December 6, 2015

After guns wound and kill, bills pile up for victims and society

Shooting victim: ‘I just saw blood gushing out of my jaw’

Claudiare Motley still has scars on his neck after a teen shot him on June 21, 2014, during an attempted carjacking. Motley estimates the resulting medical bills, lost wages and travel costs for medical appointments and court hearings have cost him about $80,000 out­-of-­pocket. Motley is pictured here in downtown Milwaukee on Oct. 14.

Mike De Sisti/Milwaukee Journal Sentinel

Claudiare Motley still has scars on his neck after a teen shot him on June 21, 2014, during an attempted carjacking. Motley estimates the resulting medical bills, lost wages and travel costs for medical appointments and court hearings have cost him about $80,000 out­-of-­pocket. Motley is pictured here in downtown Milwaukee on Oct. 14.

Precious Lives logo
Precious Lives is a two-year project investigating the problem of gun violence among young people, its causes and potential solutions in the Milwaukee area and statewide. Read the Center’s stories in the series here.

In the Milwaukee Journal Sentinel

Journal Sentinel reporter Ashley Luthern collaborated with the Center on this report and produced her own story: “Bills add up when someone is shot, and costs spill over to taxpayers”

On the Radio

Listen to the Precious Lives radio report, “The Cost of a Single Bullet,” featuring the shooting that left Claudiare Motley badly injured and deeply in debt.

Reporter Sean Kirkby spoke with Wisconsin Public Radio’s Central Time about his report. Dec. 8, 2015.

On TV

Kirkby discussed the story on Wisconsin Public Television’s Here and Now. Dec. 4, 2015.

It was 1:30 a.m. on the first day of summer in 2014, and Claudiare Motley had just dropped off a friend after coming into town for his Milwaukee Tech High School 25-year class reunion. He was parked around North 63rd Street and West Capitol Drive, writing an email on his phone, as two cars pulled up.

Motley, then 43, knew “something was going on” as one of the vehicles turned in front of him and stopped. He put his phone into his pocket, shifted his car into gear. A teenager jumped from the car and tapped Motley’s window with a gun.

He accelerated as 15-year-old Nathan King fired, shattering glass. Motley rammed the car in front of him out of the way. He sped off and looked in the rearview mirror to see if they were chasing him.

“I just saw blood gushing out of my jaw,” Motley said.

After more than a year and six surgeries to repair his injuries, Motley estimates his out-of-pocket costs to be at least $80,000, and he expects more medical expenses as he continues to recover.

His efforts to get state victim’s compensation for his medical bills not covered by insurance have been unsuccessful so far. Motley’s credit has taken a hit, and he estimates lost earnings because of time he could not work in his family’s international law firm to be between $40,000 and $60,000.

Wisconsin taxpayers and health care providers also pay a high price for gun violence. In April, Mother Jones magazine pegged the cost of gun violence to Wisconsinites in 2012 at $2.9 billion in direct and indirect costs, or $508 for every person in the state.

Those figures include the financial and psychological tolls taken when a bullet forever alters the lives of victims and shooters alike. There are lost wages, stunted futures, shattered plans, life-changing trauma.

The credit of shooting victim Claudiare Motley has taken a hit after a 2014 shooting left him paying tens of thousands of dollars in out-of-pocket medical and other expenses.

Haley Henschel / Wisconsin Center for Investigative Journalism

The credit of shooting victim Claudiare Motley has taken a hit after a 2014 shooting left him paying tens of thousands of dollars in out-of-pocket medical and other expenses.

Firearms are a big factor in crime statewide. In 2014, guns were involved in 75 percent of murders, 56 percent of armed robberies, 27 percent of aggravated assaults and 3 percent of forcible rapes, according to the state Department of Justice.

Taxpayers pay all of the costs for police, prosecutors and incarceration — and sometimes to defend the accused — in gun crimes. And 79 percent of health care costs in Wisconsin associated with firearm-related injuries are paid by the public, according to a 2014 report using 2010 data by the Urban Institute, a Washington, D.C.-based think tank.

