Amber Boyer spent early mornings last spring crawling out of her bedroom window and into her garage to make breakfast and gather medications for her then 14-year-old son Davin. 

She’d strap on a rugby-style helmet to protect her head and hair when she went back inside her Kay County home to give Davin his meals. Davin has autism and a speech delay. For the last year, he’s had increasingly aggressive behaviors, Boyer said. 

Davin started complaining about headaches in 2022. He’d need to be sedated for any medical testing to figure out why the headaches were happening. But few doctors in the state do sedation before a procedure like an MRI, Boyer said. Finding care was nearly impossible. 

Davin’s behaviors grew increasingly aggressive as his headaches continued. He was biting, pulling hair and breaking doors. By early 2023, Davin was suspended for several days from his public school. He eventually refused to attend school in person. Boyer took off almost four weeks from work to stay home with him as she looked for treatment. When Davin became a serious risk to himself or others, she took him to the emergency room. He visited hospital emergency rooms seven times in six months.  

As Davin’s behaviors escalated, Boyer moved her teenage daughter to her parents’ home, and she moved into the garage, eventually taking medical leave from work. She spent her days making calls to mental health providers, doctors, her attorney, the local school district and the Oklahoma Autism Network, trying to find someone who could help. 

Boyer could only stay inside her house at night while they both slept — her behind a steel-plated door. From the garage, she watched Davin through cameras inside the house to make sure he was safe. 

Davin has been on Oklahoma’s waiting list for developmental disability services for around a decade. Boyer has relied on private insurance and Oklahoma’s Medicaid program to help pay for his care in the meantime.

Struggling to find care is common for parents with children who have dual needs, or an intellectual or developmental disability and a mental or behavioral health challenge. 

Demand for mental and behavioral health care has spiked in recent years amid a staffing shortage, leaving some kids with complex needs behind as providers pick and choose which clients they can take on. The state has ramped up some spending on mental health care and developmental disability services but the investments haven’t been enough to allow providers to expand or feel ready to accept more youth with dual needs, officials say. 

Without better access to care, advocates say children with dual needs are more likely to end up involved with the child welfare or criminal justice system, or be sent to costly out-of-state facilities away from their families. In the 2023 fiscal year, Oklahoma spent over $5 million to send 49 kids out of state for treatment, according to data from the Oklahoma Health Care Authority. Five years ago, the state only paid for two kids to leave for treatment. Some children are likely left out of those numbers.

“It’s kind of this perfect storm, with those with a dual diagnosis in the middle of it,” said Wanda Felty, an advocate who has worked for years to get individuals with disabilities connected to state services. 

Parents turn to schools that lack resources

Oklahoma has had limited mental and behavioral health services available for youth for decades. 

Only nine counties in Oklahoma have any child and adolescent psychiatrists, according to 2022 maps from the American Academy of Child and Adolescent Psychiatry. When a child has a complex need in addition to mental or behavioral health challenges, the pool of outpatient and inpatient providers shrinks even more. 

To fill these gaps, communities rely on public schools to provide significant on-site services to kids. But special education programs are often short-staffed and under-funded. This means less of the consistent, community-based care that can play a role in keeping children from needing inpatient services or residential treatment for issues later on.

Davin’s public school was able to provide him some speech therapy throughout the years but struggled to hire the right professionals in the rural area, Boyer said. 

The school district struggled to keep up as Davin’s care needs escalated, she said. One special education teacher threatened to file assault charges against him. 

By May 2023, Davin hadn’t been to school in about two months. Two special education teachers from the school — who Davin hadn’t met before — tried to come to Boyer’s home to provide lessons. Occasionally these classes went well, but most of the time, Boyer said, Davin was too aggressive. 

Sara Coffey, a child psychiatry consultant to the state’s child welfare department and director of child and adolescent psychiatry for Oklahoma State University, frequently sees families with children who didn’t receive adequate day-to-day services like speech therapy and have started to have other mental or behavioral health issues. 

“That’s whenever they come to see me — when it gets to a point where the child, quite frankly, is older and might be larger, and there’s increased safety concerns,” Coffey said. “But it’s often something that’s been going on for years that we didn’t have the appropriate interventions and supports in place for.”

Kids with dual needs often need more than just crisis care

Getting services early can be critical to improving a child’s stability and future independence, according to the American Psychiatric Association. Problems can become more serious when families can’t find adequate levels of care in schools or the community.

Parents may take kids who are in crisis to emergency rooms, where they may be funneled to a short-stay, inpatient treatment provider if a bed is available. Longer-term, residential treatment for kids with complex needs is almost nonexistent in the state, officials said.

When Davin was home full-time, Boyer reached out to Oklahoma Human Services’ developmental disability services office but never heard back, she said. She called an autism research and advocacy organization.

The organization wanted to help, Boyer said, but the resources her son needed either didn’t exist or weren’t accessible. 

“They actually told me, once I figured something out, to call back and report to them what I was able to get accomplished so that they could help other parents,” Boyer said. 

Last June, Boyer took Davin to another emergency room in Oklahoma City to get help. Even though Davin was admitted for several days and a doctor adjusted the psychiatric medications meant to manage his behaviors, Davin was discharged without any new diagnosis or medical testing, Boyer said. The hospital said to follow up with a psychiatrist and wrote a letter saying Davin needed long-term placement. 

Many crisis interventions are short term, said RoseAnn Duplan, a policy specialist with the Oklahoma Disability Law Center. Kids are kept until they are stabilized and then they are sent home. There are few supports for families, Duplan said, so children can deteriorate quickly. 

“I think in all of these cases, had there been appropriate community-based mental health treatment for these kids to begin with, there’s a really good chance we would never have got to the level of needing inpatient care,” Duplan said.

A lack of providers equipped for complex needs

People with intellectual or developmental disabilities have co-occurring psychiatric conditions at rates that can exceed the general population, including ADHD, depression and anxiety, according to the National Association for the Dually Diagnosed.

But the state’s system has been set up to treat psychiatric needs separately from developmental disabilities, said Traylor Rains, the state’s Medicaid director. It takes highly trained clinicians to figure out where behaviors are coming from when those conditions are intertwined, he said. 

There aren’t enough of these specialists in the state to treat kids with co-occurring developmental disabilities and mental or behavioral health needs, providers said. 

Providers have to seek outside resources to access specific training on working with children with developmental disabilities, which can be expensive and time consuming, said Whitney Downie, chief program officer for Family and Children’s Services in Tulsa.

Health care facilities have to consider physical space for new clients and whether a new client will mix well with other patients, providers told The Frontier. Providers also must often adhere to strict staff-to-patient ratios. 

But a staffing shortage has plagued mental health providers in the state for years. 

If providers feel like their staff aren’t trained to handle a client’s behavior, especially if those behaviors are deemed aggressive, and still provide effective treatment, they’ll decline the patient, said Matthew Spencer, a chief clinical officer with Grand Mental Health in northeast Oklahoma. 

Grand Mental Health provides outpatient therapy and can serve kids with developmental disabilities, but only if patients have the cognitive ability to participate in therapy and benefit from it, Spencer said. If not, Grand Mental Health will refer them to a different provider, he said. 

Oklahoma has a mix of providers that do inpatient and outpatient services, but they don’t always accept kids with dual needs. Integris and SSM Health hospital systems in Oklahoma City have specialized psychiatric units for youth with developmental disabilities. The state has its own hospital in Norman that can accept kids with dual needs if they have capacity to benefit from treatment. The state also contracts with a few other providers that have longer-term programs, though not all accept kids with developmental disabilities. Another facility in Tulsa serves these youth in a residential setting, but only if they are in state custody. 

Leaders from multiple state agencies say they have asked providers across the country to come to Oklahoma or for existing providers to expand their services, but most decline, citing concerns with staffing, training and funding. 

Kids with dual needs can be more expensive to care for because of increased staffing and additional therapies. Low reimbursement rates from the state’s Medicaid program make it difficult for Oklahoma providers to expand services, especially longer-term, residential-style services. 

“Everybody knows that it’s an underserved population, and I think everybody wants to do all they can or more than they’re doing now,” said Eric Sachau, director of administrative services for Parkside Psychiatric Hospital in Tulsa. “The things that will open the doors to that are going to be a long list of things, and reimbursement is one of them.” 

In 2022, lawmakers approved $2 million in incentives to persuade providers to accept more high-needs kids, including those with developmental disabilities. Providers would get a minimum $20,000 for accepting children with complex needs and another $10,000 if a child showed progress. 

But by October of last year, only about 10% of funds had been used by five providers for eight kids, according to the Oklahoma Department of Mental Health and Substance Abuse Services. One of the providers doesn’t accept kids with developmental disabilities and another has since closed down. 

Effective in-patient treatment is increasingly only accessible out of state for some kids with complex needs. 

