A letter report issued by the General Accounting Office with an abstract that begins "Home and community-based settings have become a growing part of states' Medicaid long-term care programs, serving as an alternative to care in institutional settings, such as nursing homes. To cover such services, however, states often obtain waivers from certain federal statutory requirements. GAO was asked to review (1) trends in states' use of Medicaid home and community-based service (HCBS) waivers, particularly for the elderly, (2) state quality assurance approaches, including available data on the quality of care provided to elderly individuals through waivers, and (3) the adequacy of federal oversight of state waivers. GAO is recommending that the Administrator of CMS take steps to (1) better ensure that state quality assurance efforts are adequate to protect the health and welfare of HCBS waiver beneficiaries, and (2) strengthen federal oversight of the growing HCBS waiver programs. Although CMS raised certain concerns about aspects of the report, such as the respective state and federal roles in quality assurance and the potential need for additional federal oversight resources, CMS generally concurred with the recommendations."

This milestone report summarizes the general characteristics of scuffing damage to solid surfaces, then describes transient effects on scuffing observed during oscillating sliding wear tests of candidate material pairs for high-temperature diesel engine applications, like waste-gate bushings in exhaust gas recirculation (EGR) systems. It is shown that oxidation and the formation of wear particle layers influence the friction of such components. In the case of metallic materials in cylindrical contacts where there is a generous clearance, debris layers can form which reduce the torque over time. For ceramic combinations, the opposite effect is observed. Here, the accumulation of wear debris leads to an increase in the turning torque. High-temperature transient scuffing behavior is considered in terms of a series of stages in which the composition and morphology of the contact is changing. These changes are used to explain the behavior of 11 material pairs consisting of stainless steels, Ni-based alloys, Co-based alloys, and structural ceramics.

Bill introduced by the Texas House of Representatives relating to naming the school of pharmacy at Texas A&M University--Kingsville and its physical facility after Irma Rangel.

Bill introduced by the Texas House of Representatives relating to certain municipal orders required to be filed with the municipal secretary or clerk.

Bill introduced by the Texas House of Representatives relating to the right of residents of an area annexed for limited purposes to vote in certain municipal elections.

Bill introduced by the Texas House of Representatives relating to the duties of the district attorney in Washington and Burleson counties.

Bill introduced by the Texas House of Representatives relating to the punishment for the offense of obscenity and to certain consequences related to convictions for certain sex offenses.

Bill introduced by the Texas House of Representatives relating to the transfer of property under the jurisdiction of the Texas Department of Transportation.

Bill introduced by the Texas House of Representatives relating to the recreational facility fee charged at The University of Texas at Dallas.

Bill introduced by the Texas House of Representatives relating to the unauthorized use of toll roads in certain counties.

Bill introduced by the Texas House of Representatives relating to salary payments to municipal and county employees called to active military duty.

Bill introduced by the Texas House of Representatives relating to the returned check fee collected by a county clerk.

Bill introduced by the Texas House of Representatives relating to granting, renewing, or amending a license or registration under the Texas Radiation Control Act.

Bill introduced by the Texas House of Representatives relating to venue in the prosecution of the offense of fraudulent use or possession of identifying information.

Bill introduced by the Texas House of Representatives relating to granting a defense base development authority the power of eminent domain.

Bill introduced by the Texas House of Representatives relating to the land application of certain sludge.

Bill introduced by the Texas House of Representatives relating to the extended hours of sale for mixed beverages and beer in certain cities.

Bill introduced by the Texas House of Representatives relating to the timely filing of an application for a place on the ballot for an office of a home-rule city.

Bill introduced by the Texas House of Representatives relating to the practice of law.

Bill introduced by the Texas House of Representatives relating to a pilot program to promote and facilitate the operation of diabetes groups.

Bill introduced by the Texas House of Representatives relating to the placement in a juvenile justice alternative education program of certain students with disabilities.

Bill introduced by the Texas House of Representatives relating to the labeling, advertising, and sale of halal foods; providing a criminal penalty.

Bill introduced by the Texas House of Representatives relating to requirements for certain licensing programs administered by the state fire marshal.

Bill introduced by the Texas House of Representatives relating to the confidentiality of certain information contained in applications for ad valorem tax exempting; providing criminal penalties.