text:
Statement by
Richard S. Foster
FSA, Chief Actuary
Centers for Medicare & Medicaid Services
U.S. Department of Health and Human Services (HHS)
2008 Medicare Annual Report, Financial Portion
Committtee on Ways and Means
Subcommittee on Health
U.S. House of Representatives
Tuesday April 1, 2008
The Financial Outlook for Medicare
Chairman Stark, Representative Camp, distinguished Subcommittee members, thank you for inviting me to testify today about the financial outlook for the Medicare program as shown in the newly released 2008 annual report of the Medicare Board of Trustees. I welcome the opportunity to assist you in your efforts to ensure the future financial viability of the nation's second largest social insurance program—one that is a critical factor in the income security of our aged and disabled populations.
The financial outlook for the Medicare program, as shown in the new Trustees Report, is not markedly different from the findings in last year's report. Overall, the outlook is slightly better, with actual costs in calendar year 2007 of $432 billion, an amount that was 1.5 percent lower than previously estimated. Most of this difference is attributable to slower growth in inpatient hospital expenditures than had been estimated.
The financial status of the Medicare trust funds must be evaluated separately for each fund and for each account within the funds. I will first summarize the Trustees' findings for the separate accounts and subsequently address the overall cost of Medicare and the "Medicare funding warning" that is triggered again this year.
The Hospital Insurance (HI) trust fund once again does not meet the Trustees' formal test for short-range financial adequacy. The depletion of the HI trust fund is projected to occur early in 2019, the same year as was projected in last year's Trustees Report. Beginning in 2008, HI dedicated revenues are projected to fall increasingly short of program expenditures, eventually covering less than one-third of estimated costs by the end of the Trustees' 75-year projection period.
The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) created two separate accounts within the Supplementary Medical Insurance (SMI) trust fund—one for Part B, which continues to cover the traditional SMI services, and one for the new Part D, which provides subsidized access to prescription drug coverage. Because of the annual redetermination of financing for both Parts B and D, each account will remain in financial balance indefinitely under current law. SMI costs, however, are projected to continue increasing at a faster rate than the national economy and beneficiaries' incomes, raising concerns about the long-range affordability of scheduled financing.
Over 44 million people were eligible for Medicare benefits in 2007. HI, or Part A of Medicare, provides partial protection against the costs of inpatient hospital services, skilled nursing care, post-institutional home health care, and hospice care. Part B of SMI covers most physician services, outpatient hospital care, home health care not covered by HI, and a variety of other medical services such as diagnostic tests, durable medical equipment, and so forth. SMI Part D provides subsidized access to prescription drug insurance coverage as well as additional drug premium and cost‑sharing subsidies for low‑income enrollees. A Part D subsidy is also payable to employers who provide qualifying drug coverage to their Medicare-eligible retirees.
Only about 22 percent of Part A enrollees receive some reimbursable covered services in a given year, since hospital stays and related care tend to be infrequent events even for the aged and disabled. In contrast, the vast majority of enrollees incur reimbursable Part B costs because the covered services are more routine and the annual deductible was only $131 in 2007. Similarly, a large proportion of Part D enrollees have reimbursable prescription drug costs, given the common occurrence of prescriptions, the preponderance of zero-deductible plans, and the significant proportion of low-income enrollees, for whom the deductible does not apply.
The HI and SMI components of Medicare are financed on totally different bases. HI costs are met primarily through a portion of the FICA and SECA payroll taxes.[1] Of the total FICA tax rate of 7.65 percent of covered earnings, payable by employees and employers, each, HI receives 1.45 percent. Self-employed workers pay the combined total of 2.90 percent. Following the Omnibus Budget Reconciliation Act of 1993, HI taxes are paid on total earnings in covered employment, without limit. Other HI income includes a portion of the income taxes levied on Social Security benefits, interest income on invested assets, and other minor sources.
SMI enrollees pay monthly premiums: $96.40 for the standard Part B premium in 2008 and an average premium level of about $25 for Part D standard coverage in 2008. For Part B, the monthly premiums cover a little more than 25 percent of program costs with the balance paid by general revenue of the Federal government and a small amount of interest income. Beginning in 2007, there is a higher "income-related" Part B premium for those individuals and couples whose modified adjusted gross incomes exceed specified thresholds. When the income-related premium is fully phased in (in 2009), beneficiaries exceeding the threshold will pay premiums covering 35, 50, 65, or 80 percent of the average program cost for aged beneficiaries, depending on their income level, compared to the standard premium covering 25 percent. Part D costs are met through monthly premiums, which are designed to cover 25.5 percent of the cost of the basic benefit for an individual, with the balance paid by Federal general revenues and certain State transfer payments.
The Part A tax rate is specified in the Social Security Act and is not scheduled to change at any time in the future under present law. Thus, program financing cannot be modified to match variations in program costs except through new legislation. In contrast, the premiums and general revenue financing for both Parts B and D of SMI are reestablished each year to match estimated program costs for the following year. As a result, SMI income automatically matches expenditures without the need for legislative adjustments.
Each component of Medicare has its own trust fund, with financial oversight provided by the Board of Trustees. My discussion of Medicare's financial status is based on the actuarial projections contained in the Board's 2008 report to Congress. Such projections are made under three alternative sets of economic and demographic assumptions, to illustrate the uncertainty and possible range of variation of future costs, and cover both a "short range" period (the next 10 years) and a "long range" period (the next 75 years). The projections are not intended as firm predictions of future costs, since this is clearly impossible; rather, they illustrate how the Medicare program would operate under a range of conditions that can reasonably be expected to occur. It is important to note that the results shown in this year's report continue to be significantly more uncertain than those in past reports prior to enactment of the MMA. In particular, the Part D projections are estimated with only limited actual program experience. In addition, the Part B cost projections almost certainly understate the actual future cost of this component, due to the impact of the "sustainable growth rate" payment mechanism for physician services under current law. The projections shown in this testimony are based on the Trustees' "intermediate" set of assumptions.
Short-range financial outlook for Hospital Insurance
Chart 1 shows HI expenditures versus income since 1990 and projections through 2017. For most of the program's history, income and expenditures have been very close together, illustrating the pay-as-you-go nature of HI financing. The taxes collected each year have been roughly sufficient to cover that year's costs. Surplus revenues are invested in special Treasury securities—in effect, lending the cash to the rest of the Federal government, to be repaid with interest at a specified future date or when needed to meet expenditures.
During 1990-97, HI costs increased at a faster rate than HI income. Expenditures exceeded income by a total of $17.2 billion in 1995-97. The Medicare provisions in the Balanced Budget Act of 1997 were designed to help address this situation. As indicated in chart 1, these changes—together with subsequent low general and medical inflation and increased efforts to address fraud and abuse in the Medicare program—resulted in a decline in Part A expenditures during 1998-2000 and trust fund surpluses totaling $61.8 billion over this period. (Part of this decrease was attributable to the shift of a substantial portion of home health care costs to Part B, which improved the financial status of the HI trust fund but did not reduce Medicare costs overall.) After 2000, Part A expenditures and income converged slightly, as the Balanced Budget Refinement Act and the Benefit Improvement and Protection Act increased Part A expenditures and the 2001 economic recession resulted in lower payroll tax income for Part A.
Chart 1—HI expenditures and income
(in billions)
Starting in 2004, the MMA increased Part A expenditures, through higher payments to rural hospitals and to private Medicare Advantage health plans. Moreover, the growth rate of expenditures is expected to continue to exceed growth in revenues.[2] Total HI income, including interest earnings, is expected to be less than expenditures in 2010 and all years thereafter. (HI dedicated revenues alone are estimated to fall short of total expenditures beginning this year.) Note that even relatively small changes in growth trends for either income or expenditures could have a very significant impact on the projected difference between these cash flows. In particular, the onset of deficits in the HI trust fund could occur somewhat earlier or later than this intermediate projection.
Chart 1 also shows an upward shift in the level of HI expenditures from 2007 to 2008 and a temporary dip in income in 2008. These patterns are related, and they arise from the identification and correction of an accounting error. Specifically, a new, integrated accounting system for Medicare was phased in starting in 2005. This system inadvertently paid Part A hospice benefits from the Part B account of the SMI trust fund. As a result, Part A expenditures were too low in 2005-2007 (and Part B expenditures were too high, by the same amount). The problem was identified and corrected for future payments in September 2007, and the HI expenditures projected for 2008 and later reflect the full level of hospice benefits. The assets of the HI trust fund will be adjusted downward by approximately $12.6 billion in June 2008 to return the portfolio to the position in which it would have been if the hospice payment misallocation had not occurred. The adjustment is counted against HI income for 2008 in chart 1.
The Board of Trustees has recommended maintaining HI assets equal to at least one year's expenditures as a contingency reserve. As indicated in chart 2, HI assets at the beginning of 2008 represented 142 percent of estimated expenditures for the year. Future asset growth, reflecting the diminishing difference between income and expenditures described above, is projected to be significantly slower than expenditure growth in 2008 and later. After 2010, as assets are drawn down to cover the annual deficits, the trust fund balance would decline and would be exhausted early in 2019 under the Trustees' intermediate assumptions.
Chart 2—HI trust fund assets
(assets at beginning of year as percentage of annual expenditures)
The projected exhaustion date for the HI trust fund is the same year as was projected in last year's report but at an earlier point within the year, due to slightly lower projected payroll tax income and slightly higher projected benefits than previously estimated, together with the asset adjustment to compensate for the hospice cost misallocation.
Long-range financial outlook for Hospital Insurance
The interpretation of dollar amounts through time is very difficult over extremely long periods like the 75-year projection period used in the Trustees Report. For this reason, long-range tax income and expenditures are expressed as a percentage of the total amount of wages and self-employment income subject to the HI payroll tax (referred to as "taxable payroll"). The results are termed the "income rate" and "cost rate," respectively. Projected long-range income and cost rates are shown in chart 3 for the HI program.
Past income rates have generally followed program costs closely, rising in a step-wise fashion as the payroll tax rates were adjusted by Congress. Income rate growth in the future is minimal, due to the fixed tax rates specified in current law. Trust fund revenue from the taxation of Social Security benefits increases gradually, because the income thresholds specified in the Internal Revenue Code are not indexed. Over time, an increasing proportion of Social Security beneficiaries will incur income taxes on their benefit payments.
Chart 3—Long-range HI income and costs under intermediate assumptions
(as percentage of taxable payroll)
Past HI cost rates have generally increased over time but have periodically declined abruptly as the result of legislation to expand HI coverage to additional categories of workers, raise (or eliminate) the maximum taxable wage base, introduce new payment systems such as the inpatient prospective payment system, and make other changes. Cost rates decreased significantly in 1998-2000 as a result of the Balanced Budget Act provisions together with strong economic growth. After 2000, however, cost rates increased, partly because of the Balanced Budget Refinement Act and the Benefit Improvement and Protection Act. Cost rates are expected to continue increasing in 2008 and later and to accelerate significantly as the baby boom generation enrolls in Medicare, beginning in 2011. By the end of the 75-year period, scheduled tax income would cover only 30 percent of projected expenditures.
The average value of the financing shortfall over the next 75 years—known as the actuarial deficit—is 3.54 percent of taxable payroll. For illustration, this deficit could be closed by an immediate increase of 1.77 percentage points in the HI payroll tax rate, payable by employees and employers, each. If, instead, no changes were made until the year of asset exhaustion, then the HI payroll tax rate would require an increase of about 2.23 percent (employees and employers, each). Note, however, that such changes would correct the deficit only "on average." Initially, HI revenue would be significantly in excess of expenditures, but by the end of the period, only about one-half of the projected annual deficit would be eliminated. The long-range deficit could also be eliminated by many other approaches involving revenue increases and/or expenditure reductions, but its magnitude poses a very daunting challenge to policy makers.
Per-person HI costs are expected to increase faster than per-worker tax revenues due to health care price inflation and increases in the utilization and intensity of services. Collectively, these factors generally exceed the growth in average earnings per worker, on which HI taxes are based. Important demographic factors contribute further to this growth differential. The effect of the baby boom generation on Medicare and Social Security is relatively well known, having been discussed by actuaries and others for the last 35 years. Basically, by the time the baby boom cohorts have enrolled in Medicare, there will be about 75 percent more HI beneficiaries than there are today, but the number of covered workers will have increased by only about 20 percent. When the HI program began, there were 4.5 workers in covered employment for every HI beneficiary. As shown in chart 4, this ratio was about 3.8 workers per beneficiary in 2007. When the baby boom joins Medicare, the number of beneficiaries will increase more rapidly than the labor force, resulting in a decline in this ratio to about 2.4 in 2030 and 2.1 by 2080 under the intermediate projections. Other things being equal, there would be a corresponding increase in HI costs as a percentage of taxable payroll.
There are other demographic effects beyond those attributable to the varying number of births in past years. In particular, life expectancy has improved substantially in the U.S. over time and is projected to continue doing so. The average remaining life expectancy for 65-year-olds increased from 12.4 years in 1935 to 18.0 years currently, with an estimated further increase to about 22 years at the end of the long-range projection period. Medicare costs are sensitive to the age distribution of beneficiaries. Older persons incur substantially larger costs for medical care, on average, than do younger persons. Thus, as the beneficiaries age, over time they will move into higher-utilization age groups, thereby adding to the financial pressures on the Medicare program.
Chart 4—Workers per HI beneficiary
Financial outlook for Supplementary Medical Insurance Part B
The financial status of the SMI trust fund is very different than for HI, although rapid expenditure growth is a serious issue for both components of Medicare. The MMA established a separate account within the SMI trust fund to handle transactions for the new Medicare drug benefit. Because there is no authority to transfer assets between the new Part D account and the existing Part B account, it is necessary to evaluate each account's financial adequacy separately.
Chart 5 presents estimates of the short-range outlook for Part B. In contrast to the HI program, the income and expenditure curves for Part B remain closely related in the future. As noted previously, Part B premiums and general revenue income are reestablished annually to match expected program costs for the following year. Thus, the program will automatically be in financial balance, regardless of future program cost trends.[3]
The income amount shown in chart 5 for 2008 includes a planned reimbursement of about $12.6 billion in recognition of the inadvertent charges made to the Part B account to cover the costs of certain Part A hospice benefit payments. As described previously, this cost misallocation occurred as a result of the introduction of a new accounting system, and the problem was corrected late in 2007 for future payments. The lump sum adjustment will repay the Part B account, with interest, for the inadvertent payments in 2005-2007.
