Connecticut

Post posts about what is happening in the State of Connecticut.

The Better Deal

On Thursday, Connecticut House Republican’s Chief of Staff George Gallo resigned as the word spread about a federal investigation into how candidates used a direct mail firm out of Florida. People asked me if that wasn’t the same firm that my opponent used in 2012. It was. Yet I don’t think she is any more culpable in this than Chris Donovan was in the improprieties that took place in his Congressional campaign. It is easy to suggest that the candidate either knew, or should have known about possible illegal activity. It is too easy. It doesn’t get to the real issues. Perhaps it simply reflects one of the bigger issues.

In the Hartford Courant article about Gallo, former state GOP Chairman Chris Healy, talking about direct mail firm simply states, “we got a better deal”. A cynic might ask what that deal was. Was there any sort of illegal quid quo pro in the better deal? But this, too, perhaps doesn’t get to the real issue.

I often quote Randy Pausch’s Last Lecture in my blog, and I’ll provide a more complete version of one of my favorite quotes here:

OK, and so one of the expressions I learned at Electronic Arts, which I love, which pertains to this, is experience is what you get when you didn’t get what you wanted. And I think that’s absolutely lovely. And the other thing about football is we send our kids out to play football or soccer or swimming or whatever it is, and it’s the first example of what I’m going to call a head fake, or indirect learning. We actually don’t want our kids to learn football. I mean, yeah, it’s really nice that
I have a wonderful three-point stance and that I know how to do a chop block and all this kind of stuff. But we send our kids out to learn much more important things. Teamwork, sportsmanship, perseverance, etcetera, etcetera. And these kinds of head fake learning are absolutely important.
And you should keep your eye out for them because they’re everywhere.

What candidates want is to get elected, but most of them don’t get elected, they just get experience. This experience might help them get elected the next time around. It might turn them bitter against the system, or it might inspire something greater.

Why do we want to get elected? Hopefully, it is to make their communities better places, and this gets back to the quote from Chris Healy. What is that ‘better deal’ he spoke about?

On my campaign, we often spoke about who we would purchase our services from. We wanted to make our community a better place, and we argued whether it was better to get services from companies in the district, or if it made more sense to use less expensive companies in other parts of Connecticut. It was a difficult balance, and I don’t know how well we really did on it, but at least we didn’t spend most of our budget, a large amount of which came from a Connecticut state grant, with companies in Florida.

We also had people offer us great deals because they were friends that believed in our campaign. We sought to make sure that everyone was paid fairly for the work they did and that there was no expectation of quid quo pro, real or perceived.

Yet most importantly, the focus was on issues. I wanted to talk about health and education. I did. I wished I could have gotten into more discussions about these issues. I wish people would engage more on the issues our state faces instead of making decisions based on a few pieces of mail crafted by political consultants in Florida. I wish more political coverage in the traditional media could be about the issues, and not the horse race and the corruption.

Hopefully, I moved the needle a little bit in that direction. No, I didn’t get elected, but I got “the better deal”.

Health Equity and the 2014 CT Legislative Session

Last year, as a member of the Connecticut Health Foundation’s Health Leadership Fellows Program the group I was part of mapped out plans for bring Health Impact Assessments into Connecticut policy decisions, especially the state legislative process.

A key component of this plan was to improve the way health advocates work together during the legislative session. We set up a Google Group, CT Health Equity Bills to discuss this. As we enter another legislative session, members are encouraged to discuss upcoming bills and opportunities to testify.

I must admit, prior to becoming a CT Health Foundation fellow, I would often be asked to support various bills, and I rarely thought about these bills in terms of the impact they would have on health equity, and I suspect that many legislators don’t think about bills in terms of health equity the way I believe they should.

The Connecticut Health Foundation has published a blog post, Things We’ll Be Looking Out For During the 2014 Legislative Session. While it doesn’t address specific bills, it provides an important framework for this year’s session. I have been speaking with other organizations and hope to share thoughts about their agendas as well.

Meanwhile, I’m already getting messages from activists to support different bills. One of the first bills I received a message about was S.B. No. 23 AN ACT CONCERNING BENEFIT CORPORATIONS AND ENCOURAGING SOCIAL ENTERPRISE.. Friends have pointed me to a Change.org petition uring the senate to take up SB 23 this year.

it is early in the session and I don’t know what SB 23 is going to look like by the end of the session, but I strongly support the goal. Yet I hadn’t been thinking of this bill in terms of health equity. My gut feeling is that it won’t harm efforts for health equity and has the potential to benefit health equity efforts, but beyond that, I haven’t really thought it out much.

