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Costs Of ObamaCare Bungles Start To Add Up, With Maryland First At About $30.5M – Fox News
Maryland could end up spending as much as $30.5 million as a result of a glitch in its ObamaCare website, as the Obama administration steps in to help states with problematic exchanges.
Because of Maryland's defective exchange, the state cannot determine whether customers remain eligible for Medicaid, according to a report by state budget analysts released Thursday.
As a result, the state has agreed with the federal government to a six-month delay in determining eligibility, meaning that payments will continue to be made to customers who are not eligible until the system is fixed. The delay will cost the state $17.8 million in fiscal 2014 and $12.7 million in fiscal 2015, the analysts estimated.
On Friday, the Obama administration said it would suspend some Affordable Care Act rules to help the 14 states with their own ObamaCare sites, particularly Maryland, Massachusetts, Hawaii and Oregon, which have had the most problems.
The federal Centers for Medicare and Medicaid Services plan, completed a day earlier, states the federal government will help pay for "qualified" health-insurance plans for customers in those states who because of "exceptional circumstances" had to buy plans outside of ObamaCare exchanges, as reported first by The Washington Post.
The administration made the change before the end-of-March deadline for Americans to enroll in ObamaCare this year.
In Maryland, the exchange cannot convert income data from the existing Medicaid enrollment system into a calculation needed to review whether enrollees are qualified "because of a variety of system architectural flaws," according to budge analysts.
The exchange has been plagued by computer problems that have made it difficult for people to enroll in private health care plans since its debut Oct. 1.
State officials have decided to stick with the exchange through the open enrollment period that ends March 31 but is evaluating alternatives with an eye toward the next enrollment period that begins in November.
Among the possibilities is adopting technology developed by another state, joining a consortium of other states, partnering with the federal exchange or making major fixes to the existing system.
Thirty-six states use the federal HealthCare.gov site, which crashed and had other major problems in the first two months of enrollment.
The Maryland report said the state may need to develop an interim solution while a long-term solution is being developed. However, that process would likely take at least nine to 12 months, pushing up against the next open-enrollment period.
The report also states the development of the exchange was "a high risk undertaking" from the outset, in large part because of contractors woes, tight deadlines, constantly evolving requirement and its need to interface with work-in-progress federal databases.
The administration changes this week are not the first to ObamaCare, to be sure.
In November, Obama helped Americans about to lose policies because they didn't meet new minimum requirements by allow the substandard plans to be sold through the end of this year.
And administration officials has twice this year given medium- and large-sized employers more time to offer health insurance to most full-time workers.
However, the change this week is significant because it marks the first time the federal government has agreed to help pay for policies bought outside the new exchanges.
The coverage in the outside policies would have to be comparable to those offered on the exchange. And customers would have to start paying premiums, then get the subsidies after the state exchanges could determine their income eligibility.
Maryland Health Benefit Exchange official told The Post earlier this week that roughly 7,000 applications are stuck in state's system, but all of them might not need insurance and that officials were still looking over the administration's offer.
Related article:
45-State Study: Obamacare Offers Less Choice, Higher Prices, Breaking Another Promise – Washington Examiner
A new and comprehensive comparison of health insurance options offered by Obamacare versus private websites finds that President Obama's program offers less choice and higher prices than promised by the White House and leading Democrats.
Adding to the list of broken health care promises, the study from the National Center for Public Policy Research found that there were more and cheaper options available on websites outside the health insurance exchange in 2013 than on healthcare.gov and state Obamacare exchanges.
The report, "Obamacare Exchanges: Less Choice, Higher Prices," looked at options available for a 27-year-old single person and a 57-year-old couple in metropolitan areas across 45 states.
The report found that a 27-year-old male had about 10 more policies to choose from on eHealthinsurance.com and finder.healthcare versus the exchange. The older couple had about nine more policy choices.
Ditto for the cost findings, with the 27-year-old male having access to 32 policies that cost less than the cheapest Obamacare offering, and the 57-year-old couple access to 29 cheaper policies.
"In general, consumers had substantially more policies to choose from on private websites such as eHealthinsurance.com and Finder.healthcare.gov than they presently have on the exchanges," said the study.
"Obamacare supporters, including the president himself and Nancy Pelosi, claimed the exchanges would yield more choice and lower prices," said the study's author, David Hogberg. "This study shows those claims do not stand up."
The National Center for Public Policy Research, founded in 1982, describes itself f as a "non-partisan, free-market, independent conservative think-tank."
House Subcommittee Chairman: Obama Administration Policy Would Eliminate Half Of All Existing Medicare Part D Plans – Daily Caller
The Obama administration's new proposed rule for Medicare Part D would eliminate half of all Medicare Part D plans and raise prescription drug premiums for millions of seniors by up to 20 percent, according to a U.S. House subcommittee chairman.
"Today, the average senior has 35 different [Medicare Part D] plans to choose from this year. This rule would reduce that choice to two plans. 50% of the plans offered today will be gone, and the health care that seniors like may go with it," House Energy and Commerce Health Subcommittee chairman Rep. Joe Pitts said in a statement at a Feb. 26 hearing attended by a top administration health official.
"Limiting seniors' choices like this will inevitably lead to higher costs. By some estimates, the restriction on the number of plans that can be offered could cause premiums to rise by 10%-20%. Costs to the federal government may increase by $1.2-1.6 billion according to a study by Milliman," Pitts said. "… I urge Secretary Sebelius and Administrator Tavenner to rescind this rule."
The study Pitts cited also showed that the new rule would increase out-of-pocket drug costs for 6.9 million seniors who do not qualify for low-income subsidies, and would raise federal taxpayer costs for six million seniors who do qualify.
President Bush signed Medicare Part D into law in 2003 to subsidize prescription drug costs for Medicare beneficiaries.
The Daily Caller reported that the administration's Centers for Medicare and Medicaid Services (CMS), a division of Kathleen Sebelius' Department of Health and Human Services (HHS), recently introduced a new proposed rule on the Federal Register called "Medicare Program: Contract Year 2015 Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs."
The new rule "would revise the Medicare Advantage (MA) program (Part C) regulations and prescription drug benefit program (Part D) regulations to implement statutory requirements; strengthen beneficiary protections; exclude plans that perform poorly; improve program efficiencies; and clarify program requirements," according to the Federal Register.
The rule states that it also aims "to implement certain provisions of the Affordable Care Act."
The new rule's stated desire to "strengthen our ability to identify strong applicants for Part C and Part D program participation and remove consistently poor performers" would give the Obama administration new authority to limit health insurance and prescription drug providers under the Medicare Advantage and Medicare Part D programs.
The rule would also violate the Medicare Part D's law's "non-interference provision that prohibits the Secretary of Health and Human Services (HHS) from interfering with the negotiations between drug manufacturers and pharmacies and sponsors of prescription drug plans," according to testimony by American Action Forum president Douglas Holtz-Eakin, violating "congressional intent."
Rep. Pitts expressed confusion and anger at CMS' new rule.
"CMS itself says that 96% of the Part D claims it reviewed showed seniors saved money at preferred pharmacies, and nearly 25,500 seniors in my district have chosen Part D plans with a preferred pharmacy network. Yet CMS would take that away from them," Pitts said.
"The Medicare Part D prescription drug benefit is a government success story. Last year, nearly 39 million beneficiaries were enrolled in a Part D prescription drug plan," Pitts said.
"Competition and choice have kept premiums stable. In fact, in 2006, the first year the program was in effect, the base beneficiary premium was $32.20 a month. In 2014, the base beneficiary premium is $32.42 – a 22-cent increase over 9 years – and still roughly half of what was originally predicted," Pitts added. "More than 90% of seniors are satisfied with their Part D drug coverage because of this. African-American and Hispanic seniors report even higher levels of satisfaction, at 95% and 94%, respectively."
"The program has worked so well because it forces prescription drug plans and providers to compete for Medicare beneficiaries – putting seniors, not Washington, in the driver's seat. Part D should be the model for future reforms to the Medicare program," Pitts said.
House Energy and Commerce committee chairman Rep. Fred Upton joined with Pitts at the hearing in criticizing the new rule.
"The proposed rule, issued on January 6, 2014, appears to be a direct assault on the competitive structure of the program. It inhibits the ability of plans to obtain discounts for beneficiaries, limits the range of market segments in which they may compete, and usurps the responsibility of states to license those able to prescribe. This 700-page proposal makes numerous changes," Upton said.
CMS principal deputy administrator Jonathan Blum testified that limiting Part D sponsors to providing only two plans per region will "promote needed clarity of plan choices for beneficiaries."


