In 2018, senior executives at one of the country’s largest nonprofit hospital chains, Providence, were frustrated. They were spending hundreds of millions of dollars providing free health care to patients. It was eating into their bottom line.
The executives, led by Providence’s chief financial officer at the time, devised a solution: a program called Rev-Up.
Rev-Up provided Providence’s employees with a detailed playbook for wringing money out of patients — even those who were supposed to receive free care because of their low incomes, a New York Times investigation found.
nonprofits like Providence. They enjoy lucrative tax exemptions; Providence avoids more than $1 billion a year in taxes. In exchange, the Internal Revenue Service requires them to provide services, such as free care for the poor, that benefit the communities in which they operate.
But in recent decades, many of the hospitals have become virtually indistinguishable from for-profit companies, adopting an unrelenting focus on the bottom line and straying from their traditional charitable missions.
focused on investments in rich communities at the expense of poorer ones.
And, as Providence illustrates, some hospital systems have not only reduced their emphasis on providing free care to the poor but also developed elaborate systems to convert needy patients into sources of revenue. The result, in the case of Providence, is that thousands of poor patients were saddled with debts that they never should have owed, The Times found.
provide. That was below the average of 2 percent for nonprofit hospitals nationwide, according to an analysis of hospital financial records by Ge Bai, a professor at the Johns Hopkins Bloomberg School of Public Health.
Ten states, however, have adopted their own laws that specify which patients, based on their income and family size, qualify for free or discounted care. Among them is Washington, where Providence is based. All hospitals in the state must provide free care for anyone who makes under 300 percent of the federal poverty level. For a family of four, that threshold is $83,250 a year.
In February, Bob Ferguson, the state’s attorney general, accused Providence of violating state law, in part by using debt collectors to pursue more than 55,000 patient accounts. The suit alleged that Providence wrongly claimed those patients owed a total of more than $73 million.
Providence, which is fighting the lawsuit, has said it will stop using debt collectors to pursue money from low-income patients who should qualify for free care in Washington.
But The Times found that the problems extend beyond Washington. In interviews, patients in California and Oregon who qualified for free care said they had been charged thousands of dollars and then harassed by collection agents. Many saw their credit scores ruined. Others had to cut back on groceries to pay what Providence claimed they owed. In both states, nonprofit hospitals are required by law to provide low-income patients with free or discounted care.
“I felt a little betrayed,” said Bev Kolpin, 57, who had worked as a sonogram technician at a Providence hospital in Oregon. Then she went on unpaid leave to have surgery to remove a cyst. The hospital billed her $8,000 even though she was eligible for discounted care, she said. “I had worked for them and given them so much, and they didn’t give me anything.” (The hospital forgave her debt only after a lawyer contacted Providence on Ms. Kolpin’s behalf.)
was a single room with four beds. The hospital charged patients $1 a day, not including extras like whiskey.
Patients rarely paid in cash, sometimes offering chickens, ducks and blankets in exchange for care.
At the time, hospitals in the United States were set up to do what Providence did — provide inexpensive care to the poor. Wealthier people usually hired doctors to treat them at home.
wrote to the Senate in 2005.
Some hospital executives have embraced the comparison to for-profit companies. Dr. Rod Hochman, Providence’s chief executive, told an industry publication in 2021 that “‘nonprofit health care’ is a misnomer.”
“It is tax-exempt health care,” he said. “It still makes profits.”
Those profits, he added, support the hospital’s mission. “Every dollar we make is going to go right back into Seattle, Portland, Los Angeles, Alaska and Montana.”
Since Dr. Hochman took over in 2013, Providence has become a financial powerhouse. Last year, it earned $1.2 billion in profits through investments. (So far this year, Providence has lost money.)
Providence also owes some of its wealth to its nonprofit status. In 2019, the latest year available, Providence received roughly $1.2 billion in federal, state and local tax breaks, according to the Lown Institute, a think tank that studies health care.
a speech by the Rev. Dr. Martin Luther King Jr.: “If it falls your lot to be a street sweeper, sweep streets like Michelangelo painted pictures.”
Ms. Tizon, the spokeswoman for Providence, said the intent of Rev-Up was “not to target or pressure those in financial distress.” Instead, she said, “it aimed to provide patients with greater pricing transparency.”
“We recognize the tone of the training materials developed by McKinsey was not consistent with our values,” she said, adding that Providence modified the materials “to ensure we are communicating with each patient with compassion and respect.”
But employees who were responsible for collecting money from patients said the aggressive tactics went beyond the scripts provided by McKinsey. In some Providence collection departments, wall-mounted charts shaped like oversize thermometers tracked employees’ progress toward hitting their monthly collection goals, the current and former Providence employees said.
On Halloween at one of Providence’s hospitals, an employee dressed up as a wrestler named Rev-Up Ricky, according to the Washington lawsuit. Another costume featured a giant cardboard dollar sign with “How” printed on top of it, referring to the way the staff was supposed to ask patients how, not whether, they would pay. Ms. Tizon said such costumes were “not the culture we strive for.”
financial assistance policy, his low income qualified him for free care.
In early 2021, Mr. Aguirre said, he received a bill from Providence for $4,394.45. He told Providence that he could not afford to pay.
Providence sent his account to Harris & Harris, a debt collection company. Mr. Aguirre said that Harris & Harris employees had called him repeatedly for weeks and that the ordeal made him wary of going to Providence again.