Then, at dinner last night, I got into a fascinating discussion with a friend from Yale’s Global Health Initiative. She was at a conference where people were talking about using a social impact exchange as a means of encouraging social entrepreneurship and investment in Haiti to deal with the issues of cholera.

While I do expect the passage of SB 23 to lead quickly to the issue of Social Impact Bonds, or the establishing of a social impact exchange, and a resulting improvement in efforts to address health equity in the state, it does seem like a step in the right direction.

Another bill I was contacted about was S.B. No. 120 AN ACT CONCERNING DYSLEXIA AND SPECIAL EDUCATION.. “To include dyslexia detection, recognition and intervention education as part of the professional development program for teachers and to amend the state IEP form to include dyslexia.”

With sponsors ranging from Sen. Bye to Rep. Cafero, this seems like a pretty straight forward broadly supported bill. Yet even with a bill like this, it is important to think about how it relates to health equity. Are there disparities in the diagnosis and treatment of dyslexia in Connecticut? How are they tracked? How will they be tracked and corrected?

A final bill for this blog post: H.B. No. 5144 AN ACT CONCERNING ACCESS TO BIRTH CERTIFICATES AND PARENTAL HEALTH INFORMATION FOR ADOPTED PERSONS., “To provide adult adopted persons, twenty-one years of age or older, access to their biological parents' health information and information in the person's original birth certificate or record.”

A friend contacted me about this bill. She was adopted as a child and does not have access to information about her biological parents. While it is easy to think of this in terms idle curiosity that an adopted child might have about their history, there are important health issues to consider. Are there biological family history information that could help the adopted child better deal with their own health? Again, I don’t know much about the health equity aspects of this. Are there disparities in access to birth and health information by adopted children along racial or ethnic lines? Would this bill help address such disparities?

Over the coming days, I expect I will hear more about these and other bills. I hope you’ll join me in thinking about the impact these bills would have on health equity in our state.

Looking at the Core Curriculum from a Health Care Perspective

Yesterday, I attended a presentation on the use of tablets in health screenings. It is a project CHC has been involved with together with UConn and another health care organization and it is funded in part by the Connecticut Health Foundation.

One of the comments that particularly jumped out at me was about research that questions the effectiveness of many earlier screening programs. The problem is that these screenings often took upward of an hour and were not necessarily all that accurate.

By using tablets with targeted screenings that the patient could do, typically in four to seven minutes on a tablet while waiting for an appointment, the researchers found much greater accuracy and patient satisfaction with the screenings.

Earlier in the day, I had read an article in the New Yorker, THE DEFIANT PARENTS: TESTING’S DISCONTENTS. It was a fascinating article.

The article is full of great quotes, “One teacher remarked that, if a tester needs three days to tell if a child can read ‘you are either incompetent or cruel…’” Applying it to health care, any practice that took frustrating grueling days to administer basic tests would quickly find themselves out of business.

Part of the Affordable Care Act was the creation of the Patient-Centered Outcomes Research Institute. Perhaps, as part of education reform, we need to look at student centered outcomes research. How effective are the existing batteries of standardized tests? Are there better testing methodologies? Are the components of the core curriculum really the components that will result in the best life outcomes for the students? How does the core curriculum relate to twenty first century skills? Is the focus on the core curriculum diminishing the focus on other key 21st century skills, like creativity and collaboration?

This ties back to one of the lines in the New Yorker article,

Allanbrook says that her decision to speak out was motivated in part by thinking about the fifth-grade social-justice curriculum at the school, in which children who are about to graduate are asked to consider the question “What are we willing to stand up for?”

That especially jumped out at me. Does the school your children go to have a social justice curriculum? It seems like such a curriculum may a great example of what needs to be taught to reach twenty first century skills, and getting skipped because of excessive focus on the core curriculum.

To return to the topic of testing, the article talks about a testing process which takes “seventy minutes a day for six days” and contrasting it with “alternative tests produced by the Department of Education, one in English language arts and one in math, each lasting just forty-five minutes”.

There is another of aspect of health care that jumps out at me which I’ll introduce by way of the infamous quote from the Harvard Educated son of a University of Chicago Secretary of Education, Arne Duncan, who

described critics of the Common Core as “white suburban moms who—all of a sudden—[find] their child isn’t as brilliant as they thought they were, and their school isn’t quite as good as they thought they were.”

Yes, I am white and suburban, though I’m a father, not a mother, and I have not found any of my three daughters any less brilliant than I thought they were. The older two both skipped high school to start college at fourteen. The eldest is teaching English in Japan and the middle daughter completed her Masters in Education at age 19 and has already published three books, her most recent pointing out issues with an education system that does not sufficiently promote creativity. The youngest who is attending a great public elementary school consistently is a top scorer on standardized tests.

