Sight Saved in Haiti Thanks to Saving Sight Partner in Sight
Dr. Andrew Moyes poses with 11 year-old Miriam who receive a second cornea transplant in 2011 with tissue provided by Saving Sight.
In a developing country like Haiti, vision loss can be a devastating blow to an individual's ability to work and support one's self, not to mention his or her entire family. Glaucoma, cataracts, corneal blindness – disorders that can be treated here in the U.S. – can sink a poor family into complete and desperate poverty. In Haiti, blindness can be lethal.
Yet, in the midst of this darkness, lies hope for thousands thanks to nonprofit organizations and mission groups as well as the dedicated volunteers who support them. Volunteers like our partner in sight, Dr. Andrew Moyes of Moyes Eye Center in Kansas City, MO, who has performed sight-saving surgeries on nine mission trips to Haiti, including corneal transplants using gratis donated tissue provided by Saving Sight.
An Ophthalmologist Discovers His Mission
When Dr. Moyes was first approached to donate his time at the Northwest Haiti Christian Mission (NWHCM), he made a financial contribution, but declined the invitation to Haiti. Soon after, as he watched a video on everything the Mission offered residents – the schools, feeding programs, birthing center, orphanages – he was moved to take his first Haitian mission trip.
In 2004, Dr. Moyes joined the surgical team at the NWHCM in the Northwest Zone of Haiti, the poorest state in the poorest country in the Western Hemisphere. On his first mission trip, Dr. Moyes and his fellow doctors performed 60 cataract surgeries; by his eighth trip in February 2011, that number grew to 162 performed in just four-and-a-half days.
In addition, the surgical team is trying to ease the devastating effects of glaucoma in the country. Said Dr. Moyes, "Glaucoma is so rampant in Haiti that one-fourth of people that we see in our clinic are blinded by the disease. Glaucoma isn't even one of the World Health Organization's priorities because it is so hard to treat." However, through preventative eye exams, laser treatments to halt further vision loss, and glaucoma medications donated by Alcon and Allergan, the doctors are making headway.
"We're trying to push back how quickly people go blind. Maybe Lord willing, someone will go blind in 12 years instead of two. When you see healthy 30 year-olds who want to work, but have no light perception because of glaucoma to perform a job, it's enough to break your heart."
Dr. Moyes also uses his expertise as a renowned corneal surgeon to save sight. In August 2011 for instance, he transplanted gratis tissue from the Eye Bank to restore vision to three individuals in need, including a 26 year-old male whose corneal scar affected his ability to work and an 18-year-old female who traveled from Port-au-Prince to this rural area of the country to save her vision.
But one transplant recipient who has stuck out in his mind is Miriam, an 11 year-old suffering from congenital hereditary endothelial dystrophy, a condition that thickens and clouds the cornea. Miriam received a corneal transplant in one eye two years ago – the result was so remarkable she was able to move from a special needs orphanage to one which provided her more independence. Because of a donor family's incredible generosity here in the Midwest, Dr. Moyes was able to save her sight in her other eye, helping to provide her with a solid foundation for her future.
Continuing to Serve Both at Home and Overseas
The goal of these medical mission trips is not to perform the surgeries and walk away, but to truly help the Haitian people help themselves. Dr. Moyes and his colleagues are focused on teaching ophthalmologists in Haiti the skills they need to offer services throughout the year. In addition, because patient follow-up is so crucial after eye surgery, a Haitian ophthalmologist is available at NWHCM four days a month for follow-up exams and maintains contact with the medical team on any pertinent issues.
Even among the overwhelming circumstances – the backlog of patients, the country's challenging infrastructure, the inability to help all who need assistance, Dr. Moyes finds hope and joy in the faces of those he's helped. So much so that he has integrated his passion for the Haiti people into his professional life at Moyes Eye Center and into his personal life, now that his wife and four children often join him on mission trips.
"There's not a day that goes by that I don't think about what needs to be done, what we can do to make eye care better in Haiti. Seeing the joy in people's faces when they realize they can see again brings such joy to my heart. As anyone on a mission trip will tell you – you go there to bring blessings to others, but you will be blessed a hundredfold by them. It feels so right to serve these people."
We at the Eye Bank could not provide Dr. Moyes with gratis tissue for his mission trips without the compassion of donor families and the contributions of our generous financial supporters. To learn how you can pledge to give sight, whether around the world or in your own backyard, please visit our About Cornea Donation page.


Sekisui Chemical to expand its presence in the European automotive market
With new production facilities in the Netherlands, the company aims to meet the growing demand for interlayer films and thermal management materials used in high-power batteries and energy control units for EVs and is supporting the shift to a connected, autonomous, shared and electric industry.
Japanese automotive supplier Sekisui Chemical is seeing a growing demand for high-performance interlayer films and thermal management materials – products that reduce carbon emissions and enhance fuel efficiency, comfort and safety, and are especially relevant for EVs. Significantly stricter European average fleet limits of 95 grams of CO2 per kilometer will come into force in 2020, further boosting demand for electric cars. Sekisui is therefore building a new production line in the Netherlands for interlayer films and due for completion by the end of this year. Work is also scheduled to commence on a new plant for thermal management materials around the middle of next year. Sekisui is focusing on producing a grease-type thermal management material for use in EV batteries in Europe.
Masayuki Suda, CEO of Sekisui Chemical, explains:
"The automotive industry is facing a once-in-a-century revolution, and we can contribute to this, especially in e-mobility, with our heat management and thermal solutions," "Our products are essential for our customers to keep pace with these trends and remain competitive."
Sekisui has been a strong partner to the automotive industry for many years, with products that combine sustainability, innovation and efficiency. This was recognized at the World Economic Forum in Davos, Switzerland, when Sekisui Chemical was listed once again among the 2019 Global 100 Most Sustainable Corporations in the World. 2019 is the second consecutive and fourth time overall that Sekisui was featured in this index.
The car of tomorrow is a lightweight
With more than 70 years of experience the production and processing of plastics, lightweight is at the heart of Sekisui's work. Replacing metal in a car with high-performance plastics makes the vehicle significantly lighter – a crucial consideration in the drive to reduce carbon emissions in the automotive industry and make the shift to electric mobility.
Europe is at the center of the future automobile industry, and trends such as CASE – Connected, Autonomous, Shared and Electric – are progressing in Europe at a faster pace than in other regions. The European market, and Germany in particular, is therefore increasingly important for Sekisui, which is why the company wants to strengthen its business in Europe and continue investing in this area. Sekisui already has a considerable European presence. Among its facilities are a production facility in Spain producing raw materials for interlayer films, three production facilities for resins, interlayer films and foam in the Netherlands plus a research center for interlayer film also in the Netherlands and many more. The new production facilities mark an expansion of Sekisui's automotive campus, and of its growing presence in Europe.
Sekisui concept car now showcased in the Netherlands
In September, Sekisui celebrated the European premiere of its concept car at IAA.
Suda says :
"We are proud that we could demonstrate the decisive role played by Sekisui Chemical in shaping the future of mobility, and that our concept car and the innovative products within it were met with such enthusiasm."
Sekisui presented the concept car for the first time at the IAA and showcased several products such as Sekisui's "Luminous PVB", an interlayer film with simultaneous light function that can display information across the entire windshield and other car windows, and color carbon, a carbon-fiber material processed with sputtering technology that allows more customization options while retaining all the benefits of carbon without color degradation.
Companies: SEKISUI CHEMICAL CO.,LTD
Countries: Germany
Industries: Automotive & Road Transportation
Terms: Asia-Pacific, Business, News Worldwide
Sekisui presents a concept car that displays colored carbon fiber material
Sekisui creates a colored carbon-fiber material processed with sputtering technology: an ultra-thin layer of ionized metal particles bind directly to the surface and enables the creation of colored carbon fabrics.
Sekisui increases European film production of interlayer film for laminated glass
The company invests approximately 20 billion yen expand European film production of interlayer film for laminated glass with a new film line at its plant in Roermond, and a new resin line at its plant in Geleen, both in the Netherlands.
Teijin to acquire Benet Automotive to expand european automotive business
Teijin announces that it has agreed to wholly acquire Benet Automotive, an automotive composite and component supplier in the Czech Republic, from Jet Investment. Terms of the acquisition are not being disclosed.
Teijin to acquire Inapal to expand European automotive business
Teijin announces that it has agreed to acquire Inapal Plasticos, an automotive composite supplier in Portugal. The shares of Inapal will be purchased by Teijin Holdings, the Teijin Group's holding company in the Netherlands.
Teijin Acquires Inapal to Expand European Automotive Business
Teijin is expanding its European automotive business with the acquisition of Inapal Plasticos, an automotive composite supplier based in Portugal.
Sumitomo Bakelite invests in European manufacturing line to produce epoxy encapsulation materials for automotive
Sumitomo Bakelite has announced its intention to open a new manufacturing line to produce epoxy encapsulation composite materials for automotive applications at its Belgian production subsidiary, Vyncolit NV.
Mitsubishi Chemical to acquire European carbon fiber recycling companies
Mitsubishi Chemical Corporation decided to acquire two German carbon fiber recycling companies, CFK Valley Stade Recycling and carboNXT, through its subsidiary Mitsubishi Chemical Advanced Materials, as a part of the company's efforts to promote the circular economy. The acquisition is slated for completion around early August.
Teijin Automotive Center in Europe to expand conceptual, designing, prototype and evaluation capabilities
Teijin announces that it would establish Teijin Automotive Center Europe in Wuppertal, Germany in February as a new base for technical functions within the company's automotive composite business. The company will handle concept, designing, prototyping, evaluations, marketing and technical research for next-generation automotive components, utilizing the Teijin Group's capabilities to provide…
Carbon Conversions partners with Dell to forward sustainability goals
An electric foiling composite surfboard that can reach 45km/h


Smith v. Deuel Vocational Institute
KENNETH ARDELL SMITH, Plaintiff,
DEUEL VOCATIONAL INSTITUTE, et al., Defendants.
