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Mental Health Care in America: Why politicians and pundits are missing the point
As a mental health practitioner, I am increasingly worried about the public perception that there is a connection between mental illness and violence. The truth is that persons with severe and persistent mental illness are no more likely to be violent than the average person. It just happens that when it does occur, the person's mental health becomes a major fact in the headline. In response to the recent tragedy in California, the debate about violence and mental illness has intensified. Sadly, politicians and pundits have reduced a complex and nuanced issue to arguments about gun control and involuntary treatment of persons with severe and persistent mental illness. As a result, they miss the bigger picture; the mental health care system in the United States is broken and dysfunctional.
To illustrate, here are a few facts. The number of U.S. medical students choosing psychiatry is declining, and has been for some time. Here in North Conway, New Hampshire for example, we lack a single board-certified psychiatrist in private practice. In the United States, people are more than likely to have their psychiatric care managed by their primary care physician versus a specialist. Psychiatric bed availability is at an all-time low across the country. Individuals in need of inpatient care end up sitting in hospital emergency rooms for days waiting for a bed to become available. Insurance companies, meanwhile, continue to tighten benefits for inpatient and residential care, making it more difficult to meet eligibility criteria. The result is that inpatient units, under pressure to handle admissions in a timely manner, are having to discharge individuals as fast as possible, leading to premature discharges and outpatient treatment of persons who, in actuality, need a higher level of care. Stripped of adequate funding, outpatient community mental health clinics are unable to meet the demand, leading to long waits and increasingly stringent admission criteria. The clinicians in these clinics are overworked, vastly underpaid, and often fresh out of graduate school (I know, I was one of them back when I started out as a therapist). Even more disturbing is that treatment is increasingly secondary to ensuring compliance with a morass of federal and state regulations that have little, if any, connection to the health and wellness of those seeking treatment.
Here is one example of the dysfunctional federal regulations that exists in the mental health system. Medicare will only pay for therapy provided by a PhD psychologist, or a Masters level clinician if there is a supervising psychologist or medical physician in the building at the time of the appointment. This is despite the fact that the vast majority of therapists are Masters level counselors or social workers (deemed competent enough by private insurance and [with a caveat] federally-funded Medicaid to provide therapy without the PhD or MD requirement). In the rural community mental health clinic where I used to work, we did not have a full-time psychiatrist (increasingly common these days), meaning that we could only schedule people with Medicare for therapy on certain days and hours depending when the psychiatrist was in the building. If the psychiatrist had to leave for any reason then we had to cancel the therapy appointment or sign off on a waiver stating that it was medically necessary that the individual be seen despite the physician not being present (only valid in the case of an emergency). Not only does this regulation cause havoc for community mental health centers, it also means that people with Medicare cannot get treated by Masters level clinicians in private practice, unless there is a psychologist or psychiatrist in the practice (highly unlikely). No one has ever fully explained to me why the regulation exists, but as best I can understand, Medicare believes patients will get better care if treatment is administered by a psychologist or psychiatrist. Apparently Medicare also believes in osmosis because that is the only way the sheer presence of a psychologist or psychiatrist in a building could possibly impact therapy administered by a Masters level clinician. It is an absurd regulation, and yet, it is the reality. More disturbing, this type of regulation is commonplace in the mental health care system.
Another great example is the nonsense involving treatment plans. If you know of someone who works in community mental health, ask them to explain the issues surrounding compliance with treatment plans and signatures. To try and explain it would result in this post being much longer, and much more boring. What I can tell you from personal experience is that in the years I worked in community mental health I spent more time in clinical meetings discussing how to comply with the regulations such as treatment plan signatures (yes, you are reading that correctly. Meetings, plural, about signatures on a treatment plan), than I ever did discussing actual patient care. In conversations with others in the field of behavioral health, I have learned that my experience was not an isolated one, that this type of bureaucratic farce is systemic. Individuals with severe and persistent mental illness face enormous barriers to accessing quality care without adding the additional regulatory obfuscation that is unique to mental health care. If the same kind of dysfunction occurred for those seeking treatment for cancer, the public furor would be like nothing this country has ever seen. It simply would not be tolerated. Yet for those with severe and persistent mental illness, those who have no voice and are so vulnerable, quality care is secondary. This is not for the lack of effort on the part of providers. Clinicians who work in community mental health have a thankless job. They work incredibly hard to provide quality care to those most in need. But, they're being asked to do their job blindfolded with their hands tied behind their backs.
Here is the ugly truth about mental illness in America. No one wants to admit that it exists. Sure, people love to talk about how hard we have worked to reduce the stigma. How good deinstitutionalization was for the dignity of persons with mental illness. How advances in medication and psychotherapy have led to the overall improvement in the lives of persons with severe and persistent mental illness. This is all true and very important. In many ways we have made great strides since deinstitutionalization. However, there is another, very ugly, very disturbing reality. Many people with severe and persistent mental illness are living on the very margins of society. They are homeless. Destitute. Rejected by society. The families who support them are being asked to shoulder more of the burden as access to basic care is increasingly restricted. Research funding is nowhere near the levels needed to meet the demands of the system. The prison system has become our de facto hospitals. People have to wait months to get into treatment. People have to resort to extreme measures to try and get help. Once they get into treatment, the treatment they receive is often barely adequate, administered by providers who are vastly overworked, underpaid, and burdened by regulations that have little if anything to do with enhancing the quality of care. As a society we have failed people with severe and persistent mental illness. The asylums of yesteryear still exist, they just aren't hidden anymore inside a hospital building. Now they are hiding in plain sight.
A recent study came out that showed mental illness poses a greater mortality risk than smoking. Read that sentence again and let it sink in. Mental illness poses a greater mortality risk than smoking. The study showed that drug and alcohol abuse, for example, resulted in a reduced life expectancy between nine and twenty-four years; schizophrenia was 10-20 years. Smoking? It was 8-10 years. So despite the fact that persons with severe mental illness are no more likely to be violent than the average person, despite the fact that they are at a greater risk of dying early because of their illness, despite the fact that disability from mental illness results in one of the highest economic burdens on our society, despite the fact that persons with mental illness are enduring inhumane treatment that violates basic human rights, politicians and pundits want to argue about gun control and involuntary treatment.
