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Category Archives: Eligibilty
Legislative Update For May 10, 2017
I am a member of the Health Law Section's Legislative Committee, along with attorneys Shawn Parker, and Scott Templeton. Together we drafted summaries of all the potential House and Senate Bills that have passed one house (crossed over) and have potential of becoming laws. We published it on the NC Bar Association Blog. I figured my readers would benefit from the Bill summaries as well. Please see below blog.
On behalf of the North Carolina Bar Association Health Law Section's Legislative Committee, we are providing the following 2017 post-crossover legislative update.
The North Carolina General Assembly has been considering a substantial number of bills of potential relevance to health law practitioners this session. The Health Law Section's Legislative Committee, with the help of NCBA staff, has been monitoring these bills on virtually a daily basis.
The General Assembly's rules provide for a "crossover date" during the legislative session, which this year was April 27. The importance of that date is essentially that, with certain caveats, unless a bill has passed one chamber (House or Senate) by the crossover date, the bill will no longer be considered by the legislature. The following listing provides brief descriptions of current proposed legislation, in two categories.
The first category includes bills that passed either the House or Senate by the crossover date, and therefore remain in consideration by the legislature. The second category includes bills that did not pass either chamber before the crossover date, but because the bills contain an appropriation or fee provisions, they may continue to be considered pursuant to legislative rules.
In addition to the bills listed below, a number of bills did not make crossover and do not meet an exception to the crossover rule, and are likely "dead" for this legislative session. We recognize, however, that the legislature is capable of "reviving" legislation by various mechanisms. The Legislative Committee continues to monitor legislation during the session, and in addition to this update, we may provide further updates as appropriate, and also anticipate doing a final summary once the legislature has adjourned later this year.
Bills That Passed One Chamber by the Crossover Date.
House Bills
HB 57: Enact Physical Therapy Licensure Compact
Makes North Carolina a member of the Physical Therapy Licensure Compact, upon the 10th member state to enact the compact. Membership in the compact would allow physical therapists who hold licenses in good standing in any other compact state to practice physical therapy in North Carolina. Likewise, physical therapists holding a valid license in North Carolina would be able to practice physical therapy in any of other the compact member states.
HB 140: Dental Plans Provider Contracts/Transparency
Provides that insurance companies that offer stand-alone dental insurance are subject to the disclosure and notification provisions of G.S. 58-3-227.
HB 156: Eyeglasses Exemption from Medicaid Capitation
Adds the fabrication of eyeglasses to the list of services that are not included as part of transitioning the State Medicaid program to a capitated system.
HB 199: Establish Standards for Surgical Technology
Creates standards for surgical technology care in hospitals and ambulatory surgical facilities, specifically prohibiting employing or contracting with a surgical technologist unless that technologist produces one of four enumerated qualifications.
HB 206: N.C. Cancer Treatment Fairness
Requires insurance coverage parity so orally administered anti-cancer drugs are covered on a basis no less favorable than intravenously administered or injected anti-cancer drugs.
HB 208 : Occupational Therapy Choice of Provider
Adds licensed occupational therapists to the list of providers for whom insurers are required to pay for services rendered, regardless of limitations to access of such providers within the insurance contract.
HB 243: Strengthen Opioid Misuse Prevention (STOP) Act
Requires, among other things, practitioners to review information in the state-controlled substance reporting system prior to prescribing certain targeted controlled substance and limits the length of supply that a targeted controlled substance may be prescribed for acute pain relief.
HB 258: Amend Medical Malpractice Health Care Provider Definition
Includes paramedics, as defined in G.S. 131E-155, within the definition of health care provider for the purposes of medical malpractice actions.
HB 283: Telehealth Fairness Act
Requires health benefit plans to provide coverage for health care services that are provided via telemedicine as if the service were provided in person.
HB 307: Board Certified Behavioral Analyst/Autism Coverage
Adds board certified behavioral analysts as professionals that qualify for reimbursement for providing adaptive behavioral treatments under North Carolina's mandatory coverage requirements for autism spectrum disorder.
HB 403: LME/MCO Claims Reporting/Mental Health Amendments
Requires Local Management Entities/Managed Care Organizations (LME/MCOs) to use a state-designated standardized format for submitting encounter data, clarifies that the data submitted may be used by DHHS to, among other authorized purposes, set capitation rates. Also modifies multiple statutory requirements and references related to LME/MCOs. Limits the LME/MCOs' use of funds to their functions and responsibilities under Chapter 122C. Also limits the salary of an area director unless certain criteria are met.
HB 425: Improve Utilization of MH Professionals
Allows licensed clinical addiction specialists to own or have ownership interest in a North Carolina professional corporation that provides psychotherapeutic services. Allows licensed professional counselors or licensed marriage and family therapist to conduct initial examinations for involuntary commitment process when requested by the LME and approved by DHHS.
HB 550: Establish New Nurse Licensure Compact
Repeals the current nurse licensure compact codified at G.S. 90-171.80 – 171.94 and codifies a substantially similar compact, which North Carolina will join upon adoption by the 26th state, allowing nurses to have one multi-state license, with the ability to practice in both their home state and other compact states.
HB 631: Reduce Admin. Duplication MH/DD/SAS Providers
Directs DHHS to establish a work group to examine and make recommendations to eliminate administrative duplication of requirements affecting healthcare providers.
Senate Bills
SB 42: Reduce Cost and Regulatory Burden/Hospital Construction
Directs the N.C. Medical Care Commission to adopt the American Society of Healthcare Engineers Facility Guidelines for physical plant and construction requirements for hospital facilities and to repeal the current set of rules pertaining to such requirements under the current hospital facilities rules within the North Carolina Administrative Code.
SB 161: Conforming Changes LME/MCO Grievances/Appeals
Provides a technical change to North Carolina LME/MCO enrollee grievance statutes by renaming "managed care actions" as "adverse benefit determinations" to conform to changes in federal law.
SB 368: Notice of Medicaid SPA Submissions
Directs DHHS to notify the General Assembly when DHHS submits to the federal government an amendment to the Medicaid State Plan, or decides not to submit a previously published amendment.
SB 383: Behavioral Health Crisis EMS Transport
Directs DHHS to develop a plan for adding Medicaid coverage for ambulance transports to behavioral health clinics under Medicaid Clinical Coverage Policy 15.
SB 384: The Pharmacy Patient Fair Practices Act
Prohibits pharmacy benefits managers from using contract terms to prevent pharmacies from providing direct delivery services and allows pharmacists to discuss lower-cost alternative drugs with and sell lower-cost alternative drugs to its customers.
SB 630: Revise IVC Laws to Improve Behavioral Health
Makes substantial revisions to Chapter 122C regarding involuntary commitment laws.
Bills That Did Not Pass Either Chamber by the Crossover Date, But Appear to Remain Eligible for Consideration.
House Bills
HB 88: Modernize Nursing Practice Act
Eliminates the requirement of physician supervision for nurse practitioners, certified nurse midwives, clinical nurse specialists and certified registered nurse anesthetists.
HB 185: Legalize Medical Marijuana
Creates the North Carolina Medical Cannabis Act. Among many other provisions, it provides that physicians would not be subject to arrest, prosecution or penalty for recommending the medical use of cannabis or providing written certification for the medical use of cannabis pursuant to the provision of the newly created article.
HB 270: The Haley Hayes Newborn Screening Bill
Directs additional screening tests to detect Pompe disease, Mucopolysaccharidosis Type I, and X-linked Adrenoleukodystrophy as part of the state's mandatory newborn screening program.
HB 858: Medicaid Expansion/Healthcare Jobs Initiatives
Repeals the legislative restriction on expanding the state's Medicaid eligibility and directs DHHS to provide Medicaid coverage to all people under age 65 with incomes equal to or less than 133 percent of the federal poverty guidelines. Appropriates funds and directs the reduction of certain recurring funds to implement the act. Additionally the bill creates and imposes an assessment on each hospital that is not fully exempt from both the current equity and upper payment limit assessments imposed by state law.
HB 887: Health Insurance Mandates Study/Funds
Appropriates $200,000 to fund consultant services to assist the newly established Legislative Research Commission committee on state mandatory health insurance coverage requirements.
HB 902: Enhance Patient Safety in Radiological Imaging.
Creates a new occupational licensure board to regulate the practice of radiologic imaging and radiation therapy procedures by Radiologic Technologists and Radiation Therapists.
Senate Bills
SB 73: Modernize Nursing Practice Act
Eliminates the requirement of physician supervision for nurse practitioners, certified nurse midwives, clinical nurse specialists and certified registered nurse anesthetists.
SB 290: Medicaid Expansion/Healthcare Jobs Initiative
Repeals the legislative restriction on expanding the state's Medicaid eligibility and directs DHHS to provide Medicaid coverage to all people under age 65 with incomes equal to or less than 133 percent of the federal poverty guidelines. Appropriates funds, directs the reduction of certain recurring funds to implement the Act. Additionally the bill creates and imposes an assessment on each hospital that is not fully exempt from both the current equity and upper payment limit assessments imposed state law.
SB 579: The Catherine A. Zanga Medical Marijuana Bill
Creates the North Carolina Medical Cannabis Act. Among many other provisions, it provides that physicians would not be subject to arrest, prosecution or penalty for recommending the medical use of cannabis or providing written certification for the medical use of cannabis pursuant to the provision of the newly created article.
SB 648: Legalize Medical Marijuana
Creates the North Carolina Medical Cannabis Act. Among many other provisions, it provides that physicians would not be subject to arrest, prosecution or penalty for recommending the medical use of cannabis or providing written certification for the medical use of cannabis pursuant to the provision of the newly created article.
Please contact a member of the Health Law Section's Legislative Committee should you have any questions regarding this report. The Committee's members are Knicole Emanuel, Shawn Parker, and Scott Templeton (chair).
Knicole Emanuel Speaks Out on WRAL: You Do Not Pee in a Cup at the Dentist!
Broken Promises Could Promise Disaster for Pediatricians! or "I Don't Give a Damn" What the Law Is!
In 2013 and 2014, those of you who are primary health care physicians received a boost in Medicaid reimbursement rates up to the Medicare rates for E&M and vaccine administration CPT codes. Many of you self-attested to being primary care physicians. In other words, you determined that you act as a primary care physician. No official acting on behalf of the government reviewed your self-attestation and approved or denied your self-attestation.
What if the government decides, retroactively, that you did not qualify as a primary care physician and attempt to recoup the enhanced payments?? Is that allowed? "A retroactive take back?"
We all know that retroactive take backs occur in other types of audits!
This whole situation reminds me of my favorite movie of all time: Gone With the Wind…you know, Scarlett O'Hare, Rhett Butler, the Civil War…Over Thanksgiving, AMC had a Gone With the Wind marathon, and I must have watched it 4 times (I was sick, so I couldn't do much else).
The plot is that Rhett is in love with Scarlett the entire movie, which spans over a fictious, "movie time" of two decades. And Scarlett is not in love with Rhett the entire movie until the very end.Once she finally realizes her love for Rhett, he is beyond frustrated and wants nothing to do with her.
She asks, "Rhett, oh, Rhett, what am I supposed to do?" To which he responds, "Frankly, my dear, I don't give a damn!"
There are many themes found in Gone With the Wind, but the one most appropos is "You may think you understand reality, but, in the end, your reality may be a fictitious dream."
Similarly, in 2013 and 2014, if you are a primary health care physician, you received a boost in Medicaid reimbursement rates up to the Medicare rates for E&M and vaccine administration CPT codes. You believed the rate hike to be reality.
This rate hike was a big deal for physicians, especially pediatricians. Pediatric practices rely heavily on Medicaid, usually from 20-100%. This rate hike took a reimbursement rate of approximately 78% of the Medicare rate, which, by the way, has been frozen by our legislature at the 2002 rate, plus an additional 3% reduction, followed by another 1% reduction to 100% of the Medicare rate. Quite an increase!
Well, that so blissful increase in Medicaid rates may come back to bite you!!! You thought that you were receiving higher Medicaid reimbursement rates, but, in the end, may you have to pay it back?
The reality of receiving higher Medicaid reimbursement rates may truly only have been a fictitious dream.
"Why," you demand. "Why?" "Well," says the government, "I don't give a damn what the law is."
Caveat lector: It is not 100% certain that you will be audited. This blog is only a warning as to a possibility. If, in fact, you are audited, then you have legal rights!
Let's go over why there may be audits for those of you who self-attested to being primary care physicians…
In order to receive this increased rate hike, physicians had to self-attest that he/she :
- "Is Board certified as family medicine, general internal medicine, or pediatric medicine; and/or
- Has furnished evaluation and management services under codes described in paragraph (b) of this section that equal at least 60 percent of the Medicaid codes he or she has billed during the most recently completed CY or, for newly eligible physicians, the prior month."
If you are Board certified in family medicine, general internal medicine, or pediatric medicine, there should not be a problem. There isn't anything to argue. You are either Board certified or not.
However, if you are not Board certified, you will be relying on the government's auditors to determine whether your practice comprises 60% of applicable Medicaid codes during the most recent calendar year.
