West of the Rotunda

The way the law is written in our state I am guilty of criminal abortion.

I await the handcuffs.

First, we need to define abortion.

The definition of abortion in Idaho statute says “the use of any means to intentionally terminate the clinically diagnosable pregnancy of a woman with knowledge that the termination by those means will, with reasonable likelihood, cause the death of the unborn child…” (18-604.1)

I know people have strong feelings about abortion, (killing babies) and these words are meant to address this. But laws are made of words. Our intentions are not ink on paper.

 I treated a young woman early in my career who had successfully hidden her pregnancy until very late. It was unplanned, she was unmarried and ashamed. She had worn an overcoat into the summer.

When I examined her the size of her uterus was inconsistent with her due date, so I recommended an ultrasound. The scan revealed she was carrying a 38-week fetus with anencephaly.

Sometimes in the development of the fetus the nervous system does not do what it should. If the folds required to close off the skull don’t happen, the brain does not develop. My patient had a baby without a brain that had grown to full term size inside her. She had nurtured this fetus with her body, in shame, hiding it, but not “terminating it”. Now I needed to treat her, my patient.

Because of the conditions, I recommended she deliver, that is, “terminate her pregnancy”. Conditions were ripe. I ruptured her membranes and four hours later, her baby was delivered.

I knew, and I told my patient, the mother, the baby would not live. Some anencephalic babies do survive for a while. This baby never took a breath.

So, in this specific case, I used a “means” (rupturing the membranes) “to intentionally terminate…a pregnancy that would cause the death of an unborn child.” I am guilty of criminal abortion by Idaho statutes.

I could tell you of another patient I induced at 32 weeks gestation when we discovered her fetus to be anencephalic. This time I used drugs to get her uterus contracting. She had a family. She was Catholic. It was a decision she made with open eyes and open heart.

Many would oppose this decision. Some would even consider this criminal. Idaho does, according to the laws our elected representatives have written. I want you to consider this.

That baby did not take a breath either. But I accepted her decision and ordered the drugs and used “means” to cause the death of the unborn child. It was surviving inside her. But she wanted the pregnancy to come to an end. She did not want to keep sustaining this fetus.

 I am guilty of criminal abortion.

Some want to have this moral and practical decision of terminating a pregnancy bend on the esoteric question of when “life” begins. I’m sorry, but we all must accept that all pregnancies will end. And some fetuses will not live.  If the action of a caregiver leads to the end of a life, we all should mourn, as both these mothers and families did. But do you, someone not involved in this painful process have any right to tell the protagonists how they should choose?

I guess most Idahoans think that. The Idaho legislature has done everything they can to make abortion illegal.

I think the intent of these proclamations really is proper. All children should be nurtured, wanted, loved. We should all be doing all we can to make that ideal a reality. So, if that is our intent, do our words, do our actions reflect that?

I await your handcuffs.

In the meantime, I will keep treating my patients. We all need care.

Hand wringing and regrets fall short of substantive change. Sure, mistakes and tragedies call for a response. But bemoaning repeated mistakes or tragedies without effort to prevent or change their cause signifies acceptance of our powerlessness. We should not be so futile.

Healthy change requires thoughtful study. Then even more thoughtful consideration of options and tradeoffs must be done. I believe this was the model our founders had for our representative democracy. We have not been honoring this model.

Please consider the Dickey Amendment. In 1996, the late Representative Jay Dickey added an amendment to a budget bill that effectively cut off public funding to study gun deaths in this country as a matter of public health. The trigger for Rep. Dickey might have been a CDC supported study published in 1993. It showed that the presence of a firearm in the home increased the risk of homicide. The NRA didn’t like that evidence, so they lobbied Congress to prohibit any federal funding that might influence gun control. And such research funding stopped.

After a 2012 massacre in a Colorado movie theatre, now former Representative Dickey changed his mind. He published an opinion piece in the Washington Post with the CDC Director of the National Center for Injury Prevention and Control. They argued that the funding should be restored, and gun violence should be treated like a public health issue.

