interviews
Water and the American West
by Richard Frank
October 25, 2021
This interview with Richard Frank, professor of environmental practice at the UC Davis School of Law and Director of the California Environmental Law and Policy Center, was conducted and condensed by franknews.
frank | Can you tell me a little bit about the story of water and how it's tied to the West, and to California in particular?
Richard | A friend of mine who's a Court of Appeals Justice here in California wrote an opinion on a water law dispute and started it with the quote, "the history of California is written on its waters." And I think that the point is true of the entire American West.
Water policy and legal issues are inextricably tied to the development of the Western United States; water is the limiting factor in so many ways to settlement, to economic development, to prosperity, and to the environment and environmental preservation.
Can you talk about the difference between groundwater and surface water– and the policies that regulate each?
There are really two types of water when it comes to human consumption. There's surface water: that is the water that is transmitted by lakes, rivers, and streams. Then there is groundwater, and a substantial amount of water that Americans and the American West rely on is groundwater. That is water that is stored in groundwater aquifers, which are naturally occurring groundwater basins. Both groundwater and surface water are critical to the American West and its economy and its culture.
Traditionally a couple of things are important to note, first of all, water is finite. Second, water gets allocated in the Western United States generally at the state level. There's a limited federal role. Primarily, policy decisions about who gets how much water for what purpose are made state by state.
I think allocation is really interesting in that it's more state-level than federal. How was water and the allocation of water in California designed? Is it a public-private combination? What goes on in terms of the infrastructure of water?
Another very good question. The answer is it depends. Most of our water infrastructure is public in nature.
Again, in the American West, the regulation of water rights is generally done at the state level, but the federal government, historically, has a major water footprint in the American West because it has been federal dollars and federal design and management that really controlled much of the major water infrastructure in the American West — you know, Hoover Dam, and the complex system of dams and reservoirs on the Colorado River in California, with the Central Valley Project that was built and managed by the federal government with Shasta Dam on the upper Sacramento River as the centerpiece of that project. But we also have a California State Water Project, the key facility being the Oroville Dam and reservoir on the Southern River that is managed by state water managers. If we were starting over, that kind of parallel system would make no particular engineering or operational sense.
But, we are captive to our history.
And then you have these massive systems of aqueducts and canals that move water from one place to another throughout the American West. They are particularly responsible for moving water from surface water storage facilities to population centers. In the last 50 to 75 years, these population centers have really expanded dramatically, so you need massive infrastructure to deliver water from those storage facilities, the dams, and reservoirs, which generally are located in remote areas to the population centers. So it takes a lot of time and energy to transport the water, from where it is captured and stored to where it is needed for human use.
California has faced continuous drought – what measures is the state taking now to manage water?
Just to frame the issue a little bit — we have, as I mentioned, a growing population in the American Southwest at a time when the amount of available water is shrinking due to drought and due to the impacts of climate change. We have growing human demand for residential and commercial purposes and at the same time, we have a shrinking water supply. That is a huge looming crisis.
And it is beginning to play out in real-time. You see that playing out in real-time. For example, several different states and Mexico rely on Colorado River flows based on an allocation system that was created in the 1920s, which is overly optimistic about the amount of available water. From the 1920s until now, that water supply has decreased, and decreased, and decreased. Now you have interstate agreements, and in the case of Mexico, international agreements that allocate the finite Colorado river water supplies based on faulty, now obsolete, information. It is a real problem.
What measures do you take now, knowing this information?
If you look at the US Drought Monitor, it is obvious the problem is not limited to the Colorado River. We are in a mega-drought, so cutbacks are being imposed by federal and state water agencies to encourage agricultural, urban, and commercial water users to cut their water use and, and stretch finite supplies as much as possible through conservation efforts.
In California, we have the State Water Resources Control Board, the state water regulator in California, and they have issued curtailment orders. Meaning, they have told water rights holders, many of whom have had those water rights for over a hundred years, that, for the first time, the water that they feel they are entitled to, is not available. Local water districts are also issuing water conservation mandates; the San Francisco water department is doing that, in Los Angeles, the metropolitan water district, is urging urban users to curtail their efforts.
