Law of Attraction 'n' Small Business Ideas with Practical Manifestations

Helping the Street Children of Brazil

2010-06-13T05:25:00.000-07:00

My friend Gertrud of MetroWest Healing Center mentioned to me that she has a friend in Brazil that is helping the neighborhood street children. His name is Emerson and he is a doctor. He offers them free medical attention and it has a dramatic impact on their lives since they have so little. Gertrud recently visited Brazil for a healing seminar Emerson was giving. She met a child there and decided to start sending Emerson some money each money to care for the child.

Gertrud told me of her idea to maybe start a charity for the street children of Brazil. I researched to see what was involved in starting a charity and it seemed pretty complex. I told Gertrud that to start, we could just start sending Emerson donations to help these poor street children. I know that our time and money spent helping Emerson to do the work he is doing will go much farther since he is offering his services for free and the money goes toward supplies, etc.

I thought it would be a great idea to start gathering information on the street children of Brazil in general. Furthermore it would be fascinating to get actual stories from the children Emerson is helping to hear what they have to say. I would also like to see Emerson’s project bloom into something bigger like getting the kids educated so they can start helping themselves and the other street children.

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Representatives Return Campaign Contributions to Goldman Sachs

2010-05-01T14:29:00.000-07:00

Many representatives from both the democrat and republican parties are calling for members of the opposing party to return money that Goldman Sachs made to their respective campaigns. Ironically members of both parties receive many (and sometimes most) of their contributions from Wall Street firms. Although it can be rather depressing to think about the conflict of interest we are faced with when politicians are trying to regulate Wall Street, I did find a couple of representatives that are giving the money back and I would like to show my appreciation to them by giving them a special mention. Maybe one day companies will not make large monetary contributions to members of a political party so we can avoid having politicians in office that owe something to their beneficiaries. It would be difficult to make and enforce such a law, I think the politician himself or herself would need to implement and it would show that they held themselves to a higher standard of integrity. As voters we can help ourselves by demanding this higher standard from our politicians. It would certainly be a step in the right direction.

Democrat Blanche Lincoln and GOP senate hopefull Mark Kirk both returned the money Goldman Sachs had made to their campaigns:
http://www.publicbroadcasting.net/kuar/news.newsmain/article/1/0/1642667/Arkansas.Headlines/Lincoln.gives.Goldman.Sachs.donations.to.charity
http://news.yahoo.com/s/afp/20100419/pl_afp/useconomyfinancereformpoliticskirk_20100419214623

Article on contributions made to both parties:
http://www.miamiherald.com/2010/04/25/1597170/what-do-both-parties-have-in-common.html

Increasing US Government Regulation of the Stock Market

2010-04-28T02:40:00.000-07:00

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I write about my views of politics and legislation because by voicing my opinion I believe I am increasing the potential for my opinion to have an effect on the overall outcome of the issues we face. It also helps me to solidify my intent, which according to the law of attraction, is critical in realizing one's goals.

Now that the health care bill has been passed, the next item on the agenda is to increase government regulation of the stock market. It seems strange to me that we would want the government to try to regulate something that it has such a large stake in, another big conflict of interest. Just the fact that the SEC filed a claim against Goldman Sachs just as the government regulation bill came to the table appears unlikely to be coincidental. There have been news reports in the past that sometimes the SEC was afraid to take action against certain companies because members of the SEC feared it could affect their own personal security. Furthermore it is important to the government officials that the stock market does well. If people are making money in the stock market, they are more likely to vote for the present majority party in the next election. This could affect one’s judgment when deciding whether or not to take action against a company. What could also affect one’s judgment is if they happen to have some connection to a company, it’s sector, or an affiliate of the company. Given the size of our government, it is not unlikely that at least a few of our government officials would have a connection with a company or two. Of course the biggest potential for conflict of interest is the fact that it is usually companies that make the largest contributions toward the government official elect when they are running for office.

To me, the best solution to all of this is not necessarily more regulation or adding another branch of government. While it may do well to increase the number of jobs in the country it would probably do little toward the alleged intended effect of preventing our banking institutions from investing large unnecessary risks beyond what would be accomplished by simply enforcing the laws already in place, perhaps creating a single new law which mandates 100% disclosure and transparency of businesses, and perhaps mandating that each business hire a 3rd party auditor that needs meet some standard for proper auditors set forth by the SEC.

Continuing down the road of having the SEC alone try to regulate businesses without 3rd party involvement is a recipe for disaster. I believe we will spend a lot of tax payer money trying to get to the bottom of the Goldman Sachs claim only to find out that it is extremely expensive and probably nearly impossible to come up with every law necessary to keep bank institutions from making risky bets on the market.

We need to keep in mind that the reason banks are making risky bets on the market in the first place is that the government has removed much of the risk from the bets by offering bailouts and pouring money into the stock market over the last several years. We have created a can’t-lose situation for large banks at the tax payers’ expense. At the same time smaller businesses and banks are being left out in the cold not qualifying for bailout money since their individual failure does not have the same potential to wreak havoc on the overall economy as the failure of larger businesses and banks.

Transparency in Electing Congressional Representatives

2010-04-13T04:01:00.000-07:00

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The law of attraction is about choosing a goal and working toward it. I believe one of the best ways of working toward a goal that involves other people is to voice your opinion about the goal and suggest ways of achieving it. It is for this reason that I sometimes comment on areas such as politics.

With the many complex political issues we face today in the United States, it is far too difficult to determine whether or not our congressional representatives follow through on their promises. There are often many legitimate-sounding reasons when they fall short, including opposition from the opposing party. A lot of time is spent bashing the opposing party rather than discussing the issue at hand. To complicate the matter, the decisions and laws the representatives of one party put in place often require at least a few years before they take full effect. By that time the opposite party is in the majority and their excuse is that they are just trying to compensate for a poor decision made by the other party years ago. Furthermore the truth about whether or not the promises were fulfilled is skewed by the media and the public in accordance with their party bias.

There are two major items that we are confronted with and the first item cannot be determined until we resolve the second:

1) The citizens of this nation may or may not be making poor decisions in as far as electing representatives and resolving the various political issues the nation faces
2) The representatives we elect may or may not be following through on the promises they make to the citizens

The trouble with not knowing whether or not you are making the correct decisions to resolve political issues is that you cannot learn from your mistakes. The reason we do not know if we are making correct decisions is that when we tell our representative what direction we want to go in, the representative often does not follow through 100%. On the one hand, since the issues are so complex and since they need to cooperate with people on the opposing party, it could be argued that no issue of this nature could be followed through 100%. On the other hand we have no idea what the actual follow-through rate is, it could be 50% or lower. At any rate this uncertainty keeps us from learning from our mistakes.

It would appear that if we could get a handle on the second item, the first item should resolve itself through iterations of electing the wrong representatives and making the wrong decisions, paying for the wrong decisions, and realizing there are faster, cheaper, safer, etc. alternatives to the decisions we made in the past. If I were asked for a suggestion on the topic, I would probably suggest that a national unbiased analyst panel be put together to assess each of the representatives we have in congress to determine if and to what degree they follow through on the promises they make when campaigning for office. Said panel could be funded by a voluntary contribution, perhaps added at the bottom of our tax returns, similar to the line items for political party contributions. This would be a contribution I, myself, would gladly make in order to make it much easier to resolve the many issues our country and world face. Maybe those that contribute to the panel could suggest the representatives they would like to be reviewed. This could be helpful especially in the beginning when selecting which representatives to review first.

If, by chance, no one contributes to the analyst panel and we remain in the dark as to whether or not and to what degree our representatives follow through on their promises, then we, as a nation, have elected to take an uninformed approach to resolving the issues at hand. In doing so we will continue to make mistakes we cannot learn from while spending money we do not have. If we do choose to not contribute to such a panel or take any action at all toward improving the process of selecting representatives, at least it was a choice we made, and at some point in the future we may learn from our mistake.

In our present situation I do not think that all hope is lost. Instead I look at the possibility of our nation working together on a resolution as a great opportunity. I’m sure my suggestion is one of may possible resolutions available to us and eventually we will get it right, the only question is, “How much time will it take for us to get there?”

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Decorating for Success

2010-03-14T07:30:00.000-07:00

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I was making my breakfast this morning when I looked at the refrigerator and saw the picture I had taken of my wife standing with Yo-Yo Ma, one of the greatest cellists in the world. I took the picture maybe a month ago when we went to see him play a concert with the Boston Symphony Orchestra. Many people would love to meet him but never get a chance to. We just happened to be standing in the right spot at the right moment and he walked right to us. My wife loves this picture as she, herself, aspires to be as great a cellist as he is some day. The law of attraction can be used to bring into our lives anything we want, such as success in our career.

I then took my breakfast into our living room, where we have a music rug. It occurred to me that we do not have a formal place for my wife to practice by herself or with her string quartet, Col’ Areo, and to tutor her students. She usually does everything in the large room in the back of the house. There are major differences between the two rooms. The living room has a hardwood floor and so has excellent acoustics. The back room has a rug and drop ceiling so the sound gets lost. The back room looks like something from 1970 whereas the living room looks fairly modern. Plus the living room already has the music rug.

One thing that we learn from Feng Shui is that our environment affects the flow of energy around us. Similar to the philosoply behind the law of attraction, setting up a room for a specific purpose and decorating it with stuff that inspires us can be quite beneficial. I suggested to my wife that we have the picture of her with Yo-Yo Ma blown up, framed, and put on the wall in the living room. We can place her special cello chair and the cello on its stand in the corner of the room. We also have an advertisement for the first Col’ Areo String Quartet concert in the room. When people come to practice, they can do so right in the room and almost everything around them pertains to music and success.

We also have a sort of bookshelf that my wife bought but now does not care for so much. She will be happy to learn that it will be leaving the room to make space for the cello corner. Here is a picture of the living room right now. We have not added the picture of Yo-Yo Ma or the cello corner yet, but I'm sure you can imagine what a difference it will make. The cello corner will replace the bookshelf in the bottom picture.

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How to Manifest Goals in 30 Minutes per Day

2010-03-03T03:30:00.000-08:00

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The truth is most of us have trouble accomplishing the goals we set in a timely fashion. Some of it is due to the fact that we are bombarded with so many distractions, then we work for someone else for much of the day and need some family time. The little time that is left is often used up contemplating how to best spend that time accomplishing something worthwhile. Weeks go by and we feel like all we do is work eat and sleep and make no progress toward our own goals.

The 30 minute period needs to be completely without interruption. I know it sounds rather impossible to be focused on something for 30 consecutive minutes every day, but it needs to happen if we are to accomplish the goals we set. If the goals are important enough to us, we will find a way to make it happen. Perhaps we need to get up a little earlier in the morning or stay up a little later at night so we can work while others sleep. It probably is not a such a good idea to work toward our personal goals at lunch time since we need a break in the workday.

For myself, I try to set aside at least 30 minutes every day to work toward a single goal of mine, writing my new book. I set the goal of writing a new book as my main priority aside from family time. I also set a goal of constructing a new jacuzzi bathroom, pics to follow in a later post. I work on this other goal for at least a few hours each week. My friends and family offered to help me work on it next week, so I am really looking forward to seeing the progress we will make.

It is especially good if we can set a large goal for ourselves and work toward that goal a little each day. It builds our self esteem that we can actually accomplish the goals that we set for ourselves. We wake up each morning knowing that we made decent progress on the previous day and are excited about the progress we will be making today.

Most of the goals we set require a fixed amount of time be devoted to them. Once we devote the required duration, the goal is accomplished, and we move on to the next goal. I hope you have found this post helpful and I look forward to hearing your comments about all the new you are able to accomplish by applying this technique.

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What Needs to Happen to Make Us Happy?

2010-02-25T03:28:00.000-08:00

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I think happiness in life boils down to two questions:

1) What needs to happen for us to be happy in the present moment?

2) What are we doing to make it happen?

If we are uncertain about the answer to either of these questions, we may be left wondering what our purpose in life is, and we may feel lonely even when surrounded by friends.

It seems that we have a tendency of living either in the future or the past. We may want things to be in our life that are not there. They may have been there in the past or we may be hopeful they will be in our future. In both cases we are not living in the present moment.

The key to living in the present moment is to recognize that life is a progression. If we want something physical in the present that is not there, such as a new car, we should not allow our happiness to be delayed until the new car is in our driveway. Instead we should try to enjoy the happiness of knowing that we are taking action toward putting that new car in the driveway. The path of a new car in the driveway includes preparing for the new car, maintaining the new car once it arrives, and occasionally reminiscing about the fun you had with the new car once it is gone. All the above elements are along the path of the new car, and all can be part of our happiness. Yearning only for the moment that the new car arrives takes us out of the present moment at every other moment along the new car path. The single moment that the new car arrives in our driveway is a moment that is fleeting, and making our happiness dependent on that moment makes our happiness also fleeting.

I use a physical example above since it makes it easy to convey the idea, however the same concept could be applied to both mental and spiritual states that we seek. The law of attraction can be used to put us on the path toward that which we seek. Once we are on said path, the sought element becomes part of our life in some aspect of all levels in the present moment.

I thank you for reading and welcome your comments.

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Living Off the Grid with Tamarack Song--Video

2010-02-15T16:32:00.000-08:00

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I found this video from MTV True Life (R) where they follow around two people that partake in Tamarack Song's one year long Wilderness Guide Program (R). What I find interesting is that Mr. Song appears to be completely at peace with his surroundings while the two visitors, Derek and Ginny, both seam to be burdened with major internal conflict. Mr. Song recognizes that he is at home, even when he is in the woods. It is incredible how the mind and spirit can create totally different experiences for people in the same environment. I found this video informative as it relates to our personal balance and our ability to affect our perception of reality. Unfortuntately I am not able to embed the video, so I will offer the link instead.

Video Link http://www.mtv.com/videos/true-life-full-episode-im-living-off-the-grid-two-young-people-survive-in-the-wild/1596326/playlist.jhtml

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Meeting an Animal Spirit Guide Part 1

2010-02-13T07:10:00.000-08:00

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When one makes the conscious decision to meet an animal spirit guide, there is a period of time between making the decision and actually meeting the animal spirit. As I reported in the last post, I am in the process of reading “Shamanism as a Spiritual Practice for Daily Life” by Tom Cowan. It is not about becoming a shaman as much as it is about learning the core practices of shamanism and how to balance the spiritual and non-spiritual parts of our life. Personal balance is a key aspect of being able to effectively manifest using the Law of Attraction. It is for this reason that I am exploring and reporting on the subject.

A key part of Shamanism is connecting with an animal spirit guide. I had heard of people connecting of spirits but it never really occurred to me to try to connect with the bear spirit, or the raven spirit, for example. Believing that God is in all things and that we are here for a reason, it makes sense that all forms of life have a certain spirit to them, and connecting with those forms of life in some fashion could be beneficial to both parties. It also makes sense to me that one can watch a bear or raven and perhaps learn a lesson about of life through the observation. At the very least we can learn about living in the moment and having patience.

The second part about connecting with an animal spirit guide is that there are tons of lessons about life that we can learn by observing and connecting with other species on various levels. Therefore although one first tries to meet a single spirit guide, there are most likely many more to follow.

Third I would like to point out that the author of the book explains there are typically three ways to meet a spirit guide. The first way is the most extravagant. One goes into the woods for a day or so and fasts so as to make them more sensitive to their environment. They call out to their spirit guide and they may meet the animal physically or in their mind. During the encounter you ask the animal if they are your spirit guide and they will give you some sort of sign if they are. The second way to meet an animal spirit guide is while in a dream state. You basically imagine you are in the forest or on a beach in the middle of nowhere and you allow yourself to slip into a dream-like state of consciousness. You pay attention to all the sights and sounds that your mind plays for you and watch for any animals that may appear. The third way is to grab a drum and start playing a rhythm that feels natural to you. It is probably not the rhythm of some pop song on the radio but rather something that comes from deep inside yourself. During this drum session you can burn candles or incense (but be sure the candles are in a safe place in case you enter a dream-like state for a little while).

Finally I wondered why people would try to connect with animal spirit guides as opposed to any other type of spirit guide. The author explains that animals were here on earth a lot longer than people and they have maintained their spiritual connection whereas people have tried to break everything down logically and scientifically to the point that some of our awareness of the spiritual connection has been lost. According to Mr. Cowan, at one point in time animals and people could actually communicate with each other to the extent that they even spoke the same language.

Once you have met the animal spirit guide either in real life or in a dream-like state, they will continually offer you insights about life that you may otherwise overlook occasionally when you happen to meditate or dream. I assume guidance from such a guide is somewhat similar to most guidance we get from our dreams. Typically most Americans don’t pay much attention to our dreams, but they are a helpful guide, especially when we write them down afterwards.

Waiting for an animal spirit guide to appear can be a little frustrating. I would compare it to most other spiritual advancements one tries to achieve. At times during the waiting period it feels like we are powerless and we just need to wait until we are ready on some unconscious level to progress. At other instances we are confident that it will happen in due time. Luckily I grabbed another book about small business advertising to distract me until I am ready for the encounter. I think more guidance and insight from the subconscious mind will be quite helpful. I will keep you posted as the story unfolds.

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The Spiritual Practice of Shamanism: A Guide for Personal Balance

2010-02-11T03:32:00.000-08:00

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I have been reading a great book named “Shamanism as a Spiritual Practice for Daily Life”, by Tom Cowan. I was not interested in becoming a shaman, but rather learning some techniques for balancing mainstream reality with spiritual awareness. Personal balance is very important when one wants to be open to inspiration and when manifesting desires using the Law of Attraction.

In those tribes that maintained a shaman, the role of the shaman was primarily to offer spiritual advice to others in the tribe. In order to be spiritually aware and able to offer sensible advice to other tribe members (that most likely were less spiritually aware), the shaman needed to maintain a firm grounding in mainstream reality. Letting one’s self slip into the spiritual abyss, becoming permanently unintelligible to the rest of the tribe, was not an option for the shaman. I therefore recognize shamanism as a healthy way of balancing mainstream reality and spiritual awareness.

One thing I like about the shamanism practice is that they seem to be able to maintain the distinction between the two realities: open to spiritual messages when in the proper setting. Spiritual experiences could be had while sleeping, while gathering in a drum circle, or during various other activities. That is to say that their spiritual experiences were had in somewhat controlled environments. Shamans were probably aware of the presence of spiritual beings around them, however they were not inclined to abandon their daily activities in the tribe in order to magnify their spiritual involvement.

I am about halfway through the book and will update my blog as I find more helpful information.

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Manifesting Goals Versus Typical Work

2010-02-07T08:57:00.000-08:00

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How is manifesting goals different from working toward goals? I think this is an important question since manifesting often sometimes will require some sort of action or may appear similar to typical work to an observer. I believe that part of the answer is that manifesting is about incorporating a spiritual element in all aspects of one’s life. Typically we incorporate only mental and physical activity when we are working, playing, relaxing, and so on throughout the week. Then many of us have one sacred day each week when we focus on spiritual activities. Aside from that one day, many people are not very spiritually active.

Manifesting incorporates that spiritual aspect into life’s daily activities. Work is no longer something that you do 5 days per week from 9am to 5pm just to pay the bills. Work becomes part of the path toward enlightenment every day, and is as much a spiritual experience during the week as it is on the sacred day. The spiritual aspect we are incorporating involves an overall intent, something positive we are trying to accomplish, as well as a sense of gratitude. As one begins to incorporate their overall intent into every minute of the day, the intent becomes more and more a part of their reality, eventually experienced on both physical and mental levels as well as on the spiritual level. Aspects of one’s life that are not in harmony with the overall intent, such as bad habits, fade away and are replaced by healthy habits and routines. Meditation, praying, eating healthy, and helping other people each day are all habits easily adopted by one practicing the art of manifesting. Some people may find support for developing healthy habits through religion while others may not.

Typical work just puts food on the table and shelter over our heads. We may feel empty and used after putting our own life on hold to make money for the company we work for. The work involved in manifesting is different, it is enjoyed and done with a smile. This is because the overall goal of developing a deeper understanding of one’s self is accomplished with every passing minute. Goals that involve a physical change to one’s self or environment can be easily accomplished by staying positive and patient while remaining resolved to bring the change to fruition.

Some people find that it helps to put together a group of pictures of things you would like in your life. They look at the pictures a few times each day and get excited to harmonize their emotional state in the present with the emotional state associated with the intent. To be sure, there are many methods out there like this. The truth is, you need to find those methods that work best for you and people find them easily through personal balance.

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Dreams: Messages from the Subconscious Mind

2010-02-06T14:27:00.000-08:00

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I’ve been starting to pay more attention to my dreams lately. I think dreams are window into the subconscious mind and paying attention to them can be beneficial to coming to know one’s self. Better understanding of one’s self and personal balance are both keys to being able to manifest a better reality, and are both attainable when we respect the messages dreams offer us. A while back I started to write my dreams down in a journal but eventually stopped. I began writing them down again now and welcome their insights.

In a recent dream of mine, I bumped into a very evil character. I was not looking for him, I was waiting to meet someone else and the evil character happened to come by. I was talking to my friend Gertrud about the dream and she suggested that I look at that evil character, and all other characters in my dreams, as elements of myself. I had thought of this notion before, but sometimes hearing it from someone else can be a helpful reminder.

Assessing what I typical define as somewhat evil characteristics: strong-headedness, aggression, and combativeness, I recognized that I have an internal conflict. When the situation calls for it, as infrequent as the occasions may be, I want to be able to harness the power of these characteristics without feeling like I am evil.

Mentally I realize there is no such thing as good and evil, positive and negative, they are both just the way humans interpret reality. On the same token, as children we come to fear evil and Hell, etc. and it is sometimes difficult to rationalize with the subconscious mind. I need to find this part of me that I subconsciously shy away from because I feel it is evil and recognize that it is just another part of my being. Ultimately my intent is to be creative and help others and therefore to be mentally, spiritually, and physically active without any one part of myself is counterproductive to accomplishing my goals.

This is something I will continue to work on in the future and I am thankful that my subconscious spoke to my rational mind through the dream.

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Understanding Our Environment and Synchronicity

2010-01-23T10:04:00.000-08:00

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One key to manifesting a better reality for ones self is personal balance. To that end, I have been reading Journey to the Ancestral Self by Tamarack Song, a book focused on learning “… the skills for walking in Balance in the Wilderness, as well as in our daily lives,” (http://tamaracksong.org/bibliography.html). I found it fascinating how he re-learned to see the world with ancient wisdom after having grown up in civilized culture, which tends to view the native life-way as primitive. The book tells us how to reacquaint ourselves with nature again and how to recognize the effect that things in our natural environment (like the moon) have on all of us.

One thing I like about his book is that it is thinking outside of the box. Tamarack talks about shadowing people, animals and things. Civilized culture knows of things like reflexes and mimicking. For instance, if a person in civilized culture was to try to chase an animal, they would try to move like the animal moves, maybe even change direction instantly after the animal changes direction. The author opens our minds up to a whole new level of understanding—actually becoming the being or object observed, so as to anticipate the next move and to move instantaneously with it.

He tells us to start with imitating a tree, blowing in the breeze. We stand in front of a tree at a distance far enough so as to be able to view its full extent with head level. We put our hands on our heads to simulate the trunk of the tree with our torso down to our feet and the collection of tree branches with our arms. As the wind lightly affects the branches and trunk of the tree, so does it also affect our limbs and torso. At first, we try to move like the tree, maybe even a second after the tree moves—so as to try to be in synch with the movement. But to truly be in synch with something, we need to be moving in the same direction(s) at the same time. This sort of synchronicity takes a lot of practice and diligence, and can be attained with everything in our environment.

I think learning to synchronize ourselves with our environment is very helpful in helping us to start to take the focus off of ourselves and realize that we are just a small piece of something much greater. We start to pay attention to the birds chirping and the animals along the forest line as we pass by with the window open. I was driving down the highway trying to imagine how the place must have looked before the highway was there…how many former trees I was passing through.

What an amazing place we live in…always awaiting our discovery and new adaptation.

Link to Tamarack's book on Amazon.com: http://www.amazon.com/Journey-Ancestral-Self-Lifeway-Harmony/dp/0882681788/ref=sr_1_1?ie=UTF8&s=books&qid=1264269894&sr=8-1

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Ancient Civilizations and Fairy Tale Wisdom

2010-01-03T15:48:00.000-08:00

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One key to manifesting a better reality is personal balance and knowledge of ones self. To that end, I was talking to a friend of mine about the wisdom of the ancients. Much wisdom was passed down through generations using fairy tales. Today fairy tales are assumed to be stories created to entertain children, with little relevance to adulthood. My friend suggested I look up a book by Robert Bly named Iron John. This book studies a Grimms fairy tale for truths about manhood. Robert Bly has hosted many workshops for helping people to develop into well-grounded adults.

I also bought a book on Amazon “Journey to the Ancestral Self” by Tamarack Song. This book is about the connection we all share with our environment and with the essential self. I admit, I was rather inspired by the movie “Avatar” that my wife and I saw in the movie theater last week. The movie paints a picture of an entire civilization that acts in harmony with its environment. It also illustrates the stark contrast of the industrialized community with the foreign (alien) civilization.

I think our modern culture has lost some of the critical life lessons shared by the ancient civilizations. It would be interesting to revive this information and discuss it in an international forum. Definitely a topic I would like to learn more about.

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Using the Law of Attraction to Change the World

2009-12-26T13:51:00.000-08:00

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We often hear about the Law of Attraction as being a magical way of getting the things we want with little effort and in a short amount of time. I look at it as a way of life that slowly, but surely, brings our thoughts, words, and actions into harmony with our intentions and with what we define as reality.

It is not limited to getting us a new car or making us famous. The Law of Attraction can be used to bring about intentions like world peace, end world hunger, and disease, etc. The more we come to understand the law, the more we recognize which of our thoughts, words, and actions are not in harmony with the above intentions. We seek peace, yet we elect public officials that improve the economy by starting wars. We seek cures for disease, yet we invest in companies that profit from each epidemic. We start to realize that the small decisions we make each day contribute to the environment we all live in.

The first step toward changing the world is to identify what it is about the world that we are unhappy with. We can then identify those thoughts, words, and actions that are in harmony with present condition the world is in, that we are not happy with. Changing our own thoughts, words and actions tends to have a sort of Butterfly Effect on the rest of the world.

The dollar we used to give to companies profiting from each epidemic is no longer going to those companies. It is now going toward organizations that are seeking cures for disease. We take our votes away from the public officials starting wars and give them to the ones interested in peace.

Harmonizing our thoughts, words, and actions with our actual intentions is a slow and iterative process. However many people in my own life have come forward and voiced their support for the Practical Manifestations Project, and the project is simply an application of the above process. May we all find harmony with our intentions as we approach the year 2010.

More posts about Law of Attraction: http://practicalmanifestations.blogspot.com/search/label/law%20of%20attraction

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Stress During the Holiday Season and Stretching

2009-12-25T08:38:00.000-08:00

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The holiday season is one that can really be taxing when it comes to the stress level involved. As much as stress can be a positive thing for us and motivate us to accomplish our goals, it can also have a negative impact on our personal balance, which is a key to manifesting a better reality for ourselves.

The affect stress has on us physically is coupled by the fact that we are often taking on chores at this time of year that are not typical of other times of the year…such as shoveling snow, slipping on ice, and lugging gifts from place to place…not to mention all that driving. It is usually about trying to get too many things done in too short of a timespan. Sometimes we take our health for granted assuming that we can get everything done and feel great on the day the big holiday hits.

That is exactly what makes stretching each morning around this time of year so important. I do a fair amount of sitting each day due to a fairly long drive to work and then having a desk-job, so I needed to start incorporating a stretch routine into my wake-up routine. My upper back was bothering me and it seemed to come from tension in my lower back and stomach. After verifying with my chiropractor that my pelvis was in alignment, I sought out exercises for the lower back. I found a few exercises that actually stretch muscles in the legs like hamstrings and muscles in the groin area like sitting Indian-style and pushing both knees down with the elbows, these exercises affect lower back muscles. While lying on the floor, I also bring each knee to my chest, hold for six seconds, then release and breathe deeply in and out on the release.

These exercises, along with massaging the lower back and stomach muscles, seem to greatly reduce the aches and pains I was feeling. The stretch routine serves to wake up the various muscle groups and prepares them for the stresses of the day. Even worse than enduring all the stresses of the holiday season is having to endure them alone in bed recovering from pulling something or twisting a funny way.

For those of us that do not lift things regularly, we need to keep in mind to try to lift with our legs while keeping the back straight. Avoid turning and or reaching while lifting, if at all possible.

I wish everyone a safe and healthy holiday season!

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Family Teamwork and Staying Safe During the Holidays

2009-12-22T05:09:00.000-08:00

The holidays are great because they really can bring out the best in people. Under the challenges that the holidays bring, we may recognize strengths in others and in ourselves that we may not have seen before. In the future we can use these new-found strengths to help manifest our goals and the goals of others more easily. However, in the meantime it is very important to keep a sense of personal balance, a key to manifesting a better reality in the present.

It can be a stressful time for families trying to get everything in order…buying presents, planning events, etc. I think one of the key aspects of the holidays for families is that they get to work together as a team to accomplish the many tasks at hand. Each person can handle the tasks that they are good at. Often we realize that other family members are good at doing things we did not know they were good at doing…baking cookies, shopping for good deals on presents, maybe even shoveling snow. In these instances we each get a chance to help the other members in our family and it makes everyone feel good.

Sometimes the stress of the holidays becomes too much for people to bear. We need to remember to prioritize our tasks. We know that if we push too hard for too long, something important to us is not going to get done. By doing the tasks that are most critical first and maybe leaving a few less important tasks until the end, we are able to reduce some of the stress we experience each holiday season. One thing that is certainly a priority that sometimes gets bumped is vehicle maintenance. Given the weather conditions across most parts of the world during winter months, addressing those warning lights that show up on the dashboard can save a lot of time and money in the long run, and most importantly, keep everyone safe. Warning lights like low fuel, low tire pressure, or the infamous “check engine” light are there to help us.

I thank you for reading and wish everyone happiness and safe driving during this holiday season!

Small Business Development Help

2009-12-19T16:29:00.000-08:00

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Part of the Practical Manifestations Project is about starting an online business from scratch and sharing our story with others that can benefit from hearing about our experiences. The project is an idea we are manifesting into reality and so we offer the story as an anecdote of successful manifesting. Hopefully others can gain from our perspective.

We are marketing a book through the web site. Having never started an online business before, I like to share information that we come across that could be helpful to others that have businesses of their own. Practical Manifestations uses the Law of Attraction to bring things into our lives that we desire by creating an intent, believing it is possible to achieve, and coordinating our thoughts, words and actions with the intent.

I was researching online the other day for marketing consultants. I see a decent amount of traffic visiting the web page for the book, but I wanted to increase the number of actual sales from people viewing the page. When I looked up Rhode Island marketing consultants, I found a free service offered by Johnson and Wales University called Rhode Island Small Business Development Center. I met with them on Thursday and they were very helpful. We discussed putting together a focus group to take a survey of what they think about the book I wrote and the web site. I intend to give a presentation to the focus group prior to the survey.

