Conventional wisdom holds that Republicans are the party of “local control,” arguing that towns and counties, not big-government bureaucrats in state legislatures or the federal government, should be able to decide what rules and laws work best for them. Small-c conservatives feared overreach from distant authorities, and argued that top-down rules, like state minimum wage laws, could threaten local economies and communities in ways that legislators in faraway capital cities could never anticipate.
That orthodoxy has never been entirely true, of course—for most of the last century, the GOP has been the party that advocates for regulating women’s bodies and peeking into couples’ bedrooms—but the shift has been especially pronounced in the Washington State Legislature in the past few years, as a newly emboldened clique of rural and exurban Republicans have proposed dozens of preemption bills aimed at stopping progressive laws in liberal cities like Seattle.
This past year, according to Seattle’s Office of Intergovernmental Relations, legislators proposed 16 bills that would preempt local authority. Most are aimed at local Seattle laws or proposals that frustrate the business community—such as SB 5149, sponsored by Sen. Joe Fain of Auburn, which would put the kibosh on Seattle City Council members’ efforts to require paid family leave, or SB 5620, from Sen. Curtis King of Yakima, which would bar Seattle from regulating transportation network companies like Uber and Lyft.
Others are aimed at stopping Seattle from passing socially liberal legislation, such as two bills by Sen. Mark Miloscia, from Federal Way, to prevent Seattle from opening supervised drug consumption sites (SB 5223) and authorizing homeless encampments (SB 5656). Still others take aim at local anti-discrimination laws, like the one in Seattle prohibiting landlords from refusing to rent to tenants using Section 8 vouchers or other nontraditional income sources.
“We’re a home rule state here in Washington, but if there are jurisdictions that have an idea and want to proceed with something that bothers [legislators], especially if it’s in the business arena—because there are businesses that work across jurisdictional lines—that can create tensions and conflicts,” says Seattle Democratic Sen. Reuven Carlyle, who recently wrote a blog post panning the preemption trend. But the larger fear, Carlyle says, isn’t just businesses will have to navigate a complicated web of overlapping rules—it’s that once progressive ideas take hold in one place, they tend to spread across the state.
“Once you start to see some of these policies get some momentum at the local level—and, worst of all, actually start to work—people in other towns and cities say, ‘Hey, maybe I’d like to make a higher minimum wage too,’ and it takes off,” Carlyle says. (So far, three cities—Seattle, SeaTac, and Tacoma—have passed local minimum wages that are higher than the statewide minimum, prompting legislators to propose a bill last year that would have preempted local minimum wage laws). “That’s the fear.”
The trend isn’t just taking place in Washington; as the New York Times reported in 2015, “So-called pre-emption laws, passed in states across the country, have barred cities from regulating landlords, building municipal broadband systems and raising the minimum wage.” Many of the bills are backed or drafted by the American Legislative Exchange Council, or ALEC, a national group that provides model legislation to conservative state legislators. The Times noted that the states where such bills have actually passed—as opposed to bubbling up perennially but never quite making it through both houses, as they do in Washington—are Republican-controlled states like Texas and Arkansas.
With the state legislature split by the slimmest of margins (Republicans hold an effective 25-24 majority in the senate and Democrats control the house 50-48, it’s still hard for any of these local preemption bills to get through. But that could change, if Republicans manage to take control of both houses. “We’re one vote away from those types of bills passing,” Carlyle says. “If the Republicans took over, they would very quickly raise preemption to the top tier of legislative priorities.”
Then again, would the Democrats behave any differently if the tables were turned? Dave Williams, government relations director for the Association of Washington Cities, says both parties tend to favor preemption once they get in power. “Our experience is that the things we have to defend against are different depending on who’s in charge,” Williams says. For example, Williams says Carlyle himself “was problematic in the past about how we deal with some of the issues relating to marijuana revenues.” (Carlyle opposed past efforts to give cities a greater share of tax revenues from recreational marijuana sales).
“It goes back and forth—it’s not a one-party deal,” Williams says. “It just so happens that right now, especially on some business issues, the Republicans want to preempt” cities like Seattle. When Democrats had more power, “We tended to get mandates on environmental regulations without the money to support enforcing them.”