When he is released from prison, King — who is now paralyzed from the waist down because of a separate shooting days after he shot Motley — will probably face limited employment opportunities. Motley said he does not expect to see much of the $29,339 in court-ordered restitution.

Nathan King is wheeled out of court after being sentenced in July. King, who shot Claudiare Motley on June 21, 2014, was paralyzed from the waist down after being shot during another attempted robbery a few days later.

John Klein / For the Milwaukee Journal Sentinel

Nathan King is wheeled out of court after being sentenced in July. King, who shot Claudiare Motley on June 21, 2014, was paralyzed from the waist down after being shot during another attempted robbery a few days later.

State taxpayers paid about $1,500 for the 50 hours spent by Milwaukee County Assistant District Attorney Joy Hammond to prosecute King during the case that ended in September. They paid $1,537 for King’s attorney, Ann T. Bowe.

Residents of Wisconsin will spend about $405,000 to keep King in prison during his 12-and-a-half-year sentence for the Motley shooting and a later armed robbery in which King himself was shot. After he is released, King will be on extended supervision for seven and a half years at a cost to taxpayers of at least $21,000 in today’s dollars.

The tally for the Motley shooting — at least half a million dollars — is the cost of just one shooting in a city that this year has seen 691 people shot, including 131 killed, by firearms as of Nov. 15. That was a 77 percent increase in gun homicides from November 2014 and an 11 percent increase in nonfatal shootings.

Entire communities pay price

In addition to victims, entire communities face costs, including reduced property values in high-crime areas and increased costs to keep the public safe.

“It’s not just a problem for the individuals who are unlucky enough to get shot,” said Philip Cook, professor of public policy, economics and sociology at Duke University. “It’s a problem for whole communities. It’s a drag on economic development, it’s a drag on quality of life in a variety of ways.”

Violence was one of the things that prompted Motley to move out of his hometown of Milwaukee about eight years ago. He and his wife, Kimberley, and three children moved to Charlotte, North Carolina, in part to escape what he calls a “cultural acceptance of violence” and a “proliferation of guns and illegal drugs.”

“You always hear the bad things that could happen, but you never really think … that you actually encounter something like that,” he said.

A report from the Center for American Progress, a progressive public policy organization, suggests that a reduction in violent crime — including homicides, rapes and assaults — could have large impacts on urban areas. The report, which analyzed 2010 crime levels in Milwaukee and seven other cities, suggested a 10 percent reduction in homicides could boost residential real estate by $800 million in Milwaukee.

The report noted such a reduction could generate “large revenue gains” from property taxes, but it did not provide an estimate. Cutting homicides by 25 percent, it projected, could add $2 billion in increased housing values.

Police tape marks the scene where 13-year-old Giovonnie G. Cameron was shot and killed near Lincoln Park in Milwaukee on July 8. As of Nov. 15, fatal shootings in Milwaukee are up 77 percent compared to the same period in 2014.

Mark Hoffman / Milwaukee Journal Sentinel

Police tape marks the scene where 13-year-old Giovonnie G. Cameron was shot and killed near Lincoln Park in Milwaukee on July 8. As of Nov. 15, fatal shootings in Milwaukee are up 77 percent compared to the same period in 2014.

Experts say because the cost for each shooting is so high — often in the tens if not hundreds of thousands of dollars — anything that could reduce gun violence would likely be worth the investment.

“Almost any reasonable policy that reduces crime will pay for itself,” said David Weimer, a University of Wisconsin-Madison professor of political economy and expert in cost-benefit analysis.

But not everyone agrees on the best way to curb gun violence. Some have called for expanding background checks and for banning certain types of assault weapons.

Jeff Nass, executive director of Wisconsin Firearm Owners, Ranges, Clubs and Educators Inc., disagrees. He said any cost-benefit analysis should include the positive value that guns have when used for self-defense.