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More Show and Tell: Spud and Chloe at the Farm
Today we are excited to be a part of the blog tour for Susan B. Anderson's book Spud and Chloe at the Farm! We don't hide that Susan is a favorite around here, and we definitely don't hide that we love Spud and Chloe yarns! When we first found out that Spud and Chloe were coming to life, we were thrilled and now they're here and a definite hit!
Spud and Chloe at the Farm is a unique book, definitely the first of its kind. Not only is it full of adorable projects, but it also includes a fun story for kids, written by Susan.
Personally, I think that Susan is a genius when it comes to designing knitted toys. She has had plenty of practice, with her book Itty-Bitty Toys, as well as the very popular knit chickens and other toys that you can find on the Spud and Chloe blog. I had the opportunity to interview Susan about the process behind her newest book, so I will let her talk about many of the projects. But I thought that I'd weigh in on some of my favorites, even if it's impossible to choose!
First there are Spud, the sheep and his companion, Chloe. Totally adorable and visually true to the yarn's logo. In fact, all of the farm animals are truly adorable, and you must check them out for yourself. But the projects that really make me squeal are the accessories! Susan knit a barn! A white picket fence! Buckets! Even Hay Bales! I cannot get over the cuteness. And what is really great is that they look to be quite simple projects. She's brilliant, I tell you!
So that's enough of my babbling. Let's have Susan join in on the fun…..
Hi Susan. Thank you for joining me today. Why don't you tell us how Spud and Chloe at the Farm came about. Whose idea was it to bring these cute characters to life?
I had been doing some designing for Blue Sky Alpacas and the new Spud & Chloe line which hadn't been released yet. This was back in 2008 and 2009. I met with the owner of Blue Sky Alpacas and she asked if I could create knit versions of Spud and Chloë. I jumped at the chance. At that same meeting we started talking about making a series of books called, The Adventures of Spud & Chloë. I talked to my publisher, Artisan Books, about the idea and they gave it the green light. A farm setting for the first installment in the series seemed like the best location to start.
What was different about writing this book compared to your first three books?
There are three main differences. The Itty-Bitty books were just on my own creating whatever I dreamed up. The Spud & Chloë book had a much more specific setting and characters. It was trickier in this way. Spud & Chloë each took multiple attempts and months and months to create. I worked until they were both exactly right. The second difference is that there was another party involved, Spud & Chloë – the company. This made everything more fun but just a little more complicated in a good way. The third difference is that I wrote a children's story to go along with the knitting projects. This became a major part of the book and it was a lot of work. It was like writing two books in one.
Ok, tell us about Spud. He is so adorable!
Spud is a big, chubby sheep that wears a bow-tie. He is a lovable curmudgeon. He is witty and at times a little biting with his words but he is funny and silly at the same time. Spud is cautious to a fault but when he ends up trying new things he always has a good time in the end. Chloë knows him best and she knows his sweet and generous heart is always right under his wooly surface.
Chloe is such a cutie, tell us about her.
Chloë is the optimistic, spunky owner of Spud. She is Spud's biggest cheerleader and loving sidekick. She is always game to get out there and try new things and she is always dragging Spud along on her adventures. Chloë is forever upbeat and she is a fun-loving girl.
How did the story come to be? Was it written first and then the designs came after, or vice versa?
I made the projects first but with the story in mind as I worked. Then I wrote the story incorporating the characters in the storyline. I worked with an editor at my publisher, Suzanne Lander, and we spent hours discussing the background story and personalities of the characters before even starting the story writing. After I felt I knew the characters I started writing the story. There were many, many edits and changes and test-reads along the way. I also had to work out the storyboards for each and every frame of the cartoon-style layout of the story. The placement and actions and facial expressions of all of the characters had to be plotted out down to the smallest detail. We hired Amy Cartwright to do the illustrations for us. She did a great job bringing the story to life.
The story is run throughout the book with a cartoon frame placed on the bottom of the right-hand pages. It is also run with all of the frames together, like a regular cartoon, at the end of the book. I love the story aspect and hope to do a lot more of this in the future.
Tell us about some of the knitting techniques used in the book. Were there techniques created just for these toys?
Small 3-dimensional toys are quick to knit but they also require a lot of technique on a small scale. Although many projects use only simple shaping techniques like k2tog or ssk or kfb some are slightly more challenging with additional techniques. They toys are so fun and fast to complete that they make the perfect project for learning new techniques along the way. A lot of the techniques used in toys are the same used in sweater making.
I use a cool and unusual stitch called the twisted loop stitch to make Spud's wooly coat. I am sure I didn't make the stitch up but I haven't seen it used this way before so maybe that's a new twist.
Should we expect more knitting adventures from Spud and Chloe in the future?
I am hoping for a series of adventures for Spud & Chloë. We are already working on the next stop on the adventure trail. It is going to be a good one.
We are looking forward to their next set of adventures! Thank you to Susan and her amazing team at Spud and Chloe and Artisan Books for making us a part of the blog tour. Make sure you check out Susan's interview on the Ready! Set! Knit! podcast as well as the next stop on the blog tour with Alana of Never Not Knitting ( June 1st). And you just never know when Susan might make another appearance on our site Just sayin'….
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subset: commoncrawl


text:
At Loyola, some faculty have written a letter of outrage against Walter Block's remarks quoted in the NY Times.
One paragraph that characterizes slavery just about fits perfectly in characterizing the State:
"While the lack of free association did indeed characterize antebellum slavery in the U.S., the ownership of humans as property is merely one of the incontrovertibly unacceptable aspects of slavery. The violation of human dignity, the radical exploitation of people's labor, the brutal violence that slaveholders utilized to maintain power, the disenfranchisement of American citizens, the destruction of familial bonds, the pervasive sexual assault and the systematic attempts to dehumanize an entire race all mark slavery as an intellectually, economically, politically and socially condemnable institution no matter how, where, or when it is practiced."
It is not easy to secede personally or groupwise from being associated with the State. Most people regard it as practically impossible. The State owns a large fraction of a person's income and regulates many of his activities. It can and has sent people to war to be killed and maimed. The State violates human dignity in many ways and radically exploits people's labor. Behind its every act is the threat of brutal violence to maintain its power. The State has disenfranchised a great many citizens outright, but even those with the franchise find that their choices are extremely limited. Social programs have wrecked neighborhoods, whole communities and familial bonds. Lately there is pervasive sexual assault at airports. The State can be said systematically to dehumanize the citizens under its control. Lately, the State's policing agencies have sharply increased their brutality. The State discriminates against all sorts of groups, like drug users, employers, and people who want to buy food direct from farmers. All of this marks the State as an "intellectually, economically, politically and socially condemnable institution no matter how, where, or when it is practiced."
The people who wrote this paragraph think that Walter should be censured. They do not realize that he is taking their side against violence being visited on innocent people and that he has extended the critique of slavery to the State.1:27 pm on February 12, 2014 Email Michael S. Rozeff


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Messiesta (Shav)
Fan of 5 Teams
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Joined: 5th, Feb 11
1801 Pts
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1,801 pts » 525th +8
Fan Valuation
£8.6m » 1713th
1,272 » 469th
Last Logged In
1 Month Ago
Member Since
5th February, 2011
Vital Stats
20 year old Male
Pro (Midfielder) FC Barcelona
Recent Activity
Messiesta wrote in Barcelona Chat
A suggestion is not concrete it is merely an to instigate discussion. Now people seem to forget our great Puyol was also a RB before CB and had some people actu...
1 month ago
I doubt many defenders would have done any better at that point.
What do you guys think about Marc Bartra playing as a RB? Montoya and Douglas seem to be doing nothing to make ab entry into the squad and well Dani is not hims...
Messi, xavi, puyol, eto and Ronaldinho reunited again for porto 04 vs Barcelona 06 game.
4 months ago
Who cares what they do and who they buy. We have issues within our club to solve first and only then can we comment on others. (By problem I mean our egotistic...
5 months ago
Great, we just bought a 30 year old left back for 20 million who we are going to use as CB.
Paying 42 million for a RW who we are going to play as RB. Zubi this ain't fifa.
If anything he is using that celebration as a joke to show that "he's here". You know since he was on loan and now he is getting his chance. A celebration is ha...
So in saying that would it be wise to say that Pedro would in fact be a smarter choice to play alongside Messi and Suarez MT? Also it makes me wonder why Alexis...
So looks like Messi will be playing behind Neymar and Suarez. MT was right but now that makes me wonder where the mids will fit in. Neymar Suarez Messi ? ...
Messi to Chelsea?
The same hierarchy that let Abidal go and the same hierarchy that signed Song as a make shift CB option. People that dont like Alexis dont know football. I am g...
And we are signing Edward Cullen..I mean Suarez. Guess he will be playing CB
Oh how I wish Zubi thought like MT. We just saw glimpses of his potential but at Barcelona he would always be limited. I'll be keeping a kern eye on Arsenal now...
Welcome to FC Barcelona bravo. He joins for the next 4 seasons. https://mobile.twitter.com/weloba_es/status/481739349168758784/photo/1
Absolutely. From day one it has been crazy and it's so good to see teams like Costa Rica really thriving. But by far he biggest Argentina has done nothing but a...
Brazil vs Chile should be one hell of a match
6 months ago
What's with us selling players for so cheap and buying players for a fortune.
Some news media are reporting that Sanchez will be part of a deal to aquire Squrez. The deal is Alexis + 35 million. My two cents: get f**kd.
Sources keep saying Enrique wants him to stay so god knows lol
Messiesta just Watched
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Barcelona Vs. Villarreal
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As a midfielder, I specialize my skill set as a center defensive-mid tactician, but I can make passes as a playmaker and often rotate outside to the wings for crosses! My playin ...
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I love football!
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Askepios (Jordan Reese) from Spokane, United States
Bananaskinz (Albert) New Zealand
Barcelona and New Zealand
and England
Your probably on my page because I said something you dont agree with, so give me two rude votes for the comment that probably phrased in a way politer than how you would speak to ...
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Hi, I'm Ed and I believe that you, yes YOU, are a cool guy :D Thank you all my friends for making my day. And thanks to all who have spammed me with cool votes :). I really do ...
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I am a die hard fan of Chelsea Fc i love them with all my heart and soul, since i was 8 and my love for them has never stopped and never will.
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Owns an amateur team dedicated to a friend we lost along the way. Forza FC MATTI
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(Bolton Wanderers)
6 months ago
I replied on the Barcelona page about Naymar's role under Enrique. But if you want to hash out the thoughts on each other's walls instead, go for it.
Basically, move him closer to the middle, and always opposite the side of the pitch if the ball is out on the wing. Just let him run. Don't let him think (he ruins everything if he has to think). His footy IQ is nowhere near the others in the squad
Basically, move him closer to the middle, and always opposite the side of the pitch if the ball is out on the wing. Just let him run. Don't let him think (he ruins everything if he has to think). His footy IQ is nowhere near the others in the squad
1 year ago
Right back at you my man!
(Tottenham Hotspur)
1 year ago
Hi Shav,
Yes, I live in NZ (Whangarei) now but originally from Norway.
Where in NZ are you?
Cheers for the add, two greens your way!
Yes, I live in NZ (Whangarei) now but originally from Norway.
Where in NZ are you?
Cheers for the add, two greens your way!
1 year ago
I always wondered if Messi and Iniesta had a baby, how it would look like. Thanks for answering my dying curiosity. 2 cool votes!
1 year ago
How could you! Write on my wall so I have to face Messiesta again! Haha
I know a few complain about the lack of "freedom" in the forum. A lot times I can't stand what some may write but I just ignore it....complain to myself sometimes lol and move on.
See you around!
I know a few complain about the lack of "freedom" in the forum. A lot times I can't stand what some may write but I just ignore it....complain to myself sometimes lol and move on.
See you around!
Messiesta's dreamfooty team
Roberto Martínez
R. Fährmann
Filipe Luis
A. Laporte
Jordi Alba
M. Hummels
G. Bale
I. Rakitić
Ander Herrera
M. Mandžukić
A. Schürrle
Subs Bench:


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- New Hampshire's economy is fueled by technical innovation. From our world-class research institutions to fast-growth NH businesses, high-technology is rooted in every facet of our economy. Keep a pulse on the local movers and shakers through TechHampshire.com.
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U.S. Angel Investor Market on Solid Path of Recovery in 2011
Read the full post by UNH News on UNHedu_vertical.
DURHAM, N.H. – Following a considerable contraction in investment dollars in 2008 and 2009, the U.S. angel investor market continued to recover in 2011, a trend that began in 2010 in investment dollars and in the number of investments, according to the 2011 Angel Market Analysis released by the Center for Venture Research at the University of New Hampshire.


