The Texas Tribune: Advocates Seek Mental Health Changes, Including Power to Detain

Matt Rainwaters for Texas Monthly

The Sherman grave of Andre Thomas’s victims.

SHERMAN — A worried call from his daughter’s boyfriend sent Paul Boren rushing to her apartment on the morning of March 27, 2004. He drove the eight blocks to her apartment, peering into his neighbors’ yards, searching for Andre Thomas, Laura Boren’s estranged husband.

Expanded coverage of Texas is produced by The Texas Tribune, a nonprofit news organization. To join the conversation about this article, go to texastribune.org.

For more articles on mental health and criminal justice in Texas, as well as a timeline of the Andre Thomas case: texastribune.org

Matt Rainwaters for Texas Monthly

Laura Boren

He drove past the brightly colored slides, swings and bouncy plastic animals in Fairview Park across the street from the apartment where Ms. Boren, 20, and her two children lived. He pulled into a parking spot below and immediately saw that her door was broken. As his heart raced, Mr. Boren, a white-haired giant of a man, bounded up the stairwell, calling out for his daughter.

He found her on the white carpet, smeared with blood, a gaping hole in her chest. Beside her left leg, a one-dollar bill was folded lengthwise, the radiating eye of the pyramid facing up. Mr. Boren knew she was gone.

In a panic, he rushed past the stuffed animals, dolls and plastic toys strewn along the hallway to the bedroom shared by his two grandchildren. The body of 13-month-old Leyha Hughes lay on the floor next to a blood-spattered doll nearly as big as she was.

Andre Boren, 4, lay on his back in his white children’s bed just above Leyha. He looked as if he could have been sleeping — a moment away from revealing the toothy grin that typically spread from one of his round cheeks to the other — except for the massive chest wound that matched the ones his father, Andre Thomas (the boy was also known as Andre Jr.), had inflicted on his mother and his half-sister as he tried to remove their hearts.

“You just can’t believe that it’s real,” said Sherry Boren, Laura Boren’s mother. “You’re hoping that it’s not, that it’s a dream or something, that you’re going to wake up at any minute.”

Mr. Thomas, who confessed to the murders of his wife, their son and her daughter by another man, was convicted in 2005 and sentenced to death at age 21. While awaiting trial in 2004, he gouged out one of his eyes, and in 2008 on death row, he removed the other and ate it.

At least twice in the three weeks before the crime, Mr. Thomas had sought mental health treatment, babbling illogically and threatening to commit suicide. On two occasions, staff members at the medical facilities were so worried that his psychosis made him a threat to himself or others that they sought emergency detention warrants for him.

Despite talk of suicide and bizarre biblical delusions, he was not detained for treatment. Mr. Thomas later told the police that he was convinced that Ms. Boren was the wicked Jezebel from the Bible, that his own son was the Antichrist and that Leyha was involved in an evil conspiracy with them.

He was on a mission from God, he said, to free their hearts of demons.

Hospitals do not have legal authority to detain people who voluntarily enter their facilities in search of mental health care but then decide to leave. It is one of many holes in the state’s nearly 30-year-old mental health code that advocates, police officers and judges say lawmakers need to fix. In a report last year, Texas Appleseed, a nonprofit advocacy organization, called on lawmakers to replace the existing code with one that reflects contemporary mental health needs.

“It was last fully revised in 1985, and clearly the mental health system has changed drastically since then,” said Susan Stone, a lawyer and psychiatrist who led the two-year Texas Appleseed project to study and recommend reforms to the code. Lawmakers have said that although the code may need to be revamped, it will not happen in this year’s legislative session. Such an undertaking requires legislative studies that have not been conducted. But advocates are urging legislators to make a few critical changes that they say could prevent tragedies, including giving hospitals the right to detain someone who is having a mental health crisis.

From the time Mr. Thomas was 10, he had told friends he heard demons in his head instructing him to do bad things. The cacophony drove him to attempt suicide repeatedly as an adolescent, according to court records. He drank and abused drugs to try to quiet the noise.

bgrissom@texastribune.org

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Major Banks Aid in Payday Loans Banned by States

Major banks have quickly become behind-the-scenes allies of Internet-based payday lenders that offer short-term loans with interest rates sometimes exceeding 500 percent.

With 15 states banning payday loans, a growing number of the lenders have set up online operations in more hospitable states or far-flung locales like Belize, Malta and the West Indies to more easily evade statewide caps on interest rates.

While the banks, which include giants like JPMorgan Chase, Bank of America and Wells Fargo, do not make the loans, they are a critical link for the lenders, enabling the lenders to withdraw payments automatically from borrowers’ bank accounts, even in states where the loans are banned entirely. In some cases, the banks allow lenders to tap checking accounts even after the customers have begged them to stop the withdrawals.

“Without the assistance of the banks in processing and sending electronic funds, these lenders simply couldn’t operate,” said Josh Zinner, co-director of the Neighborhood Economic Development Advocacy Project, which works with community groups in New York.

The banking industry says it is simply serving customers who have authorized the lenders to withdraw money from their accounts. “The industry is not in a position to monitor customer accounts to see where their payments are going,” said Virginia O’Neill, senior counsel with the American Bankers Association.

But state and federal officials are taking aim at the banks’ role at a time when authorities are increasing their efforts to clamp down on payday lending and its practice of providing quick money to borrowers who need cash.