Chart 5—SMI Part B expenditures and income
(in billions)
As shown in chart 5, Part B expenditures exceeded income during 1999-2004, resulting in account deficits over this period totaling $26.8 billion. These deficits resulted in part from greater-than-expected increases in physician, outpatient hospital, and certain other Part B costs. They also occurred due to a series of legislative acts that overrode scheduled reductions in Medicare physician fees after the financing rates had already been set for a year. In particular, the Consolidated Appropriations Resolution of 2003 (CAR) and the MMA raised Part B costs above the prior-law levels used to establish beneficiary premiums and general revenue financing. This pattern continued with the Deficit Reduction Act of 2005 (DRA), the Tax Relief and Health Care Act of 2006 (TRA), and the Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA).
The resulting deficits in the Part B account drew down assets to a level that was well below the range needed for contingency purposes, as shown by the dotted lines in chart 6. Consequently, beneficiary premiums and matching general revenue financing were increased substantially for 2004, 2005, 2006, and 2007.[4] These increases, together with the planned $12.6-billion asset adjustment in June 2008, restored Part B assets to an adequate level at the end of 2007—the first such occurrence since 2002.[5] Assets are estimated to increase further by the end of 2008 under current law. A somewhat lower (but still adequate) level would result in the likely event that legislation is enacted to override a scheduled 10.6-percent reduction in physician payment rates for the second half of 2008.
Chart 6—Actuarial status of the Part B account in the SMI trust fund
(assets minus liabilities as percentage of following year's expenditures)
As suggested by the preceding discussion, the projected Part B expenditures shown in the 2008 Trustees Report are unrealistically low due to the structure of physician payments under current law. Future physician payment increases must be adjusted downward if cumulative past actual physician spending exceeds a statutory target. By the start of 2003, actual spending was already above the target level. The CAR, MMA, and DRA raised physician payments for 2004-2006 without raising the allowable target spending to match. The TRA raised the physician fee schedule update for 2007 and increased the target for 1 year, but specified that the 2008 physician fee update be computed as if the 2007 update had not been changed. Similarly, the 2007 MMSEA raised the physician fee schedule update for the first half of 2008, but the update for the second half will be computed as if the first 6 months of the year had not been changed. Together, these factors yield estimated reductions in physician payment rates of about 10.6 percent for July 2008, another 5 percent for January 2009, and an additional 5 percent for nearly every year during 2010-2016.[6] Because an aggregate 41-percent reduction in physician fees from current levels is implausible, the projected Part B expenditures shown in the 2008 Trustees Report must be considered substantially understated. By extension, costs shown for SMI, and for Medicare in total, are also understated. In the likely event that Congress continues to override the reductions in physician fees that would be required under current law, actual Part B costs could be roughly 10 to 20 percent higher than projected, and a greater increase in premium and general revenue financing would be required to match program costs and maintain assets at the necessary level.
Financial outlook for Supplementary Medical Insurance Part D
The MMA introduced the most significant changes to the program since its enactment in 1965. The new prescription drug benefit brings Medicare more in line with modern insurance coverage and medical practice while providing valuable new coverage for all beneficiaries who choose to enroll, especially those with low incomes. At the same time, of course, the new drug benefit adds substantially to the overall cost of Medicare.
Beneficiaries obtain Part D drug coverage by voluntarily purchasing insurance policies from stand-alone prescription drug plans or through Medicare Advantage health plans. The costs of these plans are heavily subsidized by Medicare through a combination of direct premium subsidies and reinsurance payments. Medicare provides further support on behalf of low-income beneficiaries and a special subsidy to employers who provide qualifying drug coverage to their Medicare-eligible retirees. The financial risk associated with the private drug plans is shared between each plan and Medicare. Medicare's cost for the various drug subsidies is financed primarily from general revenues. A declining portion of the costs associated with beneficiaries who also qualify for full Medicaid benefits is financed through special payments from State governments.
Chart 7 shows actual Part D costs in 2004-2007 and estimates through 2016. For the Part D program, the financial operations in 2004 and 2005 related only to the prescription drug discount card and low‑income transitional assistance. The full Medicare prescription drug coverage became available in 2006. Part D income and outgo have been, and will continue to be, in virtually exact balance automatically due to (i) annual adjustments of premium and general revenue income to match costs, and (ii) a flexible appropriation process under which general revenues are appropriated to the trust fund account on a daily basis as needed to cover that day's outlays. As a result of this latter feature, there is no need to maintain a contingency reserve in the Part D account.[7]
Chart 7—SMI Part D expenditures and income under alternative assumptions
(in billions)
The Part D expenditure projections shown in the 2008 Trustees Report are significantly lower than those in the 2007 report and substantially lower than the original projections from 2003. The improvement relative to last year's Trustees Report arises primarily from three factors. First, actual benefit costs in 2006 were lower than we (and the Part D plans) had estimated. In addition, the actual drug manufacturer rebates reduced Part D expenditures by 8.6 percent in 2006, significantly above the assumed level of about 5 percent. Finally, the projected cost growth trend for the next several years, which is based on our projected growth in prescription drug spending nationally, is somewhat lower than in last year's report. Collectively, these effects reduce projected Part D spending in 2008-2017 by $129 billion or about 17 percent compared to last year's report. The actual future cost of Part D remains uncertain, however, as illustrated by the projection range shown in chart 7, because only limited data are available to date on the actual operations and cost of the program.
Long-range outlook for Supplementary Medical Insurance overall
Chart 8 shows projected long-range SMI expenditures and premium income as a percentage of GDP. Under present law, Part B beneficiary premiums will continue to cover about 25 percent of total Part B costs, with the balance drawn from general revenues. Similarly, Part D beneficiary premiums are designed to cover 25.5 percent of the basic Part D benefit, on average. Because many enrollees qualify for the Part D low-income subsidy and do not have to pay full (or any) premiums, and because the low-income subsidy and retiree drug subsidy costs are not financed through premiums, total premium revenues currently represent about 9 percent of total Part D costs. The balance is paid by general revenues (77 percent) and State transfers (14 percent).[8] SMI expenditures are projected to increase at a significantly faster rate than GDP, for largely the same reasons underlying HI cost growth. For most of the past 15 years, prescription drug spending has been the fastest growing component of national health care costs. Consistent with that trend, the Medicare prescription drug spending under Part D is projected to initially grow faster than either Part A or Part B.
Chart 8—SMI expenditures and premiums as a percentage of GDP
Although each SMI account is automatically in financial balance, the program's continuing rapid growth in expenditures places an increasing burden on beneficiaries and the Federal budget. In 2010, for example, a representative beneficiary's Part B and Part D premiums would require an estimated 11 percent of his or her Social Security benefit, and another 14 percent would be needed to cover average deductible and coinsurance expenditures for the year. By 2080, about 29 percent of a typical Social Security benefit would be needed to pay the Part B and Part D premiums, and about 37 percent would be required for copayment costs. Similarly, Part B and Part D general revenues in fiscal year 2010 are estimated to equal about 11 percent of the personal and corporate Federal income taxes that would be collected in that year, if such taxes are set at their long-term, past average level, relative to the national economy. Under the same assumption, projected Part B and Part D general revenue financing in 2080 would represent over 39 percent of total income taxes.
Combined HI and SMI expenditures
The financial status of the Medicare program is appropriately evaluated for each trust fund account separately, as summarized in the preceding sections. By law, each fund is a distinct financial entity, and the nature and sources of financing are very different between the two funds. This distinction, however, frequently causes greater attention to be paid to the HI trust fund—and especially its projected year of asset depletion—and less to SMI, which does not face the prospect of depletion. It is important to consider the total cost of the Medicare program and its overall sources of financing, as shown in chart 9. Interest income is excluded since, under present law, it would not be a significant part of program financing in the long range.
Chart 9—Medicare expenditures and sources of income as a percentage of GDP
Combined HI and SMI expenditures are projected to increase from 3.2 percent of GDP in 2007 to 10.8 percent in 2082, based on the Trustees' intermediate set of assumptions. The addition of Part D increased total Medicare costs by about 13 percent in 2006, and this increment is expected to ultimately grow to more than 20 percent. In past years, total income from HI payroll taxes, income taxes on Social Security benefits, HI and SMI beneficiary premiums, and SMI general revenues was very close to total expenditures. Beginning in 2008, overall expenditures are expected to exceed the aggregate amount of these non-interest financing sources, with the growing difference arising from the projected imbalance between HI tax income and expenditures. Throughout the long-range projection period, SMI revenues would continue to approximately match SMI expenditures.
Over time, SMI premiums and general revenues would continue to grow rapidly, since, under current law, they would keep pace with SMI expenditure growth. HI payroll taxes are not projected to increase as a share of GDP, primarily because no further increases in the tax rates are scheduled under current law. Thus, as HI sources of revenue become increasingly inadequate to cover HI costs, SMI premiums and general revenues would represent a growing share of total Medicare income. Within the next 5 years, under current law, general revenues are expected to constitute the largest source of Medicare financing.
Chart 10 shows the past and projected differences between Medicare's total outlays and its "dedicated financing sources," expressed as a percentage of total outlays. This ratio is estimated to reach 45 percent of outlays within the next 7 fiscal years.[9] As required under section 801 of the MMA, the Board of Trustees has issued a determination of "excess general revenue Medicare funding," the third such determination. The corresponding determinations in the 2006 and 2007 reports triggered a "Medicare funding warning" last year. Section 802 of the MMA required the President to submit to Congress, within 15 days after the release of the FY 2009 Budget, proposed legislation to respond to the warning. Accordingly, the President submitted the proposed "Medicare Funding Warning Response Act of 2008" in February this year, and Congress must now consider it on an expedited basis. Because the difference is again projected to exceed 45 percent within the first 7 years in the 2008 annual report—specifically in 2014—a determination of projected "excess general revenue Medicare funding" is again issued, and another "Medicare funding warning" is thereby triggered.
Chart 10—Projected difference between total Medicare outlays
and dedicated financing sources, as a percentage of total outlays
Currently, most of the difference between Medicare expenditures and dedicated revenues is financed by the Part B and Part D general revenue transfers provided by law. The remainder of this difference equals the amount by which HI expenditures exceed HI tax income and premiums. This gap can be met initially by using a portion of the interest earnings on the assets of the HI trust fund and subsequently, through 2018, by redeeming the assets of the trust fund. The cash required for the payment of interest and the redemption of assets is drawn from the general fund of the Treasury.
Over time, the difference between expenditures and revenues is projected to continue to increase under current law—reflecting not only further growth in statutory general revenue transfers to Medicare, as costs for Parts B and D continue to increase, but also the widening shortfall of HI tax income compared to expenditures. Although the statute labels the total difference as "general revenue Medicare funding," it is important to note that there is no provision in current law to address the projected HI trust fund deficits once the fund's assets are depleted. In particular, it would not be possible to transfer general revenues to HI to make up the difference.
The comparison of expenditures versus dedicated revenues, as called for by section 801 of the MMA, is a useful measure of the magnitude of general revenue financing for Medicare plus the HI trust fund deficit. Similarly, the test underlying a "Medicare funding warning" can help call attention to the impact on the Federal Budget associated with the general revenue transfers to Medicare. The "Medicare funding warning," however, should not be interpreted as an indication that trust fund financing is inadequate. That assessment can be made only by comparing each trust fund account's expenditures with all sources of income provided under current law, including the statutory general fund transfers and interest payments.
In their 2008 report to Congress, the Board of Trustees emphasizes the continuing financial pressures facing Medicare and urges the nation's policy makers to take steps to address these concerns. They also argue that consideration of further reforms should occur in the relatively near future, since the earlier that solutions are enacted, the more flexible and gradual they can be. Finally, the Trustees note that early action increases the time available for affected individuals and organizations—including health care providers, beneficiaries, and taxpayers—to adjust their expectations.
I concur with the Trustees' assessment and pledge the Office of the Actuary's continuing assistance to the joint effort by the Administration and Congress to determine effective solutions to the financial challenges facing the Medicare program. I would be happy to answer any questions you might have on Medicare's financial status.
[1]Federal Insurance Contributions Act and Self-Employment Contributions Act, respectively.
[2] Health care costs, including those for Medicare, increase in proportion to the number of beneficiaries, the increase in the average price per service, the number of services performed ("utilization"), and the average complexity of services ("intensity"). In contrast, HI payroll tax revenues increase only as a function of the number of workers and the increase in average earnings.
[3] The occasional odd patterns in the projected revenues occur when the normal January 3rd payment date for Social Security benefits falls on a Saturday, Sunday, or holiday. In such cases, payment is advanced to the next earlier business day—which is generally December 31st of the prior year. This situation will affect calendar-year Part B receipts in 2009-2010 and again in 2015-2016.
[4] The increases were 13.4 percent, 17.4 percent, 13.2 percent, and 5.6 percent, respectively, for these 4 years.
[5] The adequacy of the Part B contingency reserve is measured on an incurred basis. For this purpose, the June 2008 asset adjustment is treated as an "account receivable" item at the end of 2007 and is included in assets. In the absence of this factor, Part B assets would be at the lower end of the adequate range.
[6] Following customary practice, the Medicare Trustees Report describes the average change in physician payment rates over specified periods. For example, it shows a decrease of about 10 percent for the second half of 2008 compared to the second half of 2007. Similarly, it indicates that the level for 2009 under current law would be 10 percent lower than the average level for 2008. These differences in average levels can be confused with the more commonly used physician update percentages described in the text above.
[7] Individual Part D plans would normally maintain contingency reserves in case actual costs during the year exceed their expectations.
[8] These percentages are estimates for 2008; the balance will shift somewhat over time as the State requirement declines from 90 percent to 75 percent of the forgone cost of prescription drugs for full dual beneficiaries and as the Part D national average bid and low-income subsidy benchmark demonstration programs are completed.
[9]The dedicated financing sources are principally HI payroll taxes, the portion of income taxes on Social Security benefits that is allocated to the HI trust fund, beneficiary premiums, and the special State payments to Part D. These sources of dedicated revenues are depicted in the bottom four layers in chart 9.
Last revised: June 1, 2015


