How Two Common Medications Became One $455 Million Specialty Pill

[Editor's Note: today's guest post, by the reporters at ProPublica, explores reasons for the high cost of prescription drugs for patients in the United States. Today's post is reprinted with permission.]

by Marshall Allen, ProPublica

Everything happened so fast as I walked out of the doctor's exam room. I was tucking in my shirt and wondering if I'd asked all my questions about my injured shoulder when one of the doctor's assistants handed me two small boxes of pills.

"These will hold you over until your prescription arrives in the mail," she said, pointing to the drug samples.

Strange, I thought to myself, the doctor didn't mention giving me any drugs.

I must have looked puzzled because she tried to reassure me.

"Don't worry," she said. "It won't cost you any more than $10."

I was glad whatever was coming wouldn't break my budget, but I didn't understand why I needed the drugs in the first place. And why wasn't I picking them up at my local CVS?

At first I shrugged it off. This had been my first visit with an orthopedic specialist and he, Dr. Mohnish Ramani, hadn't been the chatty type. He'd barely said a word as he examined me, tugging my arm this way and bending it that way before rotating it behind my back. The pain made me squirm and yelp, but he knew what he was doing. He promptly diagnosed me with frozen shoulder, a debilitating inflammation of the shoulder capsule.

But back to the drugs. As an investigative reporter who has covered health care for more than a decade, the interaction was just the sort of thing to pique my interest. One thing I've learned is that almost nothing in medicine 2014 especially brand-name drugs 2014 is ever really a deal. When I got home, I looked up the drug: Vimovo.

The drug has been controversial, to say the least. Vimovo was created using two readily and cheaply available generic, or over-the-counter, medicines: naproxen, also known by the brand Aleve, and esomeprazole magnesium, also known as Nexium. The Aleve handles your pain and the Nexium helps with the upset stomach that's sometimes caused by the pain reliever. The key selling point of this new "convenience drug"? It's easier to take one pill than two.

But only a minority of patients get an upset stomach, and there was no indication I'd be one of them. Did I even need the Nexium component?

Of course I also did the math. You can walk into your local drugstore and buy a month's supply of Aleve and Nexium for about $40. For Vimovo, the pharmacy billed my insurance company $3,252. This doesn't mean the drug company ultimately gets paid that much. The pharmaceutical world is rife with rebates and side deals 2014 all designed to elbow ahead of the competition. But apparently the price of convenience comes at a steep mark-up.

Think about it another way. Let's say you want to eat a peanut butter and jelly sandwich every day for a month. You could buy a big jar of peanut butter and a jar of grape jelly for less than 10 bucks. Or you could buy some of that stuff where they combine the peanut butter and grape jelly into the same jar. Smucker's makes it. It's called Goober. Except in this scenario, instead of its usual $3.50 price tag, Smucker's is charging $565 for the jar of Goober.

So if Vimovo is the Goober of drugs, then why have Americans been spending so much on it? My insurance company, smartly, rejected the pharmacy's claim. But I knew Vimovo's makers weren't wooing doctors like mine for nothing. So I looked up the annual reports for the Ireland-based company, Horizon Pharma, which makes Vimovo. Since 2014, Vimovo's net sales have been more than $455 million. That means a lot of insurers are paying way more than they should for their Goober.

And Vimovo wasn't Horizon's only such drug. It has brought in an additional $465 million in net sales from Duexis, a similar convenience drug that combines ibuprofen and famotidine, AKA Advil and Pepsid.

This year I have been documenting the kind of waste in the health care system that's not typically tracked. Americans pay more for health care than anyone else in the world, and experts estimate that the U.S. system wastes hundreds of billions of dollars a year. In recent months I've looked at what hospitals throw away and how nursing homes flush or toss out hundreds of millions of dollars' worth of usable medicine every year. We all pay for this waste, through lower wages and higher premiums, deductibles and out-of-pocket costs. There doesn't seem to be an end in sight 2014 I just got a notice that my premiums may be increasing by another 12 percent next year.

With Vimovo, it seemed I stumbled on another waste stream: overpriced drugs whose actual costs are hidden from doctors and patients. In the case of Horizon, the brazenness of its approach was even more astounding because it had previously been called out in media reports and in a 2016 congressional hearing on out-of-control drug prices.

Health care economists also were wise to it.

"It's a scam," said Devon Herrick, a health care economist with the National Center for Policy Analysis. "It is just a way to gouge insurance companies or employer health care plans."

Unsurprisingly, Horizon says the high price is justified. In fact, the drug maker wrote in an email, "The price of Vimovo is based on the value it brings to patients."

Thousands of patients die and suffer injuries every year, the company said, because of gastric complications from naproxen and other non-steroid anti-inflammatory drugs (NSAIDs). Providing pain relief and stomach protection in a single pill makes it more likely patients will be protected from complications, it said.

And Horizon stressed Vimovo is a "special formulation" of Aleve and Nexium, so it's not the same as taking the two separately. But several experts said that's a scientific distinction that doesn't make a therapeutic difference. "I would take the two medications from the drugstore in a heartbeat 2014 therapeutically it makes sense," said Michael Fossler, a pharmacist and clinical pharmacologist who is chair of the public-policy committee for the American College of Clinical Pharmacology. "What you're paying for with [Vimovo] is the convenience. But it does seem awful pricey for that."

Public outrage is boiling over when it comes to high drug prices, leading the media and lawmakers to scold pharmaceutical companies. You'd think a regulator would monitor this, but the Food and Drug Administration told me they are only authorized to review new drugs for safety and effectiveness, not prices. "Prices are set by manufacturers and distributors," the FDA said in a statement.

Horizon acquired Vimovo in November 2013 from the global pharmaceutical giant AstraZeneca. Horizon knew it faced challenges trying to get top dollar for inexpensive ingredients. "Use of these therapies separately in generic form may be cheaper," it said in its 2013 report to investors. But the company executed a shrewd strategy to give everyone -- insurers, patients, doctors and pharmacies -- the incentive to use Vimovo. It's instructive to review its playbook.

To get Vimovo covered, Horizon made deals with insurance payers and pharmacy benefit managers -- the intermediaries who help determine which drugs get reimbursed. The contracts generally included special rebates and even administrative fees for these intermediaries, the Horizon reports said, so the drug maker got paid much less than the sticker price, though it wouldn't say how much. But the company's net sales show the deals worked.

Horizon put boots on the ground to get the prescriptions rolling, expanding its sales force by the hundreds and focusing its marketing and sales efforts on doctors who already liked to prescribe brand-name drugs. The company's message to doctors emphasized the convenience of prescribing the two ingredients in a single pill and that the single pill protected patients by making it more likely they would take their medication as directed.

Horizon also primed the medical community by giving donations totaling $101,000 to the American Gastroenterology Association, a specialty nonprofit for physicians. Some doctors refuse drug-industry money, if only to at least avoid the appearance of a conflict of interest. ProPublica has done loads of stories showing why doctors taking money is indeed problematic, including one about drug makers' influence on physician specialty groups. When I went on the American Gastroenterology Association's website, the first thing I saw was a pop-up ad from a drug company. Several of the association's board members have received drug-company money, too. Horizon has made clear in its annual reports that donations to the group "help physicians and patients better understand and manage" the risks of pain relievers causing gastric problems.

Horizon also zeroed in on patients' worries about drug costs. To encourage them to fill their prescriptions, Horizon covered all or most of their out-of-pocket costs. That's why my doctor's office could promise me I wouldn't spend too much for my Vimovo. The program, Horizon told investors in reports, addressed the impact of pharmacies switching to less expensive alternatives and could "mitigate" the effect of payers searching for cheaper alternatives.

The strategy worked on me. I didn't even know why I was getting the prescription, but when they told me it wouldn't cost more than I would spend on lunch with a friend, I gave it the OK. A pharmacy I'd never heard of sent me a bottle of Vimovo for $10, even though my insurance company rejected the claim.

Turns out paying the patient's costs motivated my doctor, too. I waited until the end of my next visit to bring up Vimovo, and then we had a follow-up conversation on the phone. Ramani didn't know the price of the drug and found it "disturbing" when I told him. That was a surprise to me, but not to him. He said he leaves billing to his staff and doesn't even know how much he gets paid for a lot of the procedures he performs, let alone how much insurers are being charged for drugs. The marketing arms of companies like Horizon must count on this sort of blindness.

Ramani doesn't receive money or gifts from Horizon. (I confirmed this on ProPublica's Dollars for Docs website, which lists drug-company payments.) He said he likes Vimovo because Horizon covers the patient's out-of-pocket costs, entirely in many cases. Prescribing the generics or over-the-counter medications separately would actually cost more, he said. Which of course is exactly the company's plan. But Ramani agreed that the high cost of the drug to insurers ultimately raises overall health care costs for all Americans.

Knowing Vimovo's price, I asked him if he would continue to prescribe it. "It changes my thought process," he said. "But at the end of the day, I have to think about the patient and whether the patient will be able to pay out of pocket or not."

Ramani said the Horizon drug rep told him Vimovo prescriptions had to go through a particular pharmacy for the patient to receive financial assistance. In its 2016 annual report, Horizon wrote that prescriptions for its drugs might not be filled by certain pharmacies because of insurance-company exclusions, co-payment requirements, or incentives to use lower-priced alternatives. So that's why they didn't give me the option of picking up my pills at my neighborhood drugstore.