I am not suggesting that either issue doesn't belong in the discussion of mental health care; both are topics to consider. But here is the terrifying truth; the enhanced ability to force involuntary treatment and increased gun control legislation will not prevent future tragedies such as the one that occurred in California recently. The problem is far more systemic and in actuality has little to do with guns and violence. A violent crime occurs every 26 seconds in this country. Violent crime is not a mental health issue, it's a societal issue. If politicians and policy-makers are serious about fixing the mental health care system in America, then they will stop partisan debate and spend some time listening to those of us in the field trying to provide treatment. They might not like what they hear, the changes needed will likely be financially costly, but we might actually be able to make positive changes to the way we deliver mental health care in this country. Those who suffer from severe mental illness deserve no less than our best effort. We cannot afford to continue failing them.


text: Guest rich mc Report post Posted January 1, 2018 i have way to many colors , like 17. since some tyers have trouble finding mop in other colors perhaps we can swap just knubs. no tying. i will run the swap just need suggestions on how many knubs from each tyer?. they would have to declare the length and color and since there is no tying just clipping it could be done in short time rich mc due date n/a just mail in with a postage stamp enclosed to rich mc p o box 225 lee il 60530 color size rich mc black 2 philly chart 1.5 3 frn pink 4 fishn2 gray 5stabgnid cream 1inch 6chugbug bright yellow 1 lnch 7mike west blue 8 orange 9 tba SWAP IS CLOSED tyers need to send 30 nubs each mailed by jan 13 please Quote Share this post Link to post Share on other sites

subset: commoncrawl


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Autumn has arrived, nail art is always a topic that will be discussed every season. Unlike green and yellow nails in spring and summer, the color of deciduous leaves is always the most classic for autumn and winter nails, this color makes people feel warm and cozy. Imagine you're wearing a light sweater, gold jewelry, and yellow deciduous nails, everything is perfect.
Most fashionable girls know that when you match an outfit, you'd better pick the same color of clothes and shoes. The same rule also applies to nails color. You'd better keep the nail color in line with your clothes and pants (no need to be same, but similar). So if you want to find the best color for your own autumn and winter nail, open your wardrobe and see what color of clothes you have the most. For example, if you love to wear nude clothes, then you can have white and pink nails, which belong to the same color system as nude.
Today, I collected 40 Beautiful and simple autumn and winter nail ideas. Most of these nails are pure color, so you can make them for yourself at home, which is very simple. Of course, there are some complex ones that may not be done by non-professionals, but if you are good at nail painting, you can do so. All in all, these nails ideas are worth collecting and trying, just take a look.


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Free Public Lecture
Christina Agapakis, Creative Director, Ginkgo Bioworks
Biology can be a design medium: scientists can now "write" DNA and manipulate microbial behavior. In the future, they could also reshape entire ecosystems. Christina Agapakis is a synthetic biologist, writer, and artist who collaborates with engineers, designers, artists, and social scientists to explore the many unexpected connections between microbiology, technology, art, and popular culture. In this lecture, she will discuss current and potential uses of biotechnology in various fields from agriculture and medicine to consumer goods and renewable energy.
Free event parking at the 52 Oxford Street Garage
Presented by the Harvard Museum of Natural History in collaboration with the Microbial Sciences Initiative at Harvard University
About the speaker:
Christina Agapakis is Creative Director at Ginkgo Bioworks, an organism design company based in Boston, that is bringing biology to industrial engineering. She holds a B.A. in Molecular, Cellular, and Developmental Biology from Yale University and a Ph.D. in Biological and Biomedical Sciences from Harvard University. Her doctoral thesis focused on producing hydrogen fuel in bacteria and making photosynthetic animals. Agapakis has written on biology, technology, and culture for a number of outlets, has taught designers at the ArtCenter College of Design and biomolecular engineers at the University of California, Los Angeles. She is a founding editor of Method Quarterly, a magazine about science in the making.
Livestreaming Information:
This event will be livestreamed on the Harvard Museums of Science & Culture Facebook page. A recording of this program will be available on the HMSC Lecture Videos page approximately three weeks after the lecture.


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Welcome to Vila Pedra Mar
You will be charmed by Vila Pedra Mar, a villa with a truly unique setting endowed with every sense of the word beauty. Located on the island of Ilha Grande, one of the 'must see' places of the world, the villa is nestled amongst lush Atlantic rain forest and has 80 meters of private seafront.
Vila Pedra Mar offers three luxurious en-suite bedrooms, all with lovely ocean views and the distant mountain ranges of the mainland as a spectacular backdrop. The spacious honeymoon suite is 80 sq. meters of serenity, complete with its own rock plunge pool.
Vila Pedra Mar offers five-star luxury island living and an array of natural and man-made experiences. The villa has a private jetty and mooring, and a motor launch to explore the island and the many beaches and other attractions. There are also local boats for hire.
Swim from the jetty in the tropical sea or snorkel and view the sea-life surrounding the villa. A diving school and two small restaurants are on the adjacent beach. For the more adventurous the walking trails into the rain forest are a must.
Dine and relax in any of the three dining areas or the patio, and enjoy the food from the state-of-the-art kitchen. The roof terrace with its magnificent views invites you to sunbathe, have a barbecue or enjoy cocktails at sunset. Or you can rent the entire villa with a multilingual in-house chef to cater to your every wish. Join us for an experience of a lifetime.


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Family Planning - Hormone Replacement Therapy and The Menopause
What is The Menopause?
All women will go through the menopause. The average age of the menopause in the UK is 51 years. As it is an average, some women may experience it sooner than others, and others later. If your mother had an early menopause, it is more likely that you will too. The converse is also true.