The center has a program where Johnson and Wales University students work with small business owners to develop marketing strategies, and work on anything that will help to build the business. They work with the business owner but they do not manage the business for them. The center also offers seminars on various small business development topics. If anyone is starting a small business or manages a small business, I would definitely suggest looking into whether or not a similar small business development center is available in their area.

My first step is to better refine my business plan including an Introduction, Marketing Summary, Operations Summary, Financial Management Summary, and Executive Summary. I’ll keep you posted as the story unfolds.

Link to RI Small Business Development Center www.risbdc.org/

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Law of Attraction Investment Strategy and Shengchang Bioenergy

2009-12-07T07:52:00.000-08:00

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Below is a video from CNN on what Shengchang Bioenergy in China is doing with peanut shells, tree bark and dead corn stalks to create home heating material. Not only do they process the peanut shells but they also manufacture the furnace used to burn the low-cost material. Much of China still uses coal to heat homes. This is a greener and less-expensive alternative plus it is paying the local farmers. They figured out how to make a profit out of what others might consider garbage.

From what I can tell, a company such as this would make a great investment and is a good application of the law of attraction. It is one way to make the world more eco-friendly, decrease poverty, all while making a profit. The gains from such an investment could be put into another company doing similar work. This is how I would think the law of attraction would be applied to one's investment strategy.

Please note that this post does not suggest that people start investing in foreign countries instead of their own, but rather that an investment can bring an investor far more than just financial gains. Whatever one's native country is, their local businesses need their support to survive. Finding businesses that function according to one's values brings fulfillment on all levels. As a US citizen, I would like to find more US businesses that adopt practices similar to this Chinese company.

We can compare this strategy to the one the US uses whereby we actually pay farmers to not grow food. It is good that the farmers are being helped, but there may be more effecient ways of doing it. According to the Washington Post (see link at the end of this post) between the years 2000 and 2006, the US government paid farmers 1.3 Billion dollars to not grow food. This artificially keeps the price of food from falling through the floor.

Link to Washington Post article http://www.washingtonpost.com/wp-dyn/content/article/2006/07/01/AR2006070100962.html

Article from NextBillion.net http://www.nextbillion.net/blog/2007/11/14/shengchang-bioenergy-a-company-aspires-to-build-china-s-biomass

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Spending Money Will Improve the Economy Part 3: Applying the Law of Attraction

2009-12-06T14:38:00.000-08:00

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Links to previous segments can be found at the end of this post

How can we apply the Law of Attraction to the state of the economy? I think the key here is that everything that is going on in our world is affected directly by our own thoughts and actions. I was listening to a radio show today and the radio personality touched on this very subject, it is not what they (the politicians, big business, etc.) are doing, it is what we are allowing them to do, it is our own actions. We are the ones that put these people in power and designate which companies receive our money. When we see so much corruption and bias in the world it is because we put it there. Granted it was probably there before we showed up, but it has also been running rampant for as long as we have been alive.

For example we look at the US national deficit. It continues to grow at an alarming rate and we complain that the politicians keep allowing it to happen. In this case the politicians are actually carrying out just what we ask of them. When they are campaigning, they tell us they are going to bring more jobs to our state, better schools, tax cuts, and so on. We elect them into power because it will bring more money into our own pockets and benefit us in a lot of ways. On the other hand, the money needs to come from somewhere. Once in power the politicians bring us some of the things we ask of them and the price is another increase in the national deficit.

I believe a lot of what we are seeing around us is a direct result of our own thoughts and actions. Some of the things we are wishing and hoping for actually conflict with our real intentions and goals. The conflict runs very deep in society starting right with the food we eat. We want to be fit and healthy yet we sustain ourselves with cheap processed foods. We want to be healthy yet we sometimes take medications to mask the ailments instead of learning about the cause and finding a solution.

So where is all of this going? I think that the law of attraction sometimes requires action, sometimes requires only intent, but usually requires some combination of the two. As we come to recognize the corruption within ourselves, we can correct it. We are then more likely to recognize the corruption in the rest of our environment and in the world and know what steps we each can take to correct it. We notify our representatives, write blogs, contribute to charities, and give our business to worthy businesses. But it all started with that initial intent and that intent followed through in almost everything we thought, said, and did. I say “everything” because no one is perfect. We all do some things that are not in alignment with our intentions, but overall we made great strides toward improving the world.

Furthermore, as we create a balance within ourselves, we are more likely to be in sync with the rest of the world, including the economy. We are then able to buy when the prices are low, which is probably a part of an economic downswing, and sell when prices are high, in an economic upswing. We are no longer fighting the tide but rather recognizing the cycle and coordinating our efforts with the cycle.
Link to Spending Money Will Improve The Economy Part 2

http://practicalmanifestations.blogspot.com/2009/12/spending-money-will-improve-economy_05.html

Link to Spending Money Will Improve The Economy Part 1
http://practicalmanifestations.blogspot.com/2009/12/spending-money-will-improve-economy.html

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Spending Money Will Improve The Economy Part 2

2009-12-05T10:01:00.000-08:00

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For the previous segment, please scroll to the end of this post for the link as well as a link to a previous post on corruption and transparency.

The next thing I would like to look at is how the economy got to this point in the first place. I like to keep things simple for the sake of discussion, and I can only offer my own opinion on everything. A few years back the economy seemed to be in a recession/depression and the government decided to lower interest rates. If the government wants to boost the economy they basically have four options:

A) First is to lower the federal interest rate, the rate for loans between banks. Lowering the interest rate can put you in danger of increasing the rate of inflation, especially if you lower the interest rate drastically. Doing anything drastically will probably have major side effects as well as boosting the economy. The effect of this could be that you make only 1 or 2 percent interest on your bank savings account. You can also borrow money at a low interest rate, which has an impact on things like the housing market.

B) The second option is for the government to pump money into the economy. Drastic measures of this sort will probably have major side effects too. The money that the government uses to pump into the economy has to come from somewhere. They can raise taxes or borrow more, but this increases the national debt. Raising taxes can dampen the boost the economy experiences. Borrowing more money may seem like a great solution in the short term because the government only needs to pay interest on the borrowed money rather than come up with the full amount up front. However if more and more money is borrowed, that payment on interest can become quite large and begin to paralyze the government’s spending power and cause it to raise taxes or borrow more money. Similar to option A, option B can be quite dangerous. Unlike option A where the effect and side effects are more immediate, option B’s effect is rather immediate, but the side effect of becoming paralyzed by payments on interest, may not be felt until generations later. It is for this reason that politicians are tempted to use this option. Many people are not so concerned with the national debt as they are about their own finances, so they are not as likely to complain so long as they have money in their pocket, but it is at the expense of their children and their children’s children

C) The third option is for the government to do some sort of redistribution of government spending to allocate funds to areas that need it most. Like raising taxes, this can make the politicians that are making the moves very unpopular, particularly with the people affected by the government taking money away. There will most likely be lobbyists, unions, corporations and rallies all to voice people’s discontentment with the change. It can be very difficult for politicians to determine which areas of spending can be decreased because often some of the politicians are directly involved with said areas. Other politicians will be directly involved in the areas receiving the money, so to come to an agreement can be very difficult. This, along with option D, can be a government’s best tool. This option can be exercised quickly and eliminate a lot of waste if done right. The politicians making the decision will probably hear some complaining, but if done right, the overall effect will be very positive and there will be more people cheering than complaining. If done wrong, the politicians may have no friends left. I would put things like creating government aid plans and the like in this category as well as general government spending cuts.

D) The fourth option is for the government to change legislation. This is usually a much slower process because the government needs to give the involved parties time to conform to the new rules. If done right, over time it can help to assist people and businesses that need it most. If done wrong, it will only make the rich richer and the poor poorer or possibly have no effect at all. This is a broad category because it can include anything from improving emission standards to placing restrictions on big business. In the end it is going to cost people some money so you will hear some complaining. Like option B, it can be tempting to politicians to use this option if they design the legislation to have the most impact several years after making it government policy. It can be very helpful to giving entities like small businesses a slight advantage over large businesses to make the playing field more fair. It also could be used to increase tariffs on imported goods, which would increase the cost of imported goods to the customer, giving local businesses and workers more of an advantage.

A government may decide to apply any of these options, any combination of these options, or maybe try something I have not thought of here...or do nothing at all and take a “wait and see” approach. Each of the options will probably work if applied in the right area to the right degree. I say “probably” because the X factor is corruption. Corruption in business and in government is what turns all of these helpful tools into harmful weapons. We’ll continue this discussion in a following blog analyzing how we got to this point today of increasing government spending because of our actions a few years back where we drastically lowered the interest rate.

Link to previous segment: http://practicalmanifestations.blogspot.com/2009/12/spending-money-will-improve-economy.html

Link to "Corruption Versus Transparency" http://practicalmanifestations.blogspot.com/2009/10/corruption-versus-transparency.html

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Spending Money Will Improve the Economy

2009-12-03T14:14:00.000-08:00

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I was listening to a radio personality the other day talking about how the economy would improve if people would just spend more money. I think that money, or lack thereof, can greatly affect ones personal balance as worrying about money can draw our focus away from enjoying life and have a negative impact on our ability to manifest a better future.

I found the fact that the radio personality was suggesting people to spend more money was rather ironic because I think a lot of people are in dire situations because they have actually spent too much money. Now their buying power is very limited because a lot of their pay check goes toward paying off all the debt they have accrued. When someone has a lot of debt and continues to spend money, their options become more and more limited and may end up in bankruptcy or foreclosure on their house.

It is true, the economy works by people spending money. If no one spent money, there would be no economy. I think we need to be careful when we tell everyone to just spend more money because a general increase in spending could actually worsen the situation, leading us all into more debt, which will cause even more people to default on their loans, which will lead to more government bailouts. The people we need to spend money are those that have not already maxed out all their credit cards and taken the equity out of their homes. There are still people out there that are not in debt up to their eyeballs. Those people can probably afford to be a little more carefree about their spending and be reassured that the economy is simply in a downturn but will eventually thrive again. There are plenty of good deals out there for people in this category.

On the other hand, a lot of people are in the category where they already have a lot of debt and they are waiting for the light at the end of the tunnel. Somehow all this debt has built up and they are not sure how to change things. For these people, we need to decrease spending money that goes to supporting our lifestyle, try to pay off the debt, and look at investments that will have a greater return than the cost of interest on the debt. Of course every person is different, so one person may benefit from buying a house while another may benefit from investing in their 401K. A lot of people that owe money are paying interest rates between 10 and 20 percent. For these people, the best thing is probably to transfer to a lower interest credit card or loan that has a fixed rate for the life of the loan.

Whether the economy is in an upswing or a downswing, there are advantages and disadvantages to the educated investor. In an upswing, your income is higher, but so is the cost for products and services and the interest rate on money you are borrowing. You try to mitigate the cost for these more expensive items. In an economic downswing, your income is lower, or maybe even non-existent. In turn the cost for products and services is much lower due to the decrease in demand, since not as many people can afford them. The interest rate on money you are borrowing may also be very low. It is at these times that great investments like residential and commercial property can be acquired at much lower prices.

There are many loopholes people fall into such as crashing their credit score by defaulting on loans or losing their job. Falling into a loophole can keep people from taking advantage of both an economic upswing and downswing. Often something, or several things, happened that was out of their control, like medical bills or company downsizing, that lead to the default. Whatever the cause and however sever the consequences, we need to remain steadfast in our approach.

Money woes bring a lot of stress to us and any relationships we are maintaining, so perhaps we will need to incorporate counseling into our recovery strategy. Depending on the situation, we may also require legal advice or services to correct the situation. But like with all of life’s challenges, we do our best to remain balanced and focused on our goals.

In closing, spending does help the economy. But we want to make sure that we are investing our money properly, not just spending it to keep up with our neighbors, so that when the economic upswing comes around…we are able to enjoy it as much as everyone else.

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Preview of 60 Minutes Episode "Congo Gold"

2009-11-29T16:47:00.000-08:00

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Preview of 60 Minutes episode on "Congo Gold" airing tonight.
UPDATE: I replaced the preview video with the actual clip.

Gold mined in central Africa is being sold to fund wars among the militias. One way to make sure we do not support the wars is to track the source of mined gold. Wars around the world are the effect of conflict and imbalance both external and internal in relation to ourselves. Perpetuation of war serves to negatively impact our personal balance, and so is something we should typically try to avoid when manifesting a better reality.

According to 60 Minutes, Tiffany and Co. is the only company that tracks the source of all gold they purchase. Wal-Mart, which sells the most gold in the US, will start tracking 10% of the gold it purchases next year.

I saw the full episode this evening and it seemed quite comprehensive on the issue. I like finding issues in our world that need our attention and finding out what we can do about them. Since our companies can impact the issue, we, as consumers, can show these companies we support tracking the source of gold.

Watch CBS News Videos Online

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How to Get Paid to Blog: Amazon Kindle

2009-11-26T05:27:00.000-08:00

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As part of the Practical Manifestations Project is blogging, we like to share secrets we discover with others that may benefit.

There is a new way to get paid for writing blogs and it is offered by Amazon. Kindle ® is Amazon’s new wireless reading device that is able to download entire books in just 60 seconds. But books are not the only thing Kindle can download, blog authors can create an account with Amazon and make their own blog also available to the world for download.

If you are a blog author, visit the following link to create a new Amazon account and upload your blog: https://kindlepublishing.amazon.com/gp/vendor/sign-in

When someone wants to purchase a subscription to your blog, they can visit the Amazon Kindle store. Currently Amazon pays blog authors 30% of the subscription price when someone purchases a subscription. Furthermore, Kindle currently offers access to about 7,000 blogs. Technorati's 2008 report states there are over 133 Million blogs in the internet. This gives your blog an advantage since you are only competing with the rest of the 7,000 blogs offered on Kindle.

Link for more information on Amazon’s Kindle device:

http://www.amazon.com/Kindle-Wireless-Reading-Display-Generation/dp/B0015T963C/ref=amb_link_86172951_2?pf_rd_m=ATVPDKIKX0DER&pf_rd_s=center-1&pf_rd_r=0A654H5NX8ZR32YB3MXT&pf_rd_t=101&pf_rd_p=501372471&pf_rd_i=507846#kindle-features

For more information on the advantages and opportunities available to bloggers, please visit our blog and click on the labels “blogging secrets” or “how to blog” and check out our post below:

http://practicalmanifestations.blogspot.com/2009/06/small-biz-individual-opportunities.html

Link for Technorati's State of the Blogosphere Report for years 2004 through 2009: http://technorati.com/state-of-the-blogosphere/

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Email to My US Senator on Government Transparency and Health Care Reform

2009-11-21T23:10:00.000-08:00

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When working at creating a better world around us, and manifesting a better reality, we believe it is important to voice our thoughts and ideas to the decision-makers of the world. To stay silent now is to accept how others have decided to formulate the future of the world we live in.
I wrote to my local senator, Jack Reed, about a week ago asking if he had a blog and if not, if he was thinking of starting one. I referred him to the blog the senator of a neighboring state was hosting http://dodd.senate.gov/index.php?q=blog/1 He responded that he did not have a blog, but would add me to his email list to keep me up to date with the work he was doing. You can read my previous email here: http://practicalmanifestations.blogspot.com/2009/11/copy-of-my-email-to-ri-senator-jack.html
Below is my follow-up email asking first if my senator hosts or participates in any online forums so people can comment on and support his work and second a few questions on America's Health Care Reform Bill.

My senator is a great guy, I met him years ago when I was in Boy Scouts.

START EMAIL

Dear Senator Reed

I thank you for your quick response to my email and for adding me to your email list to receive updates on the work you are doing, I think this is a big step in the right direction. Along those lines I was wondering if there was some sort of online forum where people were allowed to discuss political issues on their mind. Perhaps you participate in a forum and fellow citizens of Rhode Island and maybe even other states are able to show their support for your work. I cannot imagine the amount of correspondence you must receive via email, telephone, mail, faxes, etc. I would think an open discussion among all citizens of Rhode Island might be more effective in resolving some of the major issues we are facing today, as opposed to each of us corresponding with you individually. I was just wondering if something like this already existed or if you were considering doing something in the future. I’m sure there would be many legalities involved, censorship, review of the censorship, and so on, however I would think the benefits would out-weigh the frustrations of setting up and managing such a forum.

The second reason I am writing to you is on my concern about the health care bill. I was wondering if provisions were being made for uncollectible debts. I would think that sizable amount of people are not going to be reimbursing the government for the health care they receive. When it comes to accounting and the federal government’s accounts receivable department, the reason behind the debts not being paid is important, but it does not pay back the debt. Assuming the federal government is reimbursed for the costs of health care through the collection of taxes, the debt could come from otherwise good tax-payers that recently started having trouble paying taxes, from people that never paid taxes and are just hoping the government never catches up with them, or from people that are here illegally, therefore not paying taxes. I would think that if everyone is being afforded health care, there will be no way to prevent a person from creating a debt in the first year and compounding it each year thereafter. The federal government’s only means for collecting the debt would be to 1) take legal action, which could have the following results a) the debt being paid, or b) putting the person in jail, which would only add to the debt. In either case certainly more debt would be incurred from legal fees. 2) attaching the debt to the person’s social security pension. Given the projections for the social security program, social security may not be around much longer, so the second option may not be viable.

So my question is: is this additional debt being carried in the budget and are provisions being made to create a cost-effective way of collecting it?

Secondly I would hope that when a person participating in the federal health care plan receives treatment, there would be a co-pay comparable to that of the insurance companies we have now. If a person incurs no immediate out-of-pocket expense at the time of treatment, there would be no incentive for the person to avoid going to the hospital for even the smallest ailment.

Finally I was wondering what checks and balances would be put into place to make sure the cost of medications and various other medical costs do not skyrocket. What is keeping the cost of medical products and services from becoming completely absurd is the fact that a few people are actually paying for them out of their own pocket, without any assistance from insurance. When we set up a program where a third party is paying for all products and services, we leave it up to the discretion of the companies to keep their prices reasonable. From past experience we know that the honor system does not work with so much money involved. Granted there will be some competition between drug companies on similar products, but this will be significantly dampened by patents.

I thank you for reading my email and I look forward to your response.
END EMAIL
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Church Feeds 5000 People in Charlotte, North Carolina

2009-11-18T02:09:00.000-08:00

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Great video I found on the internet after hearing the story on the Sirius/XM Radio. I left a comment below the video, "Great video, looking forward to more news like this :)". They need to approve my comment before the rest of the world can see it. I try to promote positive news because I believe it inspires people to do more good things, which creates a better world for everyone, which is part of my intent.

Link to video and story on FoxCharlotte.com: http://www.foxcharlotte.com/dpp/news/feeding_five_thousand_111309

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A Weekend Full of Helping People

2009-11-16T13:53:00.000-08:00

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This past weekend was a lot of fun, we were able to help a lot of people in different ways. Throughout this entire month we had been helping to promote the concerts our friends of Col’ Areo String Quartet were putting on at the Music School Carter Center in East Providence, Rhode Island. I contacted the Providence Journal Newspaper, Television Channel 10, Television Channel 12, and whofish.org and each one posted the event on their respective web site. We walked down Wickenden Street in Providence, Rhode Island and hung up flyers for the event in 4 coffee shops. I was asked to introduce the quartet at the concert and I gladly did so. Proceeds from the concert went to the Rhode Island Food Bank. We collected a fair amount of cash and canned goods and are bringing them to the Food Bank tomorrow.

One of the best parts of the concert was the fact that a new friend of ours, Paul of Supreme Coffee and Donuts of East Providence, RI on Route 6 about 1 mile east of Seekonk Speedway donated enough coffee, donuts, and muffins for 50 to 60 people to snack on during intermission. Everyone loved the coffee and donuts and we left the left-over pastries for the teachers to snack on the following day. Everything had the coffee shop name on it, so it gave the shop great publicity. I included a thank-you to the shop in my introduction. When I returned the coffee dispenser and equipment, we got to talking about how the owner of the shop was taking a collection of worn-out American flags, is doing a canned food drive to help poor people in the area, and is having Santa come on November 28th to entertain the kids. I asked Paul if they had created a FaceBook.com or MySpace.com profile yet. They said it was on their to-do list, but they were going to wait until winter to get going on the computer. We exchanged contact information and agreed to stay in touch. I told him about the Practical Manifestations project and he seemed pretty interested.

Our friend Conrad Ferla of Mass Mutual Financial Services out of the Providence office made a contribution on the behalf of his company too. We were able to let him set up an information booth at the concert hall entrance. It was a nice way of incorporating a friend in the event we were holding and maybe send a little business his way.

Next, a friend of mine was having some back pain, so I went over their house and showed them some stretching exercises and muscle massage techniques that would help. They were thrilled to know there was something they could do about the aches and pains. It was my pleasure to share the information I had learned.

Then another friend of mine was having some money troubles. We talked for a little while about some options that were available for them. It turned out that she had a few items to sell on Ebay but was unsure where to start. I told her about a store in the area that actually puts things their customers bring in on Ebay and when they sell, the shop gets a commission on the sale. I’ll be going up that way again this coming weekend, so we’ll take a ride to the Ebay shop to see what they have to say. She is also handy with carpentry so we are putting her in contact with people that need some work done on their houses.

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Tommorow's The Big Day for Col’ Areo String Quartet

2009-11-14T16:48:00.000-08:00

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Tomorrow, Sunday, November 15th, our friends of Col’ Areo String Quartet are putting on a concert at the Music School in East Providence, Rhode Island, USA. They have been practicing their hearts out and I’m sure the audience will be pleased with the performance. Part of my intent is to help people and to that end I offer my promotional services to this fantastic group of musicians.

I made a few phone calls to local coffee shops and found one that was interested in donating coffee and pastry, Supreme Coffee and Donuts of Seekonk, Massachusetts (about 4 miles down the street from the Music School). The ladies of the quartet were thrilled when we told them about the coffee shop donating the coffee and pastry.

So we got a few boxes to collect the canned good donations to bring to the Rhode Island Food Bank. We’re guessing the Food Bank is not open on Sunday, we’ll have to store the goods until Monday. Pam made up the concert programs. She has a bunch of her business cards referring people to her web site. We just have to pick up a music recorder so we can later offer a recording of the concert through the web site.

We already contacted the local newspapers and television stations. It will be exciting to see how it all goes together. It will be a great time for everyone that comes and I’m sure there will be many more concerts to come!

You can check out Pam Lowell’s Col’ Areo event page on FaceBook to confirm your attendance: http://www.facebook.com/pamela.lowell#/event.php?eid=318579155146&ref=mf

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Copy of My Email to RI Senator Jack Reed on Blogging to Create Transparency in Government

2009-11-12T15:08:00.000-08:00

Below is a copy of the email I sent to my the sentator for my state, Rhode Island, USA. I look forward to his response and to other U.S. senators and House representatives one day writing maybe a weekly blog post. In this way we can communicate with them more effectively and perhaps give them better-informed suggestions on resolutions to current issues.

BEGIN EMAIL
Dear Senator Reed,

I was wondering if you had considered starting a blog. If you are unfamiliar with blogging, it is sort of like hosting a web site, only you update the web page as often as you like and it only takes about 5 or 10 minutes to do. It is a great way to keep your supporters up to date with your official activities and elaborate on the work you are doing to improve our state and the nation. You can visit Senator Chris Dodd's blog at http://dodd.senate.gov/index.php?q=blog/1 to see the advantage it gives him and his supporters.

As a Rhode Island resident, I would like to see more transparency in our governing bodies. I believe our officials are being called on to make decisions that will have a drastic effect on the citizens of this country both today and for many years to come. With more transparency, it will make it easier for people to give educated suggestions to their respective representatives.

I appreciate you taking a moment to read my email and I look forward to one day reading your blog.

Wal*Mart The High Cost of Low Prices Clip of Chinese Factory Worker Conditions

2009-11-08T03:40:00.000-08:00

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I watched the movie "Wal*Mart The High Cost of Low Prices" last night. It covers all aspects of the effects of the company both domestic and abroad. Small businesses are terrified when a new Wal*Mart moves into town, it is extremely difficult to compete with them. One of the most moving parts of the film was footage from the conditions they provide their workers in the factories in China. You always hear about the wages and conditions companies like Wal*Mart and Nike provide their workers, but to see it is just heart-wrenching.

Both the movie clip and link to the clip on YouTube are below.

Link to video clip on YouTube.com
http://www.youtube.com/watch?v=5CzbT1hGwmM

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Helping A Friend Drop Off Job Applications

2009-11-07T08:46:00.000-08:00

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A couple weeks ago I was helping my friend find work by driving him to various stores in the shopping district in my area. He lives in another town and his car needs repairs so he has no other way of accessing stores that are not within walking distance or near a bus stop.

I like to broadcast when I hear of people doing good turns, including anecdotes of my own activities, because I believe it helps to inspire others to be helpful and giving. It's one of my favorite parts of the Practical Manifestations project.

It’s always good to make personal appearances at the places one is applying for jobs, although it can be time consuming. He went in to about 20 different businesses a couple weeks ago and I’ll take him to those same businesses to drop off the applications letting the owners know he is really interested and outgoing.

Christmas season is coming up and we are figuring at least some businesses will be hiring more people to accommodate the customer demand. I’m figuring on helping my friend every couple weeks until a business hires him. It’s just a nice thing to do each week and he really appreciates it. Plus it gives me something positive to add to the conversation when people talk to me about the economy being bad.

Here are links to previous stories on this topic:

http://practicalmanifestations.blogspot.com/2009/10/driving-friend-to-fill-out-job.html
http://practicalmanifestations.blogspot.com/2009/10/helping-friend-find-job.html

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Col’ Areo’s Concert to Benefit the Food Bank Is On November 15th, 2009, Almost A Week Away

2009-11-05T02:09:00.000-08:00

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With Pam Lowell’s string quartet Col’ Areo’s concert fast-approaching, it seems like there are a lot of things we would like to get done in a short time. I offered to help advertise for them and do whatever I could to get the word out. The Practical Manifestations Project is about helping people in the community in whatever ways we can.

Kate of the group made up some great colorful flyers and we are handing those out and putting them up in public places, so that is progressing well.

One thing I still would like to do is to contact some of the coffee shops in the area of the Carter Center for Music, where the concert is happening (see below for full details on the location and time). My friend Conrad gave me the idea of asking local coffee shops if they would be interested in donating coffee and pastry for the event. Now that we are getting down to the wire, I think I will call a few places first and then visit the ones that might be interested to close the deal. Otherwise there just might not be enough time.

I started contacting the television stations, but I have more to contact, plus the radio stations need notification as well.

A lot goes in to promoting an event. Luckily playing the instruments is all up to the members of the quartet, so I don’t have to worry about practicing too. There have been a good number of people responding that they will attend the event on the FaceBook.com event page at http://www.facebook.com/pamela.lowell?ref=ts#/event.php?eid=318579155146&ref=mf

The event is open to the public and proceeds will benefit the Rhode Island Food Bank. Entrance is with $10 or a non-perishable food donation for the Food Bank. It will be on Sunday, November 15th at 3pm at the Carter Center for Music at 667 Waterman Avenue, East Providence, Rhode Island.

Follow-up information on Col’ Areo concerts and cd’s can be found on Pamela’s web site at http://www.expressivestrings.com/

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Practical Manifestations Helps Businesses Expand

2009-11-03T02:00:00.000-08:00

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When I started the Practical Manifestations Project, I wanted it to make a difference people could see and touch, as well as feel in their hearts. I wanted it to be real to people in every way possible. I also did not want it to be limited by religious affiliation. One way to do this was to incorporate a business aspect to the project. We have created a community at our blog and on FaceBook.com of people interested in helping others. What this means for businesses is that owners can network with other helpful people which may lead to business associates or even partners.

What is great about the project is that it can be integrated into any business. All businesses can benefit from exposure and contacts and there is nothing quite like working with people that enjoy helping others. We are able to advertise our book in the side columns, but other companies can advertise whatever merchandise or services they offer in the respective columns of their blogs. I would not suggest directly advertising merchandise or services in the blog posts. It is usually better to use the posts to establish reputation and to tell how our business is helping people each day.

Perhaps even more importantly, this project can be adopted by just about anyone that has access to an internet connection. Anyone that can write about how they are helping people and making a real difference can turn those writings into a blog. Once a person has a blog, they can allow Google to advertise through their blog, which will start turning a profit at zero cost the instant someone starts clicking on their ads. They create traffic through their FaceBook.com updates on how they are helping people and through FaceBook.com’s NetworkedBlogs and Google Follower widget.

In this tough economy, it is a great way to help one’s business grow. The blog establishes reputation and lets people that enjoy helping others that you are on board with the project too. Will it instantly end everyone’s money troubles? Probably not, but then again what would. What it will do is start the ball rolling and eventually, who knows what could come of it?

Well I hope other people get as much out of this project as I do. It has given me insight into incorporating a purpose into each day. Sometimes I try to imagine the world without this project just to see what it would be like, but I cannot even fathom it.

For more information on how to blog, blogging secrets, and search engine optimization, please click on the labels (in right hand column at our blog site).

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Trip to Salem, Massachusetts on Halloween

2009-11-01T07:11:00.000-08:00

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My wife and I took a nice drive up to Salem, MA yesterday for Halloween. Like most holidays, Halloween falls on a Saturday once every seven years, so we figured it would be great to visit the place where witches and wizards were most recognized years ago.

The actual history is very sad. Several years ago, many people were burned at the stake for accusations of being involved in witchcraft. Today most believe that the women accused of being witches were actually prominent land-owners. Other people in the town did not believe women should own land so they came up with a plan to get rid of them.

When you visit Salem on Halloween these days, it seems like the whole world is up there to celebrate the holiday. People get all dressed up in costumes and they walk around the downtown shopping square. They have movies and a tour of the courthouse famous for convicting the accused witches. On top of the people wearing costumes, I’m sure many people that actually practice some witchcraft were there. Last year there were even some out-going Christians condoning the celebration.

It was great to spend the day with my wife doing something fun. We got to take a drive and do some people-watching together. Some of the costumes were really funny and we had a good time. We left at about 4pm and you could tell it was going to get pretty crazy as the night wore on. I’m sure a lot of people had fun there and I hope everyone stayed safe. I would definitely recommend the trip to anyone that gets a kick out of Halloween :)

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The Unheard Warning of Fraud on Wall Street (US Stock Market)

2009-10-29T18:43:00.000-07:00

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Fascinating story on the US government's acceptance of fraud on Wall Street in 1999, preview video clip below. Click on the link for the full length video: http://video.pbs.org/video/1302794657/chapter/5/

Preview:

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Driving a Friend to Fill out Job Applications

2009-10-28T03:12:00.000-07:00

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Saturday was a great day. A friend of mine has been looking for a second job for a couple months now to no avail. Jeff, himself, has two children that he pays child support for from a previous relationship. He recently started dating a new girl and she was struggling to pay the rent with three kids of her own. He agreed to move in with her to help pay the bills. A couple months ago Jeff told me he was starting to look for a second job to make ends meet.

I see him a few times a month and I would ask him how the job search is going. He told me it was rough since he did not have a car so he was limited to places close to bus stops or within biking distance. I’m guessing he was competing with a lot of people in a similar situation. A couple weeks ago I told Jeff that I could take him around on the following Saturday to any downtown or business district he wanted, so last Saturday he took me up on my offer.