text:
STATEN ISLAND -- A shooting in Port Richmond Sunday night has sent a teenager to the hospital with what police are calling non life-threatening injuries
According to police, the shooting took place at the intersection of Kramer Place and Mitchell Lane, and the 18-year-old male victim was taken in a private car to Richmond University Medical Center, West Brighton.
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subset: commoncrawl


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EEA Newsletter, Issue 2013/2, 16 December
The link address is: http://europeanenvironmentagencyeea.createsend1.com/t/ViewEmail/d/CDBD5EBB80F608C6/0BF79A60DD99AA392540EF23F30FEDED
For references, please go to www.eea.europa.eu/soer or scan the QR code.
This briefing is part of the EEA's report The European Environment - State and Outlook 2015. The EEA is an official agency of the EU, tasked with providing information on Europe's environment.
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Top 10 lists are always good for a debate, and here's one guaranteed to set science buffs thinking. Science News magazine listed the "Top 10 Revolutionary Scientific Theories" on its website this week, and comparing your list to theirs is a fun thing to do this weekend. The maker of this list is Tom Siegfried, the magazine's former editor and the author of numerous books and articles on scientific subjects.
So, what's a revolutionary scientific theory? And what is Siegfried's nominee for the No. 1 revolutionary theory of all time? He defines "revolutionary" theories as new "frameworks" that made it possible to solve problems that the traditional thinking couldn't work around. You'll have to read the article to see what's Siegfried's No. 1, after you make your own list, but here's a hint: It isn't evolution by natural selection. However, it'd be a pretty safe bet that theory made the list.


