Archive for the ‘News’ Category

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Dennis Blair the Intel HR Mistake

May 24, 2010

“Blair arrived at a DNI that was bloated, with a staff of several thousand, that had already calcified, institutionally, and lacked support and authority. It proved too difficult for him to break apart firewalls.  Certain things did not make sense…”

This is from Thursday’s article in The Atlantic about Admiral (Ret.) Dennis Blair’s resignation as Director of ODNI. While it’s tempting to slam bureaucratic systems for behaving like bureaucracies, my interest in the Blair story is it highlights the recurring problem of selecting folks for jobs just because they were successful at any number of other jobs, setting them (and their organizations perhaps) up for failure.

Ret. Admiral Blair

From what I read in the news and hear from the IC, it sounds like Blair made fateful political mistakes that could have been avoided with better preparation for the job. But it’s not like new government leaders are given in-briefs on how to play nice with Rahm Emanuel. Blair’s mistakes could also easily be blamed on “the system.” But which system, exactly, is at fault?

Blair is a decorated sailor and respected former leader of countless organizations. The phrase I quoted above probably didn’t surprise Blair on his first day when he arrived at NCTC; one can assume that he saw being its director as a fresh challenge he wanted to blow out of the water. But instead he couldn’t make find his way and so quit, something that might be his career first and probably one of the toughest decisions he’s made as a civilian. So I don’t blame him for failing to bring his kid gloves to the CIA and White House.

It is apparent to me that there is some HR lever that allows for the hiring non-bureaucratic bureaucrats, non-political figures to politic. Was it just an inaccurate position description that lured Blair in? Or another decision maker’s bad hiring judgment? More importantly, will it be flipped off now so that the wrong guy isn’t selected for the job again? As a taxpayer and someone interested in the success of the next ODNI, I would like to know who is responsible and what they are doing about the issue of the government system still (consistently, in my mind) not selecting the right people for jobs.

But the Washington Post’s own editorial is titled “Blair’s Replacement has Problems to Solve,” and rehashes some of the big problems Blair wasn’t able to solve during his tenure before he quit/was asked to leave. But show me one organization anywhere that doesn’t have problems. Without problems, we wouldn’t need leaders! The WaPo editor at least notes that Blair had “poor management” and  “was the product of personal as well as institutional failings.” But how about putting that under the headline “OPM, NCTC Still Searching for Capable Leader.” That’s what I wish these taxpaying, government-dissing journalists would chew on for a while.

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Obama Commencement Speech Right On

May 9, 2010

I’ve copied and pasted the following from this AFP news release. What I like about it is that Obama is noting to the graduating class of Hampton College seniors in Virginia that their education enhances their ability as a responsible citizen to think critically about actionable information in a time of information overload.

Obama argued that from the days of the pioneer politicians who founded the United States, until the modern day, education and knowledge had been the key to progress and US democracy.

He drew a line between Thomas Jefferson, the principal author of the Declaration of Independence, and today’s challenges.

“What Jefferson recognized… that in the long run, their improbable experiment — called America — wouldn’t work if its citizens were uninformed, if its citizens were apathetic, if its citizens checked out, and left democracy to those who didn’t have the best interests of all the people at heart.

“It could only work if each of us stayed informed and engaged, if we held our government accountable, if we fulfilled the obligations of citizenship.”

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Fw: Favorite New Jobs Created by Healthcare Bill

