partnership of Southern Illinois over the course of three years.[8]

MLPs present a viable solution to very real problems facing individuals today. Ellen Lawton, director of the National Center for Medical-Legal Partnership at George Washington University, summed up the importance of a partnership between legal and health care professionals such as the one that exists in MLPs saying that, “As we focus on how to build healthier communities over the next 50 years, we must remember that health does not exist in a vacuum separate from wealth, from the laws we write, from the systems we create to protect our citizens, or from the injustices that exist in each of these things. We must aim for health and justice in all practices and in all policies, knowing that more often than not, they are the same thing.”[9] In order to tackle this self-perpetuating problem, it must be approached not as two separate problems, one for lawyers and one for health professionals, but rather as one single issue. MLPs represent the partnering of individuals working in separate fields towards the same ends.

[1] “Changing the law to keep the heat and lights on,” National Center for Medical-Legal Partnership, November 1, 2010, http://medical-legalpartnership.org/utility-story/.
[2] “The Need for Medical-Legal Partnership,” National Center for Medical-Legal Partnership, accessed February 1, 2016, http://medical-legalpartnership.org/need/.
[3] James A. Teufel, Danilea Werner, Diane Goffinet, Woody Thorne, Stephen L. Brown, and Lori Gettinger, “Rural Medical-Legal Partnership and Advocacy: A Three-Year Follow-up Study,” Journal of Health Care for the Poor and Underserved 23, no. 2 (2012): 705-714, doi: 10.1353/hpu.2012.0038.
[4] “The MLP Response,” National Center for Medical-Legal Partnership, accessed February 1, 2016, http://medical-legalpartnership.org/mlp-response/.
[5] Tishra Beeson, Brittany Dawn McAllister and Marsha Regenstein, “Making the Case for Medical-Legal Partnerships: A Review of the Evidence,” National Center for Medical-Legal Partnership, February 2013,  accessed February 8, 2016, http://medical-legalpartnership.org/wp-content/uploads/2014/03/Medical-Legal-Partnership-Literature-Review-February-2013.pdf.
[6] “The MLP Response.”
[7] “Impact at a Glance,” National Center for Medical-Legal Partnership, accessed February 1, 2016, http://medical-legalpartnership.org/mlp-response/impact/; “FAQ,” National Center for Medical-Legal Partnership, accessed February 8, 2016, http://medical-legalpartnership.org/faq/.
[8] James A. Teufel, Danilea Werner, Diane Goffinet, Woody Thorne, Stephen L. Brown, and Lori Gettinger, 705-714.
[9] Ellen Lawton, “The Shared DNA of Health and Justice,” Huffington Post (blog), August 25, 2015 (4:05 p.m.), http://www.huffingtonpost.com/ellen-lawton/the-shared-dna-of-health-and-justice_b_8034788.html.

Press Release: Coalition of Conservation Groups, Industry, and Municipal Government Challenge Hatchery Permit for Impacts of PCBs to the Spokane River

For Immediate Release: January 19, 2016

Media Contacts:

Jerry White, Jr, Spokane Riverkeeper (509) 464-7614

Rick Eichstaedt, Center for Justice (509) 464-7607

Mike Petersen, The Lands Council (509) 838-4912

Adrienne Cronebaugh, Kootenai Environmental Alliance (208) 667-9093

Coalition of Conservation Groups, Industry, and Municipal Government Challenge Hatchery Permit for Impacts of PCBs to the Spokane River

Challenge seeks a permit that requires PCB testing and participating in regional PCB task force

SPOKANE, WA–Last week, a coalition of conservation groups consisting of the Spokane Riverkeeper, The Lands Council, the Kootenai Environmental Alliance, and the Lake Spokane Association, along with the Inland Empire Paper Company and the City of Coeur d’Alene filed a challenge to the Washington State Pollution Control Hearings Board of a pollution discharge permit issued by the Washington Department of Ecology for the operation of a fish hatchery on the Little Spokane River.

The appeal raises concerns about the permit’s failure to adequately address impacts of the hatchery to water quality in the Spokane River, particularly impacts from toxic polychlorinated biphenyls (PCBs).  While hatcheries do not produce PCBs, a 2006 report raised concerns about the presence of PCBs in hatchery fish food, its impact on PCB levels in fish tissue, water quality impacts in the hatchery water discharge, and impacts to PCB levels in the Spokane River.

The appeal seeks measures that would require the hatchery to conduct the same type of monitoring and to participate in the Spokane River Regional Toxics Task Force (SRRTTF) in the same manner as other PCB dischargers, including Inland Empire Paper Company and the City of Coeur d’Alene.

“The Department of Ecology and the Environmental Protection Agency requires the cities and industries on the Spokane River to vigorously monitor their discharges for PCBs and to participate in a regional toxics task force,” said Jerry White, Jr., Spokane Riverkeeper.  “We don’t want to shut down the hatchery,” said White. “We just want to make sure that all dischargers follow the same rules.”

