The latest installment of The Dilemma focuses on lightening the workplace environment
Editor’s note: All names and businesses in this dilemma case are fictitious, but the scenario is based on real occurrences.
Harden Animal Hospital takes pride in being progressive. This 16-year-old companion animal clinic with a staff of 35 is always striving for excellence. The hospital director, Dr Harden, believes that excellence comes in many forms, the most obvious being excellent medical care. Dr Harden also believes that a positive workplace environment is critical to an efficient, well-run practice and that fun distractions can relieve some of the stresses that come with caring for sick pets and concerned owners. After consulting with his practice management, he devises several activities to lighten the workday atmosphere without diverting the focus of the professional medical team.
One interesting idea was a staff bingo board. Each month, the staff member who witnesses the most circumstances on the bingo board receives a gift card. Another idea consisted of exchanging greeting cards on Valentine’s Day with bad animal jokes enclosed. An example of a exact card read, “Happy Valentine’s Day. I just tried to call the zoo, but I could not get through because the lion was busy.”
Once a month the practice celebrates all staff members who had birthdays that month. The staff members are acknowledged, a birthday cake appears in the break room, and birthday wishes are offered in word and song. This allows staff to see their coworkers not only as work colleagues but also as valued community members with lives and milestones independent of their daily medical tasks. Adding pleasant but poignant lighthearted activities to the workplace is an important part of maintaining staff morale. When veterinary staff members consider their priorities when selecting a job, they must consider workplace location, environment, and monetary compensation. In today’s stressful world, monetary compensation can’t always be assumed to be a first choice. In essence, money isn’t everything.
For many years, veterinarians have ranked too high on the list of professionals who commit suicide. Suicide is more likely among veterinarians than the general population: 1.6 times more likely for male veterinarians and 2.4 times for female veterinarians.1 We must minimize the stress veterinary professionals encounter in their day-to-day practice. The Harden Animal Hospital chose to offset some workplace stress by mixing a bit of fun into the daily routine. Other approaches to minimize the stress associated with the literal life-and-death issues of patients were staff schedule flexibility, easy access to mental health care resources, and promotion of empowerment within the workplace.
Hospital directors and hospital managers must let the staff know early on that they are always available to assist with these issues in a confidential manner. Just as there are frequent representatives who come to the clinic to detail their new product lines, there should also be an opportunity for mental health care professionals to speak to the staff about managing stress.
Some may think that this clinic was too intrusive when it came to inquiring and celebrating the staff concerning personal matters. Others see this as part of normal staff support that comes in a healthy workplace. We would like to know your thoughts.
Rosenberg's response
It’s 2023, and the veterinary medical world is changing. The workforce has gone from majority men to majority women. Family dynamics have dictated necessary changes in the veterinary workplace. Social media and telemedicine are now integral parts of veterinary practice. One of the things that has not changed—and will not change—is the stress related to dealing with the health and welfare of patients and demands of pet owners. My hope is that the same attention given to new medical advances can also be directed toward managing stress-related issues in the workplace.
Marc Rosenberg, VMD, is director of Voorhees Veterinary Center in Voorhees, New Jersey. Although many of the scenarios Rosenberg describes in his column are based on real-life events, the veterinary practices, doctors, and employees described are fictional.
Reference
Nett RJ, Witte T, Spitzer EG, Edwards N, Fowler KA. Suicide risk for veterinarians and veterinary technicians. CDC. September 4, 2019. Accessed June 28, 2023. https://blogs.cdc.gov/niosh-science-blog/2019/09/04/veterinary-suicide
Alzheimer's disease, one of the most common neurodegenerative diseases, leads to progressive loss of memory and autonomy. It is characterized by the accumulation of neurotoxic proteins in the brain, namely amyloid plaques and tau tangles. Due to the silent development of pathology over decades, very early diagnosis is of utmost importance to be able to take action as early as possible in the disease process. A team from the University of Geneva (UNIGE) and the Geneva University Hospitals (HUG) has demonstrated that tau PET - a novel imaging technique for visualizing the tau protein - can predict cognitive decline in patients much better than the imaging techniques normally used. These results, published in Alzheimer's & Dementia: The Journal of the Alzheimer's Association, argue in favor of the rapid introduction of tau PET into the clinical routine to provide patients with early and individualized solutions.
Today, one of the main diagnostic tools for Alzheimer's disease is positron emission tomography (PET), an imaging technique in which tracers are injected to visualize specific pathological processes in the brain. "PET involves injecting patients with low-level radioactive tracers that disappear within a few hours. They are designed to bind to the human molecules that we want to detect, making them visible with the PET tomographs," explains Valentina Garibotto, Associate Professor in the Department of Radiology and Medical Informatics at UNIGE Faculty of Medicine and Head Physician in the Division of Nuclear Medicine and Molecular Imaging at the HUG, who directed this research.
"Specific tracers for amyloid exist since two decades, and tracers to monitor glucose metabolism, which indicates the brain's ability to use its energy resources correctly, have long existed. However, Alzheimer's disease is complex and these two techniques are not enough to provide all the answers."
