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Monthly Archives: May 2012
Inexpensive Airplane Tickets – London.
Tons of folk ask if there are methods to pay a smaller rate than the trip agents will give you on air travel. The key's to know precisely where to look and the way the airlines do their business.
Inexpensive airplane tickets to London are a standard one. Britain is a superb place to spend a while and that's the reason why inexpensive airplane tickets to London go fairly fast. Should you be looking for an inexpensive airline ticket or tickets to London and you find them grab them unless you are alright waiting for an alternative date or flight. Trip agents have the interior info on all kinds of travel kickbacks and when the ideal time to go is if you would like to save cash. What you are actually trying to find is a reduction package that airlines offer once in a while. Tour agents are your best chance for finding these packages and if you can get one that synchronizes with your travel dates it is a smart idea to go forward and make the reservation because chances are high that you won't find an improved deal. One thing that may help to save money is being flexible with your travel dates because most airlines offer reductions for traveling during certain times during the month and even at particular times. When you find a reasonable price make that reservation because airlines are famous for changing their costs the following day. If you are sufficiently lucky to have frequent flier miles either thru the airline or with a rewards Mastercard then you need to use these to get huge rebates or free airplane tickets. They communicate with the numerous airlines and show the lowest amount the airline will accept for an airline ticket at a fixed point. If you're a gambler and can hold out you can watch the airline ticket fares drop by the day and often per hour. I fall into the class of the person who will need to go anywhere finally so that the order means nothing. Click the link to read news about travel agents
Selecting a Country For Your Hospital Therapy Abroad Can Be Downright Frightful.
From a different perspective, if you're going to multiple destinations, have particular demands, bag questions, passport issues, and anything that's beyond online booking, then by every means, book with a trip advisor. In exchange, we do not have to handle anybody on a private basis. When we book with a tour agent, the exchange becomes a private matter. Cost to Operate a Travel Office All travel agents, including inexpensive air sites, pay a good deal of cash so as to operate. Though India has been highlighted, the other selections are similarly as gorgeous. Thailand offers some of the most spotless beaches internationally. Brazil offers rainforests, Costa Rica offers jungles and beaches both, France offers gorgeous country and the glitter of Paris, Italy offers romantic villas, and Switzerland ( naturally ) offers the Swiss Alps. There are plenty more, nameless that are options that a certified medical trip agent can help you with hunting out.
Selecting a Country For Your Hospital Therapy Abroad Can Be Downright Frightening.
Irrespective of what the scale of the group, or the age of the group members, your holiday will certainly be one for the record books. They're possibly the hardest vacation to organize. Click this link for latest info on travel agents.
He / she'll have faced most issues before and will definitely be able to lead you easily when you begin to organize your cruise. The trip booker and you will then go thru researching cruise ships, transport from and to the ship when arriving and leaving the ship, and for shore trips that are a part of the general holiday. You have got to know your group when beginning this. Medical tourism is just the practice of going to another country to get medical services. Journeying abroad for medical services is a new idea to many folks, yet the select have been journeying to foreign states for ages. About 10 years gone, nations in The East noticed that the possibility exists to fill the unmet requirements of millions across the planet. There's voiced concern of safety, the information and ability of the staff, and the standard of services that are offered. If an individual would travel thousands of miles to holiday, why not travel that far to have a medical process done? If an individual is content to risk having a foreign doctor perform the process in the developed country ( E.
When arriving on board, and you being the organiser, you contact the individual in control of Cafe Bookings. This is critical in the event of a difficulty that others should be informed about. An in-depth list of the groups cabin numbers also will be convenient if you need grab a hold of them urgently and they cant be seen right away.
Save on airline ticket Methods.
This electronic book aids with not only flight ticket but also auto rental, hostels, and cruises. Have some more news all about travel agents. It tells you how it is possible to get the same kickbacks that trip advisors receive, and even get free presents. * I had heard such a large amount of different ideas on the best day to order travel but this was clear and gave categorical reasons and methods to buy plane tickets during a particular period of time of the week to get the smallest price. Solo holidaying is out, Group holidaying is in. Irrespective of what the dimensions of the group, or the age of the group members, your holiday will certainly be one for the record books. Done correctly a cleverly planned holiday that goes smoothly from start to end will give you a wonderful sense of achievement. So lets review what you must do to make the cruise go well. He / she is going to have faced most issues before and will most likely be ready to lead you easily when you begin to organize your cruise. * The e-book described a technique to get kickbacks on eBay which I didnt see on the eBay site.


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Google I/O 2012 starts tomorrow and among the various rumors of what we'll see, a 7" Nexus tablet is one of the most talked about. In fact at this point I think most Google followers are expecting I/O attendees to leave the show with a Nexus Tablet tucked under their arms. Of course we all expected Apple to show off the iPhone 5 last fall too, so nothing is certain until the day of the show.
In any event the rumor mill never stops! Gizmodo Australia claims to have the full specs of the Nexus Tablet and surprise! They're pretty much exactly what earlier rumors have been reporting all along.
To recap, that means an Asus-built tablet with a 7" display (1280 by 800 for a respectable 215 PPI) being driven by a 1.3 Ghz Nvidia Tegra 3 processor. 1 GB of RAM and 8 or 16 GB of storage. A front-facing 1.2 megapixel camera but no back-facing camera. Pricing is aimed directly at Amazon's Kindle Fire: $200 for the 8 GB model, $250 for the 16.
Two oddities that have me raising my eyebrows. The first is the inclusion of Google Wallet on what's supposed to be a WiFi only device. How will that work? And the second is the inclusion of Android Jelly Bean, which they're now saying is Android 4.1 rather than Android 5 (which makes its inclusion a lot more plausible).
Just for fun, let's tie some other news into this Nexus Tablet rumor. Hulu Plus just launched an update to its Android app that adds better support for 7" tablets and high resolution displays. As Engadget points out, the timing is perfect if they want to be on the new Nexus tablet.
Of course just the fact that Google I/O is this week should be reason enough for high profile Android apps to roll out new versions so maybe we're reading too much into all this.
Another rumor that had been floating around was that Pinterest would be launching an Android app at the event. Pinterest has nipped that one in the bud, saying they're going to be at Google I/O demoing some things, and that an Android app is in the works, but it's not ready to launch yet. That tidbit comes from VentureBeat.
Google I/O sold out quickly this year so most of us won't be there, but Google is offering the next best thing: a live feed of the keynote. I'm pretty excited to see what surprises Google has left up its sleeve!
Read more of Peter Smith's TechnoFile blog and follow the latest IT news at ITworld. Follow Peter on Twitter at @pasmith. For the latest IT news, analysis and how-tos, follow ITworld on Twitter and Facebook..

subset: commoncrawl


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S2013 Ep18: 2013 Festival | The Longest Sun
Video duration: 16:39Expires: 03/16/15
Watch and vote for ? The Longest Sun,? a short fiction film told entirely in the endangered language of Tewa. The film tells the story of Tahn Pi, a young Tewa boy, who sets out on a mythical journey to stop the sun from setting. To cast your vote, visit http://www.pbs.org/filmfestival/vote/


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January 17, 2008
Good Morning Mr. Chairman and Members of the Subcommittee:
Thank you for inviting me here today to present the Administration's views on eight bills that would affect Department of Veterans Affairs ( VA) programs that provide veteran health care benefits and services. With me today is Walter Hall, Assistant General Counsel.
H. R. 3819 Veterans Emergency Care Fairness Act of 2007
Mr. Chairman, the first bill I will discuss is H.R. 3819. VA strongly supports this measure, which would amend sections 1725 and 1728 of title 38 to make mandatory, standardize, and enhance our authority to pay expenses incurred when a covered veteran receives previously unauthorized emergency treatment in a non- VA facility. Those sections are currently discretionary (the Secretary "may reimburse" as opposed to "shall reimburse"), cover different veteran populations, and use different definitions of "medical emergency."
Currently, the Secretary may reimburse or directly pay the reasonable value of non- VA emergency treatment of a service-connected disability, a non-service-connected disability aggravating a service-connected disability, any disability of a veteran with a permanent and total disability, or for a covered vocational rehabilitation purpose. When such claims are filed, VA medical professionals must determine whether there existed an actual emergency of such nature that delay in obtaining treatment would have been hazardous to life or health. Expenses incurred once the veteran had been stabilized and could have been transferred safely to VA or another Federal facility may not be reimbursed or paid.
The Secretary may also reimburse or pay for the reasonable value of expenses incurred by a covered veteran for non- VA emergency treatment where the treatment is sought for a non-service connected disability. The statutory standard for determining whether the treatment was emergent is whether a prudent-layperson would have thought it reasonable to seek immediate medical attention. This prudent-layperson standard means that if it turns out that the veteran's condition was not an actual medical emergency, VA can still reimburse or pay the expenses. This happens, for instance, when a veteran goes to the nearest emergency room believing a heart attack is underway but a severe case of heartburn is actually diagnosed. As with claims for service-connected conditions, the Secretary is only authorized to reimburse or pay for the reasonable value of the emergency treatment, and the emergency is considered ended at the point the veteran could have been transferred safely to a VA facility or other Federal facility.
