42 CFR 440.250 - Limits on comparability of services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... § 440.255), and services for pregnant women as defined in section 1916(a)(2)(B) of the Social Security... State may provide a greater amount, duration, or scope of services to pregnant women than it provides... amount, duration, and scope to all pregnant women covered under the State plan. (q) [Reserved] (r) If...

42 CFR 440.250 - Limits on comparability of services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... § 440.255), and services for pregnant women as defined in section 1916(a)(2)(B) of the Social Security... State may provide a greater amount, duration, or scope of services to pregnant women than it provides... amount, duration, and scope to all pregnant women covered under the State plan. (q) [Reserved] (r) If...

Medicaid integrity program; limitation on contractor liability. Final rule.

PubMed

2007-11-30

The Medicaid Integrity Program (the Program) provides that the Secretary promote the integrity of the Medicaid program by entering into contracts with contractors that will review the actions of individuals or entities furnishing items or services (whether fee-for-service, risk, or other basis) for which payment may be made under an approved State plan and/or any waiver of the plan approved under section 1115 of the Social Security Act; audit claims for payment of items or services furnished, or administrative services furnished, under a State plan; identify overpayments of individuals or entities receiving Federal funds; and educate providers of services, managed care entities, beneficiaries, and other individuals with respect to payment integrity and quality of care. This final rule will provide for limitations on a contractor's liability while performing these services under the Program. The final rule will, to the extent possible, employ the same or comparable standards and other substantive and procedural provisions as are contained in section 1157 (Limitation on Liability) of the Social Security Act.

Behavioral health benefits for public employees: effect of mental health parity legislation.

PubMed

Borzi, P C; Rosenbaum, S

2001-04-01

With the passage of the Mental Health Parity Act of 1996 (MHPA), Congress took an important first step toward equalizing treatment under medical plans between physical and mental illnesses by requiring parity in annual and lifetime dollar limits between physical and mental illness. But the Act was limited in scope: it did not mandate mental health benefits nor prohibit other common types of differentials between physical and mental illnesses, such as higher cost-sharing or lower limits on outpatient visits or inpatient treatments. Before Congress' action in 1996, a few of the states had adopted some type of parity requirement. Since 1996, state parity activity has accelerated.Recently, the Center for Health Services Research and Policy through a grant from the Substance Abuse and Mental Health Services Administration of the U.S. Department of Health and Human Services, examined contracts providing for mental health benefits for state employees in eight states to assess whether legislative attempts to require parity between physical and mental illnesses resulted in noticeable differences in behavioral health benefits for state employees. We concluded that, except in states that have mandated full parity for some or all types of mental illnesses, behavioral health benefits for state employees have not changed significantly as a result of the state parity laws, since they still remain subject to traditional restrictions, such as higher cost-sharing and greater limitations on outpatient visits and inpatient treatment days, than those imposed on physical illnesses. Thus the considerable state activity surrounding mental health parity may have little effect on state employees' access to mental health services, since although state laws required parity in dollar limitations, they generally permitted the continuation of other plan design features that are more restrictive for mental health coverage. However, many of the contracts we examined were multi-year contract and may not have fully reflected recent state activity. Moreover, if Congress renews the Mental Health Parity Act when it expires in September, 2001, and expands the scope of the Act to cover some of these other plan design features, states with more limited parity laws are likely to follow. In that case, perhaps state employees with mental illnesses may see significant change in the future.

78 FR 16506 - Notice of Hearing: Reconsideration of Disapproval of Florida State Plan Amendments (SPA) 12-015

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-15

... limitation is consistent with the provision of a sufficient amount, duration, and scope to reasonably achieve...(c)(2), because it appeared to impose a limitation on outpatient hospital services that was based on... amount, duration, and scope of each service that it provides,'' and ``each service must be sufficient in...

29 CFR 553.202 - Limitations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... FAIR LABOR STANDARDS ACT TO EMPLOYEES OF STATE AND LOCAL GOVERNMENTS Fire Protection and Law Enforcement Employees of Public Agencies General Principles § 553.202 Limitations. The application of sections... organization engaged in furnishing fire protection or law enforcement services. This is so even if the services...

State laws related to billing third parties for healthcare services at public STD clinics in the United States.

PubMed

Cramer, Ryan; Loosier, Penny S; Krasner, Andee; Kawatu, Jennifer

2018-02-07

Health departments (HDs) cite state laws as barriers to billing third parties for sexually transmitted disease (STD) services, but the association between legal/policy barriers and third party HD billing has not been examined. This study investigates the relationship between laws that may limit HDs' ability to bill, clinic perceptions of billing barriers, and billing practices. Two surveys (1) clinic managers [N=246], 2) STD program managers [N=63]) conducted via a multi-regional needs assessment of federally funded HD clinics' capacity to bill for STD services, billing/reimbursement practices, and perceived barriers were combined with an analysis of state laws regarding third party billing for STD services. Statistical analyses examined relationships between laws that may limit HDs' ability to bill, clinic perceptions, and billing practices. Clinic managers reported clinics were less likely to bill Medicaid and other third parties in jurisdictions with a state law limiting their ability to bill compared to respondents who billed neither or one payer (OR=0.31, CI=0.10,0.97) and cited practical concerns as a primary barrier to billing (OR=2.83 CI=1.50,5.37). STD program managers' reports that staff believed STD services should be free (OR=0.34, CI=0.13, 0.90) was associated with not billing (not sure versus no resistance to billing); confidentiality concerns was not a reported barrier to billing among either sample. Practical concerns and clinic staff beliefs that STD services should be free emerged as possible barriers to billing, and laws less so. Attempts to initiate HD billing for STD services may benefit from staff education as well as addressing perceived legal barriers and staff concerns.

Family Well-Being in a Participant-directed Autism Waiver Program: The Role of Relational Coordination

ERIC Educational Resources Information Center

Warfield, M. E.; Chiri, G.; Leutz, W. N.; Timberlake, M.

2014-01-01

Background: Massachusetts is one of a very limited number of states exclusively employing participant-direction to deliver autism waiver services to children. A crucial element of this waiver program is the work conducted by the state's Department of Developmental Services (DDS) staff and state-approved providers with waiver families to facilitate…

Medicaid program; modification of the Medicaid upper payment limit transition period for inpatient hospital services, outpatient hospital services, nursing facility services, intermediate care facility services for the mentally retarded, and clinic services. Final rule.

PubMed

2001-09-05

This final rule modifies the Medicaid upper payment (UPL) limit provisions by establishing a new transition period for States that submitted plan amendments before March 13, 2001 that do not comply with the new UPLs effective on that date (but do comply with the prior UPLs) and were approved on or after January 22, 2001. This new transition period applies to payments for inpatient hospital services, outpatient hospital services, nursing facility services, intermediate care facility services for the mentally retarded, and clinic services.

Impediments to State Cost Saving Initiatives Under Medicaid.

DTIC Science & Technology

1981-07-29

limiting (1) nonprescription drugs, (2) nonemergency dental care for people over 21, (3) podiatry services, and (4) eye examinations and eye- glasses...nonprescription drugs, dental, optometric, and podiatry services, because the State agency had not provided ada- quate and timely notice to recipients of

75 FR 16325 - Child and Adult Care Food Program: At-Risk Afterschool Meals in Eligible States

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-01

... impose limits on the duration of meal services and the time between meal services. The proposed rule did... seven States eligible at that time ranged from 2 to 8 percent higher than afterschool meals served by...)(1), (c)(2), or (c)(3). (m) Time periods for snack and meal services--(1) At-risk afterschool snacks...

HIV Testing and HIV/AIDS Treatment Services in Rural Counties in 10 Southern States: Service Provider Perspectives

ERIC Educational Resources Information Center

Sutton, Madeline; Anthony, Monique-Nicole; Vila, Christie; McLellan-Lemal, Eleanor; Weidle, Paul J.

2010-01-01

Context: Forty percent of AIDS cases are reported in the southern United States, the region with the largest proportion of HIV/AIDS cases from rural areas. Data are limited regarding provider perspectives of the accessibility and availability of HIV testing and treatment services in southern rural counties. Purpose: We surveyed providers in the…

Children's mental-health language access laws: state factors influence policy adoption.

PubMed

Schmeida, Mary; McNeal, Ramona

2013-09-01

Despite federal legislation to equalize healthcare for children with limited English language proficiency, some state healthcare agencies and programs fall short in providing children's linguistic services for mental healthcare. While some states have been aggressive in passing cultural and linguistic laws aimed at providing protection for children, other states have not, limiting children of all ages to potential substandard care. This research uses state-level data and multivariate regression analysis to explore why some states are adopting these laws, whereas others are not. We find two dissimilar forces with unrelated goals must work in tandem to bring about policy change-the desire of civil rights and liberty groups to ensure equality in the delivery of healthcare services, and the desire of state legislature to reduce healthcare costs.

Access to hospital interpreter services for limited English proficient patients in New Jersey: a statewide evaluation.

PubMed

Flores, Glenn; Torres, Sylvia; Holmes, Linda Janet; Salas-Lopez, Debbie; Youdelman, Mara K; Tomany-Korman, Sandra C

2008-05-01

We surveyed New Jersey (NJ) hospitals to assess current language services and identify policy recommendations on meeting limited English proficiency (LEP) patients' needs. Survey with 37 questions regarding hospital/patient features, interpreter services, and resources/policies needed to provide quality interpreter services. Sixty-seven hospitals responded (55% response rate). Most NJ hospitals have no interpreter services department, 80% provide no staff training on working with interpreters, 31% lack multilingual signs, and 19% offer no written translation services. Only 3% of hospitals have full-time interpreters, a ratio of 1 interpreter:240,748 LEP NJ residents. Most hospitals stated third-party reimbursement for interpreters would be beneficial, by reducing costs, adding interpreters, meeting population growth, and improving communication. Most NJ hospitals have no full-time interpreters, interpreter services department, or staff training on working with interpreters, and deficiencies exist in hospital signage and translation services. Most NJ hospitals stated third-party reimbursement for interpreter services would be beneficial.

The impact of state behavioral health reform on Native American individuals, families, and communities.

PubMed

Willging, Cathleen E; Goodkind, Jessica; Lamphere, Louise; Saul, Gwendolyn; Fluder, Shannon; Seanez, Paula

2012-07-01

In 2005, the State of New Mexico undertook a sweeping transformation of all publicly funded behavioral health services. The reform was intended to enhance the cultural responsiveness and appropriateness of these services. To examine achievement of this objective, we conducted a qualitative study of the involvement of Native Americans in reform efforts and the subsequent impacts of reform on services for Native Americans. We found that the reform was relatively unsuccessful at creating mechanisms for genuine community input or improving behavioral health care for this population. These shortcomings were related to limited understandings of administrators concerning how tribal governments and health care systems operate, and the structural limitations of a managed care system that does not allow flexibility for culturally appropriate utilization review, screening, or treatment. However, interaction between the State and tribes increased, and we conclude that aspects of the reform could be strengthened to achieve more meaningful involvement and service improvements.

Caregiver stress: does states' expenditure on home- and community-based services matter?

PubMed

Hong, Michin; Casado, Banghwa Lee

2015-01-01

This study examined how state expenditure on home- and community-based services (HCBS) and individual factors are associated with caregiver stress. A total of 1,849 cases from the 2004 National Long-Term Care Survey were included. Gender, education, perceived physical strain, and economic hardship, as well as the number of limitations in instrumental activities of daily living (IADL) for the care recipient, were associated with caregiver stress. The cross-level interaction between service utilization and state expenditure on HCBS was significant, suggesting that living in states with a higher expenditure on HCBS is associated with reduced stress regardless of service utilization.

State Legislative Approach to Enumerating Behavioral Health Workforce Shortages: Lessons Learned in New Mexico.

PubMed

Altschul, Deborah B; Bonham, Caroline A; Faulkner, Martha J; Farnbach Pearson, Amy W; Reno, Jessica; Lindstrom, Wayne; Alonso-Marsden, Shelley M; Crisanti, Annette; Salvador, Julie G; Larson, Richard

2018-06-01

Nationally, the behavioral health workforce is in crisis because of a lack of resources, culturally responsive services, quality clinical supervision, sufficient training in evidence-based practices, and targeted recruitment and retention. Disparities in access to behavioral health care are particularly significant in New Mexico, where 25% of the population live in rural areas, and behavioral health shortages are among the highest in the nation. Additionally, as a Medicaid expansion state, New Mexico providers experience increased demand for services at a time when the state is challenged with limited workforce capacity. To address this issue, the Health Care Work Force Data Collection, Analysis and Policy Act was legislatively enacted in 2011 to systematically survey all state licensed health professionals to determine reasons for the healthcare shortage and address the shortage through policy. The Act was amended in 2012 to transfer all data to the University of New Mexico Health Sciences Center. In 2015, a total of 4,488 behavioral health providers completed a survey as a mandatory part of their license renewal. Findings from the survey indicate a dearth of licensed behavioral health providers representative of the populations served, limited access to services via Medicaid and Medicare payer sources, limited access to providers working in public health settings, and limited access to Health Information Technology. This paper describes the workforce context in New Mexico, the purpose of the legislation, the analytic findings from the survey, the policies implemented as a result of these efforts, lessons learned, and a discussion of the relevancy of the New Mexico model for other states. This article is part of a supplement entitled The Behavioral Health Workforce: Planning, Practice, and Preparation, which is sponsored by the Substance Abuse and Mental Health Services Administration and the Health Resources and Services Administration of the U.S. Department of Health and Human Services. Copyright © 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Recent changes in Medicaid policy and their possible effects on mental health services.

PubMed

Buck, Jeffrey A

2009-11-01

As Medicaid has emerged as the primary funder of public mental health services, its character has affected the organization and delivery of such services. Recent changes to the program, however, promise to further affect the direction of changes in states' mental health service systems. One group of changes will further limit the flexibility of Medicaid mental health funding, while increasing provider accountability and the authority of state Medicaid agencies. Others will increase incentives for deinstitutionalization and community-based care and promote person-centered treatment principles. These changes will likely affect state mental health systems, mental health providers, and the nature of service delivery.

Impact of Medicaid Managed Care on Illinois's Acute Health Services Expenditures for Adults with Intellectual and Developmental Disabilities

ERIC Educational Resources Information Center

Yamaki, Kiyoshi; Wing, Coady; Mitchell, Dale; Owen, Randall; Heller, Tamar

2018-01-01

States have increasingly transitioned Medicaid enrollees with disabilities from fee-for-service (FFS) to Medicaid Managed Care (MMC), intending to reduce state Medicaid spending and to provide better access to health services. Yet, previous studies on the impact of MMC are limited and findings are inconsistent. We analyzed the impact of MMC on…

Night Owl: Maryland's After-Hours Reference Service.

ERIC Educational Resources Information Center

Duke, Deborah C.

1994-01-01

Discusses "Night Owl," a Maryland public library's after hours telephone reference service. Issues include project start-up, user profiles, types of questions, volume, after hours reference accessibility, security, costs, service limits, publicity, staffing, and employee turnover. Similar services in other states are cited. (Contains six…

Universal Service Brings Fiber to Their Doorsteps.

ERIC Educational Resources Information Center

Vedro, Steven

1996-01-01

In a time of fiscal belt tightening, many states will hesitate to launch new multimillion-dollar distance education network projects. Instead they will concentrate on regulatory initiatives to stimulate the development of affordable advanced universal service by the private sector. Discusses the limitations of state regulatory strategies in the…

Assessing early implementation of state autism insurance mandates.

PubMed

Baller, Julia Berlin; Barry, Colleen L; Shea, Kathleen; Walker, Megan M; Ouellette, Rachel; Mandell, David S

2016-10-01

In the United States, health insurance coverage for autism spectrum disorder treatments has been historically limited. In response, as of 2015, 40 states and Washington, DC, have passed state autism insurance mandates requiring many health plans in the private insurance market to cover autism diagnostic and treatment services. This study examined five states' experiences implementing autism insurance mandates. Semi-structured, key-informant interviews were conducted with 17 participants representing consumer advocacy organizations, provider organizations, and health insurance companies. Overall, participants thought that the mandates substantially affected the delivery of autism services. While access to autism treatment services has increased as a result of implementation of state mandates, states have struggled to keep up with the demand for services. Participants provided specific information about barriers and facilitators to meeting this demand. Understanding of key informants' perceptions about states' experiences implementing autism insurance mandates is useful for other states considering adopting or expanding mandates or other policies to expand access to autism treatment services. © The Author(s) 2015.

7 CFR 1780.10 - Limitations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... median household income of the service area is below the higher of the poverty line or 80% of the state...) Pay any costs of a project when the median household income of the service area is more than 100 percent of the nonmetropolitan median household income of the State; (3) Pay project costs when other loan...

Cost Behavior Analysis for Planning in Higher Education. NACUBO Professional File, Volume 9, Number 5.

ERIC Educational Resources Information Center

Robinson, Daniel D.; And Others

Higher Education has experienced limited growth in recent years. Institutions, state commissions on higher education, and legislatures are faced with the prospect of providing educational services under steady-state conditions. Decisionmakers need to consider alternative means of providing educational services within resources available to the…

The Tax Limitation Movement of the 1970's: A National Perspective [Chapter Two].

ERIC Educational Resources Information Center

Benson, Charles S.; Weinstock, Phyllis

This analysis is the second of a series of seven reports on the ways that the urban fiscal crisis has affected children. During the 1970s, as a result of general public disenchantment with government, 39 states (78 percent of the 50 states) appear to have enacted tax limitations that affected children's services. Of these states, 37 imposed…

45 CFR 95.1 - Scope.

Code of Federal Regulations, 2014 CFR

2014-10-01

... of Health and Human Services GENERAL ADMINISTRATION GENERAL ADMINISTRATION-GRANT PROGRAMS (PUBLIC ASSISTANCE, MEDICAL ASSISTANCE AND STATE CHILDREN'S HEALTH INSURANCE PROGRAMS) Time Limits for States To File... State to claim Federal financial participation in expenditures under State plans approved under the...

45 CFR 95.1 - Scope.

Code of Federal Regulations, 2010 CFR

2010-10-01

... OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION GENERAL ADMINISTRATION-GRANT PROGRAMS (PUBLIC ASSISTANCE, MEDICAL ASSISTANCE AND STATE CHILDREN'S HEALTH INSURANCE PROGRAMS) Time Limits for States To File... State to claim Federal financial participation in expenditures under State plans approved under the...

45 CFR 95.1 - Scope.

Code of Federal Regulations, 2011 CFR

2011-10-01

... OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION GENERAL ADMINISTRATION-GRANT PROGRAMS (PUBLIC ASSISTANCE, MEDICAL ASSISTANCE AND STATE CHILDREN'S HEALTH INSURANCE PROGRAMS) Time Limits for States To File... State to claim Federal financial participation in expenditures under State plans approved under the...

45 CFR 95.1 - Scope.

Code of Federal Regulations, 2012 CFR

2012-10-01

... OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION GENERAL ADMINISTRATION-GRANT PROGRAMS (PUBLIC ASSISTANCE, MEDICAL ASSISTANCE AND STATE CHILDREN'S HEALTH INSURANCE PROGRAMS) Time Limits for States To File... State to claim Federal financial participation in expenditures under State plans approved under the...

45 CFR 95.1 - Scope.

Code of Federal Regulations, 2013 CFR

2013-10-01

... OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION GENERAL ADMINISTRATION-GRANT PROGRAMS (PUBLIC ASSISTANCE, MEDICAL ASSISTANCE AND STATE CHILDREN'S HEALTH INSURANCE PROGRAMS) Time Limits for States To File... State to claim Federal financial participation in expenditures under State plans approved under the...

Neighborhood scale quantification of ecosystem goods and services

EPA Science Inventory

Ecosystem goods and services are those ecological structures and functions that humans can directly relate to their state of well-being. Ecosystem goods and services include, but are not limited to, a sufficient fresh water supply, fertile lands to produce agricultural products, ...

The Impact of State Behavioral Health Reform on Native American Individuals, Families, and Communities

PubMed Central

Willging, Cathleen E.; Goodkind, Jessica; Lamphere, Louise; Saul, Gwendolyn; Fluder, Shannon; Seanez, Paula

2012-01-01

In 2005, the State of New Mexico undertook a sweeping transformation of all publicly funded behavioral health services. The reform was intended to enhance the cultural responsiveness and appropriateness of these services. To examine achievement of this objective, we conducted a qualitative study of the involvement of Native Americans in reform efforts and the subsequent impacts of reform on services for Native Americans. We found that the reform was relatively unsuccessful at creating mechanisms for genuine community input or improving behavioral health care for this population. These shortcomings were related to limited understandings of administrators concerning how tribal governments and health care systems operate, and the structural limitations of a managed care system that does not allow flexibility for culturally appropriate utilization review, screening, or treatment. However, interaction between the State and tribes increased, and we conclude that aspects of the reform could be strengthened to achieve more meaningful involvement and service improvements. PMID:22427455

7 CFR 1751.102 - Modernization Plan Developer; eligibility.

Code of Federal Regulations, 2010 CFR

2010-01-01

... SERVICE, DEPARTMENT OF AGRICULTURE TELECOMMUNICATIONS SYSTEM PLANNING AND DESIGN CRITERIA, AND PROCEDURES... services and interested parties in the State. (2) There is no time limit placed on Borrowers to develop a...

Putting It Together: A Guide to Financing Comprehensive Services in Child Care and Early Education

ERIC Educational Resources Information Center

Johnson-Staub, Christine

2012-01-01

This guide aims to help states look beyond the major sources of child care and early education funding and consider alternative federal financing sources to bring comprehensive services into early childhood settings. Why? Because the sources of child care funding historically available to states have limited supply and allowable uses, and…

Identifying National Availability of Abortion Care and Distance From Major US Cities: Systematic Online Search.

PubMed

Cartwright, Alice F; Karunaratne, Mihiri; Barr-Walker, Jill; Johns, Nicole E; Upadhyay, Ushma D

2018-05-14

Abortion is a common medical procedure, yet its availability has become more limited across the United States over the past decade. Women who do not know where to go for abortion care may use the internet to find abortion facility information, and there appears to be more online searches for abortion in states with more restrictive abortion laws. While previous studies have examined the distances women must travel to reach an abortion provider, to our knowledge no studies have used a systematic online search to document the geographic locations and services of abortion facilities. The objective of our study was to describe abortion facilities and services available in the United States from the perspective of a potential patient searching online and to identify US cities where people must travel the farthest to obtain abortion care. In early 2017, we conducted a systematic online search for abortion facilities in every state and the largest cities in each state. We recorded facility locations, types of abortion services available, and facility gestational limits. We then summarized the frequencies by region and state. If the online information was incomplete or unclear, we called the facility using a mystery shopper method, which simulates the perspective of patients calling for services. We also calculated distance to the closest abortion facility from all US cities with populations of 50,000 or more. We identified 780 facilities through our online search, with the fewest in the Midwest and South. Over 30% (236/780, 30.3%) of all facilities advertised the provision of medication abortion services only; this proportion was close to 40% in the Northeast (89/233, 38.2%) and West (104/262, 39.7%). The lowest gestational limit at which services were provided was 12 weeks in Wyoming; the highest was 28 weeks in New Mexico. People in 27 US cities must travel over 100 miles (160 km) to reach an abortion facility; the state with the largest number of such cities is Texas (n=10). Online searches can provide detailed information about the location of abortion facilities and the types of services they provide. However, these facilities are not evenly distributed geographically, and many large US cities do not have an abortion facility. Long distances can push women to seek abortion in later gestations when care is even more limited. ©Alice F Cartwright, Mihiri Karunaratne, Jill Barr-Walker, Nicole E Johns, Ushma D Upadhyay. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 14.05.2018.

20 CFR 655.640 - Service and computation of time.

Code of Federal Regulations, 2010 CFR

2010-04-01

... EMPLOYMENT OF FOREIGN WORKERS IN THE UNITED STATES Enforcement of the Limitations Imposed on Employers Using... where service is by mail. In the interest of expeditious proceedings, the administrative law judge may...

75 FR 40765 - Hours of Service; Limited Exemption for the Distribution of Anhydrous Ammonia in Agricultural...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-14

... No. FMCSA-2010-0230] Hours of Service; Limited Exemption for the Distribution of Anhydrous Ammonia in... ammonia from any distribution point to a local farm retailer or to the ultimate consumer, and from a local... anhydrous ammonia during the planting and harvesting seasons, as defined by the States in which the carriers...

Using Video to Support In-Service Teacher Professional Development: The State of the Field, Limitations and Possibilities

ERIC Educational Resources Information Center

Major, Louis; Watson, Steven

2018-01-01

Video is increasingly used to support in-service teacher professional development (TPD). Advances in affordability and usability of technology mean that interest is set to develop further. Studies in this area are diverse in terms of scale, methodology and context. This places limitations on undertaking a systematic review; therefore the authors…

Barriers to Abortion Care and Their Consequences For Patients Traveling for Services: Qualitative Findings from Two States

PubMed Central

Jerman, Jenna; Frohwirth, Lori; Kavanaugh, Megan L.; Blades, Nakeisha

2018-01-01

CONTEXT Abortion availability and accessibility vary by state. Especially in areas where services are restricted or limited, some women travel to obtain abortion services in other states. Little is known about the experience of travel to obtain abortion. METHODS In January and February 2015, in-depth interviews were conducted with 29 patients seeking abortion services at six facilities in Michigan and New Mexico. Eligible women were 18 or older, spoke English, and had traveled either across state lines or more than 100 miles within the state. Respondents were asked to describe their experience from pregnancy discovery to the day of the abortion procedure. Barriers to accessing abortion care and consequences of these barriers were identified through inductive and deductive analysis. RESULTS Respondents described 15 barriers to abortion care while traveling to obtain services, and three major consequences of experiencing those barriers. Barriers were grouped into five categories: travel-related logistical issues, system navigation issues, limited clinic options, financial issues, and state or clinic restrictions. Consequences were delays in care, negative mental health impacts and considering self-induction. The experience of barriers complicated the process of obtaining an abortion, but the effect of any individual barrier was unclear. Instead, the experience of multiple barriers appeared to have a compounding effect, resulting in negative consequences for women traveling for abortion. CONCLUSION The amalgamation of barriers to abortion care experienced simultaneously can have significant consequences for patients. PMID:28394463

State-of-the-Art Resources (SOAR) for Software Vulnerability Detection, Test, and Evaluation

DTIC Science & Technology

2014-07-01

preclude in-depth analysis, and widespread use of a Software -as-a- Service ( SaaS ) model that limits data availability and application to DoD systems...provide mobile application analysis using a Software - as-a- Service ( SaaS ) model. In this case, any software to be analyzed must be sent to the...tools are only available through a SaaS model. The widespread use of a Software -as-a- Service ( SaaS ) model as a sole evaluation model limits data

Summary - National Dissemination and the Five Target States, Part 3, Final Report for Phase II--Dissemination, Rural Shared Services.

ERIC Educational Resources Information Center

Northern Montana Coll., Havre.

The dissemination phase (Phase II) of the Rural Shared Services Project is reported in this document. Efforts of the dissemination phase were concentrated in 5 target states: Vermont, Georgia, Wyoming, Montana, and New Mexico; national dissemination was limited to attendance at national conferences, the U. S. Office of Education PREP materials for…

Functional Limitations of Vocational Rehabilitation (VR) Consumers Final Report

ERIC Educational Resources Information Center

Overman, Beth; Schmidt-Davis, Holly

2006-01-01

In response to a request from the Rehabilitation Services Administration (RSA), the Research Triangle Institute (RTI) conducted a study to examine the feasibility of developing functional status measures for planning and implementing services to consumers in the State-Federal Vocational Rehabilitation (VR) Services Program. To investigate this…

NCSU Food Service Survey Report.

ERIC Educational Resources Information Center

Gracie, Larry W.

Student perception of food service facilities at North Carolina State University was surveyed in 1977. Of 1,100 randomly selected residence hall students, 799 responses were obtained. Respondents were asked to evaluate food service facilities and to report their eating habits. Study was limited to eating habits in their rooms, in campus…

Financial Management Regulation. Volume 7B. Military Pay Policy and Procedures for Retired Pay

DTIC Science & Technology

1995-06-01

3) Enlisted members are authorized to count double time for service beyond the continental limits of the United States between 1898 and 1912 while...and made a part of the Regular Army. a. The total number of enlisted men was limited to 12,000 voluntary enlisted natives of the Philippine Islands...not on promotion list. 12. Not on promotion list. Retirement subject to completion of 5 years’ service in grade. 13. Designated for limited duty

24 CFR 3280.2 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-04-01

... engineering or architecture in a state and subject to all laws and limitations imposed by the state's Board of Engineering and Architecture Examiners and who is engaged in the professional practice of rendering service or...

24 CFR 3280.2 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-04-01

... engineering or architecture in a state and subject to all laws and limitations imposed by the state's Board of Engineering and Architecture Examiners and who is engaged in the professional practice of rendering service or...

24 CFR 3280.2 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-04-01

... engineering or architecture in a state and subject to all laws and limitations imposed by the state's Board of Engineering and Architecture Examiners and who is engaged in the professional practice of rendering service or...

Development of a state-wide pediatric palliative care service in Australia: referral and outcomes over two years.

PubMed

Herbert, Anthony; Bradford, Natalie; Donovan, Leigh; Pedersen, Lee-Anne; Irving, Helen

2014-03-01

Pediatric palliative care is an evolving specialty that aims to improve the lives of children with a life-limiting condition. As an emerging specialty, there is much to be learned about service provision and the expected outcomes that can be achieved. Additionally, quantification of the needs for pediatric palliative care is complicated by the uncertainty of defining the population that requires care. Our aim was to define the characteristics of the population cared for by a newly formed state-wide service in Queensland, Australia, and describe the development of the service over a 24-month period. Data on all referrals and outcomes were collected. Descriptive statistics were used to describe patterns including the variation in outcomes between children with oncology and non-oncology diagnoses. Other factors influencing the development of the service including involved health professionals and the model of the Australian health care system are also described. Over a 24-month period, 150 patients were referred of whom 117 subsequently died. There was a wide range of diseases and ages, and significantly, 58% of children were from regional or rural locations where there are can be limited access to specialist pediatric services. The average length of service was 83 days. A variety of factors were identified as being important for providing optimal care including ensuring equity in access, timing of referral, and continuity of care. The importance of a population-based approach to pediatric palliative care in a state that is geographically large and diverse like Queensland is highlighted. This article may provide valuable information to other health care providers who care for children with life-limiting illnesses.

Assessing Early Implementation of State Autism Insurance Mandates

ERIC Educational Resources Information Center

Baller, Julia Berlin; Barry, Colleen L.; Shea, Kathleen; Walker, Megan M.; Ouellette, Rachel; Mandell, David S.

2016-01-01

In the United States, health insurance coverage for autism spectrum disorder treatments has been historically limited. In response, as of 2015, 40 states and Washington, DC, have passed state autism insurance mandates requiring many health plans in the private insurance market to cover autism diagnostic and treatment services. This study examined…

Services to Children and the Urban Fiscal Crisis: A Comparison of Experiences Among States and Localities. A Report to the U.S. National Institute of Education.

ERIC Educational Resources Information Center

Medrich, Elliot A.; Rubin, Victor

This collection of seven reports explores the changes in children's services that have been brought about by efforts to limit local spending and taxation, and by unfavorable economic changes. The four states chosen for analysis--California, Massachusetts, Michigan, and New Jersey--represent contrasting economic circumstances and several different…

Overcoming Medicaid Reimbursement Barriers to Funding School Nursing Services for Low-Income Children with Asthma

ERIC Educational Resources Information Center

Malcarney, Mary-Beth; Horton, Katherine; Seiler, Naomi

2016-01-01

Background: School nurses can provide direct services for children with asthma, educate, and reinforce treatment recommendations to children and their families, and coordinate the school-wide response to students' asthma emergencies. Unfortunately, school-based health services today depend on an unreliable patchwork of funding. Limited state and…

Canadian and U.S. Systems of Care for the Mentally Ill Elderly.

ERIC Educational Resources Information Center

Liptzin, Benjamin

1984-01-01

Compares the United States and Canada in the funding and organization of psychiatric services for the elderly. Acute hospital, medical, and nursing home services are more accessible in Canada because of universal health insurance, but in both countries, services are limited by the small number of professionals. (JAC)

Limits on same-day billing in Medicaid hinders integration of behavioral health into the medical home model.

PubMed

Roby, Dylan H; Jones, Erynne E

2016-02-01

The potential expansion of insurance coverage through the Patient Protection and Affordable Care Act of 2010 can facilitate the reduction of access barriers and improved quality for behavioral health care. More than 5 million of the newly insured are expected to have mental health and substance use disorders. In addition, state and federal efforts to integrate behavioral and medical health needs through patient-centered medical home models and innovations in payment strategies provide an unprecedented opportunity to use federal financial support to improve not only access to care, but also improve quality through active care coordination, use of interdisciplinary teams, colocating services, and engaging in warm hand-offs between providers in the same setting. These potential advances are hindered in 24 different states because of Medicaid payment policy, with 7 explicitly limiting the ability to reimburse for physical health and behavioral health services on the same day for all providers. Without the ability for providers to be reimbursed for different services on the same day to improve behavioral and medical health care coordination, these states could be limited in their ability to improve care via patient-centered approaches and interdisciplinary team-based care that would involve physicians, clinical psychologists, psychiatrists, and other mental health professionals. Limits on same-day billing in Medicaid programs could impact up to 36.7 million people in 24 states, which is approximately 52.6% of all Medicaid enrollees. (c) 2016 APA, all rights reserved).

Barriers to Abortion Care and Their Consequences For Patients Traveling for Services: Qualitative Findings from Two States.

PubMed

Jerman, Jenna; Frohwirth, Lori; Kavanaugh, Megan L; Blades, Nakeisha

2017-06-01

Abortion availability and accessibility vary by state. Especially in areas where services are restricted or limited, some women travel to obtain abortion services in other states. Little is known about the experience of travel to obtain abortion. In January and February 2015, in-depth interviews were conducted with 29 patients seeking abortion services at six facilities in Michigan and New Mexico. Eligible women were 18 or older, spoke English, and had traveled either across state lines or more than 100 miles within the state. Respondents were asked to describe their experience from pregnancy discovery to the day of the abortion procedure. Barriers to accessing abortion care and consequences of these barriers were identified through inductive and deductive analysis. Respondents described 15 barriers to abortion care while traveling to obtain services, and three major consequences of experiencing those barriers. Barriers were grouped into five categories: travel-related logistical issues, system navigation issues, limited clinic options, financial issues, and state or clinic restrictions. Consequences were delays in care, negative mental health impacts and considering self-induction. The experience of barriers complicated the process of obtaining an abortion, but the effect of any individual barrier was unclear. Instead, the experience of multiple barriers appeared to have a compounding effect, resulting in negative consequences for women traveling for abortion. The amalgamation of barriers to abortion care experienced simultaneously can have significant consequences for patients. © 2017 The Authors. Perspectives on Sexual and Reproductive Health published by Wiley Periodicals, Inc., on behalf of the Guttmacher Institute.

Tobacco cessation among users of telephone and web-based interventions--four states, 2011-2012.

PubMed

Puckett, Mary; Neri, Antonio; Thompson, Trevor; Underwood, J Michael; Momin, Behnoosh; Kahende, Jennifer; Zhang, Lei; Stewart, Sherri L

2015-01-02

Smoking caused an average of 480,000 deaths per year in the United States from 2005 to 2009, and three in 10 cancer deaths in the United States are tobacco related. Tobacco cessation is a high public health priority, and all states offer some form of tobacco cessation service. Quitlines provide telephone-based counseling services and are an effective intervention for tobacco cessation. In addition to telephone services, 96% of all U.S. quitlines offer Web-based cessation services. Evidence is limited on the number of tobacco users who use more than one type of service, and studies report mixed results on whether combined telephone and Web-based counseling improves long-term cessation compared with telephone alone. CDC conducted a survey of users of telephone and Web-based cessation services in four states to determine the cessation success of users of these interventions. After adjusting for multiple variables, persons who used both telephone and Web-based services were more likely to report abstinence from smoking for 30 days at follow up (odds ratio = 1.3) compared with telephone-only users and with Web-only users (odds ratio = 1.5). These findings suggest that states might consider offering both types of cessation services to increase cessation success.

Use of physical therapy services among middle-aged and older adults with multiple sclerosis.

PubMed

Finlayson, Marcia; Plow, Matthew; Cho, Chi

2010-11-01

There is limited understanding of the utilization of and perceived need for physical therapy services among middle-aged and older adults with multiple sclerosis (MS). The resulting knowledge gap compromises efforts for physical therapy service planning for this population. The purpose of this study was to examine the use of and need for physical therapy services in a sample of adults with MS living in the Midwestern United States. This was a cross-sectional, descriptive study. Data from telephone interviews with 1,065 people with MS, aged 45 to 90 years, were used for the study. A multinomial regression model was used to determine factors associated with use of physical therapy services (never, within the past year, more than a year ago). Logistic regression analysis examined factors associated with unmet needs for these services. Thirty-six percent of the sample reported never using physical therapy services, 33% reported using physical therapy services within the past year, and 31% reported using physical therapy services more than a year prior to the interview. Factors associated with recent use of physical therapy services included living in an urban or suburban community, deteriorating MS status, experiencing problems with spasticity (ie, hypertonicity), having difficulty moving inside the house, being hospitalized in the past 6 months, and seeing a family physician. These same factors were associated with unmet needs. Limitations Physical therapy service use was self-reported. Data were collected in 5 Midwestern states from people 45 years of age or older, which may limit generalizability. Factors associated with use of and need for physical therapy services reflect issues of access (geographical, referrals), MS status, and mobility difficulties.

Statewide Hospital Discharge Data: Collection, Use, Limitations, and Improvements.

PubMed

Andrews, Roxanne M

2015-08-01

To provide an overview of statewide hospital discharge databases (HDD), including their uses in health services research and limitations, and to describe Agency for Healthcare Research and Quality (AHRQ) Enhanced State Data grants to address clinical and race-ethnicity data limitations. Almost all states have statewide HDD collected by public or private data organizations. Statewide HDD, based on the hospital claim with state variations, contain useful core variables and require minimal collection burden. AHRQ's Healthcare Cost and Utilization Project builds uniform state and national research files using statewide HDD. States, hospitals, and researchers use statewide HDD for many purposes. Illustrating researchers' use, during 2012-2014, HSR published 26 HDD-based articles on health policy, access, quality, clinical aspects of care, race-ethnicity and insurance impacts, economics, financing, and research methods. HDD have limitations affecting their use. Five AHRQ grants focused on enhancing clinical data and three grants aimed at improving race-ethnicity data. ICD-10 implementation will significantly affect the HDD. The AHRQ grants, information technology advances, payment policy changes, and the need for outpatient information may stimulate other statewide HDD changes. To remain a mainstay of health services research, statewide HDD need to keep pace with changing user needs while minimizing collection burdens. © Health Research and Educational Trust.

Statewide Hospital Discharge Data: Collection, Use, Limitations, and Improvements

PubMed Central

Andrews, Roxanne M

2015-01-01

Objectives To provide an overview of statewide hospital discharge databases (HDD), including their uses in health services research and limitations, and to describe Agency for Healthcare Research and Quality (AHRQ) Enhanced State Data grants to address clinical and race–ethnicity data limitations. Principal Findings Almost all states have statewide HDD collected by public or private data organizations. Statewide HDD, based on the hospital claim with state variations, contain useful core variables and require minimal collection burden. AHRQ’s Healthcare Cost and Utilization Project builds uniform state and national research files using statewide HDD. States, hospitals, and researchers use statewide HDD for many purposes. Illustrating researchers’ use, during 2012–2014, HSR published 26 HDD-based articles on health policy, access, quality, clinical aspects of care, race–ethnicity and insurance impacts, economics, financing, and research methods. HDD have limitations affecting their use. Five AHRQ grants focused on enhancing clinical data and three grants aimed at improving race–ethnicity data. Conclusion ICD-10 implementation will significantly affect the HDD. The AHRQ grants, information technology advances, payment policy changes, and the need for outpatient information may stimulate other statewide HDD changes. To remain a mainstay of health services research, statewide HDD need to keep pace with changing user needs while minimizing collection burdens. PMID:26150118

Policy reform dilemmas in promoting employment of persons with severe mental illness.