Boyer found an out-of-state facility that could accept Davin in August with the help of a therapist from Grand Mental Health. It’s a psychiatric residential treatment facility with onsite nurses, behavioral therapy technicians and a daily special education program with multiple teachers. His old school district is paying about $40,000 a month for the facility, Boyer said. 

The staff are highly trained and Davin’s behaviors have decreased significantly, Boyer said. 

He’s answering questions in school and doing homework, things Boyer said she’d never seen him do before. Someone from the state’s developmental disability services office got in touch with Boyer and is keeping an eye on Davin’s case to make sure there are services for him when he comes home. 

Coming Home 

To address the state’s mental health needs, the Oklahoma Legislature has invested hundreds of millions of dollars in the last few years in state funds and federal pandemic relief dollars to expand and build new mental health facilities for adults and children, increase payment rates to developmental disability providers and build the education pipeline for health care workers. 

One of the new facilities is a behavioral health hospital for youth, which should open in Oklahoma City under the OU Health umbrella in late 2026. The $140-million facility will have 72 beds for short- and long-term inpatient stays, an outpatient program and a partial hospitalization program, said Randy Dowell, chief executive officer of the University Hospitals Authority and Trust. 

The facility will be connected to the Oklahoma Children’s Hospital, so patients will have access to medical doctors. Oklahoma Human Services also has a foster care program available, and the facility will have a connection with the Child Study Center, a program on the campus that serves kids with developmental disabilities and trains health care providers, Dowell said. 

The success of the program will depend on staffing and whether Oklahoma kids with high needs are accepted over out-of-state patients for higher reimbursement rates. 

 “I think it’s a great start,” Dowell said. “I don’t know that it solves all the needs for the state of Oklahoma, but it definitely goes a long way in allowing us to have kids treated in the state.” 

Boyer is back at work but living with her parents and daughter while she repairs her home using a loan and help from her church to cover costs. She’s working on writing a resource book to help other parents before they get to the point she did. 

Boyer and her daughter visit Davin every week. His treatment care team has started talking about integrating Davin back home. He’ll be able to start home visits soon. 

“It’s just been really difficult. He’s pulled my hair. He’s cracked my ribs and bit me. I was afraid to get close. Now I don't feel like that at all,” Boyer said. “He’s excited to see us and we’re so excited to see him. And we have a great visit every weekend.” 

The post Oklahoma sends a growing number of kids with complex needs out of state for treatment appeared first on The Frontier.

An application filed at the Oklahoma Supreme Court on Thursday argues state law grants medical marijuana users immunity from arrest or prosecution. 

The legal challenge involves the case of Brittany Gunsolus, 27, who used marijuana edibles and topical creams during her pregnancy with a recommendation from her doctor, according to the filing. Gunsolus gave birth to a healthy baby in Lawton in October 2020 who tested positive for marijuana. Child welfare workers closed an investigation after finding Gunsolus’ home was safe and loving. But the Comanche County District Attorney still charged Gunsolus with felony child neglect in May 2021.

Attorneys for Gunsolus argue she can’t be prosecuted for using an illegal drug during her pregnancy because medical marijuana is the same as any other legal medication used at the direction of a doctor under Oklahoma law. 

At a court hearing in Comanche County in August, a prosecutor argued Gunsolus broke the law because her unborn child did not have its own, separate state license to use medical marijuana. 

Medical experts advise that women should not use marijuana while pregnant or breastfeeding, because of the potential to pass chemicals to their babies that can affect brain development.

The Frontier reached out to Comanche County District Attorney Kyle Cabelka’s office for comment on Thursday and is awaiting a response.     

The nonprofit Pregnancy Justice, which advocates for the civil rights of pregnant people, is providing legal support for Gunsolus’ court case. 

The Frontier first reported in 2022 that Oklahoma has seen a flurry of criminal cases involving women who used marijuana during their pregnancies since the state voted to legalize medical use in 2018. The Frontier has found dozens of women charged with child neglect for using marijuana during pregnancy — 17 women were prosecuted even though they had state medical marijauna licenses.

Child neglect carries a maximum sentence of life in prison in Oklahoma, but women have received probation in all of the cases The Frontier has found.

The post An Oklahoma mom’s court challenge seeks to end charges for pregnant women who use medical marijuana appeared first on The Frontier.

After a former staff member reported allegations of abuse at an Enid center for people with developmental disabilities, her photo and phone number appeared on flyers suggesting she was available for sexual encounters, she wrote in court documents. 

The flyers were posted around Enid, including on trees near another local facility for people with developmental disabilities one morning in early June, according to a police report. 

A few weeks later, the woman filed four protective orders in Garfield County District Court against coworkers at the Robert M. Greer Center in Enid. The 52-bed, state-owned facility has been at the center of an unfolding scandal involving allegations of widespread abuse of its vulnerable residents. The Oklahoma Department of Human Services continued to refer clients to the troubled center for months after reports of systemic abuse first surfaced.

The woman wrote in applications for protective orders that her coworkers had admitted to hanging the flyers around Enid to retaliate against her for reporting abuse. A judge granted all four emergency orders of protection, and all but one of the orders are still active. The woman no longer works at the Greer Center. 

The Frontier is not naming the former Greer Center employee who reported abuse because of safety concerns. Because none of the people she filed protective orders against have been criminally charged, The Frontier is not naming them either. 

Liberty of Oklahoma Corporation, the private, for-profit company that contracts with the Oklahoma Department of Human Services to manage the Greer Center, did not answer questions about whether employees accused of hanging the flyers faced any disciplinary action or if they still work at the center.

Over the past month, police have arrested six people, including a shift supervisor, on charges of conspiracy and caretaker abuse for allegedly abusing multiple residents over the last year at the Greer Center. Police began investigating the center after the former Greer employee reported systemic abuse at the facility in June, court documents say. 

“We are deeply disturbed by the reports of abuse and consider such behavior to be wholly inappropriate and unacceptable,” said Sue Nayda, chief operating officer of Liberty. The company said it couldn’t comment on specifics because of pending investigations.

The abuse included “choking clients until they were unconscious and then beating them until they regained consciousness, forms of waterboarding in the facility’s showers and enticing other clients to participate in the abuse of specific clients,” according to police. Court documents say that at least one employee tried to tell a Greer Center administrator about abuse but “he had refused to listen.” 

The Department of Human Services still didn’t halt new admissions to the facility until Nov. 16, two days after the first arrests were made and five months after systemic abuse was first reported to police. 

The agency said it wasn’t able to begin connecting all the incidents of abuse until someone made a report to Enid police on Oct. 30, which led the agency to halt admissions and raise safety protocols for remaining residents. The Enid Police Department couldn’t confirm to The Frontier that it received an abuse report on Oct. 30. 

“I think we have an opinion that if they’re getting serious allegations like this — multiple ones — that perhaps they shouldn’t continue to admit people until they figure it out,” said Joy Turner, director of investigations and monitoring for the Oklahoma Disability Law Center. 

Repetitive reports, even if they aren’t substantiated, should be a red flag, she said. Photos of the survivors turned in to police show serious bruising, which Turner said should have been seen by staff when helping individuals with bathing or dressing.  

“Some kind of light bulb has got to go off,” Turner said. The Law Center has opened its own investigation into the Greer Center and how state agencies handled reports of abuse. 

The Oklahoma Department of Human Services investigators didn’t see an imminent safety threat to residents when the incidents were initially reported, said agency spokeswoman Casey White. When the agency first investigated, the incidents “did not appear to be connected,” White said.

The Department of Human Services says it notified Enid police at the beginning of every investigation into allegations of abuse at Greer, but didn’t provide a date to The Frontier of when those investigations began. The agency isn’t legally obligated to update law enforcement about investigations into abuse of vulnerable adults beyond the initial notification unless investigators see immediate, serious safety concerns, according to state rules. 

The Enid Police Department didn’t launch its own investigation until it received a report about the alleged abuse in June. Enid Detective Frank Bruno said it was then that he learned the Department of Human Services had already been investigating the Greer Center.

Bruno wrote in an affidavit that “several of the alleged incidents of caretaker abuse at the Greer Center had also been investigated by DHS’s Office of Client Advocacy,” but “several of the investigations could not be substantiated due to the staff at the Greer Center not cooperating” and victims being nonverbal. 

The Department of Human Services denied in a statement to The Frontier that it had any difficulty conducting interviews with victims and staff or getting documents related to the cases. 

Reports of abuse or neglect at residential facilities nationwide are not unheard-of. 

It can be difficult to investigate and prosecute allegations of abuse because some vulnerable adults may be nonverbal, Bruno said. Enid police have focused their investigation on instances of abuse with witnesses and victims that could be interviewed directly.

A 2018 audit of group homes for people with developmental disabilities by the U.S. Department of Health and Human Services Office of Inspector General in a handful of states found that residents “often experienced serious injuries and medical conditions that resulted in emergency room visits.” 