He took the bus to the mall down the street from me and I picked him up with my car. I took him to over 20 different businesses at my local shopping district, an area that is doing fairly well considering the economy. He filled out a few job applications right on the spot and he took the rest to fill out afterwards. We did it all in about 3 hours and then I drove him back to his apartment about 30 miles away. Jeff is in sort of a Catch-22 since he has a decent car, but it needs repairs before he can drive it to go to work or even look for a job…but he does not have the money to repair the car until he starts receiving a second pay check. He takes his bike to his present work place.
Jeff will then send in all the job applications and call the businesses he applied to every few days to follow up. In a week or so I’ll ask him if he wants me to pick him up so he can make a personal appearance at each business he applied to and apply at a few more businesses. He is a hard worker. He’s willing to work from 11pm to 7am during the week and double-shifts on the weekend. I think the business owners will see his ambition and want to give him a chance to prove what he can do for them. He is looking for just entry-level positions and has work experience in tons of areas.

We’ll be checking in again soon with our friend Jeff to see how he is making out. Helping people in the real world is what the Practical Manifestations Project is all about and it is inspiring to be a part of it, sharing our stories helping and listing to the stories of other people.

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Social Networking Strategy Video

2009-10-26T16:17:00.000-07:00

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This is a great video on building a social networking strategy for business purposes that I found today:

If you are having trouble viewing the video, please follow this link: http://www.youtube.com/watch?v=xQdDdf5RzCg

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Where’s My Senator’s Blog or Forum?

2009-10-25T03:42:00.000-07:00

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What struck me the other day is that I have a lot of issues that I would like to discuss with my local and state representatives and I wondered what the best way to contact them was. I typed into the Google search engine “best way to contact senator” and it lead me to pages about writing them letters, emails, and placing phone calls. They were informative on how to formulate the letter or email and basically said to keep it brief and to the point.

The more I thought about it though, it seemed to me that letters, emails, and phone calls were a rather arcane way discussing the big issues with these representatives. How do I know my letter is going to get read? I live in the smallest state in the US and even we have a population of over 2 million people. I can just imagine the amount of correspondence that crosses my representatives’ desks. Assistants to the representatives must go through the mail and answer the phone and just tally up the number of correspondences on each topic for the rep. to review. Otherwise the guy or girl would never get anything done.

Furthermore, I know what my opinion is on each topic, but how do I know that I have all of the relevant information to formulate an opinion? Do I need to meet with the representative and be told the facts I was missing? That doesn’t seem very efficient either.

So I typed into Google “my senator’s blog”. One of the results was the blog for Senator Chris Dodd: http://dodd.senate.gov/?q=blog/1

This senator actually has his own blog right at the .gov site. I am able to readily see the issues that he is focused on and what he is doing about them. I see that he took a break from July to August, but every 15 days he writes what he’s up to. I would like to see him allow comments or have a forum linked to the site so I could read other people’s views on the issues he is talking about. I think this would be a much more efficient way of getting our voices heard. Granted the comments would probably need to be reviewed and approved by the representative’s staff to ensure there were no curse words or spam buried in the content. I continued to check out a few sites for the other senators at http://senate.gov/general/contact_information/senators_cfm.cfm but could not find others with blogs. I was pretty disappointed.

Going forward, I think it is important for all of our local and state representatives to have either blogs or forums. Otherwise it seems we are just adding paper to the giant paper mill. Who knows if it was read by the rep. and if it was even accurate enough to be worth reading? Writing letters and meeting with my rep. would take up a lot time for both parties to cover all of the issues. And even if he seems to understand my opinion and agrees that action needs to be taken, how do I know if he acted on it or not? I would have to put in a follow-up phone call and have his assistant ask him what he did about each of the issues we had discussed. I think a much better approach is to let him know that I would like to see him start a blog and allow people to post comments. We could each comment on his recent actions in office and maybe he agrees with us or maybe he doesn’t. Maybe he disagrees with us on a certain issue but then realizes that he is actually disagreeing with the majority of the population he is representing. To me, that would be the best scenario because the actions of our representative start to really represent the opinions of the populous. And that is something that tallying up letters, emails and phone calls can’t do. You might get an idea of what issues people feel strongly about, but you would not know if you were truly representing the consensus of the people you are representing.

Over the next few weeks, I’ll set up appointments with my representatives and ask them if they could start a blog and allow comments. I would like to see a change in strategy rather than getting into an argument about one issue or another, or worse, he agrees with me and tells me that there are just too many people on the opposing party to get anything done on that issue so we’ll have to wait 2 or 4 years before we can do anything about it. Hopefully representatives of other states would also start blogging and we could create some real transparency. Right now, the public votes in their representatives based on political affiliation, looks, and maybe a summary of their position on various issues. But we need more from our representatives than that. We are making major changes to our policies both foreign and domestic. Guessing our rep’s are representing us just is not going to cut it any more.

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American Clean Energy and Security Act of 2009

2009-10-24T04:11:00.000-07:00

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Below is a link to a video on CSpan interviewing US Senator Lisa Murkowski where Richard Cowen of Reuters asks her a question on the US paying developing countries under the American Clean Energy and Security Act of 2009 as well as a copy of H.R. 2454 - American Clean Energy and Security Act of 2009 from the official US Congress web site GoveTrak.us.

Video Link: http://www.c-spanvideo.org/program/289504-1 (start at 22:00/32:00)

This bill is interesting to read through/ Although it is dry and full of legal language, it has a major impact on how the US will be in the future. To me, the most interesting portion of the bill is Paragraph 4. Note: the bill is not actually broken into paragraphs, I added notes for paragraph headings between the direct quotes to make it a little easier to read and so I could refer to a specific section.

"5/15/2009--Introduced."

PARAGRAPH 1
"American Clean Energy and Security Act of 2009 - Amends the Public Utility Regulatory Policies Act of 1978 (PURPA) to establish a combined efficiency and renewable electricity standard that requires utilities to supply an increasing percentage of their demand from a combination of energy efficiency savings and renewable energy (6% in 2012, 9.5% in 2014, 13% in 2016, 16.5% in 2018, and 20% in 2021-2039). Provides for: (1) issuing, trading, banking, retiring, and verifying renewable electricity credits; and (2) prescribing standards to define and measure electricity savings from energy efficiency and energy conservation measures. Amends the Clean Air Act (CAA) to require the Administrator of the Environmental Protection Agency (EPA) to: (1) set forth a national strategy to address barriers to the commercial-scale deployment of carbon capture and sequestration; (2) establish an approach to certify and permit geologic sequestration; and (3) promulgate regulations to minimize the risk of escape to the atmosphere of carbon dioxide injected for purposes of geological sequestration. Amends the Safe Drinking Water Act to require the Administrator to promulgate regulations for sequestration wells. Sets forth: (1) a process to establish a Carbon Storage Research Corporation to collect assessments from distribution utilities of fossil fuel-based electricity delivered directly to consumers; and (2) performance standards for new coal-fired power plants. Amends PURPA to provide for the development of electric vehicle infrastructure. Requires the Secretary of Energy (Secretary) to establish: (1) a large-scale vehicle electrification program; and (2) a program to provide financial assistance for the manufacture of plug-in electric drive vehicles. Requires the Administrator to establish a program under which a state may create a State Energy and Environment Development Account. Sets forth provisions concerning the development of a smart grid, including provisions: (1) amending the Energy Policy and Conservation Act to provide for the inclusion of smart grid capability information on appliance energy guide labels; (2) requiring the Federal Energy Regulatory Commission (FERC) to support load-serving entities in developing their peak demand reduction goals; (3) amending the Energy Policy Act of 2005 to reauthorize the energy efficiency public information program and to include smart grid information in it; and (4) reauthorizing the energy efficient and smart appliance rebate program and revising it to include smart-grid features. Amends the Federal Power Act to require FERC to adopt electricity grid planning principles derived from a federal policy (established by this Act) on electric grid planning that facilitates the deployment of renewable and other zero-carbon energy sources for generating electricity to reduce greenhouse gases (GHGs) while ensuring reliability, reducing congestion, ensuring cyber-security, and providing for cost-effective electricity services."

PARAGRAPH 2
"Amends the Energy Policy and Conservation Act to revise: (1) rules regarding improving energy efficiency in industrial equipment; (2) efficiency standards for electric motors; (3) conservation standards for lighting and appliances; and (4) the Energy Conservation Program for Consumer Products Other Than Automobiles. Requires the Secretary to establish Clean Energy Innovation Centers to promote commercial deployment of clean, indigenous energy alternatives to fossil fuels, to reduce GHG emissions, and to ensure that the United States maintains a lead in developing and deploying state-of-the-art energy technologies. Amends the Energy Conservation and Production Act to revise energy conservation standards for new buildings. Requires the Administrator to establish: (1) standards for a national energy and environmental building retrofit policy for residences; and (2) a building energy performance labeling program. Establishes a rebate program to assist low-income households residing in pre-1976 manufactured homes in purchasing new Energy Star qualified manufactured homes. Requires the Secretary to establish a Best-in-Class Appliances Deployment Program. Requires the President to use statutory authorities to set motor vehicle emissions standards. Amends the CAA to require the Administrator to promulgate standards applicable to GHG emissions from specified mobile sources, including heavy-duty vehicles and engines, new marine vessels, locomotives, and aircraft."

PARAGRAPH 3
"Establishes within EPA a SmartWay Transport Program, a SmartWay Transport Partnership program, and a SmartWay Financing Program. Requires the Secretary to establish a program to make monetary awards to encourage owners and operators of electric energy generation facilities or thermal energy production facilities using fossil or nuclear fuel to use innovative means of recovering any thermal energy that is a potentially useful byproduct of their processes to: (1) generate additional electric energy; or (2) make sales of thermal energy not used for electric generation, in the form of steam, hot water, chilled water, or desiccant regeneration, or for other commercially valid purposes. Authorizes the Secretary to make grants to community development organizations to provide financing to businesses and projects that improve energy efficiency, develop alternative, renewable, and distributed energy supplies, provide technical assistance and promote job and business opportunities for low-income residents, and increase energy conservation in low income rural and urban communities. Safe Climate Act - Amends the CAA to require the Administrator to promulgate regulations to: (1) cap and reduce GHG emissions, annually, so that GHG emissions from capped sources are reduced to 97% of 2005 levels by 2012, 83% by 2020, 58% by 2030, and 17% by 2050; and (2) establish a federal GHG registry. Designates carbon dioxide, methane, nitrous oxide, sulfur hexafluoride, hydrofluorocarbons (HFCs) from a chemical manufacturing process at an industrial stationary source, perfluorocarbons, and nitrogen trifluoride as GHGs and establishes a carbon dioxide equivalent value for each gas. Prohibits any person from manufacturing, introducing into interstate commerce, or emitting a significant quantity of certain fluorinated gas that is generated as a byproduct during the production or use of another fluorinated gas. Requires the Administrator to establish specified emission allowances (annual tonnage limits) for: (1) each of 2012-2049; and (2) 2050 and thereafter. Provides for the establishment and distribution of compensatory allowances for the destruction and conversionary use of fluorinated gases and the nonemissive use of petroleum-based or coal-based liquid or gaseous fuel, petroleum coke, natural gas liquid, or natural gas as a feedstock. Phases in prohibitions against covered entities (including electricity sources, fuel producers and importers, industrial gas producers and importers, geological sequestration sites, industrial stationary sources, industrial fossil fuel-fired combustion devices, natural gas local distribution companies, nitrogen trifluoride sources, algae-based fuels, and fugitive emissions) exceeding allowable emission levels. Requires covered entities to demonstrate compliance through: (1) holding emission allowances (including international emission or compensatory allowances) at least as great as attributable emissions (as specified); or (2) using offset credits. Sets forth penalties for noncompliance. Provides for trading, banking and borrowing, auctioning, selling, exchanging, transferring, holding, or retiring emission allowances. Requires the Administrator to: (1) establish a strategic reserve account and place into that account specified amounts (ranging from 1% to 3%) of the emission allowances for each of calendar years 2012-2050; and (2) auction such strategic reserve allowances once each quarter of each of such years. Requires stationary sources subject to the CAA to have permits that require the covered entity to hold a number of emission allowances at least equal to the total annual amount of carbon dioxide equivalents for its combined emissions and attributable GHG emissions."

PARAGRAPH 4
"Authorizes the Administrator to designate an international climate change program as a qualifying international program for purposes of international emission allowances provisions, if certain conditions are met. Establishes the Offsets Integrity Advisory Board. Requires the Administrator, considering the Board's recommendations, to promulgate regulations establishing a program for the issuance of offset credits. Requires the Administrator to promulgate regulations concerning reducing GHG emissions from deforestation in developing countries. Sets forth provisions governing the disposition of emission allowances, including specifying allocations: (1) for supplemental emissions reductions from reduced deforestation; (2) for the benefit of electricity, natural gas, and/or home heating oil and propane consumers; (3) for auction, with proceeds for the benefit of low income consumers and worker investment; (4) to energy-intensive, trade-exposed industries; (5) for the deployment of carbon capture and sequestration technology; (6) to invest in energy efficiency and renewable energy; (7) to be distributed to Clean Energy Innovation Centers; (8) to invest in the development and deployment of clean vehicles; (9) to domestic refiners; (10) for domestic and international adaptation; (11) for domestic wildlife and natural resource adaptation; and (12) for international clean technology deployment. Requires the Administrator to auction off certain unused allowances and to deposit the proceeds for 2012-2025 into the Treasury and for 2026-2050 into the Climate Change Dividend Fund. Requires the President to distribute funds in the Consumer Climate Change Rebate Fund (established by this Act) to U.S. households."

PARAGRAPH 5
"Amends the CAA to require the Administrator to promulgate GHG emission performance standards for specified categories of stationary sources that: (1) have uncapped GHG emissions greater than 10,000 tons of carbon dioxide equivalent and are responsible for emitting at least 20% of the uncapped GHG gas emission annually; or (2) are responsible for at least 10% of the uncapped methane emissions. Requires the Administrator to promulgate regulations to phase down the consumption of and regulate the production of HFCs. Specifies consumption allowances for: (1) each of 2012-2032; and (2) 2033 and thereafter. Provides for: (1) the distribution, auction, banking, exchange, and international transfer of such allowances; and (2) the issuance of offset credits for the destruction of chlorofluorocarbons. Establishes the Stratospheric Ozone and Climate Protection Fund, into which the Administrator shall deposit all proceeds from the sale of such allowances. Requires the Administrator to promulgate regulations to reduce emissions of black carbon (light absorbing component of carbonaceous aerosols) or propose a finding that existing CAA regulations adequately regulate such emissions. Prohibits states from implementing a cap and trade program that covers any capped emissions emitted during 2012-2017. Amends the Federal Power Act to require FERC to promulgate regulations for the establishment, operation, and oversight of markets for regulated allowances. Requires the President to establish an interagency working group on carbon market oversight. Amends the Commodity Exchange Act to provide for transactions in derivatives that involve energy commodities. Gives the Commodity Futures Trading Commission (CFTC) jurisdiction over the establishment, operations, and oversight of markets for regulated allowance derivatives. Amends the CAA to require the Administrator to: (1) distribute emission allowance rebates to eligible industrial sectors (with eligibility based on specified energy, GHG, or trade intensity criteria); and (2) provide for the sale of and require submission of international reserve allowances by U.S. importers of products of industrial sectors that the President determines have suffered certain negative impacts from compliance with GHG emission requirements. Sets forth provisions concerning green jobs and worker transition, including: (1) authorizing the Secretary of Education to award grants to eligible partnerships to develop programs of study focused on emerging careers and jobs in renewable energy, energy efficiency, and climate change mitigation; and (2) providing climate change adjustment assistance to adversely affected workers. Amends the Internal Revenue Code to allow certain low income taxpayers a refundable energy tax credit to compensate such taxpayers for reductions in their purchasing power, as identified and calculated by the Environmental Protection Agency (EPA), resulting from regulation of GHGs."

PARAGRAPH 6
"Requires: (1) the Administrator to implement the Energy Refund Program to give low-income households a monthly cash energy refund equal to the estimated loss in purchasing power resulting from this Act; (2) the Secretary of State to oversee distributions of allowances from the International Clean Technology Account; (3) the President to establish within the United States Global Change Research Program a National Climate Change Adaptation Program; (4) the Secretary of Commerce to establish within the National Oceanic and Atmospheric Administration (NOAA) a National Climate Service; (5) the Secretary of Health and Human Services (HHS) to publish a strategic action plan to assist health professionals in preparing for and responding to the impacts of climate change; (6) the President to develop a Natural Resources Climate Change Adaptation Strategy; and (7) the Secretary of State to establish an International Climate Change Adaptation Program." (http://www.govtrack.us/congress/bill.xpd?bill=h111-2454&tab=summary)

For more videos on this and related topics, visit http://www.c-spanvideo.org/ and search climate developing countries.

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Microsoft's Vision of the Future

2009-10-23T12:01:00.000-07:00

Microsoft's vision of the future

Link to Microsoft's Video: http://www.youtube.com/view_play_list?p=8C7EA2FCDDE88894&search_query=microsoft%27s+vision+of+the+future

and the parody video for a couple laughs

Link to Parody Video: http://www.youtube.com/watch?v=0USn7eufXps

Law of Attraction Common Sense

2009-10-23T03:10:00.000-07:00

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It’s funny because I used to sort of categorize Law of Attraction stuff with superstition, thinking people were reading more into life than what was really there. I see Law of Attraction very differently now. Not as some hocus pocus of snapping your fingers and stuff appears right before your eyes, but rather a way of life where you stop hindering what you want to happen by thinking it can’t. To me, it’s very simple and straightforward, there is no magic to it.

I went to dinner with my wife, my brother, and my mother and father. My wife and I rode with my parents to a restaurant. As soon as my father drove into the parking garage he said those ominous words “I’m always good at finding a parking spot.” Now my father is no Merlin, he’s your typical guy that worked hard all his life for everything he has. He just thinks that he is lucky when it comes to finding parking spaces. What happened? We found a parking spot right on the first floor of the parking garage just a stone’s throw away from the restaurant. There were tons of vehicles on that floor. There was no magic to it. Assessing what he did differently, he was more patient, knowing what he was looking for would come to him in time. He drove up and down the aisles a little slower than the average person and a lot slower than that frustrated person that says, “Damn it, I never can find a good parking spot,” and ends up parking in the one furthest from the restaurant. That’s what I mean by the common sense of LOA (continued below).

We can further empower ourselves by including in our lives some power greater than we. As a Christian, I believed there was only one power greater than us and it was removed from me, there was no way of me doing all the regular real-world things I do, better and more efficiently be incorporating the Christian God in those activities. But the truth is that everything can be done better and more efficiently when we are doing it to help others, and that is because we are serving something greater than ourselves with gratitude.

We can move the obstacles that we were powerless against when we were serving ourselves. We were trying to bring more money, power, love, etc. into our lives but were limiting our strength to get those things by not incorporating the power greater than ourselves. As we incorporate that greater power we realize that all areas of our life, including money, power, and love, etc., improve by doing things to help others. We are no longer trapped into trying to be the person in the world with the most money…because we recognize that having too much money is an imbalance of life, just as having too little money. When there is an imbalance in one area of life, the other areas need to compensate, and we feel out of whack. Too much money seems like a nice problem to have, but the reality is that we lack strong relationships, our health suffers, maybe we are so famous we cannot even walk down the street, and so on.

We then realize that the power to move all obstacles is with us in the present moment. Perhaps the obstacle was the inability to recognize that what was perceived as an obstacle was only something in the way of a path we are no longer on. That is how I view the Law of Attraction and I like writing blogs to help others, but it also helps to clarify the thoughts in my own mind. With a solid structure to my beliefs, I am able to help others even more because it gives me conviction when tested. I hope you have enjoyed this piece and I look forward to continuing on my life path in your company.

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Practical Manifestations Progress Update

2009-10-22T02:43:00.000-07:00

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We launched the web site back in March of 2009 and the blog site one month later. It is now October, 2009 and we have a steady stream of visitors to both sites. We update the blog at least every-other day and we get positive feedback on our posts both at the blog site and on our FaceBook page. We have many followers through FaceBook's NetworkedBlogs and Google plus a lot of people receive blog post updates right in their email box.

Income is earned through advertising and by selling our book on Amazon.com, and both have been doing pretty well considering the short period of time we have been running. Both of our sites appear on the second page of the Google search “how to manifest anything” and the blog site has a Google Page Rank of 2. Our Alexa traffic rank is a little over 2 million. When we started it was at about 8 million, so we have shown significant improvement in this area. Income is a critical part of any online business. Although it is crucial for survival of a business, it should not be the driving force. We try to use our business to improve the lives of others and the environment.

Our book on Amazon.com has received some pretty great reviews. I need to talk to the administrators at Amazon to see how to post an “editorial review” to liven up the Amazon.com sales page a little.

On FaceBook.com we have over 2400 friends. Our blog is linked to our FaceBook profile so our friends see all of our blog updates. The blog is also linked to our Twitter page where we have about 1500 followers.

In the real world we are connecting with businesses and helping people find jobs. We are working with the quartet “Col Areo” and are looking forward to their concert on November 15th to support the Rhode Island Food Bank. We are also working with Conrad Ferla of Mass Mutual Insurance. Conrad was interested in representing his company at the concert so we are helping to facilitate this. Conrad had some great ideas on how to advertise the concert, finding sponsors, and getting businesses to donate goods. When it comes to helping people find jobs, we think it is especially important today since almost 1 out of 8 people are unemployed here in the US. We meet with our friends looking for jobs each week and see how we can help. One friend found a great job and it will help to support his girlfriend who recently hurt her back and so is out of work for a couple weeks or so. We are meeting another friend of ours to drive him to a few stores to pick up job applications since he does not have a vehicle.

All the time people tell us how inspired they are to be a part of this project. Being a part of the project is as simple as doing a good turn and telling us about it. We are meeting thousands of inspirational people and we can’t wait to see what tomorrow will bring. There is still much work to be done, but our progress so far is really encouraging.

Link to our book “Abundance and the Secret Law of Attraction” on Amazon.com: http://www.amazon.com/Abundance-Secret-Attraction-David-Lowell/dp/B002CC67HY/ref=sr_1_1?ie=UTF8&s=books&qid=1256204036&sr=8-1

Link to our FaceBook.com page: http://www.facebook.com/practicalmanifestations

Link to our Twitter.com page http://www.twitter.com/practicalmanife

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Helping a Friend Find a Job

2009-10-20T02:57:00.000-07:00

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A friend of mine is still looking for a second job to help support his girlfriend and her three children. He is a stand up guy that had some problems a few years ago but now is trying to do the right thing. He applied for work at a gas station and it looked promising, but he was involved in some petty nonsense back in 2006 that shows up on a background check, so they turned him down. He already has a day job and he’s been there for almost three years now.

I have been trying to help him find a second job for a couple months now. I saw him last Saturday and I told him to let me know if there is anything I could do to help. Right now he does not have a car so he takes the bus to work and walks most of his errands. It is very limiting looking for work without a vehicle. He figures he will get his car fixed up and inspected once he has a job that can pay for the cost. So I offered to drive him to some of the stores in my area since he lives in a neighboring town and has no other access to those stores. He was really appreciative of the offer. He figures he’ll take the bus to my area and I will pick him up at the mall. We’ll drive to all the stores that might be hiring, pick up applications, then I’ll take him back to his house. The following week we’ll probably drop the applications back off again.

I’m looking forward to it. It’s a great way to give something back to someone that is trying so hard. You can really see how a couple mistakes you made in the past can really hinder your progress in the present. But he knows what he needs to do now and I’m proud to be his friend.

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Social Media Is Changing Our Lives

2009-10-18T14:11:00.000-07:00

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Social media is all around us. Each day I hear more people mention key words like FaceBook and Twitter but I also hear things like "I quit my subscription to the daily newspaper" or "I just haven't been watching the news on TV anymore" usually citing sensationalism and a focus on bad news as the reason. We are no longer subject to what large corporations want us to know and putting a spin on public opinion, with the internet we are able to access the information ourselves and discuss our opinions with people around the globe.

And when it comes to businesses, there has never been a better time in history to basically advertise for free to millions of people. I was reading an article on Mashable.com on "5 Ways Social Media Is Changing Our Daily Lives": http://mashable.com/2009/10/16/social-media-changing-lives/

Link to video on how social media is changing our lives: http://www.blogger.com/goog_1255898417801

facebook

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Pam’s String Quartet Concert: November 15th, 3pm, 667 Waterman Ave, East Providence, RI

2009-10-17T07:01:00.000-07:00

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Pam Lowell’s String Quartet, Col’ Areo, is putting on a concert at the Carter Center for Music in East Providence, Rhode Island, USA. Proceeds from the concert will go to the Rhode Island Food Bank. Tickets will be sold at the door or people can donate a can good instead of paying for a ticket.

The four members have all been playing for many years and they recently decided to form a quartet. There are two violinists, one viola player, and one cellist. They will be playing a few pieces of well-known classical music: Dvorak’s Quartet No. 12 (American), and Haydn’s Emperor Quartet.

I’ve been to a few rehearsals and they sound great.

We will be notifying the local newspapers and television stations to help spread the word. We are thinking of talking to some pastry shops in the area to see if they would like to participate in the event. Conrad Ferla with Mass. Mutual Insurance has volunteered to be there to answer any questions people may have about life insurance.

More information on the concert to follow. Updates will be posted on Pam’s web site:

http://www.expressivestrings.com/

For more information on the Rhode Island Food Bank, please visit their site at:

http://www.rifoodbank.org/matriarch/default.asp

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Chief Auditor Testifies on AIG Bonuses to House Oversight Committee

2009-10-15T02:28:00.000-07:00

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I just happened to turn on C-span last night and they were covering the chief auditor explaining the results of the AIG Executive Bonus Payments Audit to the House Oversight Committee after the US federal government issued them 170 Billion dollar bail out. I was very interested in hearing the results straight from the source without any spin from third party media. The testimony is only about 10 minutes and I felt it was worth the time rather than hearing a 20 second blurb on the news about it.

It is important to know the details of the major mistakes we have made in the past to know what to look for in the future. The government issued the funds to AIG without issuing mandates on how the money should be spent prior to giving them the funds and without tracking it once the money was issued.

In my opinion, when a company is going bankrupt, no one gets bonuses. All contractual obligations for issuing bonuses should have been null and void prior to issuing them the bail-out. Beyond not needing to spend money on bonuses, there is a difference between assigning people reasonable bonuses and assigning people unreasonable bonuses. Figuring out which bonuses are unreasonable and defining the line between reasonable and unreasonable would probably take a fair amount of time and might even require a separate committee to review the statistics. Then we would need to figure out who set the amounts for each of the unreasonable bonuses, if there is foul play there, and what the punishment should be. But figuring out that all bonuses should have been voided prior to issuing the bail-out keeps things relatively simple. I suggest you view the video for yourself and make your own judgement.

Video (Skip to 41 minutes into the video to hear the auditor’s testimony. They give him the floor for 10 minutes then there is a question and answer period):

Link to Video Web Site:

http://www.c-spanarchives.org/program/id/213884

Background links on “Who Is AIG?”

Yahoo Answers http://answers.yahoo.com/question/index?qid=20090317101656AAhoYvu

AIG “About Us” Page

http://www.aigcorporate.com/aboutaig/index.html

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Winning the Nobel Peace Prize for Ambition

2009-10-12T15:48:00.000-07:00

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According to the article from Yahoo news (below), "The Nobel committee members made no bones about it: Helping Obama achieve ambitious peacemaking goals was their goal in awarding the prize Friday to an as-yet mostly unaccomplished U.S. president."

Winning a prize for what you set out to do, talk about new-age thinking. Whether you think he deserves the prize or not, apparently the reason it was given to him was to assist him in his efforts. In accordance with the fundamentals of the Law of Attraction, the President has a concept in his mind of what he is setting out to do. Granted it is one of the loftiest goals in history and he probably does not know exactly how he is going to bring about peace to the world, but nonetheless he is taking steps toward that goal and there are others that share his vision and they are helping him in whatever way they can.

Link to Yahoo News article:
http://news.yahoo.com/s/ap/us_obama_nobel_analysis

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Customer Satisfaction

2009-10-12T13:43:00.000-07:00

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Sometimes we find ourselves in situations where we need to spend the profit we made on a product to make sure it gets to a customer and ensure their satisfaction. I found myself in that situation today in fact. However, I know I always appreciate when people go the extra mile on my behalf, so I wanted to follow suit.

I try to look at the big picture of making one’s customer base happy as opposed to the profit from a single sale. I also know that by me taking the proper action, it is more likely that the businesses I work with will probably do the same.

I was working through Amazon and I was having some difficulty accessing my account. I have always received excellent service from Amazon in the past. On this occasion it was hard to find the proper customer division of customer service, but once I found it, we were able to correct the situation immediately.

On a previous occasion, my wife had ordered something from Amazon and the US Post Office was swamped with Christmas orders and Amazon paid extra to rush the delivery. It is wonderful to work with companies that manage business in this way and it makes you feel good to know you did the same when given the opportunity.

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A Crazy Week

2009-10-10T05:27:00.000-07:00

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This was an interesting week because I ended up pushing myself way too hard at work, which left me no time to spend with my family or for personal reflection like writing the blog. That is how I view the blog, a time for me to reflect on my life and my environment. With working so much, I had trouble keeping an internal balance. I caved to cravings for sugar and chocolate and the combination of working so much and not having an internal balance translated into a crazy week.

It’s funny how you can go several weeks and not have anything bother you then suddenly some deeply rooted emotional stuff gets stirred up. I tried to recognize all of the feelings that got stirred up for what they were and work through any issues they seemed to be tied to. As it got toward the end of the week I gave myself a few more breaks and cancelled an appointment I had scheduled so I could catch up a little. When you get to the point that you know you need a break, you can either push yourself even harder and bear the consequences or make the decision to put yourself first. Everyone reaches that threshold eventually, some just can take a little more than others, but we all get there.

Instead of going to the appointment to meet a friend, I rested that night and looked at it as some extra time I had created to help me catch up to how fast everything was coming at me. I used to never give myself a break, but as I get older, I notice the repercussions of that choice. So now it is Saturday morning. I told my wife we would spend the weekend together, that was the first thing I wanted to re-establish as a priority. Over the week work had sort of displaced everything else, and that only can go for so long before everything gets out of whack. We are going to do some fun things this weekend. My wife loves going to art festivals and craft fairs to celebrate the seasons. I like them because they make my wife happy when we go. And, admittedly, I do look at some of the knickknacks because at every knickknack shop you’ll find that really funny or strange one that will make you laugh. You’ll wonder who the heck is buying something like that…but they must be out there, because the shop would not be selling it if no one was interested in buying it.

After a crazy week there is usually a period for reflection on the week’s events. I find this period to be the best time to figure things out…after having stirred everything up. It can get a little monotonous reflecting on routine events. So it will be interesting to see what this next week will bring for me.

