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Changing YouTube Playback Speed

YouTube gives users the option to modify the playback speed of some videos. This is particularly useful in the case of videos that you are obligated to watch (training videos, terrible fan videos, the occasional conference talk, etc.) and want to get through quickly. You have the option to speed a video to one-and-a-half times normal speed and double normal speed. You can also slow a video to half speed or quarter speed, which can be handy when trying to draw out a training-over-lunch session.

In order to make a go of this, you’ll need to use the YouTube HTML5 player, which you can activate at while logged into your Google account. If you worry about browser support (for both the HTML5 video element or the various codecs), the YouTube page will show you what your browser supports. In general, if you are using a current version of your favorite browser then you should be fine.

The opening image shows where the option lives. Sadly, that awesome video of Morrissey and George Michael doing film reviews has been pulled, so instead you can try it out on this video of Hitchcock’s The Lady Vanishes (I reference it in slide 58 of my Selfish Accessibility talk). The video also has closed captions and an audio description so it’s a great example of the accessibility features available for YouTube.

When at a video, click the gear icon at the bottom right and look for the Speed menu. If the video allows you to change its playback speed, it will be there with available options. This will only apply to the selected video. If you know of a setting to have it apply to all videos, please let me know.

If you still aren’t sure where this can handy, just try listening to Thundercats dialogue (particularly Panthro) at normal speed and then again at 1.5× normal speed. To me the difference is dramatic.

4 Easy Ways to Test Responsive Styles in a Desktop Browser

First of all, I feel that I must state the obvious: if you are able to test in a mobile device, then you absolutely should. There’s no true way to understand exactly how your site will look and behave in a browser unless you actually try it.

Unfortunately, there are so many devices out there with differing screen resolutions, pixel densities, and so forth, that you’ll likely never be able to test in them all. It’s practical to have some alternative testing methods at your disposal.

resize-browser#1) Resize your browser

Okay, so this one is pretty obvious, but it’s probably the most practical solution. All modern desktop browsers (Chrome, Safari, Opera, Firefox, IE9+) understand CSS Media Queries so you can simply adjust the width of your browser to see your responsive styles in action.

I generally do my core development and testing in Chrome. Chrome has been the default browser on Android devices for some time now and its rendering engine is based on Webkit, which is what Safari employs. That means by testing in Chrome, even on your desktop, you should get a pretty good feel for how the site will function for a large percentage of mobile users.

Once I have everything in a good state, I also test my responsive styles in all other (modern) desktop browsers  that the site will support, because most of them either have a mobile version (that is similar to the desktop version) or they could be used on tablet or netbook where the responsive styles might kick in.

2) Web Developer Extension

While testing, I also like to periodically check how the site looks at common device resolutions. There is a feature in Chris Pedericks’s Web Developer extension (available for Chrome, Firefox, and Opera) that allows you to view your site at several sizes on one screen.


Under the tools tab in the menu, there is an option for “View Respsonsive Layouts” that will draw the site in IFRAMEs at multiple sizes such as 320 x 480, 600 x 800, and 768 x 1024. You can choose the “Edit Resize Dimensions” option to customize the available resolutions.

I find this particularly useful, because it allows me to quickly see if there are any obvious display issues at common dimensions. Because the extension uses an IFRAME to embed the site, you can use it for local sites, you can navigate right within each layout, and you can use your browser’s developer tools to debug issues.

3) Screenfly

Screenfly by Quirktools is very similar to the Web Developer extension in many ways. It also uses a simple IFRAME embed technique to display your site at different dimensions and, likewise, comes with all of the same advantages. However, it also offers two unique functions that I find to be quite useful.


First, Screenfly breaks down the screen resolutions by device so you can clearly associate the screen resolution with a common device. But don’t be misled, Screenfly does not emulate those devices’ behavior, just their screen resolutions.

Second, Screenfly works off query strings, which means that you can copy the URL from the address bar of your browser and send it to a colleague or client to quickly and easily demonstrate how the site will look at a specific resolution (this is how the Algonquin Studios site looks at 768 x 1024 px).