The Federal Deposit Insurance Corporation and the Consumer Financial Protection Bureau are examining banks’ roles in the online loans, according to several people with direct knowledge of the matter. Benjamin M. Lawsky, who heads New York State’s Department of Financial Services, is investigating how banks enable the online lenders to skirt New York law and make loans to residents of the state, where interest rates are capped at 25 percent.

For the banks, it can be a lucrative partnership. At first blush, processing automatic withdrawals hardly seems like a source of profit. But many customers are already on shaky financial footing. The withdrawals often set off a cascade of fees from problems like overdrafts. Roughly 27 percent of payday loan borrowers say that the loans caused them to overdraw their accounts, according to a report released this month by the Pew Charitable Trusts. That fee income is coveted, given that financial regulations limiting fees on debit and credit cards have cost banks billions of dollars.

Some state and federal authorities say the banks’ role in enabling the lenders has frustrated government efforts to shield people from predatory loans — an issue that gained urgency after reckless mortgage lending helped precipitate the 2008 financial crisis.

Lawmakers, led by Senator Jeff Merkley, Democrat of Oregon, introduced a bill in July aimed at reining in the lenders, in part, by forcing them to abide by the laws of the state where the borrower lives, rather than where the lender is. The legislation, pending in Congress, would also allow borrowers to cancel automatic withdrawals more easily. “Technology has taken a lot of these scams online, and it’s time to crack down,” Mr. Merkley said in a statement when the bill was introduced.

While the loans are simple to obtain — some online lenders promise approval in minutes with no credit check — they are tough to get rid of. Customers who want to repay their loan in full typically must contact the online lender at least three days before the next withdrawal. Otherwise, the lender automatically renews the loans at least monthly and withdraws only the interest owed. Under federal law, customers are allowed to stop authorized withdrawals from their account. Still, some borrowers say their banks do not heed requests to stop the loans.

Ivy Brodsky, 37, thought she had figured out a way to stop six payday lenders from taking money from her account when she visited her Chase branch in Brighton Beach in Brooklyn in March to close it. But Chase kept the account open and between April and May, the six Internet lenders tried to withdraw money from Ms. Brodsky’s account 55 times, according to bank records reviewed by The New York Times. Chase charged her $1,523 in fees — a combination of 44 insufficient fund fees, extended overdraft fees and service fees.

For Subrina Baptiste, 33, an educational assistant in Brooklyn, the overdraft fees levied by Chase cannibalized her child support income. She said she applied for a $400 loan from Loanshoponline.com and a $700 loan from Advancemetoday.com in 2011. The loans, with annual interest rates of 730 percent and 584 percent respectively, skirt New York law.

Ms. Baptiste said she asked Chase to revoke the automatic withdrawals in October 2011, but was told that she had to ask the lenders instead. In one month, her bank records show, the lenders tried to take money from her account at least six times. Chase charged her $812 in fees and deducted over $600 from her child-support payments to cover them.

“I don’t understand why my own bank just wouldn’t listen to me,” Ms. Baptiste said, adding that Chase ultimately closed her account last January, three months after she asked.

A spokeswoman for Bank of America said the bank always honored requests to stop automatic withdrawals. Wells Fargo declined to comment. Kristin Lemkau, a spokeswoman for Chase, said: “We are working with the customers to resolve these cases.” Online lenders say they work to abide by state laws.

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North Korea Warns U.S. Forces of ‘Destruction’ Ahead of Drills

SEOUL (Reuters) — North Korea on Saturday warned the top U.S. military commander stationed in South Korea that his forces would “meet a miserable destruction” if they go ahead with scheduled military drills with South Korean troops, North Korean state media said.

Pak Rim-su, chief delegate of the North Korean military mission to the inter-Korean truce village of Panmunjom, gave the message by phone to Gen. James Thurman, the commander of the U.S. Forces Korea, KCNA news agency said.

It came amid escalating tension on the divided Korean peninsula after the North’s third nuclear test earlier this month, in defiance of U.N. resolutions, drew harsh international condemnation.

A direct message from the North’s Panmunjom mission to the U.S. commander is rare.

North and South Korea are technically still at war after their 1950-53 conflict ended in a truce, not a peace treaty.

The U.S.-South Korean Combined Forces Command is holding an annual computer-based simulation war drill, Key Resolve, from March 11 to 25, involving 10,000 South Korean and 3,500 U.S. troops.

The command also plans to hold Foal Eagle joint military exercises involving land, sea and air manoeuvres. About 200,000 Korean troops and 10,000 U.S. forces are expected to be mobilized for the two month-long exercise which starts on March 1.

“If your side ignites a war of aggression by staging the reckless joint military exercises...at this dangerous time, from that moment your fate will be hung by a thread with every hour,” Pak was quoted as saying.

“You had better bear in mind that those igniting a war are destined to meet a miserable destruction.”

Washington and Seoul regularly hold military exercises which they say are purely defensive. North Korea, which has stepped up its bellicose threats towards the United States and South Korea in recent months, sees them as rehearsals for invasion.

North Korea threatened South Korea with “final destruction” during a debate at the U.N. Conference on Disarmament on Tuesday.

(Reporting by Sung-won Shim; Editing by Nick Macfie)

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Oscar Pistorius gets bail as murder trial looms

PRETORIA, South Africa (AP) — Oscar Pistorius walked out of court Friday — free at least for now — after a South African magistrate released him on bail, capping four days of often startling testimony that foreshadowed a dramatic trial in the Valentine's Day slaying of his girlfriend.