Besides relying on false stereotypes, the biggest problem I have with Sec. Duncan’s quote is that it reflects a different issue with the core curriculum.

In health care, we have the National Culturally and Linguistically Appropriate Services.

Provide effective, equitable, understandable and respectful quality care and services that are responsive to diverse cultural health beliefs and practices, preferred languages, health literacy and other communication needs.

One of the criticisms of standardized testing is that many such tests have been culturally biased. Is enough being done to address cultural biases with the core curriculum? Do these cultural biases also end up in the classroom as teachers “teach to the test”? Concerns about the cultural aspects of education are just one part of the larger concern about the ‘one size fits all’ aspect of the core curriculum. Should the requirements vary depending on a students learning style? Does it really matter at what age geometry is learned and at what age algebra is learned, or does what really matter is that adequate progress is made towards learning all the aspects of the core curriculum by high school graduation?

Perhaps Ken Robinson’s comment about ‘date of manufacture’ addresses this issue best

We still educate children by batches. You know, we put them through the system by age group. Why do we do that? You know, why is there this assumption that the most important thing kids have in common is how old they are. You know, it's like the most important thing about them is their date of manufacture.

Well I know kids who are much better than other kids at the same age in different disciplines. You know, or at different times of the day, or better in smaller groups than in large groups or sometimes they want to be on their own.

If you are interested in the model of learning you don't start from this production line mentality. This is essentially about conformity. Increasingly it's about that as you look at the growth of standardised testing and standardised curricula. and it's about standardisation. I believe we've got go in the exact opposite direction. That's what I mean about changing the paradigm.

(You can get the transcript of his talk here or view the great RSA Animate video of it.)

As a final note, plenty of people have criticized the Affordable Care Act. It doesn’t do enough to reform health care and perhaps some of the reforms are headed in the wrong direction. We do need to improve the Affordable Care Act while recognizing benefits that it brings.

It seems as if the same applies to education reform. We do need a core curriculum, one that really addresses the twenty first century skills our students will need. We need proper testing and scientific research into how well these skills are being taught, the impact they are having, and even on the impact of testing, and we need to introduce ideas like the CLAS standards to education and move away from a one size fits all approach to testing and education.

Back to the starting point of this blog post, research at CHC has found that by coming up with new approaches to health screening, effectiveness and satisfaction can be improved. We need to look at similar ways to do this for education, perhaps individualizing and gamifying the whole process.

So, I asked my twelve year old daughter, “What if we replaced standardized tests with computer games?”

Her response was, “That would be awesome!” and then we went on to discuss how people could use it, track student and school performance and play the games from home.

Poor Customer Service from @amitywines

Like many others, I stopped off to pick up a little bubbly to celebrate New Year’s Eve. It was a few hours before closing. The store was busy, but not bad. I wandered around for a little bit to try and find something nice. I picked up two bottles of a sparkling wine that Kim had recommended and went to check out.

The cashier swiped my card through the card reader and it didn’t work. She tried a few more times and asked another person to help her. He didn’t have much better luck so they called a manager over. He tried swiping the card through the reader and didn’t have any luck. He asked if I had a different card. I told him I didn’t I asked if he could manually enter it, and he said he couldn’t.

This struck me as odd. I know that the magnetic strip on my card is starting to wear thin. There have been a handful of stores whose reader can’t read it. Sometimes, they put the card in a plastic shopping bag, which usually does the trick. If it doesn’t, they manually enter the card number. I’ve never had the situation where I couldn’t ultimately use my card, until New Year’s Eve.

I ended up leaving without any sparkling wine. Their intransigence lost them a sale. When I got home and told the story to my wife and some friends, my wife said she knew someone there and she would contact them.

Today, she sent an email and received the following response:

My apologies on your husbands experience.
However, if a credit card or debit card does not swipe it can not be validated that the card was in fact in the store if the charge was ever disputed. That obviously would not be the case here, but it's protection against any fraudulent charges.
If the card number is entered manually there is no protection for that. The swipe can be tracked.
There is no doubt that the funds are the account and that was never in question, it is a protection policy against credit card fraud.

Our cashiers are trained to let a manager know if a credit card doesn't swipe through the system. They know they are not allowed to enter it manually.

This struck as particularly odd. As I mentioned, no other store has ever refused to manually enter the credit card number. So, I contacted some experts in bank fraud. They responded:

Hey, the store owner is wrong. Cards can be manually entered and still not liable for fraud. Swiped transactions give merchants more protection, but they're still protected if they manually enter the info correctly. Sounds like this merchant is over interpreting the reg and being extra cautious.