4) Chrome’s New Emulation Functionality

Honestly, I haven’t tried this out too much, but Chrome recently added a new feature to their Developer Tools that allows you to specify any number of rendering options, including screen resolution, pixel ratio, and media type. It also allows you to spoof user agents.


I can’t speak to how useful this tool is in reality, because I just haven’t had an opportunity to try it out, but it certainly seems like it could be pretty useful in theory.

Do you have a favorite method for testing your responsive styles? Please feel free to share in the comments thread.

Healthcare Predictive Analytics: Lets take the good and mitigate the bad

In a recent NY Times article titled “When a Health Plan Knows How You Shop“, Natasha Singer gives some thoughtful and important coverage to trends evolving in the field of Predictive Health Analytics.  At its core, the practice intends to provide insights that will help us drive toward the Triple Aim:

  • Improving the patient experience of care (including quality and satisfaction)
  • Improving the health of populations
  • Reducing the per capita cost of health care

Practitioners analyze  data from doctor visits, insurance claims, prescriptions, census records, etc.  That makes sense.  However, Singer points out that patients “may be unaware of the kinds of intimate details about their households that insurers and hospitals may use to try to sway their treatment decisions”.    What happens when hospitals and insurers begin to bolster predictive models with “details on members’ household incomes, education levels, marital status, race or ethnicity, number of children at home, number of cars and so on”?  Not surprisingly, people are getting freaked out.Scale

The most important question in the article was asked by Anita L. Allen, a privacy law expert and the vice provost for faculty at the University of Pennsylvania: “Is the larger mission to improve public health, or to make insurers and hospitals more profitable?”

Improve Public Health?

The more we know about patients’ lives, the better we can focus the finite resources of our healthcare system to improve them.  One of my favorite examples of this comes out of Camden, NJ where Jeffrey Brenner , used data to map “hot spots” of health care high-utilizers—and found a better, cheaper way to treat these costly patients through collaborative care. Brenner’s team was able to reduce hospital visits and costs by 40 to 50 percent.

Looking at tangential and seemingly unrelated data points on a large scale will allow us to spot trends and develop models.  When we apply details of an individual’s life to those models, we can identify high-risk patients and coordinate outreach before they end up in the ER.  The idea is not to cut expensive or less profitable patients out, but rather to care for them in a more-proactive way that reduces or eliminates their need for expensive hospital visits.

Make Insurers and Hospitals More Profitable?

This is the one that makes people uncomfortable, and understandably so.  No one wants details of their personal lives to be exploited for profit.  Also, Singer points out the concern that targeted marketing campaigns based on this info could “ultimately result in the inequitable provision of medical care”.   The experts argue that by focusing on “high-value” customers and procedures, providers might be pushing out “ailing, poorly insured patients.”

Since we live in a capitalist society with a free-market healthcare system, its important that we understand and accept the fact that the profit motive will always be at play.  As patients and consumers, we have tools to influence how far things go and I think we can find guidance in the way scientist and Pulitzer Prize winning author Jared Diamond approaches environmental issues.  In his book Collapse, Diamond points out that in our system, particularly with publicly traded companies, the executives have a fiduciary responsibility to maximize share-holder value by all legal means. It could actually be considered ILLEGAL for them to NOT do something to increase profits even if there’s some ethical grey area around it. Rather than get mad about it and throw our arms up in the air, he suggested its our responsibility as consumers (patients) to put pressure on the business (hospitals and insurers) by refusing to do business with “shady” operators and to put pressure on our elected officials to enact laws that protect us.  Easier said than done for sure, but the value we can derive from predictive analytics in healthcare is worth fighting for.

The Answer is Clear

Predictive Healthcare Analytics is about achieving the triple aim. Its about improving people’s lives.  Let’s not throw the baby out with the bath water  As a society, we need to allow the Jeffrey Brenner’s of the world to analyze data and take actions that clearly impact people’s lives and health for the better AND we need to do so in a way that protects us from the practitioners with less noble intentions.  I for one am willing to fight the fight. Who’s with me?