I am always impressed when a public figure admits a mistake. Too bad it took sixteen years.

Six years after this plea, after Sandy Hook, after Parkland, President Trump and Congress restored a bit of funding to this center to study gun violence. We have a lot to study, to try to figure out.

No such prohibition has ever been applied to the study of traffic fatalities. Over a 50 year span we have invested $200M in research to make our highways less lethal. It is estimated 600,000 lives have been saved. That’s about the same number of people who were the victims of gun violence in the last 20 years in our country.

Maybe my beginning assumption is flawed. Maybe careful study and consideration are not a worthy basis for public policy. Idaho’s State Senator Steve Thayne famously said as much in 2020. He was criticizing public health policy about the Covid pandemic.  Steve argued that our founders expected us all to consider our own risks and make our own decisions. In fact, he went so far as to say that listening to experts “leads to totalitarianism.”

I doubt our founders imagined four lane freeways with two-ton cars going 80 miles per hour. If they had, would they have considered traffic laws a reasonable purview for public health policy? It seems most of us agree such careful consideration is worthwhile. I am thankful for the lives saved.

I further doubt our founders considered a six-and-a-half-pound rifle that could fire 45 rounds per minute and be accurate to 600 yards.

With the current hand wringing and pleas for prayers and cries to “do something”, I question the wisdom of all the proposals. It’s not that I think we should do nothing about gun violence. I just can’t support taking a shot in the dark.

We have been prevented from studying this issue for too long. I hope we can find some solutions. I doubt there will be just one answer, and I’m sure there will be tradeoffs.

At least now, maybe, we can open our eyes and see what might work and what might not. Then you can decide if you want to listen to evidence.

When I read my last post to my wife over breakfast last week, I got an ear full. She’s the only one whom I’m sure hears my stuff because I make her listen to my impassioned rendition over the egg and toast. The passion did not persuade.

“You can’t leave it there.” Was her admonition. “You have to tell them how to go forward. What hope is there if we are all just crazies up here in North Idaho?”

I listened to her wise counsel but in my mind, I was dismissing it before I had the next cup of coffee. What did she know of dealing with the electorate? I had run for office in this state. I had been elected three times to the Idaho Senate. Then, I had indeed been unelected in my last attempt. My battle scars were evident. What validity could she bring with this criticism?

I did not blurt that back to her. I need to have a happy home. Instead, I thanked her for her comments and then went out to turn my compost. It is a source of comfort and joy for me, not unlike public service.

As I mixed the rotting leaves and grass, I noted the warmth and function of the microbes, the worms. It needed more water. There would be more lawn clippings soon and it would heat up.

And I stumbled onto a realization. My wife has in fact been an elected official. Martha served on the Board for the Moscow School District. I loved talking to her about the issues and the meetings. She got appointed when a board member stepped down, then got elected (unopposed), but resigned when our daughter got a job in the district. Not the rough and tumble of legislative races, but public service, nonetheless.

I remember her description of painful public meetings. One was about a charismatic coach that was going to be let go. His passionate followers spoke loudly. She felt their passion.

The pile of leaves and grass and kitchen scraps and coffee grounds I collect from the workplace got some buckets of water I collect from the eaves of my garage. As the summer dries out, I will need to use the hose.

She had told me of another public meeting where people shared their passions about standards-based education. Some testimony was brutal, but off the mark. She had spent the hours and listened, and the board had decided.

One thing I have learned from compost is that small things of substance work the best. A big chunk of organic matter will take a while. Chop it up and it will soon be more available for decomposition with the heat and microbes. And such service to growing plants is the purpose.

I get the sense that many of us are looking for the big chunk, the pumpkin or tree root that will fire up our compost of democracy. Such big efforts just impede. It’s the little stuff, like grass clippings and leaves that get the heat going. And good compost is wonderful.

Democracy is like compost. It takes a lot of little voices, a lot of small efforts and a lot of listening to get it hot. And that heat really breaks down stuff so plants can use it. Slow compost with the big chunks and infrequent turning works. But it takes forever. Weeds will grow.