April 12, 2010

1. Grant program for consumer assistance offices (Section 1002, p. 37)
2. Grant program for states to monitor premium increases (Section 1003, p. 42)
3. Committee to review administrative simplification standards (Section 1104, p. 71)
4. Demonstration program for state wellness programs (Section 1201, p. 93)
5. Grant program to establish state Exchanges (Section 1311(a), p. 130)
6. State American Health Benefit Exchanges (Section 1311(b), p. 131)
7. Exchange grants to establish consumer navigator programs (Section 1311(I), p. 150)
8. Grant program for state cooperatives (Section 1322, p. 169)
9. Advisory board for state cooperatives (Section 1322(b)(3), p. 173)
10. Private purchasing council for state cooperatives (Section 1322(d), p. 177)
11. State basic health plan programs (Section 1331, p. 201)
12. State-based reinsurance program (Section 1341, p. 226)
13. Program of risk corridors for individual and small group markets (Section 1342, p. 233)
14. Program to determine eligibility for Exchange participation (Section 1411, p. 267)
15. Program for advance determination of tax credit eligibility (Section 1412, p. 288)
16. Grant program to implement health IT enrollment standards (Section 1561, p. 370)
17. Federal Coordinated Health Care Office for dual eligible beneficiaries (Section 2602, p. 512)
18. Medicaid quality measurement program (Section 2701, p. 518)
19. Medicaid health home program for people with chronic conditions, and grants for planning same (Section 2703, p. 524)
20. Medicaid demonstration project to evaluate bundled payments (Section 2704, p. 532)
21. Medicaid demonstration project for global payment system (Section 2705, p. 536)
22. Medicaid demonstration project for accountable care organizations (Section 2706, p. 538)
23. Medicaid demonstration project for emergency psychiatric care (Section 2707, p. 540)
24. Grant program for delivery of services to individuals with postpartum depression (Section 2952(b), p. 591)
25. State allotments for grants to promote personal responsibility education programs (Section 2953, p. 596)
26. Medicare value-based purchasing program (Section 3001(a), p. 613)
27. Medicare value-based purchasing demonstration program for critical access hospitals (Section 3001(b), p. 637)
28. Medicare value-based purchasing program for skilled nursing facilities (Section 3006(a), p. 666)
29. Medicare value-based purchasing program for home health agencies (Section 3006(b), p. 668)
30. Interagency Working Group on Health Care Quality (Section 3012, p. 688)
31. Grant program to develop health care quality measures (Section 3013, p. 693)
32. Center for Medicare and Medicaid Innovation (Section 3021, p. 712)
33. Medicare shared savings program (Section 3022, p. 728)
34. Medicare pilot program on payment bundling (Section 3023, p. 739)
35. Independence at home medical practice demonstration program (Section 3024, p. 752)
36. Program for use of patient safety organizations to reduce hospital readmission rates (Section 3025(b), p. 775)
37. Community-based care transitions program (Section 3026, p. 776)
38. Demonstration project for payment of complex diagnostic laboratory tests (Section 3113, p. 800)
39. Medicare hospice concurrent care demonstration project (Section 3140, p. 850)
40. Independent Payment Advisory Board (Section 3403, p. 982)
41. Consumer Advisory Council for Independent Payment Advisory Board (Section 3403, p. 1027)
42. Grant program for technical assistance to providers implementing health quality practices (Section 3501, p. 1043)
43. Grant program to establish interdisciplinary health teams (Section 3502, p. 1048)
44. Grant program to implement medication therapy management (Section 3503, p. 1055)
45. Grant program to support emergency care pilot programs (Section 3504, p. 1061)
46. Grant program to promote universal access to trauma services (Section 3505(b), p. 1081)
47. Grant program to develop and promote shared decision-making aids (Section 3506, p. 1088)
48. Grant program to support implementation of shared decision-making (Section 3506, p. 1091)
49. Grant program to integrate quality improvement in clinical education (Section 3508, p. 1095)
50. Health and Human Services Coordinating Committee on Women’s Health (Section 3509(a), p. 1098)
51. Centers for Disease Control Office of Women’s Health (Section 3509(b), p. 1102)
52. Agency for Healthcare Research and Quality Office of Women’s Health (Section 3509(e), p. 1105)
53. Health Resources and Services Administration Office of Women’s Health (Section 3509(f), p. 1106)
54. Food and Drug Administration Office of Women’s Health (Section 3509(g), p. 1109)
55. National Prevention, Health Promotion, and Public Health Council (Section 4001, p. 1114)