And then agriculture. Agricultural users — farmers and ranchers — have had to get water rights in many cases through the federal government, as the federal government is the operator of these water projects. They have contracts with water users, individual farmers, ranchers, or districts, and they are now issuing curtailment orders. They're saying, we know you contracted for X amount of water for this calendar year, but we are telling you because of the drought shortages we don't have that water to supply. Our reservoirs are low at Lake Shasta or at the Oroville Dam.
When you drive from San Francisco to LA on the five, you see a lot of signage from the agricultural farming community about water. There's apparently some frustration about this. What are the other options for them?
About 80% of all human consumed water goes to agriculture. That is by far the biggest component of water use, as opposed to 20% used for urban and commercial, and industrial purposes.
Over the years, ranchers and farmers, and agricultural water districts assumed that the water would always be there — as we all do.
And the farmers and ranchers have, in hindsight, exacerbated the problem by bringing more and more land into production. You see on those drives between San Francisco and Los Angeles, particularly in the San Joaquin Valley, all these orchards are being planted. Orchards are more lucrative crops than row crops — cotton, alfalfa, and rice. But, if you are growing a row crop, you can leave the land fallow in times of drought.
We don't have to plant. If the water stopped there, or if it's too expensive to get, it may make economic sense, but if you have an orchard or a vineyard it's a high value, those are high value crops, you don't have that operational flexibility and they need to be irrigated in wet years and in dry years. Now, you see these orchards, which were only planted a few years ago, are now being uprooted because the farmers realized that they don't have the water necessary to keep those vineyards and orchards alive. For ranchers, the same thing is true with their herds. They don’t have enough water for their livestock.
The water shortage has never been drier than it is right now. Farmers and ranchers are being deprived of water that they traditionally believed was theirs and they're very understandably, very unhappy about it. They see it as a threat to their livelihood and to the livelihood of the folks who work for them. Their anger and frustration are to be expected, but it's nobody's fault.
To say, as some farmers do, that it is mismanagement by state and federal government officials, I think is overly simplistic and misplaced in the face of a mega-drought. Everybody's going to have to sacrifice. Everybody's going to have to be more efficient in how they use water. All sectors are going to need to be more efficient with the water that does exist.
Looking at this percentage breakdown of water use – is it actually important for individual users to change their water habits?
Well, every little bit helps. When you're talking about homeowners, about 70% of urban water use is for outdoor irrigation. So we're talking parks and cemeteries and golf courses and folks' yards. You know, that used to be considered part of that American dream and the California dream — you would have a big lawn in front of your house and behind your house. Truth be told, that has never made much sense in an arid environment. That's where the water savings in urban areas is critical in the way it really involves aesthetics rather than critical human needs, like water for drinking and bathing and sanitation purposes. There is a growing movement away from big lawns, and away from the type of landscaping that you see in the Eastern US — there is no drought in the Eastern United States. As Hurricane Ida and other recent storms have shown, the problem is too much water, or rather than too little in most of the Eastern United States. So it really is a tale of two countries.
We just need to recognize that the American West is an arid region. It has always been an arid region, we can't make the desert bloom with water that doesn't exist. We need to be more efficient in how we allocate those water supplies. And it seems to me in an urban area, the best way to conserve and most effective way is to reduce urban landscaping, which is the major component of urban water use.
You also write about water markets and making them better – for those who don’t know, what is the water market?
Water markets, that is, the voluntary transfer of water between water users, is more robust in some other Western states. Again Arizona and New Mexico come to mind. California somewhat surprisingly is behind the curve. We are in the dark ages compared to other states. Water markets are kind of anecdotal. There is not much of a statewide system. It is done at the local level, through individual transactions without much oversight and without much transparency. And I have concerns about all of those things.
I believe conceptually watermarks are a way to stretch scarce, finite water resources to make water use more efficient. I can, for example, allow farmers or ranchers to sell water to urban uses or commercial usage or factories in times of drought.
