Dr. Ryan Cole speaks at the "Faith, Health and Hope Global COVID Summit" at a church in Grandview, Missouri, a suburb of Kansas City, on Nov. 13, 2021. (Screenshot of video stream by The Epoch Times)

The medical board in the state of Washington is considering disciplinary action against Dr. Ryan Cole, the Idaho pathologist who serves on a public health board while advocating against COVID-19 vaccines and accusing other public health agencies of fraud.

In a 40-page response to complaints against him, Cole and his attorney argued that he did not violate any rules when he prescribed drugs to patients over telehealth and claimed COVID-19 vaccines are dangerous. But some of the arguments in the response to the Washington Medical Commission do not match Cole’s public comments.

Cole and his Eagle-based attorney, Nancy Garrett, did not respond to messages from the Sun this week. The Sun obtained the documents through a public records request to the Washington Medical Commission.

The commission’s investigators have opened two cases in response to complaints against Cole.

His laboratory, Cole Diagnostics, accepts tissue, blood and other samples from health care providers in Idaho, Washington and other states. As a pathologist, Cole is trained to examine a sample and make a diagnosis, as opposed to seeing and treating patients directly. In addition to his work as a pathologist, Cole serves on the board of Central District Health, Idaho’s largest regional public health department.

Cole was first licensed in Washington in June 2007. His license expired in May of this year, but he activated it again in June, records show.

“In times of crisis, as we have experienced in the last two years, health care providers have been asked to shoulder the enormous burden of caring for patients with COVID. I have dedicated all of my time and energy to studying COVID, testing for COVID, and helping patients in any way possible,” Cole wrote in a letter to the commission that accompanied his attorney’s letter.

None of Cole’s “actions regarding COVID have been focused at all on any financial gain,” he wrote.

“This has been purely Good Samaritan care for patients desperate for help that was not being offered elsewhere,” he wrote. “… I provided free medical care out of a real attempt to help those in need.”

What the complaints against Dr. Ryan Cole said

The first case in Washington, opened last year, stemmed from complaints that Cole improperly prescribed drugs to patients over a telehealth platform, and that he spread false and misleading information about COVID-19, masks and vaccines. The investigator completed work on that case and has forwarded his findings on to the commission.

The second case stems from Cole’s misdiagnosis of cancer in an Idaho patient, in light of his unsupported claims that COVID-19 vaccines cause cancer. That investigation was ongoing as of early spring.

The medical boards in Arizona, Minnesota and Idaho received similar complaints, the letter from Cole’s attorney said. The Idaho Board of Medicine “declined to open an investigation of Dr. Cole’s practice or his publicly held opinions,” and the other two states took “no further action” after he responded to those complaints, the letter said. It is unclear if those state boards took any action in the five months since Cole’s letter.

Laws in Arizona and Minnesota do not give the public access to any records of complaints or medical board investigations unless they result in a formal disciplinary action. Idaho law also conceals those records from the public — even from the person who filed a complaint.

Washington is the only state that allows public access to complaint and investigation records regardless of whether the board has taken formal action.

In at least one public speaking engagement, Cole referred to the complaints as “attacks” on him, “just political” and “not legal for them to do.”

The Washington board decided last year to consider disciplinary action against doctors who give harmful recommendations about COVID-19 and vaccinations. That policy echoes the position of the Federation of State Medical Boards but hasn’t been adopted by the Idaho Board of Medicine.

“Physicians … who generate and spread COVID-19 misinformation, or disinformation, erode the public trust in the medical profession and endanger patients,” the Washington Medical Commission wrote.

Cole’s attorney says he is ‘questioning the science’

In her letter to the commission, Cole’s attorney argued that the allegations “arise as an attack on public statements and presentations that Dr. Cole has offered across the country.”

She wrote that Cole’s statements are “questioning the science behind mask wearing, as well as genuine concerns regarding known and unknown complications from COVID-19 vaccinations.”

To discipline him for those statements would infringe on his constitutionally protected right to free speech, the letter said. No government agency is “the arbiter of truth, particularly with respect to matters of scientific opinions and genuine scientific debate,” it said.

“Dr. Cole has not advised patients or the general public to not receive the vaccine,” the letter said.

