Tag: Laws

US businesses propose hiding trade data used to trace abuse

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A group of major U.S. businesses wants the government to hide key import data — a move trade experts say would make it more difficult for Americans to link the products they buy to labor abuse overseas.

The Commercial Customs Operations Advisory Committee is made up of executives from 20 companies, including Walmart, General Motors and Intel. The committee is authorized by U.S. Customs and Border Protection to advise on ways to streamline trade regulations.

Last week — ahead of closed-door meetings starting Monday in Washington with senior officials from CBP and other federal agencies — the executives quietly unveiled proposals they said would modernize import and export rules to keep pace with trade volumes that have nearly quintupled in the past three decades. The Associated Press obtained a copy of the proposal from a committee member.

Among the proposed changes: making data collected from vessel manifests confidential.

The information is vitally important for researchers and reporters seeking to hold corporations accountable for the mistreatment of workers in their foreign supply chains.

Here’s how it works: Journalists document a situation where laborers are being forced to work and cannot leave. They then use the shipping manifests to show where the products end up, and sometimes even their brand names and whether they’re on a shelf at a local supermarket or a rack of clothes at a local mall.

The proposal, if adopted, would shroud in secrecy customs data on ocean-going freight responsible for about half of the $2.7 trillion in goods entering the U.S. every year. Rail, truck and air cargo is already shielded from public disclosure under U.S. trade law.

“This is outrageous,” said Martina Vandenberg, a human rights lawyer who has filed petitions with CBP seeking to block shipments of goods suspected of being made by forced labor.

“Every year we continue to import and sell millions of dollars in goods tainted by forced labor,” said Vandenberg, president of the Washington-based Human Trafficking Legal Center. “Corporate America should be ashamed that their answer to this abuse is to end transparency. It’s time they get on the right side of history.”

CBP said it would not comment on ideas that have not been formally submitted by its advisory committee but said that the group’s proposals are developed with input gathered in public meetings.

But one of CBP’s stated goals in creating what it has dubbed a “21st Century Customs Framework” is to boost visibility into global supply chains, support ethical sourcing practices and level the playing field for domestic U.S. manufacturers.

Reports by the AP and other media have documented how large quantities of clothing, electronics and seafood make their way onto U.S. shelves every year as a result of illegal forced labor that engages 28 million people globally, according to the International Labor Organization. Much of that investigative work — whether into clothing made by Uyghurs at internment camps in China’s Xinjiang region, cocoa harvested by children in the Ivory Coast or seafood caught by Philippine fishermen toiling in slave-like conditions — starts with shipping manifests.

“Curtailing access to this information will make it harder for the public to monitor a shipping industry that already functions largely in the shadows,” said Peter Klein, a professor at University of British Columbia, where he runs the Hidden Costs of Global Supply Chains project, an international collaborative between researchers and journalists.

“If anything, CBP should be prioritizing more transparency, opening up records of shipments by air, road and rail as well.”

In its 34-page presentation, the business advisory panel said its goal in further restricting access to customs data is to protect confidential business information from “data breaches” that it says “have become more commonplace, severe and consequential.”

The group also wants CBP for the first time to provide importers with advance notice whenever it suspects forced labor is being used. Activists say such a move puts whistleblowers overseas at risk of retaliation.

GM declined to comment, referring all inquiries to the Customs Operations Advisory Committee. Neither Intel nor Walmart responded to AP requests for comment.

In August alone, CBP targeted shipments valued at more than $266 million for inspection due to suspected use of forced labor, including goods subject to the recently passed Uyghur Forced Labor Prevention Act. Additionally, last month the U.S. Department of Labor added 32 products — among them acai berries from Brazil, gold from Zimbabwe and tea from India — to its list of goods possibly made with child or forced labor, making them targets for future enforcement actions.

The proposal to make vessel data confidential comes as American companies are under increasing pressure from consumers to provide greater transparency regarding their sourcing practices, something reflected in the ambitious language found in many corporate social responsibility statements.

But Vandenberg said the proposed restrictions are in line with less-touted litigation and lobby efforts by major companies to water down enforcement of the U.S. ban on forced labor.

She cited a brief filed last week by the American Chamber of Commerce, the world’s largest business federation, in a case now before a federal appeals panel in Washington. At issue is whether tech companies can be held responsible for the death and injury of children in the Democratic Republic of Congo forced to mine cobalt that ends up in products sold in the U.S.

The lawsuit was brought by families of dead and maimed children against tech giants Alphabet (the parent company of Google), Apple, Dell Technologies, Microsoft and Tesla under what’s known as the U.S. Trafficking Act, which allows victims to sue ventures that benefit financially from forced labor. The case was dismissed last year after a district judge found the companies lacked sufficient ties to the tragic working conditions in the DRC.

The Chamber of Commerce, in asking the appeals panel to uphold that decision, said the serious global problem of forced labor is best addressed by private industry initiatives, Congress and the executive branch — not U.S. courts.

