Cost for lasix

In a defiant move, AMAG Pharmaceuticals (AMAG) is refusing to voluntarily withdraw its controversial treatment for preventing premature births, despite a request to do so made earlier this month by the Food and cost for lasix Drug Administration. Instead, the drug maker is seeking a hearing to review the rationale given by the regulator for wanting its Makena medication pulled off the market.The agency explained that a required post-marketing study had failed to verify a clinical benefit and that available evidence does not show Makena is effective for its approved use. A year ago, an FDA advisory panel reached the same conclusion and recommended that the drug â which has been a standard of care across the U.S. Since it was approved nine years ago cost for lasix â should be withdrawn. Unlock this article by subscribing to STAT Plus and enjoy your first 30 days free!.

GET STARTED Log In | Learn More What is it?. STAT Plus is cost for lasix STAT's premium subscription service for in-depth biotech, pharma, policy, and life science coverage and analysis. Our award-winning team covers news on Wall Street, policy developments in Washington, early science breakthroughs and clinical trial results, and health care disruption in Silicon Valley and beyond. What's included?. Daily reporting and analysis The most comprehensive industry coverage from a powerhouse team of reporters Subscriber-only newsletters Daily newsletters to brief you on the most important industry news of the day STAT+ Conversations Weekly opportunities to engage with our reporters and leading industry experts in live video conversations Exclusive industry events Premium access to subscriber-only networking events around the country The best reporters in the industry The most trusted and well-connected newsroom in the health care industry And much more Exclusive interviews with industry leaders, profiles, and premium tools, like our cost for lasix CRISPR Trackr.Hired someone new and exciting?.

Promoted a rising star?. Finally solved that hard-to-fill spot?. Share the news with us, and weâll share it with others cost for lasix. Thatâs right. Send us your changes, and weâll find a home for them.

Donât be shy cost for lasix. Everyone wants to know who is coming and going.And here is our regular feature in which we highlight a different person each week. This time around, we note that Merck KGaA (MRK.DE) hired Danny Bar-Zohar as global head of development for its health care business. Previously, he was a partner at the Syncona venture capital firm and, before that, global head, cost for lasix clinical development &. Analytics at Novartis (NVS).

Luciano Rossetti is retiring as global head of R&D. Unlock this article by subscribing to STAT Plus and enjoy your first 30 days cost for lasix free!. GET STARTED Log In | Learn More What is it?. STAT Plus is STAT's premium subscription service for in-depth biotech, pharma, policy, and life science coverage and analysis. Our award-winning team covers news on Wall Street, policy developments in Washington, early cost for lasix science breakthroughs and clinical trial results, and health care disruption in Silicon Valley and beyond.

What's included?. Daily reporting and analysis The most comprehensive industry coverage from a powerhouse team of reporters Subscriber-only newsletters Daily newsletters to brief you on the most important industry news of the day STAT+ Conversations Weekly opportunities to engage with our reporters and leading industry experts in live video conversations Exclusive industry events Premium access to subscriber-only networking events around the country The best reporters in the industry The most trusted and well-connected newsroom in the health care industry And much more Exclusive interviews with industry leaders, profiles, and premium tools, like our CRISPR Trackr.Disarm Therapeutics, a Cambridge biotechnology firm working on new potential drugs for neurological diseases such as ALS and multiple sclerosis, will be bought by the pharmaceutical giant Eli Lilly and Company for $135 million up front.Under the deal announced Thursday, investors in the four-year-old, privately held biotech could reap up to $1.225 billion in additional payments, depending on how well Lilly does developing and marketing new medicines resulting from the acquisition. Unlock this article by subscribing to STAT Plus and enjoy your cost for lasix first 30 days free!. GET STARTED Log In | Learn More What is it?. STAT Plus is STAT's premium subscription service for in-depth biotech, pharma, policy, and life science coverage and analysis.

Our award-winning team covers news on Wall Street, policy cost for lasix developments in Washington, early science breakthroughs and clinical trial results, and health care disruption in Silicon Valley and beyond. What's included?. Daily reporting and analysis The most comprehensive industry coverage from a powerhouse team of reporters Subscriber-only newsletters Daily newsletters to brief you on the most important industry news of the day STAT+ Conversations Weekly opportunities to engage with our reporters and leading industry experts in live video conversations Exclusive industry events Premium access to subscriber-only networking events around the country The best reporters in the industry The most trusted and well-connected newsroom in the health care industry And much more Exclusive interviews with industry leaders, profiles, and premium tools, like our CRISPR Trackr.And so, another working week will soon draw to a close. Not a cost for lasix moment too soon, yes?. This is, you may recall, our treasured signal to daydream about weekend plans.

Our agenda, once again, is rather modest. We plan to catch up on some reading, promenade with our official mascot, and hang around with a short cost for lasix person or two. And what about you?. This remains a fine time to forage for apples and pumpkins. You could shop for a Halloween costume cost for lasix (feel free to write us for suggestions).

You might want to mail your ballot, but make sure the ballot box is kosher. Or you could look in on someone feeling isolated. Well, whatever you do, have a grand time. But be safe â wear a mask. Enjoy, and see you soon.

Â¦A World Health Organization study of more than 11,000 people in 30 countries concluded that remdesivir appeared to have little or no effect on 28-day mortality or length of hospital stays among hypertension medications patients, The New York Times writes.

Over the counter lasix

	Lasix	Tenoretic	Benicar hct	Revatio	Lozol sr	Zebeta
Does work at first time	Yes	Online	Yes	No	No	Yes
Best price for brand	Ask your Doctor	Yes	You need consultation	No	Yes	No
Best price	Yes	Yes	No	Yes	No	No
Does medicare pay	21h	23h	23h	14h	1h	5h
For womens	At cvs	Nearby pharmacy	No	Drugstore on the corner	Online Drugstore	At cvs
Can women take	Pharmacy	Order online	Indian Pharmacy	Online Pharmacy	At cvs	At cvs
Best way to get	Online	Yes	No	Online	Yes	Online

Experts fielded questions about the possibility that the hypertension medications lasix originated from https://crickleyflyersmtbclub.co.uk/diflucan-online/ a "lab leak" in Wuhan, China, during a hearing of a subcommittee for the House Committee on Space, Science and Technology, on Wednesday.Two microbiologists explored a range of theories, with neither ready to scrap the possibility of a "lab-associated mechanism." One of the over the counter lasix microbiologists also called attention to the "risky" research being conducted by scientists in Wuhan.In late May, President Biden called on U.S. Intelligence officials to investigate the issue, including the possibility of a lab accident or leak, and to over the counter lasix report back in 90 days.Republicans have been calling for a hearing on the origins of the lasix for months.During his opening remarks, Subcommittee Chair Bill Foster (D-Ill.) explained that Democrats had prioritized responding to the lasix, but now with treatments succeeding and cases waning, it seemed appropriate to begin examining how the lasix began."If we don't learn everything that we can about how infectious diseases like hypertension medications get started, we will be less safe moving forward," Foster said.With regard to China's potential role in the lasix, he noted that the Chinese government withheld information and "obfuscated efforts" to understand the origin of the lasix. The Chinese government's lack of transparency in relation to an international health emergency is a "very serious geopolitical and science concern," he said.But "the absence of data is not itself evidence of a lab leak or something more sinister," Foster added.The subcommittee's Ranking Member, over the counter lasix Jay Obernolte (R-Calif.), while applauding the chairman's bipartisanship, said he was frustrated by the lack of "fair and open public discourse" around the origins of hypertension. He argued that the media and "Big Tech" were so wedded to a "preordained narrative" around how the lasix began that they dismissed any other hypotheses as "xenophobic conspiracy theories."Expert witnesses also shared their perspectives on how the lasix may have started and how it found its way into humans.David Relman, MD, a microbiologist and professor at Stanford University School of Medicine in California, unpacked over the counter lasix the two competing origin theories. First, that through a "natural spillover" the lasix "jumped" from a bat to a human, or from a bat to over the counter lasix another animal and then to a human.A second theory is that the lasix has a "laboratory-associated mechanism," said Relman, who is also a senior fellow at Stanford's Center for International Security and Cooperation.The evidence for a natural spillover stems from the fact that "nearly all previous outbreaks" first identified in animals are believed to have natural origins, he added.

Also, because of the broad diversity of hypertensiones, the idea persists that a viral source is "out over the counter lasix there" but has yet to be found. He also pointed to the "extensive wildlife trade" in China, which could have played a role in the lasix jumping from over the counter lasix animals to humans and noted that "natural spillovers happen much more often than we had thought."The second argument, the "lab-leak" theory, is based on the fact that "the closest known relatives of SARS CoV-2" were found more than 1,000 miles from Wuhan, but the laboratory with the largest collection of bat-associated hypertensiones in the world is in Wuhan. He also cited the "risky work" occurring at laboratories in over the counter lasix Wuhan and the fact that lab accidents also happen "more often than we had thought." Additionally, he pointed to the lack of transparency and incomplete data samples and sequences shared by those laboratories."Neither hypothesis can be ruled in nor ruled out," Relman said. "Both are over the counter lasix plausible."On questioning by committee members, Relman expanded on the concerns over the risky studies being conducted at the Wuhan Institute of Virology. One of these studies began with a bat hypertension known as WIV1, which had previously been studied and was known to over the counter lasix be a "lasix poised for human emergence," he explained.

And one of the ways researchers at the institute studied other novel samples was to take a portion of the over the counter lasix genome sequence and insert it into the WIV1 lasix."They then resurrected a few of those lasixes and grew them in the laboratory," Relman continued. "So, now we're talking about a chimeric lasix over the counter lasix with properties that we don't know ... Those are experiments over the counter lasix that concern me.""And I'm not saying that they led to this outbreak or lasix by any means. But it's simply the kind of work that I think we as a scientific society need to think much more clearly and more deliberately about before we undertake it," he added.In his own opening remarks, Stanley Perlman, MD, PhD, of the University of Iowa in Iowa City, eliminated the idea of a lasix that was developed entirely over the counter lasix "from scratch" in a laboratory as not being a "viable possibility," but questioned whether a "naturally derived lasix" could have been manipulated.If that were the case, Perlman said, someone would have had to choose the precise hypertension to manipulate and then know how to perform those manipulations. Another thought is whether a naturally derived hypertension could have been adapted to grow in over the counter lasix a new cell type.

However, he noted, "most bat SARS-CoV-related lasixes do not grow well in cell culture over the counter lasix and ... Exist in the laboratory only as nonviable RNA."Perlman said that generally speaking, only certain lasixes are capable of growing in cross-species tissue culture cells, and most will lose disease potential when grown in a new cell culture."This leaves a naturally derived lasix, not manipulated in the laboratory, as the most likely source of SARS CoV-2," he said.Regarding the question of how the lasix moved from animals to humans, Perlman said the lasix could have been transported to Wuhan by over the counter lasix an infected human or an infected animal. He said there is growing evidence over the counter lasix to suggest that wildlife, such as raccoons, dogs, and minks are susceptible to SARS CoV-2, some of which were traded at the Wuhan seafood market.The other possibility is that the lasix was released or leaked from a laboratory in Wuhan, which does have several virology laboratories. The lasix might have been introduced to the lab by someone working with an infected animal and that person or someone else could have been infected with the lasix and, in theory, spread it in his or her community.This possibility "cannot be ruled out and must be appropriately investigated," Perlman noted over the counter lasix. Shannon Firth has been reporting over the counter lasix on health policy as MedPage Today's Washington correspondent since 2014.