PubMed

Noble, J H

1998-06-01

Recent evaluations by the U.S. General Accounting Office and the National Alliance for the Mentally Ill of reemployment efforts of the federal-state vocational rehabilitation program found that services offered by state vocational rehabilitation agencies do not produce long-term earnings for clients with emotional or physical disabilities. This paper examines reasons for these poor outcomes and the implications of recent policy reform recommendations. Congress must decide whether to take action at the federal level to upgrade programs affecting persons with severe mental illnesses or to continue to rely on state decision making. The federal-state program largely wastes an estimated $490 million annually on time-limited services to consumers with mental illnesses. Rechanneled into a variety of innovative and more appropriate integrated services models, the money could buy stable annual vocational rehabilitation funding for 62,000 to 90,000 consumers with severe mental illnesses. Larger macrosystem problems involve the dynamics of the labor market that limit job opportunities and the powerful work disincentives for consumers with severe disabilities now inherent in Social Security Disability Insurance, Supplemental Security Income, Medicare, and Medicaid.

47 CFR 54.501 - Eligibility for services provided by telecommunications carriers.

Code of Federal Regulations, 2013 CFR

2013-10-01

... schools, colleges, and universities) shall be eligible for discounts as libraries under this subpart. (3..., but not limited to, state colleges and state universities, state educational broadcasters, counties.... With one exception, eligible schools and libraries participating in consortia with ineligible private...

26 CFR 1.904(i)-1 - Limitation on use of deconsolidation to avoid foreign tax credit limitations.

Code of Federal Regulations, 2010 CFR

2010-04-01

... foreign tax credit limitations. 1.904(i)-1 Section 1.904(i)-1 Internal Revenue INTERNAL REVENUE SERVICE... United States § 1.904(i)-1 Limitation on use of deconsolidation to avoid foreign tax credit limitations... applying the foreign tax credit provisions of section 59(a), sections 901 through 908, and section 960, the...

42 CFR 441.462 - Statewideness, comparability and limitations on number served.

Code of Federal Regulations, 2012 CFR

2012-10-01

... number served. 441.462 Section 441.462 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT....462 Statewideness, comparability and limitations on number served. A State may do the following: (a) Provide self-directed PAS without regard to the requirements of statewideness. (b) Limit the population...

42 CFR 441.462 - Statewideness, comparability and limitations on number served.

Code of Federal Regulations, 2011 CFR

2011-10-01

... number served. 441.462 Section 441.462 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT....462 Statewideness, comparability and limitations on number served. A State may do the following: (a) Provide self-directed PAS without regard to the requirements of statewideness. (b) Limit the population...

42 CFR 441.462 - Statewideness, comparability and limitations on number served.

Code of Federal Regulations, 2014 CFR

2014-10-01

... number served. 441.462 Section 441.462 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT....462 Statewideness, comparability and limitations on number served. A State may do the following: (a) Provide self-directed PAS without regard to the requirements of statewideness. (b) Limit the population...

42 CFR 441.462 - Statewideness, comparability and limitations on number served.

Code of Federal Regulations, 2013 CFR

2013-10-01

... number served. 441.462 Section 441.462 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT....462 Statewideness, comparability and limitations on number served. A State may do the following: (a) Provide self-directed PAS without regard to the requirements of statewideness. (b) Limit the population...

50 CFR 38.13 - Speed limits.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 50 Wildlife and Fisheries 8 2011-10-01 2011-10-01 false Speed limits. 38.13 Section 38.13 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR (CONTINUED) THE NATIONAL WILDLIFE REFUGE SYSTEM MIDWAY ATOLL NATIONAL WILDLIFE REFUGE Prohibitions § 38.13 Speed limits. No...

50 CFR 38.13 - Speed limits.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 50 Wildlife and Fisheries 9 2013-10-01 2013-10-01 false Speed limits. 38.13 Section 38.13 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR (CONTINUED) THE NATIONAL WILDLIFE REFUGE SYSTEM MIDWAY ATOLL NATIONAL WILDLIFE REFUGE Prohibitions § 38.13 Speed limits. No...

50 CFR 38.13 - Speed limits.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 50 Wildlife and Fisheries 9 2014-10-01 2014-10-01 false Speed limits. 38.13 Section 38.13 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR (CONTINUED) THE NATIONAL WILDLIFE REFUGE SYSTEM MIDWAY ATOLL NATIONAL WILDLIFE REFUGE Prohibitions § 38.13 Speed limits. No...

50 CFR 38.13 - Speed limits.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 50 Wildlife and Fisheries 9 2012-10-01 2012-10-01 false Speed limits. 38.13 Section 38.13 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR (CONTINUED) THE NATIONAL WILDLIFE REFUGE SYSTEM MIDWAY ATOLL NATIONAL WILDLIFE REFUGE Prohibitions § 38.13 Speed limits. No...

42 CFR 441.462 - Statewideness, comparability and limitations on number served.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Statewideness, comparability and limitations on....462 Statewideness, comparability and limitations on number served. A State may do the following: (a... eligible to receive these services without regard to comparability of amount, duration, and scope of...

78 FR 63406 - Fisheries of the Northeastern United States; Atlantic Herring Fishery; Sub-Annual Catch Limit...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-24

...-Annual Catch Limit (ACL) Harvested for Management Area 3 AGENCY: National Marine Fisheries Service (NMFS... the overfishing limit, acceptable biological catch, annual catch limit (ACL), optimum yield, domestic.... The 2013 Domestic Annual Harvest is 107,800 metric tons (mt); the 2013 sub-ACL allocated to Area 3 is...

The New York State Mentoring Program.

ERIC Educational Resources Information Center

Cuomo, Matilda R.

This conference address discusses New York State programs for children and families, focusing on a mentoring program. New York State has 44 rural counties, which comprise 80% of the state's total area. Rural schools face limited financial resources and access to services. Rural school children are more likely to face failure than urban or suburban…

45 CFR 400.210 - Time limits for obligating and expending funds and for filing State claims.

Code of Federal Regulations, 2010 CFR

2010-10-01

... the funds. (2) A State's final financial report on expenditures of CMA grants, including CMA.... A State's final financial report on expenditures of social services and targeted assistance grants..., if a State's final financial expenditure report has not been received, the Department will deobligate...

7 CFR 319.73-1 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Regulations of the Department of Agriculture (Continued) ANIMAL AND PLANT HEALTH INSPECTION SERVICE... Administrator of the Animal and Plant Health Inspection Service, United States Department of Agriculture, or any... for commercial resale. Intended use includes, but is not limited to, evaluation, testing, or market...

7 CFR 319.73-1 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Regulations of the Department of Agriculture (Continued) ANIMAL AND PLANT HEALTH INSPECTION SERVICE... Administrator of the Animal and Plant Health Inspection Service, United States Department of Agriculture, or any... for commercial resale. Intended use includes, but is not limited to, evaluation, testing, or market...

7 CFR 319.73-1 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Regulations of the Department of Agriculture (Continued) ANIMAL AND PLANT HEALTH INSPECTION SERVICE... Administrator of the Animal and Plant Health Inspection Service, United States Department of Agriculture, or any... for commercial resale. Intended use includes, but is not limited to, evaluation, testing, or market...

7 CFR 319.73-1 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Regulations of the Department of Agriculture (Continued) ANIMAL AND PLANT HEALTH INSPECTION SERVICE... Administrator of the Animal and Plant Health Inspection Service, United States Department of Agriculture, or any... for commercial resale. Intended use includes, but is not limited to, evaluation, testing, or market...

7 CFR 319.73-1 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Regulations of the Department of Agriculture (Continued) ANIMAL AND PLANT HEALTH INSPECTION SERVICE... Administrator of the Animal and Plant Health Inspection Service, United States Department of Agriculture, or any... for commercial resale. Intended use includes, but is not limited to, evaluation, testing, or market...

45 CFR 46.301 - Applicability.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION PROTECTION OF HUMAN SUBJECTS... research conducted or supported by the Department of Health and Human Services involving prisoners as... is limited or barred by applicable State or local law. (c) The requirements of this subpart are in...

20 CFR 404.2114 - Services for which payment may be made.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Services for which payment may be made. (a) General. Payment may be made for VR services provided by a State VR agency in accordance with title I of the Rehabilitation Act of 1973, as amended, or by an alternate participant under a negotiated plan, subject to the limitations and conditions in this subpart. VR...

20 CFR 404.2114 - Services for which payment may be made.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Services for which payment may be made. (a) General. Payment may be made for VR services provided by a State VR agency in accordance with title I of the Rehabilitation Act of 1973, as amended, or by an alternate participant under a negotiated plan, subject to the limitations and conditions in this subpart. VR...

Access to Specialty Health Care for Rural American Indians in Two States

ERIC Educational Resources Information Center

Baldwin, Laura-Mae; Hollow, Walter B.; Casey, Susan; Hart, L. Gary; Larson, Eric H.; Moore, Kelly; Lewis, Ervin; Andrilla, C. Holly A.; Grossman, David C.

2008-01-01

Context: The Indian Health Service (IHS), whose per capita expenditure for American Indian and Alaska Native (AI/AN) health services is about half that of the US civilian population, is the only source of health care funding for many rural AI/ANs. Specialty services, largely funded through contracts with outside practitioners, may be limited by…

22 CFR 11.1 - Junior Foreign Service officer career candidate appointments.

Code of Federal Regulations, 2013 CFR

2013-04-01

... of the month in which the written examination was held. Time spent outside the United States and its... volunteer service, or required active regular or reserve military service (to a maximum of the limit of such...-order register 18 months after the date of placement on the rank-order register. Time spent in civilian...

22 CFR 11.1 - Junior Foreign Service officer career candidate appointments.

Code of Federal Regulations, 2012 CFR

2012-04-01

... of the month in which the written examination was held. Time spent outside the United States and its... volunteer service, or required active regular or reserve military service (to a maximum of the limit of such...-order register 18 months after the date of placement on the rank-order register. Time spent in civilian...

22 CFR 11.1 - Junior Foreign Service officer career candidate appointments.

Code of Federal Regulations, 2014 CFR

2014-04-01

... of the month in which the written examination was held. Time spent outside the United States and its... volunteer service, or required active regular or reserve military service (to a maximum of the limit of such...-order register 18 months after the date of placement on the rank-order register. Time spent in civilian...

22 CFR 11.1 - Junior Foreign Service officer career candidate appointments.

Code of Federal Regulations, 2011 CFR

2011-04-01

... of the month in which the written examination was held. Time spent outside the United States and its... volunteer service, or required active regular or reserve military service (to a maximum of the limit of such...-order register 18 months after the date of placement on the rank-order register. Time spent in civilian...

20 CFR 404.2114 - Services for which payment may be made.

Code of Federal Regulations, 2014 CFR

2014-04-01

... Services for which payment may be made. (a) General. Payment may be made for VR services provided by a State VR agency in accordance with title I of the Rehabilitation Act of 1973, as amended, or by an alternate participant under a negotiated plan, subject to the limitations and conditions in this subpart. VR...

20 CFR 404.2114 - Services for which payment may be made.

Code of Federal Regulations, 2012 CFR

2012-04-01

... Services for which payment may be made. (a) General. Payment may be made for VR services provided by a State VR agency in accordance with title I of the Rehabilitation Act of 1973, as amended, or by an alternate participant under a negotiated plan, subject to the limitations and conditions in this subpart. VR...

20 CFR 404.2114 - Services for which payment may be made.

Code of Federal Regulations, 2013 CFR

2013-04-01

... Services for which payment may be made. (a) General. Payment may be made for VR services provided by a State VR agency in accordance with title I of the Rehabilitation Act of 1973, as amended, or by an alternate participant under a negotiated plan, subject to the limitations and conditions in this subpart. VR...

Long Distance Relationships: Assessing the Library Service Needs of Rural Students in eLearning Courses

ERIC Educational Resources Information Center

Sterling, Lorelei; McKay, Jennifer; Ericson, Christine

2017-01-01

In states with limited road accessibility, rural students can feel isolated from library services. This article explores the creation, implementation, and results of an on-going longitudinal study assessing the library service needs of rural students in eLearning courses. To align with current practices in online pedagogies, including the…

Public Opinion on Tax and Expenditure Limitations: Attitudes in Four States. ECS Finance Facts. Special Issue.

ERIC Educational Resources Information Center

Education Commission of the States, Denver, CO. Education Finance Center.

This survey examined the attitudes of people in four states where tax or spending limitations appeared on the ballot in November 1978. It found that people had positive attitudes toward schools in their communities, believed schools are doing an above-average job, and viewed schools as a public service that should not be reduced. Results suggest…

Multiple value forest surveys in the Midsouth states

Treesearch

Victor A. Rudis

1990-01-01

State-of-the-art achievement and limitations in integrating water, range, wildlife, and recreation ("nontimber") inventories with forest surveys of the USDA-Forest Service, Southern Forest Experiment station, Forest Inventory and Analysis (FIA) Unit are reviewed.The FIA Unit surveys private and public forests in 7 Midsouth states:Alabama, Arkansas, Louisiana...

21 CFR 20.88 - Communications with State and local government officials.

Code of Federal Regulations, 2010 CFR

2010-04-01

... SERVICES GENERAL PUBLIC INFORMATION Limitations on Exemptions § 20.88 Communications with State and local... status as communications with any member of the public, except that: (1) Investigatory records compiled... 21 Food and Drugs 1 2010-04-01 2010-04-01 false Communications with State and local government...

Enhancing transit service in rural areas and native american tribal communities : potential mechanisms to improve funding and service.

DOT National Transportation Integrated Search

2014-08-01

Primary funding for rural transit comes from federal and state Departments of Transportation (DOTs). However, through numerous : surveys, rural transit providers have cited financial constraints as a major limitation to providing adequate desired tra...

42 CFR 457.618 - Ten percent limit on certain Children's Health Insurance Program expenditures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Insurance Program expenditures. 457.618 Section 457.618 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS... Children's Health Insurance Program expenditures. (a) Expenditures. (1) Primary expenditures are...

38 CFR 52.160 - Specialized rehabilitative services.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., but not limited to, physical therapy, speech therapy, occupational therapy, and mental health services for mental illness are required in the participant's comprehensive plan of care, program management... AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards § 52.160...

42 CFR 433.67 - Limitations on level of FFP for permissible provider-related donations.

Code of Federal Regulations, 2013 CFR

2013-10-01

... provider-related donations. 433.67 Section 433.67 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... permissible provider-related donations. (a)(1) Limitations on bona fide donations. There are no limitations on the amount of bona fide provider-related donations that a State may receive without a reduction in FFP...

42 CFR 433.67 - Limitations on level of FFP for permissible provider-related donations.

Code of Federal Regulations, 2012 CFR

2012-10-01

... provider-related donations. 433.67 Section 433.67 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... permissible provider-related donations. (a)(1) Limitations on bona fide donations. There are no limitations on the amount of bona fide provider-related donations that a State may receive without a reduction in FFP...

78 FR 10556 - Fisheries of the Northeastern United States; Northeast Multispecies Fishery; Trip Limit...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-14

... Fishery; Trip Limit Adjustments for the Common Pool Fishery AGENCY: National Marine Fisheries Service... Northeast multispecies common pool vessels for the remainder of the 2012 fishing year. This rule also... total catch of these stocks to approach their pertinent common pool sub-annual catch limits sub-annual...

77 FR 14697 - Fisheries of the Northeastern United States; Northeast Multispecies Fishery; Trip Limit...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-13

... Fishery; Trip Limit Adjustments for the Common Pool Fishery AGENCY: National Marine Fisheries Service...) multispecies common pool vessels for the remainder of the 2011 fishing year (FY), through April 30, 2012. This... catch of these stocks to approach their pertinent common pool sub-annual catch limits (sub-ACLs). DATES...

76 FR 18661 - Fisheries of the Northeastern United States; Northeast Multispecies Fishery; Trip Limit...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-05

... Fishery; Trip Limit Adjustments for the Common Pool Fishery AGENCY: National Marine Fisheries Service... (NE) multispecies common pool vessels for the 2010 fishing year (FY), through April 30, 2011. This... common pool sub-annual catch limits (sub-ACLs). This action is also intended to reduce catch rates of GOM...

31 CFR 316.5 - Limitation on holdings.

Code of Federal Regulations, 2014 CFR

2014-07-01

..., DEPARTMENT OF THE TREASURY BUREAU OF THE FISCAL SERVICE OFFERING OF UNITED STATES SAVINGS BONDS, SERIES E § 316.5 Limitation on holdings. (a) General limitation. The amount of Series E bonds, originally issued... any employee savings plan, as defined in paragraph (b)(1) of this section, at any time during the year...

Pregnancy, Labor, and Delivery after Ebola Virus Disease and Implications for Infection Control in Obstetric Services, United States.

PubMed

Kamali, Amanda; Jamieson, Denise J; Kpaduwa, Julius; Schrier, Sarah; Kim, Moon; Green, Nicole M; Ströher, Ute; Muehlenbachs, Atis; Bell, Michael; Rollin, Pierre E; Mascola, Laurene

2016-07-01

Many of the survivors of the 2014-2015 epidemic of Ebola virus disease (EVD) in western Africa were women of childbearing age. Limited clinical and laboratory data exist that describe these women's pregnancies and outcomes. We report the case of an EVD survivor who became pregnant and delivered her child in the United States, and we discuss implications of this case for infection control practices in obstetric services. Hospitals in the United States must be prepared to care for EVD survivors.

The effect of Philadelphia and Pennsylvania Clean Indoor Air Act on food services and drinking places sales and numbers, 1998-2011.

PubMed

Ma, Zhen-Qiang; Fisher, Monica A

2013-11-27

Philadelphia enacted its Clean Indoor Air Act (CIAA) nearly 2 years before the statewide CIAA. In this study, we assessed the economic impact of CIAAs on 4 types of food services and drinking places and addressed the predominant limitation of previous pre-post ban studies, namely the lack of control for confounders and changes in secular trends over time. We analyzed data from Pennsylvania Department of Revenue Quarterly 1998-2011 taxable county-level revenue sales and number of food services and drinking places. Region-specific and type-specific adjusted sales and number of food services and drinking places accounted for consumer spending as a general economic indicator. Segmented regression analysis of interrupted time-series methodology assessed changes in trend and level. Pennsylvania CIAA had no significant effect on adjusted sales or numbers except for an increase in sales in Philadelphia for limited-service eating places and in the surrounding 4 counties for special food services. Philadelphia CIAA was associated with an increase in adjusted numbers of full-service restaurants in Philadelphia and the rest of the state, special food services in Philadelphia, and drinking places in the rest of the state, and a decrease in the number of special food services in the surrounding counties. Philadelphia CIAA had no significant effect on adjusted sales except for an increase in special food services in the rest of the state. Overall, CIAAs had no negative business-related impact and, for the most part, suggest a positive impact on restaurant sales and numbers. Our results provide further support for comprehensive CIAA ordinance for restaurants.

The Effect of Philadelphia and Pennsylvania Clean Indoor Air Act on Food Services and Drinking Places Sales and Numbers, 1998-2011

PubMed Central

Fisher, Monica A.

2013-01-01

Introduction Philadelphia enacted its Clean Indoor Air Act (CIAA) nearly 2 years before the statewide CIAA. In this study, we assessed the economic impact of CIAAs on 4 types of food services and drinking places and addressed the predominant limitation of previous pre–post ban studies, namely the lack of control for confounders and changes in secular trends over time. Methods We analyzed data from Pennsylvania Department of Revenue Quarterly 1998–2011 taxable county-level revenue sales and number of food services and drinking places. Region-specific and type-specific adjusted sales and number of food services and drinking places accounted for consumer spending as a general economic indicator. Segmented regression analysis of interrupted time-series methodology assessed changes in trend and level. Results Pennsylvania CIAA had no significant effect on adjusted sales or numbers except for an increase in sales in Philadelphia for limited-service eating places and in the surrounding 4 counties for special food services. Philadelphia CIAA was associated with an increase in adjusted numbers of full-service restaurants in Philadelphia and the rest of the state, special food services in Philadelphia, and drinking places in the rest of the state, and a decrease in the number of special food services in the surrounding counties. Philadelphia CIAA had no significant effect on adjusted sales except for an increase in special food services in the rest of the state. Conclusion Overall, CIAAs had no negative business-related impact and, for the most part, suggest a positive impact on restaurant sales and numbers. Our results provide further support for comprehensive CIAA ordinance for restaurants. PMID:24286275

Data Use "Multi-State" Spotlight: Using Data Fidelity Tools to Improve Data Quality. Transforming State Systems to Improve Outcomes for Children with Disabilities

ERIC Educational Resources Information Center

Ruedel, Kristin; Nelson, Gena; Bailey, Tessie

2018-01-01

To evaluate interim progress toward the State-identified Measurable Result (SIMR), states require access to high-quality data from local education agencies (LEAs) and early intervention service providers. In a review of 2017 Phase III State Systemic Improvement Plans (SSIP), 43 Part C states noted limitations or concerns related to data and…

Northeast Conference on Rural HIV Service Delivery (Burlington, Vermont, October 23-24, 2000). Summary Report.

ERIC Educational Resources Information Center

McKinney, Martha M.

The Northeast Conference on Rural HIV Service Delivery was attended by 51 health and social service professionals, people with HIV, and federal and state health officials with expertise or interest in developing HIV care capacity in rural areas. Low population density, low prevalence of HIV/AIDS, rugged topography and climate, and limited health…

Services Provided to Military Dependents Who Are "Mentally Gifted" in the US Department of Defense (DoDEA) Schools

ERIC Educational Resources Information Center

Bugaj, Stephen J.

2013-01-01

The US Department of Defense Education Activity (DoDEA) is a federal agency that provides educational services to military dependents in 12 foreign countries, seven states, Cuba, and Puerto Rico. Perhaps due to its restricted audience, the general public has limited knowledge of DoDEA services; moreover, empirical information about these services…

Language Services In Hospitals Vary By Ownership And Location.

PubMed

Schiaffino, Melody K; Nara, Atsushi; Mao, Liang

2016-08-01

Twenty-four million people in the United States have limited English proficiency. They experience barriers to health care because of their inability to communicate effectively with providers. Hospitals are required to provide language services that reflect the needs of people in their communities, but these services are not available systematically. Project HOPE—The People-to-People Health Foundation, Inc.

An efficient protocol for providing integrated voice/data services to mobiles over power-limited satellite channels

NASA Astrophysics Data System (ADS)

Bose, Sanjay K.

1991-02-01

Various mobile satellite communication systems are being developed for providing integrated voice/data services over a shared satellite transponder which is power-limited in nature. A common strategy is to use slotted ALOHA request channels to request channel assignments for voice/data calls from a network management station. To maximize efficiency in a system with a power-limited satellite transponder, it is proposed that the bursty nature of voice sources be exploited by the NMS to 'over-assign' channels. This may cause problems of inefficiency and potential instability, as well as a degradation in the quality of service. Augmenting this with the introduction of simple state-dependent control procedures provides systems which exhibit more desirable operational features.

22 CFR 92.3 - Consular districts.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Consular districts. 92.3 Section 92.3 Foreign Relations DEPARTMENT OF STATE LEGAL AND RELATED SERVICES NOTARIAL AND RELATED SERVICES Introduction § 92.3 Consular districts. Where consular districts have been established, the geographic limits of the district...

The Limits of Privatization.

ERIC Educational Resources Information Center

Starr, Paul

Transferring public services and public assets to private ownership is not an entirely new idea. Governments at all levels in the United States have for years contracted out many services. However, under the recently coined label "privatization," such policies now come recommended as a more comprehensive approach to the problems of…

34 CFR 300.809 - Limitations.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 34 Education 2 2011-07-01 2010-07-01 true Limitations. 300.809 Section 300.809 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION ASSISTANCE TO STATES FOR THE EDUCATION OF CHILDREN WITH...

34 CFR 300.809 - Limitations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 2 2010-07-01 2010-07-01 false Limitations. 300.809 Section 300.809 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION ASSISTANCE TO STATES FOR THE EDUCATION OF CHILDREN WITH...

Medicaid Waivers Targeting Children With Autism Spectrum Disorder Reduce The Need For Parents To Stop Working.

PubMed

Leslie, Douglas L; Iskandarani, Khaled; Velott, Diana L; Stein, Bradley D; Mandell, David S; Agbese, Edeanya; Dick, Andrew W

2017-02-01

Several states have passed Medicaid home and community-based services waivers that expand eligibility criteria and available services for children with autism spectrum disorder. Although previous research has shown considerable variation in these waivers, little is known about the programs' impact on parents' workforce participation. We used nationally representative survey data combined with detailed information on state Medicaid waiver programs to determine the effects of waivers on whether parents of children with autism spectrum disorder had to stop working because of the child's condition. Increases in the Medicaid home and community-based services waiver cost limit and enrollment limit significantly reduced the likelihood that a parent had to stop working, although the results varied considerably by household income level. These findings suggest that the Medicaid waivers are effective policies to address the care-related needs of children with autism spectrum disorder. Project HOPE—The People-to-People Health Foundation, Inc.

Variation In Health Outcomes: The Role Of Spending On Social Services, Public Health, And Health Care, 2000-09.

PubMed

Bradley, Elizabeth H; Canavan, Maureen; Rogan, Erika; Talbert-Slagle, Kristina; Ndumele, Chima; Taylor, Lauren; Curry, Leslie A

2016-05-01

Although spending rates on health care and social services vary substantially across the states, little is known about the possible association between variation in state-level health outcomes and the allocation of state spending between health care and social services. To estimate that association, we used state-level repeated measures multivariable modeling for the period 2000-09, with region and time fixed effects adjusted for total spending and state demographic and economic characteristics and with one- and two-year lags. We found that states with a higher ratio of social to health spending (calculated as the sum of social service spending and public health spending divided by the sum of Medicare spending and Medicaid spending) had significantly better subsequent health outcomes for the following seven measures: adult obesity; asthma; mentally unhealthy days; days with activity limitations; and mortality rates for lung cancer, acute myocardial infarction, and type 2 diabetes. Our study suggests that broadening the debate beyond what should be spent on health care to include what should be invested in health-not only in health care but also in social services and public health-is warranted. Project HOPE—The People-to-People Health Foundation, Inc.

Can state early intervention programs meet the increased demand of children suspected of having autism spectrum disorders?

PubMed

Wise, Marissa D; Little, Alison A; Holliman, Jaime Bruce; Wise, Paul H; Wang, C Jason

2010-01-01

To determine whether Early Intervention programs have the capacity to accommodate the expected increase in referrals following the American Academy of Pediatrics' 2007 recommendation for universal screening of 18- and 24-month-old children for Autism Spectrum Disorders (ASD). We conducted a telephone survey of all state and territory early. Intervention coordinators about the demand for ASD evaluations, services, and program capacity. We used multivariate models to examine state-level factors associated with the capacity to serve children with ASD. Fifty-two of the 57 coordinators (91%) responded to the survey. Most states reported an increase in demand for ASD-related evaluations (65%) and services (58%) since 2007. In addition, 46% reported that their current capacity poses a challenge to meeting the 45-day time limit for creating the Individualized Family Service Plan. Many states reported that they have shortages of ASD-related personnel, including behavioral therapists (89%), speech-language pathologists (82%), and occupational therapists (79%). Among states that reported the number of service hours (n = 34) 44% indicated that children with ASD receive 5 or fewer weekly service hours. Multivariate models showed that states with a higher percentage of African-American and Latino children were more likely to have provider shortages whereas states with higher population densities were more likely to offer a greater number of service hours. Many Early Intervention programs may not have the capability to address the expected increase in demand for ASD services. Early Intervention programs will likely need enhanced resources to provide all children with suspected ASD with appropriate evaluations and services.

Changes in the Neighborhood Food Store Environment and Children's Body Mass Index at Peripuberty in the United States.

PubMed

Chen, Hsin-Jen; Wang, Youfa

2016-01-01

Little is known about the relationship between changes in food store environment and children's obesity risk in the United States. This study examines children's weight status associated with the changes in the quantity of food stores in their neighborhoods. A nationally representative cohort of schoolchildren in the United States was followed from fifth grade in 2004 to eighth grade in 2007 (n = 7,090). In 2004 and 2007, children's body mass index (BMI) was directly measured in schools. ZIP Code Business Patterns data from the Census Bureau in 2004 and 2007 characterized the numbers of food stores in every ZIP code area by type of store: supermarkets, limited-service restaurants, small-size grocery, and convenience stores. Baseline and change in the numbers of stores were the major exposures of interest. Girls living in neighborhoods with three or more supermarkets had a lower BMI 3 years later (by -.62 kg/m(2); 95% confidence interval = -1.05 to -.18) than did those living in neighborhoods without any supermarkets. Girls living in neighborhoods with many limited-service restaurants had a greater BMI 3 years later (by 1.02 kg/m(2); 95% confidence interval = .36-1.68) than did those living in neighborhoods with less than or equal to one limited-service restaurant. Exposure to a decreased quantity of small-size grocery stores in neighborhoods was associated with girls' lower BMI by eighth grade. The longitudinal association between neighborhood food environment and children's BMI differed by gender. For girls, supermarkets in neighborhoods seemed protective against obesity, whereas small-size grocery stores and limited-service restaurants in neighborhoods increased obesity risk. There was no significant longitudinal finding for boys. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

20 CFR 404.2117 - What costs will be paid.

Code of Federal Regulations, 2010 CFR

2010-04-01

... the State VR agency or alternate participant for the VR services described in § 404.2114 which were..., but subject to the following limitations: (a) The cost must have been incurred by the State VR agency.... For this purpose, State VR agencies or alternate participants will be required to seek payment or...

20 CFR 404.2117 - What costs will be paid.

Code of Federal Regulations, 2011 CFR

2011-04-01

... the State VR agency or alternate participant for the VR services described in § 404.2114 which were..., but subject to the following limitations: (a) The cost must have been incurred by the State VR agency.... For this purpose, State VR agencies or alternate participants will be required to seek payment or...

20 CFR 404.2117 - What costs will be paid.

Code of Federal Regulations, 2012 CFR

2012-04-01

... the State VR agency or alternate participant for the VR services described in § 404.2114 which were..., but subject to the following limitations: (a) The cost must have been incurred by the State VR agency.... For this purpose, State VR agencies or alternate participants will be required to seek payment or...

20 CFR 404.2117 - What costs will be paid.

Code of Federal Regulations, 2013 CFR

2013-04-01

... the State VR agency or alternate participant for the VR services described in § 404.2114 which were..., but subject to the following limitations: (a) The cost must have been incurred by the State VR agency.... For this purpose, State VR agencies or alternate participants will be required to seek payment or...

20 CFR 404.2117 - What costs will be paid.

Code of Federal Regulations, 2014 CFR

2014-04-01

... the State VR agency or alternate participant for the VR services described in § 404.2114 which were..., but subject to the following limitations: (a) The cost must have been incurred by the State VR agency.... For this purpose, State VR agencies or alternate participants will be required to seek payment or...

5 CFR 831.201 - Exclusions from retirement coverage.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 83 of title 5, United States Code: (1) Employees serving under appointments limited to one year or... subject to subchapter III of chapter 83 of title 5, United States Code, without a break in service or... of title 5, United States Code, except that this exclusion does not operate in the case of a member...

5 CFR 831.201 - Exclusions from retirement coverage.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 83 of title 5, United States Code: (1) Employees serving under appointments limited to one year or... subject to subchapter III of chapter 83 of title 5, United States Code, without a break in service or... of title 5, United States Code, except that this exclusion does not operate in the case of a member...

5 CFR 831.201 - Exclusions from retirement coverage.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 83 of title 5, United States Code: (1) Employees serving under appointments limited to one year or... subject to subchapter III of chapter 83 of title 5, United States Code, without a break in service or... of title 5, United States Code, except that this exclusion does not operate in the case of a member...

5 CFR 831.201 - Exclusions from retirement coverage.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 83 of title 5, United States Code: (1) Employees serving under appointments limited to one year or... subject to subchapter III of chapter 83 of title 5, United States Code, without a break in service or... of title 5, United States Code, except that this exclusion does not operate in the case of a member...

5 CFR 831.201 - Exclusions from retirement coverage.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 83 of title 5, United States Code: (1) Employees serving under appointments limited to one year or... subject to subchapter III of chapter 83 of title 5, United States Code, without a break in service or... of title 5, United States Code, except that this exclusion does not operate in the case of a member...

Balancing adequacy and affordability?: Essential Health Benefits under the Affordable Care Act.

PubMed

Haeder, Simon F

2014-12-01

The Essential Health Benefits provisions under the Affordable Care Act require that eligible plans provide coverage for certain broadly defined service categories, limit consumer cost-sharing, and meet certain actuarial value requirements. Although the Department of Health and Human Services (HHS) was tasked with the regulatory development of these EHB under the ACA, the department quickly devolved this task to the states. Not surprisingly, states fully exploited the leeway provided by HHS, and state decision processes and outcomes differed widely. However, none of the states took advantage of the opportunity to restructure fundamentally their health insurance markets, and only a very limited number of states actually included sophisticated policy expertise in their decisionmaking processes. As a result, and despite a major expansion of coverage, the status quo ex ante in state insurance markets was largely perpetuated. Decisionmaking for the 2016 revisions should be transparent, included a wide variety of stakeholders and policy experts, and focus on balancing adequacy and affordability. However, the 2016 revisions provide an opportunity to address these previous shortcomings. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Speech-Language Pathologists' Comfort Levels in English Language Learner Service Delivery

ERIC Educational Resources Information Center

Kimble, Carlotta

2013-01-01

This study examined speech-language pathologists' (SLPs) comfort levels in providing service delivery to English language learners (ELLs) and limited English proficient (LEP) students. Participants included 192 SLPs from the United States and Guam. Participants completed a brief, six-item questionnaire that investigated their perceptions regarding…

Attitudes toward Seeking Professional Counseling Services among Chinese International Students: Acculturation, Ethnic Identity, and English Proficiency

ERIC Educational Resources Information Center

Li, Jiaqi; Marbley, Aretha Faye; Bradley, Loretta J.; Lan, William

2016-01-01

The authors examined the help-seeking attitudes of 109 Chinese international students studying in the United States. Results revealed that significant relationships exist among acculturation, ethnic identity, English proficiency, and attitudes toward seeking professional counseling services. Limitations and recommendations for future research are…

Bilingual Human Services Educational Consortium. Final Report.

ERIC Educational Resources Information Center

Maine Univ., Orono. Bangor Community Coll.

This report presents results of the third year of a project designed to enhance employability and career mobility of limited English speaking Franco-American adults in jobs providing services for the elderly. The first section states project objectives of the college-level, credit-bearing program conducted at five university campuses: (1) to…

42 CFR 421.316 - Limitation on Medicare integrity program contractor liability.

Code of Federal Regulations, 2010 CFR

2010-10-01

... services to a MIP contractor is not in violation of any criminal law or civilly liable under any law of the United States or of any State (or political subdivision thereof) by reason of the performance of any duty...

34 CFR 300.27 - Limited English proficient.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 34 Education 2 2011-07-01 2010-07-01 true Limited English proficient. 300.27 Section 300.27 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION ASSISTANCE TO STATES FOR THE EDUCATION OF...

34 CFR 300.27 - Limited English proficient.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 2 2010-07-01 2010-07-01 false Limited English proficient. 300.27 Section 300.27 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION ASSISTANCE TO STATES FOR THE EDUCATION OF...

Are Latino immigrants a burden to safety net services in nontraditional immigrant states? Lessons from Oregon.

PubMed

López-Cevallos, Daniel

2014-05-01

The significant growth of the Latino population in the midst of an economic recession has invigorated anti-Latino, anti-immigrant sentiments in many US states. One common misconception is that Latino immigrants are a burden to safety net services. This may be particularly true in nontraditional immigrant states that have not historically served Latino immigrants. Oregon data suggest that despite a higher prevalence of poverty, use of safety net services among Latino immigrants in Oregon is lower than that among non-Latino Whites. Immigration status, costs, lack of insurance coverage, and discrimination are among the reasons for this group's limited use of services. Nevertheless, policies designed to strengthen community and institutional support for Latino immigrant families should be considered in the context of current health care and immigration reform efforts.

Are Latino Immigrants a Burden to Safety Net Services in Nontraditional Immigrant States? Lessons From Oregon

PubMed Central

2014-01-01

The significant growth of the Latino population in the midst of an economic recession has invigorated anti-Latino, anti-immigrant sentiments in many US states. One common misconception is that Latino immigrants are a burden to safety net services. This may be particularly true in nontraditional immigrant states that have not historically served Latino immigrants. Oregon data suggest that despite a higher prevalence of poverty, use of safety net services among Latino immigrants in Oregon is lower than that among non-Latino Whites. Immigration status, costs, lack of insurance coverage, and discrimination are among the reasons for this group’s limited use of services. Nevertheless, policies designed to strengthen community and institutional support for Latino immigrant families should be considered in the context of current health care and immigration reform efforts. PMID:24625168

42 CFR 433.70 - Limitation on level of FFP for revenues from health care-related taxes.

Code of Federal Regulations, 2014 CFR

2014-10-01

... care-related taxes. 433.70 Section 433.70 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... revenues from health care-related taxes. (a) Limitations. Beginning October 1, 1995, there is no limitation on the amount of health care-related taxes that a State may receive without a reduction in FFP, as...

42 CFR 433.70 - Limitation on level of FFP for revenues from health care-related taxes.

Code of Federal Regulations, 2013 CFR

2013-10-01

... care-related taxes. 433.70 Section 433.70 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... revenues from health care-related taxes. (a) Limitations. Beginning October 1, 1995, there is no limitation on the amount of health care-related taxes that a State may receive without a reduction in FFP, as...

42 CFR 433.70 - Limitation on level of FFP for revenues from health care-related taxes.

Code of Federal Regulations, 2011 CFR

2011-10-01

... care-related taxes. 433.70 Section 433.70 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... revenues from health care-related taxes. (a) Limitations. Beginning October 1, 1995, there is no limitation on the amount of health care-related taxes that a State may receive without a reduction in FFP, as...

42 CFR 433.70 - Limitation on level of FFP for revenues from health care-related taxes.

Code of Federal Regulations, 2012 CFR

2012-10-01

... care-related taxes. 433.70 Section 433.70 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... revenues from health care-related taxes. (a) Limitations. Beginning October 1, 1995, there is no limitation on the amount of health care-related taxes that a State may receive without a reduction in FFP, as...

42 CFR 433.70 - Limitation on level of FFP for revenues from health care-related taxes.

Code of Federal Regulations, 2010 CFR

2010-10-01

... care-related taxes. 433.70 Section 433.70 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... revenues from health care-related taxes. (a) Limitations. Beginning October 1, 1995, there is no limitation on the amount of health care-related taxes that a State may receive without a reduction in FFP, as...

76 FR 30035 - Fisheries of the Northeastern United States; Northeast Multispecies Fishery; Trip Limit Increase...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-24

... Fishery; Trip Limit Increase for the Common Pool Fishery AGENCY: National Marine Fisheries Service (NMFS...) multispecies common pool vessels for the 2011 fishing year (FY), through April 30, 2012. This action is... the total catch of this stock to further approach the common pool sub-annual catch limit (sub-ACL...