Such suits “often last a decade or more, imposing substantial legal and reputational costs on U.S. companies that transact business overseas,” the Chamber of Commerce wrote in a friend-of-the-court filing.

The mismatch in rules governing disclosure of trade data for different forms of transportation goes back to 1996, when lobbying by the airline industry reversed a law passed by Congress that same year that for the first time required air freight manifests be made public.

In 2017, Scottsdale, Arizona-based ImportGenius — a platform used to search shipping data — was among companies that unsuccessfully sued the federal government seeking to obtain aircraft manifests.

“Suppressing information about goods coming into our country is breathtakingly stupid,” said Michael Kanko, CEO of ImportGenius. “From discovering imports of human hair linked to forced labor, to understanding the flow of PPE during the pandemic, to tracking importers of tainted, deadly dog treats, public access to this data has empowered journalism and kept consumers safe. We need more transparency in trade, not less.”

———

AP Writer Martha Mendoza contributed to this report.

Follow Goodman on Twitter: @APJoshGoodman

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October 17, 2022
Clean Water Act at 50: environmental gains, challenges unmet

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Lifelong Cleveland resident Steve Gove recalls when the Cuyahoga River symbolized shame — fetid, lifeless, notorious for catching fire when sparks from overhead rail cars ignited the oil-slicked surface.

“It was pretty grungy,” said the 73-year-old, an avid canoeist in his youth who sometimes braved the filthy stretch through the steelmaking city. “When you went under those bridges where the trains were hauling coke from the blast furnaces, you had to watch for cinders and debris falling off.”

It wasn’t the only polluted U.S. river. But outrage over a 1969 Cuyahoga fire — the latest in a series of environmental disasters including a 3-million-gallon oil spill off California’s Santa Barbara months earlier — is widely credited with inspiring the Clean Water Act of 1972.

As officials and community leaders prepared to celebrate the law’s 50th anniversary Tuesday near the river mouth at Lake Erie, the Cuyahoga again is emblematic. This time, it represents progress toward restoring abused waterways — and challenges that remain after the act’s crackdown on industrial and municipal sewage discharges and years of cleanup work.

A 1967 survey found not a single fish in the river between Akron and Cleveland. Now, there are more than 70 species including smallmouth bass, northern pike and muskellunge. Limits on eating them have been lifted. The Cuyahoga is popular with boaters. Parks and restaurants line its banks.

“I have folks come into my office routinely from other states and around the world, wanting to see the Cuyahoga River,” said Kurt Princic, a district chief for the Ohio Environmental Protection Agency. “They want to know how we got from where it was in the ’60s to where it is today. It starts with the Clean Water Act, partnerships and hard work.”

Yet the river remains on a U.S.-Canada list of degraded “hot spots” in the Great Lakes region; it’s plagued by erosion, historic contamination, storm water runoff and sewage overflows. Toxic algae blooms appear on Lake Erie in summer, caused primarily by farm fertilizer and manure.

HALF EMPTY, HALF FULL

The Clean Water Act established ambitious goals: making the nation’s waters “fishable and swimmable” and restoring their “chemical, physical and biological integrity.” It gave the newly established U.S. Environmental Protection Agency broad authority to set and enforce regulations.

“We’ve made tremendous progress,” EPA Administrator Michael Regan said in an Associated Press interview Friday. “By passing the Clean Water Act, Congress solidified the importance of protecting our lakes, rivers and streams for generations to come.”

Experts and activists agree many waterways are healthier than they were, and cleanups continue. The Biden administration’s 2021 infrastructure package includes $50 billion to upgrade drinking water and wastewater treatment systems, replace lead pipes and cleanse drinking water of toxic PFAS, known as “forever chemicals.”

But the law’s aims have been only “halfway met,” said Oday Salim, director of the University of Michigan’s Environmental Law and Sustainability Clinic. ”If you spoke to most clean water policy advocates today, they’d be pretty disappointed in how long it has taken to get halfway.”

The measure’s crowning achievement, Salim said, is a program that requires polluting industries and sewage treatment plans to get permits limiting their releases into waters. EPA also set pollution standards for 50 industries.

Yet the agency is far behind on strengthening those requirements to reflect pollution control technology improvements, said Eric Schaeffer, a former EPA enforcement chief and executive director of the Environmental Integrity Project, which has sued the agency over the delays.

Two-thirds of the requirements haven’t been updated in more than 30 years, the group said in a March report that blamed the outdated ones for “more pollution from oil refineries, chemical plants, slaughterhouses and other industries pouring into waterways.” Pollution control plans for large watersheds and regulatory enforcement are weak, it said, while EPA and state environmental agencies have endured repeated budget cuts.

One result, Schaeffer said, is that more than 50% of lake, river and stream miles periodically assessed are still classified as impaired.