Nass, whose organization is affiliated with the National Rifle Association, argued that violence and gun issues are separate. He called for more prosecution of illegal gun possession and gun crimes.

“Bad violence is bad violence. Whether it’s done with a knife, a gun, whatever, it’s the person,” Nass said. “The people that we know are violent — that we know are in the criminal element — need to be held accountable.”

Gun violence drives up medical costs

The medical costs of shootings are often borne by taxpayers. Those costs usually begin with a trip to the hospital from the scene of the shooting.

Last year, paramedics from the Milwaukee Fire Department provided services to 297 shooting victims. The average cost was $1,300 per patient, or roughly $386,100.

Statewide, there were 349 hospitalizations and 742 emergency department visits because of firearm-related injuries in 2014, according to Department of Health Services data.

About half of emergency visits and 60 percent of hospitalizations are covered by Medicaid or Medicare, which are public insurance programs. The total amount public insurance programs paid for gun-related injuries in 2014 was about $6 million after negotiations between health care providers and the state and physician fees are factored in.

The Wisconsin Hospital Association, which provided information to the Wisconsin Center for Investigative Journalism used to reach this estimate, cautioned that it is “very rough.”

Dr. Stephen Hargarten, chair of the Department of Emergency Medicine at the Medical College of Wisconsin, said firearm injuries are “very, very expensive” to the public. Unlike knives and other methods of assault, firearms are more deadly and can leave significant long-term disabilities, he said.

Stephen Hargarten, director of the Injury Research Center at the Medical College of Wisconsin in Milwaukee, said firearm injuries are “very, very expensive” to the public.

Mike De Sisti / Milwaukee Journal Sentinel

Stephen Hargarten, director of the Injury Research Center at the Medical College of Wisconsin
in Milwaukee, said firearm injuries are “very, very expensive” to the public.

“It’s costly to all of us because a significant portion of the people who are injured with bullets are those who are on Medicaid, Medicare or self pay,” said Hargarten, director of the college’s Injury Research Center.

Ted Miller, senior research scientist at the nonprofit Pacific Institute for Research and Evaluation, said there may be additional costs for mental health care for those impacted by violence. Miller is is an expert in the costs of gun violence and other injuries at the institute, which uses research to recommend ways to improve public safety and health. For every type of homicide, he said, somewhere between 1.5 and 2.4 family members and loved ones of the victims seek mental health care.

Often, those costs, which vary from person to person, also are covered through public insurance programs, said Dr. Marlene Melzer-Lange, a professor of pediatrics at the Medical College of Wisconsin and program director of Project Ujima at the Children’s Hospital of Wisconsin in Milwaukee. Project Ujima provides mental health services to both adults and child victims of violent crime.

A small percentage of shootings leave victims paralyzed or gravely injured. That can lead to being placed on the state’s long-term care programs, which cost taxpayers roughly $3,100 a month for nursing home care or $530 a month for in-home care.

Legal, law enforcement costs high

Another cost is police response. That can vary significantly, from sending two officers to a report of shots fired to shutting down several blocks as officers canvass an area looking for evidence in a homicide. The time it takes to conduct an investigation depends on the cooperation of victims and witnesses and other factors.

“It’s different for every shooting,” said Milwaukee Police Department Sgt. Tim Gauerke. “Every one of them is based on the circumstances on hand.”

In 2014, the department dispatched units to 6,622 reported calls of shots fired — an average of 18 calls a day. Those calls may have overlapped with the 3,632 incidents of gunshots detected by the department’s ShotSpotter detection system, which allows police to pinpoint locations where a firearm has been discharged in an area of 11 square miles in the city.

That system expanded last year with a one-time funding of $350,000 split by the state and Milwaukee, and now costs the city more than $320,000 a year.

Wisconsin’s largest city has the most homicides and nonfatal shootings in the state. According to the Milwaukee Homicide Review Commission, there were 75 firearm homicides and 583 nonfatal shooting victims in the city in 2014. The Milwaukee County District Attorney’s Office prosecuted more than 1,100 cases involving a firearm last year.