“I try my best not to go to their emergency room even though my daughters have gotten sick, and I got sick,” Mr. Aguirre said, noting that one of his daughters needed a biopsy and that he had trouble breathing when he had Covid. “I have this big fear in me.”
That is the outcome that hospitals like Providence may be hoping for, said Dean A. Zerbe, who investigated nonprofit hospitals when he worked for the Senate Finance Committee under Senator Charles E. Grassley, Republican of Iowa.
“They just want to make sure that they never come back to that hospital and they tell all their friends never to go back to that hospital,” Mr. Zerbe said.
The Everett Daily Herald, Providence forgave her bill and refunded the payments she had made.
In June, she got another letter from Providence. This one asked her to donate money to the hospital: “No gift is too small to make a meaningful impact.”
Following a Script ‘Like Robots’
In 2019, Vanessa Weller, a single mother who is a manager at a Wendy’s restaurant in Anchorage, went to Providence Alaska Medical Center, the state’s largest hospital.
She was 24 weeks pregnant and experiencing severe abdominal pains. “Let this just be cramps,” she recalled telling herself.
Ms. Weller was in labor. She gave birth via cesarean section to a boy who weighed barely a pound. She named him Isaiah. As she was lying in bed, pain radiating across her abdomen, she said, a hospital employee asked how she would like to pay. She replied that she had applied for Medicaid, which she hoped would cover the bill.
After five days in the hospital, Isaiah died.
Then Ms. Weller got caught up in Providence’s new, revenue-boosting policies.
The phone calls began about a month after she left the hospital. Ms. Weller remembers panicking when Providence employees told her what she owed: $125,000, or about four times her annual salary.
She said she had repeatedly told Providence that she was already stretched thin as a single mother with a toddler. Providence’s representatives asked if she could pay half the amount. On later calls, she said, she was offered a payment plan.
“It was like they were following some script,” she said. “Like robots.”
Later that year, a Providence executive questioned why Ms. Weller had a balance, given her low income, according to emails disclosed in Washington’s litigation with Providence. A colleague replied that her debts previously would have been forgiven but that Providence’s new policy meant that “balances after Medicaid are being excluded from presumptive charity process.”
Ms. Weller said she had to change her phone number to make the calls stop. Her credit score plummeted from a decent 650 to a lousy 400. She has not paid any of her bill.
Susan C. Beachy and Beena Raghavendran contributed research.
Despite the finding, the death of Elijah McClain, a 23-year-old massage therapist, was still listed as undetermined, not a homicide.
A Black man died after a police encounter in a Denver suburb in 2019 because he was injected with a powerful sedative after being forcibly restrained, according to an amended autopsy report publicly released Friday.
Despite the finding, the death of Elijah McClain, a 23-year-old massage therapist, was still listed as undetermined, not a homicide, the report shows. McClain was put in a neck hold and injected with ketamine after being stopped by police in Aurora for “being suspicious.” He was unarmed.
The original autopsy report that was written soon after his death in August 2019 did not reach a conclusion about how he died or what type of death is was, such as if it was natural, accidental or a homicide. That was a major reason why prosecutors initially decided not to pursue charges.
But a state grand jury last year indicted three officers and two paramedics on manslaughter and reckless homicide charges in McClain’s death after the case drew renewed attention following the killing of George Floyd in 2020. It became a rallying cry during the national reckoning over racism and police brutality.
The five accused have not yet entered pleas and their lawyers have not commented publicly on the charges.
In the updated report, completed in July 2021, Dr. Stephen Cina, a pathologist, concluded that the ketamine dosage given to McClain, which was higher than recommended for someone his size, “was too much for this individual and it resulted in an overdose, even though his blood ketamine level was consistent with a ‘therapeutic’ blood concentration.”
He said he could not rule out that changes in McClain’s blood chemistry, like an increase in lactic acid, due to his exertion while being restrained by police contributed to his death but concluded there was no evidence that injuries inflicted by police caused his death.
“I believe that Mr. McClain would most likely be alive but for the administration of ketamine,” said Cina, who noted that body camera footage shows McClain becoming “extremely sedated” within a few minutes of being given the drug.
Cina acknowledged that other reasonable pathologists with different experience and training may have labeled such a death, while in police custody, as a homicide or accident, but that he believes the appropriate classification is undetermined.
Qusair Mohamedbhai, attorney for McClain’s mother, Sheneen McClain, declined a request for comment.
Dr. Carl Wigren, a forensic pathologist in Washington state, questioned the report’s focus on ketamine, saying all the available evidence — including a highly critical independent review of McClain’s death commissioned by Aurora last year — point to McClain dying as a result of compressional asphyxia, a type of suffocation, from officers putting pressure on his body while restraining him. He was struck by one passage in the city’s review citing the ambulance company’s report that its crew found McClain lying on the ground on his stomach, his arms handcuffed behind his back, his torso and legs held down, with at least three officers on top of him.
That scene was not captured on body camera footage, the report said, but much of what happened between police was not because the officers’ cameras came off soon after McClain was approached. The cameras did continue to record where they fell and captured people talking.
Just because McClain, who said he couldn’t breathe, could be heard making some statements on the footage, does not mean he was able to fully breathe, Wigren said. Ketamine, which slows breathing, could have just exacerbated McClain’s condition, but Wigren does not think it caused his death.