Regan acknowledged EPA has “some more work to do” but had an “aggressive agenda to curtail pollution and upgrade standards and enforcement policies at a pace that science allows us to do.”

“We can’t ignore that the previous administration did not take action,” he said. “We also can’t ignore that we have the same staffing levels that we had in the late ‘80s. I think we’re doing a really good job of beginning to make up for lost time.”

RUNOFF LEFT OUT

The Clean Water Act prompted many states to prohibit laundry detergents containing phosphorus. Some had labeled Lake Erie “dead” as the soaps fueled algae blooms that sapped oxygen and killed fish.

The bans caused a turnaround in the 1980s. Erie was blue once more instead of brown.

Yet the algae blooms were back within a couple of decades — this time because of a problem the Clean Water Act had sidestepped.

Its emission limits and permitting requirements apply to wastes released into waters through pipes or ditches from identifiable sources, such as factories. But it doesn’t regulate runoff pollution from indirect sources — fertilizers and pesticides from farm fields and lawns; oil and toxic chemicals from city streets and parking lots — that flow into waterways when it rains.

Such runoff pollution is now the leading cause of U.S. waterway impairments.

Scientific studies say manure and fertilizer from livestock operations spread on crop fields are largely to blame for sprawling summer algae in western Lake Erie and the “dead zone” in the Gulf of Mexico, which receives massive heartland runoff from the Mississippi River. They’re also the top pollutant in Chesapeake Bay.

Environmental groups who have long argued the law allows regulation of large livestock farm pollution sued EPA this month, demanding a tougher approach. But federal and state agencies rely mostly on voluntary programs that provide financial assistance to farms for using practices such as planting cover crops that hold soil during off-seasons and buffer strips between croplands and streams. Farm groups resist making such practices mandatory.

“Agriculture politics are the third rail,” said the Environmental Integrity Project’s Schaeffer. “The farm lobby is powerful.”

Stan Meiburg, director of the Center for Energy, Environment and Sustainability at Wake Forest University and a former EPA deputy administrator, favors requiring farms and other runoff sources to bear costs of environmental damage they cause if a workable system could be found.

“But it’s not clear to me that such a thing exists in the real world,” he said. “I find it unlikely that any legislation any time soon is going to impose wide-scale restrictions on how farmers conduct their activities.”

A more practical approach, he said, is convincing farmers that anti-runoff practices are in their economic interest.

WETLAND WARS

A case argued this month before the U.S. Supreme Court involved one of the longest-running debates about the Clean Water Act: Which waters does it legally protect?

Lakes, rivers and streams are covered, as are adjacent wetlands. But 40 years of court battles and regulatory rewrites have left unsettled the status of wetlands not directly connected to a larger water body — and of rain-dependent “ephemeral” streams that flow only part of the year.

“We want to preserve and protect our ability and statutory authority to regulate in this area,” EPA’s Regan said, describing wetlands as crucial for filtering out pollutants that otherwise would flow downstream. They also store floodwaters and provide habitat for a multitude of plants and animals.

His agency is rewriting rules for those disputed waters, even as the Supreme Court prepares to provide its own interpretation from the case of an Idaho couple who wants to build a house on land with swampy areas near a lake.

“What’s at stake here is at least half the waterways in this country,” said Jon Devine of the Natural Resources Defense Council.

The National Association of Homebuilders, which supports the Idaho couple’s challenge of an EPA order to stop work on their house, says states are better suited to oversee isolated wetlands and ephemeral streams than EPA or the U.S. Army Corps of Engineers, which handles some cases.

“The federal government doesn’t have the bandwidth to regulate every single tiny wetland away from anything that would be considered navigable,” said Tom Ward, the group’s vice president for legal advocacy. State regulation was lax 50 years ago but has improved and “they know their waters,” he said.

JUSTICE FOR ALL

Environmental justice — the quest for environmental policies that treat everyone fairly, including communities of color — is a high-profile issue nowadays, although it began with early 1980s protests over a hazardous waste landfill in an impoverished, majority-black community in Warren County, North Carolina.

But for Crystal M.C. Davis, the movement began the day after the infamous 1969 Cuyahoga fire, when Carl Stokes, Cleveland’s first Black mayor, called a news conference and filed a complaint with the state seeking help in cleaning up the river. His brother, U.S. Rep. Louis Stokes, asked Congress for help — another step toward the Clean Water Act.

“The renaissance of the Cuyahoga River is personal to us,” said Davis, who is Black and a vice president of the Alliance for the Great Lakes. “That’s why we have to stop and celebrate, even though there’s still room for improvement.”

Regan, EPA’s first Black administrator, said funding provided by the infrastructure package will help the agency apply the law in keeping with science and in partnerships with state and local agencies.

“So no matter the color of your skin … or your ZIP code, you can enjoy safe, reliable water,” he said.

———

Follow John Flesher on Twitter: @JohnFlesher.