ALLISON CLAIRE UNITED STATES MAGISTRATE JUDGE
Plaintiff, a state prisoner proceeding pro se, seeks relief pursuant to 42 U.S.C. § 1983 and has requested leave to proceed in forma pauperis pursuant to 28 U.S.C. § 1915. This proceeding was referred to this court by Local Rule 302 pursuant to 28 U.S.C. § 636(b)(1).
I. Application to Proceed In Forma Pauperis
Plaintiff has submitted a declaration that makes the showing required by 28 U.S.C. § 1915(a). ECF No. 6. Accordingly, the request to proceed in forma pauperis will be granted.
Plaintiff is required to pay the statutory filing fee of $350.00 for this action. 28 U.S.C. §§ 1914(a), 1915(b)(1). By this order, plaintiff will be assessed an initial partial filing fee in accordance with the provisions of 28 U.S.C. § 1915(b)(1). By separate order, the court will direct the appropriate agency to collect the initial partial filing fee from plaintiff's trust account and forward it to the Clerk of the Court. Thereafter, plaintiff will be obligated for monthly payments of twenty percent of the preceding month's income credited to plaintiff's prison trust account. These payments will be forwarded by the appropriate agency to the Clerk of the Court each time the amount in plaintiff's account exceeds $10.00, until the filing fee is paid in full. 28 U.S.C. § 1915(b)(2).
II. Statutory Screening of Prisoner Complaints
The court is required to screen complaints brought by prisoners seeking relief against a governmental entity or officer or employee of a governmental entity. 28 U.S.C. § 1915A(a). The court must dismiss a complaint or portion thereof if the prisoner has raised claims that are legally "frivolous or malicious, " that fail to state a claim upon which relief may be granted, or that seek monetary relief from a defendant who is immune from such relief. 28 U.S.C. § 1915A(b)(1), (2).
A claim "is [legally] frivolous where it lacks an arguable basis either in law or in fact." Neitzke v. Williams, 490 U.S. 319, 325 (1989); Franklin v. Murphy, 745 F.2d 1221, 1227-28 (9th Cir. 1984). "[A] judge may dismiss [in forma pauperis] claims which are based on indisputably meritless legal theories or whose factual contentions are clearly baseless." Jackson v. Arizona, 885 F.2d 639, 640 (9th Cir. 1989) (citation and internal quotations omitted), superseded by statute on other grounds as stated in Lopez v. Smith, 203 F.3d 1122, 1130 (9th Cir. 2000); Neitzke, 490 U.S. at 327. The critical inquiry is whether a constitutional claim, however inartfully pleaded, has an arguable legal and factual basis. Id.
"Federal Rule of Civil Procedure 8(a)(2) requires only 'a short and plain statement of the claim showing that the pleader is entitled to relief, ' in order to 'give the defendant fair notice of what the . . . claim is and the grounds upon which it rests.'" Bell Atl. Corp. v. Twombly, 550 U.S. 544, 555 (2007) (alteration in original) (quoting Conley v. Gibson, 355 U.S. 41, 47 (1957)). However, in order to survive dismissal for failure to state a claim, a complaint must contain more than "a formulaic recitation of the elements of a cause of action;" it must contain factual allegations sufficient "to raise a right to relief above the speculative level." Id. (citations omitted). "[T]he pleading must contain something more . . . than . . . a statement of facts that merely creates a suspicion [of] a legally cognizable right of action." Id. (alteration in original) (quoting 5 Charles Alan Wright & Arthur R. Miller, Federal Practice and Procedure § 1216 (3d ed. 2004)).
"[A] complaint must contain sufficient factual matter, accepted as true, to 'state a claim to relief that is plausible on its face.'" Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009) (quoting Bell Atl. Corp., 550 U.S. at 570). "A claim has facial plausibility when the plaintiff pleads factual content that allows the court to draw the reasonable inference that the defendant is liable for the misconduct alleged." Id. (citing Bell Atl. Corp., 550 U.S. at 556). In reviewing a complaint under this standard, the court must accept as true the allegations of the complaint in question, Hospital Bldg. Co. v. Rex Hosp. Trs., 425 U.S. 738, 740 (1976), as well as construe the pleading in the light most favorable to the plaintiff and resolve all doubts in the plaintiff's favor, Jenkins v. McKeithen, 395 U.S. 411, 421 (1969).
III. Complaint
Plaintiff's complaint is vague and difficult to understand. Insofar as the court can make sense of it, it appears that plaintiff is accusing defendant Morgan, a correctional officer at Deuel Vocational Institution, of "stalking" plaintiff and "openly disrespecting" him. See ECF No. 1 at 2, 6. Plaintiff alleges that defendant Morgan was "super unprofessional, " showed no courtesy to plaintiff, and did not address plaintiff by his "proper name." Id. at 2. Plaintiff further alleges that defendant Morgan opened and closed plaintiff's cell door from the control booth while plaintiff was sleeping, "as if it [were] a game." Id. at 6. Plaintiff also makes a vague reference to "employee sexual misconduct, " sodomy, and lack of inmate consent, and alleges that he suffers from mental health issues. See id. at 2.
IV. Vague and Conclusory Allegations
The court finds the allegations in plaintiff's complaint so vague and conclusory that it is unable to determine whether the current action is frivolous or fails to state a claim for relief. The court has determined that the complaint does not contain a short and plain statement as required by Fed.R.Civ.P. 8(a)(2). Although the Federal Rules adopt a flexible pleading policy, a complaint must give fair notice and state the elements of the claim plainly and succinctly. Jones v. Cmty. Redev. Agency, 733 F.2d 646, 649 (9th Cir. 1984). Plaintiff must allege with at least some degree of particularity overt acts which defendants engaged in that support plaintiff's claim. Id. Because ...


What Eliminating Barriers to Interstate Telehealth Taught Us During the Pandemic
By Julia Harris ,
Tara Hartnett ,
G. William Hoagland ,
Dena McDonough ,
Marilyn Werber Serafini
Download the brief
Early in the COVID-19 pandemic, nearly all states and the federal government approved unprecedented flexibilities in licensing rules to allow more interstate mobility for health care professionals. The lifting of restrictions on out-ofstate practitioners significantly aided the response to the crisis by expanding telehealth, bolstering care in underserved areas, increasing access to mental health services, and importantly, providing some relief for overstressed hospitals and health systems losing health care workers. Now, as temporary waivers in most states are expiring, there are opportunities to improve interstate licensure requirements so that lessons learned during the pandemic can bring long-term benefits to the health care system.
The Centers for Medicare and Medicaid Services (CMS), as well as almost every state in the country, temporarily waived the requirement that physicians be licensed in the state where their patients are located.1,2 In a matter of months, a famously territorial and complicated area of health policy unwound, creating new opportunities for patients to access care. Patients could suddenly receive care from providers practicing anywhere in the country. This was especially important for patients living in remote or medically underserved areas, as well as those with rare medical conditions. The loosened requirements also greatly expanded access to behavioral health professionals during a time of growing anxiety, depression, and substance abuse.
The temporary suspension of occupational licensing laws during state emergencies, such as natural disasters, is not new. States typically lift licensing laws for relief workers, including health care workers, to practice on a volunteer basis during disaster recovery. But the COVID-19 pandemic has impacted all states simultaneously and continues to linger almost two years later. Unfortunately, the aftershocks on the American health care workforce will be evident long after the pandemic ends.
Over the past year, states' temporary COVID-19 flexibilities for out-of-state licensure began expiring, despite the federal public health emergency due to COVID-19 remaining in effect.3,4 By the end of 2021, only about a dozen state emergency waivers for licensure requirements are expected to continue.5 A handful of states, such as Arizona, West Virginia, and Florida, passed permanent legislation allowing physicians not licensed in the state to register and provide telehealth services to in-state patients.6
Policymakers are now faced with important decisions that will affect provider licensure and patient access to care across state lines — beyond the current pandemic.
States have always maintained the authority to license and regulate health care providers. State licensing boards ensure providers practicing within their purview meet a minimum set of professional qualifications, maintain ethical standards of care, and are disciplined if necessary. This long-standing function of state licensing boards serves to protect patients from unqualified or unprofessional behavior.
Critics argue that other stakeholders, such as managed care organizations and hospitals, monitor providers' quality of care more closely than state boards. Moreover, many health economists see limits on cross-state licensure as roadblocks to healthy provider competition and innovation in health care. In certain cases, state medical boards have demonstrated a focus on limiting the supply of providers to stifle competition and further their own financial interests. In 2014, the Federal Trade Commission (FTC) sued the North Carolina State Board of Dental Examiners, arguing that the board's arbitrary prohibitions on non-dentists providing teeth-whitening services violated antitrust laws.7 This case ultimately went to the Supreme Court, which decided in favor of the FTC. The case was later referenced in Teladoc's challenge to Texas' licensure regulations that limited the use of telehealth in the state.8
One of the first major expansions of provider licensure occurred when Congress passed the Veterans E-Health and Telemedicine Support (VETS) Act of 2017, removing state licensure requirements for U.S. Department of Veterans Affairs physicians. VA policies allow a federal employee to hold a license in one state and practice in any jurisdiction. In the first year under VETS, more than 900,000 veterans used telehealth to access services, a 17% increase.9 Two-thirds of services were for tele-mental health visits.10 In November 2020, the VA issued an interim final rule further confirming its authority to allow VA health care professionals to practice their professions "consistent with the scope and requirements of their VA employment, notwithstanding any state license, registration, certification, or other requirements that unduly interfere with their practice."11 The VA's approach effectively bypasses state licensing boards and asserts federal control over its providers.
