Chairman’s Message George Soros

George Soros is chairman of the Open Society Institute.

2 Chairman’s Message George Soros

When I first began to expand my philanthropy in the United States in the mid-1990s, America was essentially an open society. But even open societies are open to improvement, and there were two areas in particular where I felt our policies were making matters worse than they might otherwise be: death and drugs. Death is a fact of life, yet people deny or ignore it, making the experience unnecessarily painful. I created the Project on Death in America to trans- form the culture of dying, in particular to reduce the pain associated with death. The project was successful and the prin- ciples of end-of-life care are now firmly established for the medical profession and, to an increasing extent, for the general public. The war on drugs was not solving the drug problem. I knew we had to explore ways to reduce the harm caused by illegal drug use and ineffective drug

5 Chairman’s Message George Soros

policies. The Open Society Institute The war-on-terror concept is counter- became a leading proponent of harm productive. It stresses military over reduction initiatives, including needle political approaches, creating innocent exchange programs to stem the spread victims and thus feeding rage and of HIV/AIDS. resentment that reinforces support for The Open Society Institute’s early terrorists. As an abstraction, it prevents programs in the United States were fol- us from dealing with each situation on lowed by many others, from after-school its own terms, lumping together groups to criminal justice to reproductive rights. that should be examined individually. In We have been especially concerned the end, the war-on-terror concept has with looking at certain professions led to the erosion of the moral authority where the values of the marketplace of the United States and has made the seem to have eroded professional stan- world a more dangerous place. dards. You can read the details in the The Open Society Institute, including pages of this report. its Washington policy arm established The attacks of September 11, 2001, in 2002, is doing what it can, but there is and President Bush’s response to still a long way to go. As this report doc- those attacks have brought even more uments, we have made mistakes—and fundamental problems. The apparently tried to learn from them. Foundations, limitless “war on terror” has given rise with all their power and influence, must to grave abuses such as torture and be especially aware of their fallibility. warrantless surveillance, justified by an And governments even more so. executive branch that appears to recog- nize no checks on presidential power.

6 7 Contents 1. 5. Chairman’s Amplifying Getting Tough Conclusion Message Young People’s Voices on Criminal Justice pg. 110 George Soros Steven Goodman Marc Mauer pg. 1 pg. 20 pg. 76

Foreword: 2. 6. Afterword: Keeping America Changing Plan A: Protecting All Moving Quickly, Open and Free the Way We Die Reproductive Health Breaking New Ground Aryeh Neier Diane E. Meier Cynthia Cooper and Ellen Chesler Gara LaMarche pg. 10 pg. 28 pg. 88 pg. 116

3. 7. Introduction Opening Baltimore Board and pg. 16 Doors to Justice Rising Staff Peter Edelman Prue Brown pg. 132 pg. 44 pg. 102

4. A Nation of Immigrants, Unfinished Bill Ong Hing pg. 60

8 9

Foreword: The Open Society Institute launched its United States Programs in 1996 to address the flaws that exist in our open society and to counter forces Keeping America that tend to undermine openness. These are matters of intrinsic importance in the United States, but they Open and Free are also of importance globally. We believe that OSI’s Aryeh Neier credibility as a foundation promoting open societies worldwide is enhanced by our readiness to address shortcomings in the country where we are based. Aryeh Neier is president of the Open Society Institute. Helping to keep the American example positive can only assist us in our global efforts. Among the flaws that OSI focused on from the start were those of the American system of criminal justice. The United States, which in 1996 shared the world’s highest rate of imprisonment with Russia, now has the top spot to itself. Many millions of Ameri- cans spend significant parts of their lives behind bars. Prison is a routine part of coming of age for a large share of the African-American male population. Yet when OSI began focusing on these matters 10 years ago, we found ourselves the only philanthropic donor spending significant sums in the field. Today, OSI’s participation is matched by a newer donor, the JEHT Foundation. Yet it remains the case that very little philanthropic support goes into efforts to address what should be recognized as a situation causing incalculable harm—and as a national disgrace.

13 Foreword Keeping America Open and Free Aryeh Neier

Even before we established a broad array of In subsequent years, OSI’s U.S. Programs has programs in the United States, OSI had initiated confronted challenges that were not anticipated a projects to deal with two other issues receiving little decade ago. Aside from the ongoing effort to reduce donor attention. In 1994, we created the Project on the harm done by the criminal justice system, prob- Death in America to promote comfort and dignity ably the most significant component of the work for the dying and The Lindesmith Center to try to of the U.S. Programs has been to address violations mitigate the harms caused by drug addiction and by of civil liberties in the period following the terrorist punitive efforts to control drug use. Both initiatives attacks of September 11, 2001. These efforts have were absorbed into the U.S. Programs. also been especially important in trying to assure that In the mid-1990s, the country went through one the influence of the United States furthers our efforts of its periodic surges in anti-immigrant sentiment, to develop open societies elsewhere. an important political factor that we are seeing again Unfortunately, it has not been possible to prevent today. The targets 10 years ago included legal immi- the United States from setting a terrible example. grants excluded by legislation from various public The Bush administration has greatly exacerbated the benefits. In response, George Soros allocated difficulty of stopping the abusive practices of other $50 million to establish the Emma Lazarus Fund. governments by its own actions contrary to the The impact was dramatic. It allowed OSI to assist rule of law: resorting to long-term incommunicado immigrant groups all over the country in protecting detention without charges or trial; disregarding the their own rights and, in the case of hundreds of thou- procedural protections of the Geneva Conventions sands of immigrants, in speeding their acquisition of and Protocols; instituting the widespread practice of citizenship. But also the very announcement of the cruel, inhuman, and degrading treatment of detain- existence of so large a fund and its availability as a ees and, in a significant number of cases, of outright quick source of support galvanized those concerned torture; and attempting, at the highest levels of with the rights of immigrants and helped turn the government, to legitimize such practices and resist tide. It was an indication of what could be done in the efforts to place legislative curbs on them. More than United States by a donor with substantial resources that, it has largely nullified the capacity of the United ready to move rapidly to address critical issues States to serve as an effective proponent of the threatening the openness of American society. human rights cause internationally.

14 15 Foreword

The Open Society Institute’s commitment to the U.S. Programs continues to reflect the dual concerns that led to its establishment a decade ago. Closing the gap between the U.S. claim that it is an open society and the actual experience of its most disadvantaged residents is immensely important in its own right. Helping to ensure that the United States lives up to the standards that it proclaims to others is essential to the cause of promoting open societies globally. For half its existence, the U.S. Programs has operated in the shadow cast by the events of September 11. Despite the difficulty of working in this climate, the effort has been worthwhile: OSI has helped make America a more open society than would otherwise be the case.

16 Introduction The Open Society Institute in the United States fosters debate, helps empower marginalized groups, and strengthens communities. While priorities and strategies have changed, the mission of the U.S. Programs is much the same today as it was a decade ago. If anything, OSI’s core values are even more relevant in the current atmosphere of hostility toward differences and opposing views. As U.S. Programs’ Director Gara LaMarche wrote at its founding: “A society in which all ideas are sub- ject to scrutiny and debate is a society more tolerant of dissent and minorities, and one more conducive to progress in social welfare and innovation in scholar- ship, science, and culture. U.S. Programs works to strengthen public discourse in areas thought to be taboo or on issues where one side of the argument dominates or drowns out the other.” This report attempts to describe the breadth and depth of OSI’s work in the United States over its first decade as it sought to open up debate and help community leaders influence government policies. Eight writers and experts, commissioned by OSI, contribute essays that describe and evaluate the foundation’s role in the progress (or lack of progress) that has occurred in seven priority areas.

19 Introduction

Steven Goodman tells how youth media has Prue Brown’s story about OSI–Baltimore shows brought young people’s views to the attention of the how a city can be turned around by a comprehensive general public, improving adult attitudes toward the approach to interconnected urban problems. age group once feared as “super-predators.” Other issues and activities are described in the Diane Meier tells the story of the Project on Death sidebars and conclusion. in America, which helped improve care of the dying Throughout the report, photographs depict and made palliative care a recognized medical spe- some of the issues OSI is working on. Recognizing cialty—and re-energized her own career as a doctor. the power of photography in exposing problems Peter Edelman evaluates OSI’s work in civil and inspiring change, OSI supports documentary justice and finds “one grand-slam move” in its sup- photographers through its Moving Walls exhibitions port of public interest fellowships and a number of and the Documentary Photography Project. other remarkable achievements. In his afterword, Gara LaMarche reflects on In the field of immigration, Bill Ong Hing praises the evolving nature of our work and predicts what the work of OSI and its grantees in restoring essen- emerging trends will challenge OSI in the decade tial government benefits to many immigrants in the ahead as it continues to preserve and expand open late 1990s, and criticizes the administration’s crack- society in the United States. down on noncitizens in the wake of September 11. In criminal justice, Marc Mauer sees encourag- ing signs of progressive reform—with OSI playing a critical role—but predicts that much more needs to be done to shift attitudes and resources away from excessive reliance on incarceration. Cynthia Cooper and Ellen Chesler report on OSI’s strategies and victories in the struggle to pro- tect the right to choose and on the promise of new options such as emergency contraception.

20 21 1. Yesterday: Fear of Teenagers Amplifying Ten years ago, a deep dread of young people spread through the nation’s main- Young People’s Voices stream public discourse. Many of society’s Steven Goodman problems—crime, violence, drug and alcohol abuse, unwanted pregnancy— Steven Goodman is the founder and executive director of the Educational Video Center and the author of Teaching were blamed on youth, particularly urban Youth Media: A Critical Guide to Literacy, Video Production, and Social Change. youth of color. Political leaders and law enforcement officials proclaimed that the United States was on the verge of a crime epidemic perpetrated by “teenage super-predators”—disaffected juvenile delinquents who killed without guilt or remorse. We were warned of a “ticking time bomb” of violent crime as well as

Education: In School and After Education in many inner-city schools barely functioned when OSI began operating in the United States a decade ago. In addition to promoting youth media and urban debate, OSI approached problems in education through support for youth organizing, arts projects, after- school programs, innovative curriculum efforts, and school restructuring.

23 Amplifying Young People’s Voices Steven Goodman

soaring rates of teen pregnancy that would of school and into correctional facilities. Evi- explode in a few years as school enrollment con- dence gathered by the end of the 1990s revealed tinued to grow. that in a number of cities, African-American The trouble was that the crisis of youth crime youths had been suspended and expelled at rates and teenage pregnancy was misplaced and greatly many times higher than those of white students: overstated. During the 1990s, teen pregnancy more than three times higher in Denver, San and abortion rates actually fell sharply, and sexual Francisco, and Austin and an astounding 22 activity declined. Youth crime also had been stead- times higher in Phoenix. In 1997, the proportion ily dropping since the early ’90s. of juvenile prison admissions for drug offenses In spite of these facts, the news media helped was three times greater among African-American create a public panic by shouting that the youthful youth than white youth. Minority youth, who crime epidemic had already arrived. Adults sur- only comprised one-third of the adolescent pop- veyed believed that young people accounted for ulation in the United States in 1997, made up 40 percent of the nation’s violent crime, a num- two-thirds of the over 100,000 youth confined in ber that was three times higher than the true rate. local detention and state correctional facilities. The climate was ripe for repressive antiyouth policies to be enacted. In the mid-1990s, states The Response: moved to prosecute juveniles as adults, enacting The Young Define Themselves “three strikes” laws and placing kids into an adult The Open Society Institute responded to the justice system with stiffer sentences and harsher crisis by establishing Youth Initiatives, includ- jail conditions. School districts adopted “zero ing the Youth Media Program and the Urban tolerance” policies that treated the most minor Debate Program. The programs supported new infractions on the same level as more serious opportunities for urban youth to connect to transgressions. These policies ended up pushing their communities, participate in the national disproportionate numbers of youth of color out dialogue, and change their negative public

One of OSI’s first grants in education went inspire and nurture the imaginations of to the Algebra Project to increase the number young people while exploring the role of the of students who successfully complete algebra arts in building communities and furthering in high school and take college preparatory open society. Supported programs provided mathematics. The Algebra Project reached arts education and career development over 40,000 traditionally underserved middle for low-income youth in cities such as school students, teaching them algebra by Boston, Chicago, and New York. relating abstract concepts to everyday experi- With the Bill & Melinda Gates Foundation ences. Java Jackson of Mississippi participated and the Carnegie Corporation, OSI created in the program and went on to teach others. the New Century High Schools Consortium “Everything was made physical,” she said, “so for New York City in December 2000 to trans- we could see it and understand it better. That form some of the city’s large, low-performing, helped me a lot because I was a slow learner. comprehensive high schools into more I couldn’t catch on just learning from a book.” effective, smaller schools. OSI’s Arts Initiative focused on efforts to But probably OSI’s most important

Radio Rookies trains young people to tell their stories. Photo: Amani Willett 25 1. Voices

image while developing critical academic and detention facilities, and, of course, over- career skills. The Youth Media Program enabled crowded schools. Power of Words many new youth video, radio, and magazine As founder and director of the Educational organizations to take root across the country, Video Center, I have worked closely with young and strengthened existing organizations, includ- people for more than 22 years. I have watched “Debate is like a link to different places. ing the Educational Video Center (EVC). students in the EVC’s Documentary Workshop, Openings for youth media in the schools grew for example, create powerful testimonials Half my family didn’t graduate high school. when the Annenberg Challenge awarded the that bore witness to the daily degradation and school reform movement a 10-year national abuse experienced by their friends, family, and I don’t want to take the easy way. I wanted $500 million grant to improve urban and rural often themselves. Their documentaries threw to take the hard way.” schools. By the late 1990s, this large-scale a light on those kids who “slipped through the support for school reform dovetailed with the cracks”—the kids who stopped coming to school DeWitt Wallace–Reader’s Digest Fund’s four- because they were constantly beat up for being Rafael Bruno year national initiative promoting student- gay or lesbian, and the kids who were caught centered professional development in reform- in police drug sweeps because they were the minded urban schools. EVC and other youth wrong color in the wrong place at the wrong media organizations worked alongside teachers time. Other programs explored cultural themes to facilitate student oral history and document- such as the hip-hop music scene that had swept “The D.C. Urban Debate League provided ary projects covering curricular subjects such the nation and the growing trend in advertising as immigration, reconstruction, and the civil to market urban youth culture back to teens. me with an outlet to express myself and ideas rights movement. Working on their documentaries at EVC vocally, stand up for what I believe in, and make Youth media programs empowered marginal- enabled many students to overcome their per- ized young people to investigate conditions sonal obstacles and show incredible resiliency. the right decisions about my future. Because in institutions that had long ignored their experi- One bright but angry student, working on a ences—homeless shelters, foster care, juvenile documentary about how youth cope with of my involvement with the Urban Debate League, I had the chance to study and debate at some of the most prestigious universities in achievement in education reform was the improve participating students’ academic creation of The After-School Corporation scores, attendance, and graduation rates. the United States.” (TASC), which has helped transform the quality Since 1998, programs supported by and availability of after-school programming TASC have reached more than 200,000 kids in less than eight years. Millions of school- in New York City, with public funding for these Laura John-Toussaint age children with both parents or their only programs increasing from $60 million to $150 parent in the workplace are left on their own million. TASC’s training program is the largest when the regular school day ends. TASC has and most comprehensive training program for helped expand after-school programs for after-school staff in the country. Additionally, these latchkey children, giving them a more TASC played a leading role in the formation Rafael Bruno was a debater at New York City’s secure and enriching environment and their of Mayor Bloomberg’s Out-of-School Time Franklin K. Lane High School. parents the assurance that their children (OST) initiative; the New York State After- are safe, supervised, and engaged. Offering school Network; and the Afterschool Alliance, Laura John-Toussaint is an Urban Debate activities from homework help to sports to a national movement that is spearheading League alumna and sophomore and debater community service, after-school programs the call for universal after-school by 2010. at the University of Oklahoma.