But as he was driven away, chased by photographers and cameramen, questions continued to hound the double-amputee Olympian about what actually happened the night he gunned down Reeva Steenkamp inside a locked bathroom in his home.

Pistorius is charged with premeditated murder, and even Chief Magistrate Desmond Nair expressed doubts about his story that he mistook the 29-year-old model for an intruder and fired out of fear.

"Why would (Pistorius) venture further into danger" by going into the bathroom at all, Nair asked.

Cries of "Yes!" went up from Pistorius' supporters when Nair announced his decision to a packed courtroom after a nearly two-hour explanation of the ruling.

Nair set bail at 1 million rand ($113,000), with $11,300 in cash up front and proof that the rest is available. The 26-year-old track star was also ordered to hand over his passports, turn in any guns he owns and keep away from his upscale home in a gated community in Pretoria, which is now a crime scene.

He cannot leave the district of Pretoria without his probation officer's permission and is not allowed to consume drugs or alcohol, the magistrate said. His next court appearance was set for June 4.

Earlier, Pistorius alternately wept and appeared solemn and composed, especially as Nair criticized police procedures in the case and as a judgment in the track star's favor appeared imminent. He showed no reaction as he was granted bail.

Pistorius left the courthouse in a silver Land Rover just over an hour after the bail conditions were set. The vehicle, tailed by motorcycles carrying television cameramen, later pulled into the home of Pistorius' uncle.

"We are relieved at the fact that Oscar got bail today, but at the same time we are in mourning for the death of Reeva, with her family," said Pistorius' uncle, Arnold Pistorius. "As a family, we know Oscar's version of what happened on that tragic night and we know that that is the truth and that will prevail in the coming court case."

Dozens of journalists and international and local television crews had converged on the red-brick courthouse to hear the decision — a sign of the global fascination with a case involving a once-inspirational athlete and his beautiful girlfriend, a law school graduate and budding reality TV show contestant.

Nair said Pistorius' sworn statement, an unusual written account of what happened during the pre-dawn hours of Feb. 14, had helped his application for bail.

"I come to the conclusion that the accused has made a case to be released on bail," Nair said.

Pistorius said he shot Steenkamp accidentally, believing she was an intruder in his house. He described "a sense of terror rushing over" him and feeling vulnerable because he stood only on his stumps before opening fire.

Prosecutors say he intended to kill Steenkamp as she cowered in fear behind the locked bathroom door after a loud argument between the two.

Yet despite poking holes in Pistorius' version of events and bringing up incidents they say highlight his temper, the state's case started to unravel during testimony by the lead investigator, Detective Warrant Officer Hilton Botha.

Botha, who faces seven charges of attempted murder in an unrelated incident, was removed from the case Thursday. His replacement, the nation's top detective, Vinesh Moonoo, stopped by the hearing briefly Friday.

While Nair leveled harsh criticism at Botha for "errors" and "blunders," he said one man does not represent an investigation and that the state could not be expected to put all "the pieces of the puzzle" together in such a short time.

The prosecution accepted the judge's decision without protest. "We're still confident in our case," prosecution spokesman Medupe Simasiku said.

Pistorius faced the sternest bail requirements in South Africa because of the seriousness of the charge, which carries a life sentence if convicted. His defense attorneys had to prove that he would not flee the country, would not interfere with witnesses or the case, and his release would not cause public unrest.

Nair questioned whether Pistorius would be a flight risk when he stood to lose a fortune in cash, cars, property and other assets. Nair also said that while it had been shown that Pistorius had aggressive tendencies, he did not have a prior record of offenses for violent acts.

Anticipating the shape of the state's case at trial, he said he had serious questions about Pistorius' account: Why didn't he try to locate his girlfriend if he feared an intruder was in the house? Why didn't he try to determine who was in the bathroom before opening fire? And why did he venture into perceived "danger" in the bathroom when he could have taken other steps to ensure his safety?

"There are improbabilities which need to be explored," Nair said, adding that Pistorius could clarify these matters by testifying under oath at trial.

Sharon Steenkamp, Reeva's cousin, said the model's family would not be watching the bail decision and had not been following the hearing.

"It doesn't make any difference to the fact that we are without Reeva," she told The Associated Press.

Before the hearing, Pistorius' longtime coach, Ampie Louw, said he hoped to put the runner back into his training routine if he got bail.

"The sooner he can start working the better," said Louw, who persuaded the double-amputee to take up track as a teenager a decade ago. But he acknowledged Pistorius could be "heartbroken" and unwilling to immediately pull on the carbon-fiber running blades that earned him the nickname "Blade Runner."

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AP Sports Writer Gerald Imray contributed to this report from Johannesburg.

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Jon Gambrell can be reached at www.twitter.com/jongambrellAP .

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Drone Pilots Found to Get Stress Disorders Much as Those in Combat Do

U.S. Air Force/Master Sgt. Steve Horton

Capt. Richard Koll, left, and Airman First Class Mike Eulo monitored a drone aircraft after launching it in Iraq.

The study affirms a growing body of research finding health hazards even for those piloting machines from bases far from actual combat zones.