Instead, my Vimovo was mailed to me from White Oak Pharmacy in Nutley, New Jersey, which is about 45 minutes from my house. I drove there to find out why. The neighborhood pharmacy is on the bottom floor of a two-story brick building on a street corner, next to a hair salon.

Vishal Chhabria, the pharmacist who owns White Oak, told me the drug company sets the price of Vimovo. He insisted his pharmacy has no special relationship or contract with Horizon. Maybe the drug company steers prescriptions his way, he said, because his pharmacy will process the coupons that reduce or eliminate the patient costs, which some pharmacies don't.

Chhabria said there is no approved generic alternative to Vimovo, so he can't suggest one to patients. And while other drugs, like over-the-counter medications, would be cheaper for the health system overall, they are more expensive for the individual patient, he said.

In poring through Horizon's financial filings, it appears the drug's run may be ending. Horizon said in its report for the first quarter of 2017 that fewer insurance companies have been willing to cover Vimovo and many that do have demanded larger rebates. As a result, Horizon has been eating more of the costs of providing the drug to patients, as they must have in my case. The prescriptions have still been coming in, but net sales were just under $5 million in the first quarter of this year, down 81 percent from the first quarter of 2016.

Critics of Vimovo say that's still more than patients should be spending on the drug. "That number should be zero," said Linda Cahn, an attorney who advises corporations, unions and other payers to help reduce their costs. "If you want to talk about waste, that's waste."

Herrick, the health care economist, said Horizon cashed in by eliminating many of the barriers in the system that are meant to control costs. The company got patients on board by covering their out-of-pocket costs. It appealed to doctors by promoting the benefits to patients. And it did an end-run around chain pharmacies, which typically might suggest a lower-priced alternative, by steering prescriptions to pharmacists who would participate in their patient-assistance program.

"Somebody brainstormed: 'How can we nullify any consumer check and balance in this supply chain? What can we do to keep the customer from asking questions?'" Herrick said.

The scheme that played out with Vimovo is bound to happen again, Herrick said. Maybe it already is. Drug companies are always on the lookout to deploy similar strategies.

I dutifully took my Vimovo for several days, until I noticed it kept me awake until 3 in the morning 2014 a rare side effect. (Perhaps they need to add a third drug to the combo.) I probably have more than 50 pills left in the bottle on my bedside table. Maybe I could sell it back to Horizon for $1,500.

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A New Design For The I've Been Mugged Blog!

Returning readers have probably noticed the new design for this blog, which went live this past Sunday. The new design better supports the wide variety of mobile devices, and automatically adapts to devices with differing screen widths. All of the content published is still available.

The new design should also provide a better reading and site experience for all users. If you have any questions or comments about the design, we welcome your feedback. Thanks for your readership!

George

 


Chief Executive At Uber Resigns. Consultant Recommended Many Changes

Uber logo Travis Kalanick, the chief executive at Uber, resigned on Tuesday. Mr. Kalanick’s departure occurred after pressure from the ride-sharing company's investors. The New York Times reported:

"Earlier on Tuesday, five of Uber’s major investors demanded that the chief executive resign immediately. The investors included one of Uber’s biggest shareholders, the venture capital firm Benchmark, which has one of its partners, Bill Gurley, on Uber’s board. The investors made their demand for Mr. Kalanick to step down in a letter delivered to the chief executive while he was in Chicago, said the people with knowledge of the situation.

In the letter, titled “Moving Uber Forward” and obtained by The New York Times, the investors wrote to Mr. Kalanick that he must immediately leave and that the company needed a change in leadership. Mr. Kalanick, 40, consulted with at least one Uber board member, and after long discussions with some of the investors, he agreed to step down. He will remain on Uber’s board of directors."

Uber has been in the news recently for a variety of reasons. During February and March of this year, there were several executive changes, and an investigative report about "Greyball," a worldwide program to thwart code enforcement inspections by local governments. In April, a class-action lawsuit claimed that Uber manipulated its mobile app to simultaneously short-change drivers and over-charge riders.

After a February, 2017 blog post by a former engineer described her workplace experiences, the company engaged Eric Holder and Tammy Albarrán, partners at the law firm Covington & Burling LLP (Covington), to conduct a thorough and objective review of the workplace issues raised by Susan Fowler in her blog post. On March 1, 2017, Uber’s Board of Directors approved the establishment of a Special Committee of the Board to oversee that review, which included the evaluation of:

"... three issues: (1) Uber’s workplace environment as it related to the allegations of discrimination, harassment, and retaliation in Ms. Fowler’s post; (2) whether the company’s policies and practices were sufficient to prevent and properly address discrimination, harassment, and retaliation in the workplace; and (3) what steps Uber could take to ensure that its commitment to a diverse and inclusive workplace was reflected not only in the company’s policies but made real in the experiences of each of Uber’s employees."

These evaluation objectives and recommendations from Covington are available online in Uber's website. Uber's board adopted all of Covington's recommendations, which cover ten areas including senior management, internal controls, training, human resources, diversity, and more. Below is an outline from the detailed, 13 page recommendations document by Covington (Adobe PDF):

"1. Changes to Senior Leadership:
a) Review and Reallocate the Responsibilities of Travis Kalanick,
b) Use the Chief Operating Officer Search to Identify Candidates Who Can Help Address These Recommendations,
c) Use Performance Reviews to Hold Senior Leaders Accountable,
d) Increase the Profile of Uber’s Head of Diversity and the Efforts of His Organization,
e) Employment Actions

2. Enhance Board Oversight:
a) Enhance the Independence of the Board,
b) Install an Independent Chairperson of the Board,
c) Create an Oversight Committee,
d) Use Compensation to Hold Senior Leaders Accountable,
e) Nominate a Senior Executive Team Member to Oversee Implementation of any Recommendations

3. Internal Controls:
a) Implement Enhancements to the Audit Committee,
b) Implement Enhancements to Uber’s Internal Controls,
c) Human Resources Record-Keeping,
d) Track Agreements with Employees

4. Reformulate Uber’s 14 Cultural Values

5. Training:
a) Mandatory Leadership Training For Key Senior Management/Senior Executive Team Members,
b) Mandatory Human Resources Training,
c) Mandatory Manager Training,
d) Interview Training

6. Improvements to Human Resources and the Complaint Process:
a) An “Owner” of Resources-Related Policies Should be Identified or Hired,
b) Increase Management Support for Human Resources,
c) Provide a Robust and Effective Complaint Process,
d) Establish Protocols with Respect to Escalating Complaints,
e) Devote Adequate Staff and Resources to Human Resources

7. Diversity and Inclusion Enhancements:
a) Establish an Employee Diversity Advisory Board,
b) Regularly Publish Diversity Statistics,
c) Target Diverse Sources of Talent,
d) Utilize Blind Resume Review,
e) Adopt a Version of the “Rooney Rule,”
f) Adopt and Promote a Sponsorship Program,
g) Recognize and Support Employee Diversity Efforts,
h) Recognize Managers for their Diversity Efforts,
i) Review Benefits Offerings
j) Unconscious Bias Review,
k) Coordinate Efforts,
l) Solicit Feedback from Employees

8. Changes in Employee Policies and Practices:
a) EEO Policies,
b) Prohibit Romantic or Intimate Relationships Between Individuals in a Reporting Relationship,
c) Institute and Enforce Clear Guidelines on Alcohol Consumption and the Use of Controlled Substances,
d) Remove Transfer Barriers,
e) Modify Uber’s Performance Review Process,
f) Make Promotion Requirements Clearer,
g) Flexible Work,
h) Catered Dinner,
i) Even Application of Policies and Practices

9. Address Employee Retention

10. Review and Assess Uber’s Pay Practices"

The recommendations seem to cover all areas of the company and its operations. Uber and its board will be judged based upon how well they implement the recommendations. What are your opinions of Uber? The recommendations?


Massive Data Breach By RNC Contractor Exposed Information Of 198 Million Voters

GOP logo A massive data breach by a contractor hired by the Republican National Committee (RNC) has exposed the personal information of 198 million likely voters. The breach happened after a contractor, Deep Root Analytics, accidentally left the database files unprotected on an internet-connected computer server. The Hill reported:

"The databases were part of 25 terabytes of files contained in an Amazon cloud account that could be browsed without logging in. The account was discovered by researcher Chris Vickery of the security firm UpGuard. The files have since been secured."

Deep Root Analytics logo Deep Root Analytics helps a variety of clients, including political organizations, advertisers, and advocacy groups, identify custom audiences for television advertising -- in this instance, likely voters. Reportedly, the data elements exposed include full names, birth dates, residential addresses, and persons' positions on a variety of topics:

"... 46 different issues ranging from "how likely it is the individual voted for Obama in 2012, whether they agree with the Trump foreign policy of 'America First' and how likely they are to be concerned with auto manufacturing as an issue..."

The files exposed during the breach also identified another contractor hired by the RNC, Target Point, which experts conclude:

"... compiled and shared the data with Deep Root. Another folder appears to reference Data Trust, another contracted firm."

At press time, Target Point had not made any statements on its website. Deep Root issued this statement:

"Deep Root Analytics has become aware that a number of files within our online storage system were accessed without our knowledge. Deep Root Analytics builds voter models to help enhance advertiser understanding of TV viewership. The data accessed was not built for or used by any specific client. It is our proprietary analysis to help inform local television ad buying.

