Download APRIL WIPs - Angelfire

APRIL & May 04 WIPs
Reply and Fifth Request
Robert M. Clarke reply, subject " RE: Kim will resend the 1099s"
My address remains same as on you records since July 2003.
"She", I suppose, means Ms. Hedgpeth; if a payee asks for MMLLC 2003 proof of income, whether ANY ONE has sent them, then IT IS
OBVIOUS that payee is asking for same documentation. I understand where Ms. Hedgpeth is coming from and I don't blame her: you are
grating on every one's last nerve UNNECESSARILY. Ms. Hedgpeth also understands that this is YOUR problem, as I do.
For the record, as of this writing, I have not received said mentioned 2003 proof since my multiple requests have been sent to you.
Sophina Aryvz
From: "RMC" <[email protected]> Reply-To: <[email protected]> To: <[email protected]> Subject: Kim will resend the
1099s Date: Fri, 16 Apr 2004 11:32:30 -0400 Hope you are well. Rmc I spoke with her yesterday and she did not seem to understand the
request and said she had already mailed the items to you. What is the correct mailing address?
WCVE Richmond PBS, along with WHTJ Charlottesville PBS, will begin broadcasting the
"G.E.D. Connection" series on Sunday, May 2 at 7:30am.
Summer Institute Dates: Look for registration forms and information about this year's
summer institutes inside the May issue of Progress. If you do not receive Progress, call 800-2370178 for registration information or look for it on the Resource Center website at
www.aelweb.vcu.edu/. Send us your home address to receive Progress.
http://www.os.dhhs.gov/policies/index.shtml#testimony is from U.S. Department of Health & Human Services • 200 Independence
Avenue, S.W. • Washington, D.C. 20201, has long pg entitled Policy and Regulations where these are the topics, and was Last revised:
February 2, 2004. See Glossary: http://aspe.hhs.gov/daltcp/diction.shtml
HHS Information and Hotline Directory A list, by subject, of Websites and public inquiry and publication phone numbers for popular topics:
http://www.hhs.gov/about/referlst.html
Mailing Address and Telephone Number: The U.S. Dept of Health & Human Services
200 Independence Avenue, S.W., Washington, D.C. 20201
Telephone: 202-619-0257, Toll Free: 1-877-696-6775
(mail sent to our Washington D.C area offices takes an additional 3-4 days to process)
Healthcare Standards
subtopic: Healthcare Informatics and Standards (takes you to "Agency for Healthcare Research and
Quality" at http://www.ahrq.gov/data/infoix.htm on Medical Infomatics within the many different medical fields, espl on tracking patient
medical history and resuting medical issues; plus other medical admin issues.
Rsch: http://www.ahrq.gov/research/primarix.htm Primary care practices working with researchers to improve community-based health
care.
Computer Manufacturers Get Low Grades on Recycling
Computer makers' environmental programs generally stink, though U.S. companies -- particularly
Dell and Hewlett-Packard -- are better than most, says an annual report released yesterday by
the Silicon Valley Toxics Coalition, an enviro group based in San Jose, Calif. No company is
recycling more than 2 percent of its products -- products chock-full of lead, polyvinyl chloride,
mercury, and other hazardous materials -- a statistic which coalition director Ted Smith called
"pathetic." Coalition researchers singled out Dell for particular praise. The company, which
received terrible scores on last year's report, has stopped using prison labor to recycle products
and launched a new recycling campaign. A number of states are considering bills that would
make manufacturers responsible, to some extent at least, for electronics recycling.
straight to the source: MSNBC, Associated Press, 20 May 2004
<http://www.gristmagazine.com/cgi-bin/forward.pl?forward_id=2488>
straight to the source: The New York Times, Laurie J. Flynn, 19 May 2004
<http://www.gristmagazine.com/cgi-bin/forward.pl?forward_id=2487>
 Good practice in workplace education is something we value as adult
educators. Mary Ellen Belfiore has consolidated what we know about good
practice in workplace education to date. You can download the report,
Workplace Literacy: National and International Perspectives on
Research and Practice, from the Ontario Literacy Coalition (OLC):
www.on.literacy.ca/whatnew/wrkplace/wrkplace.pdf
 American Memory is a gateway to rich primary source materials relating to
the history and culture of the United States. The site offers more than 7
million digital items from more than 100 historical collections:
http://memory.loc.gov/ammem/ammemhome.html
 The California Health Literacy Initiative is excited to announce the launch of
its Online Health Literacy Resource Center. To visit the Resource Center,
please go to: www.cahealthliteracy.org.
 The Plain Language Action & Information Network is a government-wide group of
volunteers working to improve communications from the federal government to the public.
Their belief is better communication will increase trust in government, reduce government
costs, and reduce the burden on the public: www.plainlanguage.gov.
 The Health and Literacy Compendium, developed by World Education in
collaboration with the National Institute for Literacy with a generous grant
from the Metropolitan Life Foundation, is one resource guide for the health
and literacy fields. This guide includes literacy curricula, student-generated
materials, and websites commonly used by literacy educators. The
Compendium is meant to encourage teachers and health educators to think
about ways to disseminate and make known to others the resources they find
valuable and to inspire people to create new materials, as gaps in the
Compendium may represent gaps in information currently available in the
field. You can find this document at: www.worlded.org/us/health/docs/comp/.
Project REACH: Recursos para la Ensenanza y el Aprendizaje de las
Culturas Hispanas offers resources on the history and literature of the Spanish
language, Latino cultures in the U.S., arts of the Spanish speaking world,
instructional materials for teaching Spanish speakers, and the Quechua culture
indigenous to the remote regions of the Peruvian Andes:
www.nflc.org/REACH/index.htm.
Theory and Practice of Online Learning edited by Terry Anderson and Fathi
Elloumi, Athabasca University, 2004, is concerned with assisting providers of
online education with useful tools to carry out the teaching and learning
transactions online. It presents the theory, administration, tools, and methods of
designing and delivering online learning. This book can be downloaded in its
entirety at: http://cde.athabascau.ca/online_book/.
 The Council of the Great City Schools has prepared this fourth edition of
Beating the Odds report to give the nation another look at how inner-city
schools are performing on the academic goals and standards set by the
states for our children. The report examines student achievement in math and
reading through spring 2003; measures achievement gaps between cities and
states, African Americans and Whites, and Hispanics and Whites; includes
new data on language proficiency, disability, and income; and looks at
academic progress: www.cgcs.org/reports/beat_the_oddsIV.html
Health Literacy: A Prescription to End Confusion is a report from the Institute
of Medicine which defines health literacy as “the degree to which individuals have
the capacity to obtain, process, and understand basic health information and
services needed to make appropriate health decisions.” This report examines
the body of knowledge in this emerging field and recommends actions to promote
a health literate society. The entire report is available:
www.aed.org/iom/pdfs/HealthLiteracyExecutiveSummary.pdf.
Cow Poop Powers California Dairy
A well-fed dairy cow produces 120 pounds of poop a day -- some 43,000 pounds a year. What to
do with all that doo? Dairy farmer Albert Straus of Marin County, Calif., puts it in a big covered
lagoon, where it decomposes and generates tons of methane gas, which he captures and uses to
power his farm, his creamery, and his electric car. In California, where 1,950 commercial dairies
house some 2 million excreting bovines, the state energy commission recently allocated $10
million in matching funds to encourage farmers to build methane digesters, and a 2003 state law
paved the way for utilities to set up "net metering" for the farmers, which makes it possible for
them to reduce or erase their electric bills. Not only will Straus save some $5,000 to $6,000 a
month in energy costs, he is preventing tons of methane (a greenhouse gas 21 times more potent
than carbon dioxide) from drifting into the atmosphere and organic pollutants from contaminating
water sources. Plus, he now has a built-in, renewable source of jokes.
straight to the source: San Francisco Chronicle, Maria Alicia Guara, 14 May 2004
<http://www.gristmagazine.com/cgi-bin/forward.pl?forward_id=2457>
Get 'Slightly' Famous (tm)
The online newsletter by Steven Van Yoder, author of
Get Slightly Famous: Become a Celebrity in Your Field and
Attract More Business with Less Effort
Visibility + Competence + Word of Mouth = REPUTATION
Getting Slightly Famous in print media means reaching a larger audience, rather
than relying entirely on human contact. After all, there is only one physical
you. No matter how much you network, get around, or attend meetings, YOU can
only
go so far.
Appearing in the media is the equivalent of expanded networking. You reach a
targeted audience of people who might buy from you, and you build a relationship
with your target market that can lead to sales. Even if you have a small local
business, media exposure helps you establish a regional or national presence
without leaving your desk.
Media exposure works because it associates your name with the authority of the
media. When you read about a business in the newspaper or hear about it on the
radio, chances are you immediately elevate that business above its competitors.
It has solidity and credibility.
Appearing in media that reach your target market establishes a bond of trust
upon
which future sales are possible. Ultimately, your Slightly Famous media strategy
will develop your reputation as a business of choice in your market niche. As
more prospects run across your name in publications targeted at them, you will
acquire an aura of expertise that will get you more business with less effort.
Publishing Articles & Columns
Bylined, contributed articles are a mainstay in many trade and special interest
publications because most cannot afford full-time writers. From fillers to
features, these magazines rely on freelance writers and contributors like you
for
at least some of their content. Often written for a small fee—or given freely in
exchange for an author bio designed to elicit business—these articles show off
the expertise of the businessperson or consultant who authored it.
Besides exposing your business to thousands of prospects, it’s possible to get
feature articles devoted entirely to your business. As a bonus, article reprints
make excellent, low cost sales literature.
The key to publishing expert articles is to package your ideas in a
benefit-oriented fashion. Tell prospects how to think about or apply your
business solution. Give readers real information they can use, regardless of
whether they will buy from you. If you don’t, and use a thinly veiled sales
pitch
instead, editors will see through it and reject the article.
Articles are usually a one-shot deal. Columns, on the other hand, are regular
engagements that allow a writer to build relationships with readers. Columns
appear on a weekly or monthly basis in newspapers, magazines, and Web sites.
They
can brand an author not just as an expert, but also as a friend, confidante, and
mentor.
You don't have to achieve “Dear Abby” status to be a successful column writer.
As
with any Slightly Famous marketing strategy, your column only needs to reach the
right people in your target market to position you as a resource.
Be A Media Resource
Bylined articles are not the only way to see your name in print. Read any
newspaper or magazine article. You will see a handful of experts quoted within
stories as diverse as international business, stock market forecasts or the
latest fashion trends.
Reporters are not experts. That's why they need experts from the business world
to create their stories. The secret is to position yourself as a media resource.
The media rely on you, the industry expert, to give substance and credibility to
their stories. Experts can be book authors, speakers, consultants, managers and
professionals. If you have knowledge about a specific subject—and that subject
can be your business—you qualify too.
People who get quoted in the media pursue a strategy to be on journalists' radar
screens when journalists write stories about their industries. They make
themselves available as expert interview sources so that journalists will think
of them when they are writing relevant stories.
When you learn how the media works, and mold your expertise into a
carefully-crafted media attracting strategy, you actually help the media do its
job in exchange for valuable exposure for your company.
With a little effort, you can become the first person on a reporter’s list when
a
story about your business area comes up. But it won't happen if you don't let
the
media know you exist!
Time, Commitment, and Consistency
You wouldn’t expect a massive return on a monetary investment overnight. The
same
goes with getting Slightly Famous in print, where huge dividends come to those
who persist.
Like all marketing activities, print media exposure is a long-term commitment
that will yield long-term rewards. Is it worth the time? Yes. Landing just a few
clients can pay for all your marketing costs for the next year.
If you don't give print media exposure a chance, you'll never know what it can
Do for you. Establishing your reputation in print takes time. But if you are
committed, an inevitable 'snowball effect' will take place and can bring you all
the business you can handle!
Resch www.worldvolunteerweb.org
Rsch www.unvolunteers.org
Photog Glossary: http://65.54.184.250/cgibin/linkrd?_lang=EN&lah=c617afc2d7bb61b55d106f86b12208e8&lat=1084821850&hm___action
=http%3a%2f%2fslclk%2eabout%2ecom%2f%3fzi%3d1%2fKsq
Marketing Your Site
The first key to getting advertisers is to make them aware of your site. This is more
than just telling people about your site. You should:

Include a link to your site's relevant features in your email signature. For
example, my Web Design Guide email signature looks like this:
...............................
Jennifer Kyrnin
About Guide to HTML
http://webdesign.about.com/
email: [email protected]
FREE HTML class:
http://webdesign.about.com/library/beginning/bl_htmlclass.htm
FREE newsletter:
http://webdesign.about.com/library/blnewsletter.htm
Get live help over the phone: http://www.keen.com/htmljenn?ref=1
...............................

Request links back to your site from all the sites that you link to. This is
especially effective when you've already linked to their site. Often they will be
happy to link to you when they find they are reciprocating already. Getting
links to your site on other sites will increase your popularity rating on Web
search engines and advertisers will be more likely to find your site.

Find innovative ways to market your site. Many companies use small,
inexpensive items with the company name on them as gifts and marketing
aids. These are especially effective if they relate to your Web site in some
way. For example, Kathy Hamlin, the Cocktails Guide at About had shot
glasses created with her site URL on them. These worked as marketing aids,
as every time someone uses it for a cocktail, they remember they could get
recipes from Kathy at her site.

Search engine placement is important, as advertisers use them just like
anyone else. So, you should be sure to Optimize your site for search engines.

Adding your site to advertiser directories is a good idea. Sites like AdBase.net
list Web sites that use online ads as a revenue stream. Adbase provides the
lister with a way to solicit advertisers directly and get the advertising
information out to them directly. This service is easy to use, and for a limited
time, basic listings are free.
Selling Your Site
Once you have started marketing your site, then you need to start selling your site
to advertisers. You should create an information sheet for your advertisers. This
sheet or Web page will detail what your site covers, the target audience, and how
your potential advertisers can get more information. For example, if you are
interested in advertising on Web Design at About, I would send you to this page.
Don't Give Up
The key to generating revenue through advertising is to not give up. You need to
continue to create a site that is valuable and useful to your readers. Advertisers will
be attracted to sites that are successful, and readers will be attracted to sites that
contain valuable information. So don't spend more time marketing and selling your
site than you do creating valuable content. Ultimately, that is what will generate
advertising revenue and keep customers returning to your site as well.
How to Prepare your Page for Search Engines
Here's How:
1. Write a descriptive <title> for the page. Make sure that your title is clear, and
contains many of the keywords within the page itself. The title tag is always found
in the <head> and is required.
2. Write a description within the <meta name="description" content=""> tag. Keep
the description to about 200 characters, and make sure it uses keywords found
within the page itself.
3. Put keywords in the <meta name="keywords" content=""> tag. You don't need
to use commas or other punctuation. Don't repeat keywords over and over in a
row. Rather, put in keyword phrases.
4. Make sure that your page includes the keywords, phrases, and the title. Most
search engines look at the repetition of the phrases in your title, description, and
keywords within the page.
Tips:
1. The meta keywords and description are not as important as the title. Pay
more attention to your title than your meta tags.
2. It is vital that your keyword phrases be found within the actual text of the
page.
3. If you repeat a word in the meta tags that isn't on the page, your page may
be penalized in the search engines.
It May Not Make You Rich, But There's Some Money In It
If you hadn't already guessed, the Web is not going to be the wellspring of wealth
that a lot of people assumed it would. Some people will get very wealthy, but
other people will earn nothing, and, in the nature of business fail and go out of
business.
However, if your goals are a bit more modest, it is not unreasonable to expect
your Web site to bring you some extra cash. Perhaps pay for the Web service it's
running on and take your family out to eat once or twice a month. Perhaps more.
Affiliate Programs
Affiliate programs are a simple way for you to get some extra cash coming from
your Web site. An affiliate program is where you partner with another company,
usually an ecommerce company, to sell their product from your Web site.
For every product you sell, you get a portion of the proceeds. The best known
affiliate program sells books for Amazon.com, but you can sell anything from car
ads to fishing flies.
Advertisements
Many sites have advertising on them, and they are another way to add a revenue
stream from your Web site. The money from advertising comes in two ways: first
from the number of people who view the ad and second from the number of
"click-throughs" on the ad. Basically, if your site gets a lot of hits (and so a lot of
people will see the ad) it will get a better rate for advertisements. But even sites
that have lower hit rates might have high numbers of clicks on the ad, and this
will get you a better rate as well.
Advertising can take the form of banner ads, which usually cost a lot, or just
sponsored links. You can see examples of each of those on About.com as well.
The banner ads on the top, bottom and sides cost more than the sponsored links
on the bottom, and they each bring in different amounts of revenue.
Other Resources
There are lots of articles and information on how to raise money from your Web
site. If you're interested in advertising, look at my Advertising resources. Affiliate
programs (also called Associate programs) are listed on my Making Money
resources page, as well as information on how to get started with associate
programs and advertising on your site. If you are ready to move on to more
advanced money making, then you should read my ECommerce resource page
Follow up at http://65.54.184.250/cgibin/linkrd?_lang=EN&lah=5d4859b14d942cd84febc58217feb787&lat=1084597334&hm___action
=http%3a%2f%2fslclk%2eabout%2ecom%2f%3fzi%3d1%2fKkT
Topics Covered by Web Design @ About






Beginning HTML
Intermediate and Advanced Web Development
XML, including markup languages such as WML, SMIL, CDF, and more
Marketing Web sites
Web hosting solutions
Web development tools
Advertising and Revenue Opportunities
The Web Design site offers many different options for advertising, at all levels and
campaign types.
About Affiliate Program
Instead of advertising your site on About, you can promote the Web Design site on
your site, and earn money for every click. About will provide banner advertisements,
search boxes, and text links for you to place on your site.
Luna Network
Luna partner sites are linked directly from the Web Design front page. They are sites
that are directly related to the Web Design topic. Luna partners receive promotion on
the About network and provide promotion to About on their network.
Sprinks
When you use Sprinks to advertise your site, you have the opportunity to spend as
much or as little as you would like on your listing. Each listing is listed based on
keywords, and you only pay as much per click as you can afford.
Banner Ads on Web Design
The Web Design site offers many opportunities for targetted banner ads on the site.
It's Bike-to-Work Week!
Put down the car keys and hop on the ten-speed: It's national Bike to Work week! According to
the Census Bureau, 99.7 percent of Americans burn gasoline on their way to work, so yes, we're
talking to you. As to the potential benefits, we turn over the mike to cycling enthusiast Julius
"Juby" Aulisio of Lakeland, Fla.: "The country would be so much better if everybody commuted
[by bike]. We probably wouldn't have gone to war in Iraq because that was all about oil. The
environment would be so much cleaner, and you wouldn't have road rage because they'd be
getting rid of all their excess energy riding. Even if we could get 5 or 10 percent of the people
commuting, the benefits to society as a whole would be incredible." Amen!
straight to the source: The Ledger, Gary White, 17 May 2004
<http://www.gristmagazine.com/cgi-bin/forward.pl?forward_id=2469>
Netherlands Prepares for Climate Change with Amphibious Homes
Builders in the low-lying Netherlands have always used ingenious means to keep the water out:
If not for a series of dikes and canals, some half of the country would be under water. But now,
with climate-change scientists predicting rising sea levels and more frequent severe storms, the
Dutch are preparing for a wetter future. In one village, they are building a series of floating
amphibious homes. These are not houseboats, but normal homes made of lightweight wood on
solid ground. But instead of being anchored to the ground, they rest on hollow, buoyant
foundations, so when the water rises, so do the homes. Builders hope that, in addition to insuring
homeowners against floods, the new houses can increase the overall habitable land in Europe's
most densely populated country.
straight to the source: MSNBC.com, Associated Press, Anthony Deutsch, 07 May 2004
<http://www.gristmagazine.com/cgi-bin/forward.pl?forward_id=2425>
www.therealhawaii.com
encourages our guests to become 'ekahi 'one' with the
ecology and the culture while on our excursions as we feel the more involved you
are, the better respect and understanding of each island. Your Native Hawaiian
guides, with their vast knowledge of the islands and their culture, will take you to
places you've only imagined in your dreams. To enjoy this excursion you should
be in good physical condition and free of any serious health problems. The
average tour time from hotel pickup to drop-off in the afternoon is approximately
4 hours. Our air-conditioned van will arrive at your hotel lobby at an assigned
time in the morning. We provide complimentary bottled water, a light lunch
("Real Tropical™" excursion only), daypack, binoculars, a hiking stick, and
rain ponchos if needed. Call us toll free at 1-877-597-7325 or order this excursion
directly on our secure server from our Reservations page. Complimentary pickup and
return in the Waikiki/Kuhio Beach area, otherwise, additional. Three tours avail:
only in Oahu, 69, 69, $49
We conduct tours Monday through Sunday, however
weekend and holiday excursions are conducted on private land. Our 'Real
Sacred' excursion does not access state trails and therefore operates on
weekends, even on holiday's. There are stringent limitations in place by the
Department of Land and Natural Resources that limit us to weekday excursions
only that overlap state lands. There are many reasons for this, including one just
to let the trails rest and recover over the weekend. We as ecologists support this
policy and know you will too. We have a limitation of the number of persons that
we take on each excursion, there's a total per day limitation placed on trail use by
DLNR. This is why we ask for first and second choices on our reservation form.
We will try to confirm your day and date requested within 24 hours of your
request. If neither day is available for one of the listed reasons, you will not be
charged and we will call and let you know of this. This instance is rare though.
We make every effort to reserve space for you on our excursions on the day you
request. To some of the most remote spots that Hawai'i has to offer. Many of
these spots are very remote and somewhat difficult to get to. Many areas have
extremely steep canyons or gorges, and some drop for almost half a mile. It is
imperative that you remain on the trail at all times. You should remain in sight of
your tour guide during the entire excursion. Your guide knows the areas well,
and is aware of areas of extreme beauty, but also of great danger. The hard
facts are that over the past several years, many hikers (even experienced) have
fallen victim to accidents and in many cases even death because of taking
unnecessary chances by getting off the trail. Many have become stranded, or
completely lost on hikes. Hawai'i has taken notice of this and is now requiring
tour companies to obtain liability insurance to lessen their burden in case of
accident. We have no choice as the cost of this insurance is enormous, and
because of insurance regulations, other than highly recommend that while on our
tour, you stay with your guide at all times.
Keep an eye on weather conditions. Flash floods are always possible with rain.
Do not cross any stream that appears to be overflowing or flooding. Stay with
your group or hike with a partner. Never hike alone! Believe us folks, it is very
easy to become disoriented on many Hawai'i trails. Hiking alone is hiking at your
own risk.
Do not take unnecessary risks. Don't climb or jump from waterfalls. Don't venture off
defined trails to areas that are not marked or are poorly marked especially if you're not a
seasoned outdoors person. Even then you are putting yourself at great risk. If you must
leave any trail without a partner, it would be wise that you have a walkie-talkie, cell phone,
or at the very least a whistle. Flashlights would come in handy also.
In Hawai'i many trail areas are overrun with introduced plants (non-native). We strongly
recommend that you wash the dirt and soil off the bottom of your shoes before leaving the
hiking area. Our guides carry a sprayer with water in it for just such a function on every
tour. This prevents introduction of the hitch hiking seeds to other parts of the island. Also
please never pick vegetation from its native location. Doing so can do one of three things.
First you may spread the seeds of the plant (if non-native) to other parts of the island, you
may actually be removing a native species from a spot where rehabilitation is taking place,
and finally many plants are considered sacred to the Hawaiians. Please respect all.
---Treating Fathers Who Maltreat--A recent article in "Clinical Psychology" argues that the intervention needs of
maltreating fathers are not met by traditional parenting programs, which may
actually support some of the problematic attitudes and behaviors of the abusive
fathers. "Effecting Change in Maltreating Fathers: Critical Principles for
Intervention Planning" describes more appropriate intervention treatments that
begin by targeting the motivations, accountability, and entitlement attitudes of
abusive men, while leaving skills development and parenting support for later in
the process.
The article draws on literature on parenting, child abuse, promoting change, and
treating batterers in order to construct principles to guide intervention with
maltreating fathers. These include:
*Given that maltreating fathers tend to be characterized by a sense of
entitlement, self-centeredness, and need for control, initial intervention
should focus on changing those attitudes, rather than on providing child
management skills that may actually enhance the father's sense of control.
*Abusive fathers often have little motivation to change; thus, treatment
needs to focus on acceptance of this need.
*Men's violent or hostile treatment of their children's mothers should be a
significant component in treatment.
*The damaged emotional security of abused children must be taken into account
as (formerly) abusive fathers attempt to rebuild relationships.
The overarching theme of this approach is to focus on changing attitudes before
attempting to enhance skills, and on transforming a self-centered perspective
into a child-centered perspective. Implications for providing these types of
intervention services are discussed. To date, two treatment programs for
maltreating fathers, including the Emerge program in Boston (see
www.emergedv.com), have been developed around these principles.
To view the abstract of this article or purchase the full text, visit the
"Clinical Psychology" website at
http://clipsy.oupjournals.org/cgi/content/abstract/11/1/95.
"Related Items"
The same issue of "Clinical Psychology" carries two additional articles on
maltreating fathers:
*"Finding Ways to Reduce the Prevalence of Child Maltreatment Among Fathers:
A Comment on the Alternative Approaches"
(http://clipsy.oupjournals.org/cgi/content/abstract/11/1/112) suggests that
long-term benefits would be greater if at-risk males were targeted for
prevention programs.
*"Advancing Change with Maltreating Fathers"
(http://clipsy.oupjournals.org/cgi/content/abstract/11/1/116) examines barriers
to intervention with fathers and suggests that a paradigm shift is necessary in
the treatment community in order to overcome these barriers and provide
appropriate services.
......................
Issue Date: May 2004
Section: Promising Practices
URL: http://cbexpress.acf.hhs.gov/articles.cfm?article_id=809
--------------------------------Shared Family Care--Shared Family Care (SFC) is a child welfare service that places an entire family
in the home of a community mentor for approximately 6 months. The mentor
provides day-to-day modeling of appropriate parenting and home management
skills, and, in essence, "reparents" the parent(s). Through a combination of
both in-home and out-of-home care, SFC helps families develop positive networks
of community resources and supports without separating children from their
parents. A recent article in the "Journal of Family Social Work" describes SFC
programs, summarizes an evaluation of two demonstration projects, and describes
challenges and helpful tips for those interested in developing an SFC program in
their community.
SFC programs exist across the country and are administered by both private and
public child welfare agencies. Although the programs vary somewhat, they share a
number of key elements:
*Mentors. Mentors are carefully screened and receive initial and ongoing
training.
*Matching mentors to clients. Prospective mentors and families meet several
times in order to allow both parties to learn more about each other and
determine if the match is appropriate.
*A rights and responsibilities agreement. All members of both families
develop and sign a written contract delineating rights and responsibilities of
both families, as well as general house rules.
*Family support team and wraparound services. Families involved in SFC often
have multiple needs. A Family Support Team helps the client identify goals,
develop service plans, and review progress. Case managers visit families
weekly.
*Aftercare. Due to the relatively short duration of the program, aftercare is
critical to provide the family ongoing support and services.
An evaluation of SFC demonstration projects in Colorado and California showed
promising results in reducing re-entry into foster care, increasing average
monthly income, and increasing independent housing for program graduates.
Additionally, although an SFC program can be expensive to develop and maintain,
SFC can be more cost-effective than some other types of out-of-home care.
The authors also offer some general tips for developing an SFC program,
including assessing community needs, assessing agency capacity, and exploring
funding sources.
A copy of this article, "Shared Family Care: Fostering the Whole Family to
Promote Safety and Stability" ("Journal of Family Social Work", Volume 7(2)) can
be obtained online for a fee from the Haworth Press at
www.haworthpress.com/store/ArticleAbstract.asp?sid=&ID=38652.
"Related Item"
The National Abandoned Infants Resource Center offers program, policy, and
evaluation resources on SFC on its website
(http://aia.berkeley.edu/information_resources/shared_family_care.html).
......................
Issue Date: May 2004
Section: Promising Practices
URL: http://cbexpress.acf.hhs.gov/articles.cfm?article_id=816
From :
First Community Credit Union
<[email protected]>
Sent :
Wednesday, March 24, 2004 10:19 AM
To :
"Sophina Aryvz" <[email protected]>
Subject :
Re: 2 accounts STILL open
|
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Sent
Messages
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Inb
ox
Sophina,
You may close an account by calling our Member Service Center at 1-800-767-8880. Our
representatives are available Monday through Friday from 8 a.m. to 7 p.m. CST and Saturdays
from 8:30 a.m. to 12:30 p.m. CST. They will also be able to transfer any money in the
account you are closing into the account you would like to revive.
We will be happy to change your address; however, we need a signed request
on file to change an address on an account. You will need to send a notarized
letter containing the following information: date, your name, account number,
indicate old address, indicate new address, indicate old phone number,
indicate new phone number and sign the letter with your legal signature. You
may send the letter to: First Community Credit Union; Attn: Financial Service
Consultant; 15715 Manchester Road; Ellisville, MO 63011. As soon as we are
able to verify your signature, we will make the changes.
Please call our Member Service Center for complete assistance with your
requests.
Thank you,
First Community Credit Union
----- Original Message ----From: Sophina
Aryvz
To: [email protected]
Sent: Tuesday, March 23, 2004 9:58 PM
Subject: 2 accounts STILL open
Subject: 2 accounts , one joint and one alone. Credit Union membership offered to me
when I was working for the Sporting News in NYC.
Date: Tue, 23 Mar 2004
To: FCCU in MO
[email protected]
Dear FCCU: I left NYC and did not inform you that I have 2 accounts open but they have
only the $25 to keep them open. This is to ask that you put in a change of address for
them and to send me info on closing one (the joint acct with Luis Gonzalez) with whom I
do not have contact with) and reviving the other (the one in my name alone). I will not be
using checks, just ATM so please send current rules and rates.
My previous addresses were: 37-07 30th Ave Astoria (aka L.I.C.) NY 11103-4341
and 84-32 57th Road, Elmhurst, NY 11373 and I may have given this further change of
address: 391 East 149th St. #210, Bronx, NY 10455
Kindly, send all mail to Sophina Aryvz 1019 Porter St., Richmond, VA 23224
I will be calling your 800 number in a few days to see if you have received my request.
Thank you kindly for your time and attention to the above.
Sophina Aryvz
From :
Sophina Aryvz <[email protected]>
Sent :
Tuesday, March 23, 2004 12:16 PM
To :
[email protected],
[email protected]
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Messages
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Inb
ox
Subject : FOOD Benefits pending verification.
Dear Mr. Butler: . Mr. or Ms. Northington has not replied to me and WORSE, has apparently not sent the form Ms. Baylor
needs for her files in order to get me FEBRUARY's access to FOOD. Yet you can understand, that I cannot keep calling and emailing Northington.
Now my food stamps have been erased because of Northington/AmeriCorp's failure to provide documentation, I have nothing
more to do with that other than to be truthful. I am being punished for having no control over AmeriCorps. Thus, perhaps
you should forward this to the Commissioner of the Dept of Social Services and set the record straight:
That my food stamps were withheld from me because AmeriCorps, also under the D of Social Svcs, did not feel like returning
the 'employment verification form' back to Ms. Baylor. I have called and sent notes to Ms. Baylor so she knows how I have
been monitoring Northington's lack of cooperation.
By the way, my doctor did want to fill out the General Relief form on my behalf but the diagnose was changed and the
corresponding medication was not going to be given to me due to lack of blood test as I fully explained to Ms. Brown when we
spoke in January '04.
There is nothing more I can do but AmeriCorps is overseen by your same dept., so why not forward this matter to the
Commissioner????????????? Below is message I sent you and I had pasted Northington/AmeriCorps' reply to me that, yes, he
knew about why I had not gotten paid. Northington, however, after that e-mail to me NEVER AGAIN contacted me in any
way.
Mr. Glenn Butler From: "Sophina Aryvz" To:
[email protected] Subject: Booklet, GR, etc. not gotten
from Hull St. Date: Mon, 16 Feb 2004 14:06:25 0500
900 E. Marshall Street, Room 330
Richmond, Virginia 23219
Telephone: 804-646-7430
Fax: 804-646-7018
e-mail: [email protected]
Mr. Butler, Your Staff's reply to my inquiry is much appreciated. Ms. Florence Brown was quite helpful and concerned. Unfortunately, because
I mentioned that AmeriCorps had not paid me, the form that Ms. Baylor needs for her file has not been returned by
From: "B.J. Northigton" To: "'Sophina Aryvz'" CC: "'John Moody'" Subject: RE: AmeriCorps Manager VA Commn on Nat &
Cmmty Svc Date: Wed, 28 Jan 2004 10:45:54 -0500 Dear Ms. Aryvz, Tom Harmon is the State Director of the Corporation for
National Service. His office has oversight of AmeriCorps VISTA and Senior Corps programs in the state. The office you
contacted this morning is the Virginia Commission on National and Community Service. I am the Executive Director of the
Commission. We provide oversight to state AmeriCorps programs. The program that you were involved with, Richmond ACES
AmeriCorps Program, comes under the purview of this office. Although you did not contact this office from the onset of your
allegations, I am somewhat familiar with your case. However, I am not aware of any "on-going so-called investigation
involving the grantee." If you have any issues that you would like to share with us, please send the information to my
attention either by e-mail or official letter. Thank you. BJ Northington Executive Director Virginia Commission on National and
Community Service www.vaservice.org -----Original Message----- From: Sophina Aryvz [mailto:[email protected]] Sent:
Wednesday, January 28, 2004 10:02 AM To: [email protected] Subject: RE: AmeriCorps Manager VA Commn on
Nat & Cmmty Svc I am besides myself with your prompt reply. Is this the office where Tom Harden is or have you replaced
him? (The site says you are 'manager' but I note your title in this reply.) If so, are you not informed of the on-going so-called
investigation involving the Grantee? Sophina Aryvz From: "B.J. Northigton" To: "'Sophina Aryvz'" CC: "'John Moody'" Subject:
RE: AmeriCorps Manager VA Commn on Nat & Cmmty Svc Date: Wed, 28 Jan 2004 09:29:16 -0500 Please direct all
correspondence to the Commission's new address: 7 North 8th Street, Fifth Floor Richmond, Virginia 23219 BJ Northington
Executive Director Virginia Commission on National and Community Service www.vaservice.org -----
Sophina Aryvz
Although auto accidents are more prevalent in the winter months, what you need
to do after an accident never changes. Obviously it is hard to think clearly after
an accident so it is important to know before you get into an accident what to do
first and what questions may need answered. This checklist will help you know
what to do after an auto accident. It is best to review it now and then print it out
and keep a copy with you in your car.
 Determine the Extent of Damage or Injuries
Try to stay calm. Panic can make others panic and the situation worse. There
needs to be a calm person to determine the extent of damage and to determine if
there are any injuries that need immediate medical attention.
 File an Accident Report with the Police
Even in a minor accident it is important to make sure there is a legal accident
report. Do not leave the scene until the police file a full report.
 Discuss the Accident Only with the Police
With everyone all shook up it can be hard not to talk about what just happened,
but that can also lead to you not thinking clearly and accurately about what
happened. It is important to limit your discussion of the accident and not to admit
any fault or liability. You should talk about the accident with the police and your
insurance agent only.
 Get the Facts
This is the part most people know to do, but often forget to after the accident for
one reason or another. It is important to get names, address, and phone
numbers of everyone involved in the accident. A description of the car and
license plate number can also be helpful, but make sure you also get their
insurance company and the vehicle identification number of their car. Don't just
think the license plate number will do because most insurance companies only
record the type of car and the vehicle identification number, not the license plate
number.
 Call you Insurance Agent
Call your agent or insurance company's 800# immediately, even at the scene
with the police if possible. Sometimes the police officer can give your insurance
company more accurate information rather than information you may not be
recording properly because of your being upset by the accident. This can save
you a lot of time later waiting for your claim to be processed.
What is a state sponsored insurance? A state sponsored plan for individuals who are not
able to obtain insurance under private companies. This coverage is usually very
expensive and will have very limited coverage's.
Tina has had 3 at-fault accidents in the past month. Since she is considered such a
high risk, she has not been able to find an insurance company that will accept her.
Finally she contacted her state commissioner and was able to get enough coverage
to drive again.
Does everyone have to have insurance? Yes. automobile liability insurance, or proof
of financial responsibility is required in all fifty states. Although each state sets their
own limits on how much insurance is needed, these are only minimum limits and in
most cases additional coverage is needed if you don't want to have to pay additional
expenses out of pocket. If you have a lease or loan on your car you are usually
required by the lender to have comprehensive and collision coverage in addition to
the state required liability coverage.
What issues are considered? Insurance companies evaluate the risks associated
with each policyholder to determine if you are a "good risk" or if your policy should
be canceled or not renewed. Insurance companies, among other factors, will
primarily review your claims, driving, and credit history. It is most favorable that
your policy will not be canceled if you don't have a history of filing frequent claims,
have maintained a clean driving record and your credit history is good with no
bankruptcy's.
What is a called a misquote. Determining your premium depends on many factors,
including where you live, the kind of car your drive, how much you drive, how much
coverage you want, your driving record, and your age.
If an error is made in reporting any of these facts, your rates won't be quoted
correctly. Misquotes can also happen if your agent makes a mistake in applying the
company's rating system. Auto insurance misquotes can happen when your
application information differs from your actual driving record.
Companies ask states' motor-vehicle divisions to verify the records of drivers they
insure. If you told your insurance agent you have a perfect driving record, and you
don't, your insurance company will charge higher premiums than your agent quotes.
To avoid misquotes, provide accurate information about your driving record and any
other facts affecting the cost of insurance, such as the make of your car or how far
you commute to work. Verify all information before signing the application.
Creating a corporate conscience
Foundation says doing good is good business
Carolyn Said, Chronicle Staff Writer
Tuesday, March 30, 2004
©2004 San Francisco Chronicle | Feedback | FAQ
URL: sfgate.com/cgibin/article.cgi?file=/chronicle/archive/2004/03/30/BUGHJ5T3EL1.DTL
Dell Inc. next month will become the first major PC-maker to
commit to specific goals for recycling computers and the toxics they
contain. The Gap developed a system to rate labor standards at its
overseas contractors and this spring will begin releasing reports on
factory working conditions in some countries. Home Depot has
stopped selling old-growth and tropical lumber.
These changes started with shareholder resolutions or discussions
with management initiated by the As You Sow Foundation in San
Francisco, in conjunction with large shareholder groups.
From a Financial District office decorated with posters on
progressive issues and full-page newspaper ads the small
organization has run, As You Sow assists shareholders, such as
foundations and socially responsible investment funds, that want to
nudge corporations toward better treatment of workers and the
environment.
As You Sow helps form shareholder coalitions, solicit support from
major investors, write shareholder resolutions and get the ear of
management. Its big selling point: It analyzes the business benefits
to companies of going green or changing their labor practices,
rather than playing the holier-than- thou card.
"We don't say do this because we're do-gooders," said Conrad
MacKerron, director of the corporate social responsibility program
at As You Sow. "We know that doesn't wash on Wall Street. We go
in and say not only is it the right thing to do, but here's the
business/economic case for it because we want this to be a
profitable company."
Further, he said, it is difficult for companies to ignore their largest
investors. "They can't dismiss you or marginalize you as some
extreme interest group. We talk about long-term value. In the age of
globalization, the most valuable thing these companies have is their
brand name. We stress over and over that getting these
controversies behind them will help maintain long-term value."
As You Sow provides "cross-cultural communication" between the
idealism of grassroots groups and the bottom-line focus of major
corporations, said Michael Passoff, associate director of the
corporate social responsibility program.
Despite its name, the group is more a consulting firm than a
foundation. It has no endowment and is funded through consulting
fees and grants. It charges between $25,000 and $50,000 to run a
campaign
Pat Nathan, sustainable-business director at Dell, said she
appreciates As You Sow's approach. Nathan said As You Sow
spoke to Dell in a "constructive, supportive manner, not asking for
the moon" and suggested that the company would benefit
financially from recycling. The group pointed out that Dell's direct
sales approach gives it "a great line of sight to customers; if anyone
could figure out the reverse logistics to get (computers) back (for
recycling), it would be Dell," she said.
As You Sow initiates that kind of campaign as part of its mission to
stay on the cutting edge of problems that resonate with the public
and have cost- effective solutions, MacKerron said. In this case, it
lined up the Calvert Funds as a co-sponsor, and found other major
shareholders who agreed that increasing recycling of computers,
which contain a variety of hazardous compounds, is an important
issue.
Now, Dell is developing what MacKerron called an aggressive but
achievable goal for how many PCs it will take back for recycling.
The company lets consumers send in old PCs for recycling for $5
and offers regular recycling days in major cities. Dell also
responded to As You Sow's suggestion that it include information
about recycling on its catalog cover, Nathan said.
As You Sow's successes, most of them incremental rather than
revolutionary, come at a time when shareholder activism is
increasing. Almost 300 shareholder resolutions on social issues
were filed last year; about the same number are expected this year,
according to Meg Voorhes, director of social issues at the Investor
Responsibility Research Center in Washington. (By contrast, more
than 600 resolutions were filed on corporate governance issues in
the wake of the accounting scandals morass.)
Shareholder resolutions on social issues are breaking new ground,
although they've been around for more than three decades and
were a major tool for anti-apartheid activists in the 1970s and
1980s.
"Shareholder advocacy is broadening in terms of the institutions
involved, " Voorhes said. "Ten or 15 years ago, religious investors
were filing the majority of shareholder proposals on social issues.
They are still the single most important group, but now public
pension funds, labor unions, socially responsible investment firms,
and groups like Amnesty International, Friends of the Earth and the
Sierra Club are all becoming active."
The other big change: Companies are listening and responding
more.
Campaigns by As You Sow and shareholders led to Coca-Cola and
Pepsi agreeing to use some recycled plastic in their bottles; Staples
and Office Depot increasing the amount of recycled content in the
paper they sell; and McDonald's and Walt Disney Co. increasing
internal monitoring of labor practices at overseas vendors.
As You Sow is talking with companies such as Starbucks, Du Pont
and Heinz about another big issue: genetically engineered foods.
Computer recycling remains a hot topic, and the group is hoping
that Dell's example will inspire other computer-makers such as
Apple, Hewlett-Packard and IBM to set their own goals.
"It's a cart-horse thing," said Patrick McGurn, vice president of
Institutional Shareholders Service, which advises large investors on
proxy votes. "Resolutions have been better written and better
targeted in recent years by some of these new-age activists (and
so) are getting higher voting support."
Many issues don't become resolutions. The very specter of a
resolution usually inspires corporations to come to the negotiating
table rather than hashing out sensitive issues in the public forum of
an annual meeting.
And social-change resolutions almost never win. Last year, socialissue proposals drew an average of 12 percent of shareholder
support, according to the Investor Responsibility Research Center.
Voorhes said that is a significant increase from an average of 7 or 8
percent in prior years.
But shareholder proposals and dialogue clearly light a fire under
companies.
"It's hard work to try to change big companies, like hitting your head
against a brick wall," said Tim Smith, a senior vice president at
Walden Asset Management and president of the Social Investment
Forum, the trade group for socially responsible investors.
"As You Sow has been a long-distance runner keeping pressure on
companies for a very long time. Their powers of dialogue and
persuasion have helped turn around some companies such as
Disney with sweatshop issues. They're not Don Quixote tilting at
windmills."
As You Sow Chairman Thomas Van Dyck, 46, founded the group in
1994 to hold corporations accountable for complying with
Proposition 65, California's toxic labeling law.
The Prop 65 side of the organization, led by Executive Director
Larry Fahn, who also is president of the Sierra Club, sues
companies that violate the toxics law and disburses the lawsuit
settlements as grants to California environmental groups.
During the past decade, As You Sow has given out about $2 million
in grants. The Prop. 65 suits have led to more disclosure about
mercury levels in fish, the elimination of formaldehyde and benzene
in construction of portable classrooms, and the removal of toluene
from nail enamel, the group said.
In his day job, Van Dyck, a co-founder of Progressive Asset
Management, consults on socially responsible investing at Piper
Jaffray & Co. in San Francisco. As You Sow branched into
corporate social responsibility in 1997.
Van Dyck sees pursuing change at the corporate level as a natural
dynamic.
"The capital markets can create social change much more quickly
than legislation or litigation because that profit incentive is in place,"
he said.
"The best management incorporates environmental and employee
practices that are more sustainable long term. You can make as
much money by doing what's right as (by doing) what's exploitative;
and in the long run, you'll do better. It's only in the short run that
exploitative practices do better because you're cheating the
system."
E-mail Carolyn Said at [email protected].
I've learned all about the Wright brothers. It's a fascinating story with lessons for all of us
-- lessons that we can apply right now in our workplaces.
Wilbur and Orville were average guys from Dayton, Ohio. They owned a bicycle
business, but they found themselves thinking more about wings than wheels. (Lesson #1
-- Have a vision.) So in 1899, they wrote to the Smithsonian Institution and gathered
everything they could find about early efforts to fly. (Lesson #2 -- Do your front-end
homework.)
They combed through every detail, searching for proven practices that would help their
invention get off the ground. Other inventors had already demonstrated the aerodynamic
wisdom of gliding, as opposed to flapping, and the Wrights followed their lead. In fact,
they worked all sorts of earlier discoveries into their designs. (Lesson #3 -- Make the
most of existing best practices.)
In other cases, facts and data convinced the brothers that they'd have to develop an
entirely new approach -- as in the case of lateral control. The prevailing method required
the pilot to shift his body left or right to attempt rolling and banking. Orville and Wilbur
knew they'd have to find a better way. (Lesson #4 -- If the facts tell you to go against the
grain, do it.)
Then the real work began. They analyzed what it would take to get airborne, and in the
process, they pinpointed four problems that had to be solved: lift, control, power, and
learning how to fly. (Lesson #5 -- Divide big challenges into smaller challenges, and take
them on one at a time.)
They built model after model, starting with kite-like gliders so they could test their ideas
on lift and control. (Lesson #6 -- Experiment, experiment, experiment.) These gliders
kept getting bigger as they fine-tuned their invention, and before long, they needed more
space. We all know where they went: Kitty Hawk, North Carolina, where the Outer Banks
offered perfect flying conditions.
Imagine telling your colleagues and family that you're going to haul your big kite to a
windy beach so you can work out the kinks. Oh, and by the way, the beach is 500 miles
from home. (Lesson #7 -- Do whatever it takes to achieve your vision. Ignore the
naysayers.)
Each test flight provided a wealth of information, and the brothers methodically made
improvements to their design. (Lesson #8 -- Great creations result from many small
creations.) And in July 1901, the tethered glider was big enough and safe enough for a
brave rider. Wilbur held on, everyone else pulled, and the glider soared across the sand.
(Lesson #9 -- Sometimes it just takes guts.)
Plenty of work still needed to be done -- not the least of which was this little problem of
power. There was none. Gasoline engines at that time were too heavy to carry the plane
and a person. So the Wright brothers turned to Charles Taylor, a mechanic
extraordinaire who worked in the bicycle shop. Taylor led the effort to build a lightenough gas engine. (Lesson #10 -- Capitalize on all that nearby know-how.)
On September 23, 1903, Wilbur and Orville left Dayton and headed once again for the
Outer Banks -- bringing along their precious cargo, the ìwhopper flying machine,î as
Wilbur called it. They spent that autumn using the glider version to sharpen their flying
skills. (Lesson #11 -- Take the time to be prepared.)
Then winter came, and they felt the time was right for their maiden flight. They tried on
December 14, but weak winds and an overeager tug on the elevator caused the ìWright
Flyerî to hit the sand. Weather conditions prevented attempts the next two days, but
December 17 seemed acceptable. Just four years after writing to the Smithsonian,
Orville climbed onto the bottom wing, eased himself into position, and pulled the release
wire. The rest is history.
The famous photo of that first flight is a story in itself. Orville and Wilbur felt so prepared,
so optimistic, that they had a camera ready and waiting. (Lesson #12 -- At the moment
of truth, throttle up your optimism.) An assistant had instructions to release the shutter
just as the Flyer slipped the bonds of its launch track.
Tom Terez is the founder of BetterWorkplaceNow.com, author of "22 Keys to Creating a Meaningful
Workplace," and president of Tom Terez Workplace Solutions Inc. He's on the road all the time doing
keynotes and workshops on workplace improvement and performance excellence. He's known for his
humor, stories, and straight talk -- and for providing ideas and tools that people can put to work right away.
Tom's presentations and projects have been with LensCrafters, SouthTrust Bank, the U.S. Postal Service,
the Social Security Administration, the Pinellas County (FL) Schools, AOL/CompuServe, Columbus
Children's Hospital, ADRA Mongolia, Lambton Hospitals of Canada, Head Start, Novozymes, the Jamaica
Office of Utilities Regulation, and many others.
BetterWorkplaceNow.com is a favorite resource for people who are working to increase employee morale
and job satisfaction. The site is full of free online tools. Tom also publishes the free biweekly "Better
Workplace Now" e-letter. For a free subscription, write to [email protected].
Contact Tom directly at [email protected].
Above article came from At HR.com, we are committed to helping you make smart HR
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An explanation of the speculative practice of shorting stock
Arbitragers, speculators and many individual investors engage in a practice known as
shorting stock. These "shorts" make money when the price of the stock they are
shorting goes down.
The Basics of Shorting Stock
I own 10 shares of company ABC at $50 per share.
You believe the stock price of ABC is grossly overvalued and is going to crash
sometime soon. You are so convinced that the stock will crash, you come to me, and
ask to borrow my ten shares of ABC and sell them at the current market price for
$50. I agree to lend you my shares as long as you pay me back ten shares of ABC at
some point in the future. You take the ten borrowed shares, sell them for $500 and
pocket the money (10 shares x $50 per share = $500).
The following week, the price of ABC stock falls to $20 per share. You call your
broker and tell him to buy 10 shares of ABC stock, at the new price of $20 per share.
You pay him the $200 (10 shares x $20 per share = $200). A few days later, you
pick up the shares of ABC and bring them by my office. "Here are the ten shares I
borrowed," you say as you put them on my desk.
Do you see what happened? You borrowed my shares of ABC, sold them for $500.
The following week, when ABC fell to $20 per share, you repurchased those ten
shares for $200 and gave them back to me. In the mean time, you pocketed the
difference of $300.
The Speculative Nature of Shorting Stock
What if the price of ABC stock had risen? The person shorting stock would have had
to buy back the shares at the new, higher price, and absorb the loss personally.
Unlike regular investing where your losses are limited to the amount of capital you
invest (i.e., if you invest $100, you cannot lose more than the $100), shorting stock
has no limit to the price you might ultimately lose. Famed investor Ben Graham told
us there is nothing stopping an overpriced stock from becoming more overpriced. In
the unlikely event the stock had shot up to $1,000 (which actually happened to
shares of Northern Pacific during a short squeeze in 1902), you would have had to
purchase ten shares at $1,000 a share for $10,000. Taking into account the $500
you received from selling the shares earlier, you would have lost $9,500 on a $500
investment.
Some investors practice shorting stock as a hedge to protect their portfolio. In most
cases, this is not required nor recommended for individual or institutional investors.
If you have selected a company you believe has excellent prospects for the next
decade, you should view a declining market as an opportunity to purchase more of a
good thing, not something to be dreaded.
Shorting Stock in Your Personal Portfolio
In order to begin shorting stock, you must open a margin account with your
brokerage firm. You will be charged interest on the borrowed funds as well as subject
to several rules and regulations that govern shorting stock (for instance, you cannot
short a penny stock, and before you can begin shorting a stock, the last trade must
be an uptick or zero-plus tick.) After taking these factors into consideration, you will,
hopefully, realize shorting stock is not a financially fattening activity in most cases.
Investing on margin can lead to fast profits of financial ruin
Whether or not you know what the financial term margin means, you may never
reach the point where you can decisively say if it is good or bad. Even those whom
have invested for years are heavily divided on the issue - to onlookers, the raging
debate of its virtue may resemble more of a theological disagreement about God or
some equally important matter as opposed to what it really is.
Defined, margin is essentially investing with borrowed money.
Any eligible investor may purchase securities on margin by borrowing money from
their broker at a fixed interest rate (for example, 9.5%) on the condition that fifty
percent of the amount invested is the investor's equity. To restate that, if you
wanted to purchase $10,000 worth of stock on margin, you would have to provide at
least $5,000 of the cash. The broker will loan you the difference.
This can be great - when the market is going up. Using this leverage, you can make
twice as much money on a successful stock investment as you could otherwise. As
enticing as this may seem, the drawbacks are equally as impressive.
The most important point to realize is that you will be charged interest for borrowing
the money. This means that if you make 13% on your investment in a year's time
and have to pay out 9% in interest, you have cut your profit down substantially. It is
more desirable for the margin investor to pick short-term plays so that they "hold"
the money for a very short amount of time, and have to pay little interest on it.
Short-term estimates on market performance are virtually impossible to correctly
anticipate, and hence risky.
The second drawback (which is the main reason for the hatred among some
investors for margin) is that the securities in your account can and will be sold if the
price of the stock falls far enough. For instance, since you are required to keep a
certain amount of equity in your account, if the value of your stock falls, your broker
may make a margin call. This means that you will be required to put additional
capital / cash into your account or the broker will sell as much stock as necessary to
force repayment of the money they lent you. This means you will be forced to sell at
precisely the time it is most damaging to do so.
In some extreme cases, margin caused serious economic troubles. In the Great
Depression era, it was only required that customers put up 10% of the amount of
the margin loan. If an investor wanted to purchase $10,000 worth of stock, they
would only be required to deposit $1,000 upfront. This wasn't a problem until the
market crashed, causing stock prices to fall. When brokers made their margin calls,
they found that no one could repay them since most of their wealth was in the stock
market - thus, the brokers sold the stock to pay back the margin loans. This created
a cycle until eventually prices were battered down and the entire market demolished.
Knowing all of this, is it wise to use margin? In short, only if you are fairly confident
about the short-term moves of the market, which is fairly impossible to predict.
Definition: A margin account lets a person borow money from a broker to purchase
securities. The difference between the amount of the loan, and the price of the
securities, is called the margin.
Definition: When the price of securities purchased on margin suddenly drop in price
and lose value, a margin call requires the investor to put more money in their
account immediately or face liqudiation of the securities to pay the loan to the broker
back.
Rsch Reuters: http://about.reuters.com/productinfo/messaging/
ESL ARCS (The Adult Reading Components Study): offers an online mini-course in reading at
the following NIFL site: http://www.nifl.gov/readingprofiles/MC_Intro.htm.
The ARCS was conducted by researchers at the National Center for the Study of Adult Learning
and Literacy (NCSALL). Nearly 1000 adult learners participated in the study, taking a variety of
reading and language tests. Using cluster analysis, ten different reading profiles were identified
from the results of these tests.
Components of this self-directed course include:
Print Skills (Alphabetics)
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
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

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Phonemics
Word Recognition
Sight Words
Word Analysis
Spelling
Reading Rate & Fluency
Meaning Skills
Word Meaning (Vocabulary)
Background Knowledge
Silent Reading Comprehension
Assessment Drives Instruction - This section will use the page listed below to show how
assessment is linked to instruction.


Comparison of three different reading profiles found in one ABE classroom
Browse All ARCS Comparison Profiles - This section features all of the ARCS
Comparison Profile descriptions as well as the comparisons of profiles in the same silent
reading group.
Using a Learner Questionnaire - This section explains the usefulness of learner questionnaires
and provides an example that you can download and use in your program.


As an adjunct to skills assessment
Downloadable learner questionnaire
Using Assessments - This section describes some common adult education assessments and
provides a list of tests that can be used in adult education programs.

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
Types of assessments and some test concepts
Test Bank listing many assessments that can be used with
adult learners
ARCS (The Adult Reading Components Study) - This section describes the research study that
forms the foundation of this website.