However, another pathologist, Dr. Deborah G. Johnson of Colorado, said McClain’s quick reaction to ketamine suggests that it was a cause of McClain’s death, but she said its use cannot be separated from the impact that the police restraint may have had. McClain may have had trouble breathing because of the restraint and having less oxygen in your system would make the sedative take effect more quickly, she said.
Both thought the death could have been labeled as a homicide — a death caused by the actions of other people — which they pointed out is a separate judgment from deciding whether someone should be prosecuted with a crime for causing it.
McClain got an overdose of ketamine, Johnson said, noting that the paramedics were working at night when it is hard to judge someone’s weight.
“Was that a mistake to send someone to prison for? I don’t think so,” she said.
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The updated autopsy was released Friday under a court order in a lawsuit brought by Colorado Public Radio, joined by other media organizations including The Associated Press. Colorado Public Radio sued the coroner to release the report after learning it had been updated, arguing that it should be made available under the state’s public records law.
Coroner Monica Broncucia-Jordan said she could not release it because it contained confidential grand jury information and that releasing it would violate the oath she made not to share it when she obtained it last year.
But Adams County District Judge Kyle Seedorf ordered the coroner to release the updated report by Friday, and a Denver judge who oversees state grand jury proceedings, Christopher Baumann, ruled Thursday that grand jury information did not have be redacted from the updated report.
Cina noted that the report was updated based on extensive body camera footage, witness statements and records that he did not have at the time of the original autopsy report, which were not made available to the coroner’s office at all or in their entirety before. Last year, Cina and Broncucia-Jordan received some material that was made available to the grand jury last year, according to court documents, but they did not say what exactly that material was.
McClain’s death fueled renewed scrutiny about the use of the ketamine and led Colorado’s health department to issue a new rule limiting when emergency workers can use it.
Last year, the city of Aurora agreed to pay $15 million to settle a lawsuit brought by McClain’s parents. The lawsuit alleged the force officers used against McClain and his struggle to survive it dramatically increased the amount of lactic acid in his system, leading to his death, possibly along with the large dose of ketamine he was given.
The outside investigation commissioned by the city faulted the police probe into McClain’s arrest for not pressing for answers about how officers treated him. It found there was no evidence justifying officers’ decision to stop McClain, who had been reported as suspicious because he was wearing a ski mask as he walked down the street waving his hands. He was not accused of breaking any law.
Police reform activist Candice Bailey had mixed emotions about seeing the amended autopsy.
“I do believe that it does get us a step closer to anything that is a semblance of justice,” said Bailey, an activist in the city of Aurora who has led demonstrations over the death of McClain.
But Bailey added that she is “extremely saddened that there is still a controversy around whether or not the EMTs and officers should be held responsible for what they did, and as to whether or not this was actually murder.”
Cooler temperatures and rain brought respite to firefighters battling the massive Fairview Fire after sweltering heat last week.
Firefighters made progress against a huge Northern California wildfire that was still growing and threatening thousands of mountain homes, while crews also battled major blazes Sunday in Oregon and Washington.
The Mosquito Fire in foothills east of Sacramento spread to nearly 65 square miles, with 10% containment, according to the California Department of Forestry and Fire Protection, or Cal Fire.
“Cooler temperatures and higher humidity assisted with moderating some fire activity,” but higher winds allowed the flames to push to the north and northeast, according to a Cal Fire incident report Sunday.
More than 5,800 structures in Placer and El Dorado counties were under threat and some 11,000 residents of communities including Foresthill and Georgetown were under evacuation orders.
In Southern California, cooler temperatures and rain brought respite to firefighters battling the massive Fairview Fire about 75 miles southeast of Los Angeles after sweltering heat last week.
The 44-square-mile blaze was 45% contained Sunday. The fire has destroyed at least 30 homes and other structures in Riverside County. Two people died while fleeing flames last Monday.
The southern part of the state welcomed the cooler weekend weather as a tropical storm veered off the Pacific Coast and faded, helping put an end to blistering temperatures that nearly overwhelmed the state’s electrical grid.
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Thunderstorms and the risk of flooding persisted in mountainous areas of greater Los Angeles on Sunday. But after Hurricane Kay made landfall in Mexico last week it quickly was downgraded and weakened further until it largely disappeared, forecasters said.
In Washington state, a raging wildfire sparked Saturday in the remote Stevens Pass area sent hikers fleeing and forced evacuations of mountain communities. There was no containment Sunday of the Bolt Creek Fire, which had scorched nearly 12 square miles of forestland east of Seattle.
“It’s going to be several days” before crews get a handle on the blaze, Peter Mongillo, spokesperson for Snohomish Regional Fire and Rescue, told the Seattle Times.
California’s Mosquito Fire has covered a large portion of the Northern Sierra region with smoke. California health officials urged people in affected areas to stay indoors where possible. Organizers of the Tour de Tahoe canceled the annual 72-mile bicycle ride scheduled Sunday around Lake Tahoe because of the heavy smoke from the blaze — more than 50 miles away. Last year’s ride was canceled because of smoke from another big fire south of Tahoe.
The Mosquito Fire’s cause remained under investigation. Pacific Gas & Electric said unspecified “electrical activity” occurred close in time to the report of the fire on Tuesday.
Scientists say climate change has made the West warmer and drier over the last three decades and will continue to make weather more extreme and wildfires more frequent and destructive. In the last five years, California has experienced the largest and most destructive fires in state history.
And the rest of the West hasn’t been immune. There were at least 18 large fires burning in Oregon and Washington, leading to evacuations and targeted power outages near Portland as the challenge of dry and windy conditions continued in the region.