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1. Earlier this week, I talked to state Sen. Mark Miloscia about a heated conversation he had with a group of student lobbyists from OneAmerica. (A source in Olympia had told me Miloscia grilled the students about their religious affiliations and belittled their views). In Miloscia’s version, he asked the students whether they were “Catholic or Christian” to illustrate a point: Representatives don’t have to have the same skin color or background as constituents in order to represent them. ” I said, ‘You can be represented based on religion, not just skin color,'” Miloscia said. Awkwardly, the group included multiple young women wearing headscarves who were obviously Muslim.
Monica Roman, one of the students who confronted Miloscia about his views on voting rights outside the senate chamber, tells a different story. She says this was actually the second time her student club, Fuerte (“strong” in Spanish) had met with Miloscia. Both times, Roman says, the students argued with Miloscia about the Voting Rights Act, a long-delayed bill that would give citizens a path to challenge voting systems that result in unequal representation. (In Yakima, citizens challenged the city’s at-large city council system, which resulted in an all-white city council in a city with a large Latino population, forcing the city to switch to more representative district elections). Both the Democratic and Republican versions of the bill would make it easier for citizens to challenge local election systems in court, but the Republican bill, sponsored by Miloscia, includes fewer protections and gives cities more time to address unrepresentative systems.
“Last year, we asked if he could represent us, and we said ‘No.’ He asked us again this year,” Roman says. The students told him that “as a white, straight male, he views things from a place of privilege, and he can’t really comprehend our experience. I think that really triggered him. He said, ‘I feel like you guys are attacking me.'” That’s when Miloscia brought religion into the conversation, Roman says.
“He was like, ‘How many of you guys are Catholics?’ when he could clearly see that we had multiple girls wearing hijabs. We were like, ‘You’re completely disregarding these Muslim girls right in front of you.'” When the group pointed out that some members of the group were Muslim, Roman says Miloscia “pointed out one of our hijabi girls and was like, ‘Can you not represent me?'”
Roman says that unlike last year, when she felt too “awkward” in the private conference room where they met with Miloscia to stand up for herself, this year, she “just laughed in his face. … I just didn’t back down. I was kind of proud of myself. I just didn’t let him yell at me.”
2. Operation Nightwatch, the overnight shelter for men that is being displaced from its current location, the Pearl Warren Building in the International District, has found a temporary home in the Next 50 Pavilion at Seattle Center, Crank has learned. Operation Nightwatch had been renting the space in the Pearl Warren which provides beds for about 75 men a night, from Compass Housing Alliance for $3,100 a month. The city previously told Operation Nightwatch it would help the group find a new space; according to Nightwatch director Rick Reynolds, the city initially handed the group a list of commercial spaces in places like Georgetown and the Rainier Valley, which rented for more than twice as much as their current space.
Meg Olberding, spokeswoman for the city’s Human Services Department, says Operation Nightwatch will not have to pay rent for the space, and can stay at Seattle Center until April 17. ” The City continues to provide resources through FAS, HSD and OEM to locate a new permanent site for this shelter program,” Olberding said in an email. “Compass is also using its relationships to find a new site, and is considering using the dining hall and lobby of its own administrative facilities as a backup in the case a location cannot be identified.”
3. At this week’s presentation about paid family leave (council member Lorena Gonzalez is proposing up to 26 weeks of paid leave for all employees in Seattle), consultant Maggie Simich presented some data that starkly illustrates the need for paid time off. Based on a survey of 400 Seattle residents who work in Seattle and 400 Seattle companies of all sizes, the survey found:
41 percent of Seattle residents did not have access to paid parental leave;
The smaller the company, the less likely it is to offer paid parental leave; 70 percent of those who worked for a company with fewer than 50 employees said they had access to paid parental leave;
Zero percent of employees said they had access to 12 weeks or more of paid leave, not counting vacation and sick time;
Half of all companies surveyed do not offer any form of paid family leave at all;
Companies in the health care, education, restaurant, and hotel industries were the least likely to offer any kind of paid leave;
And, somewhat surprisingly, six out of ten employers who offered paid leave said fewer than 10 percent of their workers had taken any kind of paid family leave within the previous year, belying the common assumption that employees (particularly women, who are most likely to take parental leave) will take advantage of paid leave if it’s offered.