To support efforts this year, the state, the city of Milwaukee and Milwaukee County formed the Milwaukee Gun Violence Reduction Initiative. The Legislature’s budget-writing committee unanimously backed $366,800 for the state to hire two assistant attorneys general to work as special prosecutors for gun cases in Milwaukee. Democratic and Republican lawmakers called the program a “Band-Aid” solution.

(From left) Arifah Akbar, Nazir Akbar and Katraile Scott stand together during a vigil for Tariq Akbar, on July 7. Tariq was shot to death July 3 in Milwaukee after watching a fireworks display with his friends. This year, Milwaukee has seen a sharp increase in shootings, which can cost taxpayers and victims tens if not hundreds of thousands of dollars each in medical bills, incarceration costs and other expenses.

Katie Klann / Milwaukee Journal Sentinel

(From left) Arifah Akbar, Nazir Akbar and Katraile Scott stand together during a vigil for Tariq Akbar, on July 7. Tariq was shot to death July 3 in Milwaukee after watching a fireworks display with his friends. This year, Milwaukee has seen a sharp increase in shootings, which can cost taxpayers and victims tens if not hundreds of thousands of dollars each in medical bills, incarceration costs and other expenses.

On the other side of firearm-related cases, the State Public Defender’s Office provides legal representation to defendants who cannot afford an attorney.

Since 2012, the office has appointed private attorneys to represent defendants in 832 armed robbery cases, paying each an average of $1,415. (Armed robbery can include any type of weapon, including a gun.) That amounts to $1.2 million and does not include the cost of paying public defender staff who represented other armed robbery suspects.

After they are convicted, inmates cost Wisconsin taxpayers an average of $32,800 a year. The average cost to supervise an offender after release is about $2,800 annually.

Police caught King, the teenager who shot Motley, shortly after the June 21, 2014, after he committed another crime. In that incident, King attempted to steal a woman’s car. She pulled out a gun and shot him, leaving King paralyzed from the waist down.

Motley fought to ensure King was tried as an adult because he felt a sentence in the juvenile system would have been too light.

Claudiare Motley is surrounded by his sisters after the sentencing of Nathan King in July. Motley, who was shot in Milwaukee last year, has undergone multiple surgeries and faced tens of thousands of dollars in bills and lost wages. Motley was one of 583 victims of nonfatal shootings in Milwaukee in 2014.

John Klein / For the Milwaukee Journal Sentintel

Claudiare Motley is surrounded by his sisters after the sentencing of Nathan King in July. Motley, who was shot in Milwaukee last year, has undergone multiple surgeries and faced tens of thousands of dollars in bills and lost wages. Motley was one of 583 victims of nonfatal shootings in Milwaukee in 2014.

“I just felt that was not enough to teach a lesson to a person who was really violent,” he said.

Gun violence costs wide-ranging

It is not just victims and perpetrators who pay a high price. There are other costs — some of them hard to quantify.

“We don’t know some of the other less easily defined costs of the fact that people in rural areas won’t come to Milwaukee because they’re scared,” said Hargarten of the Medical College of Wisconsin. “There’s an impact on tourism. There’s an impact maybe on businesses trying to locate somewhere else because the perception is that Milwaukee is not very safe.”

Miller said another understudied cost is the impact of adverse childhood experiences — serious traumas, such as witnessing or being a victim of gun violence. Studies show those experiences can harm brain development and may increase future health problems, including heart disease, depression and drug abuse.

“I think a lot of us for a long time have said violence is a public health problem, and a lot of people didn’t really believe it,” said Melzer-Lange of Project Ujima. “Your health either as a witness or as a direct victim is going to be affected downstream.”

Dr. Marlene Melzer-Lange, a professor of pediatrics at the Medical College of Wisconsin and program director of Project Ujima at the Children's Hospital of Wisconsin in Milwaukee, said children who witness violence are more likely to suffer future health problems.