H.R. 3819 would make it mandatory for the Secretary to reimburse or pay for the reasonable value of treatment for any veteran who meets eligibility criteria and would standardize the programs by applying the prudent-layperson definition of "emergency treatment" in both situations. Most importantly, it would define "emergency treatment" as continuing until (1) the veteran could have been transferred safely to a VA or other Federal facility, or (2) a VA or other Federal facility agrees to accept such transfer if, at the time the veteran could have been transferred safely, the non- VA provider makes and documents reasonable attempts to transfer the veteran to a VA facility or other Federal facility. While VA facilities work aggressively to accept the transfers once an emergency is stabilized, there have been cases where VA has been unable to find a facility that had the resources needed to furnish the care required. In those rare cases, the veteran may ultimately be liable for post-emergency costs, imposing a serious monetary hardship. The bill would appropriately foreclose this result.
Effective reimbursement or payment of emergency treatment has been an issue of concern to the Department. HR 3819 appropriately resolves important billing issues, properly placing the financial onus on the Department to provide appropriate care either in the VA or Federal system or at a non- VA facility.
VA determined funds were available within the FY2008 President's Budget level for this expanded benefit.
As a technical matter, I would like to clarify that if a veteran currently meets the eligibility criteria on which the reimbursement or direct payment claim is based, VA invariably pays the claim. Thus, changing the Secretary's authority from "may" to "shall" for purposes of both types of claims would have no practical effect. Nevertheless, we do not object to such a change.
H.R. 4146 Emergency Medical Care for Veterans in Non- VA Facilities
H.R. 4146 would also amend section 1725 of title 38 to make clear that the determination as to whether a veteran can be transferred safely to a VA or other Federal facility is to be based both on the condition of the veteran and on the availability of a bed in a Department facility that is not geographically inaccessible to the veteran.
We favor the approach in H.R. 3819, which would make the same definition of "emergency treatment" apply to claims filed pursuant to both section 1725 and 1728. H.R. 4146 would amend only section 1725. As a result, a greater benefit (i.e., VA reimbursement or payment of non- VA emergency treatment up until the point in time a VA bed is available for the eligible veteran) would be provided to veterans with non-service connected disabilities than is available to veterans under section 1728 for service-connected disabilities, a discrepancy that cannot be justified. We therefore prefer the standardization of terms, and increased consistency in application, that H.R. 3819 would provide.
H.R. 4053 Mental Health Improvements Act of 2007
Title I. Substance Use Disorders and Mental Health Care
H.R. 4053 is the companion bill to S. 2162, on which the Department testified before the Senate Committee on Veterans' Affairs this past October. While we appreciate the attention given to the critical issues addressed in this bill, we cannot support its prescriptive approach of mandating forms of treatment, treatment settings, and composition of treatment teams.
Section 102 would require the Secretary to ensure that, at each VA medical center and community based out-patient clinic ( CBOC), available services would include, at minimum: short term motivational counseling, intensive outpatient care, detoxification and stabilization, relapse prevention, ongoing aftercare and outpatient counseling, opiate substitution therapy, and pharmacological treatments aimed at reducing cravings for drugs and alcohol. The Secretary could, however, exempt an individual medical center or CBOC from providing any of the otherwise required services, but the Secretary would have to report annually to Congress on the facilities receiving an exemption, including reasons for the exemption.
Section 103 would require the Secretary to ensure concurrent VA treatment for a veteran's substance use disorder and co-morbid mental health disorder by a team of clinicians and health professionals with expertise treating substance use and mental health disorders, in conjunction with other professionals as considered appropriate by the Secretary.
Section 104 would mandate that the Secretary carry out a program to enhance VA's treatment of veterans suffering from substance use disorders and PTSD through a competitive allocation of funds to VA facilities. Funding awarded to a facility would be used for purposes specified in the bill, such as peer outreach programs through VA's Vet Centers to re-engage veterans of Operation Enduring Freedom/Operation Iraqi Freedom ( OEF/ OIF) who miss multiple appointments for post-traumatic stress disorder ( PTSD) or a substance use disorder. These peer outreach programs would need to be done in tandem with efforts of CBOCs and PTSD and substance use disorder treatment teams in VA's medical centers. Funds would also be used for collaboration between VA's urgent care clinicians and substance use disorder and PTSD professionals to ensure expedited referrals and for other specified purposes.
Section 104 would further require the Secretary to allocate $50 million from appropriated funds available for medical care for each of fiscal years 2008, 2009, and 2010 to fund these programs; the Secretary would be required to submit a report to Congress within the first year regarding the program and the facilities for which funding had been allocated. The bill would require the total expenditure for PTSD and substance use disorder programs to not be less than $50 million in excess of a specified baseline amount. (The bill would define the baseline as the amount of the total expenditures on VA's treatment programs for PTSD and substance use disorders for the most recent fiscal year for which final expenditure amounts are known, as adjusted to reflect any subsequent increase in applicable costs to deliver those programs.)
Section 105 would require the Secretary to establish not less than six national centers of excellence on PTSD and substance use disorders, to provide comprehensive inpatient treatment and recovery services to veterans newly diagnosed with these disorders. Candidate sites would be restricted to VA medical centers capable of treating concurrent PTSD and substance abuse disorders and of providing inpatient care, and located in a geographical area with a high number of veterans diagnosed with both PTSD and substance use disorders. This provision would also require the Secretary to establish a process to refer and aid the transition of veterans from these national centers to programs providing step down rehabilitation treatment.
Section 106 would require the Secretary, acting through the Office of the Medical Inspector ( OMI), to review all of VA's residential mental health care facilities, including domiciliary facilities. The OMI report must include a description of the care available in residential mental health care facilities in each Veterans Integrated Service Network; an assessment of the supervision and support provided in the VHA residential mental health care facilities; the ratio of staff members at each residential mental health care facility to patients at such facility; an assessment of the appropriateness of rules and procedures for the prescription and administration of medications to patients in such residential mental health care facilities; a description of the protocols at each residential mental health care facility for handling missed appointments; and any recommendations the Secretary considers appropriate for improvements to residential mental health care facilities. The bill requires OMT to submit to Congress a detailed report with these specified findings.
Section 107 would provide for title I of this bill to be enacted in tribute to Justin Bailey, an OIF veteran who died while under VA treatment for PTSD and a substance use disorder.
VA does not support enactment of this title. Title I is overly prescriptive and would attempt to mandate the type of treatments to be provided to covered veterans, the treatment settings, and the composition of treatment teams. Treatment decisions should be based on professional medical judgments in light of an individual patient's needs, and experienced health care clinicians and managers are in the best position to decide how best to deliver needed health care services at the local level. It is more consistent with the principles of patient-centered medicine, as well as more efficient, to focus on making these services available to patients who require them, as opposed to requiring every VA facility to provide these services.
We are also concerned that section 104 would require all the competitively funded peer outreach services to be furnished through VA's Vet Centers. This would make Vet Centers reliant on the medical centers to provide funding needed to meet the peer outreach requirements of this program. Vet Centers generally receive their funding apart from the medical centers. And we do not support section 105. VA has previously expressed its difficulties with the concept of centers of excellence as opposed to the achievement of an overall standard of delivery of excellent care on a national basis; this provision is also overly restrictive and prescriptive. I refer you to the concerns VA has previously expressed regarding disease-specific treatment centers and models. Finally, section 106 would impose extremely onerous and time-consuming requirements on the OMI, which would overwhelm that office's capacity to meet its responsibility to oversee and investigate the quality of care furnished in all lines of service throughout the VA system-an absolutely vital function within the Veterans Health Administration. To meet the mandate, the Department would have to expand that office significantly. The OMI should be focused on its general mission, not on the narrowly focused duties set forth in section 106.
Title II. Mental Health Accessibility Enhancements
Section 201 of H.R. 4053 would require that, within six months after enactment of the bill, the Secretary establish a three-year pilot program to assess the feasibility and advisability of providing eligible OIF/OEF veterans, particularly those from the National Guard or Reserve, with services including peer outreach and support, specified readjustment counseling, and other mental health services. Eligible veterans would include those who are enrolled in VA's health care system and who, for purposes of the pilot program, receive a referral from a VHA health professional to a community mental health center or to a facility of the Indian Health Service (IHS).
In providing readjustment counseling services and other mental health services to rural veterans lacking access to comprehensive VA mental health services, section 201 would require the Secretary, acting through the Office of Rural Health, to contract for those services with community mental health centers (as defined in 42 CFR §410.2) and/or IHS facilities.
Sites for the pilot must include at least two Veterans Integrated Service Networks selected by the Secretary ( VISNs). At least two of the sites would have to be located in rural areas that lack access to comprehensive VA mental health services. A participating community mental health center or IHS facility would be required, to the extent practicable, to provide readjustment counseling and other mental health services through the use of telehealth services. It would also need to utilize best practices and technologies and to meet any other requirements established by the Secretary and would have to comply with applicable VA protocols before incurring any liability on behalf of the Department. It would further be required to provide clinical information on each veteran treated, as required by the Secretary.
The Secretary would be required to carry out a national program of training for (1) veterans to provide peer outreach and peer support services under the pilot program; and required training for (2) clinicians at community mental health centers or IHS facilities to ensure they could furnish covered services in a manner accounting for factors unique to OEF/ OIF veterans' experiences, including combat and military training experiences. This provision would also establish detailed annual reporting requirements for participating centers and facilities.