Another approach to increasing provider licensure flexibilities has been through the expansion of licensure compacts, which are formal, binding, legislatively-enacted agreements between two or more states.12 Licensure compacts are currently available for physicians, nurses, emergency medical service professionals, physical therapists, psychologists, and audiology and speech language pathologists. While each compact has its own unique structure, participation can promote mutual recognition models and licensure reciprocity. Despite increased interest in licensure compacts since the start of the pandemic, gaps in state participation remain; most notably, California and New York, two of the most heavily populated states, are nonparticipants in all existing health professional compacts (see Appendix A for a complete listing of states' participation in major licensure compacts). The first licensure compact was created for nurses and, as of 2021, it holds the highest level of state participation, with 37 states plus Guam.13 Providers benefiting the most from state participation in compacts are those who deliver telehealth services, move frequently (for example, military spouses), or work or live across a state border.
The pandemic allowed for near-total policy alignment between all states and the federal government. The country's complicated patchwork of state licensure processes was suspended, allowing providers to seamlessly practice across state lines. The short-term flexibilities afforded during the pandemic provided some important clues about possible future policy directions.
Here is what provider licensure flexibilities during the pandemic demonstrated:
Licensure flexibilities have the potential to improve patient access to services. Based on early evidence, provider licensure flexibilities played a role in helping people access health care services via telehealth during the pandemic. In general, telehealth was an important tool for keeping access to care available, with nearly half (43.5%) of Medicare primary care visits provided via telehealth in April 2020, compared with less than 1% before the pandemic.14 States' reinstatement of pre-pandemic state licensure policies in 2021 caused genuine care disruptions, often with patients receiving little warning or explanation for why their access to care would change. The Johns Hopkins health system in Baltimore, Maryland, estimated that about 10% of its 330,000 patients who accessed telehealth during the pandemic were from out-of-state.15 When neighboring Virginia's waiver expired, Johns Hopkins canceled more than 1,000 virtual care appointments for patients in the state.16
Access to services can be especially hard to come by in rural areas or other underserved communities with provider shortages.17 Marshfield Clinic, a rural health system in Wisconsin, found that access to telehealth saved their patients an estimated 1.4 million driven miles from September 2019 to August 2020.18 Patients not only save travel time and money with telehealth appointments, but also have significantly lower rates of no-show appointments and patient cancellations.19 Telehealth access coupled with provider licensure flexibility gives providers the ability to export their services to underserved areas while continuing to live where they desire.
The trend of behavioral health providers moving to virtual care has increased access to mental health and substance use services. During the pandemic, behavioral health providers made a massive shift to delivering services via telehealth — vastly overshadowing telehealth utilization rates for other health care professionals.20,21 A McKinsey analysis found that in February 2021, 50% of outpatient claims for psychiatrists were delivered via telehealth, followed by 30% of claims for substance use treatment.22
In 2020, more than half of adults with mental health conditions went untreated, and the percentage was even higher in Black and Latino communities.23 Rates of mental illness and substance abuse have risen markedly since the pandemic started — symptoms of anxiety and/or depression in adults nearly quadrupled and drug overdose deaths continue to outpace all previous records.24,25The U.S. is experiencing a mental health crisis, paired with a severe shortage of psychiatrists, psychologists, and other behavioral health specialists in remote and underserved communities.26
Evidence demonstrates that the quality of tele-behavioral health services are generally equivalent to in-person care and can increase access to services.27,28 The Consolidated Appropriations Act of 2021 gave Medicare beneficiaries permanent access to tele-mental health services from home;29 prior to that, the SUPPORT for Patients and Communities Act of 2018 authorized Medicare coverage of services via telehealth for the treatment of substance use disorders and co-occurring mental health disorders.30
State officials report they are seeing more behavioral health providers moving to fully virtual practices — simultaneously enjoying the increased appointment compliance telehealth affords as well as the payment parity.31 Medicare continues to pay for telehealth services at parity through the federal public health emergency; however, a permanent reimbursement approach for Medicare has yet to be finalized. While the debate continues at the federal level, payment parity requirements are becoming more prevalent at the state level. Laws requiring the reimbursement rate be the same for inperson and telehealth services are now required for commercial plans across 21 states, for at least some subset of services.32
This shift in the behavioral health delivery system to virtual care presents new opportunities to increase patients' access to mental health and substance use treatment services. Without cross-state recognition of licensure, CMS cannot take full advantage of this opportunity to increase patient access to behavioral health services and address the growing crisis.
Data sharing is foundational to protecting the public. State licensing boards bear the responsibility for screening, monitoring, and disciplining providers in their respective states. This makes states' willingness to adopt crossstate recognition of licensure highly dependent on their confidence in the data sharing and their authority to investigate and discipline providers working from out-of-state. With the tangle of executive actions issued early in the pandemic to loosen licensure requirements, there were instances of exemptions to licensure where providers were delivering services to patients in states based on a license they held in another state; therefore, those providers were outside any investigatory or disciplinary jurisdiction by the state of practice.33 Maintaining clear accountability for providers, in all contexts in which they practice, is critical to increased licensure portability.
To promote patient safety, the U.S. Department of Health and Human Services (HHS) operates the National Practitioner Data Bank (NPDB), a web-based repository of reports concerning medical malpractice payments as well as certain adverse actions related to health care practitioners, providers, and suppliers. Registered entities such as hospitals, state licensing boards, and health plans can query the databank for information on final disciplinary actions.34 Separately, all provider compacts maintain their respective databases to share critical information regarding disciplinary actions and investigations across state borders. While the NPDB is only populated with final actions, which can come long after an initial complaint is filed, the data available through compacts is more immediate — for example, as soon as a provider who presents an imminent threat to patient safety is brought under investigation.35 Development of the technology platforms to enable secure communication among participating member boards is critical and additional investments in data infrastructure and secure data-sharing capabilities may be needed.
Additionally, federal law requires criminal background checks on all applicants within a compact.36 FBI reviews the statutory language for each compact to ensure compliance with federal law before granting State Identification Bureaus the authority to perform the background checks. The FBI has recently withheld approval for a variety of reasons, including concerns regarding privacy and fingerprinting processes, resulting in administrative roadblocks to compact participation.
New market entrants have the potential to lower prices. It is important for states to develop localized regulations, but not at the expense of robust provider competition. Reduced competition can lead to higher prices, restricted access to care, and negative impacts on quality of care.37 State licensing boards impose administrative and financial requirements for providers to practice in each state. For example, a physician who wants to expand a practice across state lines could face hundreds of dollars in licensing fees, depending on the state, as well as tedious paperwork. In 2018, the FTC released a report on the economic impacts of licensure, which included higher prices and less convenience for consumers, and recommended improving licensure portability.38
In a possible signal to the potential of new provider types, 2021 delivered record-breaking venture capital investments for digital health companies, driven in large part by telehealth investment.39 New providers like Firefly Health and Eleanor Health lean heavily into convenient, virtual care services and are building their footprints in new markets. Major insurers are also increasing their telehealth offerings. In 2021, UnitedHealth Group, the nation's largest insurance company, launched Optum Virtual Care in all 50 states and Cigna purchased MDLIVE — broadly increasing beneficiaries' access to virtual care appointments.40 Reforms to state licensure laws can increase provider competition through new providers entering the fray, which can drive improved outcomes, efficiency, and reduce costs.
Licensure flexibilities helped ease the burden on an already overtaxed health care workforce. The pandemic placed unprecedented stress on nurses, doctors, behavioral health providers, nursing home workers, and other support staff. The Office of the Inspector General at HHS reported that impacts of the pandemic were particularly traumatic for frontline nurses who faced loss of co-workers due to COVID-19, self-isolation from their families, and overwhelming loss of life. With patients' families unable to be present due to strict hospital protocols, a nurse was often the last person dying patients saw.41,42 Many staff retired early or left health care altogether — in August 2021 alone, over half a million individuals left the health care and social assistance workforce.43 A survey of health care workers found that nearly 1 in 5 quit their jobs since COVID-19 hit the U.S. and, of those who stayed in the medical field, about 1 in 5 have considered leaving.44
The strain on the health care workforce has been particularly dire in rural areas, which have long struggled to recruit and retain providers.45 Hospital associations from some of the least populated states in the nation, such as Montana, South Dakota, Wyoming, and Iowa, describe crisis-level staffing issues and fierce competition over recruiting and retaining staff.46 Health organizations in Nebraska were so desperate for staff during the Delta variant COVID-19 surge this past summer, they attempted to recruit unvaccinated nurses.47 While many states have officially ended their public health emergencies, hospitals across the country continue to struggle to maintain sufficient staffing to run facilities safely.48Maximizing provider licensure flexibilities during this extraordinary time could ease some of the staffing shortages hospitals are facing.
Lack of standardization across state lines will continue to dog proponents of a federal licensure system, requiring workaround policies. Standards of medical practice vary between states, and conflicting state laws make it difficult for providers to treat patients the same way across state lines. For example, Hawaii requires an in-person physical examination to prescribe a medication (unless referred by another clinician who conducted the exam and provided the telehealth provider with the necessary data).49 However, in Colorado, an in-person physical exam is not required. Any efforts to promote national licensure would need to be accompanied by efforts to establish national, evidence-based clinical standards of care for telehealth.
States also vary in their licensing standards — for example, while most states require criminal background checks for physicians, a handful do not.50 Achieving the right balance between stricter and looser licensing standards will continue to challenge states. One option is to promote state participation in licensure compacts, which promote reciprocity while sidestepping the challenges with creating a federal standard of care. Another
option is to increase adoption of telehealth-specific licenses.51 Twelve states currently allow providers to obtain such licenses or give telehealth-specific exceptions that allow providers to deliver services via telehealth from out-of-state.52 Sometimes these special-purpose telehealth licenses require providers to agree to certain conditions, such as not opening a physical office in that state.