Comparing imaging techniques
Flortaucipir is a radiotracer that binds to the tau protein. It was developed by a pharmaceutical company and approved by the Food and Drug Administration (FDA) in 2020. It allows the detection of tau accumulation as well as its distribution in the brain to precisely assess its role in the clinical manifestation of the disease. Scientists from the UNIGE and the HUG wanted to determine which imaging modality - amyloid PET, glucose metabolism PET, or tau PET - would best predict future cognitive decline due to Alzheimer's disease. Around 90 participants were recruited at the HUG Memory Centre.
Our results show that while the various PET measures were all associated with the presence of cognitive symptoms, confirming their role as strong indicators of Alzheimer's disease, tau PET was the best to predict the rate of cognitive decline, even in individuals with minimal symptoms."
Cecilia Boccalini, a PhD student in Professor Garibotto's team and first author of the study
Detecting individual variations
Amyloid plaques are not necessarily accompanied by cognitive or memory loss. However, the presence of tau goes hand in hand with clinical symptoms. Its absence or presence is the main determinant of whether a patient's condition remains stable or deteriorates rapidly. It has been more difficult to develop imaging techniques to visualize tau, mainly because of its lower concentration and particularly complex structure.
"This breakthrough is crucial for better management of Alzheimer's disease. Recently, drugs targeting amyloid have shown positive results. New drugs targeting the tau protein also look promising. By detecting the pathology as early as possible, before the brain is further damaged, and thanks to new treatments, we hope to be able to make a greater impact on patients' future and quality of life," Valentina Garibotto points out. "Similarly, we are beginning to map the distribution of tau in order to understand how its location in the different regions of the brain influences symptoms." Indeed, the causes and different stages of the disease are proving to be much less uniform than previously thought, and individual susceptibility to the same phenomena needs to be better understood.
These results are a strong argument in favor of incorporating tau PET into the routine clinical evaluation to assess individual prognosis and select the most appropriate therapeutic strategy for each patient.
The public intellectual Irving Kristol famously said that the definition of a neoconservative is “a liberal who has been mugged by reality.” By the same token, the definition of a convert to immigration restrictionism is a big-city mayor dealing with a surge of illegal immigration in his city.
In his desperate pleas for federal help to deal with about 100,000 migrants who have come to New York City since the spring of 2022, Mayor Eric Adams is vindicating the hawkish position on immigration with almost every utterance. All that it has taken to explode the lazy cliches that have defined the progressive position on the issue is a heavy flow of illegal immigration.
If immigration is an unalloyed good, this influx should be a boon to New York City and its future. Why stop at 100,000 if the city could have 200,000 or 300,000? If immigration has no cost, why is New York spending $5 billion this year absorbing this flow? According to Adams, New York City “is being destroyed by the migrant crisis.”
There you have it — immigration, in and of itself, has the power to bring a great city to its knees. Long gone are the days when Adams pledged during his campaign to “lift up immigrants as high as Lady Liberty lifts her torch in our harbor, as a beacon of hope for all who come to our shores.”
Now, he sounds a lot like Donald Trump, or a late Roman emperor getting undone by an influx of Vandals and Goths.
New York has been actively discouraging immigrants, or, to use the progressive line, “slamming the door on new migrants.” Flyers distributed by the city at the border say, “Housing in NYC is very expensive,” and no one can say that isn’t truth in advertising. “Please consider,” the message pleads, “another city as you make your decision about where to settle in the U.S.” In other words, why not try Philadelphia?
What Adams is learning is that the key questions when it comes to immigration are: how many, from where, with what skills and what will they do once here? The fact is — as border areas already realized — low-skilled migrants with few connections in the community showing up en masse constitutes an intolerable fiscal and social burden.
It is true that there are unique circumstances at play for Adams. Asylum seekers can’t work until their applications have been considered for six months; New York City has a right-to-shelter law that has added to the expense. If asylum seekers, many of whom are making bogus claims, were instantly handed work permits, though, it would be another incentive for illegal immigration. And even places without New York’s shelter laws are strained by the arrival of the Biden-era illegal immigrants and have been declaring states of emergency.
The wave of migrants over the past couple of years aside, immigrants to the United States are heavily reliant on public resources because they tend to be poor and have low levels of education. An analysis of Census Bureau data by the Center for Immigration Studies shows that 58 percent of households in New York State headed by immigrants use at least one welfare program. Even if illegal immigrants aren’t technically eligible for some of these programs, their U.S.-born children are.
And as we see in the current crisis, if people show up who need housing, medical care and education, no one is simply going to say no. To his credit, Adams has been focusing more attention on the federal failures at the border, but a key component of the Adams immigration plan was blocking federal enforcement. Now, immigration enforcement by the feds isn’t such a bad thing.
What New York City is seeking, after all the rote invocations of the Statue of Liberty, is fewer migrants competing with people already living in the city for resources and attention. That really shouldn’t be too much to ask. Welcome to reality, Mayor Adams.
