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A federal inmate who waited nearly a year for breast cancer surgery is now free. A judge said she had ‘grossly inadequate care’ in prison.

The moment, nearly two years ago, when she found a lump in her left breast, Angela Beck feared she would die in prison.

That fear, she said, was fueled by not only her family history of breast cancer but also by the numerous delays in medical care she had at the federal prison in Aliceville, Ala., where she was serving a sentence of 13 years and nine months. She had been convicted for her role in a large-scale methamphetamine operation in Surry County.

She didn’t get a biopsy for eight months, even though a medical expert said in court papers she should have had it done within one to two months after she found the lump in her breast. She didn’t get surgery to remove her left breast until two months after her biopsy. And delays in her after-treatment care meant she wouldn’t benefit from chemotherapy and radiation treatment.

And in all that time, she found two lumps in her right breast.

Last week, she walked out of federal prison after U.S. District Judge Catherine Eagles granted her request for compassionate release under the First Step Act of 2018. In her June 28 order, Eagles said Beck had received “grossly inadequate care” for her breast cancer while at the Federal Correctional Institute in Aliceville.

Beck had not only filed a request for compassionate release but also, through her attorneys, had filed a lawsuit to force federal prison officials to provide proper medical care. In the lawsuit, she alleges that federal prison officials violated her Eighth Amendment right against cruel and unusual punishment. That lawsuit is pending. Federal prison officials have not specifically denied the allegations but have sought to have the lawsuit dismissed.

On Tuesday, she walked into a downtown law office with her daughter and her 5-year-old granddaughter, who made fun of the bright green shirt she wore. Helen Parsonage, one of her attorneys, joked that the shirt was better than the gray prison clothes she had to wear while serving her sentence.

Beck wore circle-shaped earrings with the word “Love” inscribed in the center. It’s been an adjustment, she said. In recent days, sleeping had gotten easier.

She said she can’t believe she’s out of prison. She is getting treatment for the cancer after she had surgery to remove her left breast. But she is waiting to find out whether the cancer has spread to her right breast.

“(I) never thought this day would come,” she said.

A lump

Beck, 47, was accused of operating a methamphetamine lab at her Surry County home along with her husband, Donald Ray Beck. And according to court papers, federal prosecutors alleged that after a search of their home, they continued to manufacture and distribute methamphetamine until law-enforcement officers did a second search of their home. Beck pleaded guilty to conspiracy to distribute methamphetamine and possession of firearms in furtherance of a drug-trafficking crime.

Beck was among about 20 people, including her husband, who were indicted on charges of being part of a large-scale methamphetamine operation in Surry County. She started serving her sentence in 2013.

Then in August 2017, while taking a shower, she found a lump in her left breast. Beck had seen her mother and other relatives suffer from breast cancer.

According to court papers, she immediately notified prison officials. It wasn’t until Oct. 16, 2017, that a prison doctor examined her.

More than two months later, a surgeon examined her. About two weeks later, she had a mammogram done that showed multiple breast masses and cysts. After the prison doctor reviewed the mammogram, it was recommended that she get a biopsy.

A cancer specialist at Wake Forest Baptist Medical Center said in court papers that a biopsy should be performed within two months after a woman finds a lump in her breast. In Beck’s case, that didn’t happen.

In fact, eight months would pass before federal prison officials took Beck to get a biopsy. And when it was done, doctors found that the cancer had spread to her lymph nodes.

Doctors said she needed to have surgery to remove her left breast and the lymph nodes. The surgery, however, wasn’t done until Nov. 1, 2018.

And it took another six weeks for prison officials to take her to a follow-up appointment with the surgeon, who said she needed to see an oncologist. That appointment with the oncologist didn’t happen until April 3, 2019, a delay of about five months.

In January 2019, she found two lumps in her right breast.

During this whole time, Beck said, she wrote prison officials about the delays. She got little response. She was told, she said, that she was either on the list or that the appointment was in the process of being scheduled.

Prison officials also said they had to coordinate with Seven Corners, which manages medical care for the prison.

“I’m just thinking, ‘Am I going to get to see my children and grandbaby,’” Beck said.

Faith

Beck still recalls the prison official who told her she didn’t look terminally ill.

“I’m thinking, ‘How am I supposed to look?’” she said.

Beck pushed ahead, writing prison officials about the delays.