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The Other Side of the U.S. Health Care Issue

2009-10-07T02:18:00.000-07:00

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To me, one of the biggest causes of the high cost of health care is the fact that people are suing the hospitals and doctors for millions if not hundreds of millions of dollars. It is a sensitive issue because some of the lawsuits involve negligence on the part of doctors and it resulted in life-long impairment or even death. When we consider that someone died because of another person’s negligence, it is tempting to go after everything we can get, the sky is the limit. But in the end, hundreds of millions of dollars will not bring the person back.

On the other hand, the hospitals and doctors paying insurance to cover these massive lawsuits need to keep raising their rates to pay their insurance bills. We are seeing all the hospitals around us struggling to stay afloat and charging absorbent rates for the simplest of treatments.

I suppose the only way to bring this sort of thing back into control would be for everyone to come to an agreement on for how much money people can sue for the various types of malpractice. A couple million for malpractice/negligence with death resulting, four million…I don’t know…but something reasonable. Then each level of negligence would be tiered to a certain value for a maximum lawsuit so as to reimburse the people injured but not bankrupt the entire hospital.

Of course there would still be the issue of paying for treatment for people injured by the malpractice for the rest of their lives. This amount may be more than the maximum lawsuit amount but it is going toward treatment rather than reimbursement for other impacts. There would be all sorts of variations on this. I would think that the cost for regular hospital visits would be much more reasonable in such an environment and so paying for treatment for an injured person would also be more reasonable.

I don’t know if we will ever see such a thing put into place. But the way I see it, without some sort of cap on what people can sue for, there is no way for hospitals to survive. Even if a hospital makes a million dollars per year profit, if they get one law suit for 100 million dollars, it will take them 100 years to break even again (plus a good number of years to pay back the interest). And whether the government is footing the bill or the insurance companies, the cost is still astronomical and the rest of us all wind up paying it anyway. I would think that we, as a nation, could decide on what is reasonable to avoid bankrupting every hospital paying absorbent rates for routine hospital visits. There is nothing worse than incurring an injury or losing a loved one due to another person’s neglect. Maybe we should consider putting more of the penalty into jail time rather than increasing the dollar amount of the lawsuit, who knows? And that’s my two cents.

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To learn more about the health care reform bill, please visit:
http://energycommerce.house.gov/index.php?option=com_content&view=article&id=1687:health-care-reform&catid=156:reports&Itemid=55

Real-World Networking Part 1

2009-10-06T05:11:00.000-07:00

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So a group of friends of mine are in a string quartet named Col’ Areo. They decided have a concert on November 15th in Seekonk, Massachusetts. I offered to help advertise. I called my friend Conrad, he works for a life insurance company. He is always interested in networking and recently hosted a successful event at his house, so he was familiar with free local advertising. I thought it would be good for him to set up sort of an information table at our function so people could ask him some questions about the life insurance products his company had. It was a way of incorporating an associate in a business event. I knew it would help him and I figured he would help us with advertising, a win-win situation.

When I called him, I told him that the quartet was hosting an event and the proceeds were going to the Rhode Island Food Bank charity. Conrad told me that sometimes companies will sponsor events when they know it is for charity. He also said some businesses are just looking to promote themselves and will offer free goods and services, especially if they just recently opened. That gave me the idea of talking to a few coffee shops in the area the quartet was hosting the concert to see if they would donate free pastry and coffee for the event. I’ll look into doing that over the next couple weeks.

Conrad informed me that the local chamber of commerce actually has a long email list of businesses in the area which they send updates on current events. Members can send the chamber of commerce notifications of events they are involved in, and those notifications will be forwarded out to the thousands of other members.

We will also be telling the local newspaper, and television and radio stations.

I’ll keep you posted as we continue to help plan for this event. For more information on events for Col’ Areo, be sure to visit http://www.expressivestrings.com/

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Backing Up Your Blog (It's Easier Than You Think)

2009-10-05T10:36:00.000-07:00

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These days we need to backup all of our critical information, including the blogs we write. No one is guaranteed the blog posts they write will always be available. This may be of great concern to those that have written hundreds or even thousands of posts. Luckily there is a free and easy solution and it can be found via the link at the end of this page. We can use the Blogger Backup utility provided by CodePlex.com. We download and run the Setup file. We then run the program (Start=>All Programs=>Blogger Backup Utility=>Blogger Backup Utility.

Next to “Available Blogs” is a drop down bar. Click the arrow and then click “add/update/remove blogs”. Enter your Blogger User ID and password, then click “Login to Blogger and Get Blogs”. Then in the “Available Blogs” drop down bar, highlight your blog, select the folder you want them to go to and whatever other settings you want to change. Then click “Backup Posts”.

It’s that easy. Now all of your blog posts are saved locally, GOOD JOB!

Link for Blogger Backup: http://www.codeplex.com/bloggerbackup

Link for information to backup GMail and other Google-related information: http://mashable.com/2009/02/02/google-backup/

I thank you for reading. You are welcome to comment on this post and all of our posts in the General Discussions area of our forums at http://www.practicalmanifestations.freeforums.org/

Which of Your Blog Posts Are People Viewing Most?

2009-10-03T04:53:00.000-07:00

You are welcome to subscribe to our blog post updates via email and view our entire archive of blog posts at http://www.practicalmanifestations.com/blog

Another great feature of Google Analytics is the ability to track which pages people are viewing most often. This can be very handy to determine what your audience is interested in. Usually a blog focuses on a single subject, but within that subject there are niches. Knowing what niches people want to read about helps your blog better target your audience.

The page tracker is found at the bottom right of the Analytics Dashboard page for your blog named "Content Overview". Just click "View Report" then "View Full Report" to see how many times each page of your blog is viewed. Several of the pages will be the labels you selected, but some will be individual blog posts.

Secondly, I am creating a label named “A: Top Posts” where I will tag posts I find on Analytics to be viewed most often. To me, there is no better way for people to navigate through your archive of content than to click on tags that identify blog posts in the niche they are interested in. Otherwise they would need to scroll and click through hundreds if not thousands of posts. And we all know we lose visitors with every click. Why not make it even quicker for people to navigate through your content by telling them what other people thought was your best work?

I will begin my “favorites” label with the letter “A” because that will put the label at the top of the label list, where people will most likely see it first.

Get Blogger to Start Your New Blog

http://www.blogger.com/

Get Blogger Labels

Labels is one of the gadgets found in Blogger under “Layout”.

Get the Google Analytics Code

To track your blog pages and more with Google Analytics, you will need to set up a Google Analytics account. From there you click “Edit” next to the account you are tracking on the Overview Page. Next to “Receiving Data”, click “Check Status”. Then copy the tracking code they give you. In Blogger, click “Customize”, “Add Gadget”, click “HTML/Java Script” and paste the tracking code.

I thank you for reading. You are welcome to comment on this post and all of our posts in the General Discussions area of our forums at http://www.practicalmanifestations.freeforums.org/

Corruption Versus Transparency

2009-10-01T02:58:00.000-07:00

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Over the past few years I have seen the impact transparency has on corruption. I am interested in the topic of corruption because I feel that if I voice my oppinions on resolving issues like corruption, it will contribute to the wave of change that will bring about their resolution.

My company was doing construction for another company. When we went to sign the contract with them, part of the contract was for complete transparency of all of our financial transactions that involved them. We had to furnish them information on what we were paying our subcontractors and vendors on all items. The way this reduced corruption was that if there was a change that the owner was responsible for, we would give him a price for the new work. We needed to be completely forthright in our pricing since the owner had record of what we were paying for material, labor, equipment, etc.

How can this be applied to government and business in general? I think with the internet we have our answer. We should make things like the bills passing through our government available so the average person can read them and know whom to contact to voice their opinion. Similarly, major changes in government policy, our general economic plan, our general intent in foreign affairs, etc. could all be made known to the public via the internet. Some of this information is already available, but it would take an internet guru to find it. The people running for office, what companies are funding their campaigns? First of all I question the ethics of businesses funding politicians that create laws affecting businesses, there appears to be a major conflict of interest. But if we are going to allow that, the people should at least know what businesses are funding the politicians so we can make an educated decision on whom to vote for. Up until now we have been voting based on looks and party affiliation. We don’t have a way for the average person to recognize who would be best suited for the position. With knowledge on which companies are backing the politicians, and what the companies’ general agenda was, we would have a good idea of what direction the politician is going to take us…follow the money.

As far as businesses are concerned, we may look at the fact that all businesses traded on the stock market have publicly disclosed financials and think that transparency is not effective. In my opinion this only points out that more transparency is needed, perhaps not for the business itself, but for the auditor. How many inquiries have been brought against the auditor involving corruption, what type of auditing methods do they use? In order to properly assess a company’s financials, you need two pieces of information: 1) the company’s financials, 2) an assessment of the auditor. Needless to say, the auditor should always be a third party completely unaffiliated with the original company. This way people make an informed decision when purchasing stock. Sure the company may have impeccable financials, but they have a bogus auditor, so I think I’ll invest with someone else. It takes away a lot of the nonsense and allows us to compare apples to apples, eliminating bogus methods like anticipated worth (yes that’s one), etc.

We don’t necessarily need the government to create new laws for what businesses can and cannot do. We seem to be chasing our tails in that respect. Whenever a new law is created, the lawyers hit the books to figure a way around it. This country is democracy. We have the power to vote who we want in office, to choose what businesses to invest in and to do business with. Right now we are still powerless because although we have the right to choose, we are missing crucial information to make the right choice. Many of our sources of information are tainted, including (or especially) the mainstream media, where most people would expect to find information. The media is often times affiliated with several businesses or a political party. Of course they are not going to report bad news about their partners, and if they do, it will be sugar-coated. There is one law that could change with respect to the media, in my opinion, and that is the fact that the media is not obligated to tell the truth, even when they are well aware of what the truth is. You can watch the movie “The Corporation” if you want more details on that, see clip below.

I thank you for reading. You are welcome to comment on this post and all of our posts in the General Discussions area of our forums at http://www.practicalmanifestations.freeforums.org/

In Times of Social Unrest

2009-09-28T14:49:00.000-07:00

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It can be extremely difficult to keep focused when there seems to be chaos all around us. Corruption, confusion, and warfare run rampant in our businesses, government and in ourselves. The media does not let us forget just how much unrest there is, not for a moment. We constantly hear about corrupt politicians and business managers as well as the wars around the world we are involved in.

So how do we keep level-headed amidst all this chaos? The calmness must come from within. The surety that whatever happens to us and the rest of the world, we are going to be okay. Is it worth fighting for what we believe in, changing laws, and getting people in businesses and government that have an interest in improving things rather than just filling their pockets? Absolutely. But the way that we are most effective is by being of sound mind, body, and spirit. Although the chaos we see around us needs to be addressed immediately and fervently, we are powerless without having first attained an internal balance. Only with a balance in our mind, body, and spirit can we start to correct the injustice and mayhem around us. For it is with this balance that we can be sure we are thinking clearly and swiftly. We know we have the ability to recognize the path to the quickest and most successful solution to every problem we encounter.

For with such a balance, when we do take action against the injustice and mayhem, it is with confidence. We are able to communicate with the world more effectively and the world knows that we are forthright and our intentions are noble. Without the balance and confidence in our word, our attempts at communication is suspect, and our efforts are in vain.

When I find information in the media telling me one group or another is the problem, I try to consider how I am contributing to the problem they are talking about. The media tells me about the crazy liberals or the greedy conservatives, conspiracy this, conspiracy that, and that the leaders of some foreign countries that hate us are just insane. They point out the problem and do everything to expose the people causing it except look in the mirror. How have I supported corrupt business, exploiting third world countries, corrupt government, allowing my tax dollars to go toward causes I may or may not even believe in, and even in my own life when I knew I was supporting social injustice by tolerating it.

This all starts with us. We cannot show our leaders what we expect out of them when we, ourselves, fall far short of the expectations. Our government representatives will not begin to rid themselves of the corruption until the people they represent do so. For at that point, there will be no one for them to collaborate with. It is sort of like a house of cards on a windy day, success is imminent and certain.

We look at our businesses that have let us down because of corruption. Our stock market is basically subsidized by the government. Our major corporations are all being subsidized by the government. What has this done for us? We are now incorporating our corrupt government with our corrupt businesses and we are hoping this will help? To me, this will buy us some time by saturating the market place with government dollars, but it does not solve the problem. The government dollars will soon land in the pockets of a corrupt few and we will soon be in the same situation again. The problem is not the form of government we have or economic system we have. IN THEORY capitalism works…socialism works, communism works…they all work…in theory, and blends of them probably work as well. Big government works, small government works and so does medium-size government. Corrupt government does not work. Corrupt business does not work. No matter the size of government or the economic system you are working with, corrupt anything is sure to fail, and so do blends thereof.

As we get back to the roots of what made this country great, of what made this world great, we start to see honest, hard-working people come out of the woodwork. We are recognizing those corrupt and dishonest habits we had and dispelling them, they do not serve us anymore. We are then able to inform our leaders how to properly lead us, or elect new leaders where the existing ones become obsolete.

Every country is facing this challenge today, it is not dependent on the type of government of economic system they have adopted. It is not up to the faceless entity we define as our government to grow a sense of integrity and discipline. The people are the ones that decide what government will rule them and how it will rule them, what businesses will survive and which ones will perish. And in the cases of dictators and tyrants, eventually the people always rise up and determine for themselves how they will be governed.

And in this time of unrest, when we cover our eyes and ears, count to 4 breathing in, count to 4 holding our breath, and count to eight breathing out…all we are left with is our internal state of being. Inside we are either at peace or at war, but not both. As information comes to us about our surroundings, we can use it to create or destroy. We can become anxious, depressed, happy, sad, or angry. That is the choice we make in every moment of every day. I heard the news today of the chaos in the world and I decided to write this article to bring peace to all those that have become caught up in it. My prayers are with them and I know they will soon find peace and joy in their lives.

I thank you for reading. You are welcome to comment on this post and all of our posts in the General Discussions area of our forums at http://www.practicalmanifestations.freeforums.org/

America's Health Care Reform Bill Summary and Section-by-Section Summary

2009-09-27T00:59:00.000-07:00

Copy of the 4 Page Summary followed by the 35 page Section-by-Section Analysis of America’s Health Care Reform Bill (You are welcome to visit our blog to listen to both read aloud at http://www.practicalmanifestations.com/blog , sign up to receive blog updates via email, or follow our blog with FaceBook or Google). I am uploading it here so that people may listen if they do not get a chance to read it, I will be listening to it later this morning. A link for the full length conceptual version of the bill is at the end of this post.

4 Page Summary from the Committee on Energy and Commerce, Prepared by Committees on Energy and Commerce, Ways and Means, and Education and Labor July 14, 2009 http://energycommerce.house.gov/index.php?option=com_content&view=article&id=1687:health-care-reform&catid=156:reports&Itemid=55

SUMMARY
The bill provides quality affordable health care for all Americans and controls health care cost growth. Key provisions of the bill being released this week include:

􀂃COVERAGE AND CHOICE

􀂃AFFORDABILITY

􀂃SHARED RESPONSIBILITY

􀂃CONTROLLING COSTS

􀂃PREVENTION AND WELLNESS

􀂃WORKFORCE INVESTMENTS

I. COVERAGE AND CHOICE The bill builds on what works in today’s health care system and fixes the parts that are broken. It protects current coverage – allowing individuals to keep the insurance they have if they like it – and preserves choice of doctors, hospitals, and health plans. It achieves these reforms through:

􀂃A Health Insurance Exchange. The new Health Insurance Exchange creates a transparent and functional marketplace for individuals and small employers to comparison shop among private and public insurers. It works with state insurance departments to set and enforce insurance reforms and consumer protections, facilitates enrollment, and administers affordability credits to help low‐ and middle‐income individuals and families purchase insurance. Over time, the Exchange will be opened to additional employers as another choice for covering their employees. States may opt to operate the Exchange in lieu of the national Exchange provided they follow the federal rules.

􀂃A public health insurance option. One of the many choices of health insurance within the health insurance Exchange is a public health insurance option. It will be a new choice in many areas of our country dominated by just one or two private insurers today. The public option will operate on a level playing field. It will be subject to the same market reforms and consumer protections as other private plans in the Exchange and it will be self‐sustaining – financed only by its premiums.

􀂃Guaranteed coverage and insurance market reforms. Insurance companies will no longer be able to engage in discriminatory practices that enable them to refuse to sell or renew policies today due to an individual’s health status. In addition, they can no longer exclude coverage of treatments for pre‐existing health conditions. The bill also protects consumers by prohibiting lifetime and annual limits on benefits. It also limits the ability of insurance companies to charge higher rates due to health status, gender, or other factors. Under the proposal, premiums can vary based only on age (no more than 2:1), geography and family size.

􀂃Essential benefits. A new independent Advisory Committee with practicing providers and other health care experts, chaired by the Surgeon General, will recommend a benefit package based on standards set in the law. This new essential benefit package will serve as the basic benefit package for coverage in the Exchange and over time will become the minimum quality standard for

employer plans. The basic package will include preventive services with no cost‐sharing, mental health services, oral health and vision for children, and caps the amount of money a person or family spends on covered services in a year.

II. AFFORDABILITY To ensure that all Americans have affordable health coverage the bill:

􀂃Provides sliding scale affordability credits. The affordability credits will be available to low‐ and moderate‐ income individuals and families. The credits are most generous for those who are just above the proposed new Medicaid eligibility levels; the credits decline with income (and so premium and cost‐sharing support is more limited as your income increases) and are completely phased out when income reaches 400 percent of the federal poverty level ($43,000 for an individual or $88,000 for a family of four). The affordability credits will not only make insurance premiums affordable, they will also reduce cost‐sharing to levels that ensure access to care. The Exchange administers the affordability credits with other federal and state entities, such as local Social Security offices and state Medicaid agencies.

􀂃Caps annual out‐of‐pocket spending. All new policies will cap annual out‐of‐pocket spending to prevent bankruptcies from medical expenses.

􀂃Increased competition: The creation of the Health Insurance Exchange and the inclusion of a public health insurance option will make health insurance more affordable by opening many market areas in our country to new competition, spurring efficiency and transparency.

􀂃Expands Medicaid. Individuals and families with incomes at or below 133 percent of the federal poverty level will be eligible for an expanded and improved Medicaid program. Recognizing the budget challenges in many states, this expansion will be fully federally financed. To improve provider participation in this vital safety net – particularly for low‐income children, individuals with disabilities and people with mental illnesses – reimbursement rates for primary care services will be increased with new federal funding.

􀂃Improves Medicare. Senior citizens and people with disabilities will benefit from provisions that fill the donut hole over time in the Part D drug program, eliminate cost‐sharing for preventive services, improve the low‐income subsidy programs in Medicare, fix physician payments, and make other program improvements. The bill will also address future fiscal challenges by improving payment accuracy, encouraging delivery system reforms and extending solvency of the Medicare Trust Fund.

III. SHARED RESPONSIBILITY The bill creates shared responsibility among individuals, employers and government to ensure that all Americans have affordable coverage of essential health benefits.

􀂃Individual responsibility. Except in cases of hardship, once market reforms and affordability credits are in effect, individuals will be responsible for obtaining and maintaining health insurance coverage. Those who choose to not obtain coverage will pay a penalty of 2.5 percent of modified adjusted gross income above a specified level.

􀂃Employer responsibility. The proposal builds on the employer‐sponsored coverage that exists today. Employers will have the option of providing health insurance coverage for their workers or contributing funds on their behalf. Employers that choose to contribute will pay an amount based on eight percent of their payroll. Employers that choose to offer coverage must meet minimum benefit and contribution requirements specified in the proposal.

􀂃Assistance for small employers. Recognizing the special needs of small businesses, those with payrolls that do not exceed $500,000 are exempt from the employer responsibility requirement. The payroll penalty would then phase in starting at 2% for firms with annual payrolls over $500,000 rising to the full 8 percent penalty for firms with annual payrolls above $750,000. In addition, a new small business tax credit will be available for those firms who want to provide health coverage to their workers. In addition to the targeted assistance, the Exchange and market reforms provide a long‐sought opportunity for small businesses to benefit from a more organized, efficient marketplace in which to purchase coverage.

􀂃Government responsibility. The government is responsible for ensuring that every American can afford quality health insurance, through the new affordability credits, insurance reforms, consumer protections, and improvements to Medicare and Medicaid.

IV. PREVENTION AND WELLNESS Prevention and wellness measures of the bill include:

􀂃Expansion of Community Health Centers;

􀂃Prohibition of cost‐sharing for preventive services;

􀂃Creation of community‐based programs to deliver prevention and wellness services;

􀂃A focus on community‐based programs and new data collection efforts to better identify and address racial, ethnic, regional and other health disparities;

􀂃Funds to strengthen state, local, tribal and territorial public health departments and programs.

V. WORKFORCE INVESTMENTS The bill expands the health care workforce through:

􀂃Increased funding for the National Health Service Corp;

􀂃More training of primary care doctors and an expansion of the pipeline of individuals going into health professions, including primary care, nursing and public health;

􀂃Greater support for workforce diversity;

􀂃Expansion of scholarships and loans for individuals in needed professions and shortage areas;

􀂃Encouragement of training of primary care physicians by taking steps to increase physician training outside the hospital, where most primary care is delivered, and redistributes unfilled graduate medical education residency slots for purposes of training more primary care physicians. The proposal also improves accountability for graduate medical education funding to ensure that physicians are trained with the skills needed to practice health care in the 21st century.

VI. CONTROLLING COSTS The bill will reduce the growth in health care spending in a numerous ways. Investing in health care through stronger prevention and wellness measures, increasing access to primary care, health care delivery system reform, the Health Insurance Exchange and the public health insurance option, improvements in payment accuracy and reforms to Medicare and Medicaid will all help slow the growth of health care costs over time. These savings will accrue to families, employers, and taxpayers.

􀂃Modernization and improvement of Medicare. The bill implements major delivery system reform in Medicare to reward efficient provision of health care, rolling out innovative concepts such as accountable care organizations, medical homes, and bundling of acute and post‐acute provider payments. New payment incentives aim to decrease preventable hospital readmissions, expanding this policy over time to recognize that physicians and post‐acute providers also play an important role in avoiding readmissions. The bill improves the Medicare Part D program by creating new consumer protections for Medicare Advantage Plans, eliminating the “donut hole” and improving low‐income subsidy programs, so that Medicare is affordable for all seniors and other eligible individuals. A centerpiece of the proposal is a complete reform of the flawed physician payment mechanism in Medicare (the so‐called sustainable growth rate or “SGR” formula), with an update that wipes away accumulated deficits, provides for a fresh start, and rewards primary care services, care coordination and efficiency.

􀂃Innovation and delivery reform through the public health insurance option. The public health insurance option will be empowered to implement innovative delivery reform initiatives so that it is a nimble purchaser of health care and gets more value for each health care dollar. It will expand upon the experiments put forth in Medicare and be provided the flexibility to implement value‐based purchasing, accountable care organizations, medical homes, and bundled payments. These features will ensure the public option is a leader in efficient delivery of quality care, spurring competition with private plans.

􀂃Improving payment accuracy and eliminating overpayments. The bill eliminates overpayments to Medicare Advantage plans and improves payment accuracy for numerous other providers, following recommendations by the Medicare Payment Advisory Commission and the President. These steps will extend Medicare Trust Fund solvency, and put Medicare on stronger financial footing for the future.

􀂃Preventing waste, fraud and abuse. New tools will be provided to combat waste, fraud and abuse within the entire health care system. Within Medicare, new authorities allow for pre‐enrollment screening of providers and suppliers, permit designation of certain areas as being at elevated risk of fraud to implement enhanced oversight, and require compliance programs of providers and suppliers. The new public health insurance option and Health Insurance Exchange will build upon the safeguards and best practices gleaned from experience in other areas.

􀂃Administrative simplification. The bill will simplify the paperwork burden that adds tremendous costs and hassles for patients, providers, and businesses today.

END OF SUMMARY

35 Page Section-by-Section Analysis From the Committee on Energy and Commerce, Prepared by Committees on Energy and Commerce, Ways and Means, and Education and Labor July 14, 2009 http://energycommerce.house.gov/index.php?option=com_content&view=article&id=1687:health-care-reform&catid=156:reports&Itemid=55

America’s Affordable Health Choices Act Section-by-Section Analysis
July 14, 2009

