Category Archives: Health care

Tobacco Commission Needs Huge Makeover

tobacco leafBy Peter Galuszka

One more glaring example of mass corruption in Virginia is the grandly named Virginia Tobacco Indemnification and Community Revitalization Commission formed 14 years ago to dole out Virginia’s share of a $206 billion settlement among 45 other states with cigarette makers.

I’ve been writing for years about how millions of dollars are doled out with little oversight to economic development projects supposedly helpful to the former tobacco-growing parts of the state from the bright leaf belt around Dinwiddie out west to the burley leaf land of the mountains.

There have been no-strings giveaways to absentee tobacco quota holders, a board member sent to prison for siphoning off grant money and the shenanigans of the extended Kilgore family which is very politically powerful in those parts. The commission even figured in the McDonnell corruption trial starring the former and now convicted governor and back-slapping witnesses for the prosecution, entrepreneur and tobacco-believer Jonnie R. Williams Sr.

I revisit the issue in Sunday’s Washington Post and I ask the obvious question of why no one seems to watching the commission. I raise broader ones, too, such as why the commission  serves only people in the tobacco belt. That doesn’t seem fair since the Attorney General’s office represented all of the state in the 1998 Master Settlement Agreement against four major tobacco firms. People in Hampton Roads, Arlington, Onancock and Winchester should be benefit but get nothing from the settlement. They didn’t  because tobacco road legislators pulled a fast one back in 1999 when they set things up.

There needs to be a thorough disassembling of the commission’s current governance structure with many more people far from Tobacco Road included. There’s far too much family and friend back-scratching as it is. It is like watching a vintage episode of the Andy Griffith show but it really isn’t funny.

(Hat tip to James A. Bacon Jr. who spotted the commission as a great story back in the year 2000 when he was publisher of Virginia Business).

So, please read on.

In the “If Your Like Your Health Care Plan, You Can Keep It” Department…

then-i-saidFrom the Times-Dispatch: “After a year’s reprieve, up to 250,000 Virginians will receive notice by the end of November that their health insurance plans will be canceled because the plans do not comply with the Affordable Care Act and accompanying state law.”

Now those Virginians will have to buy new, Obamacare-compliant plans, which means they will have more benefits they may or may not want… and will cost more.

The Virginia Association of Health Plans, which has become a wholly owned subsidiary of the Obama administration, defended the forced switch. Said Executive Director Doug Gray: “I don’t call that cancellation – I call that an adjustment to the new law.”

I call it a cancellation. I’ll be that the people affected by the law call it a cancellation, too.

– JAB

A Timely Reminder: Virginia Hospitals, Even the Non-Profits, Are Very Profitable

Norfolk General Hospital, the crown jewel of the Sentara Health System, which reported annual profit of $229 million in 2013.

Norfolk General Hospital, the crown jewel of the Sentara Health System, which reported annual profit of $229 million in 2013.

One of the justifications given for expanding Virginia’s Medicaid program as part of the implementation of Obamacare is to shore up the financial condition of Virginia’s hospitals. On the assumption that Medicaid expansion would reduce the number of indigent (non-paying patients), Obamacare will cut back funds to hospitals under the established Disproportionate Share Hospital (DSH) program to help offset the cost of uncompensated care. If Virginia fails to expand Medicaid, as now seems likely, and the federal government cuts DSH funding as planned, Virginia hospitals will take a hit to the bottom line.

The debate may be academic now that Governor Terry McAuliffe has essentially punted on Medicaid expansion in the face of strong Republican opposition in the General Assembly and has proposed a scaled-down Healthy Virginia plan. But the issue still is worth revisiting. Virginia hospitals stand to lose about $386 million in payments from the DSH program between 2017 and 2022 — an average of $77 million per year. How badly will hospitals be hurt? Will cuts impair the quality of care? Do we need to worry?

Mike Thompson, president of the Thomas Jefferson Institute, a conservative think tank, has compiled the profit figures for Virginia hospitals from the Virginia Health Information Foundation. In the aggregate, in November 2013 Virginia’s hospitals had combined profits of $1.6 billion and net worth of $15 billion. The annualized DSH payments are equivalent to about 5% of 2013 profits.

