Financial Crisis or House Cleaning for Greeley District 6 Schools

Cutting budgets is never easy. Particularly when you are talking about cutting out two hundred jobs in an already economically ravaged town. Yet, there are better approaches and poorer approaches. It isn't clear yet just what approach Greeley District 6 is applying but it already doesn't look pristine. What is certain is that the School Board and Superintendent Lang of Greeley Schools District 6 are facing a serious financial reworking of the District or they are being cagey about cleaning house (restructuring/downsizing).

Maybe a little of both, eh? An interesting question isn't it.

After having read through the school district's audited financials report and the budget for the upcoming year, as posted on the District's website, I've been crunching some figures and noting some things that leave me with a lot more questions about the approach the long troubled District has taken.

(Before you keep reading, for those of you who like to skip the pertinent informational numbers--the conclusion is in the bottom three to four paragraphs. So is the District Administrative Organizational Chart.)

First of all I'd like to note that only 39.1 percent of students in this district tested proficient last year in math. 39.1 percent, grades 3-10 from the CASP scores according to an October 2009 budget presentation that Mr. Wayne Eads prepared for the board (it is available on the D6 website). I'll come back to Mr. Eads, Chief Operations Manager, later on in the article but for now let's concentrate on the numbers. This leaves a bit over 60 percent of the students as nonproficient.

Writing: 45.4 percent tested at or above proficiency. Well if we use the bell curve it doesn't seem too bad but I don't recall the theory behind education stating that more than 50% of students will not need to be proficient.

No doubt there are those that will blame the writing and reading issues on immigrant children. That argument is a whole bucket of water complete with holes. If true then the proficiency rate trend would hold similar in all districts with nonnative language speakers. ESL learners tend to be convenient political scapegoats. But we will give D6 administrators the benefit of the doubt on reading and writing simply because they have enough problems without that one.

But math? Math? The universal language. Come on people. There are more than just financial problems in the District.

Okay, let's move on to the next area. Ms. Lang cites up to $16 million in cuts may be needed in her letter delivered to staff last week through email. Shocking isn't it. No, not that Ms. Lang didn't have Mr. Eads write the letter, but that $16 million is a whole lot of money to most folks.

But that $16 million it isn't so big when you put it up against the total budget (revenues in the audited financials in 2009: $162,618,011) and examine the other budget figures for District 6 as prepared by, not the Finance Officer, not the Superintendent, but Mr. Wayne Eads, Chief Operations Manager. If you take a quick peak at the organizational chart at the bottom you'll see finance, oddly, falls under his dominion.

In 2009 budgeted reserves are $3,443,442. That is down from 2006 when reserves for general purposes (restricted reserves can not be used for general purposes) was $11,232,259 *Mr. Eads notes "We have been spending our reserves on instructional tools." The State of Anti-Education Colorado isn't too happy about the "state" of the reserves. Mr. Eads declares "This is a clear warning from the state that we are spending more than we are getting in revenue."

Or would that be that the District is making poor spending choices? Flip-a-coin.

The District is actually seeing a 2.97% revenue increase this year after restrictions the School Finance Act puts on the money reducing the overall increase. Student growth needs have already been calculated into the budget, again, according to Mr. Eads, the custodian turned Operations Director turned District Teacher Contract Negotiator turned Budget Analyst turned District Spokesperson turned School Board Advisor.

What does Ms. Lang do for her $180,000 + salary+ perks besides manage a grouping of Principals?

Mr. Eads total revenue column lists $134.3 million (this comes from Mr. Eads presentation on the current budget rounds not the audited financials quoted above from 2009). This is an increase of $5.9 million from the previous year. The audited statement, of 2009, if I am reading it correctly has a total of $165 million as actual revenues received by the District. I have no explanation for the difference. I imagine a possibility is unanticipated revenue that came in during the year (a windfall), increase in federal funding for that year, Mr. Eads is eliminating restricted funding, or the State cut that amount from the District. Take your pick or make up your own reasoning.

The district maintains eight different governmental funds. The major funds are the General Fund, the Capital Reserve Fund, Designated Special purpose Grants Fund, and the Bond Redemption Debt Service Fund. (p. 14 of the Annual Audited Financial Statement for 2009)

Mr. Eads goes on in the slide presentation to list new funding items expected in the upcoming year to cost $1.65 million. He then goes on, in October, to talk about hearing about a 10% shorfall and ponders, "What are the consequences of an actual 10% reduction in the District's budget?"

Now it starts getting more interesting, well at least for me, as Mr. Eads 'brilliantly' reduces a grossly complex budget into two simplistic categories so, I am assuming, the Board, made up of common Greeley folk, can grasp it better. Expenditures are 87% People (note Ms. Lang changes this in her letter to employees as PERSONNEL COSTS) and 13% All non-salary items which are listed as Utilities, Fuel, Textbooks, Computers, Office Supplies.

Okay so where are all the other expenses such as insurance, consultant fees (who are not personnel), maintenance, grounds keeping, etc? Did Mr. Eads leave these out or figure they were just too complex for the Board to grasp things other than certain types of expenditures? Are they in restricted funds (which would maybe explain the above referenced thirty million dollar change in revenues)?

Mr. Eads then goes on to advise the Board, "If a 10% reduction were imposed among all employee groups we would have to lay off at least 200 employees. Class sizes would increase. Programs and services would be reduced." He goes on to give slight scenario examples, advise to the board on broader economic consequences to employees and the community, and lays out criteria and a timeline for how to proceed.