“Though it might be thousands of miles from the battlefield, this work still involves tough stressors and has tough consequences for those crews,” said Peter W. Singer, a scholar at the Brookings Institution who has written extensively about drones. He was not involved in the new research.

That study, by the Armed Forces Health Surveillance Center, which analyzes health trends among military personnel, did not try to explain the sources of mental health problems among drone pilots.

But Air Force officials and independent experts have suggested several potential causes, among them witnessing combat violence on live video feeds, working in isolation or under inflexible shift hours, juggling the simultaneous demands of home life with combat operations and dealing with intense stress because of crew shortages.

“Remotely piloted aircraft pilots may stare at the same piece of ground for days,” said Jean Lin Otto, an epidemiologist who was a co-author of the study. “They witness the carnage. Manned aircraft pilots don’t do that. They get out of there as soon as possible.”

Dr. Otto said she had begun the study expecting that drone pilots would actually have a higher rate of mental health problems because of the unique pressures of their job.

Since 2008, the number of pilots of remotely piloted aircraft — the Air Force’s preferred term for drones — has grown fourfold, to nearly 1,300. The Air Force is now training more pilots for its drones than for its fighter jets and bombers combined. And by 2015, it expects to have more drone pilots than bomber pilots, although fighter pilots will remain a larger group.

Those figures do not include drones operated by the C.I.A. in counterterrorism operations over Pakistan, Yemen and other countries.

The Pentagon has begun taking steps to keep pace with the rapid expansion of drone operations. It recently created a new medal to honor troops involved in both drone warfare and cyberwarfare. And the Air Force has expanded access to chaplains and therapists for drone operators, said Col. William M. Tart, who commanded remotely piloted aircraft crews at Creech Air Force Base in Nevada.

The Air Force has also conducted research into the health issues of drone crew members. In a 2011 survey of nearly 840 drone operators, it found that 46 percent of Reaper and Predator pilots, and 48 percent of Global Hawk sensor operators, reported “high operational stress.” Those crews cited long hours and frequent shift changes as major causes.

That study found the stress among drone operators to be much higher than that reported by Air Force members in logistics or support jobs. But it did not compare the stress levels of the drone operators with those of traditional pilots.

The new study looked at the electronic health records of 709 drone pilots and 5,256 manned aircraft pilots between October 2003 and December 2011. Those records included information about clinical diagnoses by medical professionals and not just self-reported symptoms.

After analyzing diagnosis and treatment records, the researchers initially found that the drone pilots had higher incidence rates for 12 conditions, including anxiety disorder, depressive disorder, post-traumatic stress disorder, substance abuse and suicidal ideation.

But after the data were adjusted for age, number of deployments, time in service and history of previous mental health problems, the rates were similar, said Dr. Otto, who was scheduled to present her findings in Arizona on Saturday at a conference of the American College of Preventive Medicine.

The study also found that the incidence rates of mental heath problems among drone pilots spiked in 2009. Dr. Otto speculated that the increase might have been the result of intense pressure on pilots during the Iraq surge in the preceding years.

The study found that pilots of both manned and unmanned aircraft had lower rates of mental health problems than other Air Force personnel. But Dr. Otto conceded that her study might underestimate problems among both manned and unmanned aircraft pilots, who may feel pressure not to report mental health symptoms to doctors out of fears that they will be grounded.

She said she planned to conduct two follow-up studies: one that tries to compensate for possible underreporting of mental health problems by pilots and another that analyzes mental health issues among sensor operators, who control drone cameras while sitting next to the pilots.

“The increasing use of remotely piloted aircraft for war fighting as well as humanitarian relief should prompt increased surveillance,” she said.

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Many States Say Cuts Would Burden Fragile Recovery

States are increasingly alarmed that they could become collateral damage in Washington’s latest fiscal battle, fearing that the impasse could saddle them with across-the-board spending cuts that threaten to slow their fragile recoveries or thrust them back into recession.

Some states, like Maryland and Virginia, are vulnerable because their economies are heavily dependent on federal workers, federal contracts and military spending, which will face steep reductions if Congress allows the automatic cuts, known as sequestration, to begin next Friday. Others, including Illinois and South Dakota, are at risk because of their reliance on the types of federal grants that are scheduled to be cut. And many states simply fear that a heavy dose of federal austerity could weaken their economies, costing them jobs and much-needed tax revenue.

So as state officials begin to draw up their budgets for next year, some say that the biggest risk they see is not the weak housing market or the troubled European economy but the federal government. While the threat of big federal cuts to states has become something of a semiannual occurrence in recent years, state officials said in interviews that they fear that this time the federal government might not be crying wolf — and their hopes are dimming that a deal will be struck in Washington in time to avert the cuts.

The impact would be widespread as the cuts ripple across the nation over the next year.

Texas expects to see its education aid slashed hundreds of millions of dollars, which could force local school districts to fire teachers, if the cuts are not averted. Michigan officials say they are in no position to replace the lost federal dollars with state dollars, but worry about cuts to federal programs like the one that helps people heat their homes. Maryland is bracing not only for a blow to its economy, which depends on federal workers and contractors and the many private businesses that support them, but also for cuts in federal aid for schools, Head Start programs, a nutrition program for pregnant women, mothers and children, and job training programs, among others.

