Sunday, August 31, 2014

Death Panels

One of the last legacies and memories that I shared with my mother, Joan Rivers, is in critical condition and on life support after she lapsed into a coma and stopped breathing.  Joan has an amazing collection of family in her daughter and grandson and the collection of her "Joan Rangers" whom clearly are a strong supportive network of which she has relied through the rides of her career.  A career that has ranged over the course of my life which runs now into the half century mark.  Hell of a woman who brought me many laughs and all despite her tragedies.   Thank you Joan Rivers for everything you have ever done for me which made me laugh and think of my mother laughing.  A gift which I cannot repay.

So as the decision of death weighs on Miss River's family I realize again how death is something that must be planned regardless.  I found that out the hard way two years ago.

I was never clear what the idiot Sarah Palin was talking about when it came to death panels.  She was referring to a group of Doctors and Insurance agents, much like criminal courts or probation/parole groups I suspect, diagnosing and in turn recommending death for a patient as they had exceeded the maximum insurance coverage for that illness so that they would have to die.

I believe that is in fact actually done just not overtly and in fact deliberately for anyone who has had a major illness and in turn the costs and financial obligations required and getting the Insurer to pay, the Doctor bills and the lack of support in the medical profession other than turning to you over to some non profit group to provide "support" in the form of a pink bear but not in getting you to appointments, seeking alternatives, or essential other duties and responsibilities while navigating the medical industrial complex.  That you are on your own.

So when I opened my paper this morning and saw the "return" of the death panels, I wondered if that moron Sarah Palin was entering the Presidential race again. Alas no and instead it is about "end of life" care.  And once again I assumed that this was a normal and expected dialog that any terminal patient would have with their Doctor if necessary and just the word "terminal" should indicate that it in fact should be part of the treatment. And once again when it comes to the idiocy in the medical complex I forgot that I need a broad brush.

My favorite is of course the Doctor who blatantly states that if he was compensated for doing so he would actually consult with his patients regarding this issue.  Really?  Really?

Again this is an issue that needs clear collaboration and in fact here is another member seriously needed and here it comes - an ATTORNEY.   Without appropriate engagement and involvement with one suitably experienced in the legal issues of ensuring that the individual making the decision is doing so without pressure, is mentally capable and not say on drugs given by the same Doctor who is providing the end of life consult (here Suzy take this Oxy and now let's talk about you dying) and that all the legal I's and T's are crossed.  So in other words a death panel - the Doctor, the Lawyer, an Indian Chief (aka third party) and of course family and patient.

Won't happen. Costs money and needs coordination and cooperation.  Not happening.


Coverage for End-of-Life Talks Gaining Ground

PAM BELLUCK
AUG. 30, 2014

Photo

Dr. Joseph Hinterberger discussed end-of-life care with Mary Ann Zebrowski. If reimbursed, “I’d do one of these a day,” he said. Credit Heather Ainsworth for The New York Times

DUNDEE, N.Y. — Five years after it exploded into a political conflagration over “death panels,” the issue of paying doctors to talk to patients about end-of-life care is making a comeback, and such sessions may be covered for the 50 million Americans on Medicare as early as next year.

Bypassing the political process, private insurers have begun reimbursing doctors for these “advance care planning” conversations as interest in them rises along with the number of aging Americans.

People are living longer with illnesses, and many want more input into how they will spend their final days, including whether they want to die at home or in the hospital, and whether they want full-fledged life-sustaining treatment, just pain relief or something in between. Some states, including Colorado and Oregon, recently began covering the sessions for Medicaid patients.

But far more significant, Medicare may begin covering end-of-life discussions next year if it approves a recent request from the American Medical Association, the country’s largest association of physicians and medical students. One of the A.M.A.’s roles is to create billing codes for medical services, codes used by doctors, hospitals and insurers. It recently created codes for end-of-life conversations and submitted them to Medicare.

The Centers for Medicare and Medicaid Services, which runs Medicare, would not discuss whether it will agree to cover end-of-life discussions; its decision is expected this fall. But the agency often adopts A.M.A. recommendations, which are developed in meetings attended by its representatives. And the political environment is less toxic than it was when the “death panel” label was coined; although there are still opponents, there are more proponents, including Republican politicians.

If Medicare adopts the change, its decision will also set the standard for private insurers, encouraging many more doctors to engage in these conversations.

“We think it’s really important to incentivize this kind of care,” said Dr. Barbara Levy, chairwoman of the A.M.A. committee that submits reimbursement recommendations to Medicare. “The idea is to make sure patients and their families understand the consequences, the pros and cons and options so they can make the best decision for them.”

Now, some doctors conduct such conversations for free or shoehorn them into other medical visits. Dr. Joseph Hinterberger, a family physician here in Dundee, wants to avoid situations in which he has had to decide for incapacitated patients who had no family or stated preferences.

Recently, he spent an unreimbursed hour with Mary Pat Pennell, a retired community college dean, walking through advance directive forms. Ms. Pennell, 80, who sold her blueberry farm and lives with a roommate and four cats, quickly said she would not want to be resuscitated if her heart or lungs stopped. But she took longer to weigh options if she was breathing but otherwise unresponsive.

“I’d like to be as comfortable as I can possibly be,” she said at first. “I don’t want to choke, and I don’t want to throw up.”

With reimbursement, “I’d do one of these a day,” said Dr. Hinterberger, whose 3,000 patients in the Finger Lakes region range from college professors to Mennonite farmers who tie horse-and-buggies to his parking lot’s hitching post.

If Medicare covers end-of-life counseling, that could profoundly affect the American way of dying, experts said. But the impact would depend on how much doctors were paid, the allowed frequency of conversations, whether psychologists or other nonphysicians could conduct them, and whether the conversations must be in person or could include phone calls with long-distance family members.

Paying for only one session and completion of advance directives would have limited value, experts said.

“This notion that somehow a single conversation and the completion of a document is really an important intervention to the outcome of care is, I think, a legal illusion,” said Dr. Diane E. Meier, director of the Center to Advance Palliative Care. “It has to be a series of recurring conversations over years.”

End-of-life planning remains controversial. After Sarah Palin’s “death panel” label killed efforts to include it in the Affordable Care Act in 2009, Medicare added it to a 2010 regulation, allowing the federal program to cover “voluntary advance care planning” in annual wellness visits. But bowing to political pressure, the Obama administration had Medicare rescind that portion of the regulation. In doing so, Medicare wrote that it had not considered the viewpoints of members of Congress and others who opposed it.

Politically, the issue was dead. But private insurers, often encouraged by doctors, began taking steps.

“We are seeing more insurers who are reimbursing for these important conversations,” said Susan Pisano, a spokeswoman for America’s Health Insurance Plans, a trade association. The industry, which usually uses Medicare billing codes, had created its own code under a system that allows that if Medicare does not have one, and more insurance companies are using it or covering the discussions in other ways.

This year, for example, Blue Cross Blue Shield of Michigan began paying an average of $35 per conversation, face to face or by phone, conducted by doctors, nurses, social workers and others. And Cambia Health Solutions, which covers 2.2 million patients in Idaho, Oregon, Utah and Washington, started a program including end-of-life conversations and training in conducting them.

Excellus Blue Cross Blue Shield of New York does something similar, and its medical director, Dr. Patricia Bomba, has spearheaded the development of New York’s advance directive system. Doctors can be reimbursed $150 for an hourlong conversation to complete the form, and $350 for two hours.