Natural menopause is when your levels of oestrogen and progesterone that your ovaries would usually make starts to stop. Also, the ovaries stop producing eggs every month. The resulting declining levels of oestrogen in the body are thought to be responsible for the majority of menopausal symptoms. When your Doctor does a blood test to look for the menopause, this is a test for the levels of follicle stimulating hormone (FSH). FSH is a chemical made by the pituitary gland in the brain. It stimulates the ovaries to continue to release hormones. The levels of FSH rise during the menopause as the brain is working very hard to stimulate the ovaries to continue to produce oestrogen. The levels of FSH will fluctuate day to day making it sometimes difficult to interpret. This is why Doctors often prefer to decide whether you are around the time of the menopause, based on the symptoms you are experiencing, opposed to checking the FSH level.
If you are someone who has had both of their ovaries removed ie during a hysterectomy, you are said to have had an artificial menopause. In these circumstances, you can often experience worse menopausal symptoms compared to someone who has had a natural menopause. This is due to the sudden reduction in hormones opposed to a gradual decline that may be experienced with a natural menopause.
Menopause – The last menstrual period.
Perimenopause – From the beginning of menopausal symptoms to the postmenopause.
Postmenopause – This is the 12 months following your last menstrual period (menopause).
Symptoms of the Menopause
There are lots of symptoms that women can experience and these vary from person to person. Some women will have no symptoms, others will have mild symptoms, whereas a proportion of women may have significant symptoms. Symptoms can last anything between months to years.
Initial symptoms usually start while women are still having periods. Common symptoms are listed below:-
- Hot flushes
- Headaches
- Hair loss
- Night sweats
- Vaginal dryness
- Urinary leakage
- Palpitations
- Low libido
- Joint aches
- Difficulty sleeping
- Discomfort when passing urine
What to Expect in Terms of Periods
Periods will alter around the time of the menopause. As the menopause approaches, you may miss the occasional period. It is not unusual for periods to be spaced further apart. You may go several months without having a bleed. Periods will eventually stop. Sometimes women can experience heavy bleeding or bleeding in between periods around the menopause. Often this is nothing to worry about, but as occasionally this can be a sign of cancer of the womb, it is sensible to consult your GP to discuss.
How Long Is Contraception Needed For?
Under 50 years – If your last period was under the age of 50yrs, it is advised you use some form of contraception for 2 years following your last period.
Over 50 years – If your last period was over the age of 50yrs, it is advised you use some form of contraception for 1 year following your last period.
Do I Need Any Treatment for the Menopause?
No, not necessarily. If you are someone who is over 45yrs and going through the menopause, symptoms can often be managed with diet, exercise and reducing caffeine levels. If however, you are under the age of 45yrs it is sensible to make an appointment to see your GP to discuss whether hormone replacement therapy (HRT) may be indicated in your case.
Oestrogen is a hormone which helps keep bones healthy and strong. We know that if you have an early menopause (under the age of 45yrs) you are at risk of developing weak bones. This is called osteoporosis. This is why sometimes your Doctor may recommend taking hormone replacement therapy and it is important to talk to them about this.
Conservative Treatments
We know that women who eat healthily, limit their caffeine intake, do not smoke and exercise regularly manage better with menopausal symptoms. This may be all that is needed in your case.
Hormone Replacement Therapy (HRT)
In some women, menopausal symptoms can be significant and conservative measures alone might not be enough. In these cases we are likely to discuss other methods, such as hormone replacement therapy and alternatives to hormone replacement therapy which is included below.
As the majority of menopausal symptoms are believed to be due to declining levels of oestrogen, it would make sense that HRT works by replacing this 'lost' oestrogen. The HRT that is prescribed after an artificial menopause (hysterectomy) would usually contain only oestrogen. However, the HRT that is used after a natural menopause would combine both oestrogen and progesterone. The progesterone is needed to prevent the lining of the womb thickening which could give risk to abnormal cells which could if left alone could change into cancer.
HRT is available in a number of different formulations, to include tablet form, patches, or a daily gel. Some women even use the mirena coil (refer to this section on website) to provide the progesterone component of their HRT.
If you are prescribed combined HRT (oestrogen and progesterone), for at least the first 12 months, you will be given a sequential HRT preparation which will allow you to have a monthly period. When this 12 months has passed it is usual to be swapped onto a continuous combined regime which is designed to stop your monthly periods.
Benefits of HRT
- Relief of menopausal symptoms
- Prevention/treatment of osteoporosis
Risks of HRT
Each woman's individual case must be taking into consideration when prescribing HRT. We know that HRT is riskier in women who smoke, or who have other evidence of cardiovascular disease, such as high blood pressure (hypertension), chronic kidney disease, diabetes, and previous heart attacks (myocardial infarctions) and stokes. Your Doctor will weigh up the risks versus the benefits when discussing.
Breast cancer
- Current opinion is that for combined preparations of HRT, there is an increased risk of breast cancer. This is thought to only come into play after the woman has been taking the HRT for more than 5 years.
- After 5 years of stopping HRT, your risk of breast cancer returns to what it would have been as if you'd never been on HRT.
- Doctors are likely to be more cautious if you have a family history of the disease.
Cardiovascular Disease
- It is much less clear what effect on cardiovascular health HRT has.
- The consensus is that for oestrogen only HRT, there is no increased risk of heart attacks/strokes.
- For combined HRT preparations, the increased of cardiovascular disease is thought to be present if you start HRT 20 years after the menopause, and this risk is present for the first year of use only.
Venous Thromboembolism
- This includes blood clots in the legs (deep vein thrombosis) and blood clots in the lungs (pulmonary embolism).
- Taking HRT increases your risk of developing a blood clot. This is thought to be at its highest during the first year of use.
Ovarian Cancer
- The evidence here is inconclusive. Some studies have shown increased risks, whereas others have shown no increased risk.
Endometrial (Womb/Uterine) Cancer
- Risk is increased when on continuous preparations of HRT.
- Risk is also increased if you are on a sequential preparation for HRT for more than 5 years.
Contraindications to HRT Use
There are a number of reasons why it would be considered unsafe to start a woman on HRT which are listed below....
