A Story of Utah Healthcare

On Sunday it will have been nine weeks after my son left home in psychosis, convinced that a casual remark I made about calling Vocational Rehab for help with a job meant I was (in his mind) a sociopathic narcissist who he wasn’t safe to be around. He left a home to live in his car, with no savings or income. It’s not the first time that he has done something like this, but each time I worry that it might be the last time I see him.

In February there was a national shortage of his antipsychotic medication, a long acting injectable that he took every four weeks to relieve symptoms of psychosis.  Although it didn’t “cure” him, he was stable and had been at home since his last big break in 2019. Since then we had negotiated through parole visits and mental health court. He struggled to work steadily but couldn’t keep a job. He has worked at more than 40 places since he was diagnosed, but hasn’t averaged more than 3 weeks in any single job. In almost all of these jobs he has chosen not to reveal that he has a mental illness. He is fired, or quits, or stops showing up.  There are unreported accidents from work. There are timecards left unsigned and unaccounted. There are customer complaints, or employee complaints, or HR reports. Oftentimes he would come home to say that a co-worker was one of the new voices in his head tormenting him, and he didn’t want to work around them any more.  

To make up for the temporary shortage, his prescriber decided that another LAI could be prescribed. I had immediate concerns because we had tried switching over to this other medication before, and the results were that he lost efficacy in his treatment.  The three of us got on a Zoom call to discuss treatment options, and the doctor was steadfast that the treatment would work with a new method of onboarding doses before transitioning to a more standard regimen.  I was skeptical, but my son trusted the doctor and we agreed that this new plan would be followed. Less than a month after beginning the transition I contacted my son’s doctor and counsellor to say that there were some minor but noticeable changes.  It didn’t appear that the new medication had the same therapeutic effect as the one it was replacing.  This was the beginning of me regularly emailing the hospital to describe my concern as his psychosis became apparent. My son was beginning to drift into paranoia, and it was going to get harder to bring him back each day we delayed. The prescriber suggested that my son supplement his shot with an oral-form antipsychotic. This was not suitable at all – the entire reason we were using a long acting injectable was because my son didn’t take oral meds.  They asked him to come in to pick up the oral medication, and he agreed but didn’t show up. He re-scheduled, then called and cancelled the appointment.  He didn’t want to take the oral meds. He didn’t want the injection either.  He just wanted to be safe because he didn’t trust the hospital anymore, and he didn’t trust me.  

In the week before he left he would come upstairs and talk to the pets. “I’m not afraid of you”, he would say. He no longer looked at any of us, instead he would look up, or look past us, or ignore us altogether while drowning us out with the music playing in his ear buds. At night, when we were in bed, he would go to the same computer that I’m typing this on to watch Youtube videos on narcissism, trauma bonding, sociopathy, tarot and astrology.  I was finding drawings and symbols that were his attempt to cast protective spells and use magic. When he found work he would often complain that a co-worker was a narcissist.  Now that he wasn’t able to work and became more isolated, he was beginning to turn this view on me. When he left he broke his bedroom door. He was angry, or afraid, or both. I didn’t stand in his way, and just let him take what he wanted before he left home. 

My son decided in his psychosis that his doctors and counsellor who had been with him for the past 5 years weren’t safe. He decided that his family wasn’t safe. He decided that the course of treatment he had been following wasn’t safe. He left home without money in his account, without a job, with no place to go.  I was keeping tabs through his hospital until he stopped talking to them. I have called the local police department to explain that he’s out there, and if they meet him they should have a note on file that he has paranoid schizophrenia but has typically been cooperative with police. I wait to hear something, but there is nothing.  I lie awake at night wondering if I would hear him come in during the night when he is routinely up and about.  I wonder if he wants to come home but thinks he can’t.  In one of our last exchanges I told him I didn’t feel safe around him because he was using threatening language about me. I didn’t want him to come home, not until he was willing to get help. 

A few weeks ago there was an officer-involved shooting near my home that involved reports of an adult male looking into cars at a nearby park that I knew my son frequented.  When officers responded in early morning hours, the person was aggressive and was shot and killed. The area was shut down while the investigation of the scene followed. When I heard, I panicked.  Could that have been my son?  I got in the car and drove to see, not sure what I would find.  When I arrived on the east side of the park, I could see his car and my heart sank. All I could think was “Please, no“.  I approached the car slowly. The windows were down. As I came past the vehicle I could see him, sitting in the back seat.  He saw me too, and he wasn’t happy to see me. But he was there, he was alive.  