Between 2017 to 2019, people with cognitive disabilities were almost seven times more likely to be the victim of a violent crime than those that didn’t have a disability, according to the federal U.S. Bureau of Justice Statistics. 

Following a major lawsuit alleging abuse and neglect in the 1980s, Oklahoma shut down Hissom Memorial Center in Sand Springs — one of the state’s residential facilities for individuals with developmental disabilities. Over the next several decades, other residential facilities were closed in favor of community-based services. The Disability Law Center has investigated other reports of abuse at the Greer Center over the past few decades.

Greer Center staff are required to report abuse under the state’s mandatory reporting laws. State investigators will make face-to-face contact with victims, interview staff and review records. Department of Human Services’ investigative reports into allegations of abuse are kept private. 

The Department of Human Services’ investigation of Greer is still ongoing. The results of the investigation will be given to the State Department of Health and the Garfield County district attorney, the agency said. 

Liberty of Oklahoma Corporation is affiliated with Liberty Healthcare Corporation, a private, for-profit company based in Pennsylvania. Liberty also has contracts with the state to manage two facilities for youth with developmental disabilities and to end the state’s years-long waitlist for developmental disability services. Millions in taxpayer funds have gone to the company, according to a state fiscal transparency website. Last year, the company faced a data breach of personal information from over 5,000 families on the waiting list for services. 

Liberty didn’t answer specific questions about what remedial steps the company would take or how staff or administrators could have been unaware of the abuse. 

The Department of Human Services can end contracts with providers, but the agency said Greer is the only facility of its kind in the state that can meet the needs of individuals with developmental disabilities and mental or behavioral health challenges. 

A spokesperson for the Department of Human Services said Greer center staff already received additional training on how to report abuse and neglect, and the agency has placed staff on-site 24/7 for safety monitoring. Liberty is sending daily reports to the agency, a Department of Human Services spokesperson said, and has brought in two out-of-state investigators to “overhaul their internal investigation process.” 

The post After reporting alleged abuse, a former Greer Center staffer found flyers saying she was available for sex acts appeared first on The Frontier.

All-Options is a California-based nonprofit that offers information on reproductive health through the free All-Options Talk Line. The group’s website also includes links to organizations that provide information on pregnancy and adoption, as well as how to access abortion services and abortion pills. 

The state health department briefly changed its policy to include the All-Options Talk Line as a resource, as suggested by the federal government.  But it shifted its stance again more than a month later in May when it informed federal employees that it wouldn’t be able to provide that referral because of an Oklahoma law that makes helping a woman obtain an abortion a felony. The State Department of Health lost the federal funding in June over its refusal to comply.

These details come from more than eight months of communications that the Frontier requested, revealing unsuccessful negotiations between the U.S. Department of Health and Human Services and the Oklahoma State Department of Health.

Oklahoma Attorney General Gentner Drummond’s office sued last week to challenge the grant suspension, arguing that the federal government overstepped the bounds of Title X, a federal family planning program. Federal law says that program funding can’t be used to provide abortion, but the U.S. Department of Health and Human Services has added rules that require clinics to provide abortion information and referrals if a patient requests it. 

The State Department of Health will continue to work with the Attorney General’s office to reinstate the federal funding, an agency spokesperson said in a statement.

The state agency is appealing the termination and is using $4.5 million in state money to continue providing family planning services through its health departments. But without Title X funding, minors in Oklahoma have lost access to confidential services at county clinics unless they get a parent’s permission. 

After the federal government suspended funding, county health departments across the state also lost  federally sponsored discounts for family planning drugs and devices, requiring state officials to find other ways to cover the costs, according to the lawsuit. 

A spokesperson for the U.S. Department of Health and Human Services said the agency’s created a committee to review the appeal.

Parker Dockray, the executive director of All-Options, said most callers are already familiar with their range of pregnancy options, and that hotline workers never recommend any option over another. 

Dockray said some clients have been confused about whether abortion is available in their state. Peer counselors can remind patients that they can leave their state for the procedure if needed. But Dockray acknowledged that’s not an option for everyone. 

“Every person should have the right to make that decision for themselves,” Dockray said. “And certainly they should have the right to information about the options, even in a state that has decided they’re going to make one of those options illegal.” 

The federal government announced plans earlier this year to create a similar hotline that would offer comprehensive options counseling to patients across the country, but a spokesperson for the Health and Human Services department said the American Rescue Plan Act dollars that would have funded the project were taken back by Congress. 

Meanwhile, the federal government has sent the State Department of Health’s share of Title X funding to the nonprofit Missouri Family Health Council. The Missouri organization isn’t a direct service provider, but is working to coordinate a network of Oklahoma clinics that can provide confidential services to minors and other family planning resources independent from county departments. 

The Oklahoma Attorney General’s office argues in the lawsuit that the funding transfer has made the state’s appeal “futile.” The lawsuit also claims that the Missouri organization would likely be in violation of state law if it provides abortion counseling in Oklahoma, which could result in criminal charges. 

State guidance that former Attorney General John O’Connor issued last year states that law enforcement should protect free speech, but could consider pursuing cases where a person advised or encouraged a woman to get an abortion, especially if they took “tangible action” to assist them. 

Missouri Family Health Council executive director Michelle Trupiano, whose organization also coordinates Title X services for Missouri, said in October that providers never recommend one pregnancy option over another. Programs can give information about abortion providers, but they can’t take other steps like making an appointment or providing transportation. 

The post Oklahoma refused to share a hotline with abortion information before it lost health funding appeared first on The Frontier.

Meanwhile, the federal government has sent the health department’s share of family planning funding to a Missouri nonprofit to coordinate those services independent from county health departments. 

The State Department of Health is using $4.5 million in state money to continue family planning services through its network of county health departments after the U.S. Department of Health and Human Services suspended the agency’s Title X grant funding in May. Minors can still access confidential sexually transmitted infection and HIV testing at state clinics, but birth control and pregnancy testing aren’t available without permission from a parent. 

Oklahoma had the fourth-highest teen birth rate in the nation in 2021, according to the most recent data available from the Centers for Disease Control and Prevention. The Tulsa youth sexual health nonprofit Amplify has worked to prevent teen pregnancy over the last decade, but its staff worries that county health departments’ loss of federal family planning funding could limit that work. Some clinics that students and health educators have relied on for years have lost the ability to provide confidential services for minors, which could cause confusion for those trying to access resources, said Jenny Briggs, a director at Amplify.

“We know that clinic access, education, conversations with trusted adults that young people love are the biggest contributing factors to young people being able to make healthy choices and plan for their future,” Briggs said. “When we take away one of those key components, I would expect that there would be problems.” 

With $3.3 million in new federal funding, the nonprofit Missouri Family Health Council is working on a plan to administer confidential services for minors and other Title X resources in Oklahoma through a new network. The organization said it plans to apply to manage Oklahoma’s federal funding again next fiscal year too.

Clinics that participate in the federal Title X program provide confidential and low-cost family planning resources like contraceptives, counseling and testing for pregnancy for all ages, including minors. They can’t provide abortions directly, but they are required to offer information and counseling on all options, including abortion, if a pregnant patient requests it. Those guidelines haven’t been changed by the U.S. Supreme Court Dobbs v. Jackson Women’s Health Organization decision, even in states with abortion bans. 

But the State Department of Health says Oklahoma law stops it from providing patients with information on abortion. Oklahoma enacted a trigger law last year that put a near-total abortion ban from 1910 back into effect immediately after the U.S. Supreme Court overturned Roe v. Wade. Anyone who advises a woman on how to obtain an abortion can be found guilty of a felony and face a prison sentence of between two and five years.

Erica Rankin-Riley, a spokeswoman for the State Department of Health said the agency supports the work of the Missouri Family Health Council, but disagrees with the federal government’s suspension of funding over its interpretation of state law. The agency is appealing the decision. 

The State Department of Health believes it’s important to continue to provide family planning services with state funding because of its network of county health departments and long history with the Title X program, Rankin-Riley said. But the department is barred from continuing some confidential services by a state law that prevents minors from receiving physical examinations or prescription drugs without parental consent, she said. 

A handful of federal court cases have established that even in states with laws that require parental consent for minors to get contraceptives, federal rules that allow minors to receive confidential services through the Title X program take precedence. But according to Oklahoma law, outside the program, minors can only consent to medical care in specific situations, like if they’re married, emancipated from their parents, or are or have been pregnant. 

A bill that stalled in the House last year would have stopped clinics, including county health departments, from prescribing contraceptives or providing family planning counseling to minors without parental permission. In his presentation, Sen. David Bullard, R-Durant, said he was motivated to author the bill after hearing about students at Langston Hughes Academy in Tulsa who were transported to a Title X-funded clinic, where one received a removable birth control implant without parental consent. 

One of Amplify’s priorities is making sure young adults, school staff and families know how to access the family planning resources they need, now that state health department clinics have more limited services. 