These are the unsubstantiated statements Cole made in the months leading up to the letter. The statements are either categorically false or sharply at odds with the body of research on COVID-19 and the consensus of the medical community:

There is evidence that post-infection immunity may be comparable to post-vaccine immunity. A large study published recently in the New England Journal of Medicine found similar levels of protection in vaccinated patients as in COVID-recovered patients.

But, consistent with other studies, it found that vaccines after recovery from COVID-19 do indeed boost a person’s immunity against the virus.

“Vaccination enhanced protection among persons who had had a previous infection,” the study said. “Hybrid immunity resulting from previous infection and recent booster vaccination conferred the strongest protection.”

And the path to immunity by infection is far more dangerous than the path to immunity by vaccination.

To develop post-infection immunity, a person must first recover from COVID-19. People who were unvaccinated and died from the disease will never be reinfected, so their outcomes cannot be included in studies on reinfection rates.

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The letter argues that Cole is merely sharing “opinions based on his observations, and (offering) hypotheses based thereon,” and that people filing complaints and “the media have simply labeled such opinions and hypotheses as misinformation because there are no published scientific studies completed on this observational question.”

In his public statements, Cole refers to his claims as “truth.” He attempts to directly link vaccines to dangerous health conditions. Before and since his letter to the medical board, Cole has claimed, without evidence, that:

Cole defends his treatments of patients with ivermectin

The letter also argues that Cole’s practice of treating COVID-19 patients and prescribing drugs to people over a telehealth platform was above-board.

Multiple doctors who work in local hospitals made statements to the Washington Medical Commission that they had treated patients who developed severe COVID-19 after following Cole’s advice or receiving treatment from him.

Cole said in fall 2021 that he had “treated hundreds and hundreds and hundreds of patients, of the which (sic) zero have gone to the emergency room or hospital.”

The letter said Cole “has received numerous letters from patients thanking him for providing treatment they could not obtain elsewhere.”

But, it said, Cole cannot respond to the hospital doctors’ allegations because he lost access to his patients’ medical records.

“In November or December 2021, (telehealth platform) Medici discontinued its contract with myfreedoctors.com and has since locked all providers out of the medical records it maintains,” the letter said. “This is a recent development and in no way affected Dr. Cole’s ability to access such patient records close in time to such treatment.”

And since he cannot defend himself, those allegations are “therefore entirely irrelevant,” the letter said.

The system Cole used for the telehealth appointments did not keep patient records sequestered. On its website, Medici provides a step-by-step tutorial for physicians to export patient records for local storage, saying it is “a great way to ensure your practice management system has a record of the consult” but reminding health care providers that they “may still wish to document the encounter” in their own medical record-keeping systems, too.

The letter says Cole did not receive a fee, charge patients or bill health insurance for those consultations. The appointments were free, although patients could make donations to the service, the letter said.

Cole claims ivermectin was only option for COVID-19 patients

Cole believes that benefits of early treatment with ivermectin outweigh the risks, the letter said.

“Further, ivermectin was prescribed by Dr. Cole at a time when there were simply no outpatient therapeutics that were being recommended,” it said.

Ivermectin is still being evaluated for use as a COVID-19 treatment. Studies so far have not proven its effectiveness.

Most people recover from COVID-19 at home with over-the-counter medication. For people at risk of severe illness, health care providers can give monoclonal antibody treatments — available at hospitals and community sites since last fall. Health care providers recommended vaccination, though, so that patients would be less likely to need those treatments at all.

At the time Cole was prescribing ivermectin, patients could have enrolled in clinical trials for early outpatient treatments, including ivermectin. The trials did not guarantee a patient would receive their preferred drug.

One trial was open from January 2021 through early 2022. Another trial, run by the National Institutes of Health, was open from June 2021 to February 2022. (Its initial results show a three-day course of ivermectin had no effect on hospitalization or death, and it shortened illness by less than a day. Researchers plan to launch a second arm of the trial to test a higher dose.)

The Sun in February asked Cole how many patients he had referred to those trials in lieu of prescribing drugs himself. He did not respond.

Did Cole advise against public health measures?

By the time his attorney told the Washington Medical Commission he had “not advised patients or the general public to disregard public health guidelines,” Cole had become a champion of noncompliance.

“We’ve been complacent. You know: ‘The government takes care of you, they’re gonna take care of you, I’m gonna be fine, whatever, they’re going to do their thing, I’ll just be a good little boy or girl and comply,’” he said at a conference in Kansas City in November 2021. “This is a 1776 moment, really, in our history. And we’re trying to earn our freedoms back? I’m sorry, but I never gave them up. I’m an American.”