Then, if the government's auditors determine that your practice comprises of only 57% of applicable Medicaid codes, you may be charged with returning all the money you received as enhanced payments during 2013 and 2014.
And we all know how accurate some of our government's auditors are…
So there you were, a physician, happy to self-attest to being a primary care provider, happy to receive higher reimbursements for two years, and with no thought of recoupments.
Then…BOOM…you are hit with the realization that you may be liable to the government for a recoupment of those enhanced reimbursements.
Because, frankly, my Dear, the government does not give a damn. Your reality was, in fact, a mere fictitious dream.
NCTracks, MPW, and Eligibility: The Three Billy Goats Gruff
The story of The Three Billy Goats Gruff tells a tale of 3 billy goats, one puny, one small, and one HUGE. The first two billy goats (the puny and small) independently try to cross the bridge to a green pasture. They are blocked by a mean troll, who wants to eat the billy goats. Both billy goats tell the troll that a bigger billy-goat is coming that would satisfy the troll's hunger more than the puny and small goats. The troll waits for the HUGE billy-goat, which easily attacks the troll to his death.
The moral: "Don't be greedy."
My moral: "You don't always have to be HUGE, the puny and small are equally as smart." – (They didn't even have to fight).
The majority of Medicaid cards do not have expiration dates. Though we have expiration dates on many of our other cards. For example, my drivers' license expires January 7, 2018. My VISA expires April 18, 2018.
Most Medicaid cards are annually renewed, as well. Someone who is eligible for Medicaid one year may not be eligible the next.
Our Medicaid cards, generally, have an issuance date, but not an expiration date. The thought is that requiring people to "re-enroll" yearly is sufficient for eligibility status.
Similar to my CostCo card. My Costco card expires annually, and I have to renew it every 12 months. But my CostCo card is not given to me based on my personal circumstances. I pay for the card every year, which means that I can use the card all year, regardless whether I move, get promoted, or decide that I never want to shop at CostCo again.
Medicaid cards, on the other hand, are based on a person's or family's personal circumstances.
A lot can happen in a year causing someone to no longer be eligible for Medicaid.
For example, a Medicaid recipient, Susan, could qualify for Medicaid on January 1, 2015, because Susan is a jobless and a single mother going through a divorce. She has a NC Medicaid card issued on January 1, 2015. She presents herself to your office on March 1, 2015. Unbeknownst to you, she obtained a job at a law office in February (Susan is a licensed attorney, but she was staying home with the kids when she was married. Now that she is divorced, she quickly obtained employment for $70,000/year, but does not contact Medicaid. Her firm offers health insurance, but only after she is employed over 60 days. Thus, Susan presents herself to you with her Medicaid card).
If Susan presents to your office on March 1, 2015, with a Medicaid card issued January 1, 2015, how many of you would double-check the patients eligibility in the NCTracks portal?
How many would rely on the existence of the Medicaid card as proof of eligibility?
How many of you would check eligibility in the NCTRacks portal and print screen shot showing eligibility for proof in the future.
The next question is who is liable for Susan receiving Medicaid services in March when she was no longer eligible for Medicaid, but held a Medicaid card and, according to the NCTracks portal, was Medicaid eligible??
- Susan?
- You, the provider?
- NCTracks?
Do you really have to be the HUGE billy goat to avoid troll-ish recoupments?
Susan's example is similar to dental services for pregnant women on Medicaid for Pregnant Women (MPW). MPW expires when the woman gives birth. However, the dentists do not report the birth of the child, the ob/gyn does. Dentists have no knowledge of whether a woman has or has not given birth. See blog.
MPW expires upon the birth of the child, and that due date is not printed on the MPW card.
I daresay that the dentists with whom I have spoken have assured me that every time a pregnant woman presents at the dental or orthodontic offices that an employee ensures that the consumer is eligible for dental services under MPW by checking the NCTracks portal. (Small billy-goat). Some dentists go so far to print out the screenshot on the NCTracks portal demonstrating MPW eligibility (HUGE billy-goat), but such overkill is not required by the DMA Clinical Coverage Policies.
If the clinical policies, rules, and regulations do not require such HUGE billy-goat nonsense, how can providers be held up to the HUGE billy-goat standard? Even the puny billy-goat is, arguably, reasonably compliant with rules, regulations, and policies.
NCTracks is not current; it is not "live time." Apparently, even if the woman has delivered her baby, the NCTracks portal may still show that the woman is eligible for MPW. Maybe even for months…
Is the eligibility fallacy that is confirmed by NCTracks, the dentists' fault?
Well, over three (3) years from its go-live date, July 1, 2013, NCTracks may have finally fixed this error.
In the October 2015 Medicaid Bulletin, DHHS published the following:
Attention: Dental Providers
New NCTracks Edits to Limit Dental and Orthodontic Services for Medicaid for Pregnant Women (MPW) Beneficiaries
On Aug. 2, 2015, NCTracks began to deny/recoup payment of dental and orthodontic services for beneficiaries covered under the Medicaid for Pregnant Women (MPW) program if the date of service is after the baby was delivered. This is a longstanding N.C. Medicaid policy that was previously monitored through post-payment review.
According to N.C. Division of Medical Assistance (DMA) clinical coverage policy 4A, Dental Services:
For pregnant Medicaid-eligible beneficiaries covered under the Medicaid for Pregnant Women program class 'MPW,' dental services as described in this policy are covered through the day of delivery.
Therefore, claims for dental services rendered after the date of delivery for beneficiaries under MPW eligibility are outside the policy limitation and are subject to denial/recoupment.
According to DMA clinical coverage policy 4B,Orthodontic Services:
Pregnant Medicaid-eligible beneficiaries covered under the Medicaid for Pregnant Women program class 'MPW' are not eligible for orthodontic services as described in this policy.
Therefore, claims for orthodontic records (D0150, D0330, D0340, and D0470) or orthodontic banding (D8070 or D8080) rendered for beneficiaries under MPW eligibility are outside of policy limitation and are subject to denial/recoupment.
Periodic orthodontic treatment visits (D8670) and orthodontic retention (D8680) will continue to be reimbursed regardless of the beneficiary's eligibility status at the time of the visit so long as the beneficiary was eligible on the date of banding.
Seriously? "Now I'm coming to gobble you up!!"
August 2, 2015, is over two years after NCTracks went live.
In essence, what DHHS is saying is that NCTracks was inept at catching whether a female Medicaid recipient gave birth. Either the computer system did not have a way for the ob/gyn to inform NCTracks that the baby was delivered, the ob/gyn did not timely submit such information, or NCTracks simply kept women as being eligible for MPW until, months later, someone caught the mistake. And, because of NCTracks' folly, the dentists must pay.
How about, if the portal for NCTracks state that someone is eligible for MPW, then providers can actually believe that the portal is correct??? How about a little accountability, DHHS???
If you take MPW and want to avoid potential recoupments, you may need some pregnancy tests in your bathrooms.
DHHS is expecting all dentists to be the HUGE bill goat. Are these unreasonable expectations? I see no law, rules, regulations, or policies that require dentists to be the HUGE billy goat. In fact, the small and puny may also be compliant.
"You don't always have to be HUGE, the puny and small are equally as smart."
Federal Audit Spurs NC to Recoup from Dentists Who Accept MPW!!
When providers receive Tentative Notices of Overpayment (TNOs), we appeal the findings. And, for the most part, we are successful. Does our State of NC simply roll over when the federal government audits it??
A recent audit by Health and Human Services (HHS) Office of Inspector General (OIG) finds that:
"We recommend that the State agency:
- refund $1,038,735 to the Federal Government for unallowable dental services provided to MPW beneficiaries after the day of delivery; and
- increase postpayment reviews of dental claims, including claims for MPW beneficiaries, to help ensure the proper and efficient payment of claims and ensure compliance with
Federal and State laws, regulations, and program guidance."
MPW is Medicaid for Pregnant Women. Recently, I had noticed that a high number of dentists were receiving TNOs. See blog. I hear through the grapevine that a very high number of dentists recently received TNOs claiming that the dentists had rendered dental services to women who had delivered their babies.
Now we know why…
However, my question is: Does NC simply accept the findings of HHS OIG without requesting a reconsideration review and/or appeal?
It seems that if NC appealed the findings, then NC would not be forced to seek recoupments from health care providers. We already have a shortage of dentists for Medicaid recipients. See blog and blog.
And if the federal auditors audit in similar fashion to our NC auditors, then the appeal would, most likely, be successful. Or, in the very least, reduce the recouped amount, which would benefit health care providers and taxpayers.
Whenever NC receives a federal audit with an alleged recoupment, NC should fight for NC Medicaid providers and taxpayers!! Not simply roll over and pay itself back with recoupments!
This audit was published March 2015. It is September. I will look into whether there is an appeal on record.
Consider Nominating This Blog for the 2015 Best Legal Blog Contest (Please)!
The 2015 Legal Blog Contest is here!
For all you that follow this blog, thank you! I hope that you agree that I provide you with valuable and up-to-date information on Medicaid/care regulatory issues. At least, that is my hope in maintaining this blog. And maintaining this blog takes a lot of time outside my normal, hectic legal career and my time as a mom and wife. Don't get me wrong…I love blogging about these issues because these issues are near and dear to my heart. I am passionate about health care, health care providers, Medicaid and Medicare, and access to quality care.
If you are a follower, then you know that I try to keep my readers current on Medicaid/care fraud, federal and state laws, legal rights for health care providers, bills in the General Assembly germane to health care, extrapolation issues, CMS rulings, managed care matters, reimbursement rates, RAC audits and much, much more!
If you enjoy my blog, I ask a favor. Please consider nominating my blog for the 2015 Best Legal Blog Contest.
If you want to nominate my blog, please click here.
Scroll down until you see this:
Enter your name, email address, my blog address. which is:
For category, click on "Niche and Specialty." I do not believe the other categories correctly describe my blog.
And type a reason why you enjoy my blog. Much appreciated!
Going to the Dentist? You May Need to Take a Pregnancy Test!
I go to the dentist for teeth cleaning. I go to an ob/gyn for my lady parts. They each are not entwined.
Recently, a number of dentists have contacted me they are receiving Tentative Notices of Overpayment (TNOs) stating that they owe money back to the state for dental services completed on women who had already given birth.
First, what is Medicaid for Pregnant Women?
Basically, Medicaid for Pregnant Women (MPW) is a self-defining type of Medicaid coverage. It is Medicaid coverage for pregnant women.
According to DHHS, "Medicaid for Pregnant Women (MPW) only covers services related to pregnancy:
- Prenatal care, delivery and 60 days postpartum care
- Services to treat medical conditions which may complicate the pregnancy (some services require prior approval)
- Childbirth classes
- Family planning services
A pregnant woman may apply for this program before or after she delivers. A woman who has experienced a recent pregnancy loss may also be eligible."
And routine dental services are covered for MPW recipients through the date of delivery.
But, the day after the child is born…BOOM…no routine dental visits.
Here is a hypothetical example of this new issue that I have recently been made aware:
Mary is pregnant and is covered by MPW. She makes a dental appointment for August 1, 2015. She is due September 1, 2015. She gives birth to a bouncing, baby boy, whom she names Paul on July 28, 2015. Even though Paul is early, he is healthy (this is a happy hypothetical). She shows up for her dental appointment with Dr. Peter on August 1, 2015.
Herein lies a delicate subject…due to its sensitive nature, I will now revert the hypothetical to myself, personally, and only for this narrow topic.
I had my beautiful 10-year old daughter at 28 weeks. She came three months early. Despite the early delivery, I had expanded in the stomach area at least as much as a normal pregnant woman, if not more so. Chalk it up to Harris Teeter birthday cakes. After my daughter was born, the insensitive, yet rule-following nurse actually had the audacity to place me on a scale (while I was conscious and alert!). I was horrified to discover that after all that I went through that I had lost a mere 4 pounds. She must have seen my look because she quickly explained that I had been pumped with so much fluid during the procedure that my weight was inflated. Likely story, I thought. The point of this short anecdote is that I looked the same after giving birth that I did prior to giving birth. Embarrassingly, my transition back to a normal, un-pregnant body extended for a much longer than expected period of time. Chalk it up to Harris Teeter birthday cakes.
Ok, going back to our hypothetical…
Mary really wants her teeth cleaned because, once she gives birth, she knows full well that she will not be able to undergo a teeth cleaning. So when she presents herself at Dr. Peter's office and Dr. Peter asks whether she is still pregnant, she answers, "Yes, sir."
Dr. Peter, undergoing all the due diligence that a dentist can be expected, has his assistant log on to NCTracks. According to NCTracks, Mary is eligible for MPW. No changes are noted on her eligibility. Satisfied with his due diligence, Dr. Peter cleans Mary's teeth.
Two years later, Dr. Peter receives a TNO stating that he owes $10,000 back for services rendered to women after they gave birth.
Dr. Peter conducted his due diligence. Dr. Peter inquired as to the pregnancy status to the patient. Dr. Peter checked eligibility status with NCTracks.
What more would the state expect Dr. Peter do to determine whether his dental patients are indeed still pregnant? Ask them to pee in a cup? Hire a onsite ob/gyn?
You can imagine the consequences of each.
Yet, according to a number of dentists who have communicated with me, the state is placing the burden of knowing whether the dental patient is still pregnant on the dentist.
Talk about accountability! If NCTracks shows that the patient is eligible for MPW, shouldn't NCTracks be held liable instead of the dentist?
Call me crazy, but I may or may not be extremely angry if my dentist asks me to pee in cup.


