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Budget
Earmarks For Health Technology Are Called Misguided
by Aliya Sternstein
The wish list for local health information technology projects compiled by House and Senate appropriators will not build a much-needed nationwide electronic system, according to some experts in the field.
The House and Senate measures that would fund the Health and Human Services Department in fiscal 2008, H.R. 3043 and S. 1710, include nearly $18 million and nearly $12 million in earmarks, respectively, for the pet projects of specific lawmakers. Examples include $500,000 for digital healthcare equipment and facilities in Newark-Wayne Community Hospital in Newark, N.Y., and another $500,000 for the electronic intensive care unit at St. Mary Medical Center in Apple Valley, Calif.
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Proposed health IT spending*
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THE HOUSE BILL
• Columbia Memorial Hospital, Hudson, N.Y., for health information systems: $150,000
• Communi Care, Inc., Columbia, S.C., for health information systems, facilities and equipment: $285,000
• Newark-Wayne Community Hospital, Newark, N.Y., for facilities improvements and digital health care
equipment: $500,000
• St. Mary Medical Center, Apple Valley, Calif., for electronic intensive care unit: $500,000
THE SENATE BILL
• Alaska Federal Health Care Access Network, Anchorage, Alaska, to support activities of the Alaska Telemedicine Advisory Committee: 250,000; requested by Ted Stevens, R-Alaska
• Alegent Health Care System, Omaha, Neb., for a community-based Electronic Medical Records System: $100,000;requested by Chuck Hagel, R-Neb., and Bill Nelson, D-Fla.
• Association for Utah Community Health, Salt Lake City, Utah, for electronic health records for Utah Community Health Centers: $350,000; requested by Utah Republicans Robert Bennett and Orrin Hatch
• Children's Hospital Boston, Boston, Mass., for the development of comprehensive pediatric electronic medical records system: $220,000; requested by Massachusetts Democrats Edward Kennedy and John Kerry
• Hilo Medical Center, Hawaii, for a medical robotics training lab: $100,000; requested by Daniel Inouye, D-Hawaii
*This list is only a sample of the earmarks included in each bill. Click for a more complete listing for the House and Senate earmarks.
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But David Merritt, a project director at The Center for Health Transformation founded by former House Speaker Newt Gingrich, R-Ga., criticized the initiatives.
"Driving adoption of health information technology through earmarks is not the way to go," he said. "We need to fundamentally reform the way we pay providers to drive adoption of health information technology."
The effective route to broad-scale acceptance, he said, is through reimbursing healthcare providers based on outcomes. That will give providers an incentive to purchase tools that will help them achieve better outcomes -- namely health IT.
Doctors need predictable, long-term financing, not annual handouts, Merritt said. "What happens to these projects when these funds disappear? These are Band-Aids, not serious fixes."
Scot Silverstein, director of Drexel University's Institute for Healthcare Informatics, said the funding amounts are so small that they likely represent nothing of great significance.
"Even $500,000 in the IT world does not go far," he said. "A few consultants, a few computers, a piece of software here and there, a bit of customization, and poof, $500,000 is gone."
Excluding annual operating costs, which are several times greater than base development costs, $100,000 is not even enough to pay the salary and benefits of a competent IT or medical informatics specialist for a year, Silverstein added.
But a prospective recipient of $100,000 under the Senate bill is happy with the amount.
Ted Schwab, senior vice president and chief innovation officer at the hospital operator Alegent Health, said the funding would go toward helping 150 independent physicians in eastern Nebraska and southwest Iowa connect to Alegent's electronic medical record system.
Alegent Health originally requested $2.6 million for the project.
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Budget
Senate Energy Bill Would Cut Money For Computing
by Winter Casey
The Energy Department's advanced simulation and computing program would get less money than President Bush requested under the Senate bill to fund department programs in fiscal 2008.
The legislation calls for more than $300 million to be spent on the National Nuclear Security Administration program, which focuses on ensuring the safety and reliability of nuclear weapons by analyzing their performance. The budget figure falls short of Bush's request by more than $5 million, according to a committee aide.
The funding is included in a bill, S. 1751, that is awaiting floor debate. The House already has passed its own related legislation.