''Dr. Cole has not advised patients or the general public to disregard public health guidelines.''

– Nancy Garrett, attorney representing Dr. Ryan Cole in a matter before the Washington Medical Commission

According to Cole’s response to the commission, his goal is to inform the public and engage in scientific debate.

“The fact that other providers disagree with Dr. Cole, these providers have not shown any scientific studies that would render Dr. Cole’s opinions misrepresentations,” the letter said.

That rankled David Pate, a member of the state’s coronavirus working group, a former physician and lawyer, and retired CEO of St. Luke’s Health System.

“I have never listened to a presentation where either he presented both sides of the debate or where another panelist was there to debate,” Pate told the Sun. “In fact, he rejected my suggestion that he and I debate. When you only present one side and don’t represent that there are legitimate other points of view, I don’t know how that could be a debate.”

Cole’s claims about COVID-19, prevention, treatment and vaccination have been the subject of numerous fact-checking articles. The articles include links to studies and quote subject-matter experts. One fact-check article went directly to the source: the lead author of a paper Cole has cited.

“No publications demonstrate that mRNA vaccines cause cancer or autoimmune diseases,” Norbert Pardi, a research assistant professor of medicine at the University of Pennsylvania, said in an email to FactCheck.org.

“Multiple clinical trials have been performed with mRNA vaccines in the past 10 years and none of them found that mRNA vaccination caused autoimmune diseases. Further, we are not aware of any studies showing an autoimmune disease appearing many months after vaccination as Dr. Cole inaccurately suggests,” Pardi said, according to FactCheck’s article from April 2021.

Cole has dismissed such fact checks and said he plans to sue journalists over reporting on his statements. He has no active lawsuits in Idaho or federal courts.

The letter to the Washington Medical Commission makes a case for opinion and hypothesis — and freedom of speech.

But in his public interviews and speeches, he implores the public to listen to him, accuses health authorities of lying and calls public health measures a crime.

“It’s an honor to be here and to share some truth today,” Cole said at a November 2021 event in Kansas City.

“Are they lying to you? They are. This is science and data. They pulled the wool over your eyes so they could make billions,” he said. “The fact that they … are forcing you to still wear masks, that they are forcing you to get a shot to keep your employment, is criminal, plain and simple, criminal.”

FactCheck.org: Idaho Doctor Makes Baseless Claims About Safety of COVID-19 Vaccines, April 19, 2020

KTVB: St. Luke’s chief medical officer fact checks a doctor’s anti-vax claims, March 16, 2021

HealthFeedback.org: Not all coronaviruses are seasonal, contrary to pathologist Ryan Cole’s claim; COVID-19 vaccines are effective at preventing illness, April 4, 2021

AFP Fact Check: US doctor spreads false information about Covid-19 mRNA vaccines, Aug. 18, 2021

FactCheck.org and Univision Noticias: Médico de Idaho hace declaraciones infundadas sobre seguridad de vacunas contra el COVID-19, Aug. 27, 2021

Lead Stories: Dermatopathologist Ryan Cole Does NOT Back With Data His Claim That Pfizer Vaccine Weakens Patients’ Immune Systems, Sept. 21, 2021

USA Today: False claim that cancer has spiked as a result of COVID-19 vaccines, Sept. 27, 2021

HealthFeedback.org: No scientific evidence for claim by pathologist Ryan Cole that COVID-19 vaccines weaken the immune system, Sept. 27, 2021

Reuters: No evidence COVID-19 vaccines have caused increase in cancers, contrary to claims made on social media, Feb. 11, 2022

by Audrey Dutton, Idaho Capital Sun July 29, 2022

by Audrey Dutton, Idaho Capital Sun July 29, 2022

The medical board in the state of Washington is considering disciplinary action against Dr. Ryan Cole, the Idaho pathologist who serves on a public health board while advocating against COVID-19 vaccines and accusing other public health agencies of fraud.

In a 40-page response to complaints against him, Cole and his attorney argued that he did not violate any rules when he prescribed drugs to patients over telehealth and claimed COVID-19 vaccines are dangerous. But some of the arguments in the response to the Washington Medical Commission do not match Cole’s public comments.