Gee, and I thought the Superintendent did all this work with the support staff. Guess not. So an Operations Manager is left to decide or recommend the cuts to the budget which will threaten learning outcomes for 19,300 students? Why are we paying Ms. Lang again? Public Relations? Fundraising? Oversight of the Teacher's Union? Um, I don't see any evidence of activity in these areas. She has the equivalent of a CFO, an Operations Manager, a Public and Community Relations Manager, a Human Resources Person, a Security Advisor, and an Assistant Superintendent plus more.

I'd like to see Ead's resume and both Mr. Eads and Ms. Lang's job description please... thank you very much.

Let's visit the number relationships now. $16 million, the maximum predicted shortfall of revenue is, rounding numbers, right at 12 percent of Mr. Eads $134 million dollar budget. It is about 10 percent if you use the $165 million dollar budget figure (rounded up) from the audited return mentioned above (available on the D6 website).

So here are my thoughts. Do with them as you wish. I am not an accountant and there is certainly room for reasonable explanations in rebuttal here. If we could only get Ms. Lang present to answer questions.

The 10% figure does not sound as significant as $16 million dollars when put in the context of the whole budget. Although I can understand why they would put the shortfall out in concrete terms rather than a percentage. After all math proficiency in the District isn't great. If all areas of the budget receive a universal 10% reduction what would the effects be?

Why not go to the public and ask for specific help in raising funds to save specific favored programs? Why not make cuts in the "upper-crust" schools as deeply?

Here is another radical idea, if 87% of the costs are personnel based then why not encourage those able to do it to take a 10% reduction in compensation for a period of one year. Hence saving a little over $14 million with 100% participation and saving 200 jobs (according to Mr. Eads). It is a radical idea and rather a pushy one. Those making $180,000 a year, like Superintendent-What-Does-She-Do Ms. Lang would be sacrificing $18 thousand while a custodian like Eads-Used-To-Be, probably paid $18,000 a year or so would be sacrificing $1,800. On the flip side of the argument, the $1,800 would probably bite into essentials a lot more for the custodian than the $18,000 that wouldn't go into Ms. Lang's savings account. Alternative or future year benefits could be promised if better solutions develop. Although the Board's "promises" haven't proven to worth squat in contract negotiations.

So, why all the hoopla about consolidating schools, closing off buildings, selling buildings, and major changes? Hoopla is easy to create when there are other economic crisis in play throughout the State of Colorado and the Nation. Sometimes people have the tendency to overreact. Of course if you are one of the two hundred employees who have now been told job cuts are on the way a big reaction should be on the table. The sky is falling, the sky is falling, said Chicken Little.

But what if it's not. What if the crisis is only a 10% crisis, as compared to say a "huge" crisis. Let's put Chicken Little away for a moment and play out another scenario.

Greeley has a school district which has had some very hard times and made some very poor financial decisions in the past. In my own personal view the main issue in the district is poor hiring choices (see my prior posts on the topic) that have left the district riddled with semi-skilled ideologues and a "good old boy" network. They've made some improvements in the last couple of years with some minor administration changes and new Board members. But more changes are needed.

So I have to ask myself if I am a board member and have spent a couple years researching the problems and have identified the need to drastic changes to correct previous errors of judgment, how would one do that? Politely ask people to leave so you could replace them with more qualified staff and downsize the facilities? Somehow I don't think that would go over well.

The problem becomes clearer. How do you make the needed changes when faced with 87% of your costs in personnel and most of that backed by a Union--where you have to have a substantial and documented objective reason for firing someone? Laying someone off due to economics is an easier route. Additionally firing classified staff gets even easier if the Union has been substantially weakened through failed contract negotiations and faces little public sympathy in an era of recession in a working-class town. In fact, considering the District has forced contracts onto the teachers that are only one year in duration, for this current school year, it might be substantially easier. So easy that teachers may have almost no recourse at all. Political enemies are next on the list.

And then, finally, the house is clean and ready for a fresh start and the people mainly responsible for the problems in the first place get another turn at another go at fixing things without direct accountability or consequences for the initial errors.

Okay, I am not an attorney. I wish I had stayed awake during my fund accounting courses. The above is a conspiracy scenario and a rather scary one to consider. I have been through a restructuring myself and I have also been in charge of restructuring a couple of smaller corporations. I know how the strategies in management can be played out. It doesn't mean, they are playing out. But appropriate questions should be asked of the Board and their employee, Ms. Lang. Or perhaps Mr. Eads is the one to be questioned. I also know that there are presentations I haven't seen and documents I haven't read. I do not have any experience at management levels in a government supported organization. I also don't know the true legal ramifications of the contractual failures. And, truly, the Board is in a very difficult place any way you look at the situation.

Fixing both past and present errors in judgment and shortfalls with an open and forthright agenda would be the humane approach. Well, maybe not for the Board but certainly for the employees and community. Hiring highly skilled people to complete the downsizing would be sensible.

Establishing a written criteria for selecting people to be laid off based on a combination of actual performance, tenure, job duties, etc., would go a long way towards ensuring that the above scenario has not one bite of reality in it. A preliminary plan for educational quality recovery might be the next best comforting thing. How does the District go forward after the debacle.

Other things on my mind, where is Ms. Lang when the community needs to hear her professional assessment of the state of education in Greeley? Is direct oversight of the Principles and Associate Principles a good use of her time and skills during this crisis? Why is Mr. Eads signature on the cover letter of the Audited Financials in lieu of Ms. Lang's? Did Ms. Lang purposely not sign the audit? Is there another signature somewhere? Why is Mr. Eads, on the organizational chart, the supervisor of the finance officers in lieu of the Planning and Accountability Manager supervising this department? Maybe an ex-custodian has the qualifications, experience, and skills required to be in this position over a $134 million dollar budget. Maybe not. Personally, I'd feel a whole lot better if the information was coming out of Ms. Lang's mouth and not Mr. Eads'. At least I'd have a more complete picture of whether she has a handle on this mess.