According to the Senate Appropriations Committee report on its bill, because both the nuclear agency and the department's science office have major high-performance computing programs to "address emerging issues in the nation's security, economic competitiveness and scientific leadership, advances in [high-performance computing] need to be accelerated beyond what each office can accomplish individually."
The committee said it expects Energy to continue to diversify it computing potential and unite various groups with an interest in developing technologies for future supercomputing platforms.
"Important areas for research and development include advanced supercomputer architectures, new algorithms and system software to enable efficient use of emerging architectures, advanced interconnection network technologies, and advanced memory subsystems technologies that keep pace with advances in microprocessors," the committee report said.
The report calls on Energy to establish a joint program office led by the nuclear agency's administrator and the department's science undersecretary to focus on computing platforms and a long-term, national computing strategy.
The committee said Energy also is expected to research cyber-security issues related to supercomputing, and the nuclear agency should develop a better way to understand why technology systems fail.
The Senate committee recommends that the agency work to increase the safety, security and improved surveillance of weapons through the use of technology. It should work with other nations to explore opportunities to share the technologies within set boundaries, the report said.
On another front, the spending bill would give the Army permission to improve the information technology laboratory at the engineer research and development center in Vicksburg, Miss.
The measure also would provide funds for the Center for Computer-Assisted Dispute Resolution within the Army's Institute for Water Resources, which works to develop solutions to water availability and quality problems through computer technologies and water-management software, among other tasks.
The House bill for the Energy Department, meanwhile, would provide $150 million for climate-change research, such as through the use of supercomputers, according to a committee summary.
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Taxes
Internet Tax Plan In The Works May Define Access
by Winter Casey
A possible new definition of Internet access that could be included in legislation about the Internet tax moratorium set to end Nov.1 has been circulated among technology industry officials and state representatives.
A spokesman for House Judiciary Commercial and Administrative Law Subcommittee Chairwoman Linda Sanchez, D-Calif., confirmed that Sanchez is working on legislation with other senior committee members.
"She is committed to developing a win-win bill that protects the access of working families to the Internet, enables state and local governments to provide needed services, and allows the information technology industry to continue this great age of innovation," the spokesman said.
Sanchez' subcommittee held a hearing on the topic Thursday. Two witnesses, Time Warner Cable tax specialist Meredith Garwood and David Quam, the National Governors Association's federal relations director, noted that industry and state groups have been working collaboratively to address concerns regarding the definition of Internet access. Garwood noted that the Don't Tax Our Web Coalition and NGA have agreed upon a definition.
A potential compromise, linked to Sanchez' office, has been circulated among state and local groups and the business community, according to sources. The definition addresses what people refer to as the "backbone issue." An industry source said the Sanchez legislation also could extend the ban for eight to 12 years.
Mark Nebergall, president of the Software Finance and Tax Executives Council, said the backbone term generally involves "whether the ban on state taxes extends to so-called Internet backbone access that cable and phone companies have to buy in order to offer Internet access to consumers. ... It seems more clarification is needed."
The compromise definition "includes the purchase, use or sale of telecommunications by a provider of a service." It would apply the moratorium to wholesale transactions between cable and phone companies and Internet backbone or transport companies.
Michael Wendy of the Computing Technology Industry Association said his group has long been concerned by the backbone-backdoor issue and sought to close the loophole. Otherwise, he said the tax ban is meaningless.
Two sections of the definition address bundling issues. One would narrow the classes of content, such as e-mail and instant-messaging, that Internet providers can bundle. The other addresses what things would not be covered by the ban, such as "voice, audio or video programming."
Nebergall said the definition of Internet access in the current ban has been controversial because states seem "to believe it allows companies that sell Internet access to bundle other proprietary material and exempt it from all state taxes."
While some in industry would like backbone issues to be resolved, state sources have bundling concerns. Quam said the bundling issue is a huge problem for his association.
His group supports a "reasonable extension" of the tax ban, such as offered by Sens. Lamar Alexander, R-Tenn., and Tom Carper, D-Del.