- Undiagnosed vaginal bleeding
- If your periods are irregular, or if you are having bleeding with sexual intercourse or in between periods, this needs to be investigated before HRT can be considered. Make an appointment with your Doctor to discuss this further.
- Current or recent blood clot (venous thromboembolism) or heart attack (myocardial infarction). Also recurrent thromboemboli.
- Pregnancy
- Active liver disease
- Breast/endometrial cancer
- Blood clotting disorder (thrombophilic disrorder)
When to See Your Doctor When Taking HRT
When initially started on HRT, you will usually be asked to come for a review after 3 months to assess how you're getting on with it and to check your blood pressure. 3 months is really the shortest period of time needed to gauge the effect the HRT it has had. If all is well, you will then be reviewed 12 monthly.
Alternatives to HRT
Some women do not want to commence HRT but prefers to discuss other options. These are listed below.
- This is a medication originally introduced as a blood pressure medication. Now, it is no longer used for this reason.
- Clonidine does not contain hormones and is not a form of HRT.
- Clonidine is the only oral medication that is licensed to be prescribed by Doctors as an alternative to HRT.
- Clonidine gives varying results – the success rate has been quoted at around 50%. It is taken every day and thought to help target hot flushes.
Selective Serotonin Uptake Inhibitors (SSRIs)
- These medications are often used in people with anxiety and depression.
- They do not have a license for hot flushes, but some evidence has shown that they can be helpful with menopausal hot flushes, and Doctors are able to prescribe them as an off-license indication.
Vaginal Oestrogens
- These are used in women who predominantly complain of urinary leakage, discomfort when passing urine or vaginal dryness.
- They are applied locally to the vagina to increase oestrogen levels.
- Very little preparation is able to enter the circulation this way, so there aren't the same risks as taking HRT associated with it.
- These are non hormonal vaginal moisturisers which are used for vaginal dryness.
- Similar preparations can be purchased over the counter from your local chemist.
Complimentary Therapies
- These include herbal preparations such as black cohosh, red clover and evening primrose oil.
- The above have been marketed as menopausal remedies for hot flushes, but it is important to remember that just because they are marketed as 'natural' this does not mean that they are free of side effects and that they are safe to take.
- Their long term safety has not been properly assessed and a number have been identified to give risk to serious side effects ie. liver damage with black cohosh.
- Doctors generally do not advocate their use.
How To Arrange An Appointment
Appointments can be made via telephone or online if you have registered for online access. Although all GPs are qualified to discuss matters surrounding the menopause, there are a number of GPs who have a special interest in this area who you may prefer to book with. They are listed below.
Dr Kerr, Dr Hobbs, Dr Wilson, Dr Jones, Dr Simpson
Useful Resources
http://www.menopausematters.co.uk (General information on The Menopause)
http://www.menopause-exchange.co.uk (Further information, and access to the Menopause Exchange Newsletter - which includes impartial and practical information on The Menopause)


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Hello Summer?
The official season doesn't start until June 21st, but it already feels like summer here in Central Georgia. On top of the heat, it feels like summer because all the kids are out of school and area pools and lakes are packed, especially on the weekends.
The hot weather can be brutal and that's why you need to handle the heat with care. Here are a few basic tips.


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Program Overview
The State of Michigan Internship Program provides a wonderful opportunity for students to gain real world experience with the largest employer in Michigan. The State of Michigan has multiple departments, jobs and internships, and locations to choose from. All majors are welcome to apply. We believe that State of Michigan interns are making it real, making it happen, and making a difference!
Our mission is to assist students during college in their preparation for career success. We embrace collaboration with academic institutions and state departments to provide students with valuable internships that are engaging real world work and classroom learning. The State of Michigan is building the next generation of Michigan's government and community leaders.
Student advantages of the State of Michigan Internship Program include the opportunity to: explore and sample career opportunities, develop and strengthen transferable skills, interact and collaborate with industry experts, translate classroom knowledge into work environment, build experience and network, and receive academic credit while making a difference in Michigan government.
Internship offers will be contingent upon completion of a successful background check and submission of official or unofficial college transcripts.
Internship Semester Periods
Fall (September–December)
Winter/Spring (January–April)
Summer (May–August)
Visit the State of Michigan's job openings website and enter the keyword "internship" into the search field to view and apply for available internships.


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Reprint as at 31 March 2014
Changes authorised by subpart 2 of Part 2 of the Legislation Act 2012 have been made in this official reprint.
Note 4 at the end of this reprint provides a list of the amendments incorporated.
This Act is administered by the Ministry of Justice.