Cole and his Eagle-based attorney, Nancy Garrett, did not respond to messages from the Sun this week. The Sun obtained the documents through a public records request to the Washington Medical Commission.

The commission’s investigators have opened two cases in response to complaints against Cole.

His laboratory, Cole Diagnostics, accepts tissue, blood and other samples from health care providers in Idaho, Washington and other states. As a pathologist, Cole is trained to examine a sample and make a diagnosis, as opposed to seeing and treating patients directly. In addition to his work as a pathologist, Cole serves on the board of Central District Health, Idaho’s largest regional public health department.

Cole was first licensed in Washington in June 2007. His license expired in May of this year, but he activated it again in June, records show.

“In times of crisis, as we have experienced in the last two years, health care providers have been asked to shoulder the enormous burden of caring for patients with COVID. I have dedicated all of my time and energy to studying COVID, testing for COVID, and helping patients in any way possible,” Cole wrote in a letter to the commission that accompanied his attorney’s letter.

None of Cole’s “actions regarding COVID have been focused at all on any financial gain,” he wrote.

“This has been purely Good Samaritan care for patients desperate for help that was not being offered elsewhere,” he wrote. “… I provided free medical care out of a real attempt to help those in need.”

What the complaints against Dr. Ryan Cole said

The first case in Washington, opened last year, stemmed from complaints that Cole improperly prescribed drugs to patients over a telehealth platform, and that he spread false and misleading information about COVID-19, masks and vaccines. The investigator completed work on that case and has forwarded his findings on to the commission.

The second case stems from Cole’s misdiagnosis of cancer in an Idaho patient, in light of his unsupported claims that COVID-19 vaccines cause cancer. That investigation was ongoing as of early spring.

The medical boards in Arizona, Minnesota and Idaho received similar complaints, the letter from Cole’s attorney said. The Idaho Board of Medicine “declined to open an investigation of Dr. Cole’s practice or his publicly held opinions,” and the other two states took “no further action” after he responded to those complaints, the letter said. It is unclear if those state boards took any action in the five months since Cole’s letter.

Laws in Arizona and Minnesota do not give the public access to any records of complaints or medical board investigations unless they result in a formal disciplinary action. Idaho law also conceals those records from the public — even from the person who filed a complaint.

Washington is the only state that allows public access to complaint and investigation records regardless of whether the board has taken formal action.

In at least one public speaking engagement, Cole referred to the complaints as “attacks” on him, “just political” and “not legal for them to do.”

The Washington board decided last year to consider disciplinary action against doctors who give harmful recommendations about COVID-19 and vaccinations. That policy echoes the position of the Federation of State Medical Boards but hasn’t been adopted by the Idaho Board of Medicine.

“Physicians … who generate and spread COVID-19 misinformation, or disinformation, erode the public trust in the medical profession and endanger patients,” the Washington Medical Commission wrote.

Cole’s attorney says he is ‘questioning the science’

In her letter to the commission, Cole’s attorney argued that the allegations “arise as an attack on public statements and presentations that Dr. Cole has offered across the country.”

She wrote that Cole’s statements are “questioning the science behind mask wearing, as well as genuine concerns regarding known and unknown complications from COVID-19 vaccinations.”

To discipline him for those statements would infringe on his constitutionally protected right to free speech, the letter said. No government agency is “the arbiter of truth, particularly with respect to matters of scientific opinions and genuine scientific debate,” it said.

“Dr. Cole has not advised patients or the general public to not receive the vaccine,” the letter said.

These are the unsubstantiated statements Cole made in the months leading up to the letter. The statements are either categorically false or sharply at odds with the body of research on COVID-19 and the consensus of the medical community:

There is evidence that post-infection immunity may be comparable to post-vaccine immunity. A large study published recently in the New England Journal of Medicine found similar levels of protection in vaccinated patients as in COVID-recovered patients.

But, consistent with other studies, it found that vaccines after recovery from COVID-19 do indeed boost a person’s immunity against the virus.

“Vaccination enhanced protection among persons who had had a previous infection,” the study said. “Hybrid immunity resulting from previous infection and recent booster vaccination conferred the strongest protection.”

And the path to immunity by infection is far more dangerous than the path to immunity by vaccination.

To develop post-infection immunity, a person must first recover from COVID-19. People who were unvaccinated and died from the disease will never be reinfected, so their outcomes cannot be included in studies on reinfection rates.

GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX

The letter argues that Cole is merely sharing “opinions based on his observations, and (offering) hypotheses based thereon,” and that people filing complaints and “the media have simply labeled such opinions and hypotheses as misinformation because there are no published scientific studies completed on this observational question.”

In his public statements, Cole refers to his claims as “truth.” He attempts to directly link vaccines to dangerous health conditions. Before and since his letter to the medical board, Cole has claimed, without evidence, that:

Cole defends his treatments of patients with ivermectin

The letter also argues that Cole’s practice of treating COVID-19 patients and prescribing drugs to people over a telehealth platform was above-board.

Multiple doctors who work in local hospitals made statements to the Washington Medical Commission that they had treated patients who developed severe COVID-19 after following Cole’s advice or receiving treatment from him.

Cole said in fall 2021 that he had “treated hundreds and hundreds and hundreds of patients, of the which (sic) zero have gone to the emergency room or hospital.”

The letter said Cole “has received numerous letters from patients thanking him for providing treatment they could not obtain elsewhere.”

But, it said, Cole cannot respond to the hospital doctors’ allegations because he lost access to his patients’ medical records.

“In November or December 2021, (telehealth platform) Medici discontinued its contract with myfreedoctors.com and has since locked all providers out of the medical records it maintains,” the letter said. “This is a recent development and in no way affected Dr. Cole’s ability to access such patient records close in time to such treatment.”

And since he cannot defend himself, those allegations are “therefore entirely irrelevant,” the letter said.

The system Cole used for the telehealth appointments did not keep patient records sequestered. On its website, Medici provides a step-by-step tutorial for physicians to export patient records for local storage, saying it is “a great way to ensure your practice management system has a record of the consult” but reminding health care providers that they “may still wish to document the encounter” in their own medical record-keeping systems, too.

The letter says Cole did not receive a fee, charge patients or bill health insurance for those consultations. The appointments were free, although patients could make donations to the service, the letter said.

Cole claims ivermectin was only option for COVID-19 patients

Cole believes that benefits of early treatment with ivermectin outweigh the risks, the letter said.

“Further, ivermectin was prescribed by Dr. Cole at a time when there were simply no outpatient therapeutics that were being recommended,” it said.

Ivermectin is still being evaluated for use as a COVID-19 treatment. Studies so far have not proven its effectiveness.

Most people recover from COVID-19 at home with over-the-counter medication. For people at risk of severe illness, health care providers can give monoclonal antibody treatments — available at hospitals and community sites since last fall. Health care providers recommended vaccination, though, so that patients would be less likely to need those treatments at all.

At the time Cole was prescribing ivermectin, patients could have enrolled in clinical trials for early outpatient treatments, including ivermectin. The trials did not guarantee a patient would receive their preferred drug.

One trial was open from January 2021 through early 2022. Another trial, run by the National Institutes of Health, was open from June 2021 to February 2022. (Its initial results show a three-day course of ivermectin had no effect on hospitalization or death, and it shortened illness by less than a day. Researchers plan to launch a second arm of the trial to test a higher dose.)

The Sun in February asked Cole how many patients he had referred to those trials in lieu of prescribing drugs himself. He did not respond.

Did Cole advise against public health measures?

By the time his attorney told the Washington Medical Commission he had “not advised patients or the general public to disregard public health guidelines,” Cole had become a champion of noncompliance.

“We’ve been complacent. You know: ‘The government takes care of you, they’re gonna take care of you, I’m gonna be fine, whatever, they’re going to do their thing, I’ll just be a good little boy or girl and comply,’” he said at a conference in Kansas City in November 2021. “This is a 1776 moment, really, in our history. And we’re trying to earn our freedoms back? I’m sorry, but I never gave them up. I’m an American.”

– Nancy Garrett, attorney representing Dr. Ryan Cole in a matter before the Washington Medical Commission

According to Cole’s response to the commission, his goal is to inform the public and engage in scientific debate.

“The fact that other providers disagree with Dr. Cole, these providers have not shown any scientific studies that would render Dr. Cole’s opinions misrepresentations,” the letter said.

That rankled David Pate, a member of the state’s coronavirus working group, a former physician and lawyer, and retired CEO of St. Luke’s Health System.