———

Associated Press climate and environmental coverage receives support from several private foundations. See more about AP’s climate initiative here. The AP is solely responsible for all content.

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October 17, 2022
Voters to decide on California ban on flavored tobacco

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SAN DIEGO — Two years ago, California banned flavored tobacco products such as menthol cigarettes and cotton candy vaping juice, arguing that they mostly attracted kids and were especially dangerous amid the coronavirus pandemic when youth deaths spiked from respiratory complications.

But the law never took effect. Tobacco giants, including R.J. Reynolds Tobacco Co. and Philip Morris USA, spent $20 million on a campaign that gathered enough signatures to put the issue to the voters.

Californians now will decide on the Nov. 8 statewide ballot whether to toss out the law or keep it.

The issue has set off a fierce fight. The tobacco companies are pushing hard to keep from being shut out of a large portion of California’s vast market. Meanwhile, supporters of the ban, who include doctors, child welfare advocates and the state’s dominant Democratic Party, say the law is necessary to put a stop to the staggering rise in teen smoking.

However, the California Republican Party wants to repeal the law, saying it would cause a giant loss in tax revenue. The independent Legislative Analyst’s Office estimates it could cost the state tens of millions of dollars to around $100 million annually.

If voters approve, California would become the second state in the nation to enact such a ban after Massachusetts. A number of cities, including Los Angeles and San Diego, have already enacted their own bans.

It’s already illegal for retailers to sell tobacco to anyone under 21. But advocates of the ban say flavored cigarettes and vaping cartridges are still too easy for teens to obtain. The ban wouldn’t make it a crime to possess such products, but retailers who sold them to kids could be fined up to $250.

The ban, which passed the Legislature with bipartisan support, would also prohibit the sale of pods for vape pens, tank-based systems and chewing tobacco, with exceptions made for hookahs, some cigars and loose-leaf tobacco.

The tobacco industry’s campaign has painted the ban as being especially bad for Black and Latino people, who use menthol at higher rates than others.

“It’s unfair for communities of color. Bad law. Bad consequences,” said one online banner ad paid for by RAI Services, a subsidiary of Reynolds American, which is the parent company of R.J. Reynolds Tobacco.

But the ads drew a backlash from some Black leaders who call the campaign offensive.

“I am insulted that the tobacco industry would make an effort to make us believe that mentholated cigarettes are part of African American culture, and that this is a discriminatory piece of legislation against Black people,” then-Assemblywoman Shirley Weber said before the Legislature voted on the ban. Weber, a San Diego Democrat who chaired the California Legislative Black Caucus, is now California’s secretary of state.

So far the campaign to allow the law to take effect has raised more than $6 million, nearly four times more than the effort to stop it, according to state campaign finance records.

Some small neighborhood market owners favor repealing the law, calling it another blow to their businesses as they struggle to recover from a drop in sales during the pandemic.

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October 15, 2022
Parkland shooter’s life sentence could bring changes to law

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FORT LAUDERDALE, Fla. — It wasn’t long ago that Florida school shooter Nikolas Cruz would have been looking at a near-certain death sentence for murdering 17 people in Parkland, even if his jury could not unanimously agree on his fate.

Until 2016, Florida law allowed trial judges to impose a death sentence if a majority of the jurors agreed. With a 9-3 vote Thursday supporting Cruz’s execution, Circuit Judge Elizabeth Scherer would have likely sent him to Death Row for the 2018 massacre at Marjory Stoneman Douglas High.

Now, however, a vote of anything less than 12-0 means an automatic sentence of life without parole — a standard the Stoneman Douglas families and the head of the state’s prosecutors association want changed. That would again put Florida in a distinct minority among the 27 states that still have the death penalty where almost all require juror unanimity.

Ed Brodsky, president of the Florida Prosecuting Attorneys Association, believes the Legislature will next year consider changing the law it passed after a pair of court decisions rejected the old law.

“When there is an overwhelmingly majority and sentiment about what the ultimate penalty should be, should one minority voice be able to dominate and hijack justice?” said Brodsky, the elected state attorney for Sarasota County and its neighbors.

Gov. Ron DeSantis at a Friday press conference criticized the sentence, but wouldn’t specify what changes he would support.

“We need to do some reforms to be better serving victims of crimes and the families of victims of crimes and not always bend over backwards to do everything we need to for the perpetrators of crimes,” DeSantis said.

Cruz, 24, pleaded guilty a year ago to the murder of 14 Stoneman Douglas students and three staff members on Feb. 14, 2018. That left it up to the seven-man, five-woman jury to only decide whether he would be sentenced to death or life without parole.

The three-month trial included horrific prosecution videos, photos and testimony about Cruz’s murders. That was followed by defense testimony about his birth mother’s heavy drinking during pregnancy that witnesses said created a brain-damaged person who began displaying erratic, bizarre and violent behavior at age 2.