56. Advisory Group on Prevention, Health Promotion, and Integrative and Public Health (Section 4001(f), p. 1117)
57. Prevention and Public Health Fund (Section 4002, p. 1121)
58. Community Preventive Services Task Force (Section 4003(b), p. 1126)
59. Grant program to support school-based health centers (Section 4101, p. 1135)
60. Grant program to promote research-based dental caries disease management (Section 4102, p. 1147)
61. Grant program for States to prevent chronic disease in Medicaid beneficiaries (Section 4108, p. 1174)
62. Community transformation grants (Section 4201, p. 1182)
63. Grant program to provide public health interventions (Section 4202, p. 1188)
64. Demonstration program of grants to improve child immunization rates (Section 4204(b), p. 1200)
65. Pilot program for risk-factor assessments provided through community health centers (Section 4206, p. 1215)
66. Grant program to increase epidemiology and laboratory capacity (Section 4304, p. 1233)
67. Interagency Pain Research Coordinating Committee (Section 4305, p. 1238)
68. National Health Care Workforce Commission (Section 5101, p. 1256)
69. Grant program to plan health care workforce development activities (Section 5102(c), p. 1275)
70. Grant program to implement health care workforce development activities (Section 5102(d), p. 1279)
71. Pediatric specialty loan repayment program (Section 5203, p. 1295)
72. Public Health Workforce Loan Repayment Program (Section 5204, p. 1300)
73. Allied Health Loan Forgiveness Program (Section 5205, p. 1305)
74. Grant program to provide mid-career training for health professionals (Section 5206, p. 1307)
75. Grant program to fund nurse-managed health clinics (Section 5208, p. 1310)
76. Grant program to support primary care training programs (Section 5301, p. 1315)
77. Grant program to fund training for direct care workers (Section 5302, p. 1322)
78. Grant program to develop dental training programs (Section 5303, p. 1325)
79. Demonstration program to increase access to dental health care in underserved communities (Section 5304, p. 1331)
80. Grant program to promote geriatric education centers (Section 5305, p. 1334)
81. Grant program to promote health professionals entering geriatrics (Section 5305, p. 1339)
82. Grant program to promote training in mental and behavioral health (Section 5306, p. 1344)
83. Grant program to promote nurse retention programs (Section 5309, p. 1354)
84. Student loan forgiveness for nursing school faculty (Section 5311(b), p. 1360)
85. Grant program to promote positive health behaviors and outcomes (Section 5313, p. 1364)
86. Public Health Sciences Track for medical students (Section 5315, p. 1372)
87. Primary Care Extension Program to educate providers (Section 5405, p. 1404)
88. Grant program for demonstration projects to address health workforce shortage needs (Section 5507, p. 1442)
89. Grant program for demonstration projects to develop training programs for home health aides (Section 5507, p. 1447)
90. Grant program to establish new primary care residency programs (Section 5508(a), p. 1458)
91. Program of payments to teaching health centers that sponsor medical residency training (Section 5508(c), p. 1462)
92. Graduate nurse education demonstration program (Section 5509, p. 1472)
93. Grant program to establish demonstration projects for community-based mental health settings (Section 5604, p. 1486)
94. Commission on Key National Indicators (Section 5605, p. 1489)
95. Quality assurance and performance improvement program for skilled nursing facilities (Section 6102, p. 1554)
96. Special focus facility program for skilled nursing facilities (Section 6103(a)(3), p. 1561)
97. Special focus facility program for nursing facilities (Section 6103(b)(3), p. 1568)
98. National independent monitor pilot program for skilled nursing facilities and nursing facilities (Section 6112, p. 1589)
99. Demonstration projects for nursing facilities involved in the culture change movement (Section 6114, p. 1597)
100. Patient-Centered Outcomes Research Institute (Section 6301, p. 1619)
101. Standing methodology committee for Patient-Centered Outcomes Research Institute (Section 6301, p. 1629)
102. Board of Governors for Patient-Centered Outcomes Research Institute (Section 6301, p. 1638)
103. Patient-Centered Outcomes Research Trust Fund (Section 6301(e), p. 1656)
104. Elder Justice Coordinating Council (Section 6703, p. 1773)
105. Advisory Board on Elder Abuse, Neglect, and Exploitation (Section 6703, p. 1776)
106. Grant program to create elder abuse forensic centers (Section 6703, p. 1783)
107. Grant program to promote continuing education for long-term care staffers (Section 6703, p. 1787)
