Wednesday, March 29, 2017

Asset Not Forfeit

As we move into a new era, which I am unclear of exactly, we are sure that whatever reforms regarding criminal justice will be utterly abandoned. One of the many issues of course will be the return of the 1033 program that at one point Obama had halted, but like the Terminator (don't say Arnold Schwarzenegger) its back!! I for one am thrilled that Podunk Town will now have missile launchers as a part of their police equipment.

But what is more disturbing is the notion of civil asset forfeiture. Yes, this is the money maker when it comes to law enforcement. The article below discusses just what the DEA has in cash, not property nor does it break down what local agencies have taken in their search and seizures. So yes America you can be driving across country and then end up on the bus.

Since 2007, the DEA has taken $3.2 billion in cash from people not charged with a crime

By Christopher Ingraham
The Washington Post
March 29 2017

The Drug Enforcement Administration takes billions of dollars in cash from people who are never charged with criminal activity, according to a report issued today by the Justice Department's Inspector General.

Since 2007, the report found, the DEA has seized more than $4 billion in cash from people suspected of involvement with the drug trade. But 81 percent of those seizures, totaling $3.2 billion, were conducted administratively, meaning no civil or criminal charges were brought against the owners of the cash and no judicial review of the seizures ever occurred.

That total does not include the dollar value of other seized assets, like cars, homes, electronics and clothing.

These seizures are all legal under the controversial practice of civil asset forfeiture, which allows authorities to take cash, contraband and property from people suspected of crime. But the practice does not require authorities to obtain a criminal conviction, and it allows departments to keep seized cash and property for themselves unless individuals successfully challenge the forfeiture in court. Critics across the political spectrum say this creates a perverse profit motive, incentivizing police to seize goods not for the purpose of fighting crime, but for padding department budgets.

Law enforcement groups say the practice is a valuable tool for fighting criminal organizations, allowing them to seize drug profits and other ill-gotten goods. But the Inspector General's report "raises serious concerns that maybe real purpose here is not to fight crime, but to seize and forfeit property," said Darpana Sheth, senior attorney of the Institute for Justice, a civil liberties law form that has fought for forfeiture reform.

The Inspector General found that the Department of Justice "does not collect or evaluate the data necessary to know whether its seizures and forfeitures are effective, or the extent to which seizures present potential risks to civil liberties."

In the absence of this information, the report examined 100 DEA cash seizures that occurred "without a court-issued warrant and without the presence of narcotics, the latter of which would provide strong evidence of related criminal behavior."

Fewer than half of those seizures were related to a new or ongoing criminal investigation, or led to an arrest or prosecution, the Inspector General found.

"When seizure and administrative forfeitures do not ultimately advance an investigation or prosecution," the report concludes, "law enforcement creates the appearance, and risks the reality, that it is more interested in seizing and forfeiting cash than advancing an investigation or prosecution."

The scope of asset forfeiture is staggering. Since 2007 the Department of Justice's Asset Forfeiture Fund, which collects proceeds from seized cash and other property, has ballooned to $28 billion. In 2014 alone authorities seized $5 billion in cash and property from people -- greater than the value of all documented losses to burglary that year.

In most of the seizures examined by the Inspector General, DEA officers initiated encounters with people based on whether they met certain criteria, like "traveling to or from a known source city for drug trafficking, purchasing a ticket within 24 hours of travel, purchasing a ticket for a long flight with an immediate return, purchasing a one-way ticket, and traveling without checked luggage."

Some of the encounters were based on tips from confidential sources working in the travel industry, a number of whom have received large sums of money in exchange for their cooperation. In one case, officers targeted an individual for questioning on a tip from a travel industry informant that the individual had paid for a plane ticket with a pre-paid debit card and cash.

Most individuals who have cash or property seized by law enforcement do not dispute the seizure. There's no right to an attorney in forfeiture proceedings, meaning defendants must foot the bill for a lawyer themselves. In many cases, forfeiture amounts are so small that they're not worth fighting in court.

Forfeiture cases are also legally complex and difficult for individuals to win. Forfeiture cases are brought against the property, rather than the individual, leading to Kafkaesque case titles like United States v. $8,850 in U.S. Currency and United States of America v. One Men's Rolex Pearl Master Watch.

While criminal proceedings assume the defendant's innocence, forfeiture proceedings start from the presumption of guilt. That means that individuals who fight forfeiture must prove their innocence in court.

For these reasons, many defendants don't bother disputing forfeitures. The Inspector General's report, however, finds that those who do often get at least a portion of their cash returned. Only one-fifth of people who had their cash seized by the DEA disputed the seizures in court. But among those who contested the seizure, nearly 40 percent ended up getting all or some of their cash returned, suggesting that the DEA's forfeiture net ensnares many individuals not involved in wrongdoing.

In a written response to the Inspector General, the Department of Justice said it had "significant concerns" with the report, noting that global criminal enterprises launder trillions of dollars annually and calling asset forfeiture "a critical tool to fight the current heroin and opioid epidemic that is raging in the United States."

It also took issue with the Inspector General's analysis of the 100 DEA cash seizures it examined, saying more of them were connected with criminal activity than the report suggested.

The Inspector General stood by the report and dismissed the Department's concerns as "assumptions and speculation." The Drug Enforcement Administration did not respond to a request for comment.

"Nobody in America should lose their property without being convicted of a crime," said the Institute for Justice's Sheth. "If our goal is to curb crime, we should simply abolish civil forfeiture" and only forfeit property after a criminal conviction is obtained, she added.

Monday, March 27, 2017

Poor Care

When you are poor medical care is biased and based on the ability to pay. Even today with the Affordable Care Act there are serious gaps that have put people in serious financial jeopardy despite possessing insurance. That said the GOP alternative to not have hospital stays covered is laughable as most of the new plan was.

The ACA needs repair and we need to examine across the board how hospitals and medical centers and physicians are covered and in turn compensated. Which means a thorough investigation into billing practices and standards of care as defined by a national board that is supposed to do that but it seems to have little to no relevance when accrediting hospitals and those Physicians that are affiliated with it.  This is is just one of many stories about Harborview as is this about Patient Grievances regarding sexual assault while in their care. and even a very middling Consumer Report safety rating.    
Most people are ill informed and take little notice of their local facility unless they are placed within it.  In the period of 2012 to 2015,  I found numerous incidents and all of public record (which makes one wonder about the rest) about the bizarre ethics by Harborview Medical Center staff.

When I was mistreated by Harborview Medical Center in Seattle it fell under the management of the University of Washington. It served the original mandate by King County to treat all indigent patients regardless of the ability to pay but also as a teaching hospital.  In addition, they are supposedly the number one trauma center for 5 states and take that extremely possessively, demeaning other hospitals for daring to step in and do their job.  In addition they are to treat all the criminal population in both the County and City jail. In a city with a massive homeless population it is bursting at the seams and for decades has been nicknamed Harborzoo for the sheer volume of patients who are neglected and set into halls, strapped to beds and drugged as an alternative to jail.

Many of those on Medicaid and Medicare love the dump but the reality is that it makes the Veteran's Hospital seem first class. Little is done and thanks to issues that I wrote about in the last blog, malpractice cases rarely make it past go to highlight how bad it truly is. But the poor don't complain but they should and this story about Howard University Hospital was not something that shocked me in the least. Read the book, The Immortal Life of Henrietta Lacks, to understand how vulnerable a group that those of color are when it comes to medical care.

I am a white woman but I had no family, no advocates and was thought uninsured so it made it easy for Harborview to throw me into the street as a deranged brain damaged woman. I often wonder why I survived but I think it was to tell others that while color is the easy marker, gender and age are also reasons/excuses or justifications by those in authority positions to dismiss and disregard US.

Howard University Hospital shows symptoms of a severe crisis

By Cheryl W. Thompson March 25 2017

Where medical mishaps become serious: The woes of Howard University Hospital

When Howard University Hospital opened its doors as Freedmen’s in Northwest D.C. in 1862, it stood out for the medical care it offered freed slaves and became an incubator for some of the country’s brightest African American physicians.

But over the past decade, the once-grand hospital that was the go-to place for the city’s middle-class black patients has been beset by financial troubles, empty beds and an exodus of respected physicians and administrators, many of whom said they are fed up with the way it is run. The facility has faced layoffs, accreditation issues, and sexual harassment and discrimination lawsuits, and it has paid out at least $27 million in malpractice or wrongful-death settlements since 2007, a Washington Post examination has found.

The Post reviewed more than 675 medical malpractice and wrongful-death lawsuits filed since 2006 involving six D.C. hospitals: Howard University, George Washington University, MedStar Georgetown University, Providence and Sibley Memorial hospitals and MedStar Washington Hospital Center. Of that group, Howard had the highest rate of death lawsuits per bed.

The $27 million paid out by Howard represents just 22 of the 82 cases filed against the hospital and tracked by The Post; the terms of most of the settlements were not made public.

The Post also found that Howard University Hospital has frequently been cited by the District for violating the hospital’s own policies, as well as local and federal laws. City health regulators have documented dozens of problems, including little oversight of medical residents, inoperable emergency room equipment, sloppy record-keeping and a lax nursing staff.

“Howard has had a lot of instability in leadership, particularly at the hospital, which has made it difficult to have a sustainable strategy,” said Chiledum Ahaghotu, the hospital’s former chief of urology and a Howard alumnus who resigned in 2015. He now is vice president of medical affairs at MedStar Southern Maryland Hospital Center. “Accountability is an issue.”

It is very difficult to compare one hospital to another or even rate individual facilities because there are few requirements for hospitals to report their data to government agencies. But the lawsuits, other publicly available documents and more than three dozen interviews with patients, doctors, nurses, administrators and others show a hospital that is struggling.