After seven hours of deliberations, the jurors announced Thursday they unanimously agreed the prosecution’s argument for aggravating factors such as the multiple deaths and Cruz’s planning did exist, but not on whether those outweighed the mitigating circumstances. Scherer will impose Cruz’s life sentence Nov. 1.

“If this was not the most perfect death penalty case, then why do we have the death penalty at all?” said Linda Beigel Schulman, the mother of slain teacher Scott Beigel.

But some defense attorneys and capital punishment experts said it wasn’t surprising the jurors couldn’t unanimously agree. Only 18 death sentences were handed down nationwide last year, two of them in Florida.

The latest Gallup Poll showed 54% of Americans favor the death penalty, down from 80% in the mid-1990s. And while the Cruz jurors all said they could vote for the death penalty if chosen, they didn’t say they support it.

“At first glance, you think to yourself, ‘My God, how can you not vote for the death penalty?’” said Richard Escobar, a Tampa defense attorney and former prosecutor. He has tried capital cases in both roles. “But you’ve got to reflect and think to yourself, ‘If this person was truly mentally ill, you shouldn’t impose the death penalty because they got that mental illness through no fault of their own.’”

Robert Dunham, the Death Penalty Information Center’s executive director, said the Cruz case has a lot in common with the 2012 shooting at an Aurora, Colorado, movie theater where 12 people died. In that case, 11 jurors voted for death while one disagreed based on testimony about the shooter’s mental illness. That meant a life sentence.

“It’s not a question of does the murder warrant the death penalty. (Cruz) is clearly the type of case in which a jury could reasonably impose the death penalty,” Dunham said. “The question is ‘Does the defendant deserve the death penalty?’”

Florida’s law allowing for a majority jury vote had been in place for decades before it was overturned, but it was an outlier. Almost all death penalty states required unanimity throughout those years or adopted it. Alabama allows a death sentence after a 10-2 vote. Missouri and Indiana allow the judge to decide if jurors unanimously agree the aggravating circumstances exist but can’t agree on a sentence.

Then in 2016, by an 8-1 vote, the U.S. Supreme Court threw out Florida’s law, saying the judge had too much weight in the decision.

The Legislature passed a bill requiring a 10-2 jury recommendation, but the state Supreme Court overturned it. In 2017, the law was changed to require a unanimous jury.

Three years later, however, DeSantis, a Republican, replaced three retiring Florida justices with more conservative jurists and the state court rescinded the earlier decision. It said a death recommendation no longer needed to be unanimous, but legislators through three annual sessions haven’t changed the law back from unanimity. DeSantis never pushed them.

David S. Weinstein, a Miami criminal defense lawyer and former prosecutor, doesn’t think DeSantis and the Legislature will make any changes to unanimity next year, either — that would risk the U.S. Supreme Court throwing out the state law again.

“That ship has sailed,” he said.

But will the Cruz sentence make Florida prosecutors less likely to seek the death penalty?

Craig Trocino, a University of Miami law professor who previously handled death penalty appeals, doesn’t think so.

“It might even harden their resolve,” he said.

Still, he said, it is difficult to make broad predictions on the impact fringe cases like Cruz will have. No U.S. mass shooter who killed as many or more than Cruz had ever gone to trial — nine were killed by themselves or police during their attack or immediately after. A 10th is awaiting trial in Texas.

On Cruz’s side, it is rare for attorneys to have so much documentation supporting their mitigating circumstances. The Broward public defender’s office also had better-quality attorneys to assign to Cruz’s case and more money for investigations than their counterparts in smaller jurisdictions typically do, he said.

In those counties, “Mitigation would be one witness and it would be mama saying, ‘He was always a troubled kid,’” Trocino said.

——

Gresko reported from Washington, D.C. Farrington reported from Tallahassee, Florida. AP reporter Anthony Izaguirre in Tallahassee contributed to this report.

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October 14, 2022
Vegas survivors signal hope even as mass shootings persist

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LAS VEGAS — It’s been five years since carnage and death sent his family running into the night, leaving them separated and terrified as a gunman rained bullets into an outdoor country music festival crowd on the Las Vegas Strip.

The memories don’t fade, they sharpen, William “Bill” Henning said as he prepared for ceremonies in Las Vegas marking the date of the Oct. 1, 2017, massacre.

“Chaotic and unreal,” he recalled. “A human stampede. People were bleeding and screaming and running. We all got separated. We didn’t know who was alive. That was the most difficult.”

He’s now part of a survivor community thousands strong, one that’s helped him sort through the horror of what happened during the deadliest mass shooting in modern U.S. history. Fifty-eight people were killed and more than 850 were injured among a crowd of 22,000.

In the years since, the grim drumbeat of mass shootings has continued: schools in Uvalde, Texas, and Parkland, Florida; grocery stores in Buffalo, New York, and Boulder, Colorado; bars in Dayton, Ohio, and Thousand Oaks, California; a city building in Virginia Beach, Virginia; a Walmart in El Paso, Texas. Meanwhile, the debate over gun laws in the U.S. rages on, including a renewed challenge to the federal regulation sparked by the Las Vegas shooting.