108. Grant program to improve management practices and training (Section 6703, p. 1788)
109. Grant program to subsidize costs of electronic health records (Section 6703, p. 1791)
110. Grant program to promote adult protective services (Section 6703, p. 1796)
111. Grant program to conduct elder abuse detection and prevention (Section 6703, p. 1798)
112. Grant program to support long-term care ombudsmen (Section 6703, p. 1800)
113. National Training Institute for long-term care surveyors (Section 6703, p. 1806)
114. Grant program to fund State surveys of long-term care residences (Section 6703, p. 1809)
115. CLASS Independence Fund (Section 8002, p. 1926)
116. CLASS Independence Fund Board of Trustees (Section 8002, p. 1927)
117. CLASS Independence Advisory Council (Section 8002, p. 1931)
118. Personal Care Attendants Workforce Advisory Panel (Section 8002(c), p. 1938)
119. Multi-state health plans offered by Office of Personnel Management (Section 10104(p), p. 2086)
120. Advisory board for multi-state health plans (Section 10104(p), p. 2094)
121. Pregnancy Assistance Fund (Section 10212, p. 2164)
122. Value-based purchasing program for ambulatory surgical centers (Section 10301, p. 2176)
123. Demonstration project for payment adjustments to home health services (Section 10315, p. 2200)
124. Pilot program for care of individuals in environmental emergency declaration areas (Section 10323, p. 2223)
125. Grant program to screen at-risk individuals for environmental health conditions (Section 10323(b), p. 2231)
126. Pilot programs to implement value-based purchasing (Section 10326, p. 2242)
127. Grant program to support community-based collaborative care networks (Section 10333, p. 2265)
128. Centers for Disease Control Office of Minority Health (Section 10334, p. 2272)
129. Health Resources and Services Administration Office of Minority Health (Section 10334, p. 2272)
130. Substance Abuse and Mental Health Services Administration Office of Minority Health (Section 10334, p. 2272)
131. Agency for Healthcare Research and Quality Office of Minority Health (Section 10334, p. 2272)
132. Food and Drug Administration Office of Minority Health (Section 10334, p. 2272)
133. Centers for Medicare and Medicaid Services Office of Minority Health (Section 10334, p. 2272)
134. Grant program to promote small business wellness programs (Section 10408, p. 2285)
135. Cures Acceleration Network (Section 10409, p. 2289)
136. Cures Acceleration Network Review Board (Section 10409, p. 2291)
137. Grant program for Cures Acceleration Network (Section 10409, p. 2297)
138. Grant program to promote centers of excellence for depression (Section 10410, p. 2304)
139. Advisory committee for young women’s breast health awareness education campaign (Section 10413, p. 2322)
140. Grant program to provide assistance to provide information to young women with breast cancer (Section 10413, p. 2326)
141. Interagency Access to Health Care in Alaska Task Force (Section 10501, p. 2329)
142. Grant program to train nurse practitioners as primary care providers (Section 10501(e), p. 2332)
143. Grant program for community-based diabetes prevention (Section 10501(g), p. 2337)
144. Grant program for providers who treat a high percentage of medically underserved populations (Section 10501(k), p. 2343)
145. Grant program to recruit students to practice in underserved communities (Section 10501(l), p. 2344)
146. Community Health Center Fund (Section 10503, p. 2355)
147. Demonstration project to provide access to health care for the uninsured at reduced fees (Section 10504, p. 2357)
148. Demonstration program to explore alternatives to tort litigation (Section 10607, p. 2369)
149. Indian Health demonstration program for chronic shortages of health professionals (S. 1790, Section 112, p. 24)*
150. Office of Indian Men’s Health (S. 1790, Section 136, p. 71)*
151. Indian Country modular component facilities demonstration program (S. 1790, Section 146, p. 108)*
152. Indian mobile health stations demonstration program (S. 1790, Section 147, p. 111)*
153. Office of Direct Service Tribes (S. 1790, Section 172, p. 151)*
154. Indian Health Service mental health technician training program (S. 1790, Section 181, p. 173)*
155. Indian Health Service program for treatment of child sexual abuse victims (S. 1790, Section 181, p. 192)*
156. Indian Health Service program for treatment of domestic violence and sexual abuse (S. 1790, Section 181, p. 194)*
157. Indian youth telemental health demonstration project (S. 1790, Section 181, p. 204)*
158. Indian youth life skills demonstration project (S. 1790, Section 181, p. 220)*
159. Indian Health Service Director of HIV/AIDS Prevention and Treatment (S. 1790, Section 199B, p. 258)*