The data that was accessed was, to the best of our knowledge proprietary information as well as voter data that is publicly available and readily provided by state government offices. Since this event has come to our attention, we have updated the access settings and put protocols in place to prevent further access. We take full responsibility for this situation.

Deep Root Analytics maintains industry standard security protocols. We built our systems in keeping with these protocols and had last evaluated and updated our security settings on June 1, 2017.

We are conducting an internal review and have retained cyber security firm Stroz Friedberg to conduct a thorough investigation. Through this process, which is currently underway, we have learned that access was gained through a recent change in access settings since June 1. We accept full responsibility, will continue with our investigation, and based on the information we have gathered thus far, we do not believe that our systems have been hacked."

So, Deep Root wasn't aware of this breach until an outside security expert found it. Nor does the company seem certain about exactly what data elements were exposed/accessed by unauthorized persons. Not good. It makes one wonder what other undiscovered breaches may have happened.

Perhaps more troubling, the company's statement differs from news reports about the data elements exposed/accessed. The company's statement mentioned "publicly available" data, while news reports mentioned sensitive, non-public data. Hopefully, the results of Deep Root's internal breach investigation will clarify things. And, if sensitive information was truly exposed/stolen, hopefully Deep Root will do the right thing: notify breach victims and offer free credit monitoring services for at least two years.

This was not the first data breach of voter-related database data. A CouchDB breach in June 2016 exposed the sensitive information of 154 million voters. Both breaches seem to raise the question about whether political organizations, and the contractors they hire, adequately protect consumers' sensitive personal information.

Many consider this Deep Root data breach the largest voter breach ever. Yes, the data breach was undeniably massive. Why? Two measurement approaches highlight the fact.

First, the Quick Facts page at the U.S. Census Bureau site lists the population of the United States on July 1, 2015 at 321, 418,820 persons. Of those, 22.9 percent were under the age of 18. With a little "rough" math, one can calculate the population aged 18 or older at 247,813,910 persons. So, the Deep Root breach represented about 61.6 percent of the total population or 79.9 percent of the voting age population. That's almost 4 of every 5 adults aged 18 or older.

Second, the breach ranks near the largest when compared to notable data breaches during the past few years:

Regarding the AJLA portal breach earlier this year, the Privacy Rights Clearinghouse reported 1.7 million breach victims in Idaho and 430,000 in Oklahoma. Given this, the true number of breach victims is likely far higher.

What are your opinions about the Deep Root breach? Do political organizations, and the contractors they hire, adequately protect citizens' sensitive information? And, if not, what should be done?

When citizens vote, they expect privacy -- not just within voting booths. So, too, regarding the personal information and opinions data describing their voting. Arguably, voting data is different than other types of consumer information. And there is legal precedent for treating selected consumer information differently. Example: a set of privacy laws govern health care data. Perhaps, you have heard of the term: Protected Health Information (PHI). If data mining companies can't protect voters' data, then we just might need new laws to protect voting-related data: PVI = Protected Voting Information.

When data about voters is compromised (e.g., exposed and/or accessed), that is a strike at the heart of our democracy. Example: the bad guys could pressure voters using stolen information. Does the big-data/data-mining industry require oversight? Does Congress need to intervene to protect our democratic elections? What are your opinions about PVI?

[Correction: an earlier version of this blog post mentioned a database. Files were exposed, not a database nor an RNC database.]


Senator Warren Calls For the Firing Of All Wells Fargo Board Members

Wells Fargo logo In a letter sent Monday to the Federal Reserve Chair Janet Yellen, U.S. Senator Elizabeth Warren (D-Massachusetts) has called for the firing of all 12 board members at Wells Fargo bank for failing to adequately protect accountholders. CNBC reported first the Senator's letter, which read in part:

"The fake accounts scandal cost Wells Fargo customers millions of dollars in unauthorized fees and damaged many of their credit scores," the senator wrote. "The scandal also revealed severe problems with the bank's risk management practices — problems that justify the Federal Reserve's removal of all responsible Board members."

After implementing sales targets and an incentive program, many of the bank's employees secretly opened new accounts and transferred money from other accounts to fund the new accounts -- all without the customers' knowledge nor consent. In some cases, employees applied for credit cards, created PIN numbers, and operated fake e-mail accounts in customers' names.

The Consumer Financial Protection Bureau (CFPB) announced in September, 2016 the consent order with the bank. As a result of the fake-account scandal, the bank paid about $185 million in fines and fired 5,300 lower-level employees for setting up 2 million bogus accounts. Few or no senior executives have been punished.

Many Republicans and President Trump seek to defund and shut down the CFPB.

During October, 2016 Timothy J. Sloan was elected chief executive officer at Wells Fargo bank after the former CEO, John Stumpf, retired. Sloan also joined the board of directors as a member.

CNN Money reported:

"... Wells Fargo suffered from inadequate risk management systems that should have flagged the illegal activity earlier. Shareholder advisory firm Institutional Shareholder Services (ISS) agrees. ISS argued the Wells Fargo board made the scandal worse by failing to provide oversight that could have limited the damage..."

In her letter, Senator Warren urged the Federal Reserve to act:

"I urge you to use the tools Congress has given you to remove the responsible board members and protect the continued safety and soundness of one of the country's largest banks..."

Reportedly, the Senator's letter mentioned the following Wells Fargo board members: John D. Baker II, John S. Chen, Lloyd H. Dean, Elizabeth A. Duke, Enrique Hernandez, Donald M. James, Cynthia H. Milligan, Federico F. Pena, James H. Quigley, Stephen W. Sanger, Susan G. Swenson, and Suzanne M. Vautrinot.

Some banking experts see the demand as unprecedented and unlikely. All of the bank's board members were re-elected during the annual shareholder meeting in April , 2017. Also during April, the bank announced an expansion of its class-action settlement agreements for its retail sales practices. The expansion covered account holders affected as early as May, 2002 by the bogus new account scandal, and added $32 million to the settlement amount total.


Trump Administration Quietly Rolls Back Civil Rights Efforts Across Federal Government

[Editor's Note: today's guest blog post is by the reporters at ProPublica. Consent decrees are an important oversight tool to ensure corporate responsibility after wrongdoing. Today's post is reprinted with permission.]

By Jessica Huseman and Annie Waldman, ProPublica

Department of Justice logo For decades, the Department of Justice has used court-enforced agreements to protect civil rights, successfully desegregating school systems, reforming police departments, ensuring access for the disabled and defending the religious.

Now, under Attorney General Jeff Sessions, the DOJ appears to be turning away from this storied tool, called consent decrees. Top officials in the DOJ civil rights division have issued verbal instructions through the ranks to seek settlements without consent decrees -- which would result in no continuing court oversight.

The move is just one part of a move by the Trump administration to limit federal civil rights enforcement. Other departments have scaled back the power of their internal divisions that monitor such abuses. In a previously unreported development, the Education Department last week reversed an Obama-era reform that broadened the agency's approach to protecting rights of students. The Labor Department and the Environmental Protection Agency have also announced sweeping cuts to their enforcement.

"At best, this administration believes that civil rights enforcement is superfluous and can be easily cut. At worst, it really is part of a systematic agenda to roll back civil rights," said Vanita Gupta, the former acting head of the DOJ's civil rights division under President Barack Obama.

Consent decrees have not been abandoned entirely by the DOJ, a person with knowledge of the instructions said. Instead, there is a presumption against their use -- attorneys should default to using settlements without court oversight unless there is an unavoidable reason for a consent decree. The instructions came from the civil rights division's office of acting Assistant Attorney General Tom Wheeler and Deputy Assistant Attorney General John Gore. There is no written policy guidance.

Devin O'Malley, a spokesperson for the DOJ, declined to comment for this story.

Consent decrees can be a powerful tool, and spell out specific steps that must be taken to remedy the harm. These are agreed to by both parties and signed off on by a judge, whom the parties can appear before again if the terms are not being met. Though critics say the DOJ sometimes does not enforce consent decrees well enough, they are more powerful than settlements that aren't overseen by a judge and have no built-in enforcement mechanism.

Such settlements have "far fewer teeth to ensure adequate enforcement," Gupta said.

Consent decrees often require agencies or municipalities to take expensive steps toward reform. Local leaders and agency heads then can point to the binding court authority when requesting budget increases to ensure reforms. Without consent decrees, many localities or government departments would simply never make such comprehensive changes, said William Yeomans, who spent 26 years at the DOJ, mostly in the civil rights division.

"They are key to civil rights enforcement," he said. "That's why Sessions and his ilk don't like them."

Some, however, believe the Obama administration relied on consent decrees too often and sometimes took advantage of vulnerable cities unable to effectively defend themselves against a well-resourced DOJ.

"I think a recalibration would be welcome," said Richard Epstein, a professor at New York University School of Law and a fellow at the Hoover Institution at Stanford, adding that consent decrees should be used in cases where clear, systemic issues of discrimination exist.

Though it's too early to see how widespread the effect of the changes will be, the Justice Department appears to be adhering to the directive already.

On May 30, the DOJ announced Bernards Township in New Jersey had agreed to pay $3.25 million to settle an accusation it denied zoning approval for a local Islamic group to build a mosque. Staff attorneys at the U.S. attorney's office in New Jersey initially sought to resolve the case with a consent decree, according to a spokesperson for Bernards Township. But because of the DOJ's new stance, the terms were changed after the township protested, according to a person familiar with the matter. A spokesperson for the New Jersey U.S. attorney's office declined comment.