ARCS Overview
ARCS ABE and Spanish Assessment Batteries
The 10 ARCS Research Profiles
An explanation of how the ARCS relates to this website
References - This section contains all the references given on this site.
A complete list of citations
Resources - This section contains downloadable resources that can be used with adult learners
and web addresses of adult education and research sites.
Downloads:
Word lists (Basic Words, Instant Words, Signal Words)
The Word Meaning Test (WMT)
Sylvia Greene's Informal Word Analysis Inventory
Web addresses of adult education and research sites
Research
indicates that children need skills in recognizing words and comprehending
meaning to master reading and English literacy. For that to happen,
teachers need to deliver intense, explicit and supportive reading
instruction developed through targeted and continuing methods. AERA's
Research Points offers policymakers suggestions to address needs of the
increasing number of children who enter schools in America with limited or
no English.
http://www.aera.net/pubs/rp/index.htm
Costa Rica Subject to "Oil Extortion," Say Activists
Costa Rican President Abel Pacheco delighted environmentalists two years ago when he
announced a moratorium on oil exploration and open-pit mining in the country. But Harken
Energy, a Texas-based oil company, wasn't so fond of the idea. The company says Costa Rica
owes it reparations for refusing to let it proceed with offshore oil drilling; through a World Bank
body, Harken demanded (gulp) $57 billion. Costa Rica said fat chance. But the passage of the
Central American Free Trade Agreement could make it harder for small nations to stand up to
corporations and protect their environments -- and easier for extractive industries to get what they
want. Mark Engler and Nadia Martinez report on the Costa Rica case -- only on the Grist
Magazine website.
only in Grist: CAFTA may leave Central American countries vulnerable to energy giants -- by
Mark Engler and Nadia Martinez
<http://www.gristmagazine.com/maindish/engler032604.asp?source=daily>
In answering Grist's questions earlier this week, InterActivist and environmental educator Lily
Fessenden casually mentioned YIIMBY (Yes! It's in my back yard!), a project her household
instituted whereby every bit of waste they produce -- and they mean "every" -- is kept on their
property. Readers were fascinated and wrote in with all kinds of questions. Read Fessenden's
answers to learn about doing your business in a pickle bucket, composting old clothes, spreading
the Deep Ecology gospel, and more -- only on the Grist Magazine website.
only in Grist: InterActivist Lily Fessenden answers reader questions
<http://www.gristmagazine.com/interactivist/fessenden032604.asp?source=daily>
Short story authors challenge readers to write the ending
By Matt Born
(Filed: 26/03/2004)
Aspiring authors are to get the chance to write the ending to one of eight short stories begun
by leading novelists, including Ian Rankin, Fay Weldon and Sue Townsend, in a BBC
competition launched yesterday.
The best-selling writers have each produced the first three quarters of eight original short
works for End of Story, a new series for the youth-orientated digital channel BBC3.
Viewers will then have about six weeks to try to finish their chosen tale in 1,200 words.
Four judges - including the playwright and actor Kwame Kwei-Armah and author Muriel Gray will draw up a shortlist of the best entries.
The winning eight stories, which will have been chosen by the authors themselves, may be
dramatised on BBC3 in the autumn.
A number will also be broadcast on Radio 4.
As well as Townsend, creator of Adrian Mole, Rankin, best known for his Rebus detective
novels, and Weldon, the other writers taking part are Joanne Harris, Ed McBain, Marian Keyes,
Alexei Sayle and Shaun Hutson.
The BBC is publishing about 20,000 copies of the part-written stories.
Prospective wordsmiths will be able to pick up a copy free from libraries, coffee shops, petrol
stations and other public venues. The stories will also be available over the internet.
Winners will meet the authors whose work they had completed, and may even land a
publishing deal.
Stuart Murphy, the controller of BBC3, said he hoped the competition would provide a platform
for potential writers to launch their careers.
He said: "This project is very exciting for anyone who has read a book and thought they could
do better.
"This series could change the path of some people's lives for ever."
End of Story, which begins next month, was among the highlights of the BBC3 spring/ summer
season unveiled yesterday.
The season also sees the channel launch its own medical drama, Bodies.
Although it is a genre which many feel is already over-exposed on television, Mr Murphy
insisted the show was "completely different" to the likes of Holby City and Casualty.
He said the series, starring Max Beesley and Patrick Baladi, would make "uncomfortable"
viewing at times.
"Bodies gives an insight into the medical world in a way that has not been done before," added
Mr Murphy. "It deals with issues such as whistleblowing and the culture of secrecy."
WHISTLE BLOWING
By VICKI SMITH
The Associated Press
3/31/2004, 1:42 p.m. ET
MORGANTOWN, W.Va. (AP) — A judge on Wednesday set aside $600,000 punitive damages
that jurors had granted three West Virginia University police officers, saying he was wrong to let
them consider that kind of award in a whistleblowing case.
Two current officers and one former officer had sued WVU, claiming the school retaliated against
them for complaining that dorm-room burglaries were routinely mislabeled to avoid a federal
crime-reporting law.
Clawges said he turned some of those issues over to the jury, hoping they could sort it all out.
However, he failed to include in his jury charge the language of the state whistleblower law, which
spells out certain remedies juries can impose. Those include reinstatement of employment and
seniority, and awarding of back pay and other actual economic damages.
"We all ignored the black and white language of the statute, and I fault myself for that," Clawges
said. "There is no statutory authority for punitive damages in whistleblower cases."
CITIZEN-TIMES staff breaking the rules to help stop child abuse
Asheville Citizen Times - Asheville,NC,USA
... It will include clowns from The Health Adventure and a puppet show
by AmeriCorps volunteers, incorporating child-oriented messages about
personal safety and ...
<http://cgi.citizen-times.com/cgi-bin/story/columnist/52308?storytemplate=columnist>
See all stories on this topic
Tribal aid program triggers old fears
A new effort aims to identify the social problems facing the state's
Indians, but some tribes are skeptical.
BY MATT SABO
March 28 2004
Over the next three years, many of Virginia's eight state-recognized
Indian tribes will take a small step toward independence while
awaiting a decision on their efforts to gain federal recognition and
funds.
In a $120,000 federally funded program administered through the state, federal workers
will help the tribes identify their most pressing needs, in areas such as housing, elder
healthcare and education. The program would then seek money to alleviate those
problems.
In concept, the Virginia Indian Development program will unite the state's eight
recognized tribes in the common goal of tapping into funds to aid their members, just as
cities or counties reap money from the state and federal governments for similar
purposes.
But in practice, the effort is running into some of the same problems that have prevented
the tribes from gaining strength in the past - a lack of unity.
One tribe, the Pamunkey, in King William County, isn't going to participate, said its
chief, who declined to elaborate. Another tribe, the Mattaponi, is not expected to
participate, at least at first, said the program's director.
The very core of the program, a Census-like survey, is sure to raise hackles among some
of Virginia's Indians, many of whom endured decades of institutionalized racism that
included purging Indians as a distinct group from Census counts.
The Upper Mattaponi Tribe is supporting the program, but Chief Ken Adams says the
survey may cause problems.
"Typically, Indians have been surveyed to death," he says. "People have come into our
communities and asked us questions for years and years and years. Nobody likes
somebody to come to their door and ask them personal questions. We've been asked that
kind of stuff many, many times."
Adams says he still backs the program, hopeful for what it can do for his tribe.
"I think it's something that probably needs to be done to tap into the needs and the desires
of the tribes," Adams says. "Where it's going to lead to, I don't know. We just have to
wait and see, I guess."
Congress has been considering legislation that would give Virginia's tribes federal
recognition - funding like other Indian tribes. But the measure has been stalled in
committee amid fears by some that the tribes would use this authority to build casinos.
Others are unwilling to commit to perpetual payments to the Virginia tribes.
Scattered across Virginia, mostly in small, rural communities, the state's eight recognized
tribes are estimated at only about 5,000 people, Adams says. Yet 21,000 Virginians
identified themselves as American Indians in the 2000 Census.
The Virginia Indian Development program is being conducted by Americorps, a network
of national service programs.
A key component of the program is that the tribes will conduct their own census. The
census is expected to serve three purposes: Identify tribes' membership and needs;
develop plans to meet those needs; and find money to carry out the plans.
Unlike tribes in other parts of the country, Virginia's don't have federal reservations and
do not receive federal funds earmarked for Indian programs. That's because the 17thcentury treaties signed by Virginia's Indians were with England, not the United States.
Even though they are state-recognized and considered political entities, responsible for
providing services to their members, tribes don't receive funding like Virginia's towns,
cities and counties do, said Dante Desiderio, the program's director and a member of the
Sappony tribe, which straddles the Virginia-North Carolina border but is not recognized
by Virginia.
"We don't have any land, our resources are extremely limited and we're not federally
recognized, so we're not able to acquire federal funds," Desiderio said. "That's the biggest
reason we're doing this."
The program, he said, will put Virginia's tribes on a more equal footing with cities and
counties.
"It's a baby step, and really it's also a way for us to start getting programs for our
members from the state," Desiderio says.
He cites an example of an elderly tribal member who needs money for heating oil. That
person would rather receive help from the tribe than from the state, he said.
Desiderio said he's undaunted by the prospect of two tribes declining to participate.
"It's nothing new, having tribes going in different ways with different goals," he said.
He and other supporters of the program point out that one of its components is designed
to overcome these differences.
Tribal economic growth has been impeded by the varying objectives of the tribes, as well
as a lack of money and administrative expertise, says Karenne Wood, chairwoman of the
Virginia Council on Indians.
"With help from the Virginia Indian Development program, we can address different
needs without forcing tribal volunteers to become experts in multiple grant programs,"
Wood says.
"This program also helps by making it easier on grantors to fund various projects since it
will define not only the individual needs of each tribe but also the common needs of all
Virginia tribes."
[email protected] | (804) 642-1748
Copyright © 2004, Daily Press
EDUCATIONAL TOURS AND TRAVEL
http://65.54.184.250/cgibin/linkrd?_lang=EN&lah=f6e62aa24a5fa5250fdf2fbcd88876a3&lat=1080773833
&hm___action=http%3a%2f%2fglclk%2eabout%2ecom%2f%3fzi%3d6%2f1SI5
Travel and learn: languages, history, culture, sports, cooking, crafts and more.
Top 6 USA Learning Vacations
Participate in an archaelogical dig. Learn a heritage art. Go on a bear hunt. On a
learning vacation, you explore a new place while expanding your knowledge and
developing new skills.
Will You Travel as a Tourist or as an Explorer?
By Ron Gross - If you're going to be travelling this summer, how about enhancing
your experience by becoming more of an Explorer than a Tourist?
"Widowed Mother of Two Goes to Italy"
When her husband suddenly passed away five years ago, school eased Julie's loss.
Recently, this inspiring young widow has had an incredible learning experience in
Italy.
Art Workshops in Guatemala
Classes include photography, weaving, watercolor, creative writing, mixed media
and the visual, fiber, book and theatre arts, creativity, Mayan culture and courtyard
gardens/ landscape design.
Amazon Co-op
Promotes Ecotourism and sustainable use of the Amazon rainforest. Activities
include forest trekking, nature walks, animal watching, fishing, canoeing and
swimming.
Blyth & Company Travel
Focuses on educational travel and custom-designed theme packages for galleries
and museums.
East-West International Tours
Professor led tours of Russia, China, Tibet and Egypt.
Educational Travel Center: Thailand
Offers cooking, trekking, canoeing, cycling and more learning and adventure tours.
Educational Travel Review
A journal written by and for teachers who travel.
Elderhostel
An educational and travel organization for adults 55 and over.
"Edutravel: trips that teach"
Family vacation ideas for informal learning, homeschooling while travelling and tours
that teach, from your About.com Guide for Travel With Kids.
Flavours: Italian Cookery Holidays
Create authentic Italian dishes with local experts in small groups.
Historic Journeys
This collaboration between The History Channel and FAR&WIDE Travel
Corporation/IST, is a collection of six tours for history lovers.
Holbrook Educational Travel
Offers "field-based" immersion workshops for both Professional Development and
Student Study throughout Latin America and Africa.
International Adult Education
Resources for American students pursuing studies outside the USA.
Language/Culture Study Abroad
Use this directory to locate courses and schools to study language and culture
around the world.
Learning at U.S. & Canadian Parks
Environmental and historical education programs at national parks including outdoor
skills programs, workshops for teachers, nature lessons, and more.
Liberal Studies & The Arts
UW-Madison's Division of Continuing Studies offers Performing Arts Study Tours to
major cities in the U.S. and Canada, as well as Arts Seminars Abroad.
Moscow Study Trips
Learn about the political, economic and social transitions of Russia.
NETC's Adult Programs
Offers tours specially designed for adult learners only.
PBS Travel & Expeditions
Not sure where to go? PBS's extensive collection of photos and videos is guaranteed
to inspire.
Photography, Film, Video & Digital Media
An international photography school and training center for the world's
photographers, imagemakers and storytellers.
Senior Tours
Group travel opportunities ranging from educational experiences, such as
ElderHostel, to adventure travel for the over 50 crowd.
Sirius Travel
Specializes in eclipse and adventure travel in Southern California and Arizona.
therealhawaii
Exciting and educational eco-cultural excursions led by native Hawaiian tour guides.
Yucatan Mayan Adventure
Offers a 7night/8day trip combining Mayan ruins, beach/ activity time, 4&5 star
accommodations and a "Dinner with the Locals" program.
Office Depot Announces Plan to Go Green
Office-supply giant Office Depot is teaming up with respected conservation groups in an effort to
green its business practices. A new five-year, $2.2 million environmental strategy should
demonstrate that the company is "about commitment, not compliance or convenience," said
Office Depot President Bruce Nelson. The corporation is collaborating with three nonprofits -Conservation International, The Nature Conservancy, and NatureServe -- to create the Forest
and Biodiversity Conservation Alliance, which aims to convince logging companies to adopt more
responsible conservation practices. Office Depot also unveiled a new policy for buying paper
from suppliers, which is intended to protect biodiversity. "We are perfectly clear on the values we
want to promote and advance, the types of forests we want our suppliers to avoid, and the forest
practices we will and will not accept," said Nelson. The company's shift has mollified two of its
harshest critics, the enviro groups Dogwood Alliance and ForestEthics.
straight to the source: GreenBiz.com, 23 Mar 2004
<http://www.gristmagazine.com/cgi-bin/forward.pl?forward_id=2205>
straight to the source: Sun-Sentinel, Karen-Janine Cohen, 23 Mar 2004
<http://www.gristmagazine.com/cgi-bin/forward.pl?forward_id=2206>
Green Building Is Booming
Once a fringe movement, born of the 1970s energy crisis, green building is going mainstream
with a vengeance. Through its four-year-old Leadership in Energy and Environmental Design
(LEED) program, the U.S. Green Building Council has certified 149 million square feet of
commercial and high-rise residential space as green, up from 8 million in 2000. The economic
benefits are clear: According to a recent study by the California Sustainable Building Task Force,
green building raises upfront construction expenses by 2 percent, but yields tenfold savings over
20 years by reducing energy and waste costs. Even those upfront expenses are decreasing as
companies like Home Depot jump into the market with more eco-friendly, sustainable materials,
driving prices down. Green building techniques range from the high-tech, like installing motion
sensors that turn off lights when no one's in a room, to low-tech, like situating buildings to receive
maximum natural light. More and more cities require new government buildings to meet LEED
standards.
straight to the source: The Mercury News, Paul Rogers, 30 Mar 2004
<http://www.gristmagazine.com/cgi-bin/forward.pl?forward_id=2238>
straight to the source: USA Today, John Ritter, 30 Mar 2004
<http://www.gristmagazine.com/cgi-bin/forward.pl?forward_id=2239>
see also, in Grist: Who's the greenest of them all? -- NRDC's new Santa Monica building may be
the most eco-friendly in the U.S. -- by Amanda Griscom
<http://www.gristmagazine.com/powers/powers112503.asp?source=daily >
How to Compute with a Clear Conscience
The personal computer you're using right now likely contains lead, brominated fire retardants,
polyvinyl chloride, and the heavy metals cadmium, chromium, and mercury. These nasties
threaten the workers who manufacture PCs as well as the groundwater in areas where they are
landfilled -- and some 12 million are landfilled annually in the U.S. The Silicon Valley Toxics
Coalition and other environmental groups have joined forces on the Computer TakeBack
Campaign, compiling report cards that rank computer manufacturers on environmental practices
and creating guidelines for eco-friendly purchasing, use, and disposal. The Green Guide has
pulled together some of the most helpful tips in Earthly Possessions -- today on the Grist
Magazine website.
today in Grist: Tips on greener computing -- in Earthly Possessions
<http://www.gristmagazine.com/possessions/possessions040604.asp?source=da
ily>
The software can be used for adding a new Adult Education resource to an already existing Adult
Education component or parent and child together time (PACT Time) component to an existing
family literacy or family education program. A 15 user, one-year Online Language Learning
Center for US English retails for $4,485.00. The application period ends May 14, 2004.
Please log on to NCFL's web site www.famlit.org and read under announcements for more details
on eligibility and how programs can apply.
WHY PARENTS NEED LIFE INSURANCE
As a parent, you know you need life insurance, but how much? What is the
minimum amount your survivors would need for the monetary loss of you or your
spouse? It is estimated to raise a child from birth to college can cost anywhere in
the neighborhood of $700,000! Here are some quick and simple ways to get an
idea of how much life insurance you may need:
 Option 1: Determining Expenses (-) Assets: Figure a rough estimate of your
annual family budget. This would include your mortgage, child care, insurance,
and basic living expenses. Don't forget to include expenses such as vacations,
and future education plans such as private school and college. Next, estimate a
figure for your assets such as savings, social security benefits, or any other
income that will be there such as the income of a surviving spouse. Remember,
stay-at-home spouses contribute a lot to the family income by by-passing child
care, travel, cleaning, cooking, tutoring and associated costs, therefore would
need to be insured also.
 Option 2: Salary Estimate: Another quick, but more general way, would be to
take your current annual salary and multiply that by 7. For example, if you make
60,000/per year then I would recommend buying a minimum of
$420,000($60,000 X 7= $420,000).
If your estimate is high, good, it's probably right. If you are worried about the
premium cost, I would recommend choosing term life insurance. You can get a
policy for the time you would need it (the amount of time your kids would depend
on you) for a lower premium than other insurance options.
WHY IS DAYCARE SO EXPENSIVE?
Three main issues are of concern to both center and daycare providers :
expenses, time and value. What follows are excerpts.
$ Expenses $
"...Many centers are non-profit and simply charge what they need to in order to
cover expenses. Look at the expenses of childcare - food, insurance, salaries
(which by the way are WAY TO LOW in comparison to today's standards in most
professions... cc is barely above minimum wage in many areas), equipment,
supplies, some have transportation costs (buses/vans/maintenance/gas/etc), rent
of property, property taxes, to name only a few.
Many people who work in childcare end up leaving a profession they love
because the salaries are so low..." RUTHJRC
"...Parents don't understand My over head- We have to pay for everything your
child eats, drinks, uses and plays with. All the crafts and papers your child brings
home, videos they watch, As well as quarterly income taxes, our extra insurance,
Social security, gas and car maintenance, cleaning supplies, time spent "off the
clock" doing paperwork or shopping for the supplies ...well just about everything so you see we don't get to keep most of what we get paid by the parent, and we
don't get workman' s compensation or Health insurance...so If one of my kids
ends up in the Hospital I am in big trouble. I actually make less than 1/3 of the
minimum wage if I have a house full of kids-And that Wage doesn't begin to
cover the stuff my kids need let alone my Mortgage.If more parents understood
the true cost of Daycare they would understand that we providers are in this line
of work for love of kids-not money!..." LYSEKIDS
"... There is a fixed cost to running a child care facility whether it be home or
center. Many of the "invisible" costs have already been mentioned. They include,
insurance, bookkeeping, depreciation of equipment, transportation costs ( even if
you don't transport children, you do drive to the store for supplies), education and
training (required for license in most if not all states), curriculum materials,
landscaping upkeep, cleaning supplies, facility maintenance (fixing broken doors,
etc) and advertising. I may have missed some. The costs most people (non
providers) notice are food, craft supplies, paper goods (napkins, etc.) and
teacher salaries..". DADSKIDS
"...$115.00 IS cheap...on a 5 day week/10 h our day, that's only $2.30 per hour.
Babysitters get paid MUCH more than that. On that $2.30 per hour, take out your
self-employment tax; mortgage use; water, gas, electric, wear and tear on home
and furnishing; food; activities; vehicle maintenance; gas;..." SUE124
$ Time $
"...We work horribly long and hard hours. Twelve a day with children in our home.
Then the shopping trips we have to do because your child will need something
next week. Tomorrow we will spend the day cleaning all the outdoors toys and
fixing the yard and the deck so your child will be safe in our care. Sunday after
some time with our kids we will go shopping for the needs that we can think of for
the week. Monday night I'm sure we will again have a list of more that we need.
So one other night during the week will be shopping for these..." JANR1
"...Even during nap time, I sit in the room with the children while they nap and
work on the computer. Usually working on newsletters, calendars , etc., all to
keep me and my parents up to date. Even coming here is for their benefit. The
more informed and educated I am, the better it is for their child. So from 6:45 in
the morning until 6 in the evening, I am with their children..." SLK41
"...Oh, not to mention we work those 11 hours a day (or more for some providers)
with no break. Most people get two 15-minute breaks and an hour lunch where
they can actually LEAVE work. Not us..." MUNCHKINS6
$ Value $
"... it seems so expensive, but really is an investment. A good childcare program
is so needed by the children, but a bad one that costs a little less can do so much
damage to a child just the same. It's not worth saving money to damage your
child...." SLK41
"...Yes, $115/wk is a lot of money from your pocket. But, let's gain a little
perspective. As said before, does the monthly amt. you pay for your child to be
protected, loved, stimulated, entertained, socialized, nursed, educated, fed,
changed, and on and on even begin to compare to what you might pay for your
mortgage/rent, auto(s), food, medical care, clothing and utilities each month?..."
MAJORMOMMY.
Contract and Policy Tips for Family Daycare
If you are a family daycare provider, you are also a small business owner and a
professional. It is important to have a well written contract for services you will
provide. Providers from our forum have shared some of their policies.
Hours of Operation
I tell all my parents I am open 7-5 every day, and they can bring their kids anytime
during those 10 hours and it's one rate. I do charge an hourly "overtime" rate if they
come before 7 or stay after 5
Ecn8
I'm open a maximum of 10 hours a day. 7am-5:00pm. If a parent needs
me to be open a little longer, they have to give me at least a weeks notice. I don't
think you are being unreasonable.
Karenritter
My hours are 7 to 5, but contract states...Daycare is a 9 hour day, and this must
include drop off and pickup time. My hours should be able to accommodate them to
fit into their workday. If they need more than 9 hours, I will probably send them
elsewhere, as I don't want overtime. If it is on a rare occasion, I am more than
happy to help them out.
Grits4evr
Registration and Deposits
have never asked for a deposit, and never been stiffed by a parent. They have
always given me notice at least one month ahead of time. I ask for two weeks.
Jkelly531
I require reg. fee, first week up front since Now I do pre-pay and the last 2wks
termination. I tell parents if NO written termination then they still pay!! I know it's a
lot up front so I do with work with them on the dep..
Kidskornerdc
1 Have parents make a deposit equal to 2 wks payment. This is your final 2 wks of
payment from them. Guaranteed! I have had to do this too. I learned the hard way
and it cost me big time. Work w/them on the deposit, if need be, by letting them pay
you in 2 or 4 increments. Good luck!
Majormommy
I charge a $20.00 per. year non-refundable registration fee. I haven't had a parent
ask what it is for. But will tell them like you said helps cover paper work and my
time. I am thinking of raising it to $25.00.
Kidskornerdc
I charge a $15 registration fee to cover supplies, advertising, etc. I've never had a
parent question it. I am pretty low for my area. Most charge a week's tuition. I just
can't justify asking for that
Slk41
Vacations and Sick Days
I charge half rate for the first two weeks of vacation, anything over two weeks is full
charge.
Rberry41
I give 5 days sick/personal per calendar year w/o notice with no pay and 2 weeks
vacation that they can take no pay with 2 weeks notice. I go calendar year,
otherwise it gets too complicated
Pattig2
I am off and am paid for all statutory holidays, that fall on a parents regular working
day. Parents pay 1/2 fee when they are on holidays for more than 5 consecutive
working days and they do not pay a fee when I am on holidays.
Ransob
I get paid for New Year's Day, Memorial Day, Fourth of July, Labor Day,
Thanksgiving, Christmas Day and close at 2 p.m. on Christmas Eve. If any of these
holidays fall on the weekend I get Friday or Monday off/paid.
Shayronnie
Payment Schedules
On my contracts I let the parents decide on what day they want to pay me and
whether they will pay weekly, bi-wkly or monthly but it must be in advance. I tell
them to make it easy on themselves but after they fill out the contract and put down
the day and frequency, they are locked into that time and amount.
Johnnies2
I have been doing an hourly rate for the last 2 years and next week I will be
changing to a daily rate. I have one parent that I feel I have lost $1300 to $1500 on
being shorted for hours here and there just this year. Other parents have also
shorted me on hours but not to the extreme that this one parent has.
Brenda8725
You can do a daily and weekly rate, but make it a better deal to go for weekly. Say
you decide to charge $90.00 per week for full time, then make it $25.00 per day. For
part time (if you want to offer it) go for two thirds that amount, or $60.00 per week;
$16.00 per day. Then define part time as anything up to 5 hours, 59 minutes; full
time as 6 to 9 hours. Anyone leaving the child longer than 9 hours is subject to
overtime fees. Contracts would also indicate if the parent was purchasing a full or
part time slot and how many days per week. If they purchase full time, weekly, they
pay for full time weekly regardless of actual attendance.
Dadskid
Additional Fees
In our parent contract (signed by parent), ANY child who is 15 minutes late in
dropping off or 15 minutes late in picking up (according to their enrollment
schedule), I charge them $5.00 for EVERY 15 minutes! If they do call to say they will
be late, I ask how long and log that down, and I begin charging if they go past this
time frame they gave me.
Angelwink44
If they do not arrive within half an hour of expected arrival without a call I charge
$10, my contract renewal for 2002 is going to $15.
Rachelrugra
I do charge them $10 for every fifteen minutes they are late after 6:00 p.m., my
closing time. I've never had a repeat offend there!
Shayronnie
Discounts
I used to give a discount but I was losing money that way. I don't provide discounted
care to the second child, so why should I give a discount? :)I have found that
parents who truly care about having high-quality care for their child are willing to
pay for it.
Ecn8
I don't give any discounts for siblings...I figure they are filling up a slot that I could
be using for another child...then I don't have any problems with other families either
that come along...
Salylee
Rate Increases
I put an automatic 5% increase Jan 1st of each year in my contract. I debated doing
this, but I did it one because I did not want to be in the uncomfortable position of
informing parents I would be raising my rates and two there are no surprises to the
parents. It is all there in black and white. When interviewing I just tell them that I do
have the increase and that it is my incentive to always continue to improve my
program and it is minimal out of pocket for them weekly/hourly/monthly/yearly,
however they want to figure it. So far I have not had any problems or complaints
with it.
Chelz3
I raise mine a little each year to keep on track with expenses. Usually about $5 /
week. This year I didn't raise them and actually had a parent ask me if I had
forgotten to put the notice out because they were expecting it!
Ruthjrc
Discipline
I use a form of "1-2-3", "redirecting" and "time out" as a form of discipline. Any child
who is aggressive, uncontrollable and can not follow the rules, the parents will be
called to come and pick their child(ren) up. If your child continues to act in a matter
that is distributive to him/herself or to other children, childcare may be
terminated.And I have the parent sign this form when they fill out their enrollment
form. I also give the parents the option of telling me what kind of discipline they use
at home that they feel works best for their child
Susie710
I stated that I cannot care for children whose behavior is unacceptable such as
biting, hitting, fighting...etc. I know sometimes things happen, but if a child is always
acting out or running wild and causing problems, I state that they will be asked to
make other arrangements. I assure them that I do my best to make sure that their
child is kept safe and sent home in the same condition in which they arrived, free of
bruises, bite marks, etc.
www.hiaeyc.org to get idea of various earlychildcare, thou my emphasis
is on ESL for Adults but if they have kids, they too, will have to be
entertained while parent(s) is/are being tutored. Networking with other
providers may also be an off-site solution, teacher interns may be an inhouse solution.
New and Renewing memberships may be completed on-line at www.naeyc.org.
Mail Membership to: NAEYC Membersnip, P.O. Box 91756, Washington, D.C.
20090-7156.Contact HAEYC, 1806 So. King St. Ste. 30, Honolulu, Hawaii 96826.
Ph: (808) 942-4708, Fax (808) 955-2739 Email: [email protected] Website:
www.hiaeyc.org

In many places child care workers make less then public sanitation workers,
secretaries and other jobs that require a lot less education and experience. I
do get paid in smiles, hugs and recognition of appreciation from families.

I need you to read all material and notices. I am counting on you to know the
information I send to you in writing. This includes newsletters, notes and
contract material.

It is important that you communicate with me. Let me know in advance if
there will be a change in your child’s schedule, or the services you will need.

If I ask you to bring in supplies for your child, please do. And make sure
supplies are replenished as needed. This may include extra clothes, art
supplies, diapers etc.

Remember your child is not the only child in my care. Although I do my best
to provide individualized attention at times, I am often unable to change
polices or disrupt plans to accommodate the needs of one family.

Please do not send your child if they are ill. If they are too ill to participate in
the day’s activities they are too ill to be in care. I need to protect the health
of other children as well. If your child is or was ill, please notify me.

I recognize that you are the most important person in the child’s life. I hope
that we can work as a partnership for what is best for the child. Please share
with me any concerns or questions about your child’s care and development.
Work with me in helping your child learn, grow and develop.
Adult/Continuing Education
The Brain and Intelligence
Guide picks
Learn about the structure and function of your brain and try some brain exercises
to make the most of what you've got! Uncover the history of intelligence theory
and testing.
"How Brains Think"
About's Guide to Agnosticism/Atheism reviews William H. Calvin's book on
"Evolving Intelligence, Then and Now."
"The Brain: Overview"
A visual explanation of the different parts of the brain, how they work and an
example ESL/EFL exercise employing specific areas from About Guide Kenneth
Beare.
"What's In A Brain?"
Examines the structure and function of the brain, learning and intelligence. Jan
Stoltman's article is gorgeously presented in Journal e.
Brain Gym Exercises
Use these simple exercises to help your students concentrate better and improve
their learning abilities.
Brains.org
This site aims to link current psychological and neurological research and
practice in education. It includes several articles, a list of recommended books
and a free newsletter.
Emotional Intelligence
ERIC's Bettina Lankard Brown explores the relationship between emotional
intelligence and career success in this 1999 article.
How can Research on the Brain Inform Education?
Southwest Educational Development Laboratory's feature considers emotions
and the mind, multiple intelligence theory, learning environments, implications for
teaching and more.
Intelligence
About Guide to Psychology Shelley Wu presents this collection of links on
intelligence including emotional intelligence, artificial intelligence and multiple
intelligences.
Right Brain/Left Brain Thinking
Learning Theory Funhouse presents a concise summary of the roles of each side
of the brain and the implications in education.
Using Colored Pens and Pencils
The use of colored pens to help the right brain remember patterns. Each time
you use the pen it reinforces the learning process from About Guide Kenneth
Beare.
Estás en >> www.noticias.info > Ong > Medio ambiente @@ > The White House
prints your articles for $.25
per month and the while house’s pr has apparently approves reprint of his speech but need to know who paid for
it? Re: Americorps being supported by Prez Bush
The White House
The White House
http://www.whitehouse.gov/
Estados Unidos
Ong > Medio ambiente @@
Noticia nº: 22598
Agencia emisora:
sáb 24 Abr 2004
President Discusses Earth Day, National
Volunteer Week in FL
Remarks by the President on Conservation and Volunteer
Service
This week we observed Earth Day. And one way to honor the day is to honor those
citizens in our country who understand the definition of stewardship; citizens who
work to make sure that our environment is as clean as possible. And that's what
we're here to do today.
It also happens to be National Volunteer Week. (Applause.) So, yes. And what is
easy to understand is one of the reasons why the Rookery is such a place, is because
of the volunteers who have come on a daily basis to make this a special place.
(Applause.)
I want to thank David Eisner, who is the CEO of the Corporation for National and
Community Service. Thank you for coming, David. (Applause.) I see David.
Appreciate you coming. David is in charge of a lot of important programs, one of
which is AmeriCorps. I'm a strong believer in AmeriCorps.
Some people need to be reminded -- one of my favorite phrases, if you own your
own farm or ranch, every day is Earth Day, by the way. (Laughter.) Laura and I are
doing our bit by restoring natural grasses to our ranch. She wants to become a Little
Blue Stem grass seed distributor so that others will grow native grasses. It's amazing
what happens when we restored our little part of heaven to native grasses. Bobwhite
Quail are returning. Birds are showing up that we hadn't seen before. Its a fantastic
experience. Its the same thing you are doing here, and its the same concept weve
got to do to encourage others who own their land, to understand the incredible
opportunity they have to make a vital contribution to the wetlands of our country
and to the environmental prosperity of our country, as well.
To meet the goal of wetland expansion weve got to commit money, of course. You
just cant lay out a goal unless theyre willing to support. And my administration is
prepared to do so, as I said. We did a good thing in the Farm Bill, the 2002 Farm Bill,
which is still in place. One of the most important aspects of the Farm Bill was the
conservation title. It was a strong expansion of federal money available to encourage
farmers to expand areas on their farms, like wetlands. It is an important part of
meeting this national goal.
Fairfield Language Technologies was founded in 1991 with two core beliefs.
The natural way we learn native languages as children remains, for everyone,
the most successful method for learning new languages. And interactive
technology can replicate and activate that method powerfully for learners of
any age.
The software can be used for adding a new Adult Education resource to an
already existing Adult Education component or parent and child together time
(PACT Time) component to an existing family literacy or family education
program. A 15 user, one-year Online Language Learning Center for US English
retails for $4,485.00. The application period ends May 14, 2004.
Please log on to NCFL's web site www.famlit.org and read under announcements
for more details on eligibly and how programs can apply.
Noemi Aguilar
National Center for Family Literacy
325 West Main Street, Suite 300
Louisville, KY 40202
Phone: 502-584-1133 x168
Fax: 502-584-0172
Email: [email protected]
Winona LaDuke Talks About Clean Energy, Politics, and More
Readers peppered Winona LaDuke, this week's InterActivist, with questions on everything from
dams to casinos to ... you knew it was coming ... Ralph Nader. She explains why casinos on
Indian reservations are a mixed blessing, why solar energy is on her agenda right beside wind,
why grassroots organizing is so vital, and why Gore lost (hint: it wasn't because of Nader). Read
her suggestions, provocations, and explanations in InterActivist -- today on the Grist Magazine
website.
today in Grist: Winona LaDuke answers reader questions -- in InterActivist
<http://www.gristmagazine.com/interactivist/laduke042304.asp?source=daily>
How You Can Make a Difference for the Planet
With today's environmental problems so large, abstract, and intractable -- see warming, global -you're probably wondering what you, one individual, can do on Earth Day to help. (If you're one
of the people surveyed by Gallup -- see above -- perhaps you don't care, but humor us.) It's easy
to feel powerless in the face of climate change, but individual actions are making a difference.
Michael Charney, for example, created the Massachusetts Climate Action Network, a group of 15
towns in his region that purchase clean energy and use it efficiently. His activism tools were
simple: "I had a room with a phone and phone book," he says. "If you have a list of people to
call, and time to do it, you can change the world." Seth Riney started Planetran, a "limo"
company that uses hybrid Toyota Priuses to ferry people to and from Boston's Logan Airport.
He's changing an industry, he says, "just by doing it -- not by arguing policy with lawmakers."
You, too, can take action today, by doing everything from switching to compact fluorescent
lightbulbs to reducing herbicide and pesticide use to purchasing Energy Star-certified products.
After all, you don't want the U.K. to drown, do you?
straight to the source: The Christian Science Monitor, Mark Clayton, 22 Apr 2004
<http://www.gristmagazine.com/cgi-bin/forward.pl?forward_id=2352>
straight to the source: The Washington Post, Rebecca R. Kahlenberg, 22 Apr 2004
<http://www.gristmagazine.com/cgi-bin/forward.pl?forward_id=2353>
Libia Grueso Advocates for Afro-Colombians and Their Land
Speaking of taking action in the face of daunting challenges, let us tell you about Libia Grueso. A
social worker and activist who lives in Colombia's Pacific Coast region, she fights tirelessly to
protect the rich habitat in her area, which boasts some 10 percent of the world's bird species, and
to protect the civil rights of her people, Colombia's 10.6 million Afro-Colombians, descendants of
black slaves emancipated in the mid-1800s. Though she has seen wide swaths of the coast
destroyed by development and scores of fellow activists assassinated, Grueso says, "our territory
is filled with life, happiness, and liberty, and we make every effort in every instance to be happy,
despite the things that occur." Her determined activism won her a 2004 Goldman Environmental
Prize. Michelle Nijhuis chats with Grueso about the prize and her ongoing work -- today on the
Grist Magazine website.
today in Grist: Roll on, Colombia -- an interview with Libia Grueso -- in Main Dish
<http://www.gristmagazine.com/maindish/grueso042204.asp?source=daily>
today in Grist: Eyes on the prize -- interviews with the 2004 Goldman prizewinners -- in Main
Dish
<http://www.gristmagazine.com/maindish/goldman041904.asp?source=daily >
GLOSARY OF PUBLIC SECTOR TERMS
When reading public or voluntary sector documents you are often confronted with a bewildering
array of acronyms, jargon and technical phrases.
To the general public and anyone new to the public sector this can be confusing. Experienced
public servants may be familiar with the jargon used in their own field but terms used in different
sectors might sound like a foreign language.
So if you don't know your 'Almo' from your 'Asbo' or you're baffled by 'bedblocking', haven't dared
asked what 'best value' means and thought a 'ceiling' was what you find at the top of a room - our
glossary is designed to help.
It provides plain English definitions to hundreds of phrases in the public and voluntary sectors
with links to websites where you can find more information. Just click on the alphabet above to
search for the term.
It also includes advice on how to write clear and concise public documents that will be easily
understood by everyone.
If there are words or phrases we have missed and that still baffle you please contact us at
[email protected] and we will find the jargon-free definition and add it to our list.
News archive
Ethnic barrier
Jargon is preventing black and minority ethnic communities from having a say in how their
neighbourhoods should be improved.
Readers' letters: junk the jargon
Jargon attack proves baffling
Sketch: Stephen Byers has made yet another statement about local government . But did
anyone understand it?
Breaking the jargon barrier
Public services are increasingly taking on corporate language, but are they getting their message
across? Simon Parker reports.
New course for doctors who have to break bad news
Moves aim to make the process easier for both doctors and the recipients of bad news.
Social workers' image falls to an all-time low
Four out of 10 people say social workers are bureaucratic and use jargon that ordinary people do
not understand.
How to draw up a best value performance plan
Putting a best value performance plan together can be a headache. Think carefully about who
you're writing it for, and you won't go far wrong, says Adrian Barker.
Prize-winning gobbledigook
Luton council joins a record number of winners in taking home a 'golden bull' award from the
Plain English Campaign.
Floor to ceiling finance
Formulas for assessing council finance must be easier to understand, says Whitehall.
SocietyGuardian.co.uk © Guardian Newspapers Limited 2003
BROADCASTING APPRENTICESHIP
Michael Madden
http://www.broadcastertraining.com/
mailto:[email protected]
888-307-2346
Memo from the Literacy Support Center
May 2004
Mark Your Calendars!
The Collaborative Process: Finding Common Ground. The following collaboration
workshops have been scheduled regionally, from 10 A.M. - 4 P.M. Facilitators: Jennifer Stuart,
DOE Specialist, and Victoire Gerkens Sanborn, LSC Director. Registration is required. Contact
Marianne Baker at [email protected] or 800-237-0178.
May 11, Virginia National Bank, Charlottesville (FULL)
May 14, Spotsylvania Career and Technical Center, Fredericksburg
May 18, Peninsula READS, Hampton
Train the Trainer Workshop for tutor trainers. A two-day train-the-trainer workshop will be
held in Richmond on June 11 & 12. Requirements: Participants must have a minimum of one
year’s tutoring experience and be willing to volunteer as a tutor trainer for their organization. To
receive lodging reimbursement, participants must attend both days of training. Travel and dinner
will not be reimbursed. To register, contact Marianne Baker at [email protected] or 800-2370178
Summer Institute Dates: Look for registration forms and information about this year’s summer
institutes inside the May issue of Progress. If you do not receive Progress, call 800-237-0178
for registration information or look for it on the Resource Center website at www.aelweb.vcu.edu/.
Send us your home address to receive Progress.
Verizon Grant Supports Regional Trainings from ProLiteracy America: With support from
Verizon, ProLiteracy America is partnering with local literacy organizations across the nation
to sponsor trainings led by nationally recognized experts in their fields. Each training is
tailored to the identified needs of the local organizations in that region. Individual registration fees
for each two-day training program are $35 for ProLiteracy America affiliates and $50 for nonaffiliates. Travel stipends are also available. Please see the registration form for details. Hotel
arrangements must be made by the attendees. Check the schedule on the ProLiteracy Worldwide
Web site at www.proliteracy.org/reg. Registration forms will be available online for each event.
Southeast training is scheduled in Roanoke, August 6-7, at the Clarion Hotel Roanoke.
What implications does the Reading Project have
for my program? Find out at the Radford Institute!
Will my students be able to effectively use the
Inquiry Process in studying for the GED? Find
out at the Christopher Newport Institute!
Program Resources
Non-Profit Good Practice Guide. On this site find program management information on
accountability and evaluation; advocacy; communications and marketing; foundations and
grantmaking; fundraising and financial sustainability; governance; management and leadership;
staff development and organizational capacity; technology; and volunteer capacity. Go to:
http://www.nonprofitbasics.org/Default.aspx.
LEARN NC: The North Carolina Teacher’s Resources. Find lesson plans and web quests for
students on this comprehensive resource site. http://www.learnnc.org/index.nsf?OpenDatabase
Fair Data: Find detailed online Virginia maps and charts that include voter profiles, and
2000 census data on race, ethnicity and income. ESL data can be found for each county and
most major cities. Go to: www.fairdata2000.com/
Digital Divide Network: The Benton Foundation recently launched an updated Digital Divide
Network. This database, the largest of its kind on the Internet, helps individuals easily identify
local libraries, community technology centers, and additional neighborhood entities that
provide free or low-cost Internet access, IT training, and other community technology
services. Click the “Get Connected” button to search by zip code or use advanced search options
to find resources by city or state.
www.digitaldividenetwork.org/content/sections/index.cfm.
Election Resource Prepares Learners to Vote: The New England Literacy Resource Center
(NELRC) is offering free copies of the current issue of The Change Agent. The theme of this nonpartisan issue is "Voting in the 2004 Elections." The publication is available to any state or region
that is interested in helping adult literacy programs prepare learners to vote in the 2004
elections and that commits to disseminating the copies to literacy providers in the state well in
advance of the November elections. The recipient must pay for the shipping costs (about $20 for
a box of 200). (See item #2 in this section for information on the ProLiteracy pre-conference
session that will focus on this issue of The Change Agent.) This 36-page issue is written for the
adult literacy audience. It covers topics such as:
- Why vote? Examples of when a handful of votes mattered greatly
- Questions to ask and steps to take in picking a candidate
- How to evaluate campaign ads and read election literature critically
- Historical perspectives on voting
- Student narratives of their experiences with voting
To view an issue, go to www.nelrc.org/changeagent/index.htm. Send email requests, along with
the number of copies and shipping address, to: [email protected]. (From the NIFL
listservs)
GED Websites, submitted by Emily Hacker, Moderator, NIFL-Technology listserv.
GED Prep at free-ed.net, http://free-ed.net/GED/default.asp
GED Preparation Materials, http://amby.com/GED/
GED Practice Tests, www.frco.k12.va.us/ged/default.htm
GED Testing Service, www.acenet.edu/clll/ged/index.cfm
NYSED GED Resources, www.emsc.nysed.gov/workforce/ged/home.html
Steck Vaughn Free GED Practice, www.gedpractice.com/
Math Sites:
The Math Forum: Internet Mathematics Library. http://mathforum.org/library/
ThinkQuest: Algebra, http://library.thinkquest.org/10030/algecon.htm
Math2, www.math2.org/index.html
The Math Archives, http://archives.math.utk.edu/topics/
FROM
Literacy Support Center Website: www.aelweb.vcu.edu/literacy_support_center/ email: [email protected]
The Fair Data website, developed in association with the Norfolk State University Department of
Political Science, offers maps and statistics for education, environment, housing, and poverty related
issues. This information is based on the 2000 census. On this site you will find excellent charts and
statistical information for each county.
Go to http://www.fairdata2000.com/ and click on a topic on the left side.
www.iafrica.com Rsch:
What is Private Label?
The iafrica.com private label product combines the technology, skills and experience of South
Africa’s premier portal operator to provide end-to-end internet solutions. This allows our clients to serve and
maintain their web sites using the same systems as the iafrica.com portal.
At the core of the offering is the Interactive Content Manager – a modular content management system hosted
on the iafrica.com infrastructure. The iCM provides a total content management solution incorporating design,
editorial and workflow plus a host of optional web applications.
Your private label solution can either be tailor-made to your specific needs, or one of the following packaged
solutions on offer:




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
Corporate
Directory
Expo
Publisher
Radio
Business Portal
& contains this article on whistleblowing:
CAPE TOWN
Street names whistleblower looks back
Ben Maclennan
Posted Thu, 22 Apr 2004
The woman who blew the whistle on Cape Town's street names scandal three years
ago says she still feels a sense of discomfort and shame over what she did.
Victoria Johnson, who at the time was a senior legal adviser for the City of Cape
Town, is one of the contributors to a newly-released book, 'Whistleblowing Around
the World'.
The book includes contributions from former Enron vice president Sherron Watkins,
and the Chinese doctor who exposed his government's cover-up of the spread of the
respiratory illness SARS.
Johnson was the official in charge of the public participation process initiated after
then-mayor Pieter Marais' proposal to rename Adderley and Wale Streets Nelson
Mandela and FW de Klerk Avenues.
Fraud and manipulation
She exposed what she believed was fraud in the mayor's office in obtaining
submissions on the plan, and manipulation of the submissions by her immediate
superior Ben Kieser.
Johnson gave evidence at the inquiry that followed by advocate Willem Heath, and
now works as part-time legal consultant for a Cape Town firm.
The renaming scandal led to Marais' resignation, and was one of the factors that
precipitated a split in the Democratic Alliance.
Johnson says in the book that, when asked, she has no hesitation in saying she
would do what she did again.
However, she feels a "deep sense of ambiguity" over her actions.
A fundamental social rule was broken
"Whatever one may say about doing the right thing, it does not change the fact that
I broke a fundamental social rule by betraying someone I worked closely with and
who trusted me.
"No matter which way I think about it, or try to rationalise it, that fact will never go
away and so my memory of the time is always tinged with an underlying sense of
discomfort and shame," she says.
She says one of the aspects of being a whistleblower which came as a surprise was
that there never seemed to be an "end" to the matter.
"The after-effects still go on," she says. "Two years after the event I was given a
message that the New National Party caucus (in the city council) had apparently
been discussing me and 'had not forgotten' what I did.
"The message was given to a close colleague, allegedly by an NNP politician, and I
can only assume it was meant to get to me.
"I have no idea whether the caucus ever did make this statement, but the fact that
someone wanted me to think they did was disquieting."
Johnson helped create new standards
In their introduction, co-editors of the book Richard Calland, who is director of the
Open Democracy Advice Centre (Odac) and Guy Dehn say that though the
underlying issue — the renaming of two streets — was ostensibly a minor one,
Johnson's principled stand and eventual vindication have helped establish new
standards of accountable government in the Western Cape.
"As to her own career, it too has survived, though Johnson has had to endure
criticism, painful soul-searching and anxiety."
In another chapter of the book, the whistleblowing helpline adviser at Odac, Lorraine
Stober, and two Odac associates say there has been a pattern in recent
whistleblowing cases in South Africa.
"The whistle gets blown and there is a witch hunt for the whistleblower," they say.
Despite the Protected Disclosures Act, one of the biggest challenges in implementing
an effective whistleblowing mechanism in South Africa is how to promote a culture of
whistleblowing in a society that has come to equate whistleblowing with mistrust and
betrayal.
Whistleblowing, they say, has been most successful in organisations with a culture
that encourages openness and accountability.
"Without this culture, the risks of blowing the whistle are sometimes too enormous
to contemplate."
Sapa
5 Reasons To Launch a Business Blog
Why You Should Start a Corporate Weblog
While a website is a good idea for every business seeking the widest clientele
possible, a weblog (also known as a 'blog') can even do more wonders. If you
have a business and it is operating without a blog (or worse still, stuck without a
web address of its own), here are some things to think about while you ponder
what a blog can do for you and your business.
1) Blogs make business sites more personal. Since blogs are updated by
individuals (or a group of individuals), the 'voice' of the blog author/s will often
shine through. It makes a static website seem more than just a brochure or
catalogue for your goods and/or services.
Let's face it, when clients call a company for information, they're often relieved to
hear a real person's voice rather than a recorded message, right? Blogs give that
sense of talking to a 'real person.'
Of course, 'personal' doesn't mean that you need to write about your children's
latest accomplishments or how your mother spent your inheritance money. In
fact, most business blogs stir clear from these topics. However, authors of
business blogs can still make references to their family or friends without giving
out deepest darkest secrets.
For example, business blogger Lee LeFever writes about having nasal surgery in
this post. Then, he managed to relate his entry to the importance of
communication (his specialty).
2) Blogs make it fast and easy to manage content. A lot of people find website
building and maintenance so daunting that's why many individuals still opt not to
give their businesses an online presence. The current technology available for
content management in blogs removes this hurdle. Now, more than ever, it has
become easier to run a site.
With the existence of 'push button publishing,' even the most HTML-challenged
individual can start and maintain a blog using one of the software/platforms
available.
3) Dynamic content means visitors always have a reason to keep coming
back. Brick and mortar stores put up new items in display windows regularly.
Retail shops are always looking for new items to add to the list of products
available. Services are often reviewed and updated. Even restaurants and cafes
with a regular menu come up with a 'Special of the Day' for a bit of variation.
All business owners know this: customers love seeing new things. If they know
that they like the things they see in a business establishment, they would keep
coming back. They like to check for what's new or what's different.
So, why should your business keep a website static?
4) Search engines like Google are 'friendly' to sites that have fresh content.
Of course, when you put a site or a blog, you want people to find it. One major
way that people find sites on the Internet is through search engines. Since
search engines like regularly updated sites, blogs tend to rank high in search
results as opposed to static websites that are hardly updated.
5) Bloggers have the tendency to promote each other. Therefore, if you
create a great business blog that people find useful and relevant, you have a
built-in PR staff who will help spread the word about your business.
As the word about blogs continue to spread, more and more people will find this
venue an important tool in business.
This was found at http://65.54.184.250/cgibin/linkrd?_lang=EN&lah=6ba65a39574a1b84cf75b93d1da5f79a&lat=1083123149&hm___action=http%3a%2f%2fsl
clk%2eabout%2ecom%2f%3fzi%3d1%2fKPo
U.S. Ocean Commission Calls for Action to Save Seas
Our oceans are in trouble and we need to do something about it. This was the conclusion of
the first comprehensive review of U.S. ocean policy in 35 years, released today by the U.S.
Commission on Ocean Policy. The presidential commission spent 2.5 years studying coastal
areas, the Great Lakes, and 4.4 million square miles of ocean, an area considerably larger
than all 50 states combined. Among the more than 250 recommendations in the
commission's nearly 500-page draft report is the creation of a $4 billion Ocean Policy Trust
Fund, to be paid for by oil and gas royalties, the formation of a cabinet-level National Ocean
Council, the design of a system of marine education for kids, and a doubling of funds for
federal marine research. A final version of the report will be passed along to Congress and
the White House later this year.
straight to the source: The Register-Guard, Winston Ross, 19 Apr 2004
<http://www.gristmagazine.com/cgi-bin/forward.pl?forward_id=2335>
straight to the source: USA Today, Associated Press, 20 Apr 2004
<http://www.gristmagazine.com/cgi-bin/forward.pl?forward_id=2336>
see also, in Grist: Cod is dead -- Elizabeth Grossman reviews Richard Ellis' "The Empty
Ocean" -- in Books Unbound
<http://www.gristmagazine.com/books/books072403.asp?source=daily >
'Whistleblowing' Journalist Featured at May 1 Cleveland
SPJ Event 'Media Ethics: The Jury is Still Out'
Tuesday April 20, 3:34 pm ET
Press Release
Source: Cleveland Chapter of the Society of Professional Journalists
CLEVELAND, April 20 /PRNewswire/ -- In observance of National Ethics in Journalism Week, on
Saturday, May 1, the Cleveland Chapter of the Society of Professional Journalists will host "Media
Ethics: The Jury is Still Out." The day-long event will feature Jane Akre, who spent 20 years as a
network and local television reporter and anchor before becoming the first journalist ever to win a
"whistleblower" lawsuit against her own employer. The program will include researchers, who will
present their findings related to media ethics, and a Socratic panel discussion of challenges faced by
the news media. The public, media professionals and journalism/communication students are invited to
attend.
Akre and her investigative reporting partner and husband, Steve Wilson, sued Fox Television in 1998,
claiming they were fired after resisting pressure from news managers who wanted them to slant a
news story to appease an advertiser and potential litigant. In 2000, after a five-week trial, a jury agreed
that the reports Akre was pressured to air amounted to "a false, distorted or slanted" news report.
However, six years later, they are still tied up in litigation. During her SPJ Cleveland appearance, Akre
will announce an important development in their court cases. Wilson may join Akre for the
announcement, if he returns from a South American assignment in time.
National SPJ recognized Akre and Wilson with its Award for Ethics in 1998. At the time, it was only the
fourth such ethics honor given in SPJ's 89-year history. They also received the Joe Calloway Award
for Civic Courage, bestowed by a trust administered by the Ralph Nader family. For background on
their case, go to Akre and Wilson's Web site at http://www.foxbghsuit.com/
"Media Ethics: The Jury is Still Out" will be held from 9:30 a.m.-3 p.m. at the Holiday Inn, 1111
Lakeside Ave. Event cost, including lunch, is $45 for the public, $40 for SPJ members, and $20 for
students. To RSVP by April 28, call 440-333-7382, or send e-mail to [email protected].
The Society of Professional Journalists works to improve and protect journalism. SPJ is dedicated to
encouraging the free practice of journalism and stimulating high standards of ethical behavior.
Founded in 1909 as Sigma Delta Chi, and based in Indianapolis, SPJ promotes the free flow of
information vital to a well-informed citizenry; works to inspire and educate the next generation of
journalists; and protects First Amendment guarantees of freedom of speech and press. For more
information on SPJ, visit www.spj.org . For more information on the Cleveland Chapter, visit
www.spj.org/Cleveland .
PR Newswire is the official news distribution service of the Cleveland Chapter of the Society of
Professional Journalists.
Source: Cleveland Chapter of the Society of Professional Journalists
Fundraising for Adult Education
from David Tinker Biography
Seven Steps for Success
By David Tinker, Development Director,
Greater Pittsburgh Literacy Council
As an employee in adult education you have no doubt been faced with the
task of raising money to meet the budget. Like any nonprofit agency, fund
raising can be a key component in your work. Asking people, companies,
foundations, or the government for money is a vital part of being an
administrator, a board member, or any employee in a nonprofit organization.
This is especially true of people in adult education.
It is not an easy task. Because of this, it should be given your utmost attention
and professionalism. Fund raising is not begging for money. It is not hitting up
someone. It is not something to be sorry about. Rather, to paraphrase Hank
Rosso’s definition of fund raising, it is the ability to help someone in the
careful art of giving.
In this article I will go over some of the basic steps for a successful fund
raising program. Last year in America, people donated nearly $204 Billion of
which 75% came from individuals. After religion, education is the recipient of
the most donations. This includes adult education programs.
Fund raising is very cyclical. Private funders operate in cycles and I’ll go
through seven steps to follow for successful fund raising for your organization.
1. The first step is to have a basic understanding of marketing. As a fund
raiser you are marketing your product to potential donors. You will want to
identify the product to best determine how to sell it in a positive fashion.
This leads into creating and examining the case for support. A case for
support is comprised of reasons why someone should give money to your
organization. You will want to describe programs, evaluations, and financial
reporting to your prospects. You will want to have a statement of needs, i.e.
what your organization needs, and identify the level o financial support
needed.
2. Second, when raising money you should look at the environment. I’m not
talking about the trees outside of your window. Rather you want to take a look
around to see if your region facing dramatic job losses because a plant closed
down? Are you in a boomtown? Are there any regulations in place prohibiting
you from asking? Do you have the appropriate personnel and accounting
system in place? All of these factors shape the environment in which you will
be raising money.
3. Third, you will want to involve board members or other volunteers in the
fund raising process. A Board or Directors or Trustees are responsible for
your organization’s well being. They are the most effective people to ask
other for funds because they already understand your cause and need. They
are better able to validate the needs and case to the community at large.
4. Next you will want to look at selecting programs to get funded and
strategies to get them funded. Are you going to hold special events to raise
your funds? Are you going to seek funding solely through grant proposal
writing? You should consider what best suits your capabilities and make a
plan to include several different fund raising methods.
5. Fifth, before you ask someone for money, you should know how much they
have to give. How can you do that? Look at how much they’ve donated in the
past to your agency. Look at whom else they give to, look at their personal
assets, business assets, etc. You will be surprised to see how much
information about a person is in the public domain. Some people say fund
raising is 99% research and 1% ask. Knowing who to ask for how much is a
key step in the fund raising process.
6. Next, you will need to write out a clear fund raising plan so that you and
your volunteers know how the fund raising tasks will be accomplished. This
development plan does not need to be lengthy but it does need to take into
consideration everything you have done so far in fund raising.
7. Finally, you are ready to ask for the gift. Most people when surveyed say
they don’t make contributions because they haven’t been asked.
There are different ways to ask, but the most effective is two on one, i.e. a
development officer and volunteer with one donor or prospective donor. You
will be able to cover any questions that arise this way and will allow the donor
to feel a bit of belonging because others are there with them.
After you have asked for and received the gift, then you will need to begin the
process to renew the gift. When are you going to ask again? For how much?
This is where you begin the cycle from the beginning again.
Asking for money is typically viewed as the least favorite and most difficult
task in nonprofit management and fund raising. By learning and following
these steps, you, your volunteers, and other nonprofit executives will be
better prepared to undertake and complete a successful fund raising
campaign.
David Tinker is the Development Director at Greater Pittsburgh Literacy
Council (GPLC) and has been working in the fund raising field for more than
11 years. Prior to GPLC he has worked in development at Pittsburgh Vision
Services, the St. Francis Healthcare Foundation in Beech Grove, Indiana, and
a graduate assistant at the Indiana University Center on Philanthropy. He
began his career in fund raising as an intern at Ketchum Inc., Fund Raising
Counsel.
Mr. Tinker is on the President of the Western Pennsylvania chapter of the
Association of Professional Researchers for Advancement (APRA). Mr.
Tinker serves as a program committee member for the Western Pennsylvania
chapter of Association of Fundraising Professionals (AFP).
Tinker is on the Board of References at The Fund Raising School. He has
also been a previous intl board member of the APRA, etc, pub’d articles in
Nonprofit Management and Leadership, About.com’s Nonprofit Newsletter,
The Fund Raising School’s Course 100 Manual, a regular nonprofit column in
The Wilkinburg Update, and a sidebar in a newly released book on careers in
fund raising.
He has a B.A. in chemistry and English from Muskingum College, New
Concord, OH. He holds a master of public affairs with a concentration in
nonprofit management from Indiana University-Purdue University at
Indianapolis.
David Tinker
Development Director
Greater Pittsburgh Literacy Council
100 Sheridan Square, 4th Floor
Pittsburgh, PA 15206
412-661-READ
412-661-3040 FAX
[email protected]
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Public Concern at Work (PCaW) was set up in 1993 to address whistleblowing in the UK and in 2001,
established an office in Glasgow. We aim to help ensure a break with a workplace culture which
fosters complacency or cover-ups. In promoting a safe alternative to silence, we want the
whistleblower to speak without fear and for the employer to listen with intent.
PCaW runs a free, confidential helpline for anyone concerned about wrongdoing at work, but who is
unsure whether or how to raise it. The advice is aimed at helping them raise their concern so that the
issue is addressed properly and to minimise the risk that they suffer at work for doing so. It is
designed to help them understand the risks and opportunities they face. Importantly, since 1999,
most workers in the UK are protected from victimisation or unfair dismissal if they raise a genuine
concern responsibly - either with their employer, the appropriate regulator, or in particular
circumstances, more widely to the media.
In the last ten years, we have dealt with over 3,750 concerns dealing with a range of issues from
financial malpractice, clinical negligence, health and safety, dangers to public safety, and ethical
dilemmas.
We also work with employers to help them understand why it is in their interests to provide safe and
acceptable routes for staff to raise concerns.
Although many employers in England have implemented robust whistleblowing mechanisms, fewer
organisations appear to be aware of how to make whistleblowing work for them in Scotland. Audit
Scotland has done the most to try to promote whistleblowing in the public sector by designing pamphlets
for all local authorities in Scotland - but whistleblowing is not just a public sector issue.
There is a serious incentive to get it right; the cost of getting it wrong. The Public Interest Disclosure Act
1998 (PIDA) provides whistleblowers with a safe alternative to silence. PIDA protects workers who raise
concerns about a wide range of malpractice. These include possible breaches of civil, criminal, regulatory
or administrative law; miscarriages of justice; dangers to health, safety or the environment; or the
cover-up of any of these.
The act reinforces local accountability by providing the highest - and most readily available - protection
for internal disclosures. For workers in government-appointed bodies, the same tests apply to
disclosures to the sponsoring department or to a member of the Scottish Executive. PIDA also protects
workers who raise a concern directly with a specified regulator such as the Health and Safety Executive
or Audit Scotland. It is only when a worker makes a wider disclosure (eg to the media or MPs) that the
tribunal must determine whether that was reasonable in all the circumstances.
Although an effective and well- promoted whistleblowing policy can reduce the risk that wider, public
disclosures will be protected, the fact is that where a concern is not properly dealt with, there is always
a safe alternative to silence.
Where a whistleblower is victimised or dismissed in breach of PIDA, they can bring a claim to an
employment tribunal for compensation. Awards are uncapped and based on the losses suffered and the
early cases have served as a wake-up call for employers throughout the UK.
F was finance director for a subsidiary of a United States telecoms company. In 1997, when F told his
contact in the US about suspect expenses claims made by his managing director, he was told to turn a
blind eye. In late 1999, when the claims had exceeded £300,000, F raised his concerns with the US
board. F immediately found himself under pressure to leave and when he refused, he was disciplined
and dismissed. F brought a claim under PIDA.
The MD remained in post until F won his claim for interim relief. At the full hearing, the tribunal found
that the complaints against F were a "smokescreen" and he had been sacked for whistleblowing. As F
was 58 and unable to secure similar work, he was compensated for his losses of £293,000.
PIDA aims to promote a workplace culture where it is considered normal and acceptable to raise
concerns about malpractice. Importantly, it signals a change in culture.
In 2001, the then Health Secretary, Alan Milburn, told the House of Commons that Dr Stephen Bolsin
should be praised for blowing the whistle on the baby-deaths scandal at the Bristol Royal Infirmary.
In the US, Time magazine awarded its prestigious Person of the Year award at the end of 2002 to three
female whistleblowers, including Sherron Watkins of Enron.
Although some are still uncomfortable with the whistleblower label, callers to our helpline are
increasingly recognising the value of what they are doing. US campaigners have referred to
whistleblowing as "committing the truth" - should that be so hard?
• Harry Templeton is the Scottish Director of PCaW. Its helpline can be contacted on 020 7404 6609 or
at [email protected]. For more information on PCaW in Scotland, call 0141 883 6761 or go to
www.pcaw.co.uk.
Imagine being able to complete, print and route all the necessary forms
your business uses, or create legally compliant employee handbooks all with just a
few keystrokes. That's what
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More and more small businesses are turning to software to automate
time-consuming tasks and decrease the amount of paperwork in the workplace.
The MyBiz™ family of software solutions was tailor-made for busy
managers in small businesses who don't have a moment to waste. Each
MyBiz program is easy to learn and easy to use. Best of all, there's
a MyBiz solution for every personnel-related challenge.
See www.gneil.com
Native American Advocate Winona LaDuke InterActivates
Though many people are familiar with her only as the name that appeared under Ralph
Nader's on the 2000 presidential ballot, Winona LaDuke has a long and distinguished history
of defending the rights and interests of Native Americans and protecting the land on which
they live. Her latest focus is on democratizing energy production and returning political
power to Native hands by pushing for wind farms on reservations. Read about her windpowered vision and, yes, her thoughts on running with Nader, in InterActivist. And throw a
question her way by noon PDT on Wednesday, April 21 -- only on the Grist Magazine
website.
only in Grist: Winona LaDuke answers Grist's questions
<http://www.gristmagazine.com/interactivist/laduke041904.asp?source=daily
>
only in Grist: Ask LaDuke a question of your own by noon PDT on Wednesday
<http://www.gristmagazine.com/interactivist/question.asp?source=daily >
Native American Advocate Winona LaDuke InterActivates
Though many people are familiar with her only as the name that appeared under Ralph
Nader's on the 2000 presidential ballot, Winona LaDuke has a long and distinguished history
of defending the rights and interests of Native Americans and protecting the land on which
they live. Her latest focus is on democratizing energy production and returning political
power to Native hands by pushing for wind farms on reservations. Read about her windpowered vision and, yes, her thoughts on running with Nader, in InterActivist. And throw a
question her way by noon PDT on Wednesday, April 21 -- only on the Grist Magazine
website.
only in Grist: Winona LaDuke answers Grist's questions
<http://www.gristmagazine.com/interactivist/laduke041904.asp?source=daily
>
only in Grist: Ask LaDuke a question of your own by noon PDT on Wednesday
<http://www.gristmagazine.com/interactivist/question.asp?source=daily >
Initiating and Maintaining a Hepatitis C
Support Group: A How-To Program
Guide
October 2003
Hepatitis C Resource Centers
National Hepatitis C Program Office
Hepatitis C Technical Advisory Group
Department of Veterans Affairs
I. Objectives and Format of This Program
Guide
This document is intended to provide the clinician with a
how-to guide for initiating and maintaining support groups
for veterans with hepatitis C. Essentially it serves as a
primer for conceptualizing the structure and purpose of the
group and as a practical guide for organizing and
executing the logistics associated with starting a support
group. It is based on the collected experience with support
groups by members of the HCRC Support Group Guide
Planning Committee, commissioned by the National
Hepatitis C Program of VA Central Office to develop this
manual.
After discussing the benefit of support groups for patients
with hepatitis C, this manual will list and elaborate on the
suggested steps for starting a support group. These steps
range from assessing the needs of your patient population
to implementing and modifying your group based on
members' feedback. The appendixes at the end of the
manual include sample forms for use with your support
group, as well as additional sources of information
regarding hepatitis C. Future versions of this manual will
include educational modules and materials for use in the
didactic component of a support group.
A downloadable PDF version of this document is available
through the link in the left navigation bar. This document
is not copyrighted, and users are encouraged to print and
distribute as many copies as they need.
II. The Veteran's Perspective -- A Letter from Gene Mask
May 18, 2003
I was asked to write a short summary of why I feel our hepatitis C support group works
and how, as well as why I believe support groups are important. I was diagnosed with
hepatitis C in 1996. I had no idea what the disease was or what its treatment was all
about. At the time, there were no support groups and very little in the way of education
for veterans; I didn't really know how to take care of myself (or my liver). After a long
battle to get help failed, I ended up with liver failure and had to get a transplant. With
better education and access to treatment and resources, I might not have needed a
transplant. I feel fortunate that help is more readily available now for myself and other
veterans with hepatitis C. I continue to learn new things about the disease and how to live
with it, especially at the support group. I feel more empowered than ever; I am an
advocate for education on hepatitis C and am a member of the National Hepatitis C
Advisory Board and the Northwest Regional Board.
The Hepatitis C Resource Center staff at the Portland VA Medical Center has put forth
every effort to help us start our group. Our first challenge was to set up a format for the
group. I stress the necessity of having a veteran with hepatitis C participate in forming
and facilitating the group. I feel that by doing this we help the veterans open up more and
look at the group leaders as credible. In addition, having a staff member who can ensure
that the individual needs of group members are addressed is essential. I also feel that
feedback from the veterans is important. The group is for them, so we sought to tailor the
group to match their expressed needs. Their feedback establishes the basis of the group
and tells us the questions that the veterans want answers to. We feel that these
considerations help us offer the best education and support.
Even though the group is still young and changes are being made, I believe the format we
have used so far (having speakers on subjects chosen by the vets at some meetings and
open discussions at others) has worked. We have been able to provide education on
topics such as treatments, diet, and exercise, as well as a safe place to discuss personal
experiences and fears. I also feel that by including the spouse or caregiver of the veteran,
we give these individuals a chance to understand the problems the veteran is having and
offer a place to voice their concerns and feel supported. Finally, having our meeting in
the evenings makes it more available to the veteran and caregiver.
My thanks to those responsible for putting hepatitis C education and support high on the
priority list. I feel that our efforts will result in faster and better treatments for veterans
and a reduction in long-term critical care.
Sincerely,
Gene P. Mask
III. Rationale for Support Groups
Veterans with hepatitis C are an important population served by the Veterans Health
Administration. The VA is exploring and evaluating new practices to ensure that hepatitis
C--infected veterans receive the best possible health care. These patients have their own
unique set of needs stemming from such problems as deficits in disease-related
knowledge, stress due to social stigma, and medical and psychiatric comorbidity.
Antiviral treatment for hepatitis C causes unpleasant side effects for many, and the course
of treatment could be better tolerated if patients relied on each other for mutual support.
Support groups offer an effective treatment modality that can be beneficial for veterans
living with hepatitis C.
What does a support group provide?
Group cohesion -- Feelings of trust and safety are primary benefits of group affiliation,
as is the recognition of the universality of one's problems, which decreases feelings of
personal isolation.
Education -- Interpersonal learning is exchanged in group settings, and increased
knowledge about hepatitis C infection is the first step toward successful self-care and
evaluation of treatment options. Many patients have misconceptions and misinformation
about their disease, which can be remedied by group participation.
Discussion -- Veterans learn as much from each other as they do from providers and
staff. Creating an opportunity for dialogue facilitates this exchange of information.
A venue for expression of needs -- Providers can learn what veterans feel they need to
help them manage and cope with hepatitis C infection.
Prevention -- Alerting veterans and caregivers to behavioral risk factors can help limit
transmission of hepatitis C, while at the same time assure them about what kind of
contact is safe (e.g., kissing, hugging, playing with their child).
Opportunity for followup -- Weekly or even monthly participation in a group allows
providers to continue monitoring patients informally and reinforce important messages
for effective self-care.
IV. Steps in Support Group Development
Here is a general outline of the steps involved in developing a support group. Each of
these steps is expanded and elaborated on in subsequent pages:
1.
2.
3.
4.
5.
6.
7.
Conduct a needs assessment
Identify target population
Select group format
Identify resources
Attend to logistics
Establish your group
Implement a feedback function
1. CONDUCT A NEEDS ASSESSMENT
A formal or informal needs assessment is essential to help with decisions you will have to
make about group format, meeting time, group size, and so on. This needs assessment
may range from a written survey of your hepatitis C patients to simply engaging several
individuals in a discussion about what they would find helpful. As a start, you might use
a variation of the support group feedback forms contained in Appendixes E and F to find
out about patients' interests. Conducting focus groups with patients is another way to
assess the needs of your population. Focus groups can be very technical and challenging
without professional help, so if you do bring patients together to find out their opinions,
you may want to consult someone who has done this in the past.
Asking patients what they need is important; do not assume that you already know what
they want. Collect information about both the content of the group meetings (e.g., topic
interests) and logistics (e.g., when and how often to meet). Veterans will have differing
opinions as well, so you will have to go with what appears to meet the greatest need for
the greatest number of patients.
NOTE: It is important to give yourself enough time to set up your new group. Try to
allow for a 3-month lead time. It takes time to contact patients, and you will want to
allow an adequate time frame to get the word out and attend to the details of establishing
a new group.
2. IDENTIFY TARGET POPULATION
Who are the intended participants of the group? This is the first and probably the most
important decision to make. Keep in mind that patients are at varying stages of their liver
disease and have varying knowledge about hepatitis C virus (HCV). On the basis of your
needs assessment, you will have to decide who would benefit most from group
participation:
Patients on antiviral treatment?
Patients not eligible for antiviral treatment or who have failed treatment?
End-stage liver disease patients?
Any and all patients with hepatitis C and their family members?
Veterans only, or veterans and nonveteran patients?
Also, how many patients do you plan to invite? Your target population and selected
group format largely will determine this.
Don't worry if you feel that you can't address every patient's needs immediately. You
may decide to start with a very specific target population for your first support group,
then use that experience to either expand your group or start other groups.
3. SELECT GROUP FORMAT
There are a variety of group formats to consider. Groups can differ from each other on
several different dimensions. The most relevant dimensions for support groups are
structure, size, and focus (i.e., process-oriented vs. didactic in focus). A process-oriented
group is one in which attention is focused more on individual members' concerns,
thoughts, and feelings rather than on topical information provided by an `expert.` The
three dimensions mentioned are illustrated in the following figure:
Keep in mind that these dimensions are largely independent of each other. One
could have a monthly, lecture-format type of group that is highly didactic,
structured, and large. However, one also could hold a smaller group that is
process-oriented but very structured in order to achieve specific goals to
enhance patient coping and mastery. A skills-building group for patients on
interferon is an example of this type of format.
The group format you select for your patients will depend largely on their needs and your
available resources. Below are several general categories of groups. Your hepatitis C
group may be a hybrid or modification of these types.
Support Group
Objective: At a minimum, these groups provide opportunity for social interaction.
May be loosely defined, although participants usually share some characteristics.
Benefits: Vicarious learning, sharing of resources.
Patient-led vs. provider-led?
See considerations under “Co-facilitation” below.
Process-oriented vs. topic-oriented?
Topic could be predefined or ad hoc, based on the needs of the members.
Process groups are less structured, but no less challenging to ensure effectiveness
(see information under “Therapy Group” below).
Size of group: 8-12 members optimal for process-oriented group.
May be open to family members.
Example: Group for patients undergoing interferon treatment
Education-Oriented Group
Objective: Learning more than mutual support.
Organized around a topical objective.
Often a series of meetings of defined duration.
Topics established in advance.
Topical expert leads the presentation, although a facilitator usually is also present.
Social support is a byproduct rather than a primary goal.
Usually open to family members.
Example: Guest lectures for hepatitis C patients and their family members
Therapy Group
Objective: Mental health intervention.
Led and facilitated by a mental health professional.
Size limited depending on nature of group.
May be either ongoing or time-limited.
Usually organized around common diagnosis or diagnoses among patients.
Usually closed to family members or others.
Example: Psychotherapy group for patients with both post-traumatic stress disorder and
hepatitis C
Recovery Group
Objective: To promote and maintain abstinence from substance use.
Focused topic and/or mutual support -- e.g., Alcoholics Anonymous, CODA (CoDependents Anonymous).
Usually ongoing.
Drop-in approach common.
Example: Group for HVC patients recovering from intravenous drug use
Hybrid/Combination Groups
May involve a dual population.
HIV/HCV co-infection
HCV and addictions treatment
May be a dual-purpose group or involve splitting the session to address multiple goals.
Education plus support
Support plus therapy
4. IDENTIFY RESOURCES
It may be helpful to have two facilitators for a group, with one being a VA staff person or
a professional and the other, if possible, a peer facilitator.
Co-facilitation
Using two facilitators in any group has several advantages:
While one facilitator is taking a more active role by speaking to or facilitating the
group, the other facilitator can attend to the process or system issues of the group,
making note of followup issues for after the group meeting and offering a crucial
second point-of-view.
Having two facilitators offers a chance to model positive interpersonal skills:
facilitators can openly disagree on subjects and demonstrate constructive resolution.
Practically, having two facilitators means the group can continue even on days when
one facilitator is absent.
Choosing a Second Facilitator
We strongly encourage having at least one peer facilitator for the group. Many veterans
may prefer leadership from another veteran who also has HCV: such a peer facilitator
models successful coping skills and offers personal knowledge and experience with HCV
and treatment. Some veterans see a peer as a more credible source of information than a
professional. Ideal peer facilitators are often patients who have already assumed some
type of advocacy role regarding their health care or the care of other veterans. Peer
facilitators can be recruited by providers, at educational events, through local veterans
service organizations, and at other community venues.
Having a professional facilitator ensures that the interpersonal aspects of the group are
therapeutic, regardless of the group's type (e.g., educational vs. process). The professional
facilitator should train and mentor the peer facilitator in developing basic group skills just
as the peer facilitator should train and mentor the professional facilitator in the personal
experience of having HCV. This training can be formal or informal, but the most
important learning occurs with continuous feedback and discussion with debriefing after
group sessions. We recommend training peer facilitators in at least the following areas:
Communication skills: e.g., “I” statements, empathy, active listening
Motivational interviewing: e.g., developing discrepancy, rolling with resistance
Basic group and system principles and interventions: e.g., group roles, group
developmental stages, fostering cohesion
Facilitation strategies and techniques: e.g., redirecting, rewarding group behavior,
handling disruptive behavior, tolerating awkward silences
Please consult Appendix D for elaboration on these topics.
Flexibility
All that being said, groups can be successfully run by one or two facilitators, peer or
professional. In areas with limited VA resources, a group organizer may have to find
creative ways to start a group using community resources. Although VA professional
facilitators may be unavailable to lead an HCV group, they still may have the time to
mentor peer facilitators, individually or as a team, in group skills. Having a well-run
therapeutic group that addresses patients' needs is more important than adhering to a
predetermined format for which there are no local resources.
Security
Peer facilitators should be approved VA volunteers who have gone through appropriate
orientations and safety checks to ensure patients' safety, confidentiality, and well-being.
Roles
It is crucial that before the group begins, the facilitators agree on their roles and how they
will manage the group together. Facilitators may decide to be completely equal in
leadership and division of labor or to divide their responsibilities differently: one
facilitator may be the leader while the other plays a more secondary role, or one may be
in charge of the group's process (e.g., the professional facilitator) while the other is in
charge of the content (e.g., the peer facilitator). How the responsibilities are divided is not
as important as having the division clear and agreed upon by the facilitators. When a
volunteer or peer facilitates, the professional facilitator or other VA employee should
make clear to members the boundaries on the volunteer's participation.
Guest Speakers
Early on, start building a list of contacts to use as potential speakers at your meetings.
Keep in mind that many speakers need several months' lead time to commit to a specific
date or time.
Speakers should be familiar with hepatitis C patients and possess a thorough knowledge
of the topic or their specific content area. Speakers whose presentations you have
attended and enjoyed and those who are adept at drawing people into discussions are best
to invite. See Appendix G for potential content areas you may want to address.
You may also want to consider having physicians, nurses, social workers, or
psychologists attend the group sessions from time to time (or as guest speakers) to act as
further resources for the group. Ideally, these individuals should have experience in the
area of liver disease or in treating serious illness.
Many hepatitis C patients have indicated particular interest in certain topics. You can find
a list of these topics in Appendix G. Support group planners may seek out guest speakers
with specialized knowledge or expertise in these areas. (The Support Group Guide
Planning Committee plans to develop the suggested topics listed in Appendix G as
educational modules and include supplemental materials, such as lecture notes and
PowerPoint slide presentations, in future versions of this Guide.)
The American Liver Foundation
The American Liver Foundation (ALF) is another resource for starting support groups,
particularly if your group is to be based in the community rather than at a VA medical
facility. ALF has an expert speakers' bureau and provides many helpful suggestions for
structuring and conducting your support group. You may wish to contact ALF and work
together once you have an idea as to the purpose and target population of your group.
ALF is also able to list your support group on its local Web site. You may find out how to
speak with the ALF representative for your area by contacting ALF via the resource
information provided in Appendix H.
Industry Support
Corporations that develop health care products and services sometimes offer resources
that can benefit your group, such as informational materials on hepatitis C and patient
care consultants who can serve as speakers. VA rules prohibit soliciting support from
industry representatives, but donated support, such as unrestricted educational grants,
may often be used to augment the resources available from your facility. Many VA
medical centers have specific policies or procedures pertaining to acceptance of support
from outside sources, and you should make sure that you understand and abide by these.
Representatives of outside organizations that provide support should not be permitted to
attend patient support groups.
Community Resources
One mission of this manual is to help group facilitators empower veterans with
knowledge and resources that promote optimal self care. To increase information access,
we suggest you provide veterans with a resource list addressing their varied concerns.
This list could include the following:
Contact information on agencies and Web sites that promote liver health, education,
and advocacy
Relevant case management and social service resources (e.g., legal aid, Social Security,
housing, Americans with Disabilities Act, and disability rights contacts)
Recommended readings on liver health, hepatitis C, and related issues
Information on current liver research
Public health clinics and other locations that test for hepatitis (especially for significant
others)
Advocacy organizations
Other hepatitis C support groups in the community
Contact information on alcohol and drug recovery resources (such as treatment centers,
local 12-step and Self Management and Recovery Training (SMART) recovery
meetings, directories and/or contact numbers or Web sites)
This manual provides a directory of national resources (see Appendix H). You are
encouraged to add any local resources to this listing, which should be updated
periodically. Hard copies of the resource list could be made available at each group
meeting along with educational brochures about the liver and hepatitis C.
5. ATTEND TO LOGISTICS
Planning
The following planning points are important to address early on:
When are most participants available?
When is the facility available?
How frequently will people be able to meet (weekly, monthly)?
Is there adequate parking?
Is there access to audiovisual equipment?
Is the room arrangement and number of chairs sufficient for the group?
Who will be responsible for opening and closing the facility?
Location
Once you have an idea of when and how often your group will meet (at least for the first
couple of meetings) you need to secure a location for the group. Ideally, you will have
meeting space at your VA facility. The space should be large enough to seat everyone
comfortably, but if the space is too large it may feel cold and impersonal for the purpose
of the support group.
If you have to hold your support group offsite:
Some locations may require payment for use of the facility.
Contact community resources (e.g., library, town hall) or community organizations
(American Red Cross, Rotary Club, Lions Club, YMCA/YWCA, Salvation Army).
Most organizations have community relations offices as a contact point.
Also consider local hospitals, health centers, a doctor's office, or the local Visiting
Nurses Association.
Have an idea of the total number of meetings and/or the number of months you plan to
meet prior to making the initial contact call (most meetings last approximately 11/2
hours, plus time for questions).
Don't forget time for setup (refreshments, video, etc.) and cleanup.
Let your point of contact know projected dates and times, that the meetings are free of
charge, and that the group is voluntary and nonprofit.
Wherever you hold your group, be sure to consider safety issues (adequate lighting, in a
safe area), especially for night groups, to minimize the possibility of harm to or
harassment of participants. Also consider confidentiality issues when creating your signs
for the support group. For example, `Liver Support Group` would likely be preferable to
`Hepatitis C Support Group` when posting signage.
Establishing a Clinic in CPRS for the Hepatitis C Group
One important step in developing your hepatitis C group is to set up one or more clinics
in the Computerized Patient Record System (CPRS), in order to capture accurately the
workload data associated with the group. This should be done before the groups begin but
near the end of the planning process.
To set up a clinic in CPRS you will need the following information:
1. The length of each group session
2. The primary provider(s) associated with the group sessions
3. Other providers who will be routinely speaking to the group
You will need to work with your station's Decision Support Service (DSS) program
manager or analyst, or other staff responsible for creating clinics in CPRS. Find
appropriate staff to help you identify and set up the primary and secondary stop codes
within that clinic as well as local codes to capture every element of the workload
associated with the group. You may need only one clinic to capture the workload or you
may need several, depending on the providers associated with the group. Please advise
the person assisting with the clinic setup that veterans attending these clinics must not be
charged for the visit.
There may be other considerations for setting up a clinic at your facility. Some facilities
may require a review of patient education materials. Others may have a system for
reimbursement of travel costs for attending the meeting. Any requirements for individual
facilities should be addressed ahead of time, and the process should be in place prior to
the first meeting.
Referral Process
How you select and bring people into the support group will vary depending on its format
and objectives. Each method has advantages and disadvantages, as indicated below.
Referral
Strategy
Most Appropriate
Uses
Invitation in
person or by
phone
Mass mailing
Advantages
Disadvantages
For small or processoriented groups (e.g.,
patients on treatment)
Provides a personal
connection;
encourages
participation
May be time-consuming or labor
intensive, especially for larger
groups
For large groups (e.g., all
hepatitis C patients)
Reaches a wide
audience
Not very personal; provides little
feedback on who or how many will
attend;moderately time consuming
and labor intensive
Provider-referred When group participation Encourages
is recommended as part of participation and
a patient´s treatment plan compliance
Variability among providers in
willingness to refer to group
Flyer
Large groups open to all
comers
Requires least amount No feedback or control over who
of effort
will attend
Newspapers,
community
bulletin boards
When the goal is to reach
veterans not attending
clinic on a regular basis
Increases access to
underserved veterans
May increase clinical workload
Providers can be the best referral source for potential group participants. They often
know the patients' needs as well as their current health status. Discuss who might benefit
from group participation with physicians (especially gastroenterologists, hepatologists,
and infectious disease specialists), nurses (especially those who treat liver disease),
social workers, psychologists, and other mental health professionals (especially those
who work with patients with a history of substance abuse and/or chronic disease).
If you send invitations to patients by mail, our early experience with this method resulted
in a 10 to 20 percent attendance rate among those we invited. If you call selected patients
by phone, your response rate likely will be higher, and you will also have a greater sense
of who will attend by what they tell you.
Many newspapers have a community bulletin board you can access without charge.
Some States have monthly newsletters that list dates, times, and activities for public
service groups in the State. Take advantage of bulletin boards and public service
announcements from local media, making sure to clear information in accordance with
local policy.
Some institutions may require a group to be registered or approved by a patient
education coordinator or hospital education committee. Be sure to check your local
policies to see if this is the case at your site.
A flyer, either to post or to mail to potential participants, is a good visual aid to promote
your group.
Meeting Logistics
A meeting planning tool is enclosed (see Appendix B) to help keep track of what has
been done and what needs to be done for each meeting, once your meetings are under
way. Here are some considerations for your first group and beyond:
Audiovisual -- Do you have the equipment that you or your guest speaker needs for a
presentation (e.g., VCR, PowerPoint, overhead projector)?
Food/Refreshments -- Food helps to attract and maintain group participation. If
possible, provide food that is healthy for patients with liver disease (i.e., avoid highsugar sodas and caffeinated beverages). If you serve food, remember the little things
everyone needs (napkins, utensils, serving spoons).
Directions/Signs -- Patients will easily get frustrated if they have to walk the length of
the hospital to find the meeting room.
Announcements -- Groups are great forums for disseminating information, especially
information about upcoming meetings and speakers.
Handouts -- Do you have enough copies?
Brochures/Flyers -- See “Community Resources” section above.
Room Environment -- Check temperature, lighting, and seat arrangement in advance.
You may need to obtain a key beforehand to gain access to the room.
Name Tags -- Do you want people to wear them or not?
General Practice Note: START AND END ON TIME!
6. ESTABLISH YOUR GROUP
Guidelines
Having some general guidelines and expectations regarding group conduct established from the
beginning can make the group more comfortable for the members. This will help to resolve difficult
situations without appearing dictatorial. Appendix C is a list of patient rights and responsibilities you
may wish to incorporate.
Confidentiality
At the first meeting it is a good idea to establish and emphasize that every member should respect the
confidentiality and anonymity of individual group members. Your group may also decide if it is to be
open or closed to spouses, family members, or friends. Group members should feel free to express
themselves without fear that their private lives will become a matter of public knowledge outside the
group.
Mission Statement
To begin, prepare a mission statement for the first meeting (see sample in Appendix A). Ask members
to suggest changes or additions. With their input and feedback, you will be able to ensure that the
interests and needs of the group will be met. You should review this mission statement periodically to
help the group stay focused on its purpose and goals.
Potential Problem Areas
Facilitating a group, large or small, can be tricky. The following table lists common problem areas
that often arise in groups, along with some suggested remedies.
We suggest you read Appendix D to learn more about group facilitation. Many of these tools may
come in handy once the group starts.
Problem
Solution
Monopolizing the conversation
Invite others to share: “Let´s hear if some other people have
had a similar experience.”
Argumentativeness
Reflect/validate the speaker´s feelings; encourage him or her
to use the group to get additional information or others´
perspective on the issue.
Emotionality
Acknowledge their feelings; provide comfort (and tissues).
Gently shift to another group member, but come back to
“check in” with the emotional member when he or she has
stopped crying. If the person is very upset, perhaps a
facilitator could leave the group with him or her temporarily
until he or she feels better.
Incorrect information
Don´t directly challenge the information as false, but if there
is no scientific evidence to support the information, say so.
Invite the participant to discuss the issue with you later: “I
have another explanation I´d like to share with you after
group.”
Lack of participation
Invite the member to share: “I notice you have been quiet
through all of this; what are your feelings about (or your
experience with) the issue?”
Rambling
Reflect that the speaker makes a number of good points;
suggest the group focus on the most relevant point.
Interruption of the speaker with questions
If you have an invited speaker giving a lecture, point out that
there is a lot of material to cover and suggest the group hold
their questions until the end.
Question-and-Answer Period
Even if you have decided to go with an educational
or lecture-style format for your group, it is
important to allow ample time for members to ask
questions or share their comments on an issue.
Some educational presentations are informal and
allow for questions during the lecture, but often it's
best to hold questions until after the speaker has
presented all of his or her planned material.
The Social Aspect of Support Groups
Much of the strength of support groups is found in the patient-to-patient interactions that
occur before, during, and after the “official” meeting. This is when veterans share
information, compare notes, and even exchange phone numbers for informal contact
outside of the group. While starting and ending groups on time is a good suggestion from
a group management perspective, encouraging this peer-to-peer networking is important
to promote patient self-help and to let the group thrive. Perhaps you can identify a safe,
accessible place where patients can continue to talk even if your meeting room has to be
locked up or released to the next scheduled user. If this is a possibility, announce to group
members at the beginning of the meeting when the group officially ends and when and
where informal discussions may continue.
Special Considerations for Hepatitis C Groups in Mixed Outpatient and
Domiciliary Settings
1. Confidentiality. Try to choose a space that allows for persons to enter
unnoticed by the general population. Remember that hepatitis C is a
disease that often carries a stigma. Domiciliary patients may choose not to
attend rather than reveal their hepatitis C positive status.
2. Frustration. Many veterans in a substance-use domiciliary will be frustrated if
they are attempting to establish some sober time or to decrease their alcohol
intake before starting treatment. Encourage veterans to use the time to prepare
their bodies and minds for the treatment.
3. Familiarity and Group Dynamics. Domiciliary patients often spend the majority
of their time in each other's company. They may know each other well and have
patterned ways of interacting throughout the many groups within the domiciliary
program. This can affect the group dynamic in several ways you may not
anticipate, especially if you are not domiciliary staff. You will need to establish
the hepatitis C group as its own group, not just one of a number of domiciliary
groups. Holding the group outside of the domiciliary (e.g., in an outpatient clinic)
and including nondomiciliary patients can help establish this fact. Discourage
participation of those who do not have hepatitis C by offering limited hepatitis C
information in the other domiciliary health classes.
4. Origin of Hepatitis C. Those who are newly diagnosed often question the origin
of the virus or the source of their infection. Be cautious not to let this discussion
get too far within the support group. It can lead to divisiveness within the group
between those who obtained the virus from high-risk behaviors (e.g., IV drug use)
and those who did not (e.g., a blood transfusion). Mixed populations are
particularly susceptible to this dynamic as persons in the domiciliary often are
early in recovery from drug or alcohol abuse and readily disclose high-risk
behaviors.
Starting a Hepatitis C Support Group: Two Perspectives From the Field
I am a social worker at the Anchorage VA Outpatient Clinic who was tasked with developing a hepatitis C
group, although the goals and purpose of such a group initially were not well defined. First, I set out to learn
what veterans and providers hoped to achieve from this group. I found that we have two groups of patients, each
with very different needs. In addition to hundreds of outpatients with the disease, we also have a domiciliary unit
where many veterans have hepatitis C, often newly diagnosed.
I began by learning everything I could on the topic of hepatitis C. The resources I found most helpful were the
VA hepatitis C brochures and video series and the VA Web site. I also talked with the domiciliary providers and
hepatitis C specialists, as well as hepatitis C+ veterans, about what they wanted in a hepatitis C group. While
veterans wanted more information about the disease and support, providers wanted better-educated and more
compliant patients. After more than a year of research, we put together a 6-week education series, followed by a
separate ongoing support group. We offer the education series quarterly, which enables us to have guest speakers
for the 6-week series, including a patient care consultant from industry, our hepatitis C treatment provider, a
dietician, psychiatric nurse practitioner, and myself as the social worker. The support group is offered monthly
and well attended by those on treatment and those nearing the start of treatment. Veterans share their struggles
with the disease a
--Michele Richardson, MSW
I am a registered nurse working for the VA Southern Oregon Rehabilitation Center in White City, OR, the largest
freestanding domiciliary in the VA system. Most of the residents are here for substance abuse treatment.
Approximately 25 percent of this clientele are also infected with hepatitis C. In 1999, I (among others) saw a
need for some type of education/support group directed toward hepatitis C. There did not seem to be many
resources for veterans who were trying to come to grips with recent diagnoses of hepatitis C. Also, many
veterans were confused, as there are several types of viral hepatitis.
I began by inviting the few veterans I knew were infected with hepatitis C to the first few groups and modifying
my format to meet the needs of the group. The group grew by word of mouth in the first year. After some time
the group became consistent enough to qualify as a clinic. I now get referrals from other providers at my facility.
I continually refine the education part of the group as new data are published. The process part of the group also
evolves as different needs are identified. Although I have changed job positions and am now in more of a
supervisory role, I still facilitate the group. I feel it is very important for the veterans here to understand what is
confronting them and to be able to have a forum to voice their concerns. Both peers and veterans have
commented to me that this group fills these needs.
--John Penkert, BSN, CARN
7. IMPLEMENT A FEEDBACK FUNCTION
When the Session Is Over
Although a group session ends for its members, facilitators still have many important
tasks to continue the group's work.
Debriefing Between Facilitators
Facilitators should meet immediately after the group, even if only for 10 minutes, to
discuss what happened and develop plans for followup. Here are some topics you may
want to cover during your debriefing:
Clinical issues requiring followup (e.g., a participant discussed severe depression or
suicidal ideation, seemed agitated, is likely to drop out prematurely)
Process issues in the group (e.g., a participant who dominates the group or one who
does not participate, scapegoating, deflection from emotional issues)
Case formulations and intervention plans: developing therapeutic plans for individual
participants and the group as a whole
Followup list of unanswered participant questions or requests for more information
(e.g., referrals)
Process issues between facilitators: mutual feedback, examining countertransference
(i.e., personal reactions to group members), reaching agreements on practices, handling
particular situations, responding to particular requests
Evaluating the Session
Feedback form
Using a standardized feedback form (see examples in
Appendixes E and F) at the close of every group offers
continuous feedback from participants to shape the group
to their needs. Ideally, feedback should address three key
aspects:
Structure -- length, meeting times, formats
Process -- facilitation style, issues between participants
Content -- topics for guest speakers or focused
discussions
Data analysis
Once you solicit a group's feedback, it is extremely
important to use that information. Let the group know at
the outset that their feedback shapes the group, and then
show them their feedback matters by altering the group
accordingly. Members feel empowered when their efforts
create real change. To ask the group's opinions and then
not act on them risks alienating members and divesting
them from their very own group. The group
fundamentally belongs to the members to address their
concerns and needs: the process within the group should
empower members, encouraging their roles as active
participants in their own health both within and outside of
the group. The group fosters a norm of active
collaboration in their health care.
Planning the Next Group
The first meeting will generally be organizational in
nature. Each member should have the opportunity to
express what he or she would like to experience from the
group. It's important to ask, not assume, what patients will
want. Not all members will want to listen to a guest
speaker every month. Some might prefer to just vent their
emotions and learn to deal with side effects of treatment.
Collect information about both topic interests and
logistics (when, how often to meet).
Flexibility and Creativity
Groups are not set in stone and should change with the
changing composition and needs of their members.
Groups may change in purpose, focus, content, or
structure. If one group seems to have outlived its
usefulness, don't be afraid to end it and start a different
type of group that might address patients' needs in a new
way.
Attending to Members' Feedback
Facilitators may decide to make changes directly based on
member feedback, bring feedback to the group for
discussion, or engage the group in a more collaborative
planning of changes.
Reminder Calls and Letters
Reminders can work in a number of ways. One useful
strategy is for facilitators to make the initial invitation to
join the group face-to-face or by phone, then send
members reminder letters before every group meeting.
No-shows and drop-outs are common occurrences in
groups, so facilitators should agree on a followup plan for
handling them. It is especially important to follow up with
members who have expressed some important concerns or
are having a particularly difficult time with their illness. If
volunteer or peer facilitators are to contact members, the
VA facilitator should ask members' permission first,
guarantee their confidentiality, and clarify the limits on
volunteers' access to the members' medical information.
Multidisciplinary Collaboration
Group leaders should collaborate with other providers,
such as medical, mental health, and substance abuse staff.
When facilitators obtain a patient's informed consent to
join the group, they should make this collaboration and
information sharing clear. A multidisciplinary staffing of
participants' treatment is usually the most efficient way to
optimize care, but even a one-to-one collaboration
between providers of different professions, whether faceto-face or over the phone, can considerably augment care.
Group facilitators may see patients more frequently and
for longer periods than physicians, so they might offer
information on members' quality of life, support systems,
coping skills, daily challenges, and recent changes.
Facilitators may wish to ask other providers to follow up
on issues raised in group; similarly, other providers may
ask the facilitator to follow up with issues in the group.
Longstanding Groups
Just as your group may run its course and end naturally
after fulfilling its usefulness, it may also become a
mainstay of your health care facility. Don't be surprised if
the group takes on a life of its own, with members
developing their own rituals and traditions. Allow for the
group to have alternative functions, such as holiday
parties, participation in community events (e.g., local
Liver Walks), or even reunions for very long-standing
groups.
As one longtime support group member advises, stick
with a generic name for the group. Your group may
evolve over time and eventually look very different than it
did when you held the first meeting.
V. Final Thoughts
Running support groups can
be extremely rewarding, as
well as frustrating. Here are
some parting tips on how to
take care of yourself and
avoid burnout:
Network with other
providers. Process and
debrief challenges.
Coordinate care with other
providers and use a team
approach. If some of your
own issues emerge as a
result of your helping
others, seek counseling.
Keep yourself abreast of
new information by
participating in ongoing
education.
Follow the advice that you
teach to clients about
physical, mental, emotional,
social, and spiritual selfcare. Self-care is the
opposite of burnout.
Recharge yourself! Pay
attention to your personal
time away from work and
schedule activities that
make you feel better. Set
time aside for yourself. The
more you enjoy your time
away from work, the more
you have to share at work.
Recognize resentments
against clients, colleagues,
and work as signs that you
are giving too much and not
attending to your own
needs.
Set realistic goals for
yourself at work. Keep
reminding yourself, “It´s not
my job to save the world.”
Instead, focus on the
smaller ways you can make
it a better place today, if
only for one person at a
time.
Know you are making a
difference. Keep a file of all
the thank you cards and
commendations that remind
you of the many people who
appreciate what you do.
Acknowledgments
Support Group Guide Planning Committee
Michelle Blum, LCSW
Portland VA Medical Center
John Davison, MBA, PhD
VA Puget Sound Health Care System
David Indest, PsyD
Portland VA Medical Center
Gene Mask
Portland, OR
John Penkert, BSN, CARN
VA Southern Oregon Rehabilitation Center and Clinics
Michele Richardson, MSW
Alaska VA Healthcare System
Martha Shea, BSN, RN
VA Connecticut Healthcare System
Meaghan Splan, MPH
VA Puget Sound Health Care System
Kristy Straits-Tröster, PhD
VA Puget Sound Health Care System
Other Contributors
Jane Burgess, ACRN, MS
Public Health Strategic Health Care Group, Department of Veterans Affairs
James Halloran, RN, MSN, CRS
Center for Quality Management in Public Health, Department of Veterans Affairs
Marian Kerbleski, RN, BSN
San Francisco VA Medical Center
Connie Raab
Office of Public Health and Environmental Hazards, Department of Veterans Affairs
The VA Hepatitis C Resource Center Program and National Hepatitis C Program Office,
Veterans Health Administration, U.S. Department of Veterans Affairs
Appendixes
Appendix A
Hepatitis C Support Group Mission Statement (Sample)
A support group serves to empower the patient through increased knowledge gained
from speakers and other members as well as through the assurance that he/she is not
going through his/her problem alone.
Appendix B
Support Group Meeting Planning Grid
Program Title
Meeting Date
Location of Meeting
Room Reserved
Expected Attendance
Speaker
Facilitator(s)
Agenda for Meeting
Handouts
Audiovisual Equipment
Food/Refreshments
Publicity/Plans
Flyers/Newsletter
Directions Posted
Contact Person
Appendix C
Hepatitis C Support Group Participant Rights
and Responsibilities
1. We agree to participate in this program
in a group setting with other hepatitis C
patients and their families.
2. We understand the need for complete
confidentiality and trust within the group.
3. We accept an individual's choice to
actively participate or simply listen.
4. We will begin and end meetings on time.
5. We encourage “I” statements to keep
discussions in the first person.
6. We let one person speak at a time.
7. We don't let one person monopolize the
discussion.
8. We recognize the importance of actively
listening to the person who is speaking.
9. We emphasize each individual's role in the
group's success.
10. We will not be judgmental toward other
members; we are here to support, not
criticize.
11. We accept all feelings, whether they are
positive or negative.
12. We agree that each of us is responsible for
our own comments and that we need to
consider the group setting prior to
disclosing personal information. We should
keep in mind that some questions and
comments may need to be presented in an
individual session.
13. We recognize and authorize that a
participant's personal medical information
may be disclosed in the group setting in
order to respond appropriately to that
participant's questions.
By my signature below, I show that I understand
the purpose of this document.
Patient Signature
Facilitator Signature
Appendix D
Theories and Techniques for Support Group Facilitators
Systems Theories
Whenever people come together, they tend to form a system of complex interactions that
can be understood as an organic whole. Focusing exclusively on one individual's
behavior in a group ignores the context affecting that behavior: the complicated interplay
of give and take in human relationships, forming intertwined feedback loops of actions
and reactions. Systems follow certain principles:
Homeostasis -- Systems tend to maintain their status quo. Attempts to change the
system are often met with opposite, counterbalancing forces to keep the system as it
was.
Feedback -- The system has feedback loops of information that help it gauge itself and
maintain homeostasis.
Development -- Like all organisms, systems begin, grow, change, decay, and end.
Norms -- Each group develops characteristic ways of behaving and of defining
“normal” behavior.
Roles -- Individuals in a closed group tend to take on more static functions within the
group, such as “leader,” “devil's advocate,” “scapegoat,” and “identified patient.”
Stages of Group Development
Groups typically follow certain broad and overlapping stages of formation, growth, and
decay (Corey & Corey, 1997; Yalom, 1995):
Beginning -- Trust is a central issue. Participants begin to learn what it means to be a
member of the group, take tentative steps toward participating in the group, and
observe and test others' reactions to them. The facilitator works to establish an
emotionally supportive environment, fosters functional group norms, and validates
feelings of fear, ambivalence, and alienation. Early facilitator interventions focus on
acknowledging all participants' contributions and highlighting commonalities among
participants.
Transition -- Conflicts arise as participants see beyond their common goals to
differences in styles of participating. Every group has conflict, but a group becomes
therapeutic by bringing this conflict to the surface and resolving it directly and
constructively. Conflict is a natural pathway of development and is necessary for the
group to progress to cohesion. Participants become aware that to make progress in the
group, they'll need to risk becoming vulnerable and to attempt new behaviors.
Participants find their respective roles and places in the group. Facilitators' authority is
often challenged. Facilitators must be keenly attuned to transference and
countertransference and respond with process more than content in mind.
Working -- By working through the conflicts of the transition stage, the group reaches
a functional cohesiveness and trust through which it achieves its central goal.
Participants feel a common bond, disclose more, participate more, mutually support
each other, and actively facilitate the group's process. This stage is devoted to process,
so educational/informational, open-enrollment, and nonprocess-focused groups may
never reach this stage, and may not need to, in achieving their aims.
Ending -- Participants acknowledge that the group will end and struggle with finding
meaning and value in having participated even though it is ending. Participants identify
and consolidate gains, as well as plan how to generalize their new behaviors in group to
the rest of their lives. Participants may feel both happy about “graduating” and unhappy
about losing the group. This is a time when old dysfunctional behaviors may reemerge.
Participants may deny or minimize feelings of loss by saying they will keep in touch
with other group members, but facilitators must help participants discuss the loss
honestly.
Curative Factors in Group Therapy
Irving Yalom (1995) identified 12 factors in groups that may facilitate positive change:
1. Interpersonal Learning, Input -- Learning how others perceive and
experience you
2.
3.
4.
5.
Catharsis -- Learning how to express and tolerate feelings
Cohesiveness -- Feeling accepted, belonging
Self-Understanding -- Discovering and accepting parts of yourself (good and bad)
Interpersonal Learning, Output -- Learning how you typically distort the way you
perceive and experience others
6. Existential Factors -- Facing issues of injustice, isolation, and death, and that you
are ultimately responsible for your life
7. Universality -- Knowing that you are as well off (and sometimes as bad off) as
others
8. Instillation of Hope -- Gaining a sense that a solution is possible
9. Altruism -- Helping others makes you feel better about yourself
10. Family Reenactment -- A chance to have a more positive interaction with the
group than you did with your family
11. Guidance -- Getting specific advice and recommendations from others
12. Identification (Imitative Behavior) -- Learning from others' experience and trying
their behaviors
Facilitation Techniques
Certain basic techniques are easily learned and quite useful in facilitating groups:
3 Rs of Listening -- Focusing on listening rather than preparing to respond to what is
being said: preparing to listen (Readying), encouraging the speaker to say more
(Reaching), and paraphrasing what the speaker has said (Reflecting).
Immediacy -- Showing you're interested by making eye contact; nodding; reacting with
other appropriate face, body, and vocal expressions; gesturing; and maintaining an
appropriately close distance from the other person.
Addressing by Name -- Calling people by their names establishes a personal
connection and can help calm an agitated participant or focus one who is moving off
task.
“I” Statement -- A communication format focusing on the speaker's experience of the
person being addressed: “I feel [emotion] when you [behavior]; I would prefer
[alternate behavior] and/or [positive/negative consequences].”
Giving Feedback -- Sharing how a participant's behavior personally affects you. The
speaker should focus only on his or her personal reaction, focus on behavior over
character or some attribute that is more difficult to change, be very specific by giving a
concrete example, and use very recent examples.
Confrontation -- Pointing out how a participant's behavior affects you (or others in
group) and highlighting the possible consequences.
Soliciting Feedback -- Asking others for their reaction to your behavior or that of a
group participant.
Paraphrasing (Reflecting) -- Restating a participant's words in a concise way. This
shows people that you are listening and often helps them observe their own experience.
Supporting -- Acknowledging people's experience and their right to feel however they
do. This helps calm or soothe negative feelings.
Labeling -- Helping a participant name a feeling he or she is experiencing.
Perception Checking -- A three-part method for verifying the accuracy of
interpretations, including a description of the observed behavior, at least one possible
interpretation, and a request for confirmation of the interpretation. “I notice that you
[sensory data/behavior]; to me that means [interpretation]; is that right (request for
clarification)?”
Self-Disclosure -- Revealing personal information about yourself to the participants.
When a facilitator self-discloses, he or she should consider the goal in disclosing and
plan on how much to disclose. Self-disclosure is a powerful tool in the early stages of
group to help model such behavior and establish a group norm; however, the facilitator
should be careful of disclosing too much, monopolizing the group, or using the group
for personal reasons.
Praising (Stroking) -- Calling attention to a specific positive behavior of a participant
and how it affects others.
Deflecting -- Rather than responding to a communication made directly to you (the
facilitator), you open the discussion up to the group as a whole or to another specific
participant. This is a way of encouraging cross-talk between participants rather than
having each one interacting only with the facilitator. It is also a useful way of ending
one participant's monopoly of group time and inviting others into the conversation. For
example, “Has anyone else had a similar experience?”
Punctuating -- Summarizing or making an observation as a way of stressing the
importance of what has just happened or as a means of ending one train of discussion or
speaker's time and starting a new one.
Broken Record -- Repeating your statement calmly to get your point across.
Using Silence -- Tolerating or fostering awkward pauses and silences in the group. This
is one of the most useful group process techniques and one of the easiest ones to
overlook for beginning facilitators. People naturally tend to be uncomfortable with
silences and try to rush to fill the void with a new topic; however, the silences are often
times when people are becoming aware of strong or anxiety-evoking feelings or are
provoked into deep thought. Allowing a prolonged silence may deepen participants'
experience of their feelings. By not “rescuing” the group from this discomfort, the
facilitator may allow another participant to come forward and deepen or add to the
conversation. If no participant comes forward after a long enough pause or if one
attempts to move off the topic entirely, the facilitator can deepen the conversation by
saying something like, “Although nobody spoke in the past few minutes, I know that
everybody was thinking or feeling something that they didn't say. Would you please
share what you were just feeling or thinking about?” You can build your tolerance for
such silences by sitting with a group of friends or coworkers and agreeing to be silent
for the next 1, then 2, then 3 minutes. You will observe a natural tendency to end the
awkward silence by talking or laughing.
Motivational Interviewing
Miller and Rollnick (1991) articulated a nonconfrontational therapeutic approach to foster
behavior change. Many have applied their approach to work with substance use disorders,
but motivational interviewing is now proving effective with other health behavior change
as well. They recommended five therapeutic principles or activities for assisting people to
move toward behavioral change. These principles can be used in groups as well as
individually.
Express Empathy
Listen to understand.
Accept participants as they are.
Ambivalence is a normal human experience.
Reluctance to give up something that causes problems is normal.
Joining (empathically siding) with the participant can foster change.
Develop Discrepancy
Becoming aware of a behavior's consequence is an important step toward changing
it.
Everything has good and bad consequences.
Look for consequences in participants' adaptive coping, legal, health, work, and
social contexts.
Discrepancy between a behavior and important personal goals can foster change.
Explore participants' personal goals.
Participants develop the reasons for change themselves, rather than being told by the
facilitator.
Avoid Argumentation
Arguments are counterproductive.
Direct argumentation calls for a reaction from the participant.
Saying “You can't” makes people want to assert their freedom by proving they can.
Resistance signals a need to change your (the therapist's) strategy.
Roll With Resistance
“Psychological judo” -- Use the participant's inertia; sidestep an issue the participant
is “dug in” on rather than butting heads with him or her.
Perspectives can be shifted.
The participant is an ally in solving the problem.
Invite participants to try other perspectives, but don't impose them.
The participant generates solutions: Ask, “What would you like to do about this?”
Support Self-Efficacy
Believing that someone can change motivates him or her (hope).
Participants are actively making decisions about their lives (even when they decide
not to change things).
Participants (not the therapist) are responsible for choosing and making changes.
References
Corey, M.S., and G. Corey. Group Process and Practice. Pacific Grove, CA:
Brooks/Cole, 1997.
Miller, W.R., and S. Rollnick. Motivational Interviewing: Preparing People for Change.
New York: Pacific Press, 1991.
Rollnick, S., P. Mason, and C. Butler. Health Behavior Change: A Guide for
Practitioners 11th Ed. Edinburgh: Churchill Livingstone, 1999.
Yalom, I. The Theory and Practice of Group Psychotherapy, 4th Ed. New York: Basic
Books, 1995.
Appendix E
Initial Hepatitis C Support Group Feedback Form
Today's date:
I am...
a veteran
a significant
other
For significant others:
I am...
HCV+
HCV-
don't know
When did you learn you had hepatitis C?
Have you been in treatment for hepatitis C before?
Yes
No
If yes, what was the result of treatment?
a. Cleared the virus
b. Did not clear the virus
(treatment did not work)
c. Still on treatment
Has any provider ever told you treatment would not be a good idea for you?
a. Yes
b. No
c. Have not talked about
treatment with a provider
d. Already tried treatment
Please rate the following topics as to how much they interest you.
(1 = not interested at all, 7 = very interested)
Basic info about hepatitis C
1
2
3
4
5 6
7
Exercise approaches
1
2
3
4
5 6
7
Diet/nutrition
1
2
3
4
5 6
7
Alternate meds/herbal medicine
1
2
3
4
5 6
7
Understanding your lab results
1
2
3
4
5 6
7
Treatments for hepatitis C
1
2
3
4
5 6
7
Managing mood changes
1
2
3
4
5 6
7
Managing fatigue
1
2
3
4
5 6
7
Relationships
1
2
3
4
5 6
7
Liver biopsy
1
2
3
4
5 6
7
Liver transplant
1
2
3
4
5 6
7
Benefits (VA, SSA, etc.)
1
2
3
4
5 6
7
People's reactions to my hepatitis C
1
2
3
4
5 6
7
Other:
1
2
3
4
5 6
7
Which of the following formats do you prefer for this group?
Speakers
Videos/slide shows
Group discussions
Time to talk/process/vent
Other:
Would you like to attend this group (circle one):
weekly
monthly
The best day of the week to attend would be (circle one):
M
T
W Th F
The best time of day would be:
Mornin
g
Afternoo
n
Evenin
g
If you have a question or concern that was not answered today, please write it here for us to address at a future
meeting:
What did you find helpful or interesting about this group today?
What wasn't helpful about this group today? What did you not like?
Other suggestions?
Appendix F
Ongoing Support Group Evaluation Form
Today's date:
I am...
a veteran
a significant other
For significant others:
I am...
HCV+
HCV-
don't know
What information provided in this group was most helpful to you in understanding
hepatitis C?
What was least helpful?
What topics would you like to see covered more or less extensively
What topics would you like to be added to the program?
How did these group sessions help you in understanding and coping with a
diagnosis of hepatitis C?
What other changes, comments, or suggestions do you recommend?
Thank you
for your
participation.
Your
answers will
be used in
further
developing
the hepatitis
C group
program.
Appendix G
Suggested Hepatitis C Educational Topics
Many hepatitis C patients have indicated the following topics as being of particular
interest to them . Support group planners may seek out guest speakers with specialized
knowledge or expertise in these areas.
1. Your Liver & Hepatitis C
2. Understanding Lab & Biopsy Results
3. Risk of Transmission & Intimate Relationships
4. Diet & Nutrition
5. Managing Sleep, Fatigue, and Exercise
6. Interferon-based Treatment for Hepatitis C
7. Alternative & Complementary Therapies for Hepatitis C
8. Symptom & Side-effect Management
9. Liver Transplant Issues
10. Emotional Self-Care
11. Anger Management
12. Benefits & Service Connection
The Support Group Guide Planning Committee to develop these 12 topics as educational
modules and include educational materials (i.e., lecture notes, PowerPoint slide
presentations) in future versions of this Guide.
Appendix H
Hepatitis C Resources
Veterans and Providers
Veterans with Hepatitis C
www.hepatitis.va.gov/
Patient Support
Adverse Event Reporting Program
http://www.fda.gov/medwatch/index.html
HCV Advocate
http://www.hcvadvocate.org
Hep C Vets
http://www.hepcvets.com
Hep Net (Canadian Hepatitis Network)
http://www.hepnet.com
Hepatitis Central
http://www.hepatitis-central.com
HIV and Hepatitis
http://www.hivandhepatitis.com
Medscape Resource Center
http://www.medscape.com
Melissa Palmer, MD (Liver disease &
Hepatitis)
http://www.liverdisease.com
Rx List
http://www.rxlist.com
Health Organization Links
American Association for the Study of Liver
Disease
http://www.aasld.org
American Autoimmune Related Diseases
http://www.aarda.org
Association
American Gastroenterology Association
http://www.gastro.org
American Liver Foundation
http://www.liverfoundation.org
Centers for Disease Control and Prevention
http://www.cdc.gov
Hepatitis Branch
http://www.cdc.gov/ncidod/diseases/hepatitis/index.htm
Food and Drug Administration
http://www.fda.gov
Hepatitis C Society of Canada
http://www.hepatitiscsociety.com/index.htm
Hepatitis Foundation International
http://www.hepfi.org
Italian Liver Foundation
http://www.dfc.unifi.it/ilf/eng-home.htm
National Business Coalition on Health
http://www.nbch.org
National Council on Patient Information &
Education
http://www.talkaboutrx.org/select.html
National Foundation for Depressive Illness
http://www.depression.org
National Institutes of Health
http://www.nih.gov
National Center for Complementary and
Alternative Medicine
http://nccam.nih.gov
National Institute of Diabetes and Digestive
and Kidney Diseases
http://www.niddk.nih.gov/index.htm
National Library of Medicine
http://www.nlm.nih.gov
National Network for Immunization
Information
http://www.immunizationinfo.org
United European Gastroenterology Federation
http://www.uegf.org
Viral Hepatitis Prevention Board
http://www.vhpb.org
World Health Organization
http://www.who.int/health_topics/hepatitis/en
General Health Information
Dr. C. Everett Koop's Web Site
http://www.drkoop.com
Healing Well
http://www.healingwell.com
Health Finder
http://www.healthfinder.gov
Health Touch Online for Better Health
http://www.healthtouch.com/level1/menu.htm
Life Saving Alternatives to Blood
Transfusions
http://www.noblood.org
United Network for Organ Sharing (UNOS)
http://www.unos.org
Clinical Trials
Center Watch
http://www.centerwatch.com
Clinical Trials Registry
http://www.veritasmedicine.com
Veritas Medicine
http://www.veritasmedicine.com
Travel Information
CDC Healthy Travel Information
http://www.cdc.gov/travel/index.htm
WORLD Traveler Hepatitis Information
http://www.travelsafely.com
Pharmaceutical/Pharmacy
Chiron Corporation
http://www.chiron.com
Fujisawa Healthcare, Inc.
http://www.fujisawa.com
Glaxo Smith Kline
http://www.gsk.com
Home Access Health (home test kit for Hep C) http://www.homeaccess.com
Idenix Pharmaceutical
http://www.novirio.com
Intermune
http://www.intermune.com
Merck
http://www.merck.com
Priority Healthcare Corporation
http://www.priorityhealthcare.com
Priority Healthcare
http://www.hepatitisneighborhood.com
Rebetron Combination Therapy
http://www.rebetron.com
Roche
http://www.rocheusa.com
Roche-HIV
http://www.roche-hiv.com/front.cfm
Schering
http://www.beincharge.com
Walgreens Specialty Care
http://www.walgreens.com
Mental Health
Center for Mental Health Services
http://www.mentalhealth.org
Mental Help Net
http://www.mentalhelp.net
Exercise and Fitness
Health and Fitness Tips
http://www.health-fitness-tips.com
Hepatitis Neighborhood
http://www.hepatitisneighborhood.com
Centers for Disease Control and Prevention
http://www.cdc.gov
Hep C Connection 1-800-522-4372
http://www.hepc-connection.org
American Liver Foundation
http://www.liverfoundation.org
Nursing Center
http://www.nursingcenter.com
Hepatitis Foundation International 1-800-8910707
http://www.hepfi.org
Organizations
Alcoholics Anonymous World Services
475 Riverside Drive, 11th Floor
New York, NY 10115
Tel 212-870-3400
Contact to find a support group for alcoholics in your area.
American Digestive Health Foundation
7910 Woodmont Ave., Suite 700
Bethesda, MD 20814
Tel 301-654-2635
Fax 301-654-1140
American Gastroenterological Association
4930 Del Ray Ave.
Bethesda, MD 20814
Tel 301-654-2055
Fax 301-652-3890
American Liver Foundation
75 Maiden Lane
Suite #603
New York, NY 10038
1-800-GO-LIVER (465-4837); Jackie Spencer is the VA contact at ext. 134
1-888-4HEP-USA (443-7872)
Tel 212-668-1000
Fax 212-483-8179
[email protected]
Hep C Connections
1714 Poplar St.
Denver, CO 80220
Tel 303-393-9395
Fax 303-393-9358
Hep C Foundation
1502 Russett Drive
Warminster, PA 18974
Tel 215-672-2606
Fax 215-672-1518
Hepatitis Education Project
4603 Aurora Ave N.
Seattle, WA 98103
Tel 206-732-0311
http://www.hepeducation.org
Hepatitis Foundation International
30 Sunrise Terrace
Cedar Grove, NJ 07009
Tel 1-800-891-0707
Fax 973-857-5044
Society of Gastroenterology Nurses and Associates
401 North Michigan Ave.
Chicago, IL 60611-4267
Tel 1-800-245-7462
Fax 312-527-6658
Local Support Groups [Insert your local support groups here]
Suggested Reading
Dolan, Matthew. The Hepatitis C Handbook. Catalyst Press, 1997.Hepatitis
Management and Treatment, A Practical Guide for Patients, Family and
Friends(magazine).
Everson, G. and H. Weinberg. Living with Hepatitis C: A Survivors' Guide.
Hatherleigh Press, 1998.
Hepatitis Management & Treatment, A Practical Guide for Patients, Family and
Friends (magazine).
Maddrey, Willis C., M.D., and Eugene R. Schiff, M.D. eds. The Hepatitis
Workbook. A Guide to Living with Chronic Hepatitis B and C. Schering
Corporation, 2001.
National Family Caregivers Association, The Resourceful Caregiver. Mosby
Lifeline, 1996.
Pollin, Irene. Taking Charge: Overcoming the Challenges of Long-Term Illness.
MSW, and Susan K. Golant, Times Books, 1994.
Stolman, Marc D. A Guide to Legal Rights for People with Disabilities. Demos
Publications, 1994.
White, Barbara J. and Edward J. Madara. The Self-Help Source Book. Northwest
Covenant Medical Center, 1995.
About VA Programs in Hepatitis C
The Department of Veterans Affairs (VA) leads the country in hepatitis C screening,
testing, treatment, research, and prevention. VA is the largest single provider of medical
care to people with hepatitis C infection in the United States.
The National Hepatitis C Program works to ensure that veterans with or at risk for
hepatitis C receive the highest quality health care services from the VA system. Led by
the VA's Public Health Strategic Health Care Group (PHSHG) and carried out by VA
medical facilities across the country, the hepatitis C program has a comprehensive
approach to hepatitis C prevention and treatment that includes screening, testing and
counseling, patient and provider education, optimal clinical care, and management of data
to continuously improve program quality.
The Hepatitis C Resource Centers (HCRCs), a part of the National Hepatitis C Program,
develop best practices in clinical care delivery, patient education, provider education,
prevention, and program evaluation that can be used by the entire VA health care system
and other medical care systems. They function as field-based clinical laboratories for the
development, testing, evaluation, and dissemination of new and innovative products and
services for improving the quality of hepatitis C clinical care and education in every VA
medical facility.
VA provides extensive information on hepatitis C for health care providers, veterans and
their families, and the public at http://www.hepatitisc.va.gov.
User Feedback Form
The Hepatitis C Resource Center would like to hear from you about this edition of Initiating and
Maintaining a Hepatitis C Support Group: A “How-To” Program Guide. To share your opinions,
please complete this tear-out tri-fold page, fold it, and drop it in the mail. Your answers will be used to
inform development of future editions of this guide. Thank you!
1. Overall, how useful did you find this guide?
Very useful
Somewhat useful
Not at all useful
Yes
No
Yes
No
Yes
No
2. Did you find this guide to be:
a. Well organized?
If No, why not?
b. Easy to read?
If No, why not?
c. Up-to-date?
If No, why not?
3. Would you recommend this guide to other health care providers?
Yes
No
4. Which sections did you find most useful? Why?
5. What additional information would you like to have included in the guide?
6. What sections do you think should be left out of the guide?
7. Were there parts you thought were inaccurate? If so, please suggest changes:
8. How could this guide be improved?
9. What is your occupation?
10. Is there someone at your VA who would use this guide to start an HCV support group?
Yes, me
Yes, someone else
No, nobody
11. After reading the guide, how prepared do you feel to start your own HCV support group?
Very prepared
Somewhat prepared
Not at all prepared
12. What are the barriers to starting an HCV support group in your facility?
No staff
Other:
No time
Hard to identify patients/get
referrals
13. If there were someone at the HCRC to consult with on starting or running an HCV support group, would you contact
him/her?
Yes
No
Thank you for your time!
You may keep your responses anonymous, but
if you would not mind being contacted by the
HCRC for followup, would you please provide
the following?
Name:
Phone:
Email:
Northwest Hepatitis C Resource Center
VA Puget Sound Health Care System
1660 S. Columbian Way (S-152-HCRC)
Seattle, WA 98018
above is found
http://www.hepatitis.va.gov/vahep?page=tp0303-09-02
Cont rsch http://www.uchsc.edu/mpaetc/coinfection/
From board café: What do nps think X the ED titles
EXECUTIVE DIRECTOR? CEO? PRESIDENT?
In the last issue of the Board Cafe-the special issue for
staff executives-we asked for comments on the title of the
#1 staff person. Dozens of responses later, we can safely
conclude that there's no consensus. Some folks felt that
President or CEO is "more corporate," and conveys more
authority: "I had my Board change my title from Executive
Director to President/CEO . . . it's important to be on
the same level as other executives" (Steve Weisberg,
Miami). Herman Orcutt agreed: "In organizations where I
am a board member, we believe President or CEO gives our
executive director more credibility."
Others agreed that President or CEO is more corporatesounding, but didn't like the connotation: Claire
O'Connor (Hamline Midway Coalition) commented: "CEO has a
business connotation . . . I believe we should be proud of
being a different sector . . . Our ways of doing things
and talking about them are as important and we should be
careful to keep them separate. Several writers noted that
"President" confuses the top staff position with the head
of the volunteer board of directors.
Finally, several Board Cafe readers attacked pretentious
"title inflation" (Chuck Gleaves of the Kingwood Center in
Ohio). "I find the more down-to-earth the title is, the
better," wrote Helga Cook of Grove Cemetery. "I am
perfectly content with the position of Manager." And
Phyllis Haynes, Executive Director of the Arkansas
Foodbank Network, commented, "I find President and CEO
et.al. to be pretentious. I prefer Head Duck." As for me
at CompassPoint, I prefer Executive Director for myself .
. . it's nonprofit-like, understandable, and in line with
the most common practice.
LOOK UP YOUR ORGANIZATION
If you haven't already done so, take a look at
http://www.guidestar.org and find your organization's
mission and financial information, and make sure it's
accurate. You can also take a look at other similar
organizations in your area to find out their budget, top
salaries, names of board members, and program
accomplishments.
The last Board Cafe was our first special issue for
executive directors, and this issue we're back for board
members with a commentary on Sarbanes Oxley and its
applicability to nonprofits. I have to admit it's hard
not to resent the increased scrutiny of nonprofits when
there is more evidence of abuse-and with higher stakes-in
for-profit corporations and in government. Attorney Tom
Silk takes a wise stance below.
EXECUTIVE DIRECTOR? CEO? PRESIDENT?
In the last issue of the Board Cafe-the special issue for
staff executives-we asked for comments on the title of the
#1 staff person. Dozens of responses later, we can safely
conclude that there's no consensus. Some folks felt that
President or CEO is "more corporate," and conveys more
authority: "I had my Board change my title from Executive
Director to President/CEO . . . it's important to be on
the same level as other executives" (Steve Weisberg,
Miami). Herman Orcutt agreed: "In organizations where I
am a board member, we believe President or CEO gives our
executive director more credibility."
Others agreed that President or CEO is more corporatesounding, but didn't like the connotation: Claire
O'Connor (Hamline Midway Coalition) commented: "CEO has a
business connotation . . . I believe we should be proud of
being a different sector . . . Our ways of doing things
and talking about them are as important and we should be
careful to keep them separate. Several writers noted that
"President" confuses the top staff position with the head
of the volunteer board of directors.
Finally, several Board Cafe readers attacked pretentious
"title inflation" (Chuck Gleaves of the Kingwood Center in
Ohio). "I find the more down-to-earth the title is, the
better," wrote Helga Cook of Grove Cemetery. "I am
perfectly content with the position of Manager." And
Phyllis Haynes, Executive Director of the Arkansas
Foodbank Network, commented, "I find President and CEO
et.al. to be pretentious. I prefer Head Duck." As for me
at CompassPoint, I prefer Executive Director for myself .
. . it's nonprofit-like, understandable, and in line with
the most common practice.
LOOK UP YOUR ORGANIZATION
If you haven't already done so, take a look at
http://www.guidestar.org and find your organization's
mission and financial information, and make sure it's
accurate. You can also take a look at other similar
organizations in your area to find out their budget, top
salaries, names of board members, and program
accomplishments.
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This month's Main Course article is from attorney Tom
Silk, of Silk, Adler & Colvin in San Francisco.
Does Sarbanes-Oxley (SOX for short) apply to nonprofits?
SOX was passed in 2002 by Congress to apply to publicly
traded companies, in response to corporate scandals.
Since nonprofits are not publicly traded, SOX has not been
applied to nonprofits. In fact, many of the efforts to
reform for-profit corporate boards include provisions that
are already nearly universal in the nonprofit sector, such
as having a majority of board members who are not on
staff, or a finance committee with a majority of non-staff
members.
SARBANES OXLEY AND NONPROFITS
By THOMAS SILK
This article is in digest form; the full text and other
articles can be found at
http://www.silklaw.com.
In response to the corporate scandals at Enron, Arthur
Andersen, Global Crossing, and other major corporations,
Congress passed the Sarbanes-Oxley Act of 2002. Corporate
watchdog organizations and professional associations of
business and law have advocated and adopted more rigorous
best practice codes of corporate governance(1). Meanwhile,
the press has reported on scandals within the nonprofit
sector as well. So far nonprofit organizations have not
been the target of reform legislation by Congress. States
have been the first to act. New York's Attorney General
was first to propose legislation patterned after SarbanesOxley,(2) and in California SB 1262 has been introduced
(3).
My intent is not to hazard a prediction about the
likelihood of federal or state legislation or regulations
but to recognize and reflect the emergence of a
fundamental shift. Whether or not additional legislation
is enacted, community customs and practices are changing.
Moreover, a higher level of public expectation may prompt
increased media scrutiny of nonprofit sector
organizations.
The ten principles of governance are derived primarily
from four sources: the Sarbanes-Oxley Act and three
corporate governance codes published after the Act became
effective - the Report of the Task Force on Corporate
Responsibility of the American Bar Association; the
Findings and Recommendations of the Commission on Public
Trust and Private Enterprise of The Conference Board, and
Principles of Corporate Governance of The Business
Roundtable(4).
1. The board of directors of a nonprofit corporation must
engage in active, independent, and informed oversight of
the activities of the corporation, particularly those of
senior management.
2. Directors with information and analysis relevant to the
board's decision-making and oversight responsibilities are
obligated to disclose that information and analysis to the
board and not sit passively. Senior management
should recognize and fulfill an obligation to disclose to a supervising officer, to a committee of the board, or
to the board of directors - information and analysis
relevant to such person's decision making and oversight
responsibilities.
3. Every nonprofit corporation should have a
nominating/governance committee composed entirely of
directors who are not part of the (staff) management team.
The committee is responsible for nominating qualified
candidates to the board, monitoring all matters involving
corporate governance, overseeing compliance with ethical
standards, and making recommendations to the full board
for action in governance matters.
4. Every nonprofit corporation with substantial assets or
annual revenues should develop and implement a threetier annual board evaluation process whereby the
performance of the board as a whole, each board committee,
and each board member are evaluated annually. The board
should also develop and implement a process for
review and evaluation of the chief executive officer on an
annual basis.
5. Each board of directors is responsible for overseeing
corporate ethics, and consider the following actions: a)
communicate to all personnel a strong, ethical tone from
the top, b) adopt a Conflicts of Interest policy; c)
include ethics-related criteria in employee qualification
standards and in employees' annual performance reviews.
6. Every nonprofit corporation with substantial assets or
annual revenue should be audited annually by an
independent auditing firm.
7. The chief executive officer and the chief financial
officer of every nonprofit corporation should review Form
990 or Form 990-PF and other annual information returns
filed with federal and state agencies.
8. Any attorney providing legal services to a nonprofit
corporation who learns of evidence that indicates a
material breach of fiduciary duty or similar violation
shall report that evidence to the chief executive officer
of the nonprofit corporation and, if warranted by the
seriousness of the matter, to the board of directors.
9. Every nonprofit corporation should adopt a written
policy setting forth standards for document integrity,
retention, and destruction. Section 1102 of the SarbanesOxley Act provides that whoever alters or destroys any
document with the intent to obstruct the investigation or
proper administration of any matter within the
jurisdiction of any federal agency or department is guilty
of a felony. This provision applies to individuals within
nonprofit corporations as well as business corporations.
10. Every nonprofit corporation should adopt a written
policy to permit and encourage employees to alert
management and the board to ethical issues and potential
violations of law without fear of retribution. This is
based on Section 1107 of the Sarbanes-Oxley Act which
treats as a felony any discharge, demotion, or
harassment of any employee who provides to a law
enforcement official true information about the potential
commission of a federal offense. This provision also
applies to individuals within nonprofit corporations as
well as business corporations.
Editor's note: This article can help boards in three ways:
by reassuring them that Sarbanes-Oxley is not directly
applicable to nonprofits (except for principles 9 and 10),
by alerting us to principles that are likely to apply in
the future, and by making clear that however much the
precise governance provisions may vary from nonprofit to
nonprofit depending on the mission and size of the
charitable organization, there is one overarching
principle that does apply to every charity -- to ensure
that the conduct of its directors, officers, and employees
satisfies the highest ethical standard. This article and
others can be found at
http://www.silklaw.com.
(1) "Findings and Recommendations: Part 2 Corporate
Governance," Commission on Public Trust and Private
Enterprise (The Conference Board, 2003); "Principles of
Corporate Governance," (The Business Roundtable, 2002);
"Corporate Governance Practices," adopted by the American
Bar Association (2003).
(2) The Sarbanes Oxley Act, enacted on July 30, 2002,
imposes on publicly traded companies and their accountants
and lawyers new requirements designed to improve corporate
governance and thereby rebuild public trust in the
corporate sector.
(3) In January 2003, Attorney General Eliot Spitzer of New
York announced the introduction of legislation on
nonprofits similar to those enacted by Sarbanes-Oxley.
Attorney General's Legislative Program Bill # 02-03.
In
California, Attorney General Lockyer's staff developed a
legislative proposal which emerged as SB 1262, introduced
by Senator Sher on February 13, 2004.
(4) The four documents are available at the following
websites -
http://www.findlaw.com; http://www.abanet.org;
http://www.conference-board.org; and http://www.brt.org.
Related articles in previous Board Cafe issues, available
in The Best of the Board Cafe
(http://www.compasspoint.org) or free online at
http://www.boardcafe.org:
Sample Conflict of Interest Policy, January 2000
Self-Assessment Survey for the Board, May 2000
Board-Staff Contract for Financial Accountability,
November 2000
Governance Committees, March 2003
Next month in the Board Cafe: Sample Code of Ethics and
Sample Conflict of Interest Policy
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You are reading the BOARD CAFE, published monthly by
CompassPoint Nonprofit Services: 706 Mission Street, 5th
Floor, San Francisco, CA 94103; (phone) 415-541-9000;
(fax) 415-541-7708; Silicon Valley office: 1922 The
Alameda, San Jose, CA 95126; (phone) 408-248-9505; (email) [email protected], (website)
http://www.compasspoint.org/index.html. We welcome your
comments and contributions to the BOARD CAFE. If you would
like to have the BOARD CAFE delivered to you free via
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CompassPoint Nonprofit Services does not rent, exchange or
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list. We keep this information confidential.
If you value the material in the Board Cafe, please
consider making a donation to help keep it growing and
free-you can donate at
http://www4.compasspoint.org/p.asp?WebPage_ID=583.
If you are interested in joining a board, or if the board
you are on is interested in recruiting new members, see
BoardNetUSA, a partner of the Board Cafe, at
http://www.boardnetusa.org.
(c) 2004 CompassPoint Nonprofit Services
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NEW FEATURE: The Board Cafe Emporium
Different items each issue . . . and many are free
Strategic Planning for Nonprofit Organizations, a
Practical Guide and Workbook. Bestseller by
CompassPoint's Mike Allison and Jude Kaye. $39.95 +
shipping and handling at
http://www.compasspoint.org/bookstore or
http://www.amazon.com.
BoardNetUSA.org: this national, on-line service is now
open to Board Cafe subscribers. If you're looking for a
new board to join, you can "shop" here for nonprofits in
your area seeking board members. And if your board is
looking for new members, you can "advertise" here for
candidates.
http://www.boardnetusa.org
Nonprofit Genie: A free, excellent series of Frequently
Asked Questions and answers about fundraising, written by
the legendary fundraiser Kim Klein. http://www.genie.org,
then click on "FAQs" then on "Fundraising."
NetworkForGood: Quick and free way to make it possible for
people to make donations to you via the web. This site's
corporate sponsors make this service free. Don't expect
to get lots of money just by having this capacity, but if
you already have a website, you should add this feature.
QuickBooks for Not-For-Profit Organizations, by Christine
Manor and the Sleeter Group. $49 + shipping and handling.
http://www.compasspoint.org/quickbooks
Water Troubles Cause Mexico City to Sink
Mexico City is sinking -- in some areas, by as much as a foot a year, and altogether by about 30
feet over the past century. The sprawling, smoggy metropolis -- more than double the size of
greater London -- has been depleting the aquifer on which it was built, and that aquifer is now
collapsing. To meet current demand for 10.5 million gallons of water a day, the city pumps water
from two nearby river basins at a cost of some $50,000 a day for water rights alone. The sinking
city also puts massive stress on the network of water distribution and drainage systems that
spiderweb beneath it, which routinely crack, leading to a loss of around 40 percent of potable
water. The city must also now pump its sewage uphill before it can be drained into the Gulf of
Mexico. The smog-shrouded city's water troubles are a sign of things to come for the world's
metastasizing megacities. According to UNESCO, 7 billion people from 60 countries could face
water shortages by 2050.
straight to the source: The Independent, Tim Gaynor, 30 Apr 2004
<http://www.gristmagazine.com/cgi-bin/forward.pl?forward_id=2392>
Michael L. Edwards
> Virginia Municipal League
> P.O. Box 12164
> Richmond, Virginia 23241
> 804/649-8471
> 804/343-3758 (F)
> 804/400-1191 (C)
> [email protected]
>
Feds to Consider Hatchery Salmon Along with Wild in Protection Plans
When considering what measures to take to protect threatened Pacific salmon under the
Endangered Species Act, the federal government will, in a sharp break from years of policy, take
into account the number of hatchery salmon in the West's rivers. The decision, contained in a
draft document and confirmed by federal officials, is expected to inform policy as early as this
summer. The controversy over whether hatchery salmon are a legitimate substitute for wild
salmon, sparked by a 2001 court ruling that the Bush administration failed to appeal, draws an
unusually sharp line between science and politics. On the science side: Six leading experts on
salmon ecology wrote an article last month in the journal Science arguing that hatchery fish
should not be counted, and contending that their recommendations had been suppressed by
federal officials. On the politics side: Some groups that have supported the Bush administration - including utilities, timber companies, agriculture interests, and developers -- don't much like
strict salmon-protection rules.
straight to the source: The Washington Post, Blaine Harden, 29 Apr 2004
<http://www.gristmagazine.com/cgi-bin/forward.pl?forward_id=2384>
straight to the source: The Oregonian, Michael Milstein and Joe Rojas-Burke, 29 Apr 2004
<http://www.gristmagazine.com/cgi-bin/forward.pl?forward_id=2385>
A capital idea -- how to make capitalism lean, green, and nice -- by Paul Hawken, Amory Lovins,
and L. Hunter Lovins
<http://www.gristmagazine.com/books/books022200.asp?source=daily>
www.scotlandonsunday.scotscman.com offers:
If you would like to purchase prints of our best photos then please visit the
Scotsman.com Photo Gallery.
Scotsman.com Photo Gallery
We are delighted to offer you a selection of images from our archives, covering a wide range of
people, places and events in and around Scotland.
For copyright reasons we are unable to put all images on the photogallery and for any queries
regarding any images not on our site please contact us.
Picture sizes are: 12 x 8" (30 x 20cm) and 16 x 12" (40 x 30cm) - sizes are approximate.
Copyright watermarks are on the image for Internet protection only and will not appear on the final
photograph.
Look at the thumbnail pictures below or use the Search facility on the left. If you are in any doubt
of how to use this site,
please contact us.
Copyright: Photographs are sold for private use only and are not available as screensavers or
postcards. Please contact us if you wish to copy or reproduce ([email protected]).
Email: [email protected]
Telephone: +44 (0)131 620 8838/8278/8279
Fax: +44 (0)131 523 0329
Or write to:
Syndication
The Scotsman Publications Ltd.
Barclay House
108 Holyrood Road
EDINBURGH
EH8 8AS
Scotland
Rsch: www.pressnow.co.uk
sales, circulation, readership & advertising of the
www.sundayherald.com
FASTEST GROWING READERSHIP - of any Sunday newspaper in Scotland. Our readership has increased 16% year on year - twice the rate
of Scotland on Sunday.
MORE READERS THAN THE SUNDAY TIMES - after only four years in circulation, we have more readers in Scotland than the Sunday
Times!
MAXIMUM COVERAGE - In Scotland, The Herald and Sunday Herald combined has 20,000 more readers than The Scotsman and Scotland
on Sunday combined.
EVERYTHING YOU WANT FROM A SUNDAY NEWSPAPER - The Sunday Herald was rated the main newspaper people would prefer to read
if they were looking for a paper that "gives you everything you want from a Sunday paper".
BEST READ QUALITY IN STRATHCLYDE - We have 130,000 readers in Strathclyde - twice as many as Scotland on Sunday (54,000) and
the Sunday Times (70,000).
YOUNGEST SUNDAY AUDIENCE - 40% of our readers are under 35, and 55% are under 40 - higher than any UK Sunday newspaper.
NUMBER 1 IN THE CENTRAL BELT - Across the Central Belt of Scotland (where 66% of Scots live and include Edinburgh and Glasgow),
the Sunday Herald is THE paper of choice. We reach 172,000 readers in this area - the SoS reaches just 151,000 and the Sunday Times
just 116,000.
AFFLUENT - our readers have an average household income of £26,244 - the Scottish average is £18,894.
AVID SHOPPERS - Our readers spend £81 a week on shopping - more than any other Sunday newspaper in the UK.
A RECEPTIVE AUDIENCE - our readers are more likely to be tempted to buy products they see advertised than Scotland on Sunday and
Sunday Times readers.
MORE READERS - In Scotland, we deliver more readers planning to move home, change job and buy a new car in the next six months
than the Scotland on Sunday and the Sunday Times.
UNIQUE AUDIENCE - 135,000 (65%) of Sunday Herald readers do not read another Sunday broadsheet - we are their first and only choice
when looking for a quality read on a Sunday.
Sources : ABC July - December 02; NRS Apr '02 - Mar '03/Apr '01 - Mar '02; TGI April '00 - March '02; NFO Europe Sept 02; * The Drum
Newspaper of the Year Awards May 2003
http://www.opm.gov/cfc/
1900 E Street NW, Washington, DC 20415-1000 | (202) 606-1800
PCFO and LFCC Contact Information
The Office of Personnel Management maintains an up to date data base of
CFC's. To help keep the information on the data base current please forward via
fax (202/606-5056) or e-mail ([email protected]) any and all changes to the PCFO or
LFCC contact information. It is imperative that OPM maintains an up to date
data base of all CFC's. Do not wait to be contacted by OPM. As soon as you
have any changes forward them to OPM immediately. Thank you for your
attention to this request.
Note: All campaign expansions and mergers must be approved by OPM in
writing.
Introduction to CFC
The Combined Federal Campaign (CFC) is the annual fund-raising drive
conducted by Federal employees in their workplace each fall. Each year Federal
employees and military personnel raise millions of dollars through the CFC that
benefits thousands of non-profit charities. This page has been developed to
assist charitable organizations and other interested parties who seek information
about or who have questions regarding the Combined Federal Campaign (CFC).
The Office of CFC Operations at the Office of Personnel Management (OPM) is
responsible for oversight of the CFC. The Office of CFC Operations is located at
1900 "E" Street, NW, Room 5450, Washington, DC 20415. 202/606-2564, Fax
202/606-5056.
Office of CFC Operations Mission Statement
To promote and support philanthropy through a program that is employee
focused, cost-efficient, and effective in providing all federal employees the
opportunity to improve the quality of life for all.
Vision Statement
A government that encourages and enables active employee participation in
community and that fosters collaboration with business and the nonprofit sector
to achieve this goal.
http://www.cfcoverseas.org/
CFC Message
The information here is provided by the Office of CFC Operations at the Office of
Personnel Management (OPM) which is responsible for oversight of the CFC.
The CFC Story
With a tradition of commitment to the community through the selfless efforts of
Federal employees, the CFC has its roots in the many charitable campaigns of
the early 1960's. Seeing a need to bring the diversity of fundraising efforts under
one umbrella, Federal employees created the CFC--one campaign, once a year.
By allowing employees to select the organizations of their choice from a single
brochure and to make their contributions through payroll deductions, the CFC
opened wide the door to more opportunities for generous giving to literally
hundreds of worthy causes. An Executive Order made the CFC a reality, and
turned an innovative idea into a uniquely effective way for Federal employees to
help those in need across our community and throughout the world. The CFC is
the only authorized solicitation of employees in the Federal workplace on behalf
of charitable organizations. It continues to be the largest and most successful
workplace fundraising model in the world.
Visit the CFC Homepage
For information about the CFC, visit the CFC Home Page at www.opm.gov/cfc .
Fair Housing--it's Your Right
HUD has played a lead role in administering the Fair Housing Act since its adoption in
1968. The 1988 amendments, however, have greatly increased the Department's
enforcement role. First, the newly protected classes have proven significant sources
of new complaints. Second, HUD's expanded enforcement role took the Department
beyond investigation and conciliation into the area of mandatory enforcement.
Complaints filed with HUD are investigated by the Office of Fair Housing and Equal
Opportunity (FHEO). If the complaint is not successfully conciliated, FHEO
determines whether reasonable cause exists to believe that a discriminatory housing
practice has occurred. Where reasonable cause is found , the parties to the complaint
are notified by HUD's issuance of a Determination, as well as a Charge of
Discrimination, and a hearing is scheduled before a HUD administrative law judge.
Either party - complainant or respondent - may cause the HUD-scheduled
administrative proceeding to be terminated by electing instead to have the matter
litigated in Federal court. Whenever a party has so elected, the Department of
Justice takes over HUD's role as counsel seeking resolution of the charge on behalf of
aggrieved persons, and the matter proceeds as a civil action. Either form of action the ALJ proceeding or the civil action in Federal court - is subject to review in the
U.S. Court of Appeals.
Significant Recent Changes
1. The Housing for Older Persons Act of 1995 (HOPA) makes several changes to
the 55 and older exemption. Since the 1988 Amendments, the Fair Housing
Act has exempted from its familial status provisions properties that satisfy the
Act's 55 and older housing condition.
First, it eliminates the requirement that 55 and older housing have "significant
facilities and services" designed for the elderly. Second, HOPA establishes a
"good faith reliance" immunity from damages for persons who in good faith
believe that the 55 and older exemption applies to a particular property, if
they do not actually know that the property is not eligible for the exemption
and if the property has formally stated in writing that it qualifies for the
exemption.
HOPA retains the requirement that senior housing must have one person who
is 55 years of age or older living in at least 80 percent of its occupied units. It
also still requires that senior housing publish and follow policies and
procedures that demonstrate an intent to be housing for persons 55 and
older.
An exempt property will not violate the Fair Housing Act if it includes families
with children, but it does not have to do so. Of course, the property must
meet the Act's requirements that at least 80 percent of its occupied units
have at least one occupant who is 55 or older, and that it publish and follow
policies and procedures that demonstrate an intent to be 55 and older
housing.
A Department of Housing and Urban Development rule published in the April
2, 1999, Federal Register implements the Housing for Older Persons Act of
1995, and explains in detail those provisions of the Fair Housing Act that
pertain to senior housing.
2. Changes were made to enhance law enforcement, including making
amendments to criminal penalties in section 901 of the Civil Rights Act of
1968 for violating the Fair Housing Act.
3. Changes were made to provide incentives for self-testing by lenders for
discrimination under the Fair Housing Act and the Equal Credit Opportunity
Act. See Title II, subtitle D of the Omnibus Consolidated Appropriations Act,
1997, P.L. 104 - 208 (9/30/96).
Basic Facts About the Fair Housing Act
What Housing Is Covered?
The Fair Housing Act covers most housing. In some circumstances, the Act exempts
owner-occupied buildings with no more than four units, single-family housing sold or
rented without the use of a broker, and housing operated by organizations and
private clubs that limit occupancy to members.
What Is Prohibited?
In the Sale and Rental of Housing: No one may take any of the following actions
based on race, color, national origin, religion, sex, familial status or handicap:

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Refuse to rent or sell housing
Refuse to negotiate for housing
Make housing unavailable
Deny a dwelling
Set different terms, conditions or privileges for sale or rental of a dwelling
Provide different housing services or facilities
Falsely deny that housing is available for inspection, sale, or rental
For profit, persuade owners to sell or rent (blockbusting) or
Deny anyone access to or membership in a facility or service (such as a
multiple listing service) related to the sale or rental of housing.
In Mortgage Lending: No one may take any of the following actions based on race,
color, national origin, religion, sex, familial status or handicap (disability):

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Refuse to make a mortgage loan
Refuse to provide information regarding loans
Impose different terms or conditions on a loan, such as different interest
rates, points, or fees
Discriminate in appraising property
Refuse to purchase a loan or
Set different terms or conditions for purchasing a loan.
In Addition: It is illegal for anyone to:

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Threaten, coerce, intimidate or interfere with anyone exercising a fair housing
right or assisting others who exercise that right
Advertise or make any statement that indicates a limitation or preference
based on race, color, national origin, religion, sex, familial status, or
handicap. This prohibition against discriminatory advertising applies to singlefamily and owner-occupied housing that is otherwise exempt from the Fair
Housing Act.
Additional Protection if You Have a Disability
If you or someone associated with you:
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Have a physical or mental disability (including hearing, mobility and visual
impairments, chronic alcoholism, chronic mental illness, AIDS, AIDS Related
Complex and mental retardation) that substantially limits one or more major
life activities
Have a record of such a disability or
Are regarded as having such a disability
your landlord may not:
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Refuse to let you make reasonable modifications to your dwelling or common
use areas, at your expense, if necessary for the disabled person to use the
housing. (Where reasonable, the landlord may permit changes only if you
agree to restore the property to its original condition when you move.)
Refuse to make reasonable accommodations in rules, policies, practices or
services if necessary for the disabled person to use the housing.
Example: A building with a "no pets" policy must allow a visually impaired tenant to
keep a guide dog.
Example: An apartment complex that offers tenants ample, unassigned parking must
honor a request from a mobility-impaired tenant for a reserved space near her
apartment if necessary to assure that she can have access to her apartment.
However, housing need not be made available to a person who is a direct threat to
the health or safety of others or who currently uses illegal drugs.
Requirements for New Buildings
In buildings that are ready for first occupancy after March 13, 1991, and have an
elevator and four or more units:
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Public and common areas must be accessible to persons with disabilities
Doors and hallways must be wide enough for wheelchairs
All units must have:
o An accessible route into and through the unit
o Accessible light switches, electrical outlets, thermostats and other
environmental controls
o Reinforced bathroom walls to allow later installation of grab bars and
o Kitchens and bathrooms that can be used by people in wheelchairs.
If a building with four or more units has no elevator and will be ready for first
occupancy after March 13, 1991, these standards apply to ground floor units.
These requirements for new buildings do not replace any more stringent standards in
State or local law.
Housing Opportunities for Families
Unless a building or community qualifies as housing for older persons, it may not
discriminate based on familial status. That is, it may not discriminate against families
in which one or more children under 18 live with:

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A parent
A person who has legal custody of the child or children or
The designee of the parent or legal custodian, with the parent or custodian's
written permission.
Familial status protection also applies to pregnant women and anyone securing legal
custody of a child under 18.
Exemption: Housing for older persons is exempt from the prohibition against familial
status discrimination if:
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The HUD Secretary has determined that it is specifically designed for and
occupied by elderly persons under a Federal, State or local government
program or
It is occupied solely by persons who are 62 or older or
It houses at least one person who is 55 or older in at least 80 percent of the
occupied units, and adheres to a policy that demonstrates an intent to house
persons who are 55 or older.
A transition period permits residents on or before September 13, 1988, to continue
living in the housing, regardless of their age, without interfering with the exemption.
If You Think Your Rights Have Been Violated
HUD is ready to help with any problem of housing discrimination. If you think your
rights have been violated, the Housing Discrimination Complaint Form is available for
you to download, complete and return, or complete online and submit, or you may
write HUD a letter, or telephone the HUD Office nearest you. You have one year after
an alleged violation to file a complaint with HUD, but you should file it as soon as
possible.
What to Tell HUD:
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Your name and address
The name and address of the person your complaint is against (the
respondent)
The address or other identification to the housing involved
A short description to the alleged violation (the event that caused you to
believe your rights were violated)
The date(s) to the alleged violation
Where to Write or Call:
Send the Housing Discrimination Complaint Form or a letter to the HUD Office
nearest you or you may call that office directly.
If You Are Disabled:
HUD also provides:
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A toll-free TTY phone for the hearing impaired: 1-800-927-9275.
Interpreters
Tapes and braille materials
Assistance in reading and completing forms
What Happens when You File a Complaint?
HUD will notify you when it receives your complaint. Normally, HUD also will:

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Notify the alleged violator of your complaint and permit that person to submit
an answer
Investigate your complaint and determine whether there is reasonable cause
to believe the Fair Housing Act has been violated
Notify you if it cannot complete an investigation within 100 days of receiving
your complaint
Conciliation
HUD will try to reach an agreement with the person your complaint is against (the
respondent). A conciliation agreement must protect both you and the public interest.
If an agreement is signed, HUD will take no further action on your complaint.
However, if HUD has reasonable cause to believe that a conciliation agreement is
breached, HUD will recommend that the Attorney General file suit.
Complaint Referrals
If HUD has determined that your State or local agency has the same fair housing
powers as HUD, HUD will refer your complaint to that agency for investigation and
notify you of the referral. That agency must begin work on your complaint within 30
days or HUD may take it back.
What if You Need Help Quickly?
If you need immediate help to stop a serious problem that is being caused by a Fair
Housing Act violation, HUD may be able to assist you as soon as you file a complaint.
HUD may authorize the Attorney General to go to court to seek temporary or
preliminary relief, pending the outcome of your complaint, if:

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Irreparable harm is likely to occur without HUD's intervention
There is substantial evidence that a violation of the Fair Housing Act occurred
Example: A builder agrees to sell a house but, after learning the buyer is black, fails
to keep the agreement. The buyer files a complaint with HUD. HUD may authorize
the Attorney General to go to court to prevent a sale to any other buyer until HUD
investigates the complaint.
What Happens after a Complaint Investigation?
If, after investigating your complaint, HUD finds reasonable cause to believe that
discrimination occurred, it will inform you. Your case will be heard in an
administrative hearing within 120 days, unless you or the respondent want the case
to be heard in Federal district court. Either way, there is no cost to you.
The Administrative Hearing:
If your case goes to an administrative hearing HUD attorneys will litigate the case on
your behalf. You may intervene in the case and be represented by your own attorney
if you wish. An Administrative Law Judge (ALA) will consider evidence from you and
the respondent. If the ALA decides that discrimination occurred, the respondent can
be ordered:
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To compensate you for actual damages, including humiliation, pain and
suffering.
To provide injunctive or other equitable relief, for example, to make the
housing available to you.
To pay the Federal Government a civil penalty to vindicate the public interest.
The maximum penalties are $10,000 for a first violation and $50,000 for a
third violation within seven years.
To pay reasonable attorney's fees and costs.
Federal District Court
If you or the respondent choose to have your case decided in Federal District Court,
the Attorney General will file a suit and litigate it on your behalf. Like the ALA, the
District Court can order relief, and award actual damages, attorney's fees and costs.
In addition, the court can award punitive damages.
In Addition
You May File Suit: You may file suit, at your expense, in Federal District Court or
State Court within two years of an alleged violation. If you cannot afford an attorney,
the Court may appoint one for you. You may bring suit even after filing a complaint,
if you have not signed a conciliation agreement and an Administrative Law Judge has
not started a hearing. A court may award actual and punitive damages and
attorney's fees and costs.
Other Tools to Combat Housing Discrimination:
If there is noncompliance with the order of an Administrative Law Judge, HUD may
seek temporary relief, enforcement of the order or a restraining order in a United
States Court of Appeals.
The Attorney General may file a suit in a Federal District Court if there is reasonable
cause to believe a pattern or practice of housing discrimination is occurring.
GRIST Mag’s May fundraising effort
Haiku Hullabaloo is a greentastic way to exercise your creativity and donate to Grist at the
same time. And now through May 17, as part of our spring fundraiser, we have a generous
matching grant of $40,000 on the table, so every gift counts twice.
With the high-stakes November election approaching, it's never been more important to draw
attention to the environmental challenges facing our country and the world -- and Grist
has been gearing up for the task.
In the last year we've:

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ramped up our political reporting, launching our Muckraker column so that no Beltway
eco-development flies under the radar;
produced a special edition on the upcoming presidential election;
interviewed everyone from John Kerry to Robert Redford to Bush administration officials;
and
all the while, continued our tireless daily and weekly email coverage of the world's
breaking environmental news.
In coming months, we'll be putting on the afterburners.
Here's how the Haiku Hullabaloo works:
1. You make a tax-deductible donation
But we need your help.
to Grist, a 501(c)(3) nonprofit.
2. You get the chance to compose a haiku on the subject of your choice -- we suggest
Grist- or earth-related themes -- and submit it with your donation. (If donating online gives
you the creeps, you can mail a check and a poem to: Grist Magazine, 811 First Ave.,
Suite 466, Seattle, WA 98104.)
3. We publish the best haikus and you, dear readers, vote on your favorite.
4. The winner is immortalized on ... wait for it ... the very first Official Grist T-shirt! You
know the hippest kids on your block are going to want one.
5. Of course, if you simply want to donate and aren't inspired to compose a poem, that's fine
by us. But who doesn't want to write haiku? It's a hullabaloo, for Pete's sake!
For those hazy on the haiku form, we quote: "an unrhymed verse form of Japanese origin having
three lines containing five, seven, and five syllables respectively." Like so:
"Environmental"
takes five of our syllables;
none left to beg funds.
Our fundraising drives don't drag on and on like some we could mention. This one will be over on
May 17. So please make
flowing.
With gratitude,
The Grist staff
a gift, have your donation doubled, and get those creative juices
[email protected] is PLAIN TALK: Whistle-blower culture will encourage flow of
Brendan Pereira
May 02: BURIED in the bowels of the National Integrity Plan is a real gem of an idea
If nurtured, protected and allowed to grow, it will be more effective in keeping Malaysians on the straight and narrow than any
number of Anti-Corruption Agency officers could.
The plan to create a whistle-blower culture among civil servants could not have come at a better time.
It will encourage the flow of good, honest feedback which is critical to Prime Minister Datuk Seri Abdullah Ahmad Badawi's vision of
a clean Malaysia.
In theory, whistle-blowers feel dutybound to report any reasonable suspicion of abuse of power, acts of corruption or other
shenanigans to the authorities, no matter how low they are on the food chain.
That is why former New York Police Department detective Jeff Baird had come forward in the 1990s to inform a special commission
about cover-ups within the internal affairs division, where he worked.
Using a codename, he produced documents and witnesses to show that the division hid cases that might embarrass the police
force.
This is also why Sherron Watkins alerted then Enron chairman Kenneth Lay and others that the company was mired in dubious
accounting activities.
She hand-delivered her six-page warning to Lay on Aug 22, 2001. In it, she questioned the use of outside partnerships, run by
Enron executives, to keep hundreds of millions of dollars in debt off the mother company's books.
There is no such culture here.
Why? Because traditionally Malaysians are cowed by authority and position, and possibly, because many feel that the whistleblower is more likely to be branded a rat and exterminated by those higher up in the chain of command.
But there is a fighting chance for the culture to take root today.
Kota Baru MP Datuk Zaid Ibrahim says: "People want to have a say in how government is run. I believe there are more people
willing to be politically incorrect. And that is good." The Prime Minister's desire to hear the truth should also encourage the
whistleblowing culture, he adds.
Still, much more is needed before Malaysians become the eyes and ears of the system. Whistle-blowers must feel admired, not
detested.
For a start, there must be a legal framework to protect employees.
They must be protected from retaliation for reporting illegal acts of their employers. This protection applies as long as the civil
servant reasonably believes that the higher-up had committed an illegal act.
Also, for the culture of speaking out to flourish, Malaysians need to drop their love affair of shooting the messenger rather than
addressing the issue.
Some Opposition politicians have been guilty of this just after the general election. When it was suggested that their poor showing
at the polls was the result of rejection by voters, rather than the alleged shenanigans of the Election Commission, the comeback
was a shower of vitriol on the messenger.
There was no willingness to put the alternative views through the wash, dry and tumble cycle of examination.
Even harder to fathom is the reaction of some ruling coalition politicians and government officials.
They own one of the strongest mandates in Asia. Let us just examine some of the numbers: 198 out of 219 parliamentary seats
and 452 of the 505 state seats, translating to nearly 65 per cent of the popular vote.
In short, they are secure.
Yet, instead of finding out whether there is validity in the criticism of a policy or allegation of wrongdoing, the natural tendency is
to question the motive of the person who raised the red flag.
Maybe it is the easier path to take.
But this culture of shooting the messenger first is debilitating. It prevents vigorous examination of policies and allows those with
much to hide to get away.
In the longer term, it will scare off more people from being whistle-blowers.
There is only one loser if this happens: Malaysia.
THE NEW STRAITS TIMES
HEADQUARTERS www.nst.com.my
Balai Berita 31, Jalan Riong, 59100 Bangsar, Wilayah Persekutuan, MALAYSIA
Tel: 6-03-2282-3322 Fax: 6-03-2282-1434
Enroll and enrich your web site and your portal contents by participating in NSTP
e-Media Affiliate Program. This Affiliate Program is for web sites and portal sites
that are interested in hyperlinking news headlines that are published in NSTP eMedia web site on daily basis. In additions to the terms and conditions, the web
sites and portal sites shall comply to the following:

The affiliates shall retrieve headlines for daily news update from a specific
site which will be given after registration

The affiliates shall link the headlines to the full-text news that are residing
in NSTP e-Media web site
Join the Travelers Aid Network
We invite you to join Travelers Aid International. If you are a community social
service organization that deals with individuals and families in crisis; particularly if
you provide transportation assistance - TAI is the network for you. If you are an
airport that provides information, directions and helpful assistance to travelers
that are disconnected from their support systems, TAI is the network for you.
Membership benefits include:











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25% discount on bus travel - in partnership with Greyhound Lines
Pre-paid telephone calling cards - in partnership with AT&T
Discount for Annual Leadership Conference
Member Updates on issues of interest
Listserv to share professional issues/concerns with colleagues
Annual competition for $1000 NOD grant
Technical Assistance and referral services
Participation in a professional network
Agency information on the TAI Web Site
Web "home page" created and hosted for your Travelers Aid program
Listing in Travelers Aid Directory of Programs and Services
Use of Travelers Aid service mark
http://www.travelersaid.org/
If you are with a non-profit organization in a community that needs a Travelers Aid program, we
have a helpful guide to developing a Travelers Aid Transportation Assistance program. We would
be happy to share it with you.
Travelers Aid International is the NETWORK for member agencies and programs, and does not
provide direct client assistance. Please check the DIRECTORY link to find a Travelers Aid
program near you. If you are in a community that does not have a Travelers Aid program, you
might want to check with a governmental social service agency (local, county, or state
government) or consult a list of non-profit human service providers in your community that might
be able to help you.
If you would like to contact Travelers Aid International for information, please send e-mail to:
[email protected]. Most inquiries will be answered within 48 hours. Be sure to include
information regarding where you are located, as that will be helpful in making a referral.
www.deresource.org the Distance Education Resource
- Choose a Course of Study Accounting
Accounting related
Accounting technician
Acoustics
Administration of special education
Administrative and secretarial services
Adult/continuing education
Adult/continuing education administration
Advertising
The U.S. News E-Course Finder is One of the Best
The U.S. News & World Report Magazine www.usnews.com has single
handedly created the college ranking industry. Did you know that they also offer
an E-learning course and degree finder for distance learning courses, certificates
and degrees? Enter either an institution name or use the Advanced Search
option to get a customized list of schools that match your particular needs.
Copyright © 2004 U.S. News & World Report, L.P.
Instructional delivery modes
Audio
Open broadcast
CD-ROM
Satellite (Analog or Digital)
Compressed video
Videotape
Computer-aided instruction
Voice mail
E-mail
WWW/Internet
About the E-learning directory
The number of institutions offering courses and degrees taught via E-learning technologies grows
rapidly every month. To help you navigate this expanding universe, we've created a searchable
directory of E-learning providers–institutions that offer courses, certificates, and degrees via
Internet, video, CD-ROM, and other distance-education technologies.
Method of data collection
In the summer and fall of 2003, U.S. News surveyed over 2,000 traditional colleges in addition to
several online entities ("virtual universities"). Institutions reported their credit-granting E-learning
offerings for the 2002-2003 academic year. All institutions that we surveyed have at least two
characteristics in common: They are all regionally accredited and offer E-learning courses for
credit. Some of the instutitions, particularly those that offer online graduate degrees, are also
professionally accredited by an appropriate association (depending on the discipline).
Each institution that responded to our survey has a page in the directory. In addition, we have
created separate pages for online graduate degree programs in five disciplines: business,
engineering, education, public health, and library science. These online graduate degree program
profiles are also accessible from the main E-learning directory.
In the main directory, we've included schools that responded to our survey even though they did
not offer any credit-granting E-learning offerings in 2002-2003, as some may find this information
helpful.
To learn about how we use such terms as "distance education," "online education," and "Elearning," please consult our glossary.
Links to several : May 03, 2004
Google IPO Case Study
A great way to learn about IPOs is to follow the developments of a company
going public. The Google IPO is a timely story, so it is an opportunity for you to
see an IPO in action. You can treat the Google IPO as a fun case study -remember those from your school days? One site that you can use for a launch
point is Google IPO Central. You can find out the latest news and see what steps
the company is taking to go public.
Rsc http://www.gopublictoday.com/
Arild Trent (E-mail)" <[email protected]>, "Beverly Britt (E-mail)" <[email protected]>, "Bill Brittow (E-mail)" <[email protected]>,
"Chandra Smith (E-mail)" <[email protected]>, "Charles H. Garrette (E-mail)" <[email protected]>, "Charlotte Edwards (Email)" <[email protected]>, "David Sacks (E-mail)" <[email protected]>, "David Sacks (E-mail)" <[email protected]>, "Dwight
Hilton (E-mail)" <[email protected]>, "Ed Parks (E-mail)" <[email protected]>, "Elaine Wittel (E-mail)" <[email protected]>, "Gail
Lipscomb (E-mail)" <[email protected]>, "Greg Tucker (E-mail)" <[email protected]>, "Harris B. Wheeler (E-mail)" <[email protected]>,
"Hilda Braswell (E-mail)" <[email protected]>, "HRRAPP (E-mail)" <[email protected]>, "Irene Jennings (E-mail)" <[email protected]>, "John
Burgess (E-mail)" <[email protected]>, "John Butcher (E-mail 2)" <[email protected]>, "John Butcher (E-mail)"
<[email protected]>, "Johnson, W. Randolph - City Council" <[email protected]>, "Kimberly Tucker (E-mail)"
<[email protected]>, "Lynch, Charles E. - DCD" <[email protected]>, "Magdalene Mitchell (E-mail)" <[email protected]>, "Meg
Lawrence (E-mail)" <[email protected]>, "Myrtle Armstrong (E-mail)" <[email protected]>, "Neil Turnage (E-mail)" <[email protected]>,
"Norma Murdoch-Kitt (E-mail)" <[email protected]>, "Pat Hudgins (E-mail)" <[email protected]>, "Ralph Cheatham (E-mail)"
<[email protected]>, "Raymond Turner (E-mail)" <[email protected]>, "Roberta Kyle West (E-mail)" <[email protected]>, "Roberts,
Patrick G. - CMO" <[email protected]>, "Robinson, Norvell - Council Liaison" <[email protected]>, "Tariq Waajid (E-mail)"
<[email protected]>, "Theresa Jefferson (E-mail)" <[email protected]>, "Thomas James (E-mail)" <[email protected]>, "Tim Pfohl
(E-mail)" <[email protected]>, "Vanessa Johnson (E-mail)" <[email protected]>, "Wilbert H. Ware Sr. (E-mail)"
<[email protected]>, "Carolyn Worssam (E-mail)" <[email protected]>, "Deborah Earley (E-mail)" <[email protected]>,
"Denise Wise (E-mail)" <[email protected]>, "Dianna Herndon (E-mail)" <[email protected]>, "Dunlap, Douglas C. - EDI"
<[email protected]>, "Ellen Robertson (E-mail)" <[email protected]>, "Floyd Johnson (E-mail)" <[email protected]>,
"Hope Harris (E-mail)" <[email protected]>, "McQuinn, Delores - Vice Mayor" <[email protected]>, "Patterson, Samuel -
Council Liaison" <[email protected]>, "Sandra Coles (E-mail)" <[email protected]>, "Torey Edmonds (E-mail)"
<[email protected]>, "Armentrout, Kevin L. - Rec/Park" <[email protected]>, "Barbour, Malcolm D. - Rec/Park"
<[email protected]>, "Betsy Gardner (E-mail)" <[email protected]>, "Bonny Hamrick (E-mail)" <[email protected]>, "Claire
Shaffner (E-mail)" <[email protected]>, "Connie Miller (E-mail)" <[email protected]>, "David Ballard (E-mail)" <[email protected]>,
"David Martin (E-mail)" <[email protected]>, "Debbie Byrd (E-mail)" <[email protected]>, Dennis Donahue
<[email protected]>, "Dennis Gallagher (E-mail)" <[email protected]>, "Donna Knicely (E-mail)" <[email protected]>, "Douglas Wacker (Email)" <[email protected]>, Eleanor Leahy <[email protected]>, "Eliza Leitch (E-mail)" <[email protected]>, "Greg Lukanowski
(E-mail)" <[email protected]>, "Greg Muzik (E-mail)" <[email protected]>, "Gross, Linda D. - Council Liaison"
<[email protected]>, "Hampton Ford (E-mail)" <[email protected]>, "Inge Horowitz (E-mail)" <[email protected]>, "January,
Patti M. - RecPark" <[email protected]>, "Jeannie Welliver (E-mail)" <[email protected]>, "Juanita Buster (E-mail)"
<[email protected]>, "Kim Bridges (E-mail)" <[email protected]>, "Larry Hedgepeth (E-mail)" <[email protected]>, "Lee Mumford (Email)" <[email protected]>, Lee Williams <[email protected]>, "Manoli Loupassi (E-mail)" <[email protected]>, "Marie
Swider (E-mail)" <[email protected]>, "Mark Pounders (E-mail)" <[email protected]>, "Martin, William W. -DCD-"
<[email protected]>, "Mary Lois Mitchum (E-mail)" <[email protected]>, "Parnell, Ellen G. - Lib"
<[email protected]>, "Robert Creecy (E-mail)" <[email protected]>, "Ron Wisniewski (E-mail)" <[email protected]>,
"Rothert, Allen N. - CMO" <[email protected]>, "Roy Carter (E-mail)" <[email protected]>, "Sarah Mumford (E-mail)"
<[email protected]>, "Tom Gay (E-mail)" <[email protected]>, "Tom Waller (E-mail)" <[email protected]>, "Tom
Yeaman (E-mail)" <[email protected]>, "Vanloan Nguyen (E-mail)" <[email protected]>, "Will MacDougall (E-mail)"
<[email protected]>, "Wyndham Price (E-mail)" <[email protected]>, "Alan Schinteus (E-mail)" <[email protected]>,
"Alice Massie (E-mail)" <[email protected]>, "Allen Townsend (E-mail)" <[email protected]>, "Arlen Bolstad (E-mail)" <[email protected]>,
"Barbara Abernathy (E-mail)" <[email protected]>, "Beverly Burton (E-mail)" <[email protected]>, "Bill Pantele (E-mail 2)"
<[email protected]>, "Bill Pantele (E-mail)" <[email protected]>, "Bill Patten (E-mail)" <[email protected]>, "Caroline Cox (E-mail)"
<[email protected]>, "Carytown South Civic Assoc. (E-mail)" <[email protected]>, "Charles Byles (E-mail)" <[email protected]>, "Charles
Nance (E-mail)" <[email protected]>, "Christopher Maxwell (E-mail)" <[email protected]>, "Connie Bawcum (E-mail)" <[email protected]>,
"Daphne Bryant (E-mail)" <[email protected]>, "David Smith (E-mail)" <[email protected]>, "Debora Johnson-Seabrook (Email)" <[email protected]>, "Don Gehring (E-mail)" <[email protected]>, "Duront Walton (E-mail)" <[email protected]>, "Edward
Kassab (E-mail)" <[email protected]>, "Edwin Amerson (E-mail)" <[email protected]>, "Elaine Dunn (E-mail)"
<[email protected]>, "Flanary, Mark E. - DCD" <[email protected]>, "Gail Zwirner (E-mail)" <[email protected]>,
"Georgianne Stinnett (E-mail)" <[email protected]>, "Grace Silverstein (E-mail)" <[email protected]>, "Greg LeHew (E-mail)"
<[email protected]>, "Harry Kollatz (E-mail 2)" <[email protected]>, "Harry Kollatz (E-mail)" <[email protected]>, "Heather
Laird (E-mail)" <[email protected]>, "Isaac Regelson (E-mail)" <[email protected]>, "Janie Walker (E-mail)" <[email protected]>,
"Jeff Williams (E-mail)" <[email protected]>, "Jeneen White (E-mail)" <[email protected]>, "Jim Edge (E-mail)"
<[email protected]>, "Jim Leadbetter (E-mail)" <[email protected]>, "Joe Guthrie (E-mail)" <[email protected]>, "Joe Stankus
(E-mail)" <[email protected]>, "Joyce Jackson (E-mail)" <[email protected]>, Judy Vido <[email protected]>, "Kathleen
O'Keefe (E-mail)" <[email protected]>, "Kathy Colwell (E-mail)" <[email protected]>, "Kelley Lane (E-mail)"
<[email protected]>, "Ken Powell (E-mail)" <[email protected]>, "Kevin Daley (E-mail)"
<[email protected]>, "Kim Adams (E-mail)" <[email protected]>, "Lauraine Davis (E-mail)" <[email protected]>,
"Leighton Powell (E-mail)" <[email protected]>, "Marie Moore (E-mail)" <[email protected]>, "Mark Brandon (E-mail)"
<[email protected]>, "Mary Lou Carr (E-mail)" <[email protected]>, "Maura Meinhardt (E-mail)" <[email protected]>,
"Midge Liggan (E-mail)" <[email protected]>, "Nat Dance (E-mail)" <[email protected]>, "Nita Parry (E-mail)" <[email protected]>, "Norman,
Linwood P. - CMO" <[email protected]>, "Pam Brewster (E-mail)" <[email protected]>, "Pat Daniels (E-mail)"
<[email protected]>, "Raul Cantu (E-mail)" <[email protected]>, "Rita Davis (E-mail)" <[email protected]>, "Roy Burgess (E-mail)"
<[email protected]>, "Rudolph McCollum (E-mail)" <[email protected]>, "Stacey Ahyoung (E-mail)" <[email protected]>, "Steve
Johnson (E-mail 2)" <[email protected]>, "Steve Nuckolls (E-mail)" <[email protected]>, "Tirado, Jorge - DCD"
<[email protected]>, "Todd Woodson (E-mail)" <[email protected]>, "Tracy Hundley (E-mail)" <[email protected]>, "Turk
Sties (E-mail)" <[email protected]>, "Virginia Edmunds (E-mail)" <[email protected]>, "Walker, Eddie A. - RecPark"
<[email protected]>, "William Johnson (E-mail)" <[email protected]>, "Zoe Anne Green (E-mail)" <[email protected]>, "Bill
Thomas (E-mail)" <[email protected]>, "Carmen Garrison (E-mail)" <[email protected]>, "Curt Carter (E-mail)" <[email protected]>,
"Doug Smith (E-mail)" <[email protected]>, "Douglas D'Urso (E-mail)" <[email protected]>, "Gwen Hedgepeth (E-mail)" <IMCEAEX_O=THE+20CITY+20OF+20RICHMOND_OU=RICHMOND_CN=RECIPIENTS_CN=HEDGEPGC@ci.richmond.va.us>, "Helen Brunson (E-mail)"
<[email protected]>, "Jackie Jackson (E-mail)" <[email protected]>, "James \"Bo\" Middleton (E-mail)" <[email protected]>,
"Karen Feagin (E-mail)" <[email protected]>, "Lillian Peters (E-mail)" <[email protected]>, "Matt Bates (E-mail)"
<[email protected]>, "Monica Rumsey (E-mail)" <[email protected]>, "Mutter, Kurt B - Police" <[email protected]>, "Naomi
Chambers-Taylor (E-mail)" <[email protected]>, "Penny Anderson (E-mail)" <[email protected]>, "Robert C Hill (Email)" <[email protected]>, "Robert Kelly (E-mail)" <[email protected]>, "Robin Ruth (E-mail)" <[email protected]>, "Sandra Starkey (Email)" <[email protected]>, "Sarah Grier Barber (E-mail)" <[email protected]>, "Sherri Johnson (E-mail)" <[email protected]>,
"Sophina Aryvz (E-mail)" <[email protected]>, "Steve Johnson (E-mail)" <[email protected]>, "Theresa Young (E-mail)" <[email protected]>,
"Tina Tidwell (E-mail)" <[email protected]>, "Tonya Scott (E-mail)" <[email protected]>, "Yvone Spain (E-mail)"
<[email protected]>, "A. Chandler Battaile Jr. (E-mail)" <[email protected]>, "Armbruster, Benjamin F. - EcoDev"
<[email protected]>, "Beverly Coleman (E-mail)" <[email protected]>, "Bill Martin (E-mail)" <[email protected]>,
"Butler, Johnnie E. - DPW" <[email protected]>, "Coone, Marie F. - RecPark" <[email protected]>, "David Bass (E-mail)"
<[email protected]>, "David Campbell (E-mail)" <[email protected]>, "Don Charles (E-mail)" <[email protected]>, "Eric
Anderson (E-mail)" <[email protected]>, "Erika Gay (E-mail)" <[email protected]>, "Glenn, Andrew B. - DPW"
<[email protected]>, "Gray Wyatt (E-mail)" <[email protected]>, "Hughes, Fred E. - DPW" <[email protected]>, "Jack Berry (Email)" <[email protected]>, "James J. McCarthy (E-mail)" <[email protected]>, "Johnson, Yvonne T. - DSS"
<[email protected]>, "Julius Richardson (E-mail)" <[email protected]>, "Katie Taylor (E-mail)" <[email protected]>, "Laura
Bezdan (E-mail)" <[email protected]>, "Lucy Meade (E-mail)" <[email protected]>, "Michael Vandergrift (E-mail)"
<[email protected]>, "Mike Laing (E-mail)" <[email protected]>, "Nancy Burford (E-mail)" <[email protected]>,
"Nelson, Keith B. - DPW" <[email protected]>, "Pantele, William J.- City Council" <[email protected]>, "Phillip Whiteway (Email)" <[email protected]>, "Robyn Krassas (E-mail)" <[email protected]>, "Ron Faulconer (E-mail)"
<[email protected]>, "Sandi Stovall (E-mail)" <[email protected]>, "Sgt. Steve Drew (E-mail)" <[email protected]>, "Smith,
Kenneth - Health" <[email protected]>, "Surnease Drew (E-mail)" <[email protected]>, "Ted Cox (E-mail)"
<[email protected]>, "White, Jeneen Patrice - Council Liaison" <[email protected]>, "William \"Chuck\" Henley (E-mail)"
<[email protected]>, "William Daniels Jr. (E-mail)" <[email protected]>, /o=The City of
Richmond/ou=Richmond/cn=Recipients/cn=MeaseHW <IMCEAEX_O=THE+20CITY+20OF+20RICHMOND_OU=RICHMOND_CN=RECIPIENTS_CN=MEASEHW@ci.richmond.va.us>, /o=The City of
Richmond/ou=Richmond/cn=Recipients/cn=PeanorME <IMCEAEX_O=THE+20CITY+20OF+20RICHMOND_OU=RICHMOND_CN=RECIPIENTS_CN=PEANORME@ci.richmond.va.us>, /o=The City of
Richmond/ou=Richmond/cn=Recipients/cn=RamireLM <IMCEAEX_O=THE+20CITY+20OF+20RICHMOND_OU=RICHMOND_CN=RECIPIENTS_CN=RAMIRELM@ci.richmond.va.us>, /o=The City of
Richmond/ou=Richmond/cn=Recipients/cn=SimmonDK <IMCEAEX_O=THE+20CITY+20OF+20RICHMOND_OU=RICHMOND_CN=RECIPIENTS_CN=SIMMONDK@ci.richmond.va.us>, "Catherine Welsh (E-mail)"
<[email protected]>, "Cooper, Claude G. - DCD" <[email protected]>, "David Hamm (E-mail)" <[email protected]>, "Dixon,
John I - Police Capt." <[email protected]>, "El-Amin, Sa'ad - Clerk's Office" <[email protected]>, "Elois Southerland (E-mail)"
<[email protected]>, "Eric Hunter Sr. (E-mail)" <[email protected]>, "Evans, Michael A. - DSS" <[email protected]>,
"Evette Wilson (E-mail)" <[email protected]>, "H. E. Harrison (E-mail)" <[email protected]>, "Harrell, William E. - CMO"
<[email protected]>, "Harriet Hill (E-mail)" <[email protected]>, "Horton, Don - Fire" <[email protected]>, "Jean Lewis (E-mail)"
<[email protected]>, Larry Tunstall <[email protected]>, "McCoy, David M - Police Major" <[email protected]>,
"Nelson-Davis, Michelle - EcoDev" <[email protected]>, "Sandra Jones (E-mail)" <[email protected]>, "Sharon Logan (E-mail)"
<[email protected]>, "Strickler, Mark - DCD" <[email protected]>, "Watkins, Tina - Fire" <[email protected]>, "Yvonne
Pilgrim (E-mail)" <[email protected]>, "Zatcoff, Alicia R - Police Legal" <[email protected]>, "Ann Gray (E-mail)"
<[email protected]>, "Anthony Scott (E-mail)" <[email protected]>, "B. J. Jackson" <[email protected]>, Barbara Bodeman
<[email protected]>, Bill Sonnett <[email protected]>, Bob Millman <[email protected]>, "Brian Jackson (E-mail)" <[email protected]>,
"Bruce Hulcher (E-mail)" <[email protected]>, "Cary Brown (E-mail)" <[email protected]>, "Charles Pierce (E-mail)"
<[email protected]>, "Charles Plum (E-mail)" <[email protected]>, "Charlie Frith (E-mail)" <[email protected]>, "Chris
Spencer (E-mail)" <[email protected]>, "Colin Osborne (E-mail)" <[email protected]>, "Edward Ward (Email)" <[email protected]>, Ele Bigger <[email protected]>, "Fran Green (E-mail)" <[email protected]>, Gloria Bacile
<[email protected]>, "Grimm, Peter R. - City Council" <[email protected]>, "J. J. Loehr (E-mail)" <[email protected]>, "James Pickral
(E-mail)" <[email protected]>, "Jeff Willis (E-mail)" <[email protected]>, "Jeremy Seftor (E-mail)" <[email protected]>, "Jerry Miller (E-mail)"
<[email protected]>, "Jewett, Edward - Circuit Court" <[email protected]>, "Joann Charlesworth (E-mail)"
<[email protected]>, "Jock Wheeler (E-mail)" <[email protected]>, John Girardi <[email protected]>, "John Hay (E-mail)"
<[email protected]>, "Jonathan Young (E-mail)" <[email protected]>, "K. C. Funk (E-mail)" <[email protected]>,
"Kelly Harris (E-mail)" <[email protected]>, "Lois Hastings (E-mail)" <[email protected]>, "Marcia Lawton (E-mail)"
<[email protected]>, "Mary Francis Kastleberg (E-mail)" <[email protected]>, Pamela Harding <[email protected]>, Pat
Angevine <[email protected]>, "Paul Sims (E-mail)" <[email protected]>, Perry Jones <[email protected]>, "Pete Grimm (E-mail)"
<[email protected]>, "Ralph Rhudy (E-mail)" <[email protected]>, "Robert Gray (E-mail)" <[email protected]>, "Steve Barnett (Email)" <[email protected]>, Steve McCarthy <[email protected]>, "Thomas Beatty (E-mail)" <[email protected]>, "Urchie
Ellis (E-mail)" <[email protected]>, "Wendy Inge (E-mail)" <[email protected]>, "Wendy Smith (E-mail)" <[email protected]>
Rsch “Philanthropic, charitable & eleemosynary institutions, including social
service delivery uses operated by such.
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notices about events with requests to publicize them in EntreNews or to send a special
email to the distribution list. For everyone’s benefit, here are a few simple guidelines:
1) The event or content must pertain to entrepreneurs and executives growing companies in
Virginia. Information on seminars, speakers, conferences, venture fairs, and regular
meetings of organizations with entrepreneurs involved is welcome. Notices of programs
on specific technical topics that will appeal to the “techies” but not necessarily to those
who own or manage the company is not likely to be included.
2) The deadline to submit events is noon each Thursday. The newsletter is written on
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specific events at other times of the week.
Pacific-Island Dwellers Suffer from Global Warming
Now is not a good time to live on a small Pacific island. Thanks to global warming, many
researchers say, species on such islands face a variety of perils. The living coral that surrounds
the islands reacts to warmer ocean temperatures by bleaching, or as the vernacular has it, dying.
Warmer temperatures allow disease-carrying mosquitoes to travel higher into the hills to munch
on species that haven't developed resistance. And homo sapiens residing on the low-lying
islands say climate-change-generated cyclones threaten to make their homelands completely
uninhabitable, turning residents into "environmental refugees." (A group of activists recently
called on Australia, the region's biggest producer of greenhouse gases -- which has refused to
sign the Kyoto Protocol -- to create formal policies accepting such refugees.) Oh, and one other
threat to island species: Thanks to melting polar ice caps and rising sea levels, some islands, like
northwest Hawaiian Whale Skate Island, are disappearing entirely, which is troublesome for all
non-fish, non-mermaid species.
straight to the source: Honolulu Star-Bulletin, Associated Press, Jaymes Song, 03 May 2004
<http://www.gristmagazine.com/cgi-bin/forward.pl?forward_id=2397>
straight to the source: The Courier-Mail, Agence France Presse, 03 May 2004
<http://www.gristmagazine.com/cgi-bin/forward.pl?forward_id=2398>
From: Democratic Latino Organization of Virginia
Sent: Thursday, April 22, 2004 9:09 PM
mailto: [email protected]
To: pdlov
Subject: Mid Atlantic Conference to be Hosted by DNC
Dear Members and Friends of the Democratic Latino Organization of Virginia:
Nelson Reyneri, Senior Advisor to Chairman Terry McAuliffe and Director of Hispanic
Outreach and the Democratic National Committee will host the Mid Atlantic Democratic
Latino Conference. The conference will be on Cinco de Mayo, 2004 at the Democratic
National Committee Headquarters, 430 S. Capitol St. SE, Washington, DC 20003. (Two
blocks south of Capitol South Metro Station-Orange and Blue lines.)
Local Committee: ________Senate Dist: ___House Dist: ____ Cong Dist: _____
Join DNC Chairman Terry McAuliffe in bringing together Hispanic and Latino
Democrats from across the region to launch the most successful political year of all time.
Come hear your local elected Latino representatives as well as National Hispanic
Leaders.
Join DNC Chairman Terry McAuliffe, Maryland, Virginia and Washington DC
Latino Democrats as well as other State and National Democratic Leaders for a
productive day of organization and information on Latino/Hispanic Voter
participation for this important election year.
The conference is easily reached by Metro on the Orange and Blue line with the DNC
being 2 blocks south of the Capitol South Metro Station.
For more information contact Nelson Reyneri, Senior Advisor to the Chairman and
Director of Hispanic Outreach, Democratic National Committee, 202/ 863-8054,
[email protected]
Register below, or go to http://www.dlov.org/Conference.html or see www.dlov.org Send registration
to: Democratic Latino Organization of Virginia, 4710 S. 31st, Arlington, VA 22206
Philip D. Vasquez
State Chair
Democratic Latino Organization of Virginia
[email protected]
www.dlov.org
6355 Lakeview Dr.
Falls Church, VA 22041
703.731.4396 (c)
703.333.2757 (h)
fress newletter to www.expressmedia.com
same as www.financialexpress.com of India (newpaper
Published on Friday, March 7, 2003 by CommonDreams.org
What About Three-Strikes-and-You're-Out for Corporate Criminals?
by Lee Drutman
While the FBI doesn't track white-collar crime, American University Professor Jeffrey Reiman,
using conservative estimates from the Chamber of Commerce, estimated that white-collar crime
cost $338 billion in 1997 - almost 100 times the FBI's $3.8 billion estimate for street crime costs.
Of course, most people are more frightened of getting mugged outside the grocery store than
paying too much inside the grocery store because of illegal price-fixing. But odds are you'll lose
more money to illegal price-fixing and other white-collar predatory schemes.
California State Senator Gloria Romero recently introduced a bill that would hold California's lawbreaking corporations to the same standard to which the state holds its law-breaking citizens.
Three strikes and you're out. If a corporation commits three major violations that result in a fine of
at least $1 million or a death, the California Attorney General will revoke the corporation's charter.
For companies incorporated in other states, three strikes means that they will lose their right to
transact business in California.
Passing the Corporate Three Strikes law would demonstrate that California is willing to get tough
on crime in the suites, not just crime in the streets. It would create a climate where law-abiding
companies thrive and give the public a means of cracking down on recidivist corporate criminals
for marketing defective products, exposing their employees to life-threatening occupational
hazards, ripping off utility customers, or dumping toxic waste down the drain after midnight. If
California's elected officials are truly serious about helping the victims of crime, and applying a
consistent standard of justice to recidivist criminals, they will pass the Corporate Three Strikes
law.
Lee Drutman is the Communications Director for Citizen Works, a DC-based nonprofit.
For more information see www.citizenworks.org or www.corporate3strikes.org
http://www.commondreams.org/
It's been said that dreams are our roadmaps to the future. If so, where are
we headed? Common Dreams is a national non-profit citizens' organization
working to bring progressive Americans together to promote progressive
visions for America's future. Founded in 1997, we are committed to being on
the cutting-edge of using the internet as a political organizing tool - and
creating new models for internet activism.
pro.gres.sive
adj.
Moving forward;
advancing.
Proceeding in
steps; continuing
steadily by
We are funded exclusively by our members and supporters - no corporate
increments:
money, no advertising, no hidden agendas. With a small staff and a network
progressive
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change.
budget. But we can't keep moving forward without your help. Please join us
Promoting or
by clicking here.
favoring progress
toward better
conditions or new
policies, ideas, or
Breaking News & Views for the Progressive Community.
methods: a
progressive
An eclectic mix of politics, issues and breaking news with an emphasis on
politician;
progressive perspectives that are increasingly hard to find with our corporate- progressive
dominated media.
business
leadership.
NewsCenter's roots go back to the early 90's when Common Dreams Editor n.
Craig Brown (bio) was the chief-of-staff to former Congressman Tom
A person who
Andrews. With access to an incredible supply of daily newspapers,
actively favors or
magazines, journals and briefing papers, members of Congress are deluged strives for
with information but have very little time to scan through it - much less read it. progress toward
Brown created a daily 'newsclips' operation for the congressman and the
better conditions,
staff. Early every morning interns and staff would scan dozens of designated as in society or
publications looking for new articles or opeds from a list of issues that were
government.
of greatest interest to the congressman and staff. By 9 am, all staff had a
photocopied/collated copy of the 'Daily Clips' to carry with them all day and
www.dictionary.com
read in between the chaos.
NewsCenter
The magic of the internet has made it possible to create a 'Daily Clips' for you
- but even better, our NewsCenter is updated constantly -- 365-days a year.
And provides you with easy access to the 'rest of the media'.
Progressive NewsWire
Every day activists are making news and speaking out on the issues of our time. But far too often
the filter of the corporate-media ignores those voices. Progressive NewsWire brings you the
press releases and the statements from America's progressive community directly to you - no
filters, no editing. And we do it in 'real time'.
Progressive NewsWire started in June of 1998 and has archived news releases since then.
The Need for a Good Government Watchdog
ashington, DC, the nation's capital, has a city government that is inefficient,
poorly managed, and fiscally irresponsible, and that is characterized by
widespread waste, fraud, corruption, and abuse.
The structural problems facing Washington, DC, are not unique. They typify the
problems facing the inner cities of many metropolitan areas. These problems
include crime, drugs, a deteriorating infrastructure, a failing public school system,
poorly maintained and managed public housing, high taxes, and a general
breakdown in the delivery of government services. What makes Washington
unique is the fact that, even with massive budgets and federal aid, these
problems are compounded by large budget deficits and recurring fiscal crises,
the mismanagement of programs and departments, and fraud and corruption
scandals.
The creation by Congress of the DC Financial Responsibility and Management
Assistance Authority (the Control Board) in 1995 began to alleviate some of the
city's financial problems. However, the Authority's board and staff were unfamiliar
with the inner workings of the city's government, and they failed to address
effectively the serious management problems plaguing the District. The
DCFRMAA’s board was dissolved at the end of 2000, and control was returned
to the locally elected city government
Currently, several governmental bodies in the District of Columbia are charged
with investigating government waste, fraud, corruption, and abuse. Among these
offices and agencies are the Inspector General, the Auditor, the Corporation
Counsel, the Ethics Ombudsman, the Internal Affairs Division of the Metropolitan
Police Department, and the Office of Campaign Finance. However, these offices
have proven to be ineffective, inefficient, or powerless.
Moreover, in Washington, DC, the local media tend to concentrate on national
issues and give scant coverage to local governmental issues. The media seldom
devote adequate time or resources to an in-depth analysis of the problems and
inner workings of the District government.
Before DCWatch, no other citizen organization functioned primarily as a
watchdog on corruption and as an independent voice seeking to reform the
District government. The lack of such an organization has allowed governmental
waste and mismanagement to remain largely unchecked. This situation has
proven to be destructive of the fiscal order of the District, of the public's
confidence in government, and of the District's relationship with the federal
government.
DCWatch
DCWatch has been modeled after the Citizens Union in New York City, the
Committee of Seventy in Philadelphia, and the Better Government Association of
Chicago. The BGA of Chicago, for example, was established in 1923 to promote
voter registration and to make candidate endorsements. Its principal focus for the
past several decades, however, has been to eradicate government waste and
corruption through thorough, independent investigations.
In Washington, DCWatch's major official project is this web site, which attempts
to inform the public about fundamental public policy issues, the District
government, and its officials; to serve as an outlet for opinion, and to provide
informational resources for citizens.
Our hope is that DCWatch will be an aggressive, effective, non-partisan
watchdog on the city's government.
The executive director of DCWatch is Dorothy Brizill, who has been active for several
years as a community activist and civic reformer. She is political scientist who was
educated at Queens College (CUNY) and Columbia University and who has worked at
the Brookings Institution and the State Department. Her independent investigations of
government corruption and mismanagement have led to the complete reorganization of
the housing inspection unit of the Department of Consumer and Regulatory Affairs, to
federal charges of misuse of office and campaign finance violations against high-ranking
officials of the city government, and to necessary reforms in the homeless shelter
program, as well as to numerous exposés in the media. In addition, as the former
president of the Columbia Heights Neighborhood Coalition in the 14th Street corridor,
she has organized her community to fight drugs and crime; implement community
policing; force the District to clean, maintain, and manage scattered-site public housing
and District-owned properties; limit the concentration of emergency shelters; revamp the
Alcohol Beverage Control Board; and improve the delivery of basic city services.
Gary Imhoff, who is married to Dorothy Brizill, is also the vice-president and webmaster
of DCWatch. He is a Washington writer whose published books are Learning in Two
Languages: From Conflict and Controversy to Cooperative Reorganization of Schools
(Transaction Press, 1990) and The Immigration Time Bomb: The Fragmenting of America
(E.P. Dutton & Company, 1985), and whose articles have been published in the Annals of
the American Academy of Political and Social Science, USA Today, The Humanist, The
Washington Post, and English Today.
Get in Touch
DCWatch, 1327 Girard Street, N.W., Washington, D.C. 20009-4915, telephone
and fax 202-234-6982, E-mail [email protected]
http://www.urban.org/Template.cfm?NavMenuID=42
About the Urban Institute
The Urban Institute measures effects, compares options,
shows which stakeholders get the most and least, tests
conventional wisdom, reveals trends, and makes costs,
Read more about the
history of the
Urban Institute.
benefits, and risks explicit.
Our research is guided by seven tenets:
Pick the right issues. We concentrate on issues important to the country and
carry out research suited to our particular strengths. We seek a balance between
short-term and long-term studies, national and local issues, and applied and
theoretical work.
Choose or create the right methodologies. Half the challenge of research is
finding, adapting, or creating the best tools for the job—those that best account
for the evidence and explain it clearly and compellingly. Quantitative modeling is
a core competency of the Urban Institute. Another is revamping research
methodologies to broaden their application. Survey design, case studies, and
statistical analysis are other basic strengths. Often, we combine methods,
bringing multiple perspectives to such complex issues as poverty, educational
achievement, or community building.
Assemble the right team. Economists, public policy analysts, lawyers,
statisticians, urban planners, demographers, sociologists, political scientists,
communications experts, and other specialists make up Urban Institute's staff.
With such diverse expertise, we can breach academic boundaries as needed and
blend qualitative and quantitative analyses. Equally important, at the Institute
teams often complete many projects together, building institutional depth. We
also collaborate with outside researchers and other institutions and work in
partnerships with federal, state, and local agencies.
Follow the facts wherever they lead. The Institute analyzes and interprets facts
and numbers without an ideological agenda. We look beyond obvious
explanations, but don't ignore them. We make informed judgments about our
research findings but take pains to quarantine our personal beliefs when we
design and carry out studies.
Find the right words. We publicize results that validate widespread expectations
as well as those that prove surprising. We speak the language of experts with
experts but put research findings into the context of everyday life for the public.
Subject our findings to outside review. Our methods, factual accuracy, and
interpretations are all subject to outside review. The Institute's largest projects
have technical advisory boards. Smaller ones follow standard academic peerreview procedures. Books published by the Urban Institute Press are reviewed
anonymously outside the Institute.
Reach the right audiences. We direct our research findings to multiple audiences:
policymakers, program administrators, other researchers and university students,
the media, nonprofit advocacy organizations, stakeholders in the private sector,
and that important segment of the public that follows policy debates through the
daily news.
Mercury News www.mercurynews.com has stock option stories:
Free registyration if you accept cookies.
Group Petitions for Protection of Hundreds of Imperiled U.S. Species
A coalition of enviro groups, scientists, and artists petitioned the U.S. Fish and Wildlife Service
yesterday to add 225 species to the official federal list of endangered and threatened species.
The 225 are now on a candidate list that affords them no protection. It was, by a wide margin, the
largest listing petition filed since such citizen requests were authorized under the Endangered
Species Act in 1982 (the act itself passed in 1973). The move was designed in part to draw
attention to the dysfunctional listing process that has plagued the agency for years, but has grown
more acute, critics say, under the Bush administration. The species have been on the candidate
list for an average of 17 years. FWS officials estimate it would cost $153 million to list all the
species. "You can't just go to Congress and ask for $153 million to clear up the backlog," said
the agency's Betsy Lordan. "You'd get laughed at." The coalition included the Center for
Biological Diversity and science luminaries Jane Goodall, E. O. Wilson, and Paul Ehrlich.
straight to the source: The Oregonian, Joe Rojas-Burke, 05 May 2004
<http://www.gristmagazine.com/cgi-bin/forward.pl?forward_id=2406>
straight to the source: Statesman Journal, Beth Casper, 05 May 2004
<http://www.gristmagazine.com/cgi-bin/forward.pl?forward_id=2407>
straight to the source: San Francisco Chronicle, Associated Press, Arthur H. Rotstein, 05 May
2004
<http://www.gristmagazine.com/cgi-bin/forward.pl?forward_id=2408>
see also, in Grist: An interview with the Bush admin. official in charge of endangered species -by Amanda Griscom
<http://www.gristmagazine.com/maindish/manson041504.asp?source=daily>
Rschg “la Agencia EFE”
presidente y director general de EFE, Miguel Angel Gozalo.
"La formación académica de los periodistas ha sido siempre esencial y mucho
más ahora cuando las nuevas tecnologías nos obligan a reforzar los
fundamentos del buen periodismo y manejar con destreza las nuevas
tecnologías de la información", agregó Gozalo en declaraciones efectuadas en
Madrid
colaboración del Maestría de Periodismo de la Fundación EFE impartida en la
Universidad Rey Juan Carlos de Madrid y la facultad de Periodismo de FIU.
La Agencia EFE facilitará, también, que los alumnos de la maestría de
periodismo de FIU puedan hacer prácticas de periodismo en su oficina de Miami.
Para más información, diríjase a:
Por teléfono: 305-919-5940
Por correo electrónico: [email protected]
Por correo ordinario:
Saul Sztam, Assistant Dean
School of Journalism and Mass Communication
Florida International University
3000 NE 151st Street, ACII-335
North Miami, FL 33181
Contact Mag en espagnol contenido Latinos en los EEUU
http://www.contactomagazine.com/latinosindex.htm
http://www.georgetown.edu/academia/historia.html Rsch ibero-journalism:
Comisiones de la Academia Norteamericana de la Lengua Española
La Academia Norteamericana colabora, de forma continua, y a través de sus
diversas comisiones --y subcomisiones--, con la Comisión Permanente de la
Asociación de Academias --que dirige D. Humberto López Morales--, con sede
en la Real Academia Española (Madrid).
Las comisiones que trabajan en el seno de la Academia Norteamericana son las
siguientes:
La Comisión de Estudios del Español en los Estados Unidos, presidida por D.
Theodore S. Beardsley, quien es, a su vez, bibliotecario de la corporación. Los
fondos de la biblioteca de la Academia Norteamericana se encuentran en la
Hispanic Society of America, en Nueva York.
La Comisión de Lexicografía, presidida por D. Roberto A. Galván, colabora con
la Comisión de Lexicografía de la Real Academia Española en consultas léxicas
para el DRAE y para el Gran Diccionario de Americanismos, entre otros
proyectos de la RAE.
La Comisión de Gramática, presidida por D. Carlos Alberto Solé, colabora con la
Comisión de Lexicografia con artículos y notas sobre temas gramaticales de
interés.
La Comisión de Educación (de reciente creación), presidida por D. Gerardo Piña
Rosales, colabora con la Real Academia Española en la relación de libros en
español publicados en los últimos 25 años en EE.UU., para el Corpus de
referencia del español actual.
La Comisión de Traducciones Técnicas y Científicas, presidida por D. Joaquín
Segura, colabora con la Comisión de Vocabulario Técnico y Científico de la Real
Academia Española, con la Comisión de Diccionarios de la RAE, con la
Comisión Permanente de la Asociación de Academias de la Lengua Española y
con la Real Academia de Ciencias Exactas, Físicas y Naturales, de Madrid. Esta
comisión ha colaborado de modo eficaz con el Gobierno Federal norteamericano
en la elaboración del Glosario de Términos Hipotecarios y con la Sección de
Impuestos sobre la Renta en su English-Spanish Glossary of Words and
Phrases Used in Publications by the Internal Revenue Service. La Comisión de
Traducciones Técnicas y Científicas inició en junio de 1994 un proyecto cuyo
éxito ha sido rotundo: la publicación de Glosas. Esta revista--dirigida por D.
Joaquín Segura y en la que colaboran los demás vocales de la comisión--,
cuenta ya con cientos de suscriptores y llega a lugares tan distantes y dispares
como Guinea Ecuatorial y Mongolia. En Glosas (que va ya por el número 8, en
su segundo volumen) se publican comentarios sobre temas gramaticales y
lexicográficos, términos de interés recogidos del DRAE con sus equivalentes en
inglés norteamericano, neologismos del inglés y equivalentes que sugiere la
Academia Norteamericana, falsos cognados, reseñas de libros de carácter
lingüístico, etc. Glosas se envía a varias agencias de noticias como EFE,
Reuters, Prensa Asociada y a la Sección de Terminología y Referencias de la
División de Traducción y Edición del Departamento de Asuntos de la Asamblea
General y de Servicios de Conferencias de las Naciones Unidas, a la Biblioteca
del Congreso y a algunas universidades y multinacionales.
La Comisión de Estudios Medievales (que acaba de crearse), presidida por D.
Nicolás Toscano Liria, tiene entre sus proyectos el de publicar un estudio
historiográfico sobre la presencia española en Norteamérica.
La Comisión de Informática, presidida por Da. Estelle Irizarry, se encarga, entre
otros trabajos, de mantener una página electrónica de la Academia en la red
mundial. La Academia Norteamericana fue la primera academia de las 21 del
mundo hispánico en disponer de una página electrónica en la Internet. En dicha
página, actualizada periódicamente, se recoge información sobre las actividades
y proyectos en marcha de la Academia. Las dirección es:
http://www.georgetown.edu/academia/.
La Comisión de Vocabulario Médico, presidida por D. Antonio Culebras, colabora
con la Academia Española de Neurología en los Estados Unidos y con la Real
Academia de Ciencias Exactas, Físicas y Naturales, de Madrid.
Boletín de la Academia Norteamericana de la Lengua Española.
En el Boletín --dirigido por D. Eugenio Chang-Rodríguez-- se publican artículos,
reseñas, discursos de los miembros de la corporación así como información
sobre sus actividades. En este mes de noviembre aparecerán los núms. IX-X.
Gabinete de Información
El Gabinete de Información --dirigido por D. Emilio Bernal Labrada-- despliega
una incesante actividad en todos los medios informativos, dando a conocer las
actividades de la Academia Norteamericana. El Gabinete de Información ha
venido publicando últimamente en periódicos y revistas de Estados Unidos una
serie de notas biobibliográficas de miembros de la Academia Norteamericana.
Secretaría
La Secretaría de la Academia Norteamericana --de cuya administración se
encarga, de modo accidental, D. Gerardo Piña Rosales-- cumple con las
funciones que le son pertinentes: la de levantar actas de las reuniones de
trabajo, la de informar a la Secretaría de la Real Academia Española y la
Comisión Permanente de la Asociación de Academias del ingreso de nuevos
miembros y la de mantener la correspondencia de la corporación.
La Secretaría publicará próximamente el núm. 2 de la Hoja Informativa.
La idea de la fundación se venía gestando desde hacía cien años.
* Tomás Navarro Tomás, miembro de la Real Academia Española, exiliado en Nueva
York, inició el proyecto para la creación de la Academia Norteamericana de la Lengua
Española en Estados Unidos con la colaboración del chileno Carlos McHale, el español
Odón Betanzos Palacios, el ecuatoriano Gumersindo Yépes, el puertorriqueño Juan
Avilés y el español Jaime Santamaría para integrar el Comité Gestor el año 1966.
 Integran la Academia Norteamericana creadores, lingüístas, lexicógrafos,
ensayistas, investigadores científicos y literarios, historiadores de la lengua y
traductores de todas las nacionalidades del mundo hispánico. Se da entrada a ella,
también, a hispanistas residentes en Estados Unidos y a sefardíes.
 * La Academia publica un Boletín con artículos sobre la lengua española en
Estados Unidos y en ‚l se recogen tambi‚n las labores de los miembros de la
Academia y de las academias hermanas. Publica, también, Glosas, que, entre otras
cosas, presenta propuestas a la Comisión de Traducciones Técnicas y Científicas.
Suscripciones a Glosas: US$19 al año (cuatro números), con el cheque o giro postal a
nombre de la Academia Norteamericana de la Lengua Española, Tesorería, G.P.O. Box 349,
New York, NY 10016, USA.
Dos colecciones de Glosas: Vol. 1, Nos. 1 a 10; Vol. 2, Nos. 1-10. Precio por columen,
US$29.00, con el cheque o giro postal a nombre de la Academia Norteamericana de la Lengua
Española, Tesorería, G.P.O. Box 349, New York, NY 10016, USA.




Read mopre: http://www.georgetown.edu/academia/glosas.html
* La función básica de la Academia Norteamericana es la unidad y defensa del
español.
* Los fines de la Academia Norteamericana son científicos y literarios y se
excluye la política en su seno pero sin limitar ideas y pensamientos de sus
integrantes.
Su dirección es: G.P.O. Box 349, New York, NY 10116.
Telefax: 202 941-5793 y 718 761-0556
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They also so posters: Disclaimer
All content used in connection with the CafePress.com Service has been provided by CafePress.com
users and does not reflect the opinions of CafePress.com. Unauthorized use is prohibited by law.
The following general guidelines are written to help you better understand Intellectual
Property laws as they relate to your use of CafePress.com. The laws regarding
Intellectual Property can be confusing, so it is no wonder why beginners often make
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What is a Copyright? A copyright protects original work of authorship such as a picture,
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Copyright law prevents you from copying another's copyrighted work for any purpose,
making things based on the copyrighted work, distributing copies of the copyrighted
work, publicly performing the copyrighted work, displaying the copyrighted work, and in
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media. In a nutshell, copyright law protects the expression of one's idea.
What is a Trademark? A trademark is a word, name, symbol or other device that
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What is Right of Publicity? The Right of Publicity makes it unlawful to use another's
identity for commercial advantage without permission. A person's "identity" includes, for
example, his look, voice, name, nickname, professional name, and other distinctive
characteristics. For example, the Right of Publicity prohibits you using the picture of a
celebrity without authorization on your merchandise.
top
Examples of Prohibited Content
Because of intellectual property laws, CafePress.com has certain rules regarding the types of merchandise that
you can make and sell through its service. For example:





NO UNOFFICIAL MERCHANDISE
NO use of names, logos, pictures or other intellectual property of musical groups or musical artists. For
example, you cannot make Britney Spears merchandise simply because you run a fan-based Britney
Spears website or just because you downloaded her image from an internet website. You also cannot
modify the name or other intellectual property of a musical group and avoid infringement, (e.g., using
Metalika instead of Metallica).
NO use of names, logos, pictures, or other intellectual property of sports teams, colleges/universities,
clubs, or organizations such as the Los Angeles Lakers, Harvard University, or The Boy Scouts. Again,
modifications do not avoid infringement.
NO photos, logos, caricatures, or other artwork depicting celebrities, such as Michael Jackson or
Madonna, or other third parties. Just because you take a photograph of a celebrity does not give you the
right to use that photograph on merchandise, even if you digitally manipulate the photograph.
NO use of trademarks, names, or logos of companies. For example, you cannot use the name of a
company such as Nike®, a company logo such as the Nike "swoosh" trademark, or brand name such as
Coca Cola®, or a modified version of a trademark, (e.g., "Just Did It").