76 FR 53832 - Fisheries of the Northeastern United States; Northeast Multispecies Fishery; Trip Limit Decrease...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-30

... Fishery; Trip Limit Decrease for the Common Pool Fishery AGENCY: National Marine Fisheries Service (NMFS... (GB) cod for Northeast (NE) multispecies common pool vessels for the 2011 fishing year (FY), through... reduce the harvest of GOM and GB cod to prevent the common pool sub-annual catch limit (sub-ACL) from...

Oman: Reform, Security, and U.S. Policy

DTIC Science & Technology

2012-08-30

workshop in Muscat to discuss freedom of speech .3 However, evidence that the pace of change has been perceived as slow was demonstrated in 2011 in...change their government, limits on freedom of speech , and societal mores that discriminate against women. The report adds that security force...Research Service 7 Freedom of Expression/Media The State Dept. human rights report for 2011 states that the law provides for limited freedom of speech and

26 CFR 20.2011-2 - Limitation on credit if a deduction for State death taxes is allowed under section 2053(d).

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 14 2010-04-01 2010-04-01 false Limitation on credit if a deduction for State death taxes is allowed under section 2053(d). 20.2011-2 Section 20.2011-2 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) ESTATE AND GIFT TAXES ESTATE TAX; ESTATES OF DECEDENTS DYING AFTER AUGUST 16, 1954 Credits...

44 CFR 351.28 - The Department of Commerce.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Assignments § 351.28 The Department of Commerce. (a) Assist State and local governments in determining their requirements for meteorological and hydrological services for radiological emergencies and assist State and local governments in preparing to meet these requirements within the limits of available resources. (b...

44 CFR 351.28 - The Department of Commerce.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Assignments § 351.28 The Department of Commerce. (a) Assist State and local governments in determining their requirements for meteorological and hydrological services for radiological emergencies and assist State and local governments in preparing to meet these requirements within the limits of available resources. (b...

7 CFR 226.7 - State agency responsibilities for financial management.

Code of Federal Regulations, 2012 CFR

2012-01-01

... NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS CHILD AND ADULT CARE FOOD PROGRAM...) Budget approval. The State agency must review institution budgets and must limit allowable administrative claims by each sponsoring organization to the administrative costs approved in its budget. The budget...

7 CFR 226.7 - State agency responsibilities for financial management.

Code of Federal Regulations, 2014 CFR

2014-01-01

... NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS CHILD AND ADULT CARE FOOD PROGRAM...) Budget approval. The State agency must review institution budgets and must limit allowable administrative claims by each sponsoring organization to the administrative costs approved in its budget. The budget...

7 CFR 226.7 - State agency responsibilities for financial management.

Code of Federal Regulations, 2013 CFR

2013-01-01

... NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS CHILD AND ADULT CARE FOOD PROGRAM...) Budget approval. The State agency must review institution budgets and must limit allowable administrative claims by each sponsoring organization to the administrative costs approved in its budget. The budget...

Clinicians' Obligations to Use Qualified Medical Interpreters When Caring for Patients with Limited English Proficiency.

PubMed

Basu, Gaurab; Costa, Vonessa Phillips; Jain, Priyank

2017-03-01

Access to language services is a required and foundational component of care for patients with limited English proficiency (LEP). National standards for medical interpreting set by the US Department of Health and Human Services and by the National Council on Interpreting in Health Care establish the role of qualified medical interpreters in the provision of care in the United States. In the vignette, the attending physician infringes upon the patient's right to appropriate language services and renders unethical care. Clinicians are obliged to create systems and a culture that ensure quality care for patients with LEP. © 2017 American Medical Association. All Rights Reserved.

Training Requirements and Curriculum Content for Primary Care Providers Delivering Preventive Oral Health Services to Children Enrolled in Medicaid.

PubMed

Sams, Lattice D; Rozier, R Gary; Quinonez, Rocio B

2016-07-01

Despite the emphasis on delivery of preventive oral health services in non-dental settings, limited information exists about state Medicaid policies and strategies to educate practicing physicians in the delivery of these services. This study aims to determine: (1) training requirements and policies for reimbursement of oral health services, (2) teaching delivery methods used to train physicians, and (3) curricula content available to providers among states that reimburse non-dental providers for oral health services. Using Web-based Internet searches as the primary data source, and a supplemental e-mail survey of all states offering in-person training, we assessed training requirements, methods of delivery for training, and curriculum content for states with Medicaid reimbursement to primary care providers delivering preventive oral health services. RESULTS of descriptive analyses are presented for information collected and updated in 2014. Forty-two states provide training sessions or resources to providers, 34 requiring provider training before reimbursement for oral health services. Web-based training is the most common CME delivery method. Only small differences in curricular content were reported by the 11 states that use in-person didactic sessions as the delivery method. Although we found that most states require training and curricular content is similar, training was most often delivered using Web-based courses without any additional delivery methods. Research is needed to evaluate the impact of a mixture of training methods and other quality improvement methods on increased adoption and implementation of preventive oral health services in medical practices.

Financing mental health services for adolescents: a background paper.

PubMed

Kapphahn, Cynthia; Morreale, Madlyn; Rickert, Vaughn I; Walker, Leslie

2006-09-01

Good mental health provides an essential foundation for normal growth and development through adolescence and into adulthood. Many adolescents, however, experience mental health problems that significantly impede the attainment of their full potential. The majority of these adolescents do not receive needed mental health services, in part because of financial obstacles to care. This article reviews the magnitude and impact of mental health problems during adolescence and highlights the importance of insurance coverage in assuring access to mental health services for adolescents. Significant limitations in private health insurance coverage of mental health services are outlined. Recent federal and state efforts to move toward parity in private insurance coverage between mental and physical health services are discussed, including an explanation of the role of Medicaid and the State Children's Health Insurance Program (SCHIP) in providing access to mental health services for adolescents. Finally, other elements that would facilitate financial access to essential mental health services for adolescents are presented.

26 CFR 1.103(n)-3T - Private activity bond limit (temporary).

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 2 2011-04-01 2011-04-01 false Private activity bond limit (temporary). 1.103(n)-3T Section 1.103(n)-3T Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY....103(n)-3T Private activity bond limit (temporary). Q-1: What is the “State ceiling”? A-1: In general...

26 CFR 1.103(n)-3T - Private activity bond limit (temporary).

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 2 2010-04-01 2010-04-01 false Private activity bond limit (temporary). 1.103(n)-3T Section 1.103(n)-3T Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY....103(n)-3T Private activity bond limit (temporary). Q-1: What is the “State ceiling”? A-1: In general...

42 CFR 447.272 - Inpatient services: Application of upper payment limits.

Code of Federal Regulations, 2010 CFR

2010-10-01

... inpatient services furnished by hospitals, nursing facilities, and ICFs/MR within one of the following... are funded through the Indian Self-Determination and Education Assistance Act (Pub. L. 93-638). (2... hospitals, nursing facilities and ICFs/MR “ Medicaid State plan rate year 2008. (2) For all other facilities...

45 CFR 84.10 - Effect of State or local law or other requirements and effect of employment opportunities.

Code of Federal Regulations, 2012 CFR

2012-10-01

... HUMAN SERVICES GENERAL ADMINISTRATION NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR..., on the basis of handicap, imposes prohibitions or limits upon the eligibility of qualified handicapped persons to receive services or to practice any occupation or profession. (b) The obligation to...

The Telepac Project: A Service Delivery Model for the Severely Handicapped in Rural Areas.

ERIC Educational Resources Information Center

Hofmeister, Alan M.; Atkinson, Charles A.

The Utah State University (USU) "Telepac Project" is a service delivery model for homebound handicapped children living in rural areas. Designed to effectively utilize limited numbers of professional personnel, Telepac makes use of: (1) telecommunications technology; (2) parents as a basic treatment resource; and (3) the technology of…

12 CFR 704.11 - Corporate Credit Union Service Organizations (Corporate CUSOs).

Code of Federal Regulations, 2011 CFR

2011-01-01

... assets in which the corporate has a perfected security interest under state law. (3) If the limitations... 12 Banks and Banking 6 2011-01-01 2011-01-01 false Corporate Credit Union Service Organizations (Corporate CUSOs). 704.11 Section 704.11 Banks and Banking NATIONAL CREDIT UNION ADMINISTRATION REGULATIONS...

12 CFR 704.11 - Corporate Credit Union Service Organizations (Corporate CUSOs).

Code of Federal Regulations, 2010 CFR

2010-01-01

... assets in which the corporate has a perfected security interest under state law. (3) If the limitations... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Corporate Credit Union Service Organizations (Corporate CUSOs). 704.11 Section 704.11 Banks and Banking NATIONAL CREDIT UNION ADMINISTRATION REGULATIONS...

Mexican Migrant and Seasonal Farmworker Culture, Gender, and Language Ideologies: Platicas de HIV/AIDS

ERIC Educational Resources Information Center

Allison, Donald N.

2013-01-01

Lack of health access and limited health care services are major concerns for those who provide healthcare for marginalized Mexican migrant and seasonal farmworker communities (MMSF). Health risks related to several deadly illnesses generate a significant challenge in providing services to this transnational population. In the United States,…

Bilingual Pupil Services (B.P.S.), 1987-88.

ERIC Educational Resources Information Center

Berney, Tomi D.; Sjostrom, Barbara R.

The Bilingual Pupil Services Program is a long-standing state-funded project in New York City. During the 1987-88 school year, it provided supportive bilingual instruction to 1,875 Haitian, Hispanic, and Chinese children of limited English proficiency enrolled in 78 classes at 30 participating schools in 4 boroughs. The program had a clearly…

A Comparative Analysis of Domestic Violence Shelter Staff Perceptions Regarding Barriers to Services in Bosnia and Herzegovina and the United States.

PubMed

Grubb, Jonathan A; Muftić, Lisa R

2017-11-01

Service provision for domestic violence (DV) survivors has been a long-standing staple of shelters in the United States. Although shelter services provide numerous benefits for survivors, barriers tied to acquisition remain a pressing concern when combatting DV. Nevertheless, there has been minimal research exploring barriers to service acquisition on a cross-national level. As such, the current research cross-nationally examines perceptions of shelter staff regarding acquisition barriers as well as the effectiveness of local agencies to meet survivor needs and differences in populations served in the United States (specifically Texas) as well as in Bosnia and Herzegovina. Data collection stemmed from self-report surveys originally constructed in English and translated into Bosnian/Serbian/Croatian. Results underscored differences between populations served, perceptions of local agencies assisting survivors of DV, and barriers tied to cultural and financial concerns. Implications, limitations, and future directions are also discussed.

The State of Transgender Health Care: Policy, Law, and Medical Frameworks

PubMed Central

2014-01-01

I review the current status of transgender people’s access to health care in the United States and analyze federal policies regarding health care services for transgender people and the limitations thereof. I suggest a preliminary outline to enhance health care services and recommend the formulation of explicit federal policies regarding the provision of health care services to transgender people in accordance with recently issued medical care guidelines, allocation of research funding, education of health care workers, and implementation of existing nondiscrimination policies. Current policies denying medical coverage for sex reassignment surgery contradict standards of medical care and must be amended. PMID:24432926

Opportunities and limitations for using new media and mobile phones to expand access to sexual and reproductive health information and services for adolescent girls and young women in six Nigerian states.

PubMed

Akinfaderin-Agarau, Fadekem; Chirtau, Manre; Ekponimo, Sylvia; Power, Samantha

2012-06-01

Reproductive health problems are a challenge affecting young people in Nigeria. Education as a Vaccine (EVA) implements the My Question and Answer Service, using mobile phones to provide sexual and reproductive health (SRH) information and services. Use of the service by adolescent girls and young women is low. Focus group discussions were held with 726 females to assess their access to mobile phones, as well as the barriers and limitations to the use of their phones to seek SRH information and services. Results demonstrate high mobile phone access but limited use of phones to access SRH information and services. Barriers to use of these services include cost of service for young female clients, request for socio-demographic information that could break anonymity, poor marketing and publicity, socio-cultural beliefs and expectations of young girls, individual personality and beliefs, as well as infrastructural/network quality. It is therefore recommended that these barriers be adequately addressed to increase the potential use of mobile phone for providing adolescent and young girls with SRH information and services. In addition, further initiatives and research are needed to explore the potentials of social media in meeting this need.

7 CFR 4285.82 - Use of funds; changes.

Code of Federal Regulations, 2010 CFR

2010-01-01

... RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE COOPERATIVE AGREEMENTS Federal-State Research on... approved cooperative agreement shall be limited to changes in methodology, techniques, or other aspects of...

Climate change impacts on freshwater fish, coral reefs, and related ecosystem services in the United States

EPA Science Inventory

We analyzed the potential physical and economic impacts of climate change on freshwater fisheries and coral reefs in the United States, examining a reference scenario and two policy scenarios that limit global greenhouse gas (GHG) emissions. We modeled shifts in suitable habitat ...

A State-Wide Research Network for Alzheimer's Disease

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mintzer, Jacobo E.; Bachman, D. L.; Stuckey, M.

2014-03-13

The Specific Aim of the proposal was to develop an administrative structure that will facilitate the development of AD research across the state of SC by providing key services such as (but not limited to) seeking funding research opportunities, financial tracking, regulatory management, central recruitment, training for investigators and coordinators, data collection, data storing, and data processing to researchers across the state.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Heeter, J.; Bird, L.; Gelman, R.

Several states are addressing the issue of net metering program caps, which limit the total amount of net metered generating capacity that can be installed in a state or utility service territory. In this analysis, we examine net metering caps to gain perspective on how long net metering will be available in various jurisdictions under current policies. We also surveyed state practices and experience to understand important policy design considerations.

Peer-Delivered Recovery Support Services for Addictions in the United States: A Systematic Review.

PubMed

Bassuk, Ellen L; Hanson, Justine; Greene, R Neil; Richard, Molly; Laudet, Alexandre

2016-04-01

This systematic review identifies, appraises, and summarizes the evidence on the effectiveness of peer-delivered recovery support services for people in recovery from alcohol and drug addiction. Nine studies met criteria for inclusion in the review. They were assessed for quality and outcomes including substance use and recovery-related factors. Despite significant methodological limitations found in the included studies, the body of evidence suggests salutary effects on participants. Current limitations and recommendations for future research are discussed. Copyright © 2016 Elsevier Inc. All rights reserved.

Understanding structural barriers to accessing HIV testing and prevention services among black men who have sex with men (BMSM) in the United States.

PubMed

Levy, Matthew E; Wilton, Leo; Phillips, Gregory; Glick, Sara Nelson; Kuo, Irene; Brewer, Russell A; Elliott, Ayana; Watson, Christopher; Magnus, Manya

2014-05-01

Structural-level factors have contributed to the substantial disproportionate rates of HIV among Black men who have sex with men (BMSM) in the United States. Despite insufficient HIV testing patterns, however, there is a void in research investigating the relationship between structural factors and access to HIV testing and prevention services among BMSM. Building on previous scholarly work and incorporating a dynamic social systems conceptual framework, we conducted a comprehensive review of the literature on structural barriers to HIV testing and prevention services among BMSM across four domains: healthcare, stigma and discrimination, incarceration, and poverty. We found that BMSM experience inadequate access to culturally competent services, stigma and discrimination that impede access to services, a deficiency of services in correctional institutions, and limited services in areas where BMSM live. Structural interventions that eliminate barriers to HIV testing and prevention services and provide BMSM with core skills to navigate complex systems are needed.

Understanding Structural Barriers to Accessing HIV Testing and Prevention Services Among Black Men Who Have Sex with Men (BMSM) in the United States

PubMed Central

Wilton, Leo; Phillips, Gregory; Glick, Sara Nelson; Kuo, Irene; Brewer, Russell A.; Elliott, Ayana; Watson, Christopher; Magnus, Manya

2015-01-01

Structural-level factors have contributed to the substantial disproportionate rates of HIV among Black men who have sex with men (BMSM) in the United States. Despite insufficient HIV testing patterns, however, there is a void in research investigating the relationship between structural factors and access to HIV testing and prevention services among BMSM. Building on previous scholarly work and incorporating a dynamic social systems conceptual framework, we conducted a comprehensive review of the literature on structural barriers to HIV testing and prevention services among BMSM across four domains: healthcare, stigma and discrimination, incarceration, and poverty. We found that BMSM experience inadequate access to culturally competent services, stigma and discrimination that impede access to services, a deficiency of services in correctional institutions, and limited services in areas where BMSM live. Structural interventions that eliminate barriers to HIV testing and prevention services and provide BMSM with core skills to navigate complex systems are needed. PMID:24531769

Family, culture, and health practices among migrant farmworkers.

PubMed

Bechtel, G A; Shepherd, M A; Rogers, P W

1995-01-01

Migrant farmworkers and their families have restricted access to health and human services because of their frequent relocation between states, language and cultural barriers, and limited economic and political resources. Living and working in substandard environments, these families are at greater risk for developing chronic and communicable disease. In an assessment of health patterns among 225 migrant workers and their families, using personal observations, unstructured interviews, and individual and state health records, children's immunizations were found to be current, but dental caries and head lice were epidemic. Among adults, almost one third tested positive for tuberculosis exposure. Urinary tract infections were the most common health problem among women. Primary and secondary prevention were almost nonexistent because funds for these services were not readily available. The patriarchal system contributes to these problems by limiting access to family-health and social service needs. Although providing comprehensive health care to migrant communities presents unique challenges, nurses can demonstrate their effectiveness in reducing morbidity through strategic interventions and alternative uses of health delivery systems.

78 FR 62331 - Fisheries of the Northeastern United States; Atlantic Herring Fishery; Sub-Annual Catch Limit...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-17

...-Annual Catch Limit (ACL) Harvested for Management Area 1A AGENCY: National Marine Fisheries Service (NMFS..., acceptable biological catch, annual catch limit (ACL), optimum yield, domestic harvest and processing, U.S... Harvest is 107,800 metric tons (mt); the 2013 sub-ACL allocated to Area 1A is 29,775 mt, and 0 mt of the...

77 FR 10977 - Fisheries of the Northeastern United States; Atlantic Herring Fishery; Sub-Annual Catch Limit...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-24

...-Annual Catch Limit (ACL) Harvested for Management Area 1B AGENCY: National Marine Fisheries Service (NMFS... Management Area 1B per calendar day until January 1, 2013, when the 2013 sub-ACL for Area 1B becomes... that the revised Atlantic herring sub-ACL limit allocated to Area 1B for 2012 has been exceeded as of...

The Role of School Health Services in Addressing the Needs of Students with Chronic Health Conditions: A Systematic Review

ERIC Educational Resources Information Center

Leroy, Zanie C.; Wallin, Robin; Lee, Sarah

2017-01-01

Children and adolescents in the United States spend many hours in school. Students with chronic health conditions (CHCs) may face lower academic achievement, increased disability, fewer job opportunities, and limited community interactions as they enter adulthood. School health services provide safe and effective management of CHCs, often for…

20 CFR 404.327 - When you are participating in an appropriate program of vocational rehabilitation services...

Code of Federal Regulations, 2010 CFR

2010-04-01

... services approved by us; providers we may approve include, but are not limited to— (A) A public or private... carried out under an individualized program or plan; (4) An individualized education program developed under policies and procedures approved by the Secretary of Education for assistance to States for the...

The "empty void" is a crowded space: health service provision at the margins of fragile and conflict affected states.

PubMed

Hill, Peter S; Pavignani, Enrico; Michael, Markus; Murru, Maurizio; Beesley, Mark E

2014-01-01

Definitions of fragile states focus on state willingness and capacity to ensure security and provide essential services, including health. Conventional analyses and subsequent policies that focus on state-delivered essential services miss many developments in severely disrupted healthcare arenas. The research seeks to gain insights about the large sections of the health field left to evolve spontaneously by the absent or diminished state. THE STUDY EXAMINED SIX DIVERSE CASE STUDIES: Afghanistan, Central African Republic, Democratic Republic of the Congo, Haïti, Palestine, and Somalia. A comprehensive documentary analysis was complemented by site visits in 2011-2012 and interviews with key informants. Despite differing histories, countries shared chronic disruption of health services, with limited state service provision, and low community expectations of quality of care. The space left by compromised or absent state-provided services is filled by multiple diverse actors. Health is commoditized, health services are heterogeneous and irregular, with public goods such as immunization and preventive services lagging behind curative ones. Health workers with disparate skills, and atypical health facilities proliferate. Health care absorbs large private expenditures, sustained by households, remittances, charitable and solidarity funding, and constitutes a substantial portion of the country economy. Pharmaceutical markets thrive. Trans-border healthcare provision is prominent in most studied settings, conferring regional and sometimes true globalized characteristics to these arenas. We identify three distortions in the way the global development community has considered health service provision. The first distortion is the assumption that beyond the reach of state- and donor-sponsored services is a "void", waiting to be filled. Our analysis suggests that the opposite is the case. The second distortion relates to the inadequacy of the usual binary categories structuring conventional health system analyses, when applied to these contexts. The third distortion reflects the failure of the global development community to recognise-or engage-the emergent networks of health providers. To effectively harness the service provision currently available in this crowded space, development actors need to adapt their current approaches, engage non-state providers, and support local capacity and governance, particularly grassroots social institutions with a public-good orientation.

Sweeteners - sugars

MedlinePlus

... grams of sugar). The United States Department of Agriculture (USDA) Dietary Guidelines for Americans also recommends limiting ... Health and Human Services and US Department of Agriculture. 2015-2020 Dietary Guidelines for Americans. 8th ed. ...

50 CFR 20.106 - Seasons, limits, and shooting hours for sandhill cranes.

Code of Federal Regulations, 2011 CFR

2011-10-01

... sandhill cranes. 20.106 Section 20.106 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE..., and Shooting Hours Schedules § 20.106 Seasons, limits, and shooting hours for sandhill cranes. This section provides for the annual hunting of sandhill cranes in designated portions of the 48 contiguous...

34 CFR 364.13 - Under what circumstances may funds be withheld, reduced, limited, or terminated?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 2 2010-07-01 2010-07-01 false Under what circumstances may funds be withheld, reduced, limited, or terminated? 364.13 Section 364.13 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION STATE...

34 CFR 364.13 - Under what circumstances may funds be withheld, reduced, limited, or terminated?

Code of Federal Regulations, 2011 CFR

2011-07-01

... 34 Education 2 2011-07-01 2010-07-01 true Under what circumstances may funds be withheld, reduced, limited, or terminated? 364.13 Section 364.13 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION STATE...

50 CFR 20.106 - Seasons, limits, and shooting hours for sandhill cranes.

Code of Federal Regulations, 2010 CFR

2010-10-01

... sandhill cranes. 20.106 Section 20.106 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE..., and Shooting Hours Schedules § 20.106 Seasons, limits, and shooting hours for sandhill cranes. This section provides for the annual hunting of sandhill cranes in designated portions of the 48 contiguous...

50 CFR 20.107 - Seasons, limits, and shooting hours for tundra swans.

Code of Federal Regulations, 2013 CFR

2013-10-01

... tundra swans. 20.107 Section 20.107 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE..., and Shooting Hours Schedules § 20.107 Seasons, limits, and shooting hours for tundra swans. This section provides for the annual hunting of tundra swans in designated portions of the 48 contiguous United...

50 CFR 20.107 - Seasons, limits, and shooting hours for tundra swans.

Code of Federal Regulations, 2014 CFR

2014-10-01

... tundra swans. 20.107 Section 20.107 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE..., and Shooting Hours Schedules § 20.107 Seasons, limits, and shooting hours for tundra swans. This section provides for the annual hunting of tundra swans in designated portions of the 48 contiguous United...

50 CFR 20.107 - Seasons, limits, and shooting hours for tundra swans.

Code of Federal Regulations, 2012 CFR

2012-10-01

... tundra swans. 20.107 Section 20.107 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE..., and Shooting Hours Schedules § 20.107 Seasons, limits, and shooting hours for tundra swans. This section provides for the annual hunting of tundra swans in designated portions of the 48 contiguous United...

50 CFR 20.107 - Seasons, limits, and shooting hours for tundra swans.

Code of Federal Regulations, 2011 CFR

2011-10-01

... tundra swans. 20.107 Section 20.107 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE..., and Shooting Hours Schedules § 20.107 Seasons, limits, and shooting hours for tundra swans. This section provides for the annual hunting of tundra swans in designated portions of the 48 contiguous United...

46 CFR 11.501 - Grades and types of national engineer endorsements issued.

Code of Federal Regulations, 2014 CFR

2014-10-01

..., and/or gas turbine-propelled vessels allow the holder to serve within any propulsion power limitations.../or gas turbine-propelled vessels allow the holder to serve within stated propulsion power limitations... authorizes service on steam, motor, or gas turbine-propelled vessels or may authorize all modes of propulsion...

78 FR 65888 - Fisheries of the Northeastern United States; Northeast Multispecies Fishery; Trip Limit...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-04

... economic impacts to the common pool fishery. There is additional good cause to waive the delayed effective... Fishery; Trip Limit Adjustments for the Common Pool Fishery AGENCY: National Marine Fisheries Service... hake, and pollock for Northeast multispecies common pool vessels for the remainder of the 2013 fishing...

78 FR 42478 - Fisheries of the Northeastern United States; Northeast Multispecies Fishery; Trip Limit...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-16

... Fishery; Trip Limit Adjustment for the Common Pool Fishery AGENCY: National Marine Fisheries Service (NMFS... (SNE/MA) winter flounder for Northeast multispecies common pool vessels for the remainder of the 2013... Area (TAC) for the remainder of Trimester 1, through August 31, 2013, because the common pool fishery...

78 FR 54194 - Fisheries of the Northeastern United States; Northeast Multispecies Fishery; Trip Limit...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-03

... Fishery; Trip Limit Adjustments for the Common Pool Fishery AGENCY: National Marine Fisheries Service...-Atlantic winter flounder and Gulf of Maine haddock for Northeast multispecies common pool vessels for the remainder of the 2013 fishing year. NMFS is taking this action because the common pool has caught 73 percent...

31 CFR 332.5 - Limitation on holdings.

Code of Federal Regulations, 2014 CFR

2014-07-01

..., DEPARTMENT OF THE TREASURY BUREAU OF THE FISCAL SERVICE OFFERING OF UNITED STATES SAVINGS BONDS, SERIES H § 332.5 Limitation on holdings. The amount of Series H bonds, originally issued during any one calendar year, that could be held by any one person, at any one time, computed in accordance with the governing...

Provision of genetics services on Guam.

PubMed

McWalter, Kirsty; Hasegawa, Lianne; Au, Sylvia Mann

2013-12-01

Guam's geographic isolation and lack of community resources have resulted in unique healthcare needs. In 2006, the Western States Genetic Services Collaborative (WSGSC) conducted a genetics needs assessment and found that professional development is limited, families lack access to genetic services, and improved coverage of genetic testing is needed. With funding from the WSGSC, a Guam genetics outreach clinic was established and staffed by genetic counselors and a medical geneticist from Hawaii. Four clinics have been held to date. Although several challenges have been encountered, including minimal coverage of genetic testing by Guam insurance companies, limited referrals for families with private insurance, and inappropriate referral indications, the outreach clinic has been successful at increasing access to genetic services and improving professional development. With more collaborative work by staff from Guam, Hawaii, and the WSGSC, provision and reimbursement of genetic services and testing will continue to improve.

42 CFR 1001.1601 - Violations of the limitations on physician charges.

Code of Federal Regulations, 2010 CFR

2010-10-01

... AND HUMAN SERVICES OIG AUTHORITIES PROGRAM INTEGRITY-MEDICARE AND STATE HEALTH CARE PROGRAMS... charges; (iv) Whether the physician has a documented history of criminal, civil or administrative...

[The state of the art on nutrition, food safety and food security].

PubMed

Bonaccorsi, Guglielmo; Lorini, Chiara; Porchia, Barbara Rita; Capecchi, Leonardo; Malavolti, Marcella; Aggazzotti, Gabriella

2014-01-01

In Italy, public health is experiencing a phase of crisis. A contraction of services and a staff reallocation have affected in particular Food Hygiene services. We explored Pubmed and Google Ngram Viewer© to define the state of the art of research in food and nutritional field from a quantitative point of view and we focused on some areas of interest in terms of improvement of professional practice. The Italian contribution to food and nutritional research is still limited. Our findings seem to demonstrate the need of an alliance between the world of research and Public Health services, so as to develop a sustainable and effective health system.

Mortality risks and limits to population growth of fishers

Treesearch

Rick A. Sweitzer; Viorel D. Popescu; Craig M. Thompson; Kathryn L. Purcell; Reginald H. Barrett; Greta M. Wengert; Mourad W. Gabriel; Leslie W. Woods

2015-01-01

Fishers (Pekania pennanti) in the west coast states of Washington, Oregon, and California, USA have not recovered from population declines and the United States Fish and Wildlife Service has proposed options for listing them as threatened. Our objectives were to evaluate differences in survival and mortality risk from natural (e.g., predation, disease, injuries,...

78 FR 65206 - Airworthiness Directives; Bell Helicopter Textron Canada Limited (Bell) Helicopters

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-31

... engine speeds during steady- state operations. These actions are intended to alert pilots to avoid... intended to alert pilots to avoid certain engine speeds during steady- state operations, prevent failure of... decal as described in Bell Alert Service Bulletin (ASB) No. 430-05-34, dated June 10, 2005 (ASB 430-05...

78 FR 65200 - Airworthiness Directives; Bell Helicopter Textron Canada Limited (Bell) Helicopters

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-31

... vibrations at certain engine speeds during steady- state operations. These actions are intended to alert... proposed requirements were intended to alert pilots to avoid certain engine speeds during steady-state... the change, and installing a decal as described in Bell Alert Service Bulletin (ASB) No. 407-05-67...

Mental Health Commissions: making the critical difference to the development and reform of mental health services.

PubMed

Rosen, Alan; Goldbloom, David; McGeorge, Peter

2010-11-01

Several Mental Health Commissions (MHCs) have emerged in developed countries over recent years, often in connection with mental health reform strategies. It is timely to consider the types of MHC which exist in different countries, their characteristics which may contribute to making them more effective, and any possible limitations and concerns raised about them. The emerging literature on MHCs indicates, particularly with the wider types of MHCs, that they may contribute to the substantial enhancement of mental health resources and sustainability of services; mental health reform is much more likely to be implemented properly with an independent monitor such as a MHC which has official influence at the highest levels of government; and they can encourage, champion and monitor the transformation of services into more evidence-based, community-centred, recovery-oriented, consumer, family and human rights-focused mental health services. The advent of MHCs may enhance the resourcing, quality and consistency of distribution of effective clinical practices and crucial support services, and foster more relevant practice-based research. MHC variants can work in different countries and the model can be adapted to state jurisdictions, single state nations and federated systems of government, without duplicating bureaucracies. Achievements and possible limitations are considered.

Hepatitis C education and support in Australian prisons: preliminary findings of a nationwide survey.

PubMed

Dyer, Jade; Tolliday, Lyn

2009-04-01

Rates of hepatitis C infection are up to 60 times higher in correctional facilities than in the general population, yet prisoners have limited access to many methods of blood-borne virus prevention. The aim of this study was therefore to explore the efficiency of hepatitis C education and support services available in custodial settings, from the perspective of health educators and policy makers. Semi-structured interviews were conducted with 23 health professionals, from all states and territories of Australia, who were involved in the management or provision of hepatitis C education or support to prisoners. Results were interpreted using thematic analysis. Participant reports regarding the provision of hepatitis C education and support services varied considerably between prisons and across states. Interviewees identified successful services and barriers to improvement, including limited time, insufficient funding and frequent personnel changes. Many prisons were believed to have unique needs and educators from external agencies were not always aware of the medical procedures or methods of harm reduction available in particular facilities. Interviewee perceptions indicated that the delivery of hepatitis C education and support services in Australian custodial settings is marred by inconsistency. However, both education programs and psychological support services could be developed by external agencies wishing to reduce the impact of hepatitis C within the prison system.

7 CFR 58.1 - Meaning of words.

Code of Federal Regulations, 2010 CFR

2010-01-01

... from defects which affect its serviceability, including appearance as well as usability, of the... which a product is free from defects which affect its usability, including but not limited to, the state...

7 CFR 58.1 - Meaning of words.

Code of Federal Regulations, 2011 CFR

2011-01-01

... from defects which affect its serviceability, including appearance as well as usability, of the... which a product is free from defects which affect its usability, including but not limited to, the state...

20 CFR 1001.120 - Standards of performance governing State agency services.

Code of Federal Regulations, 2010 CFR

2010-04-01

... those activities or efforts including but not limited to registration, counseling, referral to... making referrals from the group of applicants meeting the specific eligibility criteria for a particular...

How states, tribes and localities are re-defining systems of care.

PubMed

Pires, Sheila A

2010-02-01

The original definition of system of care was developed 20 years ago largely in response to the fragmented services experienced by children with serious emotional disorders and their families, who, typically, were involved in multiple systems and/or receiving services from different providers. Over time, in response to national funders' pursuing system of care for different populations and their own experience, states, tribes and localities have applied system of care principles, values and operational characteristics to other populations (children and adults). The definition offered by Hodges et al., has an unintended effect of constraining the properties (and potential) of system of care in its limitation to a single population. This paper argues that the adaptations made to the original Stroul and Friedman definition in the training curriculum Building Systems of Care: A Primer adequately encompass properties that reflect state, tribal and local implementation experience and are specific to planning, implementing and evaluating a system of care, without limiting system of care to any one population.

Changing safety net of last resort: downsizing general assistance for employable adults.

PubMed

Anderson, Steven G; Halter, Anthony P; Gryzlak, Brian M

2002-07-01

General assistance (GA) has served as an income support program of last resort for people not eligible for other programs. Because each state has complete discretion to design its program, the GA services model parallels Temporary Assistance for Needy Families (TANF) in its reliance on decentralized government decision making. Thus, GA programs can provide lessons about services variability and common program features that have arisen in a decentralized income support system. This study examined the characteristics of state GA programs across several program dimensions--eligibility criteria, work requirements, time limits, administrative arrangements, and caseloads. The authors show that GA programs have changed from 1989 to 1998. Although most states retained GA programs in some form, caseloads declined as a result of tightening eligibility requirements for people considered employable. This casts doubt on the viability of GA as a safety net program for economically vulnerable people, including those who do not qualify for or exceed time limits under TANF.

Telehealth forging ahead: overcoming barriers in licensure to improve access to care for service members.

PubMed

Stout, Katie Ambrose; Martinez, Kristina

2011-01-01

The telehealth initiatives of the Department of Defense (DoD) and Veterans' Health Administration (VHA) continue to test the limits of technology to provide the best care to our service members, veterans and their families. The DoD and VHA have credentialing systems in place to allow clinical practice between facilities. New legislation in the form of the Servicemembers' Telemedicine and E-Health Portability (STEP) Act will potentially expand telehealth clinical services across state lines into the homes of our service members and veterans.

45 CFR 402.11 - Limitations on Use of SLIAG Funds.

Code of Federal Regulations, 2010 CFR

2010-10-01

... assistance, and educational services. In the event that a State does not require use of a full 10% in one of... listed in this paragraph. (e) Payments for educational services in any fiscal year may not exceed the...), (2), and (6) of this section. (1) Payments may be made to a local educational agency in a fiscal year...

RAF and Sustainment Warfighting Function

DTIC Science & Technology

2015-02-01

doctrinally require only limited external augmentation to conduct the full range of military operations (ROMO).7 Report Documentation Page Form ...Standard Form 298 (Rev. 8-98) Prescribed by ANSI Std Z39-18 72 Regionally Aligned Forces: Concept Viability and Implementation United States Army...services encompass a wide range of human resource management, financial, legal, religious, and military band support.11 Health service support ( HSS

14 CFR 61.77 - Special purpose pilot authorization: Operation of a civil aircraft of the United States and...

Code of Federal Regulations, 2010 CFR

2010-01-01

... airplanes for the public transport of passengers, mail, or cargo, in which the service passes through the... transport of passengers, mail, or cargo, in which service passes through the air space over the territory of... this section. (e) Age limitation. No person who holds a special purpose pilot authorization issued...

Access to and use of infertility services in the United States: framing the challenges.

PubMed

Adashi, Eli Y; Dean, Laura A

2016-05-01

An overview of access to and use of general infertility and assisted reproductive technology (ART) services in the United States (U.S.) shows a declining trend for the ever-use of infertility services. Moreover, the use of ART services lags relative to other member nations of the Organization for Economic Co-operation and Development (OECD). Access to and use of general infertility and ART services is primarily undermined by a severely constrained underwriting universe dominated by self-insured employers and by a finite number of state infertility insurance mandates. The contribution of traditional public and private payers to the underwriting of ART is limited. As compared with OECD member nations wherein the access to and underwriting of general infertility and ART services is universal, the current status quo in the U.S. can only be characterized as dismal. Further, the current state of affairs is socially unjust in that the right to build a family in the face of infertility appears to have become a function of economic prowess. Given the dominance of the self-insured employers as underwriters of general infertility and ART services, advocacy directed at this interest group is likely to prove most productive. Improving the state of underwriting of general infertility and ART services in the U.S. must be embraced as a central moral imperative and as an unwavering strategic goal of the professional societies entrusted with the reproductive health of women and men. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

42 CFR 438.50 - State Plan requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... limit freedom of choice by requiring recipients to receive their benefits through managed care entities..., cooperative agreement or compact with the Indian Health Service. (3) Children under 19 years of age who are...

Estimating debt capacity of New York State Health facilities.

PubMed

Hogan, A J

1985-01-01

A measure of the capacity to take on new debt is developed for health facilities. This measure is a function of the current financial position of the facility, future financial market conditions (interest rates and bond/loan maturities), and a policy variable (the debt service coverage ratio) to be set by state health policy makers. The quality of this measure was shown to depend on the quality of current health facility financial accounting data, on the quality of forecasts of interest rates and future cashflow, and on the appropriateness of the criterion debt service coverage ratio. Some of the limitations of the estimate are discussed. Consideration of the debt capacity estimate serves to highlight some crucial issues in imposing capital expenditure limits, namely the interrelationships between financial viability, interest rates and access to capital markets.

78 FR 58377 - 30-Day Notice of Proposed Information Collection: Application for a U.S. Passport: Name Change...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-23

...: Application for a U.S. Passport: Name Change, Data Correction, and Limited Passport Book Replacement ACTION... documents, to U.S. Department of State, Bureau of Consular Affairs, Passport Services, Office of Program...: Application for a U.S. Passport: Name Change, Data Correction, and Limited Passport Book Replacement. OMB...

77 FR 66746 - Fisheries of the Northeastern United States; Atlantic Herring Fishery; Sub-ACL (Annual Catch...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-07

...-ACL (Annual Catch Limit) Harvested for Management Area 1A AGENCY: National Marine Fisheries Service... catch, annual catch limit (ACL), optimum yield, domestic harvest and processing, U.S. at-sea processing, border transfer, and the sub-ACL for each management area. The 2012 Domestic Annual Harvest was set as 91...

76 FR 61061 - Fisheries of the Northeastern United States; Atlantic Herring Fishery; Sub-ACL (Annual Catch...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-03

...-ACL (Annual Catch Limit) Harvested for Management Area 3 AGENCY: National Marine Fisheries Service...-ACL (annual catch limit) for Area 3 becomes available, except when transiting as described in this notice. This action is based on the determination that 95 percent of the herring sub-ACL allocated to...

77 FR 61299 - Fisheries of the Northeastern United States; Atlantic Herring Fishery; Sub-ACL (Annual Catch...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-09

...-ACL (Annual Catch Limit) Harvested for Management Area 3 AGENCY: National Marine Fisheries Service..., annual catch limit (ACL), optimum yield, domestic harvest and processing, U.S. at-sea processing, border transfer, and the sub-ACL for each management area. The 2012 Domestic Annual Harvest was set as 91,200...

50 CFR 20.107 - Seasons, limits, and shooting hours for tundra swans.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 50 Wildlife and Fisheries 6 2010-10-01 2010-10-01 false Seasons, limits, and shooting hours for tundra swans. 20.107 Section 20.107 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR (CONTINUED) TAKING, POSSESSION, TRANSPORTATION, SALE, PURCHASE, BARTER, EXPORTATION, AND IMPORTATION OF WILDLIFE AND PLANTS ...

