Today’s federal agencies are ‘highly message-controlled.’ Here’s what that means for health reporting

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In May, The Oregonian published an alarming investigation detailing how, in the paper’s words, the US Department of Agriculture “repeatedly blinked when facing salmonella outbreaks involving Foster Farms,” one of the nation’s largest poultry processors. Foster Farms had been linked to nearly 1,000 salmonella infections from 2004 through 2014. Hundreds of people got sick. Yet the USDA “time after time…chose not to warn the public or ask Foster Farms for a recall,” wrote Oregonian health reporter Lynne Terry, and “with no reason to worry, people kept eating contaminated chicken.”

The paper’s efforts to expose the government’s weak enforcement program and the public’s vulnerability involved a pitched battle with federal officials, which Terry’s editor Les Zaitz described to me as a “long tour of duty in bureaucratic hell.” For several months, the USDA dodged questions, ignoring some queries and answering others that were not asked, going silent for long stretches, and professing a desire to help only to say repeatedly that’s not possible. Terry pushed for an interview with USDA officials. After resorting to written questions—submitting two different sets and getting back what Terry calls “largely unusable,” vague answers—the paper was finally granted a 15-minute interview with USDA Deputy Under Secretary Al Almanza.

Eventually, The Oregonian opted to publish what it had. And although it turned out to be a strong story, the process was protracted and frustrating. Terry pressed the agency to disclose how many times the government had formally requested a recall in six salmonella outbreaks dating to 2007, but the USDA—which can request but not force a recall— “declined to say,” Terry wrote. (A USDA spokesperson told me via email that the agency “did disclose this information several times.” Terry stands by her account and notes that no corrections have been requested.) Zaitz compared the extended back-and-forth with the agency to “shooting BBs against a battleship.” How eager will the paper—or any news outlet—be to re-load and take aim at the next battleship? What other stories get shelved or go untended during the struggle?

What Terry and Zaitz encountered seems to be fairly standard practice at federal agencies these days—stonewalling and running out the clock on reporters. The Obama administration came to power promising “the most transparent” administration in US history and an “unprecedented level of openness.” Instead, whether they are old timers or relative newbies, work at small outlets or large ones, belong to the trade press or live at the top of the news pecking order, health reporters told me the same thing: trying to get useful information from government agencies can be a maddening, prolonged exercise. Even those who are less critical mention instances when an agency dodged or declined to answer their questions. “There’s no question this administration has had all agencies on a very short leash,” says Politico’s food safety reporter Helena Bottmiller Evich. “There’s a strong pull to keep everyone on message. Requests are getting cleared pretty high up the chain. They don’t want them to be off message and say something that causes tension with the White House.”

These grievances aren’t unfamiliar, of course—journalists are forever complaining about government flacks. Still, it wasn’t always this way. Reporters who have covered Washington for decades talk of a time when they could reach almost anyone at the agencies, even an agency head, by phone. Jim Dickinson, who has covered the Food and Drug Administration since the 1970s for several trade publications and runs the news site FDAWebview, said in the pre-Clinton days he could walk into the FDA and talk to anybody who wanted to talk. Gail Wilensky, who headed the Medicare program under the first George Bush, says reporters could call her directly, because “to me that was smart and helpful.” Reporters point to the Clinton years as a turning point, when Hillary Clinton imposed tight rules about talking to the media on members of her team crafting the doomed Clinton health plan. Controls got progressively tighter during the administration of George W. Bush and tighter still under Obama.

A public information officer (PIO) who has worked for several federal agencies dealing with science and health and is currently employed by one confirmed the “short leash” assessment from Politico’s Evich and the changes that have occurred in Washington’s relationship to the press. “This is a brand new day for how the administration clamps down to manage communications,” he told me. “The public information model”—one that provided timely information to the public and the press about taxpayer-funded research—“is dead and has now been replaced by a highly message-controlled environment.”