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Atmospheric Italian Folk music, happy pizza for everybody
Dreaming under the Eiffel Tower of butter croissants, cafe au lait and Edith Piaf
The girl from Ipanema sends his regards - Old Scool Bossa Nova
Happy Sunday afternoon in a small American town, nice neighbors, lovely children, and the pictures are still in the black and white of the 50's.
Paulchen Panter greets Dr. No
Colorful mix for the brainstorming kitchens of the world, Think Tank Electro Track
1960\'s or 1970\'s style retro rock / funk track based on guitars and organ, reminescent of the chic of Austin Powers (\"Groovy, Baby!\"). Short track, suitable for commercials, fashion, retro media etc.
A bit like the musical accompaniment to a funeral in Mississippi
Riding with the Hoppa-Ponies on the Village Fair
Easy Sounds for Easy Going, flimsy and tasty
The kitchen trailer for all lunch magazines
Like a sweet and alluring fragrance of Grandma's kitchen. The Underscore version.
Barmusic in ist best sense
Easy Listening for the preparations for lunch, delicious and wholesome
Like a sweet and alluring fragrance of Grandma's kitchen.
Do you have a suggestion on how to improve proudmusiclibrary.com? Please use this form to send us a quick note. We are looking forward to hearing from you!


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5 Perfect Memorial Day Outfits For Every Vibe
Kick off the summer in style with 5 perfect outfits for celebrating the long weekend.
By Elizabeth Denton
Bright colors and fun prints make your gym clothes fashion-y!
Your weekend essentials:
Sporty jersey (Number 86 Airtex Sporty Tee, $44, topshop.com)
Girly baseball hat (Becky Floral Snapback, $26, boohoo.com)
See-through backpack (Clear PU Rucksack, $50, motelrocks.com)
Shiny shorts (Satin Shorts, $9.95, hm.com)
Cool kicks (Converse All Star High-Top Sneaker, $60, nastygal.com)


text:
"Nuh-uh, Twisted Pixel, our exploding guy versus scientists and intentionally similarly titled game is TOTALLY different from yours!" — me putting words in Capcom's mouth.
Thanks to the excellent round up by GameInformer for putting all of the info in one handy place. Do check out their article though I will embed the videos here, too.
Last summer Twisted Pixel released 'Splosion Man on XBLA as part of the 'Summer of Arcade' series. Though it was well-reviewed, and friends of mine would just not shut up about it (and the extremely likable donut song), I never played past the demo. There were too many other games going on at the time and I figured I could always come back to it. You know how it is. Here's what it looks like in action (starting around 11 seconds in):
You're a man. You explode. You break stuff. Simple concept, great execution. gg TP (*giggle*). Then Capcom Mobile comes out with MaXplosion:
Hmmmmmmmmmmm, yeah. Everyone picked up on it. No foolin', eh.
Base mechanic? check.
Sound style? got it.
Story concept? Big Science and M.A.D Science.
Title? Holy crap, have some dignity there.
It's even easier to paint Capcom as super evil supreme picking on the much-loved Twisted Pixel thanks to the information that 'Splosion Man was initially pitched to their console division. This incident has brought to light that Mobile is its own division, but when a company like Capcom, big and scattered around the globe as they are, makes this kind of move, it will not be ignored. Internet social media rallied behind TP and CEO Michael Wilford made a statement about the controversy.
"We're definitely not going to pursue legal action. While I think the similarities are pretty nauseating, we're too small to take on a company like Capcom. That, and we owe them one for inventing Mega Man, so we'll let them slide. I just hope they're not counting on the fact that indies can't fight back.
"In general, anything that would take our focus off of making games would be a bad decision, I think. We just need to keep our heads down making the next thing so that Capcom has something to steal next year. But I have to say, the amount of support we've seen in the last 12 hours on Twitter and over email has been awesome, and I think that's better than wining [sic] a stupid lawsuit or anything like that.
"We'll just have to make our own mobile game and I'm hopeful that Capcom will see that robbing our *** wasn't worth it in the long run. We'll let you know when we have something on the mobile front to talk about, but now we have added incentive!"
Look at it the other way: just how fast would TP be smacked down were Capcom first to market here? Yeah.
Capcom's response wasn't really helping matters along, not that a large corporate entity often makes statements exactly like this. The non-apology, safe in the knowledge that internet rage is fleeting and the general iPhone market will completely not care, follows:
"While Twisted Pixel did have discussions with our console game team about publishing 'Splosion Man' on game consoles, Capcom Mobile is a different division of Capcom with separate offices and as such, had no prior knowledge of any meetings between the console game team and Twisted Pixel. 'MaXplosion' was developed independently by Capcom Mobile. Nonetheless, we are saddened by this situation and hope to rebuild the trust of our fans and friends in the gaming community."
'Saddened'. That's up there with 'I'm sorry if someone was offended'. A total fauxpology. An answer so that people will just go away. Which part are they sad about? Sad about the shocking similarities that Wilford called "complete theft"? Sad that people noticed? Sad that they are releasing it anyway? I truly believe they didn't know about the meetings; that happens all the time. Anyone that has ever worked in even a medium-sized office knows that management is often clueless that two teams are working against each other by accident. But it's not like 'Splosion Man was an invisible release. It was also, oh, in June 2010. I cannot believe that Capcom Mobile has been working on MaXplosion for all that long. This is not the type of game that takes years of work in a bunker to complete. Even the title just feels callous. Had they waited another year or so (though that would run into Ms. 'Splosion Man), it might not have attracted this kind of negative attention. You cannot do a search for MaXplosion without all the theft posts atop the results.
If studios weren't free to use the mechanic of running and jumping and dodging, our gaming catalogues would be much, much thinner. MaXsplosion seems akin to having two guys from, uh, Newark fall into a pipe in orange and turquoise overalls, jumping on walking carrots and lizards to save a queen. Much too close, guys. This is why people are calling Capcom Mobile 'Poopy Heads' on social media sites.
Ok, so I'm calling them Poopy Heads on twitter, but maybe it can start a movement.
Since Twisted Pixel won't be spending their limited resources on a court case, I hope that this exposure has led to more sales of 'Splosion Man on XBLA. Should they release it on the App Store themselves, I'll buy it. And maybe Ms. 'Splosion Man will have some new twist that makes me grab it on launch