Nevada U.S. Rep. Dina Titus on Saturday called again for a federal law banning bump stocks, the devices used by the Las Vegas shooter that allow a semi-automatic rifle to fire repeatedly with just one pull of the trigger. They were outlawed by rule by the Trump Administration but face court challenges.

And President Joe Biden also called for renewed efforts to tighten firearms laws Saturday while mourning the victims and praising residents who came together in the aftermath of the shooting.

The president noted executive action he’s taken to crack down on ghost guns and rogue gun dealers and the passage of the first significant firearms legislation in 30 years. That bipartisan law signed by Biden in June in part boosts protections for domestic violence victims, funnels cash to states for firearms crime prevention and has money for mental health services.

“But, we’re not stopping there,” Biden said in a statement. “I am determined to seize this momentum and work with Congress to enact further commonsense gun violence prevention legislation, including banning assault weapons and high-capacity magazines, which have enabled shooters to slaughter so many innocents.”

The Las Vegas massacre is part of a horrifying uptick of shootings with especially high numbers of people killed, said James Alan Fox, a professor of criminology, law and public policy at Northeastern University in Boston. Five of the nine mass shootings in modern U.S. history with more than 20 people killed have taken place since 2016, starting with the Pulse nightclub in Orlando and continuing through the elementary school shooting in Uvalde, Texas.

“The severity of public mass shootings has increased in the past few years. That’s clear,” Fox said. “And worrisome.”

Fox oversees a database maintained by The Associated Press, USA Today and Northeastern University that tracks mass killings involving four or more people slain, not including the perpetrator. The information is drawn from media reports, FBI data, arrest records, medical examiners’ reports, prison records and other court documents.

Watching the steady stream of shootings in the U.S. is tough for survivors, said Tennille Pereira, director of a Clark County recovery and support program called the Vegas Strong Resiliency Center.

“I know when it keeps happening, people often express feelings of hopelessness,” Pereira said. “I think the big thing for Las Vegas is to be able to share with those other communities that healing does occur, and that there is hope.”

For people like Henning, part of that hope has been the bond formed with other survivors. The retired computer technician was celebrating his 71st birthday at the Route 91 Harvest Festival with friends, his wife, daughter and three teenage grandchildren when the gunfire began. He suffered a knee injury while escaping that required surgery, but his group made it out without being struck by gunfire.

“At first, the first few years, it’s not really sinking in,” he said. “The more we organize ourselves, the more that we see each other, it actually brings us back to how serious this situation was.”

Many in Las Vegas who won’t name the man who police said fired 1,057 bullets from 32nd floor windows of the Mandalay Bay resort during a span of time now memorialized in a Paramount+ streaming service documentary called “11 Minutes.”

“We don’t want to give him any more power, credibility, infamy,” Pereira said. “In this survivor population, words matter. We don’t use the word ‘anniversary.’ We use ‘remembrance.’ We try not to use the word ‘victims.’ We try to use the word ‘survivor.’”

Police and the FBI spent months investigating and concluded that gunman Stephen Paddock acted alone, meticulously planned the attack and intentionally concealed his actions. He amassed an arsenal of 23 assault-style rifles in his hotel room, including 14 fitted with bump stock devices that help the weapons fire rapidly.

Caches of weapons also were found at Paddock’s homes in Reno and Mesquite, Nevada. But he killed himself before police reached him, and local and federal officials said they never identified a clear motive for the attack.

Shortly after the shooting, the administration of then-President Donald Trump banned bump stocks under the same federal laws that prohibit machine guns. Gun-rights advocates sued, saying the weapons didn’t qualify as machine guns and it would take an act of Congress to ban them.

The ban has survived several court challenges. But a federal appeals court in New Orleans revived a case there in June, the same day the U.S. Supreme Court handed down a ruling expanding gun rights. That case marked the high court’s first major gun decision in more than a decade and has sparked a wave of court challenges to gun laws around the country.

Meanwhile, in Las Vegas, survivors are working toward a permanent memorial on a corner of the former Las Vegas Strip festival ground.

A sunrise remembrance ceremony is scheduled Saturday at the Clark County Government Center, and the names of those killed will be read 10:05 p.m. — the time the shooting started — at a downtown Las Vegas Community Healing Garden.

Survivor Sue Nelson, 67, said she fled from her front-row seat and hid for hours on the Las Vegas Strip, forming deep bonds with others who escaped. She declared she has “survivor sorrow, not survivor guilt” because she didn’t do anything wrong.

Nelson drives two hours to Las Vegas from her home in Lake Havasu, Arizona, for memorial events and gives out lapel pins shaped like little guitars and rubber wrist bands stamped with: “We Remember 10.1.17 #Honors58.”