Martha wasn’t in the kitchen when I came back. I rinsed my coffee cup and thought of my chores. She is a wise woman.

So, all of you North Idaho crazies our there, come have some coffee with Martha and me. I will show you my compost and she will cook the breakfast. You are welcome. We will listen. That’s what our representative democracy needs: a good cup of coffee and compost.

North Idaho is different.

The vast majority of my years in Idaho have been spent in the state’s Pacific time zone. Why do we operate an hour different? Obviously, because we are north of the earlier Mountain Time folks down south, and time knows latitude, doesn’t it?

I’ve heard our Governor insists we up here be called “Northern Idaho”, not “North Idaho”, lest we start getting ideas of independence. I’m sorry, but that ship has sailed.

The Salmon River is the border for our special craziness. Come on up. But pack your colander or tin foil hat and put it on your head as you cross Time Zone Bridge. You’ll fit right in.

We had a strong antigovernment streak before statehood. Florence (north of the Salmon River) was a booming mining town in 1862. A Federal judge ventured over from Walla Walla to offer justice. He convened a grand jury and asked for indictments. The miners obliged, calling President Lincoln, cabinet members, Union generals and the judge up for trial. The judge rode his horse back to Walla Walla post haste and resigned. We can discourage authority.

We proudly know our history. I’m not sure the 1890’s miners insurrection in the Silver Valley was crazy. The wealthy mine bosses lived in lavish Spokane mansions while miners starved and slaved. But the strikers crossed the government line when they blew up a mill. The means of production cannot be damaged. That got US government troops called in from Denver. Some have argued lily white North Idaho’s racism was founded on the fact that it was black US Army “Buffalo Soldiers” who rounded up strikers and stood guard with rifles over them in open pens.

The coda to this episode didn’t end with the former governor’s assassination or the famous trial of the Union mine bosses who might have ordered the hit, nor with their acquittal. Our special crazy up here might have grown out of that convoluted spectacle of injustice.

I have no idea if Richard Butler and the Aryan Nations knew this history when they came to Hayden, Idaho near Coeur d Alene. But they added to the aura we exude. We are still known for their wacko ideas, even though they are long gone. We’ve moved on to prepping for the apocalypse and wrapping ourselves in Confederate flags.

The 1990’s Ruby Ridge standoff put us back on the crazy map. Randy Weaver died this month. He survived the siege of federal gunmen on his isolated North Idaho compound, though his wife and son were killed. He too was acquitted of all charges except “failing to appear in court”. Government hasn’t learned how to handle us. Maybe we just don’t like authority.

My home, Moscow, Idaho has its own crazy streak. Indeed, one State Senator we elected to represent us called us a “cesspool of liberalism”. It wasn’t me.

I like the crazy creative twist some of our residents can exhibit.

One day over coffee at the Co-op, one of these artistic types told me of an old State Patrol car he had purchased at auction back in the day. It still had the spotlights and the black and white paint, but all the fun sirens and bubble gum lights had been stripped and it wouldn’t do 120 mph anymore. But it sure looked official. He sported a bushy head of hair and a big scruffy beard. He appreciated the odd looks he got pulling up next to a fellow citizen at an intersection.

But apparently, he went too far when he designed and installed insignia badges on the front doors. They looked too official. A real state trooper pulled him over and told him to take them off.

They were a gold shield with black lettering: “North Idaho” on top; underneath “A State of Mind”.

I took a break from posting this last two weeks. I thank my employer for the time off, I thank the editor for the respite, and I thank my wife for the adventurous time we shared.

By the time you read this the nail-biting Idaho primary election will be over. I’m not going to make any predictions about the outcome of the races. Such would be foolish. But I can confidently predict the direction Idaho will be headed in the coming few years. We will continue in about the same direction. Our state will continue to grow with lots of folks moving in, looking for their own Private Idaho.