For states that continue to opt out of licensure compacts, telehealth-specific licenses or telehealth-specific exceptions to licensure can be an effective option, especially for the delivery of behavioral health services. In addition, to remove some of the unnecessary complications, the Bipartisan Policy Center has previously recommended that Congress defer to state law and eliminate the federal requirement that providers be licensed in the state where a patient receives services.53
Momentum is building to increase interstate licensure portability through participation in licensure compacts. Over the years, federal grants have encouraged the development of licensure compacts for several professions. Currently, seven major health professional compacts exist, and more are under development (such as for physician assistants and dentists and dental hygienists).54
Because military families are frequently asked to relocate, the armed services have long invested in improving licensure portability and the creation of licensure compacts.55 In 2018, the secretaries of the Navy, Army, and Air Force sent a joint letter to the National Governors Association making it aware that military leaders would be encouraged to consider licensure reciprocity for military families in future basing decisions.56 Effective January 1, 2021, the National Defense Authorization Act included formal consideration of interstate portability of licensure as a factor in future military-basing decisions (Public Law 116-283).57 With the rise of telehealth adoption during the pandemic, state interest in compact participation grew immensely. Fifteen states enacted legislation or became effective members of PSYPACT, the compact for psychologists to practice via telehealth across state lines, since the beginning of the pandemic, bringing the total number of participating states to 26 plus the District of Columbia.58
The Interstate Medical Licensure Compact (IMLC) is a mutual agreement to expedite the traditional process to obtain an out-of-state medical license.59,60 Before the pandemic, fewer than 1% of physicians in participating states used the compact to obtain a license in another state; by March 2021, the number of physicians using the compact almost doubled, and an additional four states introduced legislation to join the IMLC. 61,62,63 The IMLC streamlines the existing system of state-based licensure, but physicians still need to pay for and maintain a license for every state in which they practice.
Some experts suggest the IMLC should go further toward true reciprocity.64,65 For example, the Nurse Licensure Compact (NLC) operates most like a driver's license and allows nurses whose primary state of residence is in a compact state to practice in all other compact states without needing to apply to the licensure boards of individual states and pay additional licensing fees.66 This multistate license structure facilitates the movement of nurses across state borders, but also contributes to pushback the NLC receives from nursing unions who fear it allows hospitals to easily hire replacement nurses during a strike.67 In September 2021, Medicare released guidance confirming its recognition of non-physician compacts, such as the NLC and PSYPACT, which do not require providers to apply independently to each state for separate licenses as is required by the IMLC for physicians.68
Given states' historical control over provider licensure as well as the lessons learned during the pandemic, the most practical path forward likely builds off the existing system of state-based licensure. Policymakers should capitalize on the newfound interest surrounding licensure compacts by reducing existing barriers to participation and incentivizing more states to join. Governors in particular have significant influence over state legislative policy priorities and can be strong advocates for licensure reform. In 2019, eight governors mentioned occupational licensing in their State of the State addresses, and relevant legislation was passed in six of the eight states.69
To further accelerate the recognition of cross-state licensure, Congress could do for Medicare beneficiaries what has already been done for veterans accessing VA care — mandate that any physician with a valid medical license be allowed to deliver services via telehealth to Medicare beneficiaries residing in any state.70 Federal legislation to permanently implement reciprocity in the Medicare program was previously proposed in 2013.71
Such a policy would necessitate additional guardrails, though. For example, bad actors in one state could maintain good standing in another and continue to care for Medicare beneficiaries. A 2019 Government Accountability Office (GAO) audit found that the VA similarly experienced challenges preventing disqualified providers from delivering patient care.72 The full delineation of provider accountability and disciplinary mechanisms would need to be further defined; however, one option could be to base provider liability on the location of the provider, rather than the location of the patient. Additionally, given the GAO audit findings, state licensing boards could receive additional incentives to continuously monitor the NPDB for provider misconduct as well as relevant training. There are several opportunities for federal leadership to promote interstate recognition of licensure. Policy options range from broad and disruptive to more oderate in nature.
Modeling prior legislation that mandated licensure reciprocity in the context of the VA, Congress should consider:
Allowing any physician with a valid medical license to deliver services via telehealth to Medicare beneficiaries residing in any state
Authorizing telehealth services for Medicare beneficiaries based on the location of the provider, rather than the location of the patient. This could apply to both issues of licensure as well as provider liability.
To minimize existing barriers to compact participation and incentivize more states to join, Congress and the administration should consider:
Additional federal incentives to promote increased state participation in licensure compacts, such as further prioritizing future military investments in states that participate in licensure compacts.
Directing an impartial entity, such as the GAO, to review existing health professional compacts and identify persistent barriers to provider and state participation, including, but not limited to, costs to providers and barriers to providers' exporting services out of state (especially to medically underserved areas).
Additional federal incentives to promote increased adoption of telehealth-specific licenses or telehealth-specific exceptions to licensure, especially for behavioral health services, for states that continue to opt out of licensure compacts.
To promote interstate provider licensure recognition, federal leaders should also consider:
Eliminating the federal requirement for Medicare, Medicaid, and the Children's Health Insurance Program providers to be licensed in the state where a patient receives services, when the provider is licensed in another state. Congress should either eliminate the federal in-state licensure requirement for practitioners licensed in another state or expand the HHS secretary's authority to waive the requirement outside of a declared emergency
Directing the FBI to issue guidance to State Identification Bureaus regarding statutory requirements for authorization to perform background checks, as this has been a challenge for states. Alternatively, the FBI could approve sample legislative language for use by state lawmakers when drafting compact legislation
While utilization of telehealth has leveled off, patients overwhelmingly want to continue using the virtual care services accessed during the pandemic.73 A July 2021 consumer survey conducted by the BPC showed that over 90% of adults were satisfied with the quality of their most recent telehealth visit and 8 in 10 said they would use telehealth in the future.74 Unfortunately, state-based licensure has historically posed a barrier to the widespread adoption of telehealth services. Moving forward, Congress and the administration will play a critical role in determining telehealth's future and breaking down barriers to licensure will be key to progress.
Appendix A: Interstate Licensure Compact Participation by State
1 Ohio was the only state that did not offer emergency or temporary licensure for out-ofstate physicians during the federal public health emergency due to COVID-19.
2 Federation of State Medical Boards, "U.S. States Territories Modifying Requirements for Telehealth in Response to COVID-19," 2021. Available at: https://www.fsmb.org/siteassets/advocacy/pdf/states-waiving-licensure-requirements-for-telehealth-inresponse-to-covid-19.pdf.
3 The secretary of the Department of Health and Human Services extended the federal public health emergency due to COVID-19 until January 13, 2022. It is anticipated this date will be extended further.
4 U.S. Department of Health and Human Services, "Public Health Emergency Declarations," 2021. Available at: https://www.phe.gov/emergency/news/healthactions/phe/Pages/default.aspx.
6 Ibid.
7 Oyez, "North Carolina Board of Dental Examiners v. Federal Trade Commission," 2021. Available at: https://www.oyez.org/cases/2014/13-534.
8 Jonah Comstock, "Teladoc's antitrust suit against the Texas Medical Board will test the limits of recent Supreme Court precedent," Mobi Health News, April 30, 2015. Available at: https://www.mobihealthnews.com/43063/teladocs-antitrustsuit-against-the-texas-medical-board-will-test-the-limits-of-recent-supreme-courtprecedent.
9 U.S. Department of Veterans Affairs, "VA reports significant increase in Veteran use of telehealth services," 2019. Available at: https://www.va.gov/opa/pressrel/pressrelease.cfm?id=5365
10 Ibid
11 Federal Register, Authority of VA Professionals To Practice Health Care, 2020. Available at: https://www.federalregister.gov/documents/2020/11/12/2020-24817/authority-of-vaprofessionals-to-practice-health-care.
12 National Center for Interstate Compacts, "What Are Interstate Compacts?," 2021. Available at: https://compacts.csg.org/compacts/.
13 National Council of State Boards of Nursing, "Nurse Licensure Compact," 2021. Available at: https://www.ncsbn.org/nurse-licensure-compact.htm
14 Assistant Secretary for Planning and Evaluation, Medicare Beneficiary Use of Telehealth Visits: Early Data from the Start of the COVID-19 Pandemic, 2020. Available at: https://aspe.hhs.gov/sites/default/files/private/pdf/263866/hp-issue-brief-medicaretelehealth.pdf.
15 Julie Appleby, "Telehealth's Limits: Battle Over State Lines and Licensing Threatens Patients' Options," Kaiser Health News, August 31, 2021. Available at: https://khn.org/news/article/state-medical-licensing-rules-threatens-telehealth-patient-options/
17 National Rural Health Association, Streamlining Telemedicine Licensure to Improve Rural America, February 2013. Available at: https://www.ruralhealth.us/getattachment/Advocate/Policy-Documents/StreamliningTelemedicineLincensuretoImproveRuralAmerica.pdf.aspx?lang=en-US.
18 BPC staff discussions with Marshfield clinic, 2021.
19 S. Jeganathan, L. Prasannan, et al., "Adherence and acceptability of telehealth appointments for high-risk obstetrical patients during the coronavirus disease 2019 pandemic," American Journal of Obstetrics and Gynecology, 2(4): 100233, 2020. Available at: https://doi.org/10.1016/j.ajogmf.2020.100233.
20 O. Bestennyy, G. Gilbert, et al., "Telehealth: A quarter-trillion-dollar post COVID-19 reality?" McKinsey & Company, July 9, 2021. Available at: https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/telehealth-a-quartertrillion-dollar-post-covid-19-reality
21 S.Y. Patel, A. Mehrotra, et al., "Variation in Telemedicine Use and Outpatient Care During the COVID-19 Pandemic in The United States," Health Affairs, 40(2), 2021. Available at: https://doi.org/10.1377/hlthaff.2020.01786
23 Bipartisan Policy Center, Tackling America's Mental Health and Addiction Crisis Through Primary Care Integration, March 2021. Available at: https://bipartisanpolicy.org/report/behavioral-health-2021/.