Using Registered Dental Hygienists to Promote a School-Based Approach to Dental Public Health

PubMed Central

Wellever, Anthony; Kelly, Patricia

2017-01-01

We examine a strategy for improving oral health in the United States by focusing on low-income children in school-based settings. Vulnerable children often experience cultural, social, economic, structural, and geographic barriers when trying to access dental services in traditional dental office settings. These disparities have been discussed for more than a decade in multiple US Department of Health and Human Services publications. One solution is to revise dental practice acts to allow registered dental hygienists increased scope of services, expanded public health delivery opportunities, and decreased dentist supervision. We provide examples of how federally qualified health centers have implemented successful school-based dental models within the parameters of two state policies that allow registered dental hygienists varying levels of dentist supervision. Changes to dental practice acts at the state level allowing registered dental hygienists to practice with limited supervision in community settings, such as schools, may provide vulnerable populations greater access to screening and preventive services. We derive our recommendations from expert opinion. PMID:28661808

Pandemic Influenza Preparedness and Response Among Immigrants and Refugees

PubMed Central

Tinker, Timothy; Vaughan, Elaine; Kapella, Bryan K.; Brenden, Marta; Woznica, Celine V.; Rios, Elena; Lichtveld, Maureen

2009-01-01

Some immigrants and refugees might be more vulnerable than other groups to pandemic influenza because of preexisting health and social disparities, migration history, and living conditions in the United States. Vulnerable populations and their service providers need information to overcome limited resources, inaccessible health services, limited English proficiency and foreign language barriers, cross-cultural misunderstanding, and inexperience applying recommended guidelines. To increase the utility of guidelines, we searched the literature, synthesized relevant findings, and examined their implications for vulnerable populations and stakeholders. Here we summarize advice from an expert panel of public health scientists and service program managers who attended a meeting convened by the Centers for Disease Control and Prevention, May 1 and 2, 2008, in Atlanta, Georgia. PMID:19461109

Access to inpatient dermatology care in Pennsylvania hospitals.

PubMed

Messenger, Elizabeth; Kovarik, Carrie L; Lipoff, Jules B

2016-01-01

Access to care is a known issue in dermatology, and many patients may experience long waiting periods to see a physician. In this study, an anonymous online survey was sent to all 274 Pennsylvania hospitals licensed by the US Department of Health in order to evaluate current levels of access to inpatient dermatology services. Although the response rate to this survey was limited, the data suggest that access to inpatient dermatology services is limited and may be problematic in hospitals across the United States. Innovation efforts and further studies are needed to address this gap in access to care.

42 CFR 54.8 - Right to services from an alternative provider.

Code of Federal Regulations, 2013 CFR

2013-10-01

... CHARITABLE CHOICE REGULATIONS APPLICABLE TO STATES RECEIVING SUBSTANCE ABUSE PREVENTION AND TREATMENT BLOCK..., but not limited to, 42 CFR Part 2 (“Confidentiality of Alcohol and Drug Abuse Patient Records”); (4...

42 CFR 54.8 - Right to services from an alternative provider.

Code of Federal Regulations, 2012 CFR

2012-10-01

... CHARITABLE CHOICE REGULATIONS APPLICABLE TO STATES RECEIVING SUBSTANCE ABUSE PREVENTION AND TREATMENT BLOCK..., but not limited to, 42 CFR Part 2 (“Confidentiality of Alcohol and Drug Abuse Patient Records”); (4...

42 CFR 54.8 - Right to services from an alternative provider.

Code of Federal Regulations, 2010 CFR

2010-10-01

... CHARITABLE CHOICE REGULATIONS APPLICABLE TO STATES RECEIVING SUBSTANCE ABUSE PREVENTION AND TREATMENT BLOCK..., but not limited to, 42 CFR Part 2 (“Confidentiality of Alcohol and Drug Abuse Patient Records”); (4...

42 CFR 54.8 - Right to services from an alternative provider.

Code of Federal Regulations, 2011 CFR

2011-10-01

... CHARITABLE CHOICE REGULATIONS APPLICABLE TO STATES RECEIVING SUBSTANCE ABUSE PREVENTION AND TREATMENT BLOCK..., but not limited to, 42 CFR Part 2 (“Confidentiality of Alcohol and Drug Abuse Patient Records”); (4...

42 CFR 54.8 - Right to services from an alternative provider.

Code of Federal Regulations, 2014 CFR

2014-10-01

... CHARITABLE CHOICE REGULATIONS APPLICABLE TO STATES RECEIVING SUBSTANCE ABUSE PREVENTION AND TREATMENT BLOCK..., but not limited to, 42 CFR Part 2 (“Confidentiality of Alcohol and Drug Abuse Patient Records”); (4...

20 CFR 655.1230 - What time limits are imposed in ALJ proceedings?

Code of Federal Regulations, 2010 CFR

2010-04-01

... OF LABOR TEMPORARY EMPLOYMENT OF FOREIGN WORKERS IN THE UNITED STATES What are the Department's... where service is by mail. In the interest of expeditious proceedings, the administrative law judge may...

The Occupational Health of Migrant and Seasonal Farmworkers in the United States. Report Summary. Second Edition.

ERIC Educational Resources Information Center

National Rural Health Care Association, Kansas City, MO.

The estimated three million United States migrant and seasonal farmworkers and their families suffer from a variety of occupational hazards and ailments exacerbated by limited, or nonexistent, health care services. Although existing migrant and seasonal farmworker health data is incomplete, general statements can be made about the health risks…

Program Overview and Performance. Fall 1997, Spring 1998, Summer 1998. Wichita State University.

ERIC Educational Resources Information Center

de Silva, Deema

This report describes activities of the Student Support Services Program at Wichita State University (Kansas) during 1997-1998, the second year of a five-year federal grant. The program is designed to meet the special needs of limited-income and first-generation college students, and includes study-skill development, peer tutoring, and academic…

Mobility Status as a Predictor of Obesity, Physical Activity, and Screen Time Use among Children Aged 5-11 Years in the United States.

PubMed

Wilson, Patrick B; Haegele, Justin A; Zhu, Xihe

2016-09-01

To examine physical activity participation, screen time habits, and the prevalence of overweight/obesity among children in the general population with mobility limitations and those enrolled in special education services. An observational, cross-sectional analysis of the 2011-2014 National Health and Nutrition Examination Survey, a representative sample of the US population. Mobility limitations, special education services utilization, proxy-reported physical activity and screen time, and overweight/obesity status were assessed in children aged 5-11 years. Boys with mobility limitations were less likely to meet physical activity guidelines (≥60 minutes daily) compared with those with no limitations (58.1% vs 74.4%, adjusted F = 4.61, P = .04). In a logistic regression model, boys with mobility limitations had significantly lower odds (0.42, 95% CI 0.20-0.86) of meeting physical activity guidelines. The prevalence of children meeting screen time recommendations (≤2 hours daily) among those receiving special education services (42.4%) was lower than children not receiving services (53.2%; adjusted F = 8.87, P < .01). In a logistic regression model, children receiving special education services showed a trend toward significantly lower odds (0.74, 95% CI 0.54-1.03, P = .07) of meeting screen time recommendations. No statistically significant differences for overweight/obesity were found. Clear differences were present in physical activity between boys with and without mobility limitations. Furthermore, children receiving special education services demonstrated a lower likelihood of meeting screen time recommendations. Children with disabilities may benefit from targeted interventions aimed at increasing physical activity while decreasing screen time. Copyright © 2016 Elsevier Inc. All rights reserved.

Quality differentials and reproductive health service utilisation determinants in India.

PubMed

Anand, Sandip; Sinha, R K

2010-01-01

This paper seeks to establish relationships between women's reproductive health service use, assessed longitudinally and by facility type, with service quality perceptions related to public or private health facilities. The study was mainly secondary and quantitative in nature. It included analysing data collected by the International Institute for Population Sciences (IIPS) and The Johns Hopkins University (JHU) as a follow-up study to the 1998-1999 National Family Health Survey (NFHS-2). The follow-up survey was carried out in Tamil Nadu, Maharashtra, Bihar and Jharkhand. In 2002-2003, these four states were selected to capture socio-economic and demographic variations. Analysis includes composite indices and logistic regression analysis. A scale was constructed to measure utilisation levels. Dimensions include: service proximity, doctor availability, waiting time, medicines, facility cleanliness, dignified treatment, privacy, service affordability and treatment effectiveness. Findings indicate that doctor availability, waiting time, cleanliness, privacy and affordability at private health facilities enhance the probability that a health facility will be used for any reproductive health purpose. At the combined states level, medicine availability and treatment effectiveness at public health facilities enhances service use. The major limitation is that the study includes only selected Indian states. The findings may enhance Indian service-quality policy. The paper's main contribution is that seemingly for the first time in India, healthcare service use has been measured longitudinally and then explained through service quality variables by comparing public and private health facilities.

Perceived Educational Needs and Preparation of Adult Protective Services Workers for Practice with End-of-Life Issues

ERIC Educational Resources Information Center

Csikai, Ellen L.; Durkin, Daniel W.

2009-01-01

As the number of older adults in the United States increases, so will the expected number of allegations of elder abuse. Adult protective services (APS) staff are likely to handle much more complex situations, and in growing numbers, due to the presence of chronic and life-limiting conditions of their clients. The APS workers, in this national…

The “empty void” is a crowded space: health service provision at the margins of fragile and conflict affected states

PubMed Central

2014-01-01

Background Definitions of fragile states focus on state willingness and capacity to ensure security and provide essential services, including health. Conventional analyses and subsequent policies that focus on state-delivered essential services miss many developments in severely disrupted healthcare arenas. The research seeks to gain insights about the large sections of the health field left to evolve spontaneously by the absent or diminished state. Methods The study examined six diverse case studies: Afghanistan, Central African Republic, Democratic Republic of the Congo, Haïti, Palestine, and Somalia. A comprehensive documentary analysis was complemented by site visits in 2011–2012 and interviews with key informants. Results Despite differing histories, countries shared chronic disruption of health services, with limited state service provision, and low community expectations of quality of care. The space left by compromised or absent state-provided services is filled by multiple diverse actors. Health is commoditized, health services are heterogeneous and irregular, with public goods such as immunization and preventive services lagging behind curative ones. Health workers with disparate skills, and atypical health facilities proliferate. Health care absorbs large private expenditures, sustained by households, remittances, charitable and solidarity funding, and constitutes a substantial portion of the country economy. Pharmaceutical markets thrive. Trans-border healthcare provision is prominent in most studied settings, conferring regional and sometimes true globalized characteristics to these arenas. Conclusions We identify three distortions in the way the global development community has considered health service provision. The first distortion is the assumption that beyond the reach of state- and donor-sponsored services is a “void”, waiting to be filled. Our analysis suggests that the opposite is the case. The second distortion relates to the inadequacy of the usual binary categories structuring conventional health system analyses, when applied to these contexts. The third distortion reflects the failure of the global development community to recognise—or engage—the emergent networks of health providers. To effectively harness the service provision currently available in this crowded space, development actors need to adapt their current approaches, engage non-state providers, and support local capacity and governance, particularly grassroots social institutions with a public-good orientation. PMID:25349625

Understanding the role of intersectoral convergence in the delivery of essential maternal and child nutrition interventions in Odisha, India: a qualitative study.

PubMed

Kim, Sunny S; Avula, Rasmi; Ved, Rajani; Kohli, Neha; Singh, Kavita; van den Bold, Mara; Kadiyala, Suneetha; Menon, Purnima

2017-02-02

Convergence of sectoral programs is important for scaling up essential maternal and child health and nutrition interventions. In India, these interventions are implemented by two government programs - Integrated Child Development Services (ICDS) and National Rural Health Mission (NRHM). These programs are designed to work together, but there is limited understanding of the nature and extent of coordination in place and needed at the various administrative levels. Our study examined how intersectoral convergence in nutrition programming is operationalized between ICDS and NRHM from the state to village levels in Odisha, and the factors influencing convergence in policy implementation and service delivery. Semi-structured interviews were conducted with state-level stakeholders (n = 12), district (n = 19) and block officials (n = 66), and frontline workers (FLWs, n = 48). Systematic coding and content analysis of transcripts were undertaken to elucidate themes and patterns related to the degree and mechanisms of convergence, types of actions/services, and facilitators and barriers. Close collaboration at state level was observed in developing guidelines, planning, and reviewing programs, facilitated by a shared motivation and recognized leadership for coordination. However, the health department was perceived to drive the agenda, and different priorities and little data sharing presented challenges. At the district level, there were joint planning and review meetings, trainings, and data sharing, but poor participation in the intersectoral meetings and limited supervision. While the block level is the hub for planning and supervision, cooperation is limited by the lack of guidelines for coordination, heavy workload, inadequate resources, and poor communication. Strong collaboration among FLWs was facilitated by close interpersonal communication and mutual understanding of roles and responsibilities. Congruent or shared priorities and regularity of actions between sectors across all levels will likely improve the quality of coordination, and clear roles and leadership and accountability are imperative. As convergence is a means to achieving effective coverage and delivery of services for improved maternal and child health and nutrition, focus should be on delivering all the essential services to the mother-child dyads through mechanisms that facilitate a continuum of care approach, rather than sectorally-driven, service-specific delivery processes.

MFC Communications Infrastructure Study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Michael Cannon; Terry Barney; Gary Cook

2012-01-01

Unprecedented growth of required telecommunications services and telecommunications applications change the way the INL does business today. High speed connectivity compiled with a high demand for telephony and network services requires a robust communications infrastructure.   The current state of the MFC communication infrastructure limits growth opportunities of current and future communication infrastructure services. This limitation is largely due to equipment capacity issues, aging cabling infrastructure (external/internal fiber and copper cable) and inadequate space for telecommunication equipment. While some communication infrastructure improvements have been implemented over time projects, it has been completed without a clear overall plan and technology standard.more »   This document identifies critical deficiencies with the current state of the communication infrastructure in operation at the MFC facilities and provides an analysis to identify needs and deficiencies to be addressed in order to achieve target architectural standards as defined in STD-170. The intent of STD-170 is to provide a robust, flexible, long-term solution to make communications capabilities align with the INL mission and fit the various programmatic growth and expansion needs.« less

77 FR 10668 - Fisheries of the Northeastern United States; Atlantic Herring Fishery; Sub-ACL (Annual Catch...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-23

...-ACL (Annual Catch Limit) Harvested for Management Area 2 AGENCY: National Marine Fisheries Service... biological catch, annual catch limit (ACL), optimum yield, domestic harvest and processing, U.S. at-sea...,200 metric tons (mt); the 2012 sub-ACL allocated to Area 2 is 22,146 mt, and 0 mt of the sub-ACL is...

78 FR 21071 - Fisheries of the Northeastern United States; Atlantic Herring Fishery; Sub-ACL (Annual Catch...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-09

...-ACL (Annual Catch Limit) Harvested for Management Area 2 AGENCY: National Marine Fisheries Service... limit (ACL), optimum yield, domestic harvest and processing, U.S. at-sea processing, border transfer...); the 2013 sub-ACL allocated to Area 2 is 22,146 mt, and 0 mt of the sub-ACL is set aside for research...

Statewide Implementation of Parenting with Love and Limits Among Youth with Co-Existing Internalizing and Externalizing Functional Impairments Reduces Return to Service Rates and Treatment Costs.

PubMed

Sterrett-Hong, Emma M; Karam, Eli; Kiaer, Lynn

2017-09-01

Many community mental health (CMH) systems contain inefficiencies, contributing to unmet need for services among youth. Using a quasi-experimental research design, we examined the implementation of an adapted structural-strategic family intervention, Parenting with Love and Limits, in a state CMH system to increase efficiency of services to youth with co-existing internalizing and externalizing functional impairments (PLL n = 296; Treatment-As-Usual n = 296; 54% male; 81% Caucasian). Youth receiving PLL experienced shorter treatment durations and returned to CMH services at significantly lower rates than youth receiving treatment-as-usual. They also demonstrated significant decreases in internalizing and externalizing symptoms over time. Findings lay the foundation for further examination of the role of an adapted structural-strategic family treatment in increasing the efficiency of CMH systems.

Medicaid provider reimbursement policy for adult immunizations☆

PubMed Central

Stewart, Alexandra M.; Lindley, Megan C.; Cox, Marisa A.

2015-01-01

Background State Medicaid programs establish provider reimbursement policy for adult immunizations based on: costs, private insurance payments, and percentage of Medicare payments for equivalent services. Each program determines provider eligibility, payment amount, and permissible settings for administration. Total reimbursement consists of different combinations of Current Procedural Terminology codes: vaccine, vaccine administration, and visit. Objective Determine how Medicaid programs in the 50 states and the District of Columbia approach provider reimbursement for adult immunizations. Design Observational analysis using document review and a survey. Setting and participants Medicaid administrators in 50 states and the District of Columbia. Measurements Whether fee-for-service programs reimburse providers for: vaccines; their administration; and/or office visits when provided to adult enrollees. We assessed whether adult vaccination services are reimbursed when administered by a wide range of providers in a wide range of settings. Results Medicaid programs use one of 4 payment methods for adults: (1) a vaccine and an administration code; (2) a vaccine and visit code; (3) a vaccine code; and (4) a vaccine, visit, and administration code. Limitations Study results do not reflect any changes related to implementation of national health reform. Nine of fifty one programs did not respond to the survey or declined to participate, limiting the information available to researchers. Conclusions Medicaid reimbursement policy for adult vaccines impacts provider participation and enrollee access and uptake. While programs have generally increased reimbursement levels since 2003, each program could assess whether current policies reflect the most effective approach to encourage providers to increase vaccination services. PMID:26403369

7 CFR 1780.10 - Limitations.

Code of Federal Regulations, 2014 CFR

2014-01-01

... funding for the project is not at reasonable rates and terms; and (4) Pay project costs when other funding... median household income of the service area is below the higher of the poverty line or 80% of the state...

7 CFR 1780.10 - Limitations.

Code of Federal Regulations, 2013 CFR

2013-01-01

... funding for the project is not at reasonable rates and terms; and (4) Pay project costs when other funding... median household income of the service area is below the higher of the poverty line or 80% of the state...

7 CFR 1780.10 - Limitations.

Code of Federal Regulations, 2011 CFR

2011-01-01

... funding for the project is not at reasonable rates and terms; and (4) Pay project costs when other funding... median household income of the service area is below the higher of the poverty line or 80% of the state...

7 CFR 1780.10 - Limitations.

Code of Federal Regulations, 2012 CFR

2012-01-01

... funding for the project is not at reasonable rates and terms; and (4) Pay project costs when other funding... median household income of the service area is below the higher of the poverty line or 80% of the state...

50 CFR 20.103 - Seasons, limits, and shooting hours for mourning and white-winged doves and wild pigeons.

Code of Federal Regulations, 2014 CFR

2014-10-01

... STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR (CONTINUED) TAKING, POSSESSION...] Editorial Note: For Federal Register citations affecting annual regulatory schedules for this section, see...

50 CFR 20.103 - Seasons, limits, and shooting hours for mourning and white-winged doves and wild pigeons.

Code of Federal Regulations, 2013 CFR

2013-10-01

... STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR (CONTINUED) TAKING, POSSESSION...] Editorial Note: For Federal Register citations affecting annual regulatory schedules for this section, see...

50 CFR 20.103 - Seasons, limits, and shooting hours for mourning and white-winged doves and wild pigeons.

Code of Federal Regulations, 2012 CFR

2012-10-01

... STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR (CONTINUED) TAKING, POSSESSION...] Editorial Note: For Federal Register citations affecting annual regulatory schedules for this section, see...

50 CFR 20.103 - Seasons, limits, and shooting hours for mourning and white-winged doves and wild pigeons.

Code of Federal Regulations, 2011 CFR

2011-10-01

... STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR (CONTINUED) TAKING, POSSESSION...] Editorial Note: For Federal Register citations affecting annual regulatory schedules for this section, see...

76 FR 49497 - Privacy Act of 1974; Department of Homeland Security/United States Secret Service-001 Criminal...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-10

... material compiled for law enforcement purposes, including but not limited to, handwriting exemplars; laboratory analyses of inks and papers; handwriting analyses; petitions for the remission of forfeitures...

7 CFR 3419.4 - Limited waiver authority.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Agriculture Regulations of the Department of Agriculture (Continued) COOPERATIVE STATE RESEARCH, EDUCATION, AND EXTENSION SERVICE, DEPARTMENT OF AGRICULTURE MATCHING FUNDS REQUIREMENT FOR AGRICULTURAL RESEARCH AND EXTENSION FORMULA FUNDS AT 1890 LAND-GRANT INSTITUTIONS, INCLUDING TUSKEGEE UNIVERSITY, AND AT...

Comparison of prescription reimbursement methodologies in Japan and the United States.

PubMed

Akaho, Eiichi; MacLaughlin, Eric J; Takeuchi, Yoshikazu

2003-01-01

To compare methods of prescription reimbursement in Japan and the United States. Data were obtained through interviews and a search of the pharmacy literature using MEDLINE, International Pharmaceutical Abstracts, the Iowa Drug Information Service, and the Internet. Search terms were pharmacy, dispensing fee, reimbursement, prescriptions, Japan, United States, and average wholesale price (AWP). A comprehensive search was done (i.e., no year limits were observed). Performed manually by the authors. The reimbursement systems for prescriptions differ widely between Japan and the United States. The reimbursement system in the United States is fairly straightforward and easy to understand; it is generally based on product cost (e.g., AWP minus a percentage) plus a small dispensing fee. The system in Japan is extremely complex. Reimbursement formulae have four components, including fees for professional dispensing, drug cost, counseling and administration, and medication supplies and devices. Additionally, various adjustments to the final amount are made based on dosage form, length of therapy, number of prescriptions dispensed by the pharmacy per month, and when the prescription is filled (e.g., after hours, on Sundays or holidays). In Japan, each pharmacist is limited to filling 40 prescriptions per day, but each "prescription" can involve several medication orders, making it difficult to compare Japanese pharmacists' workloads with those of their counterparts in the United States. In addition, Japanese pharmacists are provided remuneration for providing various cognitive services, such as taking a patient history, counseling a patient, consulting with a physician, and identifying drug-related problems. Japan and the United States have very different methods of reimbursing pharmacists for dispensing prescriptions, each with positive and negative features. Based on the features of pharmacy reimbursement systems in each country, perhaps the optimal pharmacy practice system would have workload limits that reflect safety standards and amount of support staff available, provide a fair and standardized method for determining drug cost, are relatively straightforward, pay for cognitive services, and provide care for all of citizens through of some type of national health care system.

Status of Net Metering: Assessing the Potential to Reach Program Caps

DOE Office of Scientific and Technical Information (OSTI.GOV)

Heeter, J.; Gelman, R.; Bird, L.

2014-09-01

Several states are addressing the issue of net metering program caps, which limit the total amount of net metered generating capacity that can be installed in a state or utility service territory. In this analysis, we examine net metering caps to gain perspective on how long net metering will be available in various jurisdictions under current policies. We also surveyed state practices and experience to understand important policy design considerations.

Optimal control of M/M/1 two-phase queueing system with state-dependent arrival rate, server breakdowns, delayed repair, and N-policy

NASA Astrophysics Data System (ADS)

Rao, Hanumantha; Kumar, Vasanta; Srinivasa Rao, T.; Srinivasa Kumar, B.

2018-04-01

In this paper, we examine a two-stage queueing system where the arrivals are Poisson with rate depends on the condition of the server to be specific: vacation, pre-service, operational or breakdown state. The service station is liable to breakdowns and deferral in repair because of non-accessibility of the repair facility. The service is in two basic stages, the first being bulk service to every one of the customers holding up on the line and the second stage is individual to each of them. The server works under N-policy. The server needs preliminary time (startup time) to begin batch service after a vacation period. Startup times, uninterrupted service times, the length of each vacation period, delay times and service times follows an exponential distribution. The closed form of expressions for the mean system size at different conditions of the server is determined. Numerical investigations are directed to concentrate the impact of the system parameters on the ideal limit N and the minimum base expected unit cost.

Kentucky physicians and politics.

PubMed

VonderHaar, W P; Monnig, W B

1998-09-01

Approximately 19% of Kentucky Physicians are KEMPAC members or contribute to state legislative and Gubernatorial candidates. This limited study of political activity indicates that a small percentage of physicians participate in the political process. Despite the small number of contributors to state legislative candidates, KMA's legislative and lobbying effort is highly effective and members receive high quality service and representation in the political arena.

Promoting Global Perspective and Raising the Visibility of Asia in World History: An Assignment for Pre-Service Teachers

ERIC Educational Resources Information Center

Keirn, Tim; Luhr, Eileen; Escobar, Miguel; Choudhary, Manoj

2012-01-01

Given California's role in the Pacific economy, its historic Asian heritage, and the strong and growing presence of Asian communities and businesses in the state, it is imperative that students statewide understand the history of Asia. Unfortunately, the California state curricular framework and standards in history and social science limit the…

Options for Optimal Coverage of Free C-Section Services for Poor Mothers in Indian State of Gujarat: Location Allocation Analysis Using GIS.

PubMed

Vora, Kranti Suresh; Yasobant, Sandul; Sengupta, Raja; De Costa, Ayesha; Upadhyay, Ashish; Mavalankar, Dileep V

2015-01-01

Gujarat, a western state of India, has seen a steep rise in the proportion of institutional deliveries over the last decade. However, there has been a limited access to cesarean section (C-Section) deliveries for complicated obstetric cases especially for poor rural women. C-section is a lifesaving intervention that can prevent both maternal and perinatal mortality. Poor women bear a disproportionate burden of maternal mortality, and lack of access to C-section, especially for these women, is an important contributor for high maternal and perinatal mortality in resource limited settings. To improve access for this underserved population in the context of inadequate public provision of emergency obstetric services, the state government of Gujarat initiated a public private partnership program called "Chiranjeevi Yojana" (CY) in 2005 to increase the number of facilities providing free C-section services. This study aimed to analyze the current availability of these services in three districts of Gujarat and to identify the best locations for additional service centres to optimize access to free C-section services using Geographic Information System technology. Supply and demand for obstetric care were calculated using secondary data from sources such as Census and primary data from cross-sectional facility survey. The study is unique in using primary data from facilities, which was collected in 2012-13. Information on obstetric beds and functionality of facilities to calculate supply was collected using pretested questionnaire by trained researchers after obtaining written consent from the participating facilities. Census data of population and birth rates for the study districts was used for demand calculations. Location-allocation model of ArcGIS 10 was used for analyses. Currently, about 50 to 84% of populations in all three study districts have access to free C-section facilities within a 20km radius. The model suggests that about 80-96% of the population can be covered for free C-section services with addition of 4-6 centres in critical but underserved regions. It was also suggested that upgrading of public sector facilities with minimal investment can improve the services. This study highlights utility of Geographic Information System technology for planning service centres to optimize access to vital lifesaving procedure such as C-section. Although the location allocation methodology has been available for decades, it has been used sparsely by public health professionals. This paper makes an important contribution to the literature for use of the method for planning in resource limited settings.

The state of mHealth development and use by palliative care services in sub-Saharan Africa: a systematic review of the literature.

PubMed

Allsop, Matthew J; Powell, Richard A; Namisango, Eve

2018-06-01

Current coverage of palliative care services in sub-Saharan Africa (SSA) remains woefully inadequate, but harnessing mHealth could be one approach to facilitate greater service coverage and engagement with patients with life-limiting progressive disease. A systematic literature review to identify the development and use of mHealth in palliative care services in SSA. 13 electronic databases from 1990 to 2015 were searched alongside the manual searching of journals and citation searching of included article reference lists. Articles were assessed against inclusion and exclusion criteria and study details extracted and tabulated by two researchers. Studies were plotted against a modified WHO mHealth and ICT framework to classify how they are targeting health system strengthening. Of the 1110 articles identified, 5 met the inclusion criteria, describing mHealth use in Nigeria, Uganda, Kenya and Malawi. Descriptive analysis has shown that existing mHealth interventions for palliative care services in SSA are limited in number and are being developed for use at the palliative treatment, guidance and coordination stage of care provision. Levels of detail about the development and structure of interventions are low. mHealth interventions for palliative care in SSA are limited. This is an opportune time to explore how evidence-based mHealth interventions could form part of the evolving palliative care services in the region. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Impact of social service and public health spending on teenage birth rates across the USA: an ecological study

PubMed Central

Sipsma, Heather L; Canavan, Maureen; Gilliam, Melissa; Bradley, Elizabeth

2017-01-01

Objective To examine whether greater state-level spending on social and public health services such as income, education and public safety is associated with lower rates of teenage births in USA. Design Ecological study. Setting USA. Participants 50 states. Primary outcome measure Our primary outcome measure was teenage birth rates. For analyses, we constructed marginal models using repeated measures to test the effect of social spending on teenage birth rates, accounting for several potential confounders. Results The unadjusted and adjusted models across all years demonstrated significant effects of spending and suggested that higher spending rates were associated with lower rates of teenage birth, with effects slightly diminishing with each increase in spending (linear effect: B=−0.20; 95% CI −0.31 to 0.08; p<0.001 and quadratic effect: B=0.003; 95% CI 0.002 to 0.005; p<0.001). Conclusion Higher state spending on social and public health services is associated with lower rates of teenage births. As states seek ways to limit healthcare costs associated with teenage birth rates, our findings suggest that protecting existing social service investments will be critical. PMID:28611088

Insights in Public Health: In What Ways are Hawaii's HIV Prevention Services Engaging Gay Male Couples and Using Technology?

PubMed

Sophus, Amber I; Fujitani, Loren; Vallabhbhai, Samantha; Antonio, Jo Anna; Yang, Pua Lani; Elliott, Elyssa; Mitchell, Jason W

2018-02-01

Partner-oriented services and Health Information and Communication technology (HICT) in the forms of mHealth (eg, smartphone applications), eHealth (eg, interactive websites), telemedicine, and social media play an important and growing role in HIV prevention. Accordingly, the present study sought to describe: (1) the primary and secondary HIV prevention services available in Hawai'i, (2) the prevention services that are available for gay male couples and partners, and (3) the prevention services that use HICT. Information about prevention services and use of HICT were obtained from websites and phone calls made to 19 organizations in the state, including the Hawai'i Department of Health. Overall, partner-oriented services were limited and only 1 couples-based service was currently being offered. Technology, namely social media, was used by 14 organizations, primarily to increase HIV awareness and advertise events. These findings may inform how best to adapt and better leverage the use of innovative technological tools to help expand access to HIV testing and counseling, sexual health education, and case management services for gay male couples and other MSM populations in the state.

Impact of social service and public health spending on teenage birth rates across the USA: an ecological study.

PubMed

Sipsma, Heather L; Canavan, Maureen; Gilliam, Melissa; Bradley, Elizabeth

2017-06-13

To examine whether greater state-level spending on social and public health services such as income, education and public safety is associated with lower rates of teenage births in USA. Ecological study. USA. 50 states. Our primary outcome measure was teenage birth rates. For analyses, we constructed marginal models using repeated measures to test the effect of social spending on teenage birth rates, accounting for several potential confounders. The unadjusted and adjusted models across all years demonstrated significant effects of spending and suggested that higher spending rates were associated with lower rates of teenage birth, with effects slightly diminishing with each increase in spending (linear effect: B=-0.20; 95% CI -0.31 to 0.08; p<0.001 and quadratic effect: B=0.003; 95% CI 0.002 to 0.005; p<0.001). Higher state spending on social and public health services is associated with lower rates of teenage births. As states seek ways to limit healthcare costs associated with teenage birth rates, our findings suggest that protecting existing social service investments will be critical. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The relationship between state capacity measures and allocations to children and youth with special needs within the MCH Services Block Grant.

PubMed

Margolis, Lewis H; Mayer, Michelle; Clark, Kathryn A; Farel, Anita M

2009-07-01

To examine the association between state economic, political and health services capacity and state allocations for Title V capacity for Children and Youth with Special Health Care Needs (CSHCN). Numerous datasets were reviewed to select 13 state capacity measures: per capita Gross State Product (economic); governor's institutional powers and legislative professionalism (political); percent of Children with Special Health Care Needs, percent of uninsured children, percent of children enrolled in Medicaid, state health funds as a percent of Gross State Product, ratio of Medicaid to Medicare fees, percent of children in Medicaid enrolled in managed care, per capita Medicaid expenditures for children, ratios of pediatricians/family practitioners and pediatric subspecialists per 10,000 children, and categorical versus functional state definition of CSHCN (health). Five measures of Title V capacity were selected from the Title V Information System, four that reflect allocation decisions by states and the fifth a state assessment of the role of families in Title V decision-making: ratio of state/federal Title V spending; per capita state Title V spending; percent of state Title V spending on CSHCN; state per child spending on CSHCN; and, state Title V Family Participation Score. OLS regression was used to model the association between state and Title V capacity measures. The percentage of the state's gross state product (GSP) accounted for by state health funds and the per capita GSP were positively associated with the per capita expenditures on all children. The percentage of CSHCN in the state was negatively associated with the ratio of state to federal support for Title V and the per child expenditures on CSHCN. Lower family participation scores were associated with having a hybrid legislature; however, higher family participation scores were found in states using a functional definition of special needs. Measures of state economic, political and health services capacity do not demonstrate consistent and significant associations with the Title V capacity measures that we explored. States with greater economic capacity appear to devote more financial resources to Title V. Our finding that per capita CSHCN expenditures are negatively associated with the percentage of CSHCN in the state suggests that there is an upper limit on what states devote to CSHCN. Our current understanding of what state factors influence Title V capacity remains limited.

Science-based management of public lands in southern Nevada [Chapter 11] (Executive Summary)

Treesearch

Matthew L. Brooks; Jeanne C. Chambers

2013-01-01

Landmark legislation provides guiding principles for land management planning in southern Nevada and the rest of the United States. Such legislation includes, but is not limited to, the Forest Service Organic Administration Act of 1897 (16 U.S.C. 473-478, 479-482 and 551), National Park Service Organic Act of 1916 (U.S.C. Title 16, Secs. 1-4), Wilderness Act 1964 (P.L....

Science-based management of public lands in southern Nevada [Chapter 11

Treesearch

Matthew L. Brooks; Jeanne C. Chambers

2013-01-01

Landmark legislation provides guiding principles for land management planning in southern Nevada and the rest of the United States. Such legislation includes, but is not limited to, the Forest Service Organic Administration Act of 1897 (16 U.S.C. 473-478, 479-482 and 551), National Park Service Organic Act of 1916 (U.S.C. Title 16, Secs. 1-4), Wilderness Act 1964 (P.L....

Keeping Up with California: The Impact of Massachusetts' Proposition 2-1/2 on Local Children's Services [Chapter Three].

ERIC Educational Resources Information Center

Kim, Karl E.

This analysis is the third of a series of seven reports on the ways that the urban fiscal crisis has affected children. There has been little reorganization of government services on the state, regional, or local level to compensate for the benefits to children lost as a result of local property tax limitations enacted under Proposition 2-1/2 in…

Commercial host (dram shop) liability: current status and trends.

PubMed

Mosher, James F; Cohen, Elena N; Jernigan, David H

2013-09-01

Commercial host liability (CHL, also called dram shop liability) holds alcohol retailers liable for alcohol-attributable harm caused by serving alcohol, illegally, to a patron who is already intoxicated (adult liability) or underage (underage liability). The Community Preventive Services Task Force, based on a systematic research literature review, concluded that CHL is an effective strategy for reducing excessive alcohol consumption. The current article describes the key components of CHL, its grounding in American jurisprudence, its adoption in the 50 states, and changes since 1989, when a similar assessment of these policies was conducted. The current paper focuses on three legislatively enacted restrictions: (1) increased evidentiary requirements; (2) limitations on damage awards; and (3) limitations on who may be sued. Data were collected in 2011 and analyzed in 2012 and 2013. There has been substantial erosion of CHL during the past 2 decades. Fewer states recognized CHL in 2011 than in 1989, and more statutory restrictions were imposed during the study period among states that did recognize CHL; states are more likely to recognize underage than adult liability; and six states recognized a Responsible Beverage Services Practices affirmative defense in both 1989 and 2011. Implications of these findings for public health practitioners are discussed. Copyright © 2013 American Journal of Preventive Medicine. All rights reserved.

14 CFR 211.35 - Termination of eligibility.

Code of Federal Regulations, 2010 CFR

2010-01-01

... PROCEEDINGS) ECONOMIC REGULATIONS APPLICATIONS FOR PERMITS TO FOREIGN AIR CARRIERS Freely Associated State Air... essential air transportation subsidy compensation), or subparagraph (c) (limited interstate air transportation authority), of paragraph (5) of the Agreement on Civil Aviation Economic Services and Related...

50 CFR 20.110 - Seasons, limits, and other regulations for certain Federal Indian reservations, Indian Territory...

Code of Federal Regulations, 2014 CFR

2014-10-01

... Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR (CONTINUED) TAKING, POSSESSION... reservations, Indian Territory, and ceded lands. [50 FR 35764, Sept. 3, 1985] Editorial Note: For Federal...

50 CFR 20.110 - Seasons, limits, and other regulations for certain Federal Indian reservations, Indian Territory...

Code of Federal Regulations, 2012 CFR

2012-10-01

... Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR (CONTINUED) TAKING, POSSESSION... reservations, Indian Territory, and ceded lands. [50 FR 35764, Sept. 3, 1985] Editorial Note: For Federal...

50 CFR 20.110 - Seasons, limits, and other regulations for certain Federal Indian reservations, Indian Territory...

Code of Federal Regulations, 2011 CFR

2011-10-01

... Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR (CONTINUED) TAKING, POSSESSION... reservations, Indian Territory, and ceded lands. [50 FR 35764, Sept. 3, 1985] Editorial Note: For Federal...

50 CFR 20.110 - Seasons, limits, and other regulations for certain Federal Indian reservations, Indian Territory...

Code of Federal Regulations, 2013 CFR

2013-10-01

... Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR (CONTINUED) TAKING, POSSESSION... reservations, Indian Territory, and ceded lands. [50 FR 35764, Sept. 3, 1985] Editorial Note: For Federal...

What can transaction costs tell us about governance in the delivery of large scale HIV prevention programmes in southern India?

PubMed

Guinness, Lorna

2011-06-01

This paper aims to understand the transaction costs implications of two different governance modes for large scale contracting of HIV prevention services to non-governmental organisations (NGOs) in 2 states in India as part of the National AIDS Control Programme between 2001 and 2003. Interviews at purposively selected case study NGOs, contracting agencies and key informants as well as document review were used to compile qualitative data and make comparisons between the states on five themes theoretically proposed to shape transaction costs: institutional environment, informational problems, opportunism, scale of activity and asset specificity (the degree to which investments made specifically for the contract have value elsewhere). The State AIDS Control Society (SACS) in state Y used a management agency to manage the NGO contracts whereas the SACS in state X contracted directly with the NGOs. A high level of uncertainty, endemic corruption and weak information systems served to weaken the contractual relationships in both states. The management agency in state Y enabled the development of a strong NGO network, greater transparency and control over corrupt practises than the contract model in state X. State X's contractual process was further weakened by inadequate human resources. The application of the transaction cost framework to contracting out public services to NGOs identified the key costs associated with the governance of HIV prevention services through NGO contracts in India. A more successful form of relational contract evolved within the network of the contract management agency and the NGOs. This led to improved flows of information and perceived quality, and limited corrupt practises. It is unlikely that the SACS on its own, with broader responsibilities and limited autonomy can achieve the same ends. The management agency approach therefore appears to be both transaction cost reducing and better able to cope with the large scale of these contracting programmes. Copyright © 2011 Elsevier Ltd. All rights reserved.

What can transaction costs tell us about governance in the delivery of large scale HIV prevention programmes in southern India?