Howard officials hired California-based Paladin Healthcare in October 2014 to oversee its day-to-day management and try to turn things around. The hospital posted a $58 million loss in fiscal 2014; the loss was $19 million in 2015, according to figures provided by the university.

Michael Rembis, the chief executive officer of Paladin Healthcare Management, did not return three calls seeking comment.

“It’s going through a challenging time right now, and I think they’re trying to figure out the next step,” said Oritsetsemaye Otubu, a family medicine physician who left the hospital in June after five years “to pursue other interests.” She said her patients often complained about not being able to make appointments because no one answered the hospital phones.
Howard University President Wayne A. I. Frederick, center, discusses a plan to improve Howard University Hospital at a news conference in September. (Marvin Joseph/The Washington Post)

Howard University President Wayne A.I. Frederick, a physician who also oversees the hospital, said at a news briefing in the fall that the medical facility has made “significant strides in achieving our financial and operational stability.” Officials announced that the hospital had a $4.3 million surplus at the end of June, the first time since 2012.

“We recognize we have a lot more to do,” Frederick said.

The surplus came a month after officials announced they were reducing the hospital’s workforce by 110 employees. Hospital officials now say the surplus is $21 million, even though operating revenue has remained about the same.

Frederick has raised the idea of selling the hospital, which has been a financial drain on the university, and said at the briefing that Paladin Healthcare could be “a potential owner.”

Frederick declined six interview requests from The Post, which then emailed him a series of specific questions about its findings. He declined to answer those questions and instead released financial data and a statement on the hospital’s background, noting its “commitment to high standards and quality patient care.”

Former Howard University president H. Patrick Swygert said the hospital continues to be an important partner for the medical school and D.C. residents.

“It’s been a major resource for the community for a very long time,” said Swygert, who headed the institution from 1995 to 2008. He declined to discuss the current status of the hospital, saying he’s “been away too long.”

Robert L. DeWitty Jr. always thought he would retire from Howard University Hospital. The cancer surgeon’s relationship with the hospital began in 1968 when he arrived as a medical student. He remained there through his surgical residency and was on staff for more than 30 years until August 2015, when he severed his ties, citing “an unhealthy environment.”

DeWitty said the problems start “at the highest level of management.” “I decided instead of spending the rest of my days being in an environment that was unhealthy, I would leave and go to another hospital.”

DeWitty, who now practices at Providence Hospital in Northeast Washington, said Howard has been on a rapid decline for years, prompted in part by the 2001 shuttering of the city’s only public hospital, D.C. General.

“When it closed, we became the city hospital — unofficially,” he said. “Patients have to go somewhere, and they may be discouraged from showing up at certain places.”

DeWitty described Howard University Hospital as the “second D.C. General” because it became the place where many of the city’s poorest residents would go for health care, which contributed to the hospital’s financial troubles.

“I think it probably did play a role,” DeWitty said. “It was a combination of things that made us more financially strapped than I think we should have been.”

The hospital also is poorly run, with staff often taking a year or more to bill patients, he said. Frederick acknowledged at the fall news conference that billing has been an issue, and hospital officials attributed the hospital’s financial difficulties in part to a decline in inpatient admissions.

The teaching hospital has struggled repeatedly to maintain several of its residency programs. The Chicago-based Accreditation Council for Graduate Medical Education has withdrawn the accreditation of residency programs at Howard more often than at any other D.C. hospital in the last 15 years, records show.

Howard has lost accreditation for five training programs since 2002, the council’s database shows. George Washington Hospital, MedStar Georgetown and MedStar Washington Hospital Center have lost accreditation for one program in the same time period.

The Howard programs that have lost accreditation are emergency medicine, pediatrics, urology, radiation oncology and diagnostic radiology. None of the five programs have been reaccredited, according to records. The ACGME withdrawals typically occur after repeated warnings, according to Emily Vasiliou, a spokeswoman for the accreditation council.

“We’ve lost a lot of programs,” DeWitty said. “And a lot of scholarships, too, because of that.”

Vasiliou said hospitals cannot use public money to employ residents from programs that aren’t accredited.

Jullette M. Saussy, the former medical director of D.C.’s Fire and Emergency Medical Services Department, said the hospital’s problems are widespread, from empty beds to a troubled emergency room.

“I know they’re having a hell of a time in the ER and having a hell of a time staffing it,” said Saussy, who resigned from her D.C. position in February 2016. “It’s a broken system at Howard.”

Wayne Moore, another former medical director of D.C. Fire and EMS, said he considered the hospital a “dumping ground” during his tenure.

“Certainly for the drunks and homeless and the undesirables,” said Moore, who also worked in Howard University Hospital’s emergency room before leaving in 1999.

Moore said the facility has a history of “bad care and long waits in the emergency room,” and it wasn’t unusual for patients to be left in the hallways or on gurneys.

David Rosenbaum was one of them.

Rosenbaum arrived as a John Doe at Howard’s emergency room in January 2006 after being found on the street without identification. A paramedic told a nurse he was drunk. Hospital workers failed to perform basic assessments that could have indicated the seriousness of his injuries, according to a D.C. inspector general’s report. He lay on a gurney for several hours before anyone took him to the operating room, records show. He died less than 48 hours after arriving at the emergency room.

Rosenbaum was a longtime New York Times reporter who had been mugged while taking an after-dinner stroll in his Friendship Heights neighborhood. His death sparked national outrage and sullied the hospital’s reputation. His family sued the city and the hospital, demanding that officials take steps to ensure nothing like that happened again.

The incident was supposed to be a turning point for the city’s emergency medical services and for Howard University Hospital. But at least for the hospital, it wasn’t.

Solomon J. Okoroh was known at Classic Cab Company in D.C. for picking up every fare. He needed the money to help provide for his wife and their five children, one of whom was a student at Howard University and played on its basketball team.

Shortly before 3 a.m. on June 4, 2013, Okoroh picked up two young men in Adams Morgan in Northwest Washington. Minutes after climbing into Okoroh’s taxi, one of them shot him in a botched robbery. Three undercover D.C. police officers heard a gunshot and a revving car engine. Then, Okoroh’s Ford Explorer taxi whizzed by and shots were fired inside the SUV again before it crashed.

Both suspects fled; paramedics found Okoroh bleeding heavily from his shoulder, court records show. They took him to Howard University Hospital for treatment.

Okoroh lay unattended on a gurney for 70 minutes because there was no bed available, and nurses were unable to take his blood pressure because of a “machine malfunction,” his family alleged in a lawsuit filed in 2015. When Okoroh was moved to a bed, his neck was “extremely swollen” and he was “twisting and turning,” according to the lawsuit. It was only after Okoroh was unable to breathe that the medical team realized he had been shot twice. Okoroh, 59, died within minutes.

His wife, Patience, described what happened to her husband as “horrible.” The lawsuit was dismissed in December after she decided that the matter was “going on too long,” according to her attorney, C. Jude Iweanoge.

“It was putting too much pressure on her and her family,” Iweanoge said. “She didn’t want her children to relive this.”

Okoroh said dropping the lawsuit gave her “a little peace.”

Frederick declined to comment, but the hospital released a statement saying that “Howard University does not discuss specific issues regarding individuals who receive health care services at Howard University Hospital.”

D.C. taxi driver Mohammed Nur was used to making runs to pick up fares from Howard University Hospital.

But this sweltering July 2012 evening was different.

When Nur pulled up in front of the hospital at 7:45, Patricia Moore was waiting in a wheelchair, accompanied by a hospital staffer. The 61-year-old Moore, who suffered from asthma and other ailments, had come to the emergency room four days before complaining of shortness of breath. Doctors diagnosed her with fluid around the heart, records show.

“I said, ‘What’s going on?’ ” Nur recalled in an interview. “She was alert but very, very weak. I don’t know why they released her.”

Moore, unable to walk unassisted, was helped into the cab for the 10-minute ride home to Wah Luck House, an assisted-living housing complex in nearby Chinatown. Lasan Baldwin, a home health aide who worked for other tenants in the building, said a hospital social worker called her, saying they needed someone to be there when Moore came home.

“I don’t know why they called me,” Baldwin said in an interview. “She has family.”

Baldwin said she was stunned when she saw Moore, the mother of one grown son.

“She didn’t have no shoes on and she was in a hospital gown — her whole butt was out,” Baldwin recalled in an interview. “I told the cabdriver, ‘They sent her home like this?’ ”

Nur said he had never seen anything like it in his 20 years of driving a cab.

“It was sad,” he said. “I told the aide to take care of her.”

Baldwin said she sat Moore in a chair in the lobby and went to her ninth-floor apartment to retrieve her inhaler and walker. She returned minutes later to find Moore slumped in the chair.

Baldwin called 911, and paramedics took Moore back to Howard, where she died the next day.

“Every time I think about what happened to Miss Patricia, I want to cry,” Baldwin said, adding that she used to bring McDonald’s hamburgers to Moore and a friend, a Catholic nun, who often visited her.

Moore’s son sued Howard University Hospital, which settled the case in 2015 for an undisclosed amount. Hospital officials declined to discuss the matter.

Moore’s younger sister, Kathleen, said she was appalled to learn that the hospital sent her home alone, unable to walk, still ailing and scantily clad.

“For the sake of human decency, why anybody allowed that to happen is mind-boggling,” Kathleen Moore said. “It was just awful.”

Moore said she regrets allowing her sister to go to Howard.

“When I heard she was taken there, I thought it had high standards,” Moore said. “I was so, so surprised. You always feel like people are in good hands at a hospital.”
Assessments are tricky

Measuring a hospital is complex because there are few public metrics, according to health policy and patient safety experts.