And these transplants will want more “freedoms” and less taxes. Don’t we all?

And they will look longingly at our public lands, thinking private ownership is the answer. I respectfully disagree.

You see, that was the adventure we took these last couple weeks. We explored some western public lands.

I’ve fixed up a 1985 Volkswagen camper. It climbs the grades at a modest pace. But it sleeps us warm, keeps the beer cold, and makes good coffee in the morning.

Our first stop was on Idaho’s beautiful Salmon River. Then we stayed in a Forest Service campground on Brownlee Creek amid some old growth red firs. Then, while visiting our daughter in Caldwell the first weekend we toured the Owyhees. There was a chill wind and snow on the peaks, but it’s an arid land. The ranches there are pretty far apart.

But our goal was to visit the Malheur Wildlife Refuge in southeast Oregon, outside Burns. We had been there before, but this time we took binoculars and the bird book.

The natives found the place friendly, with food and water enough to support their small population. But with white settlement the natural corrals of the Blitzen valley walls were recognized by an enterprising cattleman in the 1850’s. By the late 19^th century, it became the largest cattle ranch in the US, 160,000 acres. The cattle baron acquired some land by federal programs, some by purchase and some through legal battles. There must have been some bitterness since the ranch manager got shot by a disgruntled evicted homesteader.

The water flowing into marshes was key to the millions of migrating birds, but private property demands productivity, and water was diverted for fields and pasture. The marshes dried up and ducks died. And the surrounding farms were barely sustained.

Teddy Roosevelt was persuaded to make the area a wildlife refuge in 1908. Water rights were finally purchased for the Refuge in 1934.

Ammon Bundy chose to make a stand here a few years back. He called for the privatization of the federal lands and expected local ranchers to rise up in support. Like Putin misread the Ukrainians, Bundy got no groundswell of local support. His Sagebrush Rebellion fizzled.

But it’s still a stump speech dog whistle in this public land dominated state.

Martha and I enjoyed the birds; some we have never seen before. A quiet morning walk along the riverbank was memorable.

On the trip back up to the Palouse we passed through three National Forests. We pulled off a forest road and dispersal camped by the North Fork of the John Day River.

It’s a beautiful place up here in this sparsely populated corner of our country.

I own land. I do my best to maintain it and improve it. I expect the same for our publicly owned land. I don’t mind paying the fee for USFS or BLM campgrounds, and I appreciate that you can camp, hike, fish, or hunt on public lands. I can’t imagine the West without them.

I got a new cap to an old tooth last week. As the dentist was grinding down my old weak molar the assistant produced the new gold cap and offered it to the dentist. “Wow, that’s heavy!” he commented before cementing it into my mouth.

Wealth in my mouth.

I imagined an invading soldier shooting me in my wife’s garden as I held my hands up. Then he flipped me on my back and pulled out his Leatherman and opened my dead jaws, looking to pry out my dental wealth.

Twenty first century justice, despite the accoutrements of shoulder-fired missiles and remote-controlled drones is not too distant from the Vikings or the Huns. We take what we can. Might makes right. The school yard bully cowers us.

Russia is taking what it wants from Ukraine. She will want more. We wring our hands, dreading the nuclear arsenal we know they harbor.

What if the bullied playground colleagues thought to play differently? Bullies need to be confronted, and the nuclear end game is what they use to hold us hostage. There is a corollary to their gambit.

What would Russia do if Norway and Finland sent a column of tanks to Murmansk right now? It’s only a hundred miles or so and there’s a good road. I’m sure most of Russia’s military is looking toward Ukraine. That’s less than the distance from Kharkiv in northeast Ukraine to Mariupol, close to the Black Sea. It’s the same as a drive from Moscow, Idaho to Grangeville. It’s very doable.

The Scandinavians could easily argue the residents want their governance. Maybe their news media could dun up support.

And Turkey and Iran, with the support of Armenia and Azerbaijan might move into Georgia, in south central Russia to “free” the oppressed Georgians.