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Crime
Sen. Stevens Is Revising Internet Bill To Target Porn
by Andrew Noyes
The powerful ranking Republican of the Senate Commerce Committee is taking a second shot at legislation to keep children safe on the Internet. Alaskan Ted Stevens is reworking a bill he introduced in January, hoping to address concerns raised by free-speech advocates and educators.
His earlier bill, S. 49, would prevent the carriage of child pornography by video service providers and includes text that would require Web sites to label sexually explicit material. It also would block access to social networks and chat rooms at institutions that receive special funding for Internet access.
"Over the past six months, we've had some very constructive conversations with Stevens' staff," said John Morris of the Center for Democracy and Technology. "They're working hard to come up with a bill that addresses the problem of child safety online while avoiding some of the constitutional pitfalls."
The restrictions placed on schools and libraries that get federal e-rate money for Internet connections have been replaced in the latest draft with language calling for increased Web safety curricula. "That's something that we've long supported, and it's a very healthy thing," Morris said.
David Finkelhor, director of the Crimes Against Children Research Center at the University of New Hampshire, said research has not found that "simply having access to social-networking sites is intrinsically a risk factor." Finkelhor testified Tuesday at a Commerce Committee hearing on child protection.
"We really need to nail down the risks and have evidence of what the real dangers are," he said Friday. "Because young people are clever, engaged and spend a lot of time online, I think we'd do much better equipping them with the skills to make good judgments."
The proposed Web-labeling mandate for sexually explicit content, which Morris said would violate the First Amendment, also is gone. Instead, the draft recommends creating an FTC working group to examine the effectiveness of voluntary labeling practices.
But CDT still has concerns about portions of the would-be bill, the group said in written testimony sent to Stevens on the day of the hearing. The uneasiness pertains to "inviting the FCC to take action or investigate things in which it has no expertise," Morris said.
One section of the draft asks the FCC to work with the Justice Department and the National Center for Missing and Exploited Children to craft rules for improving Internet service providers' cooperation with government child-porn probes.
While CDT believes that child porn "should be fought at every turn," Morris said Congress has not given the FCC "any authority to issue general purpose, content-focused regulations of the Internet." The provision is a "legal minefield," he said, noting that the commission has not been "very sensitive to First Amendment concerns in the past."
The proposal also calls for an FCC rulemaking to define "social-networking Web site." According to Morris, a definition is unnecessary and it would be difficult to achieve. "There's no principled way to distinguish between MySpace, which allows profiles and communicating between members, and Daily Kos, a political blog, which allows same," he said.
Stevens staffers told Technology Daily that they hope to introduce the legislation before the August congressional recess and use the month to collect co-sponsors. But for now "we're more focused on getting it right than the timing," one aide said.
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E-Government
Sen. Durbin Uses Blog To Craft Broadband Bill
by Aliya Sternstein
In a role reversal, Sen. Dick Durbin has been blogging about bloggers all week. Since Tuesday, the Illinois Democrat has been conversing with the "netroots" on the liberal blog Open Left to have them help him write high-speed Internet legislation.
"Today I'm writing to invite you to participate in an experiment -- an interactive approach to drafting legislation on one of the most significant public policy questions today: What should be America's national broadband strategy?" Durbin wrote on Sunday.
Each night, Durbin began his online discussions by asking for legislative proposals that touch on some of his core principles, like achieving universal, affordable broadband coverage. Should the four-day series prove fruitful, Durbin wrote, "it may become the way lawmakers approach drafting bills on other issues like education, health care and foreign policy."
At the outset, Open Left and Durbin's office invited the major telecommunications and cable companies to participate. All of them declined, but on Wednesday, representatives from AT&T's Hands Off the Internet and the AT&T/Verizon Communications-backed Latino Coalition joined the online debate.
Conservative blogger Robert Bluey of the Heritage Foundation also took note of the development. He wrote on his personal blog, RobertBluey.com, that while it is admirable for Durbin to involve the netroots, "I think it's incredibly short-sighted to have a one-sided conversation with just liberals."
He added, "I wonder if he will be posting on RedState? Or if he plans to reach out to a non-ideological Web site?"
Bluey then e-mailed Durbin's office, which agreed to host a similar forum July 31 on the Republican blog RedState, where Bluey also writes.