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'Tis the season for some of our favorite artists to show their true Christmas spirit and share songs with contemporary beats that are fun to jingle-jangle to! To brighten your days during these last few weeks of December, we have compiled a playlist of some of Christmas past's most popular contemporary songs. Also be sure to check out the video above of George Strait's 2013 holiday hit "Christmas Cookies" above!
1. "I'll Be Home" – Meghan Trainor
2. "Christmas Tree" – Lady Gaga ft. Space Cowboy
3. "Oh Santa!" – Mariah Carey
4. "Christmas Cookies" – George Strait
5. "Mistletoe" – Justin Bieber
6. "Christmas in Hollis" – Run-D.M.C.
7. "Christmas Lights" – Coldplay
8. "Christmas Song" – Dave Matthews Band
9. "Don't Shoot Me Santa" – The Killers
10. "8 Days of Christmas" – Destiny's Child
– Janice Daniels KNCI/Sacramento


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Just a coincidence?poisonousteahttps://firstname.lastname@example.com:blogger.com,1999:blog-6743292846277638434.post-87655133056035354942012-05-06T18:33:41.809-07:002012-05-06T18:33:41.809-07:00Seriously, I love this skin so much. It really is ...Seriously, I love this skin so much. It really is breathtaking in its elegance and style, while sacrificing nothing in its power and warrior-ness.