Then, over on Russia’s east Pacific coast, let’s say Japan and China decided the residents of Vladivostok wanted their assistance to dissolve the oppression of Moscow.

We should not be sheep. If the playground rules are to just take what you want, then let’s encourage our allies to go get it.

The possibilities are endless.

I’m sure Finland and Estonia see value in St. Petersburg. It’s only a hundred miles from their borders. Fifty tanks could make it in a day easily. Think of all the cruise ship passengers who want to dock and tour The Hermitage. It’s a cash cow.

Comrade Putin has opened up the game. We just have to play it like he does.

It’s too bad here on our continent we are just looking at Toronto, Ottawa, and Monterrey. If Biden sees some value there, let’s get our tanks rolling. I’m sure he could convince Fox News and Facebook to sell it to us. Would we buy it?

But the game is in Europe right now. It might come to the Western Hemisphere in another generation.

This limited warfare game of taking what you want and keeping the big stick of nuclear weapons in your back pocket begets bullies. Do we want such a system for ourselves? Did we invade Iran on such a pretext? Did we and the world look the other way because of our arsenal, our economic position?

Any meaningful global response to nuclear powered bullies is crippled. Any significant worldwide sanctions through the UN or the World Court requires the consent of the nuclear empowered bullies.

The Romans had their legions, and that worked against the Gauls and the Huns. Ballistic megaton missiles up the ante.

It is hard to consider global justice from north central Idaho. But seeing the painful pictures of dead civilians in Ukraine makes my jaw ache.

Have you ever wondered about the bill you get from the doctor’s office? Why did that visit just cost $135.75? And why is my insurance only paying $89.45? But the bill says the fee is “contractually reduced” to $110.91, so I only have to pay $21.46. But then I paid a $20 copay, so now I only owe $1.46. Seems like I you got a great deal, huh?

Isn’t this American healthcare system wonderful?

The providers are free to set their charges wherever they choose. It’s a free marketplace. But if providers want to work with insurance companies, they have to negotiate the “contractual” allowable rate with that insurance company, thus the reduced rate. The insurance company is fighting for you, aren’t they? But the more they pay to providers, and the more they collect in premiums, the more they grow their company. But the lower their rates, the more people sign up with them. Keep in mind, it’s usually an employer who makes the decision which insurance company to contract with for their employees. It’s not a simple marketplace.

About half the insured lives in Idaho have government insurance, either Medicare or Medicaid. The rates they pay to providers isn’t really negotiated. Medicare sets their rates annually through a very complex process that does accept input from doctors and hospitals. Then providers can either decide to “participate” with Medicare and accept their reduced “allowable” charges, and then whatever payments are offered. Providers face the difficult choice: participate and accept the reduced rate or try to collect on your own from the patient.

Idaho Medicaid bases most of what they pay on Medicare rates. But many Medicaid services (obstetrics, newborn care) have no Medicare rates. So, then Idaho Medicaid has to set its own rates. And it turns out they are not doing this very well.

I respect any legislator that asks a difficult question publicly. Most of the time I tried to do this in private, not wanting to embarrass state agencies. But Senator Abby Lee asked this question, and the painful answer is available for you to read. She got the Office of Performance Evaluation (OPE) to answer: “How does Idaho Medicaid set its provider rates?” You can read the study. It’s public, without a FOIA request on the legislative website under “performance evaluations”.

Like all OPE studies, it’s fair and honest. It’s a testament to the Idaho legislature that they keep this painfully candid group around and ask for their input. Honestly, much of the recommendations they provide go unheeded. But the legislature hasn’t abolished their input, though they could with the stroke of a JFAC budget.

The Idaho Medicaid budget has been pared to bare bones over the last twenty years. It turns out there is almost no capacity in this organization to analyze and alter payments based on some meaningful rationale. The Division of Medicaid has consistently asked for the smallest budget it could afford, and the legislature has often undercut their requests.