"We'd be fools not to take him up on that," Durbin spokesman Joe Shoemaker said. Durbin's office also is in talks with a nonpartisan technology news site to host the e-legislation project.
Bluey said he thinks that Durbin's Open Left effort is getting positive reaction across the political spectrum. He noted one comment left on RedState: "I would hope that if Durbin did decide to engage at RedState, we would afford him some degree of respect and stick to the issue at hand. The problem comes in when some nimrod decides to start beating on him about something completely unrelated."
Next week's RedState event will be an experiment of another kind. "It seems that liberal blogs are just much more active in terms of the number of commenters," so the quantity of posts will be worth watching, Bluey said.
On Friday, Shoemaker said the project "has been a very successful experiment thus far." For example, participants have suggested that federal legislation address the issue of broadband networks run by governments in a handful of U.S. cities.
"Nobody's flamed Durbin," Shoemaker said. "There's been no sort of off-topic discussions. People have disagreed with other participants," but the content "wasn't, 'SHUT UP.'"
Open Left co-Editor Matt Stoller said the venture is engaging citizens from rural areas who typically are not a part of the legislative or lobbying process. "I haven't even wrapped my head around how to describe it," he said.
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Politics
GOP Online Experts Rally For Video Debate Format
by Heather Greenfield
Reports that some Republican presidential candidates may be wary of attending a debate hosted by CNN and the YouTube video-sharing site have spurred GOP online experts into action.
The debate, which will be based on citizen video questions already being submitted through YouTube, is scheduled for Sept. 17 in St. Petersburg, Fla. The sponsors introduced the unique format at a Democratic debate in Charleston, S.C., on Monday.
CNN has begun reviewing the 400 questions submitted for the since the GOP debate was announced a week ago. So far three campaigns have committed to attending the debate -- Sen. John McCain, libertarian Ron Paul and former Gov. Tommy Thompson.
The two leading Republican candidates appear to be leaning against participation. Former New York Mayor Rudy Giuliani may skip the event due to scheduling conflicts, and former Massachusetts Gov. Mitt Romney criticized the format, which led to one question about global warming being asked by an animated snowman.
"We'll answer questions from any American who wants to ask one and that includes one dressed up like a snowman," said Steve Grubbs, senior national advisor for the Tommy Thompson, R-Wisc.
Conservative online consultant David All, who was vocal about getting the CNN/YouTube debate and who attended the Democratic debate, has made a video appeal in defense of the format through YouTube.
"There are real people on YouTube ... even some Republicans," All said. "Yeah, you might get some tough questions [at the debate], but I'm sure you get those tough questions every day in New Hampshire and Iowa."
On Friday, All and Patrick Ruffini, a former Republican National Committee e-campaign director, joined other conservative bloggers in an online petition to "save the debate." "Don't attend, and millions of Americans will wonder if you were too afraid to answer questions from the Internet," they wrote.
And conservative blogger Michelle Malkin urged Republicans to "get in the game." She referred readers to a poll where 61 percent so far have voted for Republican participation.
A McCain spokesman declined to comment on McCain being the first Republican frontrunner to commit to the debate, and Paul's media staff could not be reached for comment.
A spokesman for Mitt Romney said his campaign has received seven other debate invitations for September and has not decided which to attend. Brian Hart, a spokesman for the campaign of Kansas Sen. Sam Brownback, said Brownback will be debating somewhere Sept. 17; it's just a question of which debate to attend. He cited a Values Voter debate also in Florida that day.
Press offices for other contenders, including Giuliani, did not return calls by press time.
DuBose Kapeluck, a political science professor at the Citadel in Charleston, said Democrats were "brave to do [the new debate format] first" and Republicans now have an idea what is coming.
Democratic National Committee Chairman Howard Dean, however, said he is not sure that will help Republicans answer the candid video questions. "They're scripted. They're old-generation," Dean said. "I think they may struggle a little bit."
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Broadband
Municipalities Score N.C. Win On Broadband Front
by Michael Martinez
Local governments have pressured lawmakers in North Carolina to back off a proposal to limit the ability of municipalities to build and operate their own high-speed Internet networks.