“It’s very difficult to come up with comprehensive measures of quality,” said Martin Makary, a surgeon who teaches health policy at the Johns Hopkins Bloomberg School of Public Health. “That’s what everyone wants, but we have to do it carefully. We don’t want to punish doctors who take on high-risk quality.”

Some patients consider being satisfied with their doctor a good metric, Makary said. But it’s not, because “it doesn’t tell you if the doctor prescribes too much medicine or whether they have a lot of experience,” he said.

Hospital infection and readmission rates also may be good measures of quality, but they are not comprehensive, Makary said.

Tejal Gandhi, a physician and chief executive officer of the National Patient Safety Foundation, agreed that it is difficult — but not impossible — for the public to find data to measure a hospital’s quality.

“It’s not that we don’t want to have good metrics,” said Gandhi, an associate professor at Harvard Medical School. “It is challenging and labor-intensive to have good, robust metrics.”

The federal government rates a variety of aspects in health care, including readmission and death rates, and timeliness and effectiveness of care. Data from the Centers for Medicare and Medicaid Services, which compares hospitals across the country, found that Howard University Hospital performed worse than other hospitals in some key categories.

For instance, the average wait time for a patient visiting Howard’s emergency department before being seen by a health-care professional was 113 minutes, compared with 27 minutes nationally and 79 minutes at other high-volume D.C. hospitals that serve roughly 40,000 to 60,000 patients per year, according to data released in December, the most recent available.

While Howard University Hospital was worse than the national average for the amount of time patients stayed in the emergency room before being admitted — 415 minutes, compared with 295 minutes nationally — it fared better than other high-volume District hospitals, which averaged 464 minutes, the data showed.

The average time that patients who came to Howard University Hospital’s emergency department with broken bones waited before being administered pain medication was 101 minutes, nearly 40 minutes longer than other D.C. hospitals. Nationally, patients waited 52 minutes.

The federal government in 2015 began awarding star ratings based on patient appraisals. The ratings are based on patient experiences with medical professionals, including communication and whether they would recommend a hospital. According to the most recent ratings on Medicare’s website, Howard University, George Washington University, Providence and MedStar Georgetown University hospitals got one star out of five. MedStar Washington Hospital Center got two stars, while Sibley Memorial was rated a three-star hospital.

The D.C. Health Regulation and Licensing Administration inspector entered the Neonatal Intensive Care Unit at Howard University Hospital at 2:55 p.m. on July 22, 2015, and counted six fragile newborns. She looked around for a nurse but saw none, even though three are assigned to the unit.

After walking the length of the nursery, she found an employee “around a corner where s/he could not observe the patients and was out of direct vision of anyone entering the nursery,” according to a health department inspection report obtained under the District’s Freedom of Information Act. The nurse was on her cellphone, and the inspector cited the hospital for “failing to provide a safe environment” for infants in the NICU, a violation of the D.C. Nurse Practice Act.

It is one of dozens of deficiencies found at the hospital over the past decade by city health regulators who are supposed to review D.C. hospitals annually for compliance with everything from laws to delivery of patient care. The inspections show lax oversight at Howard.

“If we find anything egregious, we make sure it’s taken care of before we leave the hospital,” said Sharon Lewis, senior deputy director with the D.C. Department of Health’s Health Regulation and Licensing Administration.

The agency typically doesn’t do periodic reviews to determine whether a hospital has corrected the deficiency, Lewis said. Instead, it checks back the next year during the annual review.

A complaint filed in July 2015 alleged that Howard University Hospital allowed a resident fellow to practice medicine without a license for a year, a violation of D.C. law. A health department review substantiated the allegation. That review also found that 10 of the hospital’s 26 medical fellows “lacked documented evidence” that they took the required CPR classes.

An inspection of Howard University Hospital last March found various problems: an inoperable defibrillator in the emergency room and a lack of documentation showing that medical staff had the required biennial tuberculosis screening and/or physical health exam “in accordance with established District of Columbia Municipal Regulations for Hospitals.”

In 10 of 26 cases — nearly 40 percent — Howard University Hospital staff failed to document whether pain-relieving drugs and other controlled substances were given to patients as ordered or given in a timely manner. In some instances, the drugs — Percocet, OxyContin, morphine and others — were removed from the automatic dispensing machine with no record that they were administered, according to the inspection report. Similar deficiencies were found in 2015 and 2014, records show. In one case, 11 of 13 doses of pain medication were given to a patient more than an hour late.

In another instance, a physician wrote an order for an addict to restart methadone without specific directions. There was no indication that the doctor was registered with the Drug Enforcement Administration or that the patient was in a treatment center as required by federal law.

Howard University Hospital came under scrutiny in 2007, after inspectors found the remains of 25 newborns and fetuses in its morgue, some of which had been there for several years.

The city’s health department also has cited Howard University Hospital several times for failing to provide proper care and treatment for patients with diabetes, records show.

When Frances Barnes, a retired postal worker, was admitted on Aug. 22, 2008, for a possible stroke, her family felt confident that Howard’s medical team would make her better. The hospital designated the 80-year-old Barnes, a diabetic, a high-risk patient and laid out a plan: She would be seen by a nutritionist, have a soft care bed, be turned every two hours and have a weekly skin assessment. They ordered anti-embolism stockings to help her circulation, with orders from the doctor to remove them “at least once per shift” for at least 30 minutes, according to records.

But health department documents show that the nurses failed to remove the stockings for three days at a time on three separate occasions, and they didn’t document problems with Barnes’s feet during the weekly skin assessment. It was only after Barnes’s family entered her hospital room and noticed “an extremely foul smell” that they learned of the sores, recalled Sandra Ford, one of Barnes’s eight children.

“I took her sock off and there the sores were on her foot,” Ford said. “They were big and black. I was shocked.”

The sores spread so fast that doctors had to amputate Barnes’s leg below the knee, Ford said.

Barnes’s granddaughter, Shelly Ford-Jackson, filed a complaint against the hospital, questioning the quality of Barnes’s care. Ford-Jackson is a supervisory health licensing specialist for the D.C. Department of Health.

Shelly Ford-Jackson stands on the porch of her home in Landover, Md. She filed a complaint against the hospital, questioning the quality of the care her grandmother received. (Marvin Joseph/The Washington Post)

“I kept a journal and noted everything that was going on,” she said. “I saw so many things that were done inappropriately.”

The health department found that the hospital’s nursing staff “failed to follow the standard of care” in treating Barnes, city records show.

“Final analysis determined that a violation of law was found and a deficiency was cited,” according to a health department letter to the family.

The hospital agreed to devise a plan of correction that included developing written guidelines on managing patients with anti-
embolism stockings and random monitoring of those patients three times a week for 90 days.

Barnes died on Feb. 2, 2009. Her family sued Howard University Hospital the following year and settled the case in 2011 for an undisclosed amount, court records show.

Hospital officials declined to comment on the case.

“There was blood on his blanket,” Julio Palma Jr. recalled. “But he not feel when he hurt his foot.”

The younger Palma said he called the nurse twice, who promised to take care of it.

“Nobody show up,” he said. “I was there for maybe an hour and a half. I call him [the elder Palma] in the morning and ask him if someone show up and he said ‘no.’ ”

Nurses wrapped the injured foot in gauze and discharged Palma. When his wife and a daughter cleaned him, they noticed that his big toe was black.

“They sent him home like that,” his daughter Gisa said through an interpreter.

Palma returned to the hospital to see a specialist, and “that’s when we got the bad news that they were going to cut off his big toe,” his son said.

Despite the amputation, the wound didn’t heal, so they cut off a second toe three weeks later, according to court records. Seeing no improvement, Palma went to another hospital.

“The specialist there said he had to cut higher because there was an infection,” his son said. “We never went back to Howard.”

Palma’s family said the amputations changed his life. He could no longer drive. Or work. Or dance with his wife of more than 40 years. He sank into depression.

“It was all because of Howard,” Gisa said. “They could have prevented that.”

Hospital officials declined to comment on the case.

Palma and his wife, Bertalisa Sagastume, sued the hospital in federal court in 2008 and settled for $90,000, according to their children.

D.C. Fire and EMS Chief Gregory M. Dean said that he sympathizes with families who have “compelling stories” about their experiences at Howard University Hospital, but he said that the facility is sorely needed in the nation’s capital.

“Howard is a teaching hospital,” Dean said. “It’s an institution and an incredible part of the District.”

Tort Anyone?

Lawyers who make laws. Hmm conflict of interest? Oxymoron? Or the ways laws should be written?

I am on the fence with how laws are written as clearly no one actually reads them. The reality is that we are a country of laws, written and administered and in turn implemented or rejected by those who write them.  And those are Lawyers or are they?  This is the breakdown of Congress in 2013 and not much has changed since that as we all know the dipshits are re-elected regardless.  I question our "Democrat" Jim Cooper here in Nashville as not really a Democrat as he does not describe himself as such and we could use some actual legislation that might actually represent the composition of Nashville. 

Now true we have a big animal Veternarian, Medical Doctors, a former Reality Star, (actually not just Trump check Wisconsin on that one), a Pizza parlor owner (not the one that was a pedophile sex trafficking ring that was another Lawyer who made that one up however!)  And in reality actually few in Congress are actually Lawyers!!  What?  Yes few are funny isn't.   But also Members of Congress are sixty-eight times as likely as all American adults to have practiced law.

The Supreme Court is the only body of our Government that one actually must be a practicing Lawyer/Judge.  Or so you believe.  Nope
The United States Constitution contains no prerequisites for appointment to the Supreme Court. How many U.S. Supreme Court justices have not been lawyers and what were their names?
You are certainly correct about qualifications (or lack of same) to be considered for the Supreme Court. But every single justice on the court, dating back to John Jay, has been a lawyer; each one either attended law school, took law classes, was admitted to the bar, or practiced law.

