But city officials don't want to spend the money to install the equipment for a problem they contend occurs only rarely. Instead, they'd rather spend tax dollars in court to fight the state agency ordering the cleanup.
The state Department of Environmental Quality will publish a list within the next week of sewage-treatment plants that release toxic wastes into streams, rivers and lakes. Sources within DEQ say they expect the city's 23rd Avenue and 91st Avenue plants to make that list.
It isn't making the list itself that is causing city officials heartburn. It's the fact that the federal Environmental Protection Agency can then use that list to require the city to install expensive equipment to ensure that these toxic materials are removed during the treatment process and don't wind up in the river.
The city pleads sort-of guilty to the charge, but with an explanation and a request for a suspended sentence.
Assistant City Attorney Craig Reece says the city has been doing its own tests for years of what is coming out of the two sewage plants. "Occasionally, certain toxic pollutants showed up at levels that caused DEQ some concern," he admits. "We found some things we were surprised to see there."
Such as? Well, there's been mercury and thallium, both metals considered to be highly toxic in many forms. And there have been a variety of pesticides. But Reece sees no reason for DEQ or EPA to force action by the city.
"The problems are transient," he explains, showing up from time to time as the city takes "grab" samples to monitor what is coming out of the plants. Readings of mercury showed up six times over the last three years from the 23rd Avenue treatment plant and three times from the 91st Avenue plant.
"They're probably from teeth fillings," Reece says, "which are chemically inert." But Reece acknowledges that the tests the city runs show only the presence of some form of mercury compound but does not specify which one--or whether it is benign or dangerous.
The thallium? Reece doesn't know where that comes from but only that it showed up three times at one of the plants.
The same thing holds true for the pesticides, Reece says, showing up only on rare occasions. And some of these are pesticides that were recently banned, like heptachlor. "I suspect we won't ever see that again," he guesses.
Reece's logic rings hollow to Steve Pawlowski, an administrative service officer for DEQ who is handling the hearings on the list. He acknowledges that his agency relies on the city's random sampling to determine what comes out of the plants rather than having the state do its own monitoring. But he says that doesn't make the results invalid. "It's somewhat disingenuous now to impeach their own monitoring results," he says. "They've been using those types of monitoring results as the basis for reporting under their discharge permits for years. It's somewhat odd to now attack the use of grab samples."
Dave Baron, attorney for Arizona Center for Law in the Public Interest, also has no sympathy for the city's arguments.
"The reason they've only found these things a few times is they only sample for it very rarely," he says. "You know the old saying: If you hear no evil and see no evil, then there is no evil. That's the city's attitude."
Baron agrees with Reece on one point: The problem is being caused by industries illegally dumping toxic materials into the city sewer system. But Baron contends that happens because the city's monitoring of industry is little more than a joke. He says more can be done to find out who is doing the dumping. And it isn't as hard as the city would make it sound. "Most of these toxics can come from only certain sources," he says. "The average homeowner does not dump thallium down the drain."
What really galls Baron is the attitude of the city council. When informed of what DEQ was likely to do, the council did not order a cleanup. Instead the council voted to authorize the city attorney to file suit to block the state agency from including the city's two sewage plants on the list.
"If they were taking vigorous enforcement actions against those dumpers and really going out there and trying to find violations, they wouldn't be having these kind of problems," Baron says. "The fact is, people know the city's industrial wastewater department is a paper tiger and they can pretty much dump with impunity."
FIGHTING THE BLUES The state's largest health insurer may finally be forced to raise the white flag in its multiyear battle with chiropractors.
Under pressure from House Speaker Jane Hull, Blue Cross and Blue Shield will work with its sworn enemies to talk about their differences. While this, in itself, isn't exactly a victory for the chiropractors--they didn't get the legislation they sought last session to force Blue Cross to pay for their services--they did secure a promise that may get them what they want next year.
Maybe. The insurance company has been pretty persistent.
State lawmakers slapped down the company six years ago when it refused to pay chiropractors for services to subscribers. Legislators amended the law so that Blue Cross customers would be able to choose from a variety of regulated health-care providers.
But the company and its staff of legal-beagles crafted a carefully worded change in insurance policies. No, they wouldn't prohibit payments to chiropractors, which would violate the law. Instead they limited payments for certain treatments that, just coincidentally, are performed by chiropractors.