25 Centers for Disease Control and Prevention, "Provisional Drug Overdose Death Counts," 2021. Available at: https://www.cdc.gov/nchs/nvss/vsrr/drug-overdosedata.htm
26 Think Bigger Do Good, Enhancing the Capacity of the Mental Health and Addiction
Workforce: A Framework, February 2021. Available at: https://thinkbiggerdogood.org/enhancing-the-capacity-of-the-mental-health-and-addiction-workforce-aframework/?_cldee=anVsaWFkaGFycmlzQGdtYWlsLmNvbQ%3d%3d&recipientid=contact-ddf72678e25aeb11988700155d3b3c69-e949ac3beff94a799393fb4e9bbe3757&utm_source=ClickDimensions&utm_medium=email&utm_campaign=Health%20%7C%20Mental%20Health%20Access%20%7C%2010.19.21&esid=e4588cef-7520-ec11-b6e6-002248246368.
27 Erin Shigekawa, Margaret Fix, et al., "The Current State Of Telehealth Evidence: A Rapid Review," Health Affairs, 37(12): 1975–82, 2018. Available at: https://doi.org/10.1377/hlthaff.2018.05132.
28 Sadiq Patel, Ateev Mehrotra, et al., "Variation In Telemedicine Use And Outpatient Care During The COVID-19 Pandemic In The United States," Health Affairs, February 2021. Available at: https://www.healthaffairs.org/doi/10.1377/hlthaff.2020.01786.
29 Center for Connected Health Policy, Telehealth Provisions in the Consolidated Appropriations Act, 2021 (HR 133), 2021. Available at: https://www.cchpca.org/2021/04/Appropriations-Act-HR-133-Fact-Sheet-FINAL.pdf
30 H.R. 6 – SUPPORT for Patients and Communities Act, 115th Congress (2017-2018). Available at: https://www.congress.gov/bill/115th-congress/house-bill/6
31 National Academy for State Health Policy Annual Conference, September 22, 2021, Session: Understanding the Future of Telemedicine in the Post-COVID World
32 Center for Connected Health Policy, "State Telehealth Laws and Reimbursement Policies," 2021. Available at: https://www.cchpca.org/2021/10/Fall2021_StateSummaryChart_FINAL.pdf
33 BPC staff discussions with the Nurse Licensure Compact and PSYPACT, 2021.
34 National Practitioner Data Bank, "About Us," 2021. Available at: https://www.npdb.hrsa.gov/topNavigation/aboutUs.jsp
35 BPC staff discussions with the Nurse Licensure Compact and PSYPACT, 2021
36 Bipartisan Policy Center, Bridging Health and Health Care, September 2021. Available at: https://bipartisanpolicy.org/report/bridging-health-and-health-care/.
37 U.S. Department of Health and Human Services, Reforming America's Healthcare System Through Choice and Competition, December 2018. Available at: https://www.hhs.gov/sites/default/files/Reforming-Americas-Healthcare-System-Through-Choice-andCompetition.pdf
38 Federal Trade Commission, Options to Enhance Occupational License Portability, September 2018. Available at: https://www.ftc.gov/system/files/documents/reports/options-enhance-occupational-license-portability/license_portability_policy_paper_0.pdf.
39 Heather Landi, "Digital health dollars hit $15B high driven by telehealth investment in 2021," Fierce Healthcare, July 19, 2021. Available at: https://www.fiercehealthcare.com/digital-health/telehealth-funding-soars-to-4-2b-record-shattering-2021.
40 Bruce Japsen, "UnitedHealth's Optum to Broaden Telehealth Offerings In All 50 States," Forbes, April 19, 2021. Available at: https://www.forbes.com/sites/brucejapsen/2021/04/19/unitedhealths-optum-to-broaden-telehealth-offerings-in-all50-states/?sh=693fc31747d3.
41 U.S. Department of Health and Human Services, Hospitals Reported That the COVID-19 Pandemic Has Significantly Strained Health Care Delivery, March 2021. Available at: https://oig.hhs.gov/oei/reports/OEI-09-21-00140.pdf.
42 Jane Spencer, The Guardian, and Christina Jewett, "12 Months of Trauma: More Than 3,600 US Health care Workers Died in Covid's First Year," Kaiser Health News, April 8, 2021. Available at: https://khn.org/news/article/us-health-workers-deaths-covid-loston-the-frontline/
43 U.S. Bureau of Labor Statistics, "Table 4. Quits levels and rates by industry and region, seasonally adjusted," 2021. Available at: https://www.bls.gov/news.release/jolts.t04.htm#jolts_table4.f.p
44 Gaby Galvin, "Nearly 1 in 5 Health Care Workers Have Quit Their Jobs During the Pandemic," Morning Consult, October 4, 2021. Available at: https://morningconsult.com/2021/10/04/health-care-workers-series-part-2-workforce/.
45 Aallyah Wright, "Rural Hospitals Can't Find the Nurses They Need to Fight COVID," Pew Charitable Trusts, September 1, 2021. Available at: https://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2021/09/01/rural-hospitals-cant-find-thenurses-they-need-to-fight-covid
46 BPC staff discussions with the Montana Hospital Association, South Dakota Association of Healthcare Organizations, Wyoming Hospital Association, and Iowa Hospital Association, 2021.
47 Alyssa Lukpat and Lauren McCarthy, "Nebraska is recruiting unvaccinated nurses to plug a staffing shortage," New York Times, August 26, 2021. Available at: https://www.nytimes.com/2021/08/26/us/nebraska-delta-nurses-unvaccinated.html
49 C. Shachar, A. Gupta, et al., "Modernizing Medical Licensure to Facilitate Telemedicine Delivery After the COVID-19 Pandemic," Jama Health Forum, 2(5), 2021. Available at: https://doi.org/10.1001/jamahealthforum.2021.0405
50 Federation of State Medical Boards, Criminal Background Checks by State, June 2021. Available at: https://www.fsmb.org/siteassets/advocacy/key-issues/criminalbackground-checks-by-state2.pdf.
51 A. Mullangi, M. Agrawal, et al., "The COVID-19 Pandemic—An Opportune Time to Update Medical Licensing," Jama Internal Medicine, 181(3): 307-308, 2021. Available at: https://doi.org/10.1001/jamainternmed.2020.8710
52 Center for Connected Health Policy, "Cross State Licensing," 2021. Available at: https://www.cchpca.org/topic/cross-state-licensing-professional-requirements/. See also Center for Connected Health Policy, State Telehealth Laws and Medicaid Program Policies, October 2021. Available at: https://www.cchpca.org/2021/10/Fall2021_ExecutiveSummary_FINAL.pdf.
53 Bipartisan Policy Center, Bridging Health and Health Care, September 2021. Available at: https://bipartisanpolicy.org/report/bridging-health-and-health-care/
54 The Council of State Governments, "National Center for Interstate Compacts," 2021. Available at: https://licensing.csg.org/compacts/
55 U.S. Department of Defense, "DOD Receives Approval for Grants to Develop Interstate Compacts for Licensure Portability," 2021. Available at: https://www.defense.gov/Newsroom/Releases/Release/Article/2537098/dod-receives-approval-for-grants-todevelop-interstate-compacts-for-licensure-p/
56 U.S. Department of Defense, Memorandum for the National Governors Association, 2018. Available at: https://www.defense.gov/News/Releases/Release/Article/1449706/service-secretaries-say-quality-of-schools-reciprocity-of-licenses-should-be-co/
57 H.R. 6395 – William M. (Mac) Thornberry National Defense Authorization Act for Fiscal Year 2021, 116th Congress (2019-2020). Available at: https://www.congress.gov/bill/116th-congress/house-bill/6395
58 PSYPACT, "PSYPACT Participating States," 2021. Available at: https://psypact.site-ym.com/general/custom.asp?page=psypactmap
59 Interstate Medical Licensure Compact, "A Faster Pathway to Physician Licensure," 2021. Available at: https://www.imlcc.org/a-faster-pathway-to-physician-licensure/.
60 Thirty-three states plus D.C. are participating in the IMLC. Michigan's enabling legislation included a repeal date of March 28, 2022; however, it is expected legislation will be enacted prior to that date to continue Michigan's participation in the compact.
61 A. Mehrotra, A. Nimgaonkar, et al., "Telemedicine and Medical Licensure—Potential Paths for Reform," The New England Journal of Medicine, 384: 687-690, 2021. Available at: https://doi.org/10.1056/NEJMp2031608
62 Andis Robeznieks, "Cross-state licensing process now live in 30 states," American Medical Association, April 26, 2021. Available at: https://www.ama-assn.org/practicemanagement/digital/cross-state-licensing-process-now-live-30-states
63 Interstate Medical Licensure Compact, "Participating States," 2021. Available at: https://www.imlcc.org/participating-states/
64 J. M. Liss, D. Peloquin, et al., "Mutual Recognition of Physician Licensure By States Would Provide For Better Patient Care," Health Affairs, May 10, 2021. Available at: https://www.healthaffairs.org/do/10.1377/hblog20210505.311262/full/
65 P. Chandrashekar, S.H. Jain, "Eliminating Barriers to Virtual Care: Implementing Portable Medical Licensure," The American Journal of Managed Care, 26(1): 20-22, 2020. Available at: https://doi.org/10.37765/ajmc.2020.41223
66 National Council of State Boards of Nursing, "Nurse Licensure Compact (NLC)," 2021. Available at: https://www.ncsbn.org/nurse-licensure-compact.htm.