Rich Lowry is on X @RichLowry.
DON’T LIKE HOLVEY? THERE’S AN ELECTION FOR THAT
As a life-long Democrat, I strongly oppose the efforts to recall Paul Holvey from the Oregon Legislature. Holvey has repeatedly demonstrated strong support for labor and progressive politics. It is ironic that a lone union leadership is interested in recalling him. If you don’t like him, vote against him. Trying to recall him is an abuse of the system and a false accusation against an honest and courageous representative.
Munir Katul
Eugene
‘NO’ TO THE RECALL
The full-page ad in the August 10 edition of Eugene Weekly said, “Paul Holvey is not a bad person, but we deserve a better state representative.” That says it all. While Holvey may fit that description, that is not a reason for a recall. That is what elections are for.
John Bredesen
Eugene
RECALL HOLVEY FOR BEING UNRESPONSIVE
I’ve written the Oregon Beverage Recycling Cooperative several times regarding the meager options for bottle returns here in Eugene, a city approaching 200,000 people. No response.
I submitted several letters to the editor when The Register-Guard printed them, addressing the breach of public trust regarding recycling and the lack of bottle/can return options plaguing our “progressive” state.
I wrote to Rep. Paul Holvey and attached documentation, info and suggestions regarding the lack of options our community has for bottle and can returns here in Eugene. No response.
I support the recall of Paul Holvey. No thank you for your input. No acknowledgement. No reply. No recognition of any kind.
It’s like he doesn’t really exist.
Robin Kelly
Eugene
WHY IS A UNION ATTACKING HOLVEY?
I am deeply disturbed that a union has launched an effort to recall state Rep. Paul Holvey. This effort is driven by false claims that Holvey has made “repeated attacks on the livelihoods” of Oregon workers and “shown allegiance to large corporations.” It’s also worth noting that no other union in Oregon is supporting this campaign.
Holvey’s exemplary 20-year record of fighting for workers, consumers and small businesses forcefully refutes these claims. Having worked with him on numerous occasions as a labor and political activist, I have direct knowledge of his many legislative achievements.
As a union carpenter with deep roots in the labor movement, Holvey worked diligently to create new standards, protections and opportunities that have improved the lives of working Oregonians. He led efforts to increase the state minimum wage, offer paid sick leave to Oregon workers, provide farm workers with overtime pay and expand apprenticeship programs. He has fought to curtail predatory loan practices that harm consumers and has sponsored legislation that granted small businesses tax relief to help them during the height of the COVID-19 pandemic. His career has been marked by a rare combination of persistence, passion and principle that have earned him the respect of his colleagues and his constituents.
In the words of a famous labor song, Holvey has always known which side he is on. Voters in District 8 should reject this ill-advised recall campaign and stand in solidarity with one of Oregon’s finest and most effective elected officials.
Bob Bussel
Eugene
NO STADIUM AT THE FAIRGROUNDS
Forty-three million dollars may not sound like a lot of money for some, but, with the pandemic and all the economic upheavals for everyone, I would hope that $43 million can be put toward many immediate needs in our city, county and state. For example, health care, housing, jobs, education and more.
The Elmore family, Donna Frame Tuttle and the shareholders of the San Francisco Giants have $43 million. They can build a stadium anywhere. The location of the Lane County Fairgrounds isn’t an appropriate site for any stadium. It’s a residential neighborhood. The Fairgrounds has many annual and seasonal events plus has the potential to create even more events. Maintaining a place for emergency preparedness with all the fires and natural disasters that may occur is crucial.
The city and county can hold public hearings now, regarding the building of a new stadium at the Fairgrounds. We do not need to vote on a bond measure. And what would be the environmental impacts of building and maintaining a stadium at the Fairgrounds? With almost 400,000 people living in Lane County, I think our priorities need to be with what people truly need.
Planet Glassberg
Eugene
THE STADIUM PLAN IS ALL ABOUT GIVING AWAY PUBLIC RESOURCES
I live near the Fairgrounds. The discussion of whether baseball is a good idea for the neighborhood is the wrong conversation. That is a frame designed by marketers who are paid by developers to get the win. The win is to transfer public resources, lands and funds into private control.
Developers extend their profit when they acquire public resources. Marketers argue this transfer of value is for public benefit. That frame, about the future, is extremely vague. Professional marketers sway the public and our officials with a positive vision. The public loses, exchanging material value for a rhetorical pie in the sky.
The framed counter-argument is also designed by the same marketers. A straw man argument gives the illusion of a righteous contest but is designed to lose. The lifeless “No Stadium at the Fairgrounds” vs. “Pie in the Sky” work together to strip the public of resources and extend private, individual and corporate control.
Manipulation marketing works on our human psychology, our hopefulness and fear. Through this method, private interests, kings and corporations seize resources while the public is stripped of the commons.
The only conversation we should be having is whether it is or is not a good idea to continue to deliver the commons to private interests.