26 1. Amplifying Young People’s Voices Steven Goodman

abusive relationships, felt safe enough to talk the San Francisco Bay Area, The Beat Within diversify perspectives on stories. Youth Radio documentary currently in production about for the first time about her own experience being published articles by incarcerated youth and programs can be heard on NPR and CBS. Youth Katrina evacuees evicted from their hotels in molested. “I was six when it happened,” she said. Youth Radio reporters used emails from a write columns for the San Francisco Chronicle. New York City will be used natioally by the NYC “It destroyed my sense that I could trust anyone. girl living in Kosovo to produce an intimate Youth documentaries are winning awards in Solidarity Committee for Katrina/Rita Evacuees. As we delved into the process of storyboarding, war-time radio diary for the world to hear. the Sundance, Human Rights Watch, and the In similar fashion, urban debate programs shooting scenes, and interviewing, I felt my Similarly, the Urban Debate Program gave Tribeca film festivals. The recently established have transformed young people’s lives. Over the own past experiences shaping what I brought to students a platform to look critically at issues channels Current TV and Uth TV both present past nine years, more than 31,000 urban youth the project. I was surprised how quickly EVC of great social and national importance. Urban television and broadband content by and for have become competitive academic debaters became a place where I could be open. The debaters learned to think critically, form youth. The Media That Matters Film Festival through their participation in one of the 17 urban community of friends and caring adults I found logical arguments, and engage in debates on streams youth media award winners online. debate leagues that exist in major American at EVC is still with me.” She has since gradu- critical public policy issues—renewable energy, EVC’s All That I Can Be footage on military cities. A University of Missouri study of five of ated high school and now leads peer counseling oceans policy, privacy rights, United Nations recruitment can be seen in the internationally these debate leagues found that debaters, after groups for other victims of sexual abuse. peacekeeping operations, and weapons of mass acclaimed documentary Why We Fight. And one year of participation, had improved their The programs also prepared a new and diverse destruction. In addition to learning about these now iPods, cell phones, YouTube, and Google attendance, decreased at-risk behavior, and generation of writers, reporters, camera opera- issues, high school students in the Urban Debate Video on the Internet are leading to an explosion increased their literacy scores by 25 percent tors, audio technicians, editors, producers, and Program learned analytical skills that opened of potential sites for youth media exhibition. over nondebaters. Urban debaters have higher artists for college and the media field. I remember pathways to college and its debate teams. What is so powerful about youth media is its grades and higher graduation rates, and they a student who had been transferred in and out of transformative capacity. Young people change are four times more likely than nondebaters eight different public schools in the Bronx by the Today: Social Change and and grow as they closely examine the conditions to go to college. time he came to EVC. When he had the chance Personal Transformation of their daily lives and meet youth and adult to make a documentary exploring the inequities The major social problems urban kids are organizers working to change those conditions. Tomorrow: Awakening America in the New York City school system, he jumped struggling with now have not changed all that As one EVC graduate recalled, “I was a high Sometimes when change seems elusive and at the opportunity and he never missed a day much since OSI first began funding youth media school dropout. When I was 16, I didn’t times dark, I am reminded of the citizenship in the more than 10-month-long project. After and urban debate. Youth are still writing articles think I’d make it to 18. I didn’t think I’d be schools that helped pave the way for the civil his tape was broadcast nationally on PBS, he and creating video and radio reports about alive. I ran away. My mother put me in a group rights movement by teaching black adults in the went on to college and a career in television. discrimination against new and undocumented home upstate. When I returned, I came to EVC. South how to read and pass the literacy tests for “Working on the Unequal Education docu- immigrants, police violence, birth control and The teachers trusted me, they listened to me. voting. Like those schools, youth media centers mentary changed my life,” he said. “It made AIDS, homelessness, foster care, and domestic No one had really listened to me before.” For and urban debate leagues are teaching literacy me see how unequal and totally unfair my own violence. New topics to the story roster include a documentary on the juvenile justice system, and citizenship. They are empowering kids to experience in New York City schools really anxiety about testing pressure in schools, lack he interviewed kids in detention who were a lot read, write, and speak with force and eloquence. was and also how video could be used to open of faith in the government in the wake of Hurri- like him, but he also interviewed social workers, And if we listen, I believe this generation of up other people’s eyes to those inequalities.” cane Katrina, and, of course, fear of terrorism judges, and lawyers working to create alter- young voices can challenge, provoke, and inspire Compelling stories were produced by youth and war. Urban debaters are now studying a natives for the kids. The experience opened his a fresh, open dialogue vibrant and loud enough media organizations across the country. Youth range of civil liberties policy issues related eyes to a world bigger than his own. He went to to wake the sleeping conscience of the nation. producers from the Appalachian Media Institute to the government’s war on terror from NSA college, graduated at the top of the class, and got documented the growing addiction to painkillers wiretapping to clandestine detention centers a job as a peer trainer teaching video to teenagers. in rural Kentucky. Youth trained by Radio Arte in to the Patriot Act to procedures for asylum. Not only is the process transformative for Chicago broadcast bilingual stories about their What is really new, however, is that people the youth, but their products can lead to change lives in the largest Mexican community in the are now listening to what the young have to say. in the community at large. For example, activists Midwest. Youth in New York City wrote about Youth-generated media is reaching millions working in school reform, prison reform, and life in foster care for the magazine Represent of adult listeners, viewers, and readers as human rights all still use EVC’s documentaries and refugees created videos at the Global Action media organizations court young reporters and on the International Criminal Court, the juvenile Project about their struggles for survival. In commentators to expand their audiences and justice system, and race and school equity. EVC’s

28 29 2. The Way it Was Changing In 1994, I was seriously considering leaving the practice of medicine. I had the Way We Die been a faculty member in a department Diane E. Meier of geriatrics at a major New York City academic medical center for over 10 years. Diane E. Meier is director of the Center to Advance Palliative Care and professor of geriatrics and internal medicine at the Despite objective measures of academic Mount Sinai School of Medicine. success (grants, publications, promotion), I was frustrated and unhappy with the realities of medical practice and its all- consuming focus on medical technology and the maximal possible prolongation of the dying process. I vividly recall participating in a code—an attempt to resuscitate a man of about 90 who

Ripples of Influence The Faculty Scholars Program, in which Diane Meier participated, was the centerpiece of OSI’s efforts to improve end-of-life care and transform the culture of dying in the United States. Over the nine years of its existence, the Project on Death in America supported 87 faculty scholars as well as dozens of leaders in social work and nursing.

31 2. Voices

had died of congestive heart failure. The room doing exactly what we had been taught. When crowded with interns and residents and a few a code was called, you erred on the side of life, After I’m Gone attending physicians. The patient’s wife stood attempted resuscitation, and asked questions anxiously outside while we performed vigorous later. The patient’s primary attending had not chest compressions, repeatedly shocked the chest discussed with the family the possibility of “I definitely think about after I’m gone. When with defibrillators, and administered epinephrine allowing a natural death and avoiding cardio- and other potent stimulators. This went on for pulmonary resuscitation. I knew this doctor— I was younger, I used to try and plan my funeral, 30 minutes with no restoration of heartbeat and an excellent and caring physician—but no blood pressure. When the code was “called” by one had taught him how to approach these where I’d want it, how many people I’d want the senior resident, everyone shuffled, downcast, difficult conversations, and not knowing how, to be there, what it would be like. I’ve always out of the room and went back to their waiting it seemed appropriate not to try. The violence work. The patient lay naked on the bed, covered of his patient’s death was the consequence. been scared that people would forget about me. with blood and tubes, with paper wrappings, I could see all that, but I could not see a ECG strips, machines, IV bottles and tubes, way to change it. On the surface, it was easier Eight years go by and, you know, someone who and the crash cart littering his room. None of to go along with the old routines, but my inner us made eye contact with the patient’s wife as distress and sense of helplessness about what dies isn’t the first person you think of when you we passed by. No one stopped to speak to her was happening to the practice of medicine and wake up. But I’ll find a way so that people won’t because none of the doctors involved in the to doctors and their patients made it difficult to code knew this patient or his family. Finally the get out of bed in the morning and go to work. forget about me. You know, I’ll give friends patient’s wife asked the nurse who was trying to This story illustrates the usual care in U.S. clean up the room what had happened. “Oh,” she hospitals in the mid-1990s. The technology things of mine that they’ll always have.” said, flustered, “he died. Didn’t they tell you?” imperative and the growing number of older At the time I accepted this method of hospital and chronically ill persons led to widespread care for the seriously ill and dying because I did and often reflexive application of every possible Laura Rothenberg not know any other way. As doctors we were technology to every identifiable medical

The faculty scholars, representing disciplines developed a web-based resource center from general medicine to geriatrics to psychia- for palliative medicine curricular resources try to medical ethics, continue to lead efforts to catalyze effective teaching across to improve textbooks on end-of-life care, give the country. support for grieving family members, and Susan Block and Andy Billings have estab- provide palliative care for young people, lished the leading mid-career palliative care African Americans, Native Americans, and education program in the nation, training over people in jails and prisons. 300 physicians and nurses over the last four PDIA Faculty Scholars Charles von Gunten, years. Tony Back, Bob Arnold, and James Tulsky Frank Ferris, Kathleen Puntillo, Marianne have developed a unique National Cancer Laura Rothenberg, who died of cystic fibrosis Matzo, Deb Sherman, and their colleagues Institute–funded communications skills training at the age of 21, recorded her thoughts about have provided basic training in palliative care program for oncologists in training and have living and dying in “My So-Called Lungs” to over 18,000 physicians and nurses. In addi- conducted groundbreaking research on improv- as part of the Radio Diaries series on National tion to providing training to 394 of the nation’s ing doctor-patient communication. J. Randall Public Radio. OSI supported the series medicine residency programs, David Weissman Curtis and Judith Nelson are among the produced by Joe Richman.

32 2. Changing the Way We Die Diane E. Meier

problem, regardless of the likelihood of mean- with them and, by 1997, were confident enough three hours, but then the pain began to escalate. Robert Wood Johnson Foundation asked me ingful recovery to an acceptable quality of life. to begin a palliative care consultation service. With increasing urgency and panic, she would and Christine K. Cassel, who was then my Distress with this situation resulted in surprising Expecting 50 patients our first year, we were ring the call bell, then yell for help, then scream chairperson in the Department of Geriatrics, public support for Jack Kevorkian’s methods of quickly overwhelmed by referrals and hit the 250 with pain. The nurses would tell her she had to to establish a center for providing technical gaining control over the timing and circumstances mark instead. Every patient connected us to a wait until the six hours were up. The house staff assistance to other hospitals seeking to build of death, passage of Oregon’s Death with Dignity whole team of health care professionals ready to could not understand why the dose was insuf- their own palliative care programs. The Center Act legalizing physician-assisted suicide, and a learn another way of approaching medical care ficient for the pain. Her parents were worried she to Advance Palliative Care, begun in 1999, flurry of efforts to restore patient control through for the seriously ill. This experience allowed me would become a drug addict, like one of their has contributed to an 80 percent growth in the the use of advance directives and living wills. to stay in the profession of medicine by giving other children. Everyone seemed to blame K., number of programs over the last three years. me a method and a platform to contribute to the patient, for having more pain than she should, My experience as a PDIA Faculty Scholar has A New Career Path needed change. Now there was a career path that less tolerance for it than she should, for failing been far from unique. PDIA’s creation of a new The medical profession, seeking a way to deal reflected my beliefs about what constitutes good to respond properly to the treatment. No one career path through recognition and monetary with the disconnect between its services and medical care for seriously ill and dying patients. seemed to know that the duration of action of the support for these national leaders unleashed patients’ wishes, developed the new field of Early in our palliative care service (1997– prescribed analgesic was only three hours, not enormous creative energy and resulted in the palliative care, which OSI’s Project on Death 1999) we were known as the “death” service, and six. Once the prescription was changed to every rapid establishment of a new field of medical in America (PDIA) then championed into a indeed most of our patients were within hours three hours, the problem was solved. K. became, practice. With rare exceptions, the current major transformative medical specialty. or days of death. One day, however, the medical once again, the sweet and funny person she leaders in the field of palliative medicine are That same year, 1994, at the encouragement house staff called me for help with a 24-year-old remained throughout the course of her one-year PDIA Faculty Scholars. The competition for of Robert Butler, my department chair at the woman with newly diagnosed acute leukemia, battle with her disease. She later said that the scholarships helped legitimize the field and gave Mount Sinai School of Medicine and a PDIA whom they described as a “manipulative drug- worst part of her entire experience with leukemia the scholars time away from their day jobs to board member, I and three colleagues applied seeking patient.” K., a beautiful young woman was that no one believed she was in pain. focus on building new clinical, teaching, and and received a PDIA Faculty Scholars award with severe bone pain, was undergoing induction K.’s case, and its successful resolution, was research programs. Despite the early professional for a faculty education series on palliative care. chemotherapy with every hope of cure for her the beginning of our reputation as a service to loneliness of work in palliative medicine at our Knowing just slightly more than our colleagues leukemia. Her pain medicine was ordered for call for difficult pain and symptom manage- respective institutions, the annual retreats remind- about palliative medicine, we learned along every six hours. She reported adequate relief for ment, even for patients who were not dying, ed us that we were not alone in this commitment, patients for whom the expectation and hope and that our peers were remarkable people whom was cure or significant life prolongation. we could be proud to be numbered among. In concert with the Robert Wood Johnson leaders of a nationwide effort to improve the (grief and bereavement), Lewis Cohen Transformation of Health Care Foundation’s support for the development of quality and availability of palliative care in (palliative care in end stage renal disease), The recognition that palliative care was appropri- educational content for the field, the PDIA the intensive care unit, where over 25 percent and William Breitbart and Harvey Chochinov ate for anyone with complex or serious illness, Faculty Scholars Program and its investment of Americans die. (psychiatric aspects of palliative care), independent of their prognosis and based instead in a generation of effective leaders can rightly Deb Sherman created an advanced practice among many others. on need, marked a major departure from the be credited as a primary building block for the nursing palliative care training program, one Kathleen Foley, who directed PDIA and is hospice approach to palliative care, which field. Today, more than 1,200 hospitals report a of only two in the nation, at NYU. Sean Morrison an expert on pain management, sums up the required both a prognosis of six months or palliative care program, and programs exist in is leading a newly established Kornfeld program this way: “Each PDIA faculty scholar less to live and a willingness on the part of the more than 50 percent of U.S. teaching hospitals, Foundation–funded National Palliative Care creates a ripple of influence within his or her patient to forgo further curative or life-prolong- which are the critical clinical platform for train- Research Center. Urgently needed research institution and profession and each will affect ing treatments. This new definition has the ing the next generation of physicians and nurses. on fundamental aspects of palliative care many other people in the course of his or potential to transform the health care system, As a recipient of support, I can report that practice and services has been conducted her career.” allowing people at all stages of chronic illness, PDIA’s investment was well spent. Where before by Susan Miller (nursing home patients and to receive genuinely patient-centered care. there was no specialty, now palliative care has access to palliative care), Joanne Wolfe Recognizing the importance of our hospi- the approval of the American Board of Medical (pediatric palliative care), Holly Prigerson tal palliative care consultation service, the Specialties, with its associated legitimacy and