She is also a member of the site's Enterprise over the counter lasix &. Investigative Reporting over the counter lasix team. FollowNearly half of patients hospitalized with hypertension medications experienced at least one complication, researchers found in a prospective study.There were 49.7% of over the counter lasix patients overall who developed one or more hypertension medications complications, and 43.5% of survivors with a minimum of one complication, reported Ewen M. Harrison, MBChB, PhD, from the University of Edinburgh over the counter lasix in Scotland, and colleagues.Men and adults older than age 60 were most likely to have a complication from hypertension medications, with complications reported in 54% of men and 48% of women older than age 60, authors wrote in The Lancet.The most frequent hypertension medications complications were renal (24.3%), respiratory (18.4%), and systemic (16.3%). Additional complications were cardiovascular (12.3%), neurological (4.3%), and gastrointestinal (10.8%) complications."The increasing risk of complications affecting a specific organ is positively associated with preexisting comorbidities of the same organ, age, and gender for nearly all types of complications, except for gastrointestinal and liver complications," Xiaoying Gu, MD, and Bin Cao, MD, from the National Center for Respiratory Medicine in Beijing stated in an accompanying editorial.Harrison and co-authors suggested non-respiratory related complications are linked to worse patient outcomes and understanding short-term hypertension medications complications is useful in enhancing patient management, as studies reporting mortality alone are over the counter lasix insufficient."Our results suggest that complications of hypertension medications might affect all survivor groups, rather than just those who are older and have comorbidities," Harrison and co-authors stated.Researchers studied 73,197 hypertension medications patients ages 19 and older at 302 facilities from January 17 to August 4, 2020.

Patients were included if they were adults hospitalized during the study's time frame due to hypertension medications, with a minimum of 2 months of follow-up.Primary outcome included development of complications from hypertension medications over the counter lasix during hospitalization, which was inclusive for related illnesses or organ-specific diagnoses. The authors used the "International Severe Acute Respiratory and Emerging s Consortium WHO Clinical Characterisation Protocol UK" to characterize complications in hospitalized patients.Over half of all patients were over the counter lasix men, with a mean age of 71. There were 81% of patients over the counter lasix with one comorbidity or more. Notably, 48.8% of men and 36.6% of women younger than age 60 reported over the counter lasix at least one complication."One of the most notable findings in this study is that the relative risk of death is much higher in younger patients with complications when compared with those of the same age who did not suffer a complication, whereas in older patients, the relative impact of complications on mortality appears to be lower," editorialists Gu and Cao stated.Examining demographics, hypertension medications complication rates were higher in Blacks compared to whites (57.8% vs 49.1%, respectively). Not surprisingly, adults ages 60 over the counter lasix to 69, with two or more comorbidities had the highest hypertension medications complication rate (57.9%), while adults ages 19 to 29 without comorbidities (21.2%) had the lowest rates.Patients with systemic or neurological complications were more likely to survive, but neurological complications had the strongest link with worse functional outcomes (adjusted OR 4.39, 95% CI 3.95-4.63), which the authors noted was confirmed by prior research."The effect of complications on the ability to self-care was most profound in younger patients [under 50]," the authors added.Limitations of this study included its demographic makeup, with 70% of patients being white.

Conclusions were only generalizable to hospitalized patients, and data on the timing of complications and long-term outcomes were not reported."Attention should also be paid to younger patients who are less likely to die during the acute phase but more likely to live longer with complications in the days after acute or subacute hypertension medications," the editorialists added.Co-author Thomas Drake, MBChB, also of the University of Edinburgh over the counter lasix said the study showed it is important to consider not just death from hypertension medications but other complications, as well."We are still studying the participants in our study to understand what the long-term effects of hypertension medications on their health," he said in a statement. Zaina Hamza is a staff writer for MedPage over the counter lasix Today, covering Gastroenterology and Infectious disease. She is based over the counter lasix in Chicago. Disclosures Funding was provided by the U.K. Government, U.K.

Medical Research Council, the National Institute for Health Research and the EU. Additional support came from Nahoko Shindo and Jeremy J Farrar.Harrison disclosed no conflicts of interest.Drake disclosed no conflicts of interest.Other co-authors disclosed support from GlaxoSmithKline, Janssen, Nestle, Oxford Immunotec, Pfizer, and the European Respiratory Society.Gu and Cao disclosed no conflicts of interest..

Experts fielded questions about the possibility that the hypertension medications lasix originated from a "lab leak" in Wuhan, cost for lasix China, during a hearing of a subcommittee for the House Committee on Space, Science and Technology, on Wednesday.Two microbiologists explored a range of theories, with neither ready to scrap the possibility of a "lab-associated mechanism." One of site web the microbiologists also called attention to the "risky" research being conducted by scientists in Wuhan.In late May, President Biden called on U.S. Intelligence officials to investigate the issue, including the possibility of a lab accident or leak, and to report back in 90 days.Republicans have been calling for a hearing cost for lasix on the origins of the lasix for months.During his opening remarks, Subcommittee Chair Bill Foster (D-Ill.) explained that Democrats had prioritized responding to the lasix, but now with treatments succeeding and cases waning, it seemed appropriate to begin examining how the lasix began."If we don't learn everything that we can about how infectious diseases like hypertension medications get started, we will be less safe moving forward," Foster said.With regard to China's potential role in the lasix, he noted that the Chinese government withheld information and "obfuscated efforts" to understand the origin of the lasix. The Chinese government's lack of transparency in relation to an international health emergency is a "very serious geopolitical and science concern," he said.But "the absence of data is not itself evidence of a cost for lasix lab leak or something more sinister," Foster added.The subcommittee's Ranking Member, Jay Obernolte (R-Calif.), while applauding the chairman's bipartisanship, said he was frustrated by the lack of "fair and open public discourse" around the origins of hypertension. He argued that the media and "Big Tech" were so wedded to a "preordained narrative" around how the lasix began that they dismissed any other hypotheses as "xenophobic conspiracy theories."Expert witnesses also shared their perspectives on how the lasix may have started and cost for lasix how it found its way into humans.David Relman, MD, a microbiologist and professor at Stanford University School of Medicine in California, unpacked the two competing origin theories. First, that through a "natural spillover" the lasix "jumped" from a bat to a human, or from a bat to another animal and then to a human.A second theory is that the lasix has a "laboratory-associated mechanism," said Relman, who is also a senior fellow cost for lasix at Stanford's Center for International Security and Cooperation.The evidence for a natural spillover stems from the fact that "nearly all previous outbreaks" first identified in animals are believed to have natural origins, he added.

Also, because of the broad cost for lasix diversity of hypertensiones, the idea persists that a viral source is "out there" but has yet to be found. He also pointed to the "extensive wildlife trade" in China, which could have cost for lasix played a role in the lasix jumping from animals to humans and noted that "natural spillovers happen much more often than we had thought."The second argument, the "lab-leak" theory, is based on the fact that "the closest known relatives of SARS CoV-2" were found more than 1,000 miles from Wuhan, but the laboratory with the largest collection of bat-associated hypertensiones in the world is in Wuhan. He also cited the "risky work" occurring at laboratories in Wuhan and the fact that lab accidents also happen "more often than we had thought." Additionally, he pointed to the lack of transparency and incomplete data samples and sequences shared by those laboratories."Neither hypothesis can cost for lasix be ruled in nor ruled out," Relman said. "Both are plausible."On questioning by committee members, Relman expanded on the concerns over the risky studies being conducted at the cost for lasix Wuhan Institute of Virology. One of these studies began with a bat hypertension known as WIV1, which had previously been studied and was known to be a "lasix poised for human cost for lasix emergence," he explained.

And one of the ways researchers at the institute studied other novel samples was to take a portion of the genome sequence and insert it into cost for lasix the WIV1 lasix."They then resurrected a few of those lasixes and grew them in the laboratory," Relman continued. "So, now cost for lasix we're talking about a chimeric lasix with properties that we don't know ... Those are experiments that concern me.""And I'm not saying that they led to this outbreak or cost for lasix lasix by any means. But it's simply the kind of work that I think we as a scientific society need to think much more clearly and more deliberately about before we undertake it," he added.In his own opening remarks, Stanley Perlman, MD, PhD, of the University of Iowa in Iowa City, eliminated the idea of a lasix that was developed entirely "from scratch" in a laboratory as not being a "viable possibility," but questioned whether a "naturally derived lasix" could have been manipulated.If that were the case, Perlman said, someone would have had to choose the precise hypertension to manipulate and then know how to cost for lasix perform those manipulations. Another thought is whether a naturally derived hypertension could have cost for lasix been adapted to grow in a new cell type.

However, he noted, "most bat SARS-CoV-related lasixes do not grow well in cell cost for lasix culture and ... Exist in the laboratory only as nonviable RNA."Perlman said that generally speaking, only certain lasixes are capable cost for lasix of growing in cross-species tissue culture cells, and most will lose disease potential when grown in a new cell culture."This leaves a naturally derived lasix, not manipulated in the laboratory, as the most likely source of SARS CoV-2," he said.Regarding the question of how the lasix moved from animals to humans, Perlman said the lasix could have been transported to Wuhan by an infected human or an infected animal. He said there is growing evidence to suggest that wildlife, such as raccoons, dogs, and minks are susceptible to SARS CoV-2, some of which were traded at the Wuhan seafood market.The other possibility is that the lasix was released or leaked from a laboratory in Wuhan, which does have several cost for lasix virology laboratories. The lasix might have been introduced to the lab by someone working with an infected animal and that person or someone else could have been infected with the lasix and, in theory, spread it in his or her cost for lasix community.This possibility "cannot be ruled out and must be appropriately investigated," Perlman noted. Shannon Firth has been reporting on cost for lasix health policy as MedPage Today's Washington correspondent since 2014.

She is also a member of the site's Enterprise & cost for lasix. Investigative Reporting team cost for lasix. FollowNearly half of patients hospitalized with cost for lasix hypertension medications experienced at least one complication, researchers found in a prospective study.There were 49.7% of patients overall who developed one or more hypertension medications complications, and 43.5% of survivors with a minimum of one complication, reported Ewen M. Harrison, MBChB, PhD, from the University cost for lasix of Edinburgh in Scotland, and colleagues.Men and adults older than age 60 were most likely to have a complication from hypertension medications, with complications reported in 54% of men and 48% of women older than age 60, authors wrote in The Lancet.The most frequent hypertension medications complications were renal (24.3%), respiratory (18.4%), and systemic (16.3%). Additional complications were cardiovascular (12.3%), neurological (4.3%), and gastrointestinal (10.8%) complications."The increasing risk of complications affecting a specific organ is positively associated with preexisting comorbidities of the same organ, age, and gender for nearly all types of complications, except for gastrointestinal and liver complications," Xiaoying Gu, MD, and Bin Cao, MD, from the National Center for Respiratory Medicine in Beijing stated in an accompanying editorial.Harrison and co-authors suggested non-respiratory related complications are linked to worse patient outcomes and understanding short-term hypertension medications complications is useful in enhancing patient management, as studies cost for lasix reporting mortality alone are insufficient."Our results suggest that complications of hypertension medications might affect all survivor groups, rather than just those who are older and have comorbidities," Harrison and co-authors stated.Researchers studied 73,197 hypertension medications patients ages 19 and older at 302 facilities from January 17 to August 4, 2020.