Gov. Bob McDonnell of Virginia, a Republican, warned in a letter to President Obama on Monday that the automatic spending cuts would have a “potentially devastating impact” and could force Virginia and other states into a recession, noting that the planned cuts to military spending would be especially damaging to areas like Hampton Roads that have a big Navy presence. And he noted that the whole idea of the proposed cuts was that they were supposed to be so unpalatable that they would force officials in Washington to come up with a compromise.

“As we all know, the defense, and other, cuts in the sequester were designed to be a hammer, not a real policy,” Mr. McDonnell wrote. “Unfortunately, inaction by you and Congress now leaves states and localities to adjust to the looming threat of this haphazard idea.”

The looming cuts come just as many states feel they are turning the corner after the prolonged slump caused by the recession. Gov. Martin O’Malley of Maryland, a Democrat, said he was moving to increase the state’s cash reserves and rainy day funds as a hedge against federal cuts.

“I’d rather be spending those dollars on things that improve our business climate, that accelerate our recovery, that get more people back to work, or on needed infrastructure — transportation, roads, bridges and the like,” he said, adding that Maryland has eliminated 5,600 positions in recent years and that its government was smaller, on a per capita basis, than it had been in four decades. “But I can’t do that. I can’t responsibly do that as long as I have this hara-kiri Congress threatening to drive a long knife through our recovery.”

Federal spending on salaries, wages and procurement makes up close to 20 percent of the economies of Maryland and Virginia, according to an analysis by the Pew Center on the States.

But states are in a delicate position. While they fear the impact of the automatic cuts, they also fear that any deal to avert them might be even worse for their bottom lines. That is because many of the planned cuts would go to military spending and not just domestic programs, and some of the most important federal programs for states, including Medicaid and federal highway funds, would be exempt from the cuts.

States will see a reduction of $5.8 billion this year in the federal grant programs subject to the automatic cuts, according to an analysis by Federal Funds Information for States, a group created by the National Governors Association and the National Conference of State Legislatures that tracks the impact of federal actions on states. California, New York and Texas stand to lose the most money from the automatic cuts, and Puerto Rico, which is already facing serious fiscal distress, is threatened with the loss of more than $126 million in federal grant money, the analysis found.

Even with the automatic cuts, the analysis found, states are still expected to get more federal aid over all this year than they did last year, because of growth in some of the biggest programs that are exempt from the cuts, including Medicaid.

But the cuts still pose a real risk to states, officials said. State budget officials from around the country held a conference call last week to discuss the threatened cuts. “In almost every case the folks at the state level, the budget offices, are pretty much telling the agencies and departments that they’re not going to backfill — they’re not going to make up for the budget cuts,” said Scott D. Pattison, the executive director of the National Association of State Budget Officers, which arranged the call. “They don’t have enough state funds to make up for federal cuts.”

The cuts would not hit all states equally, the Pew Center on the States found. While the federal grants subject to the cuts make up more than 10 percent of South Dakota’s revenue, it found, they make up less than 5 percent of Delaware’s revenue.

Many state officials find themselves frustrated year after year by the uncertainty of what they can expect from Washington, which provides states with roughly a third of their revenues. There were threats of cuts when Congress balked at raising the debt limit in 2011, when a so-called super-committee tried and failed to reach a budget deal, and late last year when the nation faced the “fiscal cliff.”

John E. Nixon, the director of Michigan’s budget office, said that all the uncertainty made the state’s planning more difficult. “If it’s going to happen,” he said, “at some point we need to rip off the Band-Aid.”

Fernanda Santos contributed reporting.

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Pistorius Bail Hearing Set to Resume

PRETORIA, South Africa — Oscar Pistorius, the double amputee track star accused of murdering his girlfriend, was to return to court on Friday on the fourth day of hearings this week about whether he should be granted bail in a case that has riveted the nation.

News reports said he slipped into the courthouse, his head covered by a jacket, some time before the scheduled start of hearings that have packed the courtroom with a scrum of journalists alongside legal teams, family members and onlookers.

In the latest in a series of abrupt twists in the affair on Thursday, the South African police replaced the lead investigator after revelations that he was facing seven charges of attempted murder stemming from an episode in which police officers fired at a minivan.

The change was announced a day after the investigator, Detective Warrant Officer Hilton Botha, acknowledged several mistakes in the police work and conceded that, based on the existing evidence, he could not rule out the version of events presented by Mr. Pistorius.

The prosecution says Mr. Pistorius committed the premeditated murder of Reeva Steenkamp, a 29-year-old model and law graduate, when he fired four shots through a locked bathroom door while she was on the other side in the early hours of Feb. 14.

After widespread news reports about the charges against Detective Botha, Gerrie Nel, the prosecutor, said at the start of a hearing on Thursday that he had just learned about them.

Mr. Pistorius has said that he opened fire believing there was an intruder in his home, in a gated community in Pretoria, and that he had no intention of killing Ms. Steenkamp, 29, a model and law school graduate.

But prosecutor Nel labeled Mr. Pistorius’s account “improbable.”

“What we can’t forget is the applicant is charged with murdering a defenseless, innocent woman,” Mr. Nel said.

Mr. Pistorius has said that he did not realize Ms. Steenkamp was no longer in bed as he rose to check for an intruder, shouting to her to call the police.

“You want to protect her, but you don’t even look at her?” Mr. Nel said. “You don’t even ask, ‘Reeva, are you all right?’ 

On Thursday, a police brigadier, Neville Malila, told reporters that Detective Botha was scheduled to appear in court in May on the attempted murder charges in connection with an episode in which Mr. Botha and two other police officers fired at a minivan.