Bought the champ, bought the skin, haven't looked back - so much fun. :DMatthewhttps://email@example.com:blogger.com,1999:blog-6743292846277638434.post-65495290660161323512012-04-03T23:50:36.863-07:002012-04-03T23:50:36.863-07:00Gotta love that skin, and gotta love Leona in gene...Gotta love that skin, and gotta love Leona in general. Best tank in LoL, IMO.

Oh, and Ironstylus, you still owe me that comment on my Leona fic. In case you forgot, it's found here:

http://na.leagueoflegends.com/board/showthread.php?t=1784157

Just trying to make it so you don't make broken promises, okay?Yousosmarthttps://email@example.com:blogger.com,1999:blog-6743292846277638434.post-40647087136944106872012-04-02T22:36:36.650-07:002012-04-02T22:36:36.650-07:00More please, thank you, and goodbye.More please, thank you, and goodbye.Scuzoidhttps://email@example.com:blogger.com,1999:blog-6743292846277638434.post-35362358990973341522012-02-25T00:42:12.581-08:002012-02-25T00:42:12.581-08:00omg, your real name is at the top of the page. I c...omg, your real name is at the top of the page. I could totally Facestalk you and Leona In Real Life now. That makes me feel weird. The internet is a strange place.MTaurhttps://firstname.lastname@example.com:blogger.com,1999:blog-6743292846277638434.post-59358853026173317742012-02-19T05:53:51.222-08:002012-02-19T05:53:51.222-08:00Thank you Ironstylus, I have been playing Leona si...Thank you Ironstylus,
I have been playing Leona since release. I tend to associate her with Valkyrias in Valkyria Chronicles because of her strong female figure.Unknownhttps://email@example.com:blogger.com,1999:blog-6743292846277638434.post-87198478086967839982012-02-17T23:40:23.782-08:002012-02-17T23:40:23.782-08:00The fact you've played Valkyrie Profile which ...The fact you've played Valkyrie Profile which most people seem to have missed AND Soulcaliber makes me love you even more. Although I suck at Hilde.ArcaneWeaponhttps://email@example.com:blogger.com,1999:blog-6743292846277638434.post-56312365244830462472012-02-17T08:49:36.583-08:002012-02-17T08:49:36.583-08:00Hey there IronStylus! I hope you like blogging as...Hey there IronStylus!

I hope you like blogging as much as the rest of us; getting positive feedback for your work is always a joy.

I'm excited to see what insights you post concerning your work at Riot and your life as an artist in general!Nuker Zerohttps://firstname.lastname@example.com:blogger.com,1999:blog-6743292846277638434.post-87214469723302947442012-02-17T00:32:49.567-08:002012-02-17T00:32:49.567-08:00I love the 4th art the most. The radiant colors an...I love the 4th art the most. The radiant colors and brightness really suits her. :) Leona is the 1st champion I bought joining League, and I knew nothing about her. She just looked amazing, so I bought her right when I reached 6300. I never regretted it. When I started hitting pro games, I started to see her flaws and weaknesses. I feel like these flaws blind me from continuing to play her. I really wish she had more roles other than bott. support lane. I hope for tiny additions to her passive just for jungle purposes. I really do. :(YooWeirdohttps://email@example.com:blogger.com,1999:blog-6743292846277638434.post-45760200489830223962012-02-16T23:04:30.634-08:002012-02-16T23:04:30.634-08:00I just want to commend you on this skin, it is my ...I just want to commend you on this skin, it is my favorite skin in the game and Leona is one of my top 5 favorite champions along with being my favorite tank.Ryjinhttps://email@example.com:blogger.com,1999:blog-6743292846277638434.post-2567719463117405032012-02-16T21:58:45.614-08:002012-02-16T21:58:45.614-08:00I kind of prefer the default skin, actually, but I...I kind of prefer the default skin, actually, but I'll watch for this one to go on sale for sure. Three is plenty... for now.MTaurhttps://firstname.lastname@example.com:blogger.com,1999:blog-6743292846277638434.post-60022280996639367412012-02-16T10:36:35.002-08:002012-02-16T10:36:35.002-08:00I truely love this skin. Dispite having all the o...I truely love this skin. Dispite having all the other Leona skins I couldn't resist buying this one. The armor is strong and elogant equally. And I definitly see the soul calibur influance (Another game I'm a huge fan of). Also great to see an actual breast plate.Hoofsterhttps://firstname.lastname@example.com:blogger.com,1999:blog-6743292846277638434.post-7694286645080938822012-02-15T23:43:51.739-08:002012-02-15T23:43:51.739-08:00Love it sir macaw, I now own all of the Leona skin...Love it sir macaw, I now own all of the Leona skins :DSamnitehttps://firstname.lastname@example.com:blogger.com,1999:blog-6743292846277638434.post-58962826237863747772012-02-11T22:08:10.387-08:002012-02-11T22:08:10.387-08:00I find it amazing that you worked in the Iron Sola...I find it amazing that you worked in the Iron Solari meme while still making completely badass armor. I especially want to thank you for NOT making a boob-plate, but an ACTUAL breastplate for Leona. She actually looks like she could travel to the Middle Ages and kick Joan of Arc's arse. Also: ಠ_ಠDom Kovellhttps://email@example.com:blogger.com,1999:blog-6743292846277638434.post-53544741655924431162012-02-11T22:04:07.807-08:002012-02-11T22:04:07.807-08:00I can't wait to see more stuff from the concep...I can't wait to see more stuff from the conception phase of things. I'm hoping to become a concept artist myself, so I'm always looking for more examples from the industry to inspire me =]
P.S. You're my favourite red
P.P.S. Thank you for Leona! She's certainly a step in the right direction in terms of female champions.Samurai Squashhttps://email@example.com:blogger.com,1999:blog-6743292846277638434.post-79858856042589210882012-02-11T21:23:35.633-08:002012-02-11T21:23:35.633-08:00I find it interesting how the colors and lightning...I find it interesting how the colors and lightning affected Leona's expression in the finalized piece. With the cool blues and purples and without the backlight, she looks much less fierce, almost serene. But you put that warm bordering on harsh light behind her and she suddenly looks like she's ready to smash someone.Imaliahttps://email@example.com:blogger.com,1999:blog-6743292846277638434.post-79988905738727910562012-02-11T21:14:26.454-08:002012-02-11T21:14:26.454-08:00I haven't played Leona, but all of her art and...I haven't played Leona, but all of her art and themes look really awesome to me. Even more awesome is that you acknowledge Valkyrie Profile as an inspiration - that's one of my favorite games.