Dr. Hinterberger learned of Excellus’s coverage when he called recently to ask about end-of-life discussions, but even if he undergoes Excellus’s training to qualify for reimbursement, most of his older patients have only Medicare.

Continue reading the main story

End-of-life planning has also resurfaced in Congress. Two recent bipartisan bills would have Medicare cover such conversations, and a third, introduced by Senator Tom Coburn, Republican of Oklahoma, would pay Medicare patients for completing advance directives.
But few people think the bills can pass.

“The politics are tough,” said Dr. Phillip Rodgers, co-chairman of public policy for the American Academy of Hospice and Palliative Medicine. “People are so careful about getting anywhere close to the idea that somebody might be denying lifesaving care.”

Burke Balch, director of the Powell Center for Medical Ethics at the National Right to Life Committee, said in a statement that many doctors believed in “hastening death for those deemed to have a ‘poor quality of life.’ ” If Medicare covers advance care planning, he said, that plus cost-saving motivations will pressure patients “to reject life-preserving treatment.”

Doctors deny that.

“Honestly, sometimes I’m making an argument that treatment is not as bad as you think because of our ability to mitigate side effects,” said Dr. Thomas Gribbin, a Grand Rapids, Mich., oncologist who recently persuaded two Michigan insurers to cover end-of-life conversations.

It is unclear if advance care planning saves money, but some studies suggest that it reduces hospitalizations. Many people prefer to die at home or in hospices, so cost-saving can be an inadvertent result, said Dr. William McDade, president of the Illinois State Medical Society, which asked the A.M.A. to create codes for the discussions.< The conversations do not lock people into decisions, and studies show that some change their minds in a crisis.

But evidence suggests that discussions can make a difference.

One study
found that cancer patients who previously discussed end-of-life preferences with doctors more often received care matching those wishes. Other studies suggest planning lowers stress in patients and families.

Reimbursement rates for talking are much lower than for medical procedures. But doctors say that without compensation, there is pressure to keep appointments short to squeeze in more patients. “Not to be crass about this, you’re just giving that service away,” Dr. Rodgers said.

Recently, Dr. Hinterberger took time from other patients and his duties at Schuyler Hospital in Montour Falls, N.Y., to conduct end-of-life conversations in his frank, casual style.

He told Ms. Pennell that if she experienced severe pneumonia or a serious accident, doctors might consider putting her on a ventilator or inserting a feeding tube. She could stipulate that she wanted only pain relief, essentially instructing doctors to “just kiss me and tell me you love me,” he said. Or she could ask for short-term interventions in case “you perk back up.” Or she could indicate, “I want everything. Just do it, do it,” he said.

“The middle option,” she eventually decided.

When Janice Ryan, 89, a former protective services worker with a bone marrow disorder, said she wanted nothing “unless I can recover and feel wonderful,” Dr. Hinterberger gently suggested allowing doctors to try.

“Give the doc some options,” said her husband, Dick, a retired professor. She agreed, but added, “I want quality of life; I don’t want to just be a vegetable.”

Dr. Hinterberger spent 40 minutes with Helen Hurley, 83, whose lung disease requires her to use nasal tubes connected to an oxygen tank she carries in a flowered bag. Then she tired, asking to finish the discussion in future visits, “a little at a time.”

But Mary Ann Zebrowski, 75, a retired vineyard worker with diabetes and arrhythmia, had a lot to say. She described her husband’s collapse in 2008, saying she was glad he had been resuscitated, but felt pressured to agree to a feeding tube because a doctor said, “What are you trying to do, kill your husband?” She eventually decided to remove the tube and let him die.

She said she wanted no feeding tube for herself, but short trials of other measures. Afterward, she seemed relieved, saying, “I just don’t want to put my kids through having to make these decisions.”


Saturday, August 30, 2014

The Core

I have just discovered the line of ice creams by Ben & Jerry's that have a core flavor in the center much like the jelly in the doughnut and oddly it got me thinking about my core.  Well core as related to Yoga and exercise and that if I eat many of these my core will become a pylon.

And when you realize that the spine is the core of the body and you think those with a strong spine can withstand a hurricane and the same with the idea of what a pylon is -. A steel tower supporting high-tension wires; A tower marking a turning point in a race among aircraft.;  A large structure or group of structures marking an entrance or approach;  A monumental gateway in the form of a pair of truncated pyramids serving as the entrance to an ancient Egyptian temple.

I must have one hell of pylon as I still stand.  So when I was in Yoga I decided to dedicate my session to myself.  In my quest to find anyone to help me as I navigate a system so broken and shattered that despite shoes walking through glass my feet are broken and bloody to bits and yet I am also still walking.  

And that brought the question: Am I a narcissist?  And I looked to the Attorney's that I have met (and hired yikes!), those whose bizarre blawgs (the sane ones don't call theirs that), the medical profession, the Police, the EMTs and Fire Fighters and how I have found their core rotting from the inside. The arrogance, the lying, the cover ups, the finger pointing and blame seeking are all characteristics to these professions. The education and the salaries are the only difference but the position of authority and importance are two factors they both share.

I have written about the study that found the 1% lack empathy and on that I can agree.  I think still my favorite was the bizarre conversation I had with an attorney at my gym whose practice centers on finding ways to hide the 1% money, legally I am sure.  She is actually oddly so stupid about other people and utterly odd to talk to that I can say she fits into the profile of having a conversation with an idiot.

There is one "blawger" who bemoans blogging as it no longer seems to appeal to intelligent people and he micromanages the blawg to not allow comments, posts only his posse and the random ones he does he does so to only rebuke and insult, yet while professing to not tolerate such.  Hypocrite or Lawyer?

You can now add, redundantly, to the list narcissist.  There is something inherently narcissistic about blogging, tweeting and facebooking.  You are actually addressing no one and everyone simultaneously,  doing the equivalent of a monologue in a drama.  Occasionally it may end up with a random exchange or some flogging, the internet drive by where a dog pile comes on hates you to an extent that it drives you away.  It never really lasts.  I have seen many a pledge to stop (Alec Baldwin anyone) but only to return.  The narcissism needs to be assuaged and gratified in ways that staring in a pond cannot.

The endless reality shows demonstrate that we will watch anyone do anything just to think that real people are either smarter or some how dumber than the rest of us.  It is the latter than has to explain the Kardashians or that teen agers are in fact teenagers and will watch anything.   That never changed clearly.

Which brings me to how to find the core in yourself and the one's lacking from those whom surround you.  I think work patterns and professions do provide a clue.

I found this article in Psychology Today that discusses the attributes of a narcissist and that of a workaholic.   I think that may explain the fields of municipal servant.  Even Teachers and school Administrators as they vest many long hours in a low paying field so they need to validate and justify why.  I am frequently asked why I don't full time teach and that is one reason why, I like life to have balance.

Now to truly believe this however, would assume that Doctors and Lawyers work 14 hours a day for a purpose, to do good. Right.  They are both of the professions that  advocate  the pledge "the maximum for the minimum." The turn and burn of clients, seeing patients/clients in 15 minute intervals or less, the endless complaints  about how they have such a hard job and are not paid enough yet manage to remain still on pay charts as the highest paid private sector professions next to CEO's.  So in other words bullshit artists that wear suits or white coats.

I also think this explains the odd behavior and claims that Martha Stewart makes claiming to not sleep, the Donald Trump (just the "the" before the name explains that) and the hysteria by many legislators who seem to take endless weeks off about while simultaneously complaining about the vacation of the President which is by any stretch of imagination is clearly a working one.