Sessions has long been a public critic of consent decrees. As a senator, he wrote they "constitute an end run around the democratic process." He lambasted local agencies that seek them out as a way to inflate their budgets, a "particularly offensive" use of consent decrees that took decision-making power from legislatures.

On March 31, Sessions ordered a sweeping review of all consent decrees with troubled police departments nationwide to ensure they were in line with the Trump administration's law-and-order goals. Days before, the DOJ had asked a judge to postpone a hearing on a consent decree with the Baltimore Police Department that had been arranged during the last days of the Obama administration. The judge denied that request, and the consent decree has moved forward.

The DOJ has already come under fire from critics for altering its approach to voting rights cases. After nearly six years of litigation over Texas' voter ID law -- which Obama DOJ attorneys said was written to intentionally discriminate against minority voters and had such a discriminatory effect -- the Trump DOJ abruptly withdrew its intent claims in late February.

Attorneys who worked on the case for years were barely consulted about the change -- many weren't consulted at all, according to two former DOJ officials with knowledge of the matter. Gore wrote the filing changing the DOJ's position largely by himself and asked the attorneys who'd been involved in the case for years to sign it to show continuity. Not all of the attorneys fell in line. Avner Shapiro -- who has been a prosecutor in the civil rights division for more than 20 years -- left his name off the filings written by Gore. Shapiro was particularly involved in developing the DOJ's argument that Texas had intentionally discriminated against minorities in crafting its voter ID legislation.

"That's the ultimate act of rebellion," Yeomans, the former civil rights division prosecutor, said. A rare act, removing one's name from a legal filing is one of the few ways career attorneys can express public disagreement with an administration.

Gore has no history of bringing civil rights cases. A former partner at the law firm Jones Day, he has instead defended states against claims of racial gerrymandering and represented North Carolina when the state was sued over its controversial "bathroom bill," which requires transgender people to use the facility that matched their birth gender.

All of the internal changes at the DOJ have left attorneys and staff with "a great deal of fear and uncertainty," said Yeomans. While he says the lawyers there would like to stay at the department, they fear Sessions' priorities will have devastating impact on their work.

The DOJ's civil rights office is not alone in fearing rollbacks in enforcement. Across federal departments, the Trump administration has made moves to diminish the power of civil rights divisions.

U.S. Department of Education logo The Department of Education has laid out plans to loosen requirements on investigations into civil rights complaints, according to an internal memo sent to staff on June 8 and obtained by ProPublica.

Under the Obama administration, the department's office for civil rights applied an expansive approach to investigations. Individual complaints related to complex issues such as school discipline, sexual violence and harassment, equal access to educational resources, or racism at a single school might have prompted broader probes to determine whether the allegations were part of a pattern of discrimination or harassment.

The new memo, sent by Candice Jackson, the acting assistant secretary for civil rights, to regional directors at the department's civil rights office, trims this approach. Jackson was appointed deputy assistant secretary for the office in April and will remain as the acting head of the office until the Senate confirms a full-time assistant secretary. Trump has not publicly nominated anyone for the role yet.

The office will apply the broader approach "only" if the original allegations raise systemic concerns or the investigative team argues for it, Jackson wrote in the memo.

As part of the new approach, the Education Department will no longer require civil rights investigators to obtain three years of complaint data from a specific school or district to assess compliance with civil rights law.

Critics contend the Obama administration's probes were onerous. The office "did such a thorough review of everything that the investigations were demanding and very expensive" for schools, said Boston College American politics professor R. Shep Melnick, adding that the new approach could take some regulatory pressure off schools and districts.

But some civil rights leaders believe the change could undermine the office's mission. This narrowing of the department's investigations "is stunning to me and dangerous," said Catherine Lhamon, who led the Education Department's civil rights office from August 2013 until January 2017 and currently chairs the United States Commission on Civil Rights. "It's important to take an expansive view of the potential for harm because if you look only at the most recent year, you won't necessarily see the pattern," said Lhamon.

The department's new directive also gives more autonomy to regional offices, no longer requiring oversight or review of some cases by department headquarters, according to the memo.

The Education Department did not respond to ProPublica's request for comment.

Education Secretary Betsy DeVos has also proposed cutting over 40 positions from the civil rights office. With reduced staff, the office will have to "make difficult choices, including cutting back on initiating proactive investigations," according to the department's proposed budget.

Elsewhere, Trump administration appointees have launched similar initiatives. In its 2018 fiscal plan, the Labor Department has proposed dissolving the office that handles discrimination complaints. Similarly, new leadership at the Environmental Protection Agency has proposed entirely eliminating the environmental justice program, which addresses concerns that almost exclusively impact minority communities. The Washington Post reports the plan transfers all environmental justice work to the Office of Policy, which provides policy and regulatory guidance across the agency.

Mustafa Ali, a former EPA senior adviser and assistant associate administrator for environmental justice who served more than 20 years, quit the agency in protest days before the plan was announced. In his resignation letter, widely circulated in the media, Ali suggested the new leadership was abandoning "those who need our help most."

Ryan Gabrielson contributed to this report.

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Russian Cyber Attacks Against US Voting Systems Wider Than First Thought

Cyber attacks upon electoral systems in the United States are wider than originally thought. The attacks occurred in at least 39 states. The Bloomberg report described online attacks in Illinois as an example:

"... investigators found evidence that cyber intruders tried to delete or alter voter data. The hackers accessed software designed to be used by poll workers on Election Day, and in at least one state accessed a campaign finance database. Details of the wave of attacks, in the summer and fall of 2016... In early July 2016, a contractor who works two or three days a week at the state board of elections detected unauthorized data leaving the network, according to Ken Menzel, general counsel for the Illinois board of elections. The hackers had gained access to the state’s voter database, which contained information such as names, dates of birth, genders, driver’s licenses and partial Social Security numbers on 15 million people, half of whom were active voters. As many as 90,000 records were ultimately compromised..."

Politicians have emphasized that the point of the disclosures isn't to embarrass any specific state, but to alert the public to past activities and to the ongoing threat. The Intercept reported:

"Russian military intelligence executed a cyberattack on at least one U.S. voting software supplier and sent spear-phishing emails to more than 100 local election officials just days before last November’s presidential election, according to a highly classified intelligence report obtained by The Intercept.

The top-secret National Security Agency document, which was provided anonymously to The Intercept and independently authenticated, analyzes intelligence very recently acquired by the agency about a months-long Russian intelligence cyber effort against elements of the U.S. election and voting infrastructure. The report, dated May 5, 2017, is the most detailed U.S. government account of Russian interference in the election that has yet come to light."

Spear-fishing is the tactic criminals use by sending malware-laden e-mail messages to targeted individuals, whose names and demographic details may have been collected from social networking sites and other sources. The spam e-mail uses those details to pretend to be valid e-mail from a coworker, business associate, or friend. When the target opens the e-mail attachment, their computer and network are often infected with malware to collect and transmit log-in credentials to the criminals; or to remotely take over the targets' computers (e.g., ransomware) and demand ransom payments. Stolen log-in credentials are how criminals steal consumers' money by breaking into online bank accounts.

The Intercept report explained how the elections systems hackers adopted this tactic:

"... the Russian plan was simple: pose as an e-voting vendor and trick local government employees into opening Microsoft Word documents invisibly tainted with potent malware that could give hackers full control over the infected computers. But in order to dupe the local officials, the hackers needed access to an election software vendor’s internal systems to put together a convincing disguise. So on August 24, 2016, the Russian hackers sent spoofed emails purporting to be from Google to employees of an unnamed U.S. election software company... The spear-phishing email contained a link directing the employees to a malicious, faux-Google website that would request their login credentials and then hand them over to the hackers. The NSA identified seven “potential victims” at the company. While malicious emails targeting three of the potential victims were rejected by an email server, at least one of the employee accounts was likely compromised, the agency concluded..."

Experts believe the voting equipment company targeted was VR Systems, based in Florida. Reportedly, it's electronic voting services and equipment are used in eight states. VR Systems posted online a Frequently Asked Questions document (adobe PDF) about the cyber attacks against elections systems:

"Recent reports indicate that cyber actors impersonated VR Systems and other elections companies. Cyber actors sent an email from a fake account to election officials in an unknown number of districts just days before the 2016 general election. The fraudulent email asked recipients to open an attachment, which would then infect their computer, providing a gateway for more mischief... Because the spear-phishing email did not originate from VR Systems, we do not know how many jurisdictions were potentially impacted. Many election offices report that they never received the email or it was caught by their spam filters before it could reach recipients. It is our understanding that all jurisdictions, including VR Systems customers, have been notified by law enforcement agencies if they were a target of this spear-phishing attack... In August, a small number of phishing emails were sent to VR Systems. These emails were captured by our security protocols and the threat was neutralized. No VR Systems employee’s email was compromised. This prevented the cyber actors from accessing a genuine VR Systems email account. As such, the cyber actors, as part of their late October spear-phishing attack, resorted to creating a fake account to use in that spear-phishing campaign."

It is good news that VR Systems protected its employees' e-mail accounts. Let's hope that those employees were equally diligent about protecting their personal e-mail accounts and home computers, networks, and phones. We all know employees that often work from home.