Farmers sometimes can make more money by farming water, than they can by farming crops.
There are efficiencies to be gained here.
The problem in my view is really one of transparency. The water markets are not publicly regulated, and some of the people who are engaging in water transactions like it that way, frankly, they want to operate under the radar.
In my opinion, water markets need to be overseen by a public entity rather than private or nonprofit entities. We need oversight and transparency, so that folks like you and myself can follow the markets to see who's selling water to whom, for what purpose, and make sure that those water transfers serve the public interests and not just the private interests.
There have been a number of stories in the New York Times and the Wall Street Journal and the Salt Lake City Tribune about efforts in some parts to privatize water transfer. Hedge fund managers are buying and selling water, as a means of profiting. And it strikes me that when you're talking about an essential public resource — and in California, it is embedded in the law that public water is an inherently public resource, that water is owned by the public and it can be used for private purposes, but it is an inherently public resource — the idea of commoditizing water through the private, opaque markets is very troublesome to me. I think it represents a very dangerous trend and one that needs to be corrected and avoided.
Why is California so behind?
There's no good reason for it. It's largely inexplicable that since the state was created on September 9th, 1860, we've been fighting over water. In the 19th century, it was miners versus farmers ranchers. In the 20th century, with the growth of urban communities, the evolution of California into one of the most populous states with 40 million Californians, it has been a struggle between urban and agricultural uses of water.
In the second half of the 20th century, there was a recognition that some component of water had to be left in streams to protect ecosystems, landscape, and wildlife, including the threatened and endangered wildlife. That suggestion has made agricultural users in California angry. You will see those signs that allude to the idea that food and farming are more important than environmental values. I don't happen to believe that's true. I believe both are critically important to our society. But the advocates for the environment have a proverbial seat at the water table. So that's another demand for water allocation that exists.
Do you maintain optimism?
Yes. I think it's human nature to look on the bright side. I try to do that through research scholarships and teaching. There are models for how we can do this better in the United States. Israel and Saudi Arabia and Singapore are far more efficient with their water policies and efforts. Australia went through a severe megadrought. They came out of it a few years ago, but they used that opportunity to dramatically reform their water allocation systems. That's an additional model. I think most people would agree in hindsight that their previous system was antiquated, and not able to meet the challenges of climate change and the growing water shortage in some parts of the world.
Here in the United States, we can learn from those efforts. There are also some ways to expand the water supply. Desalination for one. Again, Singapore and Saudi Arabia have led the world in terms of removing the salt content from ocean water and increasing water supply that way. In Carlsbad, California, north of San Diego, we have the biggest desalination plant in the United States right now, and that is currently satisfying a significant component of the San Diego metropolitan areas’ water needs. It's more expensive than other water supplies, but the technology is getting more refined, so the cost of desalinated water is coming down at a time when other water supplies, due to shortages and the workings of the free market are going up.
At some point, they're going to meet or get closer. Unlike some of my environmental colleagues, I think desalination is an important part of the equation.
In a proposal that came up in the recall election, one of the candidates was talking about how we just need to build a canal from the Mississippi River to California to take care of all our problems. That ignores political problems associated with that effort, as well as the massive infrastructure costs that would be required to build and maintain a major aqueduct for 2000 miles from the Mississippi to California. That's just not going to happen. Some of those pie in the sky thoughts of how we expand the water supply, I think, are unrealistic.
interviews
An Introduction to Care
by Dr. Kali Cyrus
February 12, 2020
Dr. Kali Cyrus is our February co-editor.
I’m Kali Cyrus. I'm a psychiatrist in Washington D.C. I finished residency around 2017 and moved to D.C. in 2018. When I started working in this setting, I had just moved from Connecticut and finished about a year on the Hill working for a Senator [Chris Murphy]. I finished a fellowship through the American Psychiatric Association. They pair you with someone and you essentially work as a staffer. I finished doing that before I started working here at this clinic.