Mr. Chairman, all of these services are already available to OEF/ OIF veterans, including those who served in the National Guard or the Reserves. No demonstrated need exists for the pilot program or these additional authorities, which are duplicative of currently existing authorities. It is also unclear to us how the peer outreach services to be provided under section 201 relate to the peer outreach program that would be established by section 104.
As to the requirement to contract with a community mental health center or IHS facility, VA has previously expressed a concern that imposition of such a requirement may inadvertently reduce the opportunity for a veteran to receive care from the most highly qualified contractor. Additionally, it is most often the case that when VA lacks capacity to provide mental health services in a certain rural area, the same situation exists for the community mental health centers and IHS facilities. IHS facilities, staff, and other resources should be focused on American Indians and Alaska Natives. VA and IHS have a Memorandum of Understanding (MOU) that provides the appropriate framework for cooperative ventures within the capacities of each of our two agencies, using that MOU and our current flexibilities to contract with the most appropriate provider when VA is not able to provide necessary services is the most effective way of assuring that rural veterans get the care they need.
Title III. Research
Section 301 of H.R. 4053 would require the Secretary, through the National Center for PTSD, to carry out a program of research into co-morbid PTSD and substance use disorder, including coordination of research and data collection and dissemination. The bill prescribes that the research address: co-morbid PTSD and substance use disorder; systematic integration of treatment for the disorders; and development of protocols to evaluate care of veterans with co-morbid disorders and to facilitate the cumulative clinical progress of such veterans. Section 301 would authorize $2 million to be appropriated for each fiscal year 2008 through 2011 to carry out this program and specifically require the funds be allocated to the National PTSD Center in addition to any other amounts made available to it under any other provision of law.
Section 302 would continue the Special Committee on PTSD (which is established within VHA) through 2012; otherwise the Committee's mandate would terminate after 2008. VA strongly supports continuing the Special Committee.
With the exception of the extension of the Special Committee, VA does not support the provisions in title III. VA is a world-recognized leader in the care of PTSD and substance use disorders, particularly when these conditions co-exist. Please note that the recent scientific literature review by the Institute of Medicine did not find that VA's treatments for PTSD other than Cognitive Processing Therapy (CP Therapy) and Prolonged Exposure Therapy (EP Therapy) were not efficacious; rather, the IOM concluded that the scientific literature did not show that the other therapies used by VA met its standard for unequivocally and conclusively demonstrating their efficacy in the treatment of PTSD. The activities required by title III are also redundant of VHA's on-going efforts, particularly of the research efforts being carried out by VA's National PTSD Center. We would welcome the opportunity to brief the Committee on VA's achievements and efforts in this area, along with the role of the Office of Mental Health in overseeing the PTSD and substance abuse programs.
Title IV. Assistance for Families of Veterans
In connection with the family support services authorized in chapter 17 of title 38, United States Code (i.e., mental health services, consultation, professional counseling, and training), section 401 would amend the statutory definition of "professional counseling" to expressly include "marriage and family counseling." This provision would also ease eligibility requirements for such services by authorizing their provision when "appropriate" (as opposed to "essential") for a veteran's effective treatment and rehabilitation. Section 401 provides for that these services to be available to family members in VA medical centers, Vet Centers, CBOCs, or in other facilities the Secretary considers necessary. Currently, these family support services are restricted to care provided in inpatient care settings.
Section 402 would require the Secretary to carry out, through a non- VA entity, a three-year pilot program to assess the feasibility and advisability of providing "readjustment and transition assistance" to veterans and their families in cooperation with Vet Centers. Readjustment and transition assistance would be defined as preemptive, proactive, and principle-centered, and would include assistance and training for veterans and their families in coping with the challenges associated with making the transition from military to civilian life. This provision would require the pilot program be furnished pursuant to an agreement between the Secretary and any for-profit or non-profit organization the Secretary selects as having demonstrated expertise and experience providing the designated services. The pilot program would be carried out in cooperation with 10 geographically-distributed Vet Centers, which would be responsible for promoting awareness of the assistance available to veterans and their families through the Vet Centers, the entity selected to conduct the pilot, and other appropriate mechanisms. Section 402 would establish detailed reporting requirements and authorize $1 million to be appropriated for each of fiscal years 2008 through 2010 to carry out the pilot program. Such amounts would remain available until expended.
VA does not support title IV. It is unclear how these "readjustment and transition assistance" services are intended to differ from, or interact with, the readjustment counseling services and related mental health services already available to veterans and their families through our Vet Centers. The provision conflicts in many respects with VA's existing authorities to provide readjustment counseling and related mental health services and creates confusion, especially regarding client outreach, in what is currently a highly successful program. (Indeed, the 98 percent rate of client satisfaction with the Vet Centers is the highest of all VA's programs.)
We also do not understand the implied need for use of a non- VA organization for provision of these services. Vet Centers already provide marriage and counseling services to family members as necessary to further the veteran's readjustment. Let me assure you that, when necessary, our Vet Centers readily contract with appropriate organizations and providers to ensure veterans and their families receive covered family support services. In sum, this provision would not effectively enhance current authorities or Vet Center activities; rather, we see that it has serious potential to create confusion and disruption for both VA and our beneficiaries.
If the purpose of section 402 is to authorize readjustment and transition assistance services for family members that are other than those required for the veteran's successful readjustment, we would object. In contrast to the situation with veterans, if during the provision of readjustment counseling services, Vet Center staff identify a family member's need for more complex mental health care services or other medical care that is not in furtherance of the veteran's recovery or readjustment, VA can neither refer the family member to a VA facility for such care nor refer that family member to a non- VA provider. Consequently, both our Vet Center staff and the affected family member would be placed in an untenable position.
H. R. 4231 Rural Veterans Health Care Access Act of 2007
Mr. Chairman, VA strongly opposes H.R. 4231, which would require the Secretary to implement a five-year pilot program using a voucher system to pay for mental health counseling at non- VA facilities for eligible OEF/ OIF veterans. Those eligible for this benefit are veterans eligible to receive hospital care and medical services under section 1710 of title 38, United States Code, who also: served on active duty in support of a contingency operation (as defined in section 101(13) of title 10, United States Code); are diagnosed with a mental health condition for which a certified mental health provider recommends mental health counseling; and reside at least 30 miles from a VA medical facility employing a full-time mental health professional.
Under the pilot program, the Secretary would compile and maintain a list of mental health providers, including family counseling providers, who agree to accept a voucher as payment in full for counseling services furnished to the veteran bearing the voucher and to accept VA payment at the rates specified in the bill. Providers would be required to comply with all applicable VA protocols. H.R. 4231 would also permit an eligible veteran to use these vouchers as payment in full for visits to a family counseling provider (on the list) if a certified mental health provider or the Secretary recommends that the veteran and the veteran's family receive family counseling.
Once requested by an eligible veteran, the Secretary would be required to issue a six-month supply of vouchers within 30 days. An additional six-month supply of vouchers could be provided. To receive payment under a voucher, following provision of mental health or family counseling services, the provider would submit a voucher bearing the signatures of the provider and the veteran.
Prior to the pilot program's expiration, the Secretary would be required to conduct a study of its effectiveness and, based on that study, recommend whether the program should be extended or expanded. If the Secretary determines it should be extended or expanded, H.R. 4231 would authorize the Secretary to take such action.
VA strongly objects that as now drafted the bill would permit a veteran with a diagnosed mental health condition to be eligible for individual and family counseling services under the program based on a non- VA provider's recommendation. Without exception, a recommendation for a veteran's receipt of mental health counseling services by a non- VA provider should be made only by the appropriate Department mental health professional. This is necessary to ensure a continuum of care for the veteran as well as appropriate coordination and oversight of all the medical services furnished to the veteran. This would also lessen any potential for self-referrals and conflicts of interest by participating providers.
Second, this bill would result in fragmentation of care. Vouchers would be available only for some types of care (mental health counseling) but the bill does not address their possible need for biomedically-based mental health services and evidence-based psychotherapy. H.R. 4231 could also lead to further barriers in integrating mental health services with other components of care and to the delivery of evidence-based interventions for mental health conditions.
The Office of Rural Health ( ORH) is currently collaborating across VHA to develop policies and practices that expand and adapt current initiatives, and to develop new models of care delivery that may be most appropriate for rural veterans.
More importantly, ORH will leverage the VHA's capabilities to develop partnerships with governmental and non-governmental entities to provide the best solutions to the challenges that rural veterans face and enhance the delivery of care by creating greater access, engaging in research, promulgating best practices and developing sound and effective policies to support the unique needs of enrolled veterans residing in geographically rural areas.
Lastly, we note the bill does not provide any criteria for determining the need or scope for family counseling services, whereas, it limits a veteran's eligibility to counseling services needed to treat the diagnosed mental health condition.
We further note the distance requirement would not limit this benefit to veterans residing in rural areas because those in many urban settings would likewise meet this requirement.
H.R. 2790 Director of Physician Assistant Services
H.R. 2790 would re-title the position of VHA's "Advisor on Physician Assistants" to "Director of Physician Assistant Services." This change in position title would appear to raise the incumbent and this discipline to the same level as VHA's other directors and lines of service. The bill would also expand the statutory duties of the position to require the incumbent to report to the Under Secretary for Health on all matters relating to the education and training, employment, appropriate utilization, and optimal participation of physician assistants within VA programs and initiatives. Finally, it would also require the incumbent to serve full-time and be located with the VA Central Office.