Understanding Browser Settings and Features – Internet Explorer’s Content Advisor

Cross-platform and cross-browser compatibility are key components of a successful application. This compatibility allows you and your application to reach a variety of audiences and markets. Companies (and developers!) sink significant time into browser and platform testing in an effort to provide application features across a variety of platforms.

With browser testing in mind, developers need to understand features and functionality built into the browser in order to ensure your application features function as expected. It would be an oversight on the developer’s part to complete browser testing without testing against specific browser features. One of these features, Internet Explorer’s Content Advisor, is the focus of the post. The “got-ya” for browser testing with this feature is not what it does; it’s how it does it.

IE’s Content Advisor allows you to control the types of Internet content that can be viewed on your computer. It gives control to parents and office managers who want to control what content / sites their kids / employees have access to.

One of the side-effects of Content Advisor being enabled is that each request to the particular site will also send a GET request to the root of the site. According to Microsoft, this issue occurs if Internet Explorer does not associate the scripts on a particular Web site with any existing Content Advisor rules. In this situation, Internet Explorer sends a GET request to the root of the Web site to locate the configuration file for the rule (NOTE: This explanation is for IE 6, however, I have seen this same behavior in newer versions of IE). See the screen shot below demonstrating the functionality. The screen shot is from IE 9 with Content Advisor enabled. As you can see, after the initial redirect click, there is a GET request to the root of the site.

IE Content Advisor

This is a screenshot of a request with Content Advisor enabled.

This additional request to the root of the site should make you think – what does the default page of my application do? Does it clear your user’s session, login or cookie? If so, users may be unexpected logged out of the application. Does it capture analytic data? If so, you may see falsely skewed numbers from users with this feature enabled.

Once you’ve understood the feature, it’s time to determine if you support it. In the event that you do not support the feature, it should be very clearly stated in your application, and if possible, display a message to the end user that functionality is not working because they are using an unsupported feature.

Learn more about Content Advisor here. As a final note, Content Advisor is not available by default in versions 10+ (It can be enabled through Windows’ Group Policy Editor).


Verizon Using Disabilities to Fight Net Neutrality

This post originally appeared on my blog.

On Friday, Mother Jones reported that it has three sources saying that Verizon lobbyists are making a case on Capitol Hill that net neutrality harms those with disabilities. From Mother Jones:

Three Hill sources tell Mother Jones that Verizon lobbyists have cited the needs of blind, deaf, and disabled people to try to convince congressional staffers and their bosses to get on board with the fast lane idea. But groups representing disabled Americans, including the National Association of the Deaf, the National Federation of the Blind, and the American Association of People with Disabilities are not advocating for this plan. Mark Perriello, the president and CEO of the AAPD, says that this is the “first time” he has heard “these specific talking points.”

In the absence of seeing the language Verizon is using, I can only go on what Mother Jones reported (other news outlets covering this are linking back to Mother Jones). Given the amount of cash ISPs like Verizon are lobbying to kill net neutrality ($19 million in the first quarter of 2014 alone), I don’t consider this report to be far-fetched. Certainly Verizon is unlikely to make this argument in the open — there will be a backlash when no proof is offered and disability rights groups shoot it down (as has been happening just on these rumors).

It seems to me it is in the best interest of net neutrality to react as if this report is true. Further, it seems like a good idea to make it clear disabilities cannot be used as a pawn in some armchair morality action, no matter how well elected officials feel it may poll.

I was pretty quick to jump on this on Twitter, mostly out of anger, and given the retweets and favorites from my meager following (particularly from the accessibility community) I suspect I am not alone. Feel free to retweet it to your followers (or write your own):

A quick Google search (or use your own search terms) will net you many results from people who think Verizon’s reported argument is absurd (Won’t somebody please think of the childrendisabled?).

I don’t think my blog post, which ranks nowhere on Verizon’s radar, will do much to sway its nor the FCC’s opinion, but I do want to make sure I add to the growing chorus of people publicly denouncing something Verizon is arguing behind closed doors.