Amplify works closely with Tulsa medical provider Community Health Connection, which has received federal Title X funding separately from the State Department of Health since 2016. This year, it received $216,000 in additional funding to expand family planning and continue confidential services for minors.  

The organization already has about 20,000 active patients and is anticipating several thousand more who could start receiving services in the coming months, said Jim McCarthy, Community Health Connection CEO. The health center’s three medical providers will spend a larger part of their time on offering family planning services to meet increased demand from county health clinics, he said.

Title X providers give patients the information they need to make decisions on their pregnancies, but they never advise one option over others, said Michelle Trupiano, executive director of Missouri Family Health Council. Clinics can provide patients with information on abortion providers, including names, addresses and phone numbers, and they can refer them out of state if necessary, according to program guidance. But they can’t take extra steps like providing transportation or making an appointment for a patient. 

Oklahoma’s congressional delegation wrote a letter in June calling for the Department of Health and Human Services to return Title X funding to the state and accusing federal officials of prioritizing abortion over health care. Several state delegates also introduced legislation banning the federal government from requiring Title X funding recipients to provide information on abortion.

“Oklahoma values every child and has the legal right to stand up for our children after the Supreme Court’s Dobbs decision overturned Roe v. Wade,” Lankford said in an emailed statement. “The Biden administration remains obsessed with increasing the number of abortions in America and finding ways to force taxpayers to pay for abortion or punish individuals who do not support their pro-abortion stance.” 

Then-Attorney General John O’Connor issued guidance last year encouraging law enforcement to protect free speech when enforcing Oklahoma’s abortion ban. He wrote that “mere advocacy” is protected by law, but law enforcement could consider pursuing cases where a person advised or encouraged a woman to get an abortion, especially if they took “tangible action” to help access the procedure. Attorney General Gentner Drummond, who took office in January, is working on updated guidance, but it’s unclear when it will be released, an agency spokesman said.

There’s a political climate in Oklahoma of not wanting the federal government to interfere with state politics, said Sen. Carri Hicks, D-Oklahoma City, a member of the Senate Health and Human Services committee. Despite high rates of infant and maternal mortality, she said she’s not optimistic that state leaders will adopt policies that will allow the State Department of Health to reclaim federal funding for next fiscal year. 

“I would say it’s disappointing more than anything, because again, we have plenty of data, an overwhelming amount of data that is showing that what we’re doing is trending in the wrong direction,” Hicks said. “And yet, we’re continuing to do those very same things year over year and double down on what I consider failed policy.” 

The post Without federal funding, Oklahoma minors lost access to confidential birth control and other family planning services at county clinics appeared first on The Frontier.

More than a year later, Thurman lives in a nursing home and still can’t walk.

After emergency responders took him by ambulance to a third hospital in July 2022, Thurman needed emergency surgery for an infection that had spread to his neck and blood, he said. 

“You don’t know how much pain I’m in every day,” Thurman, 42, told The Frontier recently while sitting in a wheelchair. “I feel like it’ll never go away.” 

Acting on a complaint, federal authorities launched an investigation into whether Oklahoma State University Medical Center and Hillcrest Medical Center violated a federal anti-patient dumping law for failing to treat Thurman, who was experiencing homelessness when he sought care at their emergency departments.

The Centers for Medicare and Medicaid Services sent both hospitals letters in May stating that inspectors had found the facilities were in compliance with federal rules after a review of records and interviews with staff.

The Emergency Medical Treatment and Labor Act requires hospital emergency rooms that participate in Medicare to screen and treat everyone with an emergency medical condition, regardless of ability to pay.  

Hospitals that violate the law can be fined and excluded from participating in Medicare.

But it’s rare for hospitals to face financial penalties, said Barbara DiPietro, the senior policy director with the National Health Care for the Homeless Council. When hospitals are fined, about one in five cases are for people with a mental health condition. 

“It’s a high threshold,” DiPietro said. “…Hospitals have a lot of political relationships, as well, and to sanction a hospital is not a small thing to do.” 

Hillcrest and OSU medical centers said they could not answer questions about Thurman’s case because of patient privacy laws.

“While we are pleased state and federal regulators found our hospital to be in compliance with all regulations relating to this incident, we take our responsibility to care for all individuals — including those experiencing homelessness — very seriously,” Hillcrest said in a statement. 

OSU Medical Center said in a statement that it has “a long history of providing fair and equitable care regardless of the ability to pay.”  

Dumped during summer heat wave 

Julie Bennett started bumping into Thurman after moving into her downtown Tulsa apartment in 2021. 

Thurman slept in the nearby parking lot, and spent his time picking up trash and guarding tenants’ cars at night against break-ins. Sometimes Bennett and Thurman would say hello. Occasionally she’d bring him food. Last summer, Bennett and her husband saw Thurman with what they thought was a broken wrist. He’d had his belongings stolen and got into a fight, he said. 

They brought him a sling, and a few weeks later decided they should call an ambulance as his hand swelled. Thurman went to nearby OSU Medical Center, but said the hospital wouldn’t treat him because of a previous incident at the emergency room where he was escorted out by security, he said. The hospital said it couldn’t respond to questions about the incident. 

He limped back to the parking lot where he slept.

For the next few days, Bennett and other neighbors brought ice and Gatorade to Thurman. It was the hottest week of the year in Tulsa, with temperatures that soared up to 107 degrees. Bennett batted away flies swarming around Thurman’s body. 

“He was all balled up and crying and just couldn’t move,” Bennett recalled. Neighbors called another ambulance that took Thurman a mile and a half away to Hillcrest Medical Center. 

Thurman can’t remember all the details of his time at the hospital, but said a nurse told him to get into a wheelchair. When Thurman said he couldn’t walk, the nurse pulled on his arm to get him into the chair as a security guard waited nearby. 

“I think they thought I was on drugs,” Thurman said of the incident. “But I wasn’t.” 

Security guards ultimately wheeled him across the street from the hospital and dumped him out onto the sidewalk in the middle of the night, Thurman said. A surveillance video first reported by The Tulsa World shows a person being dumped out of a wheelchair onto the sidewalk the same night. He laid there until a friend came the next morning, loaded him onto an orange flatbed dolly and pushed him back to his parking lot.

Bennett was shocked to see Thurman again when she walked to her car in the morning. He was lying next to the dolly in the parking lot and couldn’t use his hands or talk. 

A maintenance man from Bennett’s building called another ambulance a few hours later to take Thurman to a third hospital, Saint Francis. Bennett met Thurman at the hospital and waited with him for several hours in the emergency room. When nurses began to examine Thurman, they tried to get him to get out of a wheelchair and have him stand, Bennett said. Thurman said he couldn’t, but nurses insisted he could. Bennett eventually intervened. 

“I was having to explain to them what my observations were of Brent the last several days and weeks because he just couldn’t explain it,” Bennett said. 

Hospital staff determined it was a severe infection and pulled Thurman into emergency surgery. He spent the next few months in and out of intensive care, at times relying on a ventilator and feeding tubes.

The infection left his arms and legs paralyzed, and another infection flare up this year sent him to the hospital for several weeks in August.

Anti-patient dumping law often applied broadly

Inspectors from the Oklahoma State Department of Health visited OSU and Hillcrest in July and August 2022, records show. 

The federal government relies on local investigators to conduct unannounced walkthroughs, review records and interview hospital staff to investigate complaints.

The goal of inspectors is to investigate complaints and whether a facility is in overall compliance with state and federal regulations, said LaTrina Frazier, a deputy commissioner who oversees hospital inspections for the Oklahoma State Department of Health. 

Federal guidelines say investigators can interview patients and witnesses, but Thurman and Bennett said no one ever contacted them. 

State investigators send their findings to the federal Centers for Medicare and Medicaid Services for a final ruling on whether a hospital violated anti-patient dumping rules.  

The Frontier filed a Freedom of Information Act request for all of the records from the investigation, but the Centers for Medicare and Medicaid Services only released four pages of documents, including two short inspection reports that found no deficiencies at either hospital. The agency did not respond to questions about whether it reviewed the video that allegedly shows Thurman dumped on the sidewalk. 

Rade Vukmir, a doctor with the American College of Emergency Physicians, said the law is often applied too broadly by those who file complaints against hospitals. If a hospital examines someone and provides medical care for an emergency condition, then they’ve met the intent of the law. Federal guidelines say hospitals can’t be held liable for misdiagnosing a condition if they used all of their resources during a medical screening, which can range from a brief physical exam to laboratory tests and other diagnostic tools. Concerns about medical negligence or discharge procedures should be separate issues, he said. 

Patients can sue for medical negligence, but that requires finding a private attorney, which can be a challenge for people experiencing homelessness. 

Thurman was raised by his grandmother until she died when he was 12, he said. Then he was in and out of foster care and living on the streets in Tulsa. He had stints in prison and jails. Thurman can’t read well and didn’t go to school as a teenager, he said. 