Patients were included if they were adults hospitalized during cost for lasix the study's time frame due to hypertension medications, with a minimum of 2 months of follow-up.Primary outcome included development of complications from hypertension medications during hospitalization, which was inclusive for related illnesses or organ-specific diagnoses. The authors used the "International Severe Acute Respiratory and cost for lasix Emerging s Consortium WHO Clinical Characterisation Protocol UK" to characterize complications in hospitalized patients.Over half of all patients were men, with a mean age of 71. There were 81% of patients with cost for lasix one comorbidity or more. Notably, 48.8% of men and 36.6% of women younger than age 60 reported at least one complication."One of the most notable findings in this study is that the relative risk of death is much higher in younger patients with complications when compared with those of the same age who did not suffer cost for lasix a complication, whereas in older patients, the relative impact of complications on mortality appears to be lower," editorialists Gu and Cao stated.Examining demographics, hypertension medications complication rates were higher in Blacks compared to whites (57.8% vs 49.1%, respectively). Not surprisingly, adults ages 60 to 69, with two cost for lasix or more comorbidities had the highest hypertension medications complication rate (57.9%), while adults ages 19 to 29 without comorbidities (21.2%) had the lowest rates.Patients with systemic or neurological complications were more likely to survive, but neurological complications had the strongest link with worse functional outcomes (adjusted OR 4.39, 95% CI 3.95-4.63), which the authors noted was confirmed by prior research."The effect of complications on the ability to self-care was most profound in younger patients [under 50]," the authors added.Limitations of this study included its demographic makeup, with 70% of patients being white.

Conclusions were only generalizable to hospitalized patients, and data on the timing of complications and long-term outcomes were not reported."Attention should also be paid to younger patients who are less likely to die during the acute phase but more likely to live longer with complications in the days after acute or subacute hypertension medications," the editorialists added.Co-author Thomas Drake, MBChB, also of the University of Edinburgh said the study showed it is important to consider cost for lasix not just death from hypertension medications but other complications, as well."We are still studying the participants in our study to understand what the long-term effects of hypertension medications on their health," he said in a statement. Zaina Hamza is a staff writer cost for lasix for MedPage Today, covering Gastroenterology and Infectious disease. She is based in Chicago cost for lasix. Disclosures cost for lasix Funding was provided by the U.K. Government, U.K cost for lasix.

What should I tell my health care provider before I take Lasix?

They need to know if you have any of these conditions:

abnormal blood electrolytes
diarrhea or vomiting
gout
heart disease
kidney disease, small amounts of urine, or difficulty passing urine
liver disease
an unusual or allergic reaction to furosemide, sulfa drugs, other medicines, foods, dyes, or preservatives
pregnant or trying to get pregnant
breast-feeding

Furosemide lasix 40mg tablet

Key takeaways South Dakota exchange overviewSouth Dakota furosemide lasix 40mg tablet uses the federally run can you buy lasix without a prescription exchange, so residents enroll through HealthCare.gov. When was open enrollment for 2021 health insurance in South Dakota?. Open enrollment for 2021 health plans ran from November furosemide lasix 40mg tablet 1 through December 15, 2020. Outside of that window, South Dakota residents need to have a qualifying event in order to enroll in an ACA-compliant plan (on-exchange or outside the exchange). Loss of other minimum essential coverage is a qualifying event, so anyone losing employer-sponsored coverage amid the hypertension medications furosemide lasix 40mg tablet lasix is eligible to enroll in an individual market plan.South Dakota has two carriers â Avera and Sanford â offering plans in the exchange for 2021.

And they are also the only carriers offering plans in South Dakotaâs individual market (including off-exchange). There were previously two other carriers that offered plans outside the furosemide lasix 40mg tablet exchange, but they opted to leave the individual market at the end of 2016.HHS estimates that 19,000 South Dakota residents gained health insurance coverage from 2010 to 2015, as a result of the ACA. That number continued to grow, as exchange enrollment in South Dakota stood at only 21,393 at the end of the 2015 open enrollment period, and had reached 29,652 by 2018. It fell slightly in 2019, with 29,069 people signing furosemide lasix 40mg tablet up during open enrollment. But the drop in enrollment was not as significant as it was in many other states that use HealthCare.gov.

Enrollment grew slightly for 2020, with 29,331 people signing up during open enrollment (South Dakota was one furosemide lasix 40mg tablet of only a few HealthCare.gov states where enrollment increased from 2019 to 2020). And during the open enrollment period for 2021 coverage, 31,283 people enrolled in South Dakota, which is a record high for the stateâs exchange (but itâs a preliminary number. It could change once the data are finalized in early 2021).Western South furosemide lasix 40mg tablet Dakota Community Action Partnership serves as a navigator organization in the state, and received a $100,000 navigator grant in 2020, just as they did in 2019 and 2018. Navigator grants are much smaller than they were in previous years, as the Trump administration has reduced funding by about 84 percent over the last few years. But navigator funding remained at the same level from 2018 through furosemide lasix 40mg tablet 2020.South Dakota enacted legislation in 2019 that allows association health plans to operate in the state.

This aligns the stateâs rules with federal regulations issued by the Trump administration in 2018, and the South Dakota bill had unanimous support in both chambers of the stateâs legislature.How much does health insurance cost in South Dakota?. Across the more than 29,000 people who enrolled in plans through South Dakotaâs exchange for 2020, the average full-price monthly premium is $687. But most enrollees â about furosemide lasix 40mg tablet 92 percent â receive premium subsidies. After the subsidies are applied, the average premium is just $136/month.Two insurers offer coverage for 2021. Average rate furosemide lasix 40mg tablet increases about 2.6%The South Dakota Division of Insurance doesnât publicize information about rate filings until regulators have finalized the rates.

But unlike some states, regulators in South Dakota do have the authority to reject rate filings that arenât justified, or to require insurers to make adjustments to proposed rates. The Division of Insurance reviewed the insurerâs proposed furosemide lasix 40mg tablet 2021 rates over the summer of 2020 to determine if they were actuarially justified, and requested additional information from the insurers where necessary. But for both insurers, the approved rates were the same as the insurers had initially filed.The approved rate increases for 2021 in South Dakotaâs individual market are as follows, and amount to a weighted average rate increase of just under 2.6 percent:Avera. 4.29 percent furosemide lasix 40mg tablet average rate increase. Avera had 19,873 members in 2020Sanford.

0.24 percent average rate furosemide lasix 40mg tablet increase. Sanford had 14,714 members in 2020.For perspective, hereâs a look at how premiums have changed in South Dakotaâs exchange in the early years of ACA implementation:2015. According to furosemide lasix 40mg tablet a report released by the U.S. Department of Health and Human Services (HHS), the average cost for a bronze plan âthe lowest-cost option â in South Dakota was $298 a month in 2014. The national average for a bronze policy was furosemide lasix 40mg tablet $249 a month in 2014.

But the news was much better for 2015. A Commonwealth Fund analysis of average premiums across furosemide lasix 40mg tablet all metal levels for a 40-year-old non-smoker found an average premium decrease of 21 percent in South Dakota from 2014 to 2015. And an interactive map from the NY Times Upshot shows that in most areas of the state, people who switched from the 2014 benchmark (second-lowest-cost silver) plan to the new benchmark plan for 2015 were able to obtain premium decreases.When we include both on and off-exchange plans and look at the entire individual market in South Dakota, the average premium increase for 2015 was 2 percent, as calculated by PricewaterhouseCooper.2016. By 2016, only two insurers were offering plans in South Dakotaâs exchange (that continues to be the case in 2019). Averaâs average rate increase was 13.98 percent and Sanfordâs furosemide lasix 40mg tablet was 15 percent.2017.

Avera increased their average premiums by 38.15 percent for 2017, and Sanford increased theirs by an average of 36.34 percent. Since both carriers implemented very similarâand quite significantârate increases, premium subsidies also grew sharply in South Dakota for 2017 furosemide lasix 40mg tablet. HHS reported that the average benchmark plan (the second-lowest-cost silver plan in each area) premium would increase by 39 percent in South Dakota. Subsidies are tied to the cost furosemide lasix 40mg tablet of the benchmark plan, so they also had to increase to keep up with the higher prices in 2017.2018. The average rate increase for Avera was 29 percent.

For Sanford, it furosemide lasix 40mg tablet was about 16 percent. 2018 was the first year that cost-sharing reductions were not funded by the federal government, so the insurers added the cost of CSR to premiums for 2018, as described below.2019. The weighted average rate increase in South Dakotaâs individual market was a little more than 5 percent for 2019.2020 furosemide lasix 40mg tablet. The approved rate increases for 2020 in South Dakotaâs individual market amounted to a weighted average increase of about 6.5 percent:Avera. 5.5 percent average rate increase (approved filing (AVER-131948724) available via SERFF) furosemide lasix 40mg tablet.

Avera had 16,683 members in 2019Sanford. 7.5 percent average rate increase (approved filing (SANF-132018969) available via SERFF) furosemide lasix 40mg tablet. Sanford had 16,578 members in 2019.Average rate changes for 2018 jumped after Trump cut off CSR fundingAvera and Sanford both continued to offer plans for 2018. Regulators approved furosemide lasix 40mg tablet rates in September 2017 that were a little lower than the insurers and proposed. Those rates were based on the assumption that cost-sharing reduction (CSR) funding would continue in 2018.

However, when the Trump Administration announced in October 2017 that CSR funding would end immediately, South Dakota was one of the states that worked with CSM to allow insurers to use an emergency refiling process to submit new rates, with the cost of CSR added to premiums.Here are the average 2018 rate increases â before accounting for premium subsidies â for South Dakota exchange enrollees:Avera. Initially proposed average rate increase of furosemide lasix 40mg tablet 20 percent. Regulators approved an average rate increase of 17 percent in September, but insurers were allowed to refile rates after Trump cut off CSR funding, and the final approved average rate increase was 29 percent (27,000 members).Sanford. Initially proposed average furosemide lasix 40mg tablet rate increase of 11 to 14 percent. Regulators approved an average rate increase of 7.5 percent in September, but insurers were allowed to refile rates after Trump cut off CSR funding, and the final approved average rate increase was 15.9 percent (8,270 members)Initially, the proposed rates were based on the assumption that the federal government would continue to fund cost-sharing reductions (CSRs).