So, I will be extra cautious from now on as well. I will not shop at Amity Wines and I will discourage others from possibly running into similar experiences.

While I’m at it, I’ll also contact Webster’s bank to get a replacement card with a new magnetic strip. When I’ve had banking issues, their customer service has always been exemplary.

Update 1/3/2014:

A friend sent me Card Acceptance Guidelines for Visa Merchants

Starting on page 19 the document fairly clearly contradicts what the person at Amity Wines claimed.

In traditional sales environments, merchants are required to take all reasonable steps to assure that the card, cardholder, and transaction are legitimate . Proper card acceptance begins and ends with sales staff and is critical to customer satisfaction and profitability.

Later, in the section about what to do when a card doesn't swipe, it goes into detail about making an imprint to show that the card was in the store to protect against possible chargebacks.

Trumbull for Rent and World AIDS Day

Over the past week, there have been several stories that I’ve been following that all fit together in an unexpected larger theme. The first was the release of John Jorge’s Music Video, Lovin’. For those who don’t recognized the name yet, I think the first time I was him perform was in the Amity High School’s production of Rent.

I believe this was the day before Thanksgiving, which is the second story to pay some attention. Every year, we stop to give thanks for all that has been given us. As a New Englander who can trace his genealogy back to the early settlers of the Massachusetts Bay Colony, this is an important day for me. Part of what I’m thankful for is the freedoms my ancestors came to this country in search of.

Another big story for me of the past few days is my completion of National Novel Writing Month, or NaNoWriMo. I finished the first 50,000 word draft of my second novel on Saturday. There is something very empowering to set out to create something challenging and complete it. I will see if I will go through the editing and revisions necessary to get it to be presentable for publication, either through traditional channels or through self publication.

Then, there was the story in the Washington Post of a teacher resigning because of what is happening in education.

All of this leads up to World AIDS Day and an incredible article in the New Yorker, What Young Gay Men Don’t Know About Aids. I work at a Federally Qualified Health Center that treats people with AIDS. I am a Health Leadership Fellow of the Connecticut Health Foundation working with others to address health disparities in our state.

AIDS is a very important topic we need to have open and honest discussions about, which leads me to the final story I want to focus on.

An article in the Hartford Courant put it this way.

Student representatives from Trumbull High's theater department were told last Monday that the show they planned to perform next spring covered topics too "sensitive" or "controversial" for a high school.

Originally, I was planning to write an open letter to the Trumbull High School administration, pointing out how not allowing the production of Rent was incredibly short sighted. I would talk about depriving students of opportunities for prepare for their careers, as the Amity production of Rent helped John Jorge on his career. How not allowing the production went against the freedoms that our forefathers came to this country for. How not allowing the production was an affront to all people seeking to improve the lot of mankind through creativity. How not allowing the production would damage the school district by showing a heavy handed administration that doesn’t allow educators to challenge their students. How not allowing the production was an insult to the people of Trumbull by saying that students at Amity and in Greenwich where Rent has been produced are more capable of handling “sensitive” or “controversial” subjects.

But the most important topic to me was the health topic. According to The Connecticut Department of Health there were nearly 700 case of HIV infection reported in Bridgeport, the city next to Trumbull during the years 2002-2011. Yes, the rate of new infections has been going down, but every new infection with HIV is one infection too many.

HIV/AIDS is not too “sensitive” or “controversial”. HIV/AIDS is an infection which we can stop the spread of. We can do this by talking openly and honestly about the infection, about the stigma. If we care about the children in our schools, we need to have these discussions.

I am tempted to wax polemic adopting the voice of preachers I know that would point out that by preventing these discussions, there is blood on our hands. Yet I’m not sure that is effective. It isn’t really my style.

But, this evening, I went to a World AIDS Day event where another section of the quilt was unveiled. It commemorated people in Connecticut how had died as a result of AIDS. It was attended by people who were living successful lives knowing that they were HIV positive. These were people who have confronted the stigma, found out their status and were getting the treatment so that an HIV infection for them was a chronic disease, not a death sentence. These were people who knew their status and because of their knowledge, were not spreading the infection.

I wept with them as we mourned the death of loved ones.

In my heart, I prayed for those who indirectly contribute to the ongoing spread of HIV by thwarting opportunities for discussion. I wished they could have stood with me at the unveiling of this latest section of the quilt and I pray that these words might cause some to stop and think about what their decisions mean for freedom, for education, and most importantly, for health.

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