Otis Haschemeyer
Eugene
EDUCATION SHOULD ALWAYS BE CHALLENGING
Recently, the 2023 Idaho Teacher of the Year winner was harassed so frequently by right-wing parents and community members that she decided to leave the state to pursue a different career. What exactly was she harassed about? She committed the ultra-conservative sin of discussing world cultures and recognizing the existence of the United Nations. In a letter Thomas Jefferson wrote in 1816, he said, “If a nation expects to be ignorant and free, in a state of civilization, it expects what never was and never will be.”
Education is not limiting but liberating. Education should challenge us and our ideas, and lead us to challenge the world in which we participate. Education should reveal our prejudices and misconceptions. Ideally, education should lead us from knowledge to wisdom and understanding.
In the 4th century BCE, when asked where he was from, Diogenes of Greece said “I am a world citizen.” To prepare us for living in the current world, education should develop us to be citizens of the world.
Christopher and Deb Michaels
Eugene
UNLINK FROM CENTURYLINK
We live approximately 14 miles south of Eugene in a rural area. CenturyLink is our landline carrier. We have had no landline service for a week and a half now. There is no communication from CenturyLink, and it is next to impossible to reach a real person to talk to.
Our neighbor is 87 years old and has many medical issues. He does not have a computer, nor does he have a cell phone. He had a medical emergency in the midst of the phone outage and had to try to physically get himself to a neighbor’s so he could be taken to the emergency room and be taken care of.
This is 2023. It is hard to believe that we could possibly be without phone service for so long and, even more important, why is it that those of us who live in rural areas are the least and last served when it comes to communications, whether it be phones or wi-fi, etc.
CenturyLink is tone deaf and has very poor customer service. We will certainly be looking at other options.
Marion Sproul
Eugene
CORNEL WEST OFFERS A NEW APPROACH
You know, it’s truly disappointing to witness the Democratic Party resorting to fear-mongering tactics. Their attempt to frame a vote for Cornel West as somehow aiding Trump is nothing but a distortion of the truth. In fact, supporting West’s candidacy represents a principled stand against not only the Trump administration but also the Biden administration’s shortcomings.
When you cast a vote for West, you’re not just rejecting the status quo; you’re demanding a better future for all Americans. It’s about advocating for essential rights like health care and housing that should be accessible to every individual, regardless of their socioeconomic background. West’s campaign underscores the importance of prioritizing the needs of the people over political games.
It’s high time we break away from the binary thinking that a vote must only be about keeping one side out of power. We should be voting for genuine change, for policies that uplift the marginalized, and for leaders who prioritize the welfare of the entire nation. A vote for West is a vote for a more just and equitable society, where healthcare and housing are not privileges but fundamental rights.
Let’s move beyond the partisan rhetoric and focus on the issues that truly matter. Let’s support candidates like West who are committed to addressing the pressing concerns of our time and working towards a future where everyone can thrive.
Devon Lawson-McCourt
Walterville
In the September 5 special-election primary to replace Rep. David Cicilline (D-RI) in Rhode Island’s First Congressional District, a crowded field of 14 candidates has narrowed into a proxy battle between the moderate and progressive wings of the Democratic Party. With just under a month left, exact polling shows that the top two contenders are Lt. Gov. Sabina Matos and former state legislator Aaron Regunberg, who narrowly lost a race for lieutenant governor in 2018. The race also includes former Biden administration aide Gabe Amo, who has been endorsed by former chief of staff Ron Klain, and clean-energy investor Don Carlson, whose personal funding of his campaign has given him the most money in the race.
Regunberg leads the pack with both the most money raised from individuals other than the candidate’s personal finances and the most small-dollar donors, according to FEC filings. However, Matos is getting significant help in the final stretch of the race from independent-expenditure money, largely from Bold PAC, an outfit run by the Congressional Hispanic Caucus and funded by corporate donors.
The PAC recently spent $300,000 on a round of TV ad spots lauding Matos’s credentials as lieutenant governor, with another round of ads for the final weeks estimated at roughly the same price tag. Regunberg is the only candidate in the race to take the “No Big Tech Money” pledge, run by the same group that organized the No Fossil Fuel Money drive.
This is a far cry from the flood of money seen in other open-seat primaries in the past few years. Even the campaigns’ fundraising numbers have been fairly anemic for a House race. The muted interest is likely due to the fact that the race might look from outside the state like a benign contest in a safe blue district with few ideological distinctions. Regunberg is a 33-year-old local fixture popular among the state’s climate activists, while Matos, who was born in the Dominican Republic, became the first Black woman elected to statewide office in 2022.
But exact endorsements have put in stark contrast the showdown between the progressive and moderate wings of the party playing out in the race.
At the end of last month, Regunberg drew endorsements from both Sen. Bernie Sanders (I-VT) and the Congressional Progressive Caucus. This added to the list of other national figures who’ve endorsed his candidacy, including Reps. Jamie Raskin (D-MD) and Ro Khanna (D-CA). With backing from the Working Families Party as well, he’s running on left-wing policy priorities such as Medicare for All, the Green New Deal, and curbing monopoly power.