Thought you needed a businessman in the White House well how about in a gig for life reviewing all the laws of the land. Trump hates Judges and on this one I have a slight agreement, they are not infallible nor are they under any supervision, guidance or any type of oversight.  This I believe contributes to many problems we are seeing across the country with regards to both civil and criminal law and the odd decisions and behaviors being exhibited by many Judges.  That and that are elected and not appointed by a bi-partisan committee to whom they report and are responsible to.  Truly why are we voting for Prosecutors and Judges, we know nothing about them other than bullshit promises and that means what exactly.  Note that this is often mentioned with regards to Justice reform and like everything else utterly ignored.  To quote a Nashvillian: "I don't know anything about that!"

I have immense respect for Ralph Nader until he drank the kool aid that convinced him he needed to run for President.  And while I respect that and it drew attention to the two party system and its failures it may have led to a Presidency and in turn a series of events that we can now look back in anger/amazement/shock or hey not that bad considering what is in office right now.   But in turn much of what he said came to fruition.  The reality is that Democratic party sabotaged a valid candidate and what Russian could not do the Republicans managed to shoot themselves in the foot, arm and whatever body parts were left during that bizarre primary campaign. 

But now as we have the Dictator in Charge the reality is that the republic might actually become one - some cross between a Banana one and the Soviet model.  This comes in the form of disparaging the media and the source of information becomes part propaganda part bullshit and then slowly civil rights are eroded by access and in turn openness.

The first started decades ago when the banks and lenders put in an arbitration and mediation clause in all agreements to settle differences when a customer felt wronged.  The tech sector has been doing this for decades as well as a way of data mining and generating profit.  Who actually reads all the information in that agreement we check when we buy a new phone or laptop?  Then employers placed these in contracts to prevent those from often seeking jobs outside the company, under the idea of non compete and in turn prevent any whistleblowing by those who found company errors. And yes our beloved Obama Administration had no problem prosecuting whistleblowers who violated said agreements and laws in place to prevent or deter said blowers of the whistle.

Tort reform has long been a mainstay of the Republican mantra. And with Dr. Tom Price now in charge of DHS expect that will become a signature of import when it comes to Malpractice.  In many States now it is already a massive hurdle to overcome laws put in place to file a suit against a hospital or Doctor.  I live in Tennessee and they are not any different than Washington State that had both the mediation clause in the law and the mediators had to come from whom - medical providers - and in turn restored the contributory law and reduced secondary damage awards.

This I know from personal experience as I had to file my case pro se as no Attorney would touch my case as I was still alive and functioning.  Those are two factors that can severely affect one's case.

A person who has been injured by medical malpractice in Washington State should consider:
  • Any medical negligence-type claim from the state of Washington must be filed within three years of the malpractice, or within one year of discovering the injury
  • Washington State has no cap on damages, but it does place limits on the amount that an attorney can bill and collect for legal services in medical malpractice actions, thus limiting the overall costs to both plaintiffs and defendants upon resolution of a case
  • Parties to a medical malpractice case must participate in mandatory mediation, which has no effect on their right to a jury trial, but is a statutorily mandated pathway to filing medical malpractice lawsuits in Washington
  • Washington is a “pure comparative negligence” jurisdiction that allows recovery of damages regardless of the relative liability of the injured party
  • Expert testimony is not mandated by statute to validate the injured party’s claim, but most medical malpractice cases in Washington State require expert testimony to verify a deviation from medical standards

Important Deadlines Pertinent to Medical Malpractice Cases in Washington

The state of Washington gives an injured party a generous three years to file a claim after an occurrence of medical malpractice but provides a less generous one-year period if the injury is discovered later than the initial three years, expected immediate discovery period in cases of obvious medical malpractice. Further, the state has an absolute eight-year statute of repose that will prevent any claims from proceeding if they are filed more than eight years after the malpractice
Washington State also treats medical malpractice claims by minors differently than many other states, specifically, in Washington State, the time limit for starting a claim does not begin to run until a person’s eighteenth birthday. A minor’s parents can still initiate a medical malpractice claim before the child turns eighteen. If that case is not filed, then the child will typically be subject to the one-year filing period after his eighteenth birthday as his injuries will probably be known by then.
Washington State’s various statutes of limitations can run into each other and defeat a party’s claim if the injured party fails to follow the rules. For example, the Washington requires mandatory mediation, and a party’s good faith request for mediation, which must occur before filing a lawsuit, that will delay the deadline for filing the lawsuit by one year. Lawsuits filed before mediation requests if other deadlines are not met, are subject to dismissal. Having a practicing medical malpractice lawyer in Washington will be essential to gaining specific clarity on the dates and statutes of limitation applicable to your individual case.

Damages Statutes in Washington Medical Malpractice Laws Explained

Washington State does not cap damages that a party may receive in a medical malpractice action. It does apply a formulaic approach to calculating noneconomic damages as a function of an injured party’s income and lifestyle.  Washington State also exposes attorneys’ fee to a Court’s scrutiny to determine if those fees are reasonable.  Additionally, a party’s damages will be reduced in proportion to his relative liability for his injuries. Unlike several other states, Washington State will not refuse all damages if a party is more than fifty per cent liable.  If more than one doctor or facility caused the medical malpractice, Washington State treats them as “joint and several” tortfeasors and allows the injured party to collect the full amount of damages from any one of the ostensibly liable parties.

Verification of Claims via Expert Testimony in Washington Medical Malpractice Cases

Although not required by state statute, most or all medical malpractice claims in Washington State are supported by expert testimony to verify claims that standards of medical care were not met or followed. The depth and extent of expert testimony will vary with the facts of each case.
Filing a medical malpractice case in Washington State can be favorable to a plaintiff, but given legal fee review and limitations, they may not be favorable to all Washington attorneys. Persons who believe that they have been injured by a physician’s or treatment facility’s malpractice in Washington State should nonetheless consult with legal counsel at the earliest possible date to preserve and protect their potential claims via an experienced and practicing medical malpractice lawyer Washington state.

 I tried and lost despite the fact that my case was solid. I lost as I had not filed the forms with the State appropriately deemed by law informing them that I was suing them.  That I was suing a State run hospital that is one more hurdle that is added to further eliminate the rights of citizens to sue any agency of the State regardless of the type.

As for the lack of experts (which I had yet to hire as that too is another expensive hurdle)  was debatable and cited in the Summary Judgement but that was not the issue by the Appeals Court they focused on that filing form and that yes the law does not mandate experts but it should have been addressed by the plaintiff.  They never mentioned the mediation clause which is where the case should have been remanded according to the law but again how one files matters.

This is Tort Refom. And it is coming your way.  Mr. Nader wrote this for Harper's Magazine. 

The story of how tort law originally evolved from its roots in medieval England is a story of millions of actors and judicial decisions that proceeded in small but steady advances. These advances embodied the democratic principles on which our country was founded and together make up a revolutionary process of personal-conflict resolution. Tort law allows an individual who believes that he or she has been wrongfully injured in person or property to retain an attorney on a contingency fee, paid only if the plaintiff prevails. After a lawsuit has been filed, and has survived a defendant’s motion to dismiss, the plaintiff’s attorney may compel the defendant, be it a person, a corporation, or a city’s police department, to disclose factual information regarding the claim. State and federal procedures urge the contending parties to exchange all relevant information beforehand in an attempt to encourage settlements and expedite any eventual trial. The court proceedings, should there be any, are open to the press and the public. Verbatim transcripts of the trial testimony are made. In pursuit of what is called “truthful evidence,” attorneys for both sides can vigorously cross-examine witnesses. Settlement can occur at any time, but if one does not occur, the trial jury is responsible for returning a verdict and assessing damages. The judge has the authority, though it is rarely invoked, to reduce or increase the damages if he or she thinks the jury is way off base. The losing party can then appeal, again in open court. The media can track the proceedings from start to finish. No decisions by the other two branches of government come close to being so clearly refereed, so open, and so subject to public review.
The reality is that many people are entitled under the law to the truth but as we now realize the truth are just alternative facts in which we can choose those that fit our beliefs.  I believe we are in deep trouble that our rights are in jeopardy and they are by those who have no knowledge or experience in the law. When I defend a Lawyer I know we are fucked, without dinner so there will be no torte for dessert. 

Same Old Same Old

Well as we move towards the 100 day mark we have seen a pattern of the Trump Doctrine emerge:
  • Make grandiose promises. Have confusing messages regarding grandiose promises. 
  • Have conflicting messenger to deliver equally confusing and conflicting messages. 
  • Lay blame on others for their failures of the inability to deliver said grandiose promises. 
  • When that again fails find new targets to blame. 
  • Never criticize Russia. 
  • Deny Facts and blame fake news and in turn quote, cite and source fake news to validate confusing messaging and blame making. 
  • Do it all on Twitter.

When I read this I thought this is the drain the swamp portion of the grandiose promises, by putting a kid in charge who has little to no more experience than the big guy, the only difference is that one's big daddy actually served time. The guardians of the gate are now family members with a vested interest in keeping the family name as clean as possible so that once this foray into Government ends they can go back to their day jobs.

These promises of fixing what is broke has been said repeatedly by many Administrations and then the reality of Governing kicks in. The fiefdoms, the cluster fucks, the cliques and the power brokers all have their own vested interests and they too are conflicting and equally confusing but they have the messaging down to a fine art. Say what the rubes need to hear and say it repeatedly.

60 Minutes did a story last night on Fake News and profiled a strange man with a site that sounded much more like a porn site. What was interesting is  that its author/founder felt proud that he being a Lawyer some how enabled him (in between sex sessions with a male prostitute and dominatrix whose safe word is Hillary) to write whatever shit he made up in his head. Well blood flow in men from the brain drains to the penis as we know pre and post sex so that might explain it. That and the law degree. One thing he did convince me was that people confused about their sexuality and are also Lawyers are angry queens that wield big dicks. One doesn't need to be both but wow that bar exam shows me that anyone can pass it regardless of what the ABA says. Again read a "blawg" to see how far the idiocy runs in that profession. Fake news or just assholes being assholes. In other words the same old same old.