But all Americans to validate themselves and believe they are important have themselves hard wired 24/7 and that is who we seem to think and believe we are important, our work is and thereby valued.  The reality of such is a problem that many companies are now trying to shut that off at least one day a week and stopping communication during a vacation period.  I think most of that is fear and insecurity, America breeds that well.

Read the article and ask yourself if you fit that description or do you know who does.  The idea of the core of your being should come from within but we love to use extrinsic to excuse or justify why we are the way we are unless of course you are labeled by the same professions that can do so without justification other than by the position they hold.  That is some power unquestioned and unrestrained.

Perhaps it is time to rethink the expression "rotten to the core"it might need a broader brush.



Workaholic name badge The Personality of the Workaholic and the Issue of "Self"

The terrible trio of perfectionism, narcissism and workaholism
A study published this month explored the personality of workaholics. Of interest was the relation of narcissism and workaholism. That grandiose sense of self-importance that seems to be present in epidemic proportions in our society is related to the worst aspects of workaholism, so was perfectionism. I think these results reveal something interesting about the "self."

In the latest issue of Personality and Individual Differences, Malissa Clark, Ariel Lelchook and Marcie Taylor (Wayne State University) published a study on the relation of various personality traits with workaholism. Although my "pet subject" is procrastination (those people who just can't seem to get to a task), I'm also interested in those of us who can't seem to let go of work tasks. These "workaholics" are people who work to the exclusion of other life activities, are consumed with thoughts and feelings about work and often do more than is expected at work. Certainly, their lives are not models of "balance."

What caught my attention about this study is the focus on individual differences or personality traits that are related to workaholism. I'm particularly fascinated by the negative influences of narcissism and perfectionism in our lives, as these are traits that seem to be celebrated in many ways in modern American culture. 

For example, many cultural heroes of popular TV shows, particularly those shows that portray the lives of doctors, lawyers and successful business people, are hard-driving individuals who seem to have no life other than work. What each shares is a grandiose sense of his or her own self-importance that is central to the definition of narcissism.

In their study, Clark and her colleagues analyzed data from a sample of 322 working students, the majority of whom were female (73%), Caucasian (51%) or African American (27%) with an average age of 24 years and who, in addition to their studies, worked 36 hours a week on average. These participants completed self-report measures of the Big Five Personality Traits (Neuroticism, Extraversion, Openness to Experience, Conscientiousness and Agreeableness), as well as measures of Narcissism, Workaholism, Perfectionism and their tendency to experience positive and negative emotions.

The Results

There were a number of interesting findings in this study. As expected, most of the Big Five traits were related to workaholism: Neuroticism (emotional instability) positively to all aspects of workaholism, Conscientiousness negatively to the impatience component of workaholism, Agreeableness negatively to the compulsion to work, and Openness to experience was positively related to the polychronic control (multi-tasking) component of workaholism.

In terms of the other traits they measured, they found that:
  • Narcissism was positively related to workaholism overall, as well as to the components of workaholism known as impatience ("I seem to be in a hurry and racing against the clock.") and compulsion ("It's hard for me to relax when I'm not working.").
  • The high standards dimension of perfectionism (high expectations of self) was related to overall workaholism.
  • The discrepancy dimension of perfectionism (perceived gap between one's performance expectations and self-evaluation of current performance) was a significant predictor of all components of workaholism.
  • Finally, negative affect (NA) and positive affect (PA) demonstrated different relations with components of workaholism. NA (e.g., sadness, anger) was related to overall workaholism, as well as the components of impatience and compulsion. PA (e.g., happiness, joy) was related to the polychronic control component of workaholism.
Implications and concluding thoughts
Like all correlational studies, the relations among the variables leads us to much speculation and raises many new questions. Certainly the issue of causation cannot be addressed, and it's important to note this as the authors dutifully do in their closing section of the paper.

Overall, the authors have contributed to the literature by including traits (narcissism, perfectionism and affect) beyond the Big Five that are typically discussed. In doing this, they demonstrated that each of these traits is related to workaholism or at least some component of it.

Where I disagree with the authors is in their closing comments where they write that their "Results suggest that workaholism may have both positive and negative components" (p. 790). They base this conclusion on their analysis of the structure of the workaholism questionnaire, which produced a 3-component solution. Two of these components are seen as negative (i.e., impatience and compulsion), while the third is seen as a more positive component of workaholism known as polychronic control, or the preference to juggle and be in control of many tasks at once. The thing is, while the authors refer to this as multi-tasking, it has a much more negative connotation when taking into account items that make up this component such as "I prefer to do most things myself rather than ask for help." There are certainly control issues here that are not so positive, even if the measure of Positive Affect correlated with this component.

My point is, neither perfectionism nor workaholism has a positive side. Although it can be argued that perfectionism and/or workaholism result in improved performance in some organizational circumstances, both result in diminished relationships outside of work and undermine well-being overall. Each is harmful to us.

What I think we see in this study is another confirmation of how a number of negative ways of being in life coexist. In fact, I think we see these relations between perfectionism, narcissism and workaholism because they are all related to a third underlying variable - a weak sense of self that is plagued with many irrational thoughts (e.g., "I must be perfect to have worth," "I must work to have worth.") and an overcompensation for this low self-esteem with a paradoxical narcissism (individuals protect their weak sense of self with an overcompensation that portrays the self in a grandiose fashion).

It's all a matter of degree of course. It's important, even essential, to work hard, to set standards for oneself and to value self. Problems in functioning arise when we are:
  • unable to stop working and only find value in self through work (workaholism),
  • set unrealistic expectations for our performance (perfectionism), and
  • value and pursue power and self-importance to support our grandiose self-conceptions (narcissism).
Each of these problems, I believe, has its roots in our sense of self. Nurturing a sense of self as an autonomous worthwhile being apart from our accomplishments or our failures is a key developmental task. It is ours, the task eternal.

Reference
Clark, M.A., Lelchook, A.M., & Taylor, M.L. (2010). Beyond the Big Five: How narcissism, perfectionism, and dispositional affect relate to workaholism. Personality and Individual Differences, 48, 786-791.

Friday, August 29, 2014

Delivery? Back Door Please

I read an article about a new housing development in New York City and it has two doors - one for the rich and one for the poors.

Well Upstairs Downstairs meet Downton Abbey.

I have no problem with the "lower rent" people having to use another door. I don't get it other than to say to the neighbors "hey I am your poor cousin" and that usually means someone is sitting at the kids table or in the case of the above mentions - the servants section. Not a good way to build good neighbors or community.

In New York City perhaps we can come up with a new loophole - the NYC Rule - where in cities like New York, San Francisco, Miami and cities where urban real estate is highly condensed and expensive, a developer can build affordable units in the basement and the back and have a separate entrance as well.  Separate but equal and all that - the Brown decision only related to schools right?  And poor doesn't mean black vs white it means  poor vs rich and poor people are all colors.  Do shadows have colors? Oh yeah they are black. Shadow people are poor people.  We like our poors kept in the shadows, jail is preferable but in the basement is fine.

The bigger issue is affordable housing.  We build new buildings with mandates to have certain units set aside for lower incomes. Those units are smaller, less desirable as they are located below the air shaft, in the basement or faces the prison where you may end anyway.

I have to say that between the alternative, the footprint, cellblock, mini units or whatever they are called that has the square footage of a cell, the charm of an SRO or bedsit has to be an improvement.