DIVISION A – AFFORDABLE HEALTH CARE CHOICES
Sec. 100. Purpose; table of contents of division; general definitions. Provides an outline of the bill structure and a glossary of terms used throughout.
TITLE I – PROTECTIONS AND STANDARDS FOR QUALIFIED HEALTH BENEFITS PLANS
SUBTITLE A – GENERAL STANDARDS
Sec. 101. Requirements reforming health insurance marketplace. Broadly outlines the standards for reforming the health insurance marketplace.
Sec. 102. Protecting the choice to keep current coverage. Allows the maintenance of current individual health plans as “grandfathered plans” and provides for a five year grace period for current group health plans to meet specified standards (insurance and benefit requirements).
SUBTITLE B – STANDARDS GUARANTEEING ACCESS TO AFFORDABLE COVERAGE
Sec. 111. Prohibiting pre-existing condition exclusions. Prohibits the application of pre-existing condition exclusions.
Sec. 112. Guaranteed issue and renewal for insured plans. Requires guaranteed issue (no one can be denied health insurance) and renewal of insurance policies and prohibits the use of rescissions except in instances of fraud.
Sec. 113. Insurance rating rules. Limits age rating to a ratio of 2 to 1; allows variation based on geographic area and family size as permitted by state insurance commissioners and the Health Choices Commissioner. Requires a study and reports by the Health Choices Commissioner describing the differences between insured and self-insured plans and providing recommendations as appropriate to ensure that the law does not create incentives for small and midsize employers to self insure or create adverse selection in the risk pools of insured plans.
Sec. 114. Nondiscrimination in benefits; parity in mental health and substance abuse disorder benefits. Provides authority to the Health Choices Commissioner to set non-discrimination rules and ensures that mental health and substance use disorder parity and genetic nondiscrimination laws apply to qualified health benefits plans.
Sec. 115. Ensuring adequacy of provider networks. Provides authority to the Health Choices Commissioner to set network adequacy standards that qualified plans must meet.
Sec. 116. Ensuring value and lower premiums. Requires qualified plans to meet a specified medical loss ratio as defined by the Health Choices Commissioner. If plans exceed that limit, rebates to enrollees are required. Prepared by Committees on Energy and Commerce, Ways and Means, and Education and Labor July 14, 2009 2
SUBTITLE C – STANDARDS GUARANTEEING ACCESS TO ESSENTIAL BENEFITS
Sec. 121. Coverage of essential benefits package. Requires qualified plans to meet the benefit standards recommended by the Benefits Advisory Committee and adopted by the Secretary of HHS. Plans outside the Exchange must offer at least the essential benefits and others as they choose. Plans within the Exchange must meet the specified benefit packages, which includes a tier with offerings of additional benefits. Allows for the continued offering of separate excepted benefits packages as in current law outside of the Exchange.
Sec. 122. Essential benefits package defined. Outlines the broad categories of benefits required to be included in the essential benefits package, prohibits any cost-sharing for preventive benefits (including well child and well baby care), and limits annual out-of-pocket spending in the essential benefits package to $5,000 for an individual and $10,000 (indexed to CPI) for a family. Defines the initial essential benefit package as being actuarially equivalent to 70% of the package if there were no cost-sharing imposed.
Sec. 123. Health Benefits Advisory Committee. Establishes a Health Benefits Advisory Committee, chaired by the Surgeon General, with private members appointed by the President, the Comptroller General, and representatives of relevant federal agencies. The Advisory Committee will make recommendations to the Secretary of HHS regarding the details of covered health benefits as outlined in Sec. 122, including the establishment of the three tiers of coverage: basic, enhanced and premium.
Sec. 124. Process for adoption of recommendations; adoption of benefit standards. Establishes the timeline for the initial adoption of benefits by the Secretary of HHS and the period updating of standards in the future.
SUBTITLE D – ADDITIONAL CONSUMER PROTECTIONS
Sec. 131. Requiring fair marketing practices by health insurers. Provides the Health Choices Commissioner with the authority to define marketing standards that qualified plans are required to meet.
Sec. 132. Requiring fair grievance and appeals mechanisms. Requires each qualified plan to meet standards defined by the Health Choices Commissioner for timely internal grievance and appeals mechanisms and to establish an external review process that provides for an impartial, independent and de novo review of denied claims. The determination is binding.
Sec. 133. Requiring information transparency and plan disclosure. Requires qualified plans to meet standards established by the Health Choices Commissioner relating to transparency and timely disclosure of plan documents and information, including providing health care providers with information regarding their payments. It also requires the use of plain language in the disclosures (including the issuance of guidance as to what “plain language” means) and advance notice of changes to the plans.
Sec. 134. Application to qualified health benefits plans not offered through the Health Insurance Exchange. Provides flexibility to the Health Choices Commissioner to decide what protections of sections 131-133 should apply to qualified plans outside of the Health Insurance Exchange.
Sec. 135. Timely payment of claims. Applies Medicare’s timely payment of claims standards to the plans offering coverage through the Exchange.
Sec. 136. Standardized rules for coordination and subrogation of benefits. Requires the Health Choices Commissioner to establish standards for the coordination of benefits and reimbursement of payments in cases involving individuals and multiple sources of coverage (like workers’ compensation coordination). Prepared by Committees on Energy and Commerce, Ways and Means, and Education and Labor July 14, 2009 3
Sec. 137. Application of Administrative Simplification. Requires insurers and providers to use common standards for transactions such as claims payment, eligibility and enrollment building on the Health Insurance Portability and Accountability Act of 1996.
SUBTITLE E – GOVERNANCE
Sec. 141. Health Choices Administration; Health Choices Commissioner. Establishes the Health Choices Administration, an independent executive branch agency. The Health Choices Commissioner is appointed by the President.
Sec. 142. Duties and authority of Commissioner. The Health Choices Commissioner carries out functions including: establishment of qualified plan standards, establishment and operation of the Health Insurance Exchange, administration of affordability credits, and additional functions as laid out within the bill. The Commissioner can collect data necessary to carry out his or her duties and to promote quality and value and address disparities in health care. Such information can also be shared with HHS. The Commissioner also has oversight and enforcement authority including the authority to impose sanctions and suspend enrollment of a plan. This authority requires the Commissioner to coordinate with the Department of HHS, the Department of Labor and state insurance regulators.
Sec. 143. Consultation and coordination. Requires the Health Choices Commissioner to consult with other regulatory bodies and state and federal agencies in carrying out his duties and to ensure appropriate oversight and enforcement.
Sec. 144. Health Insurance Ombudsman. Establishes a Qualified Health Benefits Plan Ombudsman to assist individuals in navigating the new health reform system and report to Congress on recommendations for improvements in administration of the program.
SUBTITLE F – RELATION TO OTHER REQUIREMENTS; MISCELLANEOUS
Sec. 151. Relation to other requirements. Makes clear that this act does not supersede COBRA or HIPAA, including mental health parity and the genetic nondiscrimination act, unless their requirements prevent the application of a requirement of this title.
Sec. 152. Prohibiting discrimination in health care. Prohibits discrimination by health insurers with regard to the provision of high quality care or services.
Sec. 153. Whistleblower protection. Protects employees from retaliation by their employer for the reporting of any violations of this act and provides remedies for such retaliation in accordance with existing law in the Consumer Product Safety Act.
Sec. 154. Construction regarding collective bargaining. Preserves statutory obligations of employers to collectively bargain with employee representatives over health care.
Sec.155. Severability. Provides that if any part of this act is found unconstitutional, that other parts of the act shall not be affected. Prepared by Committees on Energy and Commerce, Ways and Means, and Education and Labor July 14, 2009 4
SUBTITLE G – EARLY INVESTMENTS
Sec. 161. Ensuring value and lower premiums. Amends the Public Health Service Act to require health insurance issuers to meet a specified medical loss ratio as defined by the Secretary effective for plan years on or after January 1, 2011. If plans exceed that limit, rebates to enrollees are required. In setting the medical loss ratio, the Secretary is to set this highest level possible that is designed to ensure adequate participation by issuers, competition in the market, and value for consumers.
Sec. 162. Ending health insurance rescission abuse. Prohibits health insurance companies from rescinding coverage except in instances of clear fraud and requires independent review of any rescission determination, effective October 1, 2010.
Sec. 163. Administrative simplification. Requires the Secretary of HHS to adopt standards for typical transactions between insurers and providers such as claims, eligibility, enrollment, and prior authorization building on the standards in the Health Insurance Portability and Accountability Act of 1996. It establishes implementation and enforcement mechanisms for such standards.
Sec. 164. Reinsurance program for retirees. Establishes a temporary reinsurance program to provide reimbursement to participating employment-based plans for part of the cost of providing health benefits to retirees (age 55-64) and their families. Employment-based plans must apply to participate and be approved by the Secretary. The program reimburses participating employment-based plans for 80% of the cost of benefits provided per enrollee in excess of $15,000 and below $90,000. The plans are required to use the funds to lower costs borne directly by participants and beneficiaries. The act appropriates $10 billion for this fund and those funds are available until expended.
TITLE II—HEALTH INSURANCE EXCHANGE AND RELATED PROVISIONS
SUBTITLE A – HEALTH INSURANCE EXCHANGE
Sec. 201. Establishment of Health Insurance Exchange; outline of duties; definitions. Establishes a Health Insurance Exchange under the purview of the Health Choices Administration that will facilitate the offering of health insurance choices. The Health Choices Commissioner establishes a process through which to obtain bids, negotiate and enter into contracts with qualified plans, and ensure that the different levels of benefits are offered with appropriate oversight and enforcement. The Commissioner also facilitates outreach and enrollment, creates and operates a risk pooling mechanism, and ensures consumer protections.
Sec. 202. Exchange-eligible individuals and employers. Defines who is eligible for participation in the Health Insurance Exchange including employers and individuals. In year one, individuals not enrolled in other acceptable coverage are allowed into the Exchange as well as small employers with 10 or fewer employees. In year two, employers with 20 and fewer employees are allowed into the Exchange. In subsequent years, the Health Choices Commissioner is granted authority to expand employer participation as appropriate, with the goal of allowing all employers access to the Exchange.
Defines acceptable coverage to include enrollment in other qualified coverage and most other federal health programs.
Medicaid-eligible individuals will generally be enrolled in Medicaid, not the Exchange. An exception is made for childless adults with incomes under 133% of poverty ($14,400 per year for an individual) who had other Prepared by Committees on Energy and Commerce, Ways and Means, and Education and Labor July 14, 2009 5
qualifying coverage within the previous six months. They have the choice to obtain coverage through Medicaid or the Exchange.
Once an individual or an employer enrolls in coverage through the Exchange, they remain eligible for Exchange coverage even if their circumstance changes and would otherwise exclude them.
Requires that employers who offer coverage through the Exchange contribute at least the required contribution toward such coverage and permit their employees the freedom to choose any plan within the Exchange.
Requires the Commissioner to conduct periodic surveys of Exchange-eligible individuals and employers to measure satisfaction.
Requires the Commissioner to conduct a study regarding access to the Exchange to determine if there are significant groups and types of individuals and employers who are not Exchange eligible, but who would have improved benefits and affordability if made eligible. The report is due in year three and year six of the Exchange and continued thereafter. It is to include recommendations as appropriate for changes to the eligibility standards.
Sec. 203. Benefits package levels. The Health Choices Commissioner specifies the benefits that must be made available in each year – including a requirement that each participating plan provide one basic plan in each service area in which they operate. It is then optional for the plan to offer one enhanced and one premium plan. The differences between the three main plans (i.e. basic, enhanced and premium) are the levels of cost-sharing required, not the benefits covered. The Commissioner shall establish a permissible range of cost-sharing variation that is not to exceed plus or minus 10% with regard to each benefit category.
There is a fourth tier called premium-plus. In this package, plans can offer extra benefits like dental or vision coverage for adults, or other non-covered benefits. To ensure consumers know what they are paying extra for, these packages must detail the cost of the extra benefits separately. Plans may offer multiple premium-plus options.
States can require the application of state benefit mandates to all Exchange participating plans, but only if there is an agreement with the Commissioner that the state will reimburse the Commissioner for any additional costs of affordability credits in that state due to the State benefit requirements.
Sec. 204. Contracts for the offering of Exchange-participating health benefits plans. Lays out the responsibilities for the Health Choices Commissioner’s contracting authority including solicitation of bids, negotiation with plans and the entering into contracts with approved plans (that will be for at least one year of duration and can be automatically renewed). Requirements include that plans be licensed in the state in which they will do business, abide by data reporting requirements as outlined by the Commissioner, provide for the implementation of affordability credits, participate in risk pooling, provide for culturally and linguistically appropriate services and communications, and with respect to the basic plan, contract for outpatient services with essential community providers as defined in the 340B program.
The Commissioner outlines the bid process, the term of the contract is for a minimum of a year, and the Commissioner enforces network adequacy including an allowance for enrollees to receive services out-of-network at no greater cost if the provider network does not meet the standards for adequacy.
The Commissioner is required to establish processes to oversee, monitor, and enforce requirements on the plans. The Commissioner has the authority to terminate plans that fail to meet the required standards. Prepared by Committees on Energy and Commerce, Ways and Means, and Education and Labor July 14, 2009 6
Sec. 205. Outreach and enrollment of Exchange-eligible individuals and employers in Exchange-participating health benefits plan. Requires the Health Choices Commissioner to conduct outreach and enrollment activities to ensure Exchange-eligible individuals and businesses are enrolled into the Exchange in a timely manner, including a toll-free hotline, maintenance of a website, creation of outreach materials written in culturally and linguistically appropriate language, and community locations for enrollment. Sets up an annual open enrollment period as well as special enrollment periods for special circumstances. Requires the Commissioner to create an auto-enrollment process for individuals who are Exchange-eligible but have not selected a plan.
The Commissioner provides for broad dissemination of information on Exchange-participating health plans in a comparative manner and can work with other appropriate entities to ensure the dissemination of this information.
Establishes rules to ensure continuity of coverage for certain newborns in Medicaid and for children eligible for CHIP. Requires the Commissioner to enter into memorandums of understanding with state Medicaid agencies to coordinate enrollment in Medicaid and the Exchange for Medicaid-eligible individuals.
Sec. 206. Other functions. The Health Choices Commissioner coordinates affordability credits and risk-pooling. In order to prevent waste, fraud and abuse, institutes a special inspector general to oversee operation of the program.
Sec. 207. Health Insurance Exchange Trust Fund. Creates a Health Insurance Trust Fund to provide necessary funding for the Health Choices Administration.
Sec. 208. Optional operation of State-based health insurance exchanges. Permits states to offer their own Exchange or join with a group of states to create their own exchange in lieu of the federal Health Insurance Exchange, provided that the state(s) perform all of the duties of the federal Exchange as approved by the Health Choices Commissioner. The Commissioner has authority to terminate state exchanges if they are not meeting their obligations.
SUBTITLE B – PUBLIC HEALTH INSURANCE OPTION
Sec. 221. Establishment and administration of a public health insurance option as an Exchange-qualified health benefits plan. Requires the Secretary of Health and Human Services to develop a public health insurance option to be offered starting in 2013 as a plan choice within the Health Insurance Exchange. It participates on a level playing field with private plan choices. Like private plans, it must offer the same benefits, abide by the same insurance market reforms, follow provider network requirements and other consumer protections.
Sec. 222. Premiums and financing. Premiums for the public option are geographically-adjusted and are required to be set so as to fully cover the cost of coverage as well as administrative costs of the plan. This includes a requirement that the public option, like private plans, include a contingency margin in its premium to cover unexpected cost variations. In order to establish the public option, there is an initial appropriation of $2 billion for administrative costs and in order to provide for initial claims reserves before the collection of premiums such sums as necessary to cover 90 days worth of claims reserves based on projected enrollment. These start up funds are amortized into the premiums for the public option to be recouped over the first 10 years of operation. The plan must be self-sustaining after that initial funding.
Sec. 223. Payment rates for items and services. The Secretary of HHS establishes geographically-adjusted provider payment rates for the public option. For the first three years, those rates are based on Medicare rates with a 5% add-on for practitioners who also participate in the Medicare program. This increase also applies to Prepared by Committees on Energy and Commerce, Ways and Means, and Education and Labor July 14, 2009 7
practitioners, like pediatricians, who do not typically participate in Medicare. After the first three years, the Secretary is granted greater flexibility in setting rates, but the general rule is that overall spending should remain consistent with the initial levels. Flexibility is provided to the Secretary to create payment rates for services not covered by Medicare, pursue delivery system reforms, make adjustments to offset geographic variations and adjust rates as necessary to assure competitiveness with Exchange-participating plans or for excessive or deficient payments. Medicare providers are presumed to also be participating in the public option unless they opt out. There are no penalties for opting out. The Secretary also has authority to negotiate prescription drug prices for the public option.
Sec. 224. Modernized payment initiatives and delivery system reform. The Secretary is empowered to move forward with delivery system reforms to change the way the public option pays for medical services to promote better quality and more efficient use of medical care. Such payment changes must seek to reduce cost for enrollees, improve health outcomes, reduce health disparities, address geographic variation in the provision of medical services, prevent or manage chronic illnesses, or promote integrated patient-centered care.
Sec. 225. Provider participation. Provides the Secretary of HHS with the authority to develop conditions of participation for the public health insurance option. Providers must be licensed in the state in which they do business. Physician participation comes in two types: preferred physicians are those physicians who agree to accept the public option’s payment rate (without regard to cost-sharing) as payment in full, participating non-preferred physicians are those who agree not to impose charges in excess of the balance billing limitations in Medicare. Providers must be excluded from participating in the public option if they are excluded from other federal health programs.
Sec. 226. Application of fraud and abuse provisions. Applies Medicare’s anti-fraud and abuse protections to the public health insurance option.
SUBTITLE C – INDIVIDUAL AFFORDABILITY CREDITS
Sec. 241. Availability through Health Insurance Exchange. Creates affordability credits to ensure that people with incomes up to 400% of federal poverty have affordable health coverage. These credits are phased out according to a schedule defined in the act as individual and family incomes up to 400% of poverty and the credits apply only to Exchange-participating plans. Affordability credits reduce the costs of both premium and annual out-of-pocket spending. Individuals apply through the Commissioner or Health Insurance Exchange for the credits, or through other entities approved by the Commissioner. The Commissioner can enter into Memorandums of Understanding with State Medicaid agencies for such determinations as well and will reimburse such agency for the costs of conducting such determinations. In the first two years, affordability credits can only be used to purchase a basic plan. After that, the Commissioner establishes a process to allow them to be used for enhanced and premium plans in a way that makes clear the individuals who select those options will be responsible for any difference in costs.
Sec. 242. Affordable credit eligible individual. In order to receive affordability credits, individuals must have individual coverage through an Exchange-participating health benefits plan (though not through an employer purchasing coverage through the Exchange). Family and individual incomes must be below 400% of the federal poverty limit to access the affordability credits, and the individual generally must not be eligible for Medicaid. In general, employees who are offered employer coverage are ineligible for affordability credits within the Exchange. Beginning in year two, employees who meet an affordability test showing that coverage under their employer-provided plan would cost more than 11% of income, are eligible to obtain income-based affordability credits in the Exchange. Prepared by Committees on Energy and Commerce, Ways and Means, and Education and Labor July 14, 2009 8
Sec. 243. Affordable premium credit. The affordable premium amount is calculated on a sliding scale starting at 1.5% of income for those at or below 133% of poverty and phasing out at 11% of income for those at 400% of poverty. The way this phaseout works is specifically detailed in the act. The reference premium is the average premium for the three lowest cost basic plans in the area in which the individual resides.
Sec. 244. Affordability cost-sharing credit. The affordability cost-sharing credit reduces cost-sharing for individuals and families at or below 133% of poverty up to 400% of the federal poverty limit as specified in the act.
Sec. 245. Income determinations. To determine income, the Health Choices Commissioner uses income data from the individual’s most recent tax return. The federal poverty level applied is the level in effect as of the date of the application. The Commissioner takes such steps as are appropriate to ensure accuracy of determinations and redeterminations to protect program integrity. Processes are established for individuals with significant changes in income to inform the Commissioner of such change. There are penalties for misrepresentation of income. The Commissioner is required to conduct a study examining the feasibility and implication of adjusting the application of the federal poverty level for different geographic areas so as to reflect the variations in the cost-of-living among various areas in the country.
Sec. 246. No Federal payment for undocumented aliens. Prohibits anyone not lawfully present in the United States from obtaining affordability credits.
TITLE III—SHARED RESPONSIBILITY
SUBTITLE A – INDIVIDUAL RESPONSIBILITY
Sec. 301. Individual responsibility. Cross-references the shared responsibility provision in the Internal Revenue Code where an individual has the choice of maintaining acceptable coverage or paying a tax.
SUBTITLE B – EMPLOYER RESPONSIBILITY
PART 1—Health Coverage Participation Requirements
Sec. 311. Health coverage participation requirements. Provides the rules that apply to an employer that elects to provide health coverage (an “offering employer”) in lieu of the payroll tax that applies to a non-offering employer. An offering employer generally must offer all of its employees the option of selecting individual or family health coverage.
Sec. 312. Employer responsibility to contribute towards employee and dependent coverage. Provides that the minimum employer contribution in the case of an offering employer is 72.5% of the premium for individual coverage, and 65% of the premium for family coverage or a proportional amount for non-fulltime employees. Family coverage for this purpose includes the employee’s spouse and qualifying children.
Sec. 313. Employer contributions in lieu of coverage. Requires an offering employer to contribute to the Exchange for each employee who declines the employer’s coverage offer and enters the Exchange via the affordability test outlined in the act. The contribution is generally 8% of the average salary for the employer. Prepared by Committees on Energy and Commerce, Ways and Means, and Education and Labor July 14, 2009 9
Sec. 314. Authority related to improper steering. Authorizes the creation of rules that would prohibit employers from engaging in practices that steer employees away from employer-offered coverage and into coverage offered under the Exchange.
PART 2—Satisfaction of Health Coverage Participation Requirements
Sec. 321. Satisfaction of health coverage participation requirements under the Employee Retirement Income Security Act of 1974. Provides rules under which an employer that is subject to ERISA makes an election to offer health coverage (an “offering employer”) in lieu of the payroll tax that applies to a non-offering employer. The employer can make a separate election for full-time employees, non-full time employees, and separate lines of business. The section also provides remedies to the Department of Labor and employees of an offering employer if the employer does not follow the rules that apply to a coverage offer.
Sec. 322. Satisfaction of health coverage participation requirements under the Internal Revenue Code of 1986. Cross-references the rules in the Internal Revenue Code relating to an employer’s election to be an offering employer.
Sec. 323. Satisfaction of health coverage participation requirements under the Public Health Service Act. Provides rules under which an employer that is subject to the Public Health Service Act makes an election to offer health coverage (an “offering employer”) in lieu of the payroll tax that applies to a non-offering employer. The employer can make a separate election for full-time employees and non-full time employees. The section also provides remedies to the Department of Health and Human Services and employees of an offering employer if the employer does not follow the rules that apply to a coverage offer.
Sec. 324. Additional rules relating to health coverage participation requirements. Requires the Exchange and the Departments of HHS, Labor, and Treasury to develop coordinated interpretative and enforcement measures with respect to offering employers.
TITLE IV—AMENDMENTS TO INTERNAL REVENUE CODE OF 1986
SUBTITLE A – SHARED RESPONSIBILITY
PART 1—Individual Responsibility
Sec. 401. Tax on individuals without acceptable health care coverage. Provides for a 2.5% additional tax on the modified adjusted gross income of an individual who does not obtain acceptable health coverage for the individual or dependents claimed on the individual’s tax return. Authorizes the Department of Treasury and the Exchange to establish a hardship exemption from the additional tax. Acceptable coverage includes grandfathered individual and employer coverage, certain government coverage (e.g., Medicare, Medicaid, certain coverage provided to veterans, military employees, retirees, and their families), and coverage obtained pursuant to the Exchange or an employer offer of coverage.
PART 2—Employer Responsibility
Sec. 411. Election to satisfy health coverage participation requirements. Provides rules under which an employer makes an election to offer health coverage (an “offering employer”) in lieu of the payroll tax that applies to a non-offering employer. This section also provides for an excise tax that applies to an offering employer if the employer fails to follow the rules governing an offer of coverage. Prepared by Committees on Energy and Commerce, Ways and Means, and Education and Labor July 14, 2009 10
Sec. 412. Responsibilities of nonelecting employers. Establishes a payroll tax of 8% of the wages that an employer pays to its employees for employers who choose not to offer coverage. Certain small employers are exempt from this or are subject to a graduated tax rate. An exempt small business is an employer with an annual payroll that does not exceed $250,000. The 8% payroll tax phases in for employers with annual payroll from $250,000 through $400,000.
SUBTITLE B – CREDIT FOR SMALL BUSINESS EMPLOYEE HEALTH COVERAGE EXPENSES
Sec. 421. Credit for small business employee health coverage expenses. Provides for a tax credit equal to 50% of the amount paid by a small employer for employee health coverage. The tax credit is phased out in the case of an employer with 10 to 25 employees, and is also phased out in the case of an employer with average wages of $20,000 to $40,000 per year.
SUBTITLE C – DISCLOSURES TO CARRYOUT HEALTH INSURANCE EXCHANGE SUBSIDIES
Sec. 431. Disclosures to carryout health insurance Exchange subsidies. Permits the Exchange to receive taxpayer return information from the Internal Revenue Service in order to assist the Exchange in determining subsidy eligibility.
SUBTITLE D – OTHER REVENUE PROVISIONS
Sec. 441. Health care surcharge on the top 1.2% of earners. The bill would require the top 1.2% of earners – households with adjusted gross income in excess of $350,000 (married filing a joint return) and $280,000 (single) – to contribute towards the cost of providing access to affordable health care for all Americans through a new health care surcharge. According to the nonpartisan Joint Committee on Taxation, this surcharge would have no impact on 98.8% of households in the United States and would only affect, at most, 4.1% of all small business owners in the United States. The health care surcharge would be imposed at progressive rates so that for married households income in excess of $350,000 and below $500,000 would be subject to a surcharge of 1%, income in excess of $500,000 and below $1 million would be subject to a surcharge of 1.5% and income in excess of $1 million would be subject to a surcharge of 5.4%. The first two rates would be increased to 2% and 3%, respectively, in the event that certain health cost savings are not achieved.
Sec. 442. Delay implementation of worldwide allocation of interest. In 2004, Congress provided taxpayers with an election to take advantage of a liberalized rule for allocating interest expense between United States sources and foreign sources for purposes of determining a taxpayer=s foreign tax credit limitation. Although enacted in 2004, this election was not available to taxpayers until taxable years beginning after 2008. Last year, the House of Representatives delayed the phase-in of this new liberalized rule for two years (for taxable years beginning after 2010) as part of the Housing and Economic Recovery Act of 2008 (P.L. 108-289). The bill would further delay the phase-in of this new rule for an additional nine years (for taxable years beginning after 2019). During the 110th Congress, the House of Representatives voted numerous times on a bipartisan basis to delay the implementation of this future tax benefit as part of: H.R. 3920 by a vote of 264 to 157 (with 38 House Republicans joining 226 House Democrats in support); H.R. 3221 (May vote) by a vote of 322 to 94 (with 95 House Republicans joining 227 House Democrats in support); H.R. 3221 (August vote) by a vote 241 to 172 (with 26 Republicans joining 215 Democrats in support); and H.R. 6049 by a vote of 272-152 (with 45 House Republicans joining 227 House Democrats in support).
Sec. 451. Limitation on treaty benefits for certain deductible payments. The bill would prevent foreign multinational corporations incorporated in tax haven countries from avoiding tax on income earned in the United States by routing their income through structures in which a United States subsidiary of the foreign Prepared by Committees on Energy and Commerce, Ways and Means, and Education and Labor July 14, 2009 11
multinational corporation makes a deductible payment to a country with which the United States has a tax treaty before ultimately repatriating these earning in the tax haven country. This provision has been modified from a previous version approved by the House of Representatives as part of H.R. 2419 (110th Congress) by a vote of 231 to 191 (with 19 House Republicans joining 212 House Democrats in support) to ensure that foreign multinational corporations incorporated in treaty partner countries will not be affected by this provision.
Sec. 452 and 453. Clarification of the economic substance doctrine. The economic substance doctrine is a judicial doctrine that has been used by the courts to deny tax benefits when the transaction generating these tax benefits lacks economic substance. The courts have not applied the economic substance doctrine uniformly. The bill would clarify the manner in which the economic substance doctrine should be applied by the courts. However, the bill does not change current-law standards used by courts in determining when to utilize an economic substance analysis. Under the provision, in any case in which the economic substance doctrine is relevant to a transaction, the economic substance doctrine would be satisfied only if (1) the transaction changes in a meaningful way (apart from federal income tax consequences) the taxpayer=s economic position, and (2) the taxpayer has a substantial non-federal tax purpose for entering into such transaction. The provision also imposes a 20% penalty on understatements attributable to a transaction lacking economic substance (penalty increased to 40% in the case of transactions in which the relevant facts affecting the tax treatment of the transaction are not adequately disclosed). This provision was previously approved by the House of Representatives as part of H.R. 4351 (110th Congress) by a vote of 226 to 193.
DIVISION B— MEDICARE AND MEDICAID IMPROVEMENTS
TITLE I—IMPROVING HEALTH CARE VALUE
SUBTITLE A – PROVISIONS RELATED TO MEDICARE PART A
PART 1—Market Basket Updates
Sec. 1101. Skilled nursing facility payment update. Provides for a market basket freeze for the second, third and fourth quarters of fiscal year 2010.
Sec. 1102. Inpatient rehabilitation facility payment update. Provides for a market basket freeze for the second, third and fourth quarters of fiscal year 2010.
Sec. 1103. Incorporating productivity improvements into market basket updates that do not already incorporate such improvements. Incorporates a productivity adjustment into the market basket update for inpatient hospitals, skilled nursing facilities, inpatient rehabilitation hospitals, psychiatric hospitals and hospice care beginning in 2010. Sets a floor for the inpatient hospital market basket update so that the combination of the productivity adjustment and any adjustments for quality reporting or meaningful use of electronic health records cannot cause the market basket update to go below zero.
PART 2—Other Medicare Part A Provisions
Sec. 1111. Payments to skilled nursing facilities. Codifies the recalibration factor included in the FY 2010 Notice of Proposed Rulemaking for the Medicare skilled nursing facility prospective payment system. Provides a budget neutral adjustment within the payment system to improve payment accuracy for non-therapy ancillary services and therapy services, directs the Secretary to analyze payments for non-therapy ancillary services for Prepared by Committees on Energy and Commerce, Ways and Means, and Education and Labor July 14, 2009 12
inclusion in a future SNF case mix reclassification system, and creates an outlier payment for nontherapy ancillary services.
Sec. 1112. Medicare DSH report and payment adjustments in response to coverage expansion. Directs the Secretary to submit a report to Congress by January 1, 2016 on Medicare disproportionate share hospital (DSH) payments. If the uninsured rate drops a certain number of percentage points between 2012 and 2014, directs the Secretary to adjust Medicare DSH payments starting in FY 2017 to the empirically justified level plus an adjustment reflecting uncompensated care costs.
SUBTITLE B—PROVISIONS RELATED TO PART B
PART 1—Physicians’ Services
Sec. 1121. Sustainable growth rate reform. Permanently reforms the formula that annually updates reimbursement rates for physician services in Medicare. The revised formula recognizes the importance of primary care by allowing these services to grow at a higher rate than other services, and does not reduce physician pay rates for increases in spending on drugs or lab services. The policy also encourages physicians to form Accountable Care Organizations by providing these organizations with their own targets and update factors. Updates payment rates by the Medicare Economic Index in 2010 as these reforms are implemented.
Sec. 1122. Misvalued codes under the physician fee schedule. Directs the Secretary to regularly review fee schedule rates for physician services paid for by Medicare, including services that have experienced high growth rates. Strengthens the Secretary’s authority to adjust fees schedule rates that are found to be misvalued or inaccurate.
Sec. 1123. Payments for efficient areas. Provides incentive payments in the Medicare program to physicians practicing in areas that are identified as being the most cost-efficient areas of the country.
Sec. 1124. Modifications to the Physician Quality Reporting Initiative (PQRI). Extends through 2012 payments under the PQRI program, which provide incentives to physicians who report quality data to Medicare. Creates a review process for physicians who choose to have their PQRI submissions reviewed and directs the Secretary to integrate the PQRI program and the “meaningful use” measures used by the health information technology incentive program.
Sec. 1125. Adjustment to Medicare payment localities. Updates the method used to determine the localities used for Medicare’s geographic adjustment factor in California, utilizing an approach that is based on metropolitan statistical areas.
PART 2—Market Basket Updates
Sec. 1131. Incorporating productivity adjustment into market basket updates that do not already incorporate such improvements. Incorporates a productivity adjustment into the market basket update for outpatient hospital services beginning in 2010. Sets a floor for the outpatient hospital market basket update so that the combination of the productivity adjustment and any adjustments for quality reporting cannot cause the market basket update to go below zero. Incorporates a productivity adjustment beginning in 2010 for ambulance services, ambulatory surgical centers, and durable medical equipment not subject to competitive bidding. Replaces the existing update for laboratory services of CPI minus 0.5 with an update of CPI less productivity, beginning in 2010. Prepared by Committees on Energy and Commerce, Ways and Means, and Education and Labor July 14, 2009 13
PART 3—Other Provisions
Sec. 1141. Rental and purchase of power-driven wheelchairs. Eliminates the option for Medicare to purchase power-driven wheelchairs with a lump-sum payment at the time the chair is supplied. Medicare would continue to make the same payments for power-driven chairs over a 13-month period. Purchase option for complex rehabilitative power wheelchairs would be maintained.
Sec. 1142. Extension of payment rule for brachytherapy. Extends payment at cost for brachytherapy for two years through 2011.
Sec. 1143. Home infusion therapy report to Congress. In many situations, Medicare does not cover equipment and services related to home infusion of prescription drugs. This provision directs the Secretary to make recommendations on the most appropriate way for Medicare to cover and pay for home infusion services.
Sec. 1144. Require ambulatory surgical centers (ASCs) to submit cost data and other data. Directs the Secretary to develop a cost report for ASCs within two years of enactment and to require reporting of cost data by ASCs for cost reporting periods beginning on or after the date when the cost report is developed. Directs the Secretary to require ASCs to submit quality data beginning in 2012.
Sec. 1145. Treatment of certain cancer hospitals. Directs the Secretary to study whether existing cancer hospitals that are exempt from the inpatient prospective payment system have costs under the outpatient prospective payment system (OPPS) that exceed costs of other hospitals, and to make an appropriate payment adjustment under OPPS based on that analysis.
Sec. 1146. Medicare Improvement Fund. Places $8 billion in the Medicare Improvement Fund.
Sec. 1147. Payment for imaging services. Increases the practice expense units for imaging services to reflect a presumed utilization rate of 75% instead of 50%. Excludes low-tech imaging such as ultrasound, x-rays and EKGs from this adjustment. Also adjusts the technical component discount on single session imaging studies on contiguous body parts from 25% to 50%.
Sec. 1148. Durable medical equipment program improvements. Provides protections for beneficiaries receiving oxygen therapy in the event an oxygen supplier goes out of business. Exempts certain pharmacies from the surety bond requirement and the need to be accredited to sell diabetic testing supplies and certain other items.
Sec. 1149. MedPAC study and report on bone mass measurement. Instructs MedPAC to conduct a study on the adequacy of Medicare payment for bone mass measurement services under the physician fee schedule.
SUBTITLE C—PROVISIONS RELATED TO MEDICARE PARTS A AND B
Sec. 1151. Reducing potentially preventable hospital readmissions. Beginning in fiscal year 2012, adjusts payments for 1886(d) hospitals, critical access hospitals and hospitals paid under 1814(b)(3) based on the dollar value of each hospital’s percentage of potentially preventable Medicare readmissions for 3 conditions with risk adjusted readmission measures that are endorsed by the National Quality Forum. Directs the Secretary to expand the policy to additional conditions in future years and authorizes the Secretary to modify the adjustment based on a hospital’s performance in readmissions compared to a ranking of hospitals nationally. Provides assistance to certain hospitals for transitional care activities to address patient noncompliance issues that may result in high readmission rates. Creates an interim readmissions policy for post-acute providers beginning in FY Prepared by Committees on Energy and Commerce, Ways and Means, and Education and Labor July 14, 2009 14
2012, and directs the Secretary to develop risk adjusted readmission rates for post-acute providers and implement a readmissions payment system for those providers similar to the hospital system on or after FY 2015. Directs the Secretary to submit a report to Congress no later than one year after date of enactment on how physicians can be incorporated into the readmissions policy. Directs the Secretary to monitor inappropriate changes in admission practices by hospitals and post-acute providers and authorizes the Secretary to penalize providers that are avoiding patients at risk of a readmission.
Sec. 1152. Post acute care (PAC) services payment reform plan. Directs the Secretary to submit to Congress no later than 3 years after date of enactment a detailed plan on how to implement post-acute bundled payments. Converts the existing Acute Care Episode demonstration project to a pilot program and expands the program so that it may include bundling of payments for hospitals and post-acute providers, effective January 1, 2011.
Sec. 1153. Home health payment update for 2010. Provides a freeze in the market basket update for home health agencies for 2010.
Sec. 1154. Payment adjustments for home health care. Accelerates the regulatory adjustment for case mix currently scheduled for 2011 so that it occurs in 2010. Directs the Secretary to rebase the home health prospective payment system for 2011, taking into account changes in the average number and types of visits per episode, change in intensity of visits, and growth in cost per episode.
Sec. 1155. Incorporating productivity improvements into market basket update for home health services. Incorporates a productivity adjustment into the market basket update for home health agencies beginning in 2010. Sets a floor for the home health market basket so that the combination of the productivity adjustment and any adjustments for quality reporting cannot cause the market basket update to go below zero.
Sec. 1156. Limitation on Medicare exceptions to the prohibition on certain physician referrals made to hospitals. Closes a loophole in the self-referral rules that allows physicians to refer patients to hospitals in which they have a direct financial interest. Prohibits physician ownership in hospitals that are new as of January 1, 2009. Grandfathers the ownership structures of all physician-owned hospitals existing prior January 1, 2009. Allows for growth of existing physician-owned hospitals within certain parameters.
Sec. 1157. Institute of Medicine Study on Geographic Adjustment Factors Under Medicare. Within one year of enactment, the Institute of Medicine will report to CMS on the validity and effects of the geographic adjusters used for Medicare physician and hospital payments, and any recommendations for improvements.
Sec. 1158. Revision of Medicare Payment Systems to Address Geographic Inequities. CMS is instructed to respond to recommendations under section 1157 and may spend up to $4 billion per year, for two years, to effect any needed increases in payment rates.
SUBTITLE D – MEDICARE ADVANTAGE REFORMS
PART 1—Payment and Administration
Sec. 1161. Phase-in of payment based on fee-for-service costs. Reduces Medicare Advantage benchmarks to fee-for-service levels over three years, reaching equality of payment rates in 2013.
Sec. 1162. Quality bonus payments. Creates an incentive system to increase payments to high quality plans and plans that demonstrate improvement, phased-in over 2011-2013, consistent with the changes in section 1161. Prepared by Committees on Energy and Commerce, Ways and Means, and Education and Labor July 14, 2009 15
Sec. 1163. Extension of Secretarial coding intensity adjustment authority. Extends CMS authority to adjust risk scores in Medicare Advantage for observed differences in coding patterns relative to fee-for-service.
Sec. 1164. Simplification of annual beneficiary election periods. Provides extra time for CMS and health plans to process enrollment paperwork during annual enrollment periods and eliminates a duplicative open enrollment period for Medicare Advantage plans.
Sec. 1165. Extension of reasonable cost contracts. Extends the period of time for which Cost plans may operate in areas that have other health plan options.
Sec. 1166. Limitation of waiver authority for employer group plans. Restricts the ability of Medicare Advantage plans to offer coverage outside their service area and grandfathers current contracts.
Sec. 1167. Improving risk adjustment for payments. Requires a study on the effectiveness of the Medicare Advantage risk adjustment system for low-income and chronically ill populations.
Sec. 1168. Elimination of MA Regional Plan Stabilization Fund. Eliminates the Medicare Advantage regional plan stabilization fund.
PART 2 – Beneficiary Protections and Anti-Fraud
Sec. 1171. Limitation on cost-sharing for individual health services. Ensures that beneficiaries in Medicare Advantage plans are not subjected to higher cost-sharing than they would face in fee-for-service Medicare. Ensures that beneficiaries dually eligible for Medicare and Medicaid are not subject to higher cost-sharing than they would face under Medicaid were they not enrolled in Medicare.
Sec. 1172. Continuous open enrollment for enrollees in plans with enrollment suspension. Allows beneficiaries in Medicare Advantage plans facing sanctions for failure to meet program rules to opt out of the plan at any time for another plan or fee-for-service Medicare.
Sec. 1173. Information for beneficiaries on MA plan administrative costs. Requires CMS to publish standardized information on medical loss ratios and other plan information to beneficiaries and the public. For plans with medical loss ratios below 85%, requires rebates and increasing penalties over time, including eventual termination of contracts.
Sec. 1174. Strengthening audit authority. Strengthens the ability of CMS to recover overpayments to plans discovered by audits.
Sec. 1175. Authority to deny plan bids. Clarifies that CMS is not obligated to accept any or every bid submitted by a Medicare Advantage or Part D plan.
PART 3 – Treatment of Special Needs Plans
Sec. 1176. Limitation on enrollment outside open enrollment period of individuals into chronic care specialized MA plans for special needs individuals. Ensures that chronic condition special needs plans (SNPs) enroll beneficiaries only during their eligibility periods.
Sec. 1177. Extension of authority of special needs plans to restrict enrollment. Extends the SNP program through 2012, and extends certain fully integrated dual eligible SNPs through 2015. Prepared by Committees on Energy and Commerce, Ways and Means, and Education and Labor July 14, 2009 16
SUBTITLE E – IMPROVEMENTS TO MEDICARE PART D
Section 1181. Elimination of coverage gap. Eliminates Part D donut hole, beginning with a $500 reduction in 2011, and completing phase-out by 2023. Pays for the elimination of the gap with funds raised by requiring drug manufacturers to provide Medicaid rebates for drugs used by full dual eligibles.
Section 1182. Discounts for certain Part D drugs in original coverage gap. Incorporates voluntary PhRMA agreement to provide discounts of 50% for brand-name drugs used by Part D enrollees in the Part D donut hole into the bill.
Section 1183. Repeal of provision relating to submission of claims by pharmacies located in or contracting with long-term care facilities. Eliminates deadlines for long-term care pharmacists to file Part D claims to allow more time for improved coordination with state Medicaid programs.
Section 1184. Including costs incurred by AIDS Drug Assistance Programs and Indian Health Service in providing prescription drugs towards the annual out-of-pocket threshold under Part D. Allows drugs provided to patients by AIDS Drug Assistance Programs or the Indian Health Service to count toward out-of-pocket costs, allowing these individuals to qualify for Part D catastrophic benefits.
Section 1185. Permitting mid-year changes in enrollment for formulary changes that adversely impact an enrollee. Allows Part D enrollees to change drug plans if the plan makes a change to the formulary that increases cost-sharing or otherwise reduces coverage.
SUBTITLE F—MEDICARE RURAL ACCESS PROTECTIONS
Sec. 1191. Telehealth expansion and enhancements. Expands Medicare’s telehealth benefit to beneficiaries who are receiving care at freestanding dialysis centers. Also establishes a Telehealth Advisory Committee to provide HHS with additional expertise on the telehealth program.
Sec. 1192. Extension of outpatient hold harmless provision. Extends the existing outpatient hold harmless provision through FY 2011.
Sec. 1193. Extension of section 508 hospital reclassifications. Extends reclassifications under section 508 of the Medicare Modernization Act through FY 2011.
Sec. 1194. Extension of geographic floor for work. Medicare adjusts fees paid for physician services based on geographic variations in costs. Extends a floor on geographic adjustments to the work portion of the fee schedule through the end of 2011, with the effect of increasing practitioner fees in rural areas.
Sec. 1195. Extension of payment for technical component of certain physician pathology services. Extends a provision that directly reimburses qualified rural hospitals for certain clinical laboratory services through the end of 2011.
Sec. 1196. Extension of ambulance add-ons. Extends bonus payments made by Medicare for ground and air ambulance services in rural and other areas through the end of 2011 Prepared by Committees on Energy and Commerce, Ways and Means, and Education and Labor July 14, 2009 17
TITLE II – MEDICARE BENEFICIARY IMPROVEMENTS
SUBTITLE A – IMPROVING AND SIMPLIFYING FINANCIAL ASSISTANCE FOR LOW INCOME MEDICARE BENEFICIARIES
Sec. 1201. Improving assets tests for Medicare Savings Program and low-income subsidy program. Increases the assets test for eligibility for the Part D low-income subsidy and Medicare Savings Programs to $17,000 for individuals and $34,000 for couples indexed annually by CPI.
Sec. 1202. Elimination of Part D cost-sharing for certain non-institutionalized full-benefit dual eligible individuals. Eliminates cost sharing for people receiving care under a home and community based waiver who would otherwise require institutional care in a facility for the mentally retarded.
Sec. 1203. Eliminating barriers to enrollment. Reduces barriers to the low-income subsidy by allowing self-certification and administrative verification of income and data sharing between IRS and SSA.
Sec. 1204. Enhanced oversight relating to reimbursements for retroactive low income subsidy enrollment. Enhances oversight to make sure that low-income beneficiaries who are owed retroactive reimbursement payments from their drug plans receive them.
Sec. 1205. Intelligent assignment in enrollment. Gives HHS authority to use an enrollment process for subsidy-eligible individuals into Part D plans that accounts for the quality, cost and/or formulary of plans.