The current field-based Advisor position was established in 2000 and is successfully meeting the bill's objectives. Nonetheless, we do not object to the change in position title, although we note that Physician Assistant services do not constitute an actual service line. We do object to the provision in the bill that would restrict the locus of the position to VA Central Office. VA derives significant benefits from having the flexibility to use field-based clinicians in this and similar positions. Often the best candidates for such positions do not wish to give up their clinical duties entirely and relocate to Washington. It is also valuable for us to keep this position as a dual, as opposed to a full-time, role to enhance the incumbent's effectiveness by maintaining a "hands-on" approach and front-line perspective. We estimate the cost of converting this position to one that is full-time would be $34,252 for fiscal year 2008 and $413,151 over a ten-year period.
H.R. 4204 Veterans Suicide Study Act
H.R. 4204 would require the Secretary to conduct a study to determine the number of veterans who have committed suicide between January 1, 1997, and the date of the bill's enactment. The study would have to be carried out in coordination with the Secretary of Defense, Veterans Service Organizations, and State public health offices and veterans agencies. The bill would require the Secretary to submit a report to Congress on his findings within 180 days of the bill's enactment.
We do not believe the study required by this bill would generate information that would further our understanding of how to effectively screen and treat veterans who may be at risk of suicide. It would merely provide us with the rates for this cohort of veterans. VA has studied suicide rates for multiple cohorts of veterans and, through such efforts, has already identified the major clinical risk factors for suicide. (In fact, we recently completed such a study for OEF/ OIF veterans that we discussed at a recent hearing before the full House Committee on Veterans' Affairs. Using the data generated from those studies, we have developed protocols and processes to mitigate those risk-factors. For these reasons, we do not support section 103.
Further, certain requirements mandated by the bill make its implementation not feasible. As now drafted, it would not afford VA the flexibility needed to develop a thorough and useful study. To design and carry out a study that is best designed to provide usable information to address the issue of veteran suicide rates, we believe the Secretary (not Congress) should determine the organization(s) with which the Department should coordinate the study. For instance, CDC currently studies suicide rates among the general population, while VA's role has been to validate the information compiled by CDC.
Additionally the 180-day timeframe is not realistic, as there is currently a two-year time lag in the information released by CDC on suicide rates. We would be glad to brief the Committee on study designs we believe would be more feasible and would better serve its ends. We estimate the cost of this bill to be $1,580,006 in fiscal year 2008 and $2,078,667 over a ten-year period.
H.R. 3458 Pilot Program on Traumatic Brain Injury Care in Rural Areas
Mr. Chairman, H.R. 3458 would require VA to carry out a five-year pilot program to enhance care to veterans with traumatic brain injury ( TBI) in five rural states (selected by the Secretary) in consultation with VA's Office of Rural Health. VA would be required to assign a VA case manager to each VA patient diagnosed with TBI. The bill would further direct the Secretary to take specific actions in the pilot program states, including:
In our view, the bill would also establish a troubling precedent by establishing contract authority separate from our fee-basis contracting authority in chapter 17 of title 38, United States Code, for the treatment of a single condition/type of injury. These typically are very complex medical cases involving co-morbidities. Treatment of TBI and TBI related conditions cannot easily be singled out from other conditions requiring simultaneous medical attention. That is, TBI cannot be treated in a vacuum. For that reason the bill has potential to fragment care for the veteran population that most needs to receive its VA health care in a well-coordinated manner with continuous monitoring and oversight. We also note the number of eligible veterans covered by the bill is potentially great, because this bill is not limited to TBI due to injuries sustained during service in combat operations.
Since the time this bill was introduced on August 4, 2007, each VA facility has put into place an OEF/ OIF case management program for severely injured OEF/ OIF members. In October of 2007, VA established the Care Management and Social Work Service to ensure that each VA facility has an appropriate treatment team caring for these veterans (to include a program manager, clinical case manager(s), transition patient advocate, and a VBA OIF/ OEF liaison). All enrolled severely injured service members receive screening for TBI, and any OEF/ OIF veteran who requests case management services may receive them.
H.R. 4107 Women Veterans Health Care Improvement Act
Title I. Studies and Assessments of Department of Veterans Affairs Health Services for Women VeteransIn general, title I of H.R. 4107 would require VA to conduct a number of studies related to health care benefits for women veterans. More specifically, section 101 would require VA, in collaboration with VHA's War-Related Injury and Illness Study Centers, to contract with one or more qualified entities or organizations to conduct an epidemiologic cohort (longitudinal) study on the health consequences of combat service of women veterans who served in OEF/OIF. The study would need to include information on their general, mental, and reproductive health and mortality. The bill would require VA to use a sufficiently large cohort of women veterans and require a minimum follow-up period of ten years. The bill also would require VA to enter into arrangements with the Department of Defense (DoD) for purposes of carrying out this study. For its part, DoD would be required to provide VA with relevant health care data, including pre-deployment health and health risk assessments, and to provide VA access to the cohort while they are serving in the Armed Forces.
Section 102 of the bill would require VA to contract with a qualified independent entity or organization to carry out a comprehensive assessment of barriers encountered by women veterans seeking comprehensive VA health care, especially for those who served in OEF/ OIF. In carrying out this study, the bill recommends VA survey women veterans who seek or receive VA health care services as well as those who do not. Section 102 would also set forth specific elements to be researched as part of the study. They include the following:
Section 103 would require VA to conduct a comprehensive assessment of all VA health care services and programs for women veterans. In particular, the assessment would need to address specialized programs for women with PTSD, homeless women, women requiring care for substance abuse or mental illnesses, and those requiring pregnancy care. In conducting this study, VA would be required to determine whether effective health care services, including evidenced-based health care services, are readily available to and easily accessed by women veterans in areas of health promotion, disease prevention and health care. The determination would need to be based on the following factors: frequency with which such services are available and provided; demographics of the women veterans population; sites where such services are available and provided; and whether, and to what extent, waiting lists, geographic distance, and other factors obstruct the receipt of any of such services at any such site.
In response to the comprehensive assessment, section 103 would further require VA to develop a program to improve the provision of health care services to women veterans and to project their future health care needs (including mental health care) and, particularly, those of women serving in the OEF/ OIF combat theaters. In so doing, VA would have to identify the services available under each program at each VA medical center and the projected resource and staffing requirements needed to meet the projected workload demands.
Section 103 would also require VA to submit, not later than one year after the bill's enactment, a report to the Congress on the conduct of this assessment. The Comptroller General of the United States would then be required to review VA's report and to submit to Congress its own report on the Department's findings, together with any recommendations for administrative or legislative action.
Mr. Chairman, we do not believe section 101 is needed because a longitudinal study is already underway. Therefore, VA does not support this provision. For several years veterans, VA, and Congress have been concerned with identifying possible war-related illnesses among returning women veterans, including adverse effects on reproductive health. To that end, in 2007, VA initiated its own 10-year study, the "Longitudinal Epidemiologic Surveillance on the Mortality and Morbidity of OIF/ OEF Veterans including Women Veterans." Several portions of the study mandated by section 101 are already incorporated into this project; however, to comply fully, we will need to increase the number of women veterans in the original longitudinal study. We already have a proposal before the Under Secretary for Health to adjust the number of study participants accordingly.
Mr. Chairman, section 101(c) of H.R. 4107 would be objectionable because it requires the DoD to provide health data on active-duty women, as well as "access to the cohort of such women while serving in the Armed Forces. This provision could require active-duty women to participate in a VA survey while still in the military. It also could require the DoD to provide private medical information before separation.
Similarly we do not believe section 102 is necessary because a similar comprehensive study is already underway. VA contracted for a "National Survey of Women veterans in FY 2007-2008," which is a structured survey based on a pilot survey conducted in VISN 21. This study is examining barriers to care (including access) and includes women veterans of all eras of service. Additionally, it includes women veterans who never used VA for their care and those who no longer continue to use VA for their health care needs.
Section 103 would require a very complex and costly study. While we maintain data on veteran populations receiving VA health care services that account for the types of clinical services offered by gender, we lack current resources to carry out such a comprehensive study within a one-year time-frame. We would therefore have to contract for such a study with an entity having, among other things, significant expertise in evaluating large health care systems. This is not to say that such a comprehensive assessment is not needed and we recognize there may well be gaps in services for women veterans, especially given that VA designed its clinics and services based on data when women comprised a much smaller percentage of those serving in the Armed Forces. (Since the 1950s, the number of women veterans using VA services has averaged between 3-5% of all veterans. With women now representing 5 % of all veterans using VA, and 38.9% of OEF/ OIF returning women veterans using VA for their health care needs, it is incumbent on us to identify gaps in services and in availability of gender-related services.) VA's Strategic Health Care Group for Women Veterans already studies and uses available data and analyses to assess and project the needs of women veterans for the Under Secretary for Health. The study required by section 103 would unacceptably divert significant funding from direct medical care.
We estimate the costs of section 101 to be $2,327,503 in fiscal year 2008 and $10,857,000 over a ten-year period. We estimate no costs for section 102 because VA's own comparable study is underway, with $975,000 in funding committed for fiscal years 2007 and 2008. Section 103 would have a cost of $4,354,000 in fiscal year 2008.