There are 19,300+ students counting on us to get it right.

The District 6 Organizational Chart--from the Audited Financial Report

(If you double click on the chart it might open up into a bigger window. If not the chart can be found inside the audited financials on the District 6 website linked above.)

Greeley Colorado District 6 School Superintendent: Up to $16 Million in Cuts

Ranelle Lang, Superintendent of Greeley Colorado District 6 School system, has proposed that all department heads produce multiple budget scenarios preparing for cuts of anywhere between eight, ten, to twelve percent or more according to a letter distributed by email (so much for Ms. Lang's personal touch and consideration) to District 6 employees.

Strength is what we need locally over the next several months and even years. We have significant challenges. The State of Colorado, reeling from the recession, must severely reduce the amount of money for K-12 education. These cuts will result in us having to pare $9 million to $16 million from our budget for the 2010-11 school year.

Have those department heads been given any guidance on what to trim? Is the least favorite employee to go? Do they not see the need for this program or that? Out it goes. Who is Captain of this ship anyhow? Where is the strategic planning for the budget cuts? Is the public going to be allowed to determine cuts? "Let's lose educating all those poor and brown people because they are, well, poor, and brown." What a recipe for disaster.

What Ms. Lang doesn't mention is any culpability on District 6's administrative watch. Relying on the fact that people assume all school districts are facing cuts is not quite the same as illustrating the depth of the problem and the history of the problem in D6 schools. Where are the reserves Ms. Lang? In economic good times reserves are created to be spent to soften the blows in economic downturns. Will you be voluntarily taking a twenty percent pay reduction for your own part? Will Mr. Eads, the custodial worker turned manager of operations turned administrative mouthpiece, be turning over his spacious and elegant official digs to save facility costs? Will the administrative offices be closed and the paper-pushers be given a seat in the back of an overcrowded classroom? Will the expansive payroll department be moved to a smaller, less costly, outside facility?

My beef isn't that Colorado is facing a downturn, although Ms. Lang would be well advised to understand the nature and trends in the recession before writing about it, it is that not once, in this letter or any other pseudo communication does the primary mission of the District rule the pages. All signs point to the fact that the Board and Administration in place do not have the skills to be managing a sinking ship. A fully floating ship might be fine under their direction but the 'Shari Lewis Lamb-Chop approach' to fixing this situation is really hard to stomach.

Education. It is about education. Education is the goal here folks. Money is the tool to achieve the goal but the goal must still be met.

Will jobs be lost and will that impact the surrounding economy? Of course it will. It doesn't take a college degree to figure that out. But it does take some intellect, some integrity, and a whole lot of spine to ensure that the cuts made impact the outcome of the educational integrity of the school district in the least intrusive way. And it takes even more character than that to admit that D6 has created, with poor management choices, a much bigger problem than any other school district faces. The voters of Greeley shouldn't escape being chastised either.

This is what Ms. Lang isn't discussing--educational outcomes. She is discussing people. She is discussing shared sacrifice between the adults and she is discussing ways for the community to help balance the checkbook. She isn't discussing educational impacts. She isn't discussing the fact that each student in this district is going to pay a price much bigger over time than any adult will be likely to pay.

District 6 already performs dismally. What is 20% less efficient than dismal?

Ms. Lang needs to be challenged to prove she is worth the money paid. Stand up to the crisis. Demand that educational value be delivered. Hold classes on the field if needed. Go camp on the doorstep of the legislators. Send the kids in who will be paying the price of these cuts for years if not decades. Let them march on Denver. Make them visible so they too can be counted.

Extend the school district into red tape and then let the State explain why it demands the board fire you when you are doing your job of educating the public--and defend yourself with that fact. Is the State really going to subsidize those oil & energy company interests when it has education bills to pay? It is extreme but then again so is the situation and the voters of Greeley just don't get it. They are looking at the checkbook online rather than the objective. They are mad because the checkbook doesn't balance!

Who cares about educational quality?

Meanwhile, behind the curtains, the job is simply not being done--seeing to the education of the youth in this district even when the tools to do the job are not being provided. Get a backbone and make EDUCATION the priority. Do something.

Do anything besides disappear from view and write comfort letters while the executioner runs the guillotine 24/7. Superintendent is a leadership position. The job is to see to the education of the youth and to communicate needs to the community in a way that is clear, concise, and delivers an accurate assessment of needs and brings home the bacon. The community and the State's job is to fund the means to make it happen. The Board's job is to see Superintendents have the tools to do their own job. Put the consequences where they belong on these groups and not upon the backs of the very students without resources in the first place to fight the political battles.

We can fund the military complex but not education? We can fund prisons but not education? We can fund Wal-Mart but not education? What is wrong with this picture? Leaders need to point to the failings of the system not be a jockey on the horse that dissembles the education system for the underclasses. And sometimes it takes a whole lot of courage to stand up and point to the real priorities.

And, by the way, it would also be nice if Ms. Lang attended to the job in person instead of distant, touchy-feeling letters of heart felt consideration as heads of your organization are about to cut off other heads with the axe. Be real. Look the people in the eye and tell them that education is the most important thing to provide when cuts come calling. Look them in the eye and tell them that you truly feel for them while you spend your own corporate salary and Mr. Eads gives operational management suggestions for cuts that will effectively slaughter what remains of the quality of education in this district.