Sec. 1206. Special enrollment period and automatic enrollment process for certain subsidy eligible individuals. Gives HHS authority to enroll subsidy-eligible beneficiaries into plans using a process that accounts for the quality, cost and/or formulary of plans, while also giving beneficiaries the option of choosing another plan.
Sec. 1207. Application of MA premiums prior to rebate in calculation of low income subsidy benchmark. Removes Medicare Advantage rebates from the calculation of the low-income subsidy benchmark in order to reduce involuntary switching of full low-income subsidy Part D enrollees.
SUBTITLE B – REDUCING HEALTH DISPARITIES
Sec. 1221. Ensuring effective communication in Medicare. Requires the Secretary of HHS to conduct a study that examines the extent to which Medicare providers utilize, offer or make available language services for beneficiaries who are limited English proficient and ways that Medicare should develop payment systems for language services.
Sec. 1222. Demonstration to promote access for Medicare beneficiaries with limited English proficiency by providing reimbursement for culturally and linguistically appropriate services. Instructs the Secretary to carry out a demonstration program to reimburse Medicare providers, in multiple provider settings, for the provision of language services. Requires the Secretary to evaluate the demonstration program and make recommendations on the expansion of such services to the entire Medicare program.
Sec. 1223. IOM Report on impact of language access services. Requires the Secretary to contract with the Institute of Medicine to conduct a study that examines the impact on the quality of care, access to care, the reduction in medical errors and costs or savings associated with the provision of language access services to limited English proficient populations. Prepared by Committees on Energy and Commerce, Ways and Means, and Education and Labor July 14, 2009 18
Sec. 1224. Definitions. Defines certain terms such as “Competent Interpreter Services”, “Language Services” and “Limited English Proficient” used in Subtitle B.
SUBTITLE C—MISCELLANEOUS IMPROVEMENTS
Sec. 1231. Extension of therapy caps exceptions process. Extends the process allowing exceptions to limitations on medically necessary therapy through 2011.
Sec. 1232. Extended months of coverage of immunosuppressive drugs for kidney transplant patients and other renal dialysis provisions. Lifts the current 36-month limitation on Medicare coverage of immunosuppressive drugs for kidney transplant patients who would otherwise lose this coverage on or after January 1, 2012 and makes technical changes to the bundled payment system for End Stage Renal Disease.
Sec. 1233. Advance care planning consultation. Provides coverage for consultation between enrollees and practitioners to discuss orders for life-sustaining treatment. Instructs CMS to modify ‘Medicare & You’ handbook to incorporate information on end-of-life planning resources and to incorporate measures on advance care planning into the physician’s quality reporting initiative.
Sec. 1234. Part B special enrollment period and waiver of limited premium enrollment penalty for TRICARE beneficiaries. Provides for a 12-month Medicare Part B special enrollment period for disabled TRICARE beneficiaries and waives increased premium penalties if beneficiaries sign up during such period.
Sec. 1235. Part B Premium Adjusted for Capital Gains. Allows capital gains from the sale of a primary residence to count as a life-changing event for purposes of using a more recent tax year for determination of the Part B income related premium.
Sec. 1236. Demonstration program on use of patient decision aids. Creates a demonstration program that uses decision aids and other technologies to help patients and consumers improve their understanding of the risks and benefits of their treatment options and make informed decisions about their medical care.
TITLE III—PROMOTING PRIMARY CARE, MENTAL HEALTH SERVICES, AND COORDINATED CARE
Sec. 1301. Accountable Care Organization pilot program. Creates an alternative payment model within fee-for-service Medicare to reward physician-led organizations that take responsibility for the costs and quality of care received by their patient panel over time. Accountable Care Organizations (ACOs) can include groups of physicians organized around a common delivery system (including a hospital), an independent practice association, a group practice, or other common practice organizations. ACOs can include nurse practitioners and physician assistants and other providers as designated by the ACO.
ACOs that reduce the costs of their patients relative to a spending benchmark are rewarded with a share of the programmatic savings, conditional on meeting quality targets as well. CMS may allow ACOs to continue operating so long as they are reducing costs while maintaining quality or improving quality while maintaining costs.
Sec. 1302. Medical home pilot program. An expansion/reorientation of the medical home demo in Medicare. Establishes a medical home pilot program to assess the feasibility of reimbursing for qualified patient-centered medical homes. There are two models in the program: 1) the independent patient-centered medical home, structured around a provider, is targeted at the top half of high-need Medicare beneficiaries with multiple Prepared by Committees on Energy and Commerce, Ways and Means, and Education and Labor July 14, 2009 19
chronic diseases, and 2) the community based medical home, is targeted at a broader population of Medicare beneficiaries with chronic diseases and allows for State-based or non-profit entities to provide care-management supervised by a beneficiary designated primary care provider. Provides approximately $1.6 billion from the Trust Fund for the 5 year pilot programs. The Secretary is authorized to expand the program only if quality measures have been met and budget neutrality is demonstrated.
Sec. 1303. Payment incentive for selected primary care services. Increases the Medicare payment rate by 5% for primary care services of physicians specializing in primary care. Physicians specializing in primary care are defined both by specialty (e.g., family practitioners, internists, and others) and by share of a practice in primary care (at least 50% of allowed charges are for primary care services). Eligible practitioners practicing in health professions shortage areas receive an additional 5%.
Sec. 1304. Increased reimbursement rate for certified nurse-midwives. Increases the payment rate for nurse midwives for covered services from 65% of the rate that would be paid were a physician performing a service to the full rate.
Sec. 1305. Coverage and waiver of cost-sharing for preventive services. Waives all Medicare cost sharing (both co-insurance and deductibles) for preventive services.
Sec. 1306. Waiver of deductible for colorectal cancer screening tests regardless of coding, subsequent diagnosis, or ancillary tissue removal. Clarifies that the deductible is waived for a screening colonoscopy even if a diagnosis is established as a result of a test or tissue is removed during the procedure.
Sec. 1307. Excluding clinical social worker services from coverage under the Medicare skilled nursing facility prospective payment system and consolidated payment. Removes clinical social worker services from coverage under the skilled nursing facility prospective payment system, which allows clinical social workers to bill separately for their services in the skilled nursing facility setting.
Sec. 1308. Coverage of marriage and family therapist services and mental health counselor services. Adds state-licensed or certified marriage and family therapists and mental health counselors as Medicare providers and pays them at the same rate as social workers.
Sec. 1309. Extension of physician fee schedule mental health add-on. Increases the payment rate for psychiatric services by 5% for two years, through the end of 2011.
Sec. 1310. Expanding access to vaccines. Transfers coverage from Medicare Part D to Medicare Part B for all Medicare-covered vaccines. Vaccines but for influenza will be paid for according to the average sales price methodology.
TITLE IV—QUALITY
SUBTITLE A—COMPARATIVE EFFECTIVENESS RESEARCH
Sec. 1401. Comparative effectiveness research. Establishes a Center for Comparative Effectiveness Research within the Agency for Healthcare Research and Quality (AHRQ) to conduct, support and synthesize research relevant to the comparative effectiveness of the full spectrum of health care items, services, and systems.
Establishes a public/private stakeholder commission known as the “Comparative Effectiveness Research Prepared by Committees on Energy and Commerce, Ways and Means, and Education and Labor July 14, 2009 20
Commission” to oversee the Center, determine national priorities for research, identify research methods and standards of evidence, support forums to increase stakeholder feedback, appoint advisory panels on specific national priorities to advise the center on research questions and methods, and make recommendations for the dissemination of findings.
The 17-member Commission will be appointed by the Secretary with input from the Comptroller General and the Institute of Medicine and will include the Director of AHRQ, the Chief Medical Officer of CMS and stakeholders including clinicians, patients, researchers, third-party payers and consumers. Clinical perspective advisory panels will provide advice on specific research questions, methods and gaps in evidence in terms of clinical outcomes for priorities identified by the Commission in order to ensure that the research is clinically relevant. The Commission and the advisory panels it appoints will be subject to strict conflict of interest requirements. The Center and the Commission are prohibited from mandating coverage, reimbursement or other policies to any public or private payer. The Center and the research it conducts are funded out of the Comparative Effectiveness Research Trust Fund (CERTF) which will receive contributions from Medicare and private health insurance plans.
SUBTITLE B -- NURSING HOME TRANSPARENCY
PART 1 - Improving Transparency of Information on Skilled Nursing Facilities and Nursing Facilities
Sec. 1411. Required disclosure of ownership and additional disclosable parties information. Requires skilled nursing facilities (SNFs) and nursing facilities (NFs) to disclose information on ownership and facility organizational structure and requires the Secretary to develop a standardized format for such information within two years of date of enactment.
Sec. 1412. Accountability Requirements. Requires SNFs and NFs to operate compliance and ethics programs on or after the date that is 36 months after enactment. Directs the Secretary to develop a quality assurance and improvement program for SNFs and NFs no later than December 31, 2011.
Sec. 1413. Nursing home compare Medicare website. Directs the Secretary to include additional information on the Nursing Home Compare website, include staffing data based on information collected under section 1416 and summary information on complaints filed for SNFs and NFs.
Sec. 1414. Reporting of expenditures. Requires SNFs to separately report expenditures for direct care services, indirect care services, capital assets, and administrative costs on cost reports for cost reporting periods beginning on or after two years after date of enactment.
Sec. 1415. Standardized complaint form. Directs the Secretary to create a standardized complaint form and requires states to establish complain resolution processes. Provides whistleblower protection for employees who complain in good faith about the quality of care or services at a facility.
Sec. 1416. Ensuring staffing accountability. Requires the Secretary to develop a program for facilities to report staffing information in a uniform format based on payroll data, including information on agency or contract staff. Effective two years after date of enactment.
PART 2 – Targeting Enforcement
Sec. 1421. Civil money penalties. Authorizes the Secretary to impose civil monetary penalties for a deficiency that results in the direct proximate cause of death of a resident. Provides additional authority to the Secretary Prepared by Committees on Energy and Commerce, Ways and Means, and Education and Labor July 14, 2009 21
to raise or adjust CMPs under certain circumstances.
Sec. 1422. National independent monitor pilot program. Directs the Secretary to establish, in consultation with the HHS Inspector General, a pilot program to develop, test and implement use of an independent monitor to oversee interstate and large intrastate chains of SNFs and NFs.
Sec. 1423. Notification of facility closure. Requires the administrator of a facility that is preparing to close to provide written notification to residents and other parties and to prepare a plan for closing that ensure safe transfer of residents to new facilities.
PART 3 – Improving Staff Training
Sec. 1431. Dementia and abuse prevention training. Requires SNFs and NFs to conduct dementia management and abuse prevention training prior to employment and, if the Secretary determines appropriate, as part of ongoing training.
Sec. 1432. Study and report on training required for certified nurse aides and supervisory staff. Requires the Secretary to study the content of training requirements for certified nurse aids and supervisory staff of SNFs and NFs and to submit a report with recommendations on content and length of training to Congress within two years of date of enactment.
SUBTITLE C—QUALITY MEASUREMENTS
Sec. 1441. Establishment of national priorities for quality improvement. Directs the Secretary to establish national priorities for performance improvement, incorporating recommendations from outside entities. These priorities should reflect areas that contribute to a large burden of disease, have high potential to decrease morbidity and mortality and improve performance, address health disparities, and have the potential to produce the most rapid change based on current evidence.
Sec. 1442. Development of new quality measures; GAO evaluation of data collection process for quality measurement. Based on the national priorities for performance improvement established in this part, the Secretary shall develop, test and update new patient-centered and population-based quality measures for the assessment of health care services. Provides $25 million for this section. Instructs GAO to periodically evaluate the program to determine the effectiveness of the quality measures and the extent to which these measures can result in quality improvement and cost savings, and report to Congress.
Sec. 1443. Multi-stakeholder pre-rulemaking input into selection of quality measures. Provides for stakeholder input into the use of quality measures for purposes of payment. Each year, the Secretary shall make public a list of measures being considered for usage for payment systems. Under a transparent process, a consensus-based entity shall convene a multi-stakeholder group to provide recommendations for the usage of measures in a timely fashion, and the Secretary shall consider these recommendations.
Sec. 1444. Application of quality measures. Ensures that quality measures selected by the Secretary are endorsed by a consensus-based entity with a contract with the Secretary under section 1890, except in certain circumstances, e.g., the measure has not been evaluated and no comparable endorsed measure exists. If the Secretary chooses to use a measure that the entity considers but does not endorse, the Secretary shall include the rationale for continued use in rulemaking. Applies this standard to inpatient hospitals, physician services, and renal dialysis services. Prepared by Committees on Energy and Commerce, Ways and Means, and Education and Labor July 14, 2009 22
Sec. 1445. Consensus-based entity funding. For the consensus based entity with a contract under section 1890, the contract amount is increased to $12 million for the years 2010-2012.
SUBTITLE D—PHYSICIAN PAYMENTS SUNSHINE PROVISION
Sec. 1451. Reports on financial relationships between manufacturers and distributors of covered drugs, devices, biologicals, or medical supplies under Medicare, Medicaid, or CHIP and physicians and other health care entities and between physicians and other health care entities. Requires manufacturers or distributors to electronically report to the HHS OIG any payments or other transfers of value above a $5 de minimis made to a “covered recipient” and requires hospitals or entities that bill Medicare to report any ownership share by a physician. Failure to report is subject to civil monetary penalties from $1000 to $10,000 (max $150,000 per year) per payment, transfer of value, or investment interest not disclosed; penalties for knowing failure to report range from $10,000 to $100,000 per payment, not to exceed $1,000,000 in one year or .1% of revenues for that year.
SUBTITLE E – PUBLIC REPORTING ON HEALTHCARE-ASSOCIATED INFECTIONS
Sec. 1461. Requirement for public reporting by hospitals and ambulatory surgical centers on healthcare-associated infections. Requires hospitals and ambulatory surgical centers to report public health information on healthcare-associated infections to the Centers for Disease Control and Prevention.
TITLE V—MEDICARE GRADUATE MEDICAL EDUCATION
Sec. 1501. Distribution of unused residency positions. Directs the Secretary to redistribute residency positions that have been unfilled for the prior 3 cost reports and direct those slots for training of primary care physicians. Special preference will be given to programs that saw a reduction in their slots under this section, have formal arrangements to train residents in ambulatory settings or shortage areas, operate three-year primary care residency programs, currently operate residency programs over their cap, or are located in states with a low physician resident to general population ratio.
Sec. 1502. Increasing training in nonprovider settings. Modifies rules governing when hospitals can receive indirect medical education (IME) and direct graduate medical education (DGME) funding for residents who train in a non-provider setting so that any time spent by the resident in a non-provider setting shall be counted toward DGME and IME if the hospital incurs the costs of the stipends and fringe benefits. Directs the HHS Office of the Inspector General to study the level of training in non-provider settings. Establishes a demonstration project whereby approved teaching health centers (which may be non-provider settings such as rural health clinics and federally qualified health centers) may become a primary care training program and receive DGME and the DGME of its contracting hospitals for such residents.
Sec. 1503. Rules for counting resident time for didactic and scholarly activities and other activities. Modifies current law to allow hospitals to count resident time spent in didactic conferences toward IME costs in the provider (i.e., hospital) setting and toward DGME in the non-provider (i.e., non-hospital) setting.
Sec. 1504. Preservation of resident cap positions from closed hospitals. Directs the Secretary to redistribute medical residency slots from a hospital that closes on or after the date that is 2 years before the enactment of this clause to other hospitals in the same State, taking into account recommendations by the senior health official in the State. Such recommendations shall be submitted not later than 180 days after the date of the Prepared by Committees on Energy and Commerce, Ways and Means, and Education and Labor July 14, 2009 23
hospital closure involved, or in the case of a hospital that closed within two years of date of enactment, not later than 180 days after enactment.
Sec. 1505. Improving accountability for approved medical residency training. Sets goals for approved medical residency training programs by setting broad goal that include: (1) training to work in non-acute traditional settings; (2) coordination of care within and across settings; (3) understanding cost and value of diagnostic and treatment options; (4) working in multi-disciplinary teams; (5) participating in quality improvement projects; and, (6) demonstrating meaningful use of electronic health records in improving quality of patient care. Directs the GAO to evaluate the extent to which residency training programs are meeting the goals cited.
TITLE VI—PROGRAM INTEGRITY
SUBTITLE A—INCREASED FUNDING TO FIGHT WASTE, FRAUD, AND ABUSE
Sec. 1601. Increased funding and flexibility to fight fraud and abuse. Provides an additional $100 million annually in funding for the Health Care Fraud and Abuse Control Fund. Allows expanded use of funds by the CMS Medicare Integrity Program.
SUBTITLE B—ENHANCED PENALTIES FOR FRAUD AND ABUSE
Sec. 1611. Enhanced penalties for false statements on provider or supplier enrollment applications. Establishes civil monetary penalties of $50,000 per violation for providers, suppliers, Medicare Advantage, or Part D plans that knowingly make false statements or misrepresentation of material fact on enrollment applications for any federal health care program.
Sec. 1612. Enhanced penalties for submission of false statements material to a false claim. Establishes civil monetary penalties of $50,000 per violation for the knowing submission of false statements or misrepresentation of material fact in information submitted to support a claim for payment.
Sec. 1613. Enhanced penalties for delaying inspections. Establishes civil monetary penalties of $15,000 per day for delaying or refusing to grant timely access to the HHS OIG for audits, investigations, or evaluations.
Sec. 1614. Enhanced hospice program safeguards. Requires the Secretary to take immediate action to remedy any violation in a hospice facility that jeopardizes the health and safety of patients. Allows intermediate sanctions such as civil monetary penalties, suspension or partial payments, appointment of temporary management to oversee operation, plans of correction, or in-service staff training, for violations that do not endanger patients.
Sec. 1615. Enhanced penalties for individuals excluded from program participation. Establishes civil monetary penalties of $50,000 per violation for any person who orders or prescribes an item or service while excluded from a federal health care program if that person knows or should know that the program from which they are excluded will be billed for the item or service.
Sec. 1616. Enhanced penalties for provision of false information by Medicare Advantage and Part D plans. Establishes civil monetary penalties for misrepresentations or false information provided by an MA or Part D plan of up to three times the payment made to the plan or plan sponsor based on the misrepresentation or false information. Prepared by Committees on Energy and Commerce, Ways and Means, and Education and Labor July 14, 2009 24
Sec. 1617. Enhanced penalties for Medicare Advantage and Part D marketing violations. Establishes new criteria for determining marketing violations, and provides greater discretion to the Secretary or the CMS Administrator to impose penalties on Medicare Advantage and Part D plans that violate marketing requirements.
Sec. 1618. Enhanced penalties for obstruction of program audits. Allows for permissive exclusion of individuals or entities found to have obstructed an investigation into or audit of fraud.
Section 1619. Exclusion of certain individuals and entities from participation in Medicare and State Health Care Programs. Clarifies definition of exclusion of Medicare and Medicaid entities under section 1128 to mean exclusion from all federal health care programs.
SUBTITLE C – ENHANCED PROGRAM AND PROVIDER PROTECTIONS
Sec. 1631. Enhanced CMS program protection authority. Allows the Secretary to designate program areas of “significant risk” in which enhanced oversight can be applied to prohibit waste, fraud, and abuse. Calls for the Secretary to establish screening procedures for new providers, which may include: licensing board checks, screening lists of those excluded from other federal or state health programs, background checks, unannounced pre-enrollment or other site visits. Allows for enhanced oversight periods (to include site visits, prepayment review, enhanced claims review) for new providers or suppliers in these areas of high risk, and allows for a moratorium on enrollment of new suppliers or service providers in areas of high risk if the Secretary determines that there would be no adverse impact on beneficiaries.
Sec. 1632. Enhanced Medicare, Medicaid, and CHIP program disclosure requirements relating to previous affiliations. Requires new suppliers or providers of services to disclose affiliations within the past 10 years with any provider or supplier that has uncollected debt or has been suspended from Medicare, Medicaid, or CHIP.
Sec. 1633. Required inclusion of payment modifier for certain evaluation and management services. Establishes a “payment modifier” when service results in ordering additional services, prescription drugs, or durable medical equipment, in order to assist efforts to identify fraud.
Sec. 1634. Evaluations and reports required under Medicare Integrity Program. Requires MIP contractors to conduct periodic evaluations and report on the effectiveness of their activities.
Sec. 1635. Require providers and suppliers to adopt programs to reduce waste, fraud, and abuse. Requires all providers and suppliers (other than physicians) to adopt compliance programs and authorizes the Secretary to disenroll a supplier or impose civil monetary penalties or other intermediate sanctions for failure to establish such a program.
Sec. 1636. Maximum period for submission of Medicare claims reduced to not more than 12 months. Reduces the period for Medicare claims submission in order to reduce “gaming” of payment systems.
Sec. 1637. Physicians who order durable medical equipment or home health services required to be Medicare enrolled physicians or eligible professionals. Requires that physicians ordering durable medical equipment or home health services billable to Medicare must be Medicare-enrolled physicians. Allows the Secretary discretion to expand this requirement to other areas if such an extension would help reduce waste, fraud, and abuse. Prepared by Committees on Energy and Commerce, Ways and Means, and Education and Labor July 14, 2009 25
Sec. 1638. Requirement for physicians to provide documentation on referrals to programs at high risk of waste and abuse. Requires physician or supplier to maintain and provide upon request of the Secretary, documentation related to the ordering of durable medical equipment, home health services, or other areas of high risk.
Sec. 1639. Face to face encounter with patient required before physicians may certify eligibility for home health services or durable medical equipment under Medicare. Requires a face-to-face (or telemedicine) encounter with a patient before a physician may certify home health services or durable medical equipment. Allows the Secretary discretion to expand this requirement to other areas if such an extension would help reduce waste, fraud, and abuse.
Sec. 1640. Extension of testimonial subpoena authority to program exclusion investigations. Clarifies that the Secretary (or designee) may subpoena documents or testimony for purposes of a program exclusion investigation.
Sec. 1641. Required repayments of Medicare and Medicaid overpayments. Clarifies that when a provider or supplier, MA or Part D plan (but not a beneficiary) becomes aware of a Medicare or Medicaid overpayment, it must be reported and returned within 60 days.
Sec. 1642. Expanded application of hardship waivers for OIG exclusions to beneficiaries of any Federal health care program. Clarifies that the hardship waiver provision applies to “beneficiaries,” as defined elsewhere in the title.
Sec. 1643. Access to certain information on renal dialysis facilities. Provides authority for the OIG to access ownership or compensation agreements between renal dialysis facilities and physicians.
Section 1644. Billing agents, clearinghouses, or other alternate payees required to register under Medicare and Medicaid. Requires billing agents, clearinghouses, or other alternate payees required to be registered under Medicare and Medicaid in a form and manner to be specified by the Secretary.
Section 1645. Conforming civil monetary penalties to False Claims Act amendments. Conforms key definitions and criteria regarding civil monetary penalty authority under the Social Security Act to match those contained in the 2009 False Claims Act amendments.
SUBTITLE D – ACCESS TO INFORMATION NEEDED TO PREVENT FRAUD, WASTE AND ABUSE
Sec. 1651. Access to information necessary to identify fraud, waste, and abuse. Clarifies that the Department of Justice, working with OIG in consultation with CMS, has access to Medicare and Medicaid claims and payment databases, in a manner that complies with privacy and security laws, including HIPAA.
Sec. 1652. Elimination of duplication between the Healthcare Integrity and Protection Data Bank and the National Practitioner Data Bank. Directs the Secretary to reduce duplication between the two databases. Allows access to the National Practitioner Databank by the VA.
Sec. 1653. Compliance with HIPAA privacy and security standards. Clarifies that HIPAA applies to the subtitle and all amendments. Prepared by Committees on Energy and Commerce, Ways and Means, and Education and Labor July 14, 2009 26
TITLE VII—MEDICAID AND CHIP
SUBTITLE A—MEDICAID AND HEALTH REFORM
Sec. 1701. Eligibility for individuals with income below 133-1/3 percent of the Federal poverty level. (a) Requires State Medicaid programs to cover non-disabled, childless adults under age 65 with income at or below 133% of FPL ($14,400 per year for an individual). The federal government would pay 100% of the costs of Medicaid coverage for this population. Effective in 2013.
(b) Requires State Medicaid programs to cover parents and individuals with disabilities under age 65 with income at or below 133% of FPL ($29,300 per year for a family of 4). The federal government would pay 100% of the costs of Medicaid coverage for individuals in these categories with incomes between the levels in effect in the state as of June 16, 2009 and 133% of FPL. Effective in 2013.
(c) Requires State Medicaid programs to cover newborns up to the first 60 days of life who do not otherwise have acceptable coverage upon birth. The federal government will pay 100% of the costs of Medicaid coverage for these newborns. Effective in 2013.
Sec. 1702. Requirements and special rules for certain Medicaid eligible individuals. Requires State Medicaid programs to enter into a memorandum of understanding with the Health Choices Commissioner to coordinate enrollment of low-income individuals into the Exchange or Medicaid as appropriate.
Sec. 1703. CHIP and Medicaid maintenance of effort. (a) Prohibits States from adopting eligibility standards, methodologies, or procedures in their CHIP programs that are more restrictive than those in effect as of June 16, 2009. Maintenance of effort ends with the opening of the Health Insurance Exchange in 2013 or, if later, the date on which (1) the Health Choices Commissioner determines that the Exchange has the capacity to support CHIP enrollees and (2) the Secretary of HHS determines that procedures are in effect to ensure timely transition without interruption of coverage.
(b) Prohibits States from adopting eligibility standards, methodologies, or procedures in their Medicaid programs more restrictive than those in effect as of June 16, 2009.
Sec. 1704. Reduction in Medicaid DSH. Requires the Secretary of HHS to report to Congress by January 1, 2016 on the continuing role of Medicaid DSH as health reform is implemented. Directs the Secretary to reduce Medicaid DSH payments to States by a total of $10 billion ($1.5 billion in FY 2017, $2.5 billion in FY 2018, and $6.0 billion in FY 2019) using a methodology that focuses on the uninsurance rate in each State and the amount of uncompensated care provided by hospitals.
Sec . 1705. Expanded outstationing. Requires State Medicaid programs to allow adults to apply for Medicaid coverage at DSH hospitals, FQHCs, and other locations than welfare offices (requirement already applies to pregnant women and children). Effective July 1, 2010.
SUBTITLE B — PREVENTION
Sec. 1711. Required coverage of preventive services. Requires State Medicaid programs to cover preventive services not otherwise covered that the Secretary determines are recommended by the U.S. Preventive Services Task Force and appropriate for Medicaid beneficiaries. Effective July 1, 2010.
Sec. 1712. Tobacco cessation. Prohibits State Medicaid programs from excluding tobacco cessation products from coverage. Effective July 1, 2010. Prepared by Committees on Energy and Commerce, Ways and Means, and Education and Labor July 14, 2009 27
Sec. 1713. Optional coverage of nurse home visitation services. Allows State Medicaid programs to cover home visits by trained nurses to families with a first-time pregnant woman or child under 2 eligible for Medicaid. Effective January 1, 2010.
Sec. 1714. State eligibility option for family planning services. Allows State Medicaid programs to cover low-income women who are not pregnant for family planning services and supplies without obtaining a waiver. Allows State Medicaid programs to cover such services for such women during a presumptive eligibility period. Effective on enactment.
SUBTITLE C — ACCESS
Sec. 1721. Payments to primary care practitioners. Requires that State Medicaid programs reimburse for primary care services furnished by physicians and other practitioners at no less than 80% of Medicare rates in 2010, 90% in 2011, and 100% in 2012 and after. Maintains the Medicare payment differentials between physicians and other practitioners. The federal government would pay 100% of the incremental costs attributable to this requirement.
Sec. 1722. Medical home pilot program. Establishes a 5-year pilot program to test the medical home concept with high-need Medicaid beneficiaries. Including medically fragile children and high-risk pregnant women. The federal government would match costs of community care workers at 90% for the first two years and 75% for the next 3 years, up to a total of $1.235 billion.
Sec. 1723. Translation or interpretation services. Provides a 75 % federal matching rate for the costs of translation or interpretation services for Medicaid-eligible adults for whom English is not the primary language. Effective January 1, 2010.
Sec. 1724. Optional coverage for freestanding birth center services. Allows State Medicaid programs to cover services provided by birth centers that are not hospitals. Effective on enactment.
Sec. 1725. Inclusion of public health clinics under the vaccines for children program. Allows children who do not have insurance coverage for immunizations to receive vaccines through the VFC program at a public health clinic. Effective upon enactment.
SUBTITLE D – COVERAGE
Sec. 1731. Optional Medicaid coverage of low-income HIV-infected individuals. Allows State Medicaid programs to cover individuals with HIV with incomes and resources below state eligibility levels for individuals with disabilities. The costs of coverage of such individuals would be matched at an enhanced rate. Effective on enactment. Sunsets on January 1, 2013.
Sec. 1732. Extending transitional Medicaid Assistance (TMA). Extends the 1-year transitional Medicaid coverage for families leaving cash assistance to work from December 31, 2010 through December 31, 2012.
Sec. 1733. Requirement of 12-month continuous coverage under certain CHIP programs. Requires stand-alone CHIP programs to provide 12-month continuous eligibility for all enrollees with incomes below 200% FPL. Effective January 1, 2010. Prepared by Committees on Energy and Commerce, Ways and Means, and Education and Labor July 14, 2009 28
SUBTITLE E – FINANCING
Sec. 1741. Payments to pharmacists. Extends current rules for Medicaid payments to pharmacists for multiple source drugs through December 31, 2010. Thereafter, limits Medicaid payments for such drugs to 130% of the weighted average manufacturer price (AMP). Redefines AMP to exclude certain price concessions, including those provided to pharmacy benefit managers, not passed through to retail pharmacies.
Sec. 1742. Prescription drug rebates. Increases the minimum manufacturer rebate for brand-name drugs purchased by State Medicaid programs from 15.1% of average manufacturer price to 22.1% of average manufacturer price, and applies the additional Medicaid rebate to new formulations of brand-name drugs. Effective January 1, 2010.
Sec. 1743. Extension of prescription drug discounts to enrollees of Medicaid managed care organizations. Requires manufacturers to pay rebates to State Medicaid programs for drugs dispensed to program beneficiaries enrolled in Medicaid managed care organizations. Effective July 1, 2010.
Sec. 1744. Payments for graduate medical education. Clarifies that State Medicaid programs may receive federal matching payments for the costs of graduate medical education. Directs the Secretary to specify program goals for the use of such funds based on workforce needs. Effective upon enactment.
SUBTITLE F – WASTE, FRAUD, AND ABUSE
Sec. 1751. Health-care acquired conditions. Prohibits federal matching payments for the cost of health care acquired conditions that are determined to be non-covered services for Medicare purposes. Effective January 1, 2010.
Sec. 1752. Evaluations and reports required under Medicaid Integrity Program. Requires Medicaid Integrity Program contractors to submit to the Secretary an annual report on integrity activities. Effective on enactment.
Sec. 1753. Require providers and suppliers to adopt programs to reduce waste, fraud, and abuse. Requires providers and suppliers participating in Medicaid (other than physicians and nursing facilities) to establish compliance programs. Effective on enactment.
Sec. 1754. Overpayments. Allows State Medicaid programs up to 1 year to return the federal share of overpayments to providers due to fraud. Effective on enactment.
Sec. 1755. Managed Care Organizations. Limits Medicaid MCO spending on administration, marketing, and distributions to shareholders to no more than 15% of Medicaid premium revenues. Effective July 1, 2010.
Sec. 1756. Termination of provider participation under Medicaid and CHIP if terminated under Medicare or other State plan or child health plan. Requires State Medicaid and CHIP programs to terminate the participation of entities or individuals if the entity or individual is terminated under Medicare, any other state Medicaid program, or any other CHIP program. Effective January 1, 2011.
Sec. 1757. Medicaid and CHIP exclusion from participation relating to certain ownership, control, and management affiliations. Requires State Medicaid and CHIP programs to exclude individuals or entities from participation if the individual or entity owns, controls, or manages an entity has unpaid overpayments or is suspended or excluded from participation. Effective January 1, 2011. Prepared by Committees on Energy and Commerce, Ways and Means, and Education and Labor July 14, 2009 29
Sec. 1758. Requirement to report expanded set of data elements under MMIS to detect fraud and abuse. Requires State Medicaid programs to include in their Management Information Systems reports to the Secretary data elements necessary for the detection of waste, fraud, and abuse. Effective on enactment.
Sec. 1759. Registration of alternate payees. Requires agents, clearinghouses, or another alternate payees that submit claims on behalf of a health care provider to register with the State and the Secretary. Denies payment for any claims submitted by an unregistered alternate payee. Effective January 1, 2012.
Sec. 1760. Denial of payments for litigation-related misconduct. Prohibits federal matching payments for costs in litigation costs in which a court imposes sanctions for litigation-related misconduct. Effective date: January 1, 2010.
SUBTITLE G – PUERTO RICO AND THE TERRITORIES
Sec.1771. Puerto Rico and Territories. Provides additional federal Medicaid matching payments to Puerto Rico and the territories totaling $10.350 billion over the period 2011 through 2019.
SUBTITLE H —MISCELLANEOUS
Sec.1781. Technical corrections. Makes technical corrections relating to the administration of the low-income subsidy program under Medicaid Part D, CHIPRA, sections 1905 and 1115 of the Social Security Act.
Sec. 1782. Extension of QI program. Eliminates the funding limitation and extends for two years (through December 2012) the qualified individuals program to assist low-income Medicare beneficiaries with paying Medicare premiums.
TITLE VIII – REVENUE-RELATED PROVISIONS
Sec. 1801. Disclosures to facilitate identification of individuals likely to be ineligible for the low-income assistance under the Medicare prescription drug program to assist Social Security Administration’s outreach to eligible individuals. Authorizes the IRS to disclose to SSA certain taxpayer return information to assist SSA in its outreach program to identify individuals who are eligible for Medicare Part D assistance.
Sec. 1802. Comparative Effectiveness Research Trust Fund; financing for Trust Fund. Establishes the trust fund for the comparative effectiveness research program. Also establishes a fee that is assessed on private insurance on the basis of the number of insured individuals to fund the research program.
TITLE IX – MISCELLANEOUS PROVISIONS
Sec. 1901. Repeal of trigger provision. Repeals Subtitle A of Title VIII of the Medicare Prescription Drug, Improvement and Modernization act, commonly referred to as the “45% trigger”.
Sec. 1902. Repeal of comparative cost adjustment (CCA) program. Repeals section 1860-1 of the Social Security Act, as added by section 241(a) of the Medicare, Prescription Drug, Improvement and Modernization Act of 2003, commonly referred to as the “premium support demonstration project.” Prepared by Committees on Energy and Commerce, Ways and Means, and Education and Labor July 14, 2009 30
Sec. 1903. Extension of gainsharing demonstration. Extends Gainsharing Demonstration of the Deficit Reduction Act of 2005 from December 31, 2009 to September 30, 2011.
Sec. 1904. Grants to States for quality home visitation programs for families with young children and families expecting children. Provides grants to States to support voluntary, evidence-based home visitation programs for pregnant women and for families with pre-school age children in order to improve the well-being, health and development of children.
Sec. 1905. Improved coordination and protection for dual eligibles. Requires CMS to establish a dedicated office to improve coordination of benefits and other policies for beneficiaries dually eligible for Medicare and Medicaid.
DIVISION C – PUBLIC HEALTH AND WORKFORCE DEVELOPMENT
Sec. 2001. Table of Contents; References.
Sec. 2002. Public health investment fund. Establishes the Public Health Investment Fund and deposits a total of $89 billion for use over the next ten years (FY 2010 – FY 2019). These funds are authorized to be appropriated by the Committee on Appropriations for activities in this Division (described below) and are over and above the level of appropriations provided for these activities for FY 2008.
TITLE I – COMMUNITY HEALTH CENTERS
Sec. 2101. Increased funding. Authorizes an additional $38 billion for use over the next ten years (FY 2010 – FY 2019) for community health centers to be appropriated from the Public Health Investment Fund (under Sec. 2002). (Such funds are over and above the level of appropriations provided for FY 2008.)
TITLE II – WORKFORCE
SUBTITLE A – PRIMARY CARE WORKFORCE
PART 1 – National Health Service Corps
Sec. 2201. National Health Service Corps. Increases loan repayment benefits for each Corps member to a maximum of $50,000 per year. Allows fulfillment of Corps service obligation through part-time service as well as through clinical teaching (for up to 20% of the period of obligated service).
Sec. 2202. Authorization of appropriations. Authorizes an additional $3.9 billion for FY 2010 through FY 2019 for the National Health Service Corps to be appropriated from the Public Health Investment Fund (under Sec. 2002). (Such sums are over and above the level of appropriations provided for FY 2008.)
PART 2 – Promotion of Primary Care and Dentistry
Sec. 2211. Frontline health providers. Establishes a loan repayment program at HRSA to address health care needs in geographic areas (“health professional needs areas”) not currently recognized as health professional Prepared by Committees on Energy and Commerce, Ways and Means, and Education and Labor July 14, 2009 31
shortage areas. Physicians and other health professionals that do not qualify to participate in the National Health Service Corps are eligible for this program.
Sec. 2212. Primary care student loan funds. Modifies an existing student loan program to make it more attractive for students to pursue careers in primary care by reducing loan interest rate to 2% below otherwise available interest rates and provides for penalties if primary care service requirements are not met.
Sec. 2213. Training in family medicine, general internal medicine, general pediatrics, geriatrics, and physician assistantship. Provides funding to support primary care training programs and build academic capacity in primary care.
Sec. 2214. Training of medical residents in community-based settings. Establishes a program to provide support for the development and operation of training programs for medical residents in community-based settings such as community health centers.
Sec. 2215. Training for general, pediatric, and public health dentists and dental hygienists. Provides funding to support training programs for general, pediatric, and public health dentists and dental hygienists, including faculty loan repayment benefits.
Sec. 2216. Authorization of appropriations. Authorizes an additional $3 billion for FY 2010 through FY 2019 for various primary care programs to be appropriated from the Public Health Investment Fund (under Sec. 2002) (Such funds are over and above the level of appropriations provided for FY 2008.)
SUBTITLE B – NURSING WORKFORCE
Sec. 2221. Amendments to Public Health Service Act. Makes a number of changes in nursing programs including increasing loan repayment benefits for nursing students and faculty; removing the cap on awards for nursing students pursuing a doctoral degree; and clarifying that nurse-managed health centers are eligible for grant awards. Authorizes an additional $1.45 billion for FY 2010 through FY 2019 for various nursing programs to be appropriated from the Public Health Investment Fund (under Sec. 2002). (Such funds are over and above the level of appropriations provided for FY 2008.)
SUBTITLE C – PUBLIC HEALTH WORKFORCE
Sec. 2231. Public health workforce corps. Establishes a public health workforce corps at HRSA to address public health workforce shortages. Modeled on the National Health Service Corps, the program provides scholarship and loan repayment support for public health professionals serving in areas of need.
Sec. 2232. Enhancing the public health workforce. Provides funding to support public health training programs.
Sec. 2233. Public health training centers. Revises the goals for the public health training grant programs to comport with the Secretary’s new national prevention and wellness strategy (under Sec. 3121).
Sec. 2234. Preventive medicine and public health training grant program. Provides funding to support training grant programs for preventive medicine physicians. Prepared by Committees on Energy and Commerce, Ways and Means, and Education and Labor July 14, 2009 32
Sec. 2235. Authorization of appropriations. Authorizes an additional $600 million for FY 2010 through FY 2019 for various public health workforce programs to be appropriated from the Public Health Investment Fund (under Sec. 2002). (Such funds are over and above the level of appropriations provided for 2008.)
SUBTITLE D – ADAPTING WORKFORCE TO EVOLVING HEALTH SYSTEM NEEDS
PART 1 – Health Professions Training for Diversity
Sec. 2241. Scholarships for disadvantaged students, loan repayments and fellowships regarding faculty positions, and educational assistance in the health professions regarding individuals from disadvantaged backgrounds. Provides scholarship and loan repayment support for individuals from disadvantaged backgrounds serving in the health professions. Provides funding for the Health Careers Opportunities Program that supports health professions schools that recruit and train individuals from disadvantaged backgrounds.
Sec. 2242. Nursing workforce diversity grants. Clarifies requirements for the Secretary to consult with various nursing associations.
Sec. 2243. Coordination of diversity and cultural competency programs. Requires the Secretary to coordinate workforce diversity and cultural and linguistic competency activities to enhance effectiveness and avoid duplication of effort.
PART 2 – Interdisciplinary Training Programs
Sec. 2251. Cultural and linguistic competence training for health care professionals. Establishes a grant program at HRSA to promote cultural and linguistic competence of health care professionals.
Sec. 2252. Innovations in interdisciplinary care training. Establishes a grant program at HRSA to support the development and operation of interdisciplinary training programs for health professionals to improve coordination within and across health care settings, including training in medical home models and models that integrate physical, mental, or oral health services
PART 3 – Advisory Committee on Health Workforce Evaluation and Assessment
Sec. 2261. Health workforce evaluation and assessment. Creates an Advisory Committee on Health Workforce Evaluation and Assessment to assess the adequacy and appropriateness of the health workforce, and to make recommendations to the Secretary on federal workforce policies to ensure the health workforce is meeting the nation’s needs.
PART 4 – Health Workforce Assessment
Sec. 2271. Health workforce assessment. Requires the Secretary to collect data on the supply, diversity, and geographic distribution of the Nation’s health workforce, including individuals participating in various federal workforce programs.
PART 5 – Authorizing of Appropriations
Sec. 2281. Authorization of appropriations. Authorizes an additional $2.2 billion for FY 2010 through FY 2019 for various workforce programs (including Centers of Excellence) to be appropriated from the Public Health Prepared by Committees on Energy and Commerce, Ways and Means, and Education and Labor July 14, 2009 33
Investment Fund (under section 2002). (Such funds are over and above the level of appropriations provided in FY 2008.)
TITLE III – PREVENTION AND WELLNESS
Sec. 2301. Prevention and wellness. Amends the Public Health Service Act by establishing a new Title XXIII and creating 10 new sections – Sec. 3111, 3121, 3131, 3132, 3141, 3142, 3151, 3161, 3162, and 3171 (described below).
SUBTITLE A – PREVENTION AND WELLNESS TRUST
Sec. 3111. Prevention and wellness trust. Establishes a Prevention and Wellness Trust that authorizes appropriations from the Public Health Investment Fund (under Sec. 2002) of $35 billion from FY 2010 through FY 2019 to fund activities under Subtitle C (Prevention Task Forces), Subtitle D (Prevention and Wellness Research), Subtitle E (Delivery of Community-Based Prevention and Wellness Services) and Subtitle F (Core Public Health Infrastructure and Activities).
SUBTITLE B – NATIONAL PREVENTION AND WELLNESS STRATEGY
Sec. 3121. National prevention and wellness strategy. Requires the Secretary to submit a national strategy designed to improve the nation’s health through evidence-based clinical and community-based prevention and wellness activities within one year of enactment and at least every two years thereafter. The strategy must identify specific national goals and standards and establish national priorities for prevention and wellness activities.
SUBTITLE C – PREVENTION TASK FORCES
Sec. 3131. Task force on clinical preventive services. Converts the existing U.S. Preventive Services Task Force into the Task Force on Clinical Preventive Services. Staffed by AHRQ, this task force of non-governmental experts conducts evidence-based systemic reviews of data and literature to determine what clinical preventive services (e.g., preventive services delivered by traditional health care providers in clinical settings) are scientifically proven to be effective.
Sec. 3132. Task force on community preventive services. Codifies the existing Task Force on Community Preventive Services. Staffed by CDC, this task force of non-governmental experts conducts evidence-based systematic reviews of data and literature to determine what community preventive services (e.g., preventive services that are not “clinical preventive services” but are delivered by nontraditional providers in nontraditional settings) are scientifically proven to be effective.
SUBTITLE D—PREVENTION AND WELLNESS RESEARCH
Sec. 3141. Prevention and wellness research activity coordination. Directs the CDC and NIH directors to take into consideration the national strategy on prevention (under Sec. 3121), recommendations from the Task Force on Clinical Preventive Services (under Sec. 3131), and recommendations from the Task Force on Community Preventive Services (under Sec. 3132) in conducting or supporting research on prevention and wellness.
Sec. 3142. Community prevention and wellness research grants. Provides funding to CDC to support research on community preventive services. Prepared by Committees on Energy and Commerce, Ways and Means, and Education and Labor July 14, 2009 34
SUBTITLE E – DELIVERY OF COMMUNITY PREVENTION AND WELLNESS SERVICES
Sec. 3151. Community prevention and wellness services grants. Establishes a grant program at CDC to fund the delivery of evidence-based, community-based prevention and wellness services across the country. Eligible entities include state and local governments, nonprofits, and community partnerships representing Health Empowerment Zones. At least 50% of these funds must be spent on implementing services whose primary purpose is to reduce health disparities.
SUBTITLE F – CORE PUBLIC HEALTH INFRASTRUCTURE
Sec. 3161. Core public health infrastructure for State, local, and Tribal Health Departments. Establishes a grant program at CDC to improve core public health infrastructure at the state, local, and tribal level. Includes formula grants to state health departments and competitive grants for state, local or tribal health departments. Establishes a public health accreditation program for health departments and laboratories.
Sec. 3162. Core public health infrastructure and activities for CDC. Authorizes additional funds for CDC to address unmet and emerging public health needs.
SUBTITLE G—GENERAL PROVISIONS
Sec. 3171. Definitions. Defines various terms for the purposes of the new Title XXXI of the Public Health Service Act. Provides for transitioning the existing U.S. Preventive Services Task Force into the new Task Force on Clinical Preventive Services and for transitioning the existing Task Force on Community Preventive Services into the new Task Force on Community Preventive Services.
TITLE IV—QUALITY AND SURVEILLANCE
Sec. 2401. Implementation of best practices in the delivery of health care. Creates a Center for Quality Improvement at the Agency for Healthcare Research and Quality to focus on quality improvement. The center will prioritize quality improvement activities, identify existing best practices, develop innovative new practices, evaluate these practices and assist entities to implement these best practices.
Sec. 2402. Assistant secretary for health information. Establishes the position of Assistant Secretary for Health Information to provide health information on key health indicators; to facilitate better data sharing; and to develop standards for the collection of data on specified populations and subpopulations.
Sec. 2403. Authorization of appropriations. Authorizes an additional $3.1 billion for FY 2010 through FY 2019 for quality improvement and data-related activities to be appropriated from the Public Health Investment Fund (under Sec. 2002). (Such funds are over and above the level of appropriations provided for FY 2008.)
TITLE V – OTHER PROVISIONS
SUBTITLE A – DRUG DISCOUNT FOR RURAL AND OTHER HOSPITALS
Sec. 2501. Expanded participation in 340B program. Extends the section 340B discounts for certain rural and other hospitals to inpatient as well as outpatient drugs.