I don’t know when I’m going to see him again.  I don’t know under what circumstances that I hear from him, or from the hospital, or a police officer, or from the metro county jail.  I have lost my son to psychosis, again.  As an adult, only he can consent to receiving treatment. The exceptions being that he is a danger to himself, or to others.  As his father I cannot request help, and I can’t talk to him in a way that would make him want to seek help.  He has been at UNI twice. The first time I implored him to get help because I was losing my son, the second time he was committed because I found him after a period of homelessness, bloodied and seeing “how far he could go” to cut himself. He doesn’t want to go back, and he thinks he knows better.  

It’s hard to say all of this.  I’m truly at a loss, and I don’t know what to do. We don’t have any laws to protect us from ourselves, and we don’t have any laws to step in when someone is experiencing psychosis.  It doesn’t matter if it leads to financial ruin, or destroying your health, or if it takes away the stability that you worked for years to have.  None of this matters.  

How do I get my son back?  How much will he suffer before something can be done? My heart is breaking for him, for my family, but also for every family who shares a similar story of loss. 

Update: Some readers responded and pointed me to Unsheltered Utah, a 501(c)3 nonprofit with outreach in the south valley. I have contacted them and they have engaged my son. Thank you.

Better Boundaries so we can Disagree Better

One of the biggest things to come out this week was the Utah Supreme Court decision that allows Better Boundaries to proceed in its case against the Utah Legislature for its issuance of gerrymandered lines before the 2020 election. It’s clear that the courts side with the people to say that we are not beholden to the special interests of legislators who seek to tie up districting in such a way that it favors their party, or their own election. Although the case has yet to have a final decision, it now has support to proceed with the validation of the Utah Supreme Court. In Utah, we have experienced a demonstration of the powers of balance between branches.

Responses from Republicans in the Utah Legislature fall flat. House Speaker Mike Schultz and Rep. Jordan Teuscher decry the Supreme Court’s decision, stating that it would be in our better interests to be served by the better judgements of elected officials, that the interests of the elected should trump the egalitarian principles our nation was founded on. Their response has been rightly criticized on social media as legally false, pretentious, and willfully ignorant.

At the same time this week, Governor Cox stated that “Disagree Better” is working at the National Governors Association. “We’ve gotten really, really good at tearing things down,” Cox told attendees gathered at The Grand America Hotel in Salt Lake City. “We need more builders. And that’s exactly what we’re trying to do.” (Deseret.com) If he’s serious, one of the most significant acts that a governor can do is to support fair districts to achieve more ideal representation of voter populations.

If we are to disagree better, we need a voice. If we are to disagree better, we need to be able to elect legislators who will represent the issues and address the causes that are important to us.

I look forward to hearing from you.

State Sovereignty and What Comes Of It

If you fly a US flag for the Fourth of July, think about what that means. You are celebrating the hard-fought freedoms of our country, and you are celebrating as a member citizen of the United States.  Think about that for a moment, then read on. If a state chooses to ignore federal laws, or specifically to write law contrary to federal law, what precedent does that set? 

The Supremacy Clause establishes that federal law generally takes precedence over state laws, and even state constitutions. With the recently passed Utah SB0057 “Utah Constitutional Sovereignty Act” our state plans to fight out in courts a concept of state’s rights that raises questions about the applicability of law and the right to govern citizens.  A question that will certainly come up is the question of Sovereign Citizens, who will seek precedence that favors their stand as willfully excerpted from the laws of government.  Their ideal is to enjoy the privileges of living in our democratic republic with its infrastructure and frameworks, but disregard their duties as citizens and abstain from legal recourse that are a consequence of their actions. If conservatives are truly a party of limited government, should their argument be that we are allowed to rule ourselves in true libertarian fashion?  Or is their argument more simply “rules for thee and not for me”?

There are frequent tests of states rights. If we take the case of medical marijuana legislated at the state level for medicinal use, or for recreational use, this was favorably received by constituents as a move away from heavy-handed government overreach, specifically for the Controlled Substances Act, and DEA Drug Schedule that classifies marijuana as a Schedule 1 substance. 