PubMed Central

Guinness, Lorna

2011-01-01

This paper aims to understand the transaction costs implications of two different governance modes for large scale contracting of HIV prevention services to non-governmental organisations (NGOs) in 2 states in India as part of the National AIDS Control Programme between 2001 and 2003. Interviews at purposively selected case study NGOs, contracting agencies and key informants as well as document review were used to compile qualitative data and make comparisons between the states on five themes theoretically proposed to shape transaction costs: institutional environment, informational problems, opportunism, scale of activity and asset specificity (the degree to which investments made specifically for the contract have value elsewhere). The State AIDS Control Society (SACS) in state Y used a management agency to manage the NGO contracts whereas the SACS in state X contracted directly with the NGOs. A high level of uncertainty, endemic corruption and weak information systems served to weaken the contractual relationships in both states. The management agency in state Y enabled the development of a strong NGO network, greater transparency and control over corrupt practises than the contract model in state X. State X’s contractual process was further weakened by inadequate human resources. The application of the transaction cost framework to contracting out public services to NGOs identified the key costs associated with the governance of HIV prevention services through NGO contracts in India. A more successful form of relational contract evolved within the network of the contract management agency and the NGOs. This led to improved flows of information and perceived quality, and limited corrupt practises. It is unlikely that the SACS on its own, with broader responsibilities and limited autonomy can achieve the same ends. The management agency approach therefore appears to be both transaction cost reducing and better able to cope with the large scale of these contracting programmes. PMID:21349622

Understanding the potential of state-based public health genomics programs to mitigate disparities in access to clinical genetic services.

PubMed

Senier, Laura; Tan, Catherine; Smollin, Leandra; Lee, Rachael

2018-06-12

State health agencies (SHAs) have developed public health genomics (PHG) programs that play an instrumental role in advancing precision public health, but there is limited research on their approaches. This study examines how PHG programs attempt to mitigate or forestall health disparities and inequities in the utilization of genomic medicine. We compared PHG programs in three states: Connecticut, Michigan, and Utah. We analyzed 85 in-depth interviews with SHA internal and external collaborators and program documents. We employed a qualitative coding process to capture themes relating to health disparities and inequities. Each SHA implemented population-level approaches to identify individuals who carry genetic variants that increase risk of hereditary cancers. However, each SHA developed a unique strategy-which we label public health action repertoires-to reach specific subgroups who faced barriers in accessing genetic services. These strategies varied across states given demographics of the state population, state-level partnerships, and availability of healthcare services. Our findings illustrate the imperative of tailoring PHG programs to local demographic characteristics and existing community resources. Furthermore, our study highlights how integrating genomics into precision public health will require multilevel, multisector collaboration to optimize efficacy and equity.

Fiber Contraction Approaches for Improving CMC Proportional Limit

NASA Technical Reports Server (NTRS)

DiCarlo, James A.; Yun, Hee Mann

1997-01-01

The fact that the service life of ceramic matrix composites (CMC) decreases dramatically for stresses above the CMC proportional limit has triggered a variety of research activities to develop microstructural approaches that can significantly improve this limit. As discussed in a previous report, both local and global approaches exist for hindering the propagation of cracks through the CMC matrix, the physical source for the proportional limit. Local approaches include: (1) minimizing fiber diameter and matrix modulus; (2) maximizing fiber volume fraction, fiber modulus, and matrix toughness; and (3) optimizing fiber-matrix interfacial shear strength; all of which should reduce the stress concentration at the tip of cracks pre existing or created in the matrix during CMC service. Global approaches, as with pre-stressed concrete, center on seeking mechanisms for utilizing the reinforcing fiber to subject the matrix to in-situ compressive stresses which will remain stable during CMC service. Demonstrated CMC examples for the viability of this residual stress approach are based on strain mismatches between the fiber and matrix in their free states, such as, thermal expansion mismatch and creep mismatch. However, these particular mismatch approaches are application limited in that the residual stresses from expansion mismatch are optimum only at low CMC service temperatures and the residual stresses from creep mismatch are typically unidirectional and difficult to implement in complex-shaped CMC.

47 CFR 25.149 - Application requirements for ancillary terrestrial components in the mobile-satellite service...

Code of Federal Regulations, 2012 CFR

2012-10-01

... fifty states, Puerto Rico and the U.S. Virgin Islands, i.e., that at least one satellite will be visible.... (i) In the 2 GHz MSS band, MSS ATC is limited to an MSS licensee's selected assignment. MSS ATC... operations shall be limited to certain frequencies: (i) In the 2000-2020 MHz/2180-2200 MHz bands (2 GHz MSS...

Quality Indicators of Cervical Cytopathology Tests in the Public Service in Minas Gerais, Brazil.

PubMed

Tobias, Alessandra Hermógenes Gomes; Amaral, Rita Goreti; Diniz, Elói Martins; Carneiro, Cláudia Martins

2016-02-01

The objective of this study is to assess the performance of cytopathology laboratories providing services to the Brazilian Unified Health System (Sistema Único de Saúde - SUS) in the State of Minas Gerais, Brazil. This descriptive study uses data obtained from the Cervical Cancer Information System from January to December 2012. Three quality indicators were analyzed to assess the quality of cervical cytopathology tests: positivity index, percentage of atypical squamous cells (ASCs) in abnormal tests, and percentage of tests compatible with high-grade squamous intraepithelial lesions (HSILs). Laboratories were classified according to their production scale in tests per year ≤ 5,000; from 5,001 to 10,000; from 10,001 to 15,000; and ≥ 15,001. Based on the collection of variables and the classification of laboratories according to production scale, we created and analyzed a database using Microsoft Office Excel 97-2003. In the Brazilian state of Minas Gerais, 146 laboratories provided services to the SUS in 2012 by performing a total of 1,277,018 cervical cytopathology tests. Half of these laboratories had production scales ≤ 5,000 tests/year and accounted for 13.1% of all tests performed in the entire state; in turn, 13.7% of these laboratories presented production scales of > 15,001 tests/year and accounted for 49.2% of the total of tests performed in the entire state. The positivity indexes of most laboratories providing services to the SUS in 2012, regardless of production scale, were below or well below recommended limits. Of the 20 laboratories that performed more than 15,001 tests per year, only three presented percentages of tests compatible with HSILs above the lower limit recommended by the Brazilian Ministry of Health. The majority of laboratories providing services to the SUS in Minas Gerais presented quality indicators outside the range recommended by the Brazilian Ministry of Health. Thieme Publicações Ltda Rio de Janeiro, Brazil.

Medicare program; coverage and payment of ambulance services; inflation update for CY 2004. Final rule with comment period.

PubMed

2003-12-05

This final rule provides the sunset date for the interim bonus payment for rural ambulance mileage of 18 through 50 miles as required by the Medicare, Medicaid and State Child Health Insurance Program Benefits Improvement and Protection Act of 2000 (BIPA) and provides notice of the annual Ambulance Inflation Factor (AIF) for ambulance services for calendar year (CY) 2004. The statute requires that this inflation factor be applied in determining the fee schedule amounts and payment limits for ambulance services.

The role of non-governmental organizations in providing curative health services in North Darfur State, Sudan.

PubMed

Yagub, Abdallah I A; Mtshali, Khondlo

2015-09-01

Conflict in North Darfur state, Western Sudan started in 2003, and the delivering of curative health services was becoming a greater challenge for the country's limited resources. NGOs have played an important role in providing curative health services. To examine the role that Non-Governmental Organizations (NGOs) have played in providing curative health services, as well as to identify the difficulties and challenges that affect NGOs in delivering curative health services. Secondary data was collected from different sources, including government offices and medical organizations in Sudan and in North Darfur state. Primary data was obtained through interviews with government and NGOs representatives. The interviews were conducted with (1) expatriates working for international NGOs (N=15) (2) health professionals and administrators working in health sector (N= 45) in the period from November 2010 to January 2011. The government in North Darfur state spent 70% of its financial budget on security, while it spent it less than 1% on providing health services. The international NGOs have been providing 70% of curative health services to the State's population by contributing 52.9% of the health budget and 1 390 health personnel. Since 2003 NGOs have provided technical assistance to the health staff. As a result, more than fifty nurses have been trained to provide care and treatment, more than twenty-three doctors have been trained in laboratory equipment operation, and approximately six senior doctors and hospital directors have received management training. NGOs have been managing and supporting 89 public health facilities, and established 24 health centres in IDP camps, and 20 health centres across all the districts in North Darfur state. The NGOs have played an important role in providing curative health services and in establishing good health facilities, but a future problem is how the government will run these health facilities after a peaceful settlement has been reached which might cause NGOs to leave the region.

Athletic Training Services in Public Secondary Schools: A Benchmark Study

PubMed Central

Pryor, Riana R.; Casa, Douglas J.; Vandermark, Lesley W.; Stearns, Rebecca L.; Attanasio, Sarah M.; Fontaine, Garrett J.; Wafer, Alex M.

2015-01-01

Context: Authors of the most recent study of athletic training (AT) services have suggested that only 42% of secondary schools have access to athletic trainers. However, this study was limited by a small sample size and was conducted more than 10 years ago. Objective: To determine current AT services in public secondary schools. Design: Cross-sectional study. Setting: Public secondary schools in the United States. Patients or Other Participants: A total of 8509 (57%) of 14 951 secondary schools from all 50 states and Washington, DC, responded to the survey. Main Outcome Measure(s): Data on AT services were collected for individual states, National Athletic Trainers' Association districts, and the nation. Results: Of the 8509 schools that responded, 70% (n = 5930) had AT services, including full-time (n = 3145, 37%), part-time (n = 2619, 31%), and per diem (n = 199, 2%) AT services, and 27% (n = 2299) had AT services from a hospital or physical therapy clinic. A total of 4075 of 8509 schools (48%) provided coverage at all sports practices. Eighty-six percent (2 394 284/2 787 595) of athletes had access to AT services. Conclusions: Since the last national survey, access to AT services increased such that 70% of respondent public secondary schools provided athletic trainers at sports games or practices. Approximately one-third of all public secondary schools had full-time athletic trainers. This number must increase further to provide appropriate medical coverage at athletic practices and games for secondary school athletes. PMID:25689559

Rehabilitation in home care is associated with functional improvement and preferred discharge.

PubMed

Cook, Richard J; Berg, Katherine; Lee, Ker-Ai; Poss, Jeffrey W; Hirdes, John P; Stolee, Paul

2013-06-01

To investigate the impact of physiotherapy (PT) and occupational therapy (OT) services on long-stay home care patients with musculoskeletal disorders. Observational study. Home care programs. All long-stay home care patients between 2003 and 2008 (N=99,764) with musculoskeletal disorders who received a baseline Resident Assessment Instrument for Home Care assessment, 1 follow-up assessment, and had discharge or death records. PT and OT. The effects of PT and OT services on transitions in functional state, discharge from home care with service plans complete, institutionalization, and death were assessed via multistate Markov models. Home care patients with deficiencies in instrumental activities of daily living and/or activities of daily living at baseline and who received home-based rehabilitation had significantly increased odds of showing functional improvements by their next assessment (for a state 3 to state 2 transition: odds ratio [OR]=1.17; 95% confidence interval [CI], 1.10-1.26; P<.0001; for a state 2 to state 1 transition: OR=1.36; 95% CI, 1.14-1.61; P=.0005). Receipt of PT/OT also significantly reduced the odds of mortality and institutionalization in this group. With increasing numbers of older adults with chronic conditions and limited funding for health care services, it is essential to provide the right services at the right time in a cost-effective manner. Long-stay home care patients who receive rehabilitation at home have improved outcomes and lower utilization of costly health services. Our findings suggest that investment in PT and OT services for relatively short periods may provide savings to the health care system over the longer term. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

A PLAN FOR LIBRARY COOPERATION IN NEW HAMPSHIRE. REPORT TO NEW HAMPSHIRE STATE LIBRARY.

ERIC Educational Resources Information Center

Little (Arthur D.), Inc., Cambridge, MA.

AS A STEP TOWARD IMPROVING SERVICES TO ALL USERS, THE NEW HAMPSHIRE STATE LIBRARY SPONSORED A STUDY OF BOTH THE SYSTEM OF LIBRARIES IN NEW HAMPSHIRE AND THEIR RESOURCES. THE STUDY ITSELF IS LIMITED TO THE POSSIBLE COORDINATION OF THE RESOURCES OF ALL TYPES OF LIBRARIES (PUBLIC, SPECIAL, SCHOOL, ACADEMIC) IN A WAY WHICH WILL MAKE THEM MORE READILY…

Disaster planning: transportation resources and considerations for managing a burn disaster.

PubMed

Kearns, Randy D; Hubble, Michael W; Holmes, James H; Cairns, Bruce A

2014-01-01

A disaster scenario with a significant number of burn-injured patients creates a tremendous challenge for disaster planners. Directing the transport of patients to the most appropriate receiving facility as soon as reasonably possible remains the aim. This review focused on both the overall process as well as an analysis of one specific state (as an example). This included the capability and limitations of the intrastate and interstate resources should a burn disaster occur. Although the results for one state may be interesting, it is the process that is essential for those involved in burn disaster planning. An overview of the quantity and quality of available ambulances and how to access these resources is provided. Ground-based ambulances have an array of capacities and levels of services ranging from basic life support to advanced (paramedic) services and include ambulance buses. This review also included private and hospital-based specialty care ambulances and aeromedical services. Finally, the review identified military or federal resources that may be an option as well. There are various local, state, and federal resources that can be called upon to meet the transportation needs of these critically injured patients. Yet, there are barriers to access and limitations to their response. It is just as important to know both availability and capability as it is to know how to access these resources. A disaster is not the time to realize these hurdles.

Nursing home bed capacity in the States, 1978-86

PubMed Central

Harrington, Charlene; Swan, James H.; Grant, Leslie A.

1988-01-01

Trends in nursing home bed supply in the States show large variations in beds per population and a gradual decline in supply per aged population. A cross-sectional time-series regression analysis was used to examine some factors associated with nursing home bed supply. Variation was accounted for by economic factors, supply of alternative services, and climate. State Medicaid reimbursement rates had negative coefficients, with supply suggesting States may be increasing rates to improve access where supply is limited. Medicaid waiver policy was not found to be significant. PMID:10312634

Delivery of health services to migrant and seasonal farmworkers.

PubMed

Arcury, Thomas A; Quandt, Sara A

2007-01-01

Farmworkers are low-paid, uninsured employees in an extremely hazardous industry, and they provide an essential service for U.S. society. This review evaluates the delivery of health services to farmworkers. It describes the farmworker population in the United States, noting characteristics (e.g., migratory and immigration status) that limit their access to and utilization of health services. It describes the health services needs of this population, including occupational health, mental health, oral health, and chronic disease treatment. Cultural, structural, legal, financial, and geographic barriers to health services utilization are described. Existing research on health services utilization among farmworkers is discussed. Programs that have been developed to address the barriers to health services utilization among farmworkers are reviewed. Finally, research needed to improve knowledge of farmworker health services utilization is suggested. These research needs include formal evaluations of existing programs and basic research to characterize the health services utilization patterns of farmworkers.

Using simplified Chaos Theory to manage nursing services.

PubMed

Haigh, Carol A

2008-04-01

The purpose of this study was to evaluate the part simplified chaos theory could play in the management of nursing services. As nursing care becomes more complex, practitioners need to become familiar with business planning and objective time management. There are many time-limited methods that facilitate this type of planning but few that can help practitioners to forecast the end-point outcome of the service they deliver. A growth model was applied to a specialist service to plot service trajectory. Components of chaos theory can play a role in forecasting service outcomes and consequently the impact upon the management of such services. The ability to (1) track the trajectory of a service and (2) manipulate that trajectory by introducing new variables can allow managers to forward plan for service development and to evaluate the effectiveness of a service by plotting its end-point state.

7 CFR 1955.130 - Real estate brokers.

Code of Federal Regulations, 2012 CFR

2012-01-01

... or limited profit buyers, any excess earnest money deposit will be credited to the purchaser's... Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS... business. (a) Type of listings. The State Director may authorize use of exclusive listings during any...

7 CFR 1955.130 - Real estate brokers.

Code of Federal Regulations, 2011 CFR

2011-01-01

... or limited profit buyers, any excess earnest money deposit will be credited to the purchaser's... Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS... business. (a) Type of listings. The State Director may authorize use of exclusive listings during any...

7 CFR 1955.130 - Real estate brokers.

Code of Federal Regulations, 2013 CFR

2013-01-01

... or limited profit buyers, any excess earnest money deposit will be credited to the purchaser's... Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS... business. (a) Type of listings. The State Director may authorize use of exclusive listings during any...

7 CFR 1955.130 - Real estate brokers.

Code of Federal Regulations, 2014 CFR

2014-01-01

... or limited profit buyers, any excess earnest money deposit will be credited to the purchaser's... Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS... business. (a) Type of listings. The State Director may authorize use of exclusive listings during any...

USEEIO: a New and Transparent United States Environmentally Extended Input-Output Model

EPA Science Inventory

National-scope environmental life cycle models of goods and services may be used for many purposes, not limited to quantifying impacts of production and consumption of nations, assessing organization-wide impacts, identifying purchasing hot spots, analyzing environmental impacts ...

7 CFR 3401.9 - Use of funds; changes.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Agriculture Regulations of the Department of Agriculture (Continued) COOPERATIVE STATE RESEARCH, EDUCATION, AND EXTENSION SERVICE, DEPARTMENT OF AGRICULTURE RANGELAND RESEARCH GRANTS PROGRAM General § 3401.9... investigator(s), or other key project personnel in the approved research project grant shall be limited to...

RoadLIFE GPS : software application for processing GPS data from US550 in northwestern New Mexico.

DOT National Transportation Integrated Search

2008-04-01

Public-private partnerships as an alternative means of delivering goods and services are receiving increased attention as state departments of transportation consider ways to maximize limited resources. In 1998 the New Mexico Department of Transporta...

20 CFR 404.1276 - Reports and payments erroneously made to Internal Revenue Service-transfer of funds-for wages...

Code of Federal Regulations, 2010 CFR

2010-04-01

... limitations remain on the earnings records. (e) Filing wage reports and paying contributions. Generally, the... regular modification cannot be used (e.g., State law does not permit the retroactive effective date which...

Medicaid managed care for mental health services: the survival of safety net institutions in rural settings.

PubMed

Willging, Cathleen E; Waitzkin, Howard; Nicdao, Ethel

2008-09-01

Few accounts document the rural context of mental health safety net institutions (SNIs), especially as they respond to changing public policies. Embedded in wider processes of welfare state restructuring, privatization has transformed state Medicaid systems nationwide. We carried out an ethnographic study in two rural, culturally distinct regions of New Mexico to assess the effects of Medicaid managed care (MMC) and the implications for future reform. After 160 interviews and participant observation at SNIs, we analyzed data through iterative coding procedures. SNIs responded to MMC by nonparticipation, partnering, downsizing, and tapping into alternative funding sources. Numerous barriers impaired access under MMC: service fragmentation, transportation, lack of cultural and linguistic competency, Medicaid enrollment, stigma, and immigration status. By privatizing Medicaid and contracting with for-profit managed care organizations, the state placed additional responsibilities on "disciplined" providers and clients. Managed care models might compromise the rural mental health safety net unless the serious gaps and limitations are addressed in existing services and funding.

[Implementation of the Mobile Emergency Medical Service in Brazil: action strategies and structural dimension].

PubMed

O'Dwyer, Gisele; Konder, Mariana Teixeira; Reciputti, Luciano Pereira; Macedo, Cesar; Lopes, Monica Guimarães Macau

2017-08-07

The Mobile Emergency Medical Service (SAMU) was the first component of the National Policy for Emergency Care implemented in Brazil in the early 2000. The article analyzed the implementation of mobile pre-hospital emergency care in Brazil. The methods included document analysis, interviews with state emergency care coordinators, and an expert panel. The theoretical reference was the strategic conduct analysis from Giddens' Structuration Theory. The results showed uneven implementation of the SAMU between states and regions of Brazil, identifying six patterns of implementation, considering the states' capacity to expand the population coverage and regionalize the service. Structural difficulties included physician retention, poorly equipped dispatch centers, and shortage of ambulances. The North and Northeast were the country's most heavily affected regions. SAMU is formatted as a structuring strategy in the emergency care network, but its performance suffered the impact of limited participation by primary care in the emergency network and especially the lack of hospital beds.

A survey of direct-to-consumer teledermatology services available to US patients: Explosive growth, opportunities and controversy.

PubMed

Fogel, Alexander L; Sarin, Kavita Y

2017-01-01

Introduction Direct-to-consumer (DTC) teledermatology is radically changing the way patients obtain dermatological care. Now, with a few clicks, patients can obtain dermatological consultations and prescription medications without a prior physician-patient relationship. To analyse all DTC teledermatology services available to US patients. Methods We performed Internet searches to identify DTC teledermatology services available through Internet webpages or through smartphone applications. For each service, the scope of care provided, cost, wait times, prescription policies and other relevant information were recorded. Results Twenty-two DTC teledermatology services are available to US patients in 45 states. Six (27%) services offer care from international physicians. Sixteen (73%) services allow patients to seek care for any reason, while six (27%) limit care to acne or anti-aging. The median reported response time for DTC teledermatology services is 48 hours from the time of patient request. The median consultation fee for companies providing care from US board-certified physicians is US$59. Across all services, consultation fees range from US$1.59 to US$250. Conclusions DTC teledermatology services are readily available to patients in most states. These services may reduce the cost of patient visits, expand access to care and increase patient convenience. However, the presence of services staffed by physicians who are not US board-certified, as well as the use of incautious language regarding prescription medications, is concerning.

Slaves of the state - medical internship and community service in South Africa.

PubMed

Erasmus, Nicolette

2012-06-05

Owing to a chronic shortage of medical staff in South Africa, sleep-deprived medical interns and community service doctors work up to 200 hours of overtime per month under the state's commuted overtime policy. Nurses moonlight in circumvention of the Basic Conditions of Employment Act. For trainee doctors, overtime over 80 hours is unpaid, and rendered involuntarily under threat of not qualifying to practise medicine in South Africa. As forced labour, and sleep deprivation amounting to cruel and degrading treatment, it is outlawed in international law. No other professional group in the country is subjected to such levels of exploitation and discrimination by the state. These abuses should be challenged under the Constitution. Solutions include the installation of electronic time-recording in state hospitals, cessation of unpaid overtime, limits on medical intern shifts to a maximum of 16 hours, and an investigation by the Human Rights Commission of South Africa.

What could the program have done differently? A qualitative examination of reasons for leaving outpatient treatment

PubMed Central

Laudet, Alexandre B.; Stanick, Virginia; Sands, Brian

2009-01-01

Attrition from treatment for substance abuse disorders (SUD) is a persistent challenge that severely limits the effectiveness of services. Though a large body of research has sought to identify predictors of retention, the perspective of clients of services is rarely examined. This exploratory qualitative study presents clients’ stated reasons for leaving outpatient treatment (N = 135, 54% of the sample of 250) and their views of what could have been done differently to keep them engaged in services. Obstacles to retention fell into program- and individual-level factors; the former includes dissatisfaction with the program, especially counselors, unmet social services needs, and lack of flexibility in scheduling; individual-level barriers to retention were low problem recognition and substance use. Study limitations are noted and the implications of findings for research and practice are discussed, emphasizing the need to understand and address clients’ needs and expectations starting at intake to maximize treatment retention and the likelihood of positive outcomes. PMID:19339133

The outer limits of the welfare state: discrimination, racism and their effect on human services.

PubMed

Wershow, H J

The European social democracies have been more generous than the United States in social provision, including services to aged. The momentum of provision has slowed down in recent years. We suggest that prosperity which has led to use of foreign laborers in menial jobs has caused this slow down. The dynamics are similar to the historical U.S. use of "non-100% Americans" as our menial workers. Changes in social policy strategies are needed: 1) universal provision, rather than programs aimed at minorities, is needed to enlist support of stable working and middle classes; 2) tax reforms, which lower progressive income-tax structures for middle incomes, and value-added tax, may be necessary to overcome anti-tax ideologies; 3) clear priorities as to most necessary services must be established by the gerontological community.

Economic benefits of meteorological services

NASA Astrophysics Data System (ADS)

Freebairn, John W.; Zillman, John W.

2002-03-01

There is an increasing need for more rigorous and more broadly based determination of the economic value of meteorological services as an aid to decision-making on the appropriate level of funding to be committed to their provision at the national level. This paper develops an overall framework for assessment of the economic value of meteorological services based on the recognition that most national meteorological infrastructure and services possess the non rival properties of public goods. Given this overall framework for determination of both total and marginal benefits, four main methodologies appropriate for use in valuation studies - market prices, normative or prescriptive decision-making models, descriptive behavioural response studies and contingent valuation studies - are outlined and their strengths and limitations described. Notwithstanding the methodological limitations and the need for a much more comprehensive set of studies for the various application sectors, it is clear that the actual and potential benefits to individuals, firms, industry sectors and national economies from state-of-the-art meteorological and related services are substantial and that, at this stage, they are inadequately recognised and insufficiently exploited in many countries.

The place of punishment: Variation in the provision of inmate services staff across the punitive turn

PubMed Central

Phelps, Michelle S.

2013-01-01

Despite the growing literature on the punitive turn, knowledge of how the experience of American imprisonment varied across time and place remain limited. This article begins to fill that gap, providing a more nuanced portrayal of rehabilitation during the punitive turn. Purpose To examine how one aspect of the rehabilitative ideal in practice—the provision of staff dedicated to inmate services—varied across time and place over the past 30 years. Methods The article presents statistics on the inmate-to-staff ratios for inmate services staff (including teachers, counselors, doctors, etc.) between the years 1979 and 2005 for all 50 U.S. states. Results The analyses reveal that, while there was a substantial decline in the services staff ratio during the 1990s and 2000s, this shift across time paled in comparison to variation across place. Northeastern prison systems, for example, maintained higher inmate services staff ratios in 2005 than Southern states in any year. In addition, results suggest state variation is related to differences in prison crowding, inmates’ racial composition, and political cultures. Conclusions The findings suggest the punitive turn was more variegated and partial than is often assumed and highlight the importance of exploring state variation in penal practices. PMID:23794764

Problems in Determining School District Need for Hurd Aid and Alternatives to the Revenue Shortfall Approach for Determining Need.

ERIC Educational Resources Information Center

Curley, John R.

In New York State there is an uneven distribution of wealth and an unequal tax burden among the small city school districts. Because of the tax limits and rising costs for goods and services, many of these school districts have found it difficult to support their educational programs without emergency aid from the state. Such aid is frequently…

Nuclear Symbiosis - A Means to Achieve Sustainable Nuclear Growth while Limiting the Spread of Sensititive Nuclear Technology

DOE Office of Scientific and Technical Information (OSTI.GOV)

David Shropshire

Global growth of nuclear energy in the 21st century is creating new challenges to limit the spread of nuclear technology without hindering adoption in countries now considering nuclear power. Independent nuclear states desire autonomy over energy choices and seek energy independence. However, this independence comes with high costs for development of new indigenous fuel cycle capabilities. Nuclear supplier states and expert groups have proposed fuel supply assurance mechanisms such as fuel take-back services, international enrichment services and fuel banks in exchange for recipient state concessions on the development of sensitive technologies. Nuclear states are slow to accept any concessions tomore » their rights under the Non-Proliferation Treaty. To date, decisions not to develop indigenous fuel cycle capabilities have been driven primarily by economics. However, additional incentives may be required to offset a nuclear state’s perceived loss of energy independence. This paper proposes alternative economic development incentives that could help countries decide to forgo development of sensitive nuclear technologies. The incentives are created through a nuclear-centered industrial complex with “symbiotic” links to indigenous economic opportunities. This paper also describes a practical tool called the “Nuclear Materials Exchange” for identifying these opportunities.« less

78 FR 54442 - Magnuson-Stevens Fishery Conservation and Management Act Provisions; Fisheries of the...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-04

... United States; Annual Catch Limits and Accountability Measures AGENCY: National Marine Fisheries Service...-Atlantic Fishery Management Council has submitted the Recreational Accountability Measures Omnibus... requesting comments from the public on the Recreational Accountability Measures Omnibus Amendment, which was...

7 CFR 322.1 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

..., DEPARTMENT OF AGRICULTURE BEES, BEEKEEPING BYPRODUCTS, AND BEEKEEPING EQUIPMENT General Provisions § 322.1... Plant Health Inspection Service of the United States Department of Agriculture. Bee. Any member of the..., including, but not limited to, beeswax for beekeeping, pollen for bee feed, or honey for bee feed...

7 CFR 322.1 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., DEPARTMENT OF AGRICULTURE BEES, BEEKEEPING BYPRODUCTS, AND BEEKEEPING EQUIPMENT General Provisions § 322.1... Plant Health Inspection Service of the United States Department of Agriculture. Bee. Any member of the..., including, but not limited to, beeswax for beekeeping, pollen for bee feed, or honey for bee feed...

7 CFR 322.1 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-01-01

..., DEPARTMENT OF AGRICULTURE BEES, BEEKEEPING BYPRODUCTS, AND BEEKEEPING EQUIPMENT General Provisions § 322.1... Plant Health Inspection Service of the United States Department of Agriculture. Bee. Any member of the..., including, but not limited to, beeswax for beekeeping, pollen for bee feed, or honey for bee feed...

7 CFR 322.1 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-01-01

..., DEPARTMENT OF AGRICULTURE BEES, BEEKEEPING BYPRODUCTS, AND BEEKEEPING EQUIPMENT General Provisions § 322.1... Plant Health Inspection Service of the United States Department of Agriculture. Bee. Any member of the..., including, but not limited to, beeswax for beekeeping, pollen for bee feed, or honey for bee feed...

7 CFR 322.1 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

..., DEPARTMENT OF AGRICULTURE BEES, BEEKEEPING BYPRODUCTS, AND BEEKEEPING EQUIPMENT General Provisions § 322.1... Plant Health Inspection Service of the United States Department of Agriculture. Bee. Any member of the..., including, but not limited to, beeswax for beekeeping, pollen for bee feed, or honey for bee feed...

7 CFR 3400.7 - Use of funds; changes.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Agriculture Regulations of the Department of Agriculture (Continued) COOPERATIVE STATE RESEARCH, EDUCATION, AND EXTENSION SERVICE, DEPARTMENT OF AGRICULTURE SPECIAL RESEARCH GRANTS PROGRAM General § 3400.7 Use... investigator(s), or other key project personnel in the approved research project grant shall be limited to...

Strand development and splice device : final report, February 3, 2009.

DOT National Transportation Integrated Search

2010-02-01

"A new device for gripping prestressing strands was developed and tested. The device could provide a means of anchoring the terminal end of a strand in order to provide a mechanism for developing bonded strand at the service limit state, to provide t...

8 CFR 235.7 - Automated inspection services.

Code of Federal Regulations, 2010 CFR

2010-01-01

... persons and vehicles which can use a DCL is limited numerically by the technology of the system. For this... United States and documentation so evidencing, criminal history and/or evidence of criminality, purpose of travel, employment, residency, prior immigration history, possession of current driver's license...

[Direct to consumer genetic testing: is it the moment?].

PubMed

Lamoril, Jérôme; Bogard, Marc

2016-01-01

Since the development of new human genome sequencing technologies at the beginning of the 2000, commercial companies have developped direct to consumer genomic services, which means without medical prescription. From 2007 to 2013, many companies have offered services assesing associated risk with human public health in the world especially in the United States. This kind of company is forbidden in France. From 2009 to 2013, in United States, under the pressure of national or state health administrations, these companies have been progressively forbidden. However, in certain parts of the world, companies are still offering such services. The latter raise many different questions such as ethical, juridical, medical, scientific, educative, professional one. Many studies and debates have demonstrated their limit and the lack of usefulness and advantage in the field of human health for the time being. The commercialization of this type of services has arrived all too soon et is not yet ripe. In our time of globalization, with the lack of international rules controlling direct access to genetic services in the field of human health, there is an urgent need to regulate. International administrations and politicians must act fast. Inevitably, under the pressure of lobbies and citizens, companies (multinational or not) will develop especially as 1) new sequencing technologies evolve rapidly, 2) are cheaper from year to year, 3) scientific and medical knowledges are progressing quickly, 4) services are spreading faster through the web and other networks.

The American Expeditionary Force Siberia: A Case Study of Operational Art with Ambiguous Strategic Objectives

DTIC Science & Technology

2014-05-22

Service Corp SecDef Secretary of Defense 1 CHAPTER 1: INTRODUCTION The political object-the original motive for the war-will thus determine...committed to the original strategic objective even though it limited his tactical options. 8 In the end, the campaign concluded with limited tangible...of these Russian military theorists. Originally , the United States Army defined operational art as “the employment of military forces to attain

Home visitation programs: An untapped opportunity for the delivery of early childhood obesity prevention

PubMed Central

Salvy, Sarah-Jeanne; de la Haye, Kayla; Galama, Titus; Goran, Michael I.

2016-01-01

Background Extant obesity efforts have had limited impact among low-income underserved children, in part because of limitations inherent to existing programs: 1) short duration and low intensity; 2) late timing of implementation, when children are already overweight or obese; 3) intervention delivery limiting their accessibility and sustainability; and 4) failure to address barriers such as a lack of culturally competent services, poverty and housing instability, which interfere with healthy lifestyle changes. Objective This concept paper proposes an innovative model of obesity prevention implemented in infancy and sustained throughout early childhood to address the limitations of current obesity prevention efforts. Specifically, we propose to integrate sustained, weekly, in-home obesity prevention as part of the services already delivered by ongoing Home Visitation Programs, which currently do not target obesity prevention. Conclusion The home visiting structure represents an ideal model for impactful obesity prevention as home visitation programs: (1) already provide comprehensive services to diverse low-income infants and families who are most at risk for obesity and poor health due to socio-economic and structural conditions; (2) services are initiated in infancy and sustained throughout critical developmental periods for the formation of healthy/unhealthy behaviors; and (3) have been in place for more than 40 years, with a widespread presence across the United States and nationwide, which is critical for the scalability and sustainability of obesity prevention. PMID:27911984

Home visitation programs: an untapped opportunity for the delivery of early childhood obesity prevention.

PubMed

Salvy, S-J; de la Haye, K; Galama, T; Goran, M I

2017-02-01

Extant obesity efforts have had limited impact among low-income underserved children, in part because of limitations inherent to existing programs: (i) short duration and low intensity; (ii) late timing of implementation, when children are already overweight or obese; (iii) intervention delivery limiting their accessibility and sustainability; and (iv) failure to address barriers such as a lack of culturally competent services, poverty and housing instability, which interfere with healthy lifestyle changes. This concept paper proposes an innovative model of obesity prevention implemented in infancy and sustained throughout early childhood to address the limitations of current obesity prevention efforts. Specifically, we propose to integrate sustained, weekly, in-home obesity prevention as part of the services already delivered by ongoing Home Visitation Programs, which currently do not target obesity prevention. The home visiting structure represents an ideal model for impactful obesity prevention as home visitation programs: (i) already provide comprehensive services to diverse low-income infants and families who are most at risk for obesity and poor health because of socio-economic and structural conditions; (ii) services are initiated in infancy and sustained throughout critical developmental periods for the formation of healthy/unhealthy behaviors; and (iii) have been in place for more than 40 years, with a widespread presence across the United States and nationwide, which is critical for the scalability and sustainability of obesity prevention. © 2016 World Obesity Federation.

Addressing the needs of Nicaraguan older adults living on the edge: A university-community partnership in international service-learning.

PubMed

Neal, Margaret B; Cannon, Melissa; DeLaTorre, Alan; Bolkan, Cory R; Wernher, Iris; Nolan, Elisabeth; López Norori, Milton; Largaespada-Fredersdorff, Carmen; Brown Wilson, Keren

2017-01-01

Nicaragua is a very low-income country entering a period of rapid aging with limited geriatric training for health care professionals. To help build capacity and to enhance student learning, a short-term international service-learning program was implemented in 2004 in partnership with the Jessie F. Richardson Foundation and Nicaraguan community stakeholders. Graduate and undergraduate students at Portland State University complete coursework for one term in the United States then travel to Nicaragua for about two weeks to participate in educational, research, and service activities, primarily in group homes for older Nicaraguans. Students learn about global aging, gerontology, community development, service learning, and Nicaraguan history and culture, then apply their gerontology-related knowledge by training direct care staff, older adults and their family members, and students. The authors describe the impetus for and evolution of the program, students' evaluation of the program, faculty observations on program benefits and challenges, lessons learned, and future plans.

Knowledge of Abortion Laws and Services Among Low-Income Women in Three United States Cities.

PubMed

Lara, Diana; Holt, Kelsey; Peña, Melanie; Grossman, Daniel

2015-12-01

Low-income women and women of color are disproportionately affected by unintended pregnancy. Lack of knowledge of abortion laws and services is one of several factors likely to hinder access to services, though little research has documented knowledge in this population. Survey with convenience sample of 1,262 women attending primary care or full-scope Ob/Gyn clinics serving low-income populations in three large cities and multivariable analyses with four knowledge outcomes. Among all participants, 53% were first-generation immigrants, 25% identified the correct gestational age limit, 41% identified state parental consent laws, 67% knew partner consent is not required, and 55% knew where to obtain abortion services. In multivariable analysis, first-generation immigrants and primarily Spanish speakers were significantly less likely than higher-generation or primarily English speakers to display correct knowledge. Design and evaluation of strategies to improve knowledge about abortion, particularly among migrant women and non-primary English speakers, is needed.

Limited English proficient Hmong- and Spanish-speaking patients' perceptions of the quality of interpreter services.

PubMed

Lor, Maichou; Xiong, Phia; Schwei, Rebecca J; Bowers, Barbara J; Jacobs, Elizabeth A

2016-02-01

Language barriers are a large and growing problem for patients in the US and around the world. Interpreter services are a standard solution for addressing language barriers and most research has focused on utilization of interpreter services and their effect on health outcomes for patients who do not speak the same language as their healthcare providers including nurses. However, there is limited research on patients' perceptions of these interpreter services. To examine Hmong- and Spanish-speaking patients' perceptions of interpreter service quality in the context of receiving cancer preventive services. Twenty limited English proficient Hmong (n=10) and Spanish-speaking participants (n=10) ranging in age from 33 to 75 years were interviewed by two bilingual researchers in a Midwestern state. Interviews were audio taped, transcribed verbatim, and translated into English. Analysis was done using conventional content analysis. The two groups shared perceptions about the quality of interpreter services as variable along three dimensions. Specifically, both groups evaluated quality of interpreters based on the interpreters' ability to provide: (a) literal interpretation, (b) cultural interpretation, and (c) emotional interpretation during the health care encounter. The groups differed, however, on how they described the consequences of poor interpretation quality. Hmong participants described how poor quality interpretation could lead to: (a) poor interpersonal relationships among patients, providers, and interpreters, (b) inability of patients to follow through with treatment plans, and (c) emotional distress for patients. Our study highlights the fact that patients are discerning consumers of interpreter services; and could be effective partners in efforts to reform and enhance interpreter services. Copyright © 2015 Elsevier Ltd. All rights reserved.

Limited English proficient Hmong- and Spanish-speaking patients’ perceptions of the quality of interpreter services

PubMed Central

Lor, Maichou; Xiong, Phia; Schweia, Rebecca J.; Bowers, Barbara; Jacobs, Elizabeth A.