I will admit to some responsibility in this. Some ten years ago I helped write the DHW and Medicaid budgets when I served on JFAC. I cut them to the bones. Maybe this was short sighted. I don’t remember any requests for an analysis of rates. Maybe they knew my knife was sharp.

But setting rates can influence behavior, and that’s how we can change some of our costly practices.

I remember when a Washington insurance company said they would pay the same for obstetric care whether the baby was born vaginally or by C-section. They wanted no financial incentive to the doctor to give up on a natural delivery and take the woman to the operating room.

Thank you to Senator Lee for asking this question. I hope my acknowledgement (from an Idaho Democrat) doesn’t hurt you in your Republican Primary.

We can all do better. Let us do so.

This article inspired this post. The paywall might block your reading of it, but I paste the text below the post. I saw similar problems in the 15 years I worked as the “jail doctor” in Latah County, so the story didn’t surprise me. We can’t always find a clear border between criminality and insanity. Justice demands we provide for all whom we have deprived their freedom.

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Imagine yourself in a brutal domestic argument. Your spouse, maybe a relative threatens you and you respond with violence. You are arrested and charged for your crime.

Now imagine further you have deep personal demons. Maybe you’ve struggled with them your whole life, managed them the best you could. Maybe such turmoil contributed to your domestic conflict, maybe it bounced you from job to job and kept you on a financial cliff. Your car is broken down and the boss fired you a few weeks back. Now, though, those problems sit with you in the county jail. They accompany just you to your arraignment where your right to freedom is removed. They do not testify on your behalf. Instead, they mock and deride you from inside your skull. The courtroom may be the picture of order, the bailiff stands, and the judge sits and the lawyers for the state and for you, banter about bail and risk. You are sent back to jail to await your trial.

The trial is speedy and definitive. You must serve time in the custody of the Idaho Department of Corrections. You have lost your freedom in this country where we say we respect “the rule of law”.

But the demons begin to win inside your small hard skull. You find no meaning to this life you have struggled through for maybe too long. Your brain stops telling you what to do. The jail deputy notices you don’t get up for breakfast. You have soiled yourself. You do not respond to the deputy’s speech. You stop responding to everything. The demons murmur or screech and you have retreated as far away as you can go.

The jail deputies ask for help. You are examined by professionals and deemed unable to care for yourself, indeed a risk to yourself and maybe a risk to others, given the history of violence presented at your trial. The county jail and the county sheriff ask for help.

Professionals have determined you need medical and psychiatric assistance. The Idaho Department of Corrections asks the Idaho Department of Health and Welfare to help. They do their evaluation. They determine you need care that the DOC cannot provide, but you are too great a risk to go to a state mental hospital.

Meanwhile, the days go by in the county lockup, your freedom long gone, and your mind possessed of demons and doubt.

This movie you have obligingly created in your mind at my request is not over. In fact, this is just episode one of the first season. It is an ongoing series. Idaho could make this a Netflix drama with little production cost. This happens every month in a different county in this wonderful state. Idaho Justice would be an excellent title, don’t you think?

This is not justice for the convicted and the severely mentally ill. This is not justice for the sheriff or deputies who swear to protect the convicted, now denied their freedom, but in their charge. This is not justice for the officers of the court, the judge and the lawyers who swear to serve. This is not justice for you and me who should know that this travesty is happening in our counties, in our state.

If you doubt that this is not just a mental Netflix series, ask to have a conversation with your local elected county sheriff. Ask them if such a scenario has occurred under their watch. See if they shift and deflect. It is a painful truth we all do not want to face.

For how we each define justice, for ourselves, and for those we have allowed “the rule of law” to deprive of their freedom is a telling definition. Please search your soul. I believe we can do better.

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Lewiston Tribune article, April 9, 2022

The plight of an inmate who has languished at the Idaho County Jail for months highlights the critical lack of mental health treatment options on the Camas Prairie.

A group of about 36 county and state officials met Thursday at the Soltman Center in Grange-ville to discuss taking the first steps toward establishing mental health services for Idaho and Lewis counties. A recovery, crisis or outreach center likely would be modeled after such facilities currently operating in Lewiston, Moscow and Orofino.