  • There is substantial research which shows that marijuana is not addictive, and has beneficial properties. 
  • Drug companies have exemptions to sell marijuana derivatives as anti-seizure medication (ex: Epidiolex by Jazz Pharmaceuticals), and as a pain-reliever and anti-nausea medication for cancer patients.
  • Allowing access to marijuana at the state level is pushing federal law to move in a just direction. 

In the case of Title IX protections, conservative legislators are doing the opposite by attempting to take away citizen protections at the federal level. Title IX prohibits discrimination based on sex in education programs and activities that receive federal financial assistance. Utah wants to claim sovereignty for the purpose of discriminating against trans students, and they are not only willing to lose federal funding for schools, but additionally grant the State Attorney General to pursue “any appropriate legal action to challenge the federal directive on the basis of state sovereignty.” None of this benefits Utahns.

  • Students and their families will unjustly face discriminatory practices.
  • The state will suffer from the loss of funding for public education, federal grants and programs.
  • Utahns will take up the burden of cost to fund expensive legal battles in the federal courts on whether or not states are allowed to willfully discriminate against a class of citizens. 

There are fights that are worthy, as in the first case. What Utah legislators are doing in the second case is a slap in the face of its people. They are claiming that federal civil rights protections can be ignored, and states can invoke discriminatory laws to burden its constituents.  They are effectively making the same argument that a Sovereign Citizen would make, but at the state level.  “Rules for thee and not for me”. 

Can a state simply write a law to say that its relationship to the federal government only applies as convenient to its legislature, that its willful participation in federal governance can be excerpted on a whim? If this is allowed, then the question becomes whether a county, municipality, city, or citizen claim the same right of sovereignty? Where is the rule of law when sovereignty can be claimed without repercussion? 

In principle, laws are designed to protect, not punish its citizens. Many of the laws we have are hard fought – the freedoms of all our people as citizens, the right to vote, the right to not be discriminated against on the basis of our age, ancestry, color, disability, ethnicity, gender, gender identity or expression, HIV/AIDS status, military status, national origin, pregnancy, race, religion, sex, sexual orientation, or veteran status. 

Take time to celebrate on this day, but recognize that our federal laws, and our state’s membership in a union of states has a long history that we should be careful to defend.

Lions and Tigers and Bears, and Book Bans

The summer is heating up, and Utah gets ready to implement a new statewide book-banning system. The Salt Lake Tribune reports that effective July 1 — ironically three days before the nation celebrates its freedom — a new law originally sponsored by Rep. Ken Ivory and Sen. Todd Weiler takes effect where books will begin to be removed based on “objective sensitive material” as defined by Utah code. There were literal discussions by the Utah State Board of Education (USBE) whether to conduct book burnings.

The bill is HB29: Sensitive Material Review Amendments, and it specifically calls out Utah Criminal Code Title 76, Chapter 10 Part 12 to define what objective sensitive material may be. The code uses terms like “contemporary community standards,” “prevailing standards in the adult community,” and “serious value”. The code is hyper-focused on expressions of sexuality and nudity.

It doesn’t mention physical violence, gore, or abuse. It doesn’t mention persecution, genocide, mass murders. It doesn’t mention drug abuse or recreational drug use. Apparently those depictions don’t constitute objective sensitive material according to the prevailing standards in (our) adult community. Here in Utah, sex is bad, bad stuff.

The law does not take into account that sexuality is identity. It doesn’t take into account, or possibly disregards that for minors a book may be the closest experience to reading about and understanding who they are. It does not factor that its “contemporary community standards” upheld are the religious dogmas of a church, and not broadly representative of religious views, culture and identity in our community. It’s unusual that the titles are works by renowned authors like Toni Morrison, Judy Blume and Margaret Atwood. These authors are now mobilizing as Authors against Book Bans – follow them on Instagram.

Article reference: New Coalition Against Book Bans Launches Nationwide With Support From Authors Like Judy Blume and Julia Quinn (People Magazine)

Our public school systems already have a system in place to monitor what’s appropriate to place on a library shelf. We have librarians who are trained, professional staff with degrees, accreditations, professional associations and administrative support to determine what students are reading, and what’s appropriate (or not) to place on a library shelf.