“Botha and two other policemen allegedly tried to stop a minibus taxi with seven people,” Brigadier Malila said. “They fired shots.” While the charges were initially dropped, “we were informed yesterday that the charges will be reinstated,” he said.

Medupe Simasiku, a spokesman for the National Prosecuting Authority, told reporters that the decision to reinstate the charges was made on Feb. 4, long before Ms. Steenkamp was killed.

Lydia Polgreen reported from Pretoria, South Africa, and Alan Cowell from London.

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A 1-2 knockout: McIlroy, Woods lose in Match Play

MARANA, Ariz. (AP) — Rory McIlroy and Tiger Woods knocked out in the first round of the Match Play Championship? Not many would have given that a snowball's chance in the desert.

Almost as surprising as the freakish snowstorm on Dove Mountain was the sight of golf's two biggest stars heading to the airport, only the second time in the 15-year history of this wild tournament that No. 1 and No. 2 didn't last more than a day.

Shane Lowry of Ireland chipped in twice and drilled a fairway metal to 3 feet to seize control, and then knocked out McIlroy with a bunker shot to 4 feet to save par on the final hole. Just as the shock was wearing off, Charles Howell III came up with kind of shots he's used to seeing Woods make in the clutch — a wedge that stopped inches from the cup on the 15th hole, and a 25-foot birdie on the 16th that carried him to a 2-and-1 victory.

"It's definitely a day I'm going to remember," said Lowry, the third player in the last four years to eliminate the No. 1 seed in the opening round.

"I had nothing to lose," Howell said.

The biggest loser Thursday might have been NBC Sports, which lost the two biggest draws.

Not even Phil Mickelson can save the day. He's not playing this year.

Howell had not faced Woods in match play since he was 17 and lost to him in the third round of the 1996 U.S. Amateur. He said he had never beaten him even in the dozens of casual games they played over the years at Isleworth before Woods moved away to south Florida.

What a time to change that losing streak.

Howell, who qualified for this World Golf Championship for the first time in five years, played a fabulous round in cold conditions. They matched scores 10 times in 14 holes before Howell came through with back-to-back birdies.

"In this format, match play is crazy," Howell said. "He's Tiger Woods. I was lucky to hang in there."

The final matches were played in near darkness, and they could have stopped after 15 holes. Woods wanted to play on, even though Howell had the momentum. Woods was 2 under for the day, and neither of them made a bogey.

"We both played well," Woods said. "He made a couple of more birdies than I did. He played well, and he's advancing."

McIlroy, the No. 1 player in the world, built a 2-up lead early in the match until Lowry rallied and grabbed the momentum by chipping in for birdie on the par-5 11th to avoid falling behind, chipping in from behind the 12th green for birdie and then ripping a fairway metal to within a few feet for a conceded eagle on the 13th to go 2 up.

Lowry missed a short par putt on the 14th, only for McIlroy to give away the next hole with a tee shot into the desert and a bunker shot that flew over the 15th green and into a cactus. But the two-time major champion hung tough, coming up with a clutch birdie on the 16th to stay in the game.

McIlroy nearly holed his bunker on the 18th, and Lowry followed with a steady shot out to 4 feet and calmly sank the putt.

"Deep down, I knew I could beat him," Lowry said. "There's a reason I'm here, and this is match play."

For McIlroy, more questions are sure to follow him to Florida for his road to the Masters. He now has played only 54 holes in the first two months of the season, missing the cut in Abu Dhabi and losing in the first round at Dove Mountain.

"You want to try and get as far as you can, but I guess that's match play," McIlroy said. "I probably would have lost by more if I had played someone else in the field. It wasn't a great quality match. But it would have been nice to get through and just get another day here and another competitive round under my belt."

The only other time the top two seeds lost in the opening round was in 2002, when Woods and Phil Mickelson lost at La Costa.

Luke Donald nearly made it the top three seeds except for a clutch performance. He holed a 10-foot birdie putt to halve the 17th hole and stay tied with Marcel Siem of Germany. Donald then birdied the 18th from 7 feet to win the match.

Louis Oosthuizen, the No. 4 seed, rallied to get past Richie Ramsay of Scotland.

The opening round was halted Wednesday after 3½ hours because of a freak snowstorm that covered Dove Mountain with nearly 2 inches. It continued to snow at times overnight, and it took nearly five hours to clear snow from the golf course for the tournament to resume.

Turns out, snow wasn't the only surprise.

"I had to play extremely well to have a chance, and I still kept waiting for that Tiger moment," Howell said.

It never came.

Woods missed short birdie chances at the 10th and 11th, but the real damage came on the 15th when he went long of the green with a wedge in hand. Howell also missed a pair of short putts on the back nine, but he came up big with the putt on the 16th.

"Really, I didn't even realize I was 2 up with two to go until I got right to the tee on 17, and it actually threw me for a bit because I never maybe was really in the moment and didn't quite realize how things were," Howell said. "And as far as beating Tiger Woods, it shows you that match play is crazy. I did have to play a good round. But yeah, it's a bit hard to believe I'm sitting here today."

Howell and Lowry will have to wait until Friday to find out their opponents.

Carl Pettersson was 1 up on Rickie Fowler through 17 holes when they stopped because of darkness. The winner gets Lowry, who will be fighting some history. Of the previous three players to beat the No. 1 seed in the opening round, all of them lost in the second round.