34 35 2.

dollar support for physician training. Where before doctors and nurses received no training in palliative care, now education in pain and symptom management, communication skills, and systems-based practice is mandatory. Where before most hospitals had never even heard of palliative care, now the majority of teaching hospitals and hospitals with over 100 beds report a program. Where before there were only a handful of fellowship-training programs in palliative medicine, now there are over 60 programs. Where before palliative care received no National Institutes of Health grants, now proposals for palliative care research are receiv- ing hundreds of awards: over 443 grants totaling $128 million dollars between 2001 and 2005. Strategic private sector investment from OSI and other funders has made all the difference. In the 11 years since I became a PDIA Faculty Scholar, my career and my life have been transformed. I am now a full-time pallia- tive medicine specialist, and I can honestly say that I love my job and look forward to going to work every morning. This work is the reason I became a doctor. I have been privileged to observe and to participate in powerful and positive change in the health care system and in the way that our patients, our fami- lies—and, soon enough, ourselves—experi- ence illness and the health care it requires.

36 Culture of Death in America

Our social and cultural environments shape how we experience loss. The images in this portfolio depict personal responses to dying, traditional rituals of mourning, and modern observances that have emerged to cope with premature deaths

Bastienne Schmidt

Schmidt and Cheng received an arts and humanities grant from the Project on Death in America to explore and document the evolving culture of death in America. Their work was featured in the first Moving Walls, OSI’s documentary photography exhibition. Philippe Cheng Bastienne Schmidt Philippe Cheng Bastienne Schmidt Philippe Cheng Bastienne Schmidt 3. Changes in the Profession Opening When my father began his law career in Minneapolis in the late 1920s, he Doors to Justice joined a profession that was still very Peter Edelman much a craft. By the time he retired in the mid-1980s, he was fortunate enough Peter Edelman is professor of law at the Georgetown University Law Center. to have remained in a relatively small firm representing clients who sought his personal help. But the practice of law had changed around him. By the second half of the 1990s, the law, especially in large firms, had become more like the business of investment banking. Law- yers were free agents moving from firm to firm for sweeter and sweeter deals.

Leading the Way In addition to support to the Equal Justice Fellowships, OSI awards its own fellowships in various areas of justice work. Some 200 lawyers, community activists, academics, photo- graphers journalists, and filmmakers have received Soros Justice Fellowships over the past decade. The fellowship program focuses on OSI’s criminal justice grantmaking priorities.

47 3. Opening Doors to Justice Peter Edelman

Partner compensation was increasingly a moving target, and evaluation is imprecise. seeing the program from multiple vantage points: mentary grants to other national organizations based on how many clients one had brought in. The world does not offer a parallel universe as as a professor who recommends students for and connected state programs, and supported an Too many law firms paid token homage at best to a control group. Even when there is success, fellowships and as a board member and partici- important PBS documentary film. The Justice at fulfilling a responsibility to improve access and it is generally the work of multiple grantees, pant-observer in the public interest field who Stake Campaign supplied the leadership and the fairness in the administration of justice. Contrib- and other forces that have come into play. sees the great contributions these talented young glue to bring all of the interested national and uting significantly to support full-time lawyers So how are we to judge OSI’s work? lawyers make as fellows and as they continue state groups together into a coordinated whole. for the poor and civil society causes was viewed Certainly the legal profession is not in observ- their careers. Nina Dastur is one fellow I know Justice at Stake built relationships with as a drain on the profession’s bottom line, and, ably better ethical condition or otherwise more well, because she was my colleague in running OSI grantees in a number of areas: with the in too many places, judging was becoming attractive qualitatively than it was 10 years a legislation clinic at Georgetown University. American Bar Association (ABA) on sentenc- more and more politicized. ago. Judicial politics have not been radi- She is now doing pathbreaking work with the ing reform; with gay and lesbian rights groups OSI’s Program on Law and Society took the cally revamped. Low-income people’s access Center for Community Change, connecting on responding to attacks on “activist judges” measure of the situation and came up with a to justice is not significantly improved. The the worlds of organizing and policy advocacy following rulings on marriage; and with the thoughtful program to address it. Reading over number of public interest lawyers, while prob- as she tries to help make D.C.’s housing trust American Constitution Society on federal the founding documents and the reports and plans ably somewhat larger, has not mushroomed. fund more responsive to low-income people. judicial nominations. Its reports showed how put forth along the way, the picture that emerges At a time when students are leaving law money and special interests were turning state is one of advice obtained from wise people, value OSI’s Contributions school with huge loan debts and public interest judicial elections into political free-for-alls and added by an excellent staff, grants made to sound And yet OSI has made a difference with one law organizations are struggling to survive, outlined how effective communications strate- organizations, and new initiatives stimulated by grand-slam move, a number of other remark- the EJW Fellowships are a major force, well gies could protect a fair and impartial judiciary. OSI where there was no appropriate entity in able achievements, and a long list of thoughtful beyond the dollars invested, in refreshing OSI has made many grants that promote place to do the work in question. OSI became grants for important work that continues on. and continuously revitalizing the field. access to justice, but there are some that strike an important convener and leader in the field. The grand slam is the vast expansion of the The Justice at Stake Campaign, another me particularly: It is always difficult to assess the contribu- Equal Justice Works (EJW) Fellowships. In worthy program, has raised awareness of the fact tion of one funder, even one as significant my experience it is rare that a foundation can that state supreme court seats are just as much for •The promotion of increased pro bono activity as OSI, to outcomes of initiatives directed at say, about something that is so significant, “We sale as seats in Congress. As part of its larger judi- by law firms and corporate counsel, especially major problems in society. The work tracks made that possible.” I have the good fortune of cial independence initiative, OSI made comple- through the work of the Pro Bono Institute

These include the death penalty, indigent Christa Gannon, one of the earliest Soros to be disrespected either and, if they were, African Americans, were arrested on defense, the challenges facing people returning Justice Fellows, ran a program called Fresh they had the power to do something about it. drug charges on the word of a white under- home from prison, sentencing reform, and alter- Lifelines for Youth in San Jose, California. The next time the boy was stopped by cover officer. At trial, 38 were convicted natives to incarceration. The program has also The program, sponsored by the county public police officers he got it right. “I did exactly despite the lack of any physical evidence. supported projects relating to the detention of defender’s office, offered an alternative how we practiced,” he said. “I stayed calm, Working with the NAACP’s Legal Defense immigrants, drug policy, and juvenile justice. to incarcerating youthful offenders. Gannon I was respectful, I didn’t lie—and they didn’t and Educational Fund, Gupta helped One fellow, Heather Barr, worked with taught the teenagers about rights and arrest me.” correct this miscarriage of justice and the Urban Justice Center in New York City responsibilities and managing conflict. More recently, another justice fellow, Vanita obtain pardons for those convicted. to raise public awareness of the increasing One teenage boy arrived in the program Gupta, helped score a larger victory that “Tulia is the tip of the iceberg,” Gupta number of mentally ill people housed in city saying, “If a cop gives me attitude, I’m going changed the lives of dozens of people and said. “Everything that allowed Tulia to jails and prisons. She won a court ruling to give it right back. That’s what you do on contributed to the debate on racism in the develop, all those symptoms are present ordering the city to provide discharge plan- the streets.” Gannon assigned him to play the criminal justice system. in the death penalty, drug policy, and the ning for the 25,000 people with mental illness police officer in role-playing exercises. Before In Tulia, a small town in the Texas criminal justice system across the board.” who are released annually from city jails. long the boy realized that cops didn’t like Panhandle, 46 men and women, mostly

48 49 3. Voices

and the Association of Corporate Counsel, and justice” to the underlying problems of low- the creation of Pro Bono Net, an invaluable tool income people, immigrants, and people of color. Deserving Justice for expanding pro bono work and using the Internet to communicate issues, opportunities, — The Law School Consortium Project, which and techniques to advance quality services for started slowly but with time has acquired “Low-income people deserve justice—safe, low-income people. momentum, continues to promote innovative uses of law school resources to encourage new lawyers clean affordable housing, quality education for — The focus on the most underserved regions to establish or join small community-based firms of the country, the South and the Plains states, serving low- and moderate-income people. their children, clean air and water—instead of through support for new offices of the Apple- a disproportionate share of pollution, health seed Foundation, committed to organizing — OSI also helped get the newly formed the bar to address systemic problems of the American Constitution Society and the Equal problems and costs, unemployment, and public poor, and an initiative by the Project for the Justice Society up and running to promote a Future of Equal Justice (the Futures Project) progressive perspective on law school campuses benefits. Low-income communities know what in the South where legal service and public concerning legal and constitutional issues. interest lawyers are particularly scarce. they need and, with resources and support, they Lessons Learned can craft the solutions to address the systemic — Equal Justice Works’ promotion of public Somewhat less successful was Law and Society’s interest careers and activities among hundreds of grantmaking aimed at promoting higher ethical problems that directly affect them. law students each year, and the group’s organiza- and professional standards among lawyers. OSI tion and administration of the Legal Services funded the ABA, for example, to ensure high Corporation of the federal Americorps program, standards of conduct by lawyers and judges “With access to quality legal services, communi- adding more lawyers, paralegals, and others and to enhance the profession’s role in serving to serve isolated, underserved people. and protecting the public interest. In fairness, ties can develop the assets, infrastructure, and OSI staff said from the beginning that such networks to ensure safe and healthy neighbor- — The judicial challenge, by the Brennan grants were a long shot, and that a long-term Center for Justice and the American Civil investment would be required for there to be a hoods—and low-income clients can protect Liberties Union, to some of the stultify- fair chance of success. With limited resources ing congressionally imposed restrictions on and pressing needs in the legal services and themselves against exploitation and rebuild their critical services previously provided by legal judicial independence areas, however, the effort services attorneys funded by the federally had to be cut short. In retrospect, it is reason- lives to provide a strong foundation for their chartered Legal Services Corporation. able to conclude that this task—essentially to change the very culture and values of the legal children’s futures.” — Superbly timed support to the Futures profession—was qualitatively beyond what Project and Pro Bono Net for the development of financial resources or other initiatives emanat- technological approaches to expand the scope of ing from outside the profession could achieve. Camille Holmes legal services, reach more people, and provide I make these comments (with the benefit of isolated communities with access, as well as hindsight, of course) to underscore the need support to the Advancement Project, the Asian for grantmakers to measure as best they can the American Justice Center, and the Futures Project magnitude of the task of institutional change they Camille Holmes is director of training for the development of systemic approaches have undertaken (and that is what the profes- and community education at the National of “community lawyering” and “community sionalism strategies were—strategies to change Legal Aid and Defender Association.

50 3. Opening Doors to Justice Peter Edelman

the behavior of large sets of institutions), and A national organization could complement state funding, is now close to the level (taking compare it to the funding they are going to invest the work of the American Bar Association, the inflation into account) of 1980. Although state toward achieving the desired changes. In retro- National Legal Aid and Defender Association, and other nonfederal sources are playing an spect, the strategic analysis that underlay the legal and the Center for Law and Social Policy. increasingly important role in supporting the profession reform grants may have been flawed. delivery of critical legal services, the field is still Support for career services offices. This grossly underfunded. A recent Legal Services Suggestions for the Future support would assist career services offices Corporation report confirms that at least 80 I would suggest four areas for possible in larger law schools to help students seek percent of the civil legal needs of poor people exploration by OSI and other funders: jobs in small and medium-sized firms and the are not being met. OSI, as a leader these past handful of private firms that do public inter- 10 years in the area of access to justice, is well Loan repayment assistance. The mountain of est work, such as employment discrimination situated to respond to this continuing challenge. debt that students take with them as they graduate litigation, for profit. I note at Georgetown a from law school is a barrier to selection of public disproportionate emphasis on recruitment by interest law as a career. The best answer would large firms. Many of our students are not inter- be federal legislation providing for forgiveness ested in these firms, but have no understanding of at least federal loans. However, I think a major of how to navigate their way to smaller firms foundation matching initiative could help law that have openings but no time or resources to schools raise funds from alumni, law firms, and conduct on-campus recruiting. A three-year others specifically targeted to loan forgiveness. grant to support the creation of career services offices would result in such positions being Civil Gideon. There is a growing move—not continued after the foundation support runs out. quite a movement yet—to push for a guarantee of counsel on the civil side for people who A Time for Progress cannot afford to retain a lawyer. Care needs to There is in fact a slight renaissance of interest be taken in the design of such a right, to apply in access to justice for lower-income people. it to situations where counsel is otherwise We are still headed in the wrong direction unavailable and perhaps to categories of cases regarding judicial independence, although that where there is widespread agreement on the will change nationally when and if the political importance of representation. OSI has funded winds change, and of course it varies state by the Maryland Public Justice Center in its efforts state. Nor am I sanguine about the direction the toward a civil Gideon in that state, but more profession is taking, speaking very generally. foundation support to pursue this broader But the situation for lower-income people feels guarantee of counsel should be considered. a bit better. This shows up not only in the 20 access to justice commissions that have been A national organization of state access to created mainly by the initiative of the Access to justice commissions. Its mission would be to Justice Support Project and the leadership of state contribute to organizing more extensive advocacy chief justices, but in the recent increases in state for funding for the Legal Services Corporation funding for civil legal services for the poor. Some and other federal funding for legal services 43 states now provide funding, which totaled for lower-income people, and higher visibility $163 million last year, including a $24 million nationally for this set of issues. I chair the District increase. Total funding for legal services for the of Columbia Access to Justice Commission. poor, counting federal funds, IOLTA (Interest on Such commissions now exist in about 20 states. Lawyers’ Trust Accounts), local foundations, and

52 53 Juveniles Joseph Rodriguez

These children of the crack/cocaine era face tremendous obstacles growing up in a world with gangs and easy access to guns. And, they face a criminal justice system with a decreasing interest in offering second chances.