Shortly after the CPC entered the race for Regunberg, Matos received support from the centrist New Democrat Coalition following other national endorsements from the Congressional Hispanic Caucus and EMILY’s List.
Cicilline, a Progressive Caucus member who led the House Antitrust Subcommittee in an anti-monopoly direction, hasn’t weighed in on the race.
MATOS’S MESSAGE HAS FOCUSED LESS on distinct policy goals and more so emphasized personal authenticity and a track record of pragmatic leadership as lieutenant governor and former president of the Providence City Council. Her exact ad is entitled “Worked Hard,” a nod to both her experience serving in government and her immigrant background working in a garment factory in New York.
But her campaign’s pitch of technocratic competence has been undermined by a exact forged ballot signature scandal that’s hanging over her campaign. Last month, the Rhode Island Board of Elections reported that dozens of signatures Matos’s campaign submitted to qualify for the ballot were invalid, traced back to either deceased residents or others who said they had never signed the nomination papers. Matos has placed the blame on one of the vendors hired by the campaign to collect signatures. The vendor, which is now facing charges, claims that the campaign never provided adequate training or instruction to its canvassers.
After initially waiving the case, the Board of Elections this week reversed course and voted to open a probe into the forged signatures. The Rhode Island state police and the attorney general’s office are carrying out active criminal investigations as well, which will drag out the scandal well beyond primary day.
Though the forged signatures don’t threaten to disqualify her nomination for the primary ballot, the whole affair has opened Matos up to scrutiny, including from other candidates in the race.
The Matos campaign’s pitch of technocratic competence has been undermined by a exact forged ballot signature scandal that’s hanging over her campaign.
“We’re living in a moment where faith in our electoral system is under threat from the right, and unfortunately this signature scandal is the kind of event that provides fodder for that,” said Regunberg in an interview with the Prospect. “I haven’t seen the lieutenant governor take ownership for that component.”
In a statement to the Prospect, Matos’s campaign responded to the criticism of her handling of the scandal. “The Lt. Governor’s campaign was defrauded by a vendor that it hired to help with signature collection. Unfortunately, our opponents have tried to use this circumstance to try to boost their profile and score political points.”
But Matos’s opponents have also tied the signature debacle to a number of past scandals that took place under her watch as president of the Providence City Council and which are now coming under renewed scrutiny.
ONE CONTROVERSY ENTAILS A SWEETHEART TAX DEAL that the city government handed a big real estate developer, just months after Matos left her post as council president in early 2022. In a drawn-out court settlement, the city made a deal with developer Buff Chace to list a number of luxury apartments as affordable housing, qualifying the firm for $30 million in tax breaks. The developer had been a major financial benefactor to the campaigns of former Mayor Jorge Elorza and most members of the city council, including Matos.
The tax giveaway has been such a drain on the city’s coffers that the current council just voted last month to challenge the deal. Though the blame largely falls on Mayor Elorza for brokering the settlement, critics argue that Matos, as president of the council, was privy to the details of the case as it made its way through court, and should have raised alarms about it. Matos’s campaign argues that she had no involvement in the settlement.
“The only thing [Matos] knew is they were seeking that tax relief,” campaign spokesperson Evan England told The Providence Journal. “Whatever came out of the negotiations and the final arrangement was after she left.”
The head of the real estate trust, Arnold Chace, is a campaign contributor to Matos’s current bid for Congress, donating $1,000 at the outset of the race, according to FEC filings.
Matos is also coming under fire for supporting a private equity transaction in 2021 that threatened to shutter several safety-net hospitals in Providence, despite the objections from local hospital unions and the state attorney general.
The transaction was the final coup de grâce by Prospect Medical Holdings and its majority owner Leonard Green & Partners, a private equity firm based in Los Angeles. In 2014, Prospect bought a Rhode Island hospital chain, CharterCARE, including two distressed hospitals in Providence, Roger Williams and Our Lady of Fatima, that served mostly low-income patients on Medicare and Medicaid. At the time, the United Nurses and Allied Professionals union, which represented workers at the hospitals, supported the deal for saving them from financial ruin. Within months of Prospect taking over, they changed their tune.
Prospect immediately sought to slash costs by laying off staff, cutting benefits, and starving the hospitals of resources. A consultant report from 2017 found that dirty and broken equipment was being used in operating rooms, because of limited stockpiles provided to staff by management.
As a 2020 ProPublica investigation showed, these cost-cutting practices followed the private equity playbook used by Prospect across its nationwide chain of safety-net hospitals: purchase precarious hospitals through leveraged buyouts, reduce costs to generate profits in the short term, and then sell off the hospital with piles of debt or file it for bankruptcy.
While quality of care declined at the hospitals in Providence, Prospect executives in 2018 issued a nearly $500 million dividend payment to shareholders, in violation of an agreement it struck with state regulators. Prospect’s top two executives, Sam Lee and David Topper, took in the lion’s share of the dividend, with over $200 million between the two of them.