I would really love to see the turnover in those cell units. I suspect they are quite high as are the rents.  The initial appeal to a new college graduate would be anything better than an dorm but still appears as one and little actual upkeep or care required.  And I would love to see these communal kitchens and areas with regards to cleanliness and upkeep.  I suspect non existent.  Anytime I speak to people about them no one knows anyone who lives there and would not so I don't meet enough idiots in which to find out the details.   I have been meaning to actually pretend to go to one to see about renting but I shudder at the thought.

So would I rent a place with the door reserved for the poors. Sure  they are my people and I would be happy to know my neighbors, as for those in "upstairs" rooms, I think we are both better off not knowing.  I'll leave it at that.

But housing that is affordable for many working poor has become a new national crisis.  We have little to ensure that this security of a room and a roof for one or more is becoming another way to penalize the poor.  We "ize" the poor as much as we can.  The article below shows that the Sheriff is coming to your door when the rent is too damn high.


Evictions Soar in Hot Market; Renters Suffer

SHAILA DEWAN
AUG. 28, 2014

MILWAUKEE — Just after 7 a.m., sheriff’s deputies knocked on the door of the duplex apartment, holding a fluorescent orange eviction notice. The process was quick and efficient. A moving crew began to carry out the family’s possessions and stack them neatly at the curb. Celeste Wilson, the tenant, appeared on the front step in pajama pants.

Ms. Wilson, 36, explained that the family had missed a month of rent when her husband fell ill, so the landlady filed for eviction. Knowing they would be thrown out, the Wilsons had already found a new home, paying a double security deposit and an extra $300 because of the open eviction case.

“It’s the stability I worry about,” Ms. Wilson said, watching her five children trickle out into the yard that had been their playground for five years. “They’ve got to start off fresh, get new friends, new neighbors. It might not show now, but maybe later on in life.”

For tens of thousands of renters, life has become increasingly unstable in recent years, even as the economy has slowly improved. Middle-class wages have stagnated and rents have risen sharply in many places, fueled by growing interest in urban living and a shortage of rental housing. The result is a surge in eviction cases that has abruptly disrupted lives, leaving families to search for not just new housing that fits their budgets but new schools, new bus routes and sometimes new jobs.

In Milwaukee County, for instance, the number of eviction cases filed against tenants leapt by 43 percent from 2010 to 2013, according to figures gathered by the Neighborhood Law Clinic at the University of Wisconsin Law School. Other parts of the country have seen similar, if less drastic spikes — and not only in high-cost cities like San Francisco.

Landlord-tenant laws and housing market conditions vary widely, and evictions are not surging everywhere. And a court filing does not necessarily result in eviction; some cases are resolved through payment plans or other agreements. But from 2010 to 2013, Maine experienced a 21 percent increase in eviction filings, Massachusetts 11 percent and Kentucky 8 percent. In the fiscal year that ended in June, New Jersey, which has some of the strongest tenant protections in the country, had one eviction filing for every six renter households. In Georgia, where court statistics do not differentiate between tenants evicted by a landlord and homeowners evicted after foreclosure, filings soared to almost 270,000 last year, a 9 percent jump since 2010. Over the same period, according to the research firm CoreLogic, the number of foreclosures dropped by half.

Perhaps the simplest explanation for the rise in evictions is a severe shortage of rental housing caused by a lack of new construction during the recession and the wave of foreclosures that turned homeowners into renters and occupied housing into abandoned blight.

A vast majority of renters live in cities, but evictions are not limited to urban settings. Rural areas like western Oklahoma, where an oil and gas boom has increased demand for housing, have also seen an increase in eviction filings.

The rising demand for, and tight supply of, apartments means landlords can now afford to be more exacting in their standards, if not outright aggressive in replacing renters with those who can pay more. In the second quarter of this year, the rental vacancy rate sunk to its lowest in almost 20 years, while rents, in inflation-adjusted dollars, remained close to their peak. Some advocates for tenants said that court filings were just the tip of the iceberg — many renters have been displaced by rising rents, threatening letters, one-time payoffs and condo conversions, without ever going to court.

The rental shortage has made the most vulnerable tenants susceptible to eviction. “So many of our clients are people of color, people with disabilities, people who have suffered extreme health crises or a long-term chronic illness,” said Christine Donahoe, a staff attorney with Legal Action of Wisconsin.

Over two days in Milwaukee County, sheriff’s deputies evicted two renters with mental illnesses, one of whom responded only to the initials V.G., for victim of government. The boss of the moving crew, Jim Brittain, said: “I’m seeing this more and more. One out of every five people we move, it seems like, have mental health issues.”

Eviction can have a domino effect: People double up with relatives, placing their hosts at risk of eviction themselves for having unauthorized guests. Children miss school, parents find themselves far from their jobs or their normal means of transportation.

“You would think that eviction is caused by job loss, but we found evidence that eviction can actually cause you to lose your job,” said Matthew Desmond, a Harvard sociologist who studied evictions in Milwaukee. He found that women in poor, minority neighborhoods were evicted at higher rates than men, and that in court cases, tenants living with children were almost three times more likely to be evicted than those without children.

“We also found evidence that people that are evicted, even years later, have higher rates of depression and higher rates of material hardship,” like hunger or lack of medical care, he said.

In some cases, economic realities have affected landlords as well as tenants, pushing them to act. In housing court in Madison, Wis., Denise Carty, a nursing consultant who owns one rental unit, said she had reluctantly filed a case against her tenant, a single mother, after years of charging below-market rent and tolerating late or missed payments. The debt had built up to more than $5,000. “I can’t sustain this anymore,” Ms. Carty said.

Even if an eviction case is ultimately dismissed or decided against the landlord, it can cause problems for a tenant who is looking for a new apartment.

In Madison, Jawana Echols, a 34-year-old mother of two, said her previous landlord filed an eviction after one late payment, and the filing has haunted her ever since, even though she settled the bill. After seven rejections, she found a new apartment with the help of a social service agency, but car repairs left her $100 short on the rent one month, so she now has a second eviction filing. Again, she paid what she owed, but she believes that her record will make it impossible to move, even though it takes her an hour and a half by bus to get to work, since her car broke down once more.

In a few states, there have been efforts to strengthen laws protecting tenants. A new law in Rhode Island seeks to keep renters in place if their residence goes through foreclosure. Virginia recently extended landlord-tenant regulations to small landlords. In Oregon, it is now illegal for a landlord to count eviction filings against a prospective tenant unless the tenant lost the case, and it is less than five years old.

But other efforts to slow evictions have been less successful. In California, a recent effort to narrow the Ellis Act, which allows rent-controlled apartments to be converted into condominiums, failed in the State Legislature. From early 2010 to early 2013, the number of Ellis Act evictions in San Francisco increased by 170 percent, while the number of evictions over all went up 38 percent, according to The San Francisco Chronicle.

And in Wisconsin, the Legislature has gutted local landlord-tenant regulations in a series of bills, barring cities from enforcing statutes that required landlords to give tenants a reason for declining to renew a lease or to assess an apartment applicant’s ability to pay based on history rather than income. Money that went to legal aid groups to help prevent homelessness, allocated beginning in 2009 as part of the federal stimulus program, has dried up. A 2012 study by the Boston Bar Association found that renters with lawyers were twice as likely to avoid eviction as those without.