In 1999, Joseph Rodriguez received a Soros Justice Media Fellowship to document the lives of juvenile offenders. This work was featured in OSI’s documentary photography exhibition Moving Walls 4.

4. Cutting Off Food Stamps A Nation of In the United States of America, 1996 was a bad year for immigrants. Immigrants, In April, Congress passed the Anti- terrorism and Effective Death Penalty Unfinished Act. In September, the Illegal Immigration Bill Ong Hing Reform and Immigrant Responsibility Act was enacted. These laws expanded Bill Ong Hing is professor of law and Asian American studies at the University of California, Davis. the list of aggravated felonies that barred convicted felons from discretionary deportation relief. The laws created new “special exclusion” proceedings and stricter requirements for asylum seek- ers, making it more difficult for certain aliens to win release from detention and

Civil Liberties after 9/11 Abuses of civil liberties in the United States soared following the terror attacks of September 11. The government enacted administrative and regulatory changes that facilitated the miscar- riage of justice and erosion of rights experienced largely by immigrant communities and members of Arab, Muslim, and South Asian communities.

63 4. Voices

gain judicial review of their cases. Moreover, recipients is minuscule.) Soros recalled relying the Illegal Immigration Reform Act bars upon government-subsidized health care for a job Feeding Off Outrage aliens who are unlawfully present in the injury he suffered while an émigré from Commu- United States for 6 to 12 months from reenter- nist Hungary in England after World War II and ing the country for three years, while those was appalled that, instead of offering immigrants “I believe that a little outrage can take you a long who are in the United States unlawfully for a helping hand, the new law would strangle them. more than a year are barred for 10 years. In response, Soros made a clear statement way. Anger has a way, though, of hollowing out It was the Personal Responsibility and Work in opposition to the anti-immigrant mood that Opportunity Reconciliation Act, signed into law was spreading through the houses of Congress. your insides. In my first job, if we helped 50 im- by President Bill Clinton on August 22, 1996, Through the Open Society Institute, Soros migrant families in a day, the faces of the five that did not sit well with George Soros, chair- donated a staggering $50 million to the cause man of the Open Society Institute. In its final of seeking equitable treatment for refugees and who didn’t qualify haunted my dreams at night. incarnation, this “welfare reform” law concerned immigrants. The new program, the Emma Laza- itself more with immigration policy reform and rus Fund—named in honor of the Jewish-Ameri- It’s like that every day. budget savings than with improving the country’s can poet whose verse is inscribed at the foot of welfare system. The reform meant that millions the Statue of Liberty—had two priorities: to assist of legal immigrants and refugees would be cut the naturalization process of those immigrants “I am deeply familiar with that hollow place that off from food stamps, Supplemental Security who were eligible and to support advocacy and Income, and other transitional programs despite educational efforts to show the unfairness of the outrage carves in your soul. I’ve fed off of it to the fact that welfare use by immigrants and refu- welfare reform toward immigrants and dampen sustain my work for many years. But it hasn’t gees is indeed transitional. (Immigrant families the law’s impact. are not disproportionate users of welfare benefits; Asked whether she was embarrassed by eaten me away completely, because it gets filled refugees have strong equitable claims to welfare; Soros’s action, then INS Commissioner Doris and the numbers of second-generation offspring Meissner answered: “Why should I find it with other, more powerful things like compas- of refugees and immigrants among welfare embarrassing? It’s a fabulous and noble thing sion, faith, family, music, the goodness of people around me—and a deep sense of gratitude that

To combat this antidemocratic trend, OSI the secret roundup and detention of immi- I have the privilege of doing my small part to made a series of grants for advocacy work, grants following the attacks. Another grantee, public education, and support to civil rights the Mexican American Legal Defense and make things better.” groups in three related areas: the impact Educational Fund, participated in a lawsuit of September 11 on immigration policy and challenging the citizenship requirement that immigrant communities, racial profiling and resulted in the firing of many legal permanent Cecilia Munoz other forms of discrimination directed at residents who worked as airport baggage people perceived to be Middle Eastern, and screeners. challenges to the civil liberties of all Ameri- Organizations like the National Immigration cans. OSI funded many immigrants’ rights Forum, the Arab Community Center for Eco- advocacy groups that had previously received nomic and Social Services, and the Asian funding from the Emma Lazarus Fund. American Justice Center (formerly the National Cecilia Munoz is vice president of the One grantee, the Center for National Asian Pacific American Legal Consortium) Office of Research, Advocacy, and Legislation Security Studies, was the lead plaintiff in a worked with a broad coalition of civil and immi- at the National Council of La Raza, a longtime federal case that successfully challenged grants’ rights advocates, faith-based groups, OSI grantee.

64 4. A Nation of Immigrants, Unfinished Bill Ong Hing

he has done. I’m distressed and sorry that the daunting to Emma Lazarus Fund grantees. areas; Filipinos, Samoans, Hmong, Viet- immigrants and refugees were assisted in their circumstances are such that there’s a need for In Northern California, naturalization namese, and other Southeast Asian peoples naturalization efforts, while millions more were such a step.” Frank Sharry, executive director of assistance included English as a Second in cities on the West Coast and in the resort again able to rely on a safety net of partially the National Immigration Forum in Washington, Language instruction, legal counseling for communities of Sun Valley and Jackson Hole. restored public benefits and food stamps. D.C., noted: “It sends a real signal of hope to problematic cases, case management, and Service providers funded through Emma immigrants who are feeling under siege. This may outreach to serve homebound and geographi- Lazarus grants offered direct services to thou- Targeting Noncitizens be the beginning of a turning point in the debate.” cally isolated individuals. In Florida, hundreds sands of naturalization applicants as well as A crackdown on noncitizens in the United Sharry’s remarks proved to be prophetic. By of homebound and institutionalized immigrants, outreach materials and presentations to millions. States after 9/11 was probably to be expected. the end of 1999, the Emma Lazarus Fund had particularly elderly and disabled people, were The vast majority of direct service cases involved After all, the 19 hijackers were foreigners distributed support to organizations that helped served through special outreach efforts, utiliz- applicants who were ready and eligible to apply. who had managed to enter the country under more than 500,000 immigrants negotiate the natu- ing home visits and visits to nursing homes and Many of the other applicants, however, were false pretenses. The United States government ralization process. Millions more received coun- other institutions. Grantees conducted client challenged by the naturalization process due implemented new procedures and reorganized seling and information that enabled them to apply intake at hundreds of community sites, includ- to English literacy problems, disabilities, old administrative institutions to ensure that all on their own. The combined efforts of Emma ing schools, homeless shelters, churches, health age, lack of transportation, lack of money for immigration visa processes and enforce- Lazarus grantees helped to win the restoration of clinics, community centers, and meal sites. filing fees, minor criminal problems, and other ment would be screened through the lens of Supplemental Security Income and food stamps One program in Boston served clients from issues. For example, Emma Lazarus funding national security. And, since the hijackers for the most-eligible immigrants in the United 77 different countries. Groups in Los Angeles helped persuade the INS to accommodate were Muslim extremists, the authorities in the States at the time the welfare reform law was worked with local INS officials to expand an hearing-impaired applicants, a stroke victim, United States resorted to profiling to target enacted. Individual states also responded by fill- outreach program that enabled applicants to have a blind applicant, and elderly individuals. Arabs, Muslims, and people from South Asia. ing some of the gaps created by welfare reform. their naturalization interview at a community Outreach efforts were necessary to raise The USA PATRIOT Act, enacted with near location rather than at INS offices. Emma Lazarus awareness about naturalization and public unanimous support and signed into law a mere Helping with Naturalization grantees served Latinos in Boise, Spokane, assistance rights. News of the inequities in the six weeks after 9/11, gave the government The challenges presented by the large numbers Yakima, Portland, Eugene, Corvallis, and welfare reform law had triggered panic in many expanded authority to search, monitor, and detain of clients and the bureaucracy of the Immi- Seattle; Japanese and Chinese senior citizens communities. The public information campaigns citizens and noncitizens as well as the wider gration and Naturalization Service were in the Seattle and Portland metropolitan of Emma Lazarus Fund grantees set the record authority to detain, deport, and file criminal straight for millions of immigrants and refugees. charges against noncitizens. Enforcement efforts Funds reached small and large immigrant have most heavily affected Arabs, Muslims, communities throughout the United States as and Sikhs who are not United States citizens. and unions on comprehensive immigration With OSI support, the New York State well as many new programs that otherwise would On November 25, 2002, as a part of the policies that are fair and equitable. Defenders Association’s Criminal Defense not have caught the attention of more central- biggest government reorganization in 50 years, The Immigrant Legal Resource Center Immigrant Project sued to curtail the ized funders. New donors were brought to the the INS was transferred from the Justice Depart- combated the treatment of civil immigration U.S. government’s practice of categorizing table. Philanthropists and local leaders took ment to the new Department of Homeland violations as criminal offenses and addressed relatively minor offenses as “aggravated the time to learn about the changing communi- Security (DHS), a cabinet-level entity that the harsh consequences of criminal convic- felonies” and citing them as grounds for ties in which they were living. Collaborations merged all or parts of 22 federal agencies and had tions. Heartland Alliance, Human Rights First, deporting noncitizens and permanently bar- emerged; small grassroots organizations were a combined budget of $40 billion and 170,000 and the Catholic Legal Immigration Network ring deported noncitizens from returning teamed with larger, more established programs. workers. INS functions were separated into two worked to ensure due process, access to to the United States. New networks of service providers, technical divisions: U.S. Citizenship and Immigration counsel, and humane conditions for immigrants assistance groups, and advocacy groups devel- Services (USCIS), which handles immigrant visa in detention and those facing deportation. oped. Service provider and technical assistance petitions, naturalization, and asylum and refugee The National Immigration Law Center, the expertise was sharpened and expanded. As a applications; and the Under Secretary for Border National Council of La Raza, and other grant- result, the capacity to serve immigrant communi- and Transportation Security, which includes ees fought proposals to use state and local ties was markedly enhanced. Immigrant rights the Bureau of Customs and Border Protection police to enforce federal immigration laws. advocates were energized. And thousands of along with Immigration and Customs Enforce

66 67 4.

ment units, for handling enforcement matters. Targeting noncitizens of certain ethnic, religious, or racial backgrounds is a national security strategy that does not make the United States any safer. In fact, this strategy narrows the opportunity to engage immigrant communities in the effort to assist law enforcement agencies in protecting the public. Because the 9/11 hijackers were foreign born, cracking down on nonciti- zens—especially those who looked like or were of the same religion as the hijackers—made sense to some. But no terrorists were apprehended using this approach. By falling for the temptation of profiling, we actually sacrificed the fundamen- tal values of openness and inclusion that we ought to have been guarding. We shamed ourselves and damaged America’s reputation in the world.

Confronting New Challenges The recent debates over immigration policies have not addressed the inequities brought about by the vestiges of the 1996 legislation and post- 9/11 clampdowns. In 2006, the battle is between the House enforcement-only approach (more border fences and enforcement funds) and the Senate comprehensive approach (more enforce- ment along with guest worker visas and a path to citizenship for the undocumented). Neither approach addresses post-9/11 ethnic profiling and deportation due process barriers erected in 1996. Nathan Glazer aptly called the United States the “permanently unfinished country.” It follows that immigration policy is permanently unfinished as well. OSI’s Emma Lazarus Fund helped lead the effort to combat anti-immigrant fervor in the late 1990s. Unfortunately, the events of 9/11 provided an impetus for attacks on immigrants once again, and those with a broader vision of America find themselves confronted with new challenges that require new answers to the old questions of xenophobia.

68 Day Laborers Jon Lowenstein

Day laborers in the new global economy are temporary workers who lack insurance, health benefits, and job security. On these pages are images of workers in Chicago: waiting at the airport for family to arrive from Mexico, paying for arrangements to get relatives to the United States, and waiting on a street corner for work.

Jon Lowenstein’s work was featured in OSI’s documentary photography exhibition Moving Walls 7.

5. The Prison Explosion Getting Tough Daunting challenges faced criminal justice reform efforts in the United on Criminal Justice States in the mid-1990s. More than two Marc Mauer decades of “get tough” sentencing policies and a raging “war on drugs” Marc Mauer is executive director of The Sentencing Project. had produced a prison population of previously unimagined dimensions and a political climate almost devoid of rational discourse on the subject of crime. The combined prison and jail population mushroomed to 1.6 million in 1995 from 330,000 in 1972, not because of increasing crime rates, but

War on Drug Policy The criminal justice system is not the only part of American society damaged by the war on drugs. Public health is another casualty. Until the recent rise of palliative care services, hospital patients with chronic and even terminal illnesses suffered great pain because doctors, either not knowing better or afraid of violating strict drug laws, often did not prescribe pain- killers in adequate amounts to be effective.