Sprawling areas of western Oregon choked by thick smoke from the fires in recent days were expected to see improved air quality on Sunday thanks to a returning onshore flow, Oregon Public Broadcasting reported.
South of Portland, more than 3,000 residents were under new evacuation orders because of the 134-square-mile Cedar Creek Fire, which has burned for over a month across Lane and Deschutes counties. Firefighters were protecting remote homes in Oakridge, Westfir and surrounding mountain communities.
According to the Northwest Interagency Coordination Center, this weekend there were more than 400 square miles of active, uncontained fires and nearly 5,000 people on the ground fighting them in the two northwestern states.
A group calling itself the Patriot Freedom Project says it has raised more than $1 million in contributions .
Facing prison time and dire personal consequences for storming the U.S. Capitol, some Jan. 6 defendants are trying to profit from their participation in the deadly riot, using it as a platform to drum up cash, promote business endeavors and boost social media profiles.
A Nevada man jailed on riot charges asked his mother to contact publishers for a book he was writing about “the Capitol incident.” A rioter from Washington state helped his father hawk clothes and other merchandise bearing slogans such as “Our House” and images of the Capitol building. A Virginia man released a rap album with riot-themed songs and a cover photograph of him sitting on a police vehicle outside the Capitol on Jan. 6, 2021.
Those actions are sometimes complicating matters for defendants when they face judges at sentencing as prosecutors point to the profit-chasing activities in seeking tougher punishments. The Justice Department, in some instances, is trying to claw back money that rioters have made off the insurrection.
In one case, federal authorities have seized tens of thousands of dollars from a defendant who sold his footage from Jan. 6. In another case, a Florida man’s plea deal allows the U.S. government to collect profits from any book he gets published over the next five years. And prosecutors want a Maine man who raised more than $20,000 from supporters to surrender some of the money because a taxpayer-funded public defender is representing him.
Many rioters have paid a steep personal price for their actions on Jan. 6. At sentencing, rioters often ask for leniency on the grounds that they already have experienced severe consequences for their crimes.
They lost jobs or entire careers. Marriages fell apart. Friends and relatives shunned them or even reported them to the FBI. Strangers have sent them hate mail and online threats. And they have racked up expensive legal bills to defend themselves against federal charges ranging from misdemeanors to serious felonies.
Websites and crowdfunding platforms set up to collect donations for Capitol riot defendants try to portray them as mistreated patriots or even political prisoners.
An anti-vaccine medical doctor who pleaded guilty to illegally entering the Capitol founded a nonprofit that raised more than $430,000 for her legal expenses. The fundraising appeal by Dr. Simone Gold’s group, America’s Frontline Doctors, didn’t mention her guilty plea, prosecutors noted.
Before sentencing Gold to two months behind bars, U.S. District Judge Christopher Cooper called it “unseemly” that her nonprofit invoked the Capitol riot to raise money that also paid for her salary. Prosecutors said in court papers that it “beggars belief” that she incurred anywhere close to $430,000 in legal costs for her misdemeanor case.
Another rioter, a New Jersey gym owner who punched a police officer during the siege, raised more than $30,000 in online donations for a “Patriot Relief Fund” to cover his mortgage payments and other monthly bills. Prosecutors cited the fund in recommending a fine for Scott Fairlamb, who is serving a prison sentence of more than three years.
“Fairlamb should not be able to ‘capitalize’ on his participation in the Capitol breach in this way,” Justice Department lawyers wrote.
Robert Palmer, a Florida man who attacked police officers at the Capitol, asked a friend to create a crowdfunding campaign for him online after he pleaded guilty. After seeing the campaign to “Help Patriot Rob,” a probation officer calculating a sentencing recommendation for Palmer didn’t give him credit for accepting responsibility for his conduct. Palmer conceded that a post for the campaign falsely portrayed his conduct on Jan. 6. Acceptance of responsibility can help shave months or even years off a sentence.
“When you threw the fire extinguisher and the plank at the police officers, were you acting in self-defense?” asked U.S. District Judge Tanya Chutkan.
“No, ma’am, I was not,” Palmer said before the judge sentenced him to more than five years in prison.
A group calling itself the Patriot Freedom Project says it has raised more than $1 million in contributions and paid more than $665,000 in grants and legal fees for families of Capitol riot defendants.
In April, a New Jersey-based foundation associated with the group filed an IRS application for tax-exempt status. As of early August, an IRS database doesn’t list the foundation as a tax-exempt organization. The Hughes Foundation’s IRS application says its funds “principally” will benefit families of Jan. 6 defendants, with about 60% of the donated money going to foundation activities. The rest will cover management and fundraising expenses, including salaries, it adds.
Rioters have found other ways to enrich or promote themselves.
Jeremy Grace, who was sentenced to three weeks in jail for entering the Capitol, tried to profit off his participation by helping his dad sell T-shirts, baseball caps, water bottles, decals and other gear with phrases such as “Our House” and “Back the Blue” and images of the Capitol, prosecutors said.
Prosecutors said Grace’s “audacity” to sell “Back the Blue” paraphernalia is “especially disturbing” because he watched other rioters confront police officers on Jan. 6. A defense lawyer, however, said Grace didn’t break any laws or earn any profits by helping his father sell the merchandise.