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1. One element of Mayor Ed Murray’s proposed $275 million homelessness levy that didn’t get mentioned at his press conference earlier this month—perhaps because it involves a significant concession to labor—is that it helps pay for higher wages for the caseworkers and counselors who will be integral to the success of the outreach and treatment elements of the proposal. (The Service Employees International Union 1199 advocated for the inclusion of higher wages in the levy.) Those workers include public health nurses and mental health and substance abuse counselors who will evaluate and treat formerly homeless people who seek services through the city’s navigation teams and at the proposed new 24-hour shelters; outreach workers who talk to people living in encampments during encampment sweeps; case managers who get people connected with rental assistance in the form of new temporary housing vouchers funded through the levy; and the people who staff the new 24-hour shelters and permanent supportive housing. Turnover in those positions is notoriously high, in large part because many people who take those jobs burn out or leave Seattle because they can’t afford to live here, and because high-quality clinical workers and case managers tend to leave for better-paying jobs in the private sector.
The exact cost of raising wages for these positions is unclear, since the increase would also apply to existing contracts. The initiative itself alludes to the wage increases just once, in this blink-and-you-missed-it line: “The Director of Finance and Administrative Services shall make appropriate allowances for (1) the higher costs of high-quality programs staffed with clinical or social service professionals and paraprofessionals and (2) a reasonable wage differential in organizations where employee wages have increased or will increase as a result of the City’s minimum wage.” A more detailed program-by-program breakdown for the initiative indicates that public health nurses and mental health counselors will be paid $45 an hour; therapists in the pilot “Journey of Hope” residential treatment program will be paid $35 an hour; substance abuse counselors and caseworkers will be paid $25 an hour; and outreach workers will be paid $22 an hour. Previously, according to SEIU, some of those workers were making as little as the $15-an-hour minimum.
Downtown Emergency Service Center director Daniel Malone argues that agencies like his need to be able to pay higher wages to attract and retain high-skilled workers. “Some of the client services that we’re able to deliver are highly dependent on establishing a trusting relationship with a person who has had, quite often, bad experiences with treatment or social services, and when somebody’s case manager is changing all the time, that really interferes with making progress with them. You needs staff who are skilled at working with and providing help to people who sometimes have challenging behaviors, and you can’t have a workforce that is always principally comprised of people who are basically brand new and just learning.”
2. State Senator Mark Miloscia—perhaps best known to readers of this blog as the Republican who proposed two bills that would ban Seattle from allowing homeless encampments and safe injection sites, respectively—met with teenagers from the immigrant rights group OneAmerica outside the Senate chamber in Olympia the other day, and things did not go smoothly.
According to the version of events I heard from a source in Olympia, Miloscia “grilled” the students (including one young woman wearing a headscarf) about whether they were “Catholic or Christian,” then engaged them in an animated argument over race and religion.
I talked to Miloscia this week, and here’s his version of the story. He says he was approached by a group of kids who “peppered” him with questions, and that one of them, a person of color, “said ‘I can only be represented by somebody who looks like me.” Miloscia (who is white) claims he used religion merely as another example of how a person could feel represented by someone who doesn’t share their race—then asked whether the teenagers were “Christian, or Catholics. I said, ‘You can be represented based on religion, not just skin color.'”
Miloscia says he noticed the young woman who looked Muslim, and thought about using her religion as an example, but didn’t want to “put her on the spot. I was going to say she could be represented by a white Muslim or an Asian Muslim, not just a black Muslim.” He said the group then discussed two versions of a statewide voting rights act—one that would give citizens the right to sue if their city’s voting system disenfranchises minority voters, and another, proposed by Miloscia, that would not. “They impressed me with their knowledge of what’s in both bills,” Miloscia says. OneAmerica didn’t want to comment on the record about the exchange, but it’s probably safe to say the admiration wasn’t mutual.
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1. In yesterday’s Morning Crank, I reported that the city lacks some basic information that would help it evaluate its progress on “Vision Zero”—the Seattle Department of Transportation’s plan to eliminate serious injuries and deaths due to traffic collisions by 2030. The city’s annual traffic report, which includes detailed information on traffic injuries and death, hasn’t been updated since 2015. That means the most recent stats on cyclist and pedestrian injuries and deaths available to the public date back to 2014—before many of the policies in Vision Zero were even implemented.