1 Title
2 Commencement
Part 1Preliminary provisions
3 Purpose of Act
4 Interpretation
5 Act binds the Crown
Part 2Legal aid
Subpart 1—When legal aid may be granted
6 Proceedings for which legal aid may be granted: criminal matters
7 Proceedings for which legal aid may be granted: civil matters
8 When legal aid may be granted: criminal matters
9 Prescribed offences
10 When legal aid may be granted: civil matters
11 When legal aid may be granted: civil matters continued
12 Other situations where legal aid refused or limited: civil matters
13 Legal aid not available to insured or indemnified persons
Subpart 2—Application and grant
14 Application for grant of legal aid
15 Special provisions relating to minors and mentally disordered persons
16 Decision on application for legal aid
16A Use of automated electronic systems for certain grants of legal aid
17 Commissioner must notify applicant when legal aid declined
18 Conditions on grant of legal aid
18A User charge payable by aided person
19 Special provisions about conditions on grants to persons involved in proceedings under Domestic Violence Act 1995
20 Interim repayments payable
21 Amount of repayment payable
22 Lead providers
23 Maximum grant
Subpart 3—After legal aid is granted
24 Provider in civil proceedings to notify other parties
25 Commissioner to be notified of change in circumstances
26 Commissioner to keep aided person informed
27 Private mediation
28 Application for amendment to grant of legal aid
29 Withdrawal of, or amendment to, grant of legal aid: criminal matters
30 Withdrawal of, or amendment to, grant of legal aid: civil matters
31 Withdrawal of grant
32 Consequences of withdrawing legal aid
Subpart 4—How Commissioner may enforce conditions of grant
33 Amount payable by aided person to Commissioner
34 Amounts payable in respect of grant are debts due to Commissioner
35 Commissioner may adjust rate of payment of debt, etc
36 Charges on proceeds of proceedings
37 Commissioner may exempt property from charge
38 Transfer of charge
39 Enforcement of charge
40 Interest on unpaid legal aid debt
41 Aided person to enforce judgment or out-of-court settlement
Deduction notices
41A Interpretation
41B Deduction of overdue amounts
41C Issue of deduction notice to State sector employer
41D Discharge of obligation
41E Deduction notices issued to banks
41F Making of deductions
41G Offences in relation to deduction notices
41H Protected earnings
41I Penalty for late deductions
41J Notices given to third parties
Decisions not to recover debt, write-offs, and refunds
42 Commissioner may decide not to recover debt in certain circumstances
43 Commissioner may write off amounts payable
44 Commissioner to refund excess payments
Subpart 5—Award of costs in civil proceedings
45 Liability of aided person for costs
46 Costs of successful opponent of aided person
Subpart 6—Legal aid grants for Treaty of Waitangi claims
47 Applications in respect of proceedings before Waitangi Tribunal
48 Assessment of financial resources
49 Commissioner to refer application to Waitangi Tribunal
50 Repayment under grant of legal aid
Subpart 7—Reconsideration, review, and appeals of legal aid decisions
51 Reconsideration
52 Grounds for review
53 Application for review
54 Powers and duties of chairperson of Tribunal on receipt of application for review
55 Review of decision by Tribunal
56 Determination of review
57 Tribunal may direct Commissioner to reconsider
58 Chairperson may direct publication of Tribunal decisions
Appeals and references on question of law
59 Appeal on question of law
60 Appeals to Court of Appeal and Supreme Court
61 References on questions of law to High Court
Subpart 8—Legal Aid Tribunal
62 Legal Aid Tribunal established
63 Functions of Tribunal
64 Appointment of members of Tribunal
65 Chairperson of Tribunal
66 Delegation by chairperson of Tribunal
67 Further provisions that apply to Tribunal in Schedule 3
Part 3Administration of legal services system
Subpart 1—Functions of Secretary for Justice and Legal Services Commissioner
Secretary for Justice
68 Functions of Secretary for Justice
69 Methods of delivery of legal services
Legal Services Commissioner
70 Legal Services Commissioner
71 Functions of Commissioner
72 Commissioner may delegate powers, functions, or duties
73 Powers of delegate
Subpart 2—Quality assurance system for providers
Providers of legal services
74 Application of this subpart
75 No person may provide legal aid service or specified legal service unless approved
76 Application for approval to provide legal aid services or specified legal services
77 Approval
78 Selection committees
79 Performance review committee
80 Further provisions relating to committees in Schedule 3
81 Obligations relating to professional conduct
82 Review of decisions of Secretary regarding approvals
83 Judicial review
Review Authority
84 Review Authority established
85 Function of Review Authority
86 Decisions of Review Authority
87 Further provisions in Schedule 3
87A Deputy Review Authority
87B Scope of functions of Deputy Review Authority
Quality assurance checks
88 Ministry may carry out quality assurance checks
Examination of claims made by providers
89 Commissioner may examine claims
90 Aided person may request examination of cost of services
91 Secretary may audit providers
92 Compliance with audits
Subpart 3—Community law centres
Community law centres
93 Definition of community law centres
94 Secretary may enter into contracts with community law centres
95 Reporting on funding of community law centres
96 Secretary may audit community law centres
Subpart 4—Payment for legal aid work, enforcement, and other matters relating to providers
Payment for legal aid work
97 Lead provider to claim for payment
98 Time frame for claiming for payment
99 Secretary to refer claim to Commissioner for decision
100 Secretary must pay approved claims
101 Interim restrictions that may be imposed by Secretary
102 Sanctions that may be imposed by Secretary
103 Cancellation
Further provisions relating to providers
104 Providers must comply with requirements of Act in prescribed manner
105 Providers not to take unauthorised payments
106 Providers to pay legal aid disbursements
107 Providers to protect Commissioner's interests in relation to charges and proceeds of proceedings
Subpart 5—Miscellaneous provisions
Disclosure of information
108 Disclosure of information
109 Disclosure of privileged communications under section 92 or 96
110 Commissioner may require financial information
111 Misrepresentation, etc
112 Offence in relation to applications for approval
113 Offences in relation to examination and audit
114 Regulations
115 Service of notices, etc
Effect of rights conferred by this Act
116 Effect of rights conferred by this Act
Part 4Transitional and savings provisions, amendments to other enactments, and repeals
Subpart 1—Transitional arrangements for transfer of Legal Services Agency to Ministry of Justice
117 Legal Services Agency disestablished
118 Public Advisory Committee disestablished
119 Transfer of assets and liabilities of Legal Services Agency to Ministry
120 Employees of Legal Services Agency
121 Terms and conditions of transferred employees
122 Continuity of employment
123 Restriction of compensation for technical redundancy
Matters to be transferred to Commissioner
124 Charges vested in Commissioner
125 References to Legal Services Board and Legal Services Agency in enactments, instruments, and registers
Subpart 2—Transition of matters commenced, approvals granted, and funding provided under former Act
Transition of applications for review under former Act
126 Interpretation
127 Review Panel continues until close of final transition day
128 Review Panel disestablished
129 Tribunal must deal with remaining applications
130 Applications under section 54(3) of former Act may be made to Tribunal after final transition day
131 Application of this Act and former Act to determination of remaining applications for review, and applications under section 54(3) of former Act
Legal aid granted and repayments made under former Act
132 Legal aid granted and repayments made under former Act
Legal aid for certain types of legal assistance in respect of Waitangi Tribunal proceedings under former Act
133 Legal aid for certain types of legal assistance in respect of Waitangi Tribunal proceedings
134 Community law centres
Listed providers under former Act
135 Listed providers under former Act
Subpart 3—Transition of matters commenced under Legal Services Act 1991
Legal aid granted and repayments made under Legal Services Act 1991
136 Legal aid granted under Legal Services Act 1991
137 Repayments in respect of certain legal aid granted under Legal Services Act 1991
Subpart 4—Amendments to other enactments
Lawyers and Conveyancers Act 2006
138 Amendments to Lawyers and Conveyancers Act 2006
139 Reference of complaint or matter to Disciplinary Tribunal
140 Notice of determination
141 Laying of charge with Disciplinary Tribunal
142 Obligation to report outcomes and recommendations
143 Order for striking off, cancellation of registration, restoration, or suspension to be filed in High Court
Consequential amendments to other enactments
144 Consequential amendments to other enactments
Subpart 5—Repeal and revocation
145 Repeal of Legal Services Act 2000
146 Revocation of Legal Services Regulations 2006
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Legal Services Amendment Act 2013
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To order a copy of "From Meteorite Impact to Constellation City", please click here: http://www.wlupress.wlu.ca/Catalog/saarinen-meteorite.shtml
From International Nickel Company to Inco, and Merger with Mond (1902–1928)
Between 1902 and 1928, International Nickel prospered from the pre-war European demands for nickel in armour plate, the military needs of the First World War, increased peacetime uses for nickel in the United States, and the impact of the roaring twenties. By 1903, nickel production from Sudbury exceeded that of its main rival, New Caledonia. This dominance became continuous after 1905. The control of Sudbury's wealth was paralleled by the dominance of International Nickel within the nickel industry. Through the use of long-term contracts with its consumers, the company was able to thwart competitors from entering the market, especially in the United States.