Stay tuned for the Utah State Board of Education to post its list of banned books on their site after the law goes into effect. July 15 Update: Links to each LEA are now published by the USBE.

In the meantime, if you want to do something for your community consider fighting censorship and starting a Little Library of Banned Books. If there is interest, I’d be happy to sponsor a workshop to build little libraries for our House District.

Are you interested? Let me know. I look forward to hearing from you.

This Week’s GOP Governor Candidates Debate

Did you watch the Gubernatorial Republican primary debate that took place on Tuesday, June 11?

Gubernatorial Debate sponsored by the Utah Debate Commission

If there is anything to take away from the Utah Republican gubernatorial debates, it’s that candidates are pandering to the conservative right of their base. There was nothing substantial from either gubernatorial candidate in the event hosted by the Utah Debate Commission. 

What we heard from Republican candidates was that federal legislation is bad because states want to do what they can’t right now, which is to strip protections from our lands and resources, and to deregulate air quality and environmental protections. Republicans think that the taxes to pay teachers is bad, but taxes to build a billionaire’s stadium is good.  Republicans don’t want to assist local economic development but will fall over themselves to grant billions in tax cuts to companies who reap benefits and pull out of the state long before any profit can be realized for the state. When it comes to citizen initiatives the will of the people can be ignored because the legislature can do what it wants. Personal rights don’t extend to women, or POC, or LGBTQ+. They want to tell us what to think, what to read, and what to believe. 

Does this sound like the government that you want to be represented by? Are you concerned that your federal tax dollars aren’t returned through federal services like access to healthcare, public school funding, and grants?  

The GOP would like you to think that they are the party of small government, but the reality is that they are a party of control and a party of profiteering. If one thing is clear, we need now more than ever to seek better representation — and the most important thing you can do this year is to show up in November to cast your vote for Brian King and Rebekah Cummings. 

Please visit https://www.kingforutah.com/ to learn more about the King and Cummings campaign for Utah Governor and Lt Governor, and make a donation towards their campaign. 

Donate: https://secure.actblue.com/donate/ws-king

A Celebration and Defense of Community

June is Pride Month, and on Saturday, June 1st I will be walking at the SoJo Summerfest Parade in South Jordan. On Sunday, June 2nd I will be walking with the Salt Lake County Democrats at the Utah Pride Parade in Salt Lake City. From a rainbow of colors, I will (quite obviously) be wearing green. On the first day we celebrate the city and our community, and on the second we celebrate and defend the people who are part of our community. There is a subtle and important difference between these two days. On the first day we show pride for our home, and on the second, we show pride for our community.

The Pride March started one year after the 1969 Stonewall Riots, and was created as a remembrance and solemn defense of identity. In the fifty years since then, the march has evolved to advocate for, educate about and celebrate the LGBTQIA+ community. According to the Pew Research Center, some 7% of Americans are lesbian, gay or bisexual, and the number is higher for our youth because culture is changing, and because younger generations are more comfortable talking about sex and gender. Nearly 10% of youth ages 18-24 identified as LGBTQIA+. This is why advocacy is so important – in recent years the US Dept of Justice reports that in Utah the number of hate crimes against people due to sexual orientation has increased six-fold between 2020 and 2022. Recent legislation has unjustly inflamed and polarized gender identity and sexual orientation issues. In Utah our LGBTQIA+ youth face discrimination, health access, mental health issues, homelessness, and suicide as significant risks.

I believe that we build UNITY in COMMUNITY. We do this by being visible, supporting our neighbors, by creating safe spaces, by respecting and celebrating our differences, and by standing together.

Legislatively, I will work to protect our individual rights. You can see my stances on DEI, LGBTQIA+ rights, healthcare, and education at https://utah44.com/issues/.

Resources

You’re invited to come and celebrate on both days. Register at https://utah44.com/get-involved/ if you want to be involved with the campaign.

https://utah44.com/find-unity-in-your-community/

I look forward to hearing from you.

Do Ethics Really Matter in Utah?

I’m speechless.