In April I wrote a post about net neutrality (We Need to Raise a Stink about Net Neutrality) where I asked people to tweet to Tom Wheeler and the FCC. In it I include plenty of references and arguments, but this video from Last Week Tonight with John Oliver (which I amended to my original post) does a better job of explaining net neutrality:

As John Oliver suggests, you can leave our own comments at the FCC site. As of a week ago there were 49,206 comments. As of this writing there are 115,213 comments. Only the most recent 10,000 comments are available to be viewed, which I cannot explain. Further, if you want to consider accessibility, as Verizon seemingly does, you may want to also ask the electronically filed responses be made available in a format other than PDF.

Keep the Focus Outline

This post originally appeared on my blog.

Animated GIF screen capture of Virgin America site.
This animated GIF is a screen capture of cycling through every interactive element (mostly links) on the page using just the tab key. You’ll note that in all but one case, the only indication of any change is in the lower left in the browser’s status bar where it shows the URL of the destination link. The URLs ending in a “#” are the booking options.

Today’s rant is inspired by all the gushing over Virgin America’s new web site — just because it’s responsive.

To be fair to Virgin America, making its site responsive is a huge win for users whose primary method of booking is via a smartphone or tablet (or, god forbid, phablet or tablone). Its new site, however, is a huge step backward for users who rely on the keyboard as their primary method of interaction.

Virgin America’s CSS has a style to identify anchors with focus (yes, there are other elements that should get focus, but I am looking at just the most basic support): a:focus {outline: thin dotted;}

What’s so frustrating is that the useful style is then overridden with this harmful declaration: a:focus {outline: none;} This override greatly decreases the usability and accessibility of the site. Unfortunately, this practice is still common on many more sites across the web.

As a web developer, one of the simplest accessibility tests you can do is unplug your mouse. Two quick things to review as part of that: Can you interact with all controls with only the keyboard? Can you tell which item has focus?

Even if you aren’t motivated to run that simple test from an overriding sense of being nice to your users, there’s a legal concern here. As I wrote last week, the U.S. Department of Justice held H&R block accountable to Web Content Accessibility Guidelines 2.0 Level A and AA Success Criteria. That means there is case law for making your consumer-facing site comply or face penalties.

By excluding focus styles, Virgin America is running afoul of one of the AA Requirement 2.4.7:

2.4.7 Focus Visible: Any keyboard operable user interface has a mode of operation where the keyboard focus indicator is visible. (Level AA)

In short, if your site doesn’t make interaction elements obvious when accessed via keyboard, not only are you hurting users, you’re opening yourself up to litigation.

Further Reading

Again, this isn’t a new issue. It even has its own mini-site at, which offers these handy links:

To add another, this article, When Do Elements Take the Focus?, might be handy to understand just when you can expect to see :focus styles get applied by a browser.


In March I wrote about how Google removed underlines from search result links. My concern there was that web developers might follow suit. Between removing keyboard focus indicators and underlines from links, I am amazed that developers do so much to make the core interaction element of the web essentially hidden to so many users. I am reproducing the list of related links here as they are relevant to the overall issue of keeping links usable:

My Efforts to Reach Virgin America (so far)

I may have contacted Virgin America on Twitter once. Or Twice. Or three times. Perhaps even a fourth time. And filed a bug with And left a comment at Wired’s article. I’ve embedded the tweets below so you an retweet if you are as whiny as I.

Update: June 27, 2014

On December 12, 2013 a rule became effective from the U.S. Department of Transportation (DOT) titled Nondiscrimination on the Basis of Disability in Air Travel: Accessibility of Web Sites and Automated Kiosks at U.S. Airports. That links points to the following section on accessibility:

Finally, we proposed a tiered implementation approach in which the WCAG 2.0 standard at Level A and AA would apply to (1) a new or completely redesigned primary Web site brought online 180 or more days after the effective date of the final rule; […]

As keyboard accessibility is one of the requirements of WCAG AA compliance, Virgin America’s new site does not honor this rule. However, if the Virgin site officially launched before June 10, 2014, then it squeaks by on a date technicality.