Its ability to meet the growing global demand for nickel was facilitated by the opening of Creighton mine in 1901 and the growth of this operation by the First World War into the world's largest operating mine.10 Its output far surpassed that of the company's other major source, Crean Hill.
Also significant was the opening of a new smelter by the CCC in Copper Cliff in 1904 which heralded the appearance of the first of three great smokestacks which dominated the Sudbury skyline for years to come. These smokestacks served to disperse the sulphur fumes released during the smelting process into the atmosphere. Around the same time, the former East and West smelters were taken out of production. Officials reorganized to increase the capital structure of the company in 1912, at which time its name was formally changed to The International Nickel Company. The opening of the Frood ore body in 1913 further solidified the company's economic position.
International Nickel's growth into a powerful monopoly soon gave rise to serious concerns in towns near their operations in Canada and the United States. In Canada, the issues were the absence of export duties on nickel and matte, and the company's lack of a refinery in the country. Politically, this became known as the "Nickel Question." Although local politicians made several appeals to the Ontario and Dominion governments, their concerns fell on deaf ears. The Ontario Metal Bounty Act (1907–17) was a timid response to the calls for Canadian refineries that had no effect whatsoever on securing nickel refining in Canada.
As well, the federal investigation of mining practices undertaken by the Committee on Mines and Minerals in 1910 led to naught. While these feeble political attempts affirmed the ability of International Nickel to manipulate the two higher levels of government, they nonetheless laid the foundation for the renewal of attacks against the company in 1914. Additional criticism resulted when International Nickel opened a new refinery at Bayonne, New Jersey in 1913. In the United States, the issue was related to the threat of antitrust action.
Following the outbreak of the First World War, International Nickel closed down its mines and smelters, whereas Mond continued its operations after a brief shutdown. This led to a public outcry that International Nickel was more interested in serving Germany, the largest importer by far of nickel products from the United States, than meeting the needs of the Allied governments.11 Reassurances that this was not the case provided by the Dominion government and the company late in 1914 did little to satisfy the press or political opposition. The call for a refinery in Canada continued, and even the Canadian Mining Journal, normally a staunch apologist on behalf of International Nickel, was in favour of Canadian refining.
The ensuing political uproar was such that the Ontario government announced the formation of an official commission in 1915 to deal with the matter. In the same year, the Dominion government took action by establishing two Munitions Resource Commissions to study the question of base metal refining in Canada. When the second commission came out firmly in favour of government aid to British America Nickel to assist the company in erecting a refinery in Canada, International Nickel saw for the first time the potential for genuine competition to replace its token and largely prearranged rivalry with Mond.
The criticism that International Nickel was a "foreign monopoly under the control of German interests" came to a head when it was reported that the German submarine Deutschland had made two trips to the United States in 1916 and taken tons of nickel, presumably of Canadian origin, back to Germany. When knowledge of these sensational events became public, International Nickel knew that the die was cast, and the company immediately decided to build a new refinery at Port Colborne in Ontario. It likewise announced the formation of The International Nickel Company of Canada as a subsidiary of International Nickel to carry out this task. Thus, when Ontario's voluminous Royal Nickel Commission report came out later in 1917, the commission saw no need to make any recommendation regarding the need for the company to establish a Canadian refinery.
Significantly, the report condemned the idea of nationalizing International Nickel or giving government aid to British America Nickel. The conservative position taken by the commission destroyed any prospect of International Nickel facing competition from either a private or public corporation. Indeed, it only took another seven years before its only real competitor, British America Nickel, disappeared from the scene.
The refinery at Port Colborne was completed in 1918, at which time all of International Nickel's assets in Canada were transferred to The International Nickel Company of Canada. As a result of this reorganization, the CCC lost its corporate identity, thereby ending its thirty-two year association with the Sudbury area that extended back to 1886. A shift in the company's new public relations strategy then became evident in 1919, when its first advertising campaign appeared in the Saturday Evening Post; another landmark that year was the registration of its trademark name, Inco.
After the First World War, the demand for nickel fell and the cartel temporarily collapsed. This decline was exacerbated by the limitations placed on naval and other armaments by the Washington Arms Conference in 1921–22. The new circumstances forced both Inco and Mond to change from pure mining companies to ones where research and the creation of new markets were critically important. These developments allowed the economic situation in Sudbury to improve during the 1920s.