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|"Tim Duffy K3LR" <email@example.com>
|Thu, 20 Dec 2007 12:22:19 -0600
I am pleased to announce that "early bird" registration for Dayton ConTest University (CTU) 2008 is now OPEN. The CTU staff is working hard to prepare an interesting and informative curriculum for 2008. CTU will be held in Dayton, Ohio on Thursday May 15, 2008. CTU 2008 will feature some of the best Radio Contest operators and station builders ("CTU Professors). They will present state of the art contesting topics that will increase your knowledge and fun. Thanks to Icom for their support of CTU 2008 and our contesting radio sport. For CTU 2008 details and registration, 2007 CTU wrap up and more information, go to: http://www.contestuniversity.com <http://www.contestuniversity.com/> Please make sure that you click on the registration page and indicate if you are a returning CTU graduate "Graduate School" or this is your first time attending CTU. Based upon the tremendous attendance at CTU 2007, I expect the CTU 2008 student registration slots will fill up fast. Space is limited. Hope to see you at CTU 2008 Thanks to Scott, KA9FOX and QTH.com for his hosting of the Contest University Web site! Merry Christmas and 73! Tim K3LR - CTU Chairman http://www.contestuniversity.com <http://www.contestuniversity.com/> _______________________________________________ CQ-Contest mailing list email@example.com http://lists.contesting.com/mailman/listinfo/cq-contest
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text:
Tag team wrestling has brought us some of the greatest matches and teams in wrestling history.
A great tag team consists of two guys that have good chemistry together (most of the time) and together put on great matches and win titles.
From, legendary performances like Wrestlemania 17's TLC match, to the great tag teams like the British Bulldogs and the Hart Foundation, this type of wrestling match can steal the show at a PPV or cement a wrestler's place in the Hall of Fame.
With the recent drought in talent in the tag team division in pro wrestling, a lot of fans forget that this past decade overall was a huge success in tag team wrestling.
I have created this slideshow to highlight the 10 greatest tag teams of the past decade.
Now, in the rankings I considered how good of a match the teams put on and how many titles they won. Some choices might be a surprise, and others will be pretty obvious.
Enjoy !


text:
Total program credits needed for graduation: 48
One academic quarter is three months. You will have a three-week break between each quarter.
To learn more, call 866.933.5860, or email us. When you connect with Capella, we will immediately put you in touch with an enrollment counselor trained to assist you with specific questions and needs for your area of interest.
Total program credits with foundational courses needed for graduation: 60.
Students in the MS in Information Systems and Technology Management degree program who do not have a bachelor's degree in Information Technology, Information Systems, Computer Science, or a similar technology degree are required to complete ISTM5004, ISTM5006, and ISTM5008 before enrolling in any course other than ISTM5002. This requirement may be waived for learners without the necessary bachelor's degree(s) who have at least eight years of relevant experience in a technology management field.
Foundational Courses
12 course quarter credits.
- Fundamentals of Information Systems (4 quarter credits)
- Databases and Programming (4 quarter credits)
- Networking Fundamentals (4 quarter credits)
Core Courses
24 course quarter credits.
- Communication Skills for Today's Information Technology Leader (4 quarter credits)
- Integration of Information Technology and Business (4 quarter credits)
- Complex Information Technology Global Enterprise Systems: Planning and Management (4 quarter credits)
- Leading a Global Information Technology Enterprise: Systems and Security (4 quarter credits)
- Analytics, Data Management, and Knowledge Management (4 quarter credits)
- Innovation, Leadership, and Ethics (4 quarter credits)
Five Elective Courses, 20 quarter credits
Recommended elective courses:
- Information Technology Security Fundamentals (4 quarter credits)
- Network Security Fundamentals and Cryptography (4 quarter credits)
- Information Security Regulatory and Legal Environment (4 quarter credits)
- Identifying and Managing Risk (4 quarter credits)
- Health Care Delivery: New Environments in Health Informatics (4 quarter credits)
- Health Care Information Systems Analysis and Design for Administrators* (4 quarter credits)
- Cornerstones of Health Informatics for Organizational Operations* (4 quarter credits)
- Leadership, Management, and Meaningful Use of Health Care Technology* (4 quarter credits)
Choose any graduate-level analytics or information technology course(s).
Capstone Course
Taken during learner's final quarter.
- Information Systems and Technology Management Capstone* (4 quarter credits)
*This course has a prerequisite. Contact an enrollment counselor or refer to the course descriptions for more information.
International Experience
Capella's International Experience takes your curriculum far beyond what you can experience with research alone. Students who join one of the annual trips gain an international perspective on global operations, supply chain management, and other key aspects of current business practices around the world.
During this one-week trip, you will have the opportunity to:
- Meet industry leaders and discuss global and regional business concerns
- Develop key job skills, such as adaptability, global understanding, tolerance, and leadership
- Engage in dialogue with senior executives of leading companies with global reach
- Meet successful entrepreneurs
- Gain first-hand experience in the many ways culture impacts the challenges and complexities of global business operations
Participants are responsible for the cost of their travel, accommodations, food and other associated expenses.
Call 866.933.5860 to speak with a Capella Counselor to learn more about the International Experience.
"Traveling to Chile was life-changing—the business, economic, societal, and global knowledge I gained was extraordinary. Before, during, and after each business visit we spent time conversing with faculty about each business, the industry, governmental policy impacts, and their financial status. I would recommend the International Experience to everyone. The investment you make in yourself as a professional is second to none."
– Tina Thompson, 2014 International Experience participant
FlexPath Self-Paced Learning Option
If you're highly motivated, looking to save time and money, and crave the freedom and flexibility of setting your own pace, you may want to consider FlexPath. Rather than face weekly deadlines, you'll work at your own pace to complete a series of assessments for each course.
There's no limit to the number of courses you can complete per session — you'll still pay the same flat tuition rate every 12 weeks.
What Can I Expect?
Most students take one to two courses at a time. One course typically requires 10 to 12 hours of study per week.
Courses are divided into 10 weekly units. Each unit consists of readings, discussions, and other activities you will be expected to complete throughout the week. Assignments are due on Sundays, though not every course requires an assignment each week.
In each course, you will receive a detailed scoring guide that describes expectations for every graded assignment.
Grades are based on your participation in weekly reading discussions and completion of assignments. You will also be assessed on your ability to demonstrate an understanding of expected outcomes for your program or specialization. These outcomes are based on the needs and performance standards of your field or discipline.
Learn more about online learning at Capella.
Transfer Credits
There are many ways to reduce tuition costs, including transferring credits which may help save time and money. You can transfer up to 12 credits into this specialization.
Sign Up for a Free One-Week Mini Course
Learn more about our online learning experience with a free one-week Mini Course.
Take an Individual Course
Whether you're completing continuing education credits, want to see if online learning is right for you, or are simply interested in a specific topic, you can enroll in many of Capella's online courses without committing to a degree program. We recommend speaking with an enrollment counselor to discuss your goals and ensure the credits you earn now can be applied to a degree program later.
To learn more, call 866.933.5860, or email us. When you connect with Capella, we will immediately put you in touch with an enrollment counselor trained to assist you with specific questions and needs for your area of interest.