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Procalcitonin-Guided Antibiotic Therapy
Outline of Material
The material in this presentation covers the results and conclusions from a systematic comparative effectiveness review entitled Procalcitonin-Guided Antibiotic Therapy. It begins with an introduction to procalcitonin and its role in guiding antibiotic therapy in adults and pediatric patients with suspected local or systemic infections. It also covers methods used to plan and execute the systematic review, clinically important questions the review sought to answer, results of the review, evidence-based conclusions about the effects of using procalcitonin to guide antibiotic therapy in patients with local or systemic infections, gaps in knowledge, and the future research needs uncovered by the systematic review.
Keywords: background | procalcitonin | antibiotic therapy | comparative effectiveness review | systematic review
- Soni NJ, Samson DJ, Galaydick JL, et al. Procalcitonin-Guided Antibiotic Therapy. Comparative Effectiveness Review No. 78 (Prepared by the Blue Cross and Blue Shield Association Technology Evaluation Center Evidence-based Practice Center under Contract No. HHSA 290-2007-10058-I). Rockville, MD: Agency for Healthcare Research and Quality; August 2012. AHRQ Publication No. 12-EHC124-EF. Available at www.effectivehealthcare.ahrq.gov/procalcitonin.cfm.
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Gunnison Sage-grouse
Gunnison Sage-grouse
(Centrocercus minimus)
Since the late 1970's researchers became aware that the sage-grouse in the Gunnison Basin of Colorado were unique from sage-grouse found elsewhere in most of the United States. In 1995, Drs. Clait Braun and Jessica Young proposed that the Gunnison Sage-grouse was a distinct species and, along with Drs. Jerry Hupp, Sara Oyler-McCance and Tom Quinn, they published their findings in the Wilson Bulletin (Young et al. 2000), for which they were awarded the Edward's Prize for the best major article published by that journal that year. The American Ornithological Union recognized the Gunnison Sage-grouse as a newly named species in 2000, after a review of the scientific data by the AOU Nomenclature Committee, which consists of the leading taxonomic specialists in North and Central America.
Species Designation
A species is on of the basic biological units used to understand patterns of biodiversity. There are several factors that biologists take into consideration when determining how to apply the designation of species to a group. While there are wide-ranging opinions on how to define a species, most species definitions or concepts consider physical, behavioral and genetic traits. The most common species concepts used to define vertebrates are the biological species concept or the evolutionary species concept. A review of the Gunnison Sage-grouse's physical, behavioral, and genetic characteristics supports species designation under the biological species concept. When examined through the lens of the evolutionary species concept, it appears that the Gunnison Sage-grouse are reproductively isolated because traits important to reproduction are significantly different from other grouse, which arouse through sexual selection. Molecular divergence in alleles not related to secondary sexual characteristics is proceeding at a slower pace (Young et al. 2000).
The traits that distinguish the Gunnison Sage-grouse include the following: they are about 2/3 the size of the Greater Sage-grouse (Hupp and Braun 1991), have differences in their plumage, and produce different mating vocalizations. For example, note the whiter and more distinct tail feathers in the Gunnison male and the filoplume feathers being tossed over his head (see photos above), in comparison to the duller colors and simpler filoplumes of the Greater Sage-grouse male (above). They use these traits in a highly elaborate strutting display that begins with a male taking a few steps forward as the wings are raised and lowered and brushed twice against the stiff feathers of his white pouch, producing loud swishing noises. In addition to the mechanical noises produced by the wing movements, males utter a distinctive series of sounds by vocalizing and popping two air sacs within their pouches. The entire display for both types of grouse lasts approximately three seconds. Grouse in Gunnison differ in their display by performing fewer displays per minute; however, they pop their yellow air sacs nine times instead of two and create different sounds (Young et al. 1994). Young (1994) found that females in the Gunnison Basin and northern Colorado avoided playbacks of male courtship vocalizations of the other species. In addition, they have different visual aspects, such as throwing their filoplumes over their head and often wag their tail at the end of their display (Young, unpublished).
Gunnison Sage-grouse primary wing feathers. Juvenile.
Genetic evidence has shown that the Gunnison Sage-grouse are genetically distinct as well. At the species level, Gunnison Sage-grouse have low levels of genetic diversity in both the nuclear and mitochondrial genomes when compared to the Greater Sage-grouse (Kahn et al. 1999, Oyler-McCance et al. 1999, Oyler Mc-Cance et al. 2005). Dr. Oyler-McCance also identified that there is a significant amount of genetic structuring among Gunnison Sage-grouse populations, suggesting little gene flow occurs among existing populations.
Females have similar plumage in both species; however, Gunnison females are about 2/3 the size of the Greater Sage-grouse females. In contrast to the difference seen in the male displays, ecological traits of females are quite similar in both species. For example, nesting, brood-rearing, and non-brood site selection by Gunnison Sage-grouse hens are similar to those chosen by Greater Sage-grouse females throughout their geographical range. In addition, despite the smaller body size of Gunnison Sage-grouse, egg and clutch sizes are in the same range as those observed in other populations (Schroeder et al. 1999). Juvenile coloration matches adults, but can be distinguished by pointed, mottled and tattered outermost primary wing feathers (National Prairie Wildlife Research Center 2006).
Life History
Despite genetic, morphological, and behavioral differences, Gunnison Sage-grouse and Greater Sage-grouse are believed to have similar life histories and habitat requirements. Most research about sage-grouse life history has been performed on Greater Sage-grouse, but the work can largely be applied to both species (GUSG RCP 2005, USFWS Federal Register).
Sage-grouse are sage obligate species; they require healthy, functioning sage ecosystems for year round survival. Sage-grouse are also considered indicator species because, if the sage habitat is not healthy, grouse populations also suffer. Due to high levels of natural variation in sage community composition, grouse are adapted to a mosaic of habitats to support their annual cycle (Birds of North America). While most sage-grouse are non-migratory, some birds can move great distances to meet their dietary requirements and find their diverse seasonal habitats (GUSG RCP 2005). Adult Gunnison Sage-grouse eat leafy vegetation and will also eat insects in summer. Although sage leaves are their preferred food, grouse will also eat succulent forbs in summer. The winter diet is completely sage based, requiring that some plants in winter habitat reach above the snow. Chicks consume insects and some forbs during brood rearing, and their diet shifts to sage in fall (Birds of North America).
Annual survival rates vary: juvenile survival from hatch to fall is estimated to be 38%. Adult females have higher annual survival rates than males, possibly due to more cryptic plumage and secretive nature, compared to the males' elaborate plumage and display activities (GUSG RCP 2005). As birds age, the male to female sex ratio declines due to lower annual survival rates for males (Birds of North America). Male survival rates are lowest during breeding season and female survival rates are lowest during nesting. Predators include golden eagles, a variety of hawks and accipiters, coyotes, red foxes, and bobcats. Nest predators include corvids, weasels, coyotes and badgers. Nest success is considered the most significant parameter influencing population dynamics (Birds of North America).
The sage-grouse annual cycle begins in mid-March, when the breeding season kicks off. Males congregate on leks, or strutting grounds, which are relatively bare, flat areas in the sage ecosystem with good acoustic qualities and high visibility for females to asses the males' dance and vocalizations. These areas also allow for easy predator detection. Sites are usually located near good nesting habitat and good cover. Males begin to attend leks in early March; however, timing varies depending on snowmelt, weather, and photoperiod. Dominant males establish their position on the lek via wing fights and chases, usually trying to secure positions near the middle of the lek (Birds of North America). Birds are highly philopatric, returning to exactly the same spot for generations, even displaying on the ice over the newly created Blue Mesa Reservoir where their lek had previously been (National Park Conservation Association 2011, High Country News 2002). Males congregate to display for females from about an hour before dawn until about an hour after sunrise, with females showing up after males, and leaving while males are still displaying. Males typically do not move more than 1.5 miles from the lek during this time (GUSG RCP 2005).
A lek system is polygamous, meaning females select which male to mate with and the male mates with several females. Approximately 70% of the copulations are by dominant males and only 10-15% of males actually breed (Birds of North America, Gunnison Sage-grouse Local Plan). This has significant conservation concerns because it reduces the effective population size (the number of individuals contributing genes to the next generation) below the absolute population size (the estimated total population) for males. It also limits genetic variation within the population. The lekking season runs for six weeks from mid-March to late-May, with the highest lek attendance typically occurring in the second week of April. Females begin nesting as soon as they have bred, and the males provide no parental care.
Nesting typically begins late April to the beginning of May; although, in early snow melt years females have laid their first eggs as early as mid-April (Colorado Parks and Wildlife, unpublished data). Research has shown that 70-80% of nests occur within two miles of leks, however, female Greater Sage-grouse have been found nesting up to 20 miles from the lek they bred at (Birds of North America). Quality nesting habitat requires live sage with sufficient canopy cover to conceal the nest and a thick forb and grass understory. Often, high vegetative diversity provides the best horizontal and vertical cover, in turn providing greatest protection from visual predators and helping with thermoregulation (Birds of North America, GUSG RCP 2005).
Nests are shallow bowls lined with feathers and leaves at the base of live sagebrush. Clutch size averages 7 to 9 eggs, with yearling females having lower clutch sizes in some populations. Incubation starts once the last egg is laid and occurs for 27 to 28 days (GUSG RCP 2005).
Sage-grouse have some of the lowest nest success rates of all upland game birds, with success rates ranging from 10 to 63% for Greater Sage-grouse (Birds of North America). Young (1994) reported a 43.2% nest success rate for Gunnison Sage-grouse in the Gunnison Basin. Nest abandonment occurs in up to 22% of nests, and is most common when the female is disturbed by human activity (Birds of North America). Re-nesting is infrequent but does occur, with typically lower clutch sizes. Hatching begins in mid-May and usually ends by July, with peak hatch occurring between June 10 and June 20 (GUSG RCP 2005).
Brood Rearing
Chicks are precocial and leave the nest with the hen within days of hatching. Hens with chicks move to areas containing succulent forbs and insects, often in wet meadows or riparian habitats where cover is tall enough to conceal the brood and provide shade. High quality brood rearing habitat is often classified as having high forb species richness (GUSG RCP 2005). Chick and juvenile survival depend on the availability of food and cover. Insects (primarily beetles, ants and grasshoppers) are the main food source for chicks during the first three weeks of life. From 4 to 8 weeks old, the diet shifts to include plant material, including a variety of succulent forbs and some sage (GUSG RCP 2005). After three months, sagebrush becomes the main dietary component. Adults will also eat some insects during spring and summer; however, forbs and sage dominate their diet.
Unsuccessful females and males will join females with broods in these wet meadows, but are not as dependent on the habitat type. As autumn approaches, flocks and broods intermix as birds move from riparian areas to sagebrush dominated habitats that still provide some green forbs. Sometimes sage-grouse will move into agricultural fields at this time of year. Fringed sagebrush is a common transitional food as grouse shift from summer to winter diets (Birds of North America).
Flock size in winter varies form 15 to 100 birds with flocks often comprised of a single sex (GUSG RCP 2005). Many males overwinter within several miles from their lek. From the end of fall through early spring, sagebrush is almost the only component of sage-grouse diets. Almost any kind of sage is consumed, though some birds select various subspecies for higher protein levels and lower monoterpene (plant defense chemical) levels (GUSG RCP 2005). While birds may have low fat reserves after severe winters, individuals gain weight throughout most winters (Birds of North America, Hupp and Braun 1989, Beck and Braun 1978). During harsh winters with high snow accumulation levels, grouse depend on very tall sage that is exposed above the snow. In extreme winters, sage-grouse burrow into snow roosts for protection against the elements. Grouse may associate with ungulates that uncover sage to browse on during the winter (Birds of North America, Patterson 1952).
Gunnison Sage-grouse have been documented moving as far as 17 miles to their winter habitat, but movements depend on severity of the winter, topography, and cover (GUSG RCP 2005). Winter habitat requires tall sage, such as that found on ridges, drainages, or southwest aspects.
Historic and Current Range
Gunnison Sage Grouse current occupied range and historic range. Map provided by the US Fish and Wildlife Service.
Historically, there has been a 90% or more loss in Gunnison Sage-grouse habitat leading to the current distribution today (Schroeder et al. 2004, GUSG RCP 2005). The Gunnison Sage-grouse Range wide Steering Committee estimates the historic range was 21,276 mi2 and the current range is estimated to 1,822 mi2, which is 8.5% of the historic range (GUSG RCP 2005). Today, only seven or eight populations of Gunnison Sage-grouse remain, depending on how populations are divided (GUSG RCP 2005). The estimated population sizes within each of the extant populations is a matter of significant concern. Only one population, the Gunnison Basin population, is estimated to have more than 500 individuals during the breeding season and that population contains approximately 75% of all remaining individuals in the species. The remaining seven populations are isolated and small, with high male counts during the 2012 breeding season ranging from 3 to 35 individuals. Several populations have disappeared since 1980 (Braun 1995, Young et al. 2000). Counts in 2005 were higher through much of the range as precipitation conditions returned to more normal levels after the 2002-2003 drought; recent drought conditions in 2012 are also a significant conservation concern.
The historic abundance prior to 1950 is unknown, but, based on historical documents and interviews, was likely orders of magnitude larger than present. Even during the past decades, lek areas in the Gunnison Basin have seen over 500 displaying males present. Currently, most leks in the Gunnison Basin have fewer than 50 males displaying and many have fewer than 20 males. Approximately 40% of the leks in the Gunnison Basin are classified as inactive and no longer have birds displaying on them. In other areas in the range, males have not attended leks for several years nor have new leks been discovered in adjacent areas.
Population Trends and Estimates
2001 - 2012 Lek Counts
Recent high male counts of males attending breeding grounds are provided courtesy of Colorado Parks and Wildlife (CPW), formerly the Colorado Division of Wildlife. Current counts do not reflect the loss of birds from the 90% habitat loss calculated in the Gunnison Sage-grouse Range wide Conservation Plan, nor the inactive or extirpated leks in any population area. As the Gunnison Sage-grouse Range wide Conservation Plan points out, lek data is most useful to determine long-term trends rather than population estimates. Comparing particular counts or lek areas can be useful to understand potential and percent decline in local areas. For example, in 1953, one lek area in the Gunnison Basin had over 500 birds attending it on a single day. A recent high count of that Ohio Creek area indicated an over 40% decline according to the Range wide Conservation Plan. In other areas of the range, Gunnison Sage-grouse have experienced greater than 90% declines on lek areas. High counts for 2005 and 2006 in the Gunnison Basin may be due in part to habitat recovery following a severe drought. Interestingly, smaller populations have not realized the same level of drought relief. Recent counts have highlighted concerns that population numbers in seven of the eight populations are becoming less sustainable and more vulnerable given low counts of males at leks. As mentioned above, there are also significant genetic diversity concerns associated with these small populations.
The counts displayed in the table above represents the high male counts (HMC) of males attending leks in the spring. Red numbers indicate the lowest recorded HMC for that population, and green numbers indicate the highest recorded HMC for that population. Note that, for the satellite populations, most of the lowest recorded counts occurred from 2009 to 2012 and most of the highest counts were recorded from 2001 to 2006. Lek count procedures were standardized in 1997, so prior count data was not included. There are two methods that have been used to estimate population sizes based on high male counts. The first estimate, found in most local conservation plans and used for the majority of Greater Sage-grouse populations, results in an overall spring population estimate for 2012 of 3,768; the second method, found in the Gunnison Sage-grouse Range wide Conservation Plan, results in an estimate of 4,621.