"I am also certain about this: Together we will figure this out. We have no choice given the cards we have been dealt."

Really? From behind a desk you are going to develop camaraderie with those who will suffer? Have you talked to the kids that are about to be thrown into larger class sizes, lose their favorite teachers, or will be turned away by their college of choice because they need remedial coursework just to be accepted? Have you commiserated with those teachers who had a contract forced down their throats or did you send Mr. Eads to do the dirty work? Go to the Greeley Education Association meetings and face the music like a professional should and bring Mr. Eads.

Okay, I'm done with this rant. You asked for my input Ms. Lang and I have given it. In the same cold impersonal way you've delivered your messages. In writing.

The Guillotine is Rolled Out For Greeley Schools District 6

Greeley's District 6 Administration and Board are in the process of organizing spring cleaning. Schools are being scheduled to be shut. Cameron will see its head roll. Jefferson is being merged. Just what that means I am not certain. It appears to mean that all the alternative students and "problems" will be stuffed into one school. Cuts are coming, to the best of my knowledge, to every area except the top run of administrators and to the middle-class white schools like Christa McAuliffe Elementary.

The kids who need the most attention, require specialized help, are lower performers in general, some from homes with fewer resources--rounded up and stuffed into one facility. What could go wrong? The newest teachers in, with the freshest skill set, may be the first out.

In the meantime it isn't clear how extensive operational cuts will be. The Operations Manager has been busy making recommendations and it appears the board is following his lead regardless of the impact on the quality of learning. Still no public appearance by Ms. Lang and her $200 thousand plus a year income.

Teachers have, or were, wearing black shirts to represent the day the Board enforced a contract upon them.

The local teachers union appears to be either overwhelmed or under performing. The mainstream media isn't covering it from a teacher's angle. The concept that the Union has been broken by the Board certainly is real from my own perspective. The public isn't likely to come to the side of the teachers when they have just dumped the plea for more public funds down the drain. And Greeley citizens as a whole do not seem willing to put pressure on the administration to make cuts across the board rather than to focus on some demographics that are not popular.

In general, it is pretty clear that the youth of Greeley are not a priority for the taxpayers. And, in my opinion, it is pretty clear that the Board, Ms. Lang, and Mr. Eads are using the opportunity to clean house. Heads on the chopping block will be the newly hired, political enemies, and any job where a highly skilled person is drawing a realistic salary and can be replaced by a common "Joe".

Of course the State is demanding cuts and probably demanding that a plan be developed and submitted to the State. Mr. Ritter, a pseudo-Democrat, is focused on the Republican agenda for the State budget even though he has decided not to be elected. We can only hope that someone will be reviewing this plan that has the guts to stand up for what is best for the education of the students.

You don't have to be a genius to figure out that if the State removes a million dollars or more from the local budget that it would serve to take out jobs which reduce incoming taxes even further which grows the problem instead of helping resolution. In the meantime while expenditures are being reduced the number of students requiring an education doesn't change. They are all still there at the doors waiting for their opportunity to enter the adult world workforce with a half-baked education and compete with other communities for real wage paying jobs.

All in all it is depressing. The future of Greeley has just been flushed down the toilet and the public doesn't seem too distressed or too informed. I think it is time to call in the State. It is time for parents to go sit outside the Governor's door. It is time to take the students along too and show them the political process and how it works when the government doesn't pay attention to the needs of the future and/or is willing to force certain segments of the population, without as much political power, to bare the brunt of poor ideology, planning, and the cuts that are the natural consequence thereof. The Greeley District 6 Administration and Board is obviously not up to the task, overwhelmed, and willing to make cuts not in the best interest of education but in the best interests of what an Operations Manager recommends. The top level administrator isn't willing to face the public or the bulk of the district's employees. The cuts have already been politicized and are likely to continue in that direction.

Just where is Ms. Lang the District Superintendent? Doesn't the public deserve to meet her face to face and have her explain her reasoning and position. After all Ms. Lang, so it seems, will be retaining her job and her contract. Shouldn't Ms. Lang have to look the teachers, staff, and operations people in the face and explain to them why they have been selected to have their careers pulled out from under them? Ms. Lang should earn those big bucks and take on the big responsibilities--regardless of how hard they may be.

The one advantage, in all this mess, possible is that the people, to the best of my knowledge, who have been hired in the past for low wages based on ideology without the appropriate skills for the job, advanced on the basis of politics rather than educational best interests, could be forced to leave. The "good-old-boy network" could be dissembled in mass firings and rehirings only, unfortunately, the "good-old-boys" are doing the firing and rehiring.

Hence the call for the State to step in.

So the picture I paint here isn't pretty. The subject isn't getting the media and public coverage it deserves. The local fish-wrap is just an extended arm of the public relations sector of the District. Of course to be fair there isn't a good solution to be had and times are tough. But the cuts and changes are being driven less by the best interests of education than by political interests and naive extremist chopping block-watch-the-heads-roll maneuvering. That, or it is being driven by sheer panic and a lack of consensus on what to do. These administrators are over their heads and don't have the skills to deal with the situation in a fair and objective way. Special hires need to be made who have the background skills and objectivity for educational purposes.

Hence the call for the State to step in, again.

Which all leads me back to the supposition, how many times can I say it, it is time for the State to come in and take over the management of Greeley Colorado's infamous District 6. For the sake of the students, the classes in Greeley without political power, the future of Greeley itself, and also for the sake of the taxpayers. Somebody needs to do the real job, the whole job, and do it with the least politics and the maximum professionalism.

And where is Ms. Lang?