text:
It was quite a contrast in weather conditions since the last time Fontainebleau senior Madison Heath set foot in LSU's Bernie Moore Track Stadium.
During the state meet on Saturday, May 4, temperatures dipped into the mid-40s, and this past weekend, they hovered around the high-80's and low-90's.
Heath put the finishing touches on a stellar season in the Class 5A Outdoor State Track and Field Championships by winning the pole vaulting title with a jump of 12 feet. Sunday, at the Governor's Games, Heath took it to new heights, jumping 12-06 to take the girls' 17/18 title.
Her effort was one of many outstanding performances on the second and final day the event that has grown by leaps and bounds and now draws competitors from several states.
Heath, who jumped a personal best of 13-0 at the Meet of Champions in Mobile, Ala., in March, hopes her performance at the Governor's Games will help her earn a college scholarship offer.
"One of the things I want to do is use this summer to help me get more consistent and comfortable jumping 13 feet," she said. "That jump was huge because it helped remove some of the mental block of that height. I have to work on many different things to help remove that barrier, but I'm feeling more confident now that I ever have before."
Heath has received interest from several major programs, including Stanford, UCLA, Tennessee and North Carolina, just to name a few. Her resume' from the 2013 season was impressive and includes the top five jumps in the New Orleans area, as well as All-Metro and All-State honors.
Heath will have another opportunity to impress next weekend when she travels to the U.S. National meet in Winston-Salem, N.C. She'll also compete in few other prestigious meets later this summer.
View complete Governor's Games results here.
Day 1: Governor's Games enjoying increasing success
LSU GREAT HAS HISTORY OF SUCCESSFUL TURNAROUNDS: As the Governor's Games concluded its final day of competition at LSU's Bernie Moore Track Stadium, former LSU basketball great Rudy Macklin soaked up the atmosphere of another successful year of competition.
His face was beaming with pride and accomplishment, along with a sense of what it meant in terms of continued growth. Those seeds were planted during his senior year of high school in Kentucky as he was being recruited by the likes of Louisville, Maryland, UCLA, Georgia Tech, Kentucky and LSU, which sought desperately to breathe new life into a program that had very little fan support.
"When it came down to the day I was going to make my decision, coach (Dale) Brown said if I went to one of those basketball powers, I would do very well," Macklin recalled. "Coach Brown also told me that they would do well without me. So, if I came to LSU, I could always say that I built something."
Macklin went along with Brown's vision, and chose the Tigers.
During Macklin's first media day, only the Daily Reveille and the Morning Advocate showed up -- a stark contrast to football's day that included media outlets from across the country.
After an exhibition, the team faced off against Tulane, which featured a front line measuring across at 6-9, 6-11, and 6-7. That night, Macklin pulled down 32 rebounds in a victory that started a streak of 10 victories.
By the time LSU reached Macklin's senior season, they were ranked in the top five and blitzed through the regular season SEC schedule, going 17-1. Its only loss was at Kentucky.
"I remember that loss at Kentucky," Macklin said with a chuckle. "Sam Bowie knocked down Howard Carter and the ref swallowed his whistle."
For those wanting more information on getting involved, Macklin can be reached at his office at (225) 342-4886; via email at email@example.com; or the website at la.governersgames.org.
Pat Mashburn can be reached at email@example.com or 504.826.3405.
NOLA.com prep sports coverage on Facebook


text:
Dan King is a force to be reckoned with. He forces and sometimes caresses cold, hard steel into glowing, heated malleability, creating fine art masterpieces with the basic tools of anvil fire and hammer. Or on another day, he might be welding a skidder.
Dan and his family rolled the dice and moved to the Adirondacks from Florida to make a new way for themselves.
"Both kids were going into new schools at the time, so we decided to take a chance and move north," Dan said in an interview outside on the lawn with the bright blue sky roiling with cumulous and the bluegreen mountain horizon across the lake. A warm summer breeze was blowing.
Article Photos
Blacksmith artist Dan King creates one of his works of art at his studio in Tupper Lake.
(Photo — Newton Greiner)
The gas forge Dan King uses runs hot, around 1,400 degrees Farenheit.
(Photo — Newton Greiner)
"We found a lot was happening in Tupper Lake," Dan said.
They bought an old hotel two blocks from the old railroad junction, and by the work that was going on there, it seemed the train might come back.
"I'm fully in favor of the tracks and the train returning," Dan said. "I think the trail and the tracks can coexist. I'd like to see the train start running again from Utica to Montreal and actually go across the border and bring goods and services across."
They expected that would happen in 2006, "but it didn't happen then," he said.
But Tupper Lake was moving toward it, and they came to town knowing that talent and personality would carry them. They got involved in the ground-level work of "dig ditches and carry water, so to speak," Dan said. As they built their own life and business, they also volunteered wherever they could.
"I think volunteers make a strong community, and it's amazing how this town pulls together, puts aside its differences and all work together when there's a family in need or a soldier is wounded or something happens," Dan said. "If that's any indication of a good community then this is a great community."
Dan tries to stay pretty much unplugged in this digital age, he said.
"I don't trust it, with the ID theft and all that (corporate) surveillance," he said.
"I make stuff with my hands, and it's the physical manifestation of my efforts that makes it rewarding."
Not only is he a blacksmith artist by trade and spirit, he has also made a niche for himself in Tupper Lake as a working man's helper. "The first year I was in Tupper Lake, I found myself lying in a pile of gravel on my back fixing the metal bracing at the concrete plant, or fabricating a new de-barker at the Tupper Lake Hardwood plant. Other times I would be repairing an oil pan on a skidder in the woods."
In the next breath he is making beautiful creations either for their sheer beauty like the intricately powerful dragon sculpture that appears in his shop window among other whimsical works, sheer art, or items for daily use like fire screens which his clients have called "the best most beautifully made ever," he admitted. At other times he finds himself twisting metal and hammering out andirons and fireplace pokers or a giant steel chandelier or an intricately ornate iron gate for a great camp somewhere deep in the woods by a pristine Adirondack lake.
"I've found there is a need for my art, as well as for utilitarian projects that people need in order to keep working."
Dan has been a rescue squad volunteer driver since the beginning of summer and also a member of the National Ski Patrol all winter.
Still he has time to play guitar and write music and maintains an open mic studio area in a space which is set up in their old hotel building, which is also their home.
"I also love fishing," Dan said. "I caught a 5-pound landlocked salmon Saturday at the bog. The whole family loves fishing. Our 14-year-old daughter loves to fish she baits her hook catches the fish, takes it off the hook and then decides for herself whether to release it or eat it, in which case she cleans and fillets it."
They also love to camp, and they love all seasons.
"We just belong here now."
Dan grew up in Charlottesville, Virginia in the Blue Ridge Mountains, which he said is "a lot like the Adirondacks." From where he lived, he said you could walk from his house to the Appalachian Trail without crossing any roads.
Dan's wife Jenn was born in Hattiesburg, Mississippi, and moved to Lakeland, Florida when she was little.
They met in Tampa at an internet cafe that one a friend of Jenn's owned at the time.
"I went there for the coffee, not the internet," Dan remembers. They were married in Tampa in 1998.
Jenn is now a certified Kripalu yoga instructor, and her artistic sensibilities are wildly evident in a diversity of different projects she likes to create.
"We're not afraid to take risks and go after things, but we've also learned you can sneak up on things," and do it gradually, "if you take your time," Dan said.
Dan is a busy blacksmith artist, especially in the summer, with his business he calls Hammersong. "The name is kind of a Viking kenting with two words combined to create a larger meaning," Dan confides. "Kind of like 'boundingwave' as the Vikings called the sea."
It combines the sound made by the hammer with the song in his heart that he listens to when he creates and becomes a meditation in blacksmithing and music.
"We have two beautiful daughters, Kelsey and Alamanda, and granddaughter, Aubrey. Kelsey is finished school and out on her own now, with her little daughter, and Alamanda will be a freshman at Tupper Lake High School in the fall. They love it here too," Dan said. "Kelsey went back to Florida for a year but decided she likes it here better."
Alamanda was named student-athlete of-the-year in eighth grade, and is a member of the volleyball and track teams as well as chorus and band, and she also loves to snowboard. She's an honor student and achieved straight "A"s last semester in middle school. "We're super proud of all of them," her dad said.
At the end of July, Dan will celebrate 20 years in business as a self employed artist-blacksmith.