*Section 10221, page 2173 of H.R. 3590 deems that S. 1790 shall be deemed as passed with certain amendments.

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News from the Lakehouse

April 3, 2010

Today my mother took a break from managing the development of her new home to ride her Honda Aquatrax jetski around Lake Murray. She capsized along with her passenger, her builder, who lost his wallet and phone. Next time she rides, she plans to use the waterproof on-board storage.

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MillerCoors?

January 13, 2010

Maybe I’m one of the last to hear but I just found out that Miller and Coors have become one. I learned through a high school friend’s blog – he actually worked as an artist on a commercial for the company. You can see the video on his blog.

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Wendy Rieger on NBC4: 7″ Too Much Snow!

December 20, 2009
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Ironies of the New(est) CIED Task Force

November 15, 2009

Aboard a flight last Tuesday, Secretary of Defense Robert Gates fumed about news leakers in the DoD to the press corps in flight with him. He then let the cat out of the bag that he’s creating a new(er) Counter-IED Task Force to provide top-cover for the Joint IED Defeat Organization. This brings up a few ironies in the JIEDDO Saga and gives you an understanding of what’s going on with the Pentagon’s counter-IED cornucopia. If you’d like to catch up, I recommend “Left of Boom,” a WaPo series written by Ric Atkinson, which kept my colleagues and me at JIEDDO on the edges of our seats as it was published.

The timing of this announcement is irony #1. Gates said he’d end the careers of leakers then he surprised everyone with this new C-IED TF. Remember that the original task force was created as an ad-hoc, stop-gap measure at a time when IEDs were the most deadly killer in Iraq. Timing for Gates’ statement couldn’t have been more awkward: two weeks prior, Duncan Hunter of the House Armed Services Committee questioned the JIEDDO Director Thomas F. Metz during his testimony, essentially saying “You’re the guy the buck is supposed to stop with. Whiskey Tango Foxtrot?” Gates announced his solution two days before Metz’s retirement ceremony.

So the Secretary’s task force with the same name and problem is irony #2. The current Joint IED Defeat Organization (pronounced Jiy-doh) started off as an Army task force in the Pentagon in 2003. JIEDDO is tasked to immediately service the COCOMs (war fighters in all uniforms) but only has the power to ‘coordinate’ and ‘advocate’ for help from the armed services. It’s a classic case of “all the responsibility without the authority.” And now, instead of capitalizing on the structure JIEDDO, the Pentagon has decided to not let JIEDDO pass Go by just editing the directive with some stronger language (and keeping the $200). [1]