One would think that hospitals should be able to absorb that hit to revenues — equivalent to a year or so of profit growth. Does the picture change when we drill into the numbers? The burden of indigent care is not apportioned equally between hospitals. Some facilities serve largely poor populations and provide extensive uncompensated care and rely more than others on the DSH funds. Also, hospital profitability varied widely from institution to institution. Several hospitals are losing money. In theory, a loss of funds could be devastating.

Thompson’s data reveals that several money-losing hospitals are part of larger health care systems; while they lose money, they feed profitable business to the tertiary care hospitals at the center of those systems, hence, they are not in danger of being shut down. Other facilities represent expansions into new markets — start-up enterprises, in effect. Their parent companies are fully prepared to bear the losses while the facilities ramp up to profitability. Then, too, there are some hospitals that appear to have serious problems. However, it’s not clear from one year’s data whether those losses are ongoing or simply the result of a one-year write-down.

It would be helpful to get a hospital-by-hospital breakdown of DSH funding and see how it compares to hospital profitability. The not-for-profit VCU Health System is reputedly the largest provider of uncompensated care in the state. But, then, it reported a profit of $130 million — a 12.8% return on equity (net worth). Would the loss of, say, $30 million a year in DSH funding be crippling? Maybe VCU could spin a tale of woe that would persuade me otherwise, but it sure doesn’t look like it.

Don’t get me wrong. Hospital profits are a good thing. Try getting your healthcare from money-losing hospitals — you won’t like it. Even not-for-profits need earnings to help fund expansions and new initiatives. But when hospitals are funded with public funds and receive special tax exemptions, the public has a right to ask tough questions.

Update: The Virginia Hospital and Healthcare Association response to Thompson’s study can be seen here. The main thrust: The data is two years old, and the financial pressure on Virginia hospitals has intensified since then.

– JAB

Richmond’s Tech Star in Kickback Scheme?

HDL LogoBy Peter Galuszka

Critics of the American healthcare system have long cited hidden charges as one reason why costs are so high and why reform is needed.

So, it is disturbing to read a report on the front page of today’s Wall Street Journal that Health Diagnostic Laboratory, arguably the most successful of the biotechnology firms to come out of a much-touted research park in Richmond, is implicated in a possible scheme to pay kickbacks to doctors who use its blood testing services.

The Journal reports:

Until late June, HDL paid $20 per blood sample to most doctors ordering its tests — more than other labs paid. For some physician practices, payments totaled several thousand dollars a week, says a former company employee.

HDL says it stopped those payments after a Special Fraud Alert on June 25 from the Department of Health and Human Services, which warned that such remittances presented “substantial risk of fraud and abuse under the anti-kickback statute.

HDL Chief Executive Tonya Mallory told the Journal that her firm “rejects any assertion” that the company grew as fast as it did “as a result of anything other than proper business practices.”

Meanwhile, HDL has sent Bacon Rebellion this updated response.

Others say that paying doctors fees sets up the chances for fraud, especially in Medicare, one of HDL’s biggest markets, the Journal reports. Other testing firms, the Journal reports, pay doctors nothing for using their services.

This is bad news for what was Richmond’s Poster Child of successful high tech startups after years of flops at the Virginia Biotechnology Research Park. Founded in 2008 under Mallory’s leadership, HDL zipped up to $383 million in revenues with 41 percent of that coming from Medicare,” the Journal says.

Much of the issue seems to be related to how accurately and fairly to define what is merely drawing a patient’s blood and how much goes for “P&H” or processing and handling. A problem is that Medicare doesn’t pay any more than $3 for merely drawing blood. HDL has estimated that the “P&H” part is worth about $17. The firm claims it has special proprietary methods that give it an edge.

According to Virginia Business magazine, which named Mallory its person of the year last year:

Mallory, 48, founded HDL in the summer of 2009. Since then, it has grown from a kitchen-table business plan to a corporation earning more than $420 million in annual revenue, employing 750 people, processing 4,000 lab samples and running more than 60,000 lab tests each day. HDL has driven near constant construction at its home in downtown Richmond’s Virginia BioTechnology Research Park, where a $68.5 million expansion soon will triple the company’s footprint to 280,000 square feet.

Last year Mallory received the Ernst & Young National Entrepreneur of the Year award in the Emerging Company category. One of the country’s most prestigious business awards for entrepreneurs, it recognizes leaders who demonstrate innovation, financial success and personal commitment as they build their businesses.