Howard Dean's Recommendation for the Current Senate Reform Bill

This comes from today's Washington Post Editorial by Dean. Oddly I couldn't find any share links on the article or I would have just posted it to Facebook. So I am putting it up on Greeleyville instead. The commentary I read initially covering Dean's role was a bit snippy. The impression I got was that the writer held that President Obama had stiffed Dean and left him out of the cherry roles in the administration. Therefore Dean is now playing the role of rogue liberal and can rally people to not back the bill rather than towing the party line.

I am not sure I buy into this analysis. It may be an odd concept but perhaps Dean is just stating the reality of how many people feel. I don't see it as a particular political strategy but it could certainly have those connotations to the inside circle. That is the problem with politics. It doesn't really matter whether the intent is there for Dean. If those "in-the-know" game players think the intent is there then they manifest it on the rest of us and the painting of a controversial relationship between Obama and Dean becomes our perception as well. A new reality so to speak. The real strategy, in my mind, is the need to create tension or increase tension when it already exists because that is what sells the news.

Here is my favorite paragraph from Dean's editorial. The whole thing is rather short and sweet but I thought this paragraph poignant. I hadn't realized that the preexisting conditions segment had been used for gain as well. Here is the link to the entire piece.

"Real health-care reform is supposed to eliminate discrimination based on preexisting conditions. But the legislation allows insurance companies to charge older Americans up to three times as much as younger Americans, pricing them out of coverage. The bill was supposed to give Americans choices about what kind of system they wanted to enroll in. Instead, it fines Americans if they do not sign up with an insurance company, which may take up to 30 percent of your premium dollars and spend it on CEO salaries -- in the range of $20 million a year -- and on return on equity for the company's shareholders. Few Americans will see any benefit until 2014, by which time premiums are likely to have doubled. In short, the winners in this bill are insurance companies; the American taxpayer is about to be fleeced with a bailout in a situation that dwarfs even what happened at AIG."

Health Reform: Senator Joe Lieberman Skewered by Ann Telnaes

Thus far, the best indication of Senator Joe, Let-the-Poor-Die, Lieberman's take on what he would like the health care bill to look like comes from a searing Washington Post Cartoon done by Ann Telnaes. She disembowels the Senator using his own words and a few well placed pen lines dancing to modern technology's tune. I've posted the link to the cartoon below along with Ann's Bio on the Washington Post.

Senator Joe Lieberman skewered by Ann Telnaes

Ann Telnaes, who was awarded the Pulitzer Prize for editorial cartooning in 2001, has published her work in newspapers and magazines around the world. Her cartoons have been exhibited at the Library of Congress, in Paris and in Jerusalem and have been collected in two books, "Humor's Edge" and "Dick.

On the Huffington Post--the best quote I've seen in print yet although I heard something very similar expressed by our own Ed Craig.

If I wanted Joe Lieberman to write health care reform, I would have voted for John McCain.

Later in the post, this tidbit of information

The Trojan Horse at the center of the Senate's health care package is the mandate that people without health insurance be forced to purchase it from private health insurance companies or pay a fine. And the dirty secret of the package is that the price they will be paying is quite high - like up to 10% of income. So the way that we move along the path towards greater coverage is that the taxpayers and poor and working class people pay more to the insurance companies. What part of this is the "good"?

I haven't seen the 10% data in a first source document anywhere but if that is true just imagine Santa Claus coming down the chimney for the insurance industry with 10% of all working class American paychecks in his sack for all the good little greedy toads and toadies in Insurance Land. I'd quit and take my blanket and lie on the steps of the Senate before I'll be shackled to an insurance company, private or nonprofit.

Good grief, both France and Britain have dared to work together to fine and limit their banking industry and America can't even find the spine to tell the Insurance Companies they have to compete to survive? I think the American Senate has been paying Lucy van Pelt for advice.

In the meantime Howard Dean is calling in an Op-Ed piece on the Washington Post for a No-Vote on the now worthless reform bill and for the Senate to start over again. On a Dr. Dean site there is a form for submitting a supportive statement to the tune of

Give America a choice. We support healthcare reform that allows individual Americans to choose either a universally available public healthcare option like Medicare or for-profit private insurance. A public option is the only way to guarantee healthcare for all Americans and its inclusion is non- negotiable.

From Susie Madrak on the CrooksandLiar's website

WASHINGTON -- Howard Dean said a public health insurance option is more important than bipartisanship, and that Democrats should pass health-care legislation that includes the option with 51 votes if necessary.

Dean added that Democrats should have "no intention" of working with Republicans if it's not the strongest possible legislation that could be passed with a simple majority.

"If Republicans want to shill for insurance companies, then we should do it with 51 votes," Dean said during a news conference at the first day of the liberal America's Future Now! conference here.

Dean, though, also praised what he called President Obama's "realist" approach to trying to pass health care reform.

If you want or need a quick lesson on how the "media" can get their own private agenda across without a word just take a look at this site and the picture of Dean the site has chosen to put up discussing his views on health reform.

Speaking of the media, here is a nice clip from the White House (Obama) on the House bill passed this summer. Note the words "...all Americans..." not "SOME" Americans. What happened to your Senate President Obama?

"I thank Chairmen Rangel, Waxman, and Miller for their hard work on this bill that fundamentally reforms the health care system. As this process moves forward, I look forward to continuing to work with all House members in ensuring this legislation helps all Americans and plays an essential role in reducing deficits and bringing fiscal sustainability to our nation."

Searching on Thomas, Library of Congress, I came across the text for December 15, 2009 that I have posted at the end of the blog. But before I post this blog-o-information clips, I thought I'd share my own poignant morning discovery. I went into Fort Collins to visit the Harmony Campus Lab to get a routine blood test ($150) done for my doctor's appointment tomorrow. I was told at the receptionist's desk I'd have to show a photo ID to the nurse. The people in front of me were told the same thing.