An attorney dropped Thurman’s case after several months and never filed a lawsuit on his behalf. 

Tulsa hospitals discharge a growing number of patients to the streets

The number of people discharged to homelessness from emergency departments in Oklahoma is growing, according to data from the State Health Department. Hospitals sent some people back to the streets or to shelters that aren’t equipped to handle their medical needs. 

In 2022 alone, emergency departments made more than 2,000 discharges to homelessness in Tulsa County — nearly four times as many as in 2020 when the state began collecting data, according to provisional figures from the State Health Department. Tulsa County residents had the most discharges to homelessness in the state in 2022.

During the height of the pandemic, the City of Tulsa used federal coronavirus relief funds for a medical respite facility for people experiencing homelessness. The facility served hundreds, but once the federal funding ran out, the program was closed.

Hospital administrators say they provide care to everyone who needs it, but that hospitals aren’t the right place for someone to stay if they don’t need acute medical treatment. This can create tension between shelters, hospitals and patients. Most hospitals employ social workers who try to coordinate discharge plans, but many individuals say they have been turned away from care or discharged early to homelessness. 

As visits to emergency departments are increasing nationally, staffing shortages have led to longer wait times and violence in emergency departments has increased, according to the American College of Emergency Physicians. 

The federal Health and Human Services Office of Inspector General settled a case similar to Thurman’s with a hospital in Alabama in 2018 for discharging a man who was “reportedly aggressive and non-compliant with staff directions.” A hospital security guard placed the man in a wheelchair and left him on the ground off hospital property. The man was found unresponsive and later died. 

Hospitals are required to screen for emergency medical conditions, which the federal government defines as being so severe that delayed medical care could be “reasonably expected” to put a person’s health in serious jeopardy. Hospitals are required to stabilize those that need treatment. 

That requirement stands even if someone is disruptive, said Rich Rasmussen, president of the Oklahoma Hospital Association. But hospitals sometimes call police or have security guards remove patients for being disruptive or violent.

But what’s considered disruptive can be subjective, said Lisa Dailey, executive director for the Treatment Advocacy Center, which supports better access to care for people with severe mental illness. Some hospital staff might see people experiencing homelessness or those in a mental health crisis as just looking for a place to sleep or trying to get drugs. 

Hospital staff should be trained in de-escalation strategies and have the resources to handle upset patients in emergency rooms, Dailey said. A 2014 report from the U.S. Commission on Civil Rights recommended more oversight from federal regulators and increased data collection and training for hospitals.

“If you don’t have appropriate training, it’s almost inevitable that you’re going to be influenced by the fact that a person who’s in a crisis can be very difficult,” Dailey said. 

Hillcrest said in a written response to The Frontier that it created a committee in 2022 to better address disruptive patients or threats of workplace violence. The hospital also offers bus passes or rides to shelters and has a social worker and patient advocate in the emergency department. 

Focusing on healing

For the last year, Thurman has lived in a nursing home tucked in the trees a few blocks from the Arkansas state line. 

It’s a bright facility with deck games on the front porch and a cafeteria with greenery painted on the walls. A large living room area broadcasts black-and-white movies for residents. Thurman doesn’t pay attention to them though, he said. 

When he first got to the nursing home, he was mean and angry. But he’s made friends with the nursing staff now and feels more comfortable.

Sometimes he sits on the porch in his wheelchair. Bennett and other friends visit when they can, bringing Dr. Peppers as a treat. Thurman recently had his 42nd birthday party at the nursing home. He does physical therapy. He says he often thinks about his time at the hospitals last summer. 

He was scared when he woke up from surgery with tubes and monitors hooked up to him. He’ll likely have to take antibiotics for the rest of his life. Sometimes he gets so sick, he has to go back to the hospital. Doctors want to perform another surgery, but Thurman worries about complications. 

“Some of the stuff makes me mad, and some of the stuff I get used to,” he said. “It’s pretty bad that it happened.” 

Bennett is arranging for a volunteer to help Thurman improve his reading ability. She also helped Thurman connect with family members. By next year, Thurman hopes he’ll have regained enough mobility to walk. 

“My hope would be that he could eventually get out of the nursing home and have enough mobility that he can move around in a wheelchair and just participate in life,” Bennett said. “Build relationships. Have healing, fulfillment.”

The post A patient-dumping probe clears two Tulsa hospitals after man left paralyzed on the streets appeared first on The Frontier.

At the Tulsa County jail, some of the sickest are held in a segregated unit, locked down for 23 hours a day because of the risk of violence and other security issues. 

The prisoners have been found incompetent to stand trial because mental illness has left them unable to understand the legal process or help an attorney with their defense. Such cases have typically been treated at the Oklahoma Forensic Center, a 216-bed facility in Vinita, where patients receive medications, talk therapy and education on how the court system works. The state’s new jail-based competency program provides medication, but some other therapeutic services are only available at the hospital in Vinita, according to court testimony in the case of one Tulsa County defendant. 

When the Oklahoma Department of Mental Health and Substance Abuse Services launched the program to treat criminal defendants with severe mental illness in county jails in December 2022, more than 200 people were on a waitlist for a bed at the Oklahoma Forensic Center — some waited a year or more. Weeks earlier, the U.S. Department of Justice announced it had launched an investigation into Oklahoma’s mental health system.

There were also rumblings of a federal lawsuit that would be filed a few months later, accusing the state of violating the constitutional rights of mentally ill Oklahomans who languish in county jails waiting for a hospital bed. The lawsuit is still pending. 

After starting the new jail program, the Department of Mental Health has claimed it no longer has a waitlist for treatment at the state hospital in Vinita because it now offers services in county jails, said Lora Howard, interim chief public defender for Tulsa County. 

“They started this jail restoration thing solely so they could say ‘we don’t have a waitlist’ because they were getting a lot of heat for having people that were a number 120-something and number 130-something on a waitlist for a bed,” Howard said.  “They don’t have adequate beds to do the treatment that’s needed. But the way around that isn’t to just not do the treatment.” 

The Tulsa County Public Defender’s Office still has dozens of clients waiting for a hospital bed because they haven’t been able to regain competence in jail and need more intensive help. The office estimates it has typically had between 30 and 45 clients waiting in jail to go to Vinita since the program started. 

“Sheriff Regalado and the professionals who provide medical care to inmates at his jail believe that these people should be in the state hospital, not in a county jail. They have not been convicted of any crime. They are simply awaiting trial,” the Tulsa County District Attorney’s Office said in a written statement on Regalado’s behalf. “A hospital offers them greater freedom of movement, a staff of medical professionals committed to providing treatment rather than mere detention, and more access to programs such as group and individual psychotherapy.” 

Tulsa County District Attorney Steve Kunzweiler told The Frontier that the sheriff had previously declined to enter into a written agreement with the Department of Mental Health to do competency treatment at the jail. 

“The sheriff — like I — has long believed that nobody who’s been adjudicated incompetent needs to be in a jail facility, and they need to be in a therapeutic setting,” Kunzweiler said. 

The Department of Mental Health already operated a pilot competency program in about 60 county facilities across the state in May when the Oklahoma Legislature passed a bill that would have made jail treatment mandatory.  But Gov. Kevin Stitt vetoed the legislation, saying many jails weren’t equipped to treat people found incompetent to stand trial. 

In response to The Frontier’s questions, Bonnie Campo, a spokesperson for the Department of Mental Health, said that some defendants have been successfully treated and regained competency in jail. Antipsychotic medication is the most common form of treatment to restore a person’s competency, she said. 

“Stabilizing the person’s mental illness generally needs to occur before other services can be effective,” Campo said. Providing medication immediately is  “better than no treatment or inadequate treatment,” she said. 

“This can help stabilize the person’s mental illness, which in many cases is the sole reason for the person being incompetent,” she said. 

The Department of Mental Health has asked Tulsa County officials to allow jail competency treatment to continue. 

“Allowing them to continue this treatment reduces their mental health symptoms as well as their level of dangerous to self or others and is a much better alternative than having them wait for a bed at the Oklahoma Forensic Center,” Campo said. “More importantly, immediately ceasing treatment for those that they are currently serving could result in potentially significant harm. “ 

The state has a contract with the provider Family & Children’s Services to run the program in Tulsa County.    

A spokesperson for Family & Children’s Services said in an email that the provider is working with the jail administration to “ensure that inmates who have been receiving competency restoration services are provided the necessary psychiatric medications to maintain continuity of patient care” after the program was abruptly halted.  

Under Family & Children’s contract with the state, the provider is required to see people in the jail program at least twice a month in person and ensure they are prescribed appropriate medication. The prisoners are required to be monitored for suicidal and homicidal thoughts and to ensure they are taking their medication. Once stabilized, the prisoners are required to receive “education and skills training” to help them understand the legal system.