The Journal, however, quotes several disgruntled employees and notes that Mallory had worked for a California firm called “Berkeley Heart Lab Inc,.” which began using tests called “biomarkers” which can predict future health problems by analyzing blood.

Mallory, who was raised in Hanover County and attended Virginia Commonwealth University, was senior lab-operations manager at Berkeley until she left for Richmond in 2008, the Journal says. Two Berkeley sales executives went with her and formed a company that ended up marketing HDL’s products.
Berkeley sued HDL, accusing it of stealing its business. HDL denied the allegations. HDL settled one case for $7 million, the Journal says, but other cases are pending.

Diet Denier

Perhaps you could call Nina Teicholz a “diet denier.” The journalist and author of “The Big Fat Surprise: Why Butter, Meat and Cheese Belong in a Health Diet,” is part of the growing backlash against a half century-long orthodoxy that aimed to limit fat and cholesterol in the American diet. That orthodoxy, which ruled the medical establishment and the federal health apparatus, unwittingly engineered a society-wide shift to the sugar-heavy diet now deemed responsible for the surge in obesity and heart disease that afflicts the country.

In her book, Teicholz delved into the history of how fats, trans-fats and cholesterol came to be demonized and how public policy strove to drive fats out of the American diet. The movement began in the 1950s with a famous study by Ancel Keys, which postulated a link between cholesterol and heart health. The American Heart Association jumped on the bandwagon in 1961, the United States Department of Agriculture issued new dietary guidelines in 1978, and momentum built from there. Food companies rolled out low-fat, low-cholesterol food products, typically substituting sugar and salt for fat. Pharmaceutical companies introduced anti-cholesterol drugs. Schools and media brainwashed generations of Americans to change their behavior.

How could things have gone so wrong? As Teicholz explains in her TED talk above:

The same group of people were on all the expert panels. They all reviewed each others’ papers. These groups controlled all of the funding, so if you didn’t get on this cholesterol bandwagon, you couldn’t get funding, you couldn’t do research, you couldn’t be a scientist. Over the course of 25 years, this diet-heart hypothesis became ingrained in the institutions. There became an institutional bias. There was a bias in the media. And everybody lined up behind this hypothesis. You couldn’t be a scientist if you didn’t get on board.

Thankfully, a new generation of scientists questioned the orthodoxy. Now researchers are focusing on the excess consumption of sugar as the main culprit responsible for our dietary woes.

Fortunately, we’ve learned from our mistakes. Our scientific, media and government officials would never enforce another orthodoxy on the grounds that “97 percent of all scientists” in a given field agree that “the science is settled.”  We’d never rig the peer-review process to suppress unpopular scientific viewpoints. We’d never channel billions of dollars of federal funding into supporting one particular point of view of a massively complex phenomenon while de-funding dissenters. We’d never demonize skeptics as “anti-science,” tools of evil, self-interested corporations and moral analogues of holocaust deniers. We’re far too enlightened in the United States to ever let that happen.

Or are we?

– JAB

RAM, Coal and Massive Hypocrisy

The Pikesville RAM clinic in 2011. Photo by Scott Elmquist

The Pikesville RAM clinic in 2011. Photo by Scott Elmquist

By Peter Galuszka

Sure it’s a photo op but more power to him.

Gov. Terry McAuliffe is freshly arrived from the cocktail and canape circuit in Europe on a trade mission and is quickly heading out to the rugged and impoverished coal country of Wise County.

There, he, Attorney General Mark Herring and Health and Human Resources Secretary William A. Hazel will participate in a free clinic to help the mountain poor get free health care. The political opportunity is simple: Many of the 1,000 or more who will be attending the Remote Area Medical clinic are exactly the kind of people getting screwed over by the General Assembly’s failure to expand Medicaid to 400,000 low income Virginians.

RAM makes its Wise run every summer and people line up often in the wee morning hours to get a free medical and dental checkup. For many, it’s the only health care they get all year unless it’s an emergency. Another problem: Distances are great in the remote mountains and hospitals can be an hour away.

Mind you, this is Coal Country, the supposedly rich area upon which Barack Obama is waging war and harming local people by not going along with coal executives’ demands on environmental disasters such as mountaintop removal, keeping deep mine safety standards light and avoiding carbon dioxide rules.