79 5. Getting Tough on Criminal Justice Marc Mauer

primarily because of public policies that substance abuse or mental illness illusory. states adopted some form of a “three-strikes” law, Shifts in drug policy. Despite the fact that nearly produced mandatory sentencing laws, In the early 1990s, an already punitive with California’s being the most far-reaching. half a million people are serving time or await- cutbacks in parole releases and increases in approach to crime policy became more severe, In that state, any felony, not just a violent or ing trial for a drug offense, the one-dimensional revocations, and other measures designed in part because of the political reaction to the serious offense, would qualify as a “third strike.” war on drugs of the 1980s has in many respects to send more people to prison and keep spike in juvenile homicides that resulted from The United States Supreme Court upheld become more varied. Support for treatment them there for longer periods of time. the emergence of crack cocaine. Crack wreaked California’s three-strikes law, failing to discern rather than incarceration is evidenced by the The launching of the war on drugs, havoc across many areas of the United States, any “cruel and unusual” punishment in the case hundreds of drug courts in operation today a Reagan administration initiative that received and particularly on low-income communities of of a man sentenced to 25 years to life for steal- and by public backing for drug policy reform bipartisan support and was broadly adopted color. But the policy response that emerged was ing golf clubs or the case of a man sentenced initiatives in states like California and Arizona. by state and local officials in the early 1980s, one born of hysteria and sensationalism, shaped to 50 years to life for stealing videotapes. State sentencing reforms. Over the past several exacerbated this trend. And the racial dynamics by lurid pictures of the drug trade that were little Thus, the mid-1990s was not an auspicious years, most states have enacted some type of of the drug war worsened the already uneven informed by rational analysis or consideration time to embark on a campaign of criminal sentencing or drug policy reform. These have racial structure of the prison population. of alternative approaches. One aspect of the justice reform. Political leaders thought being included repeals of mandatory sentencing provi- African Americans and Latinos, for example, reaction was the adoption of a host of disabilities “tough on crime” was a no-brainer, and an sions and introduction of reduced prison terms constituted three-fourths of people serving imposed on people convicted of drug offenses, increasingly conservative political climate for low-level drug offenders. Consequently, the drug terms in prison, a portion far out of line and only drug offenses, including restrictions pervaded both media and popular discourse. double-digit annual prison population increases with the percentage of African-American and on access to welfare benefits, student loans, common in the early years of the drug war have Latino drug users in the overall population. and residency in public housing that applied Signs of Progressive Reform diminished, and seven states (Delaware, Illinois, The combined impact of higher inmate even after completion of a felony sentence. As we look back on developments a decade Massachusetts, Maryland, New Jersey, New York, populations, escalating costs, and a shifting The political frenzy reached a peak in 1994 later, though, criminal justice policies and and Ohio) even experienced modest reductions political climate led to significant cutbacks in with the adoption of a massive $30.2 billion the political environment in which they are in their prison populations from 1999 to 2004. already limited prison programming budgets, federal crime bill, and another $8 billion in formed have in many ways actually moved making opportunities to gain vocational skills, funding for constructing new prisons and in a direction of progressive reform. This Declining support for the death penalty. an education, or treatment for coping with expanded death penalty provisions. Half the can be discerned in a number of areas: After the annual number of executions peaked

The war on drugs also drives illegal drug use reduce drug traffic and use while increasing efforts to change drug policies and sentenc- risk that injection drug users will contract underground and hinders public health efforts drug-related crime, disease, and suffering. ing schemes (including the adoption of and spread diseases such as HIV/AIDS that would reduce the individual and social Through conferences and panels, publica- alternatives to prison for low-level drug and hepatitis, and in advocating for harms associated with drug use, including the tions, and media outreach, The Lindesmith offenders) as central to the reform of the broader access to methadone treatment spread of HIV/AIDS through practices such as Center helped break the taboo on discussing criminal justice and incarceration systems. for people who are dependent on heroin. the sharing of contaminated needles. The situ- the subject of drugs and debating the U.S. The ACLU Foundation received funding to OSI also supported the Tides ation is the same and worse in other parts of government’s approach to controlling drug use. challenge drug testing and other abuses of Foundation’s Fund for Drug Policy Reform, the world where countries, following America’s The Lindesmith Center also helped estab- civil rights growing out of the drug war. a funders’ collaborative that oversaw many lead, treat drug use as a law enforcement lish OSI’s Harm Reduction Development The Lindesmith Center eventually spun off of the grants formerly awarded directly by OSI. problem, rather than a public health issue. Program (IHRD) in Central and Eastern Europe. and merged with the Drug Policy Foundation One grantee of the Fund for Drug Policy The Lindesmith Center, one of OSI’s first IHRD, which now operates worldwide, gained to become the Drug Policy Alliance, a research, Reform was Students for Sensible Drug programs in the United States, promoted a reputation for working to curb the spread of advocacy, and policy organization. The Drug Policy, a campus-based organization active harm reduction initiatives such as needle HIV/AIDS and other infectious diseases among Policy Alliance has played a leading role in in mounting public education campaigns exchanges and methadone substitution as drug users by supporting health services and promoting medical marijuana programs in targeted at students and other young people. an effective response to drugs in contrast promoting human rights and policy reform. several states, in developing needle to the war on drugs, which has failed to OSI’s U.S. justice programs supported exchange programs to minimize the

80 81 5.

at 98 in 1999, both public support for the death the reasons for this decline, the decline means penalty and the actual number of death sentences that the issue of crime has become less politicized Flawed Representation imposed and carried out have declined sharply. and emotional. Second, the budget crises many Much of this decline is the result of advocacy states are facing have led to a questioning of work by death penalty litigators and by aggres- the overreliance on incarceration and a search “The large number of incarcerated people and sive journalism, which has repeatedly exposed for alternatives to costly incarceration policies. the system’s flaws that make error not only a Finally, the post-9/11 climate, one where fighting criminal prosecutions threatening long-term possibility, but a frequent occurrence. These international terrorism has assumed center stage, activities also contributed to historic Supreme has shifted the locus of fear, and political atten- confinement or death has overwhelmed the Court decisions banning the death penalty for tion, from street crime to international terrorism. resources of many state criminal justice systems. juveniles and mentally retarded persons. Critical OSI Support Reentry issues gain support. While a focus on Underfunded indigent defense has predictably The Open Society Institute’s support often has issues of reentry from prison is now common- been critical to the development of criminal caused flawed representation in many cases with place in all areas of the country, 10 years ago the justice and drug policy reform efforts. In the concept had not even been formulated. Inspired area of community reentry after prison, for corresponding doubts about the reliability and by the work of Jeremy Travis, the director example, OSI grantees have been key in produc- of the National Institute of Justice in the late fairness of the verdict and sentence. Even in ing research, innovating ideas, developing pilot 1990s, reentry has united progressive reformers, programs, and evaluating successes. The Council evangelical Christians, corrections officials, and capital cases, indigent accused have been rep- of State Governments, JFA Institute, and other formerly incarcerated persons. Its basic premise OSI grantees engaged in public education and resented by sleeping attorneys, drunk attorneys, is that if the people of the United States are legal advocacy with policymakers and commu- serious about reducing crime, they must ensure nity groups in Connecticut and other states on attorneys almost completely unfamiliar with trial that prisons provide appropriate rehabilitative probation and parole reforms that have reduced services and that communities be ready to engage advocacy, criminal defense generally, or the the state’s prison population. This “justice returning members with a network of transi- reinvestment” strategy generates cost savings that tional services and stronger civil institutions. death penalty law and procedure in particular. can be used to strengthen community corrections Prison conditions once more under scrutiny. and other civil institutions in predominantly After conducting a year-long analysis of safety poor communities of color with large numbers “I have a vision that our criminal justice system and abuse in America’s prisons, a high-profile of residents moving in and out of prison. commission convened by the Vera Institute OSI’s fellowship programs have created a ought to do better. A system that treats you better of Justice called for renewed vigilance in body of scholarship and a cadre of activists addressing problems of violence and neglect. that are helping to shape public thinking in a if you’re rich and guilty than if you’re poor and The commission’s emphasis on the need for variety of program areas. James Liebman, a law innocent doesn’t meet the requirements of a oversight and accountability included key roles professor at Columbia University, has made a for corrections professionals, nongovernmental significant contribution to the public reexamina- society committed to equal justice.” organizations, citizen’s groups, and media. tion of capital punishment with groundbreaking work on error and reversals in the application How, then, did the climate change during the of the death penalty. Kerry Cook, wrongfully Bryan Stevenson past decade? On a broad scale, several trends convicted and subsequently released from death created an opportunity for reform. First, crime row after 20 years, wrote about the experience in Bryan Stevenson is executive director of the Equal Justice rates have generally been declining since the a book to be published in early 2007. Margaret Initiative of Alabama, which has succeeded in overturning early 1990s; while there is still much debate about Love produced a web-based legal resource a number of capital murder cases.

82 5. Getting Tough on Criminal Justice Marc Mauer

detailing mechanisms by which persons with ties of color in the United States has essentially reduce the use of incarceration at the sentenc- felony convictions can have their rights restored. become one of massive investment in a criminal ing stage? Can alternative justice models such OSI’s commitment to fundamental criminal justice apparatus that imposes punishment at as restorative justice and community justice justice reform and to creativity in framing record levels while draining resources from partnerships be viewed as ways to shift resources new issues has been vital to the field. Support community-strengthening investments. to more effective crime control and public safety to a national network of community-based The notion of the meaning of punish- strategies as well as provide quality legal defense advocates through Critical Resistance has ment is similarly skewed in the United States. and more just resolutions in individual cases? enhanced challenges to prison expansion and People convicted of burglary in the United Along with the day-to-day investments engaged young people in this struggle. All Of States serve more time in prison than their that OSI makes in building intellectual capital Us Or None, a California-based grassroots counterparts in England or Germany, but the and local organizing, the degree to which campaign led by formerly incarcerated people, is “results” in the United States in terms of crime these political and cultural transformations successfully challenging unreasonable employ- control are no better. Even within the United can be accomplished will determine in large ment discrimination through its Peace and States in recent years, states such as New York part what the system of justice in the United Justice Summits. Since 1997, OSI has played have lowered their prison populations while States looks like a decade from now. a significant role in fostering the movement achieving greater success in reducing crime for reform of felony disenfranchisement laws, than states that have continued to embark on initially through support of The Sentencing large-scale prison construction. This, too, reflects Project’s research on this problem and later a profound cultural orientation—one framed through support of the Right to Vote Campaign’s by considerations of race and class—that will successful efforts to challenge state policies. require a critical reexamination of how to alter over time individual racist attitudes as well as Community over Incarceration policies framed by racial dynamics that have These developments are encouraging, but there become institutionalized within the justice remains a broad agenda for reform over the next system. The beginnings of such a reexamina- decade. Since 1996, the prison population in the tion may be seen in the increasing attention United States has risen by a third, topping two being given in the United States to international million. While the rate of growth has leveled human rights norms, which, for example, were out in recent years, both the absolute and the per cited in a recent Supreme Court decision capita prisoner population numbers continue to outlawing the death penalty for juveniles. set new world standards each year because more The question remains whether alternative people are serving longer sentences and being models of responding to disorder and produc- returned to prison for parole violations. Further, ing justice can gain priority over “get tough” the racial/ethnic bias of the criminal justice policies. In a broad sense, this will involve system gives every newborn African-American a reconsideration of the appropriateness of male in the United States a one-in-three chance using the criminal justice system as a means of spending time in prison during his lifetime of addressing problems that would be better and every Latino male a one-in-six chance. served by focusing attention on poverty, The overall figures for women are lower, but racism, and other social and economic ills. their rate of incarceration is growing fastest Within the justice system itself, the chal- and the racial/ethnic ratios are identical. lenge will be to see if reentry approaches that These facts, among many others, indicate emphasize community can produce a shift in that the national approach to solving social and our notion of the function of prison. To what economic problems in low-income communi- extent can the reentry model be transposed to

84 85 The True Cost of Prison Andrew Lichtenstein

The U.S. prison industrial complex has immense social, political, and economic repercussions, includ- ing dislocations in the family lives of people who are incarcerated and difficulties for them in reenter- ing society. The photographs in this portfolio show men leaving prison in Huntsville, Texas, and families traveling from New York City to upstate prisons.

Andrew Lichtenstein received a Soros Justice Media Fellowship. His photographs were included in the second and eighth shows of the OSI documentary photography exhibition Moving Walls.

6. The Challenge Plan A: Protecting All American women made significant strides in the closing decades of the 20th Reproductive Health century, breaking down long established barriers in employment, education, and Cynthia Cooper and Ellen Chesler politics, and consolidating gains for which Cynthia Cooper is a freelance writer specializing earlier generations of women’s rights in reproductive health issues. Ellen Chesler directed OSI’s Program on Reproductive Health and Rights. advocates had fought. With Bill Clinton’s election in 1992, the United States had its first prochoice president and an adminis- tration committed to securing reproductive freedom as a cornerstone of women’s civil liberties. But the promise of these political developments was short-lived. Public policies came under the relentless assault

Spreading Choice Globally The primary mission of OSI’s Program on Repro- ductive Health and Rights was to improve access to reproductive health care and defend reproductive rights in the United States. But the program was also encouraged to collaborate with colleagues else- where in the Soros network to seed work abroad that they and others have subsequently sustained.

91 6. Plan A: Protecting All Reproductive Health Cynthia Cooper and Ellen Chesler

of a fierce conservative minority determined states to place many restrictions on access to conservatives also succeeded in capping funds aspiration techniques. OSI believed that these to push back the U.S. rights revolution and the abortion, even in the first trimester of pregnancy. for family planning and securing more than public health innovations might present an government’s responsibility for public health Since then, the states have enacted more $100 million for teaching abstinence only, rather opportunity to safeguard reproductive health and social welfare. than 300 measures undermining abortion rights, than more comprehensive approaches to sex services by reintegrating them into mainstream These new fundamentalists, quickly ascend- including parental notification or consent require- education, in the public schools—a figure that medical institutions, including hospitals, physi- ing to positions of power in the executive, ments for minors, mandatory counseling and has grown much larger in the decade since. cians’ offices, and neighborhood health care legislative, and judicial branches, identified waiting periods, and numerous arbitrary regula- centers. The foundation also hoped that education abortion, sex education, and even birth control tions on abortion providers. Most controversial OSI’s Response about these new early intervention techniques, as easily exploitable “hot button” issues. They have been the attempts to ban and criminalize OSI’s initial funding targeted the need to protect which, for most people, are less problematic than were well supported by think tanks and media abortions. Opponents of abortion used imagery and expand access to comprehensive reproductive later surgical abortions, might help develop a campaigns funded by conservative founda- of late term abortions—which, in reality, are health services, especially for young people and new politics around these issues and shift public tions. Between 1992 and 1998, for example, both small in number and most often a conse- women of color. But with the hardening of divi- discourse away from “the clash of absolutes” that the Arthur S. DeMoss Foundation alone spent quence of the health problems of the mother or sions around sexuality and the fraying of public has prevailed for decades in the abortion debate. more than $65 million on emotional ads fetus—to persuade legislatures to pass so-called debate, OSI broadened its approach to help family For these reasons, OSI joined with the condemning abortion on major television “partial birth abortion” laws so encompassing planning and prochoice organizations build Packard, Hewlett, Turner, and Ford foundations, outlets in America’s heartland that featured that they threatened all abortion procedures better informed and more active constituencies one large anonymous donor, and many smaller idyllic images of young parents and children from the 12th week on. Courts rejected the in support of progressive values and objectives. institutions and individual donors to help Planned proclaiming “Life: What a Beautiful Choice.” bans consistently, but zealous conservatives One OSI strategy involved enhancing public Parenthood Federation of America and NARAL Conservatives seized upon a legal fissure refused to accept the rulings and pushed for education and physician training about emer- Pro-Choice America counter the right’s domi- opened by the U.S. Supreme Court in its 1992 the passage of similar laws again and again. gency contraception, popularly known as the nance of public discourse on reproductive health ruling in Planned Parenthood v. Casey. Although Campaigns of intimidation and violence morning-after pill, a postcoital contraceptive and rights and diminish their political support. Casey, by a narrow vote, preserved the core against abortion providers had a chilling effect, that inhibits ovulation or disables a fertilized Today, Planned Parenthood has organized privacy doctrine providing constitutional protec- and the right’s relentless stigmatizing of abortion egg. OSI also supported new technologies for nearly 3.5 million individuals, more than one tion to abortion in Roe v. Wade, it also established began to take a toll on public and political support terminating very early pregnancies, such as million of whom are engaged regularly in a new standard of “undue burden” that allowed for reproductive rights. By 1996, congressional medication abortion or simple manual vacuum national advocacy via the organization’s robust

