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The Turbulent Tenure of Judy Martz
I write history, and I'm pretty good at writing biography.
I did this research a couple weeks ago while at the Historical Society in Helena.
I hope it expands your knowledge about the state's recent history.
Judy's Early Years
Judy Martz was born in Big Timber on July 28, 1943.
She moved to Butte at a young age and graduated from Butte High School in 1961. She then went to work as a receptionist in a doctor's office in Butte before heading east to work in a Billings sporting goods store, in 1964.
In 1963, Martz was chosen for the U.S. training team that went to Japan. She made the U.S. Olympic speed-skating team, the "first Montanan to ever make an Olympic team."
She raced the 1,500-meter race at Innsbruck in 1964. She was in first place for a time but then had a fall and finished 15th.
After that it was back to Montana. She enrolled in Eastern Montana College for two years, and was even selected as Miss Centennial Montana the same year she'd competed in the Olympics.
A big blow came to Martz in 1965 when her boyfriend, Wayne Estes, was electrocuted and killed by a downed power line. He'd just scored a record 48 points in a basketball game for Utah State and was the LA Lakers' #1 draft choice. Martz was devastated, yet later viewed the incident in a different light. "I think Wayne's death is probably the reason that I started to serve people."
She quit her Olympic training, even though she felt she had a shot at gold in 1968. She also got back together with her previous boyfriend of four years, Harry, and the two eloped to Idaho in 1965 to marry. The honeymoon didn't last long as Harry was sent off to Germany shortly thereafter to serve in the Army.
For Judy, it was back to the sporting goods store. That lasted for three years before she wanted a bigger change of scenery and became a secretary in a Los Angeles insurance office.
That lasted less then a year before she moved back to Montana in 1968 to become a manager of a Butte sporting goods store.
Harry came back from Germany that same year and the two bought a full-service gas station in Butte, which quickly went out of business when self-service stations began flooding the state. Judy was soon back to working at a different sporting goods store.
Then in 1971 they tried again, this time with a garbage business. They were only the second private garbage business in the mining city, and the two worked the route together for thirteen years. "We've had one vacation in 28 years," Martz said in 2000. "Harry's dad watched the route and we took the kids to Salt Lake City and Lagoon."
To help supplement this income, Judy also got a job as a postal carrier, in 1974.
Politics Beckons
From 1987 to 1989, Judy was the executive director of the U.S. High Altitude Sports Center. In 1989 she became a field rep for Senator Conrad Burns, a position she'd hold until 1995.
In 1995 Dennis Rehberg left the Lieutenant Governor's Office to run for Congress, leaving Governor Racicot to choose someone to fill that office. Three people encouraged Martz to put her name in, and after three weeks of praying about it, she did. Several interviews followed, and she got the job.
Racicot picked her because "of her accomplishments in the private and public sectors and because she got along well with people."
Martz was 52-years-old in March 1996 when the 47-year-old Racicot tapped her to join him on the campaign trail as his running mate. She'd been a field representative for Senator Conrad Burns in the Democratic stronghold city of Butte, where she and her husband owned a garbage disposal business, Martz Disposal Service.
By that point Racicot had raised $233,000 for his campaign while his Republican primary challenger – University of Montana law professor, Rob Natelson – had raised just $45,000.
Racicot beat him 75% to 25% in the primary that year, and in the general Racicot easily took out Democrat Judy Jacobson, 79% to 21%. In January 1997, Martz took office.
During her time as lieutenant governor, Judy gave between 320 to 360 speeches around the state each year.
By 2000, it was time for her to run for the top job herself. Mark O'Keefe ran against her on the Democratic ticket, but despite having more money and more staff, Judy beat him with 208,594 votes to O'Keefe's 192,781 votes, or 51% to 47%. Libertarian Stan Jones took 7,882 votes, or just under 2%.
Martz raised over $838,000 for her race while O'Keefe raised $2.9 million, with $2.1 million of that coming from his own pocket.
Martz got the job done by winning 45 of Montana's 56 counties.
George W. Bush won the state that year with 58% of the vote to Gore's 33%, so many figured that was a factor.
Assuming Power
A month after getting elected, Judy said she'd be the "lap dog of industry," and that the title "fits her just fine." She told it to the Montana Taxpayers Association, adding that Montana would be open for business. A Lee Newspapers poll a week later found that 43% opposed the statement while 41% supported it, with 16% undecided.
By November 2001, Montanans had a generally unfavorable view of their new governor. A Montana State University-Billings poll found that 38% disapproved of the job she was doing while 37% approved. Another 26% were undecided. The poll had asked 413 Montanans.
The next month a Lee Newspapers poll of 625 Montanans found that she had a 44% approval rating, compared to the 58% that President Bush had at the time.
The reasons were twofold. First, Martz had bought up 80 acres of Arco land in September 1999 "at below-market prices," 36% below market prices, to be exact.
The couple bought the land west of their Rocker homestead for $300 an acre, or $24,000 in total. They'd bought 24 acres of land east of the homestead that July for $833 an acre from a private property owner. News of these sales didn't come out until late-2001.
Another problem was Shane Hedges, Martz's campaign manager that ran afoul of the law.
It happened just after midnight on August 15, 2001. The 28-year-old Hedges and 32-year-old Paul Sliter – himself the House Majority Leader from Somers – were driving an SUV back from Marysville after a night of drinking at a GOP event there. The SUV veered off the winding dirt road and Sliter was thrown from the vehicle, dying at the scene.
Martz got a phone call from her chief of staff, Ed Bartlett, shortly after the crash had occurred. Martz heard the news, took a quick shower, and rushed to the hospital. It took about 40 minutes before she could see Hedges, who only had bumps and bruises. Hedges immediately broke down in tears at the sight of the governor.
It was decided that Hedges could leave the hospital, but he didn't want to. Martz suggested he come back to the governor's mansion for some rest, which he did. They arrived around 4 AM, and a half hour later law enforcement stopped by for more questions.
Hedges was so drained that he wound up staying at the governor's mansion for several days, and this led to Martz washing his "ripped and bloodied" clothing from the wreck. She's admitted to washing them the night of the accident, and this led to calls from opponents that she'd been tampering with evidence, something she strongly denied.
"The mother in me did it," Martz would later say, "Shane was like a son to me."
On August 31, Hedges pleaded guilty to negligent homicide. He served six months in the Helena Pre-Release Center before being released in April 2002. During the time he was in the center, Hedges sent many emails to Martz and others in the administration, including a critique of her 2002 State of the State speech as well as fundraising letters. Hedges eventually moved to Washington D.C. to continue his political efforts.
In April 2002 news came out that Martz may have been giving political favor to high-level donors in return for donations to her conservative political fund, the Montana Majority Fund. The donors in question were Yellowstone Club founder Tim Blixseth and publishing mogul Glenn Patch. Both said they "weren't buying clout," and Martz later said these claims were hurting economic development in the state.
The state Criminal Investigation Bureau eventually concluded that the Martz administration had used state time and telephones illegally to contact California fundraisers. Martz eventually decided to stop meeting with reporters over the fiasco.
To take attention away from the worsening crisis, Martz rallied her base. She did so by talking-up religion, homeschooling, and other conservative issues she held dear.
That June, Martz made it clear she was a big proponent of homeschooling, saying that it costs "$7,000 to educate a student in public schools when parents do it for about $300." She was an advocate of teaching children about Jesus and to say 'no' to both drugs and sex. Public school officials were not impressed.
Also that June, hearings began into the Arco land sale. That didn't stop the Western Governor's Association from choosing Martz as their chairman for 2003.
By the end of the month, however, the news had shifted to the state's finances. They were dire, with $45 million in budget shortfalls expected. Martz ordered most state agencies to cut their budgets by 3.5%, with the goal of saving $23 million. The state budget director said this wasn't good enough, so Martz called for a special session. During her speech to do so, she "began to cry, stopped reading her speech and said, 'God, I hate this.'"
The special session took place from August 5 to 11, though Judy had to call a 'one-dayer' as well – September 13– to amend HB 2 to go into effect immediately.
Things began to look better after the special session, and even more so that September when the Commissioner of Political Practices ruled that Martz had done nothing wrong in buying up the Arco land at below market value. The 35-page report concluded that Arco was not trying to influence then-lieutenant governor Martz.
By the end of that month a Lee Newspapers poll found that just 23% of Montanans approved of the job Martz was doing. President Bush had a 67% approval rating in the state at the time, while Senators Max Baucus and Denny Rehberg had 59% and 58% respectively, and Conrad Burns had 57%.
By mid-October, Martz's approval rating had fallen to 20%. At the end of December she was giving herself an "A" for effort. "We're working our backsides off," she told reporters.
By the time the 2003 Legislature was set to start, the state was looking at $250 million in biennial shortfalls. Martz wanted to cut health programs, including 70% of the budget for Mental Health Services, an agency that oversaw "5,200 Montanans suffering from schizophrenia, bipolar disorder and other mental problems."
She didn't want to raise taxes. "You can't tax your way out of a recession," she said. What she did want to do was raid the $2.6 billion "nearly-impenetrable" coal tax trust fund for $93 million to help get her $2.6 billion state general fund budget through.
Martz rationalized these moves by saying that Montana was already 46th in the nation for per capita income, which meant families were struggling and simply couldn't afford tax hikes at that time.
The 2003 Legislature was contentious. "I'm glad we only have a one-term governor," Republican state Senator John Cobb said as the session neared its end in April. "She's destroyed the human services budget. She's deliberately hurt people."
Cobb was incensed at Martz's plan to get rid of state funding to provide daycare for the working poor. The Senate passed it on a vote of 26-24.
By May 2003, Martz's approval rating had fallen to 18%. Polls showed Democrat Brian Schweitzer beating her 52% to 24% if the 2004 Election were held that day. Just 24% of Montanans were undecided. Martz had not yet decided on whether she'd run again.
That June, GOP Party Chairman Ken Miller said a Martz win in 2004 seemed unlikely. Political analyst Stuart Rothenberg put it more bluntly: "The governor would have to be delusional to run for re-election, and state Republicans would have to be crazy to nominate her."
Martz was still mum on the subject come July, but then on August 14 she announced that she'd not be seeking a second term. "My head wants to run, my body wants to run, but my heart says go be with your family," she said at a press conference that day. Martz was adamant that her low approval ratings and the scandals over Hedges, the Arco land deal, and the state phone lines used for fundraising did not factor into her decision.
Martz left office on January 3, 2005. That February she got a $2,000-a-month job with Republican Brad Johnson's Secretary of State Office to "develop a public relations campaign" to explain voting law changes.
In March 2005, Martz was named to TASER International's Board of Directors. The non-lethal device company viewed Martz's experience with law enforcement as an asset to their company.
By May 2005, the state was set to collect $150 million more in tax revenues than it'd expected.
In November 2014 it was reported that the 71-year-old Martz had recently been diagnosed with pancreatic cancer and was undergoing treatment.
Then on October 30, 2017, she died. She was 74-years-old.
Anez, Bob. "Racicot makes re-election bid official." Independent Record. 5 March 1996.
Anez, Bob. "Martz: 'I'll be the lap dog of industry.'" Helena Independent Record. 7 December 2000.
Anez, Bob. "Montana split over Martz's job performance." Helena Independent Record. 14 November 2001.
Anez, Bob. "GOP chair says Martz unlikely to win if she runs." Helena Independent Record. 6 June 2003.
Billings, Erin P. "Mart's 'lap dog' remark gets mixed response." Helena Independent Record. 17 December 2000.
Dennison, Mike. "Cobb blasts governor during budget debate." Great Falls Tribune. 9 April 2003.
Farrell, Alison and McKee, Jennifer. "Martz won't run." Helena Independent Record. 14 August 2003.
Johnson, Charles S. "Judy Martz: A Determined Competitor." Helena Independent Record. 20 February 2000.
Johnson, Charles S. "Martz says her message correct." Helena Independent Record. 9 November 2000.
Johnson, Charles S. "Less than market value." Helena Independent Record. 18 November 2001.
Johnson, Charles S. "Poll: Martz lowest, Bush highest." Helena Independent Record. 23 December 2001.
Johnson, Charles S. "Document: Martz paid more for nearby land than Arco land." Helena Independent Record. 17 March 2002.
Johnson, Charles S. "Hedges: 'Nice to be able to tap into' his experience, says Ranf." Helena Independent Record. 15 June 2002.
Johnson, Charles S. "Governor cleared on ethics complaint." Helena Independent Record. 26 September 2002.
Johnson, Charles S. "Poll: Martz at all-time low." Helena Independent Record. 29 September 2002.
Johnson, Charles S. "Martz budget dips into coal fund." Helena Independent Record. 16 November 2002.
"Martz says she'll fight to protect homeschoolers' rights." Helena Independent Record. 9 June 2002.
McLaughlin, Kathleen. "'The mother in me did it.'" Helena Independent Record. 5 January 2002.
McLaughlin, Kathleen. "Donors say they weren't buying clout." Helena Independent Record. 3 April 2002.
Smith, Ericka Schenck. "Tearful Martz orders session." Helena Independent Record. 29 June 2002.