“I have never listened to a presentation where either he presented both sides of the debate or where another panelist was there to debate,” Pate told the Sun. “In fact, he rejected my suggestion that he and I debate. When you only present one side and don’t represent that there are legitimate other points of view, I don’t know how that could be a debate.”

Cole’s claims about COVID-19, prevention, treatment and vaccination have been the subject of numerous fact-checking articles. The articles include links to studies and quote subject-matter experts. One fact-check article went directly to the source: the lead author of a paper Cole has cited.

“No publications demonstrate that mRNA vaccines cause cancer or autoimmune diseases,” Norbert Pardi, a research assistant professor of medicine at the University of Pennsylvania, said in an email to FactCheck.org.

“Multiple clinical trials have been performed with mRNA vaccines in the past 10 years and none of them found that mRNA vaccination caused autoimmune diseases. Further, we are not aware of any studies showing an autoimmune disease appearing many months after vaccination as Dr. Cole inaccurately suggests,” Pardi said, according to FactCheck’s article from April 2021.

Cole has dismissed such fact checks and said he plans to sue journalists over reporting on his statements. He has no active lawsuits in Idaho or federal courts.

The letter to the Washington Medical Commission makes a case for opinion and hypothesis — and freedom of speech.

But in his public interviews and speeches, he implores the public to listen to him, accuses health authorities of lying and calls public health measures a crime.

“It’s an honor to be here and to share some truth today,” Cole said at a November 2021 event in Kansas City.

“Are they lying to you? They are. This is science and data. They pulled the wool over your eyes so they could make billions,” he said. “The fact that they … are forcing you to still wear masks, that they are forcing you to get a shot to keep your employment, is criminal, plain and simple, criminal.”

FactCheck.org: Idaho Doctor Makes Baseless Claims About Safety of COVID-19 Vaccines, April 19, 2020

KTVB: St. Luke’s chief medical officer fact checks a doctor’s anti-vax claims, March 16, 2021

HealthFeedback.org: Not all coronaviruses are seasonal, contrary to pathologist Ryan Cole’s claim; COVID-19 vaccines are effective at preventing illness, April 4, 2021

AFP Fact Check: US doctor spreads false information about Covid-19 mRNA vaccines, Aug. 18, 2021

FactCheck.org and Univision Noticias: Médico de Idaho hace declaraciones infundadas sobre seguridad de vacunas contra el COVID-19, Aug. 27, 2021

Lead Stories: Dermatopathologist Ryan Cole Does NOT Back With Data His Claim That Pfizer Vaccine Weakens Patients’ Immune Systems, Sept. 21, 2021

USA Today: False claim that cancer has spiked as a result of COVID-19 vaccines, Sept. 27, 2021

HealthFeedback.org: No scientific evidence for claim by pathologist Ryan Cole that COVID-19 vaccines weaken the immune system, Sept. 27, 2021

Reuters: No evidence COVID-19 vaccines have caused increase in cancers, contrary to claims made on social media, Feb. 11, 2022

Idaho Capital Sun is part of States Newsroom, a network of news bureaus supported by grants and a coalition of donors as a 501c(3) public charity. Idaho Capital Sun maintains editorial independence. Contact Editor Christina Lords for questions: info@idahocapitalsun.com. Follow Idaho Capital Sun on Facebook and Twitter.

Our stories may be republished online or in print under Creative Commons license CC BY-NC-ND 4.0. We ask that you edit only for style or to shorten, provide proper attribution and link to our web site. Please see our republishing guidelines for use of photos and graphics.

Audrey Dutton, senior investigative reporter, joined the Idaho Capital Sun after 10 years at the Idaho Statesman. Her favorite topics to cover include health care, business, consumer protection issues and white collar crime. Dutton hails from Twin Falls. She attended college at Hamline University in St. Paul, Minnesota, and received a master's degree in journalism from Columbia University in New York City. Before coming home to Idaho, Dutton worked as a journalist in Minnesota, New York, Maryland and Washington, D.C. Dutton's work has earned dozens of state, regional and national awards for investigative reporting, health care and business reporting, data visualization and more.

The Idaho Capital Sun is the Gem State’s newest nonprofit news organization delivering accountability journalism on state politics, health care, tax policy, the environment and more.

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Our stories may be republished online or in print under Creative Commons license CC BY-NC-ND 4.0. We ask that you edit only for style or to shorten, provide proper attribution and link to our web site.