Federal authorities seized more than $62,000 from a bank account belonging to riot defendant John Earle Sullivan, a Utah man who earned more than $90,000 from selling his Jan. 6 video footage to at least six companies. Sullivan’s lawyer argued authorities had no right to seize the money.
Richard “Bigo” Barnett, an Arkansas man photographed propping his feet up on a desk in the office of House Speaker Nancy Pelosi, D-Calif., has charged donors $100 for photos of him with his feet on a desk while under house arrest. Defense lawyer Joseph McBride said prosecutors have “zero grounds” to prevent Barnett from raising money for his defense before a December trial date.
“Unlike the government, Mr. Barnett does not have the American Taxpayer footing the bill for his legal case,” McBride wrote in a court filing.
Texas real estate agent Jennifer Leigh Ryan promoted her business on social media during and after the riot, boasting that she was “becoming famous.” In messages sent after Jan. 6, Ryan “contemplated the business she needed to prepare for as a result of the publicity she received from joining the mob at the Capitol,” prosecutors said in court documents.
Prosecutors cited the social media activity of Treniss Evans III in recommending a two-month jail term for the Texas man, who drank a shot of whiskey in a congressional conference room on Jan. 6. Evans has “aggressively exploited” his presence at the Capitol to expand his social media following on Gettr, a social media site founded by a former Trump adviser, prosecutors wrote before Evans’ sentencing, scheduled for this coming Tuesday,
A few rioters are writing books about the mob’s attack or have marketed videos that they shot during the riot.
A unique provision in Adam Johnson’s plea agreement allows the U.S. government to collect profits from any book he gets published over the next five years. Images of Johnson posing for photographs with Pelosi’s podium went viral after the riot. Prosecutors said they insisted on the provision after learning that Johnson intends to write a memoir “of some sort.”
Ronald Sandlin, a Nevada man charged with assaulting officers near doors to the Senate gallery, posted on Facebook that he was “working out a Netflix deal” to sell riot video footage. Later, in a call from jail, Sandlin told his mother that he had met with right-wing author and filmmaker Dinesh D’Souza and was in contact with podcaster Joe Rogan. He also asked his mom to contact publishers for the book he was writing about the “Capitol incident,” prosecutors said.
“I hope to turn it into movie,” Sandlin wrote in a March 2021 text message. “I plan on having Leonardo DiCaprio play me,” he wrote, adding a smiley face emoji.
The 2022 primaries continue to be a loyalty test for former President Trump. As for the Democrats, it’s the prospect of losing control of Congress.
On Tuesday, voters in Arizona, Kansas, Michigan, Missouri, and Washington State will take to the polls in the latest round of high-profile matchups.
Republicans in Arizona will make a major choice about the future of their party, by selecting who their nominee will be, to take on Senator Mark Kelly.
Mark Brnovich, the current Republican state Attorney General, or Blake Masters, who is endorsed by former President Trump and supported by Peter Thiel.
In the Governor’s race, facing off against Democratic Secretary of State Katie Hobbs, will it be Trump endorsed former news anchor Kari Lake or Mike Pence endorsed Karrin Taylor Robson?
In Kansas, voters will pick the Republican to face off against Democrat Laura Kelly.
And in Michigan, Governor Gretchen Whitmer will learn who her Republican challenger will be.
In Missouri, in the Republican primary to replace retiring Senator Roy Blunt, will the state’s Attorney General Eric Schmitt, former Governor Eric Greitens, or representative Vicky Hartzler be victorious, in a race The Cook Political Report ranks a “solid republican hold.”
And in Washington state, two Republican reps who voted to impeach Donald Trump in 2020 will face primary challengers.
The 2022 primaries continue to be a loyalty test for former President Trump. As for the Democrats, it’s the prospect of losing control of Congress.
The software that many school districts use to track students’ progress can record extremely confidential information on children: “Intellectual disability.” “Emotional Disturbance.” “Homeless.” “Disruptive.” “Defiance.” “Perpetrator.” “Excessive Talking.” “Should attend tutoring.”
Now these systems are coming under heightened scrutiny after a recent cyberattack on Illuminate Education, a leading provider of student-tracking software, which affected the personal information of more than a million current and former students across dozens of districts — including in New York City and Los Angeles, the nation’s largest public school systems.
Officials said in some districts the data included the names, dates of birth, races or ethnicities and test scores of students. At least one district said the data included more intimate information like student tardiness rates, migrant status, behavior incidents and descriptions of disabilities.
Chicago Public Schools, the nation’s third-largest district.
Now some cybersecurity and privacy experts say that the cyberattack on Illuminate Education amounts to a warning for industry and government regulators. Although it was not the largest hack on an ed tech company, these experts say they are troubled by the nature and scope of the data breach — which, in some cases, involved delicate personal details about students or student data dating back more than a decade. At a moment when some education technology companies have amassed sensitive information on millions of school children, they say, safeguards for student data seem wholly inadequate.
“There has really been an epic failure,” said Hector Balderas, the attorney general of New Mexico, whose office has sued tech companies for violating the privacy of children and students.
In a recent interview, Mr. Balderas said that Congress had failed to enact modern, meaningful data protections for students while regulators had failed to hold ed tech firms accountable for flouting student data privacy and security.
outpacing protections for students’ personal information. Lawmakers rushed to respond.
Since 2014, California, Colorado and dozens of other states have passed student data privacy and security laws. In 2014, dozens of K-12 ed tech providers signed on to a national Student Privacy Pledge, promising to maintain a “comprehensive security program.”