Dr. Jason Beaman, ​​interim chair of the school of Forensic Sciences and former chair of psychiatry and behavioral sciences at the Oklahoma State University Center for Health Sciences, said twice-monthly, in-person visits are inadequate. And telehealth visits can be “very poor” and problematic in a jail setting, he said. 

“These are the sickest mentally ill people and if they weren’t in jail, they’d be in a hospital and we would see them every day,” Beaman said.  “What about the individuals that cannot — won’t come out of their jail cells — or they’re too dangerous, and the deputies won’t take them out of their jail cell, then they get zero treatment.” 

Some people are also receiving competency restoration treatment out of jail. 

M.J. Denman, a private Tulsa defense attorney, said he has a client, who he declined to name, who is getting competency restoration treatment on an outpatient basis in Tulsa County through Family & Children’s Services. The client receives medication while out on bond at home but gets no talk therapy or other services, he said. The client gives his word that he’s taking his medication, but nobody checks, he said. 

“T​​his is a band-aid and not even a band-aid that covers the whole wound,” Denman said. 

Some people waiting in jail for a hospital bed deteriorate further and are held in isolation in a segregated unit for the safety of themselves and others, Howard said. The Tulsa County Public Defender’s Office has resorted to filing motions for hearings to hold the Oklahoma Department of Mental Health and Substance Abuse Services in contempt of court for failing to treat clients who have waited months or longer for admission to the forensic hospital. 

After a motion is filed, the Department of Mental Health gives the client priority for a bed at Vinita and they are transferred out of the jail before a hearing can take place, Howard said.  

Facing multiple charges, including sexual battery and obstructing an officer, DeAndre Prince waited more than 17 months in the Tulsa County jail for a hospital bed after he was found incompetent to stand trial in January 2022. Federal courts have previously ruled in a case involving the state of Washington that criminal defendants have a constitutional right to treatment within a week after being found incompetent to stand trial.

In jail, Prince racked up additional charges, including assault and battery upon a detention officer and placing bodily fluids on a government employee.

Prince was held in a segregated unit, in lockdown for much of his time in jail because of violent, disruptive behavior, according to a transcript of a court hearing. 

Prince’s public defender filed a motion in May for a hearing to hold the Department of Mental Health in contempt for failing to comply with a court order to treat him at the forensic hospital. In response, the agency argued in court documents that it operated on a “very tight budget,” and that Prince was already receiving treatment at the jail. 

A 2022 report by the state Legislative Office of Fiscal Transparency found that while Oklahoma appropriations for mental health have increased by 9% since 2013, funding had actually decreased by 11% percent during that period when adjusted for inflation. Meanwhile, the state has seen a 652% increase in people waiting for treatment at the Oklahoma Forensic Center in Vinita over the last five years, from 23 people in January 2017 to 173 people in April 2022.  

In Prince’s case, a partial contempt of court hearing did take place on May 30. A public defender said the hearing was the first time Prince had been out of his segregated jail unit in months.  

A forensic hospital leader testified at the hearing that treatment available in the jail-based program is limited and that Prince had received medication but not other therapeutic services that are typically part of the competency restoration process. 

The hospital leader also testified that defendants are prioritized for a bed at Vinita after defense attorneys file a motion for a hearing to hold the Department of Mental Health in contempt for failing to treat the person at the state hospital. 

The Department of Mental Health transported Prince to Vinita for treatment six days after the hearing, before additional court testimony could take place. 

The post Oklahoma is trying to treat people with severe mental illness in jail, but many still languish in cells waiting for hospital beds appeared first on The Frontier.

 At night, the shed’s two screen doors are wired shut. Inside, is a bed piled with clothes and two car batteries, which provide enough power to run a small light and a fan the size of a palm. Showers are taken outside with five-gallon jugs of water behind a folding exercise mat that is propped on its side. And an ice chest serves as a refrigerator.

 “This is home,” said Sullivan, a 34-year-old Louisiana native whose navy-blue shirt reads “FIGHT LIKE A GIRL.”

“You’d be surprised what you can cook with a lighter,” said Sullivan, holding up a cigarette lighter and a can of cheese. “I’ve even made nachos in here, believe it or not. The tin keeps the cheese warm.”

Sullivan is among those who move in the shadows, sleeping in abandoned houses and under a canopy of trees by the railroad tracks and even in storage units. Social workers, church leaders, and volunteers say rural western Oklahoma’s ghost population of homeless are largely ignored save for a spirited few who battle daily to provide help.

There’s scant resources and no state funding. Along the Interstate-40 corridor, there is only one overnight shelter for men between Amarillo and Oklahoma City. In Elk City – a town of 11,570 residents – a nonprofit opened the community’s first day shelter recently to combat homelessness. But local leaders are reluctant to help finance an overnight shelter for fear it will attract transients.

Nationally, rural homelessness increased by nearly 6% between 2020 and 2022, according to the U.S. Department of Housing and Urban Development. Yet for those in the trenches of this struggle in Clinton and other rural communities in the state’s region, the acknowledgement of a notable homeless population is their greatest challenge.

“A lot of people in this community would be shocked if they knew how many homeless were living on the streets,” said Eli Colston, a benevolence team leader at TheEdge Church in Clinton. “There’s definitely a stigma to homelessness out here. A lot of people don’t even want to admit it’s a problem in their community. But they’re here, living under bridges and in abandoned houses and crowding into motel rooms.

“I know because I once lived on the streets … right here in Clinton.”

Colston, 34, wandered Clinton’s streets for more than two years while battling substance use.

“I saw a lot of people on the streets here,” Colston recalled. “It was not uncommon to stay in a one-bed hotel room with 35, 45 people crammed into the same room. I also lived under bridges, and once found an abandoned home between Clinton and Arapaho with the lights on and filled with a bunch of junk. I stayed there for two weeks. But I always kept moving. I never stayed in a place long enough to be noticed.”

He wears a tattoo memorializing the day he broke the chain of addiction – December 24, 2017. Five months later and still sober, he was arrested for outstanding warrants in nearby Washita County.

“It was time for me to pay the piper,” admits Colston, who said he eventually “found God ” during an eight-month stint in prison at William S. Key Correctional Center in Fort Supply.

Today, Colston helps others at this part-time job with the church, which has filled the breach left by no city or state funding. His team provides emergency assistance in a variety of ways, from utilities and clothing to food and shelter. Last year, the church provided help of some kind to 90 of 104 applicants. He estimates “at least 30%” of those he meets are homeless.  The church also provides financial support to Clinton’s Mission House, the only overnight men’s shelter along I-40 in rural Western Oklahoma.  

The shelter operates out of a century-old, two-story house covered in peeling blue paint that served as the living quarters for local nurses years ago. Mission House serves as many as 31 homeless people a day. Clients can stay for up to 90 days. Director Twyla Williams helps connect people with resources to lift them off the streets, combatting issues that range from unemployment to mental health needs. Clients must pass a drug test to be granted a bed, disqualifying some. 

Mission House serves an average of 2,200 meals a week for anyone in the community who is hungry out of an adjoining kitchen. Many of the 1,950 people the nonprofit served last year also have children. 

Mission House has an annual budget of $42,000, none of which includes city, state, or federal money. And the need is growing. TheEdge Church congregation has agreed to donate 20% of its tithings each month to the Mission House so it can eventually build a newer, larger shelter. 

Local advocates say Clinton’s homeless population is likely undercounted and there’s not enough resources to address the problem. 

“Our homeless population would definitely shock the average person living here,” said Williams, who conservatively estimated Clinton could have as many as 200 homeless people in a town of 8,380 residents.

Colston suspects that estimate is low.

“Easily, we could have as many as 200 homeless here in Clinton,” he said. “Remember, there are a lot of homeless folks that we never even come in contact with for one reason or another. But trust me, they’re out there. I’ve seen them.”

But Clinton Mayor David Berrong is skeptical. In fact, he doesn’t recall the issue of homelessness ever being addressed by the city council dating back to his first election to office in November 2016. He’s now serving his fourth term.

And there are presently no plans for the city to jump into the homeless issue.

“I think it might be more of a transient problem,” Berrong said. “But if there is a homeless problem here, I think it’s something we would address in a compassionate way as a community because it’s the right thing to do.” 

Exact numbers have always been elusive with the homeless population, and even more so in rural regions. HUD requires communities receiving federal grants to conduct an annual point-in-time count each January of the homeless population. The count includes those who live in emergency shelters, as well as on the streets. Those numbers are merely a snapshot in time, but critical in applications for federal dollars.

In January, a count in the 19-county area that includes Clinton, much of northwestern Oklahoma and the panhandle showed a homeless population of 216 people — 86 living on the streets. 

But the numbers don’t include people who are sleeping on couches, living in motels or cramped trailers with other families as homeless. 

Weather can also play a role in the numbers. If the count happens on a cold night, more people will go to shelters.