Excuse me? This is not a plane. I haven't read any terrorist threats lately to blow up Poudre Valley anything. It is a place of healthcare where people go to be cared for and to gain comfort. It is a place where people who take the Hippocratic oath work. It is not your friendly, give me your data, your ID, your social security number, your health care history, your fingerprints--so I can give it to the authorities to make sure you are going to put in your 10% to the Christmas Fund for the Insurance Elites type of place. Doctors do not swear to treat people only if they pass the photo identification test. If don't have an ID do you not pass go? Do you not get medical treatment? Maybe they can just do a skin test to see if you are brown and legal. If the medical center is really nice they can lay down a doormat in the foyer and allow the really sick and undocumented to die on a nice comfortable mat. Or the homeless, take your pick.

Really, while my rhetoric may be a bit extreme, the privacy invasion is getting out of hand. Do we surrender our individual identities in the name of efficiency? We didn't surrender it in the face of Redcoats, the Confederacy, or the Nazis. Are we going to do it under the guise of healthcare reform? I sure hope not. Electronic records may be a step towards efficiency but there are some things that are just not for sale in America. And never should be.

Here is the text page of amendments. I am not sure why I am posting this here. Maybe I am imagining that there is some one out there who can decipher and make sense of this process. From my read through it looks like the Senate is making a mountain of regulations designed to control the initial development of what the press have referred to as the "nonprofit option". This option was batted about to negate the need for a true public option. I wrote on this topic a couple of months ago suggesting it was a really bad way to produce quality care but a great way to ensure that private insurance"and medical care organizations would face little competition or reform. Here it looks like they are trying to develop the structure for a model to then be used nationwide. I could be wrong.

I repeat... I could be wrong. So if there is anyone reading with a clearer understanding of the process of amending Senate bills and you want to take a shot at it--please feel free to correct my interpretation.

TEXT OF AMENDMENTS -- (Senate - December 15, 2009)

---

``(2) EXCEPTIONS.--The following rules shall apply to a proposal transmitted pursuant to paragraph (1):

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``(A) RECOMMENDATIONS FOR ACHIEVING TARGET.--The requirement under subsection (c)(2)(A)(i) shall not apply.

``(B) REQUIRED INFORMATION.--The proposal shall not include--

``(i) recommendations described in subsection (c)(2)(A)(i), pursuant to subsection (c)(3)(B)(i); or

``(ii) an actuarial opinion by the Chief Actuary of the Centers for Medicare & Medicaid Services certifying that the proposal meets the requirements of subsection (c)(2)(A)(i), pursuant to subsection (c)(3)(B)(iii);

``(C) CONTINGENT SECRETARIAL PROPOSAL.--The Secretary shall not submit a proposal if the Board fails to submit a proposal pursuant to subsection (c)(5).

``(D) CONGRESSIONAL CONSIDERATION.--

``(i) Subparagraphs (A) and (B) of subsection (d)(3) shall be applied by substituting `subsection (c)(2)(C)' for `subparagraphs (A)(i) and (C) of subsection (c)(2)'.

``(ii) Subparagraphs (D) and (E) of subsection (d)(3) and subsection (d)(4)(B)(v) shall be applied by requiring a simple majority rather than three-fifths of the Members duly chosen and sworn.

``(iii) Subsection (d)(4)(B)(iv) shall not apply.

``(iv) Subsection (d)(4)(C)(v)(II) shall be applied by substituting `subsection (c)(2)(C)' for `subparagraphs (A)(i) and (C) of subsection (c)(2)'.

``(v) Subsection (d)(4)(E)(iv)(II) shall be applied by substituting `subsection (c)(2)(C)' for `subparagraphs (A)(i) and (C) of subsection (c)(2)'.

``(E) SECRETARIAL IMPLEMENTATION.--Subsection (e) shall not apply and the Secretary shall not implement the recommendations contained in the proposal unless the Secretary otherwise has the authority to implement such recommendations.

``(h) Annual Report With Recommendations With Respect to the Private Sector.--

``(1) IN GENERAL.--Not later than July 1, 2014, and January 15, 2015, and annually thereafter, the Board shall submit to Congress, the Secretary, and the Medicaid and CHIP Payment and Access Commission a report that includes recommendations on--

``(A) requirements under the program under this title (or requirements included in the proposal submitted under this section in the year); and

``(B) in the case of any report submitted in a year after a determination year (beginning with determination year 2017) in which the Chief Actuary of the Centers for Medicare & Medicaid Services has made a determination described in subclause (I) or (II) of subsection (c)(3)(A)(ii), other requirements determined appropriate by the Board;

that should be included in the requirements established under section 1311(c) of the Patient Protection and Affordable Care Act for a health plan to be certified as a qualified health plan, such as requirements that improve the health care delivery system and health outcomes (including by promoting integrated care, care coordination, prevention and wellness, and quality and efficiency), decrease health care spending, and other appropriate improvements

``(2) INCORPORATION INTO CERTIFICATION REQUIREMENTS.--

``(A) IN GENERAL.--The Secretary shall review the recommendations contained in the report submitted to the Secretary by the Board under paragraph (1). The Secretary may, if determined appropriate, incorporate such recommendations into the requirements for certification under such section 1311(c).

``(B) REPORT TO CONGRESS.--Not later than December 31, 2014, and June 15, 2015, and annually thereafter, the Secretary shall submit to Congress a report on the application of subparagraph (A). Such report shall include, with respect to each recommendation contained in a report submitted by the Board in that year, a description of whether or not the Secretary incorporated the recommendation into the requirements for certification under such section 1311(c), and if not, the reasons why.