First Post: https://utah44.com/slushy-campaign-finances/
Update: https://utah44.com/teuscher-pierucci-and-the-conservative-millennial-pac/

The response (below) from disclosure@utah.gov confirms that in July 2023 a total of $1,500 was transferred to Candice Pierucci two months in advance by Jordan Teuscher (apparently acting as an officer of the Conservative Millennials PAC) that went unreported for two months before it was disclosed on their campaign reports. Even though https://disclosures.utah.gov/File/279 states that contributions must be reported within 31 days of receipt.

Summarizing:

  • The Conservative Millennials PAC forwarded money through Jordan Teuscher to Candice Pierucci in July 2023 that was unreported for two months, in violation of disclosure rules.
  • Jordan Teuscher either transferred money into his personal account (this would be a separate violation it it occurred), or has at least three accounts (his personal account, the Teuscher campaign account, and the Conservative Millennials PAC account) tied to his personal Venmo. The Office of the Utah Lieutenant Governor makes it clear that Venmo can be tied to multiple personal and campaign accounts used to receive, transfer and spend money, even though it is being used for all intents and purposes as a co-mingled financial account.
  • Jordan does not disclose his role as an intermediary who received funds from the Conservative Millennials PAC (of which he is a primary officer) in transferring the funds to Candice Pierucci using his personal Venmo, which should be a violation of disclosure rules.
  • Candice Pierucci fails to report the July campaign donation she received from Teuscher for two months, which is a violation of disclosure rules.

And the Lieutenant Governor’s office plans to do nothing about it.

Their email closes by saying: “If you don’t like or agree with the laws, please work with your legislators to improve them. Should you win the election you would have the opportunity to propose new legislation as well.”

Does Utah really care about ethics? Do we care about transparency and disclosure? Does it matter that the Republican Lieutenant Governor’s office weighs in favor of two Republican legislators and a Republican PAC who are clearly engaged in improper handling of campaign finances that benefitted them?

Teuscher, Pierucci and the Conservative Millennial PAC

This is a continuation of my first post at https://utah44.com/slushy-campaign-finances/

Today I received the following:

Thank you for following up on our additional inquiry. Our initial determination stands as you provided no evidence of wrongdoing or specific code violations other than to disagree that using Venmo is mingling personal and campaign funds. That is to say, we do not view the way Representative Tesucher has represented his use of Venmo as a violation of Utah campaign finance law.

The code requires separate bank accounts, which the representative has. We have confirmed this with him on two occasions. Based upon the definition of “transactional intermediary” in 20A-11-101.5, and the representation that campaign funds are being swept into a campaign account where they are used for campaign expenditures. These transactions are being reported properly. Therefore, we find no violation of Utah law and consider this issue resolved.

Office of the Utah Lieutenant Governor

So let’s get into specifics, because I’m not sure that everything I recorded at in my previous post was reviewed or investigated.

There is evidence of an undisclosed transaction involving Jordan Teuscher, Candice Pierucci, and the Conservative Millennial PAC that was found in Teuscher’s Venmo history. Teuscher transferred money to Pierucci on July 7, 2023 with a note “Conservative Millennial PAC Donation” that is not reported.

Here’s the proof:

Slushy Campaign Finances

Reference: https://le.utah.gov/xcode/Title20A/Chapter11/20A-11-S201.html

The Office of the Utah Lieutenant Governor allows a candidate to connect a campaign account to Venmo, a mobile payment service and use that as an intermediary system to send and receive payments. I am asking the Office of the Utah Lieutenant Governor to provide an explicit statement that confirms funds can be co-mingled in mobile payment service accounts that have been set up with access to both personal and campaign accounts, and/or publish this to the disclosures site FAQ at https://disclosures.utah.gov/Help/Faqs.

The Problem

The Venmo app has a feature that allows an account to connect more than one backend bank to a single account. When money is received, it goes into the Venmo balance. When money is sent, you can choose whether to use Venmo balance funds, or money from one of the registered bank accounts. You can also transfer money in your Venmo balance to one of the registered bank accounts. It is for all intents and purposes a financial account that co-mingles funds.

What’s bothering me about this is that it appears the Office of the Utah Lieutenant Governor will allow funds to be co-mingled in a mobile payment service account. The question becomes whether the provider of a mobile payment service account (i.e. Venmo) is considered a “financial institution”.  I would argue that they are. Venmo offers direct deposit, debit and credit cards.   Setting up multiple transfer accounts with Venmo is similar to how a standard bank account works.  A bank allows to receive and make payments, as well as transfer to third parties.  Venmo is for all intents and purposes a financial institution.