Title II. Improvement and Expansion of VA Health Care Programs for Women Veterans
Section 201, titled "Improvement of Sexual Trauma Care Programs of the Department of Veterans Affairs," would require VA to train all mental health professionals who provide services to veterans under that program and to ensure such training is done in a consistent manner that includes principles of evidenced-based treatment. Section 201 would also require VA to train primary care providers in screening and recognizing the symptoms of Military Sexual Trauma (MST) and to ensure procedures exist for prompt referral of these veterans to appropriate mental health professionals. The provision recommends that VA's care and services for MST include the services of therapists who are qualified to provide counseling and who demonstrate an understanding of the burden experienced by former service members who experience both combat and MST.
Section 201 would also require VA to establish staffing standards used at VA health care facilities for full-time equivalent employees trained to provide treatment for conditions related to MST. These standards would need to ensure availability of services, and access to MST treatment, for all veterans seeking this care. This provision would also establish detailed reporting requirements for the Department.
We do not support the training-related requirements of section 201 because they are not necessary. In Fiscal Year 2007, VA funded a Military Sexual Trauma Support Team, whose mission is, in part, to enhance and expand MST-related training and education opportunities nationwide. VA also hosts an annual four-day long training session for 30 clinicians in conjunction with the National Center for PTSD, which focuses on treatment of the after-effects of MST. VA also conducts training through monthly teleconferences that attract 130 to 170 attendees each month. Recent topics included overviews of several commonly used evidence-based treatment protocols (e.g., protocols for CP Therapy, PE Therapy, and Acceptance and Commitment Therapy). VA has also recently unveiled the MST Resource Homepage, a webpage that services as a clearinghouse for MST-related resources such as patient education materials, sample power point trainings, provider educational opportunities, reports of MST screening rates by facility, and descriptions of VA policies and benefits related to MST. It also hosts discussion forums for providers. In addition, VA primary care providers screen their veteran-patients, particularly recently returning veterans, for MST, using a screening tool developed by the Department. We are currently revising our training program to further underscore the importance of effective screening by primary care providers who provide clinical care for MST within primary care settings.
We object strongly to the provision in section 201 that would require VA to establish staffing standards for this program. Staffing-related determinations must be made at the local level based on the identified needs of the facility's patient population for MST treatment and services, workload, staffing, and other capacity issues. Imposition of national staffing standards would be an utterly inefficient and ineffective way to manage a health care system that is dynamic and experiences continual changes in workload, utilization rates, etc.
Section 202 would require VA, through its National Center for PTSD, to develop and implement a plan for developing and disseminating information regarding effective treatments, including evidence-based treatments, for women veterans with PTSD and other co-morbid conditions. The plan would need to include a proposed timetable for the dissemination to all VA facilities, but in no case could dissemination occur later than one year after the bill's enactment. Section 202 would also require the plan to include any proposed additional resources needed to provide MST training and MST counseling and treatment. The measure would establish detailed reporting requirements, as well.
VA does not support section 202 because it is duplicative of activities already underway by the Department. VA is strongly committed to making state-of-the-art, evidence-based psychological treatments widely available to veterans and this is a key component of VA's Mental Health Strategic Plan. We are currently working to disseminate evidence-based psychotherapies for a variety of mental health conditions throughout our health care system. There are also two programs underway to provide clinical training to VA mental health staff in the delivery of certain therapies shown to be effective for PTSD, which are also recommended in the VA/ DoD Clinical Practice Guidelines for PTSD. Each training program includes a component to train the professional who will train others in this area, to promote wider dissemination and sustainability over time.
Section 203 would require VA to conduct a study of the Vet Centers' capacity to provide services for women veterans and to determine their capacity to provide a sufficient scope and intensity of services. Once completed, the Secretary would have to develop a plan to ensure that adequate counseling and mental health services for women veterans are available at each Vet Center, taking into account their specialized needs.
We do not support section 203 because it is not necessary and is duplicative of VA's on-going activities in this area. VA's Vet Center program is one of VA's best-received programs as it currently exists, and it already provides the services sought by this subsection. We would be glad to brief the Committee on all of our activities, particularly our extensive outreach efforts and the significant expansion now underway to increase capacity (both in terms of staff and new facilities).
Section 204 would require VA, not later than six months after the bill's enactment, to carry out a two-year pilot program to furnish child-care services (directly or indirectly) to eligible women veterans receiving certain services through the Department. Sites for the pilot program must include at least three VISNs. Child care could only be provided for the period of time that the eligible veteran receives covered services at a Department facility and is required to travel to and from the facility for those services. Eligible veterans would include women veterans who are the primary caretaker of a child (or children) and who are receiving one or more of the following health care services: regular or intensive mental health care services, or such other types of intensive health care services for which the Secretary determines the provision of child care would improve access to those services. Moreover, under section 204, VA could provide the covered child care services through a variety of means, i.e., stipends offered by child care centers (directly or by voucher system), the development of partnerships with private agencies, collaboration with other Federal facilities or program, or the arrangement of after school care. Section 204 would authorize $1.5 million to be appropriated for each year of the pilot and establish Congressional reporting requirements.
VA does not support section 204. Although we understand that the lack of available child care services can pose a barrier to access to care for some of our veterans, providing child care services -either in house or through other arrangements--would divert funds and resources from our primary mission of providing direct patient care. We note that private health care facilities do not generally provide these services. Section 204 also unjustifiably discriminates against male veterans who, but for their sex, would otherwise meet the eligibility criteria. We estimate the cost of section 204 to be $500,000 in fiscal year 2008 and $2,500,000 in fiscal year 2009.
Section 205 would require VA to establish a two-year pilot program to evaluate the feasibility and advisability of providing counseling and transition adjustment assistance for newly separated women veterans that is conducted in a group retreat setting for as long as the Secretary deems is needed to be effective. Participation in the program would be voluntary and would not require a referral from any provider. Section 205 provides that the counseling services would be individually tailored to the participants' specific needs, and they could include some or all of the following types of counseling: mental health, family and marital, role and relationship, substance use disorder, or other counseling services determined to be necessary to assist the veteran before final repatriation with her family. Section 205 would also authorizes $2 million for each year of the pilot, and require VA to submit a detailed report to Congress within six months of the pilot's completion.
VA does not support section 205. We find the intent of the legislation confusing in that it would require that counseling be at the same time provided in a group setting but specifically tailored to the individual needs of each participating veteran. We know that counseling services provided in group therapy sessions are not appropriate or effective for all veterans and/or certain mental health conditions. Determination of the appropriate treatment milieu for each veteran should be based on the clinical judgment of a trained VA professional and should not be mandated-even as a pilot program. Likewise, we object to the precedent of permitting patients to self-refer for medical care. The need for these services should be made by the appropriate VA professional who can ensure they are medically appropriate and necessary. Moreover, the veterans participating in the pilot may assume in error that their medical and counseling problems can be completely resolved through this program with no need for future VA services. We note that VA has a number of counseling and transition adjustment programs underway to meet the needs of newly discharged/separated women veterans.
Finally, section 206 would require the Department's Advisory Committee on Women Veterans, created by statute, to include women veterans who are recently separated veterans. It would also require the Department's Advisory Committee on Minority Veterans to include recently separated veterans who are minority group members. (It is noted that section 206 contains a typographical error, as the Advisory Committee on Minority Veterans was established by section 544 of title 38, United States Code, not section 542.) These requirements would apply to committee appointments made on or after the bill's enactment.
We support section 206. Given the expanded role of women and minority veterans serving in the Armed Forces, the Committees should address the needs of these cohorts in carrying out their reviews and making their recommendations to the Secretary. Having the perspective of those who have recently separated would enable the Committees to, among other things, project the future needs of these veteran-groups.
This concludes my prepared statement. I would be pleased to answer any questions you or any of the members of the Subcommittee may have.
House Committees | Senate Committees | Find my Representative | Find my Senator
Veterans and their family members who wish to contact the Department regarding a claim, benefits, or services, may call VA Toll-Free at 1 (800) 827-1000 or 1 (800) 829-4833 [TDD], or Contact the VA via the web.
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U.S. Department of Veterans Affairs - 810 Vermont Avenue, NW - Washington, DC 20420
Reviewed/Updated Date: November 10, 2009


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There are no reviews yet.
Christmas coat with shiny bright stars in Santa style. It has soft fleece inside to keep your dog warm and comfortable during the winter season. It features a velcro strip which makes it easy to put on and take off. This is a perfect outerwear for stylish and fun-loving dogs.
Material: Flannel, Fleece
Designed and handmade in Huntington Beach, California USA.
Not quite the size, color or design you're looking for? Let us know.
See our Sizing Guide.
There are no reviews yet.
Christmas coat with shiny bright stars to spark your dog's fashion sense. It has soft fleece inside to keep your dog warm and comfortable during the holiday season. It features a velcro strip which makes it easy to put on and take off. This is a perfect outerwear for stylish and fun-loving dogs.
Material: Flannel, Fleece
Designed and handmade in Huntington Beach, California USA.
Not quite the size, color or design you're looking for? Let us know.
See our Sizing Guide.
Here are some of our recent Customer Testimonials. To read more, please click here.