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Where We Stand: A Simple Breakdown Of The Rockets' Salary Cap Situation
New to the NBA's complicated salary cap structure? Confused as to where the Rockets stand financially? No problem: ESPN's Rahat Huq is here to guest post on the Rockets' cap situation.
By Tom Martin Jul 15, 2010, 3:29pm CDT
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Rahat Huq of ESPN's TrueHoop Network Rockets blog Red94.net provides his basic thoughts on the Rockets and their salary cap situation.
(Note: This post was written before the Rockets made their offer to Brad Miller on Thursday, July 15).
The news came out on Wednesday that the Houston Rockets would match the offer Kyle Lowry signed with the Cleveland Cavaliers. At the time of writing, reports slate the deal at $24million over 4 years with a team option on the fourth year.
So where do the Rockets stand now with regard to their finances?
Earlier this month, the league released its salary cap figure for the 2010-2011 season. In an unexpected surprise, the cap actually went up from last season to 58.044million.
The mid-level exception is now at 5.765million and the luxury tax threshold is at 70.307million. I explained the nuances of the tax in an article last January, but for our purposes here, the rationale behind its imposition was to establish a level playing field by penalizing high-spending teams.
After signing Patrick Patterson, matching the offer on Lowry, picking up the option on Chuck Hayes ($2.33million) and getting the news that Yao Ming would not opt out of his contract ($17.69million), the Rockets are now on the books for $67.27million in guaranteed salaries for 2010-2011. (If the current reports are true, Lowry's first year will net him roughly $5.75million. Patterson is slated to earn $1.52million.)
Two other items of imminent uncertainty surround Luis Scola and center Brad Miller. Like Lowry, the Rockets have extended a qualifying offer to Scola and have the right to match any offer he receives. Also like Lowry, the Rockets are likely to let the market dictate Luis' price range. The team will most probably offer its bi-annual exception (worth $2.08million) to Miller.
While there were numerous reports last week that the team had been shopping Scola in various sign™ proposals, it's almost certain now that they will choose to retain him after having lost out in the Bosh sweepstakes.
It is difficult to predict how much Scola could net. Of the teams with cap space, only the Nets have a need at the '4.' While Luis is past 30, his production is undeniable. As I did not foresee Lowry earning almost $6million, it would not be far-fetched to assume that Scola will sign an offer (that is subsequently matched) for at least $8million/annually. For our purposes here, we will slate Scola at $8million/annually.
If also adding Brad Miller, the team would have $77.35million in guaranteed salaries for next season, and would be $7.05million above the tax line. Because teams are penalized one dollar for every dollar by which they exceed the tax threshold, the aforementioned lineup would cost Les Alexander $84.4million.
Without Miller, keeping Scola, the team would cost Les Alexander $80.24million - $75.27million in guaranteed salaries with a tax penalty of $4.97million.
From there, one might ask if the team will make use of its mid-level exception. I wouldn't count on it. Had they nabbed Bosh, I could have seen it, but since they didn't, with such a hefty bill already, I don't think there will be an "all-in" mentality. (A player worth the league average would cost the club almost $12million.)
Still, it appears that for the first time, Les Alexander will be paying the luxury tax.
From this point onward - armed with a shopping cart of assets, enjoying the prospect of possible flexibility next summer, yet facing the uncertainty of a new collective bargaining agreement - it will be interesting to see how the Rockets' plans unfold. For now, they seem to be committing some serious cash to bringing back their key contributors.
Many thanks to Rahat for his post. For more on the Rockets from SB Nation, head over to The Dream Shake and follow SB Nation Houston and TDS on Twitter.