Tenants living in subsidized housing or using a federal housing voucher can find that support jeopardized by an eviction filing. That is why Lynette Moore and her two school-age daughters were living in Super 8 Motel in Madison about a month after being evicted from the three-bedroom house in a suburb of Milwaukee where they had lived for eight years.

The landlord had given her notice that he planned to sell the house, she said, but without a place to go, she had stayed on until he had filed against her in court. Now she is looking for work in Madison, where she hopes life will be easier, while commuting to her job as a health care aide in Milwaukee and hoping that a legal aid lawyer will be able to get her rental voucher restored. The disruption sidelined her plans to work more hours and go back to school, Ms. Moore said.

“We was just getting to the point where we could do life-changing things,” she said.

The move had come just as her daughter Aleisha, 17, was about to start her senior year in high school, and Ailyah, 10, had one year to go in elementary school. Now the two are biding their time until they start at new schools in the fall. During an interview Aleisha said little, but Ailyah chattered incessantly as she pretended to feed a toy dog, Sparky, some of her dinner.

“Abby’s going to be really mad,” Ailyah said. Abby is another stuffed animal, but unlike Sparky, she had been packed away in storage until the family finds a new home.









Thursday, August 28, 2014

A Different PD

That could stand for Police Department or Public Defender as both are the ground zero when it comes to dealing with our mental health population.   We have an enormous criminalized population which puts the US as the number 1 - in incarcerated individuals.

The prison systems estimate that approximately 25% or even more are mentally ill people and once in the system they are subject to more abuse, solitary confinement and no treatment or care provided putting all at risk.

How do people get that way? What was or wasn't done to stop the slow slide down that slippery slope. Well for many who are one paycheck away from homelessness add that you are one emotional crisis from finding oneself in need of mental health counseling.

After meeting that tragic man who said he wished his autistic son was dead or in prison right there is a good example.  I also believe that the son was misdiagnosed and in turn another indicator of how we have a broken mental health system.

Mental health counselors are largely relegated to Social Workers.  They have no medical training nor any psychological background or requirements other than a few courses. They ostensibly were established to assist those in need navigate the system but they have now become de facto mental health counselors.  Many providers have them on staff as they provide the same services as any "talk therapist" only cannot write medical script and they are compensated at much lower rates - the real truth.    Compensation and in turn ability to pay has a great deal to do with this issue and explains why Children are often misdiagnosed and treated for a myriad of "illnesses" and treated with drugs.

Then what begins there continues through adulthood and that lack of care and proper diagnosis and in turn treatment may explain why we see many wandering aimlessly through the streets.

And the idea that we have many who are legally permitted to be drug and alcohol counselors without any medical education, higher training or  college degree in a "counselor" related field (whatever that is) is even more distressing. Here in Washington State these "counselors" have to take a pledge and then over 5 years take a community class or two on the subject matter.   Is this the same type of pledge you take at AA or NA?  Frankly then you are better off there.

As even I can see as anyone that mental health disintegrates into chemical abuse as that is a type of self medication so as part of being charged in court mandates attendance and diagnosis by one of these "professionals" who are utterly disinterested and unengaged in the long term needs of these individuals. Many are taken to local hospitals and simply housed for the 72 hour time frame in which involuntary commitment is allowed by law.

And now with Obamacare there is the demand and need and in turn funding for mental health providers .  I assume they will be manned with a copy of the bullshit DSM V and a referral to a compliant Physician who will write them prescriptions for drugs that they will not take nor have the support system and financial support to do so.  And so it goes.

It takes a village and in America that village is from the classroom to the detention center and/or on meds then later in jail or wandering the streets then back in Jail where a Public Defender who has no skill set nor ability to find the appropriate resources to help their "client" pleads them and then it is back to square one.   Turn em and burn em.

We will just imprison people we don't like. But this is where a Social Worker should be. They should have access and information to appropriate treatment and facilities where they can place those in need. But that requires money and our current grant system is tied to bribes and extortion by the Government to incarcerate and prosecute.  So is that a Catch 22 or an Oxymoron?

Many are kept in jails long after their "punishment" has been served.  In New York they keep many sexual offenders long after their sentence as due to the absurd mandates written by legislators who are showing they care by throwing a bone to the great unwashed and as we know that many of those sex offenders were not and in turn those who were got no treatment and will get none upon release or likely true probationary review only to start the circle of life again.  And that is not new it fact this link is to articles many by the same reporter dating back to 1995.

This is a clear pattern - the Government fails to do its job and in turn they write more laws to ensure we will somehow comply and do so for them.  And they do it by simply taking a narrow brush to sweep a broad picture - all drinkers and drivers are killers, all children alone are in danger, all pot smokers are dealers, all black people are black and in turn dangerous, and so on.

**and that is why I do the same by going all police officers are dangerous, all lawyers are assholes, all medical professional incompetent, all social workers stupid... and then change that to all mexicans lazy, all muslims terrorists, all asians are supersmart... all white men are angry (okay that one ...) 

The below article discusses one woman's journey through the health care system or lack thereof with regards to her mental health needs.  In America it is your fault, pull yourself up by your bootstraps or hang yourself with them in order to not be a burden to other Americans. Or we can lock you up.  Pick one.

The mind is a broad sweeping landscape just like our Country and few have explored each in such detail that its complicated nature is fully understood and having boots on the ground is one good idea but frankly they are nothing more than a support network. Calling them professionals is utter nonsense and misleading.




Expansion of Mental Health Care Hits Obstacles

by ABBY GOODNOUGH
AUG. 28, 2014

The Affordable Care Act has prompted one of the largest expansions of mental health coverage in a generation, increasing access for millions, but shortfalls persist."

LOUISVILLE, Ky. — Terri Hall’s anxiety was back, making her hands shake as she tried to light a cigarette on the stoop of her faded apartment building. She had no appetite, and her mind galloped as she grasped for an answer to her latest setback.

In January, almost immediately after she got Medicaid coverage through the Affordable Care Act, she had called a community mental health agency seeking help for the depression and anxiety that had so often consumed her."

Now she was getting therapy for the first time, and it was helping, no question. She just wished she could go more often. The agency, Seven Counties Services, has been deluged with new Medicaid recipients, and Ms. Hall has had to wait up to seven weeks between appointments with her therapist, Erin Riedel, whose caseload has more than doubled.

“She’s just awesome,” Ms. Hall said. “But she’s busy, very busy.”

The Affordable Care Act has paved the way for a vast expansion of mental health coverage in America, providing access for millions of people who were previously uninsured or whose policies did not include such coverage before. Under the law, mental health treatment is an “essential” benefit that must be covered by Medicaid and every private plan sold through the new online insurance marketplaces.

The need is widely viewed as great: Nearly one in five Americans has a diagnosable mental illness, according to the Department of Health and Human Services, but most get no treatment. If the law’s goal is met, advocates say, it will reduce not only personal suffering but also exorbitant economic costs, like the higher rate of general health problems among those with mental illnesses, and their lost productivity.

Kentucky has been trying to overhaul its mental health system, partly by allowing private psychologists and social workers to accept Medicaid patients for the first time. The change is crucial, state officials say, because 85 percent of the 521,000 Kentuckians who got coverage through the state’s new insurance exchange this year were poor enough to enroll in Medicaid. Previously, only psychologists and social workers at community health centers like Seven Counties, which are quasi-governmental agencies, could provide outpatient therapy to Medicaid recipients here. Now, more than 1,000 private mental health providers statewide have signed up to treat Medicaid enrollees, according to the state.