Yesterday, SDOT responded to my request for some basic facts about the people killed or injured by traffic incidents in the past two years, including specific information about pedestrian and cyclist injuries and deaths. The numbers suggest that while Seattle is still much safer for pedestrians and cyclists than most other big cities, we’ve made only minimal progress toward reducing the number of people killed or injured in traffic, and that bicyclist and pedestrian deaths have stayed stable or inched up since the most recent traffic report.
According to the information provided by SDOT, there were 212 collisions that resulted in serious injuries or death in 2015 and 206 in 2016, compared to 186 in 2014. Seven people walking and one cyclist were killed in crashes in 2015; in 2016, those numbers were six and three, respectively. Both years represent an increase over 2014, when six pedestrians and one cyclist were killed by vehicles.
These numbers would seem to confirm the concerns council member Mike O’Brien raised last month, when he noted that Seattle should be “a city where, whether you’re walking to work or biking to go to the park or walking across the street to get groceries or go get a cup of coffee, that’s not an act of bravery but an act of daily living.” In a conversation Monday, O’Brien expressed frustration with the slow drip of traffic information from SDOT; two pedestrians who were killed by drivers in January, he noted, won’t even show up in SDOT’s numbers for another two years.
At a briefing on Vision Zero yesterday, SDOT staffer Darby Watson told the council’s transportation committee that the reason it takes so long for SDOT to release its annual traffic report is that the stats come from the Seattle Police Department’s Traffic Collision Investigation Squad, which “write[s] up a very detailed report that tells us everything about [each] collision. … And there’s a limited number of people that they’re willing to share it with, so it’s sometimes difficult to get those reports in a timely manner.” O’Brien responded, “I’m sure the police department has very good reasons for the thoroughness of their data,” but asked Watson to come back with recommendations for getting basic collision statistics to the city in a more timely manner.
2. A bill in the state legislature that would bar Seattle and King County from opening several planned supervised drug-consumption sites (rebranded last year as Community Health Engagement Locations, or CHELs) appears to be dead. The bill, sponsored by Federal Way Republican Mark Miloscia, came in response to a county opiate addiction task force recommendation for two safe-consumption sites, one in Seattle and one elsewhere in King County.
3. One of the democratizing things about the move to electronic records among state and local government agencies is that reporters and citizens no longer have to pay photocopying charges to access public records. (Another benefit is that electronic records don’t kill trees). Electronic copies are generally available for free or at a nominal charge, making information accessible to those of us without company credit cards or expense account.
But twobills in the state legislature, which passed out of the House on Friday and are now in the Senate’s state government committee, would increase the cost of electronic records and put information off-limits for those who can’t afford to pay the new charges. The proposed legislation would allow agencies such as the Seattle Police Department to charge up to ten cents per minute for audio and video files, and would allow “customized service charges” for “exceptionally large requests” that require extra staff time or expertise. Electronic scans would cost up to 10 cents a page, which is comparable to what many agencies currently charge for paper records.
The bills also gives agencies the power to deny requests from bots designed to file multiple requests per day, and would allow agencies to force requesters into potentially costly mediation to settle disputes over requests.
4. Mayor Ed Murray plans to reveal the details of his $55 million ballot measure for homelessness services and housing today at 1pm. Supporters plan to qualify the measure for the ballot by gathering signatures, rather than submitting the proposal to the city council, which would almost certainly tinker with the proposal.
If you enjoy the work I do here at The C Is for Crank, please consider becoming a sustaining supporter of the site! For just $5, $10, or $20 a month (or whatever you can give), you can help keep this site going, and help me continue to dedicate the many hours it takes to bring you stories like this one every week. This site is funded entirely by contributions from readers, which pay for the substantial time I put into reporting and writing for this blog and on social media, as well as costs like transportation, equipment, travel costs, website maintenance, and other expenses associated with my reporting. Thank you for reading, and I’m truly grateful for your support.
Insite founder Liz Evans and Portland Hotel Society manager Coco Culbertson at the Rainier Hotel in Vancouver
Yesterday, I gave a brief account of my recent trip with state Sen. Mark Miloscia and city council member Lisa Herbold to Vancouver, B.C., where we visited Insite, North America’s only supervised injection site for illegal drugs, a zero-eviction women’s housing project eviscerated by government budget cuts, and a prescription heroin clinic. After the trip, I sat down with Miloscia, who is running for state auditor, to talk about his impressions of the trip and his own views about the role of government in responding to addiction.