More information on the implications of the law are in the post New accessibility rules coming to airline websites. Are you ready?

What do you think of the NY-SHIP?

If you’re a provider, a payer, or a community group, what do you think of NY’s Health Improvement Plan (NY-SHIP)? On June 10, the P2 Collaborative hosted Hope Plavin and Joseph Anarella from the Quality and Patient Safety team at the New York State Department of Health. They responded to questions, offered insight, and accepted feedback. Everyone was clearly engaged. If you’re like me, working in Health IT, you might be curious about what concerns care leaders in our community:


  • How can we increase the clinical workload of providers without shrinking the administrative load?
  • Small and rural primary care physicians like the idea of value-based payments that incent them to spend more time with their patients on preventative efforts. But how will small practices stay in business when the administrative requirements keep increasing? For example, in the Finger Lakes CMMI grant, several small practices are sharing care coordinators. How can NYS help small practices survive the big process changes, not just the larger physician groups? How can we use the same programs to transform care among all providers regardless of size? Would an internship program relax some of the administrative burden?
  • The ongoing paperwork required for Patient-Centered Medical Homes prevents small and rural practices from even considering them. How likely will small and rural practices participate in the Advanced Primary Care model (especially stage 2 and 3)?
  • Can NYS agree on just one set of metrics across all programs? It’s an administrative burden to capture the same idea three slightly different ways for three different programs. NYS wants to align provider metrics with the NQF/NCQA standards, and stated that they’re urging CMS to do the same.
  • If we don’t win the CMS grant, what happens? The CMS grant goes for 48 months from 2015 to 2018, with a four-year sustainable period following it. If we’re not accepted, NYS will continue to push ahead on some of the programs regardless of CMS funding, while others will be delayed or curtailed. In the absence of funding, NYS expect that pilot projects, innovation programs, and surveys of community needs probably won’t happen. Those programs that move ahead would be more fragmented.
  • On the SHIN-NY (a network of exchanges for clinical data among providers), patient consents vary from RHIO to RHIO (the exchanges). This could hold back the SHIN-NY until this gets resolved. For example, in WNY, we’ve obtained a community-based consent to exchange data; patients fill out just one consent form at their PCP that covers all physicians participating in our RHIO, HEALTHeLINK. In contrast, some other regions seek consent from each practice individually, making community-wide change much harder.
  • Can providers get tax breaks for modernizing our practices? That might be a real incentive.
  • Is the pace of transformation too rapid? Long hours discourage medical students from entering the profession.
  • Can you relax nurse supervision regulations so that more nurses can operate under a single physician? This kind of workforce reform could multiply the value of our existing professionals and attract new ones too.


  • Population health metrics can’t come from claims data. The front lines are too distant from the payer to capture what happens there, and isn’t gathered in the same way that the metric formulas specify.
  • Cost transparency is slowly moving forward. As an example, there’s an innovation challenge worth $40k for software developers to create apps that help patients shop smarter.

Community Groups

  • How will we sustain care transformation programs after the initial funds disappear? NYS would like to see care givers get more efficient, and to convince payers to cover investments to that end. The answers probably vary by region. Can we continue testing grants to promote experimentation and capture successes?
  • Can NYS support evidence-based home visit programs to keep patients out of more expensive and intrusive care paths? It could be cheaper and more effective in the long term.

At the bottom line, NYSDOH supports healthcare transformations that are based on evidence, with measurable, concrete activities.

Finally, I’m pleased to learn that NYDOH has begun implementation on the All-Payer Database with Salient Management Company. I think this is one of the most politically difficult areas for government and payers to work together, and I’m glad to see this is moving. NYS mentioned that Medicaid claims are already available, with Medicare and qualified health plans up next. Commercial payers will come later. Can you guess why?

By the way, here are some recent posts with background on the NY-SHIP:

A Quick Primer on Hosting Videos

Whether captured with a phone or professionally produced, video is proving to be a powerful medium on the web and posting it on your site can improve user experience and possibly even bolster your search results placement.