NO pictures or photographs of products (such as automobiles or toys). Even if you own a product,
trademark laws still prohibit you from selling merchandise featuring pictures of it. For example, you
cannot take a picture of your car and then sell t-shirts or mugs with that picture.
top
Frequently Asked Questions
If it does not have a copyright notice, it is ok to use.
NOT REALLY. Almost all works are protected by copyright, even if they do not have a
copyright notice. Therefore, you should assume that you need to obtain permission to use
any material that you did not create.
If I do not mark up the selling price of my products, it will not be an
infringement.
FALSE. If a product is not marked up from its base price, that sale is still considered an
infringement, even if you are selling the product to yourself. Even if you post an image in
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the image.
It's on the internet, so it is ok to use it.
FALSE. Simply because an image is found on the Net does not mean that it is in the
public domain. Unless the author of the work has explicitly stated that his work is "public
domain" or that the copyright has expired because the work is very old, then you must
assume it is not. Further, a person who posts an image on the Net and claims that you
are free to use may not have had the right to post the image in the first place. Thus, your
use of the image may violate the rights of the actual copyright owner.
It is Fair Use.
PROBABLY NOT. Fair use of a work for the purposes of merchandise sale is treated very
differently than for informative purposes or for commentary. In general, a claim of fair
use of a work when it is used on merchandise will not hold up in court, especially if the
merchandise is sold for profit.
I took the photo, so I can use it however I want.
NOT EXACTLY. Simply taking a photo of a person, company, band, logo or the like does
not afford you the right to sell merchandise featuring that photograph. There are two
distinct intellectual property rights in a photograph: (1) the rights in the photograph itself
and (2) the rights in the subject of the picture, such as the product or person shown in it.
For example, if you take a photo of a car or celebrity, you only own the rights to the
photo, but not the right to use the photo of the car or celebrity for merchandise sale. In
order to sell merchandise with the image, you will need to obtain explicit permission from
the car company or celebrity.
I based my artwork on the artwork of a third party, so that is ok.
FALSE. Works that are derived from a previous work of another violate the rights of the
owner of the previous work. Therefore, if you are creating an image that is based on the
work of someone else, you need to obtain permission from the original creator prior to
your use of your work. For example, Weird Al Yankovic obtains permission from Michael
Jackson prior to recording a song based on one of Michael Jackson's songs.
It's parody, so it is ok.
FALSE. Parody used for informative purposes is treated very differently from parody used
for the sale of merchandise. Parody as a defense to infringement claims based on
merchandise sale will not hold up in court.
I am using Clip Art, so it is ok.
NOT REALLY. Most clip art, photo collections, or graphic programs contain a license
agreement. The license agreement sets forth the specific uses for the clip art. In most
instances the license does not grant you the right to use the clip art for the sale of
merchandise. You should consult the license agreement and your attorney to determine
whether you can use the clip art images on CafePress.com.
The First Amendment protects my freedom of speech, so I can use whatever
images I want.
FALSE. Freedom of speech is a constitutional protection that guarantees that the
government will not oppress your right to self-expression. It does not give you the right
to use intellectual property of another to sell or distribute merchandise.
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Sources for Information
For additional information on Copyrights, please visit the United States Copyright Office
Library of Congress at http://www.copyright.gov. For additional information on
Trademarks, please visit the United States Patent and Trademark Office at
http://www.uspto.gov. For general questions about Intellectual Property Rights
(copyrights/trademarks), please visit the Nolo Law Center at http://www.nolo.com.
top
Report Copyright/Trademark Infringement
We encourage intellectual property rights owners to contact us if they believe that their
rights have been infringed by a user. We also encourage our users to contact us if they
suspect that another user is infringing the rights of a third party. Please visit our
Intellectual Property Rights Policy for information regarding the procedure to notify us of
any alleged infringement by a user of our service.
top
CafePress.com Merchandise benefits include:
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community service providers of cultural issues that might impact the community's health practices,
and the acceptance and use of health and community resources by clients. Maintain accurate client
records and files. Use MORE Access or other relevant software for patient tracking. Collect and
assemble evaluation data for timely completion of regular and special reports. This is a grant funded
position.
Obtaining an Atty, from medical malpractice lawyers network, http://www.medical-malpracticelawyers-attorneys.com/thank_you.html
it is very important to have all of your medical records available. To request your medical records
use this medical release form. We also encourage you to take advantage of your states medical
board complaint process.
To research the license status and malpractice or disciplinary record of your doctor, please visit
our "INVESTIGATE
YOUR DOCTOR" page for some excellent investigative sources about
your physician and his/her history of lawsuits.Or visit our page "INVESTIGATE YOURHOSPITAL" to research your hospital. Click here to see if your state has a Physician Profile
Law, if so you may be able to get detailed license, Medical Malpractice, Hospital Discipline and
Criminal Conviction information.
If your case involves misdiagnosis of cancer, please click here and answer four additional
questions that will help us to expedite your case inquiry.
you should not delay attempting to secure an attorney through alternate means. The statute of
limitations, which is the time limit by which you must file your case, is a strict requirement in
potential medical malpractice cases and varies from state to state.
We also encourage all victims of medical negligence to contact your state representative or your
US Senator to prevent the door to civil justice to be closed by unfair limits on your right to access
to the civil justice system. Click here to voice your opinion to your Representatives and Senators.
Authorization to Release Medical Information Form
Name _________________
Date of treatment ____________________
This is a request and authorizes all physicians, hospitals and medical attendants
to furnish my complete and entire medical record of my treatment, diagnosis and
tests including but not limited to: all medical reports and records, nurses notes, xrays, laboratory data, and all other information to me at the address provided
below. This request and authority includes examination of originals of hospital
records, admission and discharge records, X-rays, slides, and all other data,
information and materials related to my treatment, including medical reports and
opinions, and all lab data, with no exceptions. Pease include a copy of each and
every page of the medical record including but not limited to all notes written and
dictated by physicians, consultants, nurses, and other health care providers. All
previous authorizations are cancelled, except those which permit release of
information to facilitate payment of outstanding bills by any health insurance
carrier. Please do not permit anyone else to inspect my records.
Dated:_______________
Name________________
Signature______________
Address________________
City, State_________________
http://www.mhsource.com/resource/board.html has “state by state Board directories,
Pub called “Psychiatric Times”, is called Continuing Medical Education, Inc and says
about itself: CME, Inc., a division of CMP Healthcare Media, offers the latest
information and educational resources for healthcare professionals. CME, Inc. produces a
variety of educational opportunities, including annual congresses, conferences,
multimedia home-study products, Web sites and more. In addition to these resources,
CME, Inc. publishes Geriatric Times and Psychiatric Times, the #1 publication in
psychiatry for the past eleven years.1
CME, Inc. is accredited by the Accreditation Council for Continuing Medical
Education to provide continuing medical education for physicians.
Psychiatric Congress is well-established as the 2nd largest psychiatric trade
show in the United States, providing you strong penetration into the market of
practicing clinicians. Conveniently located within one facility, this dynamic event
focuses on improving the treatment of mental health disorders and covers key
topics, such as schizophrenia, depression, psychopharmacology and more.
Target Audience: psychiatrists, primary care physicians, psychologists,
psychiatric nurses, pharmacists, social workers and counselors
Has link to http://www.mhsource.com/depconsult/jan2004.html which has q&a’s
from physicians/psychiatrist/oer mental health care providers
Q. Please explain positive response to anti-inflammatory drugs in
depressed patients.
A. It is unclear why patients with depression would have positive responses to
anti-inflammatory drugs. One reason could be the very high prevalence of
physical pain complaints. Many patients complain of back or joint pain or
headache that are associated with the severity and persistence of their
depression (Ohayon and Schatzberg, 2003). In those patients who report some
relief with anti-inflammatory medications, it is possible that relief of pain
complaints is a factor. Antidepressants also help relieve pain symptoms. Mixed
reuptake inhibitors such as duloxetine and higher-dose venlafaxine (Effexor)
appear to have significant benefit in the treatment of the painful physical
symptoms associated with depression (Goldstein et al., 2004; Stewart, 2003).
Treatment of these physical symptoms may reduce the duration of depressive
episodes and the risk of depressive relapse.
References
Goldstein DJ, Lu Y, Detke MJ et al. (2004), Effects of duloxetine on painful
physical symptoms associated with depression. Psychosomatics 45(1):17-28.
Ohayon MM, Schatzberg AF (2003), Using chronic pain to predict depressive
morbidity in the general population. Arch Gen Psychiatry 60(1):39-47.
Stewart DE (2003), Physical symptoms of depression: unmet needs in special
populations. J Clin Psychiatry 64(Suppl 7):12-16.
But has some very important ans to questions that should be common
knowledge: Q. In assessing a patient for depression, what physical and
emotional symptoms are commonly encountered?
A. I think that it depends on where the patient is presenting. As I previously
pointed out, patients presenting in mental health care settings tend to focus more
on the emotional symptoms (the sadness, tearfulness and guilt that they may be
experiencing), whereas patients presenting in primary care settings may very
well focus on the physical symptoms (the lethargy, fatigue, irritability, lack of
motivation, sleeplessness that they may be experiencing and so forth) (Sharp
and Lipsky, 2002). I think it is incumbent upon all professionals to adequately
assess both domains of the syndrome. We can't be satisfied with only focusing
our assessment and treatment efforts on those symptoms that the patient brings
to us as part of their chief complaint. We need to document and assess the entire
syndrome.
This is where I believe screening instruments can be very helpful. The Beck
Depression Inventory (BDI) as well as the Zung Depression Scale can be very
useful in documenting the entire syndromic condition (Montgomery and Asberg,
1979).
References
Montgomery SA, Asberg M (1979), A new depression scale designed to be
sensitive to change. Br J Psychiatry 134:382-389.
Sharp LK, Lipsky MS (2002), Screening for depression across the lifespan: a
review of measures for use in primary care settings. Am Fam Physician
66(6):1001-1008.
Dr. Lewis is professor in the department of psychiatry in the college of
osteopathic medicine at Nova Southeastern University. Additionally, Dr. Lewis is
deputy director and investigator for CNS Clinical Research.
Other facts on syndromes: It is unclear why patients with depression would have
positive responses to anti-inflammatory drugs. One reason could be the very high
prevalence of physical pain complaints. Many patients complain of back or joint
pain or headache that are associated with the severity and persistence of their
depression.
The SSRIs have generally been thought not to cause acute weight gain, although
some data suggest that their effect on weight may vary over time, with long-term
treatment resulting in higher-than-baseline weight in certain patients (Sussman
and Ginsberg, 1998). Conversely, nefazodone (Serzone), bupropion (Wellbutrin)
and venlafaxine tend to be weight-neutral (Ackerman and Nolan, 1998). When
choosing an antidepressant, the physician should take into consideration many
factors, such as the likelihood of associated weight gain. This is particularly
relevant in obese patients or those for whom it is important not to return to
baseline overweight status. Weight gain in antidepressant treatment is
commonly expected because most patients with depression have lost weight
during their illness. Increases beyond baseline body weight are of significant
concern. When assessing middle-aged women with depression, it is important to
ask about premenstrual mood changes and somatic changes (e.g., hot flashes,
cold sweats, interrupted sleep, changes in libido and dyspareunia). The workup
should always include a TSH level, because women are at increased risk for
thyroid dysfunction--particularly with increasing age--and thyroid dysfunction may
present with mood changes.
In those patients who report some relief with anti-inflammatory medications, it is
possible that relief of pain complaints is a factor. Antidepressants also help
relieve pain symptoms. Mixed reuptake inhibitors such as duloxetine and higherdose venlafaxine (Effexor) appear to have significant benefit in the treatment of
the painful physical symptoms associated with depression (Goldstein et al., 2004;
Stewart, 2003). Treatment of these physical symptoms may reduce the duration
of depressive episodes and the risk of depressive relapse.
References
Goldstein DJ, Lu Y, Detke MJ et al. (2004), Effects of duloxetine on painful
physical symptoms associated with depression. Psychosomatics 45(1):17-28.
Ohayon MM, Schatzberg AF (2003), Using chronic pain to predict depressive
morbidity in the general population. Arch Gen Psychiatry 60(1):39-47.
Stewart DE (2003), Physical symptoms of depression: unmet needs in special
populations. J Clin Psychiatry 64(Suppl 7):12-16.
Rsch http://www.naphs.org/
Virginia Board of Medicine
6606 W. Broad St., 4th Floor
Richmond, VA 23230-1717
(804) 662-9908
www.dhp.state.va.us
Medical Negligence
Medical malpractice can occur in and a variety of ways. When a doctor or hospital deviates from
the standard of acceptable medical care and acts negligently, the resulting injuries could be the
basis for a medical malpractice negligence claim.
medical negligence can include:
- failure to diagnose an illness
- failure to prevent surgical infection
- leaving a medical device implanted after surgery
- surgery without informed consent
- certain birth injuries and cerebral palsy
- failure to diagnose breast cancer
- late diagnosis: diminished chance of survival
- misdiagnosis
New York State Board for Medicine (Licensure)
Cultural Education Center, Room 3023
Empire State Plaza
Albany, NY 12230
(518) 474-3841
www.op.nysed.gov
A medication error is "any preventable event that may cause or lead to
inappropriate medication use or patient harm while the medication is in the
control of the health care professional, patient, or consumer," according to the
National Coordinating Council for Medication Error Reporting and Prevention.
Serious Medication Errors occur over One Million times each year. Twenty per
cent are life threatening. Each prescription mistake adds $2,000 to the cost of
hospitalization according to one study, resulting in 2 billion dollars annual
increase in hospital costs. Administering the wrong dosage or improper
combinations can cause interactions or contraindications with fatal results. 1.3
Million patients are victims of medicine injuries.
Examples of drug name confusion reported to the FDA include:
Serzone (nefazodone) for depression and Seroquel (quetiapine) for
schizophrenia
Lamictal (lamotrigine) for epilepsy, Lamisil (terbinafine) for nail infections,
Ludiomil (maprotiline) for depression, and Lomotil (diphenoxylate) for diarrhea
Taxotere (docetaxel) and Taxol (paclitaxel), both for chemotherapy
Zantac (ranitidine) for heartburn, Zyrtec (cetirizine) for allergies, and Zyprexa
(olanzapine) for mental conditions
Celebrex (celecoxib) for arthritis and Celexa (citalopram) for depression.
Most-Common Medication Mistakes:
The American Hospital Association lists these as some common types of
prescription or medication errors:
incomplete patient information (not knowing about patients'
allergies, other medicines they are taking, previous diagnoses, and
lab results, for example);
unavailable drug information (such as lack of up-to-date warnings);
miscommunication of drug orders, which can involve poor
handwriting, confusion between drugs with similar names, misuse
of zeroes and decimal points, confusion of metric and other dosing
units, and inappropriate abbreviations;
lack of appropriate drug labeling as a drug is prepared and
repackaged into smaller units;
environmental factors, such as lighting, heat, noise, and
interruptions, that can distract health professionals from their
medical tasks.
The Coalition for the Prevention of Massachusetts Medical Errors
has developed a consumer guide that encourages patients to
become "part of the health care team" along with their physicians,
nurses, and pharmacists, to prevent medication mistakes. See their
Guide for the prevention of medication errors here.
Who Tracks Medication Errors?
The Food and Drug Administration
Accepts reports from consumers and health professionals about
products regulated by the FDA, including drugs and medical
devices, through MedWatch, the FDA's safety information and
adverse event reporting program.
1-800-332-1088
www.fda.gov/medwatch/how.htm
Institute for Safe Medication Practices
Accepts reports from consumers and health professionals related to
medication. Publishes Safe Medicine, a consumer newsletter on
medication errors.
1800 Byberry Rd., Suite 810 Huntingdon Valley, PA 19006-3520
215-947-7797
www.ismp.org/Pages/Consumer.html
U.S. Pharmacopeia
MedMARX is an anonymous medication error reporting program
used by hospitals.
www.medmarx.com
12601 Twinbrook Parkway Rockville, MD 20852
1-800-822-8772
www.usp.org
Government Suicide Warning for Antidepressants
Article Source AOL
Doctors who prescribe some popular antidepressants should monitor their
patients closely for warning signs of suicide, especially when they first start the
pills or change a dose, the government warned Monday, March 22, 2004.
The Food and Drug Administration asked makers of 10 drugs to add or
strengthen suicide-related warnings on their labels.
The agency insists it's not yet clear whether the drugs actually spur suicide on
occasion - or whether the underlying mental illness is to blame. But FDA
bowed to pressure from anguished families who, at an emotional meeting last
month, blamed the pills for their loved ones' suicides and pleaded for better
warnings.
It's a difficult issue to sort out because depression itself can lead to suicide,
and studies clearly show that antidepressants have helped many people
recover from depression.
Still, until the question is settled, FDA's own scientific advisers had urged
stronger warnings that certain antidepressants may cause agitation, anxiety
and hostility in a subset of patients who may be unusually prone to rare side
effects.
Monday, FDA followed that recommendation, stressing that the most
vulnerable time is when a patient starts therapy or changes the dose.
``We think this is good advice whether the drugs increase the risk or not,'' said
FDA medical policy chief Dr. Robert Temple. ``There's a reason people are
put on therapy - their depression is worse or somebody's worried about it.
Maybe that's what drives it (reports of suicides) or maybe it's the drugs. In
either case, you really need to pay attention in the early days.''
While FDA's investigation into the possible suicide link initially focused on
children and teenagers, Monday's warning includes adults, too. The FDA had
investigated reports of suicide among adult antidepressant users in the early
1990s and concluded there was no link - but on Monday revealed that it is
reanalyzing that question.
The drugs of concern are newer generation antidepressants: Prozac, Paxil,
Zoloft, Effexor, Celexa, Lexapro, Luvox, which are called SSRIs or SSRI-like
drugs, and Remeron, Serzone and Wellbutrin, which operate differently.
Manufacturers didn't immediately say if they'd comply.
British health authorities sounded the alarm last year, saying long-suppressed
research suggests serotonin-affecting antidepressants might sometimes
increase the risk of suicidal behavior in children and teenagers. Excepting only
one drug, Prozac, that has been proven to alleviate pediatric depression,
Britain declared the other six SSRIs or SSRI-like drugs unsuitable for
depressed youth. Britain didn't mention the other three drugs listed in the U.S.
notice.
FDA issued a caution on pediatric use last year but says it doesn't yet have
proof the drugs are to blame. Among 25 studies of the suspect medications
involving 4,000 children and teens, there were no completed suicides. Some
109 patients experienced one or more possibly suicide-related behaviors or
attempts - but the studies varied dramatically in what was considered suicidal
behavior. For example, among 19 patients classified as cutting themselves,
almost all were superficial, with little bleeding.
But critics flooded an FDA meeting last month demanding stronger action and days later, the issue again made headlines when a 19-year-old woman
taking part in a study of Eli Lilly & Co.'s experimental new antidepressant
duloxetine hanged herself in a company-run facility.
Most antidepressant labels already contain some fine-print statement about
suicide, usually that the possibility is inherent with depression.
FDA asked Monday for explicit explanations of worrisome behavior changes to
be placed in bold print under the prominent ``warnings'' section of those
labels: agitation, anxiety, irritability and recklessness. Doctors spotting those
traits should consider prescribing a lower dose or stopping the drug, FDA said.
The drugs are used for many conditions other than depression; the warning
applies regardless of the reason for use.
Critics welcomed the change but said suicide complaints first were raised
many years ago.
``I'm just very sorry that it so long for them to act on this issue, because
there's been so much tragedy that occurred,'' added Jennifer Tierney of
Kernersville, N.C., who describes her daughter Jame as turning from a sweet,
popular honor student into a raging loner after taking Effexor for migraines at
age 14.
But psychiatrists caution that suicides have dropped as SSRI use has
increased round the world.
``We do a disservice to a population of people who could benefit from these
medications'' by overreacting, said Dr. Bela Sood, chair of pediatric psychiatry
at Virginia Commonwealth University.
Still, FDA's warning does alert doctors ``who in a very lackadaisical way
decide to put these kids on medications'' to do a more thorough exam - and to
tell parents what risks to watch for, Sood said.
Children in particular aren't good candidates for SSRIs if they're highly
impulsive, angry or aggressive, she said. There also is a window period of risk
just after pill use begins, before depression is really alleviated but when some
patients experience more energy.
Editor's Note: The full article can be accessed here:
See the report http://www.fda.gov/cder/drug/antidepressants/AntidepressanstPHA.htm
Drug Side Effects ignored by Doctors
Side effects from prescription medicines plague one in four patients, and when
they surface, most doctors fail to act, U.S. researchers said on Wednesday.
The findings, from a study published in the New England Journal of Medicine,
sound an alarm to the millions of Americans who take prescription drugs each
year. Some 3.34 billion prescriptions were dispensed in the United States in
2002, according to IMS Health, a provider of pharmaceutical and health care
data.
"It's a problem that is common, in many cases the impact could be prevented or
reduced, and it has a large impact on patients," said Tejal Gandhi, an internist at
Brigham & Women's Hospital in Boston and the chief author of the study.
Previous estimates have suggested that nearly 5 percent of hospital admissions - over 1 million per year -- are as a result of drug side effects. But most of the
cases are not documented.
The findings of the Gandhi team are based on prescriptions given to 1,202 adults
in four outpatient clinics in Boston.
"They found that adverse drug events were fairly frequent and usually mild,
although potentially serious, and preventable events were more frequent than
any patient or clinician would like (or should be willing to accept)," William
Tierney of the Indiana University School of Medicine said in an editorial.
Among the side effects, 13 percent were serious, such as low blood pressure or
internal bleeding, and 39 percent were preventable or potentially treatable, such
as cases where a drug was given to a patient known to be allergic to it.
In preventable cases, patients were given the wrong drug 45 percent of the time,
the wrong dose was prescribed in 10 percent of the cases, and patients were told
to take it too frequently 10 percent of the time.
"A lot of problems were going on a long time that weren't being fixed, either
because the patients didn't tell the doctor or the physicians didn't change the
medication. That was what surprised us," Gandhi told Reuters.
In nearly two-thirds of the cases, the side effects persisted because the doctor
failed to heed the warning signs. Patients who suffered in the remaining cases
did so because they never told the doctor about their symptoms.
Gandhi said the problem is important, in part, because side effects may
discourage patients from taking vital medicines, potentially worsening their
health.
Tierney said the medical community needs to use a variety of techniques to
reduce side effects, such as computer programs that check doses or a system
where patients are routinely interviewed about possible drug-related symptoms
while they wait for their appointment.
"With these 10-minute appointments, it's hard for the doctor to get into whether
the symptoms are bothering the patients," Gandhi said.
"In the absences of such efforts ... given the increasing number of powerful drugs
available to care for the aging population, the problem will only get worse,"
Tierney said.
The drugs that posed the greatest risk of side effects were the serotoninreuptake inhibitor class of antidepressants, the non-steroidal anti-inflammatory
drugs often given for joint pain, and calcium-channel blockers used to treat high
blood pressure.
Source: Copyright 2003 Reuters Limited.
Just 5 percent of U.S. doctors are responsible for 54 percent of all malpractice.
Source: National Practitioner Data Bank (NPDB). According to a recently
released NPDB report, there are about 5,000 physicians who have paid four or
more medical malpractice judgments or settlements since 1990.
By the time a physician has paid four awards, he or she stands only a 15 percent
chance of being sanctioned.
Even physicians who have paid ten or more settlements are disciplined at only a
40 percent rate.
The Medicare and Medicaid programs sanctioned fewer than one percent of
doctors who've made malpractice payments from receiving federal dollars.
The annual costs to society for medical errors in hospitals at $17 billion to $29
billion.
Only one in eight preventable medical errors committed in New York hospitals
results in a malpractice claim according to a 1990 Harvard Study.
From 1996 through 1999, Florida hospitals reported 19,885 incidents but only
3,177 medical malpractice claims. In other words, for every 6 medical errors only
1 claim is filed.
The number of new medical malpractice claims declined by about four percent
between 1995 and 2000. There were 90,212 claims filed in 1995 and 86,480
claims filed in 2000. (National Association of Insurance Commissioners).
Punitive Damages are awarded in less than 1 percent of medical malpractice
cases. (Bureau of Justice Statistics, 1996.)
Malpractice insurance costs amount to only 3.2 percent of the average
physician's revenues.
While medical costs have increased by 113 percent since 1987, the total amount
spent on medical malpractice insurance has increased by just 52 percent over
that time, less than half of medical services inflation.
The size of damage awards has been steady since 1991. The mean payout was
$135,941 in 2001, up 8.7 percent from $125,000 in 2000.
Over ten years, malpractice payouts have grown an average of 6.2 percent per
year. That's almost exactly the rate of medical inflation: an average of 6.7 percent
between 1990 and 2001.
In 2001, only 895 out of 16,676 payouts, or about 5 percent, topped $1 million.
(National Practitioner Data Bank, as quoted in Business Week, March 3, 2003.)
Only 5 percent of doctors (1 out of 20) are responsible for 54 percent of
malpractice payouts. (National Practitioner Data Bank, Sept. 1, 1990 - Sept. 30,
2002.)
Only 8 percent of doctors (1 out of 12) with 2 or more malpractice payouts have
been disciplined by their state medical board. (National Practitioner Data Bank,
Sept. 1, 1990 - Sept. 30, 2002.)
Only 17 percent of doctors (1 out of 6) who have made 5 or more malpractice
payouts have been disciplined by their state medical board. (National Practitioner
Data Bank, Sept. 1, 1990 - Sept. 30, 2002.)
From 1997 to 2000 median medical malpractice payment rose an average of 8.5
percent a year, the average premium for single health insurance coverage
increased over that time period 9.5 percent a year.
New insurance industry data and analysis, released 11-15-03, shows that the
average medical malpractice insurance payout, or closed claim, has been only
$28,524 over the last decade. Payouts in 2001 follow the same low pattern. This
figure includes all jury verdicts, settlements and other costs used by insurers to
fight claims in court.
Medical malpractice insurers are paying nothing in 77 percent of all claims filed;
in the 23 percent of cases where insurers pay anything, the average claim is only
$107,587.
According to the Harvard Medical Practice Study, only one in eight malpractice
victims ever files a claim for compensation.
Average payouts have stayed virtually flat for the last decade. The average
payout is approximately $30,000. ("average" payouts are calculated differently
than "mean" payments).
Medical malpractice costs as a percentage of national health care expenditures
are 0.55% an all-time low.
Only one in eight injured victims ever files a malpractice claim. Only one in 16
ever receives any compensation. Only one in 32 win a jury verdict.
Only 895 out of 16,676 medical malpractice payouts, or about 5%, in 2001
topped $1 million, up from 506 in 1996, according to government data.
There has been no change in the volume of medical malpractice cases in the last
five years. Injured malpractice plaintiffs win before juries in only 23% of cases.
Only 1.1% of medical malpractice plaintiffs who prevail at trial are awarded
punitive damages.
Nov. 2003 GAO report: from 1996 through 2000 into the average per capita
payments were $10 for states with noneconomic damage caps compared to $17
for states with limited reforms.
Nevada, which adopted a $350,000 cap in 2002, discovered that only two
doctors were to blame for $14 million of the $22 million in claims awarded in one
recent year. Both are still practicing.
In Florida medical malpractice claims rose just 3.7% from 1997 to 2000,
according to the National Center for State Courts.
"Medical malpractice reform is bad medicine…Yet despite this epidemic of
[medical] errors, fewer than 2% of the victims of medical malpractice ever sue
their doctors … verdicts of $1 million occur in only 4% of medical malpractice
cases, and they are usually reduced to a median of $235,000 upon final
judgment."
--BusinessInsurance.com, Joanne Wojcik, Senior Editor, Commentary, 2/24/03
Selected Statistical Resources:
http://www.insurance-reform.org
http://www.citizen.org/publications/release
http://www.citizen.org
http://centerjd.org
death by medicine
Malpractice insurance costs amount to only 3.2 percent of the
average physician's revenues according to the Medicare Payment
Advisory Commission (MedPAC)
Independent MedPAC economists also reported that premiums
rose in the aggregate in 2002 by just 4.4 percent.
2 million hospital patients acquire infections that result in 90,000
deaths each year. One CDC expert says that "many hospital
personnel fail to follow basic infection control, such as hand
washing between patient contacts." Source: Center for Disease
Control (CDC).
Dr.s brainwashing their own patients the way Nancy Wallace tried to to with me:
Frank Clemente, director of consumer advocate Public Citizen's Congress Watch
in Washington, D.C., said he's worried patients might not be getting the whole
story from physicians.
"I guess my concern is, it's a bit of a brainwashing going on. It's a one-sided view
that's being shared with their patients," Clemente said.
New York State Board for Professional Medical Conduct
New York State Dept. of Health
Office of Professional Medical Conduct
433 River St., Suite 303
Troy, NY 12180
(518) 402-0855
www.health.state.ny.us/nysdoh/opmc/main.htm
Rsch Tort reform on med malpractice and negligence http://www.medical-malpracticelawyers-attorneys.com/tort_reform_links.html
http://centerjd.org/free/mythbusters-free/MB_10%20Med%20Mal%20Myth.pdf offers :
10 Things You Should Know About …
MEDICAL MALPRACTICE
1. Insurance companies are paying victims of medical negligence on average
approximately
$30,000. Average payouts have stayed virtually flat for the last decade.1
2. Medical malpractice costs, as a percentage of national health care expenditures, are at
an all time
low, 0.55 percent.2
3. According to the National Academy of Sciences, up to 98,000 people are killed each
year by
medical errors in hospitals – far more than die from car accidents, breast cancer or
AIDS.3
4. Total national costs (lost income, lost household production, disability and health care
costs) of
negligence in hospitals are estimated to be between $17 billion and $29 billion each
year.4
5. Eight times as many patients are injured by medical malpractice as ever file a claim; 16
times as
many suffer injuries as receive any compensation.5
6. According to the National Center for State Courts, between 1992 and 2001, medical
malpractice
filings per 100,000 population have only fluctuated minimally, with an overall 1 percent
decrease in
per capita filings.6
7. Injured medical malpractice patients win before juries in only 23 percent of cases7; in
1992, the
rate was 7.5 percent higher at 30.5 percent.8 Only 1.1 percent of medical malpractice
plaintiffs who
prevail at trial are awarded punitive damages.9
8. According to studies in several states, there is no correlation between where physicians
decide to
practice and state liability laws or insurance rates.10
9. Tort law limits do not lower insurance rates; states with little or no tort law restrictions
have
experienced approximately the same changes in insurance rates as those states that have
enacted
severe restrictions on victims’ rights.11
10. Numerous hospital and medical procedures have been made safer as a result of
lawsuits,
including anesthesia procedures, catheter placements, drug prescriptions, hospital staffing
levels,
infection control, nursing home care and trauma care.12
Center for Justice & Democracy
80 Broad St., 17th Floor
New York, NY 10004
Tel: 212.267.2801
Fax: 212.764.4298
[email protected]
http://centerjd.org
NOTES
“New Study Shows Average Medical Malpractice Payout Over Last Decade Only $28,524; New
Data
Reveals Same Trends in 2001,” Americans for Insurance Reform, News Release, January 23,
2003.
2 Ibid.
1
Kohn, Corrigan, Donaldson, Eds., To Err is Human; Building a Safer Health System, Institute of
Medicine,
National Academy Press: Washington, DC (1999).
4 Ibid.
5 Harvard Medical Practice Study, Patients, Doctors and Lawyers: Medical Injury, Malpractice
Litigation,
and Patient Compensation in New York (1990).
6 Examining the Work of State Courts, 2002; A National Perspective from the Court Statistics
Project
(2003), p. 28. This finding is based on medical malpractice data from 17 states.
7 Examining the Work of State Courts, 2001; A National Perspective from the Court Statistics
Project (2001),
p. 94.
8 “Tort Trials and Verdicts in Large Counties, 1996,” U.S. Department of Justice, Office of
Justice
Programs, Bureau of Justice Statistics, NCJ-179769 (August 2000), p. 9.
9 Ibid at 7.
10 Wlazelek, Ann, “Doctors’ ad campaign baseless; They’re not fleeing Pa., but malpractice straits
create
‘hostile’ climate,” Morning Call, March 24, 2002; “Doctors not leaving Pittsburgh despite costly
insurance,”
Associated Press, November 12, 2001; Goldstein, Josh, “Recent Census of Doctors Show No
Flight from
Pennsylvania,” Philadelphia Inquirer, October 2, 2001; Leonard, Martha, “State has seen sharp
increase in
number of doctors,” Sunday Gazette Mail, February 25, 2001; Kinney and Gronfein, “Indiana’s
Malpractice
System: No-Fault by Accident,” 54 Law & Contemp. Probs. 169, 188 (1991), cited in Galanter,
Marc, “Real
World Torts,” 55 Maryland L. Rev. 1093, 1152-1153 (1996); Kinney, “Malpractice Reform in the
1990s,
Past Disappointment, Future Success?” 20 J. Health Pol. Pol’y & L. 99, 120 (1996), cited in
Galanter, Marc,
“Real World Torts,” 55 Maryland L. Rev. 1093, 1152 (1996).
11 Martin D. Weiss, Melissa Gannon and Stephanie Eakins, Medical Malpractice Caps: The
Impact of NonEconomic Damage Caps on Physician Premiums, Claim Payout Levels, and Availability of
Coverage, Weiss
Ratings, Inc. (2003); J. Robert Hunter and Joanne Doroshow, Premium Deceit: The Failure of
“Tort
Reform” to Cut Insurance Prices, Center for Justice & Democracy (1999).
12 Meghan Mulligan and Emily Gottlieb, Lifesavers: CJ&D’s Guide to Lawsuits that Protect Us
All, Center
for Justice & Democracy (2002).
3
THE SEVEN MOST IMPORTANT THINGS TO KNOW
ABOUT MEDICAL MALPRACTICE
1. Insurance
industry profits are going through the roof and not a single doctors’
group
has demanded any accountability from, or reforms of, the insurance industry for
its
excessive price-gouging of doctors.
http://centerjd.org/profits.pdf, http://www.insurance-reform.org/pr/AIRProfit.pdf
2. It has been proven repeatedly that “caps” and other “tort reforms”
do not work.
States that have enacted so-called “tort reform” have only seen their insurance
rates
continue to shoot up after passing severe liability limits. In fact, doctors from at
least
three of the nine states represented at the national news conference scheduled
for
February 10 - Ohio, Missouri and Texas - and two out of seven states being
targeted for
media campaigns - Nevada and Florida - all have severe caps and in each case,
insurers
have continued to increase insurance rates.
http://www.insurance-reform.org/pr/AIRCaps%20then%20Rate%20Hikes.pdf;
http://weissratings.com/News/Ins_General/20030602pc.htm;
http://www.weissratings.com/malpractice.asp
3. Lawsuits are not limiting access to health care. The U.S. General Accounting
Office
found, after an extensive investigation, that doctors’ groups have misled,
fabricated
evidence, or, at the very least, wildly overstated their case about how malpractice
insurance problems have limited access to health care. The only health care
access
problems that GAO could confirm were isolated and the result of factors having
nothing
at all to do with the legal system.
http://www.gao.gov/new.items/d03836.pdf; http://centerjd.org/GAOAMAltr.pdf
4. Medical malpractice costs are a tiny percentage of overall health care
expenditures.
Medical malpractice insurance and claims costs represent, at most, only 2
percent of
overall health care spending in this country, according to both the Congressional
Budget
Office and the General Accounting Office.
http://www.factcheck.org/article.aspx?docID=133; http://www.insurancereform.
org/pr/AIRhealthcosts.pdf. See also, http://www.insurancereform.org/pr/Tillinghast_Overstates.pdf
5. Medical malpractice lawsuit filings, payouts and jury verdicts are all dropping.
According to the National Center for State Courts (NCSC), “the 1992 to 2001
trend in
Center for Justice & Democracy
80 Broad St., 17th Floor
New York, NY 10004
Tel: 212.267.2801
Fax: 212.764.4298
[email protected]
http://centerjd.org
medical malpractice filings per 100,000 population has only fluctuated minimally,
with
an overall 1 percent decrease in per capita filings.”
http://www.ncsconline.org/D_Research/csp/2002_Files/2002_Tort_Contract.pdf
Total medical malpractice payouts dropped 6.9 percent from 2001 to 2002
according to a National Practitioner Data Bank (NPDB) analysis by Public
Citizen.
http://citizen.org/documents/NPDB_Data.pdf
Jury verdicts in medical malpractice cases are stagnant, even according to Jury
Verdict Research data, which tends to over-inflate award trends.
http://www.juryverdictresearch.com/Press_Room/Press_releases/Verdict_study/verdict_study2.ht
ml
6. Most malpractice is caused by a small number of doctors who are never
sanctioned.
Nothing is being done to crack down on the 5 percent of doctors (1 out of 20) that
are
responsible for 54 percent of malpractice payouts.
http://www.publiccitizen.org/congress/civjus/medmal/articles.cfm?ID=9125;
http://www.questionabledoctors.org/
7. Medical malpractice is continuing at epidemic proportions in this
country. In
1999,
the Institute of Medicine, part of the National Academy of Sciences, found that
medical
errors cause between 44,000 and 98,000 deaths in hospitals each year . Even
when using
the lower estimate, deaths due to medical errors exceed the number attributable
to the 8th
leading cause of death. More die in a given year as a result of medical errors
than from
motor vehicle accidents (43,458), breast cancer (42,297) or AIDS (16,516).
http://www.nap.edu/openbook/0309068371/html/
###
The Degree and Cost of Medical Malpractice
Key Findings of the National Academy of Sciences Institute of
Medicine
In 1999, the National Academy of Sciences Institute of Medicine released a
powerful new study
entitled To Err is Human; Building a Safer Health System, (Kohn, Corrigan,
Donaldson, Editors;
Institute of Medicine, National Academy Press, Washington, DC, 1999. ) Among
its most
important findings are the following:.
DEATHS IN HOSPITALS DUE TO MEDICAL ERRORS. The report’s findings
are
based on two large studies, one conducted in Colorado and Utah, which recently
corroborated an earlier study in New York.1 When the findings of these studies
are
“extrapolated to the over 33.6 million admissions to U.S. hospitals in 1997, the
results of the
study in Colorado and Utah imply that at least 44,000 Americans die each year
as a result of
medical errors. The results of the New York study suggest the number may be as
high as
98,000. Even when using the lower estimate, deaths due to medical errors
exceed the
number attributable to the 8th leading cause of death. More die in a given year as
a result of
medical errors than from motor vehicle accidents (43,458), breast cancer
(42,297) or AIDS
(16,516).” Pages 1, 22, 25-26.
COSTS OF PREVENTABLE MEDICAL ERRORS THAT RESULT IN INJURY.
“Total national costs (lost income, lost household production, disability and health
care costs)
of preventable adverse events … are estimated to be between $17 billion and
$29 billion, of
which health care costs represent over one-half.”2 Page 1, 22, 34. “In 1992, the
direct and
indirect costs of adverse events were slightly higher than the direct and indirect
costs of
caring for people with HIV and AIDS.” Pages 22-23, 35.
- more Brennan, Troyen A.; Leape, Lucian L.; Laird, Nan M.; et al, Incidence of adverse events and
negligence in
hospitalized patients. Results of the Harvard Medical Practice Study, N Engl J Med 324:370-376,
1991. Thomas,
Eric J.; Studdert, David M.; Burstin, Helen R.; et al. Incidence and Types of Adverse Events and
Negligent Care in
Utah and Colorado. Med Care forthcoming Spring 2000.
2 Thomas, Eric J.; Studdert, David M.; Newhouse, Joseph P.; et al. Costs of Medical Injuries in
Utah and Colorado,
Inquiry 36:255-264, 1999. See also, Johnson, W.G.; Brennan, Troyen A.; Newhouse, Joseph P.;
et al. The
Economic Consequence of Medical Injuries, JAMA 267:2487-2492, 1992.
1
Doctor Negligence
Medical malpractice can occur in and a variety of ways. But a doctor's negligence is the common
thread in all of them. When a doctor or hospital deviates from the standard of acceptable medical
care and acts negligently or with gross negligence, the resulting injuries could be the basis for a
medical malpractice negligence claim. Of course causation must be proven: that is it must be
shown that the actions or failure to act on the part of the medical provider was the actual cause of
the harm.
Examples of doctors negligence can include:
- failure to diagnose an illness
- failure to prevent surgical infection
- leaving a medical device implanted after surgery
- surgery without informed consent
- certain birth injuries and cerebral palsy
- failure to diagnose breast cancer
- late diagnosis: diminished chance of survival
- misdiagnosis
These high rates of medical errors resulting in deaths, permanent disability, and suffering are
unacceptable in our American medical system.
If your physician or health care provider has committed any of these acts, .
What to do Now?
First: Get your medical Records immediately!
If you have been injured, the burden of proof is upon you to prove a doctor's negligence. This is
best accomplished by obtaining medical records as early as possible in the process. Most
times medical records will form the basis upon which a lawsuit was filed.
Second: Talk to an attorney
Counsel should be secured at the earliest suspicion of doctor error. These cases are won or
lost on the records. Most do not realize that important medical records can be lost, altered, or
destroyed unless protective measures to secure them are taken early.
Most importantly: Submit your case evaluation
If you are your loved ones have been injured by the negligence of a doctor or medical care facility
we may be able to help you. Submit your case for a free consultation. Our network of
attorneys will help determine whether medical malpractice has occurred and if you have a viable
case.
Med POA http://www.medical-malpractice-lawyers-attorneys.com/medical_attorney.html
Center for Justice & Democracy
80 Broad St., 17th Floor
New York, NY 10004
Tel: 212.267.2801
Fax: 212.764.4298
[email protected]
http://centerjd.org
MYTHBUSTER The Degree and Cost of
Medical Malpractice
Key Findings of the National Academy of Sciences Institute of
Medicine
In 1999, the National Academy of Sciences Institute of Medicine released a
powerful new study
entitled To Err is Human; Building a Safer Health System, (Kohn, Corrigan,
Donaldson, Editors;
Institute of Medicine, National Academy Press, Washington, DC, 1999. ) Among
its most
important findings are the following:.
DEATHS IN HOSPITALS DUE TO MEDICAL ERRORS. The report’s findings
are
based on two large studies, one conducted in Colorado and Utah, which recently
corroborated an earlier study in New York.1 When the findings of these studies
are
“extrapolated to the over 33.6 million admissions to U.S. hospitals in 1997, the
results of the
study in Colorado and Utah imply that at least 44,000 Americans die each year
as a result of
medical errors. The results of the New York study suggest the number may be as
high as
98,000. Even when using the lower estimate, deaths due to medical errors
exceed the
number attributable to the 8th leading cause of death. More die in a given year as
a result of
medical errors than from motor vehicle accidents (43,458), breast cancer
(42,297) or AIDS
(16,516).” Pages 1, 22, 25-26.
COSTS OF PREVENTABLE MEDICAL ERRORS THAT RESULT IN INJURY.
“Total national costs (lost income, lost household production, disability and health
care costs)
of preventable adverse events … are estimated to be between $17 billion and
$29 billion, of
which health care costs represent over one-half.”2 Page 1, 22, 34. “In 1992, the
direct and
indirect costs of adverse events were slightly higher than the direct and indirect
costs of
caring for people with HIV and AIDS.” Pages 22-23, 35.
UNDERESTIMATION OF FIGURES. “These figures offer only a very modest
estimate
of the magnitude of the problem since hospital patients represent only a small
percentage of
the total population at risk, and direct hospital costs are only a fraction of the total
costs.”
Page 2, 26. (“More is known about errors that occur in hospitals than in other
health care
delivery systems.” Page 23.) Not included in these studies are medical errors
resulting from
care provided in ambulatory settings, outpatient surgical centers, physician
offices and
clinics, home care, retail pharmacies and nursing homes. Page 2.
MEDICATION ERRORS. “Medication errors alone (accidental poisoning by
drugs,
medicaments and biologicals, occurring either in or out of the hospital), are
estimated to
account for over 7,000 deaths annually, compared with less than 3,000 people in
1983,
almost a 3-fold increase.”3 Generalizing the results of a prior study,4 “the
increased hospital
costs alone of preventable adverse drug events affecting inpatients are about $2
billion for the
nation as a whole.” Page 1-2, 27-28. Moreover, these estimated are low because
“many
errors go undocumented and unreported.” Page 29. “It has been estimated that
for every
dollar spent on ambulatory medications, another dollar is spent to treat new
health problems
caused by medications.”5 And “for every dollar spent on drugs in nursing facilities,
$1.33 is
consumed in the treatment of drug-related morbidity and mortality, amounting to
$7.6 billion
for the nation as a whole, of which $3.6 billion as been estimated to be
avoidable.”6 Page 35.
TYPES OF ADVERSE EVENTS. “Patient safety problems of many kinds occur
during the
course of providing health care. They include transfusion errors and adverse
drug events;
wrong-side surgery and surgical injuries; preventable suicides; restraint-related
injuries or
death; hospital-acquired or other treatment-related infections; and falls, burns,
pressure
ulcers, and mistaken identity.” Page 30.
INATTENTION TO SAFETY. “Health care is a decade or more behind other
high-risk
industries [like aviation] in its attention to ensure basic safety.” Page 4. “The
likelihood of
dying per domestic jet flight is estimated to be one in eight million. Statistically,
the average
passenger would have to fly around the clock for more than 438 years before
being involved
in a fatal crash.7 …Some believe that public concern about airline safety, in
response to the
impact of news stories, has played an important role in the dramatic improvement
in safety in
the airline industry.” By comparison, “Americans have a very limited
understanding of
health care safety issues.” Page 36.
Brennan, Troyen A.; Leape, Lucian L.; Laird, Nan M.; et al, Incidence of adverse events and
negligence in
hospitalized patients. Results of the Harvard Medical Practice Study, N Engl J Med 324:370-376,
1991. Thomas,
Eric J.; Studdert, David M.; Burstin, Helen R.; et al. Incidence and Types of Adverse Events and
Negligent Care in
Utah and Colorado. Med Care forthcoming Spring 2000.
2 Thomas, Eric J.; Studdert, David M.; Newhouse, Joseph P.; et al. Costs of Medical Injuries in
Utah and Colorado,
Inquiry 36:255-264, 1999. See also, Johnson, W.G.; Brennan, Troyen A.; Newhouse, Joseph P.;
et al. The
Economic Consequence of Medical Injuries, JAMA 267:2487-2492, 1992.
3 Phillips, David P.; Christenfeld, Nicholas; and Glynn, Laura M; Increase in US Medication-Error
Deaths between
1983 and 1993, The Lancet, 351:643-44, 1998.
4 Bates, David W.; Spell, Nathan; Cullen, David J.; et al., The Costs of Adverse Drug Events in
Hospitalized
Patients, JAMA 277:307-311, 1997.
5 Alliance for Aging Research, When Medicine Hurts Instead of Helps, Washington DC: The
Alliance for Aging
Research; 1998.
6 Bootman, J. Lyle; Harrison, LTC Donald L., and Cox, Emily, The Health Care Cost of DrugRelated Morbidity
and Mortality in Nursing Facilities, Arch Intern Med. 157(18):2089-2096, 1997.
7 Federal Aviation Administration, Office of System Safety. Aviation Safety Reporting System
(ASRS) Database
[Web Page] 1999. Available at: http://nasdac.faa.gov/safety_data.
1
MEDICAL MALPRACTICE STATUTE OF LIMITATIONS
THERE ARE OTHER EXCEPTIONS AND TIME PERIODS THAT APPLY TO MOST
CASES. In addition, special rules and exceptions exist in many states for medical
malpractice cases. For example, minors can have the statute "tolled" or stopped until they
reach the age of majority in many states. Many states toll the medical malpractice statute
for incapacity. Often language exists in the statute that does not start the time limit
running until the victim knew or "should have known" about the malpractice. Special
rules can exist for medical malpractice involving hidden surgical instruments or "foreign
object" cases, in which malpractice is difficult to find in a timely manner. In addition,
where there is a death from medical malpractice, many states have "wrongful death"
statutes that govern the time limit for bringing an action. Stautes of repose can also place
absolute time limits on these exceptions. These rules and exceptions exist in almost all
states so you should not merely rely on the general rule, but should seek legal counsel as
to the specific rules and exceptions in your state governing medical malpractice Statutes
of Limitations. NY - 2 1/2 years statute of limitations. N.Y. C.P.L.R. § 214a. VA - 2
years statute of limitations. Va. Code Ann. § 8.01-243.
Rsch:
Center for Justice and Democracy
80 Broad St.
17th Floor
New York, NY 10004
[email protected]
212.267.2801
Fax: 212.764.4298
There is only one way to solve this insurance problem: reforming the business
and
accounting practices of the insurance industry.
Americans for Insurance Reform, a coalition of more than 100 consumer groups
including
the National Women’s Health Network, says that the only way to solve the problem of
skyrocketing insurance rates for doctors is to reform the insurance industry. One
important step is to repeal the industry’s exemption from anti-trust laws at both the state
and federal (McCarran-Ferguson Act) levels. These laws allow insurance companies to
price-fix, something that is illegal for other industries. Another important step is to lower
claim frequency by weeding bad doctors out of the system through enforcement of
better doctor discipline. Only 5 percent of doctors are responsible for over half the
medical malpractice in this country but few are sanctioned by state disciplinary boards.
States should enact measures contained in California’s insurance law, Proposition 103,
which required a 20 percent rate rollback and prior approval of prices by the state
insurance commissioner under rigorous standards and allows consumer groups to
intervene in rate hearings. States should also require insurers, as a condition of their
license, to undertake risk management and the insurance commissioner should monitor
this effort.
1-pg Glossary of http://centerjd.org/free/mythbusters-free/MB_glossary.htm , here abridged by
me
"Tort reforms" (or tort "deforms") are cruel laws that reduce the
protections and rights our country provides to those who are injured
by defective products, toxic chemicals, medical malpractice, and
other wrongdoing. "Tort reforms," which often change centuries-old
common law, directly interfere with the independence of our
nation's civil justice system, tying the hands of judges and juries
who hear the evidence in a case, and undermining our country's
uniquely individualized system of justice. They make it more difficult
or impossible for injured consumers to hold wrongdoers
accountable. Adding to the already existing barriers to court that
exist for injured consumers, "tort reforms" present a peril to both
family safety and democracy in our country.
Physician Profile detailed information such as Medical Malpractice, Hospital
Discipline and Criminal Convictions. If enforcement (or disciplinary) action has been
taken against a physician's license, the public documents related to the action are
available to the public. These documents may include:
Accusation: the public document stating the charges the Board has filed against
a physician.
Decision: the public document describing the legal findings of the charges in an
Accusation and identifying the penalties imposed on the physician.
Stipulated Agreement: a form of plea bargain negotiated and settled prior to a
hearing.
Temporary Restraining Order or Interim Suspension Order: issued by either a
Superior Court Judge or Administrative Law Judge to halt a physician's practice
immediately.
Public Letter of Reprimand: a lesser form of discipline that can be negotiated for
minor violations before filing formal charges or an accusation.
Citation and Fine: an alternative method by which the Board can impose a
sanction and take action against a physician for a technical violation of the law.
(Note: Citations are not considered disciplinary action.)
Other Information includes:
Disciplinary Actions by the Medical Board and pending disciplinary proceedings
in which formal charges have been filed by the Board.
Felony Criminal Convictions.
Hospital Disciplinary Actions resulting in termination or revocation of hospital staff
privileges for medical disciplinary reasons going back to January 1, 1995.
Amounts Paid as a result of Malpractice Judgments and Arbitration Awards. The
actual dollar amount of the award is provided along with the court and docket
number. info on:
- the practitioner's education and training, including other health related degrees, professional and post graduate training specialty
- the practitioner's current practice and mailing addresses
- the practitioner's staff privileges and faculty appointments
- the practitioner's reported financial responsibility
- legal actions taken against the practitioner
- board final disciplinary action taken against the practitioner
- any liability claims filed against the practitioner which exceed $5,000
the following material on physicians:
-Whether the Physician is certified in a Specialty by a Specialty Board..
-Education and Training.
-Paid Malpractice Claims within the last 10 years. The number of payments made as a
result of a Settlement of a Malpractice Claim or a Judgment against the physician in a
malpractice lawsuit or an arbitration award is provided.
-Criminal Convictions within the past 10 years.
-Hospital disciplinary actions within the past 10 years.
-Final Disciplinary actions taken by the Board during the past 10 years.
Actions within 10 years;
- Criminal Convictions for felonies;
- Hospital Disciplinary Actions
- Medical malpractice court judgments and settlements.
- Government report refutes
- Disciplinary
Here is a glossary of the most common "tort reforms:"
Collateral Source Rule
- The collateral source rule prevents a wrongdoer
from reducing its financial responsibility for the injuries it causes by
the amount an injured party receives (or could later receive) from
outside sources. Payments from outside sources are those
unrelated to the wrongdoer, like health or disability insurance, for
which the injured party has already paid premiums or taxes. The
rule also prevents juries from learning about such collateral
payments, so as not to unfairly influence with verdict. States that
have modified this rule have either completely repealed it,
mandating that payments received from health insurance, social
security or other sources be used to reduce the wrongdoer's
liability. Or, they allow juries to hear during trial about collateral
payments.
Caps (on Damages)
- A damages cap is an arbitrary ceiling on the
amount an injured party can receive in compensation by a judge or
jury, irrespective of what the evidence presented at a trial proves
compensation should be. A cap is usually defined in a statute by a
dollar figure ($100,000, $500,000, etc.) or by tying the cap to
another type of damages (e.g. two times compensatory damages).
Caps usurp the authority of judges and juries, who listen to the
evidence in a case, to decide compensation based on each specific
fact situation. Several states have declared caps unconstitutional.
Caps on Non-economic Damages
- Non-economic damages
compensate injured consumers for intangible but real
injuries, like infertility, permanent disability,
disfigurement, pain and suffering, loss of a limb or
other physical impairment. Caps or limits on noneconomic damages have a disproportionate effect on
plaintiffs who do not have high wages - like women
who work inside the home, children, seniors or the
poor, who are thus more likely to receive a greater
percentage of their compensation in the form of noneconomic damages if they are injured.
Caps on Punitive Damages
- Punitive damages, also known
as "exemplary damages," are assessed against
defendants by judges or juries to punish particularly
outrageous, deliberate or harmful misconduct, and to
deter the defendant and others from engaging in
similar misconduct in the future. It is well recognized
that the prospect of having to pay punitive damages in
a lawsuit by an injured consumer causes corporations
to build safer products and operate more safely. Many
dangerous and defective products -- including the
Ford Pinto, asbestos, and the Dalkon Shield IUD -were removed from the market because of punitive
damages. Companies often weigh the potential costs
of liability to determine whether a defective product
should be redesigned or removed from the market, or
an unsafe practice should be stopped. Capping or
limiting punitive damages allows companies to treat
liability as a cost of doing business, weakening their
deterrent impact.
Contingency Fee Limits
-- Under a contingency fee arrangement, a
lawyer agrees to take a case on behalf of an injured client without
obtaining any money up front from the client. This is a risk, because
if the case is lost, the lawyer is paid nothing. In return, the lawyer is
entitled to a percentage of the amount of money collected -- usually
one-third -- if the case is successful. This system provides injured
consumers who could not otherwise afford legal representation with
access to the courts. Typically, states limit contingency fees by
capping them sometimes way below one-third, sometimes along a
sliding scale so fee percentages decrease, sometimes drastically,
as judgments increases. The principal impact of contingency fee
limits is to make it less likely attorneys can afford to risk bringing
many cases, particularly the more costly and complex ones,
providing practical immunity for many wrongdoers
Joint and Several Liability Limits
- The doctrine of joint and several liability
is a fairness rule, developed over centuries to protect injured
consumers. It applies when more than one defendant is found fully
or substantially responsible for causing an injury (not 1% or 10%
responsible, as is commonly misstated). If one wrongdoer is
insolvent or cannot pay their share, the other fully-responsible
wrongdoers must pick up the tab, to make sure the innocent victim
is fully compensated. For example, suppose three toxic polluters
recklessly contaminate drinking water, causing leukemia in
neighborhood children. The actions of any one of them alone would
be sufficient to cause leukemia. But because three companies are
involved, each one's relative share becomes only one-third. This
fortuitous circumstance allows them to split the total compensation
each one owes the victims. But if one of those three companies
becomes insolvent and cannot pay any compensation, who should
cover it? Joint and several liability says that the other companies
must cover the insolvent company's share. When joint and several
liability is limited or abolished, however, these other wrongdoers
are not required to cover the insolvent company's share. The
wrongdoers are off the hook and the innocent victim receives far
less compensation for injuries than the judge or jury determined
they deserve.
Loser Pays -
The English "loser pays" rule, which mandates that a
losing party pay the winners' costs, is an unfair and dangerous rule.
There are good reasons why it does not exist in America. Its chief
effect is discouraging important and legitimate cases. For example,
imagine you are injured by a negligent or reckless corporation and
believe you have a strong legal case. The economic devastation
you might face upon losing your case, having to reimburse a large
company for its inflated, hourly legal bills, would surely chill your
right to file suit and attempt to hold that company accountable in
court. That is why even in Britain, where loser pays exists, "legal
expense" insurance is available, providing at least those who can
afford it with the means to protect themselves against payment of
an opponent's legal costs.
Prejudgment Interest
- Prejudgment interest is the amount of interest
that accrues on the value of an injured consumer's claim between
the time he or she files a case and the final judgment. Some states
penalize victims by prohibiting pre-judgment interest or by imposing
very low limits on pre-judgment interest rates. Laws that limit
prejudgment interest can delay timely settlements or judgments in
civil cases by reducing the monetary incentive that defendants have
to resolve cases expeditiously.
Suicide and Drugs
On March 22, 2004 the Food and Drug Administration (FDA) asked
manufacturers of ten antidepressant drugs to include in their labeling a Warning
statement that recommends close observation of patients treated with these
agents for emergence of suicidality.
Points for me to remember HCV I a public concern, abandonment
by psychiatrist in mental and professional manner, not in physical
terms, however, D. Orhan never knew I was not seeing her, Nancy
Wallace used intimidation, Dr. Lahkani’s un useable handwriting in
my records will make no contribution to my health nor assistance to
future mental healthcare providers. Local entities do not want to
ruffle VCU feathers, p[robably because of the intermingling on
boards and local political offices, This can easily be investigated.
Also was Drs Orhan and Lahkani billing for intensive treatment and
or consultations with me that were in reality non-existent. Denial of
access to DP’s blood exam and not recognizing the indications of
already consequences in the already existent blood results which
indicated toxins released. Assaging me with, “you must be one of
those people with elevated blood chemistries”
Product Liability Defenses
- The doctrine of "strict liability" has long
applied in suits involving defective products. Strict liability ensures
that one who is responsible for bringing a dangerously defective
product into the marketplace or workplace compensates those
injured by the product. However, some states have enacted new
defenses for those who manufacturer or sell defective products. For
example, some laws establish a presumption that an injury-causing
product, drug or medical device is not defective or unreasonably
dangerous if the product complies with government standards. This
benefits manufacturers that profit from weak and long out-of-date
health and safety standards, like manufacturers of cars, trains,
factory equipment and school buses. Other provisions require an
injured consumer to prove the existence of an "alternative design"
for a defective product, which would have prevented the harm but
would not have hurt the product's marketability. This forces
plaintiffs, who are at a distinct disadvantage when it comes to
knowledge about technical design alternatives, to prove the
existence of such alternatives when this defense is raised. Other
laws immunize manufacturers that produce products with design
defects if the products have "obvious risks," like tobacco, or are
considered "unavoidably unsafe," like guns -- even if a defective
gun accidentally discharges and kills someone.
Statute of Repose
- A statute of repose for products completely cuts off
liability of the manufacturer or seller of a defective product after an
arbitrarily-established number of years, such as 10 years or 15
years. (A few states have adopted statutes of repose to cut off
doctors' and hospitals' liability for medical malpractice, as well.)
Statutes of repose apply no matter how serious the injuries, how
many injuries have been caused over the years by these products
or services, or how reckless the actions of the wrongdoer were.
They cover products with expected lives much longer than typical
cut-off dates in the statute of repose, products like nuclear power
plant components, medical devices such as pacemakers, elevators,
airplanes, home appliances, playground equipment, farm
equipment, freight trains, trucks, and other industrial machinery.
Structured Settlements
- Also called "periodic payments," structured
settlement laws either mandate, allow defendants to request, or
allow courts to require that some or all payments awarded by a
judge or jury be made to the injured consumer over a long period of
time. In other words, the injured consumer is prohibited from
receiving payments in a lump sum. These provisions increase the
hardships of the most seriously injured consumers who are hit soon
after an injury with large medical costs and must make adjustments
in transportation and housing. Often, the law allows insurance
companies to pocket the money upon the plaintiff's death, instead
of paying it to a dependent spouse or child.
Trial Lawyers for Public Justice
© 2003 The TLPJ Foundation
www.tlpj.org
National Headquarters
1717 Massachusetts Avenue, NW
Suite 800
Washington, DC 20036
ph: 202-797-8600
fax: 202-232-7203
West Coast Office
One Kaiser Plaza
Suite 275
Oakland, CA 94612
ph: 510-622-8150
fax: 510-622-8155
Below was found on:
http://www.tlpj.org/search_process.cfm
Hispanic Nat'l. Bar Assoc.
8201 Greensboro Dr., Ste. 300
McLean, VA 22102
Phone:703-610-9038
FAX:703-610-9005
Email:[email protected]
Web:www.hnba.com
Inst. of Law, Psychiatry & Public Policy
Univ. of VA, Blue Ridge Hosp.
Box 100
Charlottesville, VA 22901
Phone:804-924-5435
FAX:804-924-5788
Email:[email protected]
u
Web:www.ilppp.virginia.edu/ilppp
Nat'l Org. for Women
P.O. Box 25831
Richmond, VA 23260
Web:www.now.org
Univ. of Richmond Web:law.richmond.edu/default.htm
Williams Sch. of Law
Juris Publici
28 W. Hampton Way
Univ. of Richmond, VA 23173
Univ. of Virginia Sch. of
Law
Public Interest Law
Assoc.
Web:www.law.virginia.edu
Charlottesville, VA 22903
Virginia Poverty Law Cntr.
201 W. Broad St., Ste. 302
Richmond, VA 23220
Virginia Trial Lawyers
Assoc.
700 East Main St., Ste. 1510
Richmond, VA 23219
Washington and Lee Univ.
Sch. of Law
Public Interest Law
Students Assoc.
Lewis Hall
Lexington, VA 24450
William & Mary Univ. Marshall-Wythe Sch. of Law
Amicus Curiae
P.O. Box 8795
Williamsburg, VA 23187-8795
Feminist Majority Found.
1600 Wilson Blvd., Ste. 801
Arlington, VA 22209
Council of Better Business
Bureaus
4200 Wilson Blvd.
Ste. 800
Arlington, VA 22203-1838
Phone:804-782-9430
FAX:804-649-3746
Web:www.vplc.org
Phone:804-343-1143
FAX:804-343-7124
Email:[email protected]
Web:www.vtla.com
Web:law.wlu.edu
Web:www.wm.edu/law
Phone:703-522-2214
FAX:703-522-2219
Email:[email protected]
Web:www.feminist.org
Phone:703-276-0100
FAX:703-525-8277
Web:www.bbb.org
Cntr. for Health, Environment,
and Justice
P.O. Box 6806
Falls Church, VA 22040
Phone:703-237-2249
FAX:[email protected]
Web:www.chej.org
American Civil Liberties Union - Virginia
6 N. 6th St., Ste. 400
Richmond, VA 23219
Phone:804-644-8022
Web:members.aol.com/acluva/
American Assoc. for Affirmative Action
12100 Sunset Hills Rd.
Suite 130
Reston, VA 20190
Phone:800-252-8952
FAX:703-435-4390
Email:[email protected]
Web:www.affirmativeaction.org/
American Soc. of Newspaper Editors
11690 B Sunrise Valley Dr.
Reston, VA 20191
Phone:703-453-1122
FAX:703-453-1133
Email:[email protected]
Web:www.asne.org/
Rscj Tort
Reform Links:
Business week - refutes need for tort reform
Medical Malpractice - Victims stories
Texas Patient Safety Foundation - An excellent med mal resource
Civil Justice Facts - Civil Justice Fact-sheets
Trial Lawyers for Public Justice - Consumer Advocacy Lawers
http://www.votenader.com/issues/tort.html
http://www.centerjd.org/
http://www.atla.org/
http://www.consumerwatchdog.org/insurance/tort.php3
Tort_reform_news.html
http://www.publiccitizen.org/
http://www.consumerwatchdog.org/
GAO Govermant Malpractice Report - see report
Bush Malpractice Campaign
http://www.abanet.org/pubresource/home.html find You can contact the Division for Legal
Services by e-mail at [email protected].
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Buy legal insurance...
A "prepaid legal service plan" can help you insure, in advance, that you
will have a lawyer available should the need for legal help arise.
Find a lawyer...
Learn how to get a lawyer if you can't afford one.
Get help...
Or learn to do simple legal procedures yourself through innovative local
programs designed for people who can't afford or don't want to use
traditional legal representation.
Find out how to complain about serious lawyer misconduct...
The Directory of Lawyer Disciplinary Agencies lists disciplinary agencies
responsible for handling complaints against lawyers.
Facts About The Judicial System
Frequently Asked Questions
one of the goals of the American Bar Association has been to apply the knowledge
and experience of the legal profession to promotion of the public good. This is the
overriding mission of the ABA's Division for Public Services, an Association
program division providing staff support and expertise for attorney-sponsored
programs and activities that lend focus, voice and visibility to the Association's
public services role.
Ten membership groups carry out the work of this Division:






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Special Committee on Bioethics and the Law
Standing Committee on Substance Abuse
Standing Committee on Election Law
Standing Committee on Environmental Law
Commission on Homelessness and Poverty
Commission on Immigration Policy, Practice and Pro Bono
Standing Committee on the Law Library of Congress
Standing Committee on Law and National Security
Commission on Mental and Physical Disability Law
Selected Statistical Resources:
http://www.insurance-reform.org
http://www.citizen.org/publications/release
http://www.citizen.org
http://centerjd.org
death by medicine
Through their programs, the Association studies important legal issues affecting
society and formulates remedial responses ranging from policy positions to
demonstration projects, model legislation, technical assistance, videotapes,
clearinghouses, public education initiatives, working conferences and numerous
publications. These activities are advanced with an annual budget of over $3
million, much of which is derived from gifts and grants to the Association's Fund
for Justice and Education. The members who direct these endeavors are
primarily, but not exclusively, lawyer members of the ABA. They include
distinguished legal scholars, legislators, judges, lawyers in the public interest
community, private firm practitioners, corporate and government analysts,
health and social work professionals, scientists, and economists.
Since 1973, the ABA's Commission on Mental and Physical Disability has been the primary entity
within the ABA that focuses on the law-related concerns of persons with mental and physical
disabilities. Its mission is "to promote the ABA's commitment to justice and the rule of law for
persons with mental, physical, and sensory disabilities and their full and equal participation in the
legal profession." The Commission's members include lawyers and other professionals, many of
whom have disabilities.
USING THE DIRECTORY
Neither the American Bar Association nor the Commission on Mental and Physical Disability Law
endorses any of the lawyers or legal service providers found in this Directory. The Directory is
intended only as a research tool. Please note that individuals and organizations included in this
Directory vary widely and users should question listed attorneys about important issues before
agreeing to be represented or assisted.
Among organizations listed are the government supported protection and advocacy systems,
which use the following abbreviations to designate the scope of their disability law programs.
Client Assistance Program (CAP); Protection and Advocacy for Individuals with Mental Illness
(PAMI); and Protection and Advocacy for Individual Rights (PAIR).
NOTE: This directory is currently under renovation. Some information may be no longer valid. We
apologize for the inconvenience. For assistance, please email [email protected] or call (202)
662-1571.
Contact each of these lawyers on http://www.abanet.org/scripts/disability/displayResults.jsp
Let VA Trial Lawyers Assn know that I can’t call up http://www.vtla.com/default.htm VTLA is
active in a variety of public service and education projects, is a leader in continuing legal education
seminars, publishes a number of award-winning, valuable publications, and promotes improvements to the
administration of justice in Virginia through legislative representation at the Virginia General Assembly
and before other appropriate bodies. VTLA is active in the Virginia General Assembly promoting
improvements to the administration of justice intended to enrich the quality of life in Virginia. Initiatives
have included an increase in Virginia’s medical malpractice cap, truck safety labeling, improved divorce
and property division procedures, more equitable workers' compensation statutes, and support of insurance
reforms. Members are kept informed of the activities of the General Assembly through the LAWFLASH,
published weekly during the session. VTLA and its members are committed to improving public
understanding of the legal system and of the role of trial lawyers within that system. "The Road to Virginia
Justice" has been shown to thousands of Virginia middle and high school students. The film and teaching
materials feature a drunk driving case and use that case as the vehicle for explaining the legal rights and
responsibilities of citizenship.
VTLA also works closely with Virginia law schools, sponsoring trial advocacy and moot court
competitions and law school student chapters. Additionally, VTLA sponsors the "Excellence in Journalism"
award, identifying and rewarding media efforts to expose and correct societal conditions damaging to
consumers.
Mail
Virginia Trial
Lawyers
Association
700 East Main
Street, Suite 1510
Richmond,
Virginia 23219
By Phone
(804) 343-1143
By Fax
(804) 343-7124
By e-mail
[email protected]
Jack Harris, Executive Director [email protected]
Click here to read the VTLA Pro Bono
Resolution (PDF).
Need to read about ABA’s Goal X http://www.abanet.org/disability/GoalIX12.pmd.pdf
Need to reach and study each lead on http://www.abanet.org/disability/links_new.html
Physican’s insurance http://www.vtla.com/2003%20files/Reciprocal/DIR%20Mediation.pdf
Medical Malpractice Links and Resources:
20 Tips to prevent Medical Errors This fact sheet tells what you can do to avoid medical error
http://www.ahrq.gov/consumer/surgery.htm questions to ask your doctor before surgery
Report on Medical Errors to the President
New England Journal of Medicine: The nations premier medical journal.
Medical anatomy and terms: Easy explanations of medical terms.
Human Anatomy Online: Helpful anatomy drawings
Med League Support Services - Med League Support Services, Inc.
A Legal Nurse Consulting Firm Since 1989
Facts about Lasik Surgery: Government warning and info site about this common but sometime
unsuccessful proceedure.
Pharmacy Information: Info on common Prescription drugs.
FDA site for info on drugs and medical devices: Gov site giving info on regulated and recalled
drugs as well as defective medical devices like the Sulzer hip.
Emedicine medical info
- Medical Articles and research.
Online Medical Dictionary - including cancer topics.
National Library of Medicine - The World's largest medical Library.
Cancer CancerNet - the National Cancer Institute's (NCI) many sources of cancer information
including CANCERLIT
Drug and Prescription Guide - A guide to more than 9,000 prescription and over-the-counter
medications.
Illustrated Medical Encyclopedia - 4000 Medical Topics with information, illustrations, diagnosis,
treatment and prognosis.
MEDLINEplus - Find answers to your health questions. Anatomical Topics and illustrations.
Health News - Recent Medical news by topic and date.
Illustrations of spinal cord anatomy
Spinal cord injury association web
United Brachial Plexis network
United Cerebral Palsy web page
Mammography Page - Mammography Quality Standards Act of 1992 (MQSA) Mammograms
information
Surgical Eyes - site for eye surgery
Medical Legal News Source for medical legal articles.
Texas Patient Safety Foundation - An excellent med mal resource
Medical Errors - A Federal Report on Medical Errors to the President.
http://www.guideline.gov A goverment resource on acceptible treartment guidelines
Medical Errors - http://www.ahcpr.gov - Government agency for quality health care
http://www.ismp.org/Pages/Consumer.html - Medication errors: The Institute For Safe Medication
Practices (ISMP)
Medical Errors Articles - Med League Quick Updates on Medical Error
medical malpractice.blog
http://www.myhealthfinder.com/- Best Hospitals Ranked by specialty
circumcision in law
Legal links
State Bar Associations - A list of State Trial Associations.
Civil Justice Facts - Civil Justice Fact-sheets
Verdict Search: Recent Personal Injury Jury Verdicts.
American Legal Research - Your online resource for Legal Research
http://www.atla.org - Association of Trial Lawyers of America
http://www.naag.org/ - Association of State Attorney Generals
Trial Lawyers for Public Justice - Consumer Advocacy Lawers
Recommended Links
Personal Injury : Nationwide resource to find Personal Injury Attorneys.
Medical Malpractice Lawyer - Tort Lawyer.com
Personal Injury find Personal Injury Lawyers.
Car Accidents Nationwide resource to find Car Accident Attorneys.
Legal Malpractice Nationwide resource to find Legal Malpractice Attorneys.
Wrongful Death Nationwide resource to find Wrongful Death Attorneys.
Breast Cancer Nationwide resource to find Breast Cancer Malpractice Attorneys.
Motorcycle Accidents Nationwide resource to find Motorcycle Crash Attorneys.
Medical-malpractice Nationwide resource to find medical malpractice Attorneys.
Massachusetts Personal Injury - Masachusetts Injury Attorney Referrals
Massachusetts Attorney Massachusetts Lawyer practicing in all Courts
Massachussetts Lawyer Massachusetts Attorney Referrals for Probate , Business and personal
injury
Medical Malpractice Info - Info site legal
Lawyers.com - Lawyer Listings
ExpertLaw.com - A comprehensive directory of expert witnesses with additional free services for
experts, attorneys and the public.
77 Investigations Legal Investigations in all 50 States.
Continue Rsch on search page
http://search.msn.com/results.aspx?q=Attorneys%2C+Richmond%2C+Virginia&FORM=SMCRT
Item 11 Joel Bieber’s law firm
I believe I have received improper care and treatment by two (2) MCV psychiatrist during a 2 year
span. I was being treated by theser medical professionals at The Daily Planet, a non-profit. When
I began monthly visits with them, I brought results of a recent blood test which showed in black
and white indications of Liver disease. These two MCV doctors did not research and failed to tell
me that a follow up blood test, more sensitive to what detect what the elevated blood chemistry
was indicating, was indeed available right there at The Daily Planet. I complained about repetitive
'crashes' but they made excuses and never once considered that I was very ill bodily, as if once
on anti-depressants you can never get ill. Thus these 2 doctors dispensed the wrong medication
and at the wrong dosage when they should have alarmed as their collegues at the Nelson Clinic's
Pshychiatry Dept. were;
Thus for w years I have had the wrong diagnosis of a life-threatening condition;
These doctors' superficiality treatment did nothing to spare me from preventable suicide;
Thru the Virginia Coordinated Care health program I am now diagnosed with High Blood
pressure, and am awaiting test results of my 3rd or 4th blood test. I believe that it is now
impossible to completely restore myself from the damage and loss in this situation as my liver
condition has caused toxins to be released when I could have been treated back 2 years ago.
If you feel interested in this case on contingency, please let me know at either [email protected]
or [email protected] . Thank you kindly for the courtesy of your reply.
[Federal Register: April 17, 2003 (Volume 68, Number 74)]
[Rules and Regulations]
[Page 18895-18906]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr17ap03-15]
[[Page 18895]]
=======================================================================
----------------------------------------------------------------------DEPARTMENT OF HEALTH AND HUMAN SERVICES
Office of the Secretary
45 CFR Part 160
[CMS-0010-IFC]
RIN 0938-AM63
Civil Money Penalties: Procedures for Investigations, Imposition
of Penalties, and Hearings
AGENCY: Office of the Secretary, HHS.
ACTION: Interim final rule; request for comments.
----------------------------------------------------------------------SUMMARY: This interim final rule establishes rules of procedure for the
imposition, by the Secretary of Health and Human Services, of civil
money penalties on entities that violate standards adopted by the
Secretary under the Administrative Simplification provisions of the
Health Insurance Portability and Accountability Act of 1996
(``HIPAA''). We intend that this be the first installment of a rule
that we term the ``Enforcement Rule.'' The Enforcement Rule, when
issued in complete form, will set forth procedural and substantive
requirements for imposition of civil money penalties. In the interim,
we are issuing these rules of procedure to inform regulated entities of
our approach to enforcement and to advise regulated entities of certain
procedures that will be followed as we enforce the Administrative
Simplification provisions of HIPAA.
DATES: Effective Date: This interim final rule is effective May 19,
2003.
Comment Date: Comments on the interim final rule must be received
by June 16, 2003.
Expiration Date: This interim final rule will cease to be in effect
on September 16, 2003.
ADDRESSES: In commenting, please refer to file code CMS-0010-IFC.
Because of staff and resource limitations, we cannot accept comments by
facsimile (``FAX'') transmission. Mail written comments (one original
and three copies) to the following address only: Centers for Medicare &
Medicaid Services, Department of Health and Human Services, Attention:
CMS-0010-IFC, P.O. Box 8010, Baltimore, MD 21244-8010.
Please allow sufficient time for mailed comments to be timely
received in the event of delivery delays.
If you prefer, you may deliver (by hand or courier) your written
comments (one original and three copies) to one of the following
addresses: Room 445-G, Hubert H. Humphrey (``HHH'') Building, 200
Independence Avenue, SW., Washington, DC 20201, or Room C5-14-03, 7500
Security Boulevard, Baltimore, MD 21244-1850.
(Because access to the interior of the HHH Building is not readily
available to persons without Federal Government identification,
commenters are encouraged to leave their comments in the CMS drop slots
located in the main lobby of the building. A stamp-in clock is
available for commenters wishing to retain a proof of filing by
stamping in and retaining an extra copy of the comments being filed.)
Comments mailed to the addresses indicated as appropriate for hand
or courier delivery may be delayed and could be considered late.
Comments may also be submitted electronically to the following email address: [email protected]. For e-mail procedures, see the
beginning of the SUPPLEMENTARY INFORMATION section.
For further information on viewing public comments, see the
beginning of the SUPPLEMENTARY INFORMATION section.
FOR FURTHER INFORMATION CONTACT: Karen Shaw, (202) 690-7711.
SUPPLEMENTARY INFORMATION:
Inspection of Public Comments
Comments received timely will be available for public inspection as
they are received, generally beginning approximately 3 weeks after
publication of this document, at the headquarters of the Centers for
Medicare & Medicaid Services, 7500 Security Boulevard, Baltimore,
Maryland 21244, Monday through Friday of each week from 8:30 a.m. to 4
p.m. To schedule an appointment to view public comments, call Sharon
Jones at (410) 786-9994.
Electronic Comments
We will consider all electronic comments that include the full
name, postal address, and affiliation (if applicable) of the sender and
are submitted to the electronic address identified in the ADDRESSES
section of this preamble. All comments must be incorporated in the email message because we may not be able to access attachments. Copies
of electronically submitted comments will be available for public
inspection as soon as practicable at the address provided, and subject
to the same process described, in the preceding paragraph.
Copies
To order copies of the Federal Register containing this document,
send your request to: New Orders, Superintendent of Documents, P.O. Box
371954, Pittsburgh, PA 15250-7954. Specify the date of the issue
requested and enclose a check or money order payable to the
Superintendent of Documents, or enclose your Visa or Master Card number
and expiration date. Credit card orders can also be placed by calling
the order desk at (202) 512-1800 (or toll-free at 1-866-512-1800) or by
faxing to (202) 512-2250. The cost for each copy is $10. As an
alternative, you may view and photocopy the Federal Register document
at most libraries designated as Federal Depository Libraries and at
many other public and academic libraries throughout the country that
receive the Federal Register.
This Federal Register document is also available from the Federal
Register online database through GPO Access, a service of the U.S.
Government Printing Office. The web site address is: http://www.access.gpo.gov/nara/index.html
.
Electronic Access
This document is available electronically at the following web
sites of the Department of Health and Human Services (``HHS'' or the
``Department''): http://www.hhs.gov/ocr/hipaa/ and http://www.cms.gov/hipaa/hipaa2.
Printing Office at http://www.access.gpo.gov/nara/index.html.
I. Background
This interim final rule establishes rules of procedure for the
imposition, by the Secretary of Health and Human Services, of civil
money penalties on entities that violate the Administrative
Simplification regulations (``HIPAA rules'') adopted by the Secretary
under subtitle F of Title II of HIPAA (``HIPAA provisions''). We intend
this interim final rule to be the first installment of a rule termed
the ``Enforcement Rule.'' The Enforcement Rule, when issued in complete
form, will set forth procedural and substantive requirements for
imposition of civil money penalties. In the interim, we are issuing
these rules of procedure to inform regulated entities of our approach
to enforcement and to advise regulated entities of certain procedures
that will be followed with regard to enforcement. We intend to revise
the procedural rule by the expiration date provided above.
We set out below the statutory and regulatory background of the
rule, describe our approach to enforcement of the HIPAA provisions and
rules in general and this rule in particular, and then discuss each
section of the interim final rule. We also set out our analyses of
impact and other issues under applicable law.
[[Page 18896]]
Statutory Background
HIPAA became law in 1996 (Public Law 104-191). Subtitle F of Title
II of HIPAA, entitled ``Administrative Simplification,'' requires the
Secretary of HHS to adopt national standards for certain informationrelated activities of the health care industry. The purpose of subtitle
F is to improve the Medicare program under title XVIII of the Social
Security Act (``Act''), the Medicaid program under title XIX of the
Act, and the efficiency and effectiveness of the health care system, by
mandating the development of standards and requirements to enable the
electronic exchange of certain health information. Section 262 of
subtitle F added a new Part C to Title XI of the Act. Part C (42 U.S.C.
1320d-1320d-8) requires the Secretary to adopt national standards for
certain financial and administrative transactions and various data
elements to be used in those transactions, such as code sets and
certain unique health identifiers. Recognizing that the industry trend
toward computerizing health information, which HIPAA encourages, may
increase the access to that information, the statute also requires
national standards to protect the security and privacy of the
information.
The HIPAA provisions, by statute, apply only to the following
persons:
(1) A health plan.
(2) A health care clearinghouse.
(3) A health care provider who transmits any health information in
electronic form in connection with a transaction referred to in section
1320d-2(a)(1) of this title.
42 U.S.C. 1320d-1(a)
Collectively, these entities are known as ``covered entities.'' The
statute requires certain consultations with industry as a predicate to
the issuance of standards and gives most covered entities 2 years
(small health plans have 3 years) to come into compliance with the
standards, once adopted. 42 U.S.C. 1320d-1(c), 42 U.S.C. 1320d-4(b).
The statute establishes civil money penalties and criminal penalties
for violations. 42 U.S.C. 1320d-5, 42 U.S.C. 1320d-6. HHS will enforce
the civil money penalties, while the U.S. Department of Justice will
enforce the criminal penalties.
HIPAA's civil money penalty (``CMP'') provision authorizes the
Secretary to impose CMPs, as follows:
(1) In general. Except as provided in subsection (b), the
Secretary shall impose on any person who violates a provision of
this part [42 U.S.C. 1320d et seq.] a penalty of not more than $100
for each such violation, except that the total amount imposed on the
person for all violations of an identical requirement or prohibition
during a calendar year may not exceed $25,000.
(2) Procedures. The provisions of section 1128A [42 U.S.C.
1320a-7a] (other than subsections (a) and (b) and the second
sentence of subsection (f)) shall apply to the imposition of a civil
money penalty under this subsection in the same manner as such
provisions apply to the imposition of a penalty under such section
1128A.
42 U.S.C. 1320d-5(a)
Subsection (b) of section 1320d-5 sets out a number of substantive
limitations on the Secretary's authority to impose CMPs. First, a CMP
may not be imposed with respect to an act that ``constitutes an offense
punishable'' under the criminal penalty provision. 42 U.S.C. 1320d5(b)(1). Second, a CMP may not be imposed ``if it is established to the
satisfaction of the Secretary that the person liable for the penalty
did not know, and by exercising reasonable diligence would not have
known, that such person violated the provision.'' 42 U.S.C. 1320d5(b)(2). Third, a CMP may not be imposed if the failure to comply was
due ``to reasonable cause and not to willful neglect'' and is corrected
within a certain time. 42 U.S.C. 1320d-5(b)(3). Finally, a CMP may be
reduced, if not waived entirely, ``to the extent that the payment of
such penalty would be excessive relative to the compliance failure
involved.'' 42 U.S.C. 1320d-5(b)(4).
As noted above, HIPAA incorporates by reference certain provisions
of section 1128A of the Act (42 U.S.C. 1320a-7a). Those provisions, as
relevant here, provide a number of procedural requirements with respect
to the imposition of CMPs. The Secretary may not initiate a CMP action
``later than six years after the date'' of the occurrence that forms
the basis for the CMP. The Secretary may initiate a CMP action by
serving notice ``in any manner authorized by Rule 4 of the Federal
Rules of Civil Procedure.'' 42 U.S.C. 1320a-7a(c)(1). A person upon
whom the Secretary seeks to impose a CMP must be given written notice
and an opportunity for a determination to be made ``on the record after
a hearing at which the person is entitled to be represented by counsel,
to present witnesses, and to cross-examine witnesses against the
person.'' 42 U.S.C. 1320a-7a(c)(2). There are provisions authorizing
the sanctions the hearing officer may impose for misconduct in
connection with the CMP proceeding, judicial review of the Secretary's
determination in the United States Court of Appeals for the circuit in
which the person resides, and the issuance of subpoenas by the
Secretary and the enforcement of those subpoenas. 42 U.S.C. 1320a7a(c)(4), (e), (j). These provisions are discussed more fully below.
Regulatory Background
As noted above, HIPAA requires the Secretary of HHS to adopt a
number of national standards to facilitate the exchange of certain
health information. The Secretary has already issued a number of these
HIPAA standards by regulation. We summarize these HIPAA Administrative
Simplification rules below.
[sbull] Regulations implementing the statutory requirement for the
adoption of standards for transactions and code sets (``Transactions
Rule'') were published on August 17, 2000 (65 FR 50312), and were
recently modified (68 FR 8381, February 20, 2003). The Transactions
Rule became effective on October 16, 2000, with an initial compliance
date of October 16, 2002 for covered entities other than small health
plans. The passage of the Administrative Simplification Compliance Act,
Pub. L. 107-105, in 2001 enabled covered entities to obtain an
extension of the compliance date to October 16, 2003 by filing a
compliance plan by October 15, 2002. If a covered entity (other than a
small health plan) did not file such a plan, it was required to comply
with the Transactions Rule by October 16, 2002. All covered entities
must be in compliance with the Transactions Rule, as modified, by
October 16, 2003.
[sbull] Regulations implementing the statutory requirement for the
adoption of privacy standards were published on December 28, 2000 (65
FR 82462) (``Privacy Rule''). The Privacy Rule became effective on
April 14, 2001, with an initial compliance date of April 14, 2003 for
covered entities other than small health plans. Modifications to the
Privacy Rule were published on August 14, 2002 (67 FR 53182), and
compliance with the modified privacy standards is required by the
initial compliance date, April 14, 2003, for those covered entities
that must comply by that date.
[sbull] Regulations implementing the statutory requirement for the
adoption of an employer identifier standard were published on May 31,
2002 (67 FR 38009) and became effective on July 30, 2002. The initial
compliance date is July 30, 2004 for most covered entities; small
health plans have until July 30, 2005 to come into compliance.
[sbull] Regulations implementing the statutory requirement for the
adoption of security standards were published on February 20, 2003 (68
FR 8334). They
[[Page 18897]]
are effective on April 21, 2003, and the initial compliance date for
covered entities other than small health plans is April 20, 2005; small
health plans have until April 20, 2006 to comply.
The authority for administering and enforcing compliance with the
Privacy Rule has been delegated to the Office for Civil Rights
(``OCR'') of HHS.\1\ Responsibility for administering and enforcing the
remaining HIPAA rules has been assigned to the Centers for Medicare &
Medicaid Services (``CMS'').\2\
--------------------------------------------------------------------------\1\ On December 28, 2000, the Secretary delegated to the
Director of OCR authority to enforce, administer, interpret, and
implement the Privacy Rule. 65 FR 82381.
\2\ HHS press release of October 15, 2002.
--------------------------------------------------------------------------II. General Approach
As the discussion above makes clear, the duty to comply with
certain of the HIPAA rules is now a reality for many, if not most,
covered entities. The immediacy of the compliance obligation brings
with it the issue of how these rules will be enforced. Accordingly, we
lay out below our general approach to enforcement. We then discuss how
the rules below will fit in with the projected Enforcement Rule in its
entirety and the basic approach of the interim final rule.
HHS's General Approach to Enforcement
The Department intends to seek and promote voluntary compliance
with the rules promulgated to carry out the HIPAA provisions. With
respect to the Privacy Rule, OCR has developed and is continuing to
produce guidance and a wide array of other technical assistance
materials to help covered entities effectively implement the Privacy
Rule. These materials are available on the OCR Privacy web site at
http://www.hhs.gov/ocr/hipaa. These efforts will continue after the
April 14, 2003 compliance date, as OCR learns from its compliance
activities and from those who are implementing the Privacy Rule where
additional guidance and assistance are needed. Other components of the
Department are also developing guidance and technical assistance on the
Privacy Rule for their partners.
This approach reflects the requirements in 45 CFR part 160, subpart
C, that, to the extent practicable, OCR will seek the cooperation of
covered entities in obtaining compliance with the Privacy Rule, and may
provide technical assistance to help covered entities voluntarily
comply with the Rule. See 45 CFR 160.304. As further provided in 45 CFR
160.312(a)(2), OCR will seek to resolve matters by informal means
before issuing findings of non-compliance, under its authority to
investigate and resolve complaints, and to engage in compliance
reviews.
With respect to enforcement of the remainder of the HIPAA rules,
the enforcement approach of CMS is similar. ``Enforcement activities
will focus on obtaining voluntary compliance through technical
assistance. The process will be primarily complaint driven and will
consist of progressive steps that will provide opportunities to
demonstrate compliance or submit a corrective action plan.'' HHS press
release of October 15, 2002, announcing assignment of enforcement
responsibility to CMS. CMS provides a wide variety of technical
assistance and informational materials on its Web site, at http://www.cms.gov/hipaa/hipaa2
.
HHS's Approach to the Enforcement Rule
As noted above, HHS intends to issue an Enforcement Rule in
furtherance of its implementation of 42 U.S.C. 1320d-5. The Enforcement
Rule, in its entirety, will address a number of substantive issues
relating to the imposition of CMPs under section 1320d-5, such as the
Department's policies for determining violations and calculating CMPs.
In addition, the Enforcement Rule will establish various procedures for
the imposition of CMPs, including the procedures for providing notice
and a hearing on the Secretary's determination to impose a CMP. This
interim final rule implements this latter aspect of the Enforcement
Rule.
Administrative Procedure Act
We recognize that under the Administrative Procedure Act (``APA'')
most of the above-described provisions of the Enforcement Rule must be
promulgated through notice-and-comment rulemaking. We intend to do so.
However, to allow covered entities and the public to be informed as
soon as possible of procedural requirements that will apply as
compliance proceeds, we are expediting the publication of these
procedural rules in final form. These rules set out the procedures for
provision by the agency of the statutorily required notice and hearing
and procedures for issuing administrative subpoenas. Such provisions
are exempted from the requirement for notice-and-comment rulemaking
under the ``rules of agency * * * procedure, or practice'' exemption at
5 U.S.C. 553(b)(3)(A). Even though notice-and-comment rulemaking is,
therefore, not required with respect to the procedural rules adopted
below, HHS is interested in input from the public, and thus is
requesting public comment on them. We expect to augment these
procedural rules with provisions that, while related to procedure, are
substantive in nature. We anticipate including those provisions in the
notice-and-comment rulemaking that we plan for the remainder of the
Enforcement Rule. In any event, we plan to revise the procedural rule
by the expiration date.
Approach of the Interim Final Rule
As noted above, the provisions of 42 U.S.C. 1320a-7a apply to the
imposition of a CMP under 42 U.S.C. 1320d-5 ``in the same manner as''
they apply to the imposition of CMPs under section 1320a-7a itself.
Within HHS, section 1320a-7a is implemented by the Office of Inspector
General (``OIG'') and, as pertinent here, through the OIG regulations
that are codified at 42 CFR parts 1003, 1005, and 1006. We have used
the OIG regulations as the platform for the rules below for two
reasons. First, we read the ``in the same manner as'' language of the
statute as indicating that the procedures for the imposition of CMPs
under 42 U.S.C. 1320d-5 should be, in general, similar to those used by
the OIG under 42 U.S.C. 1320a-7a. Second, HHS and much of the health
care industry have operated under the OIG regulations implementing
section 1320a-7a for more than a decade. There is, thus, a significant
body of experience with, and understanding of, the OIG procedural
rules, both within HHS and in a large part of the regulated universe.
Based on this experience, we believe that the rules below will be
workable and promote the efficient resolution of cases where the
Secretary's proposed imposition of a CMP is challenged.
Accordingly, the rules below are based upon, and are in many
respects the same as, the OIG regulations at 42 CFR parts 1003, 1005,
and 1006. We have adapted, re-ordered, or combined the OIG language in
a number of places for clarity of presentation or to reflect concepts
peculiar to the HIPAA provisions or rules. To avoid confusion, we have
also employed certain language usages in order to make the usage in the
rules below consistent with that in the other HIPAA rules (for example,
for mandatory duties, ``must'' instead of ``will'' or ``shall''; for
discretionary duties, ``may'' instead of ``has the authority to''). We
do not discuss those nonsubstantive changes below. Where we have
materially changed the language of the OIG regulations, however, we
discuss our reasons for doing so.
[[Page 18898]]
We also note that the rules below, as well as the Enforcement Rule
as a whole, are not HIPAA standards, and thus the requirement for
industry consultations in 42 U.S.C. 1320d-1(c) does not apply.
Therefore, we have not engaged in such consultations with respect to
the interim final rule below. For the same reason, HIPAA's timeframes
for compliance (42 U.S.C. 1320d-4) do not apply to the interim final
rule below.
III. Provisions of the Interim Final Rule
We discuss the interim final rule on a provision-by-provision basis
below. As a general matter, we note that the provisions adopted are in
many cases the same as or similar to analogous provisions of the OIG
regulations. Where we have closely followed the OIG regulations, we
have done so because we believe that these procedures work and
satisfactorily address issues of concern addressed in prior rulemakings
by the OIG. We do not reiterate those concerns, or their resolutions,
here, but they have informed our decisionmaking on these rules.
Applicability
Section 160.500 states that the procedures established by this
subpart are applicable to investigations, imposition of penalties, and
hearings conducted as a result of a proposed imposition of civil money
penalties. We use ``applicability'' instead of the basis and purpose
statement of the OIG regulations, because we have followed a different
format in the remainder of the HIPAA rules and wish to be consistent
with that approach. Furthermore, this preamble constitutes the
requisite basis and purpose statement.
Definitions
Definitions for the terms used in this new subpart that are not set
forth elsewhere in part 160 are included in Sec. 160.502.
[sbull] ALJ means an administrative law judge, the natural person
who presides at and conducts a hearing requested by a respondent
pursuant to this subpart.
[sbull] Entity means a legal person that is not a natural person.
The term is intended to include all manner of organizations, such as
corporations, associations, partnerships, and other entities that have
a legal existence, other than a natural person. The term ``entity'' is
necessary for this subpart to distinguish such legal persons from
natural persons, because certain procedures in this rule, such as those
involving subpoenas, are different for entities than they are for
natural persons.
The term ``entity'' should not be confused with the regulatory term
``covered entity.'' The latter term, which is defined at Sec. 160.103,
denotes those entities to which the HIPAA rules apply. The term
``entity,'' as used in this interim final rule, describes a broader
class of persons. For example, subpoenas could be directed to entities
that are not covered entities under Sec. 160.504 below.
[sbull] Penalty is defined to mean the amount calculated under 42
U.S.C. 1320d-5. This section of HIPAA sets a penalty of not more than
$100 for each violation, subject to a calendar-year cap of $25,000 for
all violations of an identical requirement or prohibition. The term
includes the plural form of the word.
[sbull] Person is defined to mean a natural person or a legal
person (such as an entity described above). The term includes, but is
not limited to, covered entities. The term is broader than ``covered
entities,'' because some sections of the provisions below by their
nature apply to persons other than covered entities in certain
circumstances. For example, the provisions for subpoenas relate to
natural persons who will be called to testify, and many, if not most,
of these persons will not be covered entities. While the term
``person'' is used generically throughout the HIPAA rules, we have
provided a definition of the term ``person'' for use in this subpart to
provide a clear and efficient way of permitting these distinctions to
be drawn. This definition is not intended to define ``person'' as that
term is used in HIPAA.
[sbull] Respondent means a person (as defined herein) upon whom a
penalty has been imposed, whether proposed or final, by the Secretary.
Respondents will necessarily be covered entities. See the discussion
below of Sec. 160.506.
Investigational Subpoenas and Inquiries
Section 160.504 provides procedures for the issuance of subpoenas
to both named persons and unnamed persons associated with subpoenaed
entities. A subpoenaed entity is required to name a natural person or
persons knowledgeable about the subjects on which information is
sought. This procedure is similar to that provided for in Rule 30(b)(6)
of the Federal Rules of Civil Procedure. Subpoenas issued under this
section may require either testimony or the production of evidence.
The procedures adopted in this section are similar to those in 42
CFR part 1006. Like Sec. 1006.4, Sec. 160.504 provides that
investigational inquiries are non-public proceedings conducted by the
Secretary. A witness is entitled to be represented by an attorney
during an investigational inquiry. However, while this section provides
for the taking of witness testimony, it does not include all of the
provisions of Sec. 1006.4 regarding claims of privilege or objections,
clarification of answers by the witness, corrections to the transcript,
or the use by the Secretary of testimony or evidence obtained in an
investigational inquiry. We anticipate addressing these issues in the
notice-and-comment rulemaking that we plan for the remainder of the
Enforcement Rule.
Basis for Penalty
Under Sec. 160.506, CMPs are imposed for violations of 42 U.S.C.
1320d-1320d-8, section 264 of Pub. L. 104-191, or the implementing
regulations at parts 160, 162 or 164 of this subchapter. CMPs may be
imposed only on covered entities. As we have stated in prior
rulemakings, it is the view of HHS that only covered entities are
subject to the HIPAA provisions and rules. Thus, only covered entities
can be liable for a CMP under 42 U.S.C. 1320d-5. See, for example, 67
FR 53252. Regulatory definition of what constitutes a violation
requiring imposition of a CMP will be addressed in the subsequent
notice-and-comment rulemaking that we plan for the remainder of the
Enforcement Rule. This section, thus, functions to clarify and
establish the linkage of the procedural rules to the criteria and
processes for the substantive determinations that are to be developed
through notice-and-comment rulemaking.
Amount of Penalty
Under Sec. 160.508, the amount of the penalty is determined in
accordance with 42 U.S.C. 1320d-5 and the provisions of this part. We
anticipate addressing how penalties will be determined in the noticeand-comment rulemaking that we plan for the remainder of the
Enforcement Rule. This section thus functions to clarify and establish
the linkage of the procedural rules to the criteria and processes for
the substantive determinations that are still to be developed.
Authority To Settle
Section 160.510 enunciates the authority of the Secretary to settle
any issue or case or to compromise any penalty during the process
addressed in this subpart. This authority is the same
[[Page 18899]]
as that set forth in Sec. 1003.106(f)(3) of the OIG regulations and
implements statutory authority provided by the first sentence of 42
U.S.C. 1320a-7a(f). It provides for flexible resolution of cases and
issues between the Secretary and a respondent. We anticipate that
factors to be taken into account in determinations regarding the amount
of penalties, like those set forth in Sec. 1003.106(a) through Sec.
1003.106(e) of the OIG regulations, will be addressed in the noticeand-comment rulemaking that we plan for the remainder of the
Enforcement Rule. This section, like the preceding sections, thus
serves to link substantive provisions yet to be developed into the
procedural process put in place by the rules below.
Notice of Proposed Determination
Section 160.514 sets forth the requirements for the notice to a
respondent sent when the Secretary proposes a penalty under this part.
These requirements are substantially the same as those in Sec.
1003.109 of the OIG regulations. Statistical sampling provisions,
however, are not included in this section at this time. We anticipate
addressing statistical sampling in the notice-and-comment rulemaking
that we plan for the remainder of the Enforcement Rule.
Failure To Request a Hearing
Under Sec. 160.516, when a respondent does not timely request a
hearing on a proposed penalty, the Secretary will impose the proposed
penalty or any less severe penalty permitted by 42 U.S.C. 1320d-5. The
penalty is then final, and the respondent has no right to appeal a
penalty imposed under these circumstances. This section is similar to
Sec. 1003.110 of the OIG regulations. This section simply states the
necessary consequence of a respondent's failure to exercise the right
to a hearing.
Collection of Penalty
Section 160.518 provides that once a determination to impose a
penalty has become final, the penalty must be collected by the
Secretary. The penalty may be recovered in a civil action in United
States District Court, or by deduction from any sum owed to the
respondent by the United States or a State agency. If the Secretary
seeks to recover the penalty in a civil action, the respondent is
prohibited from raising in that proceeding any matter that was raised
or could have been raised in a hearing or appeal under this subpart.
These provisions restate statutory provisions at 42 U.S.C. 1320a-7a(f)
and (g).
Limitations
Section 160.522 sets forth the 6-year limitations period provided
for by 42 U.S.C. 1320a-7a(c)(1). The section includes only the part of
the statutory language that is relevant to the imposition of penalties
in the context of the HIPAA rules. The statutory language concerning
the ``claim was presented'' and ``request for payment'' are not
included, because these phrases pertain to violations described in the
parts of 42 U.S.C. 1320a-7a that are not incorporated by reference into
42 U.S.C. 1320d-5. Section 160.522 accordingly differs in this respect
from Sec. 1003.132 of the OIG regulations.
Hearing Before an ALJ
The requirements for a hearing request are contained in Sec.
160.526. The parties to a hearing are the party against whom the
Secretary has proposed a penalty (the respondent) and the Secretary. We
recognize that the HHS party will be OCR and/or CMS. We have not
described the party more specifically here, however, for several
reasons. First, it is not feasible to parse out which component will
actually appear for the Secretary, because the appropriate component
(if both are not) will depend on the facts of the case. Second, the
designation of the proper party component can be handled through the
normal delegation process. Third, similar issues arise in other
sections of this interim final rule (see, for example, Sec. 160.514),
and they are handled this way in those sections as well. A consistent
approach is less confusing and more manageable.
The respondent may request a hearing following receipt of a notice
of a proposed determination. The request for a hearing must be in
writing. If the respondent fails to timely request a hearing, or
thereafter withdraws or abandons the request for a hearing, or if the
hearing request fails to raise any issue that may properly be addressed
in a hearing, the administrative law judge (ALJ) is required to dismiss
the hearing request. In such a case, the penalty becomes final, with no
further appeal permitted.
Paragraph (c) of Sec. 160.526 differs slightly from the
corresponding paragraph in Sec. 1005.2. Our provision requires
specific admissions, denials or explanations in a respondent's hearing
request. The degree of specificity required generally parallels the
requirements applicable to the notice of proposed determination at
Sec. 160.514. Based on experience in prior administrative hearings, we
believe that such additional specificity will assist the parties and
the ALJ in ascertaining the findings of fact and conclusions of law
that are actually in dispute in a case. This certainty will promote
procedural regularity and permit more timely and efficient resolution
of the case between the parties or adjudication of the case by the ALJ.
Rights of Parties; Authority of the ALJ
The provisions in Sec. 160.528 and Sec. 160.530 list the rights
of the parties and the authorities of the ALJ not specifically provided
elsewhere in this part. These sections are based upon Sec. 1005.3 and
Sec. 1005.4 of the OIG regulations, but do not address attorneys' fees
under 42 U.S.C. 406 or any limitation on the ALJ's authority to review
the Secretary's exercise of discretion to impose a penalty. We
anticipate addressing such issues in the notice-and-comment rulemaking
that we plan for the remainder of the Enforcement Rule. We have
clarified in Sec. 160.530 that a summary judgment decision constitutes
a hearing on the record.
Ex-parte Contacts
The provisions of Sec. 160.532 are designed to ensure the fairness
of the hearing by prohibiting ex-parte contacts with the ALJ on matters
in issue. Routine questions about administrative procedures or the
status of the case are permitted. These requirements are generally
applicable to administrative hearings under 5 U.S.C. 554(d)(1) and are
the same as those in Sec. 1005.5 of the OIG regulations.
Prehearing Conferences
The provisions of Sec. 160.534 closely track the provisions of the
analogous OIG regulation at Sec. 1005.6. The ALJ is required to
schedule at least one prehearing conference, in order to narrow the
issues to be addressed at the hearing and thus expedite the formal
hearing process. Matters that may be discussed at a prehearing
conference are identified and include the protection of the privacy of
individually identifiable health information submitted into evidence,
if appropriate.
Settlement
The Secretary has exclusive authority to settle any issue or case
at any time and need not obtain the consent of the ALJ. This provision
in Sec. 160.536 tracks Sec. 1003.126 of the OIG regulations.
Discovery
Consistent with the approach of Sec. 1005.7 of the OIG
regulations, Sec. 160.538 provides for limited discovery in the form
of the production for
[[Page 18900]]
inspection and copying of documents that are relevant and material to
the issues before the ALJ. Like the OIG, we are specifically not
authorizing other forms of discovery, such as depositions and
interrogatories. Prehearing discovery is not provided for under the APA
and is rarely available in administrative hearings. Full-scale
discovery is inappropriate in administrative hearings, as it would
unduly delay the streamlined administrative process. These regulations
do, however, provide for exchange of relevant and material documents,
as well as the exchange of witness lists, prior witness statements, and
exhibits before the hearing, as provided in Sec. 160.540 of the rule.
Exchange of Witness Lists, Statements, and Exhibits
Section 160.540 provides for the prehearing exchange of certain
documents, including witness lists, copies of prior statements of
witnesses, and copies of hearing exhibits.
Paragraph (a) of this section differs slightly from the
corresponding paragraph in Sec. 1005.8 of the OIG regulations, in that
it provides for the exchange of witness lists, witness statements and
exhibits at least 15 days before the hearing, but also allows the ALJ
to order an earlier exchange if he or she deems it necessary.
Paragraph (b) provides that the ALJ must exclude witnesses and
documents offered by a party that did not provide those materials
before the hearing, except where there is good cause for the failure,
or where there is not substantial prejudice to the objecting party. As
with the OIG regulations, this provision is mandatory and serves to
prevent the parties from litigating by surprise and to promote the
procedural regularity of the hearing. Paragraph (b)(3) provides that
where the witnesses or exhibits are not excluded, the ALJ must recess
the hearing for a reasonable time to allow the objecting party the
opportunity to prepare and respond to them, unless the objecting party
agrees to proceed. This paragraph differs from Sec. 1005.8(b)(3) of
the OIG regulations, under which the decision to postpone the hearing
is within the ALJ's discretion. This modification is equally beneficial
to both parties to a hearing and will reduce the potential for unfair
surprise during a hearing. It is preferable to the OIG provision that
grants the ALJ discretion, because it provides clear notice to the
parties and clear direction to the ALJ in the event witnesses or
exhibits are not excluded.
Finally, any documents exchanged before the hearing would be deemed
authentic for purposes of admissibility at the hearing unless a party
objected to a particular document before the hearing.
Subpoenas for Attendance at the Hearing
Section 160.542 outlines procedures for the ALJ to issue, and for
parties and prospective witnesses to contest, subpoenas to appear at
the hearing. Subpoenas are authorized by 42 U.S.C. 1320a-7a(j) and may
be issued by an ALJ pursuant to 5 U.S.C. 556(c). Either party may
request that the ALJ issue a subpoena, if the appearance of a witness
and the testimony are reasonably necessary for the party's case. The
subpoena procedures here are the same as those at Sec. 1005.9 of the
OIG regulations.
Fees
Section 160.544 provides for the payment of witness fees by the
party requesting a subpoena. This section tracks Sec. 1005.10 of the
OIG regulations.
Form, Filing, and Service of Papers; Computation of Time
Section 160.546 sets forth requirements for documents filed with
the ALJ. Section 160.548 outlines the method for computing time periods
under this part. These provisions track, respectively, Sec. 1005.11
and Sec. 1005.12 of the OIG regulations.
Motions
The provisions of Sec. 160.550 set forth requirements for the
content of motions and the time allowed for responses. This section
tracks Sec. 1005.13 of the OIG regulations.
Sanctions
Section 160.552 outlines the sanctions an ALJ may impose on parties
and their representatives for failing to comply with an order or
procedure, failing to defend an action, or other misconduct. These
sanctions are specifically provided for by the statutory provision at
42 U.S.C. 1320a-7a(c)(4). This section tracks Sec. 1005.14 of the OIG
regulations.
The Hearing
Section 160.554 provides for a public hearing on the record. It
allows for the admission of rebuttal evidence not exchanged before the
hearing.
This section is based upon Sec. 1005.15 of the OIG regulations,
which also addresses the burden of proof at the hearing, and provides
that the hearing is not limited to the items and information set forth
in the notice of proposed determination. We anticipate addressing those
issues in the notice-and-comment rulemaking that we plan for the
remainder of the Enforcement Rule.
Witnesses
Under Sec. 160.556, the ALJ may allow testimony to be admitted in
the form of a written statement or deposition so long as the opposing
party has a sufficient opportunity to subpoena the person whose
statement is being offered. This section also allows an HHS
investigator or other expert to be a witness, in addition to assisting
counsel for the Secretary at counsel table during the hearing. These
provisions closely track Sec. 1005.16 of the OIG regulations.
Evidence
With certain limited exceptions, the Federal Rules of Evidence are
not binding on the ALJ. However, the ALJ may apply the Federal Rules of
Evidence to exclude unreliable evidence. Section 160.558 is
substantially similar to Sec. 1005.17 of the OIG regulations, but does
not contain a paragraph corresponding to Sec. 1005.17(j) regarding
evidence as to the respondent's willingness and/or ability to enter
into a corrective action plan. We anticipate addressing this issue in
the notice-and-comment rulemaking that we plan for the remainder of the
Enforcement Rule.
The Record
Section 160.560 provides for recording and transcription of the
hearing, and for the record to be available for inspection and copying
by any person. For good cause, the ALJ may order appropriate redactions
made to the record. These provisions track Sec. 1005.18 of the OIG
regulations.
Post-Hearing Briefs
Section 160.562 provides that the ALJ has discretion to order posthearing briefs, although the parties may file post-hearing briefs in
any event if they desire. This section tracks Sec. 1005.19 of the OIG
regulations.
ALJ Decision
Section 160.564 provides that not later than 60 days after the
filing of post-hearing briefs, the ALJ shall serve on the parties a
decision making specific findings of fact and conclusions of law. The
ALJ's decision is the final decision of the Secretary.
Section 1005.20 of the OIG regulations, upon which this section is
based, provides for the ALJ to issue an ``initial decision,'' which is
then reviewable by the Departmental Appeals Board if properly appealed.
We have not provided for a second level of administrative review in
this rule, and
[[Page 18901]]
thus this section refers to the ``ALJ decision'' rather than to an
``initial decision.'' Neither section 1320a-7a nor the APA requires a
second level of administrative review, although this is generally
available in Department hearings. We anticipate addressing the issue of
further administrative review in the notice-and-comment rulemaking that
we plan for the remainder of the Enforcement Rule.
Judicial Review; Stay of ALJ Decision
Section 160.568 provides for judicial review of penalties imposed
under this part, as authorized by 42 U.S.C. 1320a-7a(e). Section
160.570 provides that a respondent may request a stay of the effective
date of a penalty pending judicial review. This section tracks Sec.
1005.22(b) of the OIG regulations.
IV. Impact Statement and Other Required Analyses
Paperwork Reduction Act
We reviewed this interim final rule to determine whether it invokes
issues that would subject it to the Paperwork Reduction Act (PRA).
While the PRA applies to agencies and collections of information
conducted or sponsored by those agencies, 5 CFR 1320.4(a) exempts
collections of information that occur ``during the conduct of . . . an
administrative action, investigation, or audit involving an agency
against specific individuals or entities,'' except for investigations
or audits ``undertaken with reference to a category of individual or
entities such as a class of licensees or an entire industry.'' The
rules adopted below come squarely within this exemption, as they deal
entirely with administrative investigations and actions against
specific individuals or entities. Therefore, we have determined that
the PRA does not apply to this rule.
Executive Order 12866; Unfunded Mandates Reform Act of 1995; Regulatory
Flexibility Act; Small Business Regulatory Enforcement Fairness Act of
1996; Executive Order 13132
We have examined the impacts of this rule as required by E.O. 12866
(September 1993, Regulatory Planning and Review), the Regulatory
Flexibility Act (RFA) (September 16, 1980, Pub. L. 96-354), section
1102(b) of the Social Security Act, the Unfunded Mandates Reform Act of
1995 (Pub. L. 104-4), and E.O. 13132.
E.O. 12866 (as amended by E.O. 13258, which merely reassigns
responsibility of duties) directs agencies to assess all costs and
benefits of available regulatory alternatives and, if regulation is
necessary, to select regulatory approaches that maximize net benefits
(including potential economic, environmental, public health and safety
effects, distributive impacts, and equity). A regulatory impact
analysis (RIA) must be prepared for major rules with economically
significant effects ($100 million or more in any 1 year). HHS has
concluded that this rule should be treated as a ``significant
regulatory action'' within the meaning of section 3(f)(4) of E.O. 12866
because the HIPAA provisions to be enforced have extremely broad
implications for the nation's health care system, and because of the
novel issues presented by, and the uncertainties surrounding,
compliance among covered entities. However, E.O. 12866 requires a full
economic impact analysis only for ``economically significant'' rules,
which are defined in section 3(f)(1) of the order as rules that may
``have an annual effect on the economy of $100 million or more, or
adversely affect in a material way the economy, productivity,
competition, jobs, the environment, public health or safety, or State,
local, or tribal governments or communities.'' Because this rule is
procedural in nature, it has no intrinsic significant economic impact;
therefore, no economic impact analysis has been prepared.
The RFA requires agencies to analyze options for regulatory relief
of small businesses. For purposes of the RFA, small entities include
small businesses, nonprofit organizations, and government agencies.
Most hospitals and most other providers and suppliers are small
entities, either by nonprofit status or by having revenues of $6
million in any 1 year. This interim final rule is purely procedural in
nature and, as such, HHS has determined that this regulation will not
have a significant economic impact on a substantial number of small
entities. The regulation simply implements procedures necessitated by
enactment of HIPAA, in order to allow the Secretary to enforce subtitle
F of Title II of HIPAA.
In addition, section 1102(b) of the Act requires us to prepare a
regulatory impact analysis if a rule may have a significant impact on
the operations of a substantial number of small rural hospitals. This
analysis must conform to the provisions of section 603 (proposed
documents)/604 (final documents) of the RFA. For purposes of section
1102(b) of the Act, we define a small rural hospital as a hospital that
is located outside of a Metropolitan Statistical Area and has fewer
than 100 beds. This rule will not have a significant impact on small
rural hospitals. The rule implements procedures necessary for the
Secretary to enforce subtitle F of Title II of HIPAA.
Section 202 of the Unfunded Mandates Reform Act of 1995 also
requires that agencies assess anticipated costs and benefits before
issuing any rule that may result in expenditure in any 1 year by State,
local, or tribal governments, in the aggregate, or by the private
sector, of $100 million. Because this rule is procedural in nature, it
will not impose a burden large enough to require a section 202
statement under the Unfunded Mandates Reform Act of 1995 (2 U.S.C. 1531
et seq.).
E.O. 13132 establishes certain requirements that an agency must
meet when it promulgates a proposed rule (and subsequent final rule)
that imposes substantial direct requirement costs on State and local
governments, preempts State law, or otherwise has Federalism
implications. This interim final rule does not have ``Federalism
implications.'' The rule does not have ``substantial direct effects on
the States, on the relationship between the national government and the
States, or on the distribution of power and responsibilities among the
various levels of government'' and therefore is not subject to E.O.
13132 (Federalism).
The Small Business Regulatory Enforcement Fairness Act of 1996 (5
U.S.C. 801 et seq.) requires that rules that will have an impact on the
economy of $100 million or more per annum be submitted for
Congressional review. Because this rule is procedural in nature, it
will not impose a burden large enough to require Congressional review
under the statute.
List of Subjects in 45 CFR Part 160
Administrative practice and procedure, Computer technology,
Healthcare, Health facilities, Health insurance, Health records,
Hospitals, Investigations, Medicaid, Medicare, Penalties, Reporting and
recordkeeping requirements.
0
For the reasons set forth in the preamble, the Department of Health and
Human Services amends 45 CFR subtitle A, subchapter C, part 160 as set
forth below.
PART 160--GENERAL ADMINISTRATIVE REQUIREMENTS
0
1. The authority citation for part 160 is revised to read as follows:
Authority: 42 U.S.C. 1302(a), 42 U.S.C. 1320d--1320d-8, and sec.
264 of Pub. L. 104-191, 110 Stat. 2033-2034 (42 U.S.C. 1320d2(note)).
[[Page 18902]]
0
2. Add a new subpart E to part 160 to read as follows:
Subpart E--Civil Money Penalties: Procedures for Investigations,
Imposition of Penalties, and Hearings
Sec.
160.500 Applicability.
160.502 Definitions.
160.504 Investigational subpoenas and inquiries.
160.506 Basis for penalty.
160.508 Amount of penalty.
160.510 Authority to settle.
160.512 [Reserved]
160.514 Notice of proposed determination.
160.516 Failure to request a hearing.
160.518 Collection of penalty.
160.520 [Reserved]
160.522 Limitations.
160.524 [Reserved]
160.526 Hearing before an ALJ.
160.528 Rights of parties.
160.530 Authority of the ALJ.
160.532 Ex parte contacts.
160.534 Prehearing conferences.
160.536 Settlement.
160.538 Discovery.
160.540 Exchange of witness lists, witness statements, and exhibits.
160.542 Subpoenas for attendance at hearing.
160.544 Fees.
160.546 Form, filing, and service of papers.
160.548 Computation of time.
160.550 Motions.
160.552 Sanctions.
160.554 The hearing.
160.556 Witnesses.
160.558 Evidence.
160.560 The record.
160.562 Post hearing briefs.
160.564 ALJ decision.
160.566 [Reserved]
160.568 Judicial review.
160.570 Stay of ALJ decision.
160.572 [Reserved]
Subpart E--Civil Money Penalties: Procedures for Investigations,
Imposition of Penalties, and Hearings
Sec. 160.500 Applicability.
This subpart applies to investigations conducted, penalties
imposed, hearings conducted, and subpoenas issued, under the authority
of 42 U.S.C. 1320d-5, relating to the imposition of civil money
penalties.
Sec. 160.502 Definitions.
For the purposes of this subpart:
ALJ means Administrative Law Judge.
Entity means a legal person.
Penalty means the amount calculated under 42 U.S.C. 1320d-5, as
determined in accordance with this part, and includes the plural of
that term.
Person means a natural or legal person.
Respondent means the person upon whom the Secretary has imposed, or
proposes to impose, a penalty.
Sec. 160.504 Investigational subpoenas and inquiries.
(a) The provisions of this paragraph govern subpoenas issued by the
Secretary in accordance with 42 U.S.C. 405(d) and (e), 1320a-7a(j), and
1320d-5 to require the attendance and testimony of witnesses and the
production of any other evidence during an investigation pursuant to
this part.
(1) A subpoena issued under this paragraph must-(i) State the name of the person to whom the subpoena is addressed;
(ii) State the statutory authority for the subpoena;
(iii) Indicate the date, time, and place that the testimony will
take place;
(iv) Include a reasonably specific description of any documents or
items required to be produced; and
(v) If the subpoena is addressed to an entity, describe with
reasonable particularity the subject matter on which testimony is
required. In that event, the named entity must designate one or more
natural persons who will testify on its behalf, and must state as to
each person so designated that person's name and address and the
matters on which he or she will testify. The person so designated must
testify as to matters known or reasonably available to the entity.
(2) A subpoena under this section must be served by-(i) Delivering a copy to the natural person named in the subpoena
or to the entity named in the subpoena at its last principal place of
business; or
(ii) Registered or certified mail addressed to the natural person
at his or her last known dwelling place or to the entity at its last
known principal place of business.
(3) A verified return by the natural person serving the subpoena
setting forth the manner of service or, in the case of service by
registered or certified mail, the signed return post office receipt,
constitutes proof of service.
(4) Witnesses are entitled to the same fees and mileage as
witnesses in the district courts of the United States (28 U.S.C. 1821
and 1825). Fees need not be paid at the time the subpoena is served.
(5) A subpoena under this section is enforceable through the
District Court of the United States for the district where the
subpoenaed natural person resides or is found or where the entity
transacts business.
(b) Investigational inquiries are non-public investigational
proceedings conducted by the Secretary.
(1) Testimony at investigational inquiries will be taken under oath
or affirmation.
(2) Attendance of non-witnesses is discretionary with the
Secretary, except that a witness is entitled to be accompanied,
represented, and advised by an attorney.
(3) The proceedings will be recorded and transcribed. The witness
is entitled to a copy of the transcript, upon payment of prescribed
costs, except that, for good cause, the witness may be limited to
inspection of the official transcript of his or her testimony.
Sec. 160.506 Basis for penalty.
The Secretary shall impose a penalty on a person who is a covered
entity and who the Secretary determines in accordance with this subpart
has violated a provision of-(a) 42 U.S.C. 1320d-1320d-8, as amended;
(b) Section 264 of Pub. L. 104-191 (42 U.S.C. 1320d-2(note)); or
(c) Parts 160, 162 or 164 of this subchapter.
Sec. 160.508 Amount of penalty.
The penalty imposed under Sec. 160.506 must be in accordance with
42 U.S.C. 1320d-5 and the applicable provisions of this part.
Sec. 160.510 Authority to settle.
Nothing in this subpart limits the authority of the Secretary to
settle any issue or case or to compromise any penalty.
Sec. 160.512 [Reserved]
Sec. 160.514 Notice of proposed determination.
(a) If a penalty is proposed in accordance with this part, the
Secretary must deliver, or send by certified mail with return receipt
requested, to the respondent written notice of the Secretary's intent
to impose a penalty. This notice of proposed determination must
include-(1) Reference to the statutory basis for the penalty;
(2) A description of the findings of fact regarding the act(s) or
omission(s) with respect to which the penalty is proposed;
(3) The reason(s) why the act(s) or omission(s) subject(s) the
respondent to a penalty;
(4) The amount of the proposed penalty;
(5) Instructions for responding to the notice, including a
statement of the respondent's right to a hearing, a statement that
failure to request a hearing within 60 days permits the imposition of
the proposed penalty without the right to a hearing under Sec. 160.554
or a right of appeal under Sec. 160.568, and the address to which the
hearing request must be sent.
(b) The respondent may request a hearing before an ALJ on the
proposed
[[Page 18903]]
penalty by filing a request therefor in accordance with Sec. 160.526
of this subpart.
Sec. 160.516 Failure to request a hearing.
If the respondent does not request a hearing within the time
prescribed by Sec. 160.526, the Secretary must impose the proposed
penalty or any less severe penalty permitted by 42 U.S.C. 1320d-5. The
Secretary must notify the respondent by certified mail, return receipt
requested, of any penalty that has been imposed and of the means by
which the respondent may satisfy the penalty. The respondent has no
right to appeal under Sec. 160.568 with respect to a penalty with
respect to which the respondent has not timely requested a hearing.
Sec. 160.518 Collection of penalty.
(a) Once a determination of the Secretary to impose a penalty has
become final, the penalty must be collected by the Secretary.
(b) The penalty may be recovered in a civil action brought in the
United States district court for the district where the respondent
resides, is found, or is located.
(c) The amount of a penalty, when finally determined, or the amount
agreed upon in compromise, may be deducted from any sum then or later
owing by the United States, or by a State agency, to the respondent.
(d) Matters that were raised or that could have been raised in a
hearing before an ALJ or in an appeal under 42 U.S.C. 1320a-7a(e) may
not be raised as a defense in a civil action by the United States to
collect a penalty under this part.
Sec. 160.520 [Reserved]
Sec. 160.522 Limitations.
No action under this subpart may be entertained unless commenced by
the Secretary, in accordance with Sec. 160.514 of this subpart, within
6 years from the date on which the latest act or omission that is the
subject of the action occurred.
Sec. 160.524 [Reserved]
Sec. 160.526 Hearing before an ALJ.
(a) The respondent may request a hearing before an ALJ. The parties
to the hearing proceeding consist of-(1) The respondent; and
(2) The Secretary.
(b) The request for a hearing must be made in writing signed by the
respondent or by the respondent's attorney and sent by certified mail,
return receipt requested, to the address specified in the notice of
proposed determination. The request for a hearing must be mailed within
60 days after notice of the proposed determination is received by the
respondent. For purposes of this section, the respondent's date of
receipt of the notice of proposed determination is presumed to be 5
days after the date of the notice unless the respondent makes a
reasonable showing to the contrary to the ALJ.
(c) The request for a hearing must clearly and directly admit,
deny, or explain each of the findings of fact contained in the notice
of proposed determination with regard to which the respondent has any
knowledge. If the respondent has no knowledge of a particular finding
of fact and so states, the finding shall be deemed denied. The request
for a hearing must also state the circumstances or arguments that the
respondent alleges constitute the grounds for any defense and the
factual and legal basis for opposing the penalty.
(d) The ALJ must dismiss a hearing request where-(1) The respondent's hearing request is not filed as required by
paragraphs (b) and (c) of this section;
(2) The respondent withdraws the request for a hearing;
(3) The respondent abandons the request for a hearing; or
(4) The respondent's hearing request fails to raise any issue that
may properly be addressed in a hearing.
Sec. 160.528 Rights of parties.
(a) Except as otherwise limited by this part, each party may-(1) Be accompanied, represented, and advised by an attorney;
(2) Participate in any conference held by the ALJ;
(3) Conduct discovery of documents as permitted by this subpart;
(4) Agree to stipulations of fact or law that will be made part of
the record;
(5) Present evidence relevant to the issues at the hearing;
(6) Present and cross-examine witnesses;
(7) Present oral arguments at the hearing as permitted by the ALJ;
and
(8) Submit written briefs and proposed findings of fact and
conclusions of law after the hearing.