Keep up the good work!

---SkartheIronside d'Windursthttps://email@example.com:blogger.com,1999:blog-6743292846277638434.post-42182012379089107022012-02-11T20:51:46.920-08:002012-02-11T20:51:46.920-08:00I actually like the art before the final adjustmen...I actually like the art before the final adjustments better, but that's jut my opinion.Metal_Koolahttps://firstname.lastname@example.com


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Yogi Tea Woman's Mother To Be
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This herbal blend includes Raspberry Leaf, traditionally used for centuries by midwives and Western herbalists to support the female system. Refreshing Spearmint, Peppermint and Fennel add bright and intriguing flavor. Relax and enjoy this special time with a cup of our soothing Woman's Mother To Be tea.*
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Drank this through my most recent pregnancy and loved it. Anything that didn't make me gag or nauseous was a win in my book. The taste wasn't the best but I'm sure it didn't it's job
A co-worker purchased this for me (along with some others) in lieu of alcohol for an x-mas gift -- fitting. It taste great makes me feel good. I love tea, so I was happy to add another to this mommy-to-be's repertoire.
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We had some great responses come through with suggestions for books to read this year! I have assembled them all, and added a few, to come up with a lot of possibilities for the polls. I had a limit of how many options could be for each poll so that's why there are three. They have different options so please go through all of them. You should be able to vote for as many as you want so please plan on checking at least 9-10. Remember, this is for the rest of the year (9 more meetings).
Also included in this are a couple long books. We discussed at the last meeting that some of us would like to read Anna Karenina but it will take more than one month. If a long book is chosen it will be considered for the June-September timeframe so we will have a couple months to read it.
The polls will stay open until the middle of October.
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He was a Spanish poet and writer, one of the greatest of all time. Antonio Machado was born in Seville in 1875, but at the age of eight he left the Andalusian city and went to Madrid. He studied at a secular and modern school. Later he traveled to Paris, where he also met Oscar Wilde and poet Rubén Darío. ...Read More »
GUILLAUME APOLLINAIRE (1880/1918) – Leader of the Surrealist movement, which marked an epoch
He became friends with avant-garde artists (including Picasso and Braque, Rousseau and Duchamp). Illegitimate son of Polish woman and an unidentified man (his father may have been a cardinal in the Church or an Italian military officer) was born in Rome. His career influenced the development of such artistic movements (as Futurism and Cubism, Dadaism, and Surrealism). Guillaume Apollinaire was bohemian artist ...Read More »
GERMAN POETRY – Love poetry of Else Lasker-Schüler
She was German poetess, the lyrical phenomenon of modern Germany. She grew up as a prodigal child, in fact, at four years she already knew how to read and write. In 1894 he moved to Berlin, where he remained until 1933. Here she published first poems. Her first collection of poems was published in 1902. Else Lasker-Schüler with a collection ...Read More »
SHE WAS DEEPLY LOVED BY RUSSIAN PEOPLE – Anna Akhmatova, short lyric poems and structured cycles
Two years before her death at the age of 76, she was chosen president of the Writers' Union. Anna Akhmatova was a Russian modernist poet, one of the most acclaimed writers in the Russian canon. Her work ranges from short lyric poems to structured cycles (such as Requiem, tragic masterpiece about the Stalinist terror). She was born into upper-class family ...Read More »
KOREAN POEMS – Chung Ho-seung
Chung Ho-seung was born in 1950 and since his debut in 1972 (with a poem featured in the Korea Daily News), he has published many poetry collections, which has achieved both critical acclaim and mass appeal. His minimal verse style interweaves the everday and the fantastic. His poems have the rhythm of songs, his vocabulary is chosen for its emotive ...Read More »
EXISTENTIALIST IDEAS MADE WITHOUT EMBARRASSMENT – Milton Acorn: Cold bundles within falling heavens
His power comes from images always drawn from everyday Island life. Milton James Rhode Acorn was a Canadian poet. He was born in Charlottetown (Prince Edward Island) and was a World War II veteran. http://meetingbenches.com/2017/04/stunning-canadian-landscapes-quebec-region/ In Montreal he published his early poems in an political magazine. With a radical personality and strong working-class sentiments, he translated these elements into his ...Read More »
THE ROMANTIC – Poem, by Adam Mickiewicz
Adam Bernard Mickiewicz was a Polish-Lithuanian poet of the Romantic period. He is seen as one of Poland's Three Bards. http://www.allposters.com/-sp/The-Birthplace-of-Adam-Bernard-Mickiewicz-1798-1855-at-Zaosie-Posters_i10076977_.htm?ac=true He was a creator of Romantic drama and has been compared both at home and in Western Europe to Byron and Goethe. Born into an impoverished noble family, he studied at the University of Wilno and in 1817 he ...Read More »
THE STARTLING POETRY OF JAPANESE MODERNIST – Chika Sagawa: uses free verse to explore interiority
Few women wrote poetry and those who did, typically used traditional forms to address domestic concerns. Chika Sagawa, born in Kawasaki Ai in 1911 was one of the most innovative poets in early-twentieth-century in Japan. Rather than relying on traditional forms, she used free verse to explore her interiority through imagery and her images were shockingly new. Not long after ...Read More »
So strong is the Persian aptitude for versifying everyday expressions, that one can encounter poetry in almost every classical work. http://meetingbenches.com/2017/04/iranian-inner-landscapes/ It spans two-and-a-half millennia. Persian literature is one of the world's oldest literatures. Very few literary works of Achaemenid Iran have survived due to the destruction of the library at Persepolis. It was a spoken poetry. Rumi's poetry is ...Read More »
Modern literary movements in Malayalam literature began in the late 19th century with the rise of Kumaran Asan, Ulloor S. Parameswara Iyer and Vallathol Narayana Menon. Malayalam literature comprises literary texts written in Malayalam (a South-Dravidian language spoken in the Indian state of Kerala). http://meetingbenches.com/2017/04/keralas-landscapes/ While the Manipravala poetry flourished (as a diversion from the mainstream), the tradition set up ...Read More »


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Thirty-six percent of home-loan applications from Chicago blacks were denied in 1991, according to a study released by the Woodstock Institute.
The denial rate for blacks was more than double that for whites, who were turned down 13.5% of the time.. Nearly 22% of the Hispanics who applied for mortgages were rejected in 1991, the study says.
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Exciting news today!
New update is ready for you in the App Store.
What's New in Version 1.9
• You can now check out the latest surf reports & photos from around the world!
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Check where the best surf is around you and share with your friends on goFlow!
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Roni & The goFlow Team


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Butler Township, Montgomery County, Ohio
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Bicentennial Festival Scheduled for Sunday, October 8 from 10am – 5pm
September 7, 2017
You're invited to join the celebration Sunday, October 8 from 10 am to 5 pm at Aullwood Farm, 9101 Frederick Pike. The festival will be jam-packed with entertainment, food and fun for all ages. Also, don't miss out on the "Butler Township Bicentennial Ale," created and brewed by Hairless Hare Brewery in honor of the
Tire Buyback Event
August 31, 2017
On Sept. 24, 2017, Montgomery County Environmental Services will host its fifth Tire Buyback event. Residents can earn $2 for every scrap/used tire they bring, up to a maximum of 10 tires per vehicle. Montgomery County Tire Buyback Montgomery County Solid Waste District Transfer and Recycling Facility 1001 Encrete Lane Moraine, OH 45439 Sunday, September
Administrative Offices Closed For Thanksgiving
August 27, 2017
The Butler Township Administrative Offices will be closed on Thursday, November 23 & 24, 2017 in observance of Thanksgiving. The offices will re-open on Monday, November 27, 2017 at 8 AM. **Please Note: Customers with service on Monday, Tuesday and Wednesday will NOT be affected by Thanksgiving. Service will NOT occur on Thursday, Nov. 23, and service
Now Hiring Full-time Firefighter/Paramedic
August 9, 2017
Full-time Firefighter/Paramedic Deadline: September 1, 2017 Butler Township is a community of approximately 7,900 residents within an 18 square mile community located in Montgomery County, Ohio (just north of Dayton at the interchange of I-70 and I-75). The Township is a widely diverse community that includes a busy business district, upscale residential neighborhoods and farms.