She eventually got into contact with James Craven, who also represented her husband. He filed a request for compassionate release, along with Parsonage. Parsonage’s law partners, including Robert Elliot, filed a lawsuit in U.S. District Court in May to get a judge to force prison officials to provide adequate medical care.

Eagles held a hearing in June and eventually issued an order to make sure that prison officials get Beck to scheduled appointments with her doctor.

Then she issued her ruling ordering Beck to be released.

She received an email telling her the news.

“I had somebody re-read it to make sure I was reading it right,” she said. “I was excited.”

The delays in medical care made her ineligible to receive chemotherapy or radiation treatment. She is taking medication, and the prognosis looks good, she said her doctors tell her.

But she hasn’t found out whether the cancer has spread to her right breast. She will soon seen a doctor and get tests done to determine if she needs treatment, surgery or nothing at all.

She receives medical care through Medicaid.

In the meantime, she said she wants to spend as much time with her children and grandchildren. Her family and the friends she made in prison as well as her faith helped her.

“As long as you have faith in God, you can go through anything,” she said.


Business
What’s in a city’s slogan? A bunch of money and time.

Winston-Salem Business Inc. and the Winston-Salem Chamber of Commerce have hired an economic development marketing firm to look into the best way to recruit, retain and grow companies, along with a new branding strategy for Forsyth County and Winston-Salem.

Development Counsellors International, based in New York and known as DCI, does business worldwide and recently worked with the Piedmont Triad Partnership to develop its Carolina Core branding.

Bob Leak, president of Winston-Salem Business Inc., said that DCI is basically looking into what the local community is good at, as well as a branding strategy.

Mark Owens, the president and chief executive of the Winston-Salem Chamber of Commerce, said that there are a lot of different components within the local community.

“How can we tell that story in a cohesive manner and how do we look at that?” Owens said. “Where is that story being told, and how do we better communicate internally in the community and externally to the world that Winston-Salem is the right place and the best place to start and grow a company? (That) is really what we are trying to look for.”

Working together

Owens and Leak said that a larger community group has been meeting regularly for months to look at ways to improve the city and county’s economic development strategy. The group includes representatives from the Downtown Winston-Salem Partnership, Venture Café, Visit Winston-Salem, Wake Forest Innovation Quarter, Winston-Salem Business Inc., the Winston-Salem Chamber of Commerce, Winston Starts, City of Winston-Salem and Forsyth County. Leak said that the Innovation Quarter initiated the meetings.

Graydon Pleasants, who is head of real estate development at the Innovation Quarter, said that officials with the Innovation Quarter look forward to continuing those discussions with those groups.

“As we all tell the story of Winston-Salem and the surrounding region from an economic development angle to our various audiences, alignment on what that story is becomes crucial,” Pleasants said. “By aligning with groups like WSBI, the chamber, Visit Winston-Salem and others, we can all work toward a common narrative about the strengths and opportunities the City of Arts and Innovation has to offer.”

“The City of Arts and Innovation” is the most recent branding slogan used by Winston-Salem. Past city slogans include “’O! Winston-Salem Now That’s Living” created in 2001, “North Carolina’s Largest City” in 1922 and “The city of progress and prosperity” in 1920.

Resolution

Winston-Salem Business Inc. receives money for business recruitment from both Forsyth County and the city of Winston-Salem. For the current fiscal year, the agency is getting $85,000 from the city.

The chamber does not receive money from the city, but it does business retention efforts for the entire county and receives county money, Owens said.

On July 25, the Forsyth County Board of Commissioners is expected to vote on a resolution for entering into a contract with Winston-Salem Business Inc. and the Winston-Salem Chamber of Commerce to provide business recruitment, retention and expansion services for six months from July 1 through the end of the year.

In previous fiscal years, the county has contracted with Winston-Salem Business for business recruitment services and with the chamber for business retention and expansion services. But for the current 2019-2020 fiscal year, the county appropriated $185,000 for all business recruitment, retention and expansion services, hoping to provide the money to one entity.

Based on the resolution, for the first six months of the current fiscal year, Winston-Salem Business would receive $50,000 and the chamber would receive $50,000 of the money.

“We pay quarterly so they will actually perform the services then invoice us based off of the services rendered,” said Kyle Haney, an economic-development specialist for Forsyth County. “Then at the end of those six months, the county will decide what organization to fund going forward.”