The Intercept report highlighted a fact about life on the internet, which all internet users should know: stolen log-in credentials are highly valued by criminals:

"Jake Williams, founder of computer security firm Rendition Infosec and formerly of the NSA’s Tailored Access Operations hacking team, said stolen logins can be even more dangerous than an infected computer. “I’ll take credentials most days over malware,” he said, since an employee’s login information can be used to penetrate “corporate VPNs, email, or cloud services,” allowing access to internal corporate data. The risk is particularly heightened given how common it is to use the same password for multiple services. Phishing, as the name implies, doesn’t require everyone to take the bait in order to be a success — though Williams stressed that hackers “never want just one” set of stolen credentials."

So, a word to the wise for all internet users: don't use the same log-in credentials at multiple site. Don't open e-mail attachments from strangers. If you weren't expecting an e-mail attachment from a coworker/friend/business associate, call them on the phone first and verify that they indeed sent an attachment to you. The internet has become a dangerous place.


Dozens Of Uber Employees Fired Or Investigated For Harassment. Uber And Lyft Drivers Unaware of Safety Recalls

Uber logo Ride-sharing companies are in the news again and probably not for the reasons their management executives would prefer. First, TechCrunch reported on Thursday:

"... at a staff meeting in San Francisco, Uber executives revealed to the company’s 12,000 employees that 20 of their colleagues had been fired and that 57 are still being probed over harassment, discrimination and inappropriate behavior, following a string of accusations that Uber had created a toxic workplace and allowed complaints to go unaddressed for years. Those complaints had pushed Uber into crisis mode earlier this year. But the calamity may be just beginning... Uber fired senior executive Eric Alexander after it was leaked to Recode that Alexander had obtained the medical records of an Uber passenger in India who was raped in 2014 by her driver."

"Recode also reported that Alexander had shared the woman’s file with Kalanick and his senior vice president, Emil Michael, and that the three men suspected the woman of working with Uber’s regional competitor in India, Ola, to hamper its chances of success there. Uber eventually settled a lawsuit brought by the woman against the company..."

News broke in March, 2017 about both the Recode article and the Grayball activity at Uber to thwart local government code inspections. In February, a former Uber employee shared a disturbing story with allegations of sexual harassment.

Lyft logo Second, the investigative team at WBZ-TV, the local CBS afiliate in Boston, reported that many Uber and Lyft drivers are unaware of safety recalls affecting their vehicles. This could make rides in these cars unsafe for passengers:

"Using an app from Carfax, we quickly checked the license plates of 167 Uber and Lyft cars picking up passengers at Logan Airport over a two day period. Twenty-seven of those had open safety recalls or about 16%. Recalls are issued when a manufacturer identifies a mechanical problem that needs to be fixed for safety reasons. A recent example is the millions of cars that were recalled when it was determined the airbags made by Takata could release shrapnel when deployed in a crash."

Both ride-sharing companies treat drivers as independent contractors. WBZ-TV reported:

"Uber told the [WBZ-TV investigative] Team that drivers are contractors and not employees of the company. A spokesperson said they provide resources to drivers and encourage them to check for recalls and to perform routine maintenance. Drivers are also reminded quarterly to check with NHTSA for recall information."

According to the president of the Massachusetts Bar Association Jeffrey Catalano, the responsibility to make sure the car is safe for passengers lies mainly with the driver. But because Uber and Lyft both advertise their commitment to safety on their websites, they too could be held responsible."


Trump Is Not the Only One Blocking Constituents on Twitter

[Editor's note: today's guest blog post, by the reporters at ProPublica, explores the emerging debate about whether the appropriate, perhaps ethical, use of social media by publicly elected officials and persons campaigning for office. Should they be able to block constituents posting views they dislike or disagree with? Is it really public speech on a privately-run social networking sites? Would you vote for person who blocks constituents? Do companies operating social networking site have a responsibility in this? Today's post is reprinted with permission.]

by Charles Ornstein, ProPublica

As President Donald Trump faces criticism for blocking users on his Twitter account, people across the country say they, too, have been cut off by elected officials at all levels of government after voicing dissent on social media.

In Arizona, a disabled Army veteran grew so angry when her congressman blocked her and others from posting dissenting views on his Facebook page that she began delivering actual blocks to his office.

A central Texas congressman has barred so many constituents on Twitter that a local activist group has begun selling T-shirts complaining about it.

And in Kentucky, the Democratic Party is using a hashtag, #BevinBlocked, to track those who've been blocked on social media by Republican Gov. Matt Bevin. (Most of the officials blocking constituents appear to be Republican.)

The growing combat over social media is igniting a new-age legal debate over whether losing this form of access to public officials violates constituents' First Amendment rights to free speech and to petition the government for a redress of grievances. Those who've been blocked say it's akin to being thrown out of a town hall meeting for holding up a protest sign.

On Tuesday, the Knight First Amendment Institute at Columbia University called upon Trump to unblock people who've disagreed with him or directed criticism at him or his family via the @realdonaldtrump account, which he used prior to becoming president and continues to use as his principal Twitter outlet.

Trump blocked me after this tweet.Let's all hope the courts continue to protect us. Never stop resisting. pic.twitter.com/TlR4zgHCoU

-- Nick Jack Pappas (@Pappiness) June 5, 2017

"Though the architects of the Constitution surely didn't contemplate presidential Twitter accounts, they understood that the president must not be allowed to banish views from public discourse simply because he finds them objectionable," Jameel Jaffer, the Knight Institute's executive director, said in a statement.

The White House did not respond to a request for comment, but press secretary Sean Spicer said earlier Tuesday that statements the president makes on Twitter should be regarded as official statements.

Similar flare-ups have been playing out in state after state.

Earlier this year, the American Civil Liberties Union of Maryland called on Governor Larry Hogan, a Republican, to stop deleting critical comments and barring people from commenting on his Facebook page. (The Washington Post reported that the governor had blocked 450 people as of February.)

Deborah Jeon, the ACLU's legal director, said Hogan and other elected officials are increasingly foregoing town hall meetings and instead relying on social media as their primary means of communication with constituents. "That's why it's so problematic," she said. "If people are silenced in that medium," they can't effectively interact with their elected representative.

The governor's office did not respond to a request for comment this week. After the letter, however, it reinstated six of the seven people specifically identified by the ACLU (it said it couldn't find the seventh). "While the ACLU should be focusing on much more important activities than monitoring the governor's Facebook page, we appreciated them identifying a handful of individuals -- out of the over 1 million weekly viewers of the page -- that may have been inadvertently denied access," a spokeswoman for the governor told the Post.

Practically speaking, being blocked cuts off constituents from many forms of interacting with public officials. On Facebook, it means no posts, no likes and no questions or comments during live events on the page of the blocker. Even older posts that may not be offensive are taken down. On Twitter, being blocked prevents a user from seeing the other person's tweets on his or her timeline.

Moreover, while Twitter and Facebook themselves usually suspend account holders only temporarily for breaking rules, many elected officials don't have established policies for constituents who want to be reinstated. Sometimes a call is enough to reverse it, other times it's not.

Eugene Volokh, a constitutional law professor at the UCLA School of Law, said that for municipalities and public agencies, such as police departments, social media accounts would generally be considered "limited public forums" and therefore, should be open to all.

"Once they open it up to public comments, they can't then impose viewpoint-based restrictions on it," he said, for instance allowing only supportive comments while deleting critical ones.

But legislators are different because they are people. Elected officials can have personal accounts, campaign accounts and officeholder accounts that may appear quite similar. On their personal and campaign accounts, there's little disagreement that officials can engage with -- or block -- whoever they want. Last month, for instance, ProPublica reported how Rep. Peter King (Republican, New York) blocked users on his campaign account after they criticized his positions on health reform and other issues.

But what about their officeholder social media accounts?

The ACLU's Jeon says that they should be public if they use government resources, including staff time and office equipment to maintain the page. "Where that's the situation and taxpayer resources are going to it, then the full power of the First Amendment applies," she said. "It doesn't matter if they're members of Congress or the governor or a local councilperson."

Volokh of UCLA disagreed. He said that members of Congress are entitled to their own private speech, even on official pages. That's because each is one voice among many, as opposed to a governor or mayor. "It's clear that whatever my senator is, she's not the government. She is one person who is part of a legislative body," he said. "She was elected because she has her own views and it makes sense that if she has a Twitter feed or a Facebook page, that may well be seen as not government speech but the voice of somebody who may be a government official."

Volokh said he's inclined to see Trump's @realdonaldtrump account as a personal one, though other legal experts disagree.

"You could imagine actually some other president running this kind of account in a way that's very public minded -- 'I'm just going to express the views of the executive branch,'" he said. "The @realdonaldtrump account is very much, 'I'm Donald Trump. I'm going to be expressing my views, and if you don't like it, too bad for you.' That sounds like private speech, even done by a government official on government property."

It's possible the fight over the president's Twitter account will end up in court, as such disputes have across the country. Generally, in these situations, the people contesting the government's social media policies have reached settlements ending the questionable practices.

After being sued by the ACLU, three cities in Indiana agreed last year to change their policies by no longer blocking users or deleting comments.

In 2014, a federal judge ordered the City and County of Honolulu to pay $31,000 in attorney's fees to people who sued, contending that the Honolulu Police Department violated their constitutional rights by deleting their critical Facebook posts.