But shortfalls in care persist. In Louisville, a city of 600,000 where The New York Times is looking periodically at the law’s impact, most new Medicaid enrollees are flowing to four adult mental health clinics run by Seven Counties. Calls to the agency’s access line, the starting point for new clients, are up by more than 40 percent this year, said Kelley Gannon, its chief operating officer.

Seven Counties declared bankruptcy last year in the face of spiraling pension costs, and a federal judge ruled that the agency could leave the state pension system. Ms. Gannon says the services it provides are not in jeopardy.

The last time Ms. Hall had seen Ms. Riedel, in late June, they had talked about her plans to return to school with a Pell Grant and work toward an associate degree. But the next day, an eviction notice arrived in Ms. Hall’s mailbox. She had fallen behind on her rent and was being ordered to court. The coping techniques she learned in therapy — taking long walks and deep, slow breaths, for example — were not helping. Nor were the antidepressants and mood stabilizer that a Seven Counties psychiatrist prescribed. And her next therapy appointment was still more than four weeks away.

Ms. Hall is 52, with spiky, short blond hair and a deeply lined face that attests to a life roiled by stress. Addictions to alcohol and the anti-anxiety drug Xanax ended her marriage and gravely damaged her relationship with her son, who is now 27. She faced losing her small downtown apartment, and with no income at the moment other than a $600 monthly alimony check, her forward momentum was under threat.

“I haven’t felt this way since I got my divorce,” she said as she stamped out her cigarette, speaking fast and sweating in the damp morning heat. “Then, I went back to Xanax, and I don’t want to do that this time. I want to be able to handle this somehow.”

Tana Jo Wright is doing her part to treat new Medicaid recipients with mental health problems. It is just not as easy as she would like.

A licensed clinical social worker, Ms. Wright opened her own practice last fall after working at a busy community clinic in the blighted West End of Louisville. In a tiny rented office with a vase of peacock feathers on her desk, she is seeing 15 clients, several of them new Medicaid recipients.

Like their physician counterparts, many private therapists refuse to accept Medicaid, which pays on average about 66 percent of what Medicare does. In addition, some therapists say, the paperwork takes too much time and the poor — who often experience more violence and trauma than those who are better off — are too challenging to treat. But Ms. Wright, 47, has a different outlook. She grew up in rural Lebanon, Ky., had a tumultuous relationship with her adoptive parents and was battered by a boyfriend at 16.

“Those experiences told me that people really need someone who will listen to them,” she said. “And I thought: ‘You can do that. You would be a good therapist because you know what people go through.’ ”

She has worked with drug addicts at a methadone clinic, with abused children and teenagers at Seven Counties, and with low-income adults at Family Health Centers, the clinic in the West End. Now that she is building her own practice, she sees more clients with Medicare and private insurance. But she said she remained committed to treating people on Medicaid, motivated by the therapists who agreed to see her when she was struggling.

“I believe in treating the whole community,” Ms. Wright said, “including people who can’t afford to pay.”

The new law is a big opportunity for mental health providers to reach more people of all income levels. But in Kentucky and the 25 other states that chose to expand Medicaid, the biggest expansion of mental health care has been for poor people who may have never had such treatment before.

Still, private providers face considerable headaches in taking on Medicaid patients, beyond the long-term deterrent of low reimbursement. Ms. Wright, for instance, is still waiting to be approved by some of the managed care companies that provide benefits to Medicaid recipients. Eager to build her client base, Ms. Wright has taken on a handful of new Medicaid enrollees for free while she waits for those companies to approve her paperwork.

“It’s been months and months,” she said. “It’s always there in my mind: Am I going to make it?”

Her clients, and the progress she sees in them, are her sustenance. There is a young man scarred by gang violence; an older woman whose daughter was murdered years ago; a veteran with post-traumatic stress disorder. And there is Sarah Davis, a Louisville native struggling to get past the bullying she experienced as a child and her negative feelings about her hometown.

Ms. Davis, 30, was teaching English in Japan when the devastating earthquake and tsunami struck in 2011. She came home, suffering nightmares and panic attacks and clashing with her parents as she tried to readjust. Earning less than $15,000 a year as a home health aide, Ms. Davis qualified for Medicaid under the new law. She heard about Ms. Wright from someone at a meditation session and has been seeing her once a week.

“So what’s happening?” Ms. Wright asked as Ms. Davis settled into a soft chair in her office one summer afternoon, tucking her legs underneath her.
They talked about Ms. Davis’s precarious finances and her trouble finding a job she loved. Then they returned to a familiar theme: Ms. Davis missing her life abroad and chafing against the realities of adulthood in Louisville, where she felt isolated and judged.

“My life used to be so beautiful and colorful, and I want that back,” she told Ms. Wright.

“There are some great things about this town if you open yourself up to experiences,” Ms. Wright countered as a small fan ruffled the peacock feathers.

Ms. Davis allowed that she had gotten back in touch with an old friend the previous week and struck up a conversation with a new neighbor. Ms. Wright, who has an emphatic laugh and a penchant for colorful “bling rings,” leaned forward and smiled.

“Two times you’ve told me you stepped out of your comfort zone. That is progress!” she said. “Take that in.”

As a teenage loner in Elizabethtown, Ky., Ms. Hall never felt normal. “I knew something was wrong with me,” she said, “but I didn’t know what.” She had a chronically ill mother and a domineering father. Always anxious, swinging between high moods and low, she started drinking heavily after she got married at 22.< Ms. Hall temporarily stopped drinking when her son was born a few years later. But then she became addicted to Xanax — “I was still numbing myself,” she said — and resumed drinking once her son started kindergarten.


Her husband divorced her in 2004 and married one of their friends. She made several suicide attempts, she said. After her father paid for her to go to rehab, she moved to Louisville in 2011 to live in a halfway house for recovering addicts. When she found the rental apartment last year, she sold her last asset, a car, so that she could afford the rent of $475 a month plus utilities. She was working at the time, running concession stands at sporting events, but making only about $500 a month.

By the beginning of this year, loneliness and grief about her severed relationships with her ex-husband, son and other family members threatened to swallow her again.

Without therapy, “I would have gone back to drinking and using drugs, because I was hurting so bad that there was nothing left for me to do,” she said. “I knew I would not live the rest of this year.”

In an interview, Ms. Riedel, 33, said that Ms. Hall’s therapy sessions had been successful because she had been so motivated — so desperate — to change.

“She’s still struggling with some pretty serious life issues,” she said, “but her attitude has changed so much. She’s so much more optimistic.”

As her outlook improved in recent months, Ms. Hall busied herself with other projects. Besides registering for community college and applying successfully for a Pell Grant, she used her new health insurance to get treatment for spinal stenosis, which causes pain and numbness in the legs and back, and forced her, she said, to leave her job. She also sought assistance from a

Even when adversity struck, Ms. Hall stayed purposeful. Within a day of getting the eviction notice, she gathered the names of a dozen organizations that might provide rent assistance, dialing one after the other from her mother’s antique rocking chair in her apartment. She did not find any organization willing to help pay her back rent, but her relentless research did lead to another option. For $248 a month, she could move to a privately operated “sober living” house. She started packing her apartment, but took a break one recent morning to attend a group-therapy session with Ms. Riedel.

“We haven’t really gotten to talk, and so much has happened,” she said. “I just want her to be proud.”