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AbbVie's psoriasis treatment drug wins first U.S. FDA approval
Merck's Keytruda obtains FDA approval as a kidney cancer therapy
Torrent Pharma recalls 1.7M Losartan bottles from the US & Puerto Rico
Innovent successfully doses first patient for the treatment of wet AMD
Eagle Pharmaceuticals expands BENDEKA™ licensing deal with Teva Pharma
Akshay Kedari Apr 16, 2019 Pharmaceuticals
The revised licensing deal extends the royalty term of U.S. BENDEKA until it is no longer sold in the nation
Eagle Pharmaceuticals, the US-based specialty pharmaceutical company, has reportedly announced that it has expanded the existing licensing agreement for BENDEKA™ (bendamustine hydrochloride) with Teva Pharmaceuticals International GmbH. As per trusted sources, the revised licensing deal would increase Eagle's royalty payment from 25% to 30% of the total sales of BENDEKA in the U.S. given that its orphan drug exclusivity has not been waived, withdrawn, and rescinded by such date.
Reportedly, the royalty rate would increase by one percentage point on each anniversary of October 1, 2019 until it reaches 32% and would remain at the same percentage point thereafter.
Chief Executive Officer of Eagle Pharmaceuticals, Scott Tarriff was reportedly quoted saying that the firm is pleased to deepen its partnership with Teva Pharmaceuticals International by expanding and extending its licensing deal for BENDEKA. Tarriff further added that Teva Pharmaceuticals has been a strong commercial partner and Eagle Pharmaceutical looks forward exploring additional areas of cooperation.
Reportedly, the new licensing agreement acknowledges the long-term value of the product which is backed by orphan drug exclusivity through December 7, 2022 and an extensive patent portfolio through 2033.
According to the press release issued by EaglePharmaceuticals, the revised licensing deal also extends the royaltyterm of U.S. BENDEKA until it is no longer sold in the nation. Reportedly, theextended royalty term acknowledges the strength of the bendamustine patentswith expiries through 2033.
For the record, the U.S. Food and Drug Administration (FDA) has granted orphan drug designation to BENDEKA and it has been approved by the regulator to treat patients from indolent B-cell non-Hodgkin lymphoma (NHL) that has progressed during or within six months of treatment with rituximab or a rituximab-containing regimen. BENDEKA has also received approval for the treatment of patients suffering from chronic lymphocytic leukemia (CLL).
Boehringer Ingelheim completes clinical trial enrollment of NASH drug
Akshay Kedari Feb 25, 2019
Sanofi's insulin prices for some patients in U.S. topple to $99/month
Mateen Dalal Apr 12, 2019
Roche's Tecentriq Regimen receives U.S. FDA approval to treat NSCLC
Mateen Dalal Dec 9, 2018
Alphamab, Ascletis enter Anti-PD-L1 deal for Hep B and other diseases
Mateen Dalal Jan 14, 2019
Akshay Kedari
A qualified computer engineering graduate, Akshay Kedari holds a commensurate passion for both writing and programming. Presently, Akshay develops content for healthcareopportunity.org and similar other portals. Apart from penning down pieces related to digitized healthcare, pharmaceuticals, and more, Akshay spends his free time enjoying bike rides and good food. He can be contacted at- [email protected] | https://twitter.com/axeyked
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Home » Science » Genghis Khan's Secret Weapon Was a Rainy Climate
Genghis Khan's Secret Weapon Was a Rainy Climate
Posted in Science, Society
Climate of Genghis Khan's ancient time extends long shadow over Asia of today
Climate was very much on Genghis Khan's side as he expanded his Mongol Empire across northeastern Asia.
That link between Mongolia's climate and its human history echoes down the centuries, according to findings reported in this week's issue of the journal Proceedings of the National Academy of Sciences(PNAS).
But climate may no longer be the boon it was during the latter, wetter part of Genghis Khan's reign. The early years were marked by drought.
Mongolia's current drought conditions could have serious consequences for the Asia region's human and other inhabitants.
The discovery linking ancient and modern history hinges on wood. Trees provide an extensive climate record in their rings.
The tree rings' tales of ebbs and flows in water availability show that Genghis Khan took power during a severe drought, says Amy Hessl, a geographer at West Virginia University and co-author of the paper.
This is a view of the modern-day Orkhon Valley near Karakorum, the ancient Mongol capital.
(Photo Credit: Amy Hessl)
But, the scientists found, the rapid expansion of Genghis Khan's empire coincided with the wettest period in the region during the last millennium.
"Through a careful analysis of tree-ring records spanning eleven centuries, the researchers have provided valuable information about a period of great significance," says Tom Baerwald, a program director for the National Science Foundation's (NSF) Dynamics of Coupled Natural and Human Systems (CNH) Program, which funded the research.
CNH is one of NSF's Science, Engineering and Education for Sustainability (SEES) programs. CNH is supported by NSF's Directorates for Geosciences; Biological Sciences; and Social, Behavioral & Economic Sciences.
"The results also provide insights into the complex interactions of climate, vegetation and human activity in semi-arid regions today," Baerwald says.
Though political realities would also have played into Genghis Khan's power grab, the regional climate at the time appears to have supported his empire's expansion.
The climate provided literal horsepower as armies and their horses fed off the fertile, rain-fed land.
Genghis Khan was enthroned in the year 1206; climate played a large part in his empire's success.
"Such a strong and unified center would have required a concentration of resources that only higher productivity could have sustained, in a land in which extensive pastoral production does not normally provide surplus resources," the paper states.
While the ramifications for past history are significant, so, too, are they for today's.
The scientists believe that human-caused warming may have exacerbated the current drought in central Mongolia, similar to the drought that coincided with Genghis Khan's initial rise to power.
"If future warming overwhelms increased precipitation, episodic 'heat droughts' and their social, economic and political consequences will likely become more common in Mongolia and Inner Asia," according to the paper.
This is the site in Mongolia where the team stayed while collecting data.
(Photo Credit: : Amy Hessl)
Source: National Science Foundation
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Once carved to perfection, don't forget to put the rest of your pumpkin to good use. From sweet classics to savoury mains, the options for the bright orange squash are endless.
The first thing you will do with your pumpkin, whether you're carving or simply cooking, is to scoop out the seeds. These little kernels are packed with vitamins and minerals and are a great source of fibre - so it would be a shame to throw them away. To roast and eat, simply clean your seeds, boil for 10 minutes to soften, then drain and dry on a paper towel. Finally toss with a little oil, spread out on a baking sheet and place them in a low oven for around 45 minutes (about 120°C) until they are crisp and golden brown. If you want to add a bit of flavour, sprinkle over salt, pepper, paprika, or whatever takes your fancy when you add the oil.
The sweet, honied flesh of the pumpkin lends itself perfectly to cakes and bakes when grated. Combine with cinnamon for lightly spiced cupcakes, enhance the sweetness with clear honey or give your favourite carrot cake recipe a makeover. If you find your grated pumpkin is a little wet once prepared, simply give it a good squeeze before using and keep an eye on it when baking - the added moisture may mean it needs a little longer in the oven.
It's often assumed that cooking pumpkin will keep you in the kitchen for quite a while. This isn't always the case as our speedy squash favourites prove. Make a moreish mid-week meal by adding diced pumpkin to pasta, roast and serve with sausages or simply serve lightly spiced as part of an antipasto or as a side.
Soft pumpkin flesh blends effortlessly into a thick, velvety soup. Simply add onions, cream and stock to keep the colour bright and bold, or give your bowl an Asian twist with Thai flavours such as lemongrass and ginger. For a blend worthy of your next dinner party, first roast the squash to exaggerate the depth of flavour and serve with contrasting pancetta.
Not a fan of the Jack O'Lantern? There are other ways to use the hard skin of your pumpkin. Bring all the beautiful Indian spice of a biryani to your squash and then serve inside the pumpkin itself. Alternatively, scoop out the seeds and strands, pour a garlic cream inside and allow it to penetrate the skin as you roast the pumpkin whole.
One mention of pumpkin pie in the Good Food office proved it to be something of a Marmite dish. Love it or hate it, nothing tastes quite like the spiced pastry. Opt for the traditional with shortcrust pastry, nutmeg and cinnamon or give it a twist with a lattice top or filo finish.
What are your top tips for cooking the winter squash?