And San Diego County agreed to pay the attorney's fees of a gun parts dealer who sued after its Sheriff's Department deleted two Facebook posts that were critical of the sheriff and banned the dealer from commenting. The department took down its Facebook page after being sued and paid the dealer $20 as part of the settlement.

Angela Greben, a California paralegal, has spent the past two years gathering information about agencies and politicians that have blocked people on social media -- Democrats and Republican alike -- filing ethics complaints and even a lawsuit against the city of San Mateo, California, its mayor and police department. (They settled with her, giving her some of what she wanted.)

Greben has filed numerous public-records requests to agencies as varied as the Transportation Security Administration, the Seattle Police Department and the Connecticut Lottery seeking lists of people they block. She's posted the results online.

"It shouldn't be up to the elected official to decide who can tweet them and who can't," she said. "Everybody deserves to be treated equally and fairly under the law."

Even though she lives in California, Greben recently filed an ethics complaint against Atlanta Mayor Kasim Reed, a Democrat, who has been criticized for blocking not only constituents but also journalists who cover him. Reed has blocked Greben since 2015 when she tweeted about him... well, blocking people on Twitter. "He's notorious for blocking and muting people," she said, meaning he can't see their tweets but they can still see his.

@LizLemeryJoy @KasimReed Mr. Mayor you are violating the #civilrights of all you have #blocked! @Georgia_AG @FOX5Atlanta @11AliveNews

-- Angela Greben (@AngelaGreben) March 7, 2015

In a statement, a city spokeswoman defended the mayor, saying he's now among the top five most-followed mayors in the country. "Mayor Reed uses social media as a personal platform to engage directly with constituents and some journalists. 2026 Like all Twitter users, Mayor Reed has the right to stop engaging in conversations when he determines they are unproductive, intentionally inflammatory, dishonest and/or misleading."

Asked how many people he has blocked, she replied that the office doesn't keep such a list.

J'aime Morgaine, the Arizona veteran who delivered blocks to the office of Rep. Paul Gosar, a Republican, said being blocked on Facebook matters because her representative no longer hosts in-person town hall meetings and has started to answer questions on Facebook Live. Now she can't ask questions or leave comments.

"I have lost and other people who have been blocked have lost our right to participate in the democratic process," said Morgaine, leader of Indivisible Kingman, a group that opposes the president's agenda. "I am outraged that my congressman is blocking my voice and trampling upon my constitutional rights."

@RepGosar ..You weren't home when I delivered this message to your office, but no worries...there WILL be more!Stop BLOCKING Constituents! pic.twitter.com/JTWGQwhxKt

-- Indivisible Kingman (@IndivisibleCD4) May 13, 2017

Morgaine said the rules are not being applied equally. "They're not blocking everybody who's angry," she said. "They're blocking the voices of dissent, and there's no process for getting unblocked. There's no appeals process. There's no accountability."

A spokeswoman for Gosar defended his decision to block constituents but did not answer a question about how many have been blocked.

"Congressman Gosar's policy has been consistent since taking office in January 2010," spokeswoman Kelly Roberson said in an email. "In short: 2018Users whose comments or posts consist of profanity, hate speech, personal attacks, homophobia or Islamophobia may be banned.'"

On his Facebook page, Gosar posts the policy that guides his actions. It says in part, "Users are banned to promote healthy, civil dialogue on this page but are welcome to contact Congressman Gosar using other methods," including phone calls, emails and letters.

Sometimes, users are blocked repeatedly.

Community volunteer Gayle Lacy was named 2015 Wacoan of the Year for her effort to have the site of mammoth fossils in Waco, Texas, designated a national monument. Lacy's latest fight has been with her congressman, Bill Flores, who was with her in the Oval Office when Obama designated the site a national monument in 2015. She has been blocked three times by Flores' congressional Twitter account and once by his campaign account. One of those blocks happened after she tweeted at him: "My father died in service for this country, but you are not representative of that country and neither is your dear leader."

Lacy said she was able to get unblocked each time from Flores' congressional account by calling his office but remains blocked on the campaign one. "I don't know where to call," she said. "I asked in his D.C. office who I needed to call and I was told that they don't have that information."

Lacy and others said Flores blocks those who question him. Austin lawyer Matt Miller said he was blocked for asking when Flores would hold a town hall meeting. "It's totally inappropriate to block somebody, especially for asking a legitimate question of my elected representative," Miller said.

In a statement, Flores spokesman Andre Castro said Flores makes his policies clear on Twitter and on Facebook. "We reserve the right to block users whose comments include profanity, name-calling, threats, personal attacks, constant harping, inappropriate or false accusations, or other inappropriate comments or material. As the Congressman likes to say 2014 2018If you would not say it to your grandmother, we will not allow it here.'"

Ricardo Guerrero, an Austin marketer who is one of the leaders of a local group opposed to Trump's agenda, said he has gotten unblocked by Flores twice but then was blocked again and "just kind of gave up."

"He's creating an echo chamber of only the people that agree with him," Guerrero said of Flores. "He's purposefully removing any semblance of debate or alternative ideas or ideas that challenge his own -- and that seems completely undemocratic. That's the bigger issue in my mind."

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Study: Police Officers Talk More Respectfully To White Residents Than Non-White Residents

Researchers analyzed the language recorded by body cameras during police stops, and concluded that police officers talk more respectfully to White residents than non-White residents. The study, published Monday in the Proceedings of the National Academy of Sciences, included 183 hours of body camera footage taken during 981 routine traffic stops in April 2014 by 245 different officers in the Oakland Police Department.

The researchers found:

"Police officers speak significantly less respectfully to black than to white community members in everyday traffic stops, even after controlling for officer race, infraction severity, stop location, and stop outcome. This paper presents a systematic analysis of officer body-worn camera footage, using computational linguistic techniques to automatically measure the respect level that officers display to community members. This work demonstrates that body camera footage can be used as a rich source of data rather than merely archival evidence, and paves the way for developing powerful language-based tools for studying and potentially improving police–community relations. "

The study included random selections of 312 utterances spoken to black residents and 102 utterances spoken to white residents. Next, 10 volunteers rated each interaction without knowing the names, races, or identifying information of the police officers. Then, the researchers used a computer model to analyze the ratings based upon scientific literature about respect.

Why this study is important:

"Despite the rapid proliferation of body-worn cameras, no law enforcement agency has systematically analyzed the massive amounts of footage these cameras produce. Instead, the public and agencies alike tend to focus on the fraction of videos involving high-profile incidents, using footage as evidence of innocence or guilt in individual encounters... Previous research on police–community interactions has relied on citizens’ recollection of past interactions or researcher observation of officer behavior to assess procedural fairness. Although these methods are invaluable, they offer an indirect view of officer behavior and are limited to a small number of interactions...

Key findings from the full report:

"... white community members are 57% more likely to hear an officer say one of the most respectful utterances in our dataset, whereas black community members are 61% more likely to hear an officer say one of the least respectful utterances in our dataset. (Here we define the top 10% of utterances to be most respectful and the bottom 10% to be least respectful.) This work demonstrates the power of body camera footage as an important source of data, not just as evidence, addressing limitations with methodologies that rely on citizens’ recollection of past interactions..."

Perhaps, most importantly (bold emphasis added):

"The racial disparities in officer respect are clear and consistent, yet the causes of these disparities are less clear. It is certainly possible that some of these disparities are prompted by the language and behavior of the community members themselves, particularly as historical tensions in Oakland and preexisting beliefs about the legitimacy of the police may induce fear, anger, or stereotype threat. However, community member speech cannot be the sole cause of these disparities... We observe racial disparities in officer respect even in police utterances from the initial 5% of an interaction, suggesting that officers speak differently to community members of different races even before the driver has had the opportunity to say much at all."

"Regardless of cause, we have found that police officers’ interactions with blacks tend to be more fraught, not only in terms of disproportionate outcomes (as previous work has shown) but also interpersonally, even when no arrest is made and no use of force occurs. These disparities could have adverse downstream effects, as experiences of respect or disrespect in personal interactions with police officers play a central role in community members’ judgments of how procedurally fair the police are as an institution, as well as the community’s willingness to support or cooperate with the police."

The findings indicate training opportunities for law enforcement, and apply only to the Oakland, California police department. Additional studies are needed to draw conclusions about other police departments. CNN interviewed Rob Voigt, the lead author of the study at Stanford University:

"We're also hoping it inspires police departments to consider cooperating with researchers more. And facilitating this kind of analysis of body camera footage will help police departments improve their relationship with the community, and it will give them techniques for better communication... When people feel they're respected by the police, they are more likely to trust the police, they are more likely to cooperate with the police, and so on and so forth. So we have reason to expect that these differences that we find have real-world effects."

I look forward to future studies. What are your opinions?


Verizon To Exit Its Copper Wire Telephone Business In Several States In 2018

Verizon logo If your home uses a copper wire telephone service, often called a "landline" or POTS (e.g., Plain Old Telephone Service), you may soon have to make a change. In Boston, Verizon will abandon its landline business in June 2018.

On Saturday, my wife received a letter via postal mail from Verizon. We live in Boston. The "Notice of Copper Retirement" stated:

"Currently, Verizon brings voice and/or data services to your home over copper cables. However, the company is updating to fiber-optic technology in your area, and will be retiring its copper facilities that currently serve you and your neighbors.