The International Union for the Conservation of Species recognizes the Gunnison Sage-grouse as a red-listed, or globally endangered, species (Storch 2000). In 2006, the Audubon Society listed the Gunnison Sage-grouse as one of the 10 most endangered birds in North America. Also in 2006, the U.S. Fish and Wildlife Service (USFWS) removed the species from any protection under the Endangered Species Act (ESA) with a listing determination. Central to the listing determination is the conclusion that the population has experienced no significant decline during the past decades, a finding that is in direct contrast to the Gunnison Sage-grouse Range wide Conservation Plan published in 2005. The USFWS reconsidered the listing status of the species in 2010 and once again recognized them as a Candidate Species, meaning protection is warranted but precluded by higher priority listed species.
Endangered Species Proposed Rule
In January 2013, the USFWS proposed listing the species as an Endangered Species. In addition, they proposed 1.7 million acres of critical habitat for the species. Following a sixty day comment period (ending March 12) and an economic analysis comment period, the USFWS will re-evaluate their decision and either maintain status as Endangered or down-list the species to Threatened. A final listing decision is expected in September 2013. For more information, and links to the Federal Register (listing decision and critical habitat designation documents) visit the USFWS Gunnison Sage-grouse website.
Indicator Species
Wildlife agencies in the United States now recognize that Gunnison Sage-grouse are indicator species for shrub-steppe habitat. An indicator species is one which, because of its unique life history and strong reliance to certain ecosystem areas, provides biologists with an indication of ecosystem health. These grouse are an ideal indicator species for uplands dominated by sagebrush (Young 1994). For example, they require a variety of habitats such as large expanses of sage with a diversity of grasses and forbs and healthy riparian ecosystems. Their habitat requirements differ during most of the year and differ for sex and age classes. Therefore, the presence of each habitat type in healthy condition in close proximity to winter, lek, nest and brood-rearing habitat is essential. A large percent of each seasonal habitat must be in the later seral stages of ecological succession to meet the requirements of the grouse. If the sagebrush ecosystem is healthy (for example: the soil is stable with little accelerated soil erosion; ecological functioning is maintained with several trophic levels of nutrient cycling; and plant and animal communities are diverse and productive), then grouse populations and productivity will indicate the success of land use management. Surveying trends in land productivity and populations of grouse can be a useful management tool for assessing the sagebrush steppe-ecosystem health.
Habitat Loss and Fragmentation
The key to maintenance of any species is providing sufficient habitat. Some causes of habitat loss and fragmentation for Gunnison Sage-grouse in the Gunnison Basin include: recreation, increased road density, the formation of Blue Mesa reservoir, housing and exurban developments, Uranium Mill Tailings Remedial Action, power lines and reduction of riparian areas. USFWS considers development and associated habitat fragmentation from roads, power lines and fencing to be the greatest threat Gunnison Sage-grouse face. A second problem is the quality of existing habitat present. Some impacts which cause a decline in habitat quality are: excessive livestock grazing, drought, land treatments, increased elk and deer populations reducing shrub vigor and distribution, and herbicides. Increasingly, oil and gas exploration in the southwestern portion of the species range is threatening habitat for breeding, nesting, and brood-rearing.
An example of the importance of good habitat can be seen in the photos above. Female Gunnison Sage-grouse are more likely to have a successful nest when vegetative cover is present. Loss of forbs and grasses can lead to increased risk of predation and decreased chances of success for young broods as they emerge from their nests.
Habitat Restoration
Case study with the Gunnison Climate Working Group: Climate Adaption Demonstration Project
[Restoration Project]
The Nature Conservancy is working with the Gunnison Climate Working Group to reduce the impacts of climate change on nature and people in the Gunnison Basin. The multiagency collaborative group recently completed the first year of a climate adaptation project to build resilience of riparian and wetland habitats across the Basin. Last fall, Bill Zeedyk, Colorado Parks and Wildlife, Bureau of Land Management, Western State Colorado University, along with landowners, partners and volunteers, built over 100 rock structures, called one rock dams, along streams at two sites on private land. This collaborative project will help improve and restore Gunnison Sage-grouse brood rearing habitat at a previously incised drainage. To view a video about the project created by Claudia Strijek, visit Strijek Design (note: you need QuickTime to view the video) or see the video on YouTube.
Trap and Transplant Program
Colorado Parks and Wildlife began a trap and transplant program in 2009 (then as the Colorado Division of Wildlife) to augment the satellite populations. Because the satellite populations have been declining for several years and are of significant conservation concern, the program began as a way to add birds to the struggling populations. It is also a way of increasing genetic diversity between the populations and prevent inbreeding. A sustainable number of birds are moved from the Gunnison Basin population to satellite populations every spring and fall. Augmented satellite populations include Crawford, Dry Creek, Dove Creek and Pinyon Mesa.
The trap and transplant program: (top right) a Gunnison Sage-grouse male being fitted with a transmitter during trapping, (middle right) the transport box at Crawford, (bottom right) male sage-grouse being released, (left) male flying towards the West Elks by Crawford.
Conservation Plans
The local Gunnison Basin Sage-grouse Conservation Plan, published in 1997, can be obtained from the Gunnison Resource Area office of the Bureau of Land Management. Within the plan, specific conservation goals and objectives are proposed to restore habitat and population numbers of the Gunnison Sage-grouse to the Gunnison Basin. In addition, over 50 conservation actions are proposed. Organizations involved with creating the plan include the Black Canyon Audubon Society, Bureau of Land Management, Colorado Parks and Wildlife (formerly the Colorado Division of Wildlife), Gunnison County Stock growers Association, Gunnison County, High Country Citizens Alliance, National Park Service, Natural Resource Conservation Service, USDA Forest Service, U.S. Fish and Wildlife, and Western State Colorado University (formerly Western State Colorado University).
Gunnison Sage-grouse chick walking away from a successful nest.
The Gunnison Sage-grouse Range wide Conservation Plan, published in 2005, can be obtained from the Colorado Parks and Wildlife website through downloading a series of PDF's. Biologists from the following agencies contributed to the plan: Bureau of Land Management, Colorado Parks and Wildlife, National Park Service, Natural Resource Conservation Service, USDA Forest Service, U.S. Fish and Wildlife and the Utah Division of Wildlife Resources.
Each local working group (except Cerro-Cimarron-Sims) has created their own local conservation plan:
Crawford 1998; Crawford 2011
Dove Creek 1998
Gunnison Basin 1997
Pinyon Mesa 2000
Poncha Pass 2000
San Juan County, Utah 2003
San Miguel Basin 1998
Viewing the Grouse
Waunita Lek Watchable Wildlife Site
The only public viewing site for Gunnison Sage-grouse is the Waunita Watchable Wildlife Site located approximately 19 miles east of Gunnison, Colorado. Please contact Sisk-a-dee at (970) 641-3959 for current information about viewing the Gunnison Grouse. Sisk-a-dee maintains an excellent viewing website with the most recent viewing information, maps, and viewing protocols. The Waunita Watchable Wildlife Site is monitored daily by volunteers from Sisk-a-dee, Western State Colorado University and Colorado Parks and Wildlife. Volunteers count birds, monitor disturbances, and educate visitors about responsible wildlife viewing.
When viewing Gunnison Sage-grouse, please keep in mind that they are highly sensitive to human disturbance. Loud, unusual sounds such as car doors slamming, radios, human voices, dogs, and people walking through brush can cause the birds to fly off. Continual disturbances can ultimately result in these birds permanently abandoning their traditional lek sites. Despite protocol implementation, birds trend toward flushing earlier and earlier since the lek site was established. While the Gunnison Basin population as a whole tends to be relatively stable, the Waunita lek is on a significant downward trend (Hicks and Magee 2012, unpublished report). It is difficult to reconcile optimal viewing opportunities with changing bird behavior and lower relative abundance; therefore, it is extremely important that visitors follow lek viewing protocol to minimize impacts.
To reduce your impact, arrive at the lek viewing area well before sunrise (at least one hour prior) and view the birds from inside your vehicle using a spotting scope or binoculars. It is essential that you remain inside your vehicle and remain as quiet as possible. Also, please refrain from starting up your vehicle and leaving the area until after the birds have completed their morning display. Your efforts will help reduce any unnecessary stress on the birds and will provide for a better viewing experience for yourself and others.
View at the Waunita Watchable Wildlife Site. Photo (c) Marcella Fremgen.
During the 2012 viewing season, the high lek counts were early in the season, likely due to an early snow melt and above-average temperatures. The high male count was 22; the high female count was 12. The total grouse count was highest on April 1st with a total of 25 grouse, which was down from 51 in 2011. The grouse counts were the lowest the site has seen since 2004. In addition, birds flushed before sunrise 95% of the days monitored.
The Watchable Wildlife Site had the lowest visitor total ever recorded with 327 visitors, from local enthusiasts and volunteers to commercial viewers from as far as Canada, the Netherlands, and Japan. The viewing trailer was occupied 15 out of 40 days during the viewing season.
Volunteers also monitor disturbances to the lek. Disturbances can include protocol violations, cars on the Waunita Road, and predators. In 2012, disturbances resulting in single or multiple birds flushing from the lek included weather (1 day), coyotes (3 days), golden eagles (3 days), human related disturbances (3 days) and other reasons (2 days).
Protocol violations are highest among private vehicle (31% of private vehicles violated protocol in 2012) and lowest in commercial bird-viewing groups (4%) and volunteers (2%). Protocol violations include arriving late, being noisy, idling the car, and leaving before all birds are done displaying. In 2012, the majority of violations were visitors arriving late.
Volunteer effort is very important to the Waunita Site. In 2012, volunteers put in a combined 324 hours to lead commercial viewing groups, monitor the birds and monitor visitors. If you are interested in volunteering, please contact Dr. Patrick Magee (firstname.lastname@example.com).
Photographing Gunnison Sage-grouse
Photographing Gunnison Sage-grouse has become a popular request among wildlife and/or avian photographers. Photography, audio recording and video recording access is limited to two photographers per lek season. For more information about photographing the Gunnison Sage-grouse, contact Jim Cochran at email@example.com or (970) 641-7604. Applications must be submitted by February 1 each year.
For information about traveling to Gunnison and finding accommodations, please visit the Gunnison-Crested Butte Tourism Association website or call (800) 814-7988.
Links, News Articles, and Information about the Gunnison Sage-grouse
Gunnison Sage-grouse Strategic Committee works at prioritizing and implementing conservation actions for grouse in the Gunnison Basin
Gunnison County Conservation Program hosts the Strategic Committee and incorporates grouse management into their county planning
Sisk-a-dee is the only organization completely dedicated to the conservation of the Gunnison Sage-grouse
High Country Citizen's Alliance also maintains a Gunnison Sage-grouse page with current conservation information
The Gunnison Sage-grouse Range wide Conservation Plan was created by an interagency team in 2005 and has important biological information and conservation assessments and goals
Sagebrush Sea has a wealth of information and news releases from the environmental communities' perspective
Gunnison Trails maintains a Gunnison Sage-grouse website and helps educate and inform recreationists
The US Fish and Wildlife Service has a Gunnison Sage-grouse webpage that has current information about its US conservation status, as well as links to the Federal Register
Colorado Parks and Wildlife maintains a Species of Special Concern website about the grouse
GIS Database for Sage Grouse and Shrubsteppe Management in the Intermountain West
High Country News - "A Scarce Bird Tests the New Rule" article from the High Country News in 2000
"The Grouse Effect" article from the National Park Conservation Association, 2011
"Newly Discovered, Nearly Extinct" article from the New York Times, 2013
Gunnison Sage-grouse Specific Literature
Aldridge, C. L., JD. J. Saher, Joanne, T. M. Childers, K. E. Stahlnecker, and Z. H. Bowen. 2012 Crucial Nesting Habitat for Gunnison Sage-grouse: A Spatially Explicit Hierarchical Approach. The Journal of Wildlife Management. 76(2) 391-406.
American Ornithological Union. 2000. Forty-Second supplement to the American Ornithologists Union Check-list for North American Birds. The Auk 117(3):847–858.
American Ornithological Union. 2002. Forty-Second supplement to the American Ornithologists Union Check-list for North American Birds. The Auk 119(3):897–906.
Commons, M.L. 1997. Movement and habitat use by Gunnison Sage Grouse (Centrocercus minimus) in southwestern Colorado. M. S. thesis. Univ. Manitoba, Winnipeg.
Gill, F. and M. Wright. 2006. Birds of the World: Recommended English Names. Princeton University Press.
Hupp, J. W. and C. E. Braun. 1991. Geographical variation among sage grouse populations in Colorado. Wilson Bull. 103: 255-261.
Kahn, N. W., C. E. Braun, J. R. Young, S. Wood, D. R. Mata, and T. W. Quinn. 1999. Molecular analysis of genetic variation among large- and small-bodied Sage Grouse using mitochondrial control-region sequences. The Auk 116(3):819-824.
Oyler-McCance, S.J., N.W. Kahn, K.P.Burnham, C.E.Braun, and T.W. Quinn. 1999. A population genetic comparison of large and small-bodied sage grouse in Colorado using microsatellite and mitochondrial DNA markers. Molecular Ecology 8: 1457-1465.
Oyler-McCance, S.J., K.P. Burnham, and C.E. Braun. 2001. Influence of changes in sagebrush on Gunnison sage grouse in Southwestern Colorado. Southwestern Naturalist 46(3): 323-331.
Oyler-McCance, S.J., J. St. John, S.E. Taylor , A.D. Apa, and T.W. Quinn. 2005. Population genetics of Gunnison sage-grouse: implications for management. Journal of Wildlife Management 69(2): 630-637.
Young, J.R. 1994. The influence of sexual selection on phenotypic and genetic divergence of Sage Grouse. Ph.D. dissertation. Purdue University, IN, USA
Young, J. R., Hupp, J. W., Bradbury, J. W., & Braun C. E. 1994. Phenotypic divergence of secondary sexual traits among sage grouse Centrocercus urophasianus populations. Anim. Behav. 47:1353-1362.
Young, J. R., Braun, C. E., Oyler-McCance, S. J., Hupp, J. W. and T. W. Quinn. 2000. A new species of Sage-Grouse from Southwestern Colorado . Wilson Bulletin 112(4):445-453.
Grouse Conservation Literature and Relevant Greater Sage-grouse Literature
Braun C.E. 1998. Sage Grouse Declines in Western North America. What are the Problems? Proc Western Assoc. State Fish and Wildl. Agencies 78:139-156.
Connelly, J.W., M. A. Schroeder, A. R. Sands, and C. E. Braun. 2000. Guidelines to manage sage grouse populations and their habitats. Wildlife Society Bulletin 28 (4): 967-985.
Hupp, J. W. and C. E. Braun. 1989. Topographic distribution of sage grouse foraging in winter. J. Wildl. Manage. 53: 823-829.
Hupp, J. W. and C. E. Braun. 1989. Endogenous reserves of adult male sage grouse during courtship. Condor: 91(2): 266-271
Schroeder, M. A., Young, J. R. and C. E. Braun 1999. Sage Grouse (Centrocercus urophasianus): In:The Birds of North America 425:1-28. (A. Poole, P. Stettenheim and F. Gill, Eds.) The Birds of North America, Inc. Philadelphia , PA.
Schroeder, M.A., C.L. Aldridge, A.D. Apa, J.R. Bohne, C.E. Braun, S.D. Bunnell, J.W. Connelly, P.A. Deibert, S.C. Gardner, M.A. Hilliard, G.D. Kobriger, S.M. McAdam, C.W. McCarthy, J.J. McCarthy, D.L. Mitchell, E.V. Rickerson, and S.J. Stiver. 2004. Distribution of sage-grouse in North America. Condor 106: 363-376.
Schroeder, M. A., J. W. Connelly, C. L. Wambolt, C. E. Braun, C. A. Hagen, and M.R. Frisina. Society for Range Management. 2006. Ecology and Management of Sage-Grouse and Sage-Grouse Habitat - A Reply. pp 3-6.
Storch, Illse (2000). Grouse Status Survey and Conservation Action Plan 2000-2004. WPA/BirdlifeSSC Grouse Specialist Group. IUCN, Gland. Switzerland and Cambridge. 112 pp.
Habitat and Sagebrush Management Literature
Baker, W. L. 2006. Fire and Restoration of Sagebrush Ecosystems. Wildlife Society Bulletin. 34:(1) 177-185.
Entwistle, P.G., A.M. DeBolt, J.H. Kaltenecker, and K. Steenhof, compilers. 2000. Proceedings: Sagebrush Steppe Ecosystems Symposium. Bureau of Land Management Publication No. BLM/ID/PT-001001+1150, Boise , Idaho , USA.
Lysne, Cindy R. 2005. Restoring Wyoming Big Sagebrush. In: Shaw, Nancy L.; Pellant, Mike; Monsen, Stephen B., comps. 2005. Sage-grouse habitat restoration symposium proceedings; 2001 June 4–7, Boise , ID. Proc. RMRS-P-38. Fort Collins , CO : U.S. Department of Agriculture, Forest Service, Rocky Mountain Research Station. p. 93-98.
Management Considerations for Sagebrush (Artemisia) in the Western United States, Bureau of Land Management 2002. A selected literature summary of sagebrush management research.
Monsen, Stephen B.; Shaw, Nancy L. 2000. Big sagebrush (Artemisia tridentata) communities: ecology, importance and restoration potential. Billings Land Reclamation Symposium, 2000 : striving for restoration, fostering technology and policy for reestablishing ecological function : March 20-24, 2000, Sheraton Billings Hotel, Billings , Montana . Bozeman : Montana State University , 2000. Publication no. 00-01.
Paige, C., and S. A. Ritter. 1999. Birds in a sagebrush sea: managing sagebrush habitats for bird communities. Partners in Flight Western Working Group, Boise, ID.
Sedgewick, James. 2004. A literature review - Habitat restoration for Gunnison Sage-Grouse.
Shaw, Nancy L.; Pellant, Mike; Monsen, Stephen B. 2005. Sage-grouse habitat restoration symposium proceedings. Proc. RMRS-P-38. Fort Collins , CO : U.S. Department of Agriculture, Forest Service, Rocky Mountain Research Station. 130 p.
Other Relevant Literature
Photos and images provided by Mike Danzenbaker, Noppadol Paothong, Helen Richardson/Denver Post, Dave Showalter, Gerrit Vyn, the San Miguel Basin Gunnison Sage-grouse Working Group, Mike Mortensen, Clay Greathouse, Marcella Fremgen, Aleshia Fremgen, Brooke Vasquez, and Dr. Patrick Magee.