text:
Top 10 Bittorent Sites: "Top 10 Bittorent Sites"
Top 10 Bittorent Sites: "Top 10 Bittorent Sites"
Links for 2005-03-22 [del.icio.us]
A big huge list of Bittorent sites
A list of bittorent sites that I use. Hope you guys like it.
(263) » Top 10 Bittorent Sites
bookmarked by 263 people
(229) » Top 10 Bittorent Sites
bookmarked by 229 people
Well, we're one day away from the official release of Picaresque. This is the day that I regret having downloaded the record when it was leaked in January. Oh well.
I spent this weekend watching and rewatching the Decemberists first video for Sixteen Military Wives. I must say, I was a little worried before watching it because they are a band with very evocative lyrical content. Which means when I listen to the songs I already see very distinct images in my head. It's like when a book you love is made into a movie and the characters don't look quite the same. And the set just doesn't seem right. And the feelings you get from looking at the screen are so much more muted than when you were reading the words and your neurons were all firing in their attempt to create a world in your head. Well, that's what happens to me at any rate.
Anyhoo, I was very happy with the product. It's a really funny video and totally fits into what the Decemeberists are all about. It's funny, it's zany, and (most importantly) it's smart and satirical. Well, it's a little heavy handed but the execution is near perfect. It was also fun to pick out all the usual suspects that orbit the Decemberists' universe making cameos (ie Death Cab for Cutie members!). I'll put up the full credits in a few days once you've all had the chance to guess.
So get a bittorent client and download the video!
Second on our penultimate Picaresque Week entry's agenda is this site by a rabid fan. Check out the Decemberists' Landmarks section to see pictures of random places that have been mentioned in their songs. I personally like this one:
And finally, to whet your appetite even more read this article from The Stranger which gives a great account of the Decemberists' history and the new album.
Tomorrow: My review of Picaresque!
More Picaresque Week: Tuesday Wednesday Thursday Friday
» Top 10 Bittorent Sites: "Here are 10 of the best bittorrent sites I have found over the past few weeks."
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bookmarked by 170 people
:: Gmail will go live April 1 | url :: Top 10 Bittorent sites. :: Yahoo buys Flickr. :: Firefox commercial. | url :: Technorati tracks 8 million pages. | url
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bookmarked by 95 people
| dvd movies upcoming movies free downloadable movies bittorent free movie downloads free dvd downloads download movies


text:
This deal has ended.
This Luxury Bedding 7pc Queen Comforter Set, listed at $129.99, is now $64.99 at Groupon Goods. Plus, shipping and returns are free. The best price we could find anywhere else is $78. The set comes in 3 styles, and includes the comforter, a bed skirt, two cushions, two pillow shams, and one breakfast pillow. It is also offered in King Size for $69.99. Sales tax is charged in most states.No longer available


text:
HourlyMore than 30 hrs/week
Start DateMarch 11, 2013
We are looking for someone to act as Server Admin for our high-traffic website.
We currently have a daytime admin, but we need someone to cover the night-shift. You will most likely be working from about 9pm ET to 5am ET.
We're not looking for an agency employee to do this, we need someone who is interested in a LONG-TERM, FULL-TIME position working EXCLUSIVELY for us. We need someone who we can rely on, if your not willing to commit to this please do not apply.
Job Requirements:
MUST have strong experience with AWS
MUST have strong skills in the following areas:
Linux (Debian/Ubuntu)
Daily Tasks:
Monitoring overall status of our system/servers
Regular maintenance
Spinning up new instances when necessary
Assorted server admin tasks
We will give you more information once we confirm that you have the necessary skills/expertise.
Skills: linux, apache
About the Client
United States
Orlando 05:41 PM
Jobs Posted
78% Hire Rate, 23 Open Jobs
Over $50,000
Total Spent
1,088 Hires, 110 Active
Avg Hourly Rate Paid
161,754 Hours


text:
Cape Town, South Africa
Hey, we made it! Internet is kinda sketchy what with all the tourists and all. But we've made it! We're staying in a hotel about a 10 minute walk from the stadium. The scene is electric and we're all having a good time. We're planning a trip around the Cape, all the way to the very tip. Should be a great time.
Enjoy the pictures.


text:
Community Soup Kitchen and Outreach Center serves Morristown and its surrounding communities. It serves lunch every day, provides links to social services and donates foods to those in need. Each year, the Soup Kitchen also hosts a job fair.
In 2010, Community Soup Kitchen served more than 56,000 meals and distributed 40 tons of food for guests to take home.
"Our goal is to help our guests get back on their feet, to become self sufficient so they don't need us anymore," said Marla Drury, Director of Development and Community Outreach.
"For 26 years, we have provided a noontime meal," Drury said. "Seven days a week, 365 days a year for 26 years, we've never missed a day. No matter what."
According to the organization's website, when the soup kitchen first opened its doors as the St. Peter's Soup Kitchen in 1984, volunteers at St. Peter's Episcopal Church served the first meal—soup, sandwiches and fruit, on a Saturday. There were eight guests.
In 1985, other congregations joined the effort to serve more people more meals. The organization's name was changed to the Community Soup Kitchen, and each congregation agreed to supply food and the volunteers to prepare and serve it.
"We now have over 30 different congregations of all faiths who form the basis of our volunteers," Drury said. "We have over 2,000 volunteers."
About eight years ago, Drury explained, Executive Director Teresa Connolly observed an increase of guests needing something more than a meal.
"So, we developed our outreach center and added it to the name," Drury said. "It's not as well known because it happens during meals. Almost everyone comes for the lunch and then makes use of the other services."
An on-staff social worker and nurses from Morristown Medical Center are available to guests during meals to help access their health needs and other concerns. After a guest's needs have been evaluated, staff can provide referrals to agencies that can help.
"Rather than duplicate services," Drury said, "we act as a bridge to help our guests connect to available services."
When needed, Drury said, representatives from other agencies, such as drug-treatment programs, come to the Soup Kitchen for more specialized evaluations.
A grant from the Fannie E. Rippel Foundation led to the establishment of the Soup Kitchen's Healthy Choices Program. Guests learn about making healthier nutritional choices at both home and at the Soup Kitchen, and volunteers are taught about healthier food preparation. Twice a week, the Community Soup Kitchen hosts a Healthy Choice Market. Local businesses donate fresh fruit, produce and other foods.
Community Soup Kitchen and Outreach Center does not receive government funding and is relies entirely on individual donations, and on congregational and corporate sponsors in order to operate.
For information on donating, congregation or individual volunteering or scheduling corporate sponsor days, visit cskmorristown.org or call (973) 267-0709.


text:
|Key Info
This charming comfort apartment is located on the 1st floor and has 2 suites and 2 bathrooms. The living room is large, spacious, and air conditioned and is also connected to the kitchen. The kitchen is fully equipped with all the necessary amenities to create delicious al fresco meals, such as a refrigerator, stove, oven, dishes and dishwasher. The living room has a satellite TV, DVD player, and twin-size sofa bed. The first suite has a double bed and bathroom with shower. The second suite has two single beds and a bathroom with shower. Both suites are air conditioned. The apartment also has its own terrace with tables and chairs. This charming apartment is ideal for up to 5 guests (or 6 guests if two are children) looking for a relaxing getaway on Lake Garda.. ExteriorsThis majestic villa is located in the ancient and picturesque town of San Felice del Benaco, on the beautiful Lake Garda.Lake Garda is the largest lake in Italy and it is located halfway between Brescia and Verona and between Venice and Milan. Surrounded by Alpine peaks, it is the perfect location to enjoy a peaceful and quiet holiday.During the summer, San Felice del Benaco becomes a vibrant and festive town, where you'll find many celebrations and cultural events. For those who love adventure and nature, the area is perfect for recreational sports such as hiking, cycling, tennis, horseback riding, golf and sailing.InteriorsThe furniture and equipment in the apartments reflect the pleasing and vaguely exotic landscape that surrounds them. Each apartment has a touch of originality in terms of vibrant colors, luminous lighting and exquisite design.All the apartments have fully-equipped kitchens where you'll find all the modern amenities for cooking delicious al fresco meals, such as a refrigerator, stove, oven, dishes and dishwasher. Each of the apartments has its own private terrace and a large and spacious living room, private bathrooms, satellite TV and several bedrooms.This majestic villa is the perfect accommodation for families or groups of friends looking for a holiday surrounded by tranquility, peace and complete relaxation.
|Sleeps up to 6, 2 bedrooms
|2 bedrooms, 2 bathrooms of which 2 family bathrooms
|Nearest travel links
|Nearest airport: Verona 50 km, 15 km
|Family friendly
|Great for children of all ages
|No pets allowed, No smoking at this property
|Internet access
|Wi-Fi available
|Double Beds (1), Single Beds (2)
|Not suitable for wheelchair users
Lake Garda


text:
Latest News
The recording of The American Lover, a collection of short stories by Rose Tremain that Kate contributed to, has been named one of the twenty best audiobooks of all time by The Telegraph newspaper!
Kate also recently recorded the first two parts of Marie Rutkoski's The Winner's Trilogy, part three to come! You can listen to excerpts of her audiobooks on Amazon.
Kate appears in the new Booking.com ad campaign, currently airing in the USA.
Following the workshop performance of her solo show Blondes Prefer Gentlemen, Kate is busy with re-writes and hopes to have the finished show up and running later in the year. Watch the trailer. She is also working on her second play, Privilege.
About Me
Hello and thanks for visiting my site! You can take a look at my CV, listen to my voice reel and check out my showreel and headshots. Please refer to the contacts page should you wish to get in touch.
A little bit about me:
I grew up in Cornwall and abandoned the big sea for the big smoke at 17 to train at Webber Douglas Academy of Dramatic Art, London.
My theatre credits range from an adolescent boy to a Shakespeare heroine, whilst on TV I have played a drunken witch in Casualty, been shot and killed in Holby and played an enthusiastic Mother in ITV drama Doc Martin. I regularly record audiobooks and have voiced all manner of computer game characters.
I love to travel and have performed all over the world. I play the clarinet, alto sax and ukulele, and sing pretty well too; for an audio clip of me singing, see the bottom of my voice reel page.
Aside from acting I enjoy anything generally outdoorsy that gets my heart pumping, yoga, diving and running around after my little boy, Gillan.
Photo: Joanna Miller Betts


text: Hello There. I'm trying to build a wrapper around XML-RPC functionality. I decided to do something like that: every class (package) have an 'our' variable, And the base class do something like: ${ref($self).'::call_table'} To decide which calls to honor. The problem is that I can't do inheritance. (because the base class in my design looks for one variable. I thought about traversing the ISA arrays, but it seen expensive. Any bright ideas? (I can do a function for every class, but that will be much uglier then just a variable per class.) Thanks, Shmuel.