Miloscia, a Republican, has said publicly that he plans to introduce legislation preempting King County from moving forward with two supervised drug-consumption sites recommended by a county task force on opiate addiction. A former B-52 pilot with, as he puts it, “18 nukes on my wing,” Miloscia says he had a religious awakening during his time in the service and became a pacifist; his political views also did a 180, and he became a vocal opponent not only of abortion rights and the death penalty, but of drug decriminalization, which he previously supported.
The C Is for Crank [ECB]: Did anything you saw in Vancouver surprise you?
MM: A few things surprised me. One is the passion and compassion of Liz [Evans, the founder of Insite] and the people there. Two, I think in the big scheme of things, we’re not that far apart. She gets the failures of the system absolutely, and I’m the same way. She said she’s a disrupter, and so am I, because we both recognize the evils and the shortfalls of the current system. It’s not working. That’s why I got into government, why I ran for office–because the human services and criminal justice side is a complete failure, and we don’t want to fix it, and people die. It’s mind-boggling to me.
The first question out of the first reporter [at KING 5, which did a brief story about the visit] was, ‘What struck you there?’ And I said, ‘That street.’ [East Hastings Street, where Insite is located, has long been Ground Zero for the drug trade in Vancouver]. I never saw that many drug addicts on one street. I grew up in New York City, but that was horrible. I saw that need, our brothers and sisters dying on the street. And then you have that clean, very well-maintained facility, government-run, and it’s like, we’re contributing to that. We’re not helping them. They’re already on death’s doorstep. They’re dying right there, and we should be helping them five years before they get to that point.
ECB: But Insite does save lives. The data, which Liz and the other Insite staff cited to you, prove that it saves lives that would have been lost to overdoses, HIV, or wound infections.
MM: You’re absolutely right. Maybe they are. But I talked to Liz about this and Liz admitted that it’s just a little patchwork process in the entire homeless heroin addiction system, which is completely broken. It’s like, stupid government! What are they doing? Do something! They have all the money, all the authority, and they’re blowing it.
“The entire way our planet operates is about telling people what to do. Criminal justice, societal pressure—everything is about telling people what to do. Now, when they have an addiction, when the drug takes over their life, that’s when they need that more than ever before.”
And she said that she hated the government getting involved, because it’s gold-plated and ineffective and the compassion goes away when bureaucrats are running it. And ultimately it doesn’t work. I believe there’s got to be accountability and prevention, because once they get into that… What’d she say, it’s going to cost $30,000, $24,000 a year? I can’t remember what figure she gave but it was an insane act of money. We’ve got, what, 50,000, 40,000 addicts in King County? Do the math.
ECB: But they’re already costing us money. The highest number I heard for any service while we were in Vancouver was around $25,000 for someone to use the prescription heroin program, and the director pointed out that that was still much cheaper than jail, which can cost as much as $150,000 a year.
MM: And that’s why I’m a big believer in any sort of diversion program at all. You need to be able to identify people as being a danger to self or a danger to others, and once you do that, you can force people into treatment.
ECB: Liz told you that there’s no evidence to suggest that forcing people into treatment works—it just gets them off the street for a few days or weeks, at huge expense, just like jail. What do you say to that?
MM: That is a crock. The entire way our planet operates is about telling people what to do. Criminal justice, societal pressure—everything is about telling people what to do. Now, when they have an addiction, when the drug takes over their life, that’s when they need that more than ever before, and the question is getting them into a treatment that works. And to be honest, it’s almost a lifetime of treatment they need, because 30 days is the worst type of treatment. You might as well not even try. You might as well get them into detox and then kick them out onto the street. And that’s what we’re not fixing.
ECB: If 30 days of treatment isn’t enough, and that costs tens of thousands of dollars already, how are you going to pay for more intensive treatment for more people?