Both insurers indicated that if CSR funding were to be eliminated (which ended up being furosemide lasix 40mg tablet the case), the rates would have to rise even more to compensate for the cost of providing CSRs to eligible enrollees. And in the days after CSR funding was eliminated, both of South Dakotaâs insurers were allowed to refile for 2018, with the cost of CSR added to premiums.In April 2017, a Kaiser Family Foundation analysis estimated that premiums for silver plans would have to rise by 16 percent in South Dakota (in addition to the rate increase that would otherwise apply) if CSRs werenât funded.The rate filings for South Dakota plans are available via SERFF. Averaâs revised filing (AVER-131179213) notes that âTo keep the Silver rates lower than those for Gold plans, despite the additional load for the non-funding of CSR payments, Avera adjusted the furosemide lasix 40mg tablet profit and risk load.â They kept the profit and risk load the same as initially proposed for Gold, Bronze, Catastrophic, and off-exchange Silver plans. But they cut it almost in half for on-exchange silver plans. This is lasix online interesting, as itâs different from the approaches that insurers in furosemide lasix 40mg tablet most other states took.

Insurers in most states simply added the cost of CSR to silver plans, and let the chips fall where they would. The result is that Gold plans in some areas of the country were cheaper than Silver plans, and Bronze (and sometimes Gold) plans were often free for furosemide lasix 40mg tablet enrollees who receive premium subsidies. But Averaâs approach helped to ensure that pricing would still âmake senseâ for their 2018 products, in terms of having the plans follow a least expensive to most expensive path as they move up from Bronze to Gold.Sanfordâs filing (SANF-131180312) that was based on a lack of federal funding for CSR was initially filed in early September. But the insurer notes that the filing was withdrawn once they decided to finalize their alternate rate proposal that was based on the assumption furosemide lasix 40mg tablet that CSR funding would continue in 2018. Sanford had to reverse course and switch to the higher rates (with the cost of CSR added to silver plan premiums) in October, after CSR funding was eliminated.People who receive premium subsidies were largely insulated from the rising premiums, as the premium subsidies grow each year to keep pace with the cost of coverage.

The subsidy amounts are based on keeping the after-subsidy cost of the second-lowest-cost silver plan (benchmark plan) furosemide lasix 40mg tablet at an affordable level â but the subsidies can be applied to any metal-level plan). And the IRS reduced the percentage of income that people have to pay for the benchmark plan in 2018, which means that net premiums were actually slightly lower in 2018 than they were in 2017 (note that some enrollees may have had to switch plans to see a decrease in net premiums, as the benchmark plan can change from one year to the next).91 percent of South Dakota exchange enrollees were receiving premium subsidies in 2017. But the other 9 percent â as well as everyone who buys coverage outside the exchange â had to shoulder the full impact of the rate increases for 2018. However, since the cost of CSR was added only to silver plans, people who donât get premium subsidies (and who thus are generally also ineligible for CSR benefits, as those have lower income limits for eligibility) were able to pick non-Silver plans for 2018 and avoid at least the portion of the average rate increase furosemide lasix 40mg tablet that was added to cover the cost of CSR. Enrollment reached a record high in 2018, dropped for the first time in in 2019, but grew again in 2020 and reached another record high for 2021Enrollment in South Dakotaâs exchange started out quite low in 2014, with just over 13,000 people enrolling.

That was furosemide lasix 40mg tablet only an estimated 11.1 percent of South Dakotaâs subsidy-eligible residents enrolled in coverage through the exchange â tying Iowa for the lowest percentage in the nation.The fact that Wellmark did not participate in the exchange was cited as one of the reasons for the low enrollment in South Dakotaâs exchange in 2014. The carrierâs huge market share and name recognition coupled with the fact that existing Wellmark members had no means of keeping their carrier and also obtaining subsidies, meant that enrollment lagged behind the rest of the country in South Dakota.South Dakotaâs percentage increase in exchange enrollments in 2016 was the ninth highest in the US, and the fourth highest of the states that use Healthcare.gov. This could be due in part to the sharp rate increases for Wellmarkâs off-exchange plans in 2016, which may have furosemide lasix 40mg tablet encouraged former Wellmark members to shop on the exchange instead.Across all the states that use HealthCare.gov, the general trend thus far has been peak enrollment in 2016, with slight declines for 2017 and again for 2018. But South Dakota is among just a handful of states where enrollment climbed steadily over each of the first five years of exchange operation. And based on preliminary data, enrollment for 2021 has reached a record high in South Dakota, with more furosemide lasix 40mg tablet than 31,000 people selecting plans (the prior record was under 30,000).Hereâs a summary of how enrollment (during open enrollment) has changed each year in South Dakotaâs exchange:2014.

13,104 people enrolled2015. 21,393 people furosemide lasix 40mg tablet enrolled2016. 25,999 people enrolled2017. 29,622 people enrolled2018 furosemide lasix 40mg tablet. 29,652 people enrolled2019.

29,069 people enrolled (the first furosemide lasix 40mg tablet time enrollment dropped in SDâs exchange)2020. 29,331 people enrolled2021. 31,283 people enrolled (preliminary data)The increase in South Dakotaâs exchange enrollment in 2017 was likely due in large part to the fact that Wellmark and DakotaCare both terminated their off-exchange plans in South Dakota at the end of 2016, and their enrollees had to seek coverage from Avera or Sanford instead, both of which offer furosemide lasix 40mg tablet plans on and off the exchange. There were ten HealthCare.gov states that saw enrollment growth in 2017, and South Dakotaâs percentage increase in total enrollment was the second-highest.Across all states that use HealthCare.gov, there was an average enrollment decline of 3.8 percent in 2019, so South Dakotaâs enrollment drop that year was less significant than average. And enrollment in the stateâs exchange increased in 2017, 2018, and 2020, despite the fact that average enrollment in HealthCare.gov states declined in each of those years.

South Dakota was one of just a handful of HealthCare.gov states where enrollment increased from 2019 to 2020 furosemide lasix 40mg tablet. What health insurance companies sell individual coverage in South Dakota?. When the exchanges debuted in 2014, three insurers â DakotaCare, Avera, and furosemide lasix 40mg tablet Sanford â offered plans the South Dakota exchange. All three offered their plans statewide.Although there were no new carriers in the South Dakota exchange in 2015, the three existing carriers offered a variety of plans, including some new HSA-qualified options from Avera and an Avera plan that gave insureds lower out-of-pocket costs if they used an Avera provider.Wellmark Blue Cross Blue Shield had 73 percent of the market share in South Dakota prior to the 2014 open enrollment period, but the insurance giant opted to stay out of the exchange in 2014, in 2015, and in 2016 (despite their lack of participation in the exchange, Wellmark said they sold more policies outside the exchange in South Dakota in 2014 than the two on-exchange carriers combined). After the furosemide lasix 40mg tablet end of 2016, Wellmark exited South Dakotaâs ACA-compliant market altogether, and stopped selling even off-exchange plans.As of 2016, DakotaCare switched to only offering plans outside the exchange.

About 7,200 DakotaCare enrollees who had coverage through the exchange in 2015 needed to select a new plan from Avera or Sanford if they wished to continue to have coverageâand subsidiesâthrough the exchange in 2016.Celtic, Wellmark, and DakotaCare were offering plans outside the exchange in South Dakota as of 2016, but all three insurers opted to exit the ACA-compliant market in South Dakota at the end of 2016. The South Dakota Division of Insurance confirmed that Sanford and Avera were the only carriers offering individual market coverage in the state as of 2017, on or off-exchange.So since 2016, Avera and Sanford have been the only insurers offering plans in the South Dakota exchange, but both insurers have offered furosemide lasix 40mg tablet coverage statewide each year.Insurance ballot initiative made headlines in 2014South Dakota was in the national news in the fall of 2014 because of a ballot initiative pertaining to health insurance networks that voters overwhelmingly approved in November. Amendment 17 was billed by supporters as âfreedom to choose your doctorâ but critics pointed out that itâs not as simple as proponents made it seem. Doctors and small or specialty hospitals were generally in favor of Amendment 17, while large insurers (including Sanford and Avera) and furosemide lasix 40mg tablet hospital networks were opposed. Ultimately, the measure passed 62 percent to 28 percent.This does not mean that patients can choose any doctor they want though.

Rather, it means that any doctor who is willing and able to comply with the terms and conditions of the health insurance carrier could enter the carrierâs network.Because narrower networks have become commonplace over the last year, policy experts in other furosemide lasix 40mg tablet states were closely watching the outcome of the SD ballot initiative. A total of 27 states have âany willing providerâ laws on their books, although only about half of them are as broad as South Dakotaâs.In the 2016 legislative session, a bill (HB1067) was introduced in an effort to roll back some of the provisions in Amendment 17, allowing carriers the option to offer both closed-network and open-network plans (plans with closed networks would be less expensive). The bill didnât advance out of committee, and this article is a good summary of the controversy surrounding HB1067.South Dakota continues to reject Medicaid expansionSouth Dakota has not expanded Medicaid under the ACA, and Governor Kristi Noem, who took office in 2019, is opposed to the idea of expanding Medicaid to cover the stateâs low-income population â despite the furosemide lasix 40mg tablet fact that the federal government would fund 90 percent of the cost.Because the state has not accepted federal funds to expand Medicaid, 20,000 South Dakota residents fall into the coverage gap â they earn too much money to qualify for Medicaid, but too little to qualify for subsidies in the exchange. If the state expands Medicaid, they will be eligible for coverage under Medicaid.The lack of Medicaid expansion disproportionately affects the Native American population in South Dakota. Officials estimate that there are 14,000 Native Americans who would gain access to furosemide lasix 40mg tablet Medicaid if the state were to expand the program.

This includes people who earn between 100 percent and 138 percent of poverty and are currently eligible for subsidies in the exchange. Many of them have not opted for private exchange plans though, for a variety of economic and cultural reasons.Former Governor Dennis Daugaard, a Republican, was in favor of Medicaid expansion, and as of late October 2014, 45 percent of surveyed South Dakota residents said they favored Medicaid expansion, while just 37 percent opposed it.In December 2015, Daugaard unveiled his proposal to expand Medicaid without needing to use additional state funds. The plan would have utilized savings on a program that the state already had to cover a portion of the cost of care furosemide lasix 40mg tablet for Native Americans provided at non-IHS facilities. Native Americans who are eligible for expanded Medicaid would have been covered under Medicaid instead, and the savings on that program would more than offset the stateâs portion of Medicaid expansion costs. By the end of February 2016, however, Daugaard had said that Medicaid expansion would not be addressed furosemide lasix 40mg tablet during the 2016 legislative session.