One factor likely contributing to the clamp-down: In today’s Washington, instead of career agency employees serving in top public information positions, former campaign officials often hold those jobs. For example, prior to joining the US Department of Health & Human Services, the agency’s current assistant secretary for public affairs, Kevin Griffis, was communications director for New Jersey Senator Cory Booker and helped run Booker’s 2013 special election campaign. He also served as a communications director for the 2008 Obama campaign, a 2006 US Senate race, and a 2005 gubernatorial campaign. Jenny Backus, who was acting assistant secretary of public affairs at HHS from 2009 to 2011, worked in communications for the 2008 Obama campaign, for the Democratic Congressional Campaign Committee, and for the Democratic National Committee. Accordingly, the agencies’ communications operations are run like political campaigns—wary of the press, stingy with information, talking point-driven. Young reporters without deep sources or contacts developed during a presidential campaign are “very unlikely to get access,” the PIO told me, and are often pointed to a website or handed talking points, while those at outlets with marquee names may get an interview if they’re “unlikely to upset the apple cart.” Interview requests go up the chain to a top official—sometimes to the assistant secretary for public affairs at the department or a similarly high-ranking official—who makes the decision.

As The Oregonian learned, getting an interview with an agency official can be a slog and may come with tight strings attached. When interviews are granted, “minders” from the agency may be present to steer the conversation away from touchy topics such as agency policy, funding, and regulations in the works—the guts of most Beltway business. When Politico’s Evich was reporting this food safety piece earlier this year, two minders sat in on her FDA interview and one of her main questions—what sorts of practices would be violations under new (but not yet implemented) food safety regulations—went unanswered. Reporters say that agencies rarely let them talk to personnel who can actually explain complicated issues they need to understand. And even access to agency experts does not guarantee answers to key questions, as Seattle Times health reporter JoNel Aleccia was recently reminded.

Aleccia, who has been covering the saga of superbugs tied to contaminated endoscopes at Seattle-area hospitals, sought to talk to the Veterans Administration official who authored a study on the risk of such contamination at VA medical centers. Aleccia made a public records request for the study in mid-May and in early August received the document, which concluded that the risk of superbug contamination at VA facilities was “very low.” But Aleccia told me she saw potential shortcomings in the analysis—shortcomings that also concerned two outside experts she consulted—and “wanted to ask [the doctor behind the study], ‘Are you sure?’” The VA made the doctor available to Aleccia— just after the Times published its initial piece. Even then, the doctor would not engage questions about “limitations” in his own study, Aleccia told me, saying instead that the VA “had investigated this to the fullest extent possible” and that he would “say to that patient in front of me…go ahead and have that procedure in the VA.” Aleccia wrote this all into an updated version of her original piece. Overall, she said, the agency was “an impediment” to putting out a full, clear story on a matter of patient safety.

Reporters point to the now-routine send your questions in writing request as another way agencies control the message—and control the speed at which they (often selectively) provide answers. The sometimes long-awaited answers can be “incredibly jargon-laden, bureaucratic, and nearly incomprehensible statements that only generally relate to the topics at hand,” says Fred Schulte, a senior reporter at the Center for Public Integrity. “They’re unusable and painful to read, and when you write for a general audience, you hesitate to use some of the crap they send. It pollutes your story to put it in there.” In late summer, Schulte reported on Medicare Advantage plans overbilling Medicare for in-home patient exams—lax government oversight of Medicare billings has been an ongoing focus for Schulte. For his August story, he sent the Centers for Medicare and Medicaid Services (CMS) written questions (at the agency’s request), including about the agency easing up on home care regulations and the potential conflicts of CMS acting administrator Andy Slavitt, who was a top executive at a subsidiary of UnitedHealth Group, a large seller of Medicare Advantage plans. CMS officials responded with a general statement about the “significant value” of in-home assessments.