Re-branding and re-doing what already exists by calling it something else is just that. Yes I see the Tech sectors influence all over this one. Down to the angry queen and he too went to law school, Peter Thiel, irony that he tells people to dump education however... hmm easier to manipulate perhaps?

Trump taps Kushner to lead a SWAT team to fix government with business ideas

By Ashley Parker and Philip Rucker The Washington Post March 26 2017

President Trump plans to unveil a new White House office on Monday with sweeping authority to overhaul the federal bureaucracy and fulfill key campaign promises — such as reforming care for veterans and fighting opioid addiction — by harvesting ideas from the business world and, potentially, privatizing some government functions.

The White House Office of American Innovation, to be led by Jared Kushner, the president’s son-in-law and senior adviser, will operate as its own nimble power center within the West Wing and will report directly to Trump. Viewed internally as a SWAT team of strategic consultants, the office will be staffed by former business executives and is designed to infuse fresh thinking into Washington, float above the daily political grind and create a lasting legacy for a president still searching for signature achievements.

“All Americans, regardless of their political views, can recognize that government stagnation has hindered our ability to properly function, often creating widespread congestion and leading to cost overruns and delays,” Trump said in a statement to The Washington Post. “I promised the American people I would produce results, and apply my ‘ahead of schedule, under budget’ mentality to the government.”

In a White House riven at times by disorder and competing factions, the innovation office represents an expansion of Kushner’s already far-reaching influence. The 36-year-old former real estate and media executive will continue to wear many hats, driving foreign and domestic policy as well as decisions on presidential personnel. He also is a shadow diplomat, serving as Trump’s lead adviser on relations with China, Mexico, Canada and the Middle East.

The work of White House chief strategist Stephen K. Bannon has drawn considerable attention, especially after his call for the “deconstruction of the administrative state.” But Bannon will have no formal role in the innovation office, which Trump advisers described as an incubator of sleek transformation as opposed to deconstruction.

The announcement of the new office comes at a humbling moment for the president, following Friday’s collapse of his first major legislative push — an overhaul of the health-care system, which Trump had championed as a candidate.

Kushner is positioning the new office as “an offensive team” — an aggressive, nonideological ideas factory capable of attracting top talent from both inside and outside of government, and serving as a conduit with the business, philanthropic and academic communities.

“We should have excellence in government,” Kushner said Sunday in an interview in his West Wing office. “The government should be run like a great American company. Our hope is that we can achieve successes and efficiencies for our customers, who are the citizens.”

The innovation office has a particular focus on technology and data, and it is working with such titans as Apple chief executive Tim Cook, Microsoft founder Bill Gates, Salesforce chief executive Marc Benioff and Tesla founder and chief executive Elon Musk. The group has already hosted sessions with more than 100 such leaders and government officials.

“There is a need to figure out what policies are adding friction to the system without accompanying it with significant benefits,” said Stephen A. Schwarzman, chief executive of the investment firm Blackstone Group. “It’s easy for the private sector to at least see where the friction is, and to do that very quickly and succinctly.”

Some of the executives involved have criticized some of Trump’s policies, such as his travel ban, but said they are eager to help the administration address chronic problems.

“Obviously it has to be done with corresponding values and principles. We don’t agree on everything,” said Benioff, a Silicon Valley billionaire who raised money for Democrat Hillary Clinton’s 2016 campaign.

But, Benioff added, “I’m hopeful that Jared will be collaborative with our industry in moving this forward. When I talk to him, he does remind me of a lot of the young, scrappy entrepreneurs that I invest in in their 30s.”

Kushner’s ambitions for what the new office can achieve are grand. At least to start, the team plans to focus its attention on reimagining Veterans Affairs; modernizing the technology and data infrastructure of every federal department and agency; remodeling workforce-training programs; and developing “transformative projects” under the banner of Trump’s $1 trillion infrastructure plan, such as providing broadband Internet service to every American.

In some cases, the office could direct that government functions be privatized, or that existing contracts be awarded to new bidders.

The office will also focus on combating opioid abuse, a regular emphasis for Trump on the campaign trail. The president later this week plans to announce an official drug commission devoted to the problem that will be chaired by New Jersey Gov. Chris Christie (R). He has been working informally on the issue for several weeks with Kushner, despite reported tension between the two.

Under President Barack Obama, Trump advisers said scornfully, some business leaders privately dismissed their White House interactions as “NATO” meetings — “No action, talk only” — in which they were “lectured,” without much follow-up.

Andrew Liveris, chairman and chief executive of Dow Chemical, who has had meetings with the two previous administrations, said the environment under Trump is markedly different.

After he left a recent meeting of manufacturing chief executives with Trump, Liveris said, “Rather than entering a vacuum, I’m getting emails from the president’s team, if not every day, then every other day — ‘Here’s what we’re working on.’ ‘We need another meeting.’ ‘Can you get us more input on this?’ ”

Kushner proudly notes that most of the members of his team have little-to-no political experience, hailing instead from the world of business. They include Gary Cohn, director of the National Economic Council; Chris Liddell, assistant to the president for strategic initiatives; Reed Cordish, assistant to the president for intergovernmental and technology initiatives; Dina Powell, senior counselor to the president for economic initiatives and deputy national security adviser; and Andrew Bremberg, director of the Domestic Policy Council.

Ivanka Trump, the president’s elder daughter and Kushner’s wife, who now does her advocacy work from a West Wing office, will collaborate with the innovation office on issues such as workforce development but will not have an official role, aides said.

Powell, a former Goldman Sachs executive who spent a decade at the firm managing public-private job creation programs, also boasts a government pedigree as a veteran of George W. Bush’s White House and State Department. Bremberg also worked in the Bush administration. But others are political neophytes.

Liddell, who speaks with an accent from his native New Zealand, served as chief financial officer for General Motors, Microsoft and International Paper, as well as in Hollywood for William Morris Endeavor.

“We are part of the White House team, connected with everyone here, but we are not subject to the day-to-day issues, so we can take a more strategic approach to projects,” Liddell said.

Like Kushner, Cordish is the scion of a real estate family — a Baltimore-based conglomerate known for developing casinos and shopping malls. And Cohn, a Democrat who has recently amassed significant clout in the White House, is the hard-charging former president of Goldman Sachs.

Trump’s White House is closely scrutinized for its always-evolving power matrix, and the innovation office represents a victory for Wall Street figures such as Cohn who have sought to moderate Trump’s agenda and project a friendly front to businesses, sometimes in conflict with the more hard-line conservatism championed by Bannon and Chief of Staff Reince Priebus.

The innovation group has been meeting twice a week in Kushner’s office, just a few feet from the Oval Office, largely barren but for a black-and-white photo of his paternal grandparents — both Holocaust survivors — and a marked-up whiteboard more typical of tech start-ups. Kushner takes projects and decisions directly to the president for sign-off, though Trump also directly suggests areas of personal interest.

There could be friction as the group interacts with myriad federal agencies, though the advisers said they did not see themselves as an imperious force dictating changes but rather as a “service organization” offering solutions.

Kushner’s team is being formalized just as the Trump administration is proposing sweeping budget cuts across many departments, and members said they would help find efficiencies.

“The president’s doing what is necessary to have a prudent budget, and that makes an office like this even more vital as we need to get more out of less dollars by doing things smarter, doing things better, and by leaning on the private sector,” Cordish said.

Ginni Rometty, the chairman and chief executive of IBM, said she is encouraged: “Jared is reaching out and listening to leaders from across the business community — not just on day-to-day issues, but on long-term challenges like how to train a modern workforce and how to apply the latest innovations to government operations.”

Trump sees the innovation office as a way to institutionalize what he sometimes did in business, such as helping New York City’s government renovate the floundering Wollman Rink in Central Park, said Hope Hicks, the president’s longtime spokeswoman.

“He recognized where the government has struggled with certain projects and he was someone in the private sector who was able to come in and bring the resources and creativity needed and ultimately execute in an efficient, cost-effective, way,” Hicks said. “In some respects, this is an extension of some of the highlights of the president’s career.”

Friday, March 24, 2017

Point Counterpoint

I get why I am not beloved in Nashville as I call out their bullshit.  I wrote my overwhelming sadness about my efforts to get along here in my blog piece, Dear Nashville.  But truth like facts are things the South sweeps it under the rug along with their immense class based racist system that places people of color in a strange passive aggressive co-dependency that has worked for over a Century. By keeping people immersed in the past by not actively talking about the past and moving into the present it seems to have an amazing ability to freeze time. I have said repeatedly Nashville is a 1953 town trapped in a 2017 present.

Nashville the aka "city of now" struggles with what that means. It means actually 2008 as that is when the real estate market was at its peak and then crash crash boom boom. The media insatiably discusses all property deals with lavish attention when they occur, such as the headquarters of LifeWay (one of the top 10 employers in the area, yes a Christian publishing company) and The Tennessean/USA Today headquarters being sold for millions; however, when the deal recently fell through it was not even reported in its own paper. I read it in the business journal printed in really really small print.

The bragging about the May Hosiery company building sold that is next door and the announcement we were getting a major tenant that was the La Roux food emporium from NOLA within a year to 18 months. That year mark has hit and unless they pull permits and get moving the 18 month mark will pass. Odd given that they kicked out the artists renting space there and now have big banners out front notifying that leasing space available. Not a word updating anyone regarding that future. But meanwhile the adjacent buildings that have been empty and pending tenants still sit empty and the future apartment projects which kicked out all the lower income tenants are also finally being open to a hearing regarding the project. This is the second one now for the same space. And the neighborhood "activist" group does nothing to inform residents/businesses of any current plans. I find them culling multiple sources in order to know what is going on in my own neighborhood.