So it was back to the statehouse this year to fight the battle all over again.
"The Blues," as Blue Cross and Blue Shield is known, has contended for years that chiropractic care is too expensive to cover. "That's baloney," says state Representative Bill English. "That's just a red herring. It's the same kind of thing they've been throwing up all these years."
Lawmakers see the issue in simple terms. Individuals buy health insurance to cover them for certain ailments and procedures. A bevy of state laws stipulates what services each branch of medicine--doctors, nurses, midwives,chiropractors--can perform. Thus, they conclude, if the condition or procedure needed is covered under the policy, it shouldn't make a bit of difference which licensed provider actually performs it.
That simple vision escapes the Blues. Its new policy limits annual payments to $250 for "non-operative, outpatient" services "which involve manipulation or adjustment for spinal, skeletal, muscular or neural disorders."
See? No mention of chiropractors.
Funny thing, though. The limit only applies in "non-operative" cases. Chiropractors don't do surgery. And the cap involves only cases of outpatient evaluation. Chiropractors don't have hospital-staff privileges. And the rest of what's limited? It's virtually identical to the Arizona law that defines what a chiropractor does.
The Blue Cross policy has other restrictions. The $250 cap also includes "associated" services. That means a spinal X-ray performed by a chiropractor counts toward the $250 limit; the same X-ray ordered by an M.D. does not.
And what does Blue Cross say about this? "No comment," responds Andrea Lazar, vice president for government relations. Why? "Because the matter is in litigation." Never mind that it was Blue Cross which sued chiropractors in the first place last year after they complained about the policy language.
A bill last session sponsored by English to close the loophole had wide support, with three quarters of the sixty-member House pledged to vote for it. But the company had a trump card: One of its votes was Speaker Hull. And she refused to bring the measure to the House floor for a final vote.
English says he doesn't believe that the fact Hull's husband, Terry, is an M.D. obstetrician is a major factor in her decision. What is? "She feels she owes something to Blue Cross and Blue Shield," English says. "I don't know whether it's campaign [contributions] or business or whatever."
Hull argues it's a question of philosophy. "I don't believe in mandating benefits," she says. "It raises prices." Yet Hull supported another bill to bar health insurers from denying coverage to children with genetic defects--a bill sought by parents of children with Down's syndrome--something insurers have complained will cost them more. How does she reconcile her stance? "We're only relatively consistent around here," she responds.
But even Hull has a breaking point. And she didn't want to be creating any more problems in the already contentious session. So she told the company to sit down with the chiropractors and "work this thing out." While that, in itself, doesn't do much, it was the rest of Hull's promise that brought them into the deal: If the two sides can't make peace by next session, she will not intercede in the battle on behalf of Blue Cross. That means if English can still line up enough votes, Hull won't raise a pinky to slow the process.
Blue Cross is trying to sound as upbeat as possible about the deal. "We continue to re-evaluate [our policies] from time to time," says company representative Robin Steckler. But the company also understands the politics of the situation. "We also recognize the fact the speaker of the House is concerned about this issue and we did it as a courtesy," says Steckler.
It may take nothing short of a miracle to actually get the two sides to make peace, because this spat isn't a simple question of an insurance company's effort to save money. It is the latest in a long history of efforts by the "traditional" medical profession to force chiropractors out of business.
In 1987 a federal court judge in Illinois concluded that the American Medical Association was guilty of a twenty-year effort "to contain and eliminate chiropractic as a profession." She said the actions, including calling chiropractic care an "unscientific cult," amounted to a conspiracy.
Despite the doctors' best efforts, chiropractors managed to get all states--including Arizona--to license them as medical professionals. It took until 1980 for the AMA to allow its members to associate with chiropractors and refer patients to them.
Yet seven years later, the federal judge concluded there were lingering efforts of the illegal boycott and conspiracy. And the hostility still exists, as shown by the repeated Blue Cross and Blue Shield efforts to limit payments to chiropractors.
It's no coincidence the insurance company was created by medical doctors. And, of the twenty board members of the Arizona organization, seven are M.D.'s, two are retired hospital executives, one is a former president of the national Blue Shield Association and one is the president of the local Blue Cross and Blue Shield.