The state House Finance Committee this week voted to alter legislation that would have restricted such broadband services. The panel substituted the original bill with one commissioning a study into the performance of municipal broadband networks.
Localities mounted an aggressive campaign to derail the original measure. Dozens of towns and cities adopted resolutions this year urging the legislature to abandon it.
Rob Thompson, a policy advocate for the North Carolina Public Interest Research Group who helped organize resistance to the bill, said municipalities were quick to realize how much the legislation would have hurt them. According to Thompson, it would have been a tough pill for local governments to swallow, considering a bill enacted last year that stripped localities of the authority to grant and receive revenue from video franchises.
In North Carolina and more than a dozen other states, video service providers seeking to enter new markets can bypass local governments by applying for statewide franchises. The lawmakers who have pushed such franchising plans have argued that they are good for consumers because they open markets to more competition.
But Thompson said North Carolina consumers are still waiting to see the benefits of the new statewide system. "I think people were reluctant to pass a municipal broadband bill like that this session because they knew that companies had failed to provide the new competition they promised to get the statewide franchising law," he said.
Under the bill approved this week by the state House Finance Committee, a committee will study for two years the "adequacy of coverage of communications services offered by current providers across the state." The North Carolina League of Municipalities noted that localities in the Tar Heel State already have invested more than $200 million in such projects.
The study group, which will include members from both chambers of the Legislature, also would be directed to analyze the effects of such networks on services offered by private companies.
Thompson said he already is worried that pro-business lawmakers on the review panel will affect what it reports back to the Legislature. State Rep. Drew Saunders, the primary sponsor of the anti-municipal broadband bill, is slated to be one of the panel's co-chairmen.
"I'm a little scared that when we come back in 2009, we'll be back where we started," Thompson said.
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On The Hill
Sen. Ensign's E-Voting Bill Inspired By His Past
by Theresa Poulson
While a Senate hearing this week centered on determining a reasonable timeframe for updating voting systems, new Senate legislation was introduced to require voter-verified paper trails for electronic ballots. The bill, S. 1869, is one of several new technology-related measures.
Bill sponsor John Ensign, R-Nev., lost his first Senate bid by several hundred votes. During a recount, votes cast on electronic machines could not be verified. "I have witnessed firsthand what happens when there is not a paper trail to determine the accuracy of a voting machine," he said. His state was the first to implement voter-verified paper trails in 2004.
"Nearly everyone in America has had a cell phone quit working or a computer crash, and we cannot afford to risk losing votes because of an electronic glitch," he added.
On the high-speed Internet front, meanwhile, Sen. Frank Lautenberg, D-N.J., introduced a bill, S. 1853, designed to foster municipally owned broadband networks. Under the bill, states could not prevent municipalities from offering such networks. The measure also would prevent municipalities with the networks from discriminating against private competitors.
A separate Senate measure, S. 1857, would establish a digital and wireless technology program.
Other tech-related bills introduced this week were:
-- H.R. 3144, H.R. 3148, H.R. 3149 and H.R. 3155, which aim to combat online crimes and strengthen the protection of intellectual property (see separate story);
-- H.R.3189, which would establish procedural checks for the use of secret anti-terrorism subpoenas known as national security letters (see separate story);
-- H.R. 3138, which would update the definition of electronic surveillance in the Foreign Intelligence Surveillance Act (see separate brief);
-- S. 1848, which would extend federal aid to service workers, communities, firms and farmers whose jobs have moved overseas (see separate summary);
-- H.R. 3194, which aims to improve the H-1B visa program for highly skilled workers by increasing the exchange of information between the Homeland Security and Labor departments;
-- H.R. 3141, which would increase funding in agreements relating to patents and nonprofit organizations to be used for scientific research, development and education;
-- H.R. 3146 and H.R. 3147, which would provide additional tools and resources to combat terrorism financing and for fighting terrorism;
-- H.R.3198, which would provide for national security reviews every four years;
-- H.R.3199, which calls for updated communications equipment, including radios, for the New York City Fire Department;
-- H.R. 3128, which will authorize a study on the feasibility of using military identification numbers instead of Social Security numbers for members of the armed forces;
-- H.R. 3162, which calls for a plan to implement a health information technology system under the Medicare program;
-- H.R. 3160, which aims to prevent corporations from exploiting tax treaties to evade U.S. income taxes;
-- And H.R. 3133, which would establish a toll-free telephone number for complaints regarding predatory lending.