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State voter ID law is far from resolved [PA]
HARRISBURG -- For anyone who breathed a sigh of relief at the October voter ID ruling -- opponents relieved that voters need not show identification in the presidential election, supporters who noted the injunction included only November -- a conference Thursday made clear the legal battle is far from over.
At a meeting with lawyers for the state and the challengers, Judge Robert Simpson, who ruled that Pennsylvania could not require voters in the November 2012 elections to show a specified form of photo identification, said he is likely to schedule a trial next summer to resolve the permanent status of the law.
Rounds of courtroom arguments and decisions earlier this year yielded only the ruling that a phase-in period built into the law -- when voters would be asked, but not required, to show photo ID -- would be extended from the April primary elections through the November general elections. There were rulings by Judge Simpson at the Commonwealth Court and by the Pennsylvania Supreme Court, but the law's constitutionality remained undecided.


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This page serves as a resource and a central hub for programming and support for graduate students at the University of Washington Bothell. We encourage you to reach out to your Graduate Advisor (see below) to share suggestions for graduate student support, resources, academic and social events, or anything that you wish to contribute to enriching graduate culture on campus.
Check the UW Bothell Calendar for academic and social events for graduate students. Please send any graduate-specific events or activities to your Graduate Advisor for posting.
ASUWB Student Government selected Cultural Studies studnet Concetta Leggio as the November 2014 Student of the Month Award recipient. Concetta is the Events Director of the new Student Philanthropy Education Program, a student group with the mission of educating students about the importance of private support and philanthropy on higher education. Concetta was instrumental in rallying the student volunteers for the W Day celebration on campus, and also deeply involved with the logistics and planning of the Veterans Appreciation Open House, serving on the tri-campus Veteran's Appreciation Committee that planned events on all three campuses to honor veterans. She worked on all of the behind-the-scenes details, and as a veteran herself, she helped the Director of Alumni Engagement & Philanthropy to put together a program that would resonate with the veterans on our campus. Congratulations Concetta!
The 2015 Bonderman Travel Fellowship application is now available - application deadline is January 12, 2015 by 12 noon PST. Bonderman Fellows will undertake international travel on their own for eight months, to six or more countries in two or more major regions of the world. Through solo travel the Fellows will focus on exploration and discovery, learning about the world and themselves in it. Up to seven graduate Fellowships will be awarded in Spring 2015. Each Fellowship carries a $20,000 award to be used only for extended solo international travel. Fellows may not conduct research, pursue an academic project, or participate in a formal program or organization. For more information please contact the Office of Merit Scholarships, Fellowships, and Awards.
UW Bothell students have the opportunity to apply for travel funds from the Student Academic Enhancement Fund (SAEF), established by the Services and Activities Fee Committee and administered by ASUWB. Awards of up to $1,500 are available to help fund students' educational travel. A complete application, including a letter of recommendation, must be submitted at least 30 days prior to the first day of the event. Applications will be reviewed on a rolling basis. You may be contacted for clarification and may be asked to present your proposal to ASUWB.
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Charlestown Beach-Pond Large 4 B.R. Modern,Newer,Clean,Maintained
Contemporary. Walk To Beach Eat In Kitchen, L.R. 2 Full Baths, Family RoomWith
Bar,Ceramic Tiled Kitchen And Baths, Wall To Wall Carpeting, 3 Decks,
Outside Shower, Plenty of Parking, Back Yard, Walk To Public Ocean
Beach With LifeGuards,,(approx 15 minutes,2-3 minutes by car) Part Time PropertyManager On Premise.Breathtaking Sunsets, Convenient Location to Newport, Point Judith,Block Island Ferry and
to Numerous Public Beaches, Tourist Attractions,Foxwoods/Mohegan Sun Casinos,Highways,Restraunts,SuperMarkets, All Shopping, Churches, Hospitals,
Airports,Pharmacy, Golf Courses,Marinas,Post Office, No Pets, Must be 21 years of age to rent and occupy,CANNOT rent for others except by written landlord authorization
All Attractions Brochures/Things To Do/See Furnished. Weekly
Activities Guide Delivered Saturday Mornings. Numerous Beaches,Mystic
Aquarium/Seaport/Village, Misquamicut Water Slide/Amusement Park With
Weekly Fireworks On Beach,Fishing, Newport Mansions, Roger Williams
Zoo,Theatre By The Sea (Summer Stock With Childrens Matinees)Marinas
With Boat Rentals, Point Judith Fishing Village With Half And Full
Day Captained Trips, Block Island And Marthas Vineyard Ferrys
BurlingGame State Park with Picnic Grounds And Fresh Water Lake
Swimming, Foxwoods And Mohegan Sun Casinos, Foxwoods Indian Museum,
Cinemas, Numerous Restraunts, Fish/Fruit/Produce Markets, Home Made
Bakeries, Ice Cream Shops, Vineyard Tours,Coast Guard Academy, Nuclear Submarine Base, Antiques, Flea Markets, Horseback Riding, BirdWatching,
Photography, Ninigret State Park, Shell Fishing, Breachway Salt Water
Cast Fishing, Bait/Fishing Shops, Golf Courses,Coffee Shops, Scenic
Drives, Farmer Markets,University Tours.
|Rate Period
|Weekend Night
My Standard Rate
Feb 1 2014 - Feb 1 2015
1 night minimum stay
Payment is usually accepted in the quoted currency (US Dollar) unless the currency and the amount is specifically agreed in advance with the owner / advertiser.