As of that morning in mid-July, Ms. Riedel’s schedule was booked six weeks out; her caseload had grown in the past year to 263 clients, up from 100 just a year before. But Seven Counties was hiring new therapists, Ms. Riedel said, and she hoped to soon return to seeing Ms. Hall once every two weeks.

Given the long waits for individual therapy sessions, Seven Counties is urging new clients to also try group therapy, for which there is no wait. Ms. Hall has sometimes attended Ms. Riedel’s weekly “Empowering Women” group, and at one recent session, she sat at an oval table with Ms. Riedel and four other women, paper and pen before her in case she gleaned something interesting. She was quiet as several of the others discussed their own problems: an abusive relationship; binge-eating; regret about growing old.

Finally, it was her turn. “Terri, how about you?” Ms. Riedel asked.

“Well, I got an eviction notice,” she said. “But I found a place, it’s for sober living. The woman who runs it accepted my application, but she wants to meet with me and talk first. I’m just praying everything goes well.”

A week later, things took another turn for the worse. Ms. Hall went home to Elizabethtown and stayed a day longer than she had planned to attend a family funeral. When she returned, she learned that she had lost the room in the sober-living house because she had not arrived on the appointed date.

She moved in temporarily with a neighbor, and then a friend, leaving her few possessions in the basement of her former building. She attended more group therapy sessions, thought about college starting and pictured herself in her first class: psychology. Last week, she finally returned to Ms. Riedel’s office, her hands shaking again as she unloaded weeks’ worth of tribulations. She talked about the pain of being judged by her family — if they knew about her eviction, she said, “they’d be madder than heck at me.” With Ms. Riedel’s support, she decided to stop contacting them for now.

ome, and Ms. Riedel offered reassurance. “You are taking steps toward a career that will give you a steady income,” she said. “You are a very resilient person. I see this as you bouncing.”

The 45 minutes flew and they made another appointment, only two weeks away. Ms. Riedel said that in the meantime, she would see if Medicaid would pay for a caseworker to help Ms. Hall with things like finding housing.
“Are you feeling O.K. right now?” Ms. Riedel asked as Ms. Hall got up to leave.

“Yes,” Ms. Hall said, tucking away her appointment card. “I’ll be fine.”



Wednesday, August 27, 2014

Tale of Two Cities

That could be any city in America - there have always been two cities - one poor often black and the other white.

Bill Moyers played an old show where he and the late poet/singer/writer/actress/amazing woman (and the only person whom I can use all that and more deservedly to describe her) visited her home in Arkansas where she was raised as a child.  She and Bill walked to the bridge that divided the two towns - the white and the black - and she commented on how small it was as in her reality and memory it was much larger.  As they got closer she turned to Bill and said I am not going over there and turned away.  The memories of that divide so powerful that even a woman of accomplishment could not bear to cross.

We have a divide here the divide used to be the ship canal bridge that divided Seattle into North and South.  But it is not a city that is easily and so simplistically divided.  A woman stopped me the other day and said I am looking for 10th Ave. I go East or West?  She said west.  Wrong hill the divide of Denny places west on Queen Anne a neighborhood of stately homes and older reputation.  I never knew it that way as frankly as a kid we would drive through and depending where you were on the hill it was not that elite but Seattle has or was a working class city so its pockets of the working class were tucked away in varying hoods and often divided by a street or two.

I remember when I first visited the Central District or the hood as it was called or is maybe and that division came at East Madison then later South Jackson. One to mark the black area the other the Asian or "International" District (aka the China in Towns)

That still exists but it is by far more racially divided and in turn divisive as gentrification has started to make its mark. It began on Capitol Hill the once "gayborhood" where the Gay Pride was held in pride display on Broadway.  It moved to the center of town and gradually the boys and the few girls that lived there have been moving away to the suburbs and places where affordability becomes more important than hipsterhood.  Notice that most hipster hoods were former black, industrial or fringe hoods where a mixed "element" lived.  The bridges are there they are just invisible.

Now we have a larger group with the Latin Americans from all the southern borders moving up and in. I am not sure if there is an area dedicated to them, their cultures and their needs as I said to my neighbor who is Mexican, you are our superheroes - invisible man - who is everywhere and we don't see or speak to him.  I think it was always that way and my parents who loved farming made sure I knew who picked my food so I never knew there were "illegals" or "legals" just people.

So when you see Ferguson you are seeing an American town under a magnifying glass and when you hold a magnifying glass on something long in the bright it burns what lies beneath.  And those who live in Ferguson are the first to say that.  This article is outstanding in how it describes the criminalization of poverty and when that belongs to black skin it is a way to ensure the status quo and this is about the white residents who are confused as to all what this means to their town and their world.

There is little belief that relief, understanding and more importantly change that will result from what transpired that day on that street that divided not just a city but now we know a nation.  And those questions that this posed and in turn problems will likely never be answered.

There have been numerous articles about the two men (well one was a boy only on the verge of manhood and the other a young man who too was barely out of short pants) who met on that street and the fatal encounter that resulted.  Two stories both tragic frankly and yet the end so different.

This is the story from the New York Times about Michael Brown and this is about the Officer who elected to murder a young man in broad daylight because he was afraid, needed affirmation or some type of validation to ensure that his authority was respected.  Read this hideous and disturbing excuse or explanation by a man whom I call Sunny Day Real Estate (a way happier name)  who teaches "homeland" security.Whatever that is.  And there is this as well from the New York Times about how Police react to situations with "Reasonable Fear" (sounds like a new movie starting Liam Neeson) as there is now the time to make sure the talking point and heads meet to lather rinse repeat.

And lastly I put this editorial that says if you think this is the tipping point the turning point or whatever euphemism to think that this will change and hope it is so.. think again.  The Supremes in their ever increasing bizarre right wing agenda to validate some very strict conservative view of the Constitution have made it unlikely that a new wind will not blow in anytime soon in any town soon.



How the Supreme Court Protects Bad Cops

ERWIN CHEMERINSKY
AUG. 26, 2014

IRVINE, Calif. — LAST week, a grand jury was convened in St. Louis County, Mo., to examine the evidence against the police officer who killed Michael Brown, an unarmed black teenager, and to determine if he should be indicted. Attorney General Eric H. Holder Jr. even showed up to announce a separate federal investigation, and to promise that justice would be done. But if the conclusion is that the officer, Darren Wilson, acted improperly, the ability to hold him or Ferguson, Mo., accountable will be severely restricted by none other than the United States Supreme Court.

In recent years, the court has made it very difficult, and often impossible, to hold police officers and the governments that employ them accountable for civil rights violations. This undermines the ability to deter illegal police behavior and leaves victims without compensation. When the police kill or injure innocent people, the victims rarely have recourse.

The most recent court ruling that favored the police was Plumhoff v. Rickard, decided on May 27, which found that even egregious police conduct is not “excessive force” in violation of the Constitution. Police officers in West Memphis, Ark., pulled over a white Honda Accord because the car had only one operating headlight. Rather than comply with an officer’s request to get out of the car, the driver made the unfortunate decision to speed away. The police chased the car for more than five minutes, reaching speeds of over 100 miles per hour. Eventually, officers fired 15 shots into the car, killing both the driver and a passenger.

The Supreme Court reversed the decision of the Court of Appeals for the Sixth Circuit and ruled unanimously in favor of the police. Justice Samuel A. Alito Jr. said that the driver’s conduct posed a “grave public safety risk” and that the police were justified in shooting at the car to stop it. The court said it “stands to reason that, if police officers are justified in firing at a suspect in order to end a severe threat to public safety, the officers need not stop shooting until the threat has ended.”