To continue to provide you service, Verizon will have to move your service to these fiber-optic facilities. If fiber is available to your home now, we will be contacting you individually soon to schedule an appointment to transition your services to fiber. Otherwise, we will be contacting you once fiber is available. In either case, we will need to move your service well before we retire the copper in your area which is scheduled for on or after June 1, 2018

We will transfer your voice services from copper to fiber at no cost to you. This transfer will not result in any change to the voice service that you currently receive from Verizon. You may continue to subscribe to the same voice service at the same price, terms, and conditions. In addition, any devices that rely upon your voice service, such as fax machines, medical devices, or security alarms connected to a central station, will continue to work in the same way as they currently do over copper. We will also provide you with a battery backup device at no charge. For almost all residential customers, that device uses standard D-cell batteries that can support up to 24 hours of standby voice service during a commercial power outage. In case of a prolonged power outage, you can simply replace the batteries and extend the backup power.

If you subscribe to our High Speed Internet service, the migration to fiber will require a change since that service is not available on our fiber facilities. The Internet access service that we offer on fiber is FiOS Internet. FiOS Internet is available at significantly faster speeds than High Speed Internet. We will offer the service at a special rate for customers who migrate from copper to fiber facilities as a result of the retirement of our copper facilities. In some cases, this price may be lower or higher than what you currently pay for internet access.

Please review the Frequently Asked Questions for additional information about the fiber update or visit us at verizon.com/fiberupgrade. If you still have questions, please call us Monday through Friday, 8 a.m. - 8 p.m., or Saturday 9 a.m. - 5 p.n. at 1-877-439-7442.

You may also contact the Federal Communications Commission or your State Commission if you have any questions. Thank you for continuing to be a loyal customer. We greatly appreciate your business.

Sincerely

Janet Gazlay Martin
Director, Network Transformation

I visited the website mentioned in the notice. That site pitches the FiOS Internet service, and doesn't explain the company's copper landline retirement activities. You have to do a little digging online to find the locations where Verizon announced its retirement of copper-wire telephone services. The locations include several states in the Northeast and Middle Atlantic regions. Earlier this month, Verizon announced the retirement of copper landlines next year in the following states, cities, and towns:

  • Delaware: Newark, Ocean View
  • Maryland: Bethesda, Columbia, Glen Burnie, Rockville, Towson
  • Massachusetts: Danvers, Dorchester, Framingham, Hanover, Lawrence, Leominster, Marblehead, Newton, North Chelmsford, Roxbury, Stoughton, West Roxbury
  • New Jersey: Bergen, Berlin, Cape May, Cranford, East Dover, East Orange, Ewing, Freehold, Hackensack, Haddonfield, Journal Square, Marlton, Medford, Merchantville, Morristown, New Brunswick, Red Bank, Somerville, Toms River, Union City, Wall Township, Woodbury
  • New York: Cayuga Williamsville, Cornwall, Mineola, Mount Vernon, Plainview Central, Skaneateles, White Plains, and multiple areas within all of the five boroughs of New York City
  • Pennsylvania: Allentown, Dormont, Glenolden, Jefferson, Jenkintown, Mayfair, Mechanicsburg, portions of Philadelphia, Pilgrim, Turtle Creek, Wilkinsburg
  • Rhode Island: portions of Providence
  • Virginia: Arlington, Falls Church, Reston, Springfield, Virginia Beach, and portions of Richmond

The telecommunications company made similar announcements during February, 2017 about other areas within the same states. Verizon is not alone. Telephone companies have planned for years to abandon their their copper landline services. In August 2015, the Institute of Electrical and Electronics Engineers (IEEE) reported that the U.S. Federal Communications Commission (FCC):

"... set new ground rules for carriers seeking to replace their old copper telephone networks. Approved by a 3-2 vote at an open meeting yesterday, the rules require carriers to notify customers in advance and to seek FCC approval before reducing services... FCC chairman Tom Wheeler and others have been pushing to shift telephone traffic to fiber optics and the Internet. Critics have charged that phone companies are allowing their old copper networks to decay to force customers to shift to fiber service. But some 37 million households —- many of them headed by elderly people —- remain on legacy copper, commissioner Mignon Clyburn noted at the hearing. Other holdouts live in rural areas that lack cellular and broadband service. Some prefer copper connections because they are independent of local power lines, and offer better 911 emergency service.

The FCC ruling requires that carriers notify retail customers at least three months before shutting down a copper network, and provide six-months notice to interconnecting carriers using the old lines. (Clyburn complained that that's much less time than the FCC gave before shutting down analog broadcast television, but voted for the measure anyway.) Carriers also must seek FCC approval if the telephone changeover would "discontinue, reduce or impair" service... In a separate vote, all five FCC commissioners agreed to require carriers to offer customers backup power supplies that maintain their phone service during prolonged power outages..."

You can read announcements by AT&T about copper landline retirements. CenturyLink notified the FCC last year about copper landline retirements in eight states: in Alabama, Florida, Michigan, Minnesota, Pennsylvania, Virginia, Washington, and Wisconsin.

Since the FCC set copper-retirement rules in 2015, technology adoption has climbed slightly. In January of this year, Pew Research reported that 77 percent of adults in the USA own a smartphone and 73 percent have broadband internet at home. However, while:

"... broadband adoption has increased to its highest level since the Center began tracking this topic in early 2000, not all Americans have shared in these gains. For instance, those who have not graduated from high school are nearly three times less likely than college graduates to have home broadband service (34 percent vs. 91 percent)... 12 percent of Americans say they are “smartphone dependent” when it comes to their online access – meaning they own a smartphone but lack traditional broadband service at home. The share of Americans who are smartphone dependent has increased 4 percentage points since 2013, and smartphone reliance is especially pronounced among young adults, nonwhites and those with relatively low household incomes."

While more people have smartphones and internet access at home, a sizeable number still have copper landlines. Phys.org reported in November 2016 the results of a recent survey:

"... 20 percent of the nation's households still view having a landline or fixed telephone as the most important of their telecommunications choices, according to a survey that queried consumers about their telephone and internet preferences... The study also found that for the average consumer, having mobile telephone service is about 3.5 times more important than a landline or fixed telephone service... Study findings suggest about 90 percent of American households have at least one mobile phone, 75 percent have fixed internet service, 58 percent have mobile internet service and 49 percent have fixed telephone service. Mobile telephone service was the most important service for the typical respondent, followed by fixed internet service, mobile internet service and fixed telephone service, although a portion rank fixed telephone first."

According to the 2012 United States Census, there are about 117 million households in the United States, and 2.59 persons on average per household. So, a substantial portion of the population will probably view negatively the termination of copper wire telephone services in their homes.

Verizon's copper termination notice was unnecessarily complicated, which could confuse many consumers. The portion of its notice which said "If fiber is available to your home..." was laughable. FiOS is already available in our neighborhood. Verizon notified me months ago, and I already migrated my antiquated DSL (Digital Subscriber Line) internet service on my phone line to FiOS. Verizon's landline business unit should know what its FiOS division is doing.The left hand should know what the right hand is doing.

So, Verizon's notice wasn't as customized nor as relevant as it could have been. It makes one wonder if, in its zeal to terminate its copper wire phone business, Verizon rushed the customer letters.

Readers of this blog remember the Boston City Council's hearings in 2015 about residents' requests for FiOS. In 2015, Verizon hadn't deployed FiOS even though it had been available in several suburban towns for many years. Example: a friend in Lexington has had FiOS since at least 2009. So, Verizon could have deployed FiOS far sooner, providing consumers more time to migrate their phone service without rushing.

What should consumers do? It depends upon your lifestyle. If you already have a smartphone, you may want to simply terminate your landline phone service and use your smartphone instead. If you don't have a smartphone, you can migrate your copper landline phone service to Verizon's FiOS fiber connection, to a smartphone, or to another telephone service provider. For example, many cable-TV providers, such as Comcast, provide phone service in residences.

Some consumers value security and privacy. If you perform phone-based banking or online banking with your desktop/laptop computer, then security is a concern. Since smartphones or wireless phones using home WiFi networks transmit using radio waves, you'll probably want to encrypt you wireless online banking transmissions to protect against theft by criminals or hackers. Several brands of Virtual Private Network (VPN) software and apps are available to encrypt your wireless transmissions. If you are unfamiliar with VPN software, this prior blog post contains links to online primers and tutorials.

If you received a copper termination letter from your phone company, what were your opinions of it? Did you switch to fiber landlines or to wireless?


3 Strategies To Defend GOP Health Bill: Euphemisms, False Statements and Deleted Comments

[Editor's Note: today's guest post is by the reporters as ProPublica. Affordable health care and coverage are important to many, if not most, Americans. It is reprinted with permission.]

by Charles Ornstein, ProPublica

Earlier this month, a day after the House of Representatives passed a bill to repeal and replace major parts of the Affordable Care Act, Ashleigh Morley visited her congressman's Facebook page to voice her dismay.

"Your vote yesterday was unthinkably irresponsible and does not begin to account for the thousands of constituents in your district who rely upon many of the services and provisions provided for them by the ACA," Morley wrote on the page affiliated with the campaign of Representative Peter King (Republican, New York). "You never had my vote and this confirms why."