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A biodynamic Cotes du Rhone- Dom. Les Aphillanthes '06
Now that I work in a natural wine bar, you'd think I'd be posting all the time about natural wines. You'd think. But no. What have I been doing, you're might be wondering? Spending all my time, now that I work nights, out on the golf course, what else? You can find me there most afternoons now. It probably...read more


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Please log in or register to manage your account
Model: ELW535XBSL Item: SHRELW535XBSL
Performs 335 advanced scientific functions. WriteView technology displays formulas as written in textbooks. DAL (Direct Algebraic Logic) makes it easy to enter formulas into the calculator. Three modes: Normal, Drill and Stat. Multi-line playback and editing function. Nine independent memories and four programmable keys. Power Source(s): Battery; Display Notation: Numeric; Number of Display Digits: 16; Display Characters x Display Lines: 16 x 4.
Sharp® Compatible FO-47DR Drum (Sharp FO47DR)
$73.53$5000 / each
Sharp® Compatible FO-47ND Toner Cartridge (Sharp FO-47ND)
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text: See this, this right here…an Oscar winning actress not afraid to bare her goods…take notice Ms. Alba. Here are great shots of Marion Cotillard topless on the set of Rust and Bone! Those things are big!It is safe to say she mades the right choice geting in this movie… for her and her big nipples.I don't know who Marion Cotillard is because I'm ignorant, but I can tell I like her body of work at least this addition to her body of work. Jesus, I need a video stat!


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Welcome to the website of Shore Animal Control. We are here to serve communities in South Jersey. For more information, please call 1 800-351-1822.
SEAVILLE - Shore Animal Control Services, which recently signed an
agreement with the Township of Lower to provide full time animal control
services for the municipality, has hired former ACO Don Montgomery on a
part time basis. Montgomery has been an integral component of this
important transition stage for the animal control company and this joint
venture will be a positive step for the community.
Shore Animal Control owner and operator Dr. Nick Holland has
known Montgomery for many years through his veterinary practice in
SEAVILLE - Shore Animal Control Services, the company which
provides animal control services for the Township of Dennis would like
to inform residents about the importance of licensing for dogs and cats.
The township recently held its annual rabies clinic and began the
process of licensing and registering dogs in the township. A late fee of
five dollars ($5.) will be charge for each dog license not secured by
Feb. 1, 2014, so the residents are encouraged to visit the township hall
to license before the increase of fees.
Lower Township to Change Animal Control for 2014VILLAS - Lower Township Council approved a $50,000 annual contract
with Shore Animal Control Services Jan. 6 that will produce a cost
savings and better efficiency for taxpayers.
Lower Township Manager Mike Voll said the township and
police department conducted an analysis of the costs of outsourcing
animal control.
"We're not cutting jobs, the three people that do part-time
animal control are not losing their jobs," said Voll. "They have
full-time jobs with the public works department."
Animal Control Receives Reports of Animals Left OutsidePets and Animals | Mon, 01/06/2014 - 1:47 am | Updated 10 hours 2 min ago | Read 400 | Commented 1 | Emailed 0By Press Release SEAVILLE - Shore Animal Control Services would like to thank the public for responding to their request for help in reporting animals left outside during the extreme cold temperatures.
NJ Residents Can Sign Up Now to Spay or Neuter Pets for Only $10County Government | Sat, 11/23/2013 - 1:37 am | Updated 3 days 15 hours ago | Read 1352 | Commented 1 | Emailed 2
By Press Release
Burak Souzer of Cape May Court House pictured with his rescue
dog Lucky, took advantage of the state program last month.
After raccoon attack, officials advise residents to get pets vaccinated
Written by Columb Higgins
Wednesday, 04 April 2012 09:00
Seaville, New Jersey: Upper Township held their 2012 Free Rabies
Vaccination Clinic last Saturday at Shore Veterinarians in Seaville. Mayor
Palombo and new Committeeman Ed Barr were there to greet residents and introduce Barr to his new duties overseeing
animal control issues for the township. Mayor Palmobo and Barr were pleased with the turnout which
included over 95 dogs and 12 cats for the February clinic. An even larger turn


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Dear All,
I am happy to announce that Microwave Films of the Marshall Islands is nearing the release of our 4th Marshallese language feature film, Ainikien Jidjid ilo Boñ (The Sound of Crickets at Night), which is a story about a family of nuclear exiles from Bikini Atoll living on Ejit Island. We are hoping to screen the film here in Majuro during the month of September. The exact dates will be announced later.
I have included a lot of people on this email who have either indirectly or directly helped with our film and/or our learning process along the way, so we thank you!
Enjoy the trailer. The music is an original composition by Nelu Debrum sung by Nelu Debrum, Lulani Ritok, Joseph Katjang and Jorkeim "JB" Bunglik.
Ainikien Jidjid ilo Boñ (The Sound of Crickets at Night) trailer:
Jack Niedenthal & Suzanne Chutaro
Microwave Films of the Marshall Islands
PO Box 3131
Majuro, MH 96960
Phone: (from U.S.) 011-692-625-3177
Fax: (from U.S.) 011-692-625-3330
Cell: (from U.S.) 011-692-455-3177
E-mail: firstname.lastname@example.com