He noted that there was still the possibility of a special legislative session later in the year, or the issue might be revisited during the 2017 legislative session. Hopes were high for a special session as late as mid-June 2016, but by June 22, Daugaard had confirmed that there would be no special session in 2016 to address Medicaid expansion, and that the issue would be pushed out past the 2016 election, into 2017 at the earliest.Daugaard had previously twice submitted a proposal to HHS for a waiver that would allow the state to expand Medicaid to people with incomes up to 100% of poverty level, instead of 138% of furosemide lasix 40mg tablet poverty level. HHS rejected Daugaardâs proposals though, saying that expansion must extend to people with incomes between 100% and 138% of poverty level in order to be approved (the Obama administration rejected statesâ attempts to expand Medicaid only to people under the poverty level, but Utah is trying to gain approval from the Trump administration for full federal funding (ie, a 90/10 split) of Medicaid expansion that only applies to people earning up to the poverty level).Grandmothered plans can renewOn November 26, 2013 the state announced that it would allow carriers to extend existing policies per President Obamaâs suggestion that non-compliant plans be allowed to remain in effect for one more year. Sanford, Wellmark and DakotaCare all opted to allow existing policies to be renewed into 2014, giving insureds another option to compare with the new ACA-compliant plans.The state has continued to go along with additional federal extensions for grandmothered furosemide lasix 40mg tablet plans, most recently allowing these plans to remain in force until the end of 2021. But enrollment in grandmothered plans has dwindled, as people can no longer purchase them.

In Sanfordâs 2018 filing (SANF-131588434), the insurer indicated that only 504 people were still enrolled furosemide lasix 40mg tablet in grandmothered Sanford plans as of 2018. And DAKOTACAREâs 2021 filing for grandmothered plans indicated that they had just 593 remaining enrollees as of 2020 (SERFF tracking number DACR-132543698).Exchange history and outreachGov. Daugaard announced in late September 2012 that HHS would be running the stateâs exchange, citing the high cost â estimated at $6.3 to $7.7 million â for ongoing operation of the exchange.The state is not playing any role in promoting ACA-compliant health insurance options or educating furosemide lasix 40mg tablet consumers about the marketplace. That decision leaves outreach efforts to the insurers and federally funded ânavigators.â Navigators are affiliated with established community outreach and advocacy groups, and they are trained to help consumers understand and use the new online marketplace. Western South Dakota Community Action Partnership received a $100,000 navigator grant in 2018.South Dakota health furosemide lasix 40mg tablet insurance exchange linksHealthCare.gov800-318-2596State Exchange Profile.

South DakotaThe Henry J. Kaiser Family Foundation overview of South Dakotaâs progress toward creating a state health insurance furosemide lasix 40mg tablet exchange.Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts..

Key takeaways cost for lasix South Dakota exchange overviewSouth Dakota uses the http://www.em-meinau-strasbourg.ac-strasbourg.fr/slideshow/lanniversaire-de-charaf/ federally run exchange, so residents enroll through HealthCare.gov. When was open enrollment for 2021 health insurance in South Dakota?. Open enrollment cost for lasix for 2021 health plans ran from November 1 through December 15, 2020.

Outside of that window, South Dakota residents need to have a qualifying event in order to enroll in an ACA-compliant plan (on-exchange or outside the exchange). Loss of other minimum essential coverage is a qualifying event, so anyone losing employer-sponsored cost for lasix coverage amid the hypertension medications lasix is eligible to enroll in an individual market plan.South Dakota has two carriers â Avera and Sanford â offering plans in the exchange for 2021. And they are also the only carriers offering plans in South Dakotaâs individual market (including off-exchange).

There were previously two other carriers that offered plans outside the exchange, but they opted to leave the individual market at the end of 2016.HHS estimates that 19,000 South Dakota residents gained health insurance coverage from 2010 to 2015, as a result of the ACA cost for lasix. That number continued to grow, as exchange enrollment in South Dakota stood at only 21,393 at the end of the 2015 open enrollment period, and had reached 29,652 by 2018. It fell slightly in cost for lasix 2019, with 29,069 people signing up during open enrollment.

But the drop in enrollment was not as significant as it was in many other states that use HealthCare.gov. Enrollment grew slightly for 2020, with 29,331 people signing up during open enrollment (South Dakota was one of only a few HealthCare.gov cost for lasix states where enrollment increased from 2019 to 2020). And during the open enrollment period for 2021 coverage, 31,283 people enrolled in South Dakota, which is a record high for the stateâs exchange (but itâs a preliminary number.

It could change once the data are finalized in early 2021).Western South Dakota Community Action Partnership serves as a navigator organization in the state, and received a $100,000 navigator grant in 2020, cost for lasix just as they did in 2019 and 2018. Navigator grants are much smaller than they were in previous years, as the Trump administration has reduced funding by about 84 percent over the last few years. But navigator funding remained at the same level from 2018 through 2020.South Dakota enacted legislation in 2019 that allows cost for lasix association health plans to operate in the state.

After the subsidies are applied, the average premium is just $136/month.Two insurers offer coverage for 2021. Average rate cost for lasix increases about 2.6%The South Dakota Division of Insurance doesnât publicize information about rate filings until regulators have finalized the rates. But unlike some states, regulators in South Dakota do have the authority to reject rate filings that arenât justified, or to require insurers to make adjustments to proposed rates.

The Division of Insurance reviewed the insurerâs proposed 2021 rates over the cost for lasix summer of 2020 to determine if they were actuarially justified, and requested additional information from the insurers where necessary. But for both insurers, the approved rates were the same as the insurers had initially filed.The approved rate increases for 2021 in South Dakotaâs individual market are as follows, and amount to a weighted average rate increase of just under 2.6 percent:Avera. 4.29 percent cost for lasix average rate increase.

Avera had 19,873 members in 2020Sanford. 0.24 percent average rate increase cost for lasix. Sanford had 14,714 members in 2020.For perspective, hereâs a look at how premiums have changed in South Dakotaâs exchange in the early years of ACA implementation:2015.

According to a report released by the U.S cost for lasix. Department of Health and Human Services (HHS), the average cost for a bronze plan âthe lowest-cost option â in South Dakota was $298 a month in 2014. The national average for a bronze policy cost for lasix was $249 a month in 2014.

But the news was much better for 2015. A Commonwealth Fund analysis of average premiums cost for lasix across all metal levels for a 40-year-old non-smoker found an average premium decrease of 21 percent in South Dakota from 2014 to 2015. And an interactive map from the NY Times Upshot shows that in most areas of the state, people who switched from the 2014 benchmark (second-lowest-cost silver) plan to the new benchmark plan for 2015 were able to obtain premium decreases.When we include both on and off-exchange plans and look at the entire individual market in South Dakota, the average premium increase for 2015 was 2 percent, as calculated by PricewaterhouseCooper.2016.

By 2016, only two insurers were offering plans in South Dakotaâs exchange (that continues to be the case in 2019). Averaâs average cost for lasix rate increase was 13.98 percent and Sanfordâs was 15 percent.2017. Avera increased their average premiums by 38.15 percent for 2017, and Sanford increased theirs by an average of 36.34 percent.

Since both carriers implemented very similarâand quite significantârate increases, premium subsidies also grew sharply in cost for lasix South Dakota for 2017. HHS reported that the average benchmark plan (the second-lowest-cost silver plan in each area) premium would increase by 39 percent in South Dakota. Subsidies are cost for lasix tied to the cost of the benchmark plan, so they also had to increase to keep up with the higher prices in 2017.2018.

The average rate increase for Avera was 29 percent. For Sanford, cost for lasix it was about 16 percent. 2018 was the first year that cost-sharing reductions were not funded by the federal government, so the insurers added the cost of CSR to premiums for 2018, as described below.2019.

The weighted average rate increase in South Dakotaâs individual market was a little more than cost for lasix 5 percent for 2019.2020. The approved rate increases for 2020 in South Dakotaâs individual market amounted to a weighted average increase of about 6.5 percent:Avera. 5.5 percent average rate increase cost for lasix (approved filing (AVER-131948724) available via SERFF).

Avera had 16,683 members in 2019Sanford. 7.5 percent average rate increase (approved filing (SANF-132018969) available via SERFF) cost for lasix. Sanford had 16,578 members in 2019.Average rate changes for 2018 jumped after Trump cut off CSR fundingAvera and Sanford both continued to offer plans for 2018.

Regulators approved cost for lasix rates in September 2017 that were a little lower than the insurers and proposed. Those rates were based on the assumption that cost-sharing reduction (CSR) funding would continue in 2018. However, when the Trump Administration announced in October 2017 that CSR funding would end immediately, South Dakota was one of the states that worked with CSM to allow insurers to use an emergency refiling process to submit new rates, with the cost of CSR added to premiums.Here are the average 2018 rate increases â before accounting for premium subsidies â for South Dakota exchange enrollees:Avera.

Initially proposed cost for lasix average rate increase of 20 percent. Regulators approved an average rate increase of 17 percent in September, but insurers were allowed to refile rates after Trump cut off CSR funding, and the final approved average rate increase was 29 percent (27,000 members).Sanford. Initially proposed average rate increase of 11 to cost for lasix 14 percent.

Regulators approved an average rate increase of 7.5 percent in September, but insurers were allowed to refile rates after Trump cut off CSR funding, and the final approved average rate increase was 15.9 percent (8,270 members)Initially, the proposed rates were based on the assumption that the federal government would continue to fund cost-sharing reductions (CSRs). Both insurers indicated that if CSR funding were to cost for lasix be eliminated (which ended up being the case), the rates would have to rise even more to compensate for the cost of providing CSRs to eligible enrollees. And in the days after CSR funding was eliminated, both of South Dakotaâs insurers were allowed to refile for 2018, with the cost of CSR added to premiums.In April 2017, a Kaiser Family Foundation analysis estimated that premiums for silver plans would have to rise by 16 percent in South Dakota (in addition to the rate increase that would otherwise apply) if CSRs werenât funded.The rate filings for South Dakota plans are available via SERFF.

Averaâs revised filing (AVER-131179213) notes that âTo keep the Silver rates lower than those for Gold plans, despite the additional load for the non-funding of CSR payments, Avera adjusted the profit and risk load.â They kept the profit and risk load the same as initially proposed for Gold, Bronze, Catastrophic, cost for lasix and off-exchange Silver plans. But they cut it almost in half for on-exchange silver plans. This is interesting, as itâs different this content from the approaches cost for lasix that insurers in most other states took.

But the insurer notes that the filing was withdrawn once they decided to finalize their alternate rate proposal that cost for lasix was based on the assumption that CSR funding would continue in 2018. Sanford had to reverse course and switch to the higher rates (with the cost of CSR added to silver plan premiums) in October, after CSR funding was eliminated.People who receive premium subsidies were largely insulated from the rising premiums, as the premium subsidies grow each year to keep pace with the cost of coverage. The subsidy amounts are based on keeping the after-subsidy cost of the second-lowest-cost silver plan (benchmark plan) at an affordable level â but the subsidies cost for lasix can be applied to any metal-level plan).

And the IRS reduced the percentage of income that people have to pay for the benchmark plan in 2018, which means that net premiums were actually slightly lower in 2018 than they were in 2017 (note that some enrollees may have had to switch plans to see a decrease in net premiums, as the benchmark plan can change from one year to the next).91 percent of South Dakota exchange enrollees were receiving premium subsidies in 2017. But the other 9 percent â as well as everyone who buys coverage outside the exchange â had to shoulder the full impact of the rate increases for 2018. However, since the cost of CSR was added only to silver plans, people who donât get premium subsidies (and who thus are generally also ineligible for CSR benefits, as those have lower income limits for cost for lasix eligibility) were able to pick non-Silver plans for 2018 and avoid at least the portion of the average rate increase that was added to cover the cost of CSR.