When the union caught wind of the payout, they tried to inform the public but seemed to be the only ones in the state raising alarms. Rep. Cicilline also blasted the company in a letter to its executives for the dividends and other financial chicanery.
In 2020, Leonard Green decided to exit Prospect and sell its majority ownership stake to Lee and Topper, the two executives who issued the dividend payouts to themselves several years prior.
The union fought the ownership transfer, suspecting that it would leave the hospital in a worse financial state, an intuition that would later be vindicated by a state AG investigation.
By contrast, Matos sung the firm’s praises and supported the transfer in statements to state regulators, which had to approve the transaction. At a meeting of the Health Services Council to review the transfer, Matos focused mainly on how the firm initially saved the two Providence hospitals in 2014 and its critical role during the pandemic, despite reports of the hospitals’ hampered response because of the cost-cutting measures.
The union assumed Matos must not have been aware of the firm’s nefarious practices at the hospitals or the dividend payments. They scheduled a meeting with her that year to tell her directly about their opposition. After the meeting, Matos did not backtrack on her support.
“If you miss something that’s one thing, we all do that, but when you’re confronted with an issue head-on and don’t do anything about it, that’s a major problem for us and raises doubts about your judgment,” said Chris Callaci, general counsel for UNAP, who held the meeting with Matos on behalf of the union.
State Attorney General Peter Neronha held up the transaction after conducting a damning investigation into the firm. It uncovered that Prospect had placed the two hospitals down as collateral on an outstanding $100 million promissory note, which indicated that the executives likely intended to sell off the hospitals with piles of debt.
“Our investigation revealed a company whose principals and investors have issued millions of dollars in dividends from a business responsible for the safety-net hospitals and services they own, which has translated into debt held by the entire system, such that liabilities now exceed assets by over $1 billion,” the report stated.
The attorney general ultimately conditioned the transfer on Prospect putting $80 million into an escrow account to cover operating costs and capital expenditures at the hospitals over the next five years. Prospect is now in the process of selling both Providence hospitals to an Atlanta-based nonprofit chain.
In a statement to the Prospect, Matos explained her rationale for supporting the sale. “The change in ownership was a complex and complicated transaction. I had no doubt that the appropriate governing bodies, including the Attorney General, Health Services Council, and state regulators would take great care in examining the underlying financial and clinical implications of the proposal.”
THE UNION STILL HARBORS RESERVATIONS about Matos, which is why they aren’t endorsing her candidacy.
“With the forged signature controversy on top of our experience with her during the Prospect transfer … it raises questions for me about her leadership,” said Callaci.
UNAP, however, isn’t endorsing Regunberg either. Instead, they’re backing state Sen. Sandra Cano.
In the final stretch before the September 5 primary, both candidates are trying to shore up support with remaining undecided voters. As Matos’s campaign prepares to run another round of TV ads, Regunberg is building an extensive ground game with the assistance of the Working Families Party.
The Regunberg campaign believes national endorsements such as from Sen. Sanders have squashed any remaining questions about whether Regunberg is the true progressive in the race. Early on, Regunberg faced attacks from local left-wing organizations such as the Rhode Island Political Cooperative and Providence DSA, both intent on casting doubt about his record, which they deemed insufficiently hostile to party leadership.
Regunberg has countered that his priorities have always been focused on getting progressive legislation passed by building broad coalitions, not casting stones. The resistance of local groups didn’t hold any sway with national left-wing standard-bearers like Sen. Sanders or Rep. Khanna, nor does it seem to have made any noticeable impact on Regunberg’s support among voters in the district.
San Francisco joined the short list of cities with reform-oriented prosecutors in 2019 with the election of Chesa Boudin, a rising star in the progressive prosecutor movement. The child of two parents incarcerated for their involvement with the leftist group Weather Underground, Boudin campaigned on ending cash bail, decarceration, and police accountability. The city saw many real results as he followed through on several of these promises his first year in the role. Boudin forbade his staff from requesting money bail under any circumstances, San Francisco’s jail population dropped by 25%, and law enforcement officers were charged in three different police brutality cases.
His term was cut short in the summer of 2022, however, when a $7.2 million recall campaign removed him from office. Support for his recall was couched in the language of public safety and racial justice, but the effort was largely funded by real estate investors, Republican billionaires, and private equity executives. A total of 26% of registered San Francisco voters participated in the special recall election, with only 15% of all San Francisco voters supporting his removal from office.
Now, Boudin is tackling the same issues from outside the electoral sphere. He spoke with In These Times about his new job at Berkeley’s Criminal Law and Justice Center and how he thinks abolitionists can win in San Francisco, California, and the nation. This interview has been edited for length, order, and clarity.
Avalon Edwards: In California, there’s this long history of over-investing in incarceration, but an equally long history of people resisting that. This year, California Democrats supported a budget plan to close five additional prisons by 2027, due in part to that organizing. What do you think the state is doing right when it comes to decarceration, and where do you feel like we could be doing more?