Howell gets either Gonzalo Fernandez-Castano or Francesco Molinari, who were all square through 15 holes.

In other matches:

— Ernie Els lost in the opening round for the sixth time. He missed a 3-foot par putt on the 16th hole that would have given him the lead, and he missed a 5-foot par putt on the 18th hole to lose to Fredrik Jacobson.

— Russell Henley, two months into his rookie season, defeated the hottest player in the field when he took down Charl Schwartzel, who had won twice and finished no worse than fifth in his last six tournaments worldwide.

— Rafael Cabrera Bello beat Lee Westwood in 19 holes after Westwood missed a 6-foot par putt on the last hole.

The opening round of the Match Play is typically the best day in golf. This one took two days, and it was unlike any other.

Nearly 2 inches of snow covered Dove Mountain on Wednesday, and with more snow overnight, nothing had changed when players began arriving Thursday morning. There already was a two-hour delay when they arrived.

"There was a guy building a snowman this morning at 8, and they said they were going off at 10:30," Henley said. "I figured it was going to be awhile"

No one had an easier day than Bo Van Pelt.

Having won six straight holes to go 5 up before snow suspended play on Wednesday, Van Pelt finally got back on the golf course and struck all of two shots — an 8-iron and a 45-foot putt. He won the 13th hole with a par to complete a 6-and-5 win over John Senden of Australia.

And then there was Sergio Garcia. He was one putt away from winning when play stopped Wednesday. He three-putted from 12 feet to lose the hole, and on the 18th hole, Thongchai Jaidee made a 6-foot birdie to send the match into overtime.

On the first extra hole, Garcia removed his cap and was putting his golf ball and tees in the bag as Jaidee settled over a 10-foot birdie. The putt ran around the back edge of the cup, giving Garcia life. He made birdie on the par-5 second hole to win in 20 holes.

So instead of hitting one shot Thursday, he had to play 19 of them. Garcia's was the first match of the tournament. It took him about 30 hours to finish.

"It's weirdness, I guess," Garcia said. "I guess at the end of the day, I was pleased to get through."

That's one thing McIlroy and Woods can't say.

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Governors Fall Away in G.O.P. Fight Against More Medicaid

Under pressure from the health care industry and consumer advocates, seven Republican governors are cautiously moving to expand Medicaid, giving an unexpected boost to President Obama’s plan to insure some 30 million more Americans.

The Supreme Court ruled last year that expanding Medicaid to include many more low-income people was an option under the new federal health care law, not a requirement, tossing the decision to the states and touching off battles in many capitols.

The federal government will pay the entire cost of covering newly eligible beneficiaries from 2014 to 2016, and 90 percent or more later. But many Republican governors and lawmakers immediately questioned whether that commitment would last, and whether increased spending on Medicaid makes sense, given the size of the federal budget deficit. Some flatly declared they would not consider it.

In Florida, where Gov. Rick Scott reversed his position and on Wednesday announced his support for expanding Medicaid, proponents say that doing so will not only save lives, but also create jobs and stimulate the economy. Similar arguments have swayed the Republican governors of Arizona, Michigan, Nevada, New Mexico, North Dakota and Ohio, who in recent months have announced their intention to expand Medicaid.

The shift has delighted supporters of the law.

“I think this means the dominoes are falling,” said Ronald F. Pollack, the executive director of Families USA, a consumer group. “The message is, ‘Even though I may not have supported and even strongly opposed the Affordable Care Act, it would be harmful to the citizens of my state if I didn’t opt into taking these very substantial federal dollars to help people who truly need it.’ ”

 Nationwide, Medicaid covers 60 million people, most of them low-income or disabled. The Congressional Budget Office has estimated that 17 million more people could be enrolled if all states took the expansion option. So far, 22 states have said they will expand the program, 17 have opted against it, and 11 have not yet decided, according to Avalere Health, a consulting firm.

Some Republican governors remain firmly opposed to the expansion of Medicaid. In her State of the State address, Gov. Nikki R. Haley said, “As long as I am governor, South Carolina will not implement the public policy disaster that is Obamacare’s Medicaid expansion.”

Gov. Rick Perry affirmed that “Texas will not expand Medicaid” and said he was proud that Texas did not follow other states “scrambling to grab every tax dollar they can.”

The change of heart for some Republican governors has come after vigorous lobbying by health industry players, particularly hospitals. Hospital associations around the country signed off on Medicaid cuts under the health care law on the assumption that their losses would be more than offset by new paying customers, including many insured by Medicaid.

Politics could also be a factor in states where Republican governors have decided to expand Medicaid. Mr. Obama won all of those states except Arizona and North Dakota in last year’s election, a fact that may have influenced several of the governors’ decisions. Some of the seven are also up for re-election next year.

Religious leaders have added a moral dimension to the campaign in some states. The Roman Catholic bishops of Salt Lake City and Little Rock, Ark., for example, have urged state officials to expand Medicaid.

The Obama administration has tried to win over skeptical state officials by offering new flexibility to manage Medicaid as they like. On the same day that he agreed to expand Medicaid in Florida, Mr. Scott got federal permission to move more Medicaid beneficiaries into private managed care plans.