Children’s Hospital of Wisconsin

Dr. Marlene Melzer-Lange, a professor of pediatrics at the Medical College of Wisconsin and program director of Project Ujima at the Children’s Hospital of Wisconsin in Milwaukee, said children who witness violence are more likely to suffer future health problems.

Schools also pay for gun violence. According to a 2013 article in the trade magazine Campus Safety, 88 percent of school districts nationwide made or planned to make security enhancements after the Sandy Hook Elementary School mass shooting in 2012.

There is also the “value of a statistical life.” Economists calculate that number by summing up what people are willing to pay for a small reduction in the probability of death. For example, if each person living in a community of 100,000 would pay $100 to reduce the number of deaths by one each year, the value of life would be $10 million.

The U.S. Department of Transportation puts the value at $9.4 million. This value is used nationwide by the department to analyze whether the cost of a certain potentially life-saving regulation or transportation improvement is worthwhile.

Miller puts the statistical value for one person injured by gun violence at $6.2 million. He said that “accounts for the pain, suffering and the lost quality of life for victims and their families.”

Victims can get some of their costs covered. Wisconsin’s Crime Victim Compensation Program caps the amount victims and their families can receive at $40,000 and only for out-of-pocket expenses. Qualifying families can also receive up to $1,000 to clean up a crime scene and $2,000 for a funeral. In all, $4.1 million was awarded in 2013-14 for 2,498 claims. The average claim paid was $3,205.

What can be done to curb violence?

Reducing gun violence requires a multi-faceted approach, experts say, with policy initiatives at the federal, state and local levels.

“If we can make those cities safer for gun violence, then they can develop and become places that thrive economically where businesses are investing in them, where employment becomes generally available,” said Cook of Duke.

Wisconsin lawmakers have offered some solutions. Gov. Scott Walker recently signed into law a bill that establishes mandatory minimum sentences for felons who commit certain violent crimes while illegally possessing a firearm.

Phil Cook, a professor of public policy, economics and sociology at Duke University, said gun violence is costly to the entire community. “It’s a drag on economic development, it’s a drag on quality of life in a variety of ways,” he said.

Duke University

Phil Cook, a professor of public policy, economics and sociology at Duke University, said gun violence is costly to the entire community. “It’s a drag on economic development, it’s a drag on quality of life in a variety of ways,” he said.

State Democrats want to expand background checks for firearm purchases and ban semiautomatic weapons. A bill with bipartisan support would prevent those who commit multiple or violent misdemeanors from purchasing a firearm for 10 years, but those bills have not moved far in the Legislature.

During a Nov. 4 discussion before voting to pay for additional prosecutors for Milwaukee gun crimes, Democrats called for more action.

“Until we get to the bottom of addressing trauma and giving people hope by giving people opportunity through jobs, nothing’s going to change,” said Sen. Lena Taylor, D-Milwaukee.

Twenty-four Democratic U.S. senators and 114 House members are urging President Barack Obama to use his executive powers to require universal background checks nationally.

State Republican lawmakers during the committee discussion saw different answers to the gun violence problem.

State Rep. Dale Kooyenga, R-Brookfield, said the problem needs to be addressed on multiple fronts. The state already has “a lot of gun laws,” and he said some of the issues may not be solvable through public policy.

“What Milwaukee needs and what kids need in Milwaukee is not more district attorneys,” Kooyenga said. “We need more fathers, and the other part of it is we need more schools.”

Sen. Alberta Darling, R-River Hills, called for more police officers and getting “habitual criminals” off the streets.

Motley agreed in part. He said repeat offenders, such as the 17-year-old who gave King the gun used to shoot him are part of “an epidemic that’s going on in the system.” Motley wants to find a way to prevent shootings and get guns off the streets, a focus that helps relieve some of the anger he feels at what happened to him.

“I’m not going to lay down. That’s not who I am,” Motley said. “And I’m just going to keep fighting.”