In Haiti, OSI supported a collaborative effort the village of Cange, where a Haitian trained by advocacy coalition now supported by OSI’s and reproductive health of women, which is of the University of Miami Miller School of the program now works in Paul Farmer’s clinic. Women’s Program. Small grants also sup- important since twice the number of African Medicine and the Haitian Ministry of Health The clinic’s women’s health services were ported seminars for medical and public health women as men have now contracted HIV/AIDS. to provide medical residency training in family also supported by a start-up grant from OSI. personnel on the value of emergency contra- A seed grant to the International Rescue and community health, with a special emphasis In Latin America, a small grant to the ception and safe, early abortion. OSI’s Public Committee provided critical funds for the on women and children. The project was an- International Planned Parenthood Federation– Health Program subsequently sponsored provision of sexual health and rights nounced in Haiti in 1998 by George Soros and Western Hemisphere Region helped finance several model training programs for physicians services, including rape counseling and then–First Lady Hillary Rodham Clinton. the provision of emergency contraception in these procedures. emergency contraception, to refugee women Despite many setbacks as a result of Haiti’s services in countries where abortion is illegal A seed grant to the Global Fund for Women in Tanzania. This pioneering intervention continuing political turmoil, the project—now and dangerous to women. helped build its first contacts among local resulted in the subsequent provision of these maintained with funds from USAID and other In Eastern Europe and the former Soviet grassroots organizations supporting women’s services as an agreed-upon standard of care public donors—is providing critically needed Union, a grant to the Polish Federation for health and empowerment and protection from among refugee populations worldwide. personnel in Cap-Haitian, the country’s second Women and Family Planning helped initiate violence in Africa. OSI supported the creation of OSI supported communications efforts that largest city, and in remote rural areas, such as ASTRA, a regional reproductive health a pan-African advocacy network for the sexual helped generate press coverage of important

92 93 6. Voices

Internet presence. Many of these individuals also Diverse religious audiences were courted support grassroots activism targeting 17 states through grants to Catholics for a Free Choice A Flagship Issue where reproductive rights are not secure. NARAL and the Black Church Initiative of the Reli- mounted a successful five-year prochoice media gious Coalition for Reproductive Choice. OSI presence in the Midwest and South and acti- also helped generate fact-based messaging “The right to choose has been a flagship issue vated its own significant number of supporters. to members of Congress and federal officials According to one recent estimate, emails and via its support for the National Women’s of the right wing since the 1970s. The other phone messages to Capitol Hill were running 5 Law Center, the National Partnership for to 1 against conservatives in battles over repro- Women and Families, the National Black side needs to tear Roe down because it repre- ductive health policy and judicial nominations Women’s Health Project, and the National sents judicial liberty, sexual liberty, women’s where reproductive choice was at stake. Public Latina Institute for Reproductive Health. education on these matters has made a difference. As a result, public opinion polls in the United liberty. Even though the right wing focuses on OSI-backed programs of the Ms. Foundation States indicate that a clear majority continues to for Women, the Feminist Majority Foundation, support reproductive rights, including abortion. the act of abortion like a laser beam, it is a Advocates for Youth, the Pro-Choice Public Education Project, Choice USA, and Medical Defending Reproductive cornerstone of an ideology—of a rigid view Students for Choice, among others, reached out Rights in the Courts of how society should function. The states that to young women who, having grown up with Substantial core support to the Center for legal abortion as a constitutional right, may Reproductive Rights (CRR) helped achieve are most hostile to reproductive rights are have become complacent about protecting it. important victories in cases brought before the Grants to normally reticent organizations of United States Supreme Court. In Stenberg v. very hostile to social rights. physicians and other health professionals have Carhart, for example, the Court overturned a made them more outspoken in resistance to Nebraska ban on dilation and extraction abortion public policies that threaten their professional because the ban lacked an exception to protect “What we also know to be true is that the right autonomy and the integrity of science generally. the mother’s health as required by Roe and, to choose is emblematic. It’s the people who are prochoice who also care about school lunch and UN conferences for advancing women’s world produced a volume of essays, Where Headstart. You see a whole pattern. It’s the Ro- rights as fundamental human rights and Human Rights Begin: Health, Sexuality, promoted U.S. ratification of CEDAW, the and Women in the New Millennium, edited setta stone—prisms of light flow from this issue.” International by Wendy Chavkin, professor of clinical Treaty for the Rights of Women. public health and obstetrics-gynecology To refresh and strengthen the intellectual at the Mailman School, and Ellen Kate Michelman infrastructure of the women’s health and Chesler, who directed OSI’s Program justice movements, and to help chart the on Reproductive Health and Rights. progress of global agreements to improve the status of women worldwide, OSI in partner- Kate Michelman is former president of NARAL ship with the Mailman School of Public Health Pro-Choice America, which, starting in 1998 of Columbia University sponsored a fellowship with support from OSI and other foundations, program open to both activists and scholars. ran a five-year media and grassroots organiz- A first class of eight fellows from around the ing campaign in key states to counter conser- vative attacks on the right to abortion.

94 6. Plan A: Protecting All Reproductive Health Cynthia Cooper and Ellen Chesler

while purporting to impose a narrow technical method, and to eliminate barriers to accessing it. It is relatively inexpensive and simple to use, access to reproductive health care—and restriction, actually permitted broader applica- With $1.5 million from its economic and it feels less intrusive and more natural to perhaps to diffuse political tensions over these tion. Nonetheless, the great public relations development investment pool, OSI became the many women than later, surgical procedures. issues—by supporting new products, training success of this ploy emboldened conservatives largest equity investor in the Women’s Capital Few people, however, contemplated the new providers, and mainstreaming reproduc- controlling Congress to pass an almost identical Corporation (WCC), the distributor of the Plan B complications and costs of training providers and tive health back into primary medicine. piece of federal legislation, which CRR, the emergency contraceptive. An additional grant to of establishing a safe delivery system in the Unit- While the political atmosphere in the United ACLU, and Planned Parenthood immediately the medical school of the University of Cali- ed States for this protocol, or for early abortion States remains volatile, and no guarantees can challenged. The three organizations also received fornia at San Francisco supported the research via simple manual vacuum aspiration techniques. be made that reproductive freedom is secure, funding from OSI for their extensive dockets necessary for WCC’s application to the Food OSI joined with other funders to assist Planned we can say with confidence that the movement of state-level reproductive rights litigation. and Drug Administration to convert Plan B from Parenthood, the National Abortion Federation, in support of those rights has been considerably Along with the New York Civil Liberties prescription to over-the-counter status, which is the Abortion Access Project, IPAS, and several strengthened, as has the capacity and the resolve Union, these groups have provided important common elsewhere in the world and would vastly other local health care providers to offer innova- of physicians and other health care personnel to legal opinions and policy strategy to help improve access to the drug and expand its use. tive education and training in early abortion. provide reproductive health services. How best advance emergency contraception and early With OSI’s active participation, WCC sold the More than 600,000 women have used medical to sustain these achievements in the face of abortion provision. With lead funding from OSI, drug to Barr Pharmaceuticals, which is continu- abortion safely in the United States. Tragically, persistent attack is the challenge we continue Planned Parenthood of Western Washington won ing to pursue approval for over-the-counter sales. however, in separate instances during the past to face. decisions establishing that exclusion of birth The delay in an FDA decision on this matter— few years, a rare infection of a lethal clostridium control pills from prescription drug coverage in after more than two years despite the approval sordellii bacteria has resulted in the deaths of five employee health plans constitutes sex discrimina- of two scientific advisory boards—received women who employed the procedure. This is an tion. The decisions produced a groundswell of enormous media coverage because it constituted outcome that has never been observed among the public support for contraceptive equity, includ- a threat to established principles of scientific 1.5 million women in Europe who have used the ing a ruling from the U.S. Equal Employment integrity in government. Depositions by the medication. In the course of its investigation, the Opportunity Commission. Many states—includ- Center for Reproductive Rights appear to reveal U.S. Centers for Disease Control and Prevention ing New York, where OSI supported NARAL unprecedented White House interference in found no direct link between the bacteria and the Pro-Choice New York in its public education FDA decision making. With action by the FDA medication; but it did discover 11 deaths from the on this matter—now have legislation affirma- stalled, OSI and others supported successful same bacteria during routine pregnancies, deliv- tively mandating contraceptive coverage. campaigns in eight states to permit pharmacists eries, and miscarriages. The investigation is now to dispense Plan B without a prescription via focusing on whether circumstances not related to New Options local pharmacy protocols. However, the FDA in the medication may be increasing susceptibility Emergency contraception (EC) became widely late August of 2006 finally approved nationwide of women in the United States to the bacteria available in the United States in 1999, when over-the-counter sales of emergency contracep- as well as on various options for surveillance, the Food and Drug Administration, ruling that tion for women over the age of 18. Though this prevention, and treatment to guarantee safety. it is safe and effective, approved a dedicated age limit regrettably still requires many teens to product. Experts have estimated that EC, if have a doctor prescribe the product, it is nonethe- Next Steps widely disseminated, could cut the country’s less a major victory for progressive advocates. OSI set out in the short term to help arm the abortion rate in half. Already, Planned Parent- Building on a long record of safe use in progressive community with more effective hood affiliates and others have compiled data Europe and Asia, the FDA in 2000 also approved policy, advocacy, and communications tools, showing declining teen pregnancy and abortion Mifeprex (formerly known as RU-486) for and it has done that. It provided support for rates in states that have increased promotion use through the seventh week of pregnancy in litigation to defend reproductive rights and to and access to the new morning-after pill. OSI combination with a second drug called miso- define affirmative rights for women to a wide became the country’s lead funder of efforts to prostol. Medication abortion is thought to hold range of reproductive health care and insurance educate consumers about the benefits of emer- great promise because it can be administered coverage, including emergency contraception. gency contraception, to train providers in this in the earliest embryonic stages of pregnancy. Over the long term, OSI hoped to improve

96 97 Motherhood Anne Hamersky, Brenda Ann Kenneally, Betty Press, Eli Reed, Mel Rosenthal, Stephen Shames

These photographs were featured in Moving Walls 9 in a group exhibition entitled “Beggars and Choosers: Motherhood Is Not a Class Privilege.” Rickie Solinger, the curator of this group exhibition, which was supported by OSI’s Program on Reproductive Health and Rights, calls for the defense of reproductive rights for all moth- ers, regardless of their social or economic status. “Rights are essential,” she says, “since most of the mothers in the exhibition do not possess the social and economic identi- ties that public policy and public opinion associate with qualified mothers.”

Anne Hamersky Brenda Ann Kenneally

Eli Reed

Anne Hamersky Stephen Shames

Anne Hamersky

Betty Press 7. A Different City Baltimore Like many other cities in 1998, Baltimore was besieged on all fronts. The growing Rising U.S. economy in the 1990s had done little Prue Brown to lower its jobless rate or increase family income. A huge gap existed between the skills Prue Brown is a Chapin Hall research fellow specializing in community change. city residents had and the skills city employ- ers needed: one out of three residents did not even have a high school degree. A powerful history of exclusion and limited opportunity among African-American residents contrib- uted to despair and violence. Drug addiction, described by the mayor of Baltimore as “the crisis that is killing our city,” afflicted about 60,000 of the city’s 650,000 residents, one of

Making a Difference The power of a community emanates from the strength of the people within it. Social change rarely occurs without the singular vision and drive that one individual can bring to the process. OSI created the Community Fellowships Program to support public service careers, increase the number of mentors and role models available to young people in inner-city neighborhoods, and promote initiatives and entrepreneurship that will empower

105 Baltimore Rising Prue Brown

the highest rates in the country. In one year place—and the right time—for a con- alone, Baltimore’s crime rate was double the centrated effort to address social problems national average and 70 percent of the 80,000 and develop creative new solutions. people arrested tested positive for drugs. And, OSI–Baltimore, launched first as a five- not surprisingly given these conditions, the city’s year program, sought to improve the lives of young people were struggling: almost one in Baltimore’s residents while changing systems three children lived in families with incomes and policies to sustain these improvements and below the poverty line, and less than one in five stimulate others. The Baltimore office’s board scored at a satisfactory level on statewide tests. decided to focus on five areas related to social These problems were one reason the Open justice: drug addiction treatment, criminal justice, Society Institute selected Baltimore as its workforce and economic development, education only U.S. field office. Another reason was that and youth development, and community justice. Baltimore, while in distress, was, in the words From 1998 through 2005, OSI spent over $50 of George Soros, “a lively community of people million and helped secure an additional $225 with civic interests” with a valuable history of million in public and private funds to build an public/private cooperation. OSI was further open society in Baltimore. Strategic investment encouraged by the number of other foundations of both staff time and resources produced tangible in Baltimore as well as a growing membership results in each of the foundation’s program areas. organization of funders (Association of Baltimore Area Grantmakers) that could provide an active A Record of Achievement forum for sharing information and developing OSI significantly strengthened and expanded collaborative strategies. These assets, combined Baltimore’s public drug treatment system. with Baltimore’s moderate size and proximity to Advised by an OSI-convened national panel of both Washington, D.C., and OSI’s national office drug treatment experts, the nonprofit Baltimore in New York City, suggested that it was the right Substance Abuse Systems doubled its capacity

these communities to increase opportunities neighborhood activism, and the building of and improve the quality of life for community a memorial for children killed by street violence. residents. Community fellows selected in Also, a youth leadership program, a litigation Baltimore and New York City represented strategy for individuals with disabilities, a a diversity of backgrounds and projects. media education program, a child develop- In Baltimore, the fellows included, among ment/community policing project, an anti– many others, public school teachers, a judge, youth-violence program, drug addiction treat- a judicial clerk, lawyers, an architect, a media ment services, and a project to help high consultant, artists, a psychologist, an associate school students explore design careers. pastor, educators, a drum maker, and a nurse. One fellow, Lauren Abramson, a psych- The fellows’ projects included a legal educa- ologist and former assistant professor at Johns tion program for inner-city youth, community- Hopkins University, wanted to establish for the based art programs, a youth choir, advocacy first time in a major American city a kind of for disabled children, the mapping of youth restorative justice technique called community resources, an environmental program, conferencing.

