If someone comes out of prison, they should have incentives set up that the person has learned a trade, and you give an incentive for a company to hire him so he can make a living for himself, Walker said Aug. 17 in Kennesaw, Georgia.

Walker, who founded Renaissance Man Food Services in 1999 as part of Americas sprawling food processing industry, then nodded to his business experience. Its my responsibility now to help, Walker declared.

The argument blends several threads of Walkers bid to unseat Sen. Raphael Warnock, a Democrat, in a marquee midterm election matchup that could determine control of the Senate. A former college and professional football star, Walker styles himself as a businessman, unapologetic Christian and someone who has overcome mental health challenges with others help.

We have to become a society that want to help, not hurt anyone, he said in Kennesaw.

Yet an Associated Press review of federal court cases, alongside other public records and statements, offers a more complicated reality. One instance at the heart of Walkers business portfolio suggests he has benefited, through a firm he touts as a principal partner and supplier, from the unpaid labor of drug offenders routed from state courts to residential rehabilitation programs in lieu of prison.

Its not possible to quantify any financial gains Walker might have gleaned over the years from undervalued labor. But some lawyers have derided the operation in question, Oklahoma-based Christian Alcoholics & Addicts in Recovery Inc., as a residential work camp that profits from a vulnerable workforce under the guise of providing alcohol and drug counseling and rehabilitation services.

CAAIR, as it is commonly known, began more than a decade ago sending residents to work at Simmons Foods Inc., a processing giant that Walker touts as a principal partner and supplier to his distributorship, Renaissance Man Food Services. State judges assigned convicted offenders to CAAIR, giving them a choice between the residential program and its requirements or serving time in conventional jails or prisons. Simmons would then contract with CAAIR for labor at its plants; CAAIR program participants were not paid.

U.S. courts have declared that type of arrangement legal, finding it akin to work programs for fully incarcerated inmates who fall outside the 13th Amendments ban on involuntary servitude except as punishment for crime. But many criminal justice experts are critical of such programs.

Drug courts are typically a pretrial diversion program, said Jillian Snider, a former New York City police officer and now policy director for the criminal justice and civil liberties program at R Street, a center-right, free-market think tank based in Washington.

Snider described the ideal design as almost like an outpatient program focused on professional counseling and skills training, with some job responsibilities that include wages. Programs based more on work than on rehabilitation and skills training, Snider said, are unique mostly to Southern states. Its just not something you see in the northeast and in the West.

A federal lawsuit, still pending against CAAIR and Simmons, has detailed how some participants were allegedly pressured to work when injured, compelled to attend religious services, and threatened with imprisonment if their work was unsatisfactory.

CAAIR, participants alleged in court, did not always provide necessary rehabilitative or psychiatric treatment, the kind that Walker has emphasized when he shares his personal story and advocates for people suffering from mental illness. CAAIR described its services in court filings as a combination of work therapy and spiritual and religious counseling.

If youre working full-time in a chicken facility, you dont have enough hours in the day to complete a full program, said Snider, explaining that talking to professional counselors and being set up with real educational advancement opportunities and skills training must be included. Theres a lot more components than working 12 hours a day cleaning chickens, she said.

Nonetheless, a trial court judge in 2020 rejected participants assertions that the program violated federal labor law. CAAIR, the court ruled, remains a permissible component of the state criminal justice system. Participants appeal is pending.

CAAIR CEO and co-founder Janet Wilkerson told The Associated Press she never had any dealings with Walker. She declined to comment further, citing ongoing litigation.

Neither Walker nor Renaissance Man Food Services was named as a defendant in the original suit, and Walkers campaign declined to comment on the matter, saying Simmons is not Walkers company. A Simmons representative did not respond to inquiries.

Yet in Walkers telling, Simmons is critical to his enterprise.

On the Renaissance website, Simmons is the only supplier or partner mentioned by name: RMFS joins with Simmons Foods to bring quality poultry, pork and bakery products to the retail and food service marketplace. The website highlights one of its locations as Siloam Springs, Arkansas, where Simmons is based. The relationship dates back as early as 2006, according to Walkers previous statements to media.

Renaissance bills itself as a certified minority owned business Walker is Black that works with supplier partners to meet the needs of our retail and food service customers. That suggests a relationship in which Walker partners with food processing firms to act as distributor so that an end-line business is buying from a minority-owned firm. For example, Walkers website denotes two diversity supplier awards from Marriott hotels.

Walker isnt always clear about the size and scope of Renaissance. Hes said he employs hundreds of workers, with frequent mentions of a chicken-processing division in Arkansas. Further, hes claimed as much as $80 million in gross sales. But when Renaissance filed federal paperwork to secure loans under the Paycheck Protection Program during the coronavirus pandemic, it reported eight employees. The company received about $182,000 under the program. In another court case, Walker gave far more modest revenue figures, indicating the company averaged about $1.5 million a year in profit from 2008 to 2017.

Walkers exaggerations could simply involve conflating some of Simmons operations as his own.

His 2022 financial disclosure form submitted to the Senate list Renaissance as paying Walker a $214,062.50 salary. Another business, H Walker Enterprises, brought Walker a $3 million payout as sole shareholder. The website of H Walker Enterprises suggests Renaissance is a subsidiary. State records list the same corporate address in Dublin, Georgia, for both.

Wilkerson established CAAIR with her husband, Don, and others. It bills itself as a faith-based enterprise to rehabilitate addicts. Its programs launched in 2008 with six men, according to its website, and by 2015 housed 200 in three dorms.

Throughout the litigation, Simmons and CAAIR have forcefully defended their practices. But one thing has never been up for dispute: The men CAAIR sent to the chicken plants were not paid.

CAAIR is a work-based program, lawyers wrote in their defense. Participants are required to perform work without compensation at various nearby work-providers, including Simmons. This requirement is no secret.

In court filings, Wilkerson described drug defendants as clients rather than employees, and she characterized them as having chosen the program voluntarily after being fully apprised of the parameters.

Participants signed documents stipulating that they did not come to CAAIR, Inc., seeking work, that CAAIR did not offer (them) a job and that they would not receive wages or other pay for my stay at CAAIR, Inc. There was one potential exception: They may be offered a gift package if they finished the program.

Simmons is a work-provider for CAAIR, Wilkerson wrote in her court filings. Simmons pays CAAIR for the work performed by CAAIR participants at a rate well above minimum wage.

Wilkerson described an intensive interview process for clients referred to her program by the courts: Prospective clients are required to read and sign paperwork acknowledging their understanding of the program.

The Admission Agreement promises a residential program of recovery including individual and group counseling, nourishing foods (and) constructive physical activity which includes work training at a job site, along with the requirement of working at a designated job site. The documents do not name any prospective companies, describe any training participants would receive or detail any labor they would perform.

The agreement included a behavioral code, with the threat of dismissal.

Minor rules violations included failure to maintain a positive attitude, failure to do assigned chores, not shaving, showering and brushing your teeth every day, not being a team player and failure to attend daily meetings, including Bible study 12-step meetings small group.

Among the major violations: theft, bringing or using drugs or alcohol, insubordination, having money or credit cards on the premises, failure to maintain your position at your assigned work provider, horseplay or wrestling at any time, and fraternizing with any females.

Those lists, participants were warned, were not comprehensive, and that other infractions determined by staff may also result in disciplinary procedures. Further, participants agreed to attend church services off premises during their first 12 weeks in residence. That came with a separate code: No sleeping in church. Use the restroom before church services start. Clients may not ride with family to/from church.

Participants were free to leave (the program) at any time, the documents state. But participants signed on to the knowledge that such an action could result in consequences from the criminal justice system for early departure, and the documents make clear that disciplinary procedures, up to and including dismissal from the program was at CAAIR staffs discretion.

In a separate federal case against another not-for-profit rehabilitation program, Simmons again defended its practices in a friend of the court brief submitted in 2020 to support DARP Inc.

Citing Simmons relationship with CAAIR, Simmons lawyers wrote that CAAIR operates on the same basic model as DARP to provide vocational opportunities for those struggling with drug and alcohol addiction. However, Simmons lawyers said, thats not the same as an employee relationship requiring federal labor law protections or even compensation.

Plaintiffs participated in DARP for their own benefit and to achieve their own rehabilitation, not for the benefit of DARP or any for-profit firm, the brief states. The lawyers said unpaid laborers receive a benefit beyond money: a sense of self-worth and accomplishment.

Like other nonprofit hospitals around the nation, Atrium logs losses on the federal health insurance program for seniors and people with disabilities as a community benefit to satisfy legal requirements for federal, state, and local tax breaks.

But for the same year that Atriums website says it recorded the $640 million loss on Medicare, the hospital system claimed $82 million in profits from Medicare and an additional $37.2 million in profits from Medicare Advantage in a federally required financial document, according to a report released Oct. 25 by the North Carolina state treasurers office.

The lack of clarity about whether health systems like Atrium gain or lose money treating Medicare recipients reflects how loosely the federal government regulates the way hospitals calculate their community benefits.

As a result, the analysis of North Carolina hospitals financial data concluded, what taxpayers get from local nonprofit hospitals in return for tax exemptions worth billions of dollars a year is unclear.

There is no transparency, no accountability, and no oversight, said North Carolina State Treasurer Dale Folwell, a Republican who is critical of Atrium and other hospitals business practices. With the hospital cartel, it is always profits over people.

Atrium did not make officials available for an interview. In a statement, spokesperson Dan Fogleman said the hospital system reported $85 million in services to Medicare patients that werent paid for in its most recent cost report to the Centers for Medicare & Medicaid Services.

And, as labor, equipment, supplies and inflation continue to drive health care costs higher, the gap between Medicare payments and costs incurred to deliver the quality care we provide has grown in the post-COVID inflationary environment, Fogleman said.

More than half of the hospitals in the United States are nonprofits or government-run. The federal government requires them to operate emergency rooms open to all patients regardless of their ability to pay, accept patients insured by Medicare, and use surplus funds to improve facilities and patient care to demonstrate they are giving back to the community.

Even though their tax-exempt status is based on charitable acts, nonprofit hospital systems sat on more than $283 billion in assets from stocks, hedge funds, venture capital, and private equity and other investments in 2019, according to a 2021 KHN analysis of IRS filings.

The hospital systems used most of that to produce income and classified only $19 billion, or about 7% of their total investments, as principally devoted to their nonprofit missions, the analysis found.

The new North Carolina report describes how hospitals self-reported Medicare profit margins differed from the financial picture they provided to the public through IRS records, annual reports, and community benefit documents.

Although most hospitals have complained of significant Medicare losses, the analysis of data from more than 100 North Carolina hospitals found that most made profits on Medicare from 2015 to 2020.

IRS audits are supposed to protect the public from fraud and abuse, but the system has major gaps, said health economists and federal watchdog groups.

Federal law requires the IRS to review community benefit activities at least once every three years. Yet the agency did not have a well-documented process to ensure that those activities are being reviewed, said a 2020 report from the Government Accountability Office.

In response to GAO recommendations, IRS leaders updated the system last year to help ensure the agency could identify cases in which hospitals were suspected of not meeting requirements.

The IRS referred nearly 1,000 hospitals nationwide to its audit division for violations of the Affordable Care Act from 2015 to 2019, but the IRS could not identify if they were related to community benefits, the GAO said.

The tax agency has no authority to determine what activities hospitals must perform to comply with the law, the GAO said. An analysis of IRS data found 30 hospitals that reported no spending on community benefits in 2016, indicating potential noncompliance, the report said.

Perhaps this is the result of the IRS being underfunded, said Vivian Ho, a health economics professor at Rice University in Houston, who worked on the North Carolina report. They dont have the resources to reconsider what information they should seek.

It is critical that the government collects accurate information from hospitals because the data affects all patients, Ho said.

Federal law forbids IRS employees from discussing tax information submitted to the agency by people or organizations, IRS spokesperson Anthony Burke said in response to questions about how effectively the government monitors hospitals.

Hospitals have long used what they report as losses on Medicare to justify charging patients with private insurance higher prices. According to a study released in 2021 by the Rand Corp., a nonprofit research organization, hospitals across the nation charge private insurers more than what they receive from Medicare for the same services.

In the Affordable Care Act, federal lawmakers mandated that to maintain their tax-exempt status, nonprofit hospitals must conduct a community health needs assessment, maintain a written financial assistance policy, set billing and collections limits, and set a limit on charges.

In written responses to KHN, the North Carolina Healthcare Association, which lobbies on behalf of hospitals, said hospitals provided $1.2 billion in charity care in 2020. It added that those community benefits can include a lot of different activities, such as covering the gap between how much a procedure costs and what a provider is reimbursed, volunteering by staff, and paying for medical outreach programs.

Providing care to vulnerable populations is part of their nonprofit mission, the statement said.

Atrium spends millions of dollars per year to provide care to people who need behavioral health care but have no safety neteven from the state, the association said.

Fogleman, the Atrium spokesperson, said an advisory commission has consistently told Congress that Medicare payments do not cover the full costs of services at most hospitals, including Atriums.

In North Carolina, large hospital systems received $1.8 billion in tax breaks in 2020, according to the state treasurers office.

The same year, lobbyists for North Carolina hospitals reported collectively losing $3.1 billion on Medicare, according to the offices report. Other data shows they made $87 million in profit.

From 2015 to 2020, the report concludes, 35 hospitals posted profits from Medicare each year.

Other hospitals listed in the report did not respond to requests for comment.

The American Hospital Association contends that the federal government reimburses providers significantly less than it costs to care for Medicare recipients. Unlike private insurers, the federal government does not negotiate prices with hospitals. Medicare bases the amount it pays on hospitals locations, labor costs, and other factors.

Melinda Hatton, the associations general counsel, said in a statement that underpayments totaled more than $75 billion in 2020. These data show that few, if any, hospitals break even much less make a profit on the basis of Medicare payments, she said.

But Glenn Melnick, a health economics and finance professor at the University of Southern California who reviewed the North Carolina data, said no one is certain how nonprofit hospitals are calculating their numbers.

The nonprofit hospital systems are getting so big, we need greater transparency, Melnick said. Health care is amazingly expensive, and it will bankrupt us if we dont get it under control.

Nonprofit hospitals receive significantly more in tax breaks than they spend on community investment or charity care, according to a report released this year by the Lown Institute, a think tank in Needham, Mass.

Using 2019 data from the IRS, researchers found that out of 275 hospital systems across the country, 227 spent less on community investments or charity care than they got in tax breaks. The deficit totaled more than $18 billion, the report said.

Leah Kane is a senior attorney for consumer protection at the Charlotte Center for Legal Advocacy, a nonprofit that provides civil legal assistance to people who cannot afford an attorney. She said her agency receives calls from people who were not offered charity care from hospitals.

She said her group is worried that hospitals are offering charity care to uninsured patients but not to other people, like the underinsured, who dont have the income to pay thousands of dollars for treatment not covered by their insurance plans.

People are angry and stressed out, Kane said. They dont know what this [debt] will mean for their lives.

KHN correspondent Aneri Pattani contributed to this report.

Each of these women came forward independent of each other, and none of them knew one another, Deputy District Attorney Paul Thompson said during his opening statement at Weinsteins Los Angeles trial.

The 70-year-old former movie mogul, already serving a 23-year sentence in New York, is charged with multiple counts of rape and sexual assault in California.

The defense countered in its opening statement that the incidents either did not happen or were consensual sex that the women redefined in the wake of the #MeToo movement.

Weinstein, prosecutor Thompson said, lorded his status as the most powerful man in Hollywood over them, talking about the female A-list actors whose careers he had made before growing aggressive.

Thompson played a video presentation with composite photos of the women who will testify and quotes from prior testimonials. Most were aspiring actors. One was an aspiring screenwriter who thought she was going to pitch him a script.

All will testify that Weinstein ignored clear signs that they did not consent, the prosecutor said, including their shaking bodies, their crying, their backing away from him, their saying no.' Four women whom Weinstein is not charged with assaulting in the case will also testify about what he did to them to demonstrate his propensity for such acts, Thompson said.

Weinstein attorney Mark Werksman told jurors that what Weinstein did with the women was considered acceptable, transactional behavior in Hollywood, where young women were seeking roles and other advantages by having sex with the powerful movie magnate.

Youll learn that in Hollywood, sex was a commodity, Werksman said.

The accusers Weinstein is charged with assaulting are expected to be identified only as Jane Doe in court, but they include Jennifer Siebel Newsom, an actor and documentary filmmaker who is married to California Gov. Gavin Newsom.

Siebel Newsom had not yet met Newsom and was an aspiring actor in 2005 when, according to his indictment, Weinstein raped her at a Beverly Hills Hotel.

Without using her name, both sides said she would testify. Werksman called her a very prominent citizen of California.

Shes made herself a prominent victim in the #MeToo movement, he added, otherwise shed be just another bimbo who slept with Harvey Weinstein to get ahead in Hollywood.

In a statement to The Associated Press, Elizabeth Fegen, who represents Siebel Newsom and two other Weinstein accusers, called the comments despicable, desperate, dishonest.

The defense is callously engaging in misogynistic name-calling and victim-shaming but survivors will not be deterred, she added.

Werksman said Siebel Newsom and many other women in the case had contact, and even initiated dealings, with Weinstein in the years after the encounters, often referring to him affectionately.

In an attempt to head off this strategy, Thompson told jurors that they would hear from a psychologist who will dispel rape myths. Key among them is the idea that a sexual assault victim would not have further contact with their assailant.

Werksman said that Weinsteins consensual acts were transformed in October 2017 with the asteroid called the #MeToo movement.

He became the smoldering, radioactive center of it, Werksman said. He is Hollywoods Chernobyl.

He said that there was suddenly a new word for the women, victim.

The AP does not typically name people who say they have been sexually abused unless they come forward publicly. Siebel Newsoms identity was first reported by the Los Angeles Times, and her attorney has told the AP and other news outlets that she is among the women Weinstein is charged with sexually assaulting who will testify during the trial.

The first of Weinsteins accusers to testify, a model and actor who was living and working in Italy when she met him at a film festival in Los Angeles in 2013, said she was stunned to find him knocking at the door of her hotel room after interacting with him briefly earlier that evening.

She said she was more confused than frightened at first, so she let Weinstein in, but he grew more aggressive. She said he eventually forced her to perform oral sex.

I was crying, choking, said the woman.

She grew increasingly emotional on the stand until she was sobbing so much that she could no longer speak.

With the court day near an end, Judge Lisa Lench called for a recess until Tuesday morning, when shell return to the stand.

At the beginning of the day, Weinstein was wheeled into court wearing a suit, and climbed into a seat next to his attorneys.

Confusion arose when Thompson during his opening statement made no mention of one accuser who had been set to testify as recently as last week. Weinstein was indicted on 11 counts overall, four of which involved the woman who was not mentioned. The district attorneys office did not address why the woman was not referenced.

Outside court, Weinsteins attorney said no charges had been dismissed.

The people left her out of their presentation, so I didnt mention her, he said. Its a glaring absence, though, in their presentation.