The big question, of course,  is why if the land is so rich in fossil fuel, are the people so poor and in need of free medical care? It’s been this way for 150 years. And now, coal’s demise got underway in Southwest Virginia in 1991 when employment peaked at about 11,000. It is now at 4,000 or less. It’s getting worse, not better.

In June 2011, by coincidence, I happened along a RAM free clinic in Pikesville, Ky., not that far from Wise when I was researching my book, “Thunder on the Mountain: Death at Massey and the Dirty Secrets Behind Big Coal.” My photographer Scott Elmquist and I spotted the clinic at a high school. There must have been hundreds of people there —  some of whom told me they had been waiting since 1:30 a.m. It was about 8:30 a.m.

Attending them were 120 medical and dental personnel from the U.S. Public Health Service. They were dressed in U.S. Navy black, grey and blue colored fatigues. The University of Louisville had sent in about 80 dental chairs.

Poverty in Pike County had been running about 27 percent, despite the much-touted riches of coal. Pike is Kentucky’s biggest coal producer.

One man I spoke with said he had a job as a security guard, but he doesn’t qualify for regular Medicaid and can’t afford a commercial plan. In other words, had I interviewed him more recently and had he been a Virginian, he would have been lost through the cracks of Medicaid expansion. Alas, he’s in luck. In 2013, Kentucky opted for a “marketplace” expansion system where federal funds would be used to help lower income buy health plans through private carriers.

Lucky the man isn’t from here. The marketplace plan is exactly the kind that McAuliffe has proposed and exactly the one that stubborn Republicans such as Bill Howell in the General Assembly are throttling. The feds would pick up the bill for expanding Medicaid to 400,000 needy Virginians, at least initially.

Yet another irony. Expanded medical benefits are available just across an invisible border in two states whose coalfield residents somehow never got the great benefits of King Coal.

Finally, Some Sense on Climate Change

mowbray archBy Peter Galuszka

Pulling the state’s head out of the sand, Gov. Terry McAuliffe has reversed his predecessor’s policy on addressing climate change.

He has reestablished a 35-member panel to see what the state can do to deal with what many scientists believe is an impending crisis. McAuliffe revived the panel first created by Democratic Gov. Tim Kaine and then left to wither away by former Republican Gov. Robert McDonnell.

Ironically, the new panel includes Michael Mann, a former University of Virginia climatologist who was the target of bitter and petty attacks by former arch-conservative Atty. Gen. Kenneth Cuccinelli over his view that mankind was responsible for carbon dioxide-driven greenhouse gases that are helping warm up the earth, melt polar ice caps and potentially flood huge sections of coastal cities such as Norfolk.

It’s about time that Virginia rejoined the 21st Century. McDonnell took the state backwards on environmental issues by gutting commissions such as this one and creating others that were devoid of ecological viewpoints and stacked with members of the fossil fuel industry and utility executives.

McAuliffe’s new commission has utility people like Dominion Virginia Power President Robert M. Blue and Bernice McIntyre of Washington Gas Light Company. But it is also well stocked with green types such as the Sierra Club, the Chesapeake Bay Foundation and the Southern Environmental Law Center whose views were pretty much in the wilderness during the McDonnell term.

It is finally time for the state to realize that climate change is real. Study after study shows that the state is vulnerable – from agricultural impacts brought on by different weather patterns to rising water in coastal areas. One area worth study is doing more to speed the switch to renewable energy sources like solar and wind.

McDonnell had pushed a policy that would make Virginia “the Energy Capital of the East Coast,” but the effort excluded renewables in favor of offshore oil and gas companies, nuclear power and coal.

Curiously, McAuliffe also favors such endeavors as offshore petroleum development. That raises questions in the face of massive fracking onshore for natural gas and the revolution it has sparked. Perhaps the new commission can provide some guidance.

It is refreshing that Virginia is finally emerging from the intellectual horse blinders that kept the debate stuck in Benghazi-style debates over emails at a British university or trying, unsuccessfully, as Cuccinelli did, to harass scientists globally over a ridiculous claim that Michael Mann had defrauded Virginia taxpayers by asserting what most climatologists do – that climate change is real and mankind is a reason for it.

Finally. . .