This is deeply disturbing. The Supreme Court now has said that whenever there is a high-speed chase that could injure others — and that would seem to be true of virtually all high-speed chases — the police can shoot at the vehicle and keep shooting until the chase ends. Obvious alternatives could include shooting out the car’s tires, or even taking the license plate number and tracking the driver down later.

The court has also weakened accountability by ruling that a local government can be held liable only if it is proved that the city’s or county’s own policy violated the Constitution. In almost every other area of law, an employer can be held liable if its employees, in the scope of their duties, injure others, even negligently. This encourages employers to control the conduct of their employees and ensures that those injured will be compensated.

A 2011 case, Connick v. Thompson, illustrates how difficult the Supreme Court has made it to prove municipal liability. John Thompson was convicted of an armed robbery and a murder and spent 18 years in prison, 14 of them on death row, because of prosecutorial misconduct. Two days before Mr. Thompson’s trial began in New Orleans, the assistant district attorney received the crime lab’s report, which stated that the perpetrator of the armed robbery had a blood type that did not match

ERWIN CHEMERINSKY
AUG. 26, 2014

IRVINE, Calif. — LAST week, a grand jury was convened in St. Louis County, Mo., to examine the evidence against the police officer who killed Michael Brown, an unarmed black teenager, and to determine if he should be indicted. Attorney General Eric H. Holder Jr. even showed up to announce a separate federal investigation, and to promise that justice would be done. But if the conclusion is that the officer, Darren Wilson, acted improperly, the ability to hold him or Ferguson, Mo., accountable will  be severely restricted by none other than the United States Supreme Court.

In recent years, the court has made it very difficult, and often impossible, to hold police officers and the governments that employ them accountable for civil rights violations. This undermines the ability to deter illegal police behavior and leaves victims without compensation. When the police kill or injure innocent people, the victims rarely have recourse.

The most recent court ruling that favored the police was Plumhoff v. Rickard, decided on May 27, which found that even egregious police conduct is not “excessive force” in violation of the Constitution. Police officers in West Memphis, Ark., pulled over a white Honda Accord because the car had only one operating headlight. Rather than comply with an officer’s request to get out of the car, the driver made the unfortunate decision to speed away. The police chased the car for more than five minutes, reaching speeds of over 100 miles per hour. Eventually, officers fired 15 shots into the car, killing both the driver and a passenger.

The Supreme Court reversed the decision of the Court of Appeals for the Sixth Circuit and ruled unanimously in favor of the police. Justice Samuel A. Alito Jr. said that the driver’s conduct posed a “grave public safety risk” and that the police were justified in shooting at the car to stop it. The court said it “stands to reason that, if police officers are justified in firing at a suspect in order to end a severe threat to public safety, the officers need not stop shooting until the threat has ended.”

This is deeply disturbing. The Supreme Court now has said that whenever there is a high-speed chase that could injure others — and that would seem to be true of virtually all high-speed chases — the police can shoot at the vehicle and keep shooting until the chase ends. Obvious alternatives could include shooting out the car’s tires, or even taking the license plate number and tracking the driver down later.

The court has also weakened accountability by ruling that a local government can be held liable only if it is proved that the city’s or county’s own policy violated the Constitution. In almost every other area of law, an employer can be held liable if its employees, in the scope of their duties, injure others, even negligently. This encourages employers to control the conduct of their employees and ensures that those injured will be compensated.

A 2011 case, Connick v. Thompson, illustrates how difficult the Supreme Court has made it to prove municipal liability. John Thompson was convicted of an armed robbery and a murder and spent 18 years in prison, 14 of them on death row, because of prosecutorial misconduct. Two days before Mr. Thompson’s trial began in New Orleans, the assistant district attorney received the crime lab’s report, which stated that the perpetrator of the armed robbery had a blood type that did not match Mr. Thompson’s. The defense was not told this crucial information. Mr. Thompson’s. The defense was not told this crucial information.

Through a series of coincidences, Mr. Thompson’s lawyer discovered the blood evidence soon before the scheduled execution. New testing was done and again the blood of the perpetrator didn’t match Mr. Thompson’s DNA or even his blood type. His conviction was overturned, and he was eventually acquitted of all charges.

The district attorney’s office, which had a notorious history of not turning over exculpatory evidence to defendants, conceded that it had violated its constitutional obligation. Mr. Thompson sued the City of New Orleans, which employed the prosecutors, and was awarded $14 million

But the Supreme Court reversed that decision, in a 5-to-4 vote, and held that the local government was not liable for the prosecutorial misconduct. Justice Clarence Thomas, writing for the majority, said that New Orleans could not be held liable because it could not be proved that its own policies had violated the Constitution. The fact that its prosecutor blatantly violated the Constitution was not enough to make the city liable.

Because it is so difficult to sue government entities, most victims’ only recourse is to sue the officers involved. But here, too, the Supreme Court has created often insurmountable obstacles. The court has held that all government officials sued for monetary damages can raise “immunity” as a defense. Police officers and other law enforcement personnel who commit perjury have absolute immunity and cannot be sued for money, even when it results in the imprisonment of an innocent person. A prosecutor who commits misconduct, as in Mr. Thompson’s case, also has absolute immunity to civil suits.

When there is not absolute immunity, police officers are still protected by “qualified immunity” when sued for monetary damages. The Supreme Court, in an opinion by Justice Antonin Scalia in 2011, ruled that a government officer can be held liable only if “every reasonable official” would have known that his conduct was unlawful. For example, the officer who shot Michael Brown can be held liable only if every reasonable officer would have known that the shooting constituted the use of excessive force and was not self-defense.

The Supreme Court has used this doctrine in recent years to deny damages to an eighth-grade girl who was strip-searched by school officials on suspicion that she had prescription-strength ibuprofen. It has also used it to deny damages to a man who, under a material-witness warrant, was held in a maximum-security prison for 16 days and on supervised release for 14 months, even though the government had no intention of using him as a material witness or even probable cause to arrest him. In each instance, the court stressed that the government officer could not be held liable, even though the Constitution had clearly been violated.

Taken together, these rulings have a powerful effect. They mean that the officer who shot Michael Brown and the City of Ferguson will most likely never be held accountable in court. How many more deaths and how many more riots will it take before the Supreme Court changes course?

Bitch Stole My Look

I love Joan Rivers Fashion Police post awards shows.   From the garish to the gorgeous we can all watch and get that sometimes you are having more than just a bad hair day.

My favorite is the "Bitch Stole My Look" or akin to I believe one of the rags has "Who wore it better?"

Even the Onion did a satiric look at the military gear cops wear and they voted on who looked better... the only one I could see similiarities were gas masks...hard to tell who carries that one off.

And on Twitter this morning I read a link to an article about how American cops are like Latin American police now.  Well there you go.  I thought frankly we were looking a little third world and sometimes you need to wonder what are the differences.

So let's look at some photos to see if you know who and where they are from:
He probably did not like being called Bobby

Canadian Cops Guarding A Tie Horton's from US takeover? 

Robo Cop, Syria or America?
Department of Homeland Security or Israeli Cops 
Africa or America
Egypt or Texas

America or DC
North Korea Lady Cops they do wear it better

One of the Americas - your pick!
Germany or the US World Cup Soccer Team 

USA or Balkan



Russia or a new James Bond


And lastly - guess?