So let’s say that you’ve got a video and you want to put it on you web site. Now what?

Edit for Length and Quality

Video files can be extremely large so you should cut out any unnecessary bits to keep the file size as small as possible. That will also help ensure that you are providing your users with quality content.

Accessibility Check

Depending on the content of your video and your audience, you may need to have it transcribed or captioned to meet legal obligations (and foster a positive user experience).

Output for Web

Video support has changed a lot in the last few years so you’ll need to make sure you output your video in a common format. Although there is some support for WebM and Ogg formats, I recommend using the MP4 format with a H264 video codec and an AAC audio codec.

Choose Your Hosting Solution

There are a lot of different options out there, but in most cases it will be easier to host your video externally with a third party solution (like YouTube, Vimeo, or Wistia) and use the tools provided by that service to embed it on your web site. Here’s why:

  1. Hosting your video with a third party means that you don’t have to worry about added strain to your server or the potential costs associated with it.
  2. Most hosting services will optimize your video for the greatest possible support across browsers, platforms, and devices. When you upload the video, they may even create multiple copies of it in different formats to be served up as needed to support the user’s setup.
  3. Most third party solutions will already come with a video player. Your video won’t play itself; you actually need a player with controls to play, pause, etc.
  4. Many video hosts like YouTube and Vimeo also include a marketplace where users can browse and search for uploaded videos. That provides added exposure to a potentially huge audience, but they will also usually allow you to keep your videos private if you prefer.
  5. Third party solutions offer tools to share or embed your video quickly and easily. They’ll usually provide a snippet of HTML that you can paste into your site and you can display the video as if you hosted it yourself.

Video Hosting Solutions


YouTube is great, because it’s free, incredibly easy to use, and has exceptional support across the various browsers, devices, and platforms. However, it can lack a certain professionalism and there are ads.


In my mind, Vimeo is essentially the hip alternative to YouTube. The videos (in general) tend to be a bit more polished and professional. It’s also free, easy to use, and has great support and they offer a paid solution if you need a richer set of options.


I only recently started working with Wistia when a client came to me with this exact question and, for professional web sites, it has become my preferred solution. Their free option is pretty limited so it does come with a cost in many cases, but they have a really great suite of tools and it’s still quick and easy to setup like the others.

Hosting video yourself

There a lot of reasons why you might choose to host a video yourself, but if you go that route, you’ll need to select and implement a video player on your site. Here are a couple of players that I’ve worked with:

JW Player

I’ve worked with JW Player for several years and I’ve found it to be a solid player with really good support across the board. It’s an excellent paid solution for professional web sites.


Video.js is an HTML5 video player with a Flash fallback for older browsers. This solution may take a bit of custom implementation, but is otherwise free.

Once the player has been implemented, you just need to upload your video and reference it on the appropriate page.


Video can be a lot of work, but there are solutions out there that can make it a lot easier and help you reap the rewards for your efforts. I’ve mentioned just a few solutions that I’ve worked with, but please add your recommendations to the comments.

Accessibility Regulation Confusion from U.S. Government

This post originally appeared on my blog.

There has been some activity lately from the U.S. federal government related to accessibility requirements for web sites. Unfortunately, that activity is sending a mixed message to many burdened with making a case for accessibility compliance in the private sector.

Good News

The U.S. Department of Justice (DoJ) made news in the accessibility community back in March by issuing a Consent Decree in a case with H&R Block requiring H&R Block to follow the Web Content Accessibility Guidelines (WCAG) 2.0. From the DoJ press release:

On Dec. 11, 2013, the Civil Rights Division and the U.S. Attorney’s Office for the District of Massachusetts filed a complaint in intervention in the lawsuit National Federal [sic] of the Blind (NFB) et al. v. HRB Digital LLC et al. to enforce Title III of the ADA [Americans with Disabilities Act]. […]

[…] The recognized international industry standards for web accessibility, known as the Web Content Accessibility Guidelines (WCAG) 2.0, can be found online and are freely available to help companies ensure that individuals with disabilities can fully and equally enjoy their web-based goods and services.