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Dr. Veselin Vukotić is Montenegrin economist, professor, politician, and co-owner of Donja Gorica University. During 1985-1988 he was part of the cabinet of Montenegro's Prime Minister Vuko Vukadinović. He served as a Minister for Privatization and Entrepreneurship in the government of the Socialist Federal Republic of Yugoslavia from 1989 to 1992.

References

Living people
Montenegrin economists
Government ministers of Yugoslavia
1949 births

redpajama_set_name: RedPajamaWikipedia


Do you have a friend in need of some encouragement this week? Here are a few quotes to help lift them up.
No one wants to be told they are wrong. Sometimes, though, the best way to learn how to do something the right way is by trying and failing. That isn't always the most comforting thing to hear when you have just made a mistake or fallen short of your own expectations, but it's the truth. Your friend might not know they need to hear this kind of truth, but they do. When someone is upset, they often need to hear these kinds of things from people they trust (e.g., you).
It is very easy to set goals when you are inspired to change and then get discouraged when change does not happen as quickly as you hope and expect that it will. If a friend is struggling to see results, they just might need to hear that taking time to grow and improve effectively is more important than speeding through it incorrectly. Remind those around you that self improvement is a first step to much greater things yet to come. There will be times of disappointment and discouragement, but in the end, it is always worth it.
If our greatest obstacles in life are ourselves, than the best way to break down those obstacles is to fill our minds with positive thoughts about persevering even when we don't think we have it in us to go on. Someone you know might need to hear that yes, they can do what they believe or have been told they cannot do. They are more capable than they believe, and so are you!
You cannot wait around for success to come find you. If you go looking for it, you will also never find it. The only way to become successful is to fill your days with activities that will somehow indirectly lead you to success. Focus on the smaller steps that will get you there, not the end result. It will never happen the way you imagine it will.
Have you ever known someone who constantly dreams about the moment when they can finally stand up and begin changing the world for the better? There are no rules that say we have to wait until one chapter in our life closes before starting another. Waiting is unnecessarily discouraging and stressful if the only thing stopping us is the belief that 'it's not the right time.' Anytime is the right time. Do it now!
The only real limitations when it comes to setting goals are the limitations we use as excuses for turning down opportunities to make our lives better. People can transform their lives all on their own by setting new goals, regardless of their age, past experiences or any limitations that might appear to stand in their way. If you are not happy with the way things are going right now, you have the power to create and hit a reset button for yourself. Throw away whatever is holding you back, because a much brighter future is waiting for you.
Everyone goes through tough times, and if you've been there, you know that sometimes the most simple yet encouraging thing you can remind someone who is struggling is that all they have to do is keep going. It is never going to be unbearable forever. If they have made it this far, they can make it even farther. Reassure your friend that they are not going through these things alone. Keep pushing them to move forward, even on their worst days. It may be exactly what they need to hear.
We all have those moments when we just don't feel like we are measuring up to certain standards we unknowingly subscribe to. If your friend is having a bit of a quarter life crisis – it happens – remind him or her that they are probably imagining a lot of the pressure they are feeling to 'become who they are supposed to be.' In reality, they do not need to be anyone other than who they choose to be. The course of their life and their decisions have always been, and will always continue to be, up to only them.
Always do the right thing for the sake of doing the right thing. No one is going to be watching you. You are not going to be rewarded or praised for doing the right thing. All you need in terms of reassurance is knowing that you did a good thing. That is what will make you feel full.
Things are going to turn out fine. You can do this.


After his defeat on Tuesday night, Mike Skinner said he felt like he had served his purpose in Ward 3 for the Franklin Board of Mayor and Aldermen.
Political newcomer Scott Speedy beat him by nearly 500 votes, and Skinner started congratulating Speedy inside the Williamson County Administrative Complex as soon as he saw early voting totals.
Skinner moved to Ward 3 in the 2004. He originally found himself involved with city government in 2008 to replace Dodson Randolph. He finished the 18 month appointment and was later elected two terms.
Though his tenure is now up, Skinner said he was proud of the City of Franklin during his 10 years. His favorite accomplishment is the creation of Eastern Flank Battlefield Park, which surrounds the historic grounds of Carnton.
"And that's turned into a real jewel," Skinner said. "People can walk and enjoy it while they enjoy Carnton."
He's also happy to see the Parks Master Plan approval in 2016, particularly the addition of a park in the eastern side of the city past Interstate 65.
"The fact that we got this new park comparable to the size Jim Warren on the east side," he said. "It's going to be really appreciated by people in that part of town.The parks master plan for trails was a large project for what the board should do when they can. I think it's a good guide so I hope more of those projects come about."
Skinner said he hoped for in the future in Ward 3 to see another overpass across Interstate 65, especially after a tanker fire destroyed and closed the existing bridge for months until it was fixed.
"We did some major road projects, like South Carothers Parkway," Skinner said. "That was a big deal, and it gives another north-south corridor route. "But I really hope the Long Lane overpass appears on the next Capital Investment Project list. We really need another crossing over Interstate 65. I hope that happens. That's something that I didn't get to."