text:
Flourless Chocolate Cake
Bookmark this recipe immediately. I promise that there is going to come a time when you are backed in a corner, you have to make something fabulous for a party/mandatory work function/end-of-a-bad-day-cure and you are going to feel trapped. You don't know what to make! You don't have time to make anything elaborate but you can't show up with a plastic-wrapped, store-bought, chemical-laden baked good. You don't have time to go to the store and your kitchen looks as though it's been ravaged by a pack of wild dogs. This is your go-to, all-purpose problem solver cake.
A chocoholic's dream, this flourless chocolate cake is fudgy, moist and perfectly devour-able. It is endlessly adaptable (top with ice cream, fresh whipped cream, berries, cherry sauce, powdered sugar, chocolate ganache) yet perfectly delicious on its own. It takes less than 10 minutes to whip up the batter and it's out of the oven in less than a half hour. Plus, I promise you that you already have at least four of the five ingredients already in your kitchen. Problem? You have met your solution!
When people are in a pinch, rushed for time or out of ingredients the solution is frequently to grab a box mix and whip up some cupcakes or a quick sheet cake. This decadent dessert takes less time to make, it is made from scratch and I promise that you will feel better about serving people something that isn't packed full of chemicals and weird hydrogenated fats.
When you have a cake that only calls for 5 ingredients, you want to use the best quality ingredients that you can get your hands on. The chocolate is the shining star here so use the best chocolate that you can find. I would suggest Green & Blacks Organic Dark Chocolate or Scharffen Berger if you can find it (if your local grocery store doesn't carry those brands, you can always order them online). Of course, if all you've got laying around is a bar of Hersheys or Nestle, don't let that stop you! I'm sure it will work out just fine.
The recipe calls for an 8 inch cake pan … which I simply didn't have. My kitchen is only stocked with 9 inchers for some reason, so I used a 9 inch tart pan instead. The cake came out a bit thin so if you like a thicker cake (keep in mind that this batter isn't going to rise!) stick with a smaller sized pan.
This cake is truly a blank canvas for your imagination to run wild in terms of toppings. Now don't get me wrong, people will be happy to gobble down this gorgeous cake plain, but just imagine topping it with some fresh berries! Or my famous red wine cherry sauce! Whipped cream! A drizzle of caramel and some chocolate shavings! The possibilities are endless.
Flourless Chocolate Cake
Yield: 1 cake
Prep Time: 10 minutes
Cook Time: 23-25 minutes
4 ounces bittersweet chocolate
1 stick (1/2 cup) unsalted butter
3/4 cup granulated sugar
3 large eggs
1/2 cup unsweetened cocoa powder
1/2 teaspoon vanilla extract (optional)
1/2 teaspoon fine grind espresso (optional)
- Preheat oven to 375 degrees. In a heat proof bowl, combine chocolate and butter. Melt the chocolate and butter using either a double boiler (heat proof bowl over a simmering pot of water) or in the microwave in 30 second intervals, stirring between each interval.
- Once fully melted, whisk in sugar. Once combined, whisk in eggs, one at a time until fully combined. Stir in vanilla and espresso (if using).
- Sift cocoa powder into the chocolate mixture. Whisk to combine.
- Pour into a greased 8 inch cake or tart pan.
- Bake 23-25 minutes. Let rest on a wire rack for 5 minutes before removing from pan.
- Serve warm topped with whipped cream, ice cream, fresh berries, chocolate shavings or other endless possibilities.
Adapted from Epicurious' Flourless Chocolate Cake
22 Responses to "Flourless Chocolate Cake"
just delectable. wow!
I need a piece of this now!
That does look amazing! Gorgeous photos of a delicious looking cake!
looks amazing! i have it bookmarked!
Looks good! I think I'll try making this sometime.
That looks fabulous!
Katie! YUM! You inspire me! Hope all is well in your life.
No mention is made of the oven temperature! I am going to try 350′F.
Russ – Yikes! Thanks for pointing that out! I totally neglected to include the temperature … only a minorly important detail. I've corrected the recipe to reflect the correct temp – 375 degrees!
Yikes! It is in the oven now and I'll let you know how it turns out at 350F. Maybe I can leave it in for 35 mins or so.
Well, I chose 350′F and left it in an additional 10 minutes and it was fine. However, next time I will try 375′F.
This looks/sounds so delicious! I'm definitely going to try it!
Absolutely Wonderful! I made one for my coworkers and they all loved it! Delicious and Moist, and oh so chocolatey! I then made another one for my family and they loved it, too! A winner with everyone. I accidentally only used 1/2 stick of butter, but it turned out marvelous anyway! I sprinkled powdered sugar on top, then had whipped cream and raspberry toppings. Thank you so much for this recipe!
Maya – So glad you liked the recipe! It has quickly become a favorite of mine. The raspberry and whipped cream topping sounds amazing. I'll have to remember that for my next batch!
This may be a silly question, but when you say sugar…what kind of sugar? Will ordinary granulated sugar suffice or do I need icing sugar?
Cheryl — My mistake for not clarifying, yes, you want to use granulated sugar. Enjoy!
I used a half and half mix of two kinds of chocolate. Lindt A Touch Of Sea Salt and Lindt Mint. Both are dark chocolate. Since I didn't use bittersweet I cut back just a bit on the sugar. After mixing and pouring into pan, I sprinkled 2 tablespoons of cocoa nibs on top. It is baking in the oven right now. Can't wait to try it with lightly sweetened whipped cream. So much flavor going on in the cake, I didn't want to add too much in the way of topping. I'll let you know how it turns out.
I used this recipe as part of an insane ice cream cake I was commissioned to make for a friend's daughter's birthday.
I added 1/2 teaspoon of salt. Also, being at high altitude, I added a heaping tablespoon of flour. Because I used Belgian dark chocolate, I decreased the sugar a tad.
Two layers of this cake, one cheesecake with chocolate crumb crust, two layers of cookies and cream ice cream (I crumbled the Oreos myself into some premium vanilla), one layer of same vanilla with cherry pie filling stirred in, one layer of chocolate pudding (less milk by a third to make it thicker), topped with brandied cherries and the whole lot covered with ganache. It's over a foot tall. Ridiculous!
It is in the oven now!! The batter was yummy I had a hard time keeping my daughter out of it!! Gonna whip up some whipping cream this should be heavenly. I will be counting the minutes lol thanks for the recipe
i will be trying this recipe this weekend to make 4″ double layer mini cakes with a chocolate mousse filling and topped with a chocolate ganache and a chocolate covered strawberry. super excited and cant wait to see how they turn out. im making them for valentines day
ooooo mmmy GOd its rediculusly easy to baake…. i lovvvvvvv ur recipe… but just wanna ask wil it b alright if i use semisweet choclate instead of bittersweet choclate. (as my dad dont like the bitter choclate taste).
This cake is weird. No mention of how much flour or baking soda. I added 2 1/2 cups flour and a ectra egg. I put in 2 tsp b powder and it was so thick. Put in 1/2 cup of coffee. Still to thick. Yuck never again.


text:
The FBI has released video and photos of two "armed and dangerous" suspects in the Boston Marathon bombing and appealed for the public's help in identifying them.
The images show two men in baseball caps. One of them was seen putting down a black backpack at the site of the second blast in Monday's attack. Both were seen walking together through the crowd.
"Somebody out there knows these individuals...though it may be difficult, the nation is counting on those with information to come forward and provide it to us," Boston FBI Special Agent in Charge Richard DesLauriers said at a Thursday briefing.
"We consider them to be armed and extremely dangerous," DesLauriers said of the men. "No one should approach them...If you see these men, contact law enforcement."
The FBI was also canvassing hobby stores in the Boston area to determine whether electrical components in the bombs were bought there, NBC News learned.
If you have any information, you are asked to not do anything on your own, but to contact:
You can view the released footage at:
Copyright 2016 Nexstar Broadcasting, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.


text:
President's Letter
Welcome to the home of the Segmenting Chapter of the AAW. Segmenters utilize the bounty of color and texture available in the many species of wood found in nature. Using these varieties, we are able to expand our creativity to design and build patterns in our work not available to the single species turner.
We are a very friendly group. If you are novice, experienced, or somewhere in between in segmenting, you will find helpful friendly advice and answers to expand your horizons.
Complete use of all the features or this site requires membership in the chapter.
Wayne Miller, President
Download the full 9-page brochure, and share the first page with your local clubs as a stand-alone flyer.
Check out our demonstrator grid
Discuss the event in the "announcements" section of the forum.
Register for the Symposium
Online registrations are now open.
Demonstrator Photos
Photo of the Week
Thank You Mr. Snelson
Segmented Woodturners is an AAW Chapter.