Thank you for reading. The full length conceptual version of the bill can be found via the following link: http://energycommerce.house.gov/index.php?option=com_content&view=article&id=1687:health-care-reform&catid=156:reports&Itemid=55

I thank you for reading. You are welcome to comment on this post and all of our posts in the General Discussions area of our forums at http://www.practicalmanifestations.freeforums.org/

Rushing the Health Care Reform Bill

2009-09-26T05:26:00.000-07:00

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Why are we trying to push trillion dollar bills through Congress? I say push because we do not have an actual bill, but rather just a concept. We also have not been given a dollar amount, as the full breadth of the cost will not be understood until it is passed, or so we are told. The concept and summary of the bill are available online for public view via the links below.

Just the concept appears to be over 1000 pages long which means the bill itself could be many times that size. I don’t know about you, but if I read a 1000 page book, there are going to be gaps in the information I will retain or even grasp, for that matter. To me, these bills should be 1000 pages at maximum, not just the concept, the entire bill. Perhaps bills for lesser amounts could be combined and could include things like a stimulus for the wooden arrow makers, but not a trillion-dollar bill, and not on something as important as health care reform.

And to take a vote on a concept is absolutely ridiculous. Similar to the previous stimulus packages, there is a big rush to get them passed. Were they effective? Well every dollar we pump into the economy is effective to some degree. Did we avert disaster? At a national unemployment rate of 12%, I would say we have not escaped the disaster with our efforts. Perhaps it would have been more disastrous had we done nothing, or maybe it would have been less disastrous had we done more, who is to say?

One thing for sure is that a concise and well-thought-out strategy for how we are going to improve the economy was never explained to the people of America. We were the source of the funding for the decisions, yet were kept in the dark as to how the money would be spent and how our contribution was going to improve the economy. We signed the checks and later found out that at least some of the money was spent on frivolous things by both companies and government. The managers of these companies made big bucks gambling the health of their respective businesses. After the money was made, the market turned south and the integrity of the businesses was in jeopardy. We send each of them a check to bail them out and do not require a business plan for recovery, nor progress reports to track them. If we had a business plan and progress reports, we would be able to judge whether or not sending them a second and third check made business sense. Instead the same managers that ran the companies into the ground the first time are given money to try it again.

I got off on a tangent but all this leads to where we are today, voting on another rush stimulus bill. Similar to the previous bills, we have little insight into what the plan is and how it will strengthen the economy. Just like the first bill for 700 Billion for the banks, we are told it needs to happen immediately. I believe in expediting things, but I also believe in doing things right and doing them once. We find ourselves adopting new strategies daily to try to stimulate the economy. Each strategy has a massive impact on our nation, completely altering the laws that made us great in the first place. If I was in the judicial system, I am sure I would have a hard time keeping up with all the changes. I I think change in general is good, change is an intrinsic part of growth. However the public needs to be made aware of what the change is and what the overall plan is.

Ohio Republican and Minority Leader John Boehner: "The American people are angry that Speaker Pelosi didn't allow the public and their elected representatives to read the trillion-dollar 'stimulus' bill or the national energy tax before they were rammed through the House…Congress can, and must, do better."

Is the heath care bill good for us or not? I don’t know. I haven’t heard a clear and concise plan on what it is, how it will affect Americans, how the bill is going to improve the economy, and how we are going to track the improvement so we know what the next move is. By tracking our improvement with a sort of business model of the economy, we recognize if we are moving in the right direction or wrong direction and if our model for making decisions is accurate or inaccurate and needs to be modified. If it needs to be modified, how does it need to be modified and can we get hints from the previous models we were working with? To me, without a plan and methods to track progress, we are just guessing at what the answer is. I have faith that we will come to the right answer in time, we always do. It is just a question of how much time we are going to need to sacrifice to get there.

Source for the Conceptual Version and the Summary of the Conceptual Version of the Bill:
http://energycommerce.house.gov/index.php?option=com_content&view=article&id=1687:health-care-reform&catid=156:reports&Itemid=55

In the News:
http://www.washingtontimes.com/news/2009/sep/23/house-lawmakers-aim-push-back-against-hasty-votes/print/

http://washingtontimes.com/news/2009/sep/24/gop-seeks-72-hour-window-to-read-bills/?feat=home_headlines

You are welcome to comment on this post and all of our posts in the General Discussions area of our forums at http://www.practicalmanifestations.freeforums.org/

Singing the Obama Song in School

2009-09-25T07:06:00.000-07:00

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I offer this information as in incite into what is going on in our world today. Perhaps as adults and parents, we are so focused on our work and just getting by that we are not paying attention to what our children are learning. When Obama gave a speech to the school children and some schools chose not to show the video, I felt it was inappropriate. When the president speeks to our country, I think we should all have the opportunity to listen. Each person can choose to listen to what is being said or not, but no one should be kept from opportunity.

I refer to the Obama speech to the school children as I see it as being a polar opposite to the video below. This video is not of the president talking to his country but rather of school children being taught a song about their leader and singing it. It conflicts with our right to choose who we want to lead our country since it is not about respecting the position of the president but rather praising a specific person of a specific political party and even substituting the president's name in place of the name Jesus. There is a portion of this song that is taken from spiritual song and modified into a song about President Obama.

I know FoxNews is not always praised for its objectivity, so I cite a second reference for the story below.

I think we need to be careful handling issues like these. Our children need to understand that we have a choice of who we want to lead the country. While the person is leading we need to make an effort to work with them in the direction they are taking us, as a country. If we disagree with their platform, means and methods, we should make our voices heard and offer constructive criticizm to help mold our future together. Often we tend to attack the party leading the country because we do not agree with their values, platform, etc. It is best if we can use our differing oppinions as an asset to help mold the future rather than a hindrance to move in any direction. As far as our children are concerned, we should make sure they know they have a choice. At the same time we do not want to scare them into thinking our schools are up to no good and have hidden agendas. Nor do we want them to think we are mad at them for obeying the teachers and school's administrative staff. Our school teachers and administrators are one of the strongest assets we have. If we disagree with what is going on in our schools, we should perhaps participate more in parent-teacher meetings, again offering constructive comments and really listening to what others are saying to us on the hot issues.

These are difficult times we are in and I am sure growing up in these times is no easy task, just as offering guidance to our children is no easy task. The more we are able to pull together and offer constructive comments, the easier it will be to guide our country and our world into a more prosperous position.

The Video and Article from FoxNews.com

A link to the video is in the middle of the article. http://www.foxnews.com/politics/2009/09/24/elementary-school-students-reportedly-taught-songs-praising-president-obama/

The Article at TheWeek.com

http://www.theweek.com/article/index/100882/The_school_where_kids_sang_Obamas_praises

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Blogging about Sensitive Personal Topics

2009-09-25T02:24:00.000-07:00

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Below is a comment I posted on the blog of a fellow blog network member, Lisa. A link to her original post, with her question, is at the end for reference.

Hi Lisa,
This is a great blog and poses the biggest question, in my opinion, we want to write real and interesting stuff that is affecting us but we don’t want others to get mad about it.

I’ll give you some insight into how I handle it and maybe it will give you a hint on what you can do. I am careful when talking about stuff that friends and family members say and do that make me mad or sensitive personal topics. I try to look at the big picture and see what lessons I, and the other people involved, all learned from the situation. This gives us a broader perspective and hopefully sets us above the he said/she said stuff. Even at that, when something is very sensitive, I won’t write about life lessons that someone else learned because they might figure out that I was talking about them. I always avoid names when it comes to life lessons others learn if it could at all become a problem to anyone. I’ll usually only use names if someone does something really special and I would like to point them out…and I know they will like the mention.