``(3) MACPAC.--The Medicaid and CHIP Payment and Access Commission shall--

``(A) review whether or not recommendations contained in a report submitted to the Commission by the Board under paragraph (1) would improve the Medicaid program under title XIX and the Children's Health Insurance Program under title XXI if implemented under such programs; and

``(B) include in the Commission's annual report to Congress the results of such review.''.

SA 3241. Mr. CARPER (for himself, Mr. Conrad, and Mrs. Shaheen) submitted an amendment intended to be proposed to amendment SA 2786 proposed by Mr. Reid (for himself, Mr. Baucus, Mr. Dodd, and Mr. Harkin) to the bill H.R. 3590, to amend the Internal Revenue Code of 1986 to modify the first-time homebuyers credit in the case of members of the Armed Forces and certain other Federal employees, and for other purposes; which was ordered to lie on the table; as follows:

On page 722, after line 20, insert the following:

SEC. 3016. INTEGRATED HEALTH CARE SYSTEM COLLABORATION INITIATIVE.

(a) In General.--In order to improve health care quality and reduce costs, the Secretary of Health and Human Services (in this section referred to as the ``Secretary'') shall develop, in consultation with major integrated health systems that have consistently demonstrated high quality and low cost (as determined by the Secretary and verified by a third party) a collaboration initiative (referred to in this section as ``the Collaborative''). The Collaborative shall develop an exportable model of optimal health care delivery to apply value-based measurement, integrated information technology infrastructure, standard care pathways, and population-based payment models, to measurably improve health care quality, outcomes, and patient satisfaction and achieve cost savings.

(b) Participation.--Prior to January 1, 2010, the Secretary shall determine 5 initial participants who will form the Collaborative and at least 6 additional participants who will join the Collaborative beginning in the fourth year that the Collaborative is in effect.

(1) INITIAL PARTICIPANTS.--Initial participants selected by the Secretary shall meet the following criteria:

(A) Be integrated health systems organized for the purpose of providing health care services.

(B) Have demonstrated a record of providing high value health care for at least the 5 previous years, as determined by the Secretary in consultation with the Medicare Payment Advisory Commission.

(C) Agree to participate in the Medicare shared savings program under section 1899 of the Social Security Act, as added by section 3022, the National pilot program on payment bundling under section 1866D of such Act, as added by section 3023, or a program under the Center for Medicare and Medicaid Innovation under section 1115A of such Act, as added by section 3021.

(D) Any additional criteria specified by the Secretary.

(2) ADDITIONAL PARTICIPANTS.--Beginning January 1, 2013, the Secretary shall select 6 or more additional participants who represent diverse geographic areas and are situated in areas of differing population densities who agree to comply with the guidelines, processes, and requirements set forth for the Collaborative. Such additional participants shall meet the following additional criteria:

(A) Be organized for the provision of patient medical care.

(B) Be capable of implementing infrastructure and health care delivery modifications necessary to enhance health care quality and efficiency, as determined by the Secretary in consultation with the Medicare Payment Advisory Commission.

(C) The participant's cost and intensity of care do not meet the definition of high value health care.

(D) Agree to participate in the Medicare shared savings program under section 1899 of the Social Security Act, as added by section 3022, the National pilot program on payment bundling under section 1866D of such Act, as added by section 3023, or a program under the Center for Medicare and Medicaid Innovation under section 1115A of such Act, as added by section 3021.

(E) The participant would benefit from such participation (as determined by the Secretary, based on the likelihood that the participant would improve its performance under section 1886(p) of the Social Security Act, as added by section 3008, section 1886(q) of such Act, as added by section 3025, or any similar program under title XVIII of the Social Security Act).

(3) ADDITIONAL CRITERIA.--In addition to the criteria described in paragraphs (1) and (2), the participants in the Collaborative shall meet the following criteria:

(A) Agree to report on quality, cost, and efficiency in such form, manner, and frequency as specified by the Secretary.

(B) Provide care to patients enrolled in the Medicare program.

(C) Agree to contribute to a best practices network and website, that is maintained by the Collaborative for sharing strategies on quality improvement, care coordination, efficiency, and effectiveness.

(D) Use patient-centered processes of care, including those that emphasize patient and caregiver involvement in shared decision-making for treatment decisions.

(E) Meet other criteria determined to be appropriate by the Secretary.

(c) Collaborative Initiative.--

(1) IN GENERAL.--Beginning January 1, 2010, the Collaborative shall begin a 2 year development phase in which initial participants share the quantitative and qualitative methods through which they have developed high value health care followed by a dissemination of that learning model to additional participants of the Collaborative.

(2) COORDINATING MEMBER.--In consultation with the Secretary, the Collaborative shall select a coordinating member organization (hereafter identified as the Coordinating Organization) of the Collaborative.

(3) QUALIFICATIONS.--The Coordinating Organization will have in place a comprehensive Medicare database and possess experience using and analyzing Medicare data to measure health care utilization, cost, and variation. The Coordinating Organization shall be responsible for reporting to the Secretary as required and for any other requirements deemed necessary by the Secretary.

(4) RESPONSIBILITIES.--The Coordinating Member shall--

(A) lead efforts to develop each aspect of the learning model;

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(B) organize efforts to disseminate the learning model for high value health care, including educating participant institutions; and

(C) provide administrative, technical, accounting, reporting, organizational and infrastructure support needed to carry out the goals of the Collaborative.