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ἱκέσιος, adverbial: cp. 1215 "ὠκεῖς", n. He extends his right hand in supplication. ὄσσοισι: Aesch. admits "ὄσσοις", and Eur. both "ὄσσοις" and "ὄσσων", in iambics no less than in lyrics. παπτήνας: with an acc. this verb usu.='to look around for,' as Il. 4.200.
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FIRST: The name of the corporation (hereinafter called the "Corporation") is Chelsea Therapeutics International, Ltd.
SECOND: The address, including street, number, city, and county, of the registered office of the Corporation in the State of Delaware is 2711 Centerville Road, Suite 400, in the City of Wilmington, County of New Castle, 19808, and the name of the registered agent of the Corporation in the State of Delaware at such address is Corporation Service Company.
THIRD: The purpose of the Corporation is to engage in any lawful act or activity for which corporations may be organized under the General Corporation Law of the State of Delaware.
FOURTH: The aggregate number of shares which the Corporation shall have authority to issue is 1,000 shares of Common Stock, par value $0.01 per share.
FIFTH: In furtherance and not in limitation of the powers conferred upon it by law, the Board of Directors of the Corporation is expressly authorized to adopt, amend or repeal the By-laws of the Corporation.
SIXTH: The Corporation reserves the right to amend, alter, change or repeal any provisions contained in this Certificate of Incorporation in the manner now or hereafter prescribed by statute, and this Certificate of Incorporation, and all rights conferred upon stockholders and directors herein, are granted subject to this reservation.
SEVENTH: To the fullest extent permitted by the General Corporation Law of the State of Delaware as it now exists and as it may hereafter be amended, no director or officer of the Corporation shall be personally liable to the Corporation or any of its stockholders for monetary damages for breach of fiduciary duty as a director or officer; provided, however, that nothing contained in this Article SEVENTH shall eliminate or limit the liability of a director or officer (i) for any breach of the director's or officer's duty of loyalty to the Corporation or its stockholders, (ii) for acts or omissions not in good faith or which involve intentional misconduct or a knowing violation of law, (iii) pursuant to Section 174 of the General Corporation Law of the State of Delaware or (iv) for any transaction from which the director or officer derived an improper personal benefit. No amendment to or repeal of this Article SEVENTH shall apply to or have any effect on the liability or alleged liability of any director or officer of the Corporation for or with respect to any acts or omissions of such director or officer occurring prior to such amendment or repeal.
EIGHTH: The Corporation shall, to the fullest extent permitted by Section 145 of the General Corporation Law of the State of Delaware, as the same may be amended and supplemented, indemnify any and all persons whom it shall have power to indemnify under said Section from and against any and all of the expenses, liabilities or other matters referred to in or covered by said Section. Such indemnification shall be mandatory and not discretionary. The indemnification provided for herein shall not be deemed exclusive of any other rights to which those indemnified may be entitled under any By-laws, agreement, vote of stockholders or disinterested directors or otherwise, both as to action in his or her official capacity and as to action in another capacity while holding such office, and shall continue as to a person who has ceased to be a director, officer, employee or agent and shall inure to the benefit of the heirs, executors and administrators of such a person. Any repeal or modification of this Article EIGHTH shall not adversely affect any right to indemnification of any persons existing at the time of such repeal or modification with respect to any matter occurring prior to such repeal or modification.
The Corporation shall to the fullest extent permitted by the General Corporation Law of the State of Delaware advance all costs and expenses (including without limitation, attorneys' fees and expenses) incurred by any director or officer within 15 days of the presentation of same to the Corporation, with respect to any one or more actions, suits or proceedings, whether civil, criminal, administrative or investigative, so long as the Corporation receives from the director or officer an unsecured undertaking to repay such expenses if it shall ultimately be determined that such director or officer is not entitled to be indemnified by the Corporation under the General Corporation Law of the State of Delaware. Such obligation to advance costs and expenses shall be mandatory, and not discretionary, and shall include, without limitation, costs and expenses incurred in asserting affirmative defenses, counterclaims and cross claims. Such undertaking to repay may, if first requested in writing by the applicable director or officer, be on behalf of (rather than by) such director or officer, provided that in such case the Corporation shall have the right to approve the party making such undertaking.
NINTH: Unless and except to the extent that the By-laws of the Corporation shall so require, the election of directors of the Corporation need not be by written ballot.
[As Filed: 06-24-2014]


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Prerequisites: It helps to be familiar with design patterns, in general, and UML class diagrams.
Builder is a design pattern concerned with object creation. If you're already familiar with lists in Python or arrays in Java, you're aware that they provide you with the ability to append and remove or pop elements. Because these data structures must anticipate mutations, they often come with extra allocations in memory to handle the size increase. This comes at a cost. Builder provides one solution to this problem, which we'll hear about later. For now, let's review a UML representation of this pattern:
In this diagram, you can see that ConcreteBuilder inherits from Builder and Director has an instance of, or aggregates, our Builder. Director is the caller in this scenario and is free to call buildPart() as many times as needed, until it's ready to finally getResult().
As we've seen in the diagram, Builders are designed to instantiate the object and provide the ability to assemble all of its components, and then return the constructed, fixed object at once. Builders also give the function caller control in putting this object together, often providing an API of methods like append or insert. The Java StringBuilder class is the perfect example of this.
// java // creates empty builder, capacity 16 StringBuilder sb = new StringBuilder(); // adds 9 character string at beginning sb.append("Greetings"); sb.append(", fellow travelers!"); sb.toString() // "Greetings, fellow travelers!"
So why is this useful? Well, it's a great way to build a complex object before calling that object's constructor. This type of approach also comes in handy when dealing with lists. Appending to lists is actually very expensive. Appending to strings is even more expensive because strings are immutable. Every time you append to a string, you're recreating the object, allocating more space and sequentially moving those elements along. With a StringBuilder, you just keep appending to the object, and receive your string at the very end, eliminating the need to move memory locations.
JavaScript: The Definitive Guide says the following about strings in JavaScript: "In JavaScript, strings are immutable objects, which means that the characters within them may not be changed and that any operations on strings actually create new strings. Strings are assigned by reference, not by value. In general, when an object is assigned by reference, a change made to the object through one reference will be visible through all other references to the object. Because strings cannot be changed, however, you can have multiple references to a string object and not worry that the string value will change without your knowing it".
Should I Use a StringBuilder in JavaScript?
// ECMA-262, section 220.127.116.11 function StringConcat() { if (IS_NULL_OR_UNDEFINED(this) && !IS_UNDETECTABLE(this)) { throw MakeTypeError("called_on_null_or_undefined", ["String.prototype.concat"]); } var len = %_ArgumentsLength(); var this_as_string = TO_STRING_INLINE(this); if (len === 1) { return this_as_string + %_Arguments(0); } var parts = new InternalArray(len + 1); parts[0] = this_as_string; for (var i = 0; i < len; i++) { var part = %_Arguments(i); parts[i + 1] = TO_STRING_INLINE(part); } return %StringBuilderConcat(parts, len + 1, ""); }
If this is your first exposure to design patterns, I hope this has been enlightening. Please continue to read up on them. And don't just stop there. Always be on the look out for all the creative solutions that come out of the open source community, or even the bodies behind languages, themselves.
Python is a great example of a language that's made tons of optimizations over the years. Have you ever heard of double ended queues? Python's collections.deque are more elegant and much faster than Python lists. Where adding or popping items from either end of a queue has O(1) complexity, inserting and removing items from the front of the list is O(n). If you're not sure what that means, read up on Big O Notation or check back for an article, soon.