That future plan, however, doesn’t help an inmate currently being held at the Idaho County Jail. The man was convicted in January during a court trial of multiple felonies, including attempted strangulation. Shortly after the conviction but before sentencing, the inmate became suddenly incapacitated, or “catatonic,” meaning he stopped eating, drinking, moving voluntarily, speaking and taking care of personal hygiene functions.

The ongoing care of the inmate, along with what sheriff’s officials believe is stonewalling by the Idaho Department of Health and Welfare to find a mental health facility where the inmate can be treated, has created what Idaho County Sheriff Doug Ulmer believes is a dangerous situation.

“Our job is to protect the community and protect the people in our jail,” Ulmer said during an interview at his office Thursday.

“This person needs help. He had a bed (in a mental health facility) to go to in Boise. Health and Welfare did their interview and said he did not meet their criteria.

“The roadblocks are being thrown up, in my opinion, by the Health and Welfare mental health group and their process. We are not set up to deal with his situation at all. It takes 24 hours a day, seven days a week checking on this person. It’s a constant pull and there’s no light at the end of the tunnel. We just keep getting this runaround from Health and Welfare. … This person shouldn’t be in our facility; he should be in a hospital and getting the help he needs.”

Michael Wraith, program manager for Health and Welfare’s Regions 1 and 2 Behavioral Health program at Coeur d’Alene, said he couldn’t comment on the specifics of any case.

Speaking in general about the department’s policies, however, Wraith said “there are a lot of nuances that come into every case that’s committed to us. Medical complications are one of the primary issues. … Sometimes, if a person is dangerously mentally ill, it slows down the process.”

Although the Idaho County inmate was evaluated by a licensed psychologist following a court order, Wraith said his department has to have additional evaluations if there are complications to a case, such as medical problems or someone who is dangerously mentally ill.

That, apparently, is what has happened in the Idaho County case.

Brian Hewson, chief deputy for the Idaho County Sheriff’s Office, said shortly after the court-ordered evaluation of the inmate, he made contact with the Idaho Department of Correction in Boise to let people there know Idaho County would be sending down the inmate.

“I told (the person he contacted), ‘We’re getting ready to load him up and we’re getting ready to transport him to you, like the court order states,’ ” Hewson said. “He says, ‘Hold your brakes, it doesn’t work that way. We have the ability to not go by a judge’s order.’ He said, ‘Judges don’t like it, but that’s the way it is.’ I go, ‘OK, that’s a new one to me, right?’ ”

Hewson continued: “He said, ‘What we need is, we need Health and Welfare to evaluate him because we go by Health and Welfare’s determination.’ (The inmate) had already been evaluated by doctors, psychologists, but that’s not good enough.”

Two workers from Health and Welfare showed up at the Idaho County Jail a couple of days later, Hewson said, and spent 10 to 15 minutes with the inmate. There was no interaction with him at all, and the workers left and filed a report for the Department of Correction.

“The Department of Correction says he does not meet their criteria because he’s not a dangerous individual,” Hewson said, pointing out that the inmate had been convicted of attempted strangulation and assault.

“We have concerns. He’s been convicted, so if he goes to a state hospital with lower security, my concern is that he is now a flight risk because he has not been sentenced yet. … We have had him at St. Joe’s several days. He was evaluated and they said he should be hospitalized but they didn’t have a bed for him.

“We don’t know where to turn,” Hewson said. “I’ve never seen roadblocks like this.”

Wraith said his department tries to have transparent communication with other agencies, but sheriff’s officers said that has not happened in this case.

“Our commitment process in general is a complicated system,” Wraith said. “So it’s not something (where) we’re intentionally creating barriers.

“Any patient that is committed to us gets placed into an appropriate facility as soon as possible,” he added.

Ulmer acknowledged that even if a recovery or crisis center was available in Idaho County it probably wouldn’t have helped out in this particular case.