While JIEDDO provides rapid responses to the war fighters’ needs, it has trouble convincing the services to take ownership of successful widgets and systems to become what the services call programs of record, or, enduring capabilities. That is, stuff to buy on layaway from JIEDDO. This promise is something JIEDDO is supposed to secure for each and every idea that merits funding per its rapid acquisition process.[2] A problem is there are already redundancies in capabilities (everyone is racing to this fight) and because the services dodn’t like JIEDDO telling them how to spend their money. Making these matters more difficult, enemy tactics outpace the 36 month transition/transfer process. Like General Metz has explained, “The bad guy doesn’t care about our budget cycles.” Even Al Qaida has said “you have the watches, we have the time.” Irony #3 is although C-IED funds have been described as ‘angel investment’ into risky new ideas that may pan out, there are virtually no buyers when the ideas go public because that new smell is gone or they don’t go public because they’re already obsolete.[3]

Enter Congress’s auditors from GAO into the halls and files of JIEDDO in 2007 and 2008. Their determination that JIEDDO had “no fiduciary oversight” came at the time that IED events were on the uptick and JIEDDO was just getting into a records management routine beyond color-coded folders and a shared network drive. No one was allowed to ask them, “Did you see where I put that funding memo?” The lack of oversight was not symptomatic of a lack of success; getting the hard work done has always been the priority and oversight in the chaos has been an after-thought. The ROI and MOE are developed concurrently with IOC and even FOC. The attitude behind rapid development in JIEDDO is (or was) “This is new and this is war!” It’s not that JIEDDO hasn’t developed successful ideas, just that once the ideas are proven, they’re supposed to be owned by the end-user so JIEDDO can move onto the next threat.

Should JIEDDO have been trudging up to Congress every quarter to explain the development status of its secret sauce? By law, yes. Would it have helped the war fighter? No (except for the continued funding from the supplemental budget). A representative’s constituency? Maybe if he gets good sound-bites like Hunter did. Perhaps government oversight was unrealistic in the environment of contracting firms responding to “Need it yesterday!” Indeed, JIEDDO didn’t get the manpower it ‘advocated’ for from the services nor OPM until pretty much this Fiscal Year. That’s 2010, people.

Does all this, plus the SecDef’s decision to create a new C-IED Task Force, suggest that JIEDDO isn’t doing its job? No, just that the job of ‘leading, advocating and coordinating’ joint service efforts is best done by a bigger dog. It’s the same sh**, different AO (Afghanistan). The new TF will be headed by the Undersecretary of Acquisition, but led by the Marine Corps’ J3. To get the services to play nice with all Pentagon-level C-IED efforts, it might take a Marine general to make sure our war fighters on the ground aren’t affected by Beltway bureaucratic failures. Ooh Rah!


[1] JIEDDO was quickly given lots of money and acquisition leeway to “defeat the IED as a weapon of strategic influence.” The organization you hear about today was officially established by DoD Directive 2000.19E in 2005. Its mission statement starts off “JIEDDO shall focus (lead, advocate, coordinate) all Department of Defense actions…”

 

[2] JIEDDO’s initiative funding, review and transfer process now called JCAAMP had been in the works ever since a bunch of scientists in the Pentagon were joined by Dr. Robin Keesee, the SES formerly appointed as Deputy Commander of RDECOM (a major R&D and Acquisition command). They had decided the best way to counter the easiest, cheapest home-made weapon was by going to the opposite end of the funding and sophistication spectrum: ramming high-tech initiatives through the R&D pipeline at top speed with more billions of dollars than you’d realize is available for what amounts to international crime fighting.

[3] JIEDDO’s rapid acquisition plan assumed that the services would not only play nice, but hold hands and skip. It was the best a bunch of salty, nerdy, military retirees who’d earned their stripes and knew the game could do to ‘coordinate’ active duty 0-6s and above. It’s why retired four-star General M.C. Meigs was originally called to the director’s chair and was given divine right to pick from le crème de la crème to help him…there was lots of bureaucracy to cut through to get the job done. But the overarching issue is still that JIEDDO creates useful products for an un-paying customer and is supposed to market them to consumers who’ve already planned out their budget.