Mr. Scott’s support for expanding Medicaid is particularly significant — Florida is the fourth most populous state — and surprising. A onetime hospital executive, he has been among the most strident critics of the health care law, and his opposition to it was a cornerstone of his 2010 campaign for governor.

The battle is not over, however. In Florida, as in many other states, expansion is subject to approval by the Legislature, whose Republican leaders have expressed misgivings. The legislative session begins next month, and advocates say they plan to press ahead with a lobbying campaign.

Leah Barber-Heinz, a spokeswoman for Florida Chain, a health advocacy group, said it was trying to inform lawmakers and the public about who would benefit from an expansion of Medicaid. More than one-fifth of Florida residents, roughly 4 million of 19 million people, lack health insurance.

“There are so many misperceptions about the uninsured,” Ms. Barber-Heinz said. “So we’re trying to show faces of who would be impacted: people who have been hit by the recession, people who have been laid off, educated people, people who own homes.”

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Sign of a Comeback: U.S. Carmakers Are Hiring

Tony Dejak/Associated Press

Joseph R. Hinrichs, head of Ford's Americas region, with a two-liter EcoBoost engine at the Cleveland plant.

DETROIT — A few years ago, American automakers cut tens of thousands of jobs and shut dozens of factories simply to survive.

But since the recession ended and General Motors and Chrysler began to recover with the help of hefty government bailouts and bankruptcy filings, all three Detroit car companies including Ford Motor Company have achieved one of the unlikeliest comebacks among industries devastated during the financial crisis.

Now steadily rising auto sales and two-tier wage concessions from labor have spurred a wave of new manufacturing investments and hiring by the three Detroit automakers in the United States. The latest development occurred on Thursday, when Ford said it was adding 450 jobs and expanding what had been a beleaguered engine plant in Ohio to feed the growing demand for more fuel-efficient cars and S.U.V.’s in the American market.

Ford, the nation’s second-largest automaker after G.M., said it would spend $200 million to renovate its Cleveland engine plant to produce small, turbocharged engines used in its top-selling models. Ford plans to centralize production of its two-liter EcoBoost engine — used in popular models like the Fusion sedan and Explorer S.U.V. — at the Cleveland facility by the end of next year.

Its move to expand production in the United States is yet another tangible sign of recovery among the Detroit auto companies. Industrywide sales in the United States are expected to top 15 million vehicles this year after sinking beneath 11 million in 2009.

Last month, G.M. announced plans to invest $600 million in its assembly plant in Kansas City, Kan., one of the company’s oldest factories in the country. And Chrysler, the smallest of the Detroit car companies, is adding a third shift of workers to its Jeep plant in Detroit.

The biggest factor in the market’s revival has been the need by consumers to replace aging, gas-guzzling models. “Pent-up demand and widespread access to credit are keeping up the sales momentum,” said Jessica Caldwell, an analyst with the auto research site Edmunds.com.

And Joseph R. Hinrichs, the head of Ford’s Americas region, explained in an interview that the company’s Ohio revival plan was “all based on increased demand.”

“We’re putting the capacity here because that’s where we need it most,” he said.

Yet even though Ford is enjoying a resurgence in the United States, it is racing to reduce costs in its troubled European division. The workers in Spain who were building the small EcoBoost engines that have been shipped to America will be moved to an assembly plant that is taking on work from a plant to be closed in Belgium.

While Ford survived the industry’s financial crisis without government help, it still cut thousands of jobs and shuttered several factories to reduce costs and bring production more in line with shrinking sales.

But now, the burst of showroom business has prompted automakers to increase output at remaining plants. In Ford’s case, the company added about 8,000 salaried and hourly jobs last year, and has said it plans to hire about 2,200 white-collar workers in 2013. Ford is also moving some vehicle production from Mexico to a Michigan plant, where it will add 1,200 jobs.

The investment in Cleveland is indicative of how Ford and other carmakers have trimmed domestic labor costs and improved productivity since the recession. Just a few years ago, the company was forced to consolidate two engine plants into one in northern Ohio, and close a major component operation. “No question we have been through a lot in northern Ohio,” Mr. Hinrichs said. “But now our North American business is very competitive with the best in the world.”

Mr. Hinrichs said that a new local agreement with the United Automobile Workers union in Cleveland paved the way for the expansion. Currently the plant employs about 1,300 workers.

The Detroit companies are also benefiting from their ability to hire lower-paid, entry-level workers as part of their national contract with the U.A.W. Many of the 450 new workers at the Cleveland plant will start at $16 an hour, compared to about $28 for veteran union members, and some of the new engine plant workers could include employees from other Ohio plants.

“With our competitive labor agreements, we can bring business back to the U.S. from Spain and Mexico,” Mr. Hinrichs said.

Employment still falls far short of levels in the 1990s, when cheap gas and the popularity of S.U.V.’s led to big profits in Detroit.

The auto manufacturing sector employed 1.1 million people in the United States as recently as 1999, according to a recent study by the Center for Automotive Research in Ann Arbor, Mich. About one-third of those jobs were in the final assembly of vehicles, and the balance in the production of auto parts.

Employment dropped as low as 560,000 in 2009. Since then, about 90,000 jobs have been added, the report said.

This article has been revised to reflect the following correction:

Correction: February 21, 2013

Because of an editing error, an earlier version of this article gave a false impression of sales among the Detroit auto companies. Overall auto sales in the United States are expected to top 15 million this year, not sales among the Detroit automakers.

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