(b) A party may appear in person or by a representative. Natural
persons who appear as an attorney or other representative must conform
to the standards of conduct and ethics required of practitioners before
the courts of the United States.
Sec. 160.530 Authority of the ALJ.
(a) The ALJ must conduct a fair and impartial hearing, avoid delay,
maintain order, and ensure that a record of the proceeding is made.
(b) The ALJ may-(1) Set and change the date, time and place of the hearing upon
reasonable notice to the parties;
(2) Continue or recess the hearing in whole or in part for a
reasonable period of time;
(3) Hold conferences to identify or simplify the issues, or to
consider other matters that may aid in the expeditious disposition of
the proceeding;
(4) Administer oaths and affirmations;
(5) Issue subpoenas requiring the attendance of witnesses at
hearings and the production of documents at or in relation to hearings;
(6) Rule on motions and other procedural matters;
(7) Regulate the scope and timing of documentary discovery as
permitted by this subpart;
(8) Regulate the course of the hearing and the conduct of
representatives, parties, and witnesses;
(9) Examine witnesses;
(10) Receive, rule on, exclude, or limit evidence;
(11) Upon motion of a party, take official notice of facts;
(12) Conduct any conference, argument or hearing in person or, upon
agreement of the parties, by telephone; and
(13) Upon motion of a party, decide cases, in whole or in part, by
summary judgment where there is no disputed issue of material fact. A
summary judgment decision constitutes a hearing on the record for the
purposes of this subpart.
(c) The ALJ may not-(1) Find invalid or refuse to follow Federal statutes or
regulations or delegations of authority by the Secretary;
(2) Enter an order in the nature of a directed verdict;
(3) Compel settlement negotiations; or
(4) Enjoin any act of the Secretary.
Sec. 160.532 Ex parte contacts.
No party or person (except employees of the ALJ's office) may
communicate in any way with the ALJ on any matter at issue in a case,
unless on notice and opportunity for both parties to participate. This
provision does not prohibit a party or person from inquiring about the
status of a case or asking routine questions concerning administrative
functions or procedures.
Sec. 160.534 Prehearing conferences.
(a) The ALJ must schedule at least one prehearing conference, and
may schedule additional prehearing conferences as appropriate, upon
reasonable notice to the parties.
(b) The ALJ may use prehearing conferences to discuss the
following-[[Page 18904]]
(1) Simplification of the issues;
(2) The necessity or desirability of amendments to the pleadings,
including the need for a more definite statement;
(3) Stipulations and admissions of fact or as to the contents and
authenticity of documents;
(4) Whether the parties can agree to submission of the case on a
stipulated record;
(5) Whether a party chooses to waive appearance at an oral hearing
and to submit only documentary evidence (subject to the objection of
the other party) and written argument;
(6) Limitation of the number of witnesses;
(7) Scheduling dates for the exchange of witness lists and of
proposed exhibits;
(8) Discovery of documents as permitted by this subpart;
(9) The time and place for the hearing;
(10) The potential for the settlement of the case by the parties;
and
(11) Other matters as may tend to encourage the fair, just and
expeditious disposition of the proceedings, including the protection of
privacy of individually identifiable health information that may be
submitted into evidence, if appropriate.
(c) The ALJ must issue an order containing the matters agreed upon
by the parties or ordered by the ALJ at a prehearing conference.
Sec. 160.536 Settlement.
The Secretary has exclusive authority to settle any issue or case
without the consent of the ALJ.
Sec. 160.538 Discovery.
(a) A party may make a request to another party for production of
documents for inspection and copying that are relevant and material to
the issues before the ALJ.
(b) For the purpose of this section, the term ``documents''
includes information, reports, answers, records, accounts, papers and
other data and documentary evidence. Nothing contained in this section
may be interpreted to require the creation of a document, except that
requested data stored in an electronic data storage system must be
produced in a form accessible to the requesting party.
(c) Requests for documents, requests for admissions, written
interrogatories, depositions and any forms of discovery, other than
those permitted under paragraph (a) of this section, are not
authorized.
(d) This section may not be construed to require the disclosure of
interview reports or statements obtained by any party, or on behalf of
any party, of persons who will not be called as witnesses by that
party, or analyses and summaries prepared in conjunction with the
investigation or litigation of the case, or any otherwise privileged
documents.
(e)(1) When a request for production of documents has been
received, within 30 days the party receiving that request must either
fully respond to the request, or state that the request is being
objected to and the reasons for that objection. If objection is made to
part of an item or category, the part must be specified. Upon receiving
any objections, the party seeking production may then, within 30 days
or any other time frame set by the ALJ, file a motion for an order
compelling discovery. The party receiving a request for production may
also file a motion for protective order any time before the date the
production is due.
(2) The ALJ may grant a motion for protective order or deny a
motion for an order compelling discovery if the ALJ finds that the
discovery sought-(i) Is irrelevant;
(ii) Is unduly costly or burdensome;
(iii) Will unduly delay the proceeding; or
(iv) Seeks privileged information.
(3) The ALJ may extend any of the time frames set forth in
paragraph (e)(1) of this section.
(4) The burden of showing that discovery should be allowed is on
the party seeking discovery.
Sec. 160.540 Exchange of witness lists, witness statements, and
exhibits.
(a) The parties must exchange witness lists, copies of prior
written statements of proposed witnesses, and copies of proposed
hearing exhibits, including copies of any written statements that the
party intends to offer in lieu of live testimony in accordance with
Sec. 160.556, at least 15 days before the hearing, unless the ALJ
orders an earlier exchange.
(b) (1) If at any time a party objects to the proposed admission of
evidence not exchanged in accordance with paragraph (a) of this
section, the ALJ must determine whether the failure to comply with
paragraph (a) of this section should result in the exclusion of that
evidence.
(2) Unless the ALJ finds that extraordinary circumstances justified
the failure timely to exchange the information listed under paragraph
(a) of this section, the ALJ must exclude from the party's case-inchief-(i) The testimony of any witness whose name does not appear on the
witness list; and
(ii) Any exhibit not provided to the opposing party as specified in
paragraph (a) of this section.
(3) If the ALJ finds that extraordinary circumstances existed, the
ALJ must then determine whether the admission of that evidence would
cause substantial prejudice to the objecting party. If the ALJ finds
that there is no substantial prejudice, the evidence may be admitted.
If the ALJ finds that there is substantial prejudice, the ALJ may
exclude the evidence, or, if he or she does not exclude the evidence,
must postpone the hearing for such time as is necessary for the
objecting party to prepare and respond to the evidence, unless the
objecting party waives postponement.
(c) Unless the other party objects within a reasonable period of
time before the hearing, documents exchanged in accordance with
paragraph (a) of this section will be deemed to be authentic for the
purpose of admissibility at the hearing.
Sec. 160.542 Subpoenas for attendance at hearing.
(a) A party wishing to procure the appearance and testimony of any
person at the hearing may make a motion requesting the ALJ to issue a
subpoena if the appearance and testimony are reasonably necessary for
the presentation of a party's case.
(b) A subpoena requiring the attendance of a person in accordance
with paragraph (a) of this section may also require the person (whether
or not the person is a party) to produce relevant and material evidence
at or before the hearing.
(c) When a subpoena is served by a respondent on a particular
employee or official or particular office of HHS, the Secretary may
comply by designating any HHS representative to appear and testify.
(d) A party seeking a subpoena must file a written motion not less
than 30 days before the date fixed for the hearing, unless otherwise
allowed by the ALJ for good cause shown. That motion must-(1) Specify any evidence to be produced;
(2) Designate the witnesses; and
(3) Describe the address and location with sufficient particularity
to permit those witnesses to be found.
(e) The subpoena must specify the time and place at which the
witness is to appear and any evidence the witness is to produce.
(f) Within 15 days after the written motion requesting issuance of
a subpoena is served, any party may file an opposition or other
response.
[[Page 18905]]
(g) If the motion requesting issuance of a subpoena is granted, the
party seeking the subpoena must serve it by delivery to the person
named, or by certified mail addressed to that person at the person's
last dwelling place or principal place of business.
(h) The person to whom the subpoena is directed may file with the
ALJ a motion to quash the subpoena within 10 days after service.
(i) The exclusive remedy for contumacy by, or refusal to obey a
subpoena duly served upon, any person is specified in 42 U.S.C. 405(e).
Sec. 160.544 Fees.
The party requesting a subpoena must pay the cost of the fees and
mileage of any witness subpoenaed in the amounts that would be payable
to a witness in a proceeding in United States District Court. A check
for witness fees and mileage must accompany the subpoena when served,
except that when a subpoena is issued on behalf of the Secretary, a
check for witness fees and mileage need not accompany the subpoena.
Sec. 160.546 Form, filing, and service of papers.
(a) Forms. (1) Unless the ALJ directs the parties to do otherwise,
documents filed with the ALJ must include an original and two copies.
(2) Every pleading and paper filed in the proceeding must contain a
caption setting forth the title of the action, the case number, and a
designation of the paper, such as motion to quash subpoena.
(3) Every pleading and paper must be signed by and must contain the
address and telephone number of the party or the person on whose behalf
the paper was filed, or his or her representative.
(4) Papers are considered filed when they are mailed.
(b) Service. A party filing a document with the ALJ or the
Secretary must, at the time of filing, serve a copy of the document on
the other party. Service upon any party of any document must be made by
delivering a copy, or placing a copy of the document in the United
States mail, postage prepaid and addressed, or with a private delivery
service, to the party's last known address. When a party is represented
by an attorney, service must be made upon the attorney in lieu of the
party.
(c) Proof of service. A certificate of the natural person serving
the document by personal delivery or by mail, setting forth the manner
of service, constitutes proof of service.
Sec. 160.548 Computation of time.
(a) In computing any period of time under this part or in an order
issued thereunder, the time begins with the day following the act,
event or default, and includes the last day of the period unless it is
a Saturday, Sunday, or legal holiday observed by the Federal
Government, in which event it includes the next business day.
(b) When the period of time allowed is less than 7 days,
intermediate Saturdays, Sundays, and legal holidays observed by the
Federal Government must be excluded from the computation.
(c) Where a document has been served or issued by placing it in the
mail, an additional 5 days must be added to the time permitted for any
response. This paragraph does not apply to requests for hearing under
Sec. 160.526.
Sec. 160.550 Motions.
(a) An application to the ALJ for an order or ruling must be by
motion. Motions must state the relief sought, the authority relied upon
and the facts alleged, and must be filed with the ALJ and served on all
other parties.
(b) Except for motions made during a prehearing conference or at
the hearing, all motions must be in writing. The ALJ may require that
oral motions be reduced to writing.
(c) Within 10 days after a written motion is served, or such other
time as may be fixed by the ALJ, any party may file a response to the
motion.
(d) The ALJ may not grant a written motion before the time for
filing responses has expired, except upon consent of the parties or
following a hearing on the motion, but may overrule or deny the motion
without awaiting a response.
(e) The ALJ must make a reasonable effort to dispose of all
outstanding motions before the beginning of the hearing.
Sec. 160.552 Sanctions.
The ALJ may sanction a person, including any party or attorney, for
failing to comply with an order or procedure, for failing to defend an
action or for other misconduct that interferes with the speedy, orderly
or fair conduct of the hearing. The sanctions must reasonably relate to
the severity and nature of the failure or misconduct. The sanctions may
include-(a) In the case of refusal to provide or permit discovery under the
terms of this part, drawing negative factual inferences or treating the
refusal as an admission by deeming the matter, or certain facts, to be
established;
(b) Prohibiting a party from introducing certain evidence or
otherwise supporting a particular claim or defense;
(c) Striking pleadings, in whole or in part;
(d) Staying the proceedings;
(e) Dismissal of the action;
(f) Entering a decision by default;
(g) Ordering the party or attorney to pay the attorney's fees and
other costs caused by the failure or misconduct; and
(h) Refusing to consider any motion or other action that is not
filed in a timely manner.
Sec. 160.554 The hearing.
(a) The ALJ must conduct a hearing on the record in order to
determine whether the respondent should be found liable under this
part.
(b) The hearing must be open to the public unless otherwise ordered
by the ALJ for good cause shown.
(c) After both parties have presented their cases, evidence may be
admitted in rebuttal even if not previously exchanged in accordance
with Sec. 160.540.
Sec. 160.556 Witnesses.
(a) Except as provided in paragraph (b) of this section, testimony
at the hearing must be given orally by witnesses under oath or
affirmation.
(b) At the discretion of the ALJ, testimony of witnesses other than
the testimony of expert witnesses may be admitted in the form of a
written statement. Any such written statement must be provided to all
other parties along with the last known address of the witness, in a
manner that allows sufficient time for the other party to subpoena the
witness for cross-examination at the hearing. Prior written statements
of witnesses proposed to testify at the hearing must be exchanged as
provided in Sec. 160.540. The ALJ may, at his or her discretion, admit
prior sworn testimony of experts that has been subject to adverse
examination, such as a deposition or trial testimony.
(c) The ALJ must exercise reasonable control over the mode and
order of interrogating witnesses and presenting evidence so as to:
(1) Make the interrogation and presentation effective for the
ascertainment of the truth;
(2) Avoid repetition or needless consumption of time; and
(3) Protect witnesses from harassment or undue embarrassment.
(d) The ALJ must permit the parties to conduct cross-examination of
witnesses as may be required for a full and true disclosure of the
facts.
[[Page 18906]]
(e) The ALJ may order witnesses excluded so that they cannot hear
the testimony of other witnesses. This provision does not authorize the
exclusion of-(1) A party who is a natural person;
(2) In the case of a party that is an entity, the officer or
employee of the party appearing for the entity pro se or designated as
the party's representative; or
(3) A natural person whose presence is shown by a party to be
essential to the presentation of its case, including a person engaged
in assisting the attorney for the Secretary.
Sec. 160.558 Evidence.
(a) The ALJ must determine the admissibility of evidence.
(b) Except as provided in this subpart, the ALJ is not bound by the
Federal Rules of Evidence. However, the ALJ may apply the Federal Rules
of Evidence where appropriate, for example, to exclude unreliable
evidence.
(c) The ALJ must exclude irrelevant or immaterial evidence.
(d) Although relevant, evidence may be excluded if its probative
value is substantially outweighed by the danger of unfair prejudice,
confusion of the issues, or by considerations of undue delay or
needless presentation of cumulative evidence.
(e) Although relevant, evidence may be excluded if it is privileged
under Federal law.
(f) Evidence concerning offers of compromise or settlement shall be
inadmissible to the extent provided in Rule 408 of the Federal Rules of
Evidence.
(g) Evidence of crimes, wrongs, or acts other than those at issue
in the instant case is admissible in order to show motive, opportunity,
intent, knowledge, preparation, identity, lack of mistake, or existence
of a scheme. This evidence is admissible regardless of whether the
crimes, wrongs, or acts occurred during the statute of limitations
period applicable to the acts or omissions that constitute the basis
for liability in the case and regardless of whether they were
referenced in the Secretary's notice of proposed determination sent in
accordance with Sec. 160.514.
(h) The ALJ must permit the parties to introduce rebuttal witnesses
and evidence.
(i) All documents and other evidence offered or taken for the
record must be open to examination by both parties, unless otherwise
ordered by the ALJ for good cause shown.
Sec. 160.560 The record.
(a) The hearing must be recorded and transcribed. Transcripts may
be obtained following the hearing from the ALJ.
(b) The transcript of the testimony, exhibits, and other evidence
admitted at the hearing, and all papers and requests filed in the
proceeding constitute the record for decision by the ALJ and the
Secretary.
(c) The record may be inspected and copied (upon payment of a
reasonable fee) by any person, unless otherwise ordered by the ALJ for
good cause shown.
(d) For good cause, the ALJ may order appropriate redactions made
to the record.
Sec. 160.562 Post hearing briefs.
The ALJ may require the parties to file post-hearing briefs. In any
event, any party may file a post-hearing brief. The ALJ must fix the
time for filing the briefs. The time for filing may not exceed 60 days
from the date the parties receive the transcript of the hearing or, if
applicable, the stipulated record. The briefs may be accompanied by
proposed findings of fact and conclusions of law. The ALJ may permit
the parties to file reply briefs.
Sec. 160.564 ALJ decision.
(a) The ALJ must issue a decision, based only on the record, which
must contain findings of fact and conclusions of law.
(b) The ALJ may affirm, increase, or reduce the penalties imposed
by the Secretary.
(c) The ALJ must issue the decision to both parties within 60 days
after the time for submission of post-hearing briefs and reply briefs,
if permitted, has expired. If the ALJ fails to meet the deadline
contained in this paragraph, he or she must notify the parties of the
reason for the delay and set a new deadline.
(d) The ALJ's decision is the final decision of the Secretary.
Sec. 160.566 [Reserved]
Sec. 160.568 Judicial review.
Judicial review of a penalty that has become final is authorized by
42 U.S.C. 1320a-7a(e).
Sec. 160.570 Stay of ALJ decision.
(a) Pending judicial review, the respondent may file a request for
stay of the effective date of any penalty with the ALJ. The request
must be accompanied by a copy of the notice of appeal filed with the
Federal court. The filing of the request automatically stays the
effective date of the penalty until such time as the ALJ rules upon the
request.
(b) The ALJ may not grant a respondent's request for stay of any
penalty unless the respondent posts a bond or provides other adequate
security.
(c) The ALJ must rule upon a respondent's request for stay within
10 days of receipt.
Sec. 160.572 [Reserved]
Dated: April 11, 2003.
Tommy G. Thompson,
Secretary.
[FR Doc. 03-9497 Filed 4-14-03; 3:54 pm]
BILLING CODE 4120-01-P
Region II - NJ, NY, PR, VI
Office for Civil Rights
U.S. Department of Health & Human Services
26 Federal Plaza - Suite 3313
New York, NY 10278
(212) 264-3313; (212) 264-2355 (TDD)
(212) 264-3039 FAX
Region IX - AZ, CA, HI, NV, AS, GU, The U.S. Affiliated Pacific Island
Jurisdictions
Office for Civil Rights
U.S. Department of Health & Human Services
50 United Nations Plaza - Room 322
San Francisco, CA 94102
(415) 437-8310; (415) 437-8311 (TDD)
(415) 437-8329 FAX
Region III - DE, DC, MD, PA, VA, WV
Office for Civil Rights
U.S. Department of Health & Human Services
150 S. Independence Mall West - Suite 372
Philadelphia, PA 19106-3499
(215) 861-4441; (215) 861-4440 (TDD)
(215) 861-4431 FAX
U.S. Department of Health and
Human Services • Office for Civil Rights
Factsheet http://www.os.dhhs.gov/ocr/privacyhowtofile.htm
HOW TO FILE A DISCRIMINATION COMPLAINT
WITH
THE OFFICE FOR CIVIL RIGHTS
The Department of Health and Human Services (HHS) Office for Civil Rights (OCR)
enforces certain Federal civil rights laws that protect the rights of all persons in the
United States to receive health and human services without discrimination based on race,
color, national origin, disability, age, and in some cases, sex and religion.
If you believe that you have been discriminated against because of your race,
color, national origin, disability, age, sex or religion by a health care or human
services provider (such as a hospital, nursing home, social service agency, etc.)
or by a State or local government health or human services agency, you may file
a complaint with the Office for Civil Rights (OCR). Complaints alleging
discrimination based on disability by programs directly operated by HHS may
also be filed with OCR. You may file a complaint for yourself or for someone else.
Be sure to include the following information in your written complaint:
questions about this form, call OCR (toll-free) at: 1-800-368-1019
http://www.os.dhhs.gov/ocr/howtofileprivacy.pdf
If you have
Complt form at
Filing a complaint with OCR is voluntary. However, without the information requested above, OCR may be
unable to proceed with your complaint. We collect this information under authority of the Privacy Rule issued
pursuant to the Health Insurance Portability and Accountability Act of 1996. We will use the information you
provide to determine if we have jurisdiction and, if so, how we will process your complaint. Information
submitted on this form is treated confidentially and is protected under the provisions of the Privacy Act of
1974. Names or other identifying information about individuals are disclosed when it is necessary for
investigation of possible health information privacy violations, for internal systems operations, or for routine
uses, which include disclosure of information outside the Department for purposes associated with health
information privacy compliance and as permitted by law. It is illegal for a covered entity to intimidate,
threaten, coerce, discriminate or retaliate against you for filing this complaint or for taking any other action to
enforce your rights under the Privacy Rule. You are not required to use this form. You also may write a letter
or submit a complaint electronically with the same information. To submit an electronic complaint, go to our
web site at:
www.hhs.gov/ocr/privacyhowtofile.html . To mail a complaint see reverse page for OCR Regional
addresses.
Your name, full address, home and work telephone numbers, email address.
If you are filing a complaint on someone's behalf, also provide the name of the
person on whose behalf you are filing.
Name, full address and phone of the person, agency or organization you believe
violated your (or someone else's) health information privacy rights or committed
another violation of the Privacy Rule.
1. The name and address of the organization or person you believe discriminated
against you.
2. How, why and when you believe you (or the person on whose behalf you are
filing the complaint) were discriminated against.
3. Any other information that would help OCR understand your complaint
Briefly describe what happened. How, why, and when do believe your (or someone
else's) health information privacy rights were violated, or the Privacy Rule
otherwise was violated?
Any other relevant information.
Please sign your name and date your letter.
The following information is optional:
Do you need special accommodations for us to communicate with you about this
complaint?
If we cannot reach you directly, is there someone else we can contact to help us
reach you?
Have you filed your complaint somewhere else?
SHOW ‘GOOD CAUSE” You must file your complaint within 180 days of the
date when the discrimination happened. OCR may extend the 180-day period if
you can show "good cause."
You can file your complaint by email at [email protected], or you can mail
or fax your complaint to the OCR Regional Office that is responsible for the state
in which you allege the discrimination took place.
(a) print the completed form and mail or fax it to the appropriate OCR Regional
Office; or (b) email the form to OCR at [email protected].
If you have any questions, or need help to file your complaint, call OCR (toll-free)
at 1-800-368-1019 (voice) or 1-800-537-7697 (TDD). You may also send an
email to [email protected].
Website: http://www.hhs.gov/ocr
Paul Cushing, Regional Manager
Office for Civil Rights
U.S. Department of Health and Human Services
150 S. Independence Mall West
Suite 372, Public Ledger Building
Philadelphia, PA 19106-9111
Main Line (215)861-4441
Hotline (800) 368-1019
FAX (215)861-4431
Severe Allergy History to speak to Dr. About http://65.54.184.250/cgibin/linkrd?_lang=EN&lah=79f6c533dca991eae412faa6675847a7&lat=1084859304&hm
___action=http%3a%2f%2fwww%2eepipen%2ecom%2fhome%2fresources_adult%2eht
ml
Patient Instructions and side effects of EpiPen http://65.54.184.250/cgibin/linkrd?_lang=EN&lah=4ffdeb18dc435dfc04930e509e3d7fe6&lat=1084860630&hm_
__action=http%3a%2f%2fwww%2eepipen%2ecom%2fepipen_prescribing%2ehtml
http://65.54.184.250/cgibin/linkrd?_lang=EN&lah=79f6c533dca991eae412faa6675847a7&lat=1084859304&hm
___action=http%3a%2f%2fwww%2eepipen%2ecom%2fhome%2fresources_adult%2eht
ml
http://65.54.184.250/cgibin/linkrd?_lang=EN&lah=79f6c533dca991eae412faa6675847a7&lat=1084859304&hm
___action=http%3a%2f%2fwww%2eepipen%2ecom%2fhome%2fresources_adult%2eht
ml
Enmergency Information Card: http://65.54.184.250/cgibin/linkrd?_lang=EN&lah=79f6c533dca991eae412faa6675847a7&lat=1084859304&hm
___action=http%3a%2f%2fwww%2eepipen%2ecom%2fhome%2fresources_adult%2eht
ml
Read Aditional Resources and Support: http://65.54.184.250/cgibin/linkrd?_lang=EN&lah=79f6c533dca991eae412faa6675847a7&lat=1084859304&hm
___action=http%3a%2f%2fwww%2eepipen%2ecom%2fhome%2fresources_adult%2eht
ml
visit http://www.hhs.gov/dab/rrformintro.html? Following this link will take you to
information on how to request an appeal of an administrative law judge (ALJ)
decision, please visit the Departmental Appeals Board Web site.
Genl Glossary of terms and definitions:
http://www.cms.hhs.gov/glossary/default.asp?Letter=ALL&Language=English#Content
Medical Acronyms found
http://www.cms.hhs.gov/acronyms/listall.asp?Letter=ALL
Acronym
Term
A&AS
Advisory & Assistance Service
A&G
Acquisitions & Grants
A&G
Administrative & General
A&R
Audit & Reimbursement
A-PT
ActionPhase Topic
A/P
Accounts Payable
A/R
Applicant and/or Recipient
A109
OMB Circular "Major Systems Acquisitions (ADP)"
A121
OMB Circular "Charge Back for ADP Services Provided to Multiple
Users"
A130
OMB Circular "Management of Federal Information Resources"
A2HA
American Association of Hospital Accountants
A76
OMB Circular "Policies for Acquiring Commercial or Industrial Products
or Services
AA
Associate Administrator
AAA
Agricultural Adjustment Administration
AAA
American Automobile Association
AABB
American Association of Blood Banks
AABH
Association for Ambulatory Behavioral Healthcare
AACN
American Association of Colleges of Nursing
AACR
American Association for Cancer Research
AADA
Abbreviated Antibiotic Drug Application
AAF
Aplastic Anemia Foundation
AAFES
Army & Air Force Exchange Services
AAFP
American Academy of Family Physicians
AAGEG
Administrative Analysis Grade Evaluation Guide
AAHA
American Association of Homes for the Aging
AAHP
American Association of Health Plans
AAHSA
American Association of Homes & Services for the Aging
AAI
Applications Alarms Infrastructure (GTE/MTS)
AAKP
American Association of Kidney Patients
AAMC
Association of American Medical Colleges
AAO
American Academy of Ophthalmology
AAP
American Academy of Pediatrics
AAPC
American Association of Professional Coders
AAPCC
Adjusted Average Per Capita Cost
AAPD
American Academy of Pediatric Dentistry
AAPHR
American Association of Physicians for Human Rights
AAPP
Affirmative Action Program Planning
AARG
Average Annual Rate of Growth
AARP
American Association of Retired Persons
AARR
Approval, Adjustment & Reject Response
AB
(BC/BSA's) Administrative Bulletin
ABA
American Banking Association
ABA
American Bar Association
ABD
Aged, Blind & Disabled
ABEND
Abnormal Ending
ABENDAID
ABEND Analysis Software
ABG
Arterial Blood Gases
ABH
Association of Behavioral Healthcare
ABN
Advanced Beneficiary Notice
ABR
American Board of Radiology
ABS
Annual Beneficiary Summary
AC
Actual Charge
AC
Allowable Cost
ACA
Amputee Coalition of America
ACC
American College of Cardiology
ACC
Automated Change Control
ACCT
Action Plan by Electronic Claims Transaction Institute
ACD
Audit Clearance Document
ACD
Automatic Cancellation Date
ACE
(Carrier) Automated Claims Examination
ACEI
Angiotensin Converting Enzyme Inhibitors
ACEP
American College of Emergency Physicians
ACERS
Annual Contractor Evaluation Reporting System
ACF
Administration for Children & Families
ACGIH
American Conference of Government Industrial Hygienists
ACH
Automated Clearing House
ACHE
American College of Healthcare Executives
ACIP
PHS Immunization Practice Advisory Committee
ACL
Access Control Lists
ACLI
American Council of Life Insurance
ACLU
American Civil Liberties Union
ACM
Association of Computing Machinery
ACMP
Audit/Civil Monetary Penalties
ACMS
Advanced Cost Management Systems
ACO
Administrative Contracting Officer
ACOG
American College of Obstetricians & Gynecologists
ACP
American College of Physicians
ACPS
Advanced Claims Processing System
ACPV
Average Cost per Visit
ACR
Adjusted Community (Contract) Rate
ACR
American College of Radiology
ACRG
Annual Compound Rate of Growth
ACRP
Adjusted Community Rate Proposal
ACRS
Accelerated Cost Recovery System
ACS
Accredited Standards Committee
ACS
American Cancer Society
ACS
American College of Surgeons
ACS
Automated Cartridge System
ACSC
Ambulatory Care Sensitive Conditions
ACSI
American Customer Satisfaction Index
ACSS
Advisory Council on Social Security
ACT
Access Control Table
ACTG
AIDS Clinical Trials Group
ACTS
Automated Case Tracking System
ACU
Automatic Calling Unit
ACV
Arithmetic Coefficient of Variation
ACYF
Administration on Children, Youth & Families
AD
Admitting Diagnosis
ADA
American Dental Association
ADA
American Dietetic Association
ADA
Americans with Disabilities Act of 1990
ADAD
After Date of Award Document
ADAMHA
Alcohol, Drug Abuse & Mental Health Administration
ADAPSO
Association of Data Processing Services Organization
ADARS
Automated DASD Archival Restoration System
ADC
Adult Day Care
ADG
Ambulatory Diagnostic Group
ADGHOSDOM
Ambulatory Diagnostic Group Hospital Dominant
ADHA
American Dental & Hygienists Association
ADJ
Adjusted Claim
ADL
Activities of Daily Living
ADMC
Advance Determination of Medicare Coverage
ADMS
Administrative Message
ADMS
Alcohol, Drug Abuse & Mental Health Services
ADOBI
Advanced DOB Information (System) (SSA)
ADP
(Medicaid) Alternative Disposition Plan
ADP
Advance Planning Document
ADP
Automated Data Processing
ADR
Alternative Dispute Resolution (EEO)
ADR
Automated Date Review
ADR
Automated Desk Review
ADS
Alternative Delivery System
ADS
Amount, Duration & Scope
ADS
Automated Data System
ADS
Automated Development System
ADSB
Application Development System Batch
ADSO
Application Development System Online
ADT
Admission/Discharge Transfer
ADWOH
Average Day's Work On Hand
AE
Administrative Enhancement
AEP
Appropriateness Evaluation Period
AERO
Automatic Earnings Recomputation Operation (MBR)
AF
Administrative Function
AFA
Alternative Form of Annuity
AFCEA
Armed Forces Communications & Electronics Association
AFDC
Aid to Families with Dependant Children (Title IV of the SS Act)
AFDS
Alternative Financing & Delivery System
AFEHCT
American Federation of Electronic Health Care Transactions
AFEHCT
Association for Electronic Health Care Transactions
AFFIRM
Association of Federal Information Resources Management
AFHHA
American Federation of Home Health Agencies
AFIPS
American Federation of Information Resources Societies
AFN
Accumulation File Number
AFPS
Accounting for Pay System
AFSCME
American Federation of State, County & Municipal Employees
AG
Affiliated Group
AGA
Association of Government Accounts
AGPAM
American Guild of Patient Account Managers
AHA
American Heart Association
AHA
American Hospital Association
AHCA
American Health Care Association
AHES
Average Hourly Earnings
AHFSA
Association of Health Facility Survey Agencies
AHIMA
American Health Information Management Association
AHP
Accountable Health Partnership
AHP
Accountable Health Plan
AHP
Alternative Health Plan
AHP
Average Historical Payment
AHPA
American Health Planning Association
AHPB
Adjusted Historical Payment Basis
AHRQ
Agency for Healthcare Research & Quality
AHSEA
Adjusted Hourly Salary Equivalency Amount
AHSS
Adhoc Sampling Survey
AI
Audit Intermediary
AICC
Anti-Inhibitor Coagulant Complex
AICPA
American Institute of Certified Public Accountants
AICR
Alternative Internal Control Review
AID
Agency for Informational Development
AID
Agency for International Development
AIF
Applications Interface Facility
AIIM
Association for Information & Image Management (trade association)
AIM
Automated Insertion Machine
AIMS
Audit Information Management System
AINS
Advanced Information Network System
AKF
American Kidney Fund
ALBN
Amount of Last Billing Notice
ALC
Active License Counter
ALC
Active Location Counter
ALC
Alternate Level of Care
ALE
Annual Loss Expectancy
ALFA
Assisted Living Federation of America
ALJ
Administrative Law Judge
ALNF
Auto Liability NoFault
ALOS
Average Length of Stay
ALS
Advanced Life Support
ALS
Advanced Logistics System
ALSO
Automatic Lump Sum Operation (MBR)
ALT
Average Length of Treatment
AM
Adjustment Module
AM
Amplitude Modulation
AMA
American Medical Association
AMASDS
Asset Management & Automated Software Distribution System
AMCRA
American Medical Care & Review Association
AMCS
Automated Medical Coding System
AMHPS
Association of Minority Health Professional Schools
AMI
acute myocardial infarction (heart attack)
AMIA
American Medical Informatics Association
AMIS
American Management Information System
AML
Arithmetic Mean of the Logarithm
AMOC
Automated Manual Ordering Cycle
AMP
Average Manufacturer's Price
AMR
Acquisition Management Review
AMRA
American Medical Records Association
AMS
Activities Management System
AMW
Average Monthly Wage
AN
Account Number (also A/N)
ANA
Administration for Native Americans
ANA
American Nurses Association
ANCHR
Access to the NCH Repository (online query to 5% sample)
ANDA
Abbreviated New Drug Applications
ANNA
American Nephrology Nurses Association
ANSCII
American National Standard Code for Information Interchange
ANSI
American National Standards Institute
ANSI X12
837
American National Standards Institute Health Data Committee X12
file format 837
AOA
Administration on Aging
AOA
American Optometric Association
AOA
American Osteopathic Association
AOLS
All Other Local Screens
AONE
American Organization of Nurse Executives
AOPA
American Orthotic & Prosthetic Association
AOR
After Outliers Removed
AOR
Application Owning Region
AP
Award Processing
APA
American Pharmaceutical Association
APA
American Psychiatric Association
APACHE
Acute Physiology & Chronic Health Evaluation
APC
Ambulatory Payment Class
APC
Average Per Capita
APC
Average Projected Costs
APCSS
Automated Production Control & Scheduling System (at HDC)
APD
Advanced Planning Documents
APDA
Accretion Premium Due Amount
APDSR
Average Per Diem State Rate
APF
Authorized Program Facility
APG
Ambulatory Patient Group
APG
Ambulatory Payment Group
APHA
American Public Health Association
APHP
Acute Partial Hospitalization Program
APHP
Applied as Hospital Insurance Premiums
APHSA
American Public Human Services Association
API
Application Programming Interface
APM
Admission Pattern Monitoring
APM
Audit Priority Matrix
APMA
American Podiatric Medical Association
APME
Advisory Panel on Medicare Education
APO
Awards Processing Operation
APP
Application Portability Profile
APPC
Advanced ProgramtoProgram Communication
APPS
(GHP) Automated Plan Payment System
APR
Acquisition Procurement Request
APR
Agency Procurement Request
APR
Average Payment Rate
APR - DRG
all payer refined - diagnosis related groups
APS
Acquisition Planning Schedule
APS
Acute Physiology Score
APS
Adjudication Payment System
APS
Annual Person Summary System
APS
Application Productivity System
APSA
American Political Science Association
APT
Automated Production Turnover
APTD
Aid to the Permanently & Totally Disabled
APWA
American Public Welfare Association (changed to APHSA)
AQI
Audit Quality Initiative
AQL
Acceptable Quality Level
AQRP
Audit Quality Review Program
AR
Accounts Receivable
AR
Alpha Representation
ARA
Assistant Regional Administrator
ARA
Associate Regional Administrator
ARC
AIDS Related Complex
ARC
American Red Cross
ARC
Association for Retarded Citizens
ARCS
Accounts Receivable & Collection System
ARF
Actuarial Reduction Factor Program (MBR)
ARF
Area Resource File
ARIMA
Arithmetic Moving Average
ARK
Arkansas Part B System
ARMIS
Ad Hoc Reports Management Information System
ARMS
Adhoc Reports Management System
ARMS
Automated Resource Management System
ARO
Annualized Rate of Occurence
ARP
Admission Review Program
ARS
Active Record Status
ARS
Advanced Record System (GSA)
ARS
Advanced Retrieval System
ARS
Age/Race/Sex
ARS
Agricultural Research Service
ARS
Altanthus Response System
ARSTOP
ARS Telephone Communications Operating Procedures
ARTEMIS
(mainframe project management software testing tool)
ARTS
Automated Reporting & Tracking System
ARU
Audio Response Unit
ARU
Automated Response Unit (Phone system with automated routing)
AS
Administrative Simplification
AS
Advanced System (AJS)
AS
American Samoa
AS
Application System
ASAP
Automated Standard Application for Payments
ASBCA
Armed Services Board of Contract Appeals
ASBCA
Armed Services Board of Contract/State Assessments
ASC
Accredited Standards Committee (ANSI)
ASC
Ambulatory Surgical/Surgery Center
ASCA
Administrative Simplification Compliance Act
ASCII
American Standard Code for Information Interchange (see ANSCII)
ASCM
Application Software Configuration Management
ASCO
American Society of Clinical Oncology
ASCP
American Society of Consultant Pharmacists
ASCPT
American Society of Clinical Pharmacology & Therapeutics
ASCT
American Society of Cytotechnology
ASCW
Audit Selection Criteria Worksheet
ASER/SA
Annual State Evaluation Report/State Assessments
ASF
Automatic System Facility
ASH
Assistant Secretary for Health
ASHP
American Society of Hospital Pharmacists
ASHRM
American Society of Healthcare Risk Management
ASI
Alert Screen Initiative
ASIC
Application Specific Integrated Circuit
ASIM
American Society of Internal Medicine
ASIS
Association Society of Industrial Security
ASM
Annuity & Survivors Master (OPM file)
ASMB
Assistant Secretary for Management & Budget
ASMH
Assembler H Software
ASMT
American Society for Medical Technologists
ASO
Administrative Services Only
ASP
Acquisition Strategy Plan
ASPA
American Society of Public Administrators
ASPE
Assistant Secretary for Planning & Evaluation
ASPEN
Automated Survey Processing Environment
ASPER
Assistant Secretary for Personnel
ASTER
Automated System for Transaction Exception Resolution
ASTHO
Association of State & Territorial Health Offices
ASTM
American Society for Testing & Materials
ASTME31
ASTM Committee 31
ASTS
American Society of Transplant Surgeons
ATARS
Audits Tracking & Reporting System
ATB
All Trunks Busy
ATBCB
Architectural & Transportation Barriers Compliance Board
ATLA
Association of Trial Lawyers of America
ATM
Aschronous Transfer Mode
ATP
Advanced Technology Projects (GTE)
ATRA
American Therapeutic Recreation Association
ATSDR
Agency for Toxic Substances & Disease Registry (EPA)
AUF
Automatic Update Facility
AUSA
Assistant United States Attorney
AUSCT
Autologous Stem Cell Transplantation
AUSU
Assistant U S Attorney
AUTO3480
HDC LMS Robotic Processing software
AVERT
AntiVirus Emergency Response Team (McAfee)
AVGS
Ambulatory Visit Groups
AVP
Assistant Vice President
AVT
Automated Voice Technology
AWAS
Automated Work Administration System
AWP
Actual Wholesale Price
AWP
Average Wholesale Price (Drugs)
AZT
Azidothymidine (AIDS drug therapy)
Bottom of page
Acronym
Term
Top of page
Audiences
B&P
Bid & Proposal
General
BA
Basic Agreement
General
BA
Budget Administration
General
BA
Budget Authority
General
BA
Business Associate
Health Care
BAAADS
Budget Apportionment Allotment Allowance &
Database System
General
BAC
Beneficiary Advisory Committee
Health Care, Medicare
Beneficiary
BAC
Billing Action Code
General
BACOM
Beneficiary Annotation & Communication
Operation
General, Health Care
BAR
Beneficiary Adjustment Report
General, Health Care
BARS
Bid Analysis & Reporting System
General
BATF
Bureau of Alcohol, Tobacco & Firearms
General, Health Care
BBA
Balanced Budget Act of 1997
Health Care, Medicare
Beneficiary
BBRA
Balanced Budget Refinement Act of 1999 (PL
106113)
Health Care, Medicare
Beneficiary
BC/BS
Blue Cross/Blue Shield
Health Care, Medicare
Beneficiary
BCA
Board of Contract Appeals
General, Health Care
BCB
Beneficiary Confidentiality Board
Health Care, Medicare
Beneficiary
BCBSA
Blue Cross/Blue Shield Association
Health Care, Medicare
Beneficiary
BCC
Billing Cycle Code
General
BCC
Block Check Character
General
BCCE
Baltimore Computer Conference & Exposition
General
BCCP
Business Continuity & Contingency Plan
General
BCD
Binary Coded Decimal
General
BCF
Benefit Correction Form
Health Care, Medicare
Beneficiary
BCN
Batch Clearance Notice
General
BD
Budget Distribution
General
BDAM
Basic Data Access Method
General
BDF
Bulk Data Facility
General
BDOD
Beneficiary Date of Death
General, Health Care
BDP
Beneficiary Database Prototype
General, Health Care
BDPC
Breakthrough Drug Pricing Committee
General, Health Care
BDPP
Beneficiary Database Prototype Project
General, Health Care
BDTS
Batched Data Transmission System
General
BEA
Budget Expense Account
General
BEA
Bureau of Economic Affairs
General
BEA
Bureau of Economic Analysis
General
BEA
Business Enterprise Area
General
BEAM
Brain Electrical Activity Mapping
General, Health Care
BEAU
Budget Expense Account Unit
General
BEER
Beneficiary Earnings Exchange Record
General, Health Care
BEI
Budget Estimating Initiative
General
BENDEX
Beneficiary & Earnings Data Exchange System
General, Health Care
BENDEX
Beneficiary Data Exchange
General, Health Care
BERT
(EDB) Beneficiary Enrollment Retrieval System
General, Health Care
BESS
Part B Extract & Summary System (nee BMAD)
General, Health Care
BEST
Beneficiary Eligibility State Tape (EDB Bene
Alpha File)
General, Health Care
BEST
Beneficiary State Totals (from SPACE System)
General, Health Care
BETOS
Berenson Eggers Type of Service
General
BF
Beneficiary File
General, Health Care
BGN
Beneficiary Given Name
General, Health Care
BHO
Behavioral Health Organization
General, Health Care
BHS
Business Health Services
General
BI
Background Investigation
General
BI
Benefits Integrity
General, Health Care
BI
Buy In
General
BIA
Business Impact Analysis
General
BIC
Beneficiary Identification Code
General, Health Care
BICEQN
BIC Equate Number
General
BIEC
BuyIn Eligibility Code
General
BIER
Billing Information Exchange Record
General
BIF
Beneficiary Insurance File
General, Health Care
BIF
Benefit Information Form
General, Health Care
BIMF
Beneficiary Inactive Master File
General, Health Care
BIPA
Benefits, Improvements & Protection Act of
2000
General, Health Care
BISC
Benefit Integrity support Center
General, Health Care
BISYNC
Binary Synchronous Communication (IBM data
communications protocol)
General
BIT
Beneficiary Inquiries Taskforce
General, Health Care
BITF
Beneficiary Implementation Task Force
General, Health Care
BITS
Beneficiary Information Tracking System
General, Health Care
BITS
Beneficiary Inquiry Tracking System
General, Health Care
BITSMIS
BITS Management Information System
General
BIW
Beneficiary Inquiries Workgroup
General, Health Care
BL
Black Lung
General, Health Care
BLASER
Black Lung Automated Search & Edit Routine
General, Health Care
BLM
Bureau of Land Management
General
BLP
Bypass Label Processing
General
BLS
Basic Life Support
General, Health Care
BLS
Bureau of Labor Statistics (DOL)
General
BLUC
Bottom Line Unit Cost
General
BLUES
Blue Cross/Blue Shield associations
General, Health Care
BMA
BioMedical Applications
General, Health Care
BMACS
Part B Medicare Automated Claims Systems
General, Health Care
BMCHRD
Bureau of Maternal & Child Health & Resources
Development
General, Health Care
BOA
Basic Ordering Agreement
General
BOAN
Beneficiary's Own Account Number (SSN)
General, Health Care
BOCMIS
Beneficiary Overpayment Control &
Management Information System
General, Health Care
BOD
Bid Opening Date
General
BOIS
Beneficiary Online Inquiry System (HI/SMI
online in HCFA)
General, Health Care
BOM
Bill of Materials
General
BOMA
Building Owners & Managers Association
General
BOME
Bureau of Medical Examiners
General, Health Care
BOR
Before Outliers Removed
General
BOSS
Best on Open Systems Solutions
General
BOSSN
Beneficiary's Own SSN
General, Health Care
BP
Benefit Period
Health Care, Medicare
Beneficiary
BP
Best Price
General
BP
Business Partner
Health Care
BPA
Blanket Purchase Arrangement (or Agreement)
General
BPC
Base Period Charge
General, Health Care
BPO
Bargain Purchase Option
General
BPR
Budget & Performance Requirements
General
BPR
Business Process Reengineering
General
BPS
Budget Preparation System
General
BPST
Bill Processing System Test
General
BQAS
Part B Quality Assurance System
General, Health Care
BR
Budget Request
General
BRA
Business Resumption Assessment
General
BRC
Base Rate Calculation
General
BRDPI
Biomedical Research & Development Price Index General, Health Care
BRDS
Bill Review Documentation Summary form
General
BRI
Basic Rate Interface
General
BRI
Benefit Rate Increase
General, Health Care
BRRR
Bills Received & Returned Report
General
BRS
Bibliographic Retrieval Service
General
BRT
Business Roundtable
General
BSA
Business Software Alliance
General
BSC
Binary Synchronous Communication
General
BSF
Benefit Stabilization Fund
General
BSP
Business Systems Planning
General
BSR
(Part B) Bill Summary Records
General, Health Care
BSRS
Benefit Savings Reporting System
General, Health Care
BSS
Beneficiary Satisfaction Survey
General, Health Care
BSS
Benefit Summary Statistics
General, Health Care
BTW
Bill Type Weight
General
BUCS
Budget Under Control System
General
BUR
Billing Update Record
General
BUTE
Beneficiary Database Update Transaction
System (HDBUTE)
General, Health Care
BVR
Budget Variance Report
General
BVS
Bureau of Vital Statistics
General
BY
Budget Year
General
Acronym
Term
Audiences
C&P
Compensation & Pension (DVA)
General
C/BR
Cost/Benefit Ratio
General
C/BR
Cost/Burden Reduction
General
C/O
Center or Office
General
C/S
Client/Server
General
C/SPS
Cost/Scheduling Performance System
General
C2IW
CAFM II Implementation Workgroup
General
CA
Certification Authority
General
CA
Change Administration
General
CA
Claims Analyst
General
CA
Competitive Advocate
General
CAAS
Certificate for Advisory & Assistance
Services
General
CAAS
Contracted Advisory & Assistance Services
General
CABBS
Carrier Bulletin Board System
General, Health Care
CABG
coronary artery bypass graft
Health Care
CABLE
Combined A/B Local Eligibility
General, Health Care
CABS
Carrier Access Billing System
General, Health Care
CABS
Contractor Administrative Budget & Cost
Reporting System
General
CABWF
Combined A/B Working File (also see CWF)
General, Health Care
CAC
Carrier Advisory Committee
General, Health Care
CAC
Categorical Assistance Code
General
CAC
Contractor Advisory Committee
General
CACO
Corporate Administrative Contracting Officer General
CAFM
Contractor Administrative, Budget &
Financial Management
General
CAGE
Contractor & Government Entity Code
(formerly FSCM)
General
CAH
Critical Access Hospital
Health Care, Medicare
Beneficiary
CAHHS
California Association of Hospitals & Health
Systems
General, Health Care
CAHPS
Consumer Assessments of Health Plans
Survey
General, Health Care,
Medicare Beneficiary
CAHSA
California Association of Home Services for
the Aged
General, Health Care
CALPERS
California Public Employees Retirement
System
Health Care, Medicare
Beneficiary
CALSO
(Death Termination System (SSA))
General, Health Care
CAMP
Carrier Accountability Monitoring Project
General, Health Care
CAMS
Customer Account Management System
General
CAN
Claim Account Number
General, Health Care
CAN
Common Accounting (or Account) Number
General
CANDA
Computer Assisted New Drug Applications
General, Health Care
CAP
Change Acceleration Process
General
CAP
community acquired pneumonia
Health Care
CAP
Corrective Action Plan
General
CAP-REL
Capital Related
General
CAPI
Computer Assisted Personal Interviewing
(software)
General
CAPS
Capitated Ambulatory Plan
General, Health Care
CAPS
Claims Automated Processing System (SSA
MBR)
General, Health Care
CAR
Corrective Action Review
General, Health Care
CAR
Cost Accounting Report
General
CARE
Center for Analytical Review & Education
General, Health Care
CARES
Contractors Analysis & Reporting System
General
CARF
Commission on Accreditation of
Rehabilitation Facilities
General, Health Care
CARRPR
Carrier Payment Record
General, Health Care
CAS
Cost Accounting Standards
General
CASB
Cost Accounting Standards Board
General
CASE
Committee on Academic Science &
Engineering Report
General
CASE
Computer Aided (or Assisted) Software
Engineering
General
CASE
Computer Assisted Systems Engineering
General, Health Care
CASF
Carrier Alphabetic State File
General, Health Care
CASL
Competition Advocate Shopping List
General
CASO
(HI) Combine & Sort Operation
General
CASPER
Certification and Survey Provider Enhanced
Reporting
General, Medicare
Beneficiary, State
CASPRO
Clinical Area Support PRO
General, Health Care
CASR
Contractor Audit & Settlement Report
(System)
General
CAST
Carrier Alpha State Microfilm/Microfiche
System
General, Health Care
CAST
Carrier Alpha State Tape
General, Health Care
CAST
Contractor Assessment Security Tool
General
CASU
Cooperative Administrative Support Program General
CAT
Computerized Axial Tomography
General
CAWR
Combined Annual Wage Reporting
General
CB
Consolidated Billing
General, Health Care
CB
Cost Benefit
General, Health Care
CBA
Cost/Benefit Analysis
General, Health Care
CBC
Cipher Block Chaining
General
CBO
Congressional Budget Office
General
CBR
CASE Based Reasoning
General
CBR
Cost Based Reimbursement
General, Health Care
CBS
Current Beneficiary Survey (by OACT)
General, Health Care
CBSR
Cost Benefit Savings Report
General, Health Care
CBSS
Customer Billing Services System
General, Health Care
CBT
Computer Based Training
General, IT
Organization
CC
Ceiling Cost
General
CC
Claims Control
General, Health Care
CC
Complication or Comorbidity
General
CC
Condition Code
General, Health Care
CC
Configuration Control
General
CCA
Catastrophic Coverage Act
General, Health Care
CCA
Child Care Association
General, Health Care
CCC
Change Control Coordination
General
CCC
Civilian Conservation Corps
General
CCC
Comprehensive Care Center
General
CCDR
Contract Cost Data Report
General
CCDRS
Contract Cost Data Reporting System
General
CCHCC
Coordinating Center for Home & Community
General, Health Care
Care
CCI
Correct Coding Initiative
General
CCITT
Consultative Committee on International
Telephone & Telegraph
General, IT
Organization
CCLR
Claims Collection Litigation Report
General, Health Care
CCM
Common Cap Module
General
CCN
Carrier Control Number
General, Health Care
CCN
Claim Control Number
General, Health Care
CCN
Correspondence Control Number
General, Health Care
CCO
Claims Collection Officer
General, Health Care
CCP
Change Control Planning
General
CCP
Comprehensive Care Provider
General, Health Care
CCP
Coordinated Care Plans
General, Health Care
CCPR
Coordinated Comprehensive Provider Review General
CCR
Cost to Charge Ratio
General
CCR
Coverage Compliance Reviews
General
CCRC
Continuing Care Retirement Community
Health Care, Medicare
Beneficiary
CCRC
Continuum of Care Residential Center
General, Health Care
CCS
Community Care Setting
General, Health Care
CCS
Contract Control System
General
CCU
(Carrier) Cost Containment Unit
General, Health Care
CCUITT
Consultive Committee on International
Telegraphy & Telephony
General
CD
Civil Defense
General
CD-RISC
Clinically Detailed Risk Information System
for Costs
General
CDB
(Carrier) Correspondence Database System
General, Health Care
CDC
Center for Disease Control
Health Care, Medicare
Beneficiary
CDC
Corporate Data Center
General
CDE
Core Data Element
General
CDF
Children's Defense Fund
General
CDI
Catastrophic Drug Insurance (Trust Fund)
General, Health Care
CDM
(Hospital) Charge Description Master (Files) General, Health Care
CDOC
Covered Days of Care
General, Health Care
CDP
Computerized Decision Procedures
General
CDR
Continuing Disability Review
General, Health Care
CDR
Critical Design Review
General
CDRG
Children's Diagnosis Related Groups
General, Health Care
CDRL
Contract Data Requirements List
General
CDRTS
COMDISCO Disaster Recovery Services
General
CDS
Central Distribution System
General
CDS
Chain Directory System
General
CDT
Current Dental Terminology
Health Care
CDW
Collision Damage Waiver
General
CDWOH
Calendar Days Work on Hand
General
CE
Covered Entity
Health Care
CEA
Cost Effectiveness Analysis
General
CEA
Council of Economic Advisors
General
CEB
Contractor Efficiency Benchmark
General
CEB
Cost Efficiency Benchmark
General
CEBMA
Computer & Business Equipment
Manufacturers Association
General
CED
Committee for Employees with Disabilities
General, Health Care
CELIP
Claim Expansion & Line Item Processing
General, Health Care
CEMS
CostEffectiveness Measurement System
General
CER
Capital Expenditure Review
General
CER
Combined Exchange Record (from the MBR)
General
(nee URIC)
CER
Comprehensive Evaluation Report
General
CER
Cost Estimating Relationship
General
CERT
Comprehensive Error Rate Testing
General
CES
Cost Estimating System
General
CES
Credential Evaluation Service
General, Health Care
CF
Case Folder Control System
General
CF
Conversion Factor
General
CFB
Cipher Feedback
General
CFE
Contractor Furnished Equipment
General
CFO
Chief Financial Officer
General
CFOA
Chief Financial Officer's Act of 1990
General
CFPP
Contracting for Prepaid Plans
General
CFR
Code of Federal Regulations
General
CFSR
Contract Funds Status Report
General
CGMP
Current Good Manufacturing Practice
General
CHA
Catholic Health Association
General, Health Care
CHA
County Health Authorities
General
CHAFF
Change of Address System (MBR)
General
CHAIN
Chain Provider Director System
General, Health Care
CHAMPUS
Civilian Health & Medical Programs of the
Uniformed Services (Now TRI-CARE)
General, Health Care
CHAMPVA
Civilian Health & Medical Program of the
Veterans Administration
General, Health Care
CHAP
Child Health Assurance Program
General, Health Care
CHAP
Community Health Accreditation Program
General, Health Care
CHAPS
Consumer Assessment of Health Plans
Survey
General, Health Care
CHBI
Commission on Health Benefits &
Integration
General, Health Care
CHC
Community Health Center
General, Health Care
CHC
Comprehensive Health Center
General, Health Care
CHC
Continuous Home Care
General, Health Care
CHCC
Center for Hospital & Community Care
General, Health Care
CHCL
Center for Health Care Law
General, Health Care
CHDR
Center for Health Dispute Resolution
General, Health Care
CHDS
(National) Charge Distribution System
General
CHER
Center of Health Economics Research (aka
HERI)
General, Health Care
CHHA
Certified Home Health Agency
General, Health Care
CHHC
Continuous Home Health Care
General, Health Care
CHI
Catastrophic Health Insurance
General, Health Care
CHICN
HI Enrollment Cards Operation (HECHICN)
General, Health Care
CHICO
Combined Health Insurance & Checkwriting
Operations
General, Health Care
CHIM
Center for Healthcare Information
Management
General, Health Care
CHIME
College of Healthcare Information
Management Executives
Health Care
CHIP
Catastrophic Health Care Program
General, Health Care
CHIP
Child Health Insurance Program
Health Care, Medicare
Beneficiary
CHMSA
Critical Health Manpower Shortage Area
General, Health Care
CHN
Community Health Network
General, Health Care
CHO
Community Health Organization
General, Health Care
CI
Catastrophic Indicator
General, Health Care
CI
Configuration Identification
General
CI
Configuration Item
General
CI
Control Interval
General
CIA
Commercial Industrial Activity (also GCIA)
General
CIADV
Carrier/Intermediary Advance Notice
General, Health Care
CICA
Competition in Contracting Act (1984)
General
CICG
Critical Infrastructure Coordination Group
General
CICO
Commercial Industrial Control Officer
General
CICS
Customer Information Control System
(replaces SSADARS)
General
CID
Commercial Item Description
General
CIEP
Contractor Inspection & Evaluation Program General
CIM
Corporate Information Management
General
CIM
Coverage Issues Manual
General, Health Care
CIMS
Case Investigation Management System
General
CIN
Common Identification Number
General
CIO
Chief Information Officer
General
CIP
Claims In Process
General, Health Care
CIP
Competitive Incentive Program
General
CIP
Continuous Improvement Process Program
General
CIP
Customer Initiated Payments
General
CIPS
(FRC) Center Information Processing
System
General
CISC
Complex Instruction Set Computing
General
CISTR
Correspondence Image Storage,
Transmission & Retrieval
General
CITIC
Consolidated Information Technology
Infrastructure Contract
General
CKD
Count Key Data
General
CKM
Constructive Key Management
General
CLAIM
Community Leaders Assisting the ICA
(Insurance Counseling Assistance) in
Missouri
General
CLCCP
Comprehensive Limiting Charge Compliance
General
Program
CLFS
Clinical Laboratory Fee Schedule
General, Health Care
CLIA
Clinical Laboratory Improvement Act (of
1965) (Amendments 1988)
General, Health Care
CLIA
Clinical Laboratory Interstate Act (or
Amendments)
General, Health Care
CLM
Current Logical Model
General
CLMA
Clinical Laboratory Management Association General, Health Care
CLOE
(Carrier) Claims Only Entry System
General, Health Care
CLT
Certified Lab Technician
Health Care, Medicare
Beneficiary
CLUW
Coalition of Labor Union Women
General
CM
Complexity Metrics
General
CM
Configuration Management
General
CM
Configuration Manual
General
CMA
Contract Management Action
General
CMA
Current Month Accrual
General
CMD
Carrier Medical Director
General, Health Care
CMD
Contractor Medical Directors
General, Health Care
CMFMRA
Consolidated Master File of Military Retirees
& Annuitants
General
CMG
Case Mix Group
General
CMG
Computer Measurement Group
General
CMG
Contractor Management Group
General
CMHC
Community Mental Health Center (or Clinic) General, Health Care
CMHS
Continuous Medical (or Medicare) History
Sample (or Study)
General, Health Care
CMI
Case Mix Index
General
CMIS
Communications Management Information
System
General
CMM
Capability Maturity Model
General, Health Care
CMN
Certified Medical Necessity
General, Health Care
CMP
Capacity Management Program
General
CMP
Career Management Program
General
CMP
Change Management Process
General
CMP
Civil Monetary Penalty
General
CMP
Competitive Medical Plan (under TEFRA)
General, Health Care
CMP
Comprehensive Medical Plan
General, Health Care
CMP
Configuration Management Plan
General
CMP-EIS
CMP Executive Information System
General
CMPL
Civil Monetary Penalty Law
General
CMPL
Civil Monetary Penalty Liability
General
CMPTS
Civil Monitory Penalty Tracking System
General
CMR
Comprehensive Medical Review
General, Health Care
CMRI
California Medical Review, Inc.
General, Health Care
CMS
Centers for Medicare and Medicaid Services
(HCFA prior to July 1, 2001)
Health Care, Medicare
Beneficiary
CMSA
Consolidated Metropolitan Statistical Area
General
CMSS
Council of Medical Specialty Societies
General, Health Care
CMTI
Customized Claims System Identifier
General
CN
Claim Number (also C/N)
Health Care, Medicare
Beneficiary
CNACO
Community Nursing & Ambulatory Care
Organization
General, Health Care
CNBC
Congress of National Black Churches
General
CNH
Community Nursing Home
General, Health Care
CNPB
Clean NonPIP Bills
General, Health Care
CNV
Conversion Phase
General
CO
Central Office
General, Health Care
CO
Change Order
General
CO
Coinsurance
General, Health Care
CO
Contract Officer
General, Health Care
CO
Control Officer
General
COA
Change of Address
Health Care, Medicare
Beneficiary
COB
Close of Business
General, Health Care
COB
Coordination of Benefits
Health Care, Medicare
Beneficiary
COBA
Coordination of Benefits Agreement
Health Care, Medicare
Beneficiary
COBC
Coordination of Benefits Contractor
Health Care, Medicare
Beneficiary
COBRA
Consolidated Omnibus Budget Reconciliation Health Care, Medicare
Act (of 1985)
Beneficiary
COC
Certificate of Competency
General
COCA
Clearinghouse on Computer Accommodation
General, IT
Organization
COF
Carrier Option File
General, Health Care
COFFE
Council of Former Federal Employees
General
COG
Continuity of Government
General
COGME
Council On Graduate Medical Education
General
COI
Certificate of Indebtedness
General
COI
Change of Intermediaries
General, Health Care
COM
Centralized Office Minicomputer
General
COM
Computer Output Microfilm
General
COM
Current Operating Month
General
COMPAS
COMDISCO Plan Automation System
General
COMSEC
Communication Security
General
CON
Certificate of Need
General
CONOPS
Concept of Operations
General
CONUS
Continual U.S. (48 Contiguous states & DC,
aka: CONTERMINOUS U.S.)
General
COO
Chief of Operations
General
COO
Chief Operating Officer
General
COOP
Continuity of Operation Plan
General
COP
Concept of Operations Papers
General
COP
Conditions of Participation
General, Health Care
COP
Continuation of Pay
General
COPC
Community Oriented Primary Care
General, Health Care
COPD
Chronic Obstructive Pulmonary Disease
General, Health Care
COPES
Community Options Program Entry System
General
CORC
Carrier of Record Control
General, Health Care
CORF
Comprehensive Outpatient Rehabilitation
General, Health Care
Facility
CORTS
Calculation of Overpayment Recovery
Timeliness System
General, Health Care
COT
Chain of Trust
Health Care
COTF
Chain Organization Task Force
General
COTR
Contract Officer's Technical Representative
General, Health Care
COWAPS
Council on Wage & Price Stability
General
CP
Claims Processing
General, Health Care
CP
Contractor Profiles
General
CP/M
Control Program for Microprocessors
General
CPA
Cost Plus Award
General, Health Care
CPAF
Cost Plus Award Fee
General, Health Care
CPAP
Common Provider Audit Program
General, Health Care
CPAP
Continuous positive airway pressure
General, Health Care,
Medicare Beneficiary
CPAS
Claims Processing Assessment System
General, Health Care
CPCM
Certified Professional Contract Manager
General
CPD
Competitive Pricing Demonstration
Health Care, Medicare
Beneficiary
CPD
Cost Per Discharge
General, Health Care
CPDA
Current Premium Due Amount
General, Health Care
CPDAH
CPDA Hospital Insurance
General, Health Care
CPE
Certified Public Expenditures
General
CPE
Contractor Performance Evaluation
General
CPEP
Contractor Performance Evaluation Program
General
(or Profile)
CPFA
Cost Plus Fee Award
General, Health Care
CPFF
Cost Plus Fixed Fee
General, Health Care
CPHA
Commission on Professional Hospital
Activities
General, Health Care
CPI
Consumer Price Index
General
CPI
Coverage Period Indicator
General
CPI-U
Consumer Price Index for Urban Areas
General
CPIC
Certification Package for Internal Controls
General
CPIF
Cost Plus Incentive Fee
General
CPM
Claims Processing Manual
General, Health Care
CPM
Clinical Performance Measure
General, Health Care
CPM
Contractor Performance Management
(Module)
General, Health Care
CPM
Critical Path Method
General
CPM/EIS
Contractor Performance Management /
Enterprise Information System
General, Health Care
CPMD
Continuous Passive Motion Device
General
CPO
Care Plan Oversight
General, Health Care
CPO
Chief of Purchasing Office
General
CPPC
Cost Plus Percentage of Cost
General, Health Care
CPQC
Claims Processing Quality Control
General, Health Care
CPR
Comparative Performance Report
General
CPR
Computerized Patient Record
General, Health Care
CPR
Contractor Performance Report
General
CPR
Cost Performance Report
General
CPR
Customary, Prevailing & Reasonable
(Charge)
General
CPRI
Computer-based Patient Record Institute
Health Care
CPRS
Contractor Performance Reporting System
General
CPS
Center for Policy Studies
General
CPS
Classified Position System
General
CPS
Critical Payment System
General, Health Care
CPSC
Consumer Products Safety Commission
General, Health Care
CPSR
Contractor Purchasing (or Procurement)
System Review
General
CPT
Claims Processing Timeliness
General, Health Care
CPT
Common Procedural Terminology
General, Health Care
CPT
Cost Per Treatment
General, Health Care
CPT
Current Procedural Terminology
General, Health Care
CPT-4
Current Procedural Terminology, Version 4
General, Health Care
CPU
Central Processing Unit
General
CPV
Cost Per Visit
General, Health Care
CQAS
Carrier Quality Assurance System (now Part
General, Health Care
B QAS)
CQI
Continuous Quality Improvement
General, Health Care
CQMR
Carrier Quarterly Medical Review
General, Health Care
CR
Change Request
General
CR
Continuing Resolution
General, Health Care
CR
Cost Report
General
CR
Cross Reference
General
CRAG
Contractor Risk Assessment Guide
General
CRAH
Change Request Approval History
General
CRAM
Cross Region Access Method
General
CRB
Change Review Board
General, Health Care
CRC
Capital Related Costs
General
CRC
Career Resource Center
General
CRC
Cyclic Redundancy Check
General
CRCC
Compensation Related Customary Charges
General
CRD
Chronic Renal Disease (aka: ESRD
(preferred))
General, Health Care
CREP
Cost Report Evaluation Program
General
CRESUS
Cost Report Evaluation System subsystem
General
CRF
Change Request Form
General
CRG
Carrier Representative Group
General, Health Care
CRI
Client Record Index
General
CRI
Controlled Rate of Increase
General
CRIPA
Civil Rights of Institutionalized Persons Act
General
CRLE
Cost Reimbursement Level of Effort
General, Health Care
CROWD
Contractor Reporting of Operational &
Workload Data
General
CRP
Common Rules Processor
General
CRP
Consolidated Review Program
General
CRS
Congressional Reporting System
General
CRS
Congressional Research Service
General
CRSL
Cost Report Settlement Log
General
CRTS
Cuff Records Tracking System
General
CRVR
Catastrophic Repeal Validation Review
General
CRVS
California Relative Value Study
General
CRWH
Change Request Work History
General
CS
Claims Services
General, Health Care
CS
Covered Services
General, Health Care
CSA
Computer Security Act of 1987
General, IT
Organization
CSA
Cross Service Agreement
General
CSAMS
Customer Service Assessment &
Management System
General
CSAP
Center for Substance Abuse Prevention
General, Health Care
CSAT
Computer Security Awareness Training
General, IT
Organization
CSC
Customer Service Center
General
CSCC
Customer Service Call Center (nee SPOC,
now CSC Customer Service Center)
General
CSD
Customer Service Desk
General
CSF
Critical Success Factor
General
CSI
Computer Security Institute
General, IT
Organization
CSIRC
Computer Security Incident Response
Capability
General, IT
Organization
CSMI
Corporate Storage Management Initiative
General
CSO
Community Service Offices
General
CSO
Customer Service Order
General
CSOT
Customer Service Outstation Team (also
OCST)
General
CSP
Certified Systems Professional
General, IT
Organization
CSP
Customer Service Plan
General
CSP
Customer Service Program
General
CSR
Core Security Requirements
General, IT
Organization
CSR
Customer Service Record
General
CSR
Customer Service Representative
General
CSR
Customer Service Request
General
CSRA
Civil Service Reform Act of 1978
General
CSRS
Civil Service Retirement System
General
CSSP
Computer Systems Security Plan
General, IT
Organization
CSSR
Communications System Segment
Replacement
General, IT
Organization
CSSR
Cost Schedule Status Report
General
CST
Consumer Service Team
General
CSTE
Council of State & Territorial Epidemiologists General, Health Care
CSTP
Carrier System Testing Project (or Program) General, Health Care
CTC
Certified Transplant Center
General, Health Care
CTMP
Contractor Task Management Plan
General
CTR
Contingency Plan Report
General
CTS
Clear To Send
General
CTS
Contracts Tracking System
General
CUI
Customer User Interface
General, IT
Organization
CVA
Current View Area
General
CVE
Common Vulnerabilities & Exposures
General
CVF
Current Value of Funds
General
CWF
Common Working File (see NCHS)
General, Health Care
CWF/MSP
Common Working File / Medicare Secondary
General, Health Care
Payer
CWFA
Common Working File Part A
General, Health Care
CWFB
Common Working File Part B
General, Health Care
CWFDOCO
Common Working File Documentation File
General, Health Care
CWFHPEP
Common Working File Host Performance
Evaluation Program
General, Health Care
CWFINFOBASE Common Working File Information Database General, Health Care
CWFM
Common Working File Maintenance
General, Health Care
CWFM/IV&V
Common Working File Maintenance /
Independent Verification & Validation
General, Health Care
CWFMC
Common Working File Maintenance
Contractor
General, Health Care
CWFMQA
CWF Medicare Quality Assurance System
General, Health Care
CWFQAS
Common Working File Quality Assurance
System
General, Health Care
CWRS
Contractor Workload Reporting System
General
CWS
Compressed Work Schedule
General
CWS
Contractor Workload System
General
CY
Calendar Year
General
CY
Critical Year