But there are other examples of why the Camas Prairie needs places for people who are having behavioral health crises.

“We have people we deal with all the time,” Ulmer said. “How many times a deputy or a policeman opens his billfold to buy somebody lunch that can’t (afford it). These people are just wandering and they have issues. They’re hungry and they need food (and shelter).

“We work with these people all the time,” Ulmer said. “So if there was an avenue we could take these people to, to get them help, that would be huge.”

Hewson added, “There’s people out there wandering around who don’t meet that criteria of being a danger to the public or themselves. And the services that we were talking about (in the resource and crisis center meeting), that would work for them if there were contacts that we could call or steer them in that direction.”

Ulmer said his office supports the idea of a behavioral health resource or crisis center in Idaho County, “but if it comes with the red tape Health and Welfare has made, we don’t want to be involved.

“We try to help people out and it kind of feels like you’re failing miserably because you keep running into this wall,” the sheriff said. “This person (the inmate) remains in our facility that we are not in any way, shape or form able to deal with. We deal with his needs because we have to, because the people who should be dealing with him aren’t. It’s aggravating.”

When I first got elected to the Idaho State Senate way back 2010, I woke up on the morning after the election to a phone call from Mountain Time Zone. I just was having coffee when the Senate Pro Tem at the time, Senator Bob Geddes, called me on my land line to welcome me to the Idaho Senate. He was very gracious. I was aware, and so, I’m sure was he, that I had won a seat formerly held by a respected Idaho Republican for 14 years. And I was an Idaho Democrat.  That Senator had been beaten in the primary by a Tea Party candidate. Then I had beaten the radical in the general election. So, Idaho Democrats gained a legislative Senate seat. I had been working so hard to knock doors in my district, I had little perspective on the statewide political landscape. But I appreciated his welcoming generosity.

The second call I got that November morning was from a guy I knew who had followed and supported my campaign. He was living out of state at the time to make big money, but his heart was in this wonderful state. I remember a question he asked me after the initial congratulatory exchange. “So, Dan, have you ever considered running as a Republican?”

I had stayed up late and wasn’t real sharp, even with that first cup of coffee. “No, I haven’t.” I answered. “The voters wouldn’t trust such a flip.” I threw out, not really being an expert on Idaho voters at that point in my political career.

But my caller knew Idaho very well. He was 25 years younger than me, and he knew the tides of this era while I harbored memories of the olden times, when Democrats could get elected to either the legislature or statewide in this leftover state. I was only thinking of my district, my election, and indeed, my service. Why should the party label matter?

But I soon learned that it did.

I was assigned to the Agriculture Committee in my first year in the Idaho Senate. An issue came before us that I needed to understand, so when I saw a senior senator not on the committee, but a rancher and I assumed more familiar with the subject I approached him. He stopped and heard my question, but then he started backing up as he answered. I followed, bending in to listen, but soon realized we were in an alcove, out of sight. He didn’t want to be seen talking to an Idaho Democrat in the halls. But his counsel was wise, and I appreciated his wisdom. I learned that good conversations must be combined with discretion. And that labels matter.

Many elected people have had to play this ugly partisan game here in Idaho. I’m not a good enough historian to make the list complete. But I think of John Peavey, former Idaho State Senator. He was first appointed to fill his mom’s seat when she got picked to run the US Mint by President Nixon. So, he served for a while as a Republican as she was, but then switched parties and got elected as a Democrat in his central Idaho district. He’s really known for his wise and provocative stand on water rights, since he was part of the lawsuit that forced the Snake River adjudication. We owe him some gratitude.

Indeed, Branden Durst, a current candidate for State Superintendent of Public Instruction sat next to me on the floor of the Idaho Senate as a Democrat. But he runs now as a far-right Republican.

Other elected officials I have served with have told me they first ran for office as a Democrat. But they understood the Idaho climate.

Some Idaho Republicans want to purify their ranks, killing RHINOS (Republicans In Name Only). I just wish we could elect folks who want our communities to thrive.