An occupational therapist helps treat injured and disabled individuals by guiding them through everyday activities. They help patients recover skills that allow them to perform regular activities of daily living and re-gain their independence. Occupational therapists work in hospitals, nursing homes and physician's offices. The job is not a desk job- most therapists spend long hours on their feet and may have to lift or support patients.
In order to work as an occupational therapist in Utah, first you must graduate from an accredited school with a Master's degree in occupational therapy. Next, you have to complete six months of clinical practice under the supervision of a licensed occupational therapist. After completing your clinical practice, you need to pass an exam offered by the National Board for Certification in Occupational Therapy in order to become a certified occupational therapist. The final step is to become licensed to work in Utah. The licensing process is straightforward and involves simply demonstrating that you have completed all of the above steps satisfactorily. An application needs to be submitted and a small fee paid. A criminal background check is part of the licensing process.
Finding an accredited school in Utah is easy- there is only one. The University of Utah, located near Salt Lake City, is the only school in the state of Utah that offers the necessary educational requirements for becoming an occupational therapist.
The college courses included in an occupational therapy program cover such as areas as anatomy, physiology, kinesiology, biomechanics and principles of occupational therapy methods.
Who Offers Certification in Utah?
Certification in occupational therapy is regulated by a national agency, the National Board for Certification in Occupational Therapy. Utah requires a 70% or greater score on the certification exam in order to become licensed.
What is a Typical Salary for an Occupational Therapist in Utah?
The median salary for an occupational therapist in 2010 was $72,320, which works out to about $35 per hour.


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Review: Crude #4
Review of: Crude #4
Emotional Drama
Crude issue 4 continues to push the emotional narrative forward through the use of excellent art work. All of the creators are working on the same page, literally and figuratively, as they produce a comic which flows effortlessly from panel to panel, page to page.
The Russian based revenge story that is Crude reaches its forth issue this week. New from Image Comics and reviewed by our contributor, Darryll Robson, Crude continues to push the boundaries of art and narrative.
Deep in the heart of Russia, a safe haven for those wishing to live their lives without judgement or interference has been turned into a den of extortion and violence. Steve Orlando and Garry Brown have created a character driven story which revolves around the bond between father and son. All of those emotions that a father feels during a child's upbringing are enhanced and experienced through the central character's journey into the unknown. The worry; the anger; the frustration; and the undying love are all part of the story.
On the surface Crude may seem like a simple vigilante story but this is just a front for the family relationship narrative running behind.
In the heart of Blackstone, Piotr continues his violent search for the those responsible for the death of his son.
But his actions haven't gone unnoticed: now every group fighting for dominance of Blackstone are hunting him down.
Dreams of Kiril as a child haunt Piotr but new revelations could change everything just as the gangs start to close in.
This issue has some big, violent, action in in but it's the relationship between Piotr and his deceased son which takes centre stage.
Steve Orlando and Garry Brown open the issue in spectacular style with a violent, highly choreographed fight scene. The aggression and anger is felt in each panel and page as Brown focuses on Piotr's animal like fighting style to illustrate the emotions that feed the character. The dominant blue colouring, with dark red splashes for the blood, highlight the coldness of the scene. These actions are not of a man enjoying himself; he is clearly fuelled by vengeance and an internal need to bring the killers of his son to a kind of vigilante justice.
This opening sequence is a perfect set up for the rest of the issue because Orlando and Co use the emotions set up in the beginning to explore Piotr's relationship with his son. The pace of the comic slows down after the first few pages and the world around the characters begins to expand. This is an issue where secrets are revealed and they feed directly into that opening fight scene causing Piotr, and through him the reader, to question his actions.
There is a juxtaposition between Piotr's memories of his son and the man that he became, as seen through those he lived and worked with. This contrast, as I have mentioned, is the heart of this issue with the cold, clinical nature of the opening fight suddenly becoming muddied. Piotr even seems to physically shrink in the panels as Brown changes the view point so that the other characters in the panels appear larger; viewing Piotr from below so the others loom over him. The physical representation of Piotr reflects the sudden turmoil of his emotions as his simple views of the world and his son are thrown into the air.
This is a comic that loves to emphasis single moments. As the story itself is a cover for a deeper, emotional story that the creators wish to tell, the art work represents pivotal moments in Piotr's emotional development often by changing a panel to stand out in some way from those around it. For example; in one sequence Lee Loughridge alters the colours of the back ground from the murky blues covering most of the page to a vibrant orange. Not only does this help to highlight the impact of rubber bullet striking Piotr but it emphasises the gut shot that he is about to get when he finally meets some people who knew his son.
Something similar happens with the speech. There is a lot of text in this issue, a lot of exposition, but Tomas Mauer manages to keep it under control, choosing overlapping or linked speech balloons depending on which part of the speech needs to be emphasised. He litters the balloons with bold text but surprisingly it is the separated speech that makes the most impact: long conversations within linked balloons stop with the final sentence or few words in their own balloon, indicating the pause taken by the character. This technique is used effectively throughout Crude helping to pace the scenes and add that element of surprise or shock.
Crude is building into a spectacular series. From the turns of the opening issue to the twists at the heart of this one, the creators keep the readers on the edge of their seats. Beautifully orchestrated fight sequences effortlessly lead into touching family dramas. This is a surprising comic and the tension and excitement is building month after month. There's no question about any of the readers coming back for issue 5
Darryll Robson is a Contributor to ComiConverse. He has a much underused Twitter account: @DarryllRobson, and his own website comiccutdown.com where he writes more about comics.
Crude #4
Crude Garry Brown Image Comics Steve Orlando