Not surprisingly, reporters have better luck getting at least a comment from an agency when their stories present good or neutral news that doesn’t threaten an agency’s interests. “When they want to leak to reporters or hype some data release, they are models of cooperation,” Schulte said. Two health reporters at high visibility publications—ProPublica’s Charles Ornstein and Forbes’ Matthew Herper—told me that at times they have found some health agencies to be cooperative and forthcoming. Herper, who writes about the FDA for Forbes, got an interview with the director of the FDA’s Office of New Drugs, who challenged a drug maker’s study of an obesity drug that boosted its share price by 30 percent. The official told Herper the results were “unreliable,” “misleading,” and “likely false.” For an August story reporting that the FDA is approving almost every drug that comes its way—by Herper’s analysis, the agency’s approval rate for 2015 was 89 percent compared to 66 percent in 2008—Herper wasn’t as lucky. He told me he “couldn’t land a real interview” with the FDA, couldn’t “get a senior official to talk on the phone,” and settled instead for a “series of emails from PR officials,” which he distilled into a paragraph in his piece. Herper said the agency “has been quite responsive to me,” so he was “surprised” that he didn’t get what he wanted in this case. He added that part of getting a response from the FDA is “knowing which PR person to contact about what,”and suggested that maybe the agency is “triaging” press calls when he or others do not get answers.

ProPublica’s Charles Ornstein points to a piece from July 2014 examining Illinois doctors overbilling Medicaid for group therapy sessions, for which a CMS spokesperson gave him an email comment describing Medicare’s rules and pointing out that “deterring improper payments” was a top agency priority. But for a story published in June showing that Medicare paid nothing for popular tranquilizers in 2012 but $377 million for the same drugs in 2013, CMS went silent—or, as Ornstein wrote, “declined to answer questions about Medicare’s suddenly soaring tab” for the pills. Ornstein was quick to note that CMS provides ProPublica with oodles of data that has enabled him and his colleagues to investigate doctors’ prescribing patterns and their billing practices. But he adds that once ProPublica analyzes the data CMS provides and returns with questions about the findings, CMS often clams up—sometimes saying nothing and other times sending an empty statement. “If they don’t have a good answer, they’re not going to answer the question,” he said.

What can be done? The Society of Professional Journalists (SPJ) has sent two letters in the last two years to the White House protesting lack of access. It got no response to the first, while the second, sent in August and signed by more than 50 journalism groups, resulted in the promise of a future meeting with White House press secretary Josh Earnest. The Association of Health Care Journalists (AHCJ) did not sign on to these letters. “We didn’t feel like they were going to accomplish anything,” said Felice Freyer, board member and vice chair of the group’s right-to-know committee. Instead she said the committee prefers to work one-on-one with individual journalists who have problems getting access.

In 2011, AHCJ and other groups pushed HHS into formulating a set of written guidelines for dealing with the press. The goal was to encourage consistency among health agencies and make it easier for the press to get information. “One could wonder if our efforts backfired,” says Washington freelancer Kathryn Foxhall, who has been active in freedom of information issues for AHCJ and SPJ. Did the rules cause the press offices to require questions in writing? Agencies began routinely asking for written questions about the same time the guidelines were finished. Laced throughout the guidelines, noted Foxhall and others, is the word “coordinate.” All HHS employees must “coordinate, in a timely manner, with the appropriate media relations office prior to releasing information that has the potential to generate media or public interest.” Reporters should know that the agency’s public affairs office “coordinates media requests” to make sure reporters get information “within their deadline.” In practice, reporters said, all this agency “coordination” for press inquiries enables slower and blander responses. ProPublica’s Ornstein, who was AHCJ president when the guidelines were written, told me that “from personal experience, they haven’t been a panacea.”

In the course of reporting this story, I went to the Department of Health and Human Services (HHS) seeking responses to the common complaints I heard from health reporters. (I chose HHS because, while the USDA and the VA are not under its umbrella, it is arguably the main health department that reporters on this beat are likely to deal with, overseeing the Centers for Disease Control, the National Institutes of Health, CMS, and the FDA). The HHS Office of Public Affairs asked me to submit questions in writing and then answered 13 of my 18 queries, often repeating similar language and phrases in response to different questions. One of my questions was about the effects on the public of excessively controlled, restricted information flow from government health agencies. That one went unanswered.

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Trudy Lieberman is a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for The Second Opinion, CJR's healthcare desk, which is part of our United States Project on the coverage of politics and policy. She also blogs for Health News Review. Follow her on Twitter @Trudy_Lieberman.