“I’m not afraid anymore,” she said. “It makes a big difference in healing when you’re not afraid anymore.”

———

Whitehurst reported from Washington.

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October 1, 2022
After #FreeBritney, California to limit conservatorships

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SACRAMENTO, Calif. — California Gov. Gavin Newsom on Friday signed a bill limiting conservatorships that grant legal guardianship over individuals, a move that comes after Britney Spears’ conservatorship case garnered national attention amid her attempts to regain control over her finances and livelihood.

The new law, authored by Democratic Assemblymember Brian Maienschein, will require that judges document all alternatives to a conservatorship before granting one. It aligns with similar legislation adopted in other states, following a push from advocates. In a statement, Newsom, a Democrat, said the state is committed to protecting the rights of Californians with disabilities.

People deemed to be unable to make certain life decisions for themselves can be placed into legal conservatorships in which a court-appointed conservator is given control over their finances and other critical aspects of their life, sometimes without their consent. They most often involve people with developmental or intellectual disabilities or those with age-related issues like dementia.

Advocacy groups contend that people like Spears, who was under a conservatorship for nearly 14 years, can become trapped in a system that removes their civil rights and the ability to advocate for themselves.

“This measure is an important step to empower Californians with disabilities to get needed support in caring for themselves and their finances, while maintaining control over their lives to the greatest extent possible,” Newsom wrote in a signing statement, calling the new law a “transformative reform to protect self-determination for all Californians.”

Spears, the pop singer and Mississippi native who has publicly struggled with her mental health, ended up at the center of a widespread #FreeBritney campaign aimed at regranting the pop singer authority over her medical, personal and financial decisions. She alleged she became a victim of misconduct at the hands of her father, James Spears, who was her conservator.

Fans and advocates rallied online and in person to bring attention to Spears’ situation. Documentaries by The New York Times and Netflix on the effects of Spears’ conservatorship brought renewed spotlight to the case and the conservatorship process more broadly. She was a 26-year-old new mother who had several public mental health struggles during the height of her career in 2008, when her father sought the conservatorship, at first on a temporary basis.

A Los Angeles judge ended Spears’ conservatorship last year, a win followed by legislative proposals to protect the rights of conservatees and efforts to make it more difficult for people to end up in one.

Maienschein, who represents parts of San Diego, thanked the governor in a statement, noting the importance of ensuring the autonomy of people with disabilities.

The new law will give potential conservatees preference for selecting a conservator and make it easier to end probate conservatorships.

Disability rights organization Disability Voices United referred to news of Newsom’s decision as historic.

“This law affirms that conservatorships should be rare and the last resort,” the group wrote. “The default should be that people with disabilities retain their rights and get support when they need it. ”

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Sophie Austin is a corps member for the Associated Press/Report for America Statehouse News Initiative. Report for America is a nonprofit national service program that places journalists in local newsrooms to report on undercovered issues. Follow Sophie Austin on Twitter.

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September 30, 2022
Lowering the Cost of Insulin Could Be Deadly

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When I heard that my patient was back in the ICU, my heart sank. But I wasn’t surprised. Her paycheck usually runs short at the end of the month, so her insulin does too. As she stretches her supply, her blood sugar climbs. Soon the insatiable thirst and constant urination follow. And once her keto acids build up, her stomach pains and vomiting start. She always manages to make it to the hospital before the damage reaches her brain and heart. But we both worry that someday, she won’t.

The Inflation Reduction Act, passed last month, aims to help people like her by lowering the cost of insulin across America. Although efforts to expand protections to privately insured Americans were blocked in the Senate, Democrats succeeded in capping expenses for the drug among Americans on Medicare at $35 a month, offering meaningful savings for our seniors, some of whom will save hundreds of dollars a month thanks to the measure. In theory, the policy (and similar ones at the state level) will help the estimated 25 percent of Americans on insulin who have been forced to ration the drug because of cost, and will prevent some of the 600 annual American deaths from diabetic ketoacidosis, the fate from which I’m trying to save my patient.

Indeed, laws capping co-payments for insulin are welcome news both financially and medically to patients who depend on the drug for survival. However, in their current version, such laws might backfire, leading to even more diabetes-related deaths overall.

How could that be true? Thanks to the development of new drugs, insulin’s role in diabetes treatment has been declining over the past decade. It remains essential to the small percent of patients with type 1 diabetes, including my patient. But for the 90 percent of Americans with diabetes who have type 2, it should not routinely be the first-, second-, or even third-line treatment. The reasons for this are many: Of all diabetes medications, insulin carries the highest risk of causing dangerously low blood sugar. The medication most commonly comes in injectable form, so administering it usually means painful needle jabs. All of this effort is rewarded with (usually unwanted) weight gain. Foremost and finally, although insulin is excellent at tamping down high blood sugar—the hallmark of diabetes and the driver of some of its complications—it is not as impressive as other medications at mitigating the most deadly and debilitating consequences of the disease: heart attacks, kidney disease, and heart failure.