text:
Ronald Nored is a lot of things to the Butler Bulldogs -- point guard, defensive stopper, organizer of locker room games of "Hangman."
But one thing the Homewood native insists he is not is a star.
"A lot of people like to talk and say, 'I saw you on TV, you've got this good stuff going, you're famous.' I'm thankful for that.
"But honestly, while it's awesome, at the same time it's not. I don't want that to be the way people think I think about myself."
However, the "star" label is one the 6-foot sophomore point guard better get used to if he continues to play the way he did in the first two rounds of the NCAA Tournament.
Nored is averaging 9.0 points, 4.5 assists, and 1.5 steals as No. 5 seed Butler advances to play No. 1 seed Syracuse today in Salt Lake City, having beaten UTEP 77-59 and Murray State 54-52 to advance to the Sweet 16 for the third time in eight years.
It was Nored who stepped up against the Racers, breaking a 50-50 tie with a layup and free throw with 25 seconds left in the game, then clamped down on a double-team with Gordon Hayward that forced a Murray State turnover, keeping the Racers from getting a last-second shot off.
Nored's 15 points against Murray State led Butler, the first time in his 65-game college career that Nored has led his team in scoring. That, along with a game-high six assists, made Nored a hard player not to notice.
Chances are good that Butler will need that again -- and more -- against Syracuse.
"Syracuse is really good, no doubt about that," Nored said. "We've watched film and the coaches have broken it down to the point where we believe if we execute, we have a chance."
Nored is enjoying this NCAA Tournament run.
"I had about 70 text messages after the (Murray State) game, and a ton on Facebook," Nored said. "What made me the most happy was the people calling and e-mailing me from Homewood -- people I grew up with, that I love hanging out with, who've watched me grow up -- telling me they're proud. That means a ton, because part of what we're doing is for them.
"If nothing else happens, I can look back and say I had a great time doing this. So many people are watching. I hope they're enjoying it. It's my favorite deal -- to see other people smile and other people be happy."
Which brings us back to Butler's favorite locker room time killer, Hangman, the game in which one person thinks of a name or phrase and the rest of the players try to guess it, letter by letter.
"Look, we're all still goofy," Nored said. "I'm still going on 20 (years old) acting like the 5-year-old kid I've always felt like. We're just having as much fun as we can."
Join in the conversation by commenting below or e-mail Melick at firstname.lastname@example.com.


text:
This deal has ended.
Today only, Walmart has the Hamilton Beach 5-Quart Portable Slow Cooker, in silver or red, for $19.94. Even with $4.97 shipping, this is a more than $8 savings over the next lowest price. You can save shipping charges by picking it up at a nearby Walmart or FedEx Office location. Sales tax is charged in most states.No longer available


text:
The Oregon Department of Transportation said Wednesday the Historic Columbia River Highway won't reopen until next week.
A rockslide on June 5 blocked the highway, as a thousand cubic yards of rock and debris tumbled down about a hundred yards west of the Stark Street Bridge.
The highway is closed between Woodard Road and the bridge. Travelers may connect with the historic highway by taking Interstate 84's Exit 22 to Corbett.
ODOT anticipated opening the highway by midweek, but it issued a news release Wednesday saying a high-reach excavator wouldn't likely finish bringing down large rock outcroppings from the 120-foot face before Friday.
Then work crews will take final steps to re-opening, including removal of debris, inspection of the rock face and inspection of the road.
No date has been set for reopening.
-- Andre Meunier


text:
nice video, but i hate it when people flat out ask for rep...
Here is a link to an amazing halo video. This guy is amazing! rep me if you enjoy it!
Wii games that I own: Zelda, The godfather, Wii sports, Resident Evil 4.
Next up: Metroid Prime 3 Corruption
nice video, but i hate it when people flat out ask for rep...
Originally Posted by The_Loose_Cannon
Originally Posted by Darkprinny
rep YOU because you posted a link?
jeeze this is getting sad
Everything in this signature except for this text was made by Wiired, he is my creator and almighty.
thats what i was saying..Originally Posted by Sovieto
Originally Posted by The_Loose_Cannon
Originally Posted by Darkprinny
this guy reminds me of a friend and for something that's not yours why would we rep you
Spoiler Alert!Metric: Tiger, you're posts always make me laugh. Then they make me feel a bit sorry for you. =\
The_Next_Tiger: Thanks man I love to make people laughSpoiler Alert!SAVE A COW EAT A VEGETARIANSpoiler Alert!Blackjack: video games come out on tuesdays, Though they do make exceptions.
Spoiler Alert!Sarai_132: who fuking cares! calm downSpoiler Alert!Chicagoan: I have Pokemon Rangers game, and I beated it.Spoiler Alert!JoonKimDDS: Sometimes wiimote requires too much muscle work to perform a move.Spoiler Alert!Mushroomedmario: the moral is only trust wikipedia...for everything
Huh... Y'know, I think I've seen this before... I could have sworn that this video was posted before by some moron on a Wii forum about more than a YEAR after the video was made, and after everyone and their moms have ****in' seen it...
...Wait, scratch that. That movie was ADDED more than a year ago. It was made a hell of a long time ago.
;D I only wish I could negative-rep you for asking for so much when you didn't even do SO LITTLE, but did NOTHING. xP
Last edited by Kumoriken; 05-19-2007 at 11:23 PM.


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Breakfast & Wi-Fi
Daily breakfast plus Wi-Fi. Breakfast for up to two adults and two kids ages 5 and under.
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Wake up to breakfast for four and internet access when you book your next stay at any participating hotel or resort in the Hilton HHonors™ portfolio.
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When you stay at participating Waldorf Astoria Hotels & Resorts through December 31, enjoy a $150 golf credit for your stay.
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text:
SPRINGFIELD – Chad Wiseman said it best.
"When guys who aren't scorers can score, that helps a lot," the Springfield Falcons center said Thursday.
With three key forwards unavailable, the Falcons continue to inch up the standings in the American Hockey League's Atlantic Division.
The 4-3 victory over Lowell Wednesday gives Springfield momentum as it hits the road for games in Providence Friday and Hershey Saturday night.
Trailing 3-2 with two minutes left, the Falcons scored twice within a 33-second span, taking two points after it looked as if they would get none.
They were within three points of first-place Manchester, and in third place entering Thursday's AHL action.
"These types of games go a long way toward changing your culture (to winning)," coach Rob Daum said.
"We score enough to know we've got a chance."
That was not the case last season, when the Falcons finished next to last in AHL scoring.
This year, they rank eighth among 29 teams. After scoring a meager 188 goals in an 80-game season a year ago, the Falcons have already registered 53 in 18 games.
They are missing forwards Chris Minard, Ryan Potulny and Liam Reddox, but are getting help from other sources.
Minard is questionable for the weekend with a head injury that has kept him out for two weeks.
He has played in only 11 games, but has nine goals, just two behind league leader Bruce Bochenski of Norfolk.
Potulny and Reddox were called up to Edmonton.
"It's good to see that with guys getting called up, we're not saying we have no chance to win," said Linglet, a left wing who ranks second in the AHL in points (22) and assists (15), and has seven goals.
Hartford's Corey Locke had 25 points entering Thursday night's game against Wilkes-Barre/Scranton.
The Falcons' line of Wiseman, Linglet and Colton Fretter contributed two goals Wednesday.
Fretter took Minard's spot on right wing. When Minard comes back, Daum will have to decide whether to break up a line that has been effective.
As a rule, he does not like doing that.
"A lot of coaches juggle guys (who are playing well) to get other guys going. I say, if guys are going well, leave them alone," Daum said.
"There comes a time when it's not working. Then you change."
"Our line is just trying to keep things simple and go to the net," Wiseman said.
He thought Springfield's best line Wednesday was the combination of Ryan MacMurchy, Ryan O'Marra and Colin McDonald, which delivered two goals.
MacMurchy's first goal of the season broke a 3-3 tie with 1:21 remaining.
It came 33 seconds after Wiseman had tied it with his sixth goal.
The other goals came from O'Marra's third of the season, and Fretter's fourth.
Defenseman Chris Armstrong is day-to-day with a sore ankle. He has missed the last two games.
Minard is getting closer to a return.
"He's skating now. We'll take him on the trip, and even if he doesn't play, I'm hoping he can practice," Daum said.
Improved scoring is keeping the Springfield Falcons in the hunt
Email the author
on November 19, 2009 at 5:15 PM, updated November 19, 2009 at 5:18 PM
SPRINGFIELD – Chad Wiseman said it best.


text:
Fire and Environmental Research
Applications Team
Pacific Wildland Fire Sciences Laboratory
400 N 34th Street, Suite 201
Seattle, WA 98103
(206) 732-7800
One of the most
difficult and expensive part of developing a physics-based fire model is obtaining the basic data about fuels, winds, and ignition patterns, along with the heat generated at different places in the fire as it moves across the burn area.
Large projects, often called campaigns because of their complexity, involve a wide variety of cooperators -- research organizers, incident command teams, prescribed burn crews, scientists, field data collection teams, meteorologists, aircraft, unmanned aerial vehicles, and more.
Smaller projects are often organized to test field data collection methods. They also provide trial runs for scientists who must collaborate closely when collecting data. Valuable data is gathered in these smaller burns, but their greatest value lies in increasing the likeihood of success of large burns in the future.
To learn more about field data collection activities:
A Case Study of the Communitied Affect By the Witch and Guejito Case Fires (2009)
Simulation Model
Field Experiments
Lab Experiments
Validation Studies
Development Status
Community Partnership
We acknowledge funding from the Joint Fire Science Program under Project 07-1-5-08 and 11-2-1-11
Team Lead: Ruddy Mell
U.S. Forest Service - PNW- FERA
Last Modified: Monday, 16 December 2013 at 14:18:38 CST