“What we are after is parity,” said Mike Petersen, director of The Lands Council.  “The other dischargers are spending a significant amount of money and time monitoring impacts and participating in the Toxics Task Force.  It is not unreasonable to expect that the Fish and Wildlife do the same.”

“Communities on both side of the state are taking the problem of PCBs in the Spokane River seriously,” Adrienne Cronebaugh, director of the Kootenai Environmental Alliance based in Coeur d’Alene, Idaho.  “That means every potential source of PCBs needs to take action to reduce and, if possible, eliminate PCBs.”

Once widely used in everything from electrical insulators to underwater paint, PCBs are now considered a long-lived pollutant associated with increased risk of cancer, reduction of immune function and impairment of the neurological development of fetuses.  The family of chemicals, polychlorinated biphenyls, lasts for years in the environment. PCBs can concentrate in fat, and are passed along through the food chain when one animal eats another.  PCBs are toxic in extremely small quantities.  Current regulations prohibit PCB dischargers in quantities measured in the parts per quadrillion.

The Spokane Hatchery operated by the Washington Department of Fish and Wildlife was built in 1934 and is one of the State’s original hatcheries. It is one of the major Rainbow Trout facilities in the state. The facility also raises German Brown Trout, Eastern Brook Trout, Cutthroat Trout, Tiger Trout, and Kokanee Salmon.

The Pollution Control Hearings Board hears appeals from orders and decisions made by the Department of Ecology. The Board consists of three members, who are appointed by the governor and confirmed by the State Senate for staggered six-year terms.

Pollution Enforcement in Washington State (or lack thereof)

Washington State has two approaches to protect the quality of the public’s water from agricultural pollution. Sadly, neither is functioning to provide the healthy, clean water that the public is entitled to.  In one approach, the federal government provides funding that is made available through the counties and the State to fund voluntary programs to address agricultural water quality problems. In the second approach, the Washington Water Pollution Control Act gives the Washington Department of Ecology (WDOE) the authority to regulate farm practices that protect water quality. This authority was upheld by the Washington Supreme Court in the Lemire vs Ecology case in August of 2013.  Ideally, participation by the agricultural industry in voluntary programs would work in concert with regulatory frameworks to re-enforce a culture of lawful behavior and practices that ensure public values are protected.

Enforcement and complaints1
Figure 1. Comparison of the number of pollution complaints received, and violation letters, warning letters, and financial penalties issued by Ecology by region.

Within the regulatory process, Ecology identifies farm operations that are polluting the public’s water through citizens’ complaints and a Watershed Evaluation Process. They proceed with offering farm operations technical and financial assistance to correct their behavior and improve their practices via violation letters.  If the behavior is not corrected, then punitive orders may be issued with associated fines.  As a result of a Freedom Of Information request, we received data on the number of complaints, violation letters, warning letters, orders and fines levied by the Department of Ecology since the Lemire case was decided in August of 2013.  We also received information on the types of pollution these violation letters addressed.  These data show that Ecology’s rarely uses their regulatory ability and agricultural pollution violations continue to go unaddressed in Washington State.

In the Eastern Region and the Spokane River Watershed, regulatory framework is in place but through inaction has become dysfunctional and counter-productive.   For example, since the Lemire case in the Eastern Region, 74 complaints have been lodged with WDOE and  129 follow-up, violation letters that offer technical and financial assistance have been sent to farm operations that are violating water quality law.  Astoundingly, no administrative orders have been issued nor fines levied.  (To illustrate this pattern, see Figure 1 for comparison of Eastern Regional Office to Bellingham Field Office).

Enforcement and complaints
Figure 2. The number and percentage of identified agricultural pollution violations fixed in Ecology’s Eastern Region since August, 2013.

Further, records show that of those 129 problem cases identified by WDOE, only a single farm has corrected their behavior and cleaned up their operations.  Inside the Eastern Region, the Spokane River tributary of Hangman Creek continues to have the worst water quality in the state (Figure 3).  In this watershed our records show that out of 22 active pollution cases (since 2013) none have been corrected.

wqi
Figure 3. Comparison of Ecology’s water quality index of selected streams in Washington State. A lower water quality index indicates worse water quality. For more information go to: http://www.ecy.wa.gov/programs/eap/fw_riv/docs/WQIOverview.html

This inaction has created a norm in which agricultural industry breaks the law with impunity and virtually ignores water quality concerns. Ultimately, this inaction has sent a clear message that actual protection of the public’s surface water is not a priority for WDOE and emboldened polluters with the message that absolutely no enforcement is forthcoming for violators. In our watershed, as across the State, lawful behavior has broken down and as a result, the public is knowingly being deprived of clean water, healthy fisheries and functioning ecological corridors that our rivers should deliver.  As our campaign for clean water in Washington State develops, we will soon have ways that you can let your voice be heard.  Citizens speaking for clean water are the most powerful tool we have to let our legislators know that the public demands action.