2015-01-01

Background Language barriers are a large and growing problem for patients in the U.S. and around the world. Interpreter services are a standard solution for addressing language barriers and most research has focused on utilization of interpreter services and their effect on health outcomes for patients who do not speak the same language as their healthcare providers including nurses. However, there is limited research on patients’ perceptions of these interpreter services. Objective To examine Hmong- and Spanish-speaking patients’ perceptions of interpreter service quality in the context of receiving cancer preventive services. Methods Twenty limited English proficient Hmong (n=10) and Spanish-speaking participants (N=10) ranging in age from 33 to 75 years were interviewed by two bilingual researchers in a Midwestern state. Interviews were audio taped, transcribed verbatim, and translated into English. Analysis was done using conventional content analysis. Results The two groups shared perceptions about the quality of interpreter services as variable along three dimensions. Specifically, both groups evaluated quality of interpreters based on the interpreters’ ability to provide: (a) literal interpretation, (b) cultural interpretation, and (c) emotional interpretation during the health care encounter. The groups differed, however, on how they described the consequences of poor interpretation quality. Hmong participants described how poor quality interpretation could lead to: (a) poor interpersonal relationships among patients, providers, and interpreters, (b) inability of patients to follow through with treatment plans, and (c) emotional distress for patients. Conclusions Our study highlights the fact that patients are discerning consumers of interpreter services; and could be effective partners in efforts to reform and enhance interpreter services. PMID:25865517

Linguistic and Cultural Barriers to Care

PubMed Central

Ngo-Metzger, Quyen; Massagli, Michael P; Clarridge, Brian R; Manocchia, Michael; Davis, Roger B; Iezzoni, Lisa I; Phillips, Russell S

2003-01-01

CONTEXT Primarily because of immigration, Asian Americans are one of the fastest growing and most ethnically diverse minority groups in the United States. However, little is known about their perspectives on health care quality. OBJECTIVE To examine factors contributing to quality of care from the perspective of Chinese- and Vietnamese-American patients with limited English language skills. DESIGN Qualitative study using focus groups and content analysis to determine domains of quality of care. SETTING Four community health centers in Massachusetts. PARTICIPANTS A total of 122 Chinese- and Vietnamese-American patients were interviewed in focus groups by bilingual interviewers using a standardized, translated moderator guide. MAIN OUTCOME MEASURES Domains of quality of care mentioned by patients in verbatim transcripts. RESULTS In addition to dimensions of health care quality commonly expressed by Caucasian, English-speaking patients in the United States, Chinese- and Vietnamese-American patients with limited English proficiency wanted to discuss the use of non-Western medical practices with their providers, but encountered significant barriers. They viewed providers' knowledge, inquiry, and nonjudgmental acceptance of traditional Asian medical beliefs and practices as part of quality care. Patients also considered the quality of interpreter services to be very important. They preferred using professional interpreters rather than family members, and preferred gender-concordant translators. Furthermore, they expressed the need for help in navigating health care systems and obtaining support services. CONCLUSIONS Cultural and linguistically appropriate health care services may lead to improved health care quality for Asian-American patients who have limited English language skills. Important aspects of quality include providers' respect for traditional health beliefs and practices, access to professional interpreters, and assistance in obtaining social services. PMID:12534763

Mobile prehospital emergency care: an analysis of implementation in the State of Rio de Janeiro, Brazil.

PubMed

O'Dwyer, Gisele; Machado, Cristiani Vieira; Alves, Renan Paes; Salvador, Fernanda Gonçalves

2016-06-01

Mobile prehospital care is a key component of emergency care. The aim of this study was to analyze the implementation of the State of Rio de Janeiro's Mobile Emergency Medical Service (SAMU, acronym in Portuguese). The methodology employed included document analysis, visits to six SAMU emergency call centers, and semistructured interviews conducted with 12 local and state emergency care coordinators. The study's conceptual framework was based on Giddens' theory of structuration. Intergovernmental conflicts were observed between the state and municipal governments, and between municipal governments. Despite the shortage of hospital beds, the SAMUs in periphery regions were better integrated with the emergency care network than the metropolitan SAMUs. The steering committees were not very active and weaknesses were observed relating to the limited role played by the state government in funding, management, and monitoring. It was concluded that the SAMU implementation process in the state was marked by political tensions and management and coordination weaknesses. As a result, serious drawbacks remain in the coordination of the SAMU with the other health services and the regionalization of emergency care in the state.

The Effects of Medicaid Policy Changes on Adults' Service Use Patterns in Kentucky and Idaho

PubMed Central

Marton, James; Kenney, Genevieve M.; Pelletier, Jennifer E.; Talbert, Jeffery; Klein, Ariel

2013-01-01

Background In 2006, Idaho and Kentucky became two of the first states to implement changes to their Medicaid programs under authority granted by the 2005 Deficit Reduction Act (DRA). The DRA granted new flexibility in the design of state Medicaid programs, including a state plan amendment (SPA) option for changes that previously would have required a waiver. This paper uses state Medicaid administrative data to analyze the impact of Medicaid policy changes implemented in these states through a series of SPAs in 2006 and 2007. Methods Changes in utilization are examined for multiple services, including physician, dental, and ER visits, inpatient stays, and prescriptions, among non-elderly adult Medicaid recipients following changes in cost sharing, reimbursement, service delivery, and covered services. Where possible, enrollees not affected by the changes served as a comparison group. Results While relatively few adults in Idaho received a wellness exam after such coverage was added, the adoption of managed care for dental services was associated with increased receipt of dental care, including preventive care. The new limits on brand name prescriptions in Kentucky were associated with a reduction in the proportion of enrollees with two or more monthly name brand prescriptions while the small copayments introduced did not appear to have a dramatic impact. Conclusions We find that changes in financial incentives on both the supply-side (such as reimbursement increases) and the demand-side (i.e., benefit changes) alone may not be enough to generate the desired levels of preventive care, especially among those with chronic health conditions. PMID:24800159

The effects of Medicaid policy changes on adults' service use patterns in Kentucky and Idaho.

PubMed

Marton, James; Kenney, Genevieve M; Pelletier, Jennifer E; Talbert, Jeffery; Klein, Ariel

2012-01-01

In 2006, Idaho and Kentucky became two of the first states to implement changes to their Medicaid programs under authority granted by the 2005 Deficit Reduction Act (DRA). The DRA granted new flexibility in the design of state Medicaid programs, including a state plan amendment (SPA) option for changes that previously would have required a waiver. This paper uses state Medicaid administrative data to analyze the impact of Medicaid policy changes implemented in these states through a series of SPAs in 2006 and 2007. Changes in utilization are examined for multiple services, including physician, dental, and ER visits, inpatient stays, and prescriptions, among non-elderly adult Medicaid recipients following changes in cost sharing, reimbursement, service delivery, and covered services. Where possible, enrollees not affected by the changes served as a comparison group. While relatively few adults in Idaho received a wellness exam after such coverage was added, the adoption of managed care for dental services was associated with increased receipt of dental care, including preventive care. The new limits on brand name prescriptions in Kentucky were associated with a reduction in the proportion of enrollees with two or more monthly name brand prescriptions while the small copayments introduced did not appear to have a dramatic impact. We find that changes in financial incentives on both the supply-side (such as reimbursement increases) and the demand-side (i.e., benefit changes) alone may not be enough to generate the desired levels of preventive care, especially among those with chronic health conditions.

Q. What are conscience clauses, and how do they affect a woman's right to choose?

PubMed

Querido, M

1998-10-01

In the US, state and federal legislatures and regulatory agencies have adopted a variety of conscience clauses to exempt health care organizations and providers from liability if they cite moral or religious reasons for their refusal to 1) provide abortions, sterilizations, or family planning services; 2) refer patients or discuss these services with patients; or 3) fund these services. When participating in the creation of huge medical conglomerates, Roman Catholic hospitals routinely apply conscience clauses to their mergers with secular hospitals and managed care organizations. A conscience clause that permits Medicaid managed care plans to refuse to provide such services also allows them to prohibit their physicians from discussing such services with patients. While Medicaid mandates that if a managed care organization refuses such services, individuals can seek these services from any other Medicaid provider, the language used to inform patients of their rights is often elusive and vague. In some states, legislation is pending that would require employers to cover contraceptives in their health insurance plans. One such bill that was vetoed in California included a conscience clause that clearly provided alternative means for enrollees to obtain contraception. Some states have also considered allowing pharmacists to refuse to dispense medications that offend their moral or religious views. Pharmacist conscious clauses could limit women's access to postcoital contraception, so reproductive rights activists have attempted to modify these clauses and continue to scrutinize proposed legislation.

DAVID-WS: a stateful web service to facilitate gene/protein list analysis

PubMed Central

Jiao, Xiaoli; Sherman, Brad T.; Huang, Da Wei; Stephens, Robert; Baseler, Michael W.; Lane, H. Clifford; Lempicki, Richard A.

2012-01-01

Summary: The database for annotation, visualization and integrated discovery (DAVID), which can be freely accessed at http://david.abcc.ncifcrf.gov/, is a web-based online bioinformatics resource that aims to provide tools for the functional interpretation of large lists of genes/proteins. It has been used by researchers from more than 5000 institutes worldwide, with a daily submission rate of ∼1200 gene lists from ∼400 unique researchers, and has been cited by more than 6000 scientific publications. However, the current web interface does not support programmatic access to DAVID, and the uniform resource locator (URL)-based application programming interface (API) has a limit on URL size and is stateless in nature as it uses URL request and response messages to communicate with the server, without keeping any state-related details. DAVID-WS (web service) has been developed to automate user tasks by providing stateful web services to access DAVID programmatically without the need for human interactions. Availability: The web service and sample clients (written in Java, Perl, Python and Matlab) are made freely available under the DAVID License at http://david.abcc.ncifcrf.gov/content.jsp?file=WS.html. Contact: xiaoli.jiao@nih.gov; rlempicki@nih.gov PMID:22543366

Insurance Exchange Marketplace: Implications for Emergency Medicine Practice

PubMed Central

Rankey, David S.

2012-01-01

The Patient Protection and Affordable Care Act of 2010 requires states to establish healthcare insurance exchanges by 2014 to facilitate the purchase of qualified health plans. States are required to establish exchanges for small businesses and individuals. A federally operated exchange will be established, and states failing to participate in any other exchanges will be mandated to join the federal exchange. Policymakers and health economists believe that exchanges will improve healthcare at lower cost by promoting competition among insurers and by reducing burdensome transaction costs. Consumers will no longer be isolated from monthly insurance premium costs. Exchanges will increase the number of patients insured with more cost-conscious managed care and high-deductible plans. These insurance plan models have historically undervalued emergency medical services, while also underinsuring patients and limiting their healthcare system access to the emergency department. This paradoxically increases demand for emergency services while decreasing supply. The continual devaluation of emergency medical services by insurance payers will result in inadequate distribution of resources to emergency care, resulting in further emergency department closures, increases in emergency department crowding, and the demise of acute care services provided to families and communities. PMID:22900107

DAVID-WS: a stateful web service to facilitate gene/protein list analysis.

PubMed

Jiao, Xiaoli; Sherman, Brad T; Huang, Da Wei; Stephens, Robert; Baseler, Michael W; Lane, H Clifford; Lempicki, Richard A

2012-07-01

The database for annotation, visualization and integrated discovery (DAVID), which can be freely accessed at http://david.abcc.ncifcrf.gov/, is a web-based online bioinformatics resource that aims to provide tools for the functional interpretation of large lists of genes/proteins. It has been used by researchers from more than 5000 institutes worldwide, with a daily submission rate of ∼1200 gene lists from ∼400 unique researchers, and has been cited by more than 6000 scientific publications. However, the current web interface does not support programmatic access to DAVID, and the uniform resource locator (URL)-based application programming interface (API) has a limit on URL size and is stateless in nature as it uses URL request and response messages to communicate with the server, without keeping any state-related details. DAVID-WS (web service) has been developed to automate user tasks by providing stateful web services to access DAVID programmatically without the need for human interactions. The web service and sample clients (written in Java, Perl, Python and Matlab) are made freely available under the DAVID License at http://david.abcc.ncifcrf.gov/content.jsp?file=WS.html.

Thresholds for protecting Pacific Northwest ecosystems from atmospheric deposition of nitrogen: state of knowledge report

USGS Publications Warehouse

Cummings, Tonnie; Blett, Tamara; Porter, Ellen; Geiser, Linda; Graw, Rick; McMurray, Jill; Perakis, Steven S.; Rochefort, Regina

2014-01-01

The National Park Service and U.S. Forest Service manage areas in the states of Idaho, Oregon, and Washington – collectively referred to in this report as the Pacific Northwest - that contain significant natural resources and provide many recreational opportunities. The agencies are mandated to protect the air quality and air pollution-sensitive resources on these federal lands. Human activity has greatly increased the amount of nitrogen emitted to the atmosphere, resulting in elevated amounts of nitrogen being deposited in park and forest ecosystems. There is limited information in the Pacific Northwest about the levels of nitrogen that negatively affect natural systems, i.e., the critical loads. The National Park Service and U.S. Forest Service, with scientific input from the U.S. Geological Survey, have developed an approach for accumulating additional nitrogen critical loads information in the Pacific Northwest and using the data in planning and regulatory arenas. As a first step in that process, this report summarizes the current state of knowledge about nitrogen deposition, effects, and critical loads in the region. It also describes ongoing research efforts and identifies and prioritizes additional data needs.

45 CFR 1340.12 - Application process.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, CHILD ABUSE AND NEGLECT PREVENTION AND TREATMENT PROGRAM CHILD ABUSE AND NEGLECT PREVENTION AND TREATMENT Grants to States... office, agency, or organization need not be limited in its mandate or activities to child abuse and...

77 FR 47322 - Magnuson-Stevens Act Provisions; Fisheries Off West Coast States; Biennial Specifications and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-08

... overfished stocks by remaining within their rebuilding ACLs. Limited Entry (LE) Fixed Gear Fishery Management... Specifications and Management Measures; Inseason Adjustments AGENCY: National Marine Fisheries Service (NMFS... to biennial groundfish management measures. SUMMARY: This final rule announces inseason changes to...

Turkish School Counselors and Counselor Educators' Perceptions about Multicultural Counseling

ERIC Educational Resources Information Center

Hatunoglu, Askim

2017-01-01

This paper examines the topic of multicultural counseling in Turkey, where school-based multicultural counseling services remain comparatively limited in scope and application. Participants consisted of twenty-three counselors working in secondary or high schools and fourteen counselor educators from several state universities. While the…

45 CFR 1340.12 - Application process.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, CHILD ABUSE AND NEGLECT PREVENTION AND TREATMENT PROGRAM CHILD ABUSE AND NEGLECT PREVENTION AND TREATMENT Grants to States... office, agency, or organization need not be limited in its mandate or activities to child abuse and...

45 CFR 1340.12 - Application process.

Code of Federal Regulations, 2014 CFR

2014-10-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, CHILD ABUSE AND NEGLECT PREVENTION AND TREATMENT PROGRAM CHILD ABUSE AND NEGLECT PREVENTION AND TREATMENT Grants to States... office, agency, or organization need not be limited in its mandate or activities to child abuse and...

45 CFR 1340.12 - Application process.

Code of Federal Regulations, 2012 CFR

2012-10-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, CHILD ABUSE AND NEGLECT PREVENTION AND TREATMENT PROGRAM CHILD ABUSE AND NEGLECT PREVENTION AND TREATMENT Grants to States... office, agency, or organization need not be limited in its mandate or activities to child abuse and...

45 CFR 1340.12 - Application process.

Code of Federal Regulations, 2013 CFR

2013-10-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, CHILD ABUSE AND NEGLECT PREVENTION AND TREATMENT PROGRAM CHILD ABUSE AND NEGLECT PREVENTION AND TREATMENT Grants to States... office, agency, or organization need not be limited in its mandate or activities to child abuse and...

Development of load and resistance factor design for ultimate and serviceability limit states of transportation structure foundations.

DOT National Transportation Integrated Search

2011-12-01

"Most foundation solutions for transportation structures rely on deep foundations, often on pile foundations : configured in a way most suitable to the problem at hand. Design of pile foundation solutions can best be pursued by clearly : defining lim...

The impact of urban spatial structure on travel demand in the United States

DOT National Transportation Integrated Search

2003-03-20

Attempts to limit urban growth or to change its form are motivated by three concerns-to preserve open space and foster urban development that is more aesthetically appealing, to reduce the cost of providing public services, and to reduce dependence o...

49 CFR 266.3 - Rail Service Assistance Program.

Code of Federal Regulations, 2010 CFR

2010-10-01

... construction assistance; (6) Planning assistance; and (7) Program operations assistance. (b) Special limitations on planning assistance and program operation assistance. (1) A State is eligible to receive up to $100,000, or 5 percent of its entitlement, whichever is greater, as planning assistance; and (2) A...

Indiana | Solar Research | NREL

Science.gov Websites

Incentive Programs Indiana exempts solar PV modules, racking, and inverter from state sales and use taxes . The entire solar generating system is exempt from property taxation. Utility Incentive Programs Utility Incentive Limitations Northern Indiana Public Service Company (Solar PV feed-in-tariff) $0.1564

Common state mechanisms regulating tribal tobacco taxation and sales, the USA, 2015.

PubMed

DeLong, Hillary; Chriqui, Jamie; Leider, Julien; Chaloupka, Frank J

2016-10-01

Native American tribes, as sovereign nations, are exempt from state tobacco excise taxation, and self-govern on-reservation activity in the USA. Under Federal law, state excise taxes are owed by non-members purchasing tobacco on tribal land, but states are limited in how they enforce or collect these taxes. This study highlights the various policy approaches that states have taken to regulate tobacco sales on tribal lands given jurisdictional challenges. State laws (statutes, regulations and case law), Attorney General opinions, and revenue notices and rulings effective as of 1 January 2015 for all 50 states and the District of Columbia were compiled using Boolean searches in Lexis-Nexis and Westlaw. Laws were limited to those addressing taxation compacts or tobacco sales involving tribal entities. Master Settlement Agreement laws and non-codified tribal codes/compacts were excluded. Twenty of the 34 states with tribal lands address tribal tobacco sales. Fourteen states address intergovernmental compacts: 11 are tobacco specific, and suggest or require specific provisions. Fifteen states address tribal tax stamps: 2 explicitly prohibit stamping tribally sold products, 9 stamp all products, and 4 stamp some. Prepayment of excise tax is required in 12 states: 6 on all products, 4 on products in excess of quota, and 2 on products sold by non-tribal retailers. 6 states use quotas to limit tax-free tobacco available to tribes. Many states with a tribal presence have no formal strategies for non-members purchasing tobacco on tribal lands. Formalising policies and harmonising tax rates may assist states in collecting tax revenue from non-tribal consumers. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Reforming the mission of public dental services.

PubMed

Wright, F A C; List, P F

2012-10-01

Australia has a complex history of providing public dental services to its communities. From the early days of Colonial settlement, the provision of dental care to the Australian public has largely been driven and influenced by organized groups and associations of dentists. The Constitution of Australia, under Section 51 xxiii A, allows for the Commonwealth to provide for medical and dental services. Unlike the United Kingdom, however, dental services have not been embedded into a universal national health service agenda. In 1974, that the Australian Government through the Australian School Dental Program provided the first funding and national direction for public dental services - and that, limited to children. The Commonwealth Dental Health Program 1993-1997 was the second national endeavor to provide public dental services, this time to financially disadvantaged adults. Since that time, public dental service responsibility has been shuttled between States/Territories and the Commonwealth. A new paradigm for public dental services in Australia requires strong Commonwealth leadership, as well as the commitment of State and Territories and the organized dental profession. The National Health and Hospitals Reform Commission provided the most recent scenario for a radical change in mission. This paper canvases the competing roles of strategic, functional, and structural issues in relationship to social network and policy issues, which must be recognized if Australians truly seek to reform public dental services. © 2012 John Wiley & Sons A/S.

Instances of Use of United States Armed Forces Abroad, 1798-2014

DTIC Science & Technology

2014-09-15

Garcia, and Thomas J. Nicola . Instances of Use of United States Armed Forces Abroad, 1798-2014 Congressional Research Service Contents...landing zones near the U.S. Embassy in Saigon and the Tan Son Nhut Airfield. Mayaguez incident. On May 15, 1975, President Ford reported he had ordered...Report R41989, Congressional Authority to Limit Military Operations, by Jennifer K. Elsea, Michael John Garcia and Thomas J. Nicola . CRS Report R43344

The Case for Licensure of Applied Behavior Analysts

PubMed Central

Dorsey, Michael F; Weinberg, Michael; Zane, Thomas; Guidi, Megan M

2009-01-01

The evolution of the field of applied behavior analysis to a practice-oriented profession has created the need to ensure that the consumers of these services are adequately protected. We review the limitations of the current board certification process and present a rationale for the establishment of licensing standards for applied behavior analysts on a state-by-state basis. Recommendations for securing the passage of a licensure bill also are discussed. PMID:22477697

Mental health surveillance among children--United States, 2005-2011.

PubMed

Perou, Ruth; Bitsko, Rebecca H; Blumberg, Stephen J; Pastor, Patricia; Ghandour, Reem M; Gfroerer, Joseph C; Hedden, Sarra L; Crosby, Alex E; Visser, Susanna N; Schieve, Laura A; Parks, Sharyn E; Hall, Jeffery E; Brody, Debra; Simile, Catherine M; Thompson, William W; Baio, Jon; Avenevoli, Shelli; Kogan, Michael D; Huang, Larke N

2013-05-17

Mental disorders among children are described as "serious deviations from expected cognitive, social, and emotional development" (US Department of Health and Human Services Health Resources and Services Administration, Maternal and Child Health Bureau. Mental health: A report of the Surgeon General. Rockville, MD: US Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, and National Institutes of Health, National Institute of Mental Health; 1999). These disorders are an important public health issue in the United States because of their prevalence, early onset, and impact on the child, family, and community, with an estimated total annual cost of $247 billion. A total of 13%-20% of children living in the United States experience a mental disorder in a given year, and surveillance during 1994-2011 has shown the prevalence of these conditions to be increasing. Suicide, which can result from the interaction of mental disorders and other factors, was the second leading cause of death among children aged 12-17 years in 2010. Surveillance efforts are critical for documenting the impact of mental disorders and for informing policy, prevention, and resource allocation. This report summarizes information about ongoing federal surveillance systems that can provide estimates of the prevalence of mental disorders and indicators of mental health among children living in the United States, presents estimates of childhood mental disorders and indicators from these systems during 2005-2011, explains limitations, and identifies gaps in information while presenting strategies to bridge those gaps.

Feasibility, Benefits, and Limitations of a Penicillin Allergy Skin Testing Service.

PubMed

Narayanan, Prasanna P; Jeffres, Meghan N

2017-06-01

To critically examine the feasibility, benefits, and limitations of an inpatient penicillin skin testing service and how pharmacists can be utilized. A PubMed search was performed from July 2016 through September 2016 using the following search terms: penicillin skin testing, penicillin allergy, β-lactam allergy. Additional references were identified from a review of literature citations. All English-language studies assessing the use of penicillin skin testing as well as management and clinical outcomes of patients with a β-lactam allergy were evaluated. The prevalence of people self-identifying as penicillin allergic ranges from 10% to 20% in the United States. Being improperly labeled as penicillin allergic is associated with higher health care costs, worse clinical outcomes, and an increased prevalence of multidrug-resistant infections. Penicillin skin testing can be a tool used to clarify penicillin allergies and has been demonstrated to be a successful addition to antimicrobial stewardship programs in multiple health care settings. Prior to implementing a penicillin skin testing service, institutions will need to perform a feasibility analysis of who will supply labor and accept the financial burden as well as identify if the positive benefits of a penicillin skin testing service overcome the limitations of this diagnostic test. We conclude that institutions with high percentages of patients receiving non-β-lactams because of penicillin allergy labels would likely benefit the most from a penicillin skin testing service.

Medicare and state health care programs: fraud and abuse; electronic health records safe harbor under the anti-kickback statute. Final rule.

PubMed

2013-12-27

In this final rule, the Office of Inspector General (OIG) amends the safe harbor regulation concerning electronic health records items and services, which defines certain conduct that is protected from liability under the Federal anti-kickback statute, section 1128B(b) of the Social Security Act (the Act). Amendments include updating the provision under which electronic health records software is deemed interoperable; removing the electronic prescribing capability requirement; extending the sunset provision until December 31, 2021; limiting the scope of protected donors to exclude laboratory companies; and clarifying the condition that prohibits a donor from taking any action to limit or restrict the use, compatibility, or interoperability of the donated items or services.

An audience research study to disseminate evidence about comprehensive state mental health parity legislation to US State policymakers: protocol.

PubMed

Purtle, Jonathan; Lê-Scherban, Félice; Shattuck, Paul; Proctor, Enola K; Brownson, Ross C

2017-06-26

A large proportion of the US population has limited access to mental health treatments because insurance providers limit the utilization of mental health services in ways that are more restrictive than for physical health services. Comprehensive state mental health parity legislation (C-SMHPL) is an evidence-based policy intervention that enhances mental health insurance coverage and improves access to care. Implementation of C-SMHPL, however, is limited. State policymakers have the exclusive authority to implement C-SMHPL, but sparse guidance exists to inform the design of strategies to disseminate evidence about C-SMHPL, and more broadly, evidence-based treatments and mental illness, to this audience. The aims of this exploratory audience research study are to (1) characterize US State policymakers' knowledge and attitudes about C-SMHPL and identify individual- and state-level attributes associated with support for C-SMHPL; and (2) integrate quantitative and qualitative data to develop a conceptual framework to disseminate evidence about C-SMHPL, evidence-based treatments, and mental illness to US State policymakers. The study uses a multi-level (policymaker, state), mixed method (QUAN→qual) approach and is guided by Kingdon's Multiple Streams Framework, adapted to incorporate constructs from Aarons' Model of Evidence-Based Implementation in Public Sectors. A multi-modal survey (telephone, post-mail, e-mail) of 600 US State policymakers (500 legislative, 100 administrative) will be conducted and responses will be linked to state-level variables. The survey will span domains such as support for C-SMHPL, knowledge and attitudes about C-SMHPL and evidence-based treatments, mental illness stigma, and research dissemination preferences. State-level variables will measure factors associated with C-SMHPL implementation, such as economic climate and political environment. Multi-level regression will determine the relative strength of individual- and state-level variables on policymaker support for C-SMHPL. Informed by survey results, semi-structured interviews will be conducted with approximately 50 US State policymakers to elaborate upon quantitative findings. Then, using a systematic process, quantitative and qualitative data will be integrated and a US State policymaker-focused C-SMHPL dissemination framework will be developed. Study results will provide the foundation for hypothesis-driven, experimental studies testing the effects of different dissemination strategies on state policymakers' support for, and implementation of, evidence-based mental health policy interventions.

Factors influencing the demand of the service of community based animal health care in Zimbabwe.

PubMed

Mutambara, J; Dube, I; Matangi, E; Majeke, F

2013-11-01

This study was done to find out about animal health service providers and factors that determined demand for community based veterinary service delivery in smallholder sector of Zimbabwe. Focus group discussions and a questionnaire was used to collect data on veterinary services providers and socio-economic factors related to animal health from a sample (N=333) smallholder livestock farmers from Gutu district of Masvingo province in Zimbabwe. Analytical techniques used were descriptive statistics, K-mean cluster analysis and Tobit regression model. Results showed that the majority of farmers (45%) obtained services from both Community Based Animal Health Workers (CBAHWs) and Department of Veterinary Service (DVS), 25% DVS only, 20% used CBAHWs while 10% did not seek any services. Further analysis showed that distance to CBAHW, distance to AHMC and employment status were significantly related to demand for CBAHWs with coefficients of -1.5, 0.7 and -10.3, respectively. The study thus concluded that CBAHW is an alternative animal health service delivery approach already practiced in smallholder farming sectors of Zimbabwe. Socio-economic factors significantly influenced the demand for CBAHW services. Given limited resources by state sponsored veterinary services, it is recommended that the CBAHWs approach should be encouraged as supplementary service provider especially in areas further DVS. These community organizations can be empowered by the state to deliver more improved services based on hygiene and modern science at a relatively low cost to farmers. Copyright © 2013 Elsevier B.V. All rights reserved.

42 CFR 411.384 - Disclosing advisory opinions and supporting information.

Code of Federal Regulations, 2010 CFR

2010-10-01

... HEALTH AND HUMAN SERVICES MEDICARE PROGRAM EXCLUSIONS FROM MEDICARE AND LIMITATIONS ON MEDICARE PAYMENT... Department of Justice, or any other Department or agency of the United States in connection with an advisory..., and will not be made publicly available. (d) Documents submitted by the requestor to CMS in connection...

48 CFR 22.1003-4 - Administrative limitations, variations, tolerances, and exemptions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... market prices for the maintenance, calibration, or repair of such equipment. As defined at 29 CFR 4.123(e... or otherwise available for inspection by customers, and states prices at which sales currently, or... employees servicing the same equipment of commercial customers. (iv) The apparent successful offeror...

45 CFR 2553.43 - What cost reimbursements are provided to RSVP volunteers?

Code of Federal Regulations, 2014 CFR

2014-10-01

...: (1) Accident insurance. Accident insurance covers RSVP volunteers for personal injury during travel...) Excess automobile liability insurance. (i) For RSVP volunteers who drive in connection with their service... volunteers carry on their own automobiles; or (B) The limits of applicable state financial responsibility law...

45 CFR 2553.43 - What cost reimbursements are provided to RSVP volunteers?

Code of Federal Regulations, 2010 CFR

2010-10-01

...: (1) Accident insurance. Accident insurance covers RSVP volunteers for personal injury during travel...) Excess automobile liability insurance. (i) For RSVP volunteers who drive in connection with their service... volunteers carry on their own automobiles; or (B) The limits of applicable state financial responsibility law...

45 CFR 2553.43 - What cost reimbursements are provided to RSVP volunteers?

Code of Federal Regulations, 2013 CFR

2013-10-01

...: (1) Accident insurance. Accident insurance covers RSVP volunteers for personal injury during travel...) Excess automobile liability insurance. (i) For RSVP volunteers who drive in connection with their service... volunteers carry on their own automobiles; or (B) The limits of applicable state financial responsibility law...

45 CFR 2553.43 - What cost reimbursements are provided to RSVP volunteers?

Code of Federal Regulations, 2011 CFR

2011-10-01

...: (1) Accident insurance. Accident insurance covers RSVP volunteers for personal injury during travel...) Excess automobile liability insurance. (i) For RSVP volunteers who drive in connection with their service... volunteers carry on their own automobiles; or (B) The limits of applicable state financial responsibility law...

45 CFR 2553.43 - What cost reimbursements are provided to RSVP volunteers?

Code of Federal Regulations, 2012 CFR

2012-10-01

...: (1) Accident insurance. Accident insurance covers RSVP volunteers for personal injury during travel...) Excess automobile liability insurance. (i) For RSVP volunteers who drive in connection with their service... volunteers carry on their own automobiles; or (B) The limits of applicable state financial responsibility law...

Public private partnerships : evaluating ESALs and weigh-in-motion data for US 550 in northern New Mexico, roadLife, Altris vehicle classification system.

DOT National Transportation Integrated Search

2007-08-01

Public-private partnerships as an alternative means of delivering goods and services are receiving increased attention as state departments of transportation consider ways to maximize limited resources. In 1998 the New Mexico Department of Transporta...

45 CFR 261.42 - Which reductions count in determining the caseload reduction credit?

Code of Federal Regulations, 2010 CFR

2010-10-01

... AND HUMAN SERVICES ENSURING THAT RECIPIENTS WORK How Will We Determine Caseload Reduction Credit for... requirements or State changes in eligibility rules since FY 2005 that directly affect a family's eligibility..., time limits, full family sanctions, and other new requirements that deny families assistance when an...

78 FR 15934 - North Pacific Fishery Management Council; Public Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-13

... (USCG) Report United States Fish & Wildlife Service (USFWS) Report Protected Species Report 2. Observer... replacement Gulf of Alaska (GOA) sideboards. 4. Steller Sea Lions (SSL) Environmental Impact Statement (EIS... following issues: 1. Round Island Analysis. 2. Steller Sea Lions. 3. Scallop SAFE. 4. CQE block limits. 5...

Don't Outsource It. Do It!

ERIC Educational Resources Information Center

Nuzzo, David

1999-01-01

Discusses outsourcing in library technical-services departments and how to make the department more cost-effective to limit the need for outsourcing as a less expensive alternative. Topics include experiences at State University of New York at Buffalo; efficient use of computers for in-house programs; and staff participation. (LRW)

78 FR 66252 - Airworthiness Directives; Bell Helicopter Textron Canada Limited (Bell) Helicopters

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-05

... actions are intended to alert pilots to avoid certain engine speeds during steady- state operations...%. The proposed requirements were intended to alert pilots to avoid certain engine speeds during steady... the RFMs, advising pilots of the change, and installing a decal as described in Bell Alert Service...

Child-Centered Group Play Therapy with African American Boys at the Elementary School Level

ERIC Educational Resources Information Center

Baggerly, Jennifer; Parker, Max

2005-01-01

African American boys face numerous challenges in society within the United States, including prejudice, discrimination, racism, economic hardship, limited access to support services, educational biases, and community violence. According to Pierce (1988), the psychic assault of subtle racism against African American boys erode their…

High skew link slab bridge system with deck sliding over backwall or backwall sliding over abutments : appendices.

DOT National Transportation Integrated Search

2011-09-01

AASHTO LRFD (2010) requires combined live and thermal load effects for the service : limit state design. The Design Procedure described in the appendix will follow the : rationale developed by Ulku et al. (2009). Link slab design moments are calculat...

76 FR 54392 - Animal Welfare; Importation of Live Dogs

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-01

... Live Dogs AGENCY: Animal and Plant Health Inspection Service, USDA. ACTION: Proposed rule. SUMMARY: We... of certain live dogs. Consistent with this amendment, this proposed rule would, with certain limited exceptions, prohibit the importation of dogs from any part of the world into the continental United States or...

Family culture in mental health help-seeking and utilization in a nationally representative sample of Latinos in the United States: The NLAAS.

PubMed

Villatoro, Alice P; Morales, Eduardo S; Mays, Vickie M

2014-07-01

Considering the central role of familismo in Latino culture, it is important to assess the extent to which familismo affects mental health help-seeking. This study examined the role of behavioral familismo, the level of perceived family support, in the use of mental health services of Latinos in the United States. Data come from the National Latino and Asian American Study (NLAAS), a representative household survey examining the prevalence of mental disorders and services utilization among Latinos and Asian Americans. Analyses were limited to Latino adults with a clinical need for mental health services, indexed by meeting DSM-IV diagnostic criteria for any mood, anxiety, or substance use disorder during the past 12 months (N = 527). One-third of Latinos with a clinical need used any type of service in the past year, including specialty mental health, general medical, and informal or religious services. High behavioral familismo was significantly associated with increased odds of using informal or religious services, but not specialty or medical services. Self-perceived need and social perceptions of need for care within close networks (i.e., told by family/friends to seek professional help) also were significant predictors of service use. These results carry important implications toward expansions of the mental health workforce in the informal and religious services settings.

A patient mobility framework that travels: European and United States-Mexican comparisons.

PubMed

Laugesen, Miriam J; Vargas-Bustamante, Arturo

2010-10-01

To develop a framework that parsimoniously explains divergent patient mobility in the United States and Europe. Review of studies of patient mobility; data from the 2007 Flash Eurobarometer and the 2001 California Health Interview Survey was analyzed; and we reviewed government policies and documents in the United States and Europe. Four types of patient mobility are defined: primary, complementary, duplicative, and institutionalized. Primary exit occurs when people without comprehensive insurance travel because they cannot afford to pay for health insurance or directly finance care, as in the United States and Mexico. Second, people will exit to buy complementary services not covered, or partially covered by domestic health insurance, in both the United States and Europe. Third, in Europe, patient mobility for duplicative services provides faster or better quality treatment. Finally, governments and insurers can encourage institutionalized exit through expanded delivery options and financing. Institutionalized exit is developing in Europe, but uncoordinated and geographically limited in the United States. This parsimonious framework explains patient mobility by considering domestic health system characteristics relating to cost and quality. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.

Expanded Scopes Of Practice For Dental Hygienists Associated With Improved Oral Health Outcomes For Adults.

PubMed

Langelier, Margaret; Continelli, Tracey; Moore, Jean; Baker, Bridget; Surdu, Simona

2016-12-01

Dental hygienists are important members of the oral health care team, providing preventive and prophylactic services and oral health education. However, scope-of-practice parameters in some states limit their ability to provide needed services effectively. In 2001 we developed the Dental Hygiene Professional Practice Index, a numerical tool to measure the state-level professional practice environment for dental hygienists. We used the index to score state-level scopes of practice in all fifty states and the District of Columbia in 2001 and 2014. The mean composite score on the index increased from 43.5 in 2001 to 57.6 in 2014, on a 100-point scale. We also analyzed the association of each state's composite score with an oral health outcome: tooth extractions among the adult population because of decay or disease. After we controlled for individual- and state-level factors, we found in multilevel modeling that more autonomous dental hygienist scope of practice had a positive and significant association with population oral health in both 2001 and 2014. Project HOPE—The People-to-People Health Foundation, Inc.

Priority strategies for India's family planning programme

PubMed Central

Pachauri, Saroj

2014-01-01

Strategies to accelerate progress of India's family planning programme are discussed and the importance of improving the quality and reach of services to address unmet contraceptive need by providing method choice is emphasized. Although there is a growing demand for both limiting and spacing births, female sterilisation, is the dominant method in the national programme and use of spacing methods remains very limited. Fertility decline has been slower in the empowered action group (EAG) States which contribute about 40 per cent of population growth to the country and also depict gloomy statistics for other socio-development indicators. It is, therefore, important to intensify efforts to reduce both fertility and mortality in these States. A rationale has been provided for implementing integrated programmes using a gender lens because the lack of women's autonomy in reproductive decision-making, compounded by poor male involvement in sexual and reproductive health matters, is a fundamental issue yet to be addressed. The need for collaboration between scientists developing contraceptive technologies and those implementing family planning services is underscored. If contraceptive technologies are developed with an understanding of the contexts in which they will be delivered and an appreciation of end-users’ needs and perspectives, they are more likely to be accepted by service providers and used by clients. PMID:25673535

Financing state newborn screening programs: sources and uses of funds.

PubMed

Johnson, Kay; Lloyd-Puryear, Michele A; Mann, Marie Y; Ramos, Lauren Raskin; Therrell, Bradford L

2006-05-01

Financing for newborn screening is different from virtually all other public health programs. All except 5 screening programs collect fees as the primary source of program funding. A fee-based approach to financing newborn screening has been adopted by most states, to ensure consistent funding for this critical public health activity. Two types of data are reported here, ie, primary data from a survey of 37 state public health agencies and findings from exploratory case studies from 7 states. Most of the programs that participated in this survey (73%) reported that their newborn screening funding increased between 2002 and 2005, typically through increased fees and to a lesser extent through Medicaid, Title V Maternal and Child Health Services Block Grant, and state general revenue funding. All of the responding states that collect fees (n = 31) use such funds to support laboratory expenses, and most (70%) finance short-term follow-up services and program management. Nearly one half (47%) finance longer-term follow-up services, case management, or family support beyond diagnosis. Other states (43%) finance genetic or nutritional counseling and formula foods or treatment. Regardless of the source of funds, the available evidence indicates that states are committed to maintaining their programs and securing the necessary financing for the initial screening through diagnosis. Use of federal funding is currently limited; however, pressure to provide dedicated federal funding would likely increase if national recommendations for a uniform newborn screening panel were issued.

State welfare reform policies and maternal and child health services: a national study.