I was just doing this a couple of days a week, it was supposed to be a six month contract, I was going to be moving on to another job in Virginia. This was a way to bide my time, but I ended up loving the setting, feeling really passionate about the patients and the team that I was working with, and recently signed on to be full time. One of the things that made me want to look more into this was working on the Hill. I've just recently found my perspective on how many barriers are ridiculous, people don’t understand the minutiae of it.
I'd come from a different system in New Haven, Connecticut, which has a really good state public mental health system – I only realized in coming to D.C. I have the benefit of prior experience to see what systems do differently and how things could be functioning here. I was caught extremely off guard, and was surprised by how nonfunctioning the system was. I’m trying to find some answers myself, which worked out well to work with someone trying to also.
What does the dysfunction look like?
It's funny, when I first moved here, I was working at Senator Chris Murphy's office who's from Connecticut. I saw him at an event and told him how the system didn't function so well. He said, "You were always telling me how bad the Connecticut system was." And he laughed at me, and I realized what I think I know – I try to be as objective as I can.
One difference is that the state of Connecticut, like most States, run their public mental health system. They have a number of state sponsored clinics throughout regions of the state. Everyone who runs that clinic system in that area meets on a regular basis and acts as mom to all the hospitals. The long term state hospital and all of these centers are modeled to function the same way, depending on the population you're serving. You usually just have a clinic where you go for urgent care. If you don't know where to go, you can show up between nine to five, get an evaluation, and they will hold you in that clinic until you find a provider if you have insurance, or they'll transfer you up to their team.
Some have integrated medical offices. The one in New Haven I worked at had a primary care hub in it, and they have a 3-1-1. Everyone has one of these. It’s where you call if you're suicidal, or you need to talk to someone, and they're usually connected to some sort of local state psych hospital. A lot of these clinics have an ACT team.
Where I worked in New Haven was special because we also had a partnership with Yale, and were staffed by residents, staffed by psychiatrists who were also faculty at Yale – social workers, psychologists, psychiatrists, and providers who were actually paid by the state of Connecticut. It was a public private partnership. It was definitely a wealthier system. It was more functioning because we had a lot of manpower.
As it turns out in D.C., most of the community health work is done by either nonprofit or for profit core service agencies. That's the difference. Much of the care is provided by entities that have a profit driven motive – you need to stay afloat.
If I back up, D.C., District of Columbia, is not a state. That's something to keep in mind. They pay organizations, called core service agencies, to provide services. While this may be a private nonprofit, you're still run by the state. You can imagine that your profit motive is different because you are accountable to the same standard group.
The agencies vary in what they provide. If you're a bigger core service agency, you not only offer psychiatric services, you may also offer vans. You pick people up – if the city pays you to see one of your clients, through Medicaid & Medicare, you know you can say, "I'll take them.” You make more money because you have the van. You can continue to transport clients where they need to be – transportation is a huge thing. Otherwise, you have to rely on the Metro system and specialized forms of medical vans. But these agencies can also then say, "Well, we also have some group homes." If a client goes with them, they can house them in homes that meet every service, and pay staff members to be there around the clock.
They might also have Home Health Aides. Their own nursing staff, which are usually people with a bachelor's degree, not nursing degrees, who sit with patients all day.
In Connecticut you go to the closest hospital, then to one of the state public outpatient centers. In D.C. they have one centralized health point triage, that is in an office building. I'm used to the ER – where someone from a psychiatry team will evaluate you with a social worker that night, and then decide if you're in crisis, get you hospitalized.
The biggest difference is when clients are in crisis in Connecticut, we're able to get that person hospitalized. In D.C. they would go to the triage center, CPAP, to be evaluated. Everyone has to go through there and if they need to be hospitalized, it's more than likely not going to happen, because there are not a lot of places to go. The standard here is not to encourage you to go to hospitalization. They hold you in this triage center – and of course you calm down, you're in a structured environment, you're not on the street with all the stress, and then it’s "Oh you've calmed down" and you let you go. You literally have to be a danger to yourself or others, say you're going to kill someone.
Everything is state by state. What are some of your overarching concerns in the U.S. pertaining to mental health? Especially in patients where their living situation is chaotic, dangerous, or unpredictable?