Recent arguments I have with my spouse, friends and relatives probably do not belong on my blog. Once published, a blog is permanent, and basically impossible to un-do. As time passes, sometimes people become less sensitive about issues, and maybe a blog about the life lessons learned are appropriate. With issues like this, I will ask things like “Are we really listening?” Maybe I notice that a friend or family member just isn’t hearing the things I say to them. They might not even know I have an issue with it. In this case I might look at the general phenomenon of miscommunication. Perhaps more importantly, I could look at when people tell me stuff and I misunderstood them. There is a big difference between this sort of philosophical writing and giving you a script of what I said and what my friend, Harry, said, and how he obviously is a jerk.

On the other hand, there are a lot of things that happen in my life that are very positive and not really sensitive. If the people involved saw I wrote about the incident and told the world, they would probably be pretty pleased. I try to stick to these topics a little more anyway because I feel like the reader gets a boost from hearing positive things. Positive things are much easier to write about and usually carry with them less of a chance of others becoming upset when they hear about it.

I hope my comment has been helpful and I look forward to your many blogs to follow!
Sincerely,
Bill Lowell

Link to Lisa's post: http://marriedinarkansas.blogspot.com/2009/09/my-delimma.html?showComment=1253870623622#c8076735218607552752

You are welcome to comment on this post and all of our posts in the General Discussions area of our forums at http://www.practicalmanifestations.freeforums.org

Helping People Find the Time to Blog

2009-09-24T15:10:00.000-07:00

Finding the time to blog is even more critical than blogging on things people want to read about. We need to make sure that our information is accurate and interesting, but if we don’t have any time to write it, no one will ever see it.

I try to make my blogging and networking as automatic as possible. I blend blogging into my day as much as possible. When I talk to people, when I read stuff, just about anything I do, should be somehow pertinent to my blog. Blogging is a lifestyle. I don’t look at it as a chore. A lot of times I discover things and want to make a note of it or link for myself for later reference. I will often later refer to blogs I wrote for quick links. Blogging helps me keep record of my thoughts and intents as the weeks pass by. It also helps me to put the ideas into a coherent structure rather than just ramblings in my head.

By talking with people and working at a computer during most of the day, I come across a lot of information that I want to share with people and begin discussions on. It is only a natural progression to put my thoughts into words and share it with the world and see who has an opinion on the topic they would like to share with me.

In the car, on my way to and from work, I listen to talk radio on world events (from Sirus satellite radio). During the day, I’ll check on the world and national news at Yahoo News. Then I talk to people throughout the day about what is going on, so I get plenty of opportunities to gain different perspectives on current topics.

Then it comes down to making blogging a priority. If I start to watch television, I start to think about all the great blogs I could write, especially during commercials. What a waste of our time commercials are. Commercials for things we are interested in are good, but 99% of the commercials I see are completely irrelevant to me. They are just blindly firing products at an audience. Since writing the blog is a priority of mine, it takes nothing to stop for 10 or 15 minutes a day and write something on my mind or about something I found on the internet. I’ve been trying to include a few more links to other sites where I find information. Movie current events and so on serve to complement the blog well so it is not all just a bunch of words. Links also take some of the pressure off the author too since I am able to let the reader form their own opinion about the source of information.

So how can others find the time to blog? It depends on the person and how much they have going on in their life. Blogging should be relaxing, a moment to reflect on what we see and hear over the course of the day. Maybe we put on some classical music and let our mind write the words for us. I like to keep the blog focused on helping people and improving the world, but these topics are so broad that they allow me to capture just about anything I would be thinking about. Like I say, it is a lifestyle. The blog is our mind poured out into words. We try our best to keep it on topic. I would certainly have a tough time if my blog was trying to promote car sales and I limited myself to writing about different cars and their stats. It would get pretty boring very fast and I would find it hard to make blogging a priority. On the other hand, if I was selling cars and enjoyed cars and car sales, it would much easier write about my experiences selling cars, meeting people interested in cars, writing some of the stories they share with me, new cars coming out, etc. I could establish my reputation for knowing a lot about cars, thereby probably boosting my business, without being boring and just writing about car stats and comparing car x with car y. The blog would be the life of a car salesman, someone interested in integrity and helping people through honest business. As I met more people through my blog interested in buying a car or helping me establish my business reputation, it would be easier to bump some of the lower priority things in my life to squeeze some blogging into my tasks for the day.

A few techniques: Saving internet pages under “Favorites”; Copying and pasting and opening links in new tabs/windows; Writing blogs in Microsoft Word and copying and pasting them into Blogger to avoid losing any content. I also keep most of my conversations public so that many people can participate in them. I try to avoid emails and instant messaging because I find these forms of communication rather limiting and time consuming. I would much rather exchange well-thought-out blocks of information with many people as opposed to short blurbs with one or two people over the course of a 15 or 20 minute period. Of course this rule of thumb would not apply to my personal relationships. To the contrary, I prefer one-on-one in person conversations with my close friends and relatives. Business allows for totally different forms of communication and I think it is important to distinguish between the two types of relationships when considering which form of communication to use.

So to conclude, blogging is about making the blog a priority. In order to make the blog a priority, we usually need to see some positive results arise from the activity. If we are writing tons of blogs and not hearing that anyone is reading them, it is hard to convince ourselves that we are boosting business or having any impact whatsoever. Maybe we need to exchange links with other bloggers and get our blog site address out there more before we try to push out material when our mind are just not that into it. Once it’s a priority, I would suggest making the blog a part of your lifestyle rather than a chore you do like washing the dishes. Everything you experience throughout the day should be helping contribute to your blog material. Then we try to automate our other networking tasks by using sites like Ping.fm, which sends our status updates to multiple social networking sites with a single entry. Finally it comes down to typing and maneuvering around the internet quickly, and that just takes practice.

I hope this blog has been helpful and will encourage all of us to become better bloggers.

Obama Speaks at the UN

2009-09-24T04:25:00.000-07:00

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Visit msnbc.com for Breaking News, World News, and News about the Economy

I thank you for reading. You are welcome to comment on this post and all of our posts in the General Discussions area of our forums at http://www.practicalmanifestations.freeforums.org

Another AIG Bail Out?

2009-09-23T12:00:00.000-07:00

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I heard that we are discussing yet another AIG bail out here in the US. This amazes me because we already bailed out this company and found that they were abusing the funds we allocated to them.

I have a couple questions. When does the public get to vote on all these stimulus packages, who gets them, and for how much. Secondly, the money sent to these companies appears to be a sort of hand out. Why would this not work like a typical contract: a service or product is provided and the provider of the service or product is reimbursed for the cost incurred plus profit and overhead. The benefit to the contract is that the involved parties all have incentive to complete the task expected of them. The way this would relate to AIG is that AIG is looking for money. We would tell AIG they need to complete certain tasks in order to get portions of the money they are seeking. A schedule would be established on when we would expect each task to be done. The tasks would hopefully improve AIG's bottom line, but also help the economy in general.

By loaning money to AIG, we, as taxpayers, are basically buying stock. Since we are virtual shareholders, we should have a say on how the money is spent, especially when it comes to the borrowed money. There would be no question on whether or not additional private jets and large scale parties are in the budget. Obviously there is no room for this in this economy.

It just seems to me that we are paying a lot of money toward a plan that does not appear to have a schedule for completion, milestones, or even a schedule for payment. From what I gather, the money is paid up front to these companies in a lump sum and later we need to find out second-hand how the borrowed money was mishandled.

Is there an end in sight to our exponentially escallating national debt? When do our lenders start to question the worthiness of our credit? I mean under the previous administration I believe the national deficit doubled and we appear to be headed in the same direction under this administration.

It is just my oppinion, but needless to say, I would like to see the public consulted more on these affairs. I am just surprised to see we have let it go so far. I hold myself responsible for the way things are and I am glad we are starting to pull together to help straighten everything out.

Link for AIG Story: http://ph.news.yahoo.com/mb/20090922/tbs-as-aig-stabilizes-new-and-easier-bai-ae83b27.html

I thank you for reading. You are welcome to comment on this post and all of our posts in the General Discussions area of our forums at http://www.practicalmanifestations.freeforums.org

Social Networking to Do Good

2009-09-22T02:16:00.000-07:00

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Good morning everyone! I found a couple great blog posts while surfing the internet titled "15 Ways to Use Social Networks for Finding the Good" and "How to: Do Good on Twitter", both by Josh Catone

http://mashable.com/2009/06/26/social-media-social-change-sites/

http://mashable.com/2009/09/01/how-to-do-good-on-twitter/

I thank you for reading. You are welcome to comment on this post and all of our posts in the General Discussions area of our forums at http://www.practicalmanifestations.freeforums.org

Boring Monday?

2009-09-21T12:55:00.000-07:00

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So it’s Monday and maybe we find it hard to motivate ourselves. Why is that? Are we so focused on the little things that we forget to look at the big picture? Or maybe we’re so focused on the big picture that we forget to pay attention to the moment.

I was talking with a friend at lunch about how the kids in our schools had the option to watch or not to watch the president’s speech a week or so ago. I thought about how the world is rapidly changing around us, yet the kids seem to not be paying attention. Current events probably seem very boring to them in comparison to the most recent video game. Then I thought of what it was like when I was in school, how hard it was to pay attention to current events and politics because it seemed to have absolutely no bearing on my life.

Now I look around at all the screwy laws and realize just how much bearing all that stuff in current events really had. As a kid, I also thought I had absolutely no power to change any of the stuff going on around me, so that was a second reason not to pay attention to it. I now know I was wrong on that one too.

We fast-forward to the present moment. At this moment I don’t feel very motivated, for whatever reason. I had a headache and had trouble focusing. What is the purpose of this moment we are in? Why am I writing this, why are you reading this? Maybe you wear many hats (between being a parent, working, etc.), or maybe you are in a transition between jobs. Wherever we are in this present moment, there is a purpose for our position, and the way that we feel. There is something to be learned in this moment. It may seem boring or lonely, but here we are. The purpose of this moment is for each of us to discover. We can work in groups or we can think about it on our own. Perhaps within each so-called boring moment is a time for reflection. We are not on a roller-coaster at an amusement park or at the beach with our loved ones. Not at this moment, we’re just relaxing or taking a short break at work.

So what am I going to do with this somewhat boring moment? I am going to think about all the things that I was not paying attention to and how I can start paying more attention to them. This moment is impregnated with an opportunity to change our lives. It feels boring at first because we have the opportunity to reflect on what is going on and we squander it away. Sometimes we feel as though life is just a series of waiting periods, at the end of each wait lies something entertaining. Yet the entertainment only lasts for a short time, then it is back to waiting. Waiting for the weekend, for the party, for dinner, etc.

What could I have done when I was a kid while all these changes were going on in the world? I guess for starters I could have written down exactly what it was that I was paying attention to instead of the important changes going on. I could have learned about what was going on and then…

Now wait a minute, once we learned what was going on, what could we have done about it? I guess this is the point I always had trouble with as a kid. What do we offer kids in the way of helping them to have a positive impact on the world? Sure they can be good and help their friends and family, but what else? What if they want to reach out and make a global impact? What do we offer them? As kids, our options seemed a little more limited. We could have joined the Peace Corps or become a minister going on missions to help the poor and hungry. But all that comes later. We could have volunteered at the local church or homeless center. Somehow doing these things feels rather limiting to me. I love that people volunteer, I think their services are invaluable. On the other hand, I think that we each have a place. I don’t know, I would think some kids would like to see their efforts have an immediate global impact. That is the kind of feeling I had growing up.

However that is exactly what I see with social networking. It is an opportunity for young adults to have an impact on the entire world with just a few key strokes. Any time, day or night, people can affect the world in a positive way. They can find other people that share their views and begin a collaborative effort to improve the way things are. This moment is no longer boring and lifeless, even for those with giant expectations. It is an opportunity to think about how we can best utilize our time, how we are not going to let another moment go by unnoticed. And what can kids do until they are young adults and able to social network? They can pay attention to all of the changes going on in our world and start formulating opinions on what they think of the way things are, about the changes, and about where they think this is all heading. I think, at a minimum, that would minimize the shock they would experience when they get to be our age and realize just what is going on. And just maybe they would have a head start at helping to change things for the better. That’s what I would tell myself if I was a kid again anyway.

I thank you for reading. You are welcome to comment on this post and all of our posts in the General Discussions area of our forums at http://www.practicalmanifestations.freeforums.org

Google Wave Preview for Communication and Collaboration

2009-09-20T12:52:00.000-07:00

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According to Google, "Google Wave is a new tool for communication and collaboration on the web". It is an incredible new form of instant communication where you can exchange links, embed maps, etc. and most importantly have a live conversation with numerous people regarding all of the above. You can watch the movie below or follow the link at the end of this post.

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Link to Google's Wave web site: http://www.wave.google.com

Comments About Stardom, A Response to Zorin's Post

2009-09-19T04:20:00.000-07:00

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I started commenting on Zorin Diaconescu's post AND WHO'S GONNA PAY FOR ALL THAT? from his blog (a link for his blog is above and at the end of this post) when I realized my comment would make a great blog itself. Check out his blog post if you wish to see what I am responding to.

I think the star system works for now because there is a lot of money to be made by affiliates of the stars. I guess we should start off with the beggining of television. The actors on television at its beginning were people that could not do anything else. They were paid minimum wage and were sort of outcasts. Over time people realized that the guys and girls on television had power. If they drank coke, it sent a message out to the audience to have a coke. Then the advertisers got into it and the average person cannot even get near these stars, you have a better chance of meeting the president or leader of your country. Stardom makes a lot of people a lot of money.

I think that over time society will realize that how much global influence you have (i.e. friends and written, verbal, and video broadcasts you create each day) is a choice people make. You figure out how globally influential you want to be, and you take action each day toward that goal. Your favorite movie star maybe appears in front of a few million people each year. If you have a few million friends and contacts through various networks and affiliations that all read, listen to, or watch your material, guess what? You're just as influential as that movie star. You can get the designer clothing and have a driver if you want, or you can continue living your life like you did before, everything is a choice. Right now you may only have a few thousand friends on FaceBook, MySpace, and Twitter, and a few hundred followers of your Blog, but your sphere of influence is growing at an alarming rate every day. Your favorite movie star has to spend months making a movie to be influential again, or maybe they have a television show. But usually that movie star is just acting out what someone else tells them to do, they are acting off a script.

How great is it that we, as bloggers or whatever, have no script. We are doing everything improv, including setting the stage, deciding what we will talk about, picking out which advertisers will support our work, even deciding what audience we will talk about. Now to me that's stardom. I don't care if you have a half-dozen people tuning in. You're getting YOUR message out there.

Sometimes I watch television or movies and I feel bad for the big actors and actresses. A lot of them are trapped in the endless cycle of chasing money and fame and unfaithful girlfriends or boyfriends. It is pretty sad when you think about it. I am going to pray for these actors and actresses that they may find peace and harmony with their true selves and recognize that the nonsense a lot of them are chasing is just that, nonsense.

As bloggers we have tremendous power to have a positive impact on the world. If we disagree with this stardom business, we can change it with our broadcasts. For those actors and actresses out there, just coming up, I applaud you for your efforts. I try to gain fans for my blog just as you try to gain fans for your work, so I know how difficult it is. I hope as you become more popular you will contribute to the scripts you are acting out, so that you can be conveying the message you are trying to get across, not the message of somebody just looking to make a buck.

Zorin's blog: http://zorin-iself.blogspot.com/2009/08/and-whos-gonna-pay-for-all-that.html

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The Self-sabotaging Mind

2009-09-18T17:46:00.000-07:00

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What is with our minds always holding us back? We try to lose weight, we try to stop drinking alcohol, we try to stop smoking, our minds are always in the way. We wear patches on our arms, take pills that make us sick when we eat fat or drink alcohol, yet we continue with the bad habits no matter what the repercussions.

It’s crazy when you think about it. You think you want to change that bad habit, but there is some part of you that does not want to change. That part of you is hundreds of times stronger than your will power. Not to mention some of these habits have self-perpetuating chemicals in them as well.

How do we fix it? Of course the answer depends on the person. I know for me with alcohol and sugar, it was a choice I made. However the choice, alone, was powerless. It was a choice reinforced by counseling and the willingness to do anything and everything to quit the habits. I felt like my friends and co-workers might make fun of me when they saw me drinking non-alcoholic beer, drinking seltzer instead of soda, eating peanuts instead of doughnuts, etc., and I was okay with it. Making the choice is one thing, having the strength to carry through with that choice in the face of any temptation is another animal altogether. Reason being, the choice is just a few words that appeased us and we thought we would try to employ in our life. Strength to carry out our choice comes from every cell in our mind and body. When every cell resonates in harmony with our choice, there is no room for temptation.

When we find us sabotaging ourselves, most often at the root, is a lack of self-love. We need a reason to treat ourselves well. When we see an ugly old person in the mirror, we find it difficult to find the energy to maintain our health, that is because we see a lost cause. That person in the mirror is so far gone, what is the use of trying to return to their healthy and sexy glory?

Finding that self-love will give us the strength to change the myriad other things in our lives that resonate the bad habits. Where we find that self-love is in our thoughts and actions, talking to counselors, hypnosis, etc. We do whatever it takes to find that self-love and reinforce it with our thoughts and actions every moment of every day. We then develop a palate for self-love and recognize those things in our lives that contradict the love. There may be millions of little contradictions or one big contradiction. It does not matter. We have connected with that inner strength that is hundreds times more powerful than will-power alone. This new strength then becomes what we define as will-power, and that power is limitless.

I hope this post finds you in good mental and physical health. If so, may it serve to reinforce your efforts to maintain your health. If not, may it be the cornerstone of the foundation for your new life, one of endless health and limitless prosperity.

You are welcome to comment on all of our posts in the General Discussions area of our forums at http://www.practicalmanifestations.freeforums.org

Who's Following My Blog?

2009-09-16T14:30:00.000-07:00

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What good are blog statistics if you cannot connect with the people visiting? You would know a certain number of people visited the blog this week and it was a little more or a little less than last week, but is it the same group of people visiting, and how do you reach them to see what they think of your recent posts?

There is plenty of free software that tracks how many people visit your blog each day, where they’re from, etc. But if you’re looking for real names and contact information, you will need to resort to a few different social media sites and widgets.

Of course at the top of the list are the Google Follower Widget and the FaceBook’s NetworkedBlogs Widget. All links are given at the end of this post for the convenience of the audio listeners. These are pretty handy because when someone follows with Google, you can find out what blogs they host and which ones they follow. If the person set up a Google profile, you will also be able to view their profile to find out their email address or other contact information. The NetworkedBlogs Widget creates a link to the follower’s own blog and FaceBook profile. If you request the person as a friend on FaceBook, you can start communicating about blogs, etc.

So that works great for people that want to follow your blog, but what about people that just visit? Maybe they want to follow but do not know how or maybe they did not see anything on your blog that interested them. All is not lost, you can still find these people through other networks.

Please keep in mind that we are not looking to bother people that are not interested in our blog. If a person seems like they are interested in my blog, I might ask them if they would like to be my friend on one of the social networks. My blog is not intended to sell things with the stuff I write, and it is about improving people’s lives and the world. I can see if the person has a lot of friends in common with me. Since most of my friends are in to positive thinking, if a person has a lot of friends in common with me, they are probably a positive thinker, and open-minded about meeting new people. On the other hand, if someone only has a couple of friends in common with me, they might not want to be bothered by friend requests. Also, I would not suggest writing emails trying to sell stuff to people you have not first established a connection with. It is far better for them to find you.

So if we want to see who the people are that are visiting our blog, we can load widgets from MyWebLog (a Yahoo affiliate), BlogCatalog, or TwitterCounter (from TwitterRemote). MyWebLog is a social media site that allows you to befriend other people, exchange emails, etc. People register their blog with MyWebLog and others can discover their blog. Similar to MyWebLog, people can also register their blog with BlogCatalog, add people as friends, or send them messages. Then there is TwitterCounter. This widget basically tracks any Twitter users that visit the site. When you click on a visitor’s link, it will take you to their TwitterCounter profile, which has links to their Twitter profile and web site. With each of the above services, there are widgets that you can install on your blog. The widget is nice because visitors to your blog can see who else is visiting and they can maybe connect with each other.
If you have enabled comments on your blog, people might leave their contact information so you can find them on other social networks.
There are also a few sites that take your blog post and re-post it on your profile’s blog page in their network. FaceBook’s NetworkedBlogs, Digg, and Multiply are examples of such sites. These sites are great because it gives you exposure to people that have not even been to your site. On the network site they can post comments and have discussions with other people that like/dislike your content.
These are all great ways to build a following and connect with your visitors and followers. They are all powerful tools, but I cannot stress enough the importance of respecting your visitors and not just trying to sell stuff to strangers. The purpose of a blog is to establish connections and a reputation for knowing what we are talking about. We would not want to do anything that might compromise this intent.

LINKS
Google Follower Widget: http://www.google.com/support/blogger/bin/answer.py?answer=141483
FaceBook’s NetworkedBlogs: http://apps.facebook.com/blognetworks/index.php
MyWebLog: http://www.myweblog.com/
Add your blog under “My Sites and Services”
Then click “Widgets”
BlogCatalog: http://www.blogcatalog.com/
Click “Manage Blogs”
Then click “Add a Blog”
Submit your blog
Then click “Create a Widget”
TwitterCounter: http://www.twittercounter.com/
Digg: http://www.digg.com/
In upper navigation, click “Submit New” to submit your new blog
Multiply: http://www.multiply.com/
Under “Post Content” click “Blog”
Scroll to the bottom and click the appropriate link under “Import Blog”

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Pamela Lowells New String Quartet

2009-09-14T17:14:00.000-07:00

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I am excited about Pam’s new quartet. They are still deciding on a name, but they do have a good one in mind. From what I hear they are looking at doing their first concert in November of this year. It will be at a church and the proceeds will go to the church. The point of the concert is to perform and gain publicity. I think it is great they are more concerned with getting their name out there rather than putting money in their pocket. In the future I think they will also be leaning toward charity concerts. They have all been playing for several years, but just recently they decided to get together as a quartet to perform.

A couple weeks ago Pam played in the Guitar Under the Stars Concert in Hartford, CT, USA. It was a great performance combining the sound of Latin guitars with a full orchestra. There were several terrific musicians there. It’s nice because the venue is small enough that you are able to really talk to the musicians after the concert. It is a great place to meet some really talented individuals. One such musician was Jofre Romarion, I was quite impressed with him…you can read the full blog post about Jofre at http://practicalmanifestations.blogspot.com/2009/09/inspirational-musician.html

Music is just a wonderful part of our lives. I am thankful that my lovely Pamela shares her talent with me and the rest of the world. When the date and venue are firm, we will be sure to publicize it on our FaceBook page at http://www.facebook.com/practicalmanifestations

Pamela also has her own web site with her contact information for cello lessons and to hire her and her associates to play at various functions: http://www.expressivestrings.com

Comments on this blog and all our blog posts are welcome in the General Discussions area of our Forums at http://www.practicalmanifestations.freeforums.org

Those Pesky Marketers

2009-09-13T06:19:00.000-07:00

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People are advertising to us constantly…it’s in our email inbox, our FaceBook inbox, comments to our blogs and in our forums…everywhere. It has become commonplace where just about anyone on the internet is trying to sell one thing or another—whether it be a product or service. These advertisers can be rather pesky. Not that it is the same person or company consistently advertising to us (those are obviously spammers), but rather all the correspondence from advertisers combined can be quite bothersome to delete from our email inbox every morning.

I guess I don’t view marketers and advertisers to be as pesky as most people though. I usually try to look at the advantages to whatever situation I am in. When people advertise to me, I think to myself, “What can I do with this person advertising to me…how can I make this a win/win situation for both the advertiser and myself?” One thing I could do is figure out how to connect with the person in a way that will help promote my own products and services whenever their promote their products and services.

Before I decide whether or not to connect with the person, I need to figure out whether the way they are advertising and what they are advertising would help my business or hinder my business. Are they just spamming the world with no idea if their audience is interested in their product, or are they establishing relationships with people and trying to find real solutions for things these people need? In the former instance, a relationship with the advertiser is probably going to hinder my business. People will think that I am a spammer if I hang around a bunch of spammers. On the other hand, if the advertiser is establishing real relationships and helping people find solutions, it could be a great advantage to coordinate my efforts with the advertiser and probably get some indirect traffic when people see my links on the advertiser’s web site.

Once I have decided that the contact would be good for business, I can then connect with them in various ways. The first way, and strongest affiliation, would be to establish a link on their site, or have them mention my site, products or services on their site. To do this, you need to contact the advertiser and explain how the connection will benefit them. It is best if the two sites are somehow relevant to each other…this will improve their rankings in search engine searches.

Next would be to be a friend of theirs on FaceBook, MySpace, or a follower of their blog through Google Follower Widget, or FaceBook’s NetworkedBlogs. This is not as strong an affiliation since there may be hundreds or thousands of friends and followers, so your link to your own profile or web page will get lost in the herd. If there are links on the advertiser’s site, usually there will be a maximum of a couple dozen. The last option would be to post a comment on their blog site or in their forums. You want to be sure that you, yourself, are not spamming…the comment is on topic, etc. The purpose of the comment should be to comment on the text, not to promote your own site. At the end of the comment, you can say your name and give a link to your site (if permitted).

In this way you are basically building a network of people and companies advertising for you for free. They are putting in the time, money, and effort to advertise, and if they are doing it in an honest manner, you might as well catch some indirect traffic from them. In return you are probably doing some advertising yourself. You may be using similar tactics to them, or your tactics may be very different. Your new advertising partner will be able to benefit from your traffic spill-over just as you benefit from his/hers.

In any event, we want to make sure that the people and companies we are aligning ourselves with are acting with integrity. Our own company’s image will be tarnished or embellished by the affiliation. Therefore, once establishing a link or connection, we should check back in with our affiliates to verify they are still acting with integrity and have not lowered their operation standards. This is especially true for links, but can be expanded to include even our FaceBook and MySpace friends and FaceBook NetworkedBlog and Google followers too.

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What Has Happened To Us?

2009-09-11T03:53:00.000-07:00

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We have spent our whole lives working like dogs each day, coming home after work, having a couple beers and falling asleep. The next day it was back to the grind. We now find ourselves in a society that seems to have lost all common sense. We hear about these crazy court cases where people win for not taking responsibility for themselves. How did it happen? My guess is that it is due to the lack of fairness in the legal system. By this I mean when a person sues a big company, the dollar amount at stake means a lot more to the person than it does to the big company. When the person wins their first case for a few million where they are not taking responsibility for their own actions, they can then spend that money on the next case and keep pushing the envelope. The lawyers involved are looking to make a name for themselves and are willing to take the cases as high in the legal system as they can go.

In no way does this criticize the many legitimate court cases of malpractice and neglect. When someone makes a mistake, they should make an effort to correct the mistake and make it right.

We have seen a slow but steady deterioration of the legal systems. There are just so many cases being reviewed that it is a long time between the date of the incident and the date it shows up in court. Then the losing party can appeal the decision twice, so it triples the amount of work for judges. With so much nonsense being submitted, it becomes difficult to discern the real cases from the nonsense. Plus the nonsense is backed by big bucks. With enough money behind it, even the biggest lie starts to look plausible.

Similar is the situation of big companies filing claims that push the envelope out of the realm of common sense. We can see it in the pollution of our environment, the minimum wage, and working conditions.

While we were working so hard for all those years, we assumed that common sense would take precedence over nonsense. We weren’t paying attention to the trend, leading to a world where the laws and rulings are founded on money, not common sense.

Is it the judges’ fault? I don’t think any one person or group is to blame. Like I said, these cases are submitted individually and even the big lies look plausible with a lot of money behind them. I don’t know if I could do any better reviewing each of these cases. I know I would be swayed by the simple fact that a person was injured or incurred some sort of loss. Whether it was their own fault or not, I would want to help the person and it would be difficult to deny the person’s claim 100% when obviously everyone is at least a little responsible for what happens to the people and things they interact with. Everything is connected in some way or other.

Is it the fault of the people and companies that are not taking responsibility for themselves? Yes. But it is just as much your and my own fault. We can’t just go around pointing the finger at people we feel are the guilty ones. We haven’t been taking responsibility for all of our actions either. We haven’t been building an environment that gives people and companies incentive to take responsibility for their own actions. We have been letting money guide our purchasing power and our day-to-day decisions, without concern for how it is impacting our friends and environment.

Furthermore we let our fellow men and women drown in desperation and did not lend them a hand. In reaction to being desperate, they inadvertently helped to deteriorate the legal structures of our great nations. We see the results of our actions each day when we hear the current events.

Where do we go from here? All is not lost. We are all still here, so we are still able to do something about our irresponsible thoughts and actions. Our nations are still full of good people that want what is right. We have some desperate friends that are willing to derail what we know is right for the sake of their own survival. We need to take action to help our friends find work, find their dignity again. We also need to put these bogus claims in check by taking them seriously when building our cases against them. Much more is at stake than the dollar amount of the case, winning each case against the nonsense is another brick in the foundation of a society full of responsible adults and children.

By taking action, we are showing our children what is right, and that it is worth fighting for. More important that any one person’s survival is the common-sense-based legal structure that we use to help all us interact fairly. However, a person’s survival does not need to be at stake. We help people by doing things ourselves, not by swaying the legal system in their favor. This being said, I am sure that we will find a return to common sense in our legal systems around the world starting today.

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Are We Losing Touch?

2009-09-08T14:50:00.000-07:00

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With so many sources of information out there it is becoming very easy to select what news we want to hear and discard the rest. I suppose this is good in some aspects and bad in others. One question we can ask ourselves is this, “How do we know we are making a difference in the world if we don’t know what is going on?” On the other hand, we do not want to be hard-wired to the local and global media basing our lives on what the media tells us.

Of course eastern philosophy would suggest we try to find middle ground between complete seclusion and complete immersion. But how do you find middle ground when the news is so over-the-top? After only an hour of television news you might feel like you need a dose of Prozac just to get by. My guess is that the average person has just become so numb to television news that the television companies feel they need to sensationalize the news and find horrific things happening between next door and the opposite end of the world just to boost ratings a bit. There has to be a better way. If we can stay in touch by reading and listening to information rather than seeing it on television, I think it would keep us in touch with reality while not overloading us. This way we can keep an eye on the real world and monitor what kind of difference we are making.

Then there is the question of “How do we relate to other people when everyone else is overloaded?” I think this question is even tougher than finding the middle ground. All the time we interact with people that do not seem to be present in the moment. They are overloaded and have learned to distance their consciousness from their physical being. I think it is easy to become frustrated with society. Maybe what appears to be lack of intelligence is actually just disconnectedness. Not the spiritual disconnectedness of a conscious being but rather the disconnectedness one experiences when immersed in an overbearing reality and feeling numb to it all.

I think as we are able to express compassion and caring toward these numb individuals and show them that life does not need to be a saga of endless tragedy and media bombardment, they will start to find themselves and begin to align their efforts with their true purpose. We all experience how overbearing reality can be from time to time. Yet we know that we are not alone. We have the luxury of communication with other people and through this communication we learn more about ourselves and our environment. In particular we learn how flexible we and our environment are to the point that it becomes difficult to define us from our environment.

I hope this post finds you well and that you will take a moment today to help someone in need.

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