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Brussels-based media platform for expertise and civil society initiatives for Ukraine and the EU
Promote Ukraine is an independent media and civil society platform that gives voice to experts from Ukraine and the EU on the issues relevant to both parties. It is a politically and governmentally independent organization with the seat in Brussels.
We are the voice of Ukrainian civil society in Brussels. We empower Ukrainians to take up their role as free European citizens.
Our Impact. We boost the visibility of Ukraine within the EU. We strive for a behavioural change in relation to Ukraine and Ukrainians in terms of mutual respect, dignity and responsibility.
Our Goal. We promote Ukraine in political, business and non-governmental circles of European countries and we support the application of European values in Ukraine.
Promote Ukraine seeks to facilitate relations between the European Union, its member states and Ukraine by walking the paths of culture, know-how, organisation, cooperation, information and entrepreneurship.
Our Method. The long-term perspective of Promote Ukraine is to establish a network "Successful Ukrainians – Prosperous Ukraine" – a network of people who are ready to use their skills and time in benefit of Ukraine.
We act according to the principles of mutual respect, inclusion, autonomy and support. We strongly believe that it is people that make the change happen.
Since its establishment on the 9th of May 2014, Promote Ukraine went through several transformations. Consisting of Ukrainians of Belgium, it was perceived as a diaspora organization. Nevertheless, our main goal has been to deliver the truth about Ukraine not only to the Belgians but also to other European audiences – ordinary citizens, experts, and politicians. It was also important for us to follow up on the democratic process in Ukraine itself. Therefore, we perceived ourselves as an international NGO where our members could apply analytical skills to create such instruments as articles, videos, podcasts, and at the same time, give a platform to others to do so through interviews, conferences, round tables, and other events.
Today, Promote Ukraine has several unique instruments to promote European integration of Ukraine with the help of expertise. First of all, we re-organized the website in order to give more space for EU-Ukraine-Russia relevant news, commentaries, and interviews from Ukrainian and European experts and policymakers.
We launched a printed and online journal, called Brussels Ukraїna Review which we share among policymakers of Ukraine and the EU. We invite experts from Kyiv and Brussels but also from other capitals of the European Union to share their views in the journal. We will make sure that the right people read it.
We launched a mobile application Leads Ukraine to share events on Ukraine, organized by NGOs, embassies, analytical centers (think-tanks) of all over the world, as well as information from these organisations such as statements, calls, policy papers, etc.
Every week we make a European Press Review where we summarize issues related to Ukraine that were mentioned in German, Dutch, Belgian, French, Austrian, Swiss, and Italian newspapers. This, to constantly have an idea about the image of Ukraine in Europe.
We launched a series of sociological surveys on important topics where there is a common element for Ukrainians and Europeans. Together with the Institute of Sociology of the Kyiv National Economic University we form questions and analyze answers.
Hugues Mingarelli EU Ambassador to Ukraine
"It has been my pleasure to have the opportunity to speak at events of Promote Ukraine. I believe that such initiatives are absolutely necessary in order to introduce such an important and beautiful European country like Ukraine to foreign audience."
Luc Jacobs Ambassador of Belgium to Poland and to Lithuania
"In the course of the past two years Promote Ukraine has matured into a credible and effective opinion maker in projecting a nuanced image of today's Ukraine abroad".
Laurens Soenen Belgian Ministry of Foreign Affairs
"International NGO that is changing the perception about Ukraine in Brussels and the European Union"
Promote Ukraine


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Winners of Business in the Community?s Responsible Business Awards 2017 announced
Anglian Water have been named one of the most responsible businesses in the UK, along with 16 other companies at the 2017 Responsible Business Awards.
[Pictured: Mark Pendlington, Director of Corporate Affairs; Chris Newsome, Director of Asset Management; Peter Simpson, Chief Executive.
Anglian Water, which supplies water and water recycling services to more than six million households, plus business customers in the east of England and Hartlepool, won the prestigious Responsible Business of the Year award for its commitment to reducing its carbon consumption and helping customers waste less water through its 'Love Every Drop' programme. The water company re-uses resources as much as possible, taking a circular economy approach. For example, it has created a new £25m a year market for bio-solids, a fertiliser created as a by-product of the water-recycling process. This nutrient-rich product offsets the need for inorganic fertiliser in the agricultural sector and has created demand which far outstrips supply.
The business also plays a big part in its community – supporting customers in vulnerable circumstances and leading the way on the health and wellbeing of their own employees.
Other winners include Tesco, who won The Experian Award for Building Stronger Communities Award for donating over five million meals worth of food to people in food poverty, and National Grid, which won The Unipart Award for Outstanding Employment award for a range of employment programmes supporting former offenders, young people not in education, employment or training, as well as for improving the number of women and people from minority and ethnic groups in their workforce.
International business, Cisco won the UPS International Disaster Relief and Resilience Award for its dedicated, full-time disaster response team who can deploy anywhere in the world in three days to get phone lines and internet connections back up after disasters. The team, supported by 350 trained Cisco volunteers, have responded to 39 disasters on six continents and connected more than 600,000 people during acute crises.
Another international winner was SunnyMoney, who won The Unilever Global Development Award. They are a social enterprise with a mission to eradicate the kerosene lamp from Africa by 2020, said to be responsible for more deaths then HIV and Malaria combined. The company has introduced affordable solar light to the continent where 600 million people still do not have access to electricity – benefitting 10 million people to date.
Amanda Mackenzie OBE, Chief Executive of Business in the Community, commented: "Congratulations to the 2017 Responsible Business Award winners for being inspirational yet practical examples of the difference business can make to address some of society's biggest issues. The winning businesses are all different, they span sectors and continents and range from large high street names to small start-ups. What unites them is a belief that with courage vision and leadership, business can do remarkable things for good."
The Awards Gala took place at the Royal Albert Hall last night and was presented by broadcasters Jeremy Vine and Emily Maitlis. It celebrated and championed the hundreds of inspiring businesses who entered the awards and who make a difference by taking action to build more inclusive workplaces, stronger communities and address global challenges such as sustainability.
This year's Gala was hosted by Veolia, the UK's leading resource management company and Business in the Community's Responsible Business of the Year 2016.
Estelle Branchlianoff, Senior Executive Vice-President for Veolia UK and Ireland, comments: "The calibre of businesses at last night's Responsible Business Awards and Gala Dinner was outstanding, and proof that both global multinationals to SMEs can be a powerful force for good in society. One year after our own 'Responsible Business of the Year' recognition, my conviction is that 'people, planet, profit', often referred to as 'The Triple Bottom Line', is stronger than ever, as people want to buy from, work and partner with socially responsible businesses. I'd like to take this opportunity to congratulate all the entries from this year's awards and wish Anglian Water every success as we pass the baton on."
The headline sponsors of the 2017 Responsible Business Awards are Experian, Unilever, UPS, Aviva, Barclays, Fujistu, UBS, Unipart Group. The full list of winners is available here.
For more information about Business in the Community or the Responsible Business Awards finalists contact Alex Delaney, 020 7566 8694 / 07766 161419 or email alex.delaney@bitc.org.uk.
The full list of 2017 Responsible Business Awards Winners is:
Responsible Business of the Year:
Winner: Anglian Water
Small company winner: We Are Vista
Aviva Award for Championing an Ageing Workforce:
Winner: Barclays
Barclays Award for Building Resilient Business
Winner: Adler and Allan
BITC Award for Environmental Leadership, supported by the Department for Environment, Food & Rural Affairs
Winner: National Grid
Small company winner: Lakes Free Range Eggs Co.
Highly commended: British Sugar
Experian Award for Building Stronger Communities
Winner: TESCO
Highly commended: Engie
Fujitsu Award for Responsible Business in the Digital Age
Winner: Unipart
Small company winner: Parcelly
UBS Award for Education
Winner: ESH Group
Small company winner: Dragon LNG SME
Highly commended: British Land
Unilever Award for Global Development supported by Business Fights Poverty
Winner: SunnyMoney
Winner: WaterHealth International
Unipart Award for Outstanding Employment
UPS Award for International Disaster Relief & Resilience Award supported by DFID
Winner: Cisco
Small company winner: what3words
Highly commended: Dr Zigs and EY
Business in the Community
Business in the Community is the Prince's Responsible Business Network. Our members work together to tackle a wide range of issues that are essential to building a fairer society and a more sustainable future.
We engage thousands of businesses through our programmes driven by our core membership of over 800 organisations from small enterprises to global corporations.
The Responsible Business Awards
Business in the Community's Responsible Business Awards brings to life how businesses are creating innovative and sustainable solutions to our most pressing challenges, inspiring thousands of others to make a lasting difference and adding value back to their own business.
Now in its 20th year, the awards, rigorously assessed by independent business peers, are widely acknowledged as one of the most respected endorsements of responsible business in the UK and abroad. Open to companies of any size, sector or scale, a wide range of businesses enter, demonstrating the breadth and depth of responsible business.
Each year, over 250 business peers assess the entries, endorsement planters are used by companies to profile their achievement, inspiring thousands of people to be a motivated part of the Prince's Responsible Business Network.
In 2017 Business in the Community received 249 entries for the Responsible Business Awards, 72 were shortlisted, and 48 companies were named finalists and there were 16 winners.