Enrollment reached a record high in 2018, dropped for the first time in in 2019, but grew again in 2020 and reached another record high for 2021Enrollment in South Dakotaâs exchange started out quite low in 2014, with just over 13,000 people enrolling. That was only an estimated 11.1 percent of South Dakotaâs subsidy-eligible residents enrolled in coverage through the exchange â tying cost for lasix Iowa for the lowest percentage in the nation.The fact that Wellmark did not participate in the exchange was cited as one of the reasons for the low enrollment in South Dakotaâs exchange in 2014. The carrierâs huge market share and name recognition coupled with the fact that existing Wellmark members had no means of keeping their carrier and also obtaining subsidies, meant that enrollment lagged behind the rest of the country in South Dakota.South Dakotaâs percentage increase in exchange enrollments in 2016 was the ninth highest in the US, and the fourth highest of the states that use Healthcare.gov.

This could be due in part to the sharp rate increases for Wellmarkâs off-exchange plans in 2016, which may have encouraged former Wellmark members to shop on the exchange instead.Across all the states that use HealthCare.gov, the general trend thus far has been peak cost for lasix enrollment in 2016, with slight declines for 2017 and again for 2018. But South Dakota is among just a handful of states where enrollment climbed steadily over each of the first five years of exchange operation. And based on preliminary data, enrollment for 2021 has reached a cost for lasix record high in South Dakota, with more than 31,000 people selecting plans (the prior record was under 30,000).Hereâs a summary of how enrollment (during open enrollment) has changed each year in South Dakotaâs exchange:2014.

13,104 people enrolled2015. 21,393 people cost for lasix enrolled2016. 25,999 people enrolled2017.

29,622 people cost for lasix enrolled2018. 29,652 people enrolled2019. 29,069 people enrolled (the first time cost for lasix enrollment dropped in SDâs exchange)2020.

29,331 people enrolled2021. 31,283 people enrolled (preliminary data)The increase in South Dakotaâs exchange enrollment in cost for lasix 2017 was likely due in large part to the fact that Wellmark and DakotaCare both terminated their off-exchange plans in South Dakota at the end of 2016, and their enrollees had to seek coverage from Avera or Sanford instead, both of which offer plans on and off the exchange. There were ten HealthCare.gov states that saw enrollment growth in 2017, and South Dakotaâs percentage increase in total enrollment was the second-highest.Across all states that use HealthCare.gov, there was an average enrollment decline of 3.8 percent in 2019, so South Dakotaâs enrollment drop that year was less significant than average.

And enrollment in the stateâs exchange increased in 2017, 2018, and 2020, despite the fact that average enrollment in HealthCare.gov states declined in each of those years. South Dakota was one of cost for lasix just a handful of HealthCare.gov states where enrollment increased from 2019 to 2020. What health insurance companies sell individual coverage in South Dakota?.

When the exchanges debuted in 2014, three insurers â cost for lasix DakotaCare, Avera, and Sanford â offered plans the South Dakota exchange. All three offered their plans statewide.Although there were no new carriers in the South Dakota exchange in 2015, the three existing carriers offered a variety of plans, including some new HSA-qualified options from Avera and an Avera plan that gave insureds lower out-of-pocket costs if they used an Avera provider.Wellmark Blue Cross Blue Shield had 73 percent of the market share in South Dakota prior to the 2014 open enrollment period, but the insurance giant opted to stay out of the exchange in 2014, in 2015, and in 2016 (despite their lack of participation in the exchange, Wellmark said they sold more policies outside the exchange in South Dakota in 2014 than the two on-exchange carriers combined). After the end of 2016, Wellmark exited South Dakotaâs ACA-compliant market altogether, and stopped selling even off-exchange cost for lasix plans.As of 2016, DakotaCare switched to only offering plans outside the exchange.

About 7,200 DakotaCare enrollees who had coverage through the exchange in 2015 needed to select a new plan from Avera or Sanford if they wished to continue to have coverageâand subsidiesâthrough the exchange in 2016.Celtic, Wellmark, and DakotaCare were offering plans outside the exchange in South Dakota as of 2016, but all three insurers opted to exit the ACA-compliant market in South Dakota at the end of 2016. The South Dakota Division of Insurance confirmed that Sanford and Avera were the only carriers offering individual market coverage in the state as of 2017, on or off-exchange.So since 2016, Avera and Sanford have been the only insurers offering plans in the South Dakota exchange, but both insurers have offered coverage cost for lasix statewide each year.Insurance ballot initiative made headlines in 2014South Dakota was in the national news in the fall of 2014 because of a ballot initiative pertaining to health insurance networks that voters overwhelmingly approved in November. Amendment 17 was billed by supporters as âfreedom to choose your doctorâ but critics pointed out that itâs not as simple as proponents made it seem.

Doctors and small or specialty hospitals were generally in favor cost for lasix of Amendment 17, while large insurers (including Sanford and Avera) and hospital networks were opposed. Ultimately, the measure passed 62 percent to 28 percent.This does not mean that patients can choose any doctor they want though. Rather, it means cost for lasix that any doctor who is willing and able to comply with the terms and conditions of the health insurance carrier could enter the carrierâs network.Because narrower networks have become commonplace over the last year, policy experts in other states were closely watching the outcome of the SD ballot initiative.

A total of 27 states have âany willing providerâ laws on their books, although only about half of them are as broad as South Dakotaâs.In the 2016 legislative session, a bill (HB1067) was introduced in an effort to roll back some of the provisions in Amendment 17, allowing carriers the option to offer both closed-network and open-network plans (plans with closed networks would be less expensive). The bill didnât advance out of committee, and this article is a good summary of the controversy surrounding HB1067.South Dakota continues to reject Medicaid expansionSouth Dakota has not expanded Medicaid under the ACA, and Governor Kristi Noem, who took office in 2019, is opposed to the idea of expanding Medicaid to cover the stateâs low-income population â despite the fact that the federal government would fund 90 percent of the cost.Because the state has not accepted federal funds to expand Medicaid, 20,000 South Dakota residents fall into the cost for lasix coverage gap â they earn too much money to qualify for Medicaid, but too little to qualify for subsidies in the exchange. If the state expands Medicaid, they will be eligible for coverage under Medicaid.The lack of Medicaid expansion disproportionately affects the Native American population in South Dakota.

Officials estimate that there are 14,000 Native Americans who would gain cost for lasix access to Medicaid if the state were to expand the program. This includes people who earn between 100 percent and 138 percent of poverty and are currently eligible for subsidies in the exchange. Many of them have not opted for private exchange plans though, for a variety of economic and cultural reasons.Former Governor Dennis Daugaard, a Republican, was in favor of Medicaid expansion, and as of late October 2014, 45 percent of surveyed South Dakota residents said they favored Medicaid expansion, while just 37 percent opposed it.In December 2015, Daugaard unveiled his proposal to expand Medicaid without needing to use additional state funds.

The plan would have utilized savings on a program that the state already had to cover a portion of the cost of care for Native cost for lasix Americans provided at non-IHS facilities. Native Americans who are eligible for expanded Medicaid would have been covered under Medicaid instead, and the savings on that program would more than offset the stateâs portion of Medicaid expansion costs. By the end of February 2016, however, Daugaard had said that Medicaid expansion would not be addressed during cost for lasix the 2016 legislative session.

He noted that there was still the possibility of a special legislative session later in the year, or the issue might be revisited during the 2017 legislative session. Hopes were high for a special session as late as mid-June 2016, but by June 22, Daugaard had confirmed that there would be no special session in 2016 to address Medicaid expansion, and that the issue would be pushed out past cost for lasix the 2016 election, into 2017 at the earliest.Daugaard had previously twice submitted a proposal to HHS for a waiver that would allow the state to expand Medicaid to people with incomes up to 100% of poverty level, instead of 138% of poverty level. HHS rejected Daugaardâs proposals though, saying that expansion must extend to people with incomes between 100% and 138% of poverty level in order to be approved (the Obama administration rejected statesâ attempts to expand Medicaid only to people under the poverty level, but Utah is trying to gain approval from the Trump administration for full federal funding (ie, a 90/10 split) of Medicaid expansion that only applies to people earning up to the poverty level).Grandmothered plans can renewOn November 26, 2013 the state announced that it would allow carriers to extend existing policies per President Obamaâs suggestion that non-compliant plans be allowed to remain in effect for one more year.

Sanford, Wellmark and DakotaCare all opted to allow existing policies to be renewed into 2014, giving insureds another option to compare with the new ACA-compliant plans.The state has continued to go along with cost for lasix additional federal extensions for grandmothered plans, most recently allowing these plans to remain in force until the end of 2021. But enrollment in grandmothered plans has dwindled, as people can no longer purchase them. In Sanfordâs 2018 filing (SANF-131588434), the cost for lasix insurer indicated that only 504 people were still enrolled in grandmothered Sanford plans as of 2018.

And DAKOTACAREâs 2021 filing for grandmothered plans indicated that they had just 593 remaining enrollees as of 2020 (SERFF tracking number DACR-132543698).Exchange history and outreachGov. Daugaard announced in late September 2012 that HHS would be running the stateâs exchange, citing the high cost â estimated at $6.3 cost for lasix to $7.7 million â for ongoing operation of the exchange.The state is not playing any role in promoting ACA-compliant health insurance options or educating consumers about the marketplace. That decision leaves outreach efforts to the insurers and federally funded ânavigators.â Navigators are affiliated with established community outreach and advocacy groups, and they are trained to help consumers understand and use the new online marketplace.

Western South Dakota Community Action Partnership received a $100,000 navigator grant in 2018.South Dakota cost for lasix health insurance exchange linksHealthCare.gov800-318-2596State Exchange Profile. South DakotaThe Henry J. Kaiser Family Foundation overview of South Dakotaâs progress toward creating a state health insurance cost for lasix exchange.Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006.

She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts..

Lasix for water retention

GREAT FALLS, https://ioin.co.uk/kamagra-100mg-oral-jelly-price Mont lasix for water retention. Â For months, the jail in central Montanaâs Cascade County was free of the hypertension, which seemed as distant a threat as it did in much of the nationâs rural Mountain West.Then a few people who had the lasix were arrested. By the time Paul Krogue, the jailâs medical director, realized there was a lasix for water retention problem, nearly 50 inmates were infected in the jail, where some had been sleeping on mats on an overcrowded floor. After several weeks, Mr.