67 Hailey Mensik, "State lawmakers mull out-of-state nurse licenses after pandemic rollbacks," Healthcare Dive, May 4, 2021. Available at: https://www.healthcaredive.com/news/state-lawmakers-mull-out-of-state-nurse-licenses-after-pandemicrollbacks/598441/
68 Centers for Medicare & Medicaid Services, Medicare Clarifies Recognition of Interstate License Compact Pathways, September 2021. Available at: https://www.cms.gov/files/document/se20008.pdf
69 National Conference of State Legislatures, Occupational Licensing Final Report: Assessing State Policies and Practices, December 2020. Available at: https://www.ncsl.org/research/labor-and-employment/occupational-licensing-final-report-assessingstate-policies-and-practices637425196.aspx
71 H.R. 3077 – TELE-MED Act of 2013, 113th Congress (2013-2014). Available at: https://www.congress.gov/bill/113th-congress/house-bill/3077
72 U.S. Government Accountability Office, "Veterans Health Administration: Greater Focus on Credentialing Needed to Prevent Disqualified Providers from Delivering Patient Care," 2019. Available at: https://www.gao.gov/products/gao-19-6
74 Joann Donnellan, "New Survey: Virtual Care Could Keep Low-Acuity Cases Out of Emergency Department," Bipartisan Policy Center, August 4, 2021. Available at: https://bipartisanpolicy.org/press-release/telehealth-survey/
75 Audiology and Speech-Language Pathology Interstate Compact, "Compact Map," Accessed November 8, 2021. Available at: https://aslpcompact.com/compact-map/
76 The EMS Compact, "Multistate Privilege to Practice for EMS Personnel," 2021. Available at: https://www.emscompact.gov/
78 National Council of State Boards of Nursing, "Nurse Licensure Compact (NLC)," 2021. Available at: https://www.ncsbn.org/nurse-licensure-compact.htm
79 The Occupational Therapy Compact (OTC) becomes effective once enacted by 10 states. Occupational Therapy Licensure Compact, "Compact Map," 2021. Available at: https://otcompact.org/compact-map/
80 PSYPACT, "PSYPACT Participating States," 2021. Available at: https://psypact.site-ym.com/general/custom.asp?page=psypactmap.
81 Physical Therapy Compact, "Compact Map," 2021. Available at: http://ptcompact.org/ptc-states.
Future of Health


Softball player's family tie to sports
Softball catcher Cheyenne Kuhn is living out one of her dreams of playing for her dad and her sister for the UCA Sugar Bears.
Cheyenne is the daughter of Head Coach David Kuhn, and sister of student assistant coach Taylor Kuhn.
One of the reasons Cheyenne got involved with softball was from watching her dad's softball team. She started playing when she was four years old because she loved watching the girls play with such compassion, she said.
"My wife and kids have been with me everywhere I have coached. They have done fieldwork, laundry, painting, building, renovations, landscaping, tarp duty and have helped me at practice," Coach Kuhn said.
Head Coach Kuhn just received his 600th win as a head coach.
"It was nice to get it at home at UCA. The team played well, it was a good win. It was nice to hear from so many friends, family and former players," Coach Kuhn said.
Cheyenne was extremely proud of her dad's success.
"I may be bias[ed], but he is one of the greatest coaches I know," Kuhn said.
Cheyenne's awards include being on the 2014-15 Conference Commissioner's Honor Roll, being four year varsity letterman at Conway High, three-time All-Conference selection and participating in the Arkansas Senior All-Star Game.
Kuhn plays catcher for the UCA Sugar Bears and a redshirt freshman this year for softball.
Cheyenne credits winning the Southland Conference Tournament last year as her biggest accomplishment. It will be a week she will never forget, she said.
"The most rewarding part about playing for the Sugar Bears is the relationships that I have made with my teammates on the team," Kuhn said. "My teammates are always there for one another and we always have each other's backs no matter the situation."
Cheyenne and Taylor were able to accomplish two of their goals for the past two years.
"One of my biggest dreams was to play college softball with my sister, while one of her biggest dreams was to play for dad," Kuhn said.
Cheyenne's parents have played a big role in her life. She said she considers both as role models. Her dad because he taught her about God, and always pushed her to practice.
"I never realized until later on … how grateful I was to have him push me to the best of my ability. I would not be the Christian and softball player I am today without him," Cheyenne Kuhn said.
Her mom because of how caring, unselfish and hardworking she is, Cheyenne Kuhn said.
"I hope that I will be able to become half the woman my mom is," Cheyenne Kuhn said.
Coach Kuhn also credits his success to his family.
"I could have never been successful without them. They've been there to help me every step of the way in my 18 years of college coaching," he said.
Cheyenne and her dad feel blessed to share these moments as a family.
"The best part of having my dad as my coach is that we are able to all be together with each other all the time," Kuhn said.
"It's amazing to work with both of my daughters and be around my family. I cherish every moment," Coach Kuhn said.
Cheyenne and Taylor are close as well. Cheyenne said her sister is one of her role models, and not only a big sister, but a best friend.
"I can always talk to her for help in my hitting if I'm struggling or if I'm doing bad catching. She corrects my mistakes," Cheyenne Kuhn said. "She is my best friend and I'm grateful to have her as my coach."
Cheyenne plans to attend graduate school after college, but before she does, one of her goals is to win another championship with her and sister.
Both Cheyenne and Taylor want to follow their dad's footsteps and become a softball coaches when their education has been completed.
This article originally appeared in the April 6, 2016 print edition of The Echo.
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Commentary and OPINION
THE WEST INDIAN ONLINE
Home COMMUNITY Frank: An Immigrant Success Story
DIASPORA NEWS
Frank: An Immigrant Success Story
Dr. Frank Islam and his wife Debbie Driesman with United States President Joseph Biden.
By Dr Vishnu Bisram
Immigrants have been coming to America for centuries attracted to it by stories of boundless opportunities. Few immigrants are not success stories or have not improved their quality of life relative to the home country. One stand out example is that of Frank Islam who hails from Azamgarh, Uttar Pradesh (UP), India. Many indentured laborers come from Azamgarh and their descendants from Guyana, Trinidad, etc. now settle in USA. Islam was a pioneer among Indian immigrants pursuing tertiary education in America, becoming a trailblazer in wealth accumulation and philanthropy giving back some of what he earned to help others. He became well-known and respected by prominent Americans (including Presidents, Governors, etc.) especially in the political establishment and humanitarian groups in the USA. He has been recognized and honored for being a role model and his charitable activities.
Islam came from a humble family that prized education and work ethic. And he used these qualities to pursue education and become a success story in the US. He has used his wealth to help others in America as well as groups in India.
Islam came to the US in 1970 almost penniless, studied computer science, while worked his way to pay for school. After earning MS in computer science, he worked full time for different companies for two decades. Then, after getting married, and his wife decide they would launch their own company. They founded the QSS Group, an information technology firm, in 1994. The QSS Group had more than 3,000 employees and some $300 million revenue. They sold the company in 2007 and set up a private investment holding company, FI Investment Group. Then they used the proceeds from their investment to set up their Driesman Foundation that focuses mostly, though not exclusively on supporting public education in America and India – on training newer generations in business, management, education, art and culture, and peace and conflict-resolution Frank Islam and Debbie and other fields. Islam prides himself on offering support for the poor to lift themselves. He sponsors programs that help to change people's life and outcomes of society. He has also involved himself in activities to benefit the Democratic party and communities.
During his professional career, he garnered multiple industry awards for business leadership, entrepreneurship, and excellence. And for his outstanding contributions to humanity, Islam received honorary doctorates from several universities including Aligarh University (UP) and Maulana Azad University (Rajasthan).
In accepting his multiple doctorates, Islam stated that he did so with "humility not for me, but in recognition of all those who have made a difference in society through their leadership, education, and public service." In addition to receiving honorary doctorates for his achievements and contributions to humanitarian causes, Islam was honored by a Kerala-based Cochin Herald journal for his efforts to promote education. Islam said he has been investing in education because it "provides 'the keys to the kingdom".
Dr. Islam was also honored by the Montgomery Business Hall of Fame for his successful business achievement. He helped in fundraising drives for scholarships at the Universities at Shady Grove, Maryland. He told a gathering as a patron of a fundraiser: "If it weren't for education and people willing to help me when I came to this country as a very young man, I would not be where I am today. I know first-hand that education helps people reach their potentials, get good jobs and make their communities stronger."
Islam has left an indelible imprint in the Indian American community.
Indian diaspora in America ought to be proud of his achievement and his generosity. He has shown that through personal sacrifices and dint of hard work, one can succeed in the US.
The views expressed in this column are solely those of the writer and do not necessarily represent the views of the THE WEST INDIAN.
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Editorial: Don't Let Game Streaming Be The Future
Robert argues against a digital-only future.
By Robert Marrujo. Posted 10/17/2019 20:00 Comment on this ShareThis
Google Stadia was given an official unveiling to the public at GDC 2019 in San Francisco. The project had initially bowed as a closed beta dubbed Project Stream back in 2018, where users were able to play Assassin's Creed Odyssey utilizing the tech that would ultimately come to power Stadia. While it isn't the first of its kind, Stadia is being promoted as the "future" of gaming: console-level experiences streamed via any web-enabled smart device that can run the Google Chrome web browser. A max resolution of 4K HDR, 60 FPS, and 5.1 surround sound are possible. By all accounts, it's pretty amazing stuff— from a purely technological standpoint.
I have a relative whose significant other had passed away in the '80s. He owned an NES which made its way to my grandma's house and started me, and eventually my sister, on our paths to being lifelong gamers. One of my earliest memories in life, not even just of playing video games, but of life itself, is of Tetris being played on that NES. By the time I was in my late teens and going to college, my aunt had allowed me to take that NES, complete in its box with all the games, and add it to my collection. It's an item that I cherish for a variety of different reasons, not the least of which being the personal, familial ties that it has.