Two UMW Daughters of the ’60s

Birmingham By Peter Galuszka

Just a few days ago, Elena Siddall, a Mathews County Republican activist and Tea Party Patriot, posted her account on the Rebellion of being a social worker in New York in the 1960s and the wrong-headedness of Saul Alinsky, a leftist organizer who had had a lot of influence back in the day, among others. I won’t comment on Ms. Siddall’s lively account and conservative point of view. But I do notice one thing: she is a 1963 graduate of what is now the University of Mary Washington, which then was considered the female side of the University of Virginia (campuses being segregated by sex back then).

I have a tie as well to Mary Wash, which is now coed. My daughter graduated from there last year and my cousin-in-law, now living in Tennessee, went there was well before moving on the U.Va. nursing. Our family experience at Mary Wash has been a big positive and I support the school. So, it is with considerable interest that I noticed that the Spring 2014 issue of the University of Mary Washington Magazine had a cover story of a different kind of graduate than Ms. Siddall with some very different views.

So, in the interest of providing some equal time among women who came of age during those years of intense ethical and political awareness, I thought I’d toss in the magazine story to further the debate and show that not every Eagle from Mary Wash thinks like Ms. Siddall (no disrespect intended).

The story has to do with Nan Grogan Orrock, class of ’65, the daughter of an Abingdon forest ranger, who got the civil rights fever when it wasn’t always easy for a young, white woman in Virginia to be an activist. But activist she was, from exhorting her classmates to join protests, to spending summers and other time in the Deep South demonstrating with African-Americans in SNCC, to staring down the real possibility of being beaten or killed and to even today, when she’s been active in the Georgia legislature shaking things up, such as trying to get the Confederate flag off public buildings.

The article, written by Mary Carter Bishop, class of ’67, is intriguing. The writer is a career journalist who was part of a team that won a Pulitzer in 1980 for the Philadelphia Inquirer when that paper was one of the liveliest and best in the nation.

As Bishop writes:Nan Grogan Orrock ’65 is among the South’s most veteran and well-respected advocates of social change. She is one of the longest-serving and most progressive members of the Georgia legislature and has left her mark on every sector of social justice: civil rights, women’s rights, worker rights, gay rights, environmental rights.

“She’s chased after cross-burning Ku Klux Klansmen, cut sugar cane in Cuba, started an alternative newspaper, organized unions, led strikes, been arrested a bunch of times, and still stands on picket lines. At 70, she’s far from done. I had to finally get to know her. The week before Christmas, I flew to Atlanta and sat down with her at the State Capitol.”

Please read both accounts – Ms. Siddall’s and Ms. Bishop’s article – and see ideas through opposite prisms of the 1960s involving two obviously very bright women.

From Budget Crisis to Constitutional Crisis

mcauliffeby James A. Bacon

We live in truly extraordinary times in Virginia. Never in my 61 years have I had occasion to ask myself, “Do Virginians believe in the rule of law or the rule of men?”

Governor Terry McAuliffe exercised his prerogative as governor yesterday to veto portions of the state budget passed by both houses of the General Assembly. Among the items he nixed was $20 million in funding for about 35 vacant or new judgeships. As I understand the state constitution (and I am no expert) he was fully within his rights to do so. Republicans can wail and gnash their teeth at the injustice or foolhardiness of it all, but nobody questions the fact that Virginia’s governor possesses the right to exercise a line-item veto.

More controversially, McAuliffe vetoed language in the budget bill specifying that Virginia’s Medicaid program cannot be expanded unless the General Assembly explicitly appropriates money for it. “The amendment is unnecessary,” he stated, “given its intent to restrict an appropriation that does not exist anywhere in the budget.” Republicans argue that the governor can veto the entire budget bill or he can veto specific appropriations but he cannot veto language in the bill that he does not like. Again, I am no constitutional law expert but the Republican argument seems plausible. The issue could well wind up being decided by the ultimate arbiter on state constitutional questions, the Virginia Supreme Court.

Then there is McAuliffe’s promise to find a way to bypass the will of the legislature and enact Medicaid expansion on his own authority. The money is there for the taking, with 100% of the funding provided by the federal government for the next few years under the provisions of the Affordable Care Act. The problem is that Medicaid is administered by the state and any federal pass-through funds must be incorporated in the state budget, which under any traditional interpretation of the state Constitution requires legislative approval.

Calling expanded health care coverage a “moral imperative,” according to the Times-Dispatch, McAuliffe directed Secretary of Health and Human Services Bill Hazel to give him a plan by Sept. 1 on “how we can move Virginia health care forward even in the face of the demagoguery, lies, fear and cowardice that have gripped this debate for too long.”