He said that the remaining $85,000 would be available for that organization approved by the board, starting Jan. 1.

Owens said the possibility of one entity will be looked at by the consultants.

“There will be a component of it that either confirms the setup that we have currently or potentially provides alternative suggestions on just how to best operate as one entire community, whether that means one new entity or keeping the entities separate,” Owens said. “That’s still going to be part of the process conversation.”

DCI’s contract started July 1 and its report is expected to be completed in the fall.

Leak said that the consultant’s work will include interviews, starting in August, with a number of different community constituents such as private citizens, business leaders and elected officials.

He said that DCI will get those people’s opinions “on what they think Winston-Salem and Forsyth County are all about then use that to try to create a strategy that we can all embrace going forward.”

He said that once the report is ready, the chamber and Winston-Salem Business Inc.’s boards will be able to look at the feedback from the consultant and go from there.

“It may be make a decision,” Owens said. “It may be keep things the same.”

He said that the county commissioners will also get to see the report.

“Then the county (commissioners) can consider their funding solutions according to what they feel is best,” Owens said.

Don Martin, co-chairman of the Forsyth County Board of Commissioners, said that bringing in a consultant is a good idea, that getting information would be helpful for the area’s economic development efforts.

“It’s giving you what’s the best practice in this arena to try to improve our economic development activities and coordination,” Martin said. “Is it better to put it under a single umbrella with everybody working together or keep the two umbrellas we’ve got, or whatever?”


Local
Ultimatums, accusations threaten to deadlock progress on state budget, Medicaid expansion in North Carolina

The issuance of ultimatums — whether real or perceived — has approval of a new state budget stuck over Medicaid expansion in North Carolina.

Attempts to reach across the aisle in Raleigh for votes (Republican legislators to support expansion, Democrats to support an expansionless budget) are being decried as interloping, if not bribery, with GOP offers of earmarking money in the budget for special projects in Eastern North Carolina to sway those Democratic legislators.

All of which makes it more likely that budget negotiations will take weeks, if not months, to reach a compromise.

The latest salvo was fired Thursday by the N.C. Senate’s 29 Republicans in a letter they sent to Democratic Gov. Roy Cooper stating their opposition to Cooper’s budget proposal.

Cooper vetoed the GOP budget compromise June 28. It would take every GOP legislator, as well as at least seven Democratic votes in the N.C. House and at least one Democratic vote in the Senate to override the veto.

The letter was sent as the House Republican leadership chose to take a four-day break — until Monday night — from considering voting on the veto override and Medicaid-expansion legislation, House Bill 655. The House took up neither in its seven most recent floor sessions.

Cooper expressed, including in an interview with the Winston-Salem Journal last week, his confidence in not only the budget veto surviving an override vote but also of enough GOP votes to pass HB655.

“We definitely have the votes in the House for passage of the Medicaid expansion bill even with the work and premium requirements, but that alone doesn’t get Medicaid expansion,” Cooper told the Journal.

The House Health Committee recommended HB655 by a 25-6 vote July 8. The bill was fast-tracked to the House floor July 9, where it has sat unaddressed since.

Cooper said that “there are nine to 10 Senate Republicans who are amendable to a settlement on Medicaid expansion.”

The Senate GOP’s letter claimed that Cooper’s supposed speaking “on behalf of Senate Republicans ... mischaracterized our body’s budget position.”

The letter was designed to “outline the Senate Republican caucus’ budget position to you. ... With respect, we do not presume to speak for you or your positions. We request the same courtesy in return.”

The GOP senators stressed their belief that the latest version of the budget “reflects compromise between the House, Senate and Executive Branch.”

“We passed a good solid budget with bipartisan support,” said state Sen. Joyce Krawiec, R-Forsyth. “The governor has refused to allow the budget to become law unless he gets what he wants.

“Teacher raises, school funding, state employee raises and many more important spending priorities are put on hold because of the governor’s refusal to work with the legislature,” Joyce said. “I hope he reconsiders.”

Special session offered

The Republican senators repeated their offer of holding a special session after the budget is signed into law “devoted exclusively to health care access issues, including your top priority of Medicaid expansion.”

“We oppose your ultimatum that no 2019-21 budget will become law unless the legislature first passes Medicaid expansion,” the letter said.