Sumo is a 5 month old Bulldog who was born with Spina Bifada, he cannot co troglodyte potty and will be a diaper-baby all his life. Sumo is the newest member of Southern California Bulldog Rescue (SCBR). I am Sumo's Foster Mom and Sumo will live with me and my family Iwhile we complete work on his medical issues.
Once Sumo passes his medical, SCBR will find a suitable forever home for Sumo, a home familiar with Bulldogs who are also diaper babies. Your products are fabulous and make my life easier as a foster Mom! And your products will be a real plus for the folks who ultimately adopt Sumo. Thank you so much!!
Debra & Sumo
Sumo - Perris, CA
Beyond cute this is on my 'Lilo'! Very nice quality & still looks brand new after the wash!
Laurie H. - Blaine, MN
These diapers are so cute, and I really wanted a pair for my 14-year old dog, but couldn't get the size just right. After a couple of returns and re-purchasing, and a couple of e-mails, they were able to customize a pair for us with a larger hole for her tail. Barkerwear was very helpful with the whole process and now my dog is looking snazzy and feels comfortable in this diaper (I can tell).
Laura T. - Alpharetta, GA
Oh my goodness, if you are looking for the perfect diaper for your sweetie, get Barkerwear! Seriously. In addition to being simply adorable, they are made of very high quality soft nylon blend fabric and are carefully sewn. Not too thick or thin and definitely not "crunchy" feeling like other brands I have tried. I can tell they are going to last a long time. They are obviously designed by someone who loves and knows dogs. The tail hole is in a perfect spot; it doesn't crimp or put pressure on the tail area at all (I problem I had with other brands). I have an English Bulldog with virtually no waistline, who I thought was going to be hard to fit. The circumference or waistline measurements on the site are accurate, so be sure to measure your dog with a flexible tape measure. The velcro straps allow you to tighten or loosen the diaper around the dog as needed to ensure a perfect fit. I ordered both the Large and XL and kept the XL because she needed the extra fabric for her curvy derrière. I just snugged up the velcro around her "waist" and they are perfect. She has worn them all day since they arrived and has not fussed once. (There is a picture attached below- the best angle I could do!) For those of us who use diapers for incontinence, Barkerwear also makes diaper liners that I recommend getting to absorb the urine. Incidentally, when I asked to return the Large pair I did not keep, the company was wonderful about the return. They made it super easy and were very accommodating. I will watch for other products from Barkerwear because I am really impressed. If this tells you anything about how good I think they are, this is the first and only product in TEN years I have felt compelled to post a review about!
Pam V. - Minneapolis, MN
High quality male wraps. (belly bands) Large velcro closure. These made in USA have wide variety of fun prints. The fabric, padding and stitching is all top quality. Shipping was prompt and arrived much earlier than estimated. Very pleased with product and seller.
Cynthia R. - Blackwell, OK
I initially got this for my 14-year old Labrador, who has some muscle tone loss in his hind quarters – So I thought the medium might be a better fit, but these are tiny. They are still absolutely adorable, so I gifted them to my sister for her Morkie. 🙂
Tia - Forney, TX
Very helpful with exchanging for a larger size and bending over backward to get me a more customized fit for my dog.
Laura T. - Alpharetta, GA
Fast shipping.
John O. - Washington, DC
So cute on my Lilo & nice quality.
Laurie H. - Blaine, MN
*Suggested Weight is for reference purposes only and should not be used as a tool to select sizes since each pet is different*
It is a good idea to go up one size if your dog is between sizes.
|Barkertime Size
|Waist (Diaper)
|Waist (Belly band)
|Suggested Weight
|Extra Small
|8" - 10"
|14" - 16"
|9'' - 12''
|8'' - 10''
|4 - 8 lbs
|10" - 12"
|16" - 18"
|12'' - 15''
|10'' - 12''
|8 - 15 lbs
|12" - 14"
|18" - 20"
|15'' - 18''
|13'' - 16''
|15 - 35 lbs
|14" - 16"
|20" - 22"
|18'' - 22''
|17'' - 21''
|35 - 55 lbs
|Extra Large
|16'' - 18''
|22'' - 24''
|22'' - 30''
|22'' - 26''
|55 - 85 lbs
|30'' - 43''
|27'' - 32''
|85 - 130 lbs
Recommended sizing by breed:
XX-Small: Teacup and dogs under 5 lbs
X-Small: Australian Terrier, Chihuahua, Pomeranian, Toy Poodle, Yorkshire Terrier
Small: Boston Terrier, Jack Russell Terrier, Maltese, Pug, Silky Terrier
Medium: Bichon Frise, Beagle, Cocker Spaniel, Corgi, Scottish Terrier
Large: Brittany Spaniel, Bulldog, Collie, Schnauzer, Springer Spaniel
X-Large and over: Doberman Pinscher, German Shepherd, Golden Retriever, Labrador Retriever, Rottweiler
Do you have a question, comment or suggestion about this product? We'd love to hear from you.
For wholesale inquiries, click here.
If you feel that we don't offer a size, color or style of this product that would fit your fur baby perfectly, you can request a custom order and have something made just for you. You can even send us your own fabric and have us make the product for you! Depending on the product, our turnaround time is usually within one week. Fill out this short form and let us know what you have in mind.
Please note that custom orders (items that are custom made to your pet's measurements) are non-returnable and non-refundable. They can be exchanged on a case-by-case basis.
This is not a licensed product. Barkertime is not affiliated with, endorsed or sponsored by the designer and manufacturer of the fabric used to make this product.
Designed and handmade in Huntington Beach, California USA.
Soft fleece trimming for your pet's comfort.
Material: Flannel.
Designed and handmade in Huntington Beach, California USA.
Not quite the size, color or design you're looking for? Let us know.
See our Sizing Guide.
Designed and handmade in Huntington Beach, California USA.


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For love of the game: Read all about it By Fred Koch
FOR THE LOVE OF THE CUBS: AN A--TO--Z PRIMER FOR CUBS FANS OF ALL AGES, by Frederick C. Klein, illustrated by Mark Anderson, Triumph Books, $16.95; ages 8--12.
I grew up on the Northwest Side of Chicago, therefore I'm a Cub fan. My girlfriends and I went to Wrigley Field (built in 1914) every summer on Ladies Day (free for women) to watch the Cubs. They weren't winning any pennants then either, but we had great fun at the ol' ballpark.
In this book, each letter of the alphabet offers a short rhyme and a caricature of a famous Cub. "S" is for Santo, Sandberg and Sosa (the only current Cub player included in the book).
Sosa is expected to surpass Ernie Banks as the team's all--time home--run leader. Banks, who hit 512 of them, is the "B" as well as co--author of the book's forward. Throughout the pages are bits of Cubs history and highlights of the careers of famous former Cubs. What fun to sit down with dad, grandpa or even great--grandpa and reminisce about the players they remember from each generation. KIRBY PUCKETT'S BASEBALL GAMES, by Kirby Puckett and Andrew Gutelle, illustrated by Paul Meisel, Workman Publishing, $13.95; ages 5--10.
Are you looking for ways to improve your baseball skills and have fun at the same time? Hall of Famer Kirby Puckett, former Minnesota Twins player, offers young players a book full of tips for improving play. Along with the suggestions, this book has 34 games to help improve the four basic baseball skills: hitting, running, catching and throwing. The book comes with a baseball autographed by Puckett and marked to show the proper finger placement for right-- and left--handed pitchers. IT TAKES A TEAM, by Mike Cameron with Greg Brown, Triumph Books, $15.95; ages 8--11.
Mike Cameron is the center fielder with the Seattle Mariners team that won the American League West title in 2001. The team didn't get to the World Series because it lost to the New York Yankees in the championship series, but what a remarkable year the Mariners had. They won 116 regular--season games, tying a record set by the 1906 Chicago Cubs.
In 2002, it was Cameron himself who had the remarkable year. On May 2, 2002, playing in Chicago against the White Sox, Cameron became the 13th player in Major League Baseball history to hit four home runs in one game. Coming into that game, he had been in a batting slump. No player has ever hit five homers in one game.
It took Cameron a long time to come into his own as a ballplayer. He played six seasons on six different teams in the minor leagues—including a stint with the White Sox, where he played with baseball wannabes Michael Jordan and Bo Jackson. His first job in the big leagues came with Cincinnati before he finally settled in Seattle.
Cameron emphasizes throughout the book the importance of teamwork and working together. He shares many words of wisdom and advice that he has learned over the years.
FOR THE LOVE OF BASEBALL, by Rennay Craats, Weigl Publishers, $6.95; ages 5--8.
Children know very little about the game when they head onto the field for their first T--ball game. When the coach tells them to go to left field, he often gets a blank look. This book, as well as others in the sport series published by Weigl Publishers, is a good one for beginners.
The book begins at the beginning, with background information about the sport, then proceeds to explain what equipment is needed to play, and a diagram of the field—important information for kids who wouldn't otherwise know about left field.
The book offers a list of Web sites where answers to more questions can be found.
PRINCESS FIDGETY FEET, by Pat Posner, illustrated by Philip Norman, McGraw Hill, $15.95; ages 4--8.
Princess Bridget wants to play soccer more than anything else. Her fidgety feet are always ready to play. But that simply isn't something a royal princess should think about doing.