Baltimore artist Rebecca Yenawine with youth in her after-school arts education program. Photo: Joe Rubino 107 7. Baltimore Rising Prue Brown

to more than 25,000 individuals treated annu- are involved in the criminal justice system, staff from the role OSI played by funding the Safe ment providers, human service organizations, ally and tripled its annual budget to over $50 worked to create a groundswell of public and and Sound Campaign to help create Baltimore’s advocacy groups, employers, and foundations million. Baltimore achieved the largest increase private support for finding ways to reduce the new comprehensive system of after-school in the Baltimore region. The task force coordi- in drug treatment capacity of any U.S. city in social and economic costs of incarceration. More programs that now includes more than 100 nates private and public funding to increase the the last 25 years. In the years between the late than $20.3 million in public and private funds providers serving 14,000 students each year. skills, incomes, and economic opportunities 1990s and 2005, expanding access to treatment were leveraged to create new programs and poli- OSI made the lead five-year grant of $6.25 of low-wage workers and the unemployed. so dramatically has in turn cut drug-related visits cies focused on helping people find employment million to the campaign, which helped leverage Recognizing the momentum that OSI to Baltimore emergency rooms by 30 percent, and become productive citizens following their more than $28 million in additional funding. had created and the significant return on the overdose deaths by 34 percent, new HIV diag- release. Organizations like Goodwill and Catholic In this effort, as in other areas, OSI contributed foundation’s eight-year investment, George noses by 25 percent, and property crimes by 41 Charities made people reentering society a key more than money. OSI provided technical assis- Soros signaled his willingness to provide an percent. OSI’s ability to leverage new resources service constituency needing special attention. tance and supported related programming. For additional $10 million challenge if business and promote the adoption of key system changes Trini Selden, a 35-year-old mother of three, example, it spearheaded a citywide, school-based and civic leaders, foundations, and generous was the result of building relationships with key received help from an OSI-funded organization initiative that brought education and community individuals invested $20 million to continue agencies, constituencies, and local and state called Alternative Directions. After spending youth organizations together to increase summer the work in Baltimore. Based on the success of governments, exposing local players to drug much of 1996 to 2000 in jail for crimes related to and after-school programming; and it incubated OSI–Baltimore’s drug treatment work, Soros treatment options used successfully elsewhere, her drug addiction, Selden completed a 28-day and then spun off an urban debate league that also recently announced a $10 million national and supporting advocacy to increase the public’s detoxification and drug treatment program. She now operates in 26 city high schools throughout initiative to enable other cities to build on the understanding and support for treatment. then went into a residential program, Marian Baltimore. Working closely with other funders Baltimore model of creating comprehensive OSI attempted to break the destructive cycle House, where she learned parenting, computer, in the region, OSI initiated a collaboration with systems of care for drug-dependent people. of incarceration and recidivism by encouraging and job readiness skills. Reunited with her chil- 10 Baltimore-based foundations to work with the treatment rather than prison for nonviolent drug dren, she found a job as a legal secretary, rented Baltimore City Public School System in a $20 Looking Forward offenders and by removing barriers that prevent a house, and has stayed sober for five years. million, five-year high school reform initiative OSI’s presence in Baltimore has generated a people leaving prison from successfully return- OSI also worked to improve schools and and a partnership with the Gates Foundation. belief that the goals of social justice and system ing to the community. In a city where more than expand opportunities for youth during nonschool The 70 fellows who have graduated from reform are achievable. The agenda of change one-half of all young African-American men hours. One important accomplishment resulted OSI’s Community Fellowship Program reinforce is unfinished and remains compelling. More and extend the foundation’s work in criminal treatment slots need to be created for Baltimore’s justice, drug addiction, youth, and social justice addicts, people in prison need help as they by testing innovative strategies throughout transition back to the city’s neighborhoods, Community conferencing brings together with innovative projects. Carlos Briceno of Baltimore’s most challenged neighborhoods. and schools need to find new ways of reduc- offenders, victims, and family or friends, to the Harlem Internet Radio Training Station With OSI support, advocates and organiza- ing the city’s dropout rate. OSI’s partners are see a problem from different perspectives. developed and implemented training courses tions have strengthened their capacity, program- enthusiastic about working with the foundation The victims decide on restitution, and all reach in radio for youth and senior citizens. Thin- ming, accountability, and sustainability—and to address these and other important goals. a collective decision about how to repair the ley Kalsang of the New York City Tibetan helped make the fields in which OSI works OSI’s experience in Baltimore underscores material and emotional damage. Community Outreach Center created an infrastructure more organized, efficient, and robust. For the long-term nature of the economic, social, conferencing works for a variety of disputes, of resources for social and legal services example, OSI’s long-term support for the Public and political conditions that erode justice and from misdemeanor crimes of young offenders, between the Tibetan refugee community and Justice Center transformed its capacity to carry impede opportunity for many of the city’s such as vandalism, to school-related issues, service providers. Subhash Kateel established out system change while helping to promote residents. As a civic catalyst powerful enough such as truancy, to incidents affecting the Families for Freedom to organize people collaboration and efficiency within the broader to effect demonstrable changes, OSI–Baltimore quality of community life, such as neighbor- whose relatives were detained after 9/11. public-interest law community in Baltimore. has helped to create the political will to realize hood conflicts . Similarly, OSI helped support the evolution a standard of justice and opportunity that has The New York City Community Fellowships of the Job Opportunities Task Force from a been long sought but slow to develop. Moving Program, which is now being operated by volunteer effort to a sophisticated workforce forward, OSI–Baltimore can point to these New York University, also supported leaders intermediary with over 500 workforce develop- changes as a way of engaging, inspiring, advo

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cating, and collaborating with colleagues both inside and outside the city in the effort to build Listening to People a better future for all of Baltimore’s citizens. Visiting Baltimore in May 2005, George Soros noted that the city, which drew his atten- “It’s really important to listen to people in tion eight years before because it seemed to be “sinking,” was now “rising,” but it would take the community and allow them to express their time for the city’s reputation to catch up with its more promising reality. In the spring of 2006, views first. If we are going to spend as much Baltimore Sun columnist Dan Rodricks noted time as we do fighting for public dollars for that “when historians look back at Baltimore’s long, debilitating cycle of drug addiction—and addiction treatment, we have to listen to people, how we finally got out of it—they will likely refer to the decade since 1997 as the Soros respect their concerns, understand their fears years, a time when a Hungarian-born billionaire put his money into the city’s effort to wake and worries, and create an ongoing dialogue. up from its heroin-induced nightmare.” Attitudes don’t change overnight. You’ve got to hear everyone’s story and then you can see if you can resolve problems so that both the citizens and treatment centers alike take owner- ship of the problems and the solutions. Lots of little good faith efforts can build a lot of support, so that treatment becomes an asset to the community.”

Carlos Hardy

Carlos Hardy is director of drug treatment for the Citizens Planning and Housing Association, which OSI–Baltimore funded in its work to mobilize community support for drug addiction treatment in the city.

110 Conclusion After 10 years, thousands of grants, and more than $800 million in expenditures, OSI has too many activities and achievements in the United States to document them comprehensively in this report. Other initiatives that deserve special attention can only be acknowledged here for their significance to OSI’s mission.

Welfare Reform. In the early years, welfare reform was a priority issue. Welfare reform legislation in 1996 shifted responsibility from the national government to the states. OSI provided support for state and local advocacy campaigns to protect poor families from arbitrary treatment or severe benefit reductions. In a successful effort in Tennessee, grassroots groups and the Tennessee Justice Center helped shape implementation and enforcement of the state’s new welfare laws, including “good cause” exceptions to regulations terminating benefits. The coalition collected the stories of 200 welfare recipients who lost benefits unfairly and petitioned for reinstatement and policy changes. One example: Kelli Smith, a 19-year-old mother, lost her benefits because she decided to finish high school, rather than quit school to take a job. She got her benefits back—and everyone benefited from the state’s important policy decision to recognize education as the equivalent of work.

113 Conclusion

Democratic Participation. Cynicism and declining the doctor-patient relationship. OSI has supported participation, the polarization of public debate, and the creation of alliances between consumer and the power of money threaten America’s representa- medical groups and convened medical and eco- tive democracy. OSI works to revitalize the institu- nomic leaders to analyze challenges to professional tions and practice of democracy. Public financing values within medicine. This work will continue, with is one approach OSI has supported in an effort to OSI support, at the new Institute of Medicine as reduce the influence of money in politics. a Profession at the Columbia College of Physicians and Surgeons. Urban Initiatives. OSI selected Baltimore (page 102) for a comprehensive approach to urban problems in Southern Initiatives. OSI promotes democratic education, youth development, welfare devolution, social change in the South. It has supported local crime and incarceration, and drug policy. OSI also organizations working to increase political participa- awarded a series of grants aimed at community- tion, information flow, and public accountability. building efforts in New York City. It supported the Washington Office. OSI had an earlier presence Beacons Community Leadership Initiative of the Fund in Washington, D.C., but with the passage of the for the City of New York to strengthen the capacities Patriot Act and other restrictions on civil liberties it of individuals, including youth, who were addressing reconstituted its Washington office as a vital compo- their community’s needs and opportunities. nent of OSI’s advocacy efforts in the United States. Media. A vigorous media offering a wealth of inform- OSI–Washington, D.C., encourages responsible ation and diverse views on important public issues is U.S. cooperation with other nations on matters that a vital element to an open, democratic society. OSI require a global response, such as the environment works to foster universal access to information, more and disease; helps to protect an open society in the open, ethical journalism, a diversity of voices, and in- United States by defending civil liberties and pro- depth coverage of societal problems. moting fair and responsible criminal justice policies; and represents in Washington the many parts of the Medicine as a Profession. OSI is concerned that Open Society Institute/Soros foundations network. the marketplace threatens to subvert the core values of the practice of medicine—with the driving force of money lowering quality of care and compromising

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Afterword: It has been an extraordinary privilege to serve as the first—and so far, the only!—director of OSI’s U.S. Programs since its establishment in 1996. Moving Quickly, I want to conclude this 10th anniversary report with some observations about the evolution of the Breaking New Ground approaches we have followed, and some lessons Gara LaMarche we have learned, and offer a few thoughts on the challenges of the next 10 years.

Gara LaMarche is the director Services and Advocacy of U.S. Programs and vice president of the Open Society Institute. There has been a steady and pronounced shift in the nature of U.S. Programs funding since we started. In the early days, we spent far more on services and far less on advocacy. The Algebra Project, a multisite initiative to improve the math skills of inner-city and rural students of color, was one example of our service focus, as were the first several years of our criminal justice initiative, then called the Center on Crime, Communities, and Culture, which supported a variety of demonstration projects. The $50 million spent by the Emma Laza- rus Fund went mostly to services such as naturaliza- tion assistance and legal help. But the $10 million or so for advocacy—support for coalitions to press for restoration of safety net benefits for legal immigrants, for instance—was well spent, resulting in public edu- cation campaigns that spurred Congress to restore $16 billion in benefit cuts. The coalitions whose

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capacity we helped to strengthen then (often build- foundations (and, increasingly, individual donors) ing on years of support by the Ford Foundation) form and to a considerable extent through funding collab- the backbone of today’s immigrant rights movement. oratives that we create or join. A partial listing of these The $100 million-plus for The After-School Cor- collaboratives includes the Proteus Fund (state cam- poration is the last major service-heavy commitment paign finance, civic engagement, and civil marriage), of the U.S. Programs, and even it is conditioned on the State Fiscal Analysis Initiative (state budget and a 3:1 match by other funders. Today virtually all of our policy centers), the Four Freedoms Fund (immigrant funding is aimed at affecting public policy and invest- rights), the Racial Justice Collaborative, the State Wel- ments, not modeling services or replacing them. fare Redesign Grants Pool, and the Tides Foundation’s Death Penalty Mobilization Fund. We have also sup- Interplay of OSI and Partner Funding ported public charity foundations, including the Ms. Since we take on issues that others, at least initially, Foundation for Women, Southern Partners Fund, the deem too controversial, like drug policy or the death Jewish Fund for Justice, and the Robin Hood Founda- penalty, we have a history of acting nearly alone at tion, all of which have used OSI support for regranting first. But there is no area of work in which we have to small organizations we can’t reach directly. not over time been joined, and often surpassed, by other funders. If there is one thing that is universally Investment in People believed—and, it seems, generally admired—about From our beginnings in 1996, the U.S. Programs OSI as a funder, it is that we go where others fear has made considerable use of grants and awards to tread and open up a safe path. to individuals as a strategy for affecting change. All our funding strategies aimed at creating We may have established or funded more fellow- or increasing public obligations—drug treatment ships than any foundation in the United States. Else- in Baltimore, high school reform and urban debate where in this report, you will find brief descriptions of in various cities, access to after-school programs, the Project on Death in America’s Faculty Scholars, and so on—have succeeded, to one degree or an- the Soros Justice Fellows, the Equal Justice Works other, in institutionalizing public support, despite the Fellows, and the Baltimore and New York City fiscal constraints of federal, state, and city budgets. Community Fellows. We work very closely with dozens of other Another large program, the Individual Project

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Fellowships, provided support for new ideas and ini- tiatives that otherwise might not have found a place in the foundation’s grantmaking programs. Precisely because of this expansive mission, the strategic impact of the fellows was hard to measure and to justify. Yet OSI funded over 100 writers, scholars, and advocates, who have produced a great deal of important work that continues to emerge to this day, some years after we ended the program. To cite just one area, OSI supported reporting on ethnic conflict that resulted in significant books and articles by a number of journalists, including Samantha Power, the late Elizabeth Neuffer, David Rohde, and Laura Silber, who is now OSI’s director of public affairs. Early in 2006 we announced a one-time round of Katrina Media Fellowships for writers, journalists, photographers, and filmmakers, including some Mary London survived Hurricane Katrina despite having youth media, who are working on a variety of proj- floodwaters in her house for weeks. Photo: Clarence Williams ects aimed at contributing to a national conversation on the race and class inequalities that Hurricane Katrina laid bare in New Orleans and the Gulf Coast region.

Voices of the Marginalized In the last few years, there has been much talk in the foundation and nonprofit world about theories of social change. My own theory is that any signifi- cant change involves a variety of actors employing

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a variety of methods in a kind of interdependent more engaged support is needed. Some never make ecosystem. There is no one route to change and, for a successful transition to advocacy and empower- most issues, research, opinion-shaping, grassroots ment, because of resistance by the system, or inter- organizing, and other elements all come into play, nalized oppression, or both. We have to keep at it. in varying mixes and proportions. Each organization and funder must decide which part of the ecosystem The Capacity to React Fast to emphasize. Since we have a living donor and little of the bureau- An important OSI focus in the United States cracy that accompanies many philanthropic enter- has been to enhance the capacity of marginalized prises, OSI has always been good at moving quickly groups to press for change on their own behalf—an to deal with unanticipated crises, challenges, and edgier form of grantmaking that many foundations, opportunities. Indeed, some of our biggest initia- more comfortable with elite sectors, tend to avoid. tives, such as the Emma Lazarus Fund, came about We have made grants to and otherwise assisted virtually overnight. (George Soros told me and OSI groups working with young people in juvenile deten- President Aryeh Neier on September 7, 1996, that tion, former prisoners and their families, chronic pain he wanted to commit $50 million dollars to fight sufferers, IV drug users, low-income poor women, the termination of immigrants’ benefits, and on immigrant workers, transgendered persons, and an September 30 he was announcing the program at array of others whose voices traditionally have not the National Press Club in Washington, D.C., with been heard in policy debates. They have our ear and Antonio Maciel, the fund’s new director, present and we have their back. It is probably the aspect of OSI’s ready to start work.) role in the United States of which I am most proud. As our program commitments mounted in sub- At the same time, it would be wrong to pretend, sequent years, our financial ability to deal with cri- even after 10 years, that this approach to social ses grew somewhat constrained, so that when we change is not challenging, and filled with many set- moved to make emergency grants for the defense of backs as well as gains. It is not enough simply to civil liberties in the weeks following September 11, give those who have lacked access and influence a we had to borrow funds from other programs, and forum and some money. Lifetimes and generations from future years, to do it. But we did manage to of marginalization and discrimination cut deep, and act quickly, and we have stayed the course. OSI has

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been among the largest and most stalwart of funders supporting challenges to the Patriot Act, mass questioning of immigrants, NSA surveillance, Guantánamo, Abu Ghraib, and a host of other fundamental human rights violations that now stain the record and reputation of the world’s leading democracy. Nevertheless, as a consequence of this funding experience, we decided, as various programs came to an end a few years ago, not to start new ones, but to keep more of our grant funds as flexible as possible (with attendant staffing adjustments) so that we could explore new issues and respond to emerging opportunities. This flexible approach enabled us, in the last year alone, to make three rounds of grants so far to deal with the myriad consequences of Hurricane Katrina; to provide substantial support to advocacy In the aftermath of Hurricane Katrina, two residents of New Orleans wait for a military transport. Photo: Clarence Williams groups fighting to keep right-wing judges from dom- inating the Supreme Court and federal appeals courts; and to support a public education campaign that helped derail President Bush’s plans for privati- zation of Social Security, which would have led the way to the unraveling of other social protections. In addition, more flexible funds have enabled us to explore responses to threats to academic freedom, the integrity of science, and other open society challenges.