Now, imagine this same story in 2019 and it's a Google Stadia controller as opposed to an NES. What legacy, what significance will the ephemeral, intangible world that streaming represents have when passing things down from one generation to the next? What sort of bonds between fathers and sons, mothers and daughters, will be built when rather than sharing cherished heirlooms, people are instead passing along logins to subscription services? "That's right, Timmy, 30 years ago your grandad logged into that same account and streamed Destiny 2 for the first time. Oh, I can remember the utter joy he felt when he upgraded to platinum membership and the picture quality got really good."
That scenario doesn't quite seem to hold the same weight as someone getting their aunt's old Sega Genesis passed down to them, does it? At least, that's how I tend to feel when I look at the march towards an all-digital future that humanity seems intent on. Despite my objections, I do try to keep an open mind about these things, and so I've sought out and continue to seek out other people's opinions on this issue. It was during one of these talks that a friend of mine pointed out that the sort of emotional attachment and fond memories I have towards my NES could be possible for someone whose first video game experience is Stadia and its controller. I suppose there's nothing mutually exclusive about these two things. As I grapple with my distaste for what Stadia represents, though, I think my objections are more multifaceted than I initially took them to be.
Streaming. Digital-only content. Even Nintendo fans aren't immune to this. Nintendo has openly discussed that it's currently looking internally into how the company might utilize the technology. We're already at a point where the NES catalogue of games is digitized and locked behind a paywall— in its case, the endless monthly/annual fees of Nintendo Switch Online. I can pass my NES cartridges and console down to anyone I want, but I can't do that with a bunch of ROMs that are tethered to an online service that will eventually be replaced. At least games that are downloaded to a hard drive are somewhat physically present; no corporation can come and shut off my access to everything I downloaded to my Wii U, for example. The NES library on my Switch, however, has to get a weekly check-in from the Internet fairy that works for Nintendo, and once Switch is replaced… well, what happens to those games, then? Do I get to keep them? Or do I get told that I have to buy the new console and keep playing them on its online service?
The problem, I feel, is monetization. Every entertainment company from Disney to Apple is trying to find a way to stop letting consumers buy things and, instead, make them rent. Really, that's all Hulu, Netflix, Amazon Video, Apple Music, and all of the other streaming platforms are: glorified rental services. Despite the fact that the overwhelming majority of content that users enjoy is stuff that they'll never stop wanting to watch. Look no further than the millions of views that shows like Friends and The Office, two series that ended years ago, continue to garner. Why keep paying endlessly to enjoy content that you'll never want to stop hearing, watching, or playing?
I'm no Luddite trying to push a nihilistic dystopian view of the future, but I am trying to have an honest conversation about the genuine problems facing consumers. Streaming and all-digital content represents an utter loss of consumer control. Returning to Google Stadia for a moment, I keep coming to this same thought— people will be paying $60 for software just like they already do on top of an additional monthly fee to access a console that they will never, ever own. Even the game itself is dubiously the "property" of the consumer. How can they "own" something if it's in the cloud of a corporation? Once the servers shut down, the only "system" that the game can be played on is also gone, rendering the software itself useless.
It's an issue that extends to Nintendo's mobile offerings. Many of them are fun, solid experiences, but they're also completely dependent on internet connectivity and Nintendo's servers. Pokémon Duel, one of those mobile titles, is shutting down at the end of this month. Every cent that users spent on the game will, on October 31, be rendered useless. The shutdown notice on the Pokémon website even notes that, while some functionality will remain once the service ends, that "[it's] possible that you will become unable to use the Library function due to OS version upgrades, device change, or other issues." Bye-bye. Gone.
I'm not naive; there are countless ways that old games become unplayable. Yet, I think there's a big difference between a console breaking down, for instance, and simply being told that the company streaming to me has gone belly-up, moved on to new/different content, or is simply unwilling to continue to allow users to play, watch, or listen to something. As I pointed out above, things in the cloud are of suspect ownership to the consumer, yet consumers are in waves forking over cash for the right to click "login" on a phone or a computer and access something that's only theirs until access gets cut off. Ask those who forgot to transfer their UltraViolet movies over to another service at the end of July how they feel about their purchases now versus two or three years ago. Suddenly, all those bits of data seem like so much lint and dust.
There are legitimate reasons why digital-only can be a good thing. It lessens the impact on the environment to not print on paper or produce plastics for game cases. It cuts back on space for people who don't have a lot of shelves or the means of storing a bunch of games, books, CDs, etc. I can't pretend that these justifications are (ironically) immaterial. I love technology and how it can propel humanity in different directions that people otherwise might never have been able to go. I cannot and will not, however, ignore that ultimately streaming and all-digital media is in the hands of powers that the everyday person has minimal sway over. Apple, Google, Nintendo— all of these corporations are out for profit. Some, like Nintendo, I think are fairer to consumers, but at the end of the day every company is in service to two things above all: fiscal gains and shareholders.
The second it becomes financially burdensome to support something, companies bail. Look no further than the impending closure of the YouTube service on PlayStation 3 as one of countless instances of this reality. Nothing lasts forever, but I can almost guarantee that you'll get a lot more mileage out of your old Nintendo 64 and copy of Ocarina of Time than your Stadia controller and its subscription service. In the world of design, planned obsolescence has been a part of making everything from shoes to fashion for decades. Your phone is made to become obsolete after a couple of years. Your car. Your clothes. And in the case of video games, your console. With streaming, though, companies like Google and Sony have glommed onto the fact that it's easier and possibly even more lucrative to not even make a system that eventually breaks down or goes out of fashion— now they just want to get your money every month and convince you that you're better off with them having every physical component under their control, with the exception of that shiny controller in your hands. I'm sure it's next on the list.
I know a lot of people feel different ways about this issue and that how a person spends their money isn't anyone's else's business. At the same time, I want to caution everyone to at least think about where we're all heading. The Microsofts and Apples of the world don't have your back. Even seemingly benevolent entities like Nintendo are going to prioritize itself over consumers. Don't let anyone else, especially companies, dictate the terms of how you consume media, where you consume media, and when it's time to take that media away. I suppose if nothing else, think about the cherished items and heirlooms in your own home and how different your life would be if the person who gave them to you only had the screen of a phone or TV with a login window to point to, instead.


Beyond the Surface
The environment is the driving force behind Thibodaux woodworker David Bergeron's work
Jeffrey Roedel,
Romero & Romero
It's 7 a.m. and David Bergeron is up with the sun. There's a smattering of fresh materials — junk to some, and new only to Bergeron's woodshop — waiting to be sorted, strategically stacked and readied for rebirth.
The artist saved this wood from languishing in a landfill. The material has weathered in wait for years and generations, making its way across the South and the neighborhoods of New Orleans, into much of coastal Louisiana closer to Bergeron's current home of Thibodaux.
As Bergeron gets to work on these vintage materials, he isn't so much fiddling with old wood as assuming the role of a caretaker for something that could speak of stories of old. Maybe even a forgotten truth.
These slats and boards are the former bones of his city and he wakes up every morning to resurrect the dead.
He launched Bergeron Woodworks in his mid-20s, and now at 45, the Delgado Community College alum has built with his hands a kaleidoscopic body of reclaimed woodwork, from $30 geometric picture frames to intricate custom-built benches, beds and tables that fetch thousands.
Growing up on the West Bank, Bergeron watched his grandfather, a woodworker and gardener, make a proud living and build the family homestead on a third-grade education.
"I kind of bounced around construction and was lucky enough to encounter a few very talented people," Bergeron says. "I just tried to keep my mouth shut and watch."
His work is time-intensive, due to the nature of the materials and the fact that he's doing everything he can to maintain the integrity and color of the wood. It didn't take long for Bergeron's playful colors — which reflect the city's personality and his constant attention to detail — to catch the eye of the House of Blues. For a decade he helped to define the eclectic rainbow remix of designs that became part of the unforgettable aesthetic of the Decatur Street music mecca.
"At the beginning, [House of Blues] had a really talented in-house art and design department that was very focused on keeping the founder's vision intact," Bergeron says. "It was an incredible learning experience that I could not put a price on."
With the House of Blues as a client, Bergeron's sense of story and his passion for environmentally-friendly work led to three separate creative projects for the Bonnaroo Music & Arts Festival in Tennessee, including a series of 10-foot by 10-foot frames for housing acclaimed rock photographer Danny Clinch's work. The festival founders responded well to the principals of sustainability that Bergeron's work professes, but this wasn't always the case. Twenty years ago the populace was much more timid about purchasing furniture from salvaged materials.
"People would approach the work with interest and then back off when you said it was from the trash," Bergeron recalls. "Now when you say it's from the trash they move forward."
Protecting the environment has always been his driving force, he says. In 2016 alone, Bergeron diverted more than five tons of material from the waste stream.
"When its all said and done, that is something I will lay my head on," he says.
If de-nailing wood slats for days on end has his muscles feeling like they are filled with battery acid, or the soothing effects of a new color palette of well-weathered materials has his childlike wonder lit and aloft, all of it is part of his process and central to the more fundamental desire Bergeron holds for his life's work. He wants to see beyond the surface of all things — inanimate and living. At the very heart of Bergeron's craft is a search for a kind of glory in someone else's garbage, a rescue mission for the rebirthed and bright future of what was once cast away.
"The most rewarding thing is creating value in a piece of material that is otherwise unwanted," Bergeron says. "I think that with a little time and creativity, all people and materials have value."
What do you do for fun when you're not putting in 10 hours inside the shop? I've been really getting into the work of the abstract expressionist painter Richard Diebenkorn lately — for whatever that's worth. Mostly, I'm an outdoors kind of person. So running I love. Being out in nature, hiking and beer. I'm trying to get a better grip on the organic gardening thing too, but that is proving to be quite the learning curve, ha.
Do you feel like you have to seek out inspirations and explore other people's art to move forward? People are always recommending that I check out the work of so-and-so, but I'm a firm believer in 'protecting the eye.' In other words, I feel like everything we take in or experience affects us so I like to curate that very carefully.
