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 "Saving Jobs, Saving Public Dollars:..." 
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Saving Jobs, Saving Public Dollars: Intervening Before Disability
by: Linda Rosenberg

Juan was a delivery driver, but his health problems were putting him at risk of losing his job. His diabetes was poorly controlled and had caused foot ulcers that made it difficult for him to walk. He also had bipolar disorder, which was not being controlled. When he joined the Working Well program in Harris County, Texas, Juan worked with a case manager to get orthopedic shoes, to receive support in developing a diabetic diet and exercise plan, and to make an appointment with a psychiatrist to bring his mental health condition under control. As a result, Juan was able to continue working full time as a delivery driver and received a raise for exceptional performance (Bohman, Stoner, & Chimera, 2009).

Working Well is part of the Demonstration to Maintain Independence and Employment, which is funded by the Centers for Medicare and Medicaid Services. The DMIE is one of the federal initiatives currently evaluating the impact of earlier intervention for people with mental illnesses (earlier interventions in the context of this article refer to interventions prior to application for Social Security Benefits but do not include first onset interventions).

Current federal policy provides support - through Social Security Disability Insurance and Supplemental Security Insurance - for people who are no longer able to work. These programs, in turn, act as gateways to health insurance - Medicare in the case of SSDI and Medicaid for those who quality for SSI. This safety net is vital for people who are too disabled to work. Once people qualify for Social Security, however, they rarely move off it, despite strong evidence that many people with mental health problems want to and can work. People with mental illnesses now constitute the largest and most rapidly growing group of Social Security disability beneficiaries, and every year only 1 percent of people who qualify for SSDI on the basis of a mental illness leave the rolls and return to work.

The DMIE represents a break with existing policy. Its purpose is to actively support people who are at risk of becoming too disabled to work, so that they can remain in their jobs and do not apply for public disability programs. Two of the demonstration sites, Texas and Minnesota, focus on people with serious mental illnesses and people with chronic physical health problems who also have a mental health condition. The ingredients that make up the service packages in Minnesota and Texas are similar: comprehensive health insurance, including dental and vision services as well as behavioral health benefits; employment supports; and a "broker" who works with participants to help them keep their jobs. The broker’s role is broad; it can range from helping a participant get an appointment with a psychiatrist to finding him or her place to live to organizing child care (Gimm & Weathers, 2007).

Early results are promising. In Minnesota, the DMIE intervention is proving to be effective in improving clients’ access to healthcare services, health and functional status, job stability, and earnings. It has also reduced the number of applications for SSDI (Linkins & Brya, 2009). Analysis indicates that earlier interventions, such t time. It was a long time ago, yet even then it was multiculturalism working - two entirely different cultures happy together in respect and enjoyment of one another. Sadly, all this time later, that kind of harmony is not universal across all people from all cultures. Perhaps it is time to thrash out some hard and fast rules. Bund as a result you get higher rate of return. Bush believes that investing in private accounts could financially secure America’s children and grandchildren.

This appealing plan has gathered an overwhelming support from younger workers. But all the same, not all are convinced. They still worry that the instability of the market could wipe out their benefits. But if Social Security is not reformed, benefits will have to be cut down by a quarter or payroll taxes will have to be increased by fifty percent. Just the same, reformed or not, Social Security will mostly affect the younger working population. Whether private accounts are used or taxes are increased, the duty of eliminating the system’s debt lies on younger workers. Whatever reform will be implemented today will impact the financial decisions you will make at present. In any case, Social Security will decide how you plan, save or spend your money over this decade.

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Viojieley Gurrobat loves readings books in her spare time. She writes stories and poems about anything under the sun. For comments and suggestions kindly visit

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0662472f52+How To Build Your Law Practice With Dignityã/by: Trey Ryder

Lawyers spend thousands of dollars on complex marketing plans.

But then, often, other priorities seize their attention and their marketing plans gather dust. Here's the marketing plan I use for my clients.

STEP #1: Identify the services you want to market and the niche you want to fill. When prospects hear your name, you want them to associate you with a specific type of services. For example, John Wilbanks is an estate planning attorney. Karen Ambrose is a tax lawyer. Mark O'Connor is a corporate lawyer.

STEP #2: Identify the clients you want to attract. If you expect to hit your target, you must know where to aim. Identify your prospects by

Demographics: These are characteristics that identify individuals by who they are (including gender, age, marital and family status, and occupation) -- and what they have (including education, income, car and home).

Psychographics: These are characteristics that identify individuals by what tals had to be contained in areas with or without a protective liner for months or years before eventual disposition to cap landfills or to be recycled back into constructing the artery as backfill and concrete aggregate.

Testing was done on CA/T demolition materials. The following list shows which contaminants the DEP was testing on recycled construction material. This test was used by the Massachusetts Highway Department and the Department of Environmental Protection in the mid 1990s to determine the levels of contamination acceptable for storage in unlined facilities at Mass Port sites. Some material was destined for use in capping landfills and for use in recreational parks. Other dirt was recycled into the 3.8 million cubic feet of concrete that is the Big Dig. While I am not a chemical engineer, I would like to know if the DEP or the Joint Venture tested for other elements.

Contaminant Criteria (mg/kg)

PCB - 10ppm
TPH - 3,000
PAH - 300

Arsenic - 40

Cadmium- 25

Chromium - 500

Lead - 500

Mercury - 10

The test used was the often questionable TCLP.

If a truckload of dirt (excavated materials from the tunnel preparation) tested positive, DEP permission to store the materials was required. The DEP employees in charge of the permission process were salaried by the CA/T Joint Venture of Bec

Tue Nov 03, 2009 2:31 pm
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