Think about it in terms of, are you in crisis, and how do we keep you out of crisis?
They need a psychiatrist or a clinic to go to. They need someone who can give medications, or therapy, to keep them from being in crisis. For people like you and me it's tough to find a psychiatrist! The first thing people say to me when they learn I'm a shrink is, "Oh my God, I need a psychiatrist so badly." Especially if you're a person of color or another minority identity, you're probably looking for someone who looks like you. For whatever reason people can't find us.
If you break your ankle, it's pretty straight forward. You go to the hospital, they wrap it up. You may need surgery, you may need an MRI. Those doctors are going to get paid, that ER is going to get paid. Those x-ray technicians are going to get paid. It's clear.
Psychiatry has always been a bit of the bastard of medicine in that an emergency is fuzzier. It's like, "Oh well this person is high. Maybe that's why they're violent towards themselves." They don't have clear standards to reimburse because that looks different across States.
Someone who's high, someone who wants to die, or someone who's depressed, looks so different. To be able to say, "You should get reimbursed at this amount" you would need so many different scales – we call this issue “paired”. People talk about this in policies, that there's no mental health care. There's no mental health period. That essentially means mental health and behavioral care does not get reimbursement from Medicaid, from Medicare, or even your private insurance. What happens is that most people don't participate. Psychiatrists don't work with insurance companies, don't work with Medicaid, don't work with Medicare, don't work with Blue Cross, because you're going to get a reimbursement of $20 when you could be charging out of pocket.
We also have non-visible communities that don't have people around to show what it looks like to get preventative screenings in mental health care. This is probably more visible as it pertains to substance use. You have so many people trying to get sober, but where do they go once they get sober? AA? That's all we know.
In the eighties mental health treatment moved to this model of not wanting people to be locked up, to be in straight jackets, to be in jail, mental health prisons, which is a very worthy goal they're advocating for. We shouldn't just keep it as the hospital. But what happened was that everything was deinstitutionalized. The community will take care of you, but they never set that up in the community. A lot of people aren't in favor of hospitalization, but that's actually the backup in crisis.
The second way of thinking through this is, what happens when you're in crisis and, as it turns out, because we deinstitutionalized our form of care, we can't rely on structures that were in place, we're relying instead on community structures that were never put in place. If you're in crisis, you need to be watched 24/7. Think about a friend who's depressed, who's suicidal – you might sit up all night and watch them if this is your partner, if this is your mother. But are you going to be awake 24/7? That person could wake up, grab something out of the medicine cabinet and hurt themselves. That's why they need crisis care.
There's a third category of people who for mental health reasons aren't showering, aren't taking their medications – people living with their parents, living with their friends, and are deteriorating. Who's going to make them eat? It's quite paternalistic.
Again, if you're not being reimbursed at the same level as other specialties, that means you're not making as much money as a system, which means it's usually the mental health part of the hospital that loses money. If you're going to run this kind of shit for crisis, you know you're going to lose money. If they are available, and functioning, and making money, they're probably private hospitals – that's where I would end up. My insurance would pay for me to go get hospitalized day to day at a fancy private hospital that is going to make money, which means my insurance company, because I have good insurance, will pay the hospital more money or, I will pay someone out of pocket if need be, to make sure I have care. Those are the hospitals that end up doing really well.
What happens if you don't have the private hospital? What happens if you have a public hospital but all the beds are full? You end up having people at ERs. That's actually what's been happening in recent years.
People show up to the hospital because they need help, they get to the ER and there's nowhere to send them. So they sit in the ER bed for a day, a few days, up to a week. I've seen people sit in this little ER room waiting for another spot to open.
So what do you do? Each State has its own struggle depending on where they decide to invest their resources and money. One aspect you see that’s surprising to me, as maybe a naive, idealistic person, is that you have Medicaid and Medicare that reimburses pretty well for outpatient community, but there are field players taking advantage of that system, making money, but not provide a level of care that keeps people out crisis. That's what I've seen to be happening in D.C.