MM: You’ve got to focus on prevention. That’s the only way you rightsize the problem. Do an analysis of why people are turning to drugs. If you want to solve the problem rather than just maintain it, slow the growth. To solve any problem, it’s all about preventing the causes. That’s where it’s cheaper. That’s where you get results. And that’s, to be honest, where the bulk of the money needs to be spent. We’re triaging now. If we do everything in a system-wide manner, yes, there’s a way I see her program working–if it’s just a temporary stair-step program to get people into treatment. I try not to get visibly angry over the destigmatization of drugs and ‘It’s all about choice’–but that’s the wrong approach. It’s hard for people to choose to get out of their addiction. It’s carrots and sticks, for all of history–that’s how you motivate people. If you have no stick, you’ll never get a person to the point [of entering treatment] unless they hit literally rock bottom and are at death’s doorstep.
ECB: But if every addict decided they wanted to get into treatment tomorrow, we’d be thousands of beds short. And we don’t currently have the capacity to put every heroin addict on Suboxone or methadone. Are you in favor of funding treatment on demand?
MM: What I believe is when people want treatment now, you get them treatment now. So yes, that’s where you probably get your most success. If I was going to put money into triage, absolutely, get that right now. But do the math. We’re going to need $5 billion. And that’s why we’ve got to do prevention and stop it.
“I try not to get visibly angry over the destigmatization of drugs and ‘It’s all about choice’–but that’s the wrong approach. It’s hard for people to choose to get out of their addiction.”
ECB: Will you concede that you’re never going to stop from using drugs and doing dumb stuff through prevention, though? You can conceivably reduce it, but it’s going to be above zero, because people are going to continue to use drugs. What do you do with the people who are going to still use drugs and end up getting addicted?
MM: I’m going to slightly disagree with your assumption, because at the end of the day, this whole discussion we’re having is a distraction from, what is our plan to cut heroin drug use down from 50,000 down to a manageable 1,000? [It needs to be] done right, with a huge cultural stigmatization–this is controversial when I say it–and going after the root causes.
“I firmly believe that just like with homelessness, literally half the money we’re spending is spent on ineffective programs, wasteful programs, and we don’t get results because we don’t measure that.”
I started having that conversation with Liz, I said, ‘Why do people start using drugs?’ And she said, ‘Pain, broken relationships.’ That’s just another name for religion, family, community: Those networks that keep people sane and that stabilize people before it reaches the state of, you’re living in the Jungle with your heroin buddies and part of a gang. When you‘re part of a strong community like that, it’s really hard to move there. The societal, community, family, pressure prevents you from going there. The bottom line is that’s what it takes for people to get out of their addiction. You’ve got to develop that support structure around them.
A nurse at the Crosstown Clinic in Vancouver, where addicts come several times daily to inject prescription heroin.
ECB: You’ve said you don’t want a safe injection or consumption site in King County. Why do you want to interfere with local control by passing legislation making Seattle’s desire to experiment with that model impossible?
MM: Part of the reason is, if you look at where Canada’s going, with medicinal heroin, they’re still not getting rid of the root causes. They’ve still got a heroin epidemic going on, so they’re not solving the root problem. So while in the short term, I believe it slowed the deaths–instead of it taking you five years to die on the streets, it’s now taking you ten years–at the same time, it’s not solving the underlying root causes that ultimately lead to addiction.
ECB: Have you read the heroin task force report?
MM: Yeah, ten times already.
ECB: It seems to me that they’re trying to do exactly what you’re saying you want.
MM: There’s a lot of good things in there. But we know how task forces are done, and there’s really nothing in there that I haven’t seen before. It’s all the same stuff. And anybody who’s been involved in this knows that the problems haven’t changed from the 80s. It’s the same problems. The solution is the same thing. But government never does it. Government screws up the implementation every single time. But they get to spin that report and say, ‘Oh, we’re doing something.’ But does the system, the boots on the ground, really change?
ECB: The task force is only recommending safe consumption sites for two years, as a pilot project. Why not let them try and see what happens?
MM: OK, so let’s think. We’re going to take this radical change. If we scale it up, we’re going to need to do 80 sites in King County alone. Then we’ll do medicinal heroin and we’re going to continue down that path.
ECB: But nobody’s talking about doing that here.