Supporters of the pledge said the Federal Trade Commission, which polices deceptive privacy practices, would be able to hold companies to their commitments. President Obama endorsed the pledge, praising participating companies in a major privacy speech at the F.T.C. in 2015.
The F.T.C. has a long history of fining companies for violating children’s privacy on consumer services like YouTube and TikTok. Despite numerous reports of ed tech companies with problematic privacy and security practices, however, the agency has yet to enforce the industry’s student privacy pledge.
In May, the F.T.C. announced that regulators intended to crack down on ed tech companies that violate a federal law — the Children’s Online Privacy Protection Act — which requires online services aimed at children under 13 to safeguard their personal data. The agency is pursuing a number of nonpublic investigations into ed tech companies, said Juliana Gruenwald Henderson, an F.T.C. spokeswoman.
company’s site says its services reach more than 17 million students in 5,200 school districts. Popular products include an attendance-taking system and an online grade book as well as a school platform, called eduCLIMBER, that enables educators to record students’ “social-emotional behavior” and color-code children as green (“on track”) or red (“not on track”).
Illuminate has promoted its cybersecurity. In 2016, the company announced that it had signed on to the industry pledge to show its “support for safeguarding” student data.
Concerns about a cyberattack emerged in January after some teachers in New York City schools discovered that their online attendance and grade book systems had stopped working. Illuminate said it temporarily took those systems offline after it became aware of “suspicious activity” on part of its network.
On March 25, Illuminate notified the district that certain company databases had been subject to unauthorized access, said Nathaniel Styer, the press secretary for New York City Public Schools. The incident, he said, affected about 800,000 current and former students across roughly 700 local schools.
For the affected New York City students, data included first and last names, school name and student ID number as well as at least two of the following: birth date, gender, race or ethnicity, home language and class information like teacher name. In some cases, students’ disability status — that is, whether or not they received special education services — was also affected.
said they were outraged. In 2020, Illuminate signed a strict data agreement with the district requiring the company to safeguard student data and promptly notify district officials in the event of a data breach.
kept student data on the Amazon Web Services online storage system. Cybersecurity experts said many companies had inadvertently made their A.W.S. storage buckets easy for hackers to find — by naming databases after company platforms or products.
a spate of cyberattacks on both ed tech companies and public schools, education officials said it was time for Washington to intervene to protect students.
“Changes at the federal level are overdue and could have an immediate and nationwide impact,” said Mr. Styer, the New York City schools spokesman. Congress, for instance, could amend federal education privacy rules to impose data security requirements on school vendors, he said. That would enable federal agencies to levy fines on companies that failed to comply.
One agency has already cracked down — but not on behalf of students.
Last year, the Securities and Exchange Commission charged Pearson, a major provider of assessment software for schools, with misleading investors about a cyberattack in which the birth dates and email addresses of millions of students were stolen. Pearson agreed to pay $1 million to settle the charges.
Mr. Balderas, the attorney general, said he was infuriated that financial regulators had acted to protect investors in the Pearson case — even as privacy regulators failed to step up for schoolchildren who were victims of cybercrime.
“My concern is there will be bad actors who will exploit a public school setting, especially when they think that the technology protocols are not very robust,” Mr. Balderas said. “And I don’t know why Congress isn’t terrified yet.”
At first glance, the Skittles package appears to be just like the one sold in the candy aisle of a supermarket: It has block letters filled in with white, a flowing rainbow and a red candy that replaces the dot above the letter “i.”
A closer look reveals some small differences: a background pattern of small, stylized marijuana leaves; a warning label; and numbers that reveal the amount of THC, the intoxicating substance in cannabis, in each piece of candy.
The images are included in a lawsuit that the Wm. Wrigley Jr. Company, owned by the candy behemoth Mars Inc., filed in May against five companies for selling cannabis-infused edibles that look like our old friends Skittles, Starburst and Life Savers. Though the suit focuses on intellectual property rights, the plaintiffs also argue that the copycat products could lead people, particularly children, to mistakenly ingest drugs.
recreational marijuana consumption roamed by pandemic-stressed adults.
In recent years, lawsuits similar to the one filed by Wrigley have been brought by the Hershey Company (against TinctureBelle for products resembling Reese’s Peanut Butter Cups, Heath bars, Almond Joy bars and York peppermint patties), Mondelez International (against a company hawking Stoney Patch Kids) and Ferrara Candy Company (against a store selling Medicated Nerds Rope). These lawsuits have all been settled, with the smaller companies agreeing to halt production and sales of the offending products.
Many public health officials fret that without proper regulation, accidental ingestion cases will continue to rise among children as the availability of edibles grows. Some poison control centers have already observed this trend in their data.
For example, there were 122 cases of exposure to THC for children under 5 in Washington State in the first nine months of 2020, compared to 85 for the same time period in 2019. The most common side effects reported included vomiting, lethargy and chest pain.
the illegal market is still thriving.
“When companies like these create headlines for doing what we’ve purposely avoided at Wana, I feel anger and frustration,” said Joe Hodas, the chief marketing officer at Wana Brands, a Colorado company that sells cannabis-infused products.
A recent review of the websites belonging to defendants in the Wrigley suit turned up cannabis-infused offerings like Stoner Patch Dummies, the Worlds Dankest Gushers, Gasheads Xtremes Sourfuls, Trips Ahoy, Buttafingazzz and Caribo Happy Cola.