Chesa Boudin: We have created a culture where people expect, as the only possible response to harm that occurs in the community, a punitive carceral response. Changing that requires not only doing the political, organizing, and education work, but it requires shifting culture and building out alternative infrastructure. The year before I took office in San Francisco, there were about a million calls to police. About 5% of those were violent crimes in progress. Police are wasting resources, and in many instances, exposing themselves to harm and causing harm to others. When they’re the first line of response, it’s more expensive for taxpayers, it’s less effective, it’s more likely to result in somebody getting shot and killed. It means that police are spread too thin to do the job that they’re uniquely positioned to do, which is to respond to violent crimes in progress. That’s a long term fight, building out an alternative infrastructure that can respond in real time to overdoses, or to find people shelter, or to do all of the things that police are being asked to do. We have to not only invest the money, we have to also take the time to normalize having a social worker or a case manager respond to a 911 call.
Those of us who are in the struggle are in it because of the urgency of the issues we’re working on. And yet, we also have to have the commitment to stay the course and take the time. I heard the candidate for Harlem City Council, who was one of them Central Park Five, Yusef Salaam, speak recently. He was exonerated after Trump tried to have him put to death for a rape he didn’t commit. He said, we need to have 50-year plans, 100-year plans. The kind of change that we’re talking about is in response to hundreds of years of racial oppression of slavery, of Jim Crow. And so for us to expect that it’s going to happen overnight, it’s just not realistic.
AE: A lot of abolitionists would argue that you can’t simultaneously be an abolitionist and a prosecutor. Do you identify as an abolitionist?
CB: I’ve had a lot of those conversations. One of them I had with Angela Davis, who supported my election and publicly opposed my recall. She said, “Do you see yourself as an abolitionist?” I said, “I’m not sure. My dream would be to live in a world where we don’t have jails or prisons or crime or police. But I also don’t think it’s a good idea to just open the prison gates and let everybody out. I think we don’t have the infrastructure to support people. We have people who are really damaged and who are really violent and who we, at the moment, don’t have good alternatives for.” She said, “Well, that’s the work we have to do in the movement. We have to build those alternatives.”
AE: Dr. Ruth Wilson Gilmore says, it’s not just about taking down death-making institutions, but also creating life-affirming ones. That is abolitionist work, the housing work, the healthcare work, the mental health services work— all of that falls under the category of abolition, not just direct prison closures.
CB: I think that when folks who identify as abolitionist are dogmatic in saying any prosecutor can’t be an abolitionist, or is undermining our movement, or any resources that go to the county jail or the state prison is bad, that’s really dangerous. Let’s say that there are people with disabilities living in the county jail, and those people can’t access outdoors, or the phones to call their loved ones, or a visiting room. We would all agree that that’s a deprivation of rights and we want to sue the county jail to rectify the violation of that person’s rights. I don’t think that’s controversial. And yet, the remedy that would likely be imposed by the court might be anathema to an abolitionist, because the remedy would likely be to deliver the county jail more money to put in elevators, or to build ramps. If you’re too narrow in your approach, you abandon the person with disabilities to live in unthinkable, unconstitutional conditions. Some of the solutions will mean more resources going into a system that’s failing us. That’s why it’s critical that we are also simultaneously doing the work of building out those alternatives.
AE: There’s something especially heinous about the rate of pretrial detention in California, how often we’re keeping people trapped in jails with particularly bad conditions that aren’t built for long-term confinement. What can accountability look like for these facilities? There is no such thing as a humane jail. There is no safe cage that is going to provide healthcare or medical care in a way that is meaningful for anybody.
CB: Jails are built to cage human beings. It’s hard to think about what could be more of an inhumane structure than a cage, right? A lot of folks who do criminal justice reform point to Northern Europe as a model for a more humane approach to criminal punishment, and to separation from society. There’s a range of conditions– prisons and jails can be much worse, or they can be less worse. If we’re going to have prisons, people should have access to college, to health care, to exercise, to decent nutrition. When you live in a country like Norway or Germany, where everybody in the country has access to some level of universal healthcare, or more access to basic income, or basic nutrition, then it’s not politically controversial to make those things available to people who are being punished for committing crimes. In the United States, we’ve eviscerated systematically, with the complicity of both Republican and the Democratic Party over decades, the social safety net. We have left people on the outside in a position where it’s very easy to divide and conquer politically. That blue collar worker who’s struggling to pay rent, to put their kids through school, to pay out their own college debt, to put food on the table– they look at people who’ve committed crimes and they say, “Why should they get these things that I work so hard for, for free?” My answer is everybody should get a free education, everybody should get free health care. If you have that social safety net, then it’s not controversial.
"We've eviscerated systematically, with the complicity of both Republican and the Democratic Party over decades, the social safety net. We have left people on the outside in a position where it's very easy to divide and conquer politically."
AE: There are a couple of bills moving through the legislature in California right now to abolish involuntary servitude and create a minimum wage for incarcerated workers. That is a part of the larger conversation about having a minimum wage generally. You can’t really separate how people are treated inside prisons from how they’re being treated outside.