PubMed

Romero, D; Chavkin, W; Wise, P H; Hess, C A; VanLandeghem, K

2001-09-01

Welfare reform (Personal Responsibility and Work Opportunity Reconciliation Act of 1996) resulted in dramatic policy changes, including health-related requirements and the administrative separation of cash assistance from Medicaid. We were interested in determining if changes in welfare and health policies had had an impact on state MCH services and programs. We conducted a survey in fall 1999 of state MCH Title V directors. Trained interviewers administered the telephone survey over a 3-month period. MCH directors from all 50 states, Washington, DC, and Puerto Rico participated (n = 52; response rate = 100%). Among the most noteworthy findings is that similar proportions of respondents reported that welfare policy changes had either helped (46%) or hindered (42%) the agency's work, with most of the positive impact attributed to increased funding. MCH data linkages with welfare and other social programs were low. Despite welfare reform's emphasis on work, limited services and exemptions were available for mothers with CSHCN. Almost no efforts have been undertaken to specifically address the needs of substance abusers in the context of new welfare policies. Few MCH agencies have developed programs to address the special needs of women receiving TANF who either have health problems themselves or have children with health problems. Recommendations including increased MCH and family planning funding and improved coordination between TANF and MCH to facilitate linkages and services are put forth in light of reauthorization of PRWORA.

Committee Opinion No. 708 Summary: Improving Awareness of and Screening for Health Risks Among Sex Workers.

PubMed

2017-07-01

The population of women who sell or exchange sex or intimate sexual services for material goods or services, also called "sex work," often is unrecognized in the typical obstetric and gynecologic practice. The prevalence of this behavior among adult women is difficult to quantify because of its frequent omission from the routine sexual history by women and clinicians. Data on the prevalence of sex work in the United States are largely lacking. The American College of Obstetricians and Gynecologists supports increasing awareness about the health risks, preventive care needs, and limited health care services for female sex workers.

Committee Opinion No 708: Improving Awareness of and Screening for Health Risks Among Sex Workers.

PubMed

2017-07-01

The population of women who sell or exchange sex or intimate sexual services for material goods or services, also called "sex work," often is unrecognized in the typical obstetric and gynecologic practice. The prevalence of this behavior among adult women is difficult to quantify because of its frequent omission from the routine sexual history by women and clinicians. Data on the prevalence of sex work in the United States are largely lacking. The American College of Obstetricians and Gynecologists supports increasing awareness about the health risks, preventive care needs, and limited health care services for female sex workers.

The use of market research to design healthcare offerings. A case study of a senior citizen community.

PubMed

Rummel, A; Francis, J; Duserick, F; Enke, E

1994-01-01

With a growing elderly population, there is little argument that the healthcare system in the United States must understand the needs and wants of its elderly consumers. This is especially important in a rural community where services can be limited and access to these services is difficult for consumers. Marketing research is one way in which rural healthcare facilities can gain market information not only to enhance their product offerings, but also to ensure that proper and sufficient services are provided. This article presents a case study of a long-term healthcare facility using marketing research.

Public health services and systems research: current state of finance research.

PubMed

Ingram, Richard C; Bernet, Patrick M; Costich, Julia F

2012-11-01

There is a growing recognition that the US public health system should strive for efficiency-that it should determine the optimal ways to utilize limited resources to improve and protect public health. The field of public health finance research is a critical part of efforts to understand the most efficient ways to use resources. This article discusses the current state of public health finance research through a review of public health finance literature, chronicles important lessons learned from public health finance research to date, discusses the challenges faced by those seeking to conduct financial research on the public health system, and discusses the role of public health finance research in relation to the broader endeavor of Public Health Services and Systems Research.

Provision of social services in Namibia.

PubMed

Kaure, A

1994-03-01

Whereas Namibia is not a welfare state, the government which has emerged from the colonial period is expected to provide social services to address the social inequities of that period. The Constitution requires the government to promote and maintain the welfare of the people by adopting policies to ensure equal opportunities for men and women, access by all to health and education, reasonable assess to public facilities and services, a pension to senior citizens, and just and affordable benefits to the unemployed, the incapacitated, the indigent, and the disadvantaged. The International Labor Organization (ILO) prepared a report on the development of social security in Namibia which stated that the country's social protection schemes are centered on formal sector employees with the financing for those schemes coming from that sector. Within the formal sector, however, there are disparities, and those who have irregular or lower-paid employment are generally less protected. The ILO report calls for reforms which would recognize the relationship between economic development and social policy while putting limited resources to the best possible use. The Director of Social Services, however, has stated that the government may not have the resources to provide such services. For example, there is a widespread need for old-age homes, but no money to provide them. The government must exert its efforts to rectify the inequities of the colonial era such as the provision of pensions based on race. in 1991-92 alone, social pensions totaled 1.8% of the country's gross national produce, yet many people are not reached by the social services staff. The new labor bill and the draft bill on social security will alleviate some, but not all, of these problems. Whereas the social security bill provides for maternity benefits, unemployment benefits are nonexistent and deemed infeasible at the present time. The government's efforts to increase public health have led to the creation of clinics and health facilities in remote areas and a shift to primary health care. These health services are not free but will be provided to citizens who are too poor to pay. The government provides free primary education, but students must pay for secondary and university education. Since most people who benefit from Namibia's limited social security schemes are those urban residents who are formally employed, a shift from delivery of services to a redistribution of income may be the answer to the society's needs.

Blood banking services in India.

PubMed

Sardana, V N

1996-01-01

India's health care sector has made impressive strides toward providing health for all by the year 2000. That progress, however, has not been supported by a modern transfusion services network which continues to improve itself. In India, blood collection, storage, and delivery occur mainly in blood banks attached to hospitals, most of which are under central and state government controls. A significant portion of blood banking activity is also done by voluntary agencies and private sector blood banks. A study found the blood transfusion services infrastructure to be highly decentralized and lacking of many critical resources; an overall shortage of blood, especially from volunteer donors; limited and erratic testing facilities; an extremely limited blood component production/availability/use; and a shortage of health care professionals in the field of transfusion services. Infrastructural modernization and the technical upgrading of skills in the blood banks would, however, provide India with a dynamic transfusion services network. The safety of blood transfusion, the national blood safety program, HIV testing facilities, modernization of blood banks, the rational use of blood, program management, manpower development, the legal framework, voluntary blood donation, and a 1996 Supreme Court judgement on the need to focus greater attention upon the blood program are discussed.

Expanding oral care opportunities: direct access care provided by dental hygienists in the United States.

PubMed

Naughton, Doreen K

2014-06-01

Dental hygienists expand access to oral care in the United States. Many Americans have access to oral health care in traditional dental offices however millions of Americans have unmet dental needs. For decades dental hygienists have provided opportunities for un-served and under-served Americans to receive preventive services in a variety of alternate delivery sites, and referral to licensed dentists for dental care needs. Publications, state practice acts, state public health departments, the American Dental Hygienists' Association, and personal interviews of dental hygiene practitioners were accessed for information and statistical data. Dental hygienists in 36 states can legally provide direct access care. Dental hygienists are providing preventive services in a variety of settings to previously un-served and under-served Americans, with referral to dentists for dental needs. Dental hygienists have provided direct access to care in the United States for decades. The exact number of direct access providers in the United States is unknown. Limited research and anecdotal information demonstrate that direct access care has facilitated alternate entry points into the oral health systems for thousands of previously un-served and underserved Americans. Older adults, persons with special needs, children in schools, pregnant women, minority populations, rural populations, and others have benefited from the availability of many services provided by direct access dental hygienists. Legislatures and private groups are becoming increasingly aware of the impact that direct access has made on the delivery of oral health care. Many factors continue to drive the growth of direct access care. Additional research is needed to accumulate qualitative and quantitative outcome data related to direct access care provided by dental hygienists and other mid level providers of oral health services. Copyright © 2014 Elsevier Inc. All rights reserved.

Constitutional limits on federal legislation practically compelling medical employment: Wong v Commonwealth; Selim v Professional Services Review Committee.

PubMed

Faunce, Thomas

2009-10-01

A recent decision by the High Court of Australia (Wong v Commonwealth; Selim v Professional Services Review Committee (2009) 236 CLR 573) (the PSR case) has not only clarified the scope of the Australian constitutional prohibition on "any form of civil conscription" in relation to federal legislation concerning medical or dental services (s 51xxiiiA), but has highlighted its importance as a great constitutional guarantee ensuring the mixed State-federal and public-private nature of medical service delivery in Australia. Previous decisions of the High Court have clarified that the prohibition does not prevent federal laws regulating the manner in which medical services are provided. The PSR case determined that the anti-overservicing provisions directed at bulk-billing general practitioners under Pt VAA of the Health Insurance Act 1973 (Cth) did not offend the prohibition. Importantly, the High Court also indicated that the s 51(xxiiiA) civil conscription guarantee should be construed widely and that it would invalidate federal laws requiring providers of medical and dental services (either expressly or by practical compulsion) to work for the federal government or any specified State, agency or private industrial employer. This decision is likely to restrict the capacity of any future federal government to restructure the Australian health care system, eg by implementing recommendations from the National Health and Hospitals Reform Commission for either federal government or private corporate control of presently State-run public hospitals.

Rationing is a reality in rural physiotherapy: a qualitative exploration of service level decision-making.

PubMed

Adams, Robyn; Jones, Anne; Lefmann, Sophie; Sheppard, Lorraine

2015-03-27

Deciding what health services are provided is a key consideration in delivering appropriate and accessible health care for rural and remote populations. Despite residents of rural communities experiencing poorer health outcomes and exhibiting higher health need, workforce shortages and maldistribution mean that rural communities do not have access to the range of services available in metropolitan centres. Where demand exceeds available resources, decisions about resource allocation are required. A qualitative approach enabled the researchers to explore participant perspectives about decisions informing rural physiotherapy service provision. Stakeholder perspectives were obtained through surveys and in-depth interviews. A system theory-case study heuristic provided a framework for exploration across sites within the investigation area: a large area of one Australian state with a mix of rural, regional and remote communities. Thirty-nine surveys were received from participants in eleven communities. Nineteen in-depth interviews were conducted with physiotherapist and key decision-makers. Increasing demand, organisational priorities, fiscal austerity measures and workforce challenges were identified as factors influencing both decision-making and service provision. Rationing of physiotherapy services was common to all sites of this study. Rationing of services, more commonly expressed as service prioritisation, was more evident in responses of public sector physiotherapy participants compared to private physiotherapists. However, private physiotherapists in rural areas reported capacity limits, including expertise, space and affordability that constrained service provision. The imbalance between increasing service demands and limited physiotherapy capacity meant making choices was inevitable. Decreased community access to local physiotherapy services and increased workforce stress, a key determinant of retention, are two results of such choices or decisions. Decreased access was particularly evident for adults and children requiring neurological rehabilitation and for people requiring post-acute physiotherapy. It should not be presumed that rural private physiotherapy providers will cover service gaps that may emerge from changes to public sector service provision. Clinician preference combines with capacity limits and the imperative of financial viability to negate such assumptions. This study provides insight into rural physiotherapy service provision not usually evident and can be used to inform health service planning and decision-making and education of current and future rural physiotherapists.

‘On the Perimeter of the Lawful’: Enduring Illegality in the Irish Family Planning Movement, 1972-1985

PubMed Central

Cloatre, Emilie; Enright, Máiréad

2017-01-01

Between 1935 and 1985, Irish law criminalized the sale and importation of condoms. Activists established illegal markets to challenge the law and alleviate its social consequences. They distributed condoms through postal services, shops, stalls, clinics, and machines. Though they largely operated in the open, their activities attracted little direct punishment from the state, and they were able to build a stable network of medical and commercial family planning services. We use 30 interviews conducted with former activists to explore this history. In doing so, we also examine the limits of ‘illegality’ in describing acts of everyday resistance to law, arguing that the boundaries between legal and illegal, in the discourses and practices of those who sought to challenge the state, were shifting and uncertain. In turn, we revisit ‘illegality’, characterizing it as an assemblage of varying selectively-performed political practices, shaped by complex choreographies of negotiation between state and non-state actors. PMID:29307949

The experiences of survivors and trauma counselling service providers in northern Uganda: Implications for mental health policy and legislation.

PubMed

Liebling, H; Davidson, L; Akello, G F; Ochola, G

Previous research in northern Uganda found high levels of trauma-related difficulties amongst the conflict-affected population. There is international evidence that psychological therapy can reduce depression, as one of the psychological effects of trauma, but very limited literature regarding the experiences of trauma counselling in Sub-Saharan Africa. The current British Academy and Leverhulme-funded research investigated the experiences of service users and providers of trauma services in Kitgum and Gulu, northern Uganda. It also examined their implications for mental health policy and legislation. A decision was made to utilise qualitative methodology to highlight the in-depth experiences of participants. The researcher's carried out interviews with 10 women and 10 men survivors attending trauma services in Kitgum and Gulu. The researchers also interviewed 15 key informants in Kitgum, Gulu and Kampala including trauma counselling service providers, ministers, cultural leaders and mental health professionals. The authors report the findings of the research based on thematic analysis of the interviews. Themes included the experiences of survivors, bearing witness and instilling hope, constraints to service provision, stigma and abuse, holistic approach, service providers doing their best, specialist populations, limited understanding, training and skills development, gaps in service provision and mental health policy and legislation. The interviews resulted in a clear indication that counselling and medication was valued by service users, and that service providers felt the treatments that were provided improved depression, and increased empowerment and engagement in social activities. However, the authors argue that there was a limit to the benefits that could be achieved without using the holistic approach that the survivors requested. Thus, in cases of trauma arising from conflict, there is a clear need for the state to ensure reparation and/or justice for the atrocities witnessed by and perpetrated against survivors. This might include the provision of compensation, which would help to meet social needs and reduce feelings of shame and anger. Copyright © 2016 Elsevier Ltd. All rights reserved.

Legitimization of regulatory norms: Waterfowl hunter acceptance of changing duck bag limits

USGS Publications Warehouse

Schroeder, Susan A.; Fulton, David C.; Lawrence, Jeffrey S.; Cordts, Steven D.

2014-01-01

Few studies have examined response to regulatory change over time, or addressed hunter attitudes about changes in hunting bag limits. This article explores Minnesota waterfowl hunters’ attitudes about duck bag limits, examining attitudes about two state duck bag limits that were initially more restrictive than the maximum set by the U.S. Fish and Wildlife Service (USFWS), but then increased to match federal limits. Results are from four mail surveys that examined attitudes about bag limits over time. Following two bag limit increases, a greater proportion of hunters rated the new bag limit “too high” and a smaller proportion rated it “too low.” Several years following the first bag limit increase, the proportion of hunters who indicated that the limit was “too high” had declined, suggesting hunter acceptance of the new regulation. Results suggest that waterfowl bag limits may represent legal norms that influence hunter attitudes and gain legitimacy over time.

76 FR 37059 - Agency Information Collection Activities: Proposed Collection; Comment Request-Form FNS-339...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-24

... Nutrition Program for Women, Infants and Children (WIC); the WIC Farmers' Market Nutrition Program (FMNP... be open for public inspection at the office of the Food and Nutrition Service during regular business... State budget restrictions or limitations including, at a minimum, hiring freezes, work furloughs, and...

Composting of Municipal Solid Wastes in the United States.

ERIC Educational Resources Information Center

Breidenbach, Andrew W.

To gain more comprehensive knowledge about composting as a solid waste management tool and to better assess the limited information available, the Federal solid waste management program, within the U. S. Public Health Service, entered into a joint experimental windrow composting project in 1966 with the Tennessee Valley Authority and the City of…

Supporting aging in place & assisted living through home care.

PubMed

Gorshe, N

2000-06-01

This article defines assisted living, discusses the pros and cons of limited regulation, scope of service, Aging-in-Place partnerships, and how home care agencies can work with assisted-living facilities to provide care. It also examines a study on assisted living in six states that is funded by the Robert Wood Johnson Foundation.

Developing qualitative ecosystem service relationships with the Driver-Pressure-State-Impact-Response framework: A case study on Cape Cod, Massachusetts

EPA Science Inventory

Understanding the effects of environmental management strategies on society and the environment is critical for evaluating their effectiveness but is often impeded by limited data availability. In this article, we present a method that can help scientists to support environmental...

Tax and Expenditure Limitation in Retrospect and in Prospect.

ERIC Educational Resources Information Center

Shapiro, Perry; And Others

1979-01-01

The message of Proposition 13 appears to be a demand for smaller residential property tax burdens but not for a reduction in current service levels for most public sector activities. Available from Stanley J. Bowers, Executive Director, NTA-TIA, 21 East State Street, Columbus, OH 43215; sc $5.00. (Author/IRT)

The AFS Volunteer Resources Study: Summary of Findings from Germany Study.

ERIC Educational Resources Information Center

Zeutschel, Uli; Hansel, Bettina

An ongoing debate exists on the issue of volunteering and its political implications in West Germany. Critics of the social welfare system have a direct impact on volunteerism. The ruling coalition aims to limit public spending in the social services sector while the "grassroots" movement emphasizes the danger of state-provided services…

Pacific Islands Regional Office — National Marine Fisheries Service -

Science.gov Websites

Regulation Summaries Annual Catch Limits Sea Turtle Interactions Seabird Interactions Seabird Guide Whales and Dolphins Sea Turtles Species of Concern Corals Laws/Policies/Guidelines Endangered Species Act ? Report Marine Animals State-Wide Hotline 888-256-9840 Report sea turtle, monk seal, dolphin and whales

Inmate Recidivism as a Measure of Private Prison Performance

ERIC Educational Resources Information Center

Spivak, Andrew L.; Sharp, Susan F.

2008-01-01

The growth of the private corrections industry has elicited interest in the comparative performance of state and private prisons. One way to measure the service quality of private prisons is to examine inmates' postrelease performance. Current empirical evidence is limited to four studies, all conducted in Florida. This analysis replicates and…

The use of LIDAR Technology for Measuring Mixing Heights under the Photochemical Assessment Monitoring Program; leveraging research under the joint DISCOVER-AQ/FRAPPÉ Missions

EPA Science Inventory

The operational use of ceilometers across the United States has been limited to detection of cloud-base heights across the Automatic Surface Observing Systems (ASOS) primarily operated by the National Weather Service and the Federal Aviation Administration. Continued improvements...

77 FR 895 - Tribal Child Welfare

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-06

... such as, State rules that may limit the number of children in the home, Indian Health Service safety... policies, safety, sanitation, and protection of civil rights (see sections 471(a)(10) and 479B(c)(2) of the... permits a title IV-E agency to waive the application of a standard unrelated to safety for relative foster...

14 CFR 1251.109 - Effect of State or local law or other requirements and effect of employment opportunities.

Code of Federal Regulations, 2012 CFR

2012-01-01

... AERONAUTICS AND SPACE ADMINISTRATION NONDISCRIMINATION ON BASIS OF HANDICAP General Provisions § 1251.109... or other requirement that, on the basis of handicap, imposes prohibitions or limits upon the eligibility of qualified handicapped persons to receive services or to practice any occupation or profession...

14 CFR 1251.109 - Effect of State or local law or other requirements and effect of employment opportunities.

Code of Federal Regulations, 2013 CFR

2013-01-01

... AERONAUTICS AND SPACE ADMINISTRATION NONDISCRIMINATION ON BASIS OF HANDICAP General Provisions § 1251.109... or other requirement that, on the basis of handicap, imposes prohibitions or limits upon the eligibility of qualified handicapped persons to receive services or to practice any occupation or profession...

14 CFR 1251.109 - Effect of State or local law or other requirements and effect of employment opportunities.

Code of Federal Regulations, 2011 CFR

2011-01-01

... AERONAUTICS AND SPACE ADMINISTRATION NONDISCRIMINATION ON BASIS OF HANDICAP General Provisions § 1251.109... or other requirement that, on the basis of handicap, imposes prohibitions or limits upon the eligibility of qualified handicapped persons to receive services or to practice any occupation or profession...

14 CFR 1251.109 - Effect of State or local law or other requirements and effect of employment opportunities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... AERONAUTICS AND SPACE ADMINISTRATION NONDISCRIMINATION ON BASIS OF HANDICAP General Provisions § 1251.109... or other requirement that, on the basis of handicap, imposes prohibitions or limits upon the eligibility of qualified handicapped persons to receive services or to practice any occupation or profession...

14 CFR § 1251.109 - Effect of State or local law or other requirements and effect of employment opportunities.

Code of Federal Regulations, 2014 CFR

2014-01-01

... NATIONAL AERONAUTICS AND SPACE ADMINISTRATION NONDISCRIMINATION ON BASIS OF HANDICAP General Provisions... local law or other requirement that, on the basis of handicap, imposes prohibitions or limits upon the eligibility of qualified handicapped persons to receive services or to practice any occupation or profession...

Emerald ash borer impacts on visual preferences for urban forest recreation settings

Treesearch

Arne Arnberger; Ingrid E. Schneider; Martin Ebenberger; Renate Eder; Robert C. Venette; Stephanie A. Snyder; Paul H. Gobster; Ami Choi; Stuart Cottrell

2017-01-01

Extensive outbreaks of the emerald ash borer (Agrilus planipennis; EAB), an invasive forest insect, are having serious impacts on the cultural ecosystem services of urban forests in the United States and other countries. Limited experience with how such outbreaks might affect recreational opportunities prompted this investigation of visitors to a...

21 CFR 20.84 - Disclosure to consultants, advisory committees, State and local government officials commissioned...

Code of Federal Regulations, 2014 CFR

2014-04-01

... the same restrictions with respect to the disclosure of such data and information as any other Food... 21 Food and Drugs 1 2014-04-01 2014-04-01 false Disclosure to consultants, advisory committees... AND HUMAN SERVICES GENERAL PUBLIC INFORMATION Limitations on Exemptions § 20.84 Disclosure to...

21 CFR 20.84 - Disclosure to consultants, advisory committees, State and local government officials commissioned...

Code of Federal Regulations, 2012 CFR

2012-04-01

... the same restrictions with respect to the disclosure of such data and information as any other Food... 21 Food and Drugs 1 2012-04-01 2012-04-01 false Disclosure to consultants, advisory committees... AND HUMAN SERVICES GENERAL PUBLIC INFORMATION Limitations on Exemptions § 20.84 Disclosure to...

21 CFR 20.84 - Disclosure to consultants, advisory committees, State and local government officials commissioned...

Code of Federal Regulations, 2010 CFR

2010-04-01

... the same restrictions with respect to the disclosure of such data and information as any other Food... 21 Food and Drugs 1 2010-04-01 2010-04-01 false Disclosure to consultants, advisory committees... AND HUMAN SERVICES GENERAL PUBLIC INFORMATION Limitations on Exemptions § 20.84 Disclosure to...

21 CFR 20.84 - Disclosure to consultants, advisory committees, State and local government officials commissioned...

Code of Federal Regulations, 2011 CFR

2011-04-01

... the same restrictions with respect to the disclosure of such data and information as any other Food... 21 Food and Drugs 1 2011-04-01 2011-04-01 false Disclosure to consultants, advisory committees... AND HUMAN SERVICES GENERAL PUBLIC INFORMATION Limitations on Exemptions § 20.84 Disclosure to...

21 CFR 20.84 - Disclosure to consultants, advisory committees, State and local government officials commissioned...

Code of Federal Regulations, 2013 CFR

2013-04-01

... the same restrictions with respect to the disclosure of such data and information as any other Food... 21 Food and Drugs 1 2013-04-01 2013-04-01 false Disclosure to consultants, advisory committees... AND HUMAN SERVICES GENERAL PUBLIC INFORMATION Limitations on Exemptions § 20.84 Disclosure to...

42 CFR 438.704 - Amounts of civil money penalties.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Amounts of civil money penalties. 438.704 Section... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE Sanctions § 438.704 Amounts of civil money penalties. (a) General rule. The limit on, or the maximum civil money penalty the State may impose varies...

42 CFR 438.704 - Amounts of civil money penalties.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Amounts of civil money penalties. 438.704 Section... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE Sanctions § 438.704 Amounts of civil money penalties. (a) General rule. The limit on, or the maximum civil money penalty the State may impose varies...

42 CFR 438.704 - Amounts of civil money penalties.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Amounts of civil money penalties. 438.704 Section... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE Sanctions § 438.704 Amounts of civil money penalties. (a) General rule. The limit on, or the maximum civil money penalty the State may impose varies...

42 CFR 438.704 - Amounts of civil money penalties.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false Amounts of civil money penalties. 438.704 Section... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE Sanctions § 438.704 Amounts of civil money penalties. (a) General rule. The limit on, or the maximum civil money penalty the State may impose varies...

42 CFR 438.704 - Amounts of civil money penalties.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Amounts of civil money penalties. 438.704 Section... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE Sanctions § 438.704 Amounts of civil money penalties. (a) General rule. The limit on, or the maximum civil money penalty the State may impose varies...

78 FR 65202 - Airworthiness Directives; Bell Helicopter Textron Canada Limited (Bell) Helicopters

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-31

... engine speeds during steady-state operations. These actions are intended to alert pilots to avoid certain... operation between speeds of 71% and 92%. The proposed requirements were intended to alert pilots to avoid... amending the RFM, advising pilots of the change, and installing a decal as described in Bell Alert Service...

Measuring short-crop reference evapotranspiration in a humid region using electronic atmometers

USDA-ARS?s Scientific Manuscript database

The Crop Water Use phone app is a weather-based program developed by the Missouri Extension Service to help farmers with irrigation scheduling. A limitation of the program is that it only works on Missouri fields. The app is linked to the state agricultural weather station network, which supplies da...

75 FR 46904 - Request for Proposals: Fiscal Year 2010 Funding Opportunity for Research on the Economic Impact...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-04

... supporting documentation for completed tasks include, but are not limited to, questionnaire or interview... 2009 research. 6. The performance of subcontracting services, oversight, and financial controls for the... United States Government and the eligible recipient during the performance of the research in the...

15 CFR 8b.10 - Effect of state or local law or other requirements and effect of employment opportunities.

Code of Federal Regulations, 2014 CFR

2014-01-01

... the Secretary of Commerce PROHIBITION OF DISCRIMINATION AGAINST THE HANDICAPPED IN FEDERALLY ASSISTED..., on the basis of handicap, imposes prohibitions or limits upon the eligibility of qualified handicapped individuals to receive services, participate in programs or activities, or practice any occupation...

15 CFR 8b.10 - Effect of state or local law or other requirements and effect of employment opportunities.

Code of Federal Regulations, 2013 CFR

2013-01-01

... the Secretary of Commerce PROHIBITION OF DISCRIMINATION AGAINST THE HANDICAPPED IN FEDERALLY ASSISTED..., on the basis of handicap, imposes prohibitions or limits upon the eligibility of qualified handicapped individuals to receive services, participate in programs or activities, or practice any occupation...

15 CFR 8b.10 - Effect of state or local law or other requirements and effect of employment opportunities.

Code of Federal Regulations, 2011 CFR

2011-01-01

... the Secretary of Commerce PROHIBITION OF DISCRIMINATION AGAINST THE HANDICAPPED IN FEDERALLY ASSISTED..., on the basis of handicap, imposes prohibitions or limits upon the eligibility of qualified handicapped individuals to receive services, participate in programs or activities, or practice any occupation...

15 CFR 8b.10 - Effect of state or local law or other requirements and effect of employment opportunities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... the Secretary of Commerce PROHIBITION OF DISCRIMINATION AGAINST THE HANDICAPPED IN FEDERALLY ASSISTED..., on the basis of handicap, imposes prohibitions or limits upon the eligibility of qualified handicapped individuals to receive services, participate in programs or activities, or practice any occupation...

15 CFR 8b.10 - Effect of state or local law or other requirements and effect of employment opportunities.

Code of Federal Regulations, 2012 CFR

2012-01-01

... the Secretary of Commerce PROHIBITION OF DISCRIMINATION AGAINST THE HANDICAPPED IN FEDERALLY ASSISTED..., on the basis of handicap, imposes prohibitions or limits upon the eligibility of qualified handicapped individuals to receive services, participate in programs or activities, or practice any occupation...

21 CFR 312.6 - Labeling of an investigational new drug.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Section 312.6 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS FOR HUMAN USE INVESTIGATIONAL NEW DRUG APPLICATION General Provisions § 312.6 Labeling of... human use shall bear a label with the statement “Caution: New Drug—Limited by Federal (or United States...

The Amish and the State.

ERIC Educational Resources Information Center

Kraybill, Donald B., Ed.

The opportunity for religious freedom brought the Amish from Europe to North America as early as 1737. And for many generations, conflicts between the Amish and the U.S. government were limited to Amish objections to military service. However, as the government's regulatory power grew in the 20th century, clashes between the Amish and the state…

Going the Extra Mile: Supporting Distance Education at University of Alaska Fairbanks

ERIC Educational Resources Information Center

Hahn, Suzan; Lehman, Lisa; Dupras, Rheba

2007-01-01

The Elmer E. Rasmuson Library at the University of Alaska Fairbanks has a long history of supporting distance education through state-of-the-art, remote access services. Harsh climate conditions (heavy snowfall and icing, high winds, and extreme temperatures), rugged terrain, limited road and telephone systems, and permafrost that prevents the…

14 CFR 294.30 - Scope of service and equipment authorized.

Code of Federal Regulations, 2014 CFR

2014-01-01

... between any point or points in Canada and any point or points in the United States using small aircraft. (b) Nothing in this part shall be construed as authorizing the operation of large aircraft in charter... with the limitations and conditions of this part using aircraft designed to have: (1) A maximum...

14 CFR 294.30 - Scope of service and equipment authorized.

Code of Federal Regulations, 2012 CFR

2012-01-01

... between any point or points in Canada and any point or points in the United States using small aircraft. (b) Nothing in this part shall be construed as authorizing the operation of large aircraft in charter... with the limitations and conditions of this part using aircraft designed to have: (1) A maximum...

14 CFR 294.30 - Scope of service and equipment authorized.

Code of Federal Regulations, 2011 CFR

2011-01-01

... between any point or points in Canada and any point or points in the United States using small aircraft. (b) Nothing in this part shall be construed as authorizing the operation of large aircraft in charter... with the limitations and conditions of this part using aircraft designed to have: (1) A maximum...

Scope-of-practice laws for nurse practitioners limit cost savings that can be achieved in retail clinics.

PubMed

Spetz, Joanne; Parente, Stephen T; Town, Robert J; Bazarko, Dawn

2013-11-01

Retail clinics have the potential to reduce health spending by offering convenient, low-cost access to basic health care services. Retail clinics are often staffed by nurse practitioners (NPs), whose services are regulated by state scope-of-practice regulations. By limiting NPs' work scope, restrictive regulations could affect possible cost savings. Using multistate insurance claims data from 2004-07, a period in which many retail clinics opened, we analyzed whether the cost per episode associated with the use of retail clinics was lower in states where NPs are allowed to practice independently and to prescribe independently. We also examined whether retail clinic use and scope of practice were associated with emergency department visits and hospitalizations. We found that visits to retail clinics were associated with lower costs per episode, compared to episodes of care that did not begin with a retail clinic visit, and the costs were even lower when NPs practiced independently. Eliminating restrictions on NPs' scope of practice could have a large impact on the cost savings that can be achieved by retail clinics.

Increasing reach by offering choices: Results from an innovative model for statewide services for smoking cessation.

PubMed

Keller, Paula A; Schillo, Barbara A; Kerr, Amy N; Lien, Rebecca K; Saul, Jessie; Dreher, Marietta; Lachter, Randi B

2016-10-01

Although state quitlines provide free telephone counseling and often include nicotine replacement therapy (NRT), reach remains limited (1-2% in most states). More needs to be done to engage all smokers in the quitting process. A possible strategy is to offer choices of cessation services through quitlines and to reduce registration barriers. In March 2014, ClearWay Minnesota SM implemented a new model for QUITPLAN® Services, the state's population-wide cessation services. Tobacco users could choose the QUITPLAN® Helpline or one or more Individual QUITPLAN® Services (NRT starter kit, text messaging, email program, or quit guide). The program website was redesigned, online enrollment was added, and a new advertising campaign was created and launched. In 2014-2015, we evaluated whether these changes increased reach. We also assessed quit attempts, quit outcomes, predictors of 30-day abstinence, and average cost per quit via a seven-month follow-up survey. Between March 2014-February 2015, 15,861 unique tobacco users registered, which was a 169% increase over calendar year 2013. The majority of participants made a quit attempt (83.7%). Thirty-day point prevalence abstinence rates (responder rates) were 26.1% for QUITPLAN Services overall, 29.6% for the QUITPLAN Helpline, and 25.5% for Individual QUITPLAN Services. Several variables predicted quit outcomes, including receiving only one call from the Helpline and using both the Helpline and the NRT starter kit. Providing greater choice of cessation services and reducing registration barriers have the potential to engage more tobacco users, foster more quit attempts, and ultimately lead to long-term cessation and reductions in prevalence. Copyright © 2016 Elsevier Inc. All rights reserved.

Designing the Cash and Counseling Demonstration and Evaluation.

PubMed

Doty, Pamela; Mahoney, Kevin J; Simon-Rusinowitz, Lori

2007-02-01

The Cash and Counseling Demonstration and Evaluation (CCDE) was designed as an experiment in shifting the paradigm in home and community-based long-term care from a professional/bureaucratic model of service delivery to one emphasizing consumer choice and control. The experimental intervention was an individualized budget offered in lieu of traditional Medicaid-covered services, such as agency-delivered aide services or a plan of care developed and coordinated by a professional case-manager, which typically involves authorization for several different providers to deliver a range of services. Within the spending limits established by their budgets, program participants were largely free to choose the types and amounts of paid services and supports they judged best able to meet their disability-related personal assistance needs. Medicaid beneficiaries in selected states who volunteered to participate. In all of the participating state Medicaid programs, beneficiaries eligible to participate included elders and younger adults with chronic disabilities and, in one state, adults and children with mental retardation/developmental disabilities could also participate. Minor children and adults with cognitive impairment could participate via representatives (family or friends who agreed to assist them in managing their services or to act as their surrogate decision-makers). Members of the CCDE management team describe the rationale for and implications of key design decisions. Key design decisions included the choice of research methodology (random assignment of CCDE participants in each state to treatment and control groups), selection of the state sites (AR, FL, NJ, NY), and the need for the CCDE to comply with federal waiver requirements for Medicaid research and demonstration projects. Principle Findings. The CCDE design was successfully implemented in three of the four state Medicaid programs selected for participation. The successful implementation of the CCDE (results from the evaluation are reported elsewhere) led to replication efforts in other states. The CCDE also inspired changes in Medicaid law and policy, including the 2002 "Independence Plus" Initiative by the Centers for Medicare and Medicaid and sections of the Deficit Reduction Act of 2005 intended to promote consumer-direction in Medicaid.

Designing the Cash and Counseling Demonstration and Evaluation

PubMed Central

Doty, Pamela; Mahoney, Kevin J; Simon-Rusinowitz, Lori

2007-01-01

Ojective The Cash and Counseling Demonstration and Evaluation (CCDE) was designed as an experiment in shifting the paradigm in home and community-based long-term care from a professional/bureaucratic model of service delivery to one emphasizing consumer choice and control. The experimental intervention was an individualized budget offered in lieu of traditional Medicaid-covered services, such as agency-delivered aide services or a plan of care developed and coordinated by a professional case-manager, which typically involves authorization for several different providers to deliver a range of services. Within the spending limits established by their budgets, program participants were largely free to choose the types and amounts of paid services and supports they judged best able to meet their disability-related personal assistance needs. Study Population Medicaid beneficiaries in selected states who volunteered to participate. In all of the participating state Medicaid programs, beneficiaries eligible to participate included elders and younger adults with chronic disabilities and, in one state, adults and children with mental retardation/developmental disabilities could also participate. Minor children and adults with cognitive impairment could participate via representatives (family or friends who agreed to assist them in managing their services or to act as their surrogate decision-makers). Data Sources Members of the CCDE management team describe the rationale for and implications of key design decisions. Study Design Key design decisions included the choice of research methodology (random assignment of CCDE participants in each state to treatment and control groups), selection of the state sites (AR, FL, NJ, NY), and the need for the CCDE to comply with federal waiver requirements for Medicaid research and demonstration projects. Principle Findings The CCDE design was successfully implemented in three of the four state Medicaid programs selected for participation. Conclusions The successful implementation of the CCDE (results from the evaluation are reported elsewhere) led to replication efforts in other states. The CCDE also inspired changes in Medicaid law and policy, including the 2002 “Independence Plus” Initiative by the Centers for Medicare and Medicaid and sections of the Deficit Reduction Act of 2005 intended to promote consumer-direction in Medicaid. PMID:17244289

The organization and delivery of family planning services in community health centers.

PubMed

Goldberg, Debora Goetz; Wood, Susan F; Johnson, Kay; Mead, Katherine Holly; Beeson, Tishra; Lewis, Julie; Rosenbaum, Sara

2015-01-01

Family planning and related reproductive health services are essential primary care services for women. Access is limited for women with low incomes and those living in medically underserved areas. Little information is available on how federally funded health centers organize and provide family planning services. This was a mixed methods study of the organization and delivery of family planning services in federally funded health centers across the United States. A national survey was developed and administered (n = 423) and in-depth case studies were conducted of nine health centers to obtain detailed information on their approach to family planning. Study findings indicate that health centers utilize a variety of organizational models and staffing arrangements to deliver family planning services. Health centers' family planning offerings are organized in one of two ways, either a separate service with specific providers and clinic times or fully integrated with primary care. Health centers experience difficulties in providing a full range of family planning services. Major challenges include funding limitations; hiring obstetricians/gynecologists, counselors, and advanced practice clinicians; and connecting patients to specialized services not offered by the health center. Health centers play an integral role in delivering primary care and family planning services to women in medically underserved communities. Improving the accessibility and comprehensiveness of family planning services will require a combination of additional direct funding, technical assistance, and policies that emphasize how health centers can incorporate quality family planning as a fundamental element of primary care. Copyright © 2015 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

New service interface for River Forecasting Center derived quantitative precipitation estimates

USGS Publications Warehouse

Blodgett, David L.

2013-01-01

For more than a decade, the National Weather Service (NWS) River Forecast Centers (RFCs) have been estimating spatially distributed rainfall by applying quality-control procedures to radar-indicated rainfall estimates in the eastern United States and other best practices in the western United States to producea national Quantitative Precipitation Estimate (QPE) (National Weather Service, 2013). The availability of archives of QPE information for analytical purposes has been limited to manual requests for access to raw binary file formats that are difficult for scientists who are not in the climatic sciences to work with. The NWS provided the QPE archives to the U.S. Geological Survey (USGS), and the contents of the real-time feed from the RFCs are being saved by the USGS for incorporation into the archives. The USGS has applied time-series aggregation and added latitude-longitude coordinate variables to publish the RFC QPE data. Web services provide users with direct (index-based) data access, rendered visualizations of the data, and resampled raster representations of the source data in common geographic information formats.

[Analysis of the effectiveness of the public health system with special reference to the health of children].

PubMed

Köhler, L; Brogren, P O

1990-01-01

A well structured, efficient health service is an important component of the welfare state, in Sweden for example. But its significance for the state of the nation's health is limited and will be affected, inter alia, by life styles and the environment. A progressive health policy must be based on cooperation between various sectors of society, and here the health service plays a central part. Therefore social policy must be well documented and subjected to continuous review. This is an important prerequisite for planning and correction at different levels. The analysis must take account of society as a whole, organization, and the individual! In so doing, greater significance should be attributed to the effectiveness and quality of the health service than to structures, capacity and statistics. With reference to the health of children in the Nordic countries, it is encouraging to see that this conception of evaluation has also gained greater acceptance in preventive care, firstly in the field of paediatric health care and more recently in the school health service as well.

Implementation of data node in spatial information grid based on WS resource framework and WS notification

NASA Astrophysics Data System (ADS)

Zhang, Dengrong; Yu, Le

2006-10-01

Abstract-An approach of constructing a data node in spatial information grid (SIG) based on Web Service Resource Framework (WSRF) and Web Service Notification (WSN) is described in this paper. Attentions are paid to construct and implement SIG's resource layer, which is the most important part. A study on this layer find out, it is impossible to require persistent interaction with the clients of the services in common SIG architecture because of inheriting "stateless" and "not persistent" limitations of Web Service. A WSRF/WSN-based data node is designed to hurdle this short comes. Three different access modes are employed to test the availability of this node. Experimental results demonstrate this service node can successfully respond to standard OGC requests and returns specific spatial data in different network environment, also is stateful, dynamic and persistent.