Combating the stigma of a hidden problem 

For 14 years, trips to the bus station to pick up another homeless person from some smaller town were commonplace for Lawton Housing Authority executive director Jervis Jackson.  During that period, his agency led the Southwest Oklahoma Continuum of Care in a mission to end homelessness before handing over leadership to another nonprofit in 2021.

“A lot of rural communities outside of Lawton never wanted to admit they had a homeless problem,” Jackson said. “One town in Stephens County would pick up someone who was homeless and give them a meal. They might even put them up in a hotel for a night. But the next morning, they would put them on a bus and ship them to Lawton.

“The feeling was always the same: ‘We don’t have a homeless problem. We have a transient problem.’ That attitude prevails throughout those rural communities.”

This year’s county identified 409 total homeless people – 316 of whom were unsheltered, for the 16-county region that includes Lawton – Oklahoma’s sixth largest city with a population of 91,542 people.

Jackson estimates that about 85% of the homeless population counted in those numbers is in Lawton. It becomes harder to get an accurate count of homeless people in rural areas, he said. 

Liberty McArthur, executive director of the Western Oklahoma Family Care Center, said she’s had to spend time raising awareness about the hidden problem of homelessness in her community. She started the organization in  2018 to fight homelessness in Elk City, 28 miles west of Clinton on Interstate-40.

“I’d go around town to try and raise money,” McArthur recalled. “Some people would say, ‘Oh Liberty, why are you doing that? We don’t have a homeless problem.’ Some people are just so far removed from that world, and well, you don’t know what you don’t know.

In January, the Western Oklahoma Family Care Center opened a day shelter where the homeless population can rest, shower, eat, and pick up hygiene supplies. The shelter is in the old National Guard Armory and is open from 10 a.m. to 5 p.m. Monday through Friday. The non-profit also oversees a food pantry, as well as a medical and dental clinic.

“We’re trying to get an overnight shelter, but so far, the city council doesn’t want one,” McArthur said. “They think an overnight shelter would be a magnet for transients and then crime would rise. But I don’t think an overnight shelter would be a beacon for homelessness. I do think it would help those who are already homeless in our community.”

The face of homelessness in Clinton is as varied and complex as one might find anywhere in the nation. Mental illness, substance use, past criminal records, and those without the safety net of a family are all part of the equation. Although it isn’t as obvious as a group of roadside tents amid a cluster of trees in Oklahoma City or Tulsa.

Mission House is at the epicenter of the problem. 

Sullivan said she journeyed to Oklahoma with her partner of 12 years to be close to her two children, who live with their stepmother in neighboring Weatherford. Both she and her partner were strung out on heroin and being evicted from their rental home when her partner “took off.”

 For a while, Sullivan worked in the deli of a local grocery store, only to lose her job over her alcoholism – an issue she admits she still battles along with her drug addiction.

 “I want to get clean,” Sullivan said. “I don’t wanna live this way. It’s not something I’m proud of, but I’m afraid of moving too far away from my kids.”

 Sullivan sometimes walks into town to eat a meal at the Mission House, where Williams welcomes everyone with a hot plate of food and a smile.

“If it were just up to me, I’d let everyone who needed help live here,” Williams said. “Why should people care? Well, number one, it’s the Christian thing to do. But what if this was your daughter? Or what if this man was your brother? Sometimes, people don’t care until it touches their lives directly.

“I just love people. And I love what I do.”

Cesar Jimenez said he was traveling from Las Vegas with “two friends” in search of work when they abandoned him at a Motel 6 in Clinton.

 “I was scared,” said Jimenez, 42. “I had no money. I have no family. I was standing in the pouring rain outside a Dollar General when a local man asked if I had a place to stay.”

The man introduced Jimenez to Colston, who brought him to the Mission House.

“I truly believe I would have died if I had been left on the streets. This place saved my life.”

Williams is now trying to help Jimenez find employment.

Stephanie Freeberg, meanwhile, has been one the shelter’s great success stories since her arrival in March. Her life spiraled into homelessness after 18 years in the United States Air Force, where she said she was honorably discharged after a medical mix-up. Her prompt exit from the military left her two years shy of qualifying for a pension.

 “Instead, I ended up with nothing,” said Freeberg, now 46. “People said, ‘Why don’t you sue?’ I’m like, ‘Sue the government? Really?’ 

Freeburg ended up staying with friends in Sayre. Then she landed a job in Elk City working with medical records, where she worked for three years.

 “But I made some bad decisions. I quit my job to go to school, only to learn I couldn’t get any financial help from my military service. I should have never quit my job without first having something firm in place. That’s when my life spiraled out of control.”

Depression set in, and with seemingly nowhere to turn, Freeberg descended into the darkest period of her life. In 2016, she ended up living in an abandoned building in downtown Burns Flat, a town of 1,955 people in Washita County. At night, she slept on a mattress under a pile of blankets. Her only companions for six years were seven cats.

“The police chief said I could either go to jail or the Mission House,” Freeberg said. “I really had no choice. I was just forced to gather my things and leave. The worst part was leaving my cats – my babies.”

Williams and her volunteer staff instantly recognized Freeberg as a perfect fit for Clinton’s Wear It Again thrift store, which helps finance the Mission House through its sales. Freeberg has already been promoted to store manager. As an employee, she also receives a weekly stipend and her own room at the shelter.

 “I’m a very private person,” Freeberg said. “So, this is hard to talk about. I don’t blame anyone for what happened. I take full accountability for my bad decisions. Depression played a part, of course. I felt like a complete failure. And when you get so far down, that hole gets pretty deep.

Freeburg said help from Mission House has given her hope again.  

“People look at you a certain way when you are homeless,” Freeberg said. “A lot of people choose to close their eyes. But for every person who closes their eyes, there are others who are there to help.”

Ron J. Jackson, Jr. is a bestselling author and award-winning journalist who has been writing professionally for 38 years. For more on his work, go to www.ronjjacksonjr.com

The post In rural Oklahoma, homelessness remains a hidden problem appeared first on The Frontier.

Dr. Rebecca Lewis, a family physician practicing obstetrics at St. Mary’s Regional Medical Center, and her patients were left to decide between inducing delivery early, or waiting until the baby died in the womb or the patient went into septic shock. 

The patient wasn’t facing medical complications, but they decided to start labor early, which Lewis said she believes prevented the woman from experiencing the further psychological harm of a potential life-threatening emergency. 

“If that came in tonight, would I be able to make that same decision legally?” Lewis said. “It’s still such a gray area.” 

The Oklahoma Supreme Court has ruled twice in recent months to overturn state laws that only allow for abortions during life-threatening medical emergencies, stating that requiring doctors to wait doesn’t serve a compelling state interest.

But an Oklahoma law from 1910 that outlaws most abortions is still in effect. That law says abortions are allowed only when necessary to preserve a mother’s life. Otherwise, medical professionals can be charged with a felony and face up to five years in prison.  But doctors still aren’t certain when they can perform the procedure. Other states that have banned most abortions including Utah, Georgia and Louisiana have laws with more specific language, permitting terminating a pregnancy  to prevent serious, irreversible damage to a life-sustaining organ, but Oklahoma’s law contains no specifics or clear definitions.

The Frontier interviewed three medical providers who said a lack of consensus on how to interpret the recent state court rulings makes it difficult to make decisions while treating patients. 

Lewis said many of the doctors she knows interpret the law to mean that abortion is appropriate if the mother’s life will be at risk in the next 24 hours, but that leaves out lots of situations that could be detrimental to patients’ health and wellbeing. 

Oklahoma Attorney General Gentner Drummond said before the most recent state Supreme Court ruling in May that doctors should be given “substantial leeway” in deciding when abortion is appropriate. 

Phil Bacharach, a spokesperson for Drummond’s office, said in an email that staff are reviewing and potentially updating guidance based on the most recent Supreme Court decision, and they could include definitions for preserving the life of a mother. 

Neither the Oklahoma Board of Medical Licensure and Supervision or the Oklahoma State Board of Osteopathic Examiners have guidance published on their websites based on the most recent state court rulings, though Board of Osteopathic Examiners executive director Michael Leake said he’s working to develop some.  

The American College of Obstetricians and Gynecologists’ official position is that abortions can be medically necessary. The organization opposes efforts to impede access or criminalize health care providers. But Molly Meegan, general counsel for ACOG said doctors can only follow the organizations’ guidance as far as state laws will allow.  

ACOG can’t offer individual doctors legal advice, but Meegan said the organization encourages hospital administrators to help doctors navigate their work. 

“A lot of institutions haven’t provided enough guidance,” Meegan said. “Most doctors are operating in what feels like a very scary and chaotic environment.” 

Oklahoma Call for Reproductive Justice, an abortion access group, was the plaintiff in two lawsuits that struck down narrow exceptions for medically necessary abortions in the state. Board member Priya Desai said the organization has tried to push back on what they see as the highest impact laws, and they saw similar bans in states like Texas cause spikes in out-of-state abortions. 