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Hp Deskjet 1050 Driver Download – Hp Deskjet 1050 Driver Free Download. HP Deskjet 1050 All-in-One Printer is a HP item that can be utilized to print, sweep and duplicate utilizing the USB link. HP Deskjet 1050 All-in-One Printer is suitable for the reasons of you're home or little business, a highlights' portion of the HP Deskjet 1050 All-in-One Printer is Height 156 mm, Width 427 mm, Depth 306 mm, Weight 3.6 kg, Print speed at 4800 dpi, Black content Up to 20ppm and ColorUp to 16 ppm, checks Resolution: Up to 1200 x 1200 optical dpi, Color: 24-bit shading, 8-bit grayscale (256 levels of dim) Maximum output size from glass : 216 x 297 mm (8.5 x 11.7 in), HP Deskjet 1050 All-in-One Printer is anything but difficult to utilize, on the off chance that you need to have a printer that is modest and productive, you ought to consider the HP Deskjet 1050 All-in-One Printer.
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On November 24, 2013, Pastor Robert Truelove of Christ Reformed Church in Lawrenceville, Georgia, preached a sermon titled 'A Quiverfull of Confusion Part 2'. This sermon is part of a series he is preaching on the Quiverfull Movement. My point in this blog post is not to assess the scriptural merit of the quiverfull mentality, but I would like to focus on Pastor's Truelove exposition of the Dominion Mandate, also know as the Creation Mandate, from Genesis 1:26-28.
In general, the Quiverfull Movement is made up of conservative Christians who promote procreation and eschew all forms of birth control. They contend that children are a blessing from the Lord and man should not interfere with that process, but the criticism of the Quiverfull Movement comes from their legalistic view that you are to have as many children as you can regardless of financial burden or health risks.
Starting out, Pastor Truelove asks: "Does the Dominion Mandate preclude family planning in the life of a Christian couple? He answers: "No, when we do that we add the commandments of men to the Scripture." The phrase 'be fruitful' is not a command, but a blessing (see Gen. 9:1, 7; 16:10; 17:2, 20), and we can not thwart God's plan for us to be fruitful and multiply (Psalm 127:3). Having children is not a legal requirement of man, but a blessing from God at His perfect timing. Pastor Truelove goes on to point out that the animals in Genesis 8:17 should also be fruitful, multiply, and swarm the earth. However, we (including the Quiverfull proponents) do control animal population.
It is Pastor Truelove's next correlation that caught my attention and prompted this post. In Genesis 1:27 God created man in His own image. He states that man's function or purpose was to bear forth the divine image declaring by his own very life and being the glory of God and His kingship over creation. Man was to multiply God's image in the Dominion Mandate, but sin came into the world through the Fall and man could not longer fulfill the mandate because the image of God in man was marred by his sin nature. Therefore, as fallen men, we cannot revitalize Eden through having as many children as possible.
However, as New Testament believers, the Dominion Mandate is now fulfilled in the Great Commission (Matt. 28:18-20), which commands believers to spread the gospel to all nations and make disciples baptizing them in the name of the Father, of the Son, and of the Holy Spirit. Pastor Truelove contends that man bears the image of God after the Fall through Jesus Christ. Christ is the image of God (2 Cor. 4:4; Col. 1:15), and God predestinated the elect to be conformed to the image of His Son (Rom. 8:29). Therefore, the fulfilling of the Dominion Mandate is not fulfilled simply by having children, but it is fulfilled by the proclamation of the gospel where sinners come to Christ through the regenerating power of the Holy Spirit. The believer conforms to the image of Jesus, who is the image of God; thereby restoring the image of God in man and making us the image bearers we were created to be. Apart from Christ, man cannot fulfill his purpose to glorify God by bearing the image of God and declaring His sovereign rule over creation.
"So God created man in his own image, in the image of God created he him; male and female created he them. And God blessed them, and said unto them, Be fruitful, and multiply, and replenish the earth, and subdue it: and have dominion over the fish of the sea, and over the fowl of the air, and over every living thing that moveth upon the earth," (Gen. 1:26-28).
"So God created man in his own image, in the image of God created he him; male and female created he them. And God blessed them, and said unto them, Be fruitful, and multiply, and replenish the earth, and subdue it: and have dominion over the fish of the sea, and over the fowl of the air, and over every living thing that moveth upon the earth," (Gen. 1:26-28).


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Products & ServicesSee also: Categories | Featured Products | More Information
Supplier: Electro-Optical Products Corporation
Description: No Description Provided
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- Device Type: Chopper
- Device Technology: Mechanical
- Aperture: 0.4016 inch
- Frequency Range: 10 to 1000 Hz
Supplier: Meadowlark Optics, Inc.
Description: Our liquid crystal shutter uses twisted nematic liquid crystals to provide a vibration-free mechanical shutter alternative. The twisted nematic liquid crystal switches between a state that rotates the input polarization by 90° with no voltage applied and a state that makes no
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- Device Type: Shutter
- Device Technology: Electro-optic
- Aperture: 0.7000 inch
- Shutter Speed: 400000 ns
Standards and Technical Documents - Standard Test Methods for Instrumental Measurement of Distinctness-of-Image Gloss of Coating Surfaces -- ASTM D5767Supplier: ASTM International
Description: 1.1 This test method describes the measurement of the distinctness-of-image (DOI) gloss of coating surfaces using electro-optical measuring techniques. The coatings must be applied to planar rigid surfaces. The scale values obtained from the alternative methods cited do not agree. 1.2 ThreeShow More
Supplier: SPIE
Description: are proving to be an attractive and low-cost solution to a range of device problems requiring high optical functionality and high optical performance. MOEMS solutions include optical devices for telecommunication, sensing, and mobile systems such as v-grooves, gratings,Show More
Supplier: Denton Vacuum
Description: ® accommodates up to 8 cathodes with triaxis adjustment of radius, distance, and angular presentation to provide <+/-5% coating uniformity. Each cathode can be optimized for a different deposition process and target matter. Independent electro-pneumatic source shutters andShow More
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Electro Optical Components, Inc.
CO2 Laser Optics: Reflective Mirrors
unavailable elsewhere. Much of their business is working with customers to solve challenging optical problems across many industries as varied as Defense, Chemical, Nuclear, Environmental Monitoring, Aerospace, Printing, and Scientific Research. We welcome enquiries at an early stage, where (read more)
Browse Optical Mirrors Datasheets for Electro Optical Components, Inc.
Electro Optical Components, Inc.
Fiber Optic Transmission and TransFlex Probe
On-line transmission spectroscopy in liquids at long distance
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Flexible and robust for industrial applications in harsh environment
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Browse Optical Filters Datasheets for Electro Optical Components, Inc.
Electro Optical Components, Inc.
Diamond Optics and Detectors
Diamond has an exceptionally high transmission over a very broad range of wavelengths (Diamond Optical Transmission Properties). It is extremely hard and chemically inert; making CVD diamond the optimal choice in applications demanding higher power, larger area, resistance to hazardous materials (read more)
Browse Optical Lenses Datasheets for Electro Optical Components, Inc.
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Surface modification technologies XIII
…where a transparent electrode is needed) such as liquid-crystal displays, electro chromic displays, thermochromic displays, light emitting diodes, electroluminescence devices, TV camera vidicons, image storage and display devices, charge injection devices, charge coupled devices, electro optical shutters , image intensifiers, photovoltaic solar…
Mobile lidar complex for ecological monitoring of the atmosphere
Cavity dumping of the laser is provided by an electro optical shutter , including crystal DKDP and thin-film polarizer.
A high-energy YAG:Nd3+ laser with fiber destroyed radiation coherence
(a) Radiation pulse and (c) its Fourier transform at the output of the master laser with an effective cavity length of 90 cm, a DKDP crystal based electro optical shutter , and a 5° glass wedge as the output mirror and (b) the…
• PLZT(lead lanthanum Zirconate Titanate ceramic wafers), electro optical shutters , only transmit 15-17 percent of light from a CRT.
Real-time optical characterization of laser oxidation process in bimetallic direct write gray scale photomasks
house designed laser writing system consists of a laser control computer, an argon CW laser, an electro - optical shutter , a mechanical shutter and a system of objectives and lenses system [16].
Calibrating grayscale direct write bimetallic photomasks to create 3D photoresist structures
The photomask-writing system, shown in Figure 3, consists of a continuous wave (CW) argon laser (488/514 nm), a computer-controlled high precision (±0.5 µm) X-Y-Z table, an electro - optical shutter , and various objective lenses (50x, 200x, and 50…
A real time sectional image measuring system using time sequentially coded grating method
A PLZT electro - optical shutter 'array is used for projecting time sequentially coded grating patterns on the object.
Liquid Crystalline Polymers
More recently, Almeida et al. (2009b) reports on the production of an electro - optical shutter where two layers of non-woven mat of HPC and cellulose acetate (CA) were electrospun on the surface of the conductive indium tin oxide-coated substrates.
Field-Sequential Electronic Stereoscopic Projector
In the technique we invented, 120 fields, alternately left and right, are presented on a video display screen, and these images are viewed through electro - optical shutters .
Shutterless Fixed Pattern Noise Correction For Infrared Imaging Arrays
This viewing of a thermal reference source generally involves use of electro- mechanical or electro - optical shutters which detracts from the mechanical simplicity of the staring imager.