126 Afterword Moving Quickly, Breaking New Ground Gara LaMarche

What Have We Accomplished? is one of the most exciting and inspiring examples The judgment of others—including the outside com- of civic engagement in the United States today. We mentators we invited to contribute to this 10th anni- stood with those seeking to uphold civil liberties in versary volume—is much more reliable than mine on the dark days after September 11, and helped them this score. But I can say what I am most proud of. hold the line in many ways. We helped create a vibrant network of urban Despite my feelings about the limits of large-scale debate leagues. We helped change the way Ameri- funding, we were critical in helping bring into being can culture, policy, and medical practice deals with several new and promising organizations that fill the end of life. We opened up a debate about drug important gaps in the progressive policy infrastruc- policy and its consequences, including an appall- ture—organizations such as the American Constitu- ingly high rate of imprisonment. We sparked and tion Society and the Brennan Center for Justice. helped to sustain a movement to restore full voting rights for former prisoners. We helped to create What I Regret mapping tools to document, and then to incubate I wish we had embraced an explicit racial justice the concept of “justice reinvestment”—capturing analysis much earlier in our criminal justice and other criminal justice spending for social investments that work, since no strategy that fails to take account of deter offense and incarceration, an approach that is this reality can be truly effective. I wish we had done actually being put to use in a number of cities. the same with gender, too often ghettoized in our We have been instrumental in the beginning of extremely important work to protect abortion rights a turnaround for one American city, Baltimore, and and promote emergency contraception and other in so doing have modeled an approach that other measures to change the dynamics of the reproduc- cities, and other philanthropies, might emulate. We tive rights debate. Women need to be at the center have fostered a network of youth media practitioners of any progressive vision. I wish we did more to rec- whose voices have improved the way society looks ognize and harness the role of culture, particularly at young urban people of color, contributed new per- popular culture, as a tool for social change. Our spectives to public policy debates, and sowed the youth and criminal justice work was ahead of the seeds for the next generation of journalists. We pro- curve in embracing hip-hop activism, and we play a vided backing for an immigrant rights movement that leading role in documentary film and photography,

128 129 Afterword Moving Quickly, Breaking New Ground Gara LaMarche

but there is much more to be done, and this could be the world. The emerging generation will have vastly much more thoroughly integrated into a wider range different preferences and habits than anyone read- of OSI activities. Yet we are moving in the right direc- ing this report. Video and computer games, for tion on all these fronts. example—not CDs, DVDs, television, and movies—are the leading source of entertainment revenue in the What Next? United States today. Many have social content, for Just as the work of the U.S. Programs has evolved in better or worse, and influencing it should be a major a decade in ways we could not anticipate in 1996, I communications priority. OSI’s relatively strong con- expect the same in the coming 10 years. To be frank, nection to youth movements will help us understand however coherent our programs and strategies look and adapt to these trends. in retrospect, to a great extent they were improvised Broken Contracts. The social contract is fraying and opportunistic, and I believe, given a base of in most of the developed world, but in the United strong core values and principles, the best interven- States, despite the preservation of Social Security, tions are of that nature. Grandiose long-range plans it is virtually sundered. The postwar employer-based are rarely successful for states or foundations. system of health insurance and pensions left many That said, here are a few final thoughts on trends people out, but for the vast American middle class it we need to recognize and reflect in our strategies has been remarkably effective, in part because of the as we enter our second decade of work in the impact of labor unions in manufacturing industries United States: (both of which are going the way of the dinosaur). New Ways to Communicate. How people receive, As one employer after another jettisons pensions process, and act on information continues to change and health coverage, millions of Americans face eco- dramatically, and must be taken into account in nomic insecurity. In good times, they will be strained everything we do. The personalization, instantaneity, by consumer debt and the cost of private coverage; portability, and miniaturization of media are rapidly in bad times, the safety net will not be there to break intensifying, as are the ease and proliferation of their fall. The current situation can result in misery means for ordinary people to communicate and and its attendant social and political consequences, connect with one another and with anyone around or it can spark a new alliance of business, labor,

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and citizens to press for greater public responsibility With the support of our farsighted trustees, the in, for example, health care. expertise, energy, and strategic savvy of our terrific staff, and the passionate commitment and honest Changing Racial and Ethnic Realities. By now it is advice we have come to expect from the hundreds, a commonplace to note that the United States, with if not thousands, of grantees, fellows, and advisers California and Texas leading the way, is becoming who now comprise OSI’s extended family, I know a “majority-minority” country. But we have gener- we can rise to these challenges and any others that ally failed to take account so far of the vast diversity emerge in the decades ahead. within ethnic communities—the usually undifferenti- ated Latino (Mexican, Guatemalan, Puerto Rican, Cuban, Honduran, etc.) and Asian (Pakistani, Chinese, Thai, Vietnamese, Bangladeshi, Korean, etc.) populations—and the differences among them and with black Americans descended from slaves (not to mention the increasingly diverse African immigrant population.) Central American and Asian immigrants can now be found in nearly every corner of the United States, and dominate industries from Nebraska meatpacking to Maine blueberry harvest- ing to Los Angeles garment making. The media on which these communities rely is invisible to many Americans, and when it emerges—as in the Span- ish-radio disc jockeys so instrumental in stoking protests over the immigration bill—we are stunned by its pervasiveness and power. Moreover, familiar racial identities and black-white-brown categories are becoming blurred and will increasingly affect civil rights protections and strategies.

132 133 Board and Open Society Institute Orelda Hicks OSI—Baltimore Staff Program Assistant George Soros Diana Morris Chairman Erlin Ibreck Director Director, Grantmaking Strategies Aryeh Neier Elena Cox Staff President William Johnston Director, Development Program Officer Stewart J. Paperin Aurie Hall Executive Vice President Nicole Kief Director, Criminal Justice Program Associate Gara LaMarche Mildred Johnson Vice President and Director of John Kowal Executive Assistant U.S. Programs Director, Constitutional Democracy Initiatives Pamela King Director, Baltimore Community Raquiba LaBrie Fellowships & Initiatives Board of Trustees Director, Sentencing and Incarceration Alternatives Project Debra Rubino Leon Botstein Director, Strategic Communications Geoffrey Canada Anna Lefer Program Officer Justin Schaberg Joan B. Dunlop Program Assistant Lani Guinier Gladys Lopez Aryeh Neier Program Assistant Daniela Schukart Program Associate David J. Rothman Karla Lopez Thomas M. Scanlon, Jr. Program Assistant Robert Schwartz, M.D. John G. Simon Director, Drug Addiction Treatment George Soros (Chair) Antonio Maciel Director of the U.S. Justice Fund Jane Sundius Jonathan Soros Director, Education and Youth Herbert Sturz Amanda Margulies Development Senior Program Associate Spenser Villwock U.S. Programs Staff Lori McGlinchey Program Assistant Program Officer OSI New York Sonia Mohan OSI—Baltimore Advisory Board U.S. Justice Fund Program Gara LaMarche Administrator Clinton Bamberger OSI Vice President and Director of Deborah Callard U.S. Programs Noel Pinero Hon. Andre Davis Program Officer/Information Specialist Nancy Youman Marilynn Duker Deputy Director of U.S. Programs Sasha Post Michael Gaines, Sr. Special Assistant to the Vice President Sherrilyn Ifill Amy Anderson and Director of U.S. Programs Joseph T. Jones, Jr. Executive Assistant, Maria Teresa Rojas Will Jordan After-School Program Deputy Director, Grantmaking Susan Leviton Strategies Donald Manekin Jacqueline Baillargeon Herbert Sturz Director, Gideon Project Rochelle Rosenbaum Michael Ward Kate Black Administrative Assistant Program Officer Dawn Smalls OSI—Washington, D.C., Staff Program Officer Nancy Chang Stephen Rickard Program Officer Alvin Starks Director, OSI–Washington, D.C. Sophia Conroy Associate Director, Racial Justice Initiative Morton Halperin Program Associate Director of U.S. Advocacy Nidia Córdova-Vázquez Susan Tucker Program Assistant Director, The After Prison Initiative Mary Anne Anderson Administrative Assistant Leslie Glauberman Betsy Uhrman Assistant to the Vice President and Program Associate Manuela Campbell Director of U.S. Programs Christina Voight Administrative Assistant Aida Henriquez-Brown Program Assistant Venus Campbell Administrative Assistant Program Associate 135 Board and Staff

Lynthia Gibson-Price Herbert Sturz Ana O. Dumois Sadie Breeland Adam Hodkin Thomas O’Toole M.D. Administrator Uri Treisman Kathleen Foley, M.D. Beth Breger Helena Huang Jessie Owen Alison Giffen Joanne Lynn, M.D. Susan Brown Ricardo Huerta Thomas Palley Policy Analyst Emma Lazarus Fund Velvet Miller Eric Cadora Katharine Huffman Amit Pandya Arthur Helton Patricia Prem Claudia Calhoon Rachel Hurley Michael Pardy Gene Guerrero David J. Rothman Mary Callaway Kyoko Inouye Naeema Paskel Senior Policy Analyst Bill Ong Hing Esther Lardent William Zabel Amanda Campbell Jeanette Irwin Alicia Carretero Pelfrey Zoe Hudson Carlos Daniel Levy Colleen Campbell Mireille Jacobson Rebecca Peters Senior Policy Analyst Vilma S. Martinez Program on Reproductive Health Sarah Cassetta Jeffrey Johnson Miriam Porter Dana Johnson Gary Meisel and Rights Holly Catania Whitney Johnson Andi Pringle Executive Assistant to the Director Cecilia Munoz Joel E. Cohen Jessica Chao Jennifer Johnson-Spence Sushma Raman Karen Narasaki Marcia Gillespie Ellen Chesler Rochelle Johnson-Williams Abe Rein Regina Johnson Grace Christ Patrice Kanada Michael Risher Administrative Coordinator Gerald L. Neuman Kathryn Kolbert Jenry A.J. Ramos Sylvia Law Joanna Cohen Navneet Kathuria Benita Robinson Helen Lawing Russell Sakaguchi Kristin Luker Phillip Coffin Ted Kiem Josh Robinson Executive Assistant to the Director of Margery Tabankin Wanda Nowicka Tanya Coke Herbert Kohl Marsha Rosenbaum U.S. Advocacy Dorothy Roberts Monique Cole Ellen Komp Julie Ruckel Joseph Onek Program on Law and Society Allan Rosenfield Julie Cooper Karma Kreizenbeck Catherine Samuels Senior Policy Analyst Dorothy Thomas Mary Beth Corrazini Martha Larson Shayna Samuels Clinton Bamberger Mary Cotter Joshua Leeman Eva Marie Santiago Twyla Robinson Zachary Carter Southern Initiative Patrice Cromwell David Leven Jocelyn Sargent Program Assistant John Curtin, Jr. Ashley Crout Eric Lotke Jeanne Scanlon Wendy Feliz Sefsaf Peter Edelman Dee Davis Stacey Cumberbatch Angela Wai Hing Louie Mark Schmitt Communications Liaison Officer Bryant Garth Scott Douglas Debbie Curley Sallie Lynch Sharda Sekaran Robert Gordon Lynn Walker Huntley Felicity Daly Cassie Madden Sabrina Shaw Mary Spears Daniel Greenberg Leroy Johnson Receptionist Indara Davis Christopher Madison Emilia Sherifova Lani Guinier Burt Lauderdale Kerri Demers Nancy Mahon Linda Shipley Nkechi Taifa James Head Judy Matsuoka Katherine Diaz Jane Manners Karen Sieminski Senior Policy Analyst Robert Joffe William Quigley Dominique Dieudonne Vince Marrone Beth Carr Siti Esther Lardent Graciela Sanchez Karen Dreitlein Andrew Martin Johana Skalsky David Luban Malika Sanders Mindy Duitz Colbert Martin Elizabeth Slagle Former Advisory Boards Hon. Abner Mikva Bryan Stevenson Darin Dunston Elizabeth Matish Deborah Small Richard E. Mulroy Leah Wise Michael Economos Julie McCarthy Francess Smith Deborah Rhode Arts Initiative Sue Eldredge Julie McCrady Nathaniel Smith Barbara Paul Robinson Former U.S. Programs Staff Lisa Ellington Lea McDermid Pamela Franklin Sohn Leon Botstein Fern Schair Jamie Evans Lee McDermott Toni Stanton Wendy Ewald John G. Simon Daniel Abrahamson Maggie Adams Karyn Fish Patrick McGreevy Diane Stredicke Rocco Landesman Gerald Torres Kathleen Foley, M.D. Jennifer McNeeley M.D. Christina Suarez Susan Weber Soros David Wilkins Yasser Aggour Christopher Anderson Vanessa Foster Andy Miara Edward Sunderland Penelope Anderson John Fox David Mickenberg Marlo Tablante Center on Crime, Communities Medicine as a Profession Ronnie Frankel Fran Miller Donna Taliercio and Culture David Angeles David Blumenthal, M.D. Marianne Apostolides Nina Gadmer Mahita Mishra Ty Trippet Alfred Blumstein Norman Daniels Felicity Aulino Jerry Garcia Virginia Moracho Farrah Trinker Paul Chevigny Eli Ginzberg Glenn Backes Mimi Ghez Kevin Griffin Moreno Mabel Tso Madeleine LaMarre Jerome Kassirer, M.D. Robert Bannon Jennifer Traska Gibson Jo-Ann Mort Amarilis Urena Hon. 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