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Clarification
Wednesday's PM Edition reported that Sallie James of the Cato Institute said her father once owned a casino. James said in an e-mail that her father actually was CEO of the Adelaide Casino.
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Today's Feature:
Executive Summary
Democratic presidential hopefuls took blunt questions via online video in Charleston, S.C., this week at a debate co-sponsored by CNN and YouTube.
Every Friday, read the Executive Summary by K. Daniel Glover.
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E-briefs
Crime: A former Qwest Communications International executive has received six years in prison for insider trading, AP reports. Former CEO Joseph Nacchio was sentenced Friday after being convicted in April of making stock sales when he knew Qwest faced financial risk and without telling investors. Judge Edward Nottingham ordered Nacchio to forfeit the $52 million in assets he gained from the illegal stock sales, imposed the maximum $19 million fine, and ordered him to serve an additional two years of probation after serving his sentence. "The crimes the defendant has been found guilty of are crimes of overarching greed," Nottingham said. Attorneys argued whether Nacchio should be granted bail while he appeals his conviction. Nacchio faced up to seven years and three months in prison but declined to testify at his sentencing hearing.
E-Government: A lawsuit filed Thursday against former Arkansas Gov. Mike Huckabee accuses the Republican presidential hopeful of breaking state law when his administration destroyed government-owned hard drives as he left office in January. AP reports that a lawsuit filed in Pulaski County Circuit Court accuses Huckabee of violating the state's Freedom of Information Act and a law prohibiting damaging a computer without authorization. The state's Ethics Commission previously has dismissed two complaints that Jim Parsons, a self-described "gadfly," has filed against Huckabee over the hard drives' destruction. The lawsuit, described in the filing as a "citizen complaint," asks the court to "send a message that destroying public records is not the standard operating procedure" of elected officials when they leave office. Attorney General Dustin McDaniel last week said he could find no reason to pursue any action against Huckabee over the 91 destroyed hard drives.
Security: Republicans on the House Intelligence Committee on Friday accused Chairman Silvestre Reyes of not doing enough to address needed reforms to the Foreign Intelligence Surveillance Act. In a letter signed by the entire minority on the panel, top Republican Peter Hoekstra of Michigan argued that Congress is "dragging its feet in responding to the dire warning from the [intelligence] community that it can't get the vital intelligence that may tip us off to the next [terrorist] attack." Hoekstra also said committee Republicans want to work with Democrats to solve the problem before the August congressional recess. Reyes, D-Texas, wrote to one of his biggest critics earlier in the week -- New Mexico Republican Heather Wilson -- telling her to curb her "partisan rhetoric." Wilson introduced a bill on Tuesday to amend FISA to permit, without warrants, wiretaps of foreign citizens outside of U.S. borders.
Civil Liberties: Kazakhstan and Georgia are among the countries imposing too many restrictions on how citizens use the Internet, AP reports. A report by the Organization for Security and Cooperation in Europe released Thursday said online policing by the countries is "a bitter reminder of the ease with which some regimes -- democracies and dictatorships alike -- seek to suppress speech that they disapprove of, dislike or simply fear." About two dozen countries practice Internet censorship, said Miklos Haraszti, head of the group's media freedom office. Kazakh Information Minister Yermukhamet Yertysbayev, for example, has vowed to purge Kazakh sites of "dirt" and "lies." Yertysbayev insisted in a speech Thursday at OSCE headquarters that Kazakhstan was committed to expansion of Internet access and making media more free. Separate research by the Open Net Initiative found questionable online restrictions in Belarus, China, Hong Kong, Sudan, Tunisia, Uzbekistan and elsewhere.
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President -- John Fox Sullivan, 202-739-8468
Editor in Chief -- Louis Peck, 202-739-8481
Editor -- K. Daniel Glover (bio)
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