During this period of reorientation, Robert Stanley led the charge for Inco. The Bayonne refinery in the United States was closed in 1921, and a new rolling mill for converting Monel (a nickel-copper alloy) into ingots for rods and sheets was erected at Huntington, West Virginia in 1922. By the middle of the 1920s, the growing demand for nickel plating by the automobile industry, and the adoption of new chromenickel-iron alloys for use in kitchens, cables, and telephone and radio communication devices, all combined to encourage production from the mines in Sudbury. To meet the power demands for its present and future needs, Inco constructed a new hydroelectric plant at Big Eddy on the Spanish River in 1927.
Indispensable in war, nickel had now become even more indispensable in peace. In the Sudbury area, the growing demand for nickel focused attention on the problem of Frood mine. Since different parts of the Frood ore body were jointly owned by Inco and Mond, the latter company's officials suggested that "what was needed, if the mine were to be properly developed and all the ore recovered, was single ownership and not a duplication of effort."14 Joint ownership, Lord Melchett argued, would have many advantages: it would conserve ore, reduce costs by approximately 19 per cent, and save huge sums on capital expenditures and equipment.
From Inco's point of view, the strategic importance of the Frood deposit was not only related to the fact that it was a "deposit of dimensions" whose ores had a high content of precious metals, including platinum but also because the future outlook of its own Creighton mine was uncertain. Robert Stanley readily accepted Melchett's offer. It was simply too good for Inco to refuse at the price agreed upon. All the usual benefits of corporate concentration, near-market monopoly, economies of scale, and large profits were inherent in the merger, without any obvious disadvantages. Given the buoyancy of the market, moreover, the timing was ideal.
Company officials reached an agreement to merge the two operations effective January 1, 1929. The merger involved a series of stock exchanges whereby Inco became the parent organization and Mond was relegated to a subsidiary position to control operations in Great Britain. A new company known as International Nickel Company was formed to take control of all operations in the United States. With this action, Inco acquired the following properties: the Frood Extension; the Garson and Levack mines; the smelter at Coniston; a nickel refinery in Clydach, Wales; a precious metals refinery at Acton, London; and Henry Wiggins & Company, which operated rolling mills, fabricating, and chemical plants in Birmingham.
Prior to the merger, Inco took the step of making the parent company a Canadian corporation. One reason for this move was to avoid antitrust action in the United States because of the elimination of Mond as a "competitor" in that country. While Inco became nominally Canadian, executive control remained firmly in the hands of its American directors. The merger gave the new company worldwide control over 90 per cent of the nickel market, thereby solidifying Inco as a global monopoly and Stanley's position as head of Inco.
The US control of Inco was paralleled by the country's concern about controlling nickel as a strategic wartime mineral. For example, during the 1920s and early 1930s, paranoia existed in certain US circles concerning the possibility of a theoretical war between the United States and the British Empire that would use Canada as a theatre of warfare. Added to this paranoia was the belief held by many Americans in the expansionist ideology of "Manifest Destiny:" that the United States had the inherent and inevitable right to controlall of North America. To prepare for this unlikely scenario, the United States government even prepared a Joint Army and Navy Basic War Plan in 1924 that included the option of invading Canada and preparing the provinces and territories for statehood. This plan was approved in 1930, and updated in 1934 and 1935. One of the critical aspects of this plan was its repeated emphasis on the need to control Sudbury's vital nickel deposits via an invasion route through Sault Ste. Marie.
As noted in the report, "Unless nickel can be obtained from the Sudbury mines, serious shortage in that important warmaking material will develop … within a few months after the war begins." The document is instructive, as it reveals the enormous strategic global importance of the Sudbury nickel deposits at the time.16 Another part of the strategy involving northern Ontario was a proposal to generate hydroelectric power at James Bay. While nothing official came out of this plan, it is pertinent to note that the idea of hydroelectric generation at James Bay has since been revisited on several occasions, notably in the form of the Grand Canal Project proposed in 1959 involving the diversion of water to dry areas in the United States.
Another outcome of the 1929 merger was the consolidation of the hydroelectric plants previously owned by the two companies. While they were among the biggest customers for power generated by Ontario's Hydro-Electric Power Commission, they also relied on local sources of hydroelectric power. As early as 1902, International Nickel established a subsidiary known as the Huronian Power Company for the purpose of developing power sources along the Spanish River. A plant, known as High Falls, was built on one side of an island in 1905; it was the first to supply the mining industry with power in Northern Ontario. In order to regulate the flow of the Spanish River, the company acquired the rights to eleven crib dams reaching as far north as the river's source at Biscotasing Lake.
A second High Falls plant was built on the other side of the island in 1917. The two plants supported a small community of eighteen homes and a one-room elementary school in a setting that looked "more like a slumbering New England village than a nerve-centre of Northern Ontario." Completed in 1920, with a length of 358 metres and a maximum height of 45 metres, the Big Eddy dam was the largest in Canada at that time. It also transformed the physical setting by creating a new lake (Agnew), some forty kilometres in length. After the merger in 1929, Mond's subsidiary, the Lorne Power Company, which had built power plants at Wabageshik on the Vermilion River in 1909 and Nairn Falls on the Spanish River in 1915, was absorbed into the new entity. END
The Book
From Meteorite Impact to Constellation City is a historical geography of the City of Greater Sudbury. The story that began billions of years ago encompasses dramatic physical and human events. Among them are volcanic eruptions, two meteorite impacts, the ebb and flow of continental glaciers, Aboriginal occupancy, exploration and mapping by Europeans, exploitation by fur traders and Canadian lumbermen and American entrepreneurs, the rise of global mining giants, unionism, pollution and re-greening, and the creation of a unique constellation city of 160,000.
The title posits the book's two main themes, one physical in nature and the other human: the great meteorite impact of some 1.85 billion years ago and the development of Sudbury from its inception in 1883. Unlike other large centres in Canada that exhibit a metropolitan form of development with a core and surrounding suburbs, Sudbury developed in a pattern resembling a cluster of stars of differing sizes.