Our previous issue described the requirements and introduced an encounter form for documenting these visits. Now we answer your questions about this newest Medicare benefit.
Fam Pract Manag. 2011 Mar-Apr;18(2):13-15.
The expansion of Medicare preventive services coverage that took effect on Jan. 1 of this year provides a valuable opportunity for you and your patients to focus on preventive screening and wellness, particularly in the context of an annual wellness visit (AWV), the newest Medicare benefit. However, providing and billing for such visits is, of course, complicated. Our January/February issue cover story provided an overview of Medicare preventive services and two tools to help you deliver, document and bill for them, but a single article could not cover all the details associated with these benefits. You responded with a number of good questions, the answers to which are given below.
What ICD-9 codes should be used with the HCPCS codes for annual wellness visits (G0438 and G0439)?
The Centers for Medicare & Medicaid Services (CMS) did not specify the ICD-9 codes that should be used. Individual Part-B contractors may designate specific codes, but typically ICD-9 codes in the V70 range have been accepted.
Do I understand correctly that, other than measuring vital signs, no physical exam is required?
The following vitals – height, weight, BMI or waist circumference, blood pressure and other measurements as appropriate – are the minimum requirements. Physicians must determine the level of physical examination necessary to create a personalized prevention plan based on the patient's risk factors and health goals and to encourage patient utilization of other preventive services, as this is the purpose of the AWV. Remember that you may provide other covered Medicare preventive services at the same encounter if indicated and your schedule permits, although you should check with the Medicare administrative contractor in your region to confirm that you will be paid for the additional service, as described in the next question.
If I perform the clinical breast and pelvic exam (G0101) at the same encounter as the AWV, will Medicare pay for the breast and pelvic exam in addition to the AWV?
In other words, because WPS considers the breast and pelvic exam to overlap with the exam portion of the AWV, physicians must subtract the amount charged for the breast and pelvic exam from their usual charge for the AWV. The Pap smear collection and handling (Q0091) could probably be charged without a reduction of the AWV fee.
Does documenting that a patient was "alert and oriented × 3" (to person, place and time) cover the requirement to "review and document the detection of any cognitive impairment that the individual may have"?
Therefore, your documentation should include an assessment gained from observation, patient interview and input from caregivers present at the encounter. CMS does not require that physicians use a specific assessment tool, but the documentation should include evidence of assessment, such as notations of the patient's general appearance, affect, speech, memory and motor skills.
Does the initial annual wellness visit (HCPCS code G0438) apply only to patients who are new to my practice?
No. The AWV codes do not distinguish between new and established patients. Rather, the initial AWV is billed the first time a Medicare beneficiary receives an AWV that includes all of the elements required by CMS. The subsequent AWV code is reported for patients who have previously received an AWV service, whether at your practice or elsewhere.
It will be difficult to be certain whether one year has elapsed since the Welcome to Medicare visit or initial AWV if the patient is new to my practice. Is it necessary to provide patients with an Advance Beneficiary Notice (ABN) so that we can bill them should they receive the subsequent service prior to their eligibility?
No ABN is required, but it is a good idea to verify the patient's preventive services eligibility and provide those who request the service prior to eligibility with an ABN confirming their agreement to pay. Based on CMS instructions to Medicare contractors, claims for an AWV provided before 11 full months have passed since the last AWV will be denied with a "PR" code, indicating patient responsibility. Note that knowledge of the patient's past preventive services, such as last colonoscopy or the onetime benefit for the pneumococcal vaccination, will facilitate development of the preventive care plan at the annual wellness visits. If your practice is not using the 270/271 electronic eligibility transactions or another Medicare eligibility inquiry program, you may wish to consider options for incorporating this into your scheduling or pre-visit preparation processes.
Where can we learn about conducting electronic eligibility inquiries to determine our patient's eligibility for Medicare preventive services?
You may contact your Medicare administrative contractor, your practice management software vendor or your claims clearinghouse for specific information on options available to you. These will likely include the 270/271 electronic inquiries that are conducted like electronic claims submissions, with the 270 sending your inquiries and the 271 returning the report to you. Another option may be to use the online provider-service portal offered by the Medicare administrative contractor; this may be less expensive and meet your needs if you don't expect to make daily inquiries. However, the 270/271 transactions likely allow for batch inquiries that could save time and effort when inquiries for multiple patients are necessary. These resources can also help determine which patients have Medicare Advantage coverage or have Medicare as a secondary payer.
What is the definition of a "health professional" or "health educator," both of which may provide AWVs if working under the supervision of a physician, according to the regulations? Do these individuals need to have received formal education leading to a specific degree, or can they be trained?
Neither the legislation that expanded the preventive services benefits (the Affordable Care Act) nor the regulations that CMS created and implemented provide an answer to this question. Given that, the criteria may boil down to whether the person is licensed in the state, working within the scope of practice allowed by the state and, as you said, under the direct supervision of a physician. The concept of team care should enable physicians to include the licensed professionals who are best suited to provide a portion of the AWV service, based on individual patients' needs. Remember that "direct supervision" requires the physician to be in the office suite and readily available to offer assistance and direction as needed. The AWV should be billed by the supervising physician.
Note that the regulations allow physician assistants, nurse practitioners and clinical nurse specialists to provide the AWV. Physician supervision of these health care providers should align with state requirements. For instance, where direct supervision of nurse practitioners is not required, the nurse practitioner may provide and bill for the AWV under his or her NPI number.
Can I still provide a preventive service as described by CPT codes 99387 and 99397 to Medicare patients who wish to have a routine physical that doesn't include all the elements of an AWV?
Yes. The CPT preventive service codes could be submitted when the elements required for an AWV are not provided but the service meets CPT's definition of an age- and gender-appropriate preventive medicine service. These services are still not covered by Medicare Part B and as such are an out-of-pocket expense to the patient. If you provide a Medicare-covered service (such as a breast or pelvic exam) on the same date, you must subtract the Medicare payment for the covered service from your usual charge for the preventive service before billing the patient.
If a patient requests a head-to-toe physical and the AWV, may I bill for both?
CMS stated in the final rule for the 2011 Medicare Physician Fee Schedule that both services may be billed but also noted that "it would be difficult to distinguish an AWV from another preventive medicine E/M service furnished in the same encounter that would be reported under a preventive medicine services E/M CPT code as there is substantial overlap in the components of CPT codes 99381 through 99397 and HCPCS codes G0438 and G0439 reported for the AWV." If you choose to provide and bill for both services on the same date, you should take into account the overlap of elements such as history and counseling when determining what to charge the patient for the non-covered preventive service (99381–99397).
How does payment for the AWV compare to payment for a preventive service described by CPT codes 99387 or 99397?
Since there is no Medicare coverage for the preventive services visits described by CPT, these codes are not priced in the Medicare Physician Fee Schedule. However, CMS does assign relative value units (RVUs) to them. The RVUs for the initial annual wellness visit are higher than the RVUs for either of the preventive services visits, and the RVUs for the subsequent annual wellness visit are lower than these. Here are the total RVUs assigned to each of the relevant services: G0438 – 4.74, G0439 – 3.16, 99387 – 4.16, and 99397 – 3.48. In general, the higher the RVUs, the higher the payment.
We hope these answers will make it a bit easier to provide your patients with the preventive services they need.
Cindy Hughes is the AAFP's coding and compliance specialist, a contributing editor to Family Practice Management and co-author of FPM's Getting Paid blog at http://blogs.aafp.org/fpm/gettingpaid/. Author disclosure: nothing to disclose.
Send additional questions or comments to fpmedit@aafp.org.