MM: They’re doing it in Canada! It’s the next step. It doesn’t work unless you go to the next step. That’s why everybody wants to put it in that little silo: ‘Oh, this is all we’re doing.’ But no, no–if we want to change the system, we have to have real reform. How does this scale up and look systemwide? And then when you look at that you go, ‘All our resources are going into this, it doesn’t work, per se, and we’re ignoring the key factor of prevention.’
ECB: What do you think does work?
MM: Show me the numbers. No one talks about efficiencies or effectiveness. I firmly believe that just like with homelessness, literally half the money we’re spending is spent on ineffective programs, wasteful programs, and we don’t get results because we don’t measure that. But that’s the data I want. I want to know that, ‘Okay, Mark, if you do this program systemwide, it’ll save “X” lives.’
ECB: But the only way to get data on harm reduction is to do harm reduction.
MM: Oh, true, right. But what I’d like to see is, let’s fix the $1 billion we’re spending right now, which we know at least half a billion of it are wasteful, are ineffective, are not getting results. Let’s design a plan to focus on prevention, versus, let’s get distracted and put us on the path to, frankly, legalization and decriminalization.
ECB: What do you think of the LEAD program, which diverts people committing drug crimes out of the jail system?
MM: Oh, it’s fantastic.
ECB: But that involves not arresting people.
MM: As long as they get them in a treatment plan, I’m fine. Do harm reduction and treatment, I’m fine. But there’s got to be no choice. It can’t be, ‘Well, I’m going to do this for ten years.’ It’s like Housing First. I’m for Housing First, but after 30 days, pick a time, you’ve got to get with the program. Come up to me with programs that get them from Point A to Point B. Show me the data. I know behavior modification and I know this: Human behavior has been the same for as long as we’ve been on this planet. Carrots and sticks.
ECB: Do you have an opinion on long-term buprenorphine treatment?
MM: I want to see an efficient, effective, ethical program that works, that gets results. So I’m not opposed to it, but it’s a different focus from just giving you free government help and, we’re just waiting for a light bulb to magically turn on, versus being in a program where you’re monitored with ankle [bracelets], diversion programs, all that stuff. I want to be part of that solution. I think that’s the way to go, with that public stigma. And people don’t like doing this, but you have to scare the kids and scare the adults.
ECB: I grew up in the age of Just Say No and it didn’t work. Neither did DARE. Both of those programs were geared toward trying to scare kids.
MM: Of course it didn’t work. Those are government-run programs. When the program doesn’t work, you know that within 45 days of the program starting and you change the program. But that doesn’t stop you from trying to find a program that scares people and stigmatizes them. Look at Korea. Look at Japan. There’s all kinds of cultures where it does work. But it takes thought. It’s all about culture and attitudes, so people don’t turn to drugs. There’s a whole science about why people turn to drugs or do self-destructive behaviors, and it brings us back to the family and religion discussion, or the values discussion, or the culture discussion. That’s the heart and soul of how people decide to avoid listening to the little devil on their shoulder versus the angel on their shoulder. That’s just human nature. We all struggle. All of us deal with the choices that we make.
ECB: Was your mind changed by anything that you saw or heard in Vancouver?
MM: Like I said, Liz completely shocked me. She gets the problem and the gets the solution and she admits that her thing isn’t solving the problem. She’s trying to break up the system. But the practice per se of clinics–I think, no. My opinion didn’t change at all. I still think it’s a distraction from us working on the really tough issue.
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The weekend before last, I took a second trip up to Vancouver, B.C. to visit Insite, North America’s only safe-injection site and, as such, the likely model for two proposed safe consumption sites (which will include space for people who smoke meth, heroin, crack, and other drugs as well as injection stations) in King County. (The sites are among many recommendations that came out of the county’s heroin and opiate addiction task force.) I visited Insite previously over the summer, when program manager Darwin Fisher gave me a tour of the facility and the Downtown Eastside neighborhood that surrounds it. That time, Insite was open for business, and a steady stream of clients filed through; each told the staffer at the desk her code name and what drugs she was bringing in, and settled into one of 13 mirrored booths that line one wall of the tidy facility. I watched as drug users fresh off the streets searched for veins in their feet, did their makeup, washed their hands for what might’ve been the first time in days.