“The situation has become more and more egregious,” said Christopher Gindlesperger, a spokesman for the National Confectioners Association, a trade organization in D.C. with 350 members, including Mars Inc., Hershey’s, Ferrara and Mondelez. “The cannabis companies cannot and should not be allowed to tarnish existing brands at will. It creates consumer confusion.”
joined the list), and 18 of them, including New York, have legalized recreational marijuana as well. Though sales in New York are not expected to begin until 2022 at the earliest, businesses are rushing to grab real estate and prepare for the market’s opening. Some are already selling Delta-8-THC, derived from hemp, in candy form.
an infamous commercial spot.
considered 1 to 2 milligrams of THC, but effects vary based on many factors, like body weight and how much food the consumer ate that day.
Accidental consumption can affect anyone, but, Dr. Schauer said, “it has primarily impacted children because they can confuse cannabis edible products with other edible products, because most edibles look like candy or cookies or cake.” She pointed to reports compiled by poison control centers in Colorado and Washington, the two earliest states to legalize recreational cannabis use, in 2012.
Between 2014 and 2018, annual calls to the Washington Poison Center about children under 5 being unintentionally exposed to cannabis nearly tripled, rising from 34 to 94. In 2017, Washington State began requiring that all edibles have a logo stating “Not for Kids” (not that this will mean much to a 2-year-old).
edibles are the leading method by which children under 5 accidentally consume cannabis. In 2019, in Colorado, 108 people under the age of 19 were accidentally exposed to cannabis. In 2011, the year before the state legalized recreational use, that number was 16.
Like Washington, Colorado now requires packaging of edibles to include a warning symbol. The state also bans the use of the word “candy” on any marijuana packaging, and the sale of edibles that look like people, animals or fruit.
Dr. Schauer said other ways to reduce the risks of accidental ingestion include mandating childproof packaging, requiring that each edible item in a package is individually wrapped, limiting the potency of each individual edible, and educating consumers who live with children on how to store their cannabis products.
Making packages that will not catch the eye of a child is important, she said. In Canada, for example, where cannabis is legal, federal law requires packaging to have a uniform color and a smooth texture, and not to have cutout windows, scents, sounds or inserts (among other requirements).
Despite the stringency of Canada’s laws, as recently as mid-May, a child was hospitalized in the province of New Brunswick after eating Stoneo cookies that were made to look like Oreos, according to the Canadian Broadcasting Corporation.
In America, state laws are far less strict; for the most part, they prohibit the inclusion of cartoon characters and make general statements about how the packaging should not appeal to a child.
“The risks can be much more limited than we’ve seen them be so far,” Dr. Schauer said.
Mr. Hodas has three children, aged 12, 17 and 19. He has been in the cannabis industry for more than seven years. When he has products at home, he keeps them secure in bags made by StashLogix. It may not slow down a motivated 15-year-old, but it will stop a toddler, he said.
“If you have it locked up, and you keep in a place where they can’t reach it or see it, that’s the best way to prevent ingestion,” Mr. Hodas said.
To parents of a certain age, the situation may bring to mind the 1983 public service announcement “We’re Not Candy,” in which a barbershop quartet of singing pills on television advises children “to have a healthy fear of us.”
That the products now under scrutiny are a form of candy, just enhanced — and that no one is watching the same screen anymore — makes it difficult to imagine a marijuana meme so memorable.
At first glance, the Skittles package appears to be just like the one sold in the candy aisle of a supermarket: It has block letters filled in with white, a flowing rainbow and a red candy that replaces the dot above the letter “i.”
A closer look reveals some small differences: a background pattern of small, stylized marijuana leaves; a warning label; and numbers that reveal the amount of THC, the intoxicating substance in cannabis, in each piece of candy.
The images are included in a lawsuit that the Wm. Wrigley Jr. Company, owned by the candy behemoth Mars Inc., filed in May against five companies for selling cannabis-infused edibles that look like our old friends Skittles, Starburst and Life Savers. Though the suit focuses on intellectual property rights, the plaintiffs also argue that the copycat products could lead people, particularly children, to mistakenly ingest drugs.
recreational marijuana consumption roamed by pandemic-stressed adults.
In recent years, lawsuits similar to the one filed by Wrigley have been brought by the Hershey Company (against TinctureBelle for products resembling Reese’s Peanut Butter Cups, Heath bars, Almond Joy bars and York peppermint patties), Mondelez International (against a company hawking Stoney Patch Kids) and Ferrara Candy Company (against a store selling Medicated Nerds Rope). These lawsuits have all been settled, with the smaller companies agreeing to halt production and sales of the offending products.
Many public health officials fret that without proper regulation, accidental ingestion cases will continue to rise among children as the availability of edibles grows. Some poison control centers have already observed this trend in their data.
For example, there were 122 cases of exposure to THC for children under 5 in Washington State in the first nine months of 2020, compared to 85 for the same time period in 2019. The most common side effects reported included vomiting, lethargy and chest pain.
the illegal market is still thriving.
“When companies like these create headlines for doing what we’ve purposely avoided at Wana, I feel anger and frustration,” said Joe Hodas, the chief marketing officer at Wana Brands, a Colorado company that sells cannabis-infused products.
A recent review of the websites belonging to defendants in the Wrigley suit turned up cannabis-infused offerings like Stoner Patch Dummies, the Worlds Dankest Gushers, Gasheads Xtremes Sourfuls, Trips Ahoy, Buttafingazzz and Caribo Happy Cola.