Further, what is the audit capacity for forensic research of these types of payments? I’m concerned that this is breaching the “trust but verify” capability of their office. 

Specifically: 

  • How do they identify that the amount received in a Venmo transaction is the same amount that is deposited into a campaign account? 
  • How do they identify that the timeliness of the transaction is reported to avoid disclosure reporting requirements (ex: is the contribution received when the money is transferred in Venmo, or when the balance is transferred to an account? Is the contribution ever reported if it never touches the actual campaign account? )
  • How is money tracked if it is in a Venmo balance, never transferred to the campaign account, then used to pay for something else? 
  • How do they track payments or money transfers between two candidates that both use a mobile payment service like Venmo? 
  • What is an intermediary, if that person is allowed to receive funds and forward them to another party, and that transaction is not reported?
  • Are they able to request account audits from candidates for mobile payment services?  
  • Are there specific mobile payment services that are allowed, or disallowed?  Not all mobile payment services allow for a single account to create backend connections to multiple bank accounts.

My concern is that what’s in place is an honor system that can easily be disregarded, and the lack of public transparency is of significant concern.  I contend that it is also a violation of Utah Code 20A-11-S201.

Spot the Difference

Situation One: A candidate opens a bank account, and begins to conduct transactions through it. The transactions include personal deposits and expenditures, as well as processing of campaign-related donations, expenses and transfers of money to other candidates. The candidate connects a separate personal bank account and a dedicated campaign account to this bank account so that they can transfer funds to and from the general account to the personal and campaign accounts. This is a campaign violation for co-mingled accounts.

Situation Two: A candidate opens a mobile payment account, and begins to conduct transactions through it. The transactions include personal deposits and expenditures, as well as processing of campaign-related donations, expenses and transfers of money to other candidates. The candidate connects a separate personal bank account and a dedicated campaign account to this mobile payment account so that they can transfer funds to and from the mobile payment account to the personal and campaign accounts. This is (apparently) NOT a campaign violation for co-mingled accounts.

My concern is that what’s in place is lazy. It is dependent on an honor system that can easily be disregarded, and the lack of public transparency is of significant concern.  If a candidate wants to play fast and loose with both campaign contributions and campaign payments, there is no verifiable means of holding that candidate accountable. 

A Gold Standard

  • A campaign account is set up using personal ID, a signed candidacy declaration from the clerk’s office, and a Section 527 – Political organization Federal EIN for the campaign.
  • Cash and checks are deposited and processed through the account.
  • Online payment services have a singular relationship to the campaign account, and can electronically deposit funds to the account (ex: ActBlue online donation form for political candidates)
  • Payments from the account should be in the form of debit card, online debit using the bank routing and account number, check or certified check drawn from the account.
  • A cash withdrawal from a campaign account is typically discouraged, but can be done with a receipt to verify the expense.

The Case Applied

From disclosure@utah.gov, sent May 9, 2024

Potential co-mingling of funds:
A Venmo account has the capacity to house multiple bank accounts. With this knowledge, and information provided by Rep. Teuscher regarding his specific Venmo account, we find that funds have not been co-mingled. As Rep. Teuscher has separate bank accounts within his one Venmo account, there has been no violation of 20A-11-201.


Jordan Teuscher (Utah Representative for House District 44) uses a personal Venmo account to receive campaign contributions, and to make campaign expenditures.  The Venmo account activity is not limited to campaign related activity.  The majority of transactions on his Venmo account @jordanteuscher are clearly personal in nature, which indicates this account is not (or should not be) tied to his separate campaign bank account. Teuscher appears to be co-mingling funds through his Venmo account in violation of Utah law. 

Teuscher either knew or should have known that it is impermissible for a statewide candidate to co-mingle funds. Teuscher – who serves as the chairman of the House Committee on Ethics – should be versed in these regulations. It is troubling that Teuscher is looking to further weaken Utah campaign finance reporting laws with the introduction of HB160 in 2024.

Multiple campaign violations appear to occur in 2020, 2021, 2022 and 2023.

Here is the proof: