Republican Stategery

In the Wall Street Journal this morning (and in many news casts), the reports are all about law makers' desires to fix the Affordable Care Act.

Did I miss something?  Republican strategic ineptness is astounding.

The Republicans practically committed political suicide "shutting down" the federal government.  It is truly amazing to me that so many people got so worked up over not being able to go to the park.  The federal park system did seem like the only government program affected by the "Great Shutdown of 2013."  In any case, Republicans went to the mat over shutting down the federal government over a desire to repeal or change the Affordable Care Act.  It was laudable but foolish.  Democrats would not budge on changing it, period.

Now the Obama administration and Democrats generally claim ignorance to the effect of millions of people losing their ability to renew plans in the individual insurance marketplace.  Never mind it was predicted and documented in the federal register back in 2010.  If you think the current situation is bad, just wait until the employer market is impacted.  In the June 17, 2010 Federal Register on page 34553, a Kaiser Foundation employer survey is quoted that predicts between 39% to 69% of employer plans will lose grandfather status (that is the "if you like your plan, you can keep your plan, period" rule) in 2013.

Message to Republicans: Leave the ACA Alone!  You spent so much capital in the shutdown trying to change the ACA.  You showed that you wanted to make changes for the very reasons that are now becoming known.  But that time has now passed.  As Americans in general and independents in particular see the impact of left-winged Democratic socialism, they will flock back to the Republican party.  All you need to say is vote for Republicans in 2014, and change will be on the way.

HHS Wolves Guarding The Privacy and Security Hen House

As a former technology executive of a health and welfare benefits technology company, I am well versed in privacy and security regulations governing the protection of health information.  Those regulations are promulgated by...wait for it...the U.S. Department of Heath and Human Services, or HHS.  Yes, the very same department responsible for the failed rollout of the insurance marketplaces of 34 states.  If the totality of the problem was simply the inability of HHS to sell insurance products through their web site, that would be one thing...

Security and privacy regulations of "protected health information", or PHI, are governed by a law first passed in 1996 called the Health Insurance Portability and Privacy Act (more commonly know as HIPAA).  That law, associated amendments, and the HITECH act enacted as part of the infamous "shovel ready" American Recovery and Reinvestment Act of 2009 (or ARRA) and their associated regulation have transformed the information technology, data handling, and personnel management environment for companies (or their departments) that deal in personal health information.  There are stiff penalties and disclosure requirements for compliance failures.  The Office for Civil Rights (OCR) maintains a "wall of shame" for those covered entities that have faced enforcement action.

In the businesses where I served, our company would sign "business associate" agreements with our clients.  The purpose of those agreements was ensure that our company and those sub-contractors that we hired would appropriately safeguard protected health information of our client's employees.  Those safeguards were stringent and costly.  They ranged from hiring practices (including background checks) to numerous technological investments, to extensive training and finally a rigorous audit regimen.

This leads me to numerous questions now that the federal government is so involved in the procurement of health care:

1. Is HHS subject to the HIPAA law?
2. Is HHS a business associate to the health plans to which they are collecting personally identifiable information for the provision of health care?
3. Have contractors that HHS is using to build the technology for the marketplaces signed business associate agreements with HHS?
4. Has an independent auditor (not the OIG, which is again...part of HHS) established an opinion on the appropriateness of operational controls (via a Reporting on Controls at a Service Organization of the SSAE16 auditing standard or other established auditing standard) to assure those using the exchange that their information will in fact be safeguarded?
5. Will HHS disclose their own privacy violations to the OCR, and will those be posted on their own wall of shame?

Katy ISD Board of Trustees, Fix THIS: Portable Education vs. Permanent Football

Following up to my earlier posts, I decided to research the portable education infrastructure that Katy ISD is grappling with.  Ask yourself...is this the best we can do for our kids' public education in a district with vast resources?  I believe (I hope) this is why the November 5 bond did not pass.  KISD Board of Trustees - please prioritize the elimination of portable education first prior to providing for more permanent football.

Katy Elementary Schools

Fun Facts: 35 elementary schools, 27 schools with portable buildings representing 77% of the schools with temporary classrooms, and 174 portable buildings in all.  This information derived from pictures from Google Maps.

Fun Conjecture: Each portable building holds two classrooms (this I know because I attended classes with my daughter), each classroom holds ~20 kids, and lets assume 80% occupancy (this is a WAG), so that is 174 * 2 * 20 * 0.8 = 5,568 children in portable education facilities.  Of the 30,602 elementary students (derived from page 35 of this presentation), I estimate ~18% are attending class in portable buildings.  Ask yourself: how many elementary school students participate in extracurricular activities that would be hosted at the new proposed football stadium?  I am going to guess none, zero.  So, $70MM that benefits none of the 30,000 elementary students while 1/5 of them attend class in temporary facilities.  Hmm...

Katy ISD Board of Trustees: Reset Your Priorities

The voters spoke on November 5th and it was not even close.  Katy ISD voters, by a 55 to 45 margin, said no to extravagance over education.  The area's rapid growth has strained basic infrastructure.  In my last blog, I wrote about my experience in my daughter's overcrowded elementary school.  That school is not an exception.  In the coming weeks, I intend to document, for the benefit of Katy ISD Trustees, the scope of the problem.

This was never a battle over taxes, per se, or whether a new stadium was actually needed, or whether the trustees played loose with the justification.  A new stadium probably is justifiable.  A STEM center IS warranted (the Wall Street Journal just this morning has an article documenting MBA migration away from finance to tech).  The Ag Center is in keeping with the cultural roots of the area.  This is simply a statement about priorities.  Cover the basics first...adequate classrooms and adequate transportation.

I hope Katy ISD Board of Trustees got the message, but lets not rely on one ballot box defeat.