Then we have the city itself. The supposed liberal bastion in the sea of red. I will gracefully say yes and there are probably liberals in Memphis, Chattanooga and where there are people anywhere. I lived in Seattle and to say that it was a blue state ignored the eastern section of the state that was not. It is largely agrarian and so it is under populated and largely of migrants who may or may not be documented or even citizens so the heavily populated western half dominate the political arena until you actually go to the State legislature and find otherwise. That said, yes pot is legal and it is in Colorado a state with a very similar composition and yet it took much longer in California and that is a large state with really only two pocket of liberalism, Los Angeles and San Francisco. Again they are heavily populated and they suck the air out of the room to the point one realizes that some of the most powerful representatives in Congress are in fact California REPUBLICANS.

But Washington and California as well as Oregon and the Southwest corridor - including Arizona as well as the Sunbelt states are rising in population overall. After years of stagnant migration people are moving in the United States and they are moving there. Gee I thought Nashville was number one! No, Nashville did not even make the top 25 on the U.S. Census list. Shh don't tell anyone.

Who is moving here? Most of the transplants I meet are from within Tennessee itself as this is where there are jobs. The rest are from the 5 corners, Kentucky, Virginia and some from Indiana and Ohio. The reality is people go where there are jobs and there are plenty of low end service jobs and largely medical ones (until that crashingly ends with ACA) and some manufacturing ones just outside the Nashville corridor. If this city was so great we would have higher percentage of educated professionals, higher wages and well less bullshit. That is not going to happen. You come here and realize that regardless of what happens here it stays here and then is promptly overridden, ignored or made illegal thanks to the oppressive regressive State Legislature. This is a State that did not benefit the actual people of Tennessee with regards to the ACA but the business and colleges made out like gangbusters. Remember access is not the same as availability. So no we don't have any expansion of Medicaid and our health problems demonstrate that as there was only one provider on the site as the other major providers, Blue Cross/Blue Shield pulled out, further limiting choices and availability.

We are one of the ground zero red states in school choice for quite some time. If it really worked again that number of educated would rise. Well we have graduated them from high schools but the ones who make it to college 40% are in need of remedial education. So instead of realizing we just pushed them out Tennessee has made those courses actual credit worthy classes that go towards their degree/certificate. So instead of 80 credits in college courses that expand skills or knowledge some of them are actually basic classes that are for reading/writing and math. And that does what exactly? It enables kids to get through college and falsely elevate the college "completion" rates. Gosh could I get the same towards a Ph.D? Well this is the State that rejected a woman's Master's Degree from Harvard so she could be a school principal. We could use her here as she is from here but how dare she go to the Ivy League! But this may also explain all these inflated Ph.d's I encounter here. They are like candies passed out to anyone stupid enough to spend the money on a degree where the salary rates are the lowest in the Country for educators. Sure makes sense. But then we also have Nashville School of the Law which only enables graduates to practice law in where? Tennessee. However, after 5 years they are welcome to try to pass the bar in other states. Good luck with that one. I would love to see those numbers of those who do.

So as we wait for more Mae Beavers exciting new religious oppressive discriminatory laws, while also pending the notion of running for Governor (I for one can't wait!!) the issue is not the law but how much it will cost the State. Not that the Supreme Court settled the matter and that is in fact utterly discriminatory, no it is about money. This is the point I have said repeatedly it is always about money here, anything or anyone else is collateral damage.

'Natural Marriage' bill could cost Tennessee over $9B
Kirk A. Bado , USA TODAY NETWORK - Tennessee 8:48 a.m. CT March 23, 2017

Legally recognizing only marriages between a man and a woman could cost the state over $9 billion, according to the Tennessee Natural Marriage Defense Act's extensive fiscal note.

Sponsored by Rep. Mark Pody, R-Lebanon, and Sen. Mae Beavers, R-Mt. Juliet, the bill states that it is the policy of Tennessee to defend only “natural marriage between one man and one woman regardless of any court decision to the contrary.”

This is a direct contrast to the U.S. Supreme Court ruling in Obergefell v. Hodges, which legally recognizes same-sex marriages across the nation.

“The bill will result in marriages of same-sex couples being null and void in Tennessee, whether married in Tennessee or in another state; and will also result in same-sex married couples being denied services offered to different-sex married couples,” the fiscal note concludes.

This means that over $7 billion in federal funds to TennCare could be jeopardized if the health service organization denies coverage to same-sex couples that would otherwise be eligible under federal law. Additionally, over $2 billion in funds from the Department of Human Services would also be at risk.

The $9 billion price tag does not include the decrease in state and local revenue on marriage licenses or loss of business, nor does it include legal fees that the state would incur from any lawsuits stemming from the new law.

"I'm a fiscal conservative, I want to fight for every single dollar we have up here, but I'm not going to be bullied by potential threats by the federal government," Pody said.

The Wilson County lawmakers are familiar with wading into contentious social issues.

Both Beavers and Pody were sponsors of the controversial “bathroom bill” which could have put over $1 billion in federal funds at risk as well. The bill, which would have required students in public schools to use the bathroom corresponding with the sex listed on their birth certificate, failed died for the session in a Senate committee on Wednesday.

Earlier this session, the lawmakers were both run out of their own news conference announcing their controversial bills by protesters. Beavers is also mulling a run for governor as a conservative option after the news surfaced that gubernatorial candidate Sen. Mark Green, R-Clarksville, is under strong consideration to be named secretary of the Army.

LGBT rights advocates have condemned the marriage bill as another example of the "slate of hate," the state legislature has proposed this session.

"We have watched again and again as lawmakers propose legislation that sends the clear message that LGBT Tennesseans are less than — that they and their families deserve fewer rights than others," Hedy Weinberg, the executive director of the ACLU of Tennessee, said at a news conference earlier this month.

The bill will be heard in the House Civil Justice Subcommittee on Tuesday.

The bathroom bill that the Beav had tried to pass took a pisser and died. So come to Nashville and pee wherever you want! But get high, no.

House approves bill to block Nashville, Memphis marijuana laws
Joel Ebert , USA TODAY NETWORK - Tennessee March 23, 2017 |

Nashville’s Metro Council made history Tuesday by approving the city’s first measure to allow lesser civil penalties for people caught with small amounts of marijuana.

The House of Representatives approved a bill on Thursday that would nullify the partial marijuana decriminalization laws approved in Nashville and Memphis last year.

The legislation, sponsored by Rep. William Lamberth, R-Cottontown, would repeal any local law that is inconsistent with penalties in state statues pertaining to drug control and narcotics. The bill would also prevent local governments from creating their own sanctions.

The legislation was introduced in response to ordinances passed by city councils in Memphis and Nashville.

The local laws gave police in Nashville and Memphis the discretion to hand out lighter civil citations for possession of small amounts of marijuana.

Nashville's lighter civil citation had been issued only 39 times for possession of small amounts of marijuana since the law's adoption, according to Metro police spokesman Don Aaron, compared to 963 state citations.

Last year, Tennessee Attorney General Herbert Slatery said the Memphis and Nashville ordinances violated state statute.

The House voted 65-28 in favor of the bill.

Six Republicans, including House Speaker Beth Harwell, who is weighing a bid for governor, were among the dissenting votes.

Much of the chamber's debate centered on arguments about local control, with several Democrats saying the state should not be making decisions that overrule local governments.

Rep. Antonio Parkinson, D-Memphis, said during the 2017 legislative session there’s been an “onslaught” of efforts by lawmakers to dictate to local governments what they can do.

“The individuals that were elected by those cities, by those communities, by those voters know what’s best at the local level," he said.

Aside from the discussion about local control, others, including Rep. Mike Stewart, D-Nashville, and Rep. Craig Fitzhugh, D-Ripley, said the matter should not be settled by lawmakers but in the court system.

Lamberth pushed back against many of the arguments he faced, saying his legislation was merely an effort to provide uniformity across the state while also working to curb any potential discrimination.

Lamberth has frequently argued that the local ordinances could let police officers to issue citations unfairly to certain people while letting others walk away.

"Lady justice is blind sir, and Nashville took that blind off and insisted that their officer choose on the side of the road what penalties should be meted out. That is a decision for a judge under our law and that ordinance set back criminal justice a hundred years," he said.

Although most Republicans voted in favor of the legislation, a few, including Rep. Jeremy Faison, R-Cosby, openly criticized the measure. Faison, who has advocated for medical marijuana legislation, said because of inaction by federal and state lawmakers, local governments have been forced to make changes to marijuana laws.

"We have informed lawmakers that we are opposed to this piece of legislation and we are disappointed that the House voted to approve it today," said Sean Braisted, Nashville Mayor Megan Barry's press secretary. "We will continue to monitor its progress in the state Senate."

Metro councilman Dave Rosenberg, who sponsored Nashville’s marijuana ordinance, characterized the chamber's action as an overreach and disregard of local authority.

“The majority in the Tennessee House abandoned the principles of limited government and local control and ignored the will of the people of Nashville, instead yielding to the archaic Nixon-era hysteria of a small group of legislators who live outside of Nashville.”

Rosenberg said there’s likely little Metro can do to keep the city’s decriminalization ordinance in tact if the state bill is signed into law by Haslam.

“Honestly, I think this is within the state’s rights to stomp on our throats like this, and there’s not a lot we can do about it.”

The Senate delayed voting on its version of the bill until Monday.

This is how it works in a deep red sea state. In Washington there were many cities that enacted laws regarding the use of Marijuana and that debate will always be an ongoing one until it won't. Either the lobbying groups that really run legislation fund an opposition issue or a victim group finds a way to coerce a Legislator, as in the case of MADD, don't drive drunk but high is not their area of import, this issue is now simply a matter of law. And other states are now finding out the same. Do I think pot will ever be legal in any red sea state? Youhavegottobefuckingkiddingme

I live in a bubble. I am exhausted trying and that I would have to become like these people in order to fit in clearly an idiot.

He who trims himself to suit everyone will soon whittle himself away. ~Raymond Hull

Thursday, March 23, 2017

Dear Nashville,

Today was another long long day. I have tried every possible way short of joining a Church to connect with someone, anyone here. 

I tried Volunteering at the Frist Center for the Arts which is an amazing place to visit.  Just visit. My first assignment was in the Arts Center.  I work with kids all day and it is largely kids that visit.  I have written about that before with the other two volunteers who were not two people I would expect nor should be volunteering in that specific area.

And today in true Nashville fashion I was baited and switched when I agreed to come back and try something else that was less demanding.  And I was placed in the coat room.  This reminded me so much of Nashville Public Schools down to the cell I was placed in, I truly thought I must give people here some type of vibe that freaks them the fuck out.  So I told the Coordinator that this was it. I am done. I gave him the highlight reel and that I wanted to meet adults to find friends or some social contacts but that the Volunteers here are just not social, the environment is just conducive to that and well that is So, Nashville frankly. 

It is impossible when you are older to meet people. Period.  And when you are just looking for a lunch companion or movie pal it is impossible.  I don't care about anything other than a sense of humor and some intellect, those two in fact are co-joined at the hip and that is a matter of fact, not an alternative one.  So in a Town-City where only 33% are educated with 91% Christian it makes it tough as that last one often cancels out the other.

Aside from the raging lack of humor I have never met people so isolated and suspicious of strangers as I have here.  It is like a giant high school and the cool kids don't just have a table they have the whole cafeteria.

Now some of this is age and as one approaching 60 and not mph I get it.  I have nothing attached to my vagina via a ring or a cord.  I am not easily classified as hetero or gay and does that really matter? How about the idea of fucking anyone but myself makes me cringe.  I have a shitty job but it does not define me.  I read voraciously, love a lot of music, movies, theater and even watch TV.  Apparently no one here does anything but drink, go to the Predators, Titans or the College games and eat out, and do so a lot.   I am not big on eating out but I cannot remember the last time since moving here having a meal, a coffee, a drink or even a meaningful conversation with an Adult since I moved here at the end of June.

I have health problems.  So when you keep asking me, "why did you come here?" My response is a lie.  I cannot say I came for the medical tourism for dental work I could not get in Seattle as cheap as it is here and by actually decent Surgeons, so that answer is a little long, personal and really none of your fucking business.

 My job as a Substitute Teacher has enabled me to actually first hand experience your 40 year old failed social experiment and it deserves an F.   I hate myself walking into each building and facing the children that are just smaller versions of the adults I encounter. They are rude, arrogant, utterly judgemental, oddly hyper sexual (which again tells me that the Teacher did not kidnap that kid, define kidnap and yes by law he did but I suspect that there had been an ongoing sexual relationship that precluded the running away), and utterly stupid.  Yes I said stupid. It at times is embarrassing to listen to children talk as if I am not there and the conversations I hear make me physically sick.   But when kids actually think memorizing the Presidents, the year they served and in order is a mark of intelligence and not a Jeopardy question it tells me that they are learning nothing.  And that is just some of the lessons I have had to administer.

Then there is the down time that I use to go to the Y and have coffee and be ostensibly the last pedestrian in Nashville. Seriously I feel waking is like taking a life risk. When I rent a car I feel the same way it is as if everyone is rushing to go nowhere but get there fast.

I watch as my overpriced Apartment is blocked on a daily basis for hours at a time by traffic thanks to the endless trains that cross literally in front of my home.  The blasting horns that run 24/7 at decibels that are deafening and utterly unnecessary seems to at times almost deliberate as one engineer ran them 16 times in one crossing.  There is an opioid crisis with train personnel and in Tennessee so clearly he is doubling down on the drugs as the maximum by law regarding horns is 8.

I know this as I pull up law and read it.  I have contacted the local representative here numerous times, attended permit meetings asking why they are green lighting a project that will add to the noise pollution and to the  traffic blocked almost daily, should they not be warned?  I certainly wasn't in the hysteria and stupidity of the Manager who rented me my home.

I should have known then when he had no keys to show me the actual unit I was interested in and when I asked about the train, the brush off, and seeming endless other hurdles to rent should have been a red flag.  The endless demands to have rental insurance, an intense and overly intrusive background check that was fucked up and mishandled and all that had tied up in a one day when I had tried working with him from Seattle for weeks.   And all while trying to deal with the assholes from Allied Van Lines who were equally inflexible.  My move was already not a good sign and  this was my introduction to Southern Hospitality.   Since  that time I have watched almost the entire building turn over residents in less than 6 months as the building slowly falls apart with each turnover.

But Nashville despite my issues I am not stopping on getting this area declared a silent zone as now it is just a matter of obstinacy as frankly I am exhausted just arguing with the idiots who refuse to believe how bad it is. I asked one person who tried to do this in East Nashville for advice, ideas, etc.; her response, "it's hard, good luck." Okay thanks.  That seems to be the standard other than, "I don't know anything about that."  Which is frankly the number one expression here next to, "whose gonna pay for that?"

I spend the day in conflict with someone just by doing something.  There is no way around the reality that I clearly alienate everyone I come into contact with.

And this was again evident at the Dental Office when I was ranting about my lack of communication, my lack of a proper treatment plan, coordination and cost estimate that I ran my mouth off on another bad day when I was sick with a rash, since discovered it was an allergic reactions, a cold and just general frustration from dealing with the Nashville Public Schools.  So when I said, "it would be easier if I just blew my teeth out with a gun then maybe I would get help. " And this in turn led to Cops 4 days later showing up at my home.  Then diagnosing me as being depressed and anxious, ya think??? then giving me a Dental referral. How So, Nashville.

And when I relate even this tale, I am met with shaking heads and asking why I said that if I wasn't going to do it and asked if I  was Sectioned 8.  Oh my god they don't even understand hyperbole let alone what that word means.  It is as if I speak a foreign language.. oh wait I don't speak Americanese.   It also explains the blank looks I get when simply just trying to teach kids and why I stopped.  Well that and the absurd wages which btw thanks for the raise, apparently a decade over due but it will not change my feelings about the kids, the schools, their staffs, it just means I will hate myself a little less.

But in the interim, while I await said surgery/procedures, when I try to meet others if I am not asked why I came I am asked what Church I go to or if I am married.  When both are responded in the negative I am told I need to join their Church and get a husband.  My response is, "So your Church has a lot of men with vagina's?"  That ends it.  Regardless, and even if I was a Lesbian it is all just so full of bullshit and ignorance that you become exhausted trying to come up with snark as a response. And no I don't care if they think I'm gay.  I should of changed my name to Beaver after your nutfuck of  a representative who is obsessed with all things sexual.  Again these hyper sexual kids do grow up to be adults and add the Jesus and it like humor confuses the matter. 

And my last attempt today finally made me realize - Nashville you win.  I am just hoping to get out of here - ALIVE (I don't want any cops at my door) - with my new dental work and a great smile to go with it as soon as possible.

I have Rivendell Writers Colony to look forward to and the chance to write and to MTSU and their writing program, so there are good things on the horizon but ironically none of that is here in Nashville.  I will just crash here and wait to get the fuck out as soon as I can.

Nashville, you broke what Seattle tried and failed to do.  Then I realized I came here broken and you cannot heal me.  You are incapable you are too broken as well.

Wednesday, March 22, 2017

Protest you say?

I read this and busted out laughing. Why? Because this state is deep in the red sea and anyone who questions the status quo regardless is looked upon with suspicion.

I had a nice chat with a native Tennessean who is black and said that we focus on too much of what divides us versus that which unites us and that is why the Legislative body both locally and nationally can ignore and in turn circumvent rational decisions that would benefit the status quo and instead support a select elite. Why bother when in reality few turn up to town halls, public meetings and legislative offices. Until they do.

And when they do you have seen massive change as I have said 3 million votes guaranteed are superior to 3 million dollars that does not guarantee one's re-election. Quid pro quo and all that.

So when I read this article today about the varying protests that have been the result of the Donald Trump election and the policies proposed that have led to many to hit the streets, the halls, the offices and act on the history of America that gave us this democracy in the first place, I was not surprised that it was questioned as legitimate, valid or long lasting.

I have elected to not participate as I trust few to none here in the Volunteer State. I have made it my business to attend transit meetings, write Senators, attend varying other permit meetings and ones about sidewalks as those are the issues that I find of import. And when I talk to people about those issues they respond with the standard, "I don't know anything about that."  And when I do encounter people who have elected to protest about the bigger issues this seems to be their first time at the rodeo and it is less about the issues and more about feeling and not being alone in the deep red sea.

And the young man I spoke to I asked point blank did he vote and did his peers? He did but his friends did not. They see politics as a white issue and not something they connect with. Yes and because of that you reap what you sew. Some of my most virulent arguments/debates at public transit are with people of color as they are afraid bus fares will raise and yet when I ask few ride the bus but this is not about that, what it is about is fear of gentrification and be pushed out. Because change is about white people and their needs and on some level they are right and yet this is an issue that affects all but when you are divided you cannot see anything beyond that line that does so. 

And when I asked this same young man about issues such as sidewalks and buses that benefit a community he said that the bus issue was voted on last year and it failed. I informed him yes that was then and this was now and did he know of INMotion the new transit plan passed and approved and was now in search of funding, which includes changing laws to allow County's and Cities to vote on their own infrastructure needs and in turn funding plans. He did not. Of course not. As the year that was voted on it was a different Mayor and was a grand experiment in meddling by the Koch Brothers to see if they could in fact alter local legislative bills. And why yes after a hostile campaign and divisive misinformation it was shot down. A year later the current Mayor ran on that issue, won the office and she has made it her trademark, including having a free bus day and pushing for the growth of transit at every opportunity. He did not vote for her or knew any of this. Ah an uniformed populace is an easily manipulated populace.

Again, I want to point out that while the state of Tennessee has less than 30% of its population seeking post secondary education, it appears that the entire 33% live here in Nashville. Funny I actually meet few of said educated ones that are actually from Nashville, so they likely leave once they figure out how fucked up it is here. And yes it is mighty fucked up. But the people seem to prefer it that way. And then they don't.

So of course the local paper is horrified that people have the audacity to protest and clearly see this as again some "outside" influence, sort of like the Russians and the elections, that are causing all this conflict. Well irony is that most of the people I do meet again are not from here and NONE of them are partaking in any of this and why? We are working for a shitty wages and don't have the time or inclination to do so. BTW the transit meetings,etc are often held in the evenings so I can go. I would not waste my days off to sit in the capital building with any of the natives as I truly do not like them. And while I agree with the idea that any port in the storm and strange bedfellows, I meet enough in my day gig that no, not in my off hours.

So will this last? I have no clue but I am glad someone is.

What's behind the rise in protesters in Tennessee

Kirk A. Bado , USA TODAY NETWORK - Tennessee Published March 21, 2017 |

They came in threes and fours, carpooling or splitting an Uber to Gov. Bill Haslam's State of the State address in January. Hundreds of demonstrators filled the halls, bearing signs, donning pink knit hats and shouting chants. Officers of the Tennessee Highway Patrol stood on the fringes maintaining order.

“Why are all these people here?” a visibly confused Rep. John Mark Windle asked a group of officers guarding the door to the House chamber.

The hundreds of demonstrators who descended on the state Capitol were here for myriad issues.

Ask 10 different protesters and you are bound to get 10 different answers. Some were demonstrating against President Donald Trump’s recent executive order on immigration, some wore the knitted pink hats of the Women’s March, others demanded the revival of the failed Insure Tennessee from Haslam to expand health insurance access to low-income Tennesseans.

Yet they all rallied around the loose theme of “We are Watching” to remind lawmakers they will hold them to extra scrutiny.

This would be the first of weekly demonstrations coined “Moral Mondays” after similar protests in North Carolina. The opening weeks of the 110th General Assembly have been marked with a sharp rise in protesters taking their concerns directly to their representatives.

"I am heartened and thankful that people of all political persuasions are coming together and saying, 'This isn't America. This isn't traditional Democrat or Republican," said Bernie Ellis, 67, of Fly, Tenn. protesting outside of the State of the State address.

“We just cannot be quiet."

The State of the State protest is part of a larger national wave of activism seemingly inspired in part by Trump’s election in November. At least half a million people took to the streets in Washington D.C. for the Women’s March in January, with 15,000 Nashvillians joining in a sister march from Cumberland Park to Public Square.

The new zeal for activism is evident at all levels of Tennessee government.

Two state lawmakers were run out of their own news conference promoting bills that would define marriage as only between one man and one woman and a bill requiring students in public schools to use the bathroom assigned to the sex on their birth certificate in early February. Nashvillians angry over a Metro police officer's fatal shooting of Jocques Clemmons, a 31-year-old black man, brought a Metro council meeting to a dramatic halt as they demanded more dynamic action from the city.

Demonstrators temporarily halted a Nashville council meeting on Tuesday, Feb. 21, 2017. The demonstrators demanded the city take action in the aftermath of the shooting death of Jocques Clemmons by a Nashville police officer. Jessica Bliss / The Tennessean

And an alternative town hall was formed by activists outside a town hall U.S. Rep. Marsha Blackburn held at the Fairview City Hall, which had a limited capacity of 130 people.

But nowhere is it more prominent and consistent than in the halls of the Tennessee General Assembly. Residents have taken to the statehouse in some degree at least every week since the 110th General Assembly convened in January.

Caleb Banks, 25, of Spring Hill, has been to almost 20 demonstrations since January and plans to organize many more before the session is expected to end in April. He says the power of these demonstrations come from their independence from any one party and a previously politically inactive constituency finally paying attention.

“A lot of people who were never involved before are getting involved now. And I think that’s where the shock and awe is coming from Republicans,” Banks said, “They haven’t seen anything like this since they’ve been in office."

Protesters are nothing new to the Tennessee General Assembly. During the 2002 legislative session, anti-income tax protesters descended on the Capitol, and at one point punched a Tennessean editor, confusing him for a lawmaker. The last two legislative sessions have seen demonstrators demanding lawmakers pass Insure Tennessee. In 2012, "Occupy Nashville" protesters were forcibly removed from Legislative Plaza after camping out for months in solidarity of the "Occupy Wall Street" movement.

But unlike previous flares of activism, there does not seem to be one unifying rallying cry for these new liberal demonstrators. While the demonstrators have loosely organized under the theme of “We are Watching,” the frequent demonstrators at the Capitol are not championing one mandate.

Comparisons have been drawn between today’s more liberal activists and the more conservative Tea Party movement that sprang up in 2009 in the wake of President Barack Obama’s victory and his push for the Affordable Care Act. Republicans took full advantage of their newly excited base to gain seats on the state and federal levels across the nation. Republicans have controlled both chambers in Tennessee since 2010.

The demonstrations aren't all for liberal causes, though.

Former conservative talk radio host Steve Gill has led several successful grassroots insurgencies at the statehouse, and recently helped organize conservative protests against Haslam’s proposed gas tax. He says that the most efficient protests are focused on a single issue and attract the most eyeballs, so he had one of the demonstrators show up to a committee meeting in a giant red foam gas can costume to draw attention.

“You gotta give the media guys crack cocaine for their eyeballs,” he said.

Gill’s demonstrators have a little more of a receptive audience than the more liberal groups at the Capitol. Certain protest groups have been met with disdain by Republicans in the statehouse. Sen. Paul Bailey, R-Sparta, drew ire from demonstrators after he tweeted that several protesters at the State of the State were paid. He declined to provide evidence to support his claim, and nearly 150 protesters shouted “We pay you!” into the Senate chamber in response to his allegations.

But no lawmaker has been more of focal point then Sen. Mae Beavers, R-Mt. Juliet. After being run out of her own news conference by demonstrators against her controversial “Natural Marriage” bill, Beavers called for stricter security at the Capitol and that anyone disrupting the legislative process should be imprisoned.

In the ensuing weeks, Beavers has hired personal security to guard her office from protesters.

Beavers did not respond to multiple calls by the USA TODAY NETWORK - Tennessee for comment.

On the other hand, Democratic lawmakers have embraced the zeal of the protesters and hope to spin it into electoral success. With Republicans firmly controlling a super-majority in both the House and Senate, this will be an uphill battle. Some Democratic lawmakers have held impromptu meet and greets with citizens in between chants during protests. Rep. Bo Mitchell, has taken to wearing a “We Are Watching” button on the House floor in solidarity with the demonstrators.

“I’m very excited about it because it’s citizens coming up to watch their employees,” he said.

But Democrats are struggling to bridge the gap between these self-organizing groups and the party. Bernie Ellis, one of the organizers of the Blackburn alternative town hall, posted a message to supporters on Facebook before the event expressing how surprised he was that the Williamson County Democrats had not heard about them yet.

“I just left a meeting of the Williamson County Democrats. Amazingly, more than half the folks in attendance had not yet heard of our ‘alternative’ town hall, but most now plan to attend,” the post read.

Gill contends that the liberal activists are failing to resonate with lawmakers because they do not reflect the views of most Tennesseans. In 2016, Trump won every county in the state except for three and carried the state with 61.1 percent of the vote.

“What the liberals struggling with is that they are trying to change people’s mind and create outrage against what Tennesseans think,” Gill said.

Now the Democrats are trying to reverse their losing trend and have begun taking more active measures to sustain the momentum. State legislators are holding open town halls every Thursday to connect directly with demonstrators. But there is a gap between the independent organizers and established power. Lack of focusing on a specific agenda item might be the root cause.

“This is grassroot organizing, and there a lot people who don’t have a whole lot of experience,” Banks said.

Although, the new activists demonstrate for more liberal causes, they do not identify with any party and say they plan to hold all elected officials accountable when elections role around in 2018.

“Most of these organizers don’t organize with either party,” Banks said, “These grassroots organizers are trying to hold every politician accountable.”

But that might be one of their downfalls, according to Gill. Unless they can rally around one pointed issue, they will continue to be written off, he said.

“A lot of the liberal protesters are all over the map. They hate everything," he said. "That’s not really an effective public policy debate."

Time will tell whether activists will be able to maintain their presence at the Capitol and turn it into action. Although crowds were thinner the first week of March, demonstrators who are there still have the same intensity as those first arriving back in January.

They still line the hall between the two chambers in the State Capitol, creating a canyon of DIY signs and knit hats for legislators to traverse from the elevator to their desks. It’s loud, and the high vaulted ceilings in the statehouse make for a loud echo.

Sherri Beal, 56, of Nashville, stood behind the velvet ropes wearing a pink knit hat on her head and waving an American flag.

Like others gathered here, she’s not present for any one reason. Others around her held up signs calling for a Medicare expansion, gun restrictions and an end to outsourcing ot state services. She does not like Trump’s stance on immigration and thinks that LGBT residents need more protection.

Yet her whole reason for being here, and those gathered around her, could be condensed into one simple mandate.

“Just listen to us," she said, "Please treat us with respect.”