Krogue got a call that s were spreading to a side of the jail that had been lasix-free.He hung up the phone and put his head in his hands.âI just kind of lost it, like, âMy God, I donât lasix for water retention know how much longer I can do this,ââ Mr. Krogue, a nurse practitioner, recalled. ÂI was just scared that Iâm not going to be able to see it through, that Iâm going to get sick â you just feel so exhausted and itâs just a lot.âThe Mountain West, which for months avoided the worst of the lasix, has rapidly devolved into one of the most alarming hot spots in a country that recorded its eight millionth confirmed case on Thursday, a day when more than 65,000 cases were announced nationwide, the most in a single day since July.Seventeen states, including many in the Mountain West, have added more cases in the past week than any other week of the lasix. And the spread through sparsely populated areas of rural America has created problems in small towns that lack critical resources â lasix for water retention including doctors â even in ordinary times.Wyoming, which did not have 1,000 total cases until June, recently added more than 1,000 in a single week.

Reports of new s have recently reached record levels in Alaska, Colorado and Idaho. And Montana, where more than half of the stateâs cases have been announced since August, is averaging more than 500 cases per day.In Cascade County, more than 300 inmates and staff members have been infected in a facility meant to hold 365 people, the countyâs first major outbreak in a region where the lasix is suddenly surging.The county seat, Great Falls, is seeing its worst case lasix for water retention numbers yet. The local hospital and its 27-bed hypertension medications unit is at capacity. The county health department is racing to hire new contact tracers.

And Mr lasix for water retention. Krogue, who also teaches nursing at Montana State Universityâs Great Falls campus, has seen attendance in his classes dwindle as students fall ill or quarantine.âI was just scared that Iâm not going to be able to see it through, that Iâm going to get sick,â said Paul Krogue, the jailâs medical director.Credit...Tailyr Irvine for The New York TimesOne place where the s have spread has been local jails, which are confined, often crowded spaces. Jails are staples of local communities and tend to have people coming and going lasix for water retention more quickly than prisons. Jails can hold everyone from people awaiting criminal trials for months to those picked up for a suspended driverâs license for a few hours.

With so many people filtering in and out, jails pose extra risks for the lasixâs spread â not only inside facilities but in potentially feeding outbreaks in the rest of the community.Nationally, jails and prisons have seen disproportionate rates of and death, with a mortality rate twice as high as in the general population and an rate more than four times as high, according to recent data.A New York Times database has tracked clusters of at least lasix for water retention 50 hypertension cases in a dozen rural jails in Montana, Idaho, Utah and New Mexico during the lasix. Among them. The Purgatory Correctional Center in Hurricane, Utah, with 166 s. The jail lasix for water retention in Twin Falls, Idaho, with 279.

And, in New Mexico, the Cibola County Correctional Center, which has reported 357 cases.In Cascade County, s at the jail make up about a quarter of all known lasix cases in the county. Health authorities say lasix for water retention that the jailâs outbreak, which began in mid-August, was not believed to be the main cause of the communityâs recent surge, but that it had led to some cases. In the past two months, Mr. Krogue said, the jail released 29 people who were considered actively infected.s at the jail make up about a quarter of Cascade Countyâs known lasix cases.Credit...Tailyr Irvine for The New York TimesGreat Falls, home to about 58,000 residents, is in the less mountainous part of Montana, with the Missouri River flowing through and a large oil refinery on its banks.

The Cascade County Detention Center sits along lasix for water retention a highway at the edge of town. Drive five miles in any direction and you are surrounded by wide-open plains.Montana requires that masks be worn inside businesses and indoor public spaces, and many people in Great Falls wear them when walking around downtownâs Central Avenue, where shops and cafes are still recovering from shutting down in the spring. Others go lasix for water retention without masks, citing the open space and lack of crowds.Bob Kelly, the mayor, said people had not been overly worried about how the jail outbreak might affect the rest of town when it started.âI think that by the very definition of a jail, hopefully, the disease will be incarcerated, as well as the patients,â he said. ÂIs there concern?.

Sure, thereâs concern lasix for water retention. But is there overreaction?. No.âThe mayor of Great Falls said that residents had considered the jailâs outbreak a distant concern at first.Credit...Tailyr Irvine for The New York TimesSome residentsâ nonchalance about the risks of the lasix, said Mr. Krogue, the jailâs medical director, can be traced lasix for water retention to a spring and early summer when almost no one in Cascade County knew anyone who had been sickened.âWe benefited from that early on,â he said.

ÂBut in some ways, I think it did us a disservice, too, because it also created a certain level of complacency.âThat has quickly shifted now, he said, as cases have spiked.The number of active cases known to county officials on any given day has risen sharply to about 600, according to Trisha Gardner, Cascade Countyâs health officer. The county has seen 1,261 cases and six deaths during lasix for water retention the lasix, a Times database shows. Some of the cases have been tied to the jail outbreak, she said, and others have been connected to bars and restaurants. Even figuring out what has led to some cases has been complex, she said, as residents have been reluctant to cooperate with contact tracers.âOur hospitals are at capacity, our public health system is at capacity,â she said.

ÂItâs not sustainable at this rate.âWhen the outbreak at lasix for water retention the jail began, social distancing was impossible, the authorities said. Three inmates shared cells designed for two. At night, men slept on thin blue pads in every available lasix for water retention space. On the floor in the day room, in shower stalls, in stairwells, in hallways outside of cells.Inmates did not receive masks until August, and jail officials said many have refused to wear them.In interviews with more than a dozen inmates and their family members, inmates described the jail during the outbreak as chaotic and unsanitary.

They said their pleas for help often went unanswered by nurses and guards.Newly arriving inmates were not always quarantined from one another before their test results were known because of a lack of space, inmates and jail officials said.Owen Hawley, 30, said every inmate in his living area of 38 men had tested positive for the lasix. He said he had been unable to eat for three days, had intensive body aches and suffered from a headache so powerful it felt as lasix for water retention if it was âbehind my eyes.ââAfter the fourth day of like, not eating and stuff, I just shut off, you know?. Â he said.A jail area set aside for quarantining new inmates.Credit...Tailyr Irvine for The New York TimesAt one point, Mr. Hawley said, he and other prisoners protested lasix for water retention the way the lasix was being handled by refusing to leave their living areas and by blocking new inmates from entering.

Everyone was ultimately tested, Mr. Hawley said, and each prisoner was given a disposable mask.Sierra Jasmine Wells, 25, another inmate, said women in her dormitory had grown ill, one after the next.âEveryone around lasix for water retention me was getting sick and it was tough on me,â she said. ÂBy then, I had already accepted the fact that I was going to get sick.âWhen she became infected, she said, she was given cough syrup and Tylenol.âI kind of was just left alone to deal with it,â she said.Jesse Slaughter, the county sheriff who oversees the jail, said that the jailâs medical staff was doing everything it could, and that he had been seeking health care assistance from other counties. Officials defended their handling of the outbreak, noting that all inmates received standard medications including Tylenol twice a day and were taken to area hospitals when they needed added care.

Seven inmates, as well as some staff members, were hospitalized lasix for water retention. No one from the jail has died from the lasix, officials said.Sheriff Jesse Slaughter, who oversees the jail, said he had been seeking health care assistance from other counties.Credit...Tailyr Irvine for The New York TimesMr. Krogue said lasix for water retention that since the start of the outbreak he had been working up to 16 hours each day and sleeping in his basement, away from his wife and children. He remains healthy but says he fears bringing the lasix home.

The lasix has slowed some in the jail, and officials have moved some inmates to other facilities, but other prisons and jails in the state are now seeing outbreaks.âYou can start to see what some of these other places experienced much earlier on, and we just didnât have that experience, but itâs certainly happening now,â Mr. Krogue said lasix for water retention. ÂItâs just real in a way that it wasnât.âLucy Tompkins reported from Great Falls, Maura Turcotte from Chicago and Libby Seline from Lincoln, Neb. Reporting was contributed by Izzy ColÃ³n from Columbia, Mo., Brendon Derr from Phoenix, Rebecca Griesbach from Tuscaloosa, Ala., Danya Issawi and Timothy Williams from New York, Ann Hinga Klein from Des Moines, lasix for water retention K.B.

Mensah from Silver Spring, Md., and Mitch Smith from Chicago.Start Preamble Federal Transit Administration (FTA), DOT. Notice of lasix for water retention funding opportunity. The hypertension Disease 2019 (hypertension medications) public health emergency Start Printed Page 63654has had a significant impact on transit operations. During a series of FTA listening sessions held over the last three months, transit agencies asked FTA to support research to identify solutions to address the operational challenges that they are facing as a result of hypertension medications.

In response, FTA makes available through this Notice of Funding Opportunity (NOFO) funding to support research demonstration grants to public transit agencies to develop, deploy, and demonstrate innovative solutions that improve the operational efficiency of transit agencies, as well as enhance the mobility of lasix for water retention transit users affected by the hypertension medications public health emergency. Demonstration grants under this NOFO are authorized under FTA's Public Transportation Innovation Program (49 U.S.C. 5312). Eligible projects will demonstrate innovative solutions to improve the operational efficiencies of transit systems and enhance mobility for their communities in four major areas.

(1) Vehicle, facility, equipment and infrastructure cleaning and dis. (2) exposure mitigation measures. (3) innovative mobility such as contactless payments. And (4) measures that strengthen public confidence in transit services.

The total funding available for awards under this NOFO is $10,000,000. FTA may supplement this amount if additional funding becomes available. Applicants must submit completed proposals for funding opportunity FTA-2020-015-TRI through the GRANTS.GOV âAPPLYâ function by 11:59 p.m. Eastern Time on November 2, 2020.

Prospective applicants should register as soon as possible on the GRANTS.GOV website to ensure they can complete the application process before the submission deadline. Application instructions are available on FTA's website at http://transit.dot.gov/âhowtoapply and in the âFINDâ module of GRANTS.GOV. FTA will not accept mail and fax submissions. Start Further Info Please send any questions on this notice to Jamel El-Hamri email.

Jamel.El-Hamri@dot.gov phone. 2020-366-8985. A Telecommunication Device for the Deaf (TDD) is available for individuals who are deaf or hard of hearing at 1-800-877-8339. End Further Info End Preamble Start Supplemental Information Table of Contents A.

Program Description B. Federal Award Information C. Eligibility Information D. Application and Submission Information E.

Application Review Information F. Federal Award Administration Information G. Federal Awarding Agency Contact Information A. Program Description The Public Transportation hypertension medications Research Demonstration Grant Program is funded through the Public Transportation Innovation Program (49 U.S.C.

5312), with the goal to develop, deploy, and demonstrate innovative solutions that improve the operational efficiency of transit agencies, as well as enhance the mobility of transit users affected by the hypertension medications public health emergency. Eligible projects will propose to develop and deploy innovative solutions in four major areas. (1) Vehicle, facility, equipment and infrastructure cleaning and dis. (2) exposure mitigation measures.

(3) innovative mobility such as contactless payments. And (4) measures that strengthen public confidence in transit. As required by 49 U.S.C. 5312(e)(4), projects funded under this NOFO must participate in an evaluation by an independent outside entity that will conduct a comprehensive evaluation of the success or failure of the projects funded under this subsection and any plan for broad-based implementation of the innovation promoted by successful projects.

B. Federal Award Information FTA makes available $10,000,000 in fiscal year (FY) 2020 funds under the Public Transportation Innovation Program (49 U.S.C. 5312) to finance the Public Transportation hypertension medications Research Demonstration Grant Program. FTA may supplement the total funds available if additional funding becomes available at the time project selections are made.