Cooper said last week that it is “a fantasy to think Medicaid expansion would happen in a special session.” Analysts have said that once Cooper signs into law a state budget without Medicaid expansion, he will lose his leverage on the issue.

Cooper has said he supports a two-track approach to ending the current session, with one focused on health-care issues, including Medicaid expansion, with the N.C. secretary of health. Dr. Mandy Cohen, in charge. The other track would be “on the larger budget framework.”

According to a statement from Cooper’s office, his budget plan “recommends expanding Medicaid to bring $4 billion into North Carolina’s economy, create an estimated 40,000 jobs and provide more affordable health care for 500,000 people.”

“It needs to be in the budget because it would add $4 billion to the $24 billion budget, and it would prove to be one of the most pivotal economic initiatives the state has ever undertaken,” Cooper said. “There’s no reason to hold a special session on health care when there is a vehicle to move forward in front of us now.”

Given the intense opposition from Senate leader Phil Berger, R-Rockingham, and other key GOP senators, there is no guarantee HB655 or any expansion legislation would be heard in the Senate during the current session or a special session.

Some analysts say that reality makes Berger’s pledge hollow.

Berger has criticized HB655 for including an assessment charge to hospital and medical providers that he says will serve eventually as a tax on patients. The bill has drawn criticism for requiring Medicaid recipient work and pay a premium to help finance health insurance.

Mitch Kokai, senior policy analyst with the John Locke Foundation, a conservative-leaning research group, said Senate Republicans likely would use a special session “to promote ideas that would work better to boost health-care access and reduce costs; certificate-of-need reform; reduced restrictions on health practitioners’ scope of practice; and other market-oriented ideas that focus on the supply side of health care.”

However, those Senate legislative efforts have drawn resistance in the House.

“The letter signifies that Gov. Cooper is not likely to see much success trying to drive a wedge between Republican Senate leaders and the rest of the GOP caucus,” Kokai said. “Sen. Berger is not the only Republican who considers Medicaid expansion to be a misguided proposal.

“As long as the governor refuses to budge from his insistence on a budget deal including Medicaid expansion, a deal is unlikely.”

Back-and-forth debate

Cooper responded to the Senate GOP’s letter by issuing a statement on the governor’s office website that asks where is the Senate GOP’s counterproposal is to his budget compromise released July 8.

“The offer would close the health care coverage gap, raise teacher pay, cut taxes for people and guarantee school construction while balancing the budget and saving money in the rainy day fund,” the statement said. “It also included all the local projects that were in the Republican legislative budget.”

“The ball is in the Republicans’ court,” Cooper spokeswoman Sadie Weiner said, “and they should stop trying to bribe Democrats to override the governor’s veto and submit their counterproposal.” .

“Republicans are demanding that access to health care be taken off the table as a precondition to negotiate. Gov. Cooper has offered a comprehensive response to the Republican budget, while Republican leaders continue to sound a one-note rejection,” Weiner said.

She said that while “Cooper has not issued an ultimatum on any issue, Republican leaders continue to insist that he has.”

“Instead of negotiating, Republican leaders have spent their time recklessly and irresponsibly auctioning off the headquarters for the Department of Health and Human Services, cynically risking vital jobs and services, to any Democrat who will join them to override the governor’s budget veto.

“Republicans do not have the votes to override this veto, and with each passing day they are disrespecting North Carolinians who voted for more balance in government,” Weiner said.

“They are running out of fig leaves to hide their true intentions.”

Waiting for right time

House Speaker Tim Moore, R-Cleveland, told reporters after the July 8 session — the first session to skip a vote — that “we’re going to wait until the time is right.”

Berger has said the Senate is inclined to stick with its plans to adjourn the current session Monday and to reconvene Aug. 27 for a limited session. However, Moore has said the House not is likely to follow the same timeline.

Berger said, “We will continue to have negotiations with the House” on an adjournment date.

“The speaker has some expectations that an override will take place, and I am hopeful that is the case,” Berger said.

“We have been here a while and I don’t know that it makes a lot of sense for us to keep people here for an indefinite period of time.”

Kokai said GOP legislative leaders “still seem to be in the mode of recruiting Democratic votes for a budget veto override.”

“As long as that effort continues, the likelihood of intensive negotiations with the governor’s office appears remote.”