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Join 50,000 ASA members who stay informed and connected.
UPDATE YOUR PROFILE? Login to MyASA and update your professional profile! Login Now »
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The Electronic Health Record (EHR) Incentive Program is overseen by the Centers for Medicare & Medicaid Services (CMS) for physicians participating in the Medicare component and individual state Medicaid agencies for physicians participating in the Medicaid program. Similar to other quality reporting programs, the EHR Incentive Program uses payment incentives and payment adjustments to encourage the adoption, implementation and use of certified EHR technology. The American Recovery and Reinvestment Act created the EHR Incentive Program.
Under the program there are two categories of professionals: "Hospital-based eligible professionals" and "Eligible Professionals" (EPs). Hospital-based eligible professionals are not eligible to receive the incentive payments and are exempt from future penalties. To be deemed a hospital-based eligible professional, one needs to provide 90 percent or more of their covered services in a hospital inpatient or emergency room setting. CMS determines this by looking at the place of service codes (POS codes) on the codes a physician submits for payment under Medicare (POS code 21 for Inpatient Hospital and POS code 23 for Emergency Room - Hospital). The majority of anesthesiologists do not provide 90% or more of their covered services in the hospital inpatient or ER setting unless one exclusively does cardiac, transplant or critical care work. The majority of the codes submitted by anesthesiologists are for Outpatient Hospital (POS code 22) or Ambulatory Surgical Center (POS code 24).
A majority of anesthesiologists are deemed EPs and thus eligible to receive the incentive payments for demonstrating "meaningful use" of EHRs. Because anesthesiologists were not initially intended to be deemed EPs when the law was debated, many of the meaningful use requirements do not reflect the typical practice of anesthesiology, making it difficult for anesthesiologists to achieve meaningful use. Only a fraction of anesthesiologists have been able to meet Meaningful Use Stage 1 program requirements.
As a result of ASA's advocacy efforts, CMS created a hardship exemption for anesthesiologists, which exempts anesthesiologists from payment penalties that will begin in 2015. The exemption recognizes the state of commercially available EHR technology for anesthesiologists, workflow challenges and the nature of the patient-anesthesiologist relationship. The exemption was granted as part of the Meaningful Use Stage 2 Final Rule in 2012.
The hardship exemption is automatically determined and annually based on a physician's specialty designation under the Provider, Enrollment, Chain and Ownership System (PECOS). Physicians with the Anesthesiology specialty designation of "05" do not need to complete the hardship exemption form. CMS reserves the right to revisit this exemption at any point. ASA has and will continue to advocate that this important exemption be maintained.
Anesthesiologists may attempt to become meaningful users and receive incentives, as the hardship exemption only applies to the penalties. CMS and the Office of the National Coordinator for Health Information Technology (ONC) have provided several resources for physicians seeking to participate in the EHR Incentive Program. To learn more about the program, physicians are encouraged to use the CMS eligibility tool and review the CMS-produced "Beginner's Guide". EPs must participate in meaningful use by 2014 to earn incentives under the Medicare program. The Medicaid EHR Incentive Program extends incentives to 2016.
ONC is the "principal federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information." ONC supports "the adoption of health information technology" and promotes "nationwide health information exchange to improve health care." The agency was established in 2004 and mandated through the Health Information Technology for Economic and Clinical Health Act (HITECH) in 2009. Similar to CMS, ONC is an agency under the Department of Health and Human Services and their participation in and support of various policy committees informs upon the direction and planning of meaningful use requirements within the EHR Incentive Program.
ONC provides physicians and practices with a variety of information on how to take the first steps toward implementing EHRs in your practice, achieving meaningful use and supporting the implementation of EHRs. ONC also supports educational efforts on HIT implementation and use of EHRs. In particular, ONC is hosting several meetings and webinars as part of Health IT Week (September 15 - 19, 2014).
ASA continues to advocate that the criteria to meet meaningful use be applicable to anesthesiologists. In 2013, ASA stressed the importance of maintaining the hardship exemption in comments submitted to the ONC Health IT Policy Committee regarding their recommendations for Meaningful Use Stage 3. ASA supported the Health IT Policy Committee's recommendation to exclude specialists from the prevention reminder objective and to exclude eligible professionals who do not administer immunizations from the immunization objective. ASA also recommended excluding anesthesiologists from other requirements, including the clinical summary requirement, syndromic surveillance, e-communication with patients and computerized order entry for transfers of care objectives. ASA expressed support for allowing reporting to a registry as a menu objective. ASA also recommended additional flexibility for physicians who achieve a close percentage of the objectives.
ASA has also worked with Representative Diane Black (TN-06) on legislation that, if enacted into law, would ease anesthesiologists' participation in the EHR Incentive Program by exempting anesthesiologists from some of the criteria required to demonstrate meaningful use. Such criteria include exempting anesthesiologists from providing clinical summaries to patients, exempting anesthesiologists from being required to provide patients with an electronic copy of their health information and exempting anesthesiologists and other eligible professionals from implementing drug-to-drug and drug-to-allergy interaction checks.
July 21, 2014: ASA submitted comments regarding CMS proposed modifications to the Medicare and Medicaid EHR Incentive Programs for 2014. Many of the proposed provisions were finalized by CMS on August 28, 2014.
January 14, 2013: ASA Comment Letter to ONC Health IT Policy Committee regarding proposed criteria for Meaningful Use Stage 3.
May 7, 2012: ASA Comment Letter to CMS regarding the Meaningful Use Stage 2 proposed rule.
February 18, 2011: ASA sent a letter to the CMS Office of E-Health Standards & Services regarding to applicability of Meaningful Use Stage 1 criteria to common anesthesiologist practice sites.
December 15, 2010: ASA sent a joint letter with the American College of Radiology and the College of American Pathologists to CMS requesting consideration of the workplace environment and patient-physician relationship that may limit the ability of certain physicians to meet EHR Incentive Program requirements.
March 15, 2010: ASA submitted comments to CMS on the EHR Incentive Program Proposed Rule.
When the EHR Incentive Program was launched, ASA compiled a table linking individual Meaningful Use Stage 1 Objectives and Criteria with their applicability to the workplace environment that an anesthesiologist typically practices. Please note that slight changes have been made on several of the meaningful use objectives since the publication of this table.
Please direct your questions on the EHR Incentive Program to the ASA Quality and Regulatory Affairs (QRA) Department. QRA may be contacted at (202) 289-2222 or by e-mail at email@example.com.


text:
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- 31, Male
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- Kiel/Germany
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Latest News
Whats up Newgrounds,
maybe some people have noticed that I deleted my old songs from the Platform.
The reasons are told pretty quickly - I have changed the Genre.
Previously HandsUp / Dance, now it's House / Electro.
I hope you enjoy the songs and I still might get some more feedback.
One thing I would say if my songs are already rated negative, then please also writes a justification. Then I can continue to try to make better songs.
So long
Latest Audio Submissions
|If I lose Myself (nDozer Remix
|House Song
|Sync (Intro Mix)
|House Song
|House Song
|Don't go (Demo)
|Trance Song


text:
Personal touch boosts Central High's grad rate
High Point Central High School joined the specialty high schools this year that have contributed to the county school district's graduation rate rising to a new record.
Although the school did not join Penn-Griffin School of the Arts, the Academy at Central High School and the group of schools with 100 percent graduation rates, High Point Central showed the greatest one-year gain of 6.9 percentage points, from 77.6 percent to 84.5 percent. The district 2013 average graduation rate was 86.2 percent, a new high.
Central High School Principal Bob Christina said a new program he started with the Class of 2013 called Keeping Seniors on Track offered a personal touch.
Christina divided the senior class into 20 groups of five students each, then assigned each group to a school staffer as mentor.
"We met with our students weekly, targeting grades, homework, attendance, discipline, and what was going on at home. The personal relationship part was exceptional. It made the difference. It kept our seniors on track, because they knew there was someone on staff who was focused on their success," Christina said.
One special target was a group of 150 students.
"And almost all of them graduated," he said.
Performance among other High Point area high schools was mixed. Ragsdale High School was at 90 percent, up 3 points and Southwest was 92.1 percent, down just slightly from last year. T.W. Andrews was 86.9 percent, down from 87.6 percent. Ragsdale reached 90 percent for the first time ever.
For the district, the 2013 graduation rate was the highest since the state began calculating graduation based on a four-year cohort in 2006. At that time, the district graduation rate was 74 percent, a difference of 12.2 percentage points from 2013. The four-year cohort measures the number of students who entered ninth grade in 2009-10 and graduated four years later.
The Guilford County rate was up from 84.5 percent last year and exceeded the 2013 state average of 82.5 percent and rates in five other large school districts which were all below the state average.
"Once again, the data shows our students are making great strides, thanks to their efforts and the outstanding work of our educators," said Superintendent Mo Green. "Our students are not only graduating at record rates, they are achieving educational excellence."
Magnet schools and academies again had the highest graduation rates. At 100 percent were the Middle College at Bennett, the Early College at Guilford College, the Middle College at GTCC-Greensboro, the Middle College at GTCC-High Point, the Middle College at North Carolina A&T State University and Weaver Academy.
The district goal is to reach a 90 percent graduation rate.
"Graduation is the only option for us," Green said. "You set the bar higher if you want to go higher. But funding is critical. To get to 100 percent, you need adequate funding. We have had to do more with less and that is not a good model."
North Carolina's high school graduation rate also was a record level at 82.5 percent, up from 80.4 percent in 2012. Among the other large districts, Charlotte-Mecklenburg was 81 percent, Durham County, 79.6 percent, Forsyth, 82.1 percent and Wake 81 percent.
The state's graduation rate has risen by 14.2 percentage points over the past seven years. The gain mirrors similar trends nationwide. North Carolina, like other states, used to report inflated graduation numbers. But states were forced to come up with a more standardized measurement as part of the federal No Child Left Behind program.
The Class of 2013
Davidson County: The county schools graduation rate increased to 85.2 percent from 82 percent a year ago. Lexington City rose to 86.1 percent from 79 percent. Thomasville dropped to 71.4 percent from 77.8 percent.
Randolph County: Trinity High School was 90.9 percent, 91.1 percent for Wheatmore and 88 percent for Randleman High School.