The organization worked together with Physicians for Human Rights and the Center for Reproductive Rights on a study of Oklahoma hospitals, which found that almost none have clear policies on when to perform emergency abortions. 

Desai said her group believes that hospitals should outline clear emergency abortion policies for doctors, but she thinks the liability associated might prevent some from creating them.

Oklahoma City OB-GYN Dr. Dana Stone asked that her hospital not be named because she isn’t authorized to speak on the organization’s behalf. She said hospital attorneys created broad guidelines for doctors after Roe v. Wade was overturned. But black-and-white rules often don’t work for a subject as gray as medicine, she said. 

At her facility, Stone said decisions to perform a medically necessary abortion are made with a team that includes an anesthesiologist, a nurse and other hospital staff. Team members have always been able to refuse to participate in the procedure for any reason.

But if a team member expresses concerns for a legal reason, it often halts medical plans for a patient, Stone said. 

Lewis, the physician from Enid, said she doesn’t perform abortions herself, but if she believes one is necessary, she refers the patient to a gynecologist at her hospital. She said hospital administrators have clarified that doctors’ priority should be saving the life of the mother when they can, which she said has been clearer guidance than some hospitals. 

Dr. William Po, an OB-GYN who also serves as the vice chair of Oklahoma’s ACOG section, asked that his hospital not be named because he wasn’t authorized to speak on its behalf. Po said his hospital hasn’t given doctors guidelines to interpret the law, and administrators have also said that they’d give physicians legal support in a civil case but not if they face criminal charges. 

In cases where he believes an abortion is medically necessary, he will refer patients to a medical professional outside the facility, where they receive extra counseling before they decide whether to end the pregnancy. 

The most helpful outcome would be for legislators to write clearer laws outlining what doctors can and can’t do, Po said. 

“Medical standard of care is not being done when you’re faced with substantial criminal penalties,” Po said. “We all want to do the right thing. We all want to follow the law. We all want to save our patients and give good medicine. And when you have a law with such a blanket statement, it’s difficult to navigate those waters.” 

The post After court rulings, Oklahoma doctors are still confused about when abortion is legal to save a patient’s life appeared first on The Frontier.

During the final days of the 2023 legislative session, the anti-abortion group Oklahomans For Life sent its members an early-morning email marked “URGENT.”  

Tony Lauinger, chairman of the group, urged support for Senate Bill 368, which would have made it easier for survivors of rape and incest to obtain legal abortions in Oklahoma. 

“Those thinking SB 368 is not pro-life ‘enough’ are thinking short-term rather than recognizing the reality of pro-abortion momentum since Roe V. Wade was overturned last June,” Lauinger wrote. He did not respond to requests for comment.

Voters in six other states have defeated abortion-ban proposals or have enshrined abortion access into state constitutions through statewide votes last year. An Amber Integrated poll conducted in August 2022 found that 62% of likely Oklahoma GOP runoff voters said they supported access to abortion in cases of rape, incest or medical emergencies. In his email, Lauinger also mentioned an internal poll where 71% of Oklahoma voters supported exceptions for rape and incest of a minor reported to law enforcement. 

Currently, state law bans all abortions except to save the life of the mother. 

Anti-abortion lawmakers say they are in a dilemma: Support legislation that could make it easier for some women to get abortions, or risk successful legal challenges and backlash from voters.

To reduce momentum behind a potential state question restoring abortion access in Oklahoma and avoid future legal challenges, some conservative lawmakers want to narrow the state’s abortion ban. Sen. Julie Daniels, R-Bartlesville, said efforts failed this year after Gov. Kevin Stitt wouldn’t commit to supporting Senate Bill 368, which Stitt’s office disputes. Several lawmakers also said they wouldn’t support any exceptions beyond saving the life of the mother, Daniels said.

“What happened was a difference of opinion among pro-life legislators,” said Daniels, who has written many of the state’s abortion laws and tried to run Senate Bill 368. “But short of those exceptions, the pro-life movement is losing those wars in other states. We didn’t want that to happen to us.”

Abortion rights advocates say even if lawmakers add exceptions to state law, local groups will continue to push for access to abortion. 

“We are clear in our position that Oklahomans need and deserve abortion access,” said Tamya Cox-Touré, director of the ACLU of Oklahoma. Cox-Touré said it’s surprising lawmakers think that adding exceptions for rape and incest of a minor reported to law enforcement would stop a potential state question. “We know that an overwhelming number of attacks and sexual assaults go unreported. These exceptions are unworkable.” 

States with rape and incest exceptions typically require a woman to prove that an assault occurred by filing a police report. But most sexual assaults nationwide go unreported, according to the Rape, Abuse and Incest National Network.

Requiring someone who has been sexually assaulted to report to law enforcement can be traumatizing and difficult, especially if they were abused by an intimate partner or family member, said Priya Desai, a board member with Oklahoma Call for Reproductive Justice

And despite the existing exception for saving the life of the mother, women have had to travel out of state to receive emergency health care because Oklahoma doctors said they didn’t think they had the legal coverage to perform the abortion procedure, according to The Oklahoman. 

“They think that these exemptions are going to pacify people, but in reality, the truth is that these exemptions don’t really help that many people,” Desai said.

In February, when Daniels first presented a version of the bill to clearly state exceptions in state law, she told other lawmakers that she didn’t expect rape and incest exceptions to be used frequently. Since last spring when Oklahoma’s most recent abortion bans were approved, no abortions have been reported to the State Department of Health, but it’s unclear how the new laws have affected reporting requirements.

Oklahoma lawmakers enacted several, sometimes conflicting, abortion bans last year in anticipation of Roe V. Wade being overturned. Only one of those bills contained exceptions for rape and incest. 

The Oklahoma Supreme Court overturned those bans in recent weeks after abortion rights groups sued and the court ruled that the Oklahoma constitution protects a woman’s right to have an abortion to save her own life. Now, the state’s abortion ban is only propped up by a 1910 law that bans abortions except to save the life of the mother. 

The state Supreme Court’s actions have made lawmakers feel more urgency to make state laws on abortion consistent and include some exceptions, said Sen. Jessica Garvin, R-Duncan. But some legislators have concerns about backlash from anti-abortion voters if they include exceptions throughout state abortion laws. 

“To take a stance on exclusions is difficult for some because maybe they are worried about the next election,” Garvin said. “Unfortunately, there are a lot of people who are not willing to publicly talk about their stance on abortion. But these are conversations that have to be had.” 

Senate Pro Tem Greg Treat, R-Oklahoma City, told reporters this spring he would support clarifying exceptions to the abortion ban. By the end of the session, Treat said the idea was “controversial” and wouldn’t advance this year.

“Although it’s not something that I would be extremely excited about, I would know that it would protect our ability to protect unborn life to a much greater level if a state question were to come forward,” Treat said in March. 

Stitt said during his 2022 gubernatorial campaign that he would sign a bill that clearly defined exceptions for rape and incest. A representative for Stitt’s office said it was “absolutely not true” that he wouldn’t commit to supporting Senate Bill 368 this session.

“The governor wasn’t noncommittal, rather he hadn’t yet expressed one way or another before it was too late for the bill to advance,” spokeswoman Kate Vesper said. 

Republican lawmakers nationwide are considering exceptions to abortion bans as a way to ward off state questions. Legislatures in other states and in Oklahoma have looked to make the initiative petition process more difficult, as well.

In recent years, Oklahoma lawmakers have tried to pass bills that would increase the number of signatures needed to file an initiative petition, raise the percentage of voters that have to approve a state question and lengthen the time to challenge petitions. Since 2016, Oklahoma voters have approved sweeping criminal justice reforms, expanded Medicaid and legalized medical marijuana — all policy areas the Legislature drug its feet on.

As the state’s Republican majority tries to figure out what approach it will take to clarify laws in the future, local abortion rights groups are preparing to launch an education campaign with an eye on an eventual statewide vote on reproductive rights. 

Advocacy groups say a state question is one way to restore abortion access in the state. The groups could also bring additional lawsuits to the state Supreme Court in hopes of a ruling that people have the right to elective abortions in the state, something the court hasn’t done in past court cases. 

Local abortion rights organizations are also working with groups in other states that have had successful state questions. One initiative petition was filed in Oklahoma last year to restore abortion access, but it was quickly withdrawn.

“We know that when these measures are put to the people through strategic, comprehensive, community-led efforts, abortion wins,” Cox-Touré said. “We know that this is going to be a multi-million dollar effort, and we have to get it right.” 

Voters in other conservative states have pushed back against abortion bans in statewide votes, including a landslide victory in Kansas for abortion rights. Advocates say that gave them hope a state question on abortion access could eventually succeed in Oklahoma. 

The post Despite support from some pro-lifers, efforts to soften Oklahoma’s strict abortion ban failed this year at the Legislature appeared first on The Frontier.