This time, I wasn’t alone, and I wasn’t visiting during business hours. Instead, I was playing third wheel to an unlikely pair of elected officials—uberliberal Seattle city council member Lisa Herbold, and conservative Republican state Senator (and candidate for state auditor) Mark Miloscia. Herbold, a supporter of safe consumption sites, invited Miloscia along in hopes of getting him to see the ways that Insite has benefited the surrounding neighborhood, and to view harm reduction through a more sympathetic lens. Miloscia has said he plans to propose legislation that would bar all cities from authorizing safe consumption sites—a sort of companion bill to his proposal to prevent Seattle from relaxing its policy on encampment sweeps.
Over the course of a long morning and part of the afternoon, Miloscia, Herbold, and I toured Insite, wandered around the Downtown Eastside, talked harm reduction over lunch with City of Vancouver urban health planner Chris Van Veen and Insite founder Liz Evans, and toured a clinic that prescribes heroin to addicts who don’t respond to methadone or suboxone, two common drugs prescribed as part of treatment for heroin addiction. We also visited the Rainier Hotel, a zero-eviction apartment building for women that used to be a thriving, successful drug treatment center; in 2013, thanks to what Evans calls the government’s “culture of bureaucracy,” it lost public funds for its addiction programs and is now single-room occupancy housing.
Fisher, Evans, and Coco Culbertson, a manager at the Portland Hotel Society, the nonprofit that runs Insite, walked a very curious (and at times visibly distressed) Miloscia through the admission process (more on that here), and explained the benefits of the services Insite provides. “Coming in here from the street, where you’re going to get water wherever you can find it”—that is, from a puddle in an alley— “it’s like going from the third world to the first world in a sense, because of that running water,” Fisher said. Deaths from HIV, overdose, and soft-tissue injury infections have declined dramatically in the surrounding neighborhood and in Vancouver as a whole, and detox admissions have increased (to 400 a year, according to Fisher), because Insite builds trust with its clients and doesn’t judge them, Fisher explained. Later, Evans would say that harm reduction programs like Insite have had an unanticipated side effect: Because people are no longer dying so young, “we’re treating chronic conditions in a population that’s aging ten years more than they would have 20 years ago. That’s incredible. We’re seeing chronic health conditions win a population that used to just die.”
Miloscia, who stared, aghast, at the drug users displaying goods for sale, shooting up, and chilling out on the sidewalks around Insite as Evans explained how programs like Insite and the Rainier Hotel save money, peppered the Canadians with questions: How do you know this is working? (They have data and studies that say it is). Why not just focus on prevention? (Prevention is just one pillar; you need to deal with people after they get addicted as well). And: “When do we say, enough is enough, and you have to rejoin society?”
That question was really at the heart of Miloscia’s objections to the Canadian experiment: Why coddle people who will continue to stay addicted, according to Evans, an average of 14 years, instead of just shaming them for their bad behavior, pushing them toward their own “rock bottom,” and if all else fails, forcing them into treatment? This is a fundamental difference in philosophy between those who advocate for harm reduction and those who believe in prevention and punishment. Evans and the other advocates argued that not only does forcing people into treatment not work, blaming and shaming only pushes people further into the shadows—and further away from help. “We would like to believe that forced treatment works, but it does not,” Evans said over lunch. “If we make people feel their life matters… their outcomes are going to be way better than if we push them further away.
“We have been so ingrained with this belief that telling people that what they’re doing is wrong and bad works, but it doesn’t work. In 25 years, I have never seen a drug user stop using because we told them they were wrong and bad.”
Miloscia is a firm believer in stigmatizing drug use and forcing people into treatment. He thinks it works. But what Miloscia really believes in, he says, is prevention—”scaring” parents and kids, in his words, into never picking up a drug in the first place. Tomorrow, I’ll have a post-Vancouver Q&A with Miloscia in which the conservative senator talks about what he learned from Vancouver, what he thinks of King County’s current approach to addiction, and whether anything he saw changed his mind.
If you enjoy the work I do here at The C Is for Crank, please consider becoming a sustaining supporter of the site! For just $5, $10, or $20 a month (or whatever you can give), you can help keep this site going, and help me continue to dedicate the many hours it takes to bring you stories like this one every week. This site is run entirely on contributions from readers, which pay for my time as well as costs like transportation, equipment, travel costs, website maintenance, and other expenses associated with my reporting. Thank you for reading, and I’m truly grateful for your support.