Many of Sudbury's most characteristic attributes are undergoing transformation. Its rocky terrain and the negative impact from mining companies are giving way to attractive neighbourhoods and the planting of millions of trees. Greater Sudbury's blue-collar image as a union powerhouse in a one-industry town is also changing; recent advances in the fields of health, education, retailing, and the local and international mining supply and services sector have greatly diversified its employment base. This book shows how Sudbury evolved from a village to become the regional centre for northeastern Ontario and a global model for economic diversification and environmental rehabilitation.
The Author
Oiva Saarinen received an Honors B.A. (1960) and an M.A. (1969) from the University of Western Ontario and a Ph.D. in Geography from the University of London in 1979. He retired from Laurentian University in 2003. He is the author of Between a Rock and a Hard Place: A Historical Geography of the Finns in the Sudbury Area (WLU Press, 1999).
To order a copy of "From Meteorite Impact to Constellation City", please click here: http://www.wlupress.wlu.ca/Catalog/saarinen-meteorite.shtml


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Active participation in the life of the parish by giving fully of your time, talent and treasure and by regularly attending Sunday Mass and Holy Days of Obligation is a requirement for attendance at Our Lady of Lourdes Parish School.
|Pre-K3 to 5th Grade
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Tuition rate includes fees for testing, books, supplies, as appropriate
|Families with two or more children enrolled in the school will receive a discount of $500.00 per child.
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Additional Fees That May Apply
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All new students must commence registration process within five business days of receipt of acceptance letter.


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What you share in the Retirement Profile stays within TIAA. This material is for informational or educational purposes only and does not constitute investment advice under ERISA. No changes will be made to your actual accounts. This material does not take into account any specific objectives or circumstances of any particular investor, or suggest any specific course of action. Investment decisions should be made based on the investor's own objectives and circumstances. Certain products and services are only available to eligible individuals.
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Chairman, Institute of New Economic Thinking (2013-present)
Chairman, Financial Services Authority (2008-13)
World-renowned expert on global economic trends, global finance and the Chinese financial system
Lord Adair Turner is a world-renowned expert on global economic trends, global finance, macro prudential regulation and the Chinese financial system. Since 2013 he has served as Senior Fellow at the Institute for New Economic Thinking (INET), a new think tank founded by George Soros dedicated to re-thinking the field of economics in the wake of the financial crisis. Since 2015 he has served as Chair of the Governing Board.
Lord Turner served as Chairman of the Financial Services Authority (FSA), the regulatory body overseeing the financial services industry in the UK, from 2008 until its abolition in March 2013. He successfully rebuilt the institution's reputation after the financial crisis and negotiated changes to the regulatory regime. Under his leadership, the FSA produced an influential report in 2009 (the Turner Review) recommending a rethink of global banking regulation in response to the credit crunch and collapse of global banking liquidity.
He has also been Chairman of the Overseas Development Institute and a Visiting Professor at the London School of Economics and Cass Business School, City University. He is also former Chairman of the Pensions Commission, the Committee on Climate Change and the Low Pay Commission. He became a cross-bench member of the House of Lords in 2005. Until September 2008, Lord Turner was non-executive Director at Standard Chartered Bank. Previously he was Vice-Chairman of Merrill Lynch Europe, and Director General of the Confederation of British Industry (CBI). Prior to that, between 1992 and 1995, he built McKinsey's practice in Eastern Europe and Russia as a Director.
Lord Turner has written several books, "Just Capital – The Liberal Economy" (2001) and "Economics after the Crisis – Objectives and Means" (2012). His book, "Between Debt and the Devil: money, credit and fixing global finance", was published by Princeton University Press in 2015, and focused on how to reform the global financial system after the crisis. In 2016, China Business News made "Between Debt and the Devil" its Book of the Year.
Lord Adair Turner was appointed Chair of the Energy Transitions Commission in 2016.
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I began my yoga journey about six years ago when several friends took me to my first yoga class. Since that time, I've noticed old injuries disappear and myself become more calm, more open and stronger both mentally and physically. Yoga has changed my life. Baptiste Yoga became my focus very shortly after I began my practice when I went to an All Day Immersion in Boston. I was drawn to the intelligent sequencing and spiritual focus of Baron's practice. It became evident that after each practice I would feel not only challenged but completely renewed.
I'm excited to be a Certified Baptiste Instructor and continue to be a student of this powerful practice and all of the amazing teachers around me. My intention as a teacher is to share my love of the practice and leave people feeling empowered, strong, and balanced. I know that this practice can change people's lives as it did mine.


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A newly published study examined attitudes toward four potential U.S. Federal tobacco regulations (banning menthol from cigarettes, reducing nicotine levels in cigarettes, banning candy and fruit flavored electronic cigarettes, and banning candy and fruit flavored little cigars and cigarillos) and associations with individual and state variables. A nationally representative phone survey of 4,337 adults assessed attitudes toward potential policies.
Findings included:
- Most respondents supported three out of four policies.
- Respondents that were female, non-white, Latino, living below the poverty line, had less than high school education, were of older age, did not smoke, had higher trust in government, and were exposed to national tobacco control campaigns had higher odds of expressing favorable attitudes toward potential new tobacco regulations than did their counterparts.
- While differences in attitudes were observed by individual demographic characteristics, behaviors, and beliefs, a majority of participants supported most of the potential new tobacco regulations surveyed.
Source: Schmidt et al. (2018). Attitudes towards Potential New Tobacco Control Regulations among U.S. Adults. International Journal of Environmental Research and Public Health, Jan 5, 15(1).


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Special emphasis programs are an important part of the civil rights program at the Natural Resources Conservation Service. The special emphasis program managers assist Mississippi's State Conservationist in ensuring that equal opportunity is present in all aspects of NRCS programs and services. The State Conservationist and staff provide leadership to identify the underrepresented and ensure that positive actions are being taken to address problem areas. Special Emphasis Program Managers provide advice and assistance to the State Conservationist and management staff to help meet civil rights program goals and objectives. Special Emphasis Program Managers also assist the State Conservationist with effective communications among all persons involved with the civil rights responsibilities.
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