Your work used the old bones of structures of New Orleans, so in a very tangible way, New Orleans influences your work. Why did you decide this was the place for your woodwork to thrive? Can you define the spirit of the city? New Orleans has an openness that is a lot harder to find in the rest of the South. I grew up in a lower-to-middle income, blue-collar and culturally-diverse area, and I wouldn't change that for anything. Just people helping people and figuring it all out.
You've certainly figured things out, and had some incredibly recognizable clients like the House of Blues and Bonnaroo. You must have come across some celebrities. I did do a piece for Brad Pitt's Make It Right 9 Project in the Lower 9th Ward, and I got to meet him. I went to introduce myself, and he says 'Oh, I know who you are, I love your stuff.'
That's a great story. Pitt seems to be someone with a keen eye for design and construction and I can't imagine how many new people he met and worked with during the entire project, so that's a compliment. Any tales of rock 'n' roll from working for the Bonnaroo? I don't think any of my rock 'n' roll stories are fit for print, ha!
Categories: Features, Theatre + Art


Mengistu Worku
Occupations Association football player Association football manager
Countries Ethiopia
Death December 16, 2010 (Addis Ababa)
Mengistu Worku (Amharic: ; 1940 – 16 December 2010) was an Ethiopian footballer, recognised as the best Ethiopian footballer in history. He is best known for his role in the final of the 1962 African Nations Cup, and for being the head coach to take the Ethiopian national football team to the African Nations Cup in Libya in 1982.
During the 1962 African Nationals Cup, Mengistu scored 1 goal in the final of the 3rd African cup against Egypt, when Ethiopia won their only major trophy to date. Ethiopia finished as top scorer of that tournament with 4 goals on the final day. He debuted with Saint-George SA in 1957 and remained with the club for the entirety of his career. Mengistu was given numerous, offers to play professionally for teams in Italy and France, as well as Egypt's El Zamalek, but like earlier legend and coach Ydnekatchew, he refused all offers and stayed in Ethiopia wearing Saint George's characteristic "V" across his chest. Mengistu wore the number 8 for the entirety of his club and national team career. His international career began in 1958 and ended in 1970, following disappointment in the 7th African Nations cup in Sudan, where Ethiopia finished bottom of their group. He still managed to score 3 goals, the only Ethiopian goals in that tournament. Mengistu played 2 more years with Saint George, retiring in 1972. He is the seventh-highest scorer in the history of the African Cup Of Nations with 10 goals.
Mengistu coached the national team after retirement, but the team failed to match the success it found during his playing days. He did, however, coach the country to their first-ever CECAFA cup title in 1987, when the tournament was hosted by Ethiopia.
In 2001, Mengistu was struck by a tumor, and doctors had told him he had only months to live. With treatment unavailable in Ethiopia, the Ethiopian billionaire Mohammed Al Amoudi paid for Mengistu to travel to South Africa for treatment. "It was because of Al Amoudi that I am standing before you today," he said on Ethiopian television.
At the 2002 CECAFA Cup, Mengistu was honored before the tournament kickoff by the Council for East and Central Africa Football Association, along with five other east African footballers and three referees, including Tesfaye Gebreyesus, the Ethiopian who refereed at three ACN tournaments.
African Cup of Nations Top Scorer: 1962 (shared with Badawi Abdel Fattah)


Sweden watch: Men to blame for Global Warming
We can breathe a sigh of relief now that we know who's winning the battle of the sexes in combating global warming.
The November 10 issue of New Scientist magazine reported a study by Gerd Johnsson-Latham of the Swedish Ministry of Sustainable Development that concludes "Swedish men are being blamed for having a disproportionately large impact on global warming."
"The fact that women travel less than men, measured in person-kilometres per car, plane, boat and motorcycle – means that women cause considerably fewer carbon dioxide emissions than men, and thus considerably less climate change," Johnsson-Latham said in the report.
In April 2006, Johnsson-Latham authored a report pondering a similar issue, "Do women leave a smaller ecological footprint than men?"
"Women do not escape censure, however," the magazine report said. "The report notes that in Sweden, women spend four times as much as men on consumer goods and - in a further dig at men, albeit unintended – 20 times as much on hygiene products."
Recent leftwing-claims have linked cow and Norwegian moose flatulenceto global warming. In addition, warming has been blamed as a cause of wild fires, hurricanes and the Minnesota bridge collapse.
BMI's Special Report "Fire & Ice: Journalists have warned of climate change for 100 years, but can't decide weather we face an ice or warming"
Climate of Bias: BMI's page devoted to global warming and climate change in the media.
Misandry


Missouri Planned Parenthood Closes Abortion Referral Center in Kirksville
State | Steven Ertelt | Sep 23, 2009 | 9:00AM | WASHINGTON, DC
by Steven Ertelt
LifeNews.com Editor
Kirksville, MO (LifeNews.com) — Planned parenthood is closing a center in Kirksville, in the sparsely populate northeastern portion of Missouri, that did not do abortions but made referrals for them. Planned Parenthood in Kirksville will be closing permanently in November after the economic downturn left it with an insufficient number of clients.
The center had been operating for 38 years but the economy and a shortage of rural nurse practitioners left it unable to continue operating.
Tri-Rivers Planned Parenthood staffer Ecsi Davis said, "It was a very difficult decision for us. It was a long time coming. We've had lots of meetings. This is not a sudden decision by any means."
TRPP was created in 1996 from the merger of Planned Parenthood of Northeast Missouri and Parenthood of the Central Ozarks.
Rita Diller, national director of American Life League's Stop Planned Parenthood project told LifeNews.com in a statement that she is excited about the news.
"After 38 years in business, Planned Parenthood officials cited declining client numbers and a lack of donations as reasons for closing the facility. According to our records this marks the 14th Planned Parenthood clinic to either close or announce its closing in 2009," she said.
"It just goes to prove that when people find out the truth about Planned Parenthood, they stop contributing and quit going," Diller continued.
Earlier this month, Planned Parenthood of Indiana said it would close five of its 34 centers across the state due to changes in the way the federal government allocates family planning funds. The decision to close the centers comes after an expose' found two of them hiding instances of possible statutory rape.
In April, the Planned Parenthood abortion business in Virginia closed its center in Lynchburg, which did not do abortions but made referrals for them.
In March, Planned Parenthood of the Great Northwest closed its facility in Monroe, Washington due to tough economic times. That facility saw its last customer on March 31.
Although the center did not do abortions, it made abortion referrals to other Seattle-area Planned Parenthood centers that do both surgical and drug-induced abortions.
In January, the Planned Parenthood center in Latham, New York, a suburb of Albany, announced it would be closing.
The Latham facility is the smallest the organization oversees and, while it didn't do surgical abortions, it dispensed the dangerous RU 486 abortion drug that has killed more than a dozen women worldwide and injured over 1,100 in the U.S. alone.
At the end of 2008, the total number of Planned Parenthood centers dropped from 855 in 2007 to 844 last year. The number of local affiliates of the Planned Parenthood federation decreased from 108 to 99.
While Planned Parenthood cuts its total number of centers providing non-abortion services, the number of abortion facilities is in the rise. It jumped to 295 last year from 287 the year prior.
The centers are closing despite the record amount of money the abortion business received from the federal government in the last fiscal year.
The total government grants and contracts received by PPFA affiliates from government sources including state, local and federal governments, increased from $337 million to $350 million.
Looking at Planned Parenthood data from 1997 to the present, the increase in government funding corresponds with an increase in the number of abortions. (See image)
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Finding wit and wisdom in "Looking for Me: A Novel"
In "Looking for Me: A Novel" it's easy to see why the main character, Teddi Overman, chooses to surround herself with antiques, where the past is more storied, than messy - which is often the case with human history. However, in the course of the novel Teddi travels back down the road to path of her own history, in an effort to deal and heal from her own past.
Antoinette Rahn
From the moment I opened the package which contained the review copy of "Looking for Me: A Novel," I was intrigued, and hopeful that the story inside would match my expectations. I wasn't disappointed.
New York Times best selling author Beth Hoffman invites the reader to join her to peer through the looking glass into Teddi Overman's life, and see if we catch a glimpse of ourselves therein. I would say there were more than a few moments during the story where I saw myself, a version of me anyway.
In her storytelling, Ms. Hoffman makes use of the flashback technique as we accompany Teddi on a trip back home, literally and figuratively. As they say, you can never really go home again, and in this tale we can easily see why Teddi opts to let the antiques she works with be the only things that celebrate the past. However, as we learn through this story, by limiting what we let our hearts feel, we limit whatever healing may take place.
I thoroughly enjoyed the way Ms. Hoffman explored Teddi's relationship to the antiques she works to repair and sell in her shop, and how she makes the pieces more of the central characters, rather than an after thought. I also found myself charmed by the character of Mr. Palmer, the iconic antiques guru who takes Teddi under his wing, as his protégé. He reminded me of many a mentor I've known in my life, be it in the field of antiques, business, journalism, or education. Under the tough exterior is someone who sees potential in another, and wants nothing more for them to tap into that potential and soar.
Dealing, or more correctly, not dealing with the unusual 'loss' of her brother, is a significant aspect of Teddi's story, but I appreciated the way Ms. Hoffman revolved that factor of the story, loosely tying it all together.
My two favorite phrases in this book are:
"Don't forget where you came from."
"We will be known forever by the tracks we leave."
This book is available at booksellers nationwide, and directly from the publisher: Penguin Books.
booksantique fiction
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Kurtzweil's Antiques & Restoration
Bargain John Antiques
Cool and Collected Antiques
Midwest Pickers
C. Middleton Antiques and Uniques
Grain Bin Antique Town
The Great Midwest Antique Mall
South County Antique Mall