(5) DEVELOPMENT OF LEARNING MODEL.--

(A) IN GENERAL.--Initial participants in the Collaborative shall work together to develop a learning model based on their experience that includes a reliance on evidence based care that emphasizes quality and practice techniques that emphasize efficiency, joint development and implementation of health information technology, introduction of clinical microsystems of care, shared decision-making, outcomes and measurement, and the establishment of an e-learning distributive network, which have been put into practice at their respective institutions.

(B) RESPONSIBILITIES.--The Coordinating Member shall do the following:

(i) Partner with initial participants to comprehensively understand each institution's contribution to providing value-based health care.

(ii) Provide and measure value-based health care in a manner that ensures that measures are aligned with current measures approved by a consensus-based organization, such as the National Quality Forum, or other measures as determined appropriate by the Secretary, while also incorporating patient self-reported status and outcomes.

(iii) Create a replicable and scalable infrastructure for common measurement of value-based care that can be broadly disseminated across the Collaborative and other institutions.

(iv) Implement care pathways for common conditions using standard measures for assessment across institutions, targeting high variation and high cost conditions, including but not limited to--

(I) acute myocardial infarction (AMI) and angioplasty;

(II) coronary artery bypass graft surgery and percutaneous coronary intervention;

(III) hip or knee replacement;

(IV) spinal surgery; and

(V) care for chronic diseases including, but not limited to, diabetes, heart disease, and high blood pressure.

(v) Deploy and disseminate the comprehensive learning model across initial participant institutions, achieving improvements in care delivery and lowering costs, and demonstrating the portability and viability of the processes.

(6) ADDITIONAL BEST PRACTICES.--As additional methods of improving health care quality and efficiency are identified by members of the Collaborative or by other institutions, Initial Participants in the Collaborative shall incorporate those practices into the learning model.

(d) Implementation of Learning Model.--Beginning January 1, 2013, as additional participants are selected by the Secretary, Initial Participants in the Collaborative shall actively engage in the deployment of the learning model to educate each additional participant in the common conditions that have been identified.

(1) DISSEMINATION OF LEARNING MODEL.--Dissemination methods shall include but not be limited to the following methods:

(A) Specialized teams deployed by the Initial Participants to teach and facilitate implementation on site.

(B) Distance-learning, taking advantage of latest interactive technologies.

(C) On-line, fully accessible repositories of shared learning and information related to best practices.

(D) Advanced population health information technology models.

(2) EVALUATION OF PARTICIPANTS.--

(A) IN GENERAL.--Evaluation of initial participants shall be based on documented success in meeting quality and efficiency measurements. Specific statistically valid measures of evaluation shall be determined by the Secretary.

(B) PERFORMANCE TARGETS.--The Secretary shall develop performance targets for participants. Performance targets developed under the preceding sentence shall be based on whether participants have improved their performance under section 1886(p) of the Social Security Act, as added by section 3008, section 1886(q) of such Act, as added by section 3025, or any similar program under title XVIII of the Social Security Act (as determined by the Secretary).

(e) Measurement of Learning Model.--Participants shall implement techniques under the comprehensive learning model. The Secretary shall determine whether such implementation improves quality and efficiency, including cost savings relative to baseline spending for the common conditions specified under subsection (c)(5)(B)(iv) and quality measures endorsed by a consensus-based organization or otherwise chosen by the Secretary. The Collaborative shall prepare a report annually on each participant's performance with respect to the efficiency and quality measurements established by the Secretary. Such report shall be submitted to the Secretary and Congress and shall be made publicly available.

(f) Administrative Payment.--For purposes of carrying out this section, there are authorized to be appropriated $228,000,000, to remain available until expended. Amounts appropriated under the preceding sentence shall be distributed in the following manner:

(1) The Coordinating Organization shall receive $10,000,000 per year for program development related to the Collaborative, including for health information technology and other infrastructure, project evaluations, analysis, and measurement, compliance, auditings and other reporting. Not less than $5,000,000 of such funds shall be provided for education and training, including for support for the establishment of training teams for the Collaborative, to assist in the integration of new health information technology, best practices of care delivery, microsystems of care delivery, and a distributive e-learning network for the Collaborative.

(2) Each Initial Participant shall receive $4,000,000 per year for internal program development for health information technology and other infrastructure, education and training, project evaluations, analysis, and measurement, and compliance, auditing, and other reporting.

(3) Beginning in 2013, the Secretary may provide funding to additional participants in the Collaborative in an amount not to exceed $4,000,000 per participant per year under the same use guidelines as apply to the Initial Participants.

(g) Continuation or Expansion.--

(1) TERMINATION.--Subject to paragraph (2), the Collaborative shall terminate on the date that is 6 years after the date on which the Collaborative is established.

(2) EXPANSION.--The Secretary may continue or expand the Collaborative if the Collaborative is consistently exceeding quality standards and is not increasing spending under the program.

(h) Termination.--The Secretary may terminate an agreement with a participating organization under the Collaborative if such organization consistently failed to meet quality standards in the fourth year or any subsequent year of the Collaborative

(i) Reports.--

(1) PERFORMANCE RESULTS REPORTS.--The Secretary shall provide such data as is necessary for the Collaborative to measure the efficacy of the Collaborative and facilitate regular reporting on spending and cost savings results relative to a value-based program initiative.

(2) REPORTS TO CONGRESS.--Not later than 2 years after the date the first agreement is entered into under this section, and annually thereafter, the Secretary shall submit to Congress and make publicly available a report on the authority granted to the Secretary to carry out the Collaborative under this section. Each report shall address the impact of the use of such authority on expenditures for, access to, and quality of,