The next day, Morley said, her comment was deleted and she was blocked from commenting on or reacting to King's posts. The same thing has happened to others critical of King's positions on health care and other matters. King has deleted negative feedback and blocked critics from his Facebook page, several of his constituents say, sharing screenshots of comments that are no longer there.

"Having my voice and opinions shut down by the person who represents me -- especially when my voice and opinion wasn't vulgar and obscene -- is frustrating, it's disheartening, and I think it points to perhaps a larger problem with our representatives and maybe their priorities," Morley said in an interview.

King's office did not respond to requests for comment.

As Republican members of Congress seek to roll back the Affordable Care Act, commonly called Obamacare, and replace it with the American Health Care Act, they have adopted various strategies to influence and cope with public opinion, which polls show mostly opposes their plan. ProPublica, with our partners at Kaiser Health News, Stat and Vox, has been fact-checking members of Congress in this debate and we've found misstatements on both sides, though more by Republicans than Democrats. The Washington Post's Fact Checker has similarly found misstatements by both sides.

Today, we're back with more examples of how legislators are interacting with constituents about repealing Obamacare, whether online or in traditional correspondence. Their more controversial tactics seem to fall into three main categories: providing incorrect information, using euphemisms for the impact of their actions, and deleting comments critical of them. (Share your correspondence with members of Congress with us.)

Incorrect Information

Representative Vicky Hartzler (Republican, Missouri) sent a note to constituents this month explaining her vote in favor of the Republican bill. First, she outlined why she believes the ACA is not sustainable -- namely, higher premiums and few choices. Then she said it was important to have a smooth transition from one system to another.

"This is why I supported the AHCA to follow through on our promise to have an immediate replacement ready to go should the ACA be repealed," she wrote. "The AHCA keeps the ACA for the next three years then phases in a new approach to give people, states, and insurance markets plenty of time to make adjustments."

Except that's not true.

"There are quite a number of changes in the AHCA that take effect within the next three years," wrote ACA expert Timothy Jost, an emeritus professor at Washington and Lee University School of Law, in an email to ProPublica.

The current law's penalties on individuals who do not purchase insurance and on employers who do not offer it would be repealed retroactively to 2016, which could remove the incentive for some employers to offer coverage to their workers. Moreover, beginning in 2018, older people could be charged premiums up to five times more than younger people -- up from three times under current law. The way in which premium tax credits would be calculated would change as well, benefiting younger people at the expense of older ones, Jost said.

"It is certainly not correct to say that everything stays the same for the next three years," he wrote.

In an email, Hartzler spokesman Casey Harper replied, "I can see how this sentence in the letter could be misconstrued. It's very important to the Congresswoman that we give clear, accurate information to her constituents. Thanks for pointing that out."

Other lawmakers have similarly shared incorrect information after voting to repeal the ACA. Representative Diane Black (Republican, Tennessee) wrote in a May 19 email to a constituent that "in 16 of our counties, there are no plans available at all. This system is crumbling before our eyes and we cannot wait another year to act."

Black was referring to the possibility that, in 16 Tennessee counties around Knoxville, there might not have been any insurance options in the ACA marketplace next year. However, 10 days earlier, before she sent her email, BlueCross BlueShield of Tennessee announced that it was willing to provide coverage in those counties and would work with the state Department of Commerce and Insurance "to set the right conditions that would allow our return."

"We stand by our statement of the facts, and Congressman Black is working hard to repeal and replace Obamacare with a system that actually works for Tennessee families and individuals," her deputy chief of staff Dean Thompson said in an email.

On the Democratic side, the Washington Post Fact Checker has called out representatives for saying the AHCA would consider rape or sexual assault as pre-existing conditions. The bill would not do that, although critics counter that any resulting mental health issues or sexually transmitted diseases could be considered existing illnesses.

Euphemisms

A number of lawmakers have posted information taken from talking points put out by the House Republican Conference that try to frame the changes in the Republican bill as kinder and gentler than most experts expect them to be.

An answer to one frequently asked question pushes back against criticism that the Republican bill would gut Medicaid, the federal-state health insurance program for the poor, and appears on the websites of Representative Garret Graves (Republican, Louisiana) and others.

"Our plan responsibly unwinds Obamacare's Medicaid expansion," the answer says. "We freeze enrollment and allow natural turnover in the Medicaid program as beneficiaries see their life circumstances change. This strategy is both fiscally responsible and fair, ensuring we don't pull the rug out on anyone while also ending the Obamacare expansion that unfairly prioritizes able-bodied working adults over the most vulnerable."

That is highly misleading, experts say.

The Affordable Care Act allowed states to expand Medicaid eligibility to anyone who earned less than 138 percent of the federal poverty level, with the federal government picking up almost the entire tab. Thirty-one states and the District of Columbia opted to do so. As a result, the program now covers more than 74 million beneficiaries, nearly 17 million more than it did at the end of 2013.

The GOP health care bill would pare that back. Beginning in 2020, it would reduce the share the federal government pays for new enrollees in the Medicaid expansion to the rate it pays for other enrollees in the state, which is considerably less. Also in 2020, the legislation would cap the spending growth rate per Medicaid beneficiary. As a result, a Congressional Budget Office review released Wednesday estimates that millions of Americans would become uninsured.

Sara Rosenbaum, a professor of health law and policy at the Milken Institute School of Public Health at George Washington University, said the GOP's characterization of its Medicaid plan is wrong on many levels. People naturally cycle on and off Medicaid, she said, often because of temporary events, not changing life circumstances -- seasonal workers, for instance, may see their wages rise in summer months before falling back.

"A terrible blow to millions of poor people is recast as an easing off of benefits that really aren't all that important, in a humane way," she said.

Moreover, the GOP bill actually would speed up the "natural turnover" in the Medicaid program, said Diane Rowland, executive vice president of the Kaiser Family Foundation, a health care think tank. Under the ACA, states were only permitted to recheck enrollees' eligibility for Medicaid once a year because cumbersome paperwork requirements have been shown to cause people to lose their coverage. The American Health Care Act would require these checks every six months -- and even give states more money to conduct them.

Rowland also took issue with the GOP talking point that the expansion "unfairly prioritizes able-bodied working adults over the most vulnerable." At a House Energy and Commerce Committee hearing earlier this year, GOP representatives maintained that the Medicaid expansion may be creating longer waits for home- and community-based programs for sick and disabled Medicaid patients needing long-term care, "putting care for some of the most vulnerable Americans at risk."

Research from the Kaiser Family Foundation, however, showed that there was no relationship between waiting lists and states that expanded Medicaid. Such waiting lists pre-dated the expansion and they were worse in states that did not expand Medicaid than in states that did.

"This is a complete misrepresentation of the facts," Rosenbaum said.

Graves' office said the information on his site came from the House Republican Conference. Emails to the conference's press office were not returned.

The GOP talking points also play up a new Patient and State Stability Fund included in the AHCA, which is intended to defray the costs of covering people with expensive health conditions. "All told, $130 billion dollars would be made available to states to finance innovative programs to address their unique patient populations," the information says. "This new stability fund ensures these programs have the necessary funding to protect patients while also giving states the ability to design insurance markets that will lower costs and increase choice."

The fund was modeled after a program in Maine, called an invisible high-risk pool, which advocates say has kept premiums in check in the state. But Senator Susan Collins (Republican, Maine) says the House bill's stability fund wasn't allocated enough money to keep premiums stable.

"In order to do the Maine model 2014 which I've heard many House people say that is what they're aiming for -- it would take $15 billion in the first year and that is not in the House bill," Collins told Politico. "There is actually $3 billion specifically designated for high-risk pools in the first year."

Deleting Comments

Morley, 28, a branded content editor who lives in Seaford, New York, said she moved into Representative King's Long Island district shortly before the 2016 election. She said she did not vote for him and, like many others across the country, said the election results galvanized her into becoming more politically active.

Earlier this year, Morley found an online conversation among King's constituents who said their critical comments were being deleted from his Facebook page. Because she doesn't agree with King's stances, she said she wanted to reserve her comment for an issue she felt strongly about.

A day after the House voted to repeal the ACA, Morley posted her thoughts. "I kind of felt that that was when I wanted to use my one comment, my one strike as it would be," she said.

By noon the next day, it had been deleted and she had been blocked.

"I even wrote in my comment that you can block me but I'm still going to call your office," Morley said in an interview.

Some negative comments about King remain on his Facebook page. But King's critics say his deletions fit a broader pattern. He has declined to hold an in-person town hall meeting this year, saying, "to me all they do is just turn into a screaming session," according to CNN. He held a telephonic town hall meeting but only answered a small fraction of the questions submitted. And he met with Liuba Grechen Shirley, the founder of a local Democratic group in his district, but only after her group held a protest in front of his office that drew around 400 people.

"He's not losing his health care," Grechen Shirley said. "It doesn't affect him. It's a death sentence for many and he doesn't even care enough to meet with his constituents."

King's deleted comments even caught the eye of Andy Slavitt, who until January was the acting administrator of the Centers for Medicare and Medicaid Services. Slavitt has been traveling the country pushing back against attempts to gut the ACA.

.@RepPeteKing, are you silencing your constituents who send you questions? Assume ppl in district will respond if this is happening.

-- Andy Slavitt (@ASlavitt) May 12, 2017

Since the election, other activists across the country who oppose the president's agenda have posted online that they have been blocked from following their elected officials on Twitter or commenting on their Facebook pages because of critical statements they've made about the AHCA and other issues.

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