Role of the private sector in vaccination service delivery in India: evidence from private-sector vaccine sales data, 2009-12.

PubMed

Sharma, Abhishek; Kaplan, Warren A; Chokshi, Maulik; Zodpey, Sanjay P

2016-09-01

India's Universal Immunization Programme (UIP) provides basic vaccines free-of-cost in the public sector, yet national vaccination coverage is poor. The Government of India has urged an expanded role for the private sector to help achieve universal immunization coverage. We conducted a state-by-state analysis of the role of the private sector in vaccinating Indian children against each of the six primary childhood diseases covered under India's UIP. We analyzed IMS Health data on Indian private-sector vaccine sales, 2011 Indian Census data and national household surveys (DHS/NFHS 2005-06 and UNICEF CES 2009) to estimate the percentage of vaccinated children among the 2009-12 birth cohort who received a given vaccine in the private sector in 16 Indian states. We also analyzed the estimated private-sector vaccine shares as function of state-specific socio-economic status. Overall in 16 states, the private sector contributed 4.7% towards tuberculosis (Bacillus Calmette-Guérin (BCG)), 3.5% towards measles, 2.3% towards diphtheria-pertussis-tetanus (DPT3) and 7.6% towards polio (OPV3) overall (both public and private sectors) vaccination coverage. Certain low income states (Uttar Pradesh, Rajasthan, Madhya Pradesh, Orissa, Assam and Bihar) have low private as well as public sector vaccination coverage. The private sector's role has been limited primarily to the high income states as opposed to these low income states where the majority of Indian children live. Urban areas with good access to the private sector and the ability to pay increases the Indian population's willingness to access private-sector vaccination services. In India, the public sector offers vaccination services to the majority of the population but the private sector should not be neglected as it could potentially improve overall vaccination coverage. The government could train and incentivize a wider range of private-sector health professionals to help deliver the vaccines, especially in the low income states with the largest birth cohorts. We recommend future studies to identify strengths and limitations of the public and private health sectors in each Indian state. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Sudan: The Crisis in Darfur and Status of the North-South Peace Agreement

DTIC Science & Technology

2011-04-08

million in support of the elections. In a joint statement, Secretary of State Clinton, Norwegian Foreign Minster Jonas Store, and United Kingdom...restricted owing to renewed fighting in eastern Jebel Marra and Jebel Moon.”10 In some areas there are no health services available and only limited... Health and Child Survival (State) 3,245 6,327 7,036 7,036 12,397 Global Health & Childe Survival (USAID) 17,488 23,185 30,010 32,083 38,510

MRI: update on technology diffusion and acquisition.

PubMed

Hoppszallern, S; Hughes, C; Zimmerman, R A

1991-04-01

Over the past three years, magnetic resonance imaging (MRI) has become accepted as a valuable diagnostic tool, and its applications continue to expand. During this time, the number of units installed in the United States doubled. By 1990 about 2,000 MRI units were in place in the United States and nearly 20 percent of the MRI-installed base was mobile, according to a research study conducted by the Hadley Hart Group (Chicago) and Drew Consultants, Inc. (Concord, MA). With the introduction of the prospective payment system, many hospitals were hesitant to spend limited capital on new technology, such as MRI. At the same time, freestanding diagnostic imaging centers were on the rise. Some hospitals and entrepreneurs who foresaw the potential of MRI in health care pioneered its use in the clinical setting. Hospitals began to examine new partnership arrangements and alternative forms of financing, so that they too could offer MRI services. By the end of 1988, the majority of hospitals offering MRI services did not own their own unit and about 40 percent of the hospitals offering MRI services were in a mobile configuration according to the Hadley Hart Group. While the technology has been diffused into 100-bed hospitals via mobile service vendors in some parts of the country, many medium-sized and large hospitals also have entered the MRI services market in this fashion. In the larger hospitals, the patient demand or need for the service often would justify acquisition of MRI, but the expense of the technology, and in many areas restrictive state health planning policies, modified purchase of MRI systems by hospitals. Mobile service vendors offered hospitals a way to startup MRI services in a limited fashion without a major capital expenditure and its associated risk. As hospitals gain experience with mobile MRI and achieve or exceed their early utilization projections, administrators are reevaluating the need to expand services to a full-time fixed site. Early fixed-site MRI providers have been constantly upgrading their MRI capability while planning on adding more units. The technology itself has continued to improve, primarily through the implementation of new software that permits new techniques such as MR angiography (MRA) to be performed. Units are available in a wide price range, price usually reflecting both the field strength (0.5 tesla units cost less) as well as the additional capabilities beyond routine imaging (MRA, spectroscopy).(ABSTRACT TRUNCATED AT 400 WORDS)

Family well-being in a participant-directed autism waiver program: the role of relational coordination.

PubMed

Warfield, M E; Chiri, G; Leutz, W N; Timberlake, M

2014-12-01

Massachusetts is one of a very limited number of states exclusively employing participant-direction to deliver autism waiver services to children. A crucial element of this waiver program is the work conducted by the state's Department of Developmental Services (DDS) staff and state-approved providers with waiver families to facilitate the implementation of the participant-direction model. Our study investigates the effect of the collaboration between state providers and family caregivers on family well-being. We conducted a survey of 74 families who have been utilising waiver services for at least 6 months. Participants were asked to rate the coordination with providers as well as to report on parenting stress and impact of waiver services on family functioning. Data from in-home child and family assessments conducted by the state were also abstracted from program records. After controlling for a host of variables hypothesised to affect the outcomes of interest, we found that the family's view of how well they coordinated with formal providers is significantly associated all of the outcomes. Families who reported greater coordination with state providers experienced lower parenting stress and reported a more positive impact on family functioning. Child externalising behavioural problems and caregiver's health rating also contributed to parenting stress and family functioning. Our findings highlight the importance of establishing a collaborative partnership with waiver families in promoting family well-being. These results suggest that training and/or resources that foster team building and communication can positively impact family functioning among families with young children with autism. © 2013 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

Suicide mortality at time of armed conflict in Ukraine.

PubMed

Yur'yev, Andriy; Yur'yeva, Lyudmyla

2015-12-01

The purpose of this review is to explore the dynamics of suicide mortality rates in Ukraine during an ongoing armed conflict between 2014 and 2015. Suicide mortality data were obtained by reviewing annual analytical releases from the State Service for Emergent Situations of Ukraine and annual release of Russian Federal Service of State Statistics. Suicide mortality in mainland Ukraine and in the Crimea region demonstrated a mild decrease, whereas suicide mortality in the regions directly involved in the armed conflict demonstrated a prominent decrease. The results of this review support Durkheim theory. The limitation of this review includes general concern about quality of data at time of armed conflict in the country. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

42 CFR 440.255 - Limited services available to certain aliens.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Limited services available to certain aliens. 440... Limits Applicable to All Services § 440.255 Limited services available to certain aliens. (a) FFP for services. FFP is available for services provided to aliens described in this section which are necessary to...

42 CFR 440.255 - Limited services available to certain aliens.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false Limited services available to certain aliens. 440... Limits Applicable to All Services § 440.255 Limited services available to certain aliens. (a) FFP for services. FFP is available for services provided to aliens described in this section which are necessary to...

42 CFR 440.255 - Limited services available to certain aliens.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Limited services available to certain aliens. 440... Limits Applicable to All Services § 440.255 Limited services available to certain aliens. (a) FFP for services. FFP is available for services provided to aliens described in this section which are necessary to...

42 CFR 440.255 - Limited services available to certain aliens.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Limited services available to certain aliens. 440... Limits Applicable to All Services § 440.255 Limited services available to certain aliens. (a) FFP for services. FFP is available for services provided to aliens described in this section which are necessary to...

42 CFR 440.255 - Limited services available to certain aliens.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Limited services available to certain aliens. 440... Limits Applicable to All Services § 440.255 Limited services available to certain aliens. (a) FFP for services. FFP is available for services provided to aliens described in this section which are necessary to...

Emerging Roles for Peer Providers in Mental Health and Substance Use Disorders.

PubMed

Chapman, Susan A; Blash, Lisel K; Mayer, Kimberly; Spetz, Joanne

2018-06-01

The purpose of this study was to identify and assess states with best practices in peer provider workforce development and employment. A growing body of research demonstrates that peer providers with lived experience contribute positively to the treatment and recovery of individuals with behavioral health needs. Increased employment opportunities have led to policy concerns about training, certification, roles, and reimbursement for peer provider services. A case study approach included a national panel of subject matter experts who suggested best practice states. Researchers conducted 3- to 5-day site visits in four states: Arizona, Georgia, Texas, and Pennsylvania. Data collection included document review and interviews with state policymakers, directors of training and certification bodies, peer providers, and other staff in mental health and substance use treatment and recovery organizations. Data collection and analysis were performed in 2015. Peer providers work in a variety of settings, including psychiatric hospitals, clinics, jails and prisons, and supportive housing. A favorable policy environment along with individual champions and consumer advocacy organizations were positively associated with robust programs. Medicaid billing for peer services was an essential source of revenue in both Medicaid expansion and non-expansion states. States' peer provider training and certification requirements varied. Issues of stigma remain. Peer providers are low-wage workers with limited opportunity for career growth and may require workplace accommodations to maintain their recovery. Peer providers are a rapidly growing workforce with considerable promise to help alleviate behavioral health workforce shortages by supporting consumers in attaining and maintaining long-term recovery. This article is part of a supplement entitled The Behavioral Health Workforce: Planning, Practice, and Preparation, which is sponsored by the Substance Abuse and Mental Health Services Administration and the Health Resources and Services Administration of the U.S. Department of Health and Human Services. Copyright © 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

"Trade creep" and implications of the Transatlantic Trade and Investment Partnership Agreement for the United Kingdom National Health Service.

PubMed

Koivusalo, Meri; Tritter, Jonathan

2014-01-01

The ambitious and comprehensive Transatlantic Trade and Investment Partnership Agreement (TTIP/TAFTA) agreement between the European Union and United States is now being negotiated and may have far-reaching consequences for health services. The agreement extends to government procurement, investment, and further regulatory cooperation. In this article, we focus on the United Kingdom National Health Service and how these negotiations can limit policy space to change policies and to regulate in relation to health services, pharmaceuticals, medical devices, and health industries. The negotiation of TTIP/TAFTA has the potential to "harmonize" more corporate-friendly regulation, resulting in higher costs and loss of policy space, an example of "trade creep" that potentially compromises health equity, public health, and safety concerns across the Atlantic.

Hospital competition and financial performance: the effects of ambulatory surgery centers.

PubMed

Carey, Kathleen; Burgess, James F; Young, Gary J

2011-05-01

Ambulatory surgery centers (ASCs), limited-service alternatives for treating surgery patients not requiring an overnight stay, are a health-care service innovation that has proliferated in the U.S. and other countries in recent years. This paper examines the effects of ASC competition on revenues, costs, and profit margins of hospitals that also provided these services as a subset of their general services in Arizona, California, and Texas during the period 1997-2004. We identified all ASCs operating during the period in the 49 Dartmouth Hospital Referral Regions in the three states. The results of fixed effects models suggested that ASCs are meaningful competitors to general hospitals. We found downward pressure on revenues, costs, and profits in general hospitals associated with ASC presence. Copyright © 2010 John Wiley & Sons, Ltd.

Jordan's 2002 to 2012 Fertility Stall and Parallel USAID Investments in Family Planning: Lessons From an Assessment to Guide Future Programming

PubMed Central

Spindler, Esther; Bitar, Nisreen; Solo, Julie; Menstell, Elizabeth; Shattuck, Dominick

2017-01-01

Health practitioners, researchers, and donors are stumped about Jordan's stalled fertility rate, which has stagnated between 3.7 and 3.5 children per woman from 2002 to 2012, above the national replacement level of 2.1. This stall paralleled United States Agency for International Development (USAID) funding investments in family planning in Jordan, triggering an assessment of USAID family planning programming in Jordan. This article describes the methods, results, and implications of the programmatic assessment. Methods included an extensive desk review of USAID programs in Jordan and 69 interviews with reproductive health stakeholders. We explored reasons for fertility stagnation in Jordan's total fertility rate (TFR) and assessed the effects of USAID programming on family planning outcomes over the same time period. The assessment results suggest that the increased use of less effective methods, in particular withdrawal and condoms, are contributing to Jordan's TFR stall. Jordan's limited method mix, combined with strong sociocultural determinants around reproduction and fertility desires, have contributed to low contraceptive effectiveness in Jordan. Over the same time period, USAID contributions toward increasing family planning access and use, largely focused on service delivery programs, were extensive. Examples of effective initiatives, among others, include task shifting of IUD insertion services to midwives due to a shortage of female physicians. However, key challenges to improved use of family planning services include limited government investments in family planning programs, influential service provider behaviors and biases that limit informed counseling and choice, pervasive strong social norms of family size and fertility, and limited availability of different contraceptive methods. In contexts where sociocultural norms and a limited method mix are the dominant barriers toward improved family planning use, increased national government investments toward synchronized service delivery and social and behavior change activities may be needed to catalyze national-level improvements in family planning outcomes. PMID:29284697

The Impact of the Affordable Care Act on Funding for Newborn Screening Services.

PubMed

Costich, Julia F; Durst, Andrea L

2016-01-01

The Affordable Care Act requires most health plans to cover the federal Recommended Uniform Screening Panel of newborn screening (NBS) tests with no cost sharing. However, state NBS programs vary widely in both the number of mandated tests and their funding mechanisms, including a combination of state laboratory fees, third-party billing, and other federal and state funding. We assessed the potential impact of the Affordable Care Act coverage mandate on states' NBS funding. We performed an extensive review of the refereed literature, federal and state agency reports, relevant organizations' websites, and applicable state laws and regulations; interviewed 28 state and federal officials from August to December 2014; and then assessed the interview findings manually. Although a majority of states had well-established systems for including laboratory-based NBS tests in bundled charges for newborn care, billing practices for critical congenital heart disease and newborn hearing tests were less uniform. Most commonly, birthing facilities either prepaid the costs of laboratory-based tests when acquiring the filter paper kits, or the facilities paid for the tests when the kits were submitted. Some states had separate arrangements for billing Medicaid, and smaller facilities sometimes contracted with hearing test vendors that billed families separately. Although the Affordable Care Act coverage mandate may offset some state NBS funding for the screenings themselves, federal support is still required to assure access to the full range of NBS program services. Limiting reimbursement to the costs of screening tests alone would undermine the common practice of using screening charges to fund follow-up services counseling, and medical food or formula, particularly for low-income families.

Routine measurement of outcomes in Australia's public sector mental health services

PubMed Central

Pirkis, Jane; Burgess, Philip; Coombs, Tim; Clarke, Adam; Jones-Ellis, David; Dickson, Rosemary

2005-01-01

Objective This paper describes the Australian experience to date with a national 'roll out' of routine outcome measurement in public sector mental health services. Methods Consultations were held with 123 stakeholders representing a range of roles. Results Australia has made an impressive start to nationally implementing routine outcome measurement in mental health services, although it still has a long way to go. All States/Territories have established data collection systems, although some are more streamlined than others. Significant numbers of clinicians and managers have been trained in the use of routine outcome measures, and thought is now being given to ongoing training strategies. Outcome measurement is now occurring 'on the ground'; all States/Territories will be reporting data for 2003–04, and a number have been doing so for several years. Having said this, there is considerable variability regarding data coverage, completeness and compliance. Some States/Territories have gone to considerable lengths to 'embed' outcome measurement in day-to-day practice. To date, reporting of outcome data has largely been limited to reports profiling individual consumers and/or aggregate reports that focus on compliance and data quality issues, although a few States/Territories have begun to turn their attention to producing aggregate reports of consumers by clinician, team or service. Conclusion Routine outcome measurement is possible if it is supported by a co-ordinated, strategic approach and strong leadership, and there is commitment from clinicians and managers. The Australian experience can provide lessons for other countries. PMID:15840170

[Profile of public dental care for children and adolescents in São Luís, Maranhão State].

PubMed

Batista da Silva, Mariana Carvalho; da Silva, Raimundo Antônio; Costa Ribeiro, Cecília Cláudia; Nogueira da Cruz, Maria Carmem Fontoura

2007-01-01

This profile of public dental care for children/adolescents in São Luís, Maranhão State, Brazil, is based on a survey conducted through interviews, designed to identify these services and help upgrade Health Services available in this city. It describes the pediatric dental care available and the age groups attended, the qualifications of the practitioners involved, the types of treatment for primary and permanent teeth and oral health education programs run at the Municipal Healthcare Units with dental facilities, analyzed through visits and structured interviews. The findings show that dental care was available for children/adolescents (mainly between 6 and 12 years old) at 91.1% of the Healthcare Units offering daily and universal care (65.75%), as well as at those whose services are limited to certain specialties and/or specific days (34.15%). All the public Healthcare Units offered surgical treatment for permanent teeth. Fillings are used more for permanent teeth than primary teeth. Among the public Healthcare Units, 25 (55.5%) did not offer or run oral health programs. At most (75.5%) of the Units visited, dental treatment for children and adolescents is limited to basic care and directed mainly to permanent teeth. The traditional welfare model of providing care as freely demanded remains in place.

Development and Implementation of a Novel Prehospital Care System in the State of Kerala, India.

PubMed

Brown, Heather A; Douglass, Katherine A; Ejas, Shafi; Poovathumparambil, Venugopalan

2016-12-01

Most low- and middle-income countries (LMICs) have struggled to find a system for prehospital care that can provide adequate patient care and geographical coverage while maintaining a feasible price tag. The emergency medical systems of the Western world are not necessarily relevant in developing economic systems, given the lack of strict legislation, the scarcity of resources, and the limited number of trained personnel. Meanwhile, most efforts to provide prehospital care in India have taken the form of adapting Western models to the Indian context with limited success. Described here is a novel approach to prehospital care designed for and implemented in the State of Kerala, India. The Active Network Group of Emergency Life Savers (ANGELS) was launched in 2011 in Calicut City, the third largest city in the Indian State of Kerala. The ANGELS integrated an existing fleet of private and state-owned ambulances into a single network utilizing Global Positioning System (GPS) technology and a single statewide call number. A total of 85 volunteer emergency medical certified technicians (EMCTs) were trained in basic first aid and trauma care principles. Public awareness campaigns accompanied all activities to raise awareness amongst community members. Funding was provided via public-private partnership, aimed to minimize costs to patients for service utilization. Over a two-year period from March 2011 to April 2013, 8,336 calls were recorded, of which 54.8% (4,569) were converted into actual ambulance run sheets. The majority of calls were for medical emergencies and most patients were transported to Medical College Hospital in Calicut. This unique public-private partnership has been responsive to the needs of the population while sustaining low operational costs. This system may provide a relevant template for Emergency Medical Services (EMS) development in other resource-limited settings. Brown HA , Douglass KA , Ejas S , Poovathumparambil V . Development and implementation of a novel prehospital care system in the State of Kerala, India. Prehosp Disaster Med. 2016;31(6):663-666.

Status of costing hospital nursing work within Australian casemix activity-based funding policy.

PubMed

Heslop, Liza

2012-02-01

Australia has a long history of patient level costing initiated when casemix funding was implemented in several states in the early 1990s. Australia includes, to some extent, hospital payment based on nursing intensity adopted within casemix funding policy and the Diagnostic Related Group system. Costing of hospital nursing services in Australia has not changed significantly in the last few decades despite widespread introduction of casemix funding policy at the state level. Recent Commonwealth of Australia National Health Reform presents change to the management of the delivery of health care including health-care costing. There is agreement for all Australian jurisdictions to progress to casemix-based activity funding. Within this context, nurse costing infrastructure presents contemporary issues and challenges. An assessment is made of the progress of costing nursing services within casemix funding models in Australian hospitals. Valid and reliable Australian-refined nursing service weights might overcome present cost deficiencies and limitations. © 2012 Blackwell Publishing Asia Pty Ltd.

Neoliberal Justice and the Transformation of the Moral: The Privatization of the Right to Health Care in Colombia.

PubMed

Abadía-Barrero, César Ernesto

2016-03-01

Neoliberal reforms have transformed the legislative scope and everyday dynamics around the right to health care from welfare state social contracts to insurance markets administered by transnational financial capital. This article presents experiences of health care-seeking treatment, judicial rulings about the right to health care, and market-based health care legislation in Colombia. When insurance companies deny services, citizens petition the judiciary to issue a writ affirming their right to health care. The judiciary evaluates the finances of all relevant parties to rule whether a service should be provided and who should be responsible for the costs. A 2011 law claimed that citizens who demand, physicians who prescribe, and judges who grant uncovered services use the system's limited economic resources and undermine the state's capacity to expand coverage to the poor. This article shows how the consolidation of neoliberal ideology in health care requires the transformation of moral values around life. © 2015 by the American Anthropological Association.

State Medicaid abortion policies continue to be challenged; courts reach varying conclusions.

PubMed

1979-08-01

There is no consensus by the courts on what states may or may not legally do with regard to Medicaid funding of abortion. In Georgia a federal judge ruled that the state may not limit coverage of Medicaid abortions to those reimbursable by the federal government under the Hyde Amendment. In California funding of Medi-Cal abortions is permitted only if the woman's life is endangered; pregnancy is ectopic; the woman was raped; a minor under age 16; a victim of incest; the fetus is abnormal; or woman will suffer physical health damage. In Michigan Government William G. Milliken vetoed an appropriation of $1 for therapeutic abortion attached to a bill for hospital, physicians, and pharmacological services. Circuit Judge Jack W. Warren held that the governor did not have the authority to veto just one portion of the appropriation but must veto the entire bill. A New Jersey superior court judge has held unconstitutional proposed state guidelines which restricted Medicaid funding of abortions to those situations covered by the Hyde Amendment. A Hawaii circuit court has ruled that the state Department of Social Services and Housing has the authority to use state funds to pay for elective abortions for Medicaid recipients.

State prescription drug price Web sites: how useful to consumers?

PubMed

Tu, Ha T; Corey, Catherine G

2008-02-01

To aid consumers in comparing prescription drug costs, many states have launched Web sites to publish drug prices offered by local retail pharmacies. The current push to make retail pharmacy prices accessible to consumers is part of a much broader movement to increase price transparency throughout the health-care sector. Efforts to encourage price-based shopping for hospital and physician services have encountered widespread concerns, both on grounds that prices for complex services are difficult to measure and compare accurately and that quality varies substantially across providers. Experts agree, however, that prescription drugs are much easier to shop for than other, more complex health services. However, extensive gaps in available price information--the result of relying on Medicaid data--seriously hamper the effectiveness of state drug price-comparison Web sites, according to a new study by the Center for Studying Health System Change (HSC). An alternative approach--requiring pharmacies to submit price lists to the states--would improve the usefulness of price information, but pharmacies typically oppose such a mandate. Another limitation of most state Web sites is that price information is restricted to local pharmacies, when online pharmacies, both U.S. and foreign, often sell prescription drugs at substantially lower prices. To further enhance consumer shopping tools, states might consider expanding the types of information provided, including online pharmacy comparison tools, lists of deeply discounted generic drugs offered by discount retailers, and lists of local pharmacies offering price matches.

Older Adults with Intellectual Disabilities: Targets for Increasing Victimization, a Call for a Preemptive Screening Policy

ERIC Educational Resources Information Center

Strasser, Sheryl; O'Quin, Karen; Price, Thomas; Leyda, Elizabeth

2012-01-01

The aging population is a rapidly growing demographic in the United States. Isolation, limited autonomy, and declining physical and mental health render many older adults vulnerable to abuse, neglect, and exploitation. As the population grows, so does the need for Adult Protective Services (APS). This article highlights an ultrasensitive subgroup…

South Carolina | Midmarket Solar Policies in the United States | Solar

Science.gov Websites

voluntary renewable energy goal of 2% distributed energy in 2021. Carve-out: 0.25% of total generation from energy portfolio standard, but a goal for distributed generation by 2021. The Distributed Energy Resource Fast Track Process Study Process System size limit: Not specified; South Carolina Public Service

1972 Directory of Library Resources for the Blind and Physically Handicapped. Second Revised Edition.

ERIC Educational Resources Information Center

Library of Congress, Washington, DC. Div. for the Blind and Physically Handicapped.

Residents of the United States, its territories and possessions, and American citizens temporarily living abroad who are unable to read or use ordinary print because of physical limitations are eligible for free library service provided by the Library of Congress and a system of cooperating regional libraries. The Library of Congress Division for…

1970 Directory of Library Resources for the Blind and Physically Handicapped.

ERIC Educational Resources Information Center

Library of Congress, Washington, DC. Div. for the Blind and Physically Handicapped.

Residents of the United States, its territories and possessions, and American citizens temporarily living abroad who are unable to read or use ordinary print because of physical limitations are eligible for free library service provided by the library of Congress and a system of cooperating regional libraries. The Library of Congress Division for…

75 FR 74616 - Airworthiness Directives; The Boeing Company Model 737-600, -700, -700C, -800, and -900 Series...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-01

... Fuel System Airworthiness Limitations, the requirements of Appendix H.1(a) of the Federal Aviation... Additional Service Information The ATA, on behalf of its member AirTran Airways, requested that we approve... comment, AirTran Airways stated that the information notices clarify and provide corrections to Boeing...

34 CFR 606.10 - What activities may and may not be carried out under a grant?

Code of Federal Regulations, 2010 CFR

2010-07-01

... of teacher education designed to qualify students to teach in public elementary or secondary schools... limited to, a State plan for desegregation of higher education. (3) Activities or services that relate to... grant? 606.10 Section 606.10 Education Regulations of the Offices of the Department of Education...

34 CFR 606.10 - What activities may and may not be carried out under a grant?

Code of Federal Regulations, 2011 CFR

2011-07-01

... of teacher education designed to qualify students to teach in public elementary or secondary schools... limited to, a State plan for desegregation of higher education. (3) Activities or services that relate to... grant? 606.10 Section 606.10 Education Regulations of the Offices of the Department of Education...

20 CFR 416.1338 - If you are participating in an appropriate program of vocational rehabilitation services...

Code of Federal Regulations, 2010 CFR

2010-04-01

... approved by us; providers we may approve include, but are not limited to— (A) A public or private... carried out under an individualized program or plan; (4) An individualized education program developed under policies and procedures approved by the Secretary of Education for assistance to States for the...

On the Capacity of Attention: Its Estimation and Its Role in Working Memory and Cognitive Aptitudes

ERIC Educational Resources Information Center

Cowan, N.; Elliott, E.M.; Scott Saults, J.; Morey, C.C.; Mattox, S.; Hismjatullina, A.; Conway, A.R.A.

2005-01-01

Working memory (WM) is the set of mental processes holding limited information in a temporarily accessible state in service of cognition. We provide a theoretical framework to understand the relation between WM and aptitude measures. The WM measures that have yielded high correlations with aptitudes include separate storage-and-processing task…

The Effectiveness of Off Campus Multi-Institutional Teaching Centers as Perceived by Students

ERIC Educational Resources Information Center

Flores-Mejorado, Dina; Edmonson, Stacey; Fisher, Alice

2008-01-01

The purpose of this study was to examine and compare the perceptions of undergraduate and graduate students of a selected state university in Texas attending the Multi Institutional Teaching Center (MITC)/The University Center (TUC) or the main campus regarding the effectiveness of student services. As universities face limited resources and…

Land Use, Recreation, and Wildlife Habitats: GIS Applications Using FIA Plot Data

Treesearch

Victor A. Rudis

2001-01-01

Spatial contexts govern whether and how land is used. Forest surveys inventory land uses from sampled plots and provide common forest resource summaries with limited information about associated nearby uses, or the landscape context. I used the USDA Forest Service's Forest Inventory and Analysis program of the South-Central States survey region (Alabama, Arkansas...

78 FR 60307 - Spring Pygmy Sunfish Candidate Conservation Agreement With Assurances; Receipt of Applications...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-01

... the Land Trust of North Alabama as a cooperator for the conservation of the spring pygmy sunfish. Each Applicant is a limited liability company, created and existing under the laws of the State of Alabama. The... prior consultation with the Service. The Land Trust of North Alabama, as a cooperator to each CCAA...

Learning E.S.L. with Los Cumbancheros 1988-89. OREA Evaluation Section Report.

ERIC Educational Resources Information Center

Berney, Tomi D.; Adelman, Deborah

The Learning English as a Second Language (ESL) with Los Cumbancheros project was developed through the collaborative efforts of several New York State Government offices, community school districts in the Bronx, and the private corporate sector. Its objective was to provide supplemental services to at-risk students of limited English proficiency…

Fire Setting Behavior in a Child Welfare System: Prevalence, Characteristics and Co-Occurring Needs

ERIC Educational Resources Information Center

Lyons, John S.; McClelland, Gary; Jordan, Neil

2010-01-01

Fire setting is one of the most challenging behaviors for the child welfare system. However, existing knowledge about its prevalence and correlates has been limited to research on single programs. The Illinois Department of Children and Family Services initiated a uniform assessment process at entry into state custody using a trauma-informed…

Employment Selections of Resident and Non-Resident Graduates of Physical Therapy Programs in Underserved Western States

ERIC Educational Resources Information Center

Swart, Kathryn D.

2011-01-01

Background and Purpose: Physical therapy (PT) is an essential component of the healthcare system in providing a comprehensive treatment plan for patients with functional limitations. The demand for physical therapy services is projected to expand in the next eight years, leading to an increased need for practicing physical therapists. The Mountain…

We Jumped on the Live Reference Band Wagon, and We Love the Ride!

ERIC Educational Resources Information Center

Schaake, Glenda; Sathan, Eleanor

2003-01-01

Memorial Hall Library in Andover, Massachusetts wanted to offer live reference service online but with limited resources, they couldn't do it alone. The 24/7 Reference cooperative program administered by the California State Library required Memorial Hall's librarians to monitor only 10 hours a week in return for live reference coverage. Memorial…

A Historical Analysis of Special Education Services in Conservative Christian Schools Since 1950

ERIC Educational Resources Information Center

Craig, Kristi-Lynn

2010-01-01

This study examines the historical progression of the availability of special education in Conservative Christian Schools in the United States since 1950. Due to the limited nature of research in this field, a historical analysis was used to better understand how the development of special education in Conservative Christian Schools compares to…

20 CFR 429.206 - What if my claim involves a commercial carrier or an insurer?

Code of Federal Regulations, 2011 CFR

2011-04-01

... the maximum payment limitations set forth in § 429.201. However, if the resulting amount after making... service preclude reasonable filing of a claim or diligent prosecution, or the evidence indicates a demand... correspondence, documents, and other evidence pertinent to the matter. (e) You must assign to the United States...

20 CFR 429.206 - What if my claim involves a commercial carrier or an insurer?

Code of Federal Regulations, 2014 CFR

2014-04-01

... the maximum payment limitations set forth in § 429.201. However, if the resulting amount after making... service preclude reasonable filing of a claim or diligent prosecution, or the evidence indicates a demand... correspondence, documents, and other evidence pertinent to the matter. (e) You must assign to the United States...

20 CFR 429.206 - What if my claim involves a commercial carrier or an insurer?

Code of Federal Regulations, 2013 CFR

2013-04-01

... the maximum payment limitations set forth in § 429.201. However, if the resulting amount after making... service preclude reasonable filing of a claim or diligent prosecution, or the evidence indicates a demand... correspondence, documents, and other evidence pertinent to the matter. (e) You must assign to the United States...

20 CFR 429.206 - What if my claim involves a commercial carrier or an insurer?

Code of Federal Regulations, 2012 CFR

2012-04-01

... the maximum payment limitations set forth in § 429.201. However, if the resulting amount after making... service preclude reasonable filing of a claim or diligent prosecution, or the evidence indicates a demand... correspondence, documents, and other evidence pertinent to the matter. (e) You must assign to the United States...

77 FR 65044 - Agency Information Collection Activities: Proposed Request and Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-24

..., including our 800 number, online applications, mail services, or, in limited circumstances, face- to-face... stating why they believe SSA should rescind the ban and allow them to conduct business with us on a face-to-face basis in one of our offices. There is no printed form for this request; banned individuals...

77 FR 64114 - Agency Information Collection Activities: Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-18

... Policies'' form will be used by entities involved in the export of US goods and services, to provide Ex-Im... request. Form Title: EIB 92-51 Application for Special Buyer Credit Limit (SBCL) Under Multi-Buyer Credit Insurance Policies. SUMMARY: The Export-Import Bank of the United States (Ex-Im Bank), as a part of its...

Marie Russo: An Oral History of the Italian Settlement House

ERIC Educational Resources Information Center

Beard, Kathryn H.

2010-01-01

The Settlement House Movement in the United States was a response by progressive reformers to meet the needs of urban poor and immigrant families in the early years of the 20th century. Some settlements were outreach services of churches. There are limited accounts of the experiences of the individuals who used the settlement houses. This study…

Medicaid Waivers and Public Sector Mental Health Service Penetration Rates for Youth.

PubMed

Graaf, Genevieve; Snowden, Lonnie

2018-01-22

To assist families of youth with serious emotional disturbance in financing youth's comprehensive care, some states have sought and received Medicaid waivers. Medicaid waivers waive or relax the Medicaid means test for eligibility to provide insurance coverage to nonpoor families for expensive, otherwise out-of-reach treatment for youth with Serious Emotional Disturbance (SED). Waivers promote treatment access for the most troubled youth, and the present study investigated whether any of several Medicaid waiver options-and those that completely omit the means test in particular-are associated with higher state-wide public sector treatment penetration rates. The investigators obtained data from the U.S. Census, SAMHSA's Uniform Reporting System, and the Centers for Medicare and Medicaid Services. Analysis employed random intercept and random slope linear regression models, controlling for a variety of state demographic and fiscal variables, to determine whether a relationship between Medicaid waiver policies and state-level public sector penetration rates could be observed. Findings indicate that, whether relaxing or completely waiving Medicaid's qualifying income limits, waivers increase public sector penetration rates, particularly for youth under age 17. However, completely waiving Medicaid income limits did not uniquely contribute to penetration rate increases. States offering Medicaid waivers that either relax or completely waive Medicaid's means test to qualify for health coverage present higher public sector treatment rates for youth with behavioral health care needs. There is no evidence that restricting the program to waiving the means test for accessing Medicaid would increase treatment access. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Sharing information about diagnosis and outcome of first-episode psychosis in patients presenting to early intervention services.

PubMed

Farooq, Saeed; Green, Debra J; Singh, Swaran P

2018-05-04

First-episode psychosis (FEP) can be a serious and debilitating disease, but there is limited literature on how to inform patients and carers about its diagnosis and outcome. We aimed to examine the attitudes, practices and views of clinicians working in Early Intervention Service about sharing information on diagnosis and outcome of FEP. A 26-item questionnaire was sent electronically to clinical staff who have been involved in the discussion of FEP diagnosis in Early Intervention Services in the West Midlands, UK. A total of 51 clinicians completed the questionnaire. All respondents stated that patients or carers of those presenting with FEP wish to be informed of their diagnosis, and three-quarters (76%) felt there is a need to develop guidelines on how to inform about diagnosis; 57% stated that they usually use broad diagnostic groups such as psychosis when discussing diagnosis, and only 11% use the term schizophrenia. A total of 40% thought that the therapeutic relationship and treatment adherence (58%) would improve if patients know about their diagnosis; 42 (88%) respondents felt that the likely outcome of the illness should also be discussed with patients when the diagnosis is communicated. The clinicians were aware that service users wished to be informed about the diagnosis and outcome of FEP but had no guidance on the subject. Despite the limitations of an online self-administered survey, the study highlights the need for guidance and improving clinical practice in discussing the diagnosis of FEP in a vulnerable population. © 2018 John Wiley & Sons Australia, Ltd.

Ensuring financial access to hearing AIDS for infants and young children.

PubMed

Limb, Stephanie J; McManus, Margaret A; Fox, Harriette B; White, Karl R; Forsman, Irene

2010-08-01

Many young children with permanent hearing loss do not receive hearing aids and related professional services, in part because of public and private financing limitations. In 2006 the Children's Audiology Financing Workgroup was convened by the National Center for Hearing Assessment and Management to evaluate and make recommendations about public and private financing of hearing aids and related professional services for 0- to 3-year-old children. The workgroup recommended 4 possible strategies for ensuring that all infants and young children with hearing loss have access to appropriate hearing aids and professional services: (1) clarify that the definition of assistive technology, which is a required service under Part C of the Individuals With Disabilities Education Act (IDEA), includes not only analog hearing aids but also digital hearing aids with appropriate features as needed by young children with hearing loss; (2) clarify for both state Medicaid and Children's Health Insurance Programs that digital hearing aids are almost always the medically necessary type of hearing aid required for infants and young children and should be covered under the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program; (3) encourage the passage of private health insurance legislative mandates to require coverage of appropriate digital hearing aids and related professional services for infants and young children; and (4) establish hearing-aid loaner programs in every state. The costs of providing hearing aids to all 0- to 3-year old children in the United States are estimated here.

Consumer, physician, and payer perspectives on primary care medication management services with a shared resource pharmacists network.

PubMed

Smith, Marie; Cannon-Breland, Michelle L; Spiggle, Susan

2014-01-01

Health care reform initiatives are examining new care delivery models and payment reform alternatives such as medical homes, health homes, community-based care transitions teams, medical neighborhoods and accountable care organizations (ACOs). Of particular interest is the extent to which pharmacists are integrated in team-based health care reform initiatives and the related perspectives of consumers, physicians, and payers. To assess the current knowledge of consumers and physicians about pharmacist training/expertise and capacity to provide primary care medication management services in a shared resource network; determine factors that will facilitate/limit consumer interest in having pharmacists as a member of a community-based "health care team;" determine factors that will facilitate/limit physician utilization of pharmacists for medication management services; and determine factors that will facilitate/limit payer reimbursement models for medication management services using a shared resource pharmacist network model. This project used qualitative research methods to assess the perceptions of consumers, primary care physicians, and payers on pharmacist-provided medication management services using a shared resource network of pharmacists. Focus groups were conducted with primary care physicians and consumers, while semi-structured discussions were conducted with a public and private payer. Most consumers viewed pharmacists in traditional dispensing roles and were unaware of the direct patient care responsibilities of pharmacists as part of community-based health teams. Physicians noted several chronic disease states where clinically-trained pharmacists could collaborate as health care team members yet had uncertainties about integrating pharmacists into their practice workflow and payment sources for pharmacist services. Payers were interested in having credentialed pharmacists provide medication management services if the services improved quality of patient care and/or prevented adverse drug events, and the services were cost neutral (at a minimum). It was difficult for most consumers and physicians to envision pharmacists practicing in non-dispensing roles. The pharmacy profession must disseminate the existing body of evidence on pharmacists as care providers of medication management services and the related impact on clinical outcomes, patient safety, and cost savings to external audiences. Without such, new pharmacist practice models may have limited acceptance by consumers, primary care physicians, and payers. Copyright © 2014 Elsevier Inc. All rights reserved.

Breast cancer screening services: trade-offs in quality, capacity, outreach, and centralization.

PubMed

Güneş, Evrim D; Chick, Stephen E; Akşin, O Zeynep

2004-11-01

This work combines and extends previous work on breast cancer screening models by explicitly incorporating, for the first time, aspects of the dynamics of health care states, program outreach, and the screening volume-quality relationship in a service system model to examine the effect of public health policy and service capacity decisions on public health outcomes. We consider the impact of increasing standards for minimum reading volume to improve quality, expanding outreach with or without decentralization of service facilities, and the potential of queueing due to stochastic effects and limited capacity. The results indicate a strong relation between screening quality and the cost of screening and treatment, and emphasize the importance of accounting for service dynamics when assessing the performance of health care interventions. For breast cancer screening, increasing outreach without improving quality and maintaining capacity results in less benefit than predicted by standard models.