Under the terms of the five year decree, H&R Block’s website, tax filing utility and mobile apps will conform to the Level AA Success Criteria of the WCAG 2.0. […] H&R Block will also pay $45,000 to the two individual plaintiffs, and a $55,000 civil penalty.

Essentially the DoJ stepped into a lawsuit, identified an accepted standard to follow, and put some teeth in its action in the form of a financial penalty (both in cash and H&R Block’s cost to rebuild its offerings). For those who champion accessibility, this is a win.

It’s not the first. Back in 2012 the DoJ filed a Statement of Interest in a battle between Netflix (never mind that it’s in a PDF) and the National Association of the Deaf that the absence of closed captioning violates the ADA. Earlier this year it also filed a Statement of Interest in a case against Lucky Brand Jeans (another PDF) for its inaccessible customer-facing credit card swipe machines (which probably inhabit far more stores than just Lucky’s).

The DoJ has effectively been enforcing ADA laws for private entities, not just state and local governments. This is A Good Thing™

Bad News

Let’s ignore the fact that the DoJ can’t get the name of the National Federation of the Blind correct in a press release, or that the ADA site provides Statements of Interest from the DoJ as PDF files (you can learn some more about PDF accessibility at Denis Boudreau’s a11y Tips site).

The Laws

The DoJ was expected to release a set of legally binding standards for web site accessibility back in April. That deadline flew by with hardly a word from the DoJ. Instead, buried in a Unified Agenda (a catch-all planning document), The DoJ casually mentioned that it’s been delayed until March of 2015. You can credit Seyfarth Shaw LLP for catching that one.

As the Law Office of Lainey Feingold notes, this has been happening for years:

The web regulations have been pending since July 26, 2010 when the DOJ issued its Advanced Notice of Proposed Rule Making (ANPRM). The public comment period ended on January 24, 2011. Ever since then, the DOJ has been announcing deadlines for the next step — and then moving those deadlines as the target date approaches.


The H&R Block Consent Decree has some dates associated with adhering to the ruling. One of them (14.d) has come and gone:

  1. Web Accessibility Policy [underline theirs, not mine]: By June 1, 2014, H&R Block shall adopt and implement a Web Accessibility Policy consistent with the attachment at Exhibit A and as approved by the Private Plaintiffs and the United States. By June 1, 2014, H&R Block shall: […]
    1. make publicly available and directly link from the homepage, a statement of H&R Block’s policy to ensure that persons with disabilities have full and equal enjoyment of the goods, services, facilities, privileges, advantages, and accommodations of H&R Block, through, its mobile applications, and its Online Tax Preparation Product; […]

When I visit the H&R Block home page, I see no link or content related to accessibility, disabilities, nor the ADA (if I am wrong, please correct me). I even made an archived version from the Wayback Machine so you can see it in case H&R Block changes it tomorrow (see how you can make your own).

Granted, that requirement is only a week overdue, but given that the DoJ is four years overdue on issuing regulations, one could argue that deadlines don’t carry much weight with the DoJ.

Just Setting a Good Example

The DoJ site itself is not exactly a shining beacon of accessibility. From the odd image map on the logo (really, one image, two links to the same location?) to text as images, it could use some help. If you head over to the DoJ Acccessibility Information page you will see it states that the DoJ is committed to provide its content in accordance with Section 508 of the Rehabilitation Act.

If you’ve been working in web accessibility, then you may be aware of the government web site devoted to Section 508, which requires that Federal agencies’ electronic and information technology is accessible to people with disabilities, and which is intended to be used by federal employees:

As I challenged on Twitter, try using it with your keyboard. Go ahead. Just try it.

For the more technical among my readers, here’s an example of the CSS declarations of agony (files linked in this tweet):

For added fun, find the Skip link and then see where it takes you.

The government body in charge of creating rules for making sites accessible is built based on the requirements of a federal site that itself is a complete cluster. It may, in fact, be a brilliant parody site showing government workers how not to build a compliant site.

Or it might really be the best they can do.