“The situation has become more and more egregious,” said Christopher Gindlesperger, a spokesman for the National Confectioners Association, a trade organization in D.C. with 350 members, including Mars Inc., Hershey’s, Ferrara and Mondelez. “The cannabis companies cannot and should not be allowed to tarnish existing brands at will. It creates consumer confusion.”
joined the list), and 18 of them, including New York, have legalized recreational marijuana as well. Though sales in New York are not expected to begin until 2022 at the earliest, businesses are rushing to grab real estate and prepare for the market’s opening. Some are already selling Delta-8-THC, derived from hemp, in candy form.
an infamous commercial spot.
considered 1 to 2 milligrams of THC, but effects vary based on many factors, like body weight and how much food the consumer ate that day.
Accidental consumption can affect anyone, but, Dr. Schauer said, “it has primarily impacted children because they can confuse cannabis edible products with other edible products, because most edibles look like candy or cookies or cake.” She pointed to reports compiled by poison control centers in Colorado and Washington, the two earliest states to legalize recreational cannabis use, in 2012.
Between 2014 and 2018, annual calls to the Washington Poison Center about children under 5 being unintentionally exposed to cannabis nearly tripled, rising from 34 to 94. In 2017, Washington State began requiring that all edibles have a logo stating “Not for Kids” (not that this will mean much to a 2-year-old).
edibles are the leading method by which children under 5 accidentally consume cannabis. In 2019, in Colorado, 108 people under the age of 19 were accidentally exposed to cannabis. In 2011, the year before the state legalized recreational use, that number was 16.
Like Washington, Colorado now requires packaging of edibles to include a warning symbol. The state also bans the use of the word “candy” on any marijuana packaging, and the sale of edibles that look like people, animals or fruit.
Dr. Schauer said other ways to reduce the risks of accidental ingestion include mandating childproof packaging, requiring that each edible item in a package is individually wrapped, limiting the potency of each individual edible, and educating consumers who live with children on how to store their cannabis products.
Making packages that will not catch the eye of a child is important, she said. In Canada, for example, where cannabis is legal, federal law requires packaging to have a uniform color and a smooth texture, and not to have cutout windows, scents, sounds or inserts (among other requirements).
Despite the stringency of Canada’s laws, as recently as mid-May, a child was hospitalized in the province of New Brunswick after eating Stoneo cookies that were made to look like Oreos, according to the Canadian Broadcasting Corporation.
In America, state laws are far less strict; for the most part, they prohibit the inclusion of cartoon characters and make general statements about how the packaging should not appeal to a child.
“The risks can be much more limited than we’ve seen them be so far,” Dr. Schauer said.
Mr. Hodas has three children, aged 12, 17 and 19. He has been in the cannabis industry for more than seven years. When he has products at home, he keeps them secure in bags made by StashLogix. It may not slow down a motivated 15-year-old, but it will stop a toddler, he said.
“If you have it locked up, and you keep in a place where they can’t reach it or see it, that’s the best way to prevent ingestion,” Mr. Hodas said.
To parents of a certain age, the situation may bring to mind the 1983 public service announcement “We’re Not Candy,” in which a barbershop quartet of singing pills on television advises children “to have a healthy fear of us.”
That the products now under scrutiny are a form of candy, just enhanced — and that no one is watching the same screen anymore — makes it difficult to imagine a marijuana meme so memorable.
A man in Arizona builds his shrunken cars out of refrigerators, but you’d never know it by looking at them. In Washington State, a teacher built his car from a boat, and there’s no mistaking it. And in Ghana, a student built a car that looks like a ramshackle DeLorean — and if you guessed that he made it with junkyard scraps, you’d be right.
Their creations turn heads, bring smiles and get them around town, all because they see promise in materials most of us would never put to use in the garage.
Kelvin Odartei Cruickshank, who is 19 and lives in Accra, Ghana’s capital city, has had a passion for building machines since he was 10. “I started by building prototype or micro-machines such as vacuum cleaners, robots, cars, a helicopter, etc.,” he said in interviews that were conducted via email and WhatsApp.
He moved on to bigger machines and got to work building, from scratch, a two-person car made from scrap materials that cost around $200. It took three years to complete. Mr. Cruickshank used scrap metal and parts not normally used in cars because of financial constraints.
a 1928 Chevy two-door sedan. The car is less than four and a half feet high and is just nine feet long — about 70 percent the size of the original. The engine clocks in at 13 horsepower, with 12-inch pneumatic tires and a three-speed transmission “from a 1964 three-wheeled mail cart,” he said.
“I didn’t have room for a full-size car in the trailer park we lived in, nor money to buy one, so I built my own little car,” he said. The project used nine old refrigerators and “was a work in progress for eight years,” Mr. Adams said.
Dwarf Car Museum in Maricopa.
All of his cars draw looks.
“A man was beside me at a stoplight,” Mr. Adams said of a quick neighborhood jaunt in the Grandpa Dwarf. “He looked down at me and said, ‘Hey, man, where’d you get that, out of a crackerjack box?’”
Mr. Adams also recalled an officer stopping him on the highway. “When he came up to my door,” he said, “he got down on his knees and looked in the window at me and said, ‘Sir, this is the first time I ever had to get on my knees to talk to somebody in a car.’”
Mr. Lorentz, too, enjoys making people laugh. “I tell my students they need to think ‘outside the boat,’” he said.
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