62+ famous engineering company logo design examples 2018, this collection, is a must-have for designers. We have shared many different business logo designs, including construction logo designs, marketing, consulting, building and many more, but not "engineering company logo design" yet. Engineering is much more popular than any other type of business. There are several types of engineering companies out there but only few of them are popular, which includes chemical engineering, computer engineering, electrical, geological and civil engineering.
62+ famous engineering company logo design examples 2018, therefore, are so relevant for designers working in this industry. Today, I am sharing the best engineering company logo design from all different types of engineering companies. So, if you are looking for engineering company logo design idea and inspiration, then you have landed on the right page.
When it comes to crafting a logo design, you have to follow the industry trend to know what type of logo designs are popular and what's trending, but in engineering company logo design you have many choices. You can go beyond traditional logo designs. The first step in creating a logo design for an engineering company is to understand the type of engineering and what are the services or products the company is offering. Once you understand the company's objectives, then you can come up with an idea to design a logo.
Usually, engineering-related business logo designs are simple and straightforward because they are not used in marketing or branding a lot until they are related to construction and computer engineering. One-color logo design is a great option for an engineering company logo along with the business name and a tagline. The font should be simple as well and easy to read.
The following collection of logo designs has different types of logos, which include text-only logo designs, illustration-based logo designs and also those logo designs that have both elements.
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THIS is the shocking moment a jogger appears to deliberately shove a schoolboy out of his way.
The youngster was walking along a riverside path with a pal when a pair of runners headed towards them.
The apparently unprovoked push was captured on CCTV at 12:45pm today and shows the victim minding he own business before he is barged out of the way.
Staff at the nearby Inn Deep pub in Glasgow, Scotland posted the footage on their Facebook page and urged the public to "name and shame" the culprit.
The two boys are then seen to carry on walking before glancing back towards the jogger.
Another man is also seen to look on in shock as he watches the jogger run away.
Inn Deep wrote on Facebook: "We just witnessed a jogger assault a school kid. Absolutely no need for that at all. Let's get him named and shamed. Please share!"
It comes as a millionaire banker was cleared of being the so-called Putney Bridge Pusher.
American Eric Bellquist was detained after shocking footage showed a jogger pushing a woman into a bus on Putney Bridge.
He was forced to go into hiding and hire bodyguards after receiving online death threats.


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Should Parties Be Able To Expel Members
Should Parties Be Able To Expel Members?
Political parties get a bad rap. A dying generation of pundits like David Broder bemoan "excess" partisanship, while President Obama desperately tries to get a tiny handful of Republicans to sign onto his plans and make them "bipartisan." We're taught by the "objective" media to "vote for the person not the party."
But in the post-civil rights era, as the Republicans have gone South literally and figuratively, American political parties have come to mean more than they ever have in our history. They now have at least some level of ideological consistency, and they provide necessary voter cues and structure to the political system. I've also found them, at least locally, to be a meritocracy. As a newcomer to Iowa City two decades ago, I was brought in and brought along, and the Democratic Party played the main role in making me the Respected Community Leader (ha!) I am today.
But political parties are hybrid creatures, part private organization and part public entity. The party, as a body, is under a crazyquilt of 50 state laws and has relatively little say in its membership or candidates.
In some ways, that's a good thing. Back in the bad old days, some Southern Democratic parties defined free association as Whites Only. But two recent legal cases raise questions about how much say a political party should have in defining itself.
The Suffolk County, New York Conservative Party is attempting to expel registered voters. (Tangent: New York law lets candidates run on multiple ballot lines, and several small parties exist mainly for this sort of cross-endorsement, called "fusion.") The back story: the police union was in a dispute with the sheriff and packed the small but significant party to try to deprive him of the Conservative line.
Small parties are extremely vulnerable to that sort of hostile takeover. Back at the turn of the century, the Pat Buchanan Brigade successfully outvoted the remnants of Ross Perot's Reform Party, prompting the lone Reform elected official, Minnesota Gov. Jesse Ventura, to leave the party. The Reform lawsuits are still flying over that one, even though the stakes are little more than the last $15 in the party bank account. Last year in Florida, Republicans ran "moles" as Green Party candidates, hoping to draw votes away from Democrats.
"New York election law has for decades contained a provision making it possible for a qualified political party to disenroll individual voters," writes Richard Winger of Ballot Access News, "if the party can show that the voters joined the party even though they are not in sympathy with its ideas."
Iowa is officially considered a "closed primary" state, meaning that you have to be registered with a party to vote in its primary. But other states have deadlines or limits on party changes, sometimes as much as a year. In Iowa you can change party on the spot.
Here in the People's Republic, folks openly refer to the June Democratic primary as "the real election" for courthouse offices. Literally hundreds of Republicans, including some names anyone in town would recognize, cross over to select the Democratic Party's candidates. In fairness, it sometimes works the other way, most notably in the 1994 gubernatorial primary between Terry Branstad and Fred Grandy. But Branstad himself called that a once in a lifetime event.
Now, of course, under present Iowa law people have every right to do that. But the legal right doesn't make it right.
It's not only party membership that's a live question. "My issue is with the way candidates can appropriate the name of a private group," said Wahkiakum County, Washington Democratic Party chair Krist Novoselic, who recently protested the state's primary law by filing (then quickly withdrawing) for local office under the label "Grange Party."
"The Grange is a non-partisan organization that does not offer candidates for public office," wrote Novoselic, who is also a Grange leader and a grunge leader; he used to play in a band called Nirvana. "The Grange may spend time and money to try and make this clear through media communications. However, the Grange cannot rebut my party preference on the public ballot, the only place a voter is guaranteed to see my claim."
Novoselic underscores a problem that local old-timers will recall: the embarrassing 1992 candidacy of "Democrat" Jan Zonneveld. He was, shall we say, eccentric, opposed many key Democratic Party issues, and endorsed Perot over Bill Clinton. But he'd collected the signatures, no one else filed, and as far as the law was concerned he was the Democratic nominee for Congress. We were stuck with the guy and had to come up with some very creative distancing strategies, as well as figuring out who to write in.
It would be interesting to see how New York's party expulsion law and Novoselic's proposed changes in party labeling would play out if applied everywhere. Should Joe Lieberman, after losing the Democratic primary and endorsing John McCain, get to call himself an "Independent Democrat?" And Republicans seem bent on purging all hints of moderation from their party, yet Jim Leach and Colin Powell still get to call themselves Republicans. How do you distinguish between the vanishing breed of pure independents, who simply want to vote for a candidate, and cynical interlopers into a party?
That's a tough call. People have sincere changes of heart. One of the greatest Democrats I know first ran for partisan office as a Republican, before joining the Democrats in Watergate-driven disgust.
But people don't have multiple, back-to-back changes of heart. If you hosted the caucuses at your house, or gave the party thousands of dollars, or asked "how soon can I change back" when you get your ballot, you really shouldn't be choosing the other party's candidates.