What You Should Do

Keep coding (or start coding) your sites to meet Web Content Accessibility Guidelines 2.0 Level A and AA Success Criteria. This is the requirement the DoJ put in its ruling against H&R Block, the most recent example we have of where the federal government is defining a standard.

And then stop worrying. As WebAIM notes, fear of litigation isn’t the best reason to make a site accessible. You should do it because it’s the right thing to do. Of course, in my HTML5 Developer Conference talk, I argue that making accessibility all about you (slide 13) is probably a more effective means of getting developers to implement, but I leave that decision up to your personal level of narcissism.


  • Assets, the accessible, Bootstrap-based development framework from the federal government (really from the Centers for Medicare & Medicaid Services).

Update: June 9, 2014

Read my post about Assets, the U.S. government framework based on Bootstrap 3, and PayPal’s accessibility plug-in, which promises to make your existing Bootstrap implementation accessible: Accessible Bootstrap Frameworks

Update: June 25, 2014

In a release last week from the National Federation of the Blind (NFB), the NFB and a bling business owner reached an agreement with the Small Business Administration because its web site violated Section 508 (read a brief from the law firm representing the NFB). This is newsworthy for two reasons:

  • The SBA is a government agency and is being held to the only current federal law pertaining to web site accessibility, effectively stating the government has to follow its own rules.
  • The site, the one housing the rules to which the SBA is being held, doesn’t follow those very rules, as I noted above.

I am struggling to find a way to describe how absurd this is. I am open to suggestions.

A Look at the CMS Medicare Geographic Variation Dashboard

The open government and open data movement continues to gather steam.  The Centers for Medicare and Medicaid Services (CMS) announced their latest addition to this treasure trove of data at this years’ Health Datapalooza conference in DC.  The Medicare Geographic Variation Dashboard gives us a tool to better understand Medicare utilization and how it varies across geographical regions.  The release is exciting for a couple of reasons.  First, it packages the data up into an easy to use interface that allows the non-technical user to quickly get started.  You don’t have to download the raw data, and you don’t need expertise with a database engine or analytic suite. You can just open the state or county level dashboards and get started right now!  And if that’s not enough for you or you just want to dig a little deeper, all of the raw data is available here.  It contains all of the supporting data and much more, broken out by year (2008-2012).

I won’t get into any specific analysis of the data in this post. This Commonwealth Fund Washington Health Policy Week In Review offers a few examples of the types of insights you can derive.  Here, I just want to take you on the tour of the tool so that you can get started on your own analysis.

Note: The dashboard does require an Adobe Flash plug-in.

State: Geographic Variation Dashboard

The state-level tool opens up to a snapshot of the Total Per Capita Costs for each state in 2012.  Click on the map to select a state and you’ll be presented with a summary of how that state’s standardized costs compare to the national averages as a total and across specific segments like Inpatient, Post-Acute Care, Hospice, and more.  Lastly you’ll get a look at how that state’s costs have trended year-to-year from 2008 – 2012 and how it compares to the national trend over that same time period.

Here’s a look at Florida:

CMS State Level Geo Variation Dashboard

County: Geographic Variation Dashboard

The county dashboard lets you drill down and compare the numbers across every county in each state.  It’s backed by a ton of data, so you’ll have to be a bit patient while it loads. Once you’re in there you can select a state from the map and get a snapshot of how each county’s costs stack up to the state and national per capita costs.  Again you have the option to look at total costs or drill down into more specific areas of spending.  Also, you can select an individual county from the drop-down and compare its costs to the state average.

Here’s a look at Albany County in New York:

CMS County Level Geo Variation Dashboard

You can also look at a time trend for a specific county by selecting the “Time Trend” option on the bottom-right. Here’s a look at the trend in Part B Drug Per Capita Costs in Erie County New York from 2008-2012:

CMS County Level Geo Variation Dashboard - time trend

This is just one example of a vast and growing number of publicly available data sets from CMS and others.  Check out the Research, Statistics, Data and Systems page for additional CMS resources and check out our post on Open Healthcare Data Sets for some more.