Read: People are clamoring to buy old insulin pumps

Large clinical trials have shown that two newer classes of diabetes medicines, SGLT2 inhibitors and GLP-1 receptor agonists, outperform alternatives (including insulin) in reducing the risk of these disabling or deadly outcomes. Giving patients these drugs instead of older options over a period of three years prevents, on average, one death for about every 100 treated. And SGLT2 inhibitors and GLP-1 receptor agonists pose less risk of causing dangerously low blood sugar, generally do not require frequent injections, and help patients lose weight. Based on these data, the American Diabetes Association now recommends SGLT2 inhibitors and GLP-1 receptor agonists be used before insulin for most patients with type 2 diabetes.

When a young person dies from diabetic ketoacidosis because they rationed insulin, the culprit is clear. But when a patient with diabetes dies of a heart attack, the absence of an SGLT2 inhibitor or GLP-1 receptor agonist doesn’t get blamed, because other explanations abound: their uncontrolled blood pressure, the cholesterol medication they didn’t take, the cigarettes they continued to smoke, bad genes, bad luck. But every year, more than 1,000 times more Americans die of heart disease than DKA, and of those 700,000 deaths, a good chunk are diabetes-related. (The exact number remains murky.) Diabetes is a major reason that more than half a million Americans depend on dialysis to manage their end-stage kidney disease, and that about 6 million live with congestive heart failure. The data are clear—SGLT2 inhibitors and GLP-1 receptor agonists could help reduce these numbers.

Still, uptake of these lifesaving drugs is sluggish. Only about one in 10 people with type 2 diabetes is taking them (fewer still among patients who are not wealthy or white). The main cause is simple and stupid: American laws prioritize profits and patents over patients. Because SGLT2 inhibitors and GLP-1 receptor agonists remain under patent protections, drug companies can charge exorbitant rates for them: hundreds if not thousands of dollars a month, sometimes even more than insulin. Doctors spend hours completing arduous paperwork in the hopes of persuading insurers to help our patients, but we’re frequently denied anyway. And even when we do succeed, many patients are left with painful co-payments and deductibles. The most maddening part is that despite their substantial up-front expense, these medications are quite cost-effective in the long run because they prevent pricey complications down the road.

Read: The risks of over-the-counter diabetes treatments

This is where addressing the cost of insulin—and only insulin—becomes problematic. Doctors are forced daily to decide between the best medication for our patients and the medication that our patients can afford. Katie Shaw, a primary-care physician with a bustling practice at Johns Hopkins, where I’m a senior resident, told me that plenty of her patients can’t afford SGLT2 inhibitors and GLP-1 receptor agonists. In such instances, Shaw is forced to use older oral alternatives and occasionally insulin. “They’re better than nothing at all,” she said.

If the cost of insulin is capped on its own, insulin will be more likely to jump in front of SGLT2 inhibitors and GLP-1 receptor agonists in treatment plans. That will mean more disease, more disability, and more death from diabetes.

Medicare patients might avoid some of these effects thanks to provisions in the IRA allowing Medicare to negotiate drug prices and capping out-of-pocket spending on prescriptions at $2,000 a year. The law also guarantees price negotiations for a handful of medications, but SGLT2 inhibitors and GLP-1 receptor agonists won’t necessarily be on the list. And most Americans are not on Medicare. Already, Shaw said, the patients in her practice who tend to be least able to afford SGLT2 inhibitors and GLP-1 receptor agonists are working-class people with private insurance. Some health centers, including the one Shaw and I work at, enjoy access to a federal drug-discount program that can make patent-protected medications, including SGLT2 inhibitors and GLP-1 receptor agonists, more affordable for the uninsured. But most Americans without insurance aren’t so lucky.

It would be cruel to choose between a world in which more people with type 2 diabetes are nudged toward a drug that won’t stave off the most dangerous complications, and one in which those with type 1 diabetes are priced out of life. In place of capping the out-of-pocket cost of just insulin, lawmakers should cap the out-of-pocket cost of all diabetes medications. This will both protect Americans dependent on insulin and smooth SGLT2 inhibitors’ and GLP-1 receptor agonists’ path to their revolutionary public-health potential.

Read: Big Pharma’s go-to defense of soaring drug prices doesn’t add up

The argument for lowering the cost of these drugs for patients is the same as the argument for insulin affordability: that it is both foolish and inhumane to make lifesaving diabetes medications unaffordable when their use prevents costly and deadly downstream complications.

Patients like mine need affordable access to insulin. But even more need access to SGLT2 inhibitors and GLP-1 receptor agonists. If the laws stop at insulin, many Americans could die unnecessarily—not from inadequate access to insulin, but from preferential access to it.

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Michael Rose

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September 5, 2022