CB: Everybody in the prison comes from a community, comes from a family. If we want to make our communities safer, we know how to do it. We know that people who are housed, educated, clothed, and have access to healthcare are far less likely to not only commit crime, but to be victims of crimes. We make the choice as a society not to provide entire swaths of our population with those basic necessities, and we systematically deprive and undermine efforts by certain communities to Strengthen their conditions and their quality of life. When my dad got out of prison, the state of New York knew exactly who he was, because they kept him in prison for 40 years. And yet when he was released, he didn’t have any kind of state identification that he could use to open a bank account or to sign a lease or to get a job. We set people up to fail. If we care about preventing somebody from being victimized, we have to do the work to set people up to succeed. We have a population of folks who have been in cages for years, they’ve experienced trauma, they’ve been victims of violence, many of them have used violence in the past. So if we know that about them, the right-wing response to say, “let’s create all these barriers to reentry,” is a response that necessarily creates more victims of crime.
AE: The word “crime,” indicates to me a state narrative of harm and violence that doesn’t always encompass things like wage theft, it often doesn’t cover state violence. It doesn’t cover most interpersonal domestic violence, or sexual violence that is never reported for a variety of reasons.
CB: How about drug use on Ivy League campuses?
AE: Right. There’s a million kinds of harm, and things that are technically crimes that will never be considered in what we call a crime rate. Is the idea of a “crime rate” a useful measure when we’re trying to talk about what might actually be harm? Somebody’s not getting housing because they have a criminal record– that’s harm, but it’s not a crime.
CB: I do find it useful. When I was District Attorney, I had a particular job that I was trying to do. The traditional way that DA’s offices are run, is that they are recipients of whatever the police bring them. And the vast majority of cases that most district attorneys will prosecute are cases that the police initiate. And if you’re doing that, then you’re limiting yourself to the categories of crime that are traditionally reported. Every one of the categories is a crime that involves real victims, so I think it’s important not to minimize. If we have a thousand robberies in San Francisco, it does warrant attention and intervention. But there’s lots of categories of crime that are not reported at all. When I was District Attorney we tried to do, in regard to this conversation, two things. One, we tried to make sure that in the cases the police brought us, we were intervening in ways that were as effective and humane as possible. Obviously, a lot of cases we didn’t file. But the ones that we did file, we tried to get people into diversion programs, treatment programs, job programs, housing programs, we tried to identify root causes of crime and tailor accountability. Not to simply be a pseudonym for cage, but rather to look at changing behavior, and to use the criminal case as an opportunity for intervention and for transforming lives away from crime, away from victimization and poverty. The other goal was to dedicate far more resources than ever to investigating and prosecuting the kinds of crimes that police will never bring us. That’s why we created a worker protection unit. That’s why we filed a civil case against the manufacturers of ghost guns. I didn’t want to sit back and wait for the police to bring me yet another Black or brown young man who was living in fear in his own neighborhood because of the proliferation of firearms, and ask me to prosecute him. I wanted to stop the guns from coming into our community in the first place. I wanted to do it in a way that held those companies making millions of dollars in profits off of violence in our communities accountable. In the process, we made very powerful enemies who contributed to the recall against me.
"We tried to identify root causes of crime and tailor accountability. Not to simply be a pseudonym for cage, but rather to look at changing behavior, and to use the criminal case as an opportunity for transforming lives away from crime, away from victimization and poverty."
AE: Paying attention to current District Attorney Brooke Jenkins’ period in office, there’s been a real shift in priorities. The failure to prosecute Banko Brown’s killer stands out to me in a city that prides itself on protecting the rights of queer and trans people. How do you react to these developments? What do these decisions reflect about the values of the city?
CB: I live in San Francisco. I love San Francisco. I’ve dedicated my professional career to trying to make San Francisco a fairer and a juster city. It’s sad to see the developments in the last year or so. We’re obviously experiencing a major regression in terms of the direction our city is moving in terms of its values. Because it’s such a deep blue city, Fox News likes to pretend that San Francisco is a really progressive city. The reality is that our Democratic Party, because it’s the only party in town, is a really broad and diverse party. We have people who would be Republicans if they lived in another state. But in California, those people call themselves Democrats. That’s why we see a lot of our local government today picking up and responding directly to headlines from the New York Post or Fox News. With organizing and education, people are gonna see through the lies. I think we’re going to take back our city.
AE: Why did you take on this new role as director of the Criminal Law and Justice Center at Berkeley? What projects are you feeling excited about tackling there?
CB: It’s a job that combines teaching with research, and publishing with advocacy. There’s the added benefit of being surrounded by the next generation of judges and public defenders and reform prosecutors and immigration advocates and tenants’ rights lawyers. I’m excited to learn from and help shape the next generation of folks who are going to be on the front lines of all the issues that I care about. There’s such a rich ecosystem of criminal justice advocates, working on everything from restoring the right to vote, to expanding reentry services to victim-centered restorative processes, to police accountability, conditions of confinement, bail reform.