So Princess Bridget only goes to the castle tower to watch other children play the game. The newspaper boy sometimes comes to the tower to report on his team, and he and Princess Bridget sneak in a little soccer game. The king is aware of his daughter's desire and hires Miss Posy to turn her into a princess. Unfortunately, Princess Bridget has no idea how parading around with books on her head can be of any benefit when all she wants to do is play soccer. Turns out Miss Posy has a secret of her own that she shares with Bridget.
Find out how discipline and control help Princess Bridget get to play soccer and who her coach will be.
WILLY THE WIZARD, by Anthony Browne, Candlewick Press, $5.99; ages 4--8.
I like Willy the little chimpanzee and you will, too. He has a hard time competing in a world of big gorillas. In this story, he wants to play soccer but doesn't have cleats and can't afford to buy any. Every week he watches practice, but nobody passes the ball to him and he never gets picked to play. One night Willy meets a stranger who gives him a pair of magic cleats.
With these cleats on his feet, Willy can really play and is picked for the team. Is it those special shoes, or Willy's hard work and dedication that get him the chance to play? Browne has written several other books where Willy's determination and hard work have led to his successes.
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This column was originally published on RealMoney on Sept. 13 at 10:40 a.m. EDT. It's being republished as a bonus for TheStreet.com readers.The activist battle against Bally's Fitness ( BFT) is going to another level as Pardus Capital Management appears to be joining Liberation's effort. I first wrote about Liberation and Bally's on
"PCM has communicated with management of the Company, and expects to continue to communicate with management of the Company." Pardus also threw in the line that funds do when they want to start talking with the other activists: "Depending upon such factors that PCM may from time to time deem relevant, PCM may, among other things, (i) communicate with other shareholders of the Company..."Pardus's confidence, and Liberation's bet, achieved a substantial boon in the past two weeks as Bally's reworked some of its debt agreements with its bondholders. Let me just state that when a company defaults on its bonds, that is often the best time to buy its stock. Why? Because the hedge funds that own the bonds will do anything they can to avoid reporting a writedown on that debt to their investors. In Bally's case, the "writedown avoidance efforts" began on Aug. 5, when two bondholders sent notice that Bally's was in default of their bonds because of earnings restatements that Bally's was in the process of filing. Bondholders typically have covenants in their loan agreements which trigger a default if the company does not file financial statements on time. Bally's has been under an SEC investigation for its earnings and is restating from 2000 to 2004. Bally's was given 30 days to either get a waiver extending its deadline or to file the restatements. Once the company defaults, even if it's a default based on a financial reporting covenant, bankruptcy is often a short hop away. On Aug. 31, Bally's announced that the bondholders who had previously notified them they were in default had sent the company a waiver extending the deadline of the Financial Reporting Covenant (the line item in the loan agreement that said the company was in default unless it filed financial statements on a regular basis) until Nov. 30, 2005. For taking on this additional risk, the bondholders got paid handsomely. One group of bondholders received $15 cash for every $1,000 invested (effectively raising their already high interest rate of 9.875% by another 1.50% on the year) and the other group of bondholders got the choice between $20 or 9.2 shares of stock for every $1,000 invested. They also changed slightly the terms of the loan agreement, making it more difficult for Bally's to default.


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How Practice Determines Method and Method Determines PracticeEmerald Publishing Limited 2009; US$ 199.00
This ebook aims to show how the research process fits into the greater business and community landscape. A great deal of theoretical work and empirical practice underpins the conceptual development of qualitative research, but this ebook strives to bring together multidirectional network learning and addresses gaps in both literature and practice. more...
Chinese Food MarketingEmerald Publishing Limited 2009; US$ 199.00
The papers in this ebook seek to examine the significant developments and critical issues involved in Chinese Food Marketing. Containing approximately 20 percent of the worlds population and enjoying annual gross domestic product growth of up to 10 percent, China ranks high on the agendas of both business leaders and policy makers. The industry... more...
Memorable Customer ExperiencesTaylor and Francis 2016; US$ 149.95
Experiential marketing - or memorable customer experiences - is proving a popular tool amongst businesses seeking to make an impact in a competitive world. Yet the scramble to achieve a presence among experience providers has led many companies to design and implement experiential marketing without integrating it with their overall marketing strategy.... more...
The New Cultures of FoodTaylor and Francis 2016; US$ 149.95
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Our Programs
The LCD Philippines Foundation has three core programs:
Other Services and Activities
- Support for Everyday Living – As well as our core programs, the LCD Philippines Foundation engages in other community and advocacy work to provide general support to the disabled community, working alongside 35 affiliated Cheshire homes and services all over the country as well as other NGOs and community organizations.
- CHIIPS – We also participate in the Cheshire International Intern Placement Scheme (CHIIPS), through which we receive interns from the UK for a six month exchange of information, experiences and ideas. Past interns have included occupational and physio therapists, and fundraising and economic empowerment specialists.


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UC Merced announces the U.S. Green Building Council has awarded platinum LEED certification to the Social Sciences and Management Building.
Every building project on campus has already or is expected to attain LEED (Leadership in Energy and Environmental Design) certification, meaning it meets or exceeds standards for sustainability.
UC Merced is being built green from the ground up, with a deep commitment to sustainability in all forms, from landscaping and water to recycling and energy efficiency.
The campus has its Triple Net Zero Commitment to consume zero net energy, produce zero landfill waste and produce zero net greenhouse gas emissions, and sustainability is a watchword in all the campus does.
"It has been an excellent collaborative effort of the entire Design and Construction team in partnership with Facilities Management to achieve this recognition," said campus architect Tom Lollini. "This is our second platinum certification, and lines up subsequent projects to achieve similar results through the USGBC Multi-Building Pilot program, in which UC Merced has served as a national leader."
The campus LEED scorecard so far is one silver certification, eight gold certifications and two platinum certifications, with five platinum certifications pending. The campus completed the Student Activities and Athletics Center last fall, and has several new buildings opening over the next two to three years: the Half Dome student housing, which opens later this month; the Student Services Building; Science and Engineering Building 2; and the Classroom and Academic Office Building – all of which are expected to achieve LEED platinum status.
Attaining LEED platinum certification, the highest ranking in the four-tiered system, means rigorous attention to sustainable design criteria and a thorough documentation and review process.
Lollini said the work has been a team effort. UC Merced's continuing success in attaining exceptional LEED outcomes is a collaborative effort with campus facilities staff, and a tribute to the leadership of Design & Construction LEED Director Mark Maxwell, who has developed innovative and effective strategies to ensure campus buildings consistently exceed sustainability goals.
UC Merced's sustainability efforts aren't limited to construction, either. They include:
- involving students in sustainability projects, from water-saving competitions in the residence halls to their daily participation in recycling and composting programs;
- energy efficiency in all buildings;
- diverting as much from area landfills as possible by recycling. For example, since the campus began construction, it has generated 9,444 tons of construction waste, and diverted 7,760 tons — 82 percent.
- production of more than 2 million kilowatt hours of electricity by the campus' solar farm – equaling 14 percent of campus usage;
- reduction of food packaging waste through the reusable containers;
- reuse of cleansing chemicals in science labs
These efforts are good for the environment and the campus budget.
"From a life-cycle perspective, each of these projects is achieving or exceeding the maximum energy and water savings credits available within the LEED accreditation program, saving the campus significant operating costs over the expected life of these buildings." Lollini said. "Think $2 million per year in energy savings for the current building inventory times the 50- to 100-year life of these buildings, and it adds up to a very sound business decision."


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Tony Awards 2012 Best and Worst Fashion: Who Hit and Who Missed? (PHOTOS)
Jessica Chastain and Amanda Seyfried were just some of the major stars of Hollywood who turned heads Sunday night at the 2012 Tony Awards in New York.
Chastain in particular had everyone talking in a nude dress by Mario Schwab, which she paired with Harry Winston jewels and Giuseppe Zanotti heels.
Celebuzz asked the Oscar-nominated actress how she manages to look so good on so many red carpets. Her response? "My trick is to have amazing people around me," she revealed exclusively.
Meanwhile, Seyfried practically stole the show on the red carpet, in a mutli-colored dress by Givenchy and Fred Leighton jewels. It was a pretty big risk for the 26-year-old beauty — but did it pay off?
Check out these dresses, plus more looks from the 66th Annual Tony Awards, in our best and worst fashion gallery, above!


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Weve updated The Hall of Presidents with a new president—George W. Bush, the 43rd president of the United States.
(Hey, this is Yester World, not Today World.)
So step into the lobby and wait for the show to begin.
Its actually a good thing if the performance doesnt begin right away.
There are plenty of interesting artifacts to see in display cases.
It doesnt matter if youre a Republican, a Democrat, or independent.
The speech by George W. Bush will be devoid of controversial issues.
Sit close enough to admire the Disney Audio-Animatronics figures sculpted by Disney Legend Blaine Gibson—even if that means youll be too close to fully take in the multi-screen projections that are also part of the show.
Gibson was involved in sculpting all 42 presidents for this show.
He even came out of retirement to sculpt Ronald Reagan, George Bush, Bill Clinton and now, George W. Bush.
The narrator calls the name of each president.
Finally, the narrator says,
"And the current president of the United States, George W. Bush."
President Bush speaks:
"My Fellow Americans, when we look back on the history of this country, we see a record of almost unbelievable energy, sacrifice, hard work—of impossible dreams that our ancestors dreamed and made real.