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Olympic Level Training and Recovery Resources in Boulder
Professional athletes have access to a handful of specialists to keep them on their 'A' game. A team of massage therapists, coaches, chiropractors, recovery tools and services, gait analysis, blood lactate testing, and nutritionists.
But what does the aspiring endurance athlete or the dedicated weekend warrior who is dedicated to training at a high level?
More and more of these Olympic and elite level services are now becoming available to those of us who are just looking to be the best we can be.
Opened this summer was the All Sport Recovery Club where for a low monthly fee ($59.99) athletes have access to Olympic level recovery tools like the Normatec MVP Compression Boots used by Team Garmin-Cervelo, foam rollers and self massage tools, cold laser and ultrasound treatments, an ice bath, free 15min massage sessions 5x a week. Other services such as massage, chiropractic, graston treatments and level 4 ultrasound are also offered for a lower than your insurance premium price. They even offer a large selection of Mix 1, Honey Milk, or coffee and tea while you recover. And don't forget the free WiFi.
Stop by to check them out. Your first session is free and they will give you a full tour of the facilities.
High Altitude Spine and Sport just recently added an Alter-G treadmill to their clinic, the first one open to the public in Boulder/Denver metro area. Because the AlterG® uses differential air pressure chambers to precisely lift the user from 100% to as little as 20% of the user's calibrated body weight, it has become a favorite alternate training method among elite athletes which allows them to safely return to full weight-bearing running after or during an injury.
"The ability to train safely, rehab quickly, and recover faster utilizing this unit is a nice luxury to have, especially with the winter weather fast approaching." states Dr. Richard Hansen, DC CSCS on his website. Dr Hansen is also a cross country coach at XC Coach @PeaktoPeak High School.
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The price starts at $1 per minute, but deeper discounts are available in Punch Cards and memberships. For example, purchasing a block of 360 minutes (6 hours) saves you $90. You can even try it for yourself for free for 15 minutes.
Dr. Hansen's services also include Chiropractic, ART, Kenisio Taping, Graston treatments, Functional Assessment keep you running healthy and strong.
Book appointments online at http://highaltitudesportsrehab.com/alter-g/ or call them at 303-442-0355 or email Dr. Hansen at firstname.lastname@example.com to inquire about testing out the Alter-G or additional questions.
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Boulder Center for Sports Medicine
One of the top sports medicine facilities in the country. Athletes travel from all over the country for their services.
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Brad Hudson is a world-renowned coach for athletes ranging from mid-distance events through the marathon. Individual coaching from Brad, James Carney and Tyler McCandless is handled online and in person if you live in the Denver/Boulder area.
Led by Bob Seebohar, MS, RD, CSSD, CSCS who has worked with many Olympic and elite endurance athletes, he helps athletes Burn more fat and conserve precious carbohydrate stores while reducing the likelihood of gastrointestinal (GI) distress in training and racing which he calls Metabolic Efficiency Training.
Fuel4mance offers both Metabolic Efficiency Assessment and Lactate Threshold Testing.


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We are pleased to congratulate the BC Children's Hospital investigators who were recently awarded Na...
Here are Dr. Mariana Brussoni's top five reasons why parents should let their kids play outside, exp...
Getting the kids off to school in the morning and into bed in the evening are struggles most parents...
The Child & Family Research Institute is committed to the education and training of our research community including full-time trainees (masters and doctoral students, postdoctoral fellows and clinical research trainees), summer students, and clinical research coordinators.
First established in 2003, the Research Education Office at the Child & Family Research Institute organizes education and networking events for trainees, coordinators and the public, including the annual Mini Med School series; administers trainee funding competitions; and manages the institute's summer student research program for undergraduate and medical students.
For more information on the education and training opportunities at CFRI and to access the Research Education Program event calendar visit the CFRI Training website.
A key role of the BC Children's Hospital Research Institute is supporting individual researchers and research teams. We provide infrastructure and core services to facilitate investigators' ability to conduct research on site, and ensure their research activities are in compliance with all policies and procedures.
Clinical trials & facilities, Biostatistics, Data management, Lab & pharmacy services
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Training opportunities for volunteers, students, trainees and clinical research fellows


text: The folks from Pepsi were in town on June 18th to roll out their new cola formula that uses "real sugar". Pepsi's new tag line Real BIG is to be tied to a variety of promotions where Pepsi takes ordinary situations and makes them Real BIG. The promotion that was held in Milwaukee caught minor league baseball teams, the Mudhens and Angels, scheduled to play at the Rock Complex in Franklin, off base. To their surprise, two GO Riteway motorcoaches showed up, one wrapped with Pepsi's new campaign theme, and transported both teams to Miller Park where they played their June 18th game… Ordinary to Real BIG! These two teams will now be stars in an upcoming MLB Real Big Summer campaign by Pepsi. It was an exciting event for everyone involved.


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Most marketing, sales, and training programs miss a critical factor: There is no one-size-fits-all message or salesperson type. You won't persuade buyers by imitating industry best practices or using the same approach for every interaction.
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Shark Week
Voodoo Sharks
Season 102 Episode 6
There have been rumors of a monster shark living in bayous of Louisiana. A team of Cajun fishermen head out to prove its existence while a shark scientist attempts to research bull sharks living in a freshwater lake just outside of New Orleans.
- 43 min
- Premiered 08/05/2013


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Download Sharon Ng apk 4.0.7 free for Android smartphone
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Exhibit A
The usual suspects;
The trail follows the roads through the campground with a few very low grade hills. It's 0.25k to the loop and if you ski all of the main loops it's another 2.88km. The trail is suitable for all abilities of both skate and classic skiers. The skate lane is wide, good for passing, and as a result the campground can accommodate many skiers. The mostly wind-sheltered trail is durable and well-drained and is usually open for skiing all season Dec.-Apr. Views can include ponds and the Mendenhall lake and glacier. Skiers with dogs should keep them under control and clean up after them. There is a permanent outhouse next to the Skaters Cabin and the USFS usually opens the restrooms across from the backpackers loop. Parking is in front of Skaters Cabin, Skaters Cabin Road, Juneau, AK 99801.
When snow and lake ice conditions permit. Ski at your own risk! The trail leaves from the Skaters Cabin. The ski loop distance varies but is usually ~5-6 km. The trail is suitable for all abilities of both skate and classic skiers and can be opened or closed for weeks at a time depending on conditions. Lake skiing can offer outstanding views of the surrounding mountains and Mendenhall Glacier but can be windy and foggy. Skiers with dogs should keep them under control and clean up after them. There is an outhouse next to the Skaters Cabin. Parking is in front of Skaters Cabin, Skaters Cabin Road, Juneau, AK 99801.
The usual suspects;
Speed bumps, pavement patches, it's all over but the crying. Where there is snow it is wet and fast. We made 2 laps at 11 am, but the base is going quickly,
Being groomed this morning. Water on the lake, it may be over for the season.
No grooming on Wed. Machine still down
No grooming tomorrow. All machines broken***
Groomed and reset campground this am. Hardly anyone there. Left lake alone, waiting for cooler temps.
Campground groomed at 7 and again at 11. Warm, fast, sunny day and the birds are singing.
Lake and campground groomed late afternoon on Thursday. Great Spring conditions.
Scott groomed the campground and lake for skate and classic. All is well.
The background; John Staub nursed the skidoo around the loops with one steering rod. Then he headed out onto the lake and bogged down in the Fresh. With aid, thank you masked man, and Peter…Details
Peter groomed the Lake ,Camp Ground and Montana creek today. Thanks Peter
Scott has been working on the campground and lake all morning. As of noon he has successfully rolled everything and is now trying to set a classic track. The snow is heavy and it is…Details