Sen. Donald McEachin, D-Henrico, chairman of the Senate Democratic Caucus, vowed that Democrats would stand behind the governor “like a solid wall.” Reports Michael Martz with the T-D:

McEachin, a lawyer, also supported McAuliffe’s vow to expand health coverage by unspecified executive actions. “I’m comfortable with the legality of it,” he said, while declining to say how the governor plans to proceed.

I cannot imagine what novel legal doctrine Democrats might call upon to eviscerate the power of the legislature, but they can rest assured that they will face a battle royal from Republicans who will regard any such effort as an attempt to usurp the legislature’s constitutional powers.

McAuliffe appears to be modeling himself after President Barack Obama who, frustrated by his inability to get his legislative agenda through a hostile House of Delegates, has chosen to rule by executive action. The most notable of his unilateral actions has been expansion of the regulatory purview of the Environmental Protection Agency from air pollutants enumerated by the Clean Air Act to carbon dioxide, a chemical essential to life on the planet, on the grounds that CO2 contributes to global warming.

Impressed by the moral righteousness of their causes and contemptuous of Republicans who in their “demagoguery, lies, fear and cowardice” resist their efforts to re-engineer the nation according to their wishes, Democrats seem increasingly willing to dispense with the niceties of constitutional law. Rest assured, if the shoe were on the other foot — if, say, Sarah Palin or Ken Cuccinelli attempted to impose their agenda by such means — they would be howling that Republicans were dismantling the republic. Frankly, I am amazed how subdued the Republican reaction has been so far.

While McAuliffe calls them demagogues, liars and cowards, they have refused — so far — to respond in kind. But if the governor sticks to his guns and tries to impose Medicaid expansion against the wishes of the electorate (if we believe the polls) and both houses of the General Assembly, it won’t be long before people start calling him an usurper and  tyrant. He had better watch himself. His power grab could generate so much ill will that the Republican-dominated legislature will cut him off at the knees in any way it can. He will find himself a lame duck governor a mere half year into his administration.

Want to Combat Noise Pollution? Measure It

I’m a big fan of city life but I’m the first to acknowledge that there are drawbacks to crowding and congestion. The foremost of those is noise. Cities are noisier than the burbs and the countryside. The older I get (I’m 61 now), the larger the noise factor looms in my consideration of things. Even in suburbs, it doesn’t take much commotion to jangle my nerves. In the early morning birds can drive me crazy with all their chirping and cawing and twittering. As for children, don’t get me started. The noise-oblivious little monsters can be worse than freight trains. If it sounds like I’m turning into a cranky old man… yes, I believe that’s exactly what’s happening.

As a rule, cities are even noisier than the burbs. People are more densely packed in urban areas, so there are more people — more drunks, more wife beaters, more backyard dogs, more buses, more sirens, more jackhammers, more big, honking HVACs — generating sound waves within hearing distance. Cities also have more concrete and masonry that reflect sound and less in the way of trees, bushes and vegetative mass to dampen it. According to the World Health Organization (WHO), problems resulting from too much noise include poor work and school performance and even cardiovascular problems. Clearly, in the battle for livability, the noise factor favors suburbs, small towns and rural areas.

How does a city combat that disadvantage? Ordinances can limit excessive noise from construction, honking horns or barking dogs. Transportation officials can build sound walls along highways. Aside from such obvious measures, one useful place to start is to measure decibel levels to visualize where noise is the worst. Thanks to the increasing ubiquity of smart phones, the practice of noise mapping is spreading around the world.

In 2010 the Sony Computer Science Lab in Paris released an app, NoiseTube, that anyone can download and use to record decibel levels wherever they go. Users can tag particularly obnoxious noise sources and display them on Google Maps. The data can be aggregated to create noise maps accessible to researchers and city officials.

Sony appears to have neglected its website. NoiseTube.com claims to have data from 509 cities worldwide (including Norfolk, Virginia Beach, Richmond, Scottsville and Lynchburg) but the data doesn’t upload to my PC. Regardless, the code is open source, and anyone is free to improve upon it. Creating regional noise maps sounds like a cool community project to undertake. I’d volunteer to participate.  If there are any civic hackers in Virginia looking for a project, let me know.

– JAB