We see injustice, too, that weighs on our hearts even today.
But for every injustice there has always been a voice crying out to right it. And America has always listened to those voices.
"We are listening today.
And perhaps it falls to us, to this first generation of 21st century Americans, to say, once and for all, that no child, no race, no creed, no ethnic community will ever again be left out of the American dream.
Through education, through the opportunity to work and to enjoy the fruits of that work, we can open every closed door, expand the horizons of all Americans.
"Again and again we return to the same simple principles: freedom, equality.
The freedom to create, to prosper, to dream.
Equality before the law, in the workplace, and a chance for a better life.
And each time, in the process, America grows stronger.
The beacon of democracy grows brighter.
The world looks with new astonishment at what free people can do.
We the people are just getting started."
If you think the George Bush in the Hall of Presidents looks too young,
just remember that he looked a lot younger at the beginning of his administration than eight years later.
The Hall of Presidents was one of the original attractions at the Magic Kingdom when the park opened October 1, 1971.
Richard Nixon, the 37th president, was in the White House.
The show had 36 Audio-Animatronic presidents, because Grover Cleveland held the office as the 22nd and 24th president (and it would have been silly to have two Grover Clevelands).
Although the Magic Kingdom attraction goes back to 1971, the idea is much older.
Walt Disney planned to add a Revolutionary War era-themed land called Liberty Street to Disneyland.
The 1958 Disneyland souvenir map provided a glimpse at what was planned.
After Liberty Street failed to achieve its announced 1959 opening, it remained on park maps as a "future development" for several years.
In "The Magic Worlds of Walt Disney," an article in the August 1963 issue of National Geographic, writer Robert de Roos described how Abraham Lincoln would eventually be part of an attraction called One Nation Under God:
I went out into the street again with Walt [Disney] and Wathel Rogers, who supervised the Enchanted Tiki Room. We entered another building and I got a shock; I almost bumped smack into Abraham Lincoln!
The illusion was alarming. The tall, lonely man sits in a chair much as in the Lincoln Memorial in Washington, D. C. But this is no cold stone figure; this Lincoln is man-size—and so realistic it seems made of flesh and blood.
"Lincoln is part of a Disneyland project called 'One Nation Under God'" Wathel Rogers explained. "It will start with a Circa-rama presentation of great moments in constitutional crises.
"Circarama is a special motion-picture technique Walt developed for Disneyland and the Brussels World's Fair. The Bell Telephone Circarama now at Disneyland tells the story of the great sights of America. It has a 360-degree screen. The audience is surrounded by the continuous action, as if they were moving with the camera and able to see in all directions.
"The Circarama for the 'One Nation Under God' showing will have a 200-degree screen. After the Circarama showing, a curtain will close, then open again to reveal the Hall of Presidents. The visitor will see all the Chief Executives modeled life-size. He'll think it's a waxworks—until Lincoln stands up and begins to talk."
There was never a Liberty Street or One Nation Under God at Disneyland.
But Great Moments with Mr. Lincoln—with only the 16th president—opened at the New York Worlds Fair in April 1964 and at Disneyland in July 1966.
Since the 1971 opening of the Hall of Presidents in the Magic Kingdoms Liberty Square (not Liberty Street), seven presidents have joined the roll-call:
Gerald Ford, Jimmy Carter, Ronald Reagan, George Bush, Bill Clinton, George W. Bush, and Barack Obama.
For the first four, the changes were fairly minor.
There was plenty of room on the stage for more presidents.
The original 1971 presentation dramatically touched on key moments in American history.
The screens would rise.
The narrator would call each presidents name, and the Audio-Animatronic figure would nod or gesture in some way.
Only Abraham Lincoln would speak.
That changed when Bill Clinton became president in 1993.
Clintons Audio-Animatronic doppelgänger did not simply nod; he gave a speech (recorded by the real Bill Clinton).
Also, the focus of the attraction changed—not because of Clinton, but because of Eric Foner, a professor of history at Columbia University.
In 1991, Foner contacted Disneys then-CEO Michael Eisner with concerns about how Great Moments with Mr. Lincoln failed to deal with slavery and the issue of race.
Eisner listened.
He invited Foner to rework The Hall of Presidents.
Although the original 1971 script included the issue the slavery, the new script, narrated by poet Maya Angelou, focused more attention on slavery, injustice, and "that 'We the People' must mean all the people."
In January 2001, George W. Bush was sworn in as the 43rd president.
By giving Bill Clinton a speaking part eight years earlier, Disney could no longer just update the The Hall of Presidents with a nodding figure and another name on the roll-call.
On July 4, 2001, Disney announced that The Hall of Presidents would close in late summer and re-open in late fall with a likeness of George W. Bush, delivering a speech recorded by his real-life counterpart.
On November 4, 2008, America elected Barack Obama as the 44th president.
A few days earlier, the The Hall of Presidents closed for an extensive refurbishment.
Officially, the attraction reopened July 4, 2009, with Audio-Animatronic President Obama speaking in place of his predecessor.
Actually, Bush still has a speaking role in The Hall of Presidents.
The film includes President Bush on a bullhorn at Ground Zero after the September 11 attacks: "I can hear you! The rest of the world can hear you!"—followed by chants of "USA, USA…"
Click here to discuss this page on the Yesterland Discussion Forum at MiceChat!
Under New Management
Magic Kingdom Skyway
© 2009-2013 Werner Weiss — Disclaimers, Copyright, and Trademarks
Updated July 5, 2013.
Photograph of Hall of Presidents George W. Bush banner: Werner Weiss, 2002.
Photograph of Hall of Presidents George W. Bush banner (wide): Werner Weiss, 2002.
Photograph of Hall of Presidents interior: Allen Huffman, 2007.
Publicity photograph of George W. Bush in Hall of Presidents: © Disney.
Official photograph of George W. Bush: Eric Draper, White House photographer, 2003.
Photograph of Hall of Presidents exterior: Werner Weiss, 2004.
Excerpt from 1962 Disneyland souvenir map: © Disney.
Photograph of Hall of Presidents refurbishment: Werner Weiss, 2009.
Photograph of Hall of Presidents construction sign: Werner Weiss, 2009.
Publicity photograph of Obama Audio-Animatronic programming: © Disney.


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Starry night skies are components of the special places the National Park Service protects. Our national parks hold some of the last remaining harbors of darkness and provide opportunities for the public to experience this critical resource. Animals rely on natural cycles of light and dark for navigation, protection, mating and predation. Natural lightscapes are integral to many cultures. Light pollution disrupts these relationships. NPS helps preserve night viewsheds for future generations.
O Radiant Dark! O Starry Night!
Animals Need the Dark
Naturally dark night skies have a big role to play in supporting wildlife and park ecosystems.
Teens and Turtles Inside Parks
Volunteers at Gulf Island National Seashore help sea turtle hatchlings to the sea.
Camping Under the Stars
What better way to experience the great outdoors than camping in a national park under a star-filled sky?
Last updated: June 22, 2017


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New Interviews with "The Apparently Kid"
The video of Noah Ritter doing an interview with a reporter at his local county fair almost broke the internet yesterday, and now HE'S BACK!!
Watch his first interview here.
Here are 2 more funny interviews he did this week, and take note...he's a Steelers fan! I know, it's not by choice, but he'll thank his grandpa when he gets older!
The Steelers part is about :31 seconds into this one.
ABC News | More ABC News Videos
Originally from West By God Virginia!
I'm a Veteran (USA INF), a photographer, I love to surf, and I'm a huge fan of The Walking Dead and 24.Need to know more? Email me.


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The Barns at Wolf Trap Presents Melissa Manchester and Catie Curtis, Nov. 17-18
Grammy Award-winning singer/songwriter, actress, and composer Melissa Manchester returns to The Barns at Wolf Trap to showcase her beloved sound influenced by her heroes Paul Simon, Bette Midler, Barbara Streisand, and Barry Manilow. Boasting almost four decades of experience as an entertainer and master of several different performance genres, Manchester's classic, sultry voice and intimate performance style have been the catalyst for the majority of her widespread success. Her songs have been recorded by Barbra Streisand, Alison Krauss, Roberta Flack, Johnny Mathis, and many others.
Manchester has also had starring roles acting and singing on stage in Andrew Lloyd Webber's SONG AND DANCE and MUSIC OF THE NIGHT, Sondheim's SWEENEY TODD, and most recently in the Chicago premiere of HATS! Her recent receipt of the Governor's Award from the National Academy of Recordings Arts and Sciences is proof of her a place as one of the most influential and versatile performers of the past four decades.
The performance will be Thursday, November 17, 2011 at 8 p.m. Tickets are $35.
Catie Curtis was last at The Barns in the spring of 2009, "folk-rock goddess"-as termed by The New Yorker-Catie Curtis returns in support of 'Hello Stranger', her 10th and latest release. An acoustic string band album featuring stripped down versions of her classic songs, 'Hello Stranger' is a response to Curtis's fan's request for a recording that captures the spirit and intimacy of her live shows. The record features Nashville all-star pickers Stuart Duncan (fiddle, mandolin), Alison Brown (banjo), Todd Phillips (bass), George Marinelli (guitar/mandolin/dobro), and Kenny Malone (percussion).