FTA will grant pre-award authority starting on the date of the project award announcement for selected projects and should be completed within 24 months from the date of award. Funds are available only for eligible expenses incurred after the announcement of project selections. C. Eligibility Information (1) Eligible Applicants Eligible applicants include State and local governmental authorities, direct recipients of Urbanized Area (49 U.S.C.

5307) and Rural Area (49 U.S.C. 5311) formula funds, and Indian tribes. Eligible applicants are limited to FTA grantees or subrecipients who would be the primary beneficiaries of the innovative products and services that are developedâtypically public transit agencies. Except for projects proposed by Indian tribes, proposals for projects in rural (non-urbanized) areas must be submitted as part of a consolidated State proposal.

States and other eligible applicants also may submit consolidated proposals for projects in urbanized areas. The submission of the Statewide application will not preclude the submission and consideration of any application from other eligible recipients in an urbanized area in a State. Proposals may contain projects to be implemented by the recipient or its subrecipients. Eligible subrecipients include public agencies, private nonprofit organizations, and private providers engaged in public transportation.

Eligible applicants may submit consolidated proposals for projects. (2) Cost Sharing or Matching The maximum Federal share of project costs is 100 percent. FTA may give additional consideration to applicants that propose a local share and may view these applicants as more competitive. The applicant must document the source(s) of the local match, if any, in the grant application.

For any applicants proposing match, eligible local match sources include the following. Cash from non-Government sources other than revenues from providing public transportation services. Revenues derived from the sale of advertising and concessions. Revenues generated from value capture financing mechanisms.

Funds from an undistributed cash surplus. Replacement or depreciation cash fund or reserve. New capital. Or in-kind contributions.

(3) Eligible Projects Eligible projects will propose innovative solutions to improve operational efficiencies of transit agencies and enhance the mobility of transit users, through projects that demonstrate innovative solutions for. Vehicle, facility, equipment and infrastructure cleaning and dis. Exposure mitigation measures such a real-time notification of rail and bus passenger loads. New multi-modal payment innovative mobility systems such as contactless payments.

And measures that strengthen public confidence in transit. Each applicant may only submit one proposal.Start Printed Page 63655 D. Application and Submission Information (1) Address and Form of Application Submission Applications must be submitted through GRANTS.GOV. Applicants can find general information for submitting applications through GRANTS.GOV at www.fta.dot.gov/âhowtoapply, along with specific instructions for the forms and attachments required for submission.

Mail and fax submissions will not be accepted. (2) Content and Form of Application Submission a. Proposal Submission A complete proposal submission consists of at least two forms. 1.

The SF-424 Mandatory Form (downloadable from GRANTS.GOV) and 2. The supplemental form for the FY 2020 hypertension medications Demonstration Program (downloadable from GRANTS.GOV), which is available on FTA's website at (placeholder for FTA hypertension medications Demonstration Program). The application must include responses to all sections of the SF-424 mandatory form and the supplemental form unless a section is indicated as optional. FTA will use the information on the supplemental form to determine applicant and project eligibility for the program and to evaluate the proposal against the selection criteria described in part E of this notice.

FTA will accept only one supplemental form per SF-424 submission. FTA encourages applicants to consider submitting a single supplemental form that includes multiple activities to be evaluated as a consolidated proposal. Applicants may attach additional supporting information to the SF-424 submission, including but not limited to letters of support, project budgets, or excerpts from relevant planning documents. Supporting documentation must be described and referenced by file name in the appropriate response section of the supplemental form, or it may not be reviewed.

Information such as applicant name, Federal amount requested, local match amount, description of areas served, etc., may be requested in varying degrees of detail on both the SF-424 form and supplemental form. Applicants must fill in all fields unless stated otherwise on the forms. If applicants copy information into the supplemental form from another source, they should verify that the supplemental form has fully captured pasted text and that it has not truncated the text due to character limits built into the form. Applicants should use both the âCheck Package for Errorsâ and the âValidate Formâ validation buttons on both forms to check all required fields.

Applicants should also ensure that the Federal and local amounts specified are consistent. Addressing the deteriorating conditions and disproportionately high fatality rates on our rural transportation infrastructure is of critical interest to the Department, as rural transportation networks face unique challenges in safety, infrastructure condition, and passenger and freight usage. Consistent with the R.O.U.T.E.S. Initiative, the Department encourages applicants to consider how the project will address the challenges faced by rural areas.

B. Application Content The SF-424 Mandatory Form and the supplemental form will prompt applicants for the required information, including. I. Applicant Name ii.

Dun and Bradstreet (D&B) Data Universal Numbering System (DUNS) number iii. Key contact information (contact name, address, email address, and phone number) iv. Congressional district(s) where project will take place v. Project Information (title, executive summary, and type) vi.

A detailed description of the need for the project vii. A detailed description of how the project will support the Program objectives viii. Evidence that the applicant can provide the local cost shares ix. A description of the technical, legal, and financial capacity of the applicant x.

A detailed project budget xi. Details on the local matching funds xii. A detailed project timeline xiii. Whether the project impacts an Opportunity Zone (3) Unique Entity Identifier and System for Award Management (SAM) Each applicant is required to.

(1) Be registered in SAM before submitting an application. (2) provide a valid unique entity identifier in its application. And (3) continue to maintain an active SAM registration with current information at all times during which the applicant has an active Federal award or an application or plan under consideration by FTA. These requirements do not apply if the applicant.

(1) Is excepted from the requirements under 2 CFR 25.110(b) or (c). Or (2) has an exception approved by FTA under 2 CFR 25.110(d). FTA may not make an award until the applicant has complied with all applicable unique entity identifier and SAM requirements. If an applicant has not fully complied with the requirements by the time FTA is ready to make an award, FTA may determine that the applicant is not qualified to receive an award and use that determination as a basis for making a Federal award to another applicant.

All applicants must provide a unique entity identifier provided by SAM. Registration in SAM may take as little as 3-5 business days, but there can be unexpected steps or delays. For example, the applicant may need to obtain an Employer Identification Number. FTA recommends allowing ample time, up to several weeks, to complete all steps.

For additional information on obtaining a unique entity identifier, please visit www.sam.gov. (4) Submission Dates and Times Project proposals must be submitted electronically through GRANTS.GOV by 11:59 p.m. Eastern on November 2, 2020. Mail and fax submissions will not be accepted.

FTA urges applicants to submit applications at least 72 hours prior to the due date to allow time to correct any problems that may have caused either GRANTS.GOV or FTA systems to reject the submission. Proposals submitted after the deadline will only be considered under extraordinary circumstances not within the applicant's control. Deadlines will not be extended due to scheduled website maintenance. GRANTS.GOV scheduled maintenance and outage times are announced on the GRANTS.GOV website.

Within 48 hours after submitting an electronic application, the applicant should receive two email messages from GRANTS.GOV. (1) Confirmation of successful transmission to GRANTS.GOV. And (2) confirmation of successful validation by GRANTS.GOV. If the applicant does not receive confirmation of successful validation or receives a notice of failed validation or incomplete materials, the applicant must address the reason for the failed validation, as described in the email notice, and resubmit before the submission deadline.

If making a resubmission for any reason, applicants must include all original attachments regardless of which attachments were updated and check the box on the supplemental form indicating this is a resubmission. Applicants are encouraged to begin the process of registration on the GRANTS.GOV site well in advance of the submission deadline. Registration is Start Printed Page 63656a multi-step process, which may take several weeks to complete before an application can be submitted. Registered applicants may still be required to update their registration before submitting an application.

Registration in SAM is renewed annually and persons making submissions on behalf of the Authorized Organization Representative (AOR) must be authorized in GRANTS.GOV by the AOR to make submissions. (5) Funding Restrictions Funds may be used for post-award expenditures only. Funds under this NOFO cannot be used to reimburse projects for otherwise eligible expenses incurred prior to the date of project award announcements. (6) Other Submission Requirements FTA encourages applicants to identify scaled funding options in case insufficient funding is available to fund a project at the full requested amount.

If an applicant indicates that a project is scalable, the applicant must provide an appropriate minimum funding amount that will fund an eligible project that achieves the objectives of the program and meets all relevant program requirements. The applicant must provide a clear explanation of how a reduced award would affect the project budget and scope. FTA may award a lesser amount whether or not the applicant provides a scalable option. E.

Application Review Information (1) Project Evaluation Criteria Addressing the deteriorating conditions and disproportionately high fatality rates on our rural transportation infrastructure is of critical interest to the Department, as rural transportation networks face unique challenges in safety, infrastructure condition, and passenger and freight usage. Consistent with the R.O.U.T.E.S. Initiative, the Department will consider how the project will address the challenges faced by rural areas. In addition, the Department will review and consider applications for funding pursuant to this Notice in accordance with the President's September 2, 2020 memorandum, entitled Memorandum on Reviewing Funding to State and Local Government Recipients of Federal Funds that Are Permitting Anarchy, Violence, and Destruction in American Cities, consistent with guidance from the Office of Management and Budget and the Attorney General and with all applicable laws.

FTA will evaluate proposals submitted according to the following criteria. (a) Project Innovation and Impact. (b) Project Approach. (c) National Applicability.

(d) Commercialization and/or Knowledge Transfer. And (e) Technical, Legal and Financial Capacity. FTA encourages each applicant to demonstrate how a project supports all criteria with the most relevant information the applicant can provide, regardless of whether such information has been specifically requested or identified in this notice. A.

Project Innovation and Impact i. Effectiveness of the project in achieving and demonstrating the specific objectives of this program. Ii. Demonstration of benefits in addressing the needs of the transit agency and industry and impacts to infrastructure, equipment, transit workforce, and riders.

Iii. Degree of improvement over current and existing technologies, designs, and/or practices applicable to the transit industry. B. Project Approach i.

Quality of the project approach such as existing partnerships, collaboration strategies and level of commitment of the project partners. Ii. Proposal is realistic in its approach to fulfill the milestones/deliverables, schedule and goals. C.

National Applicability i. Degree to which the project could be replicated by other transit agencies regionally or nationally. Ii. Ability to evaluate technologies, designs and/or practices in a wide variety of conditions and locales.

Iii. Degree to which the technology, designs and/or practices can be replicated by other transportation modes. D. Commercialization and/or Knowledge Transfer i.

Demonstrates a realistic plan for moving the results of the project into the transit marketplace (patents, conferences, articles in trade magazines, webinar, site visits, etc.). Ii. How the project team plans to work with the industry on improving best practices, guidance and/or standards, if applicable. Iii.

Demonstrate a clear understanding and robust approach to data collection, access and management. E. Technical, Legal and Financial Capacity Capacity of the applicant and any partners to successfully execute the project effort. There should be no outstanding legal, technical, or financial issues with the applicant that would make this a high-risk project.

(2) Review and Selection Process An FTA technical evaluation committee will evaluate proposals based on the published project evaluation criteria. Members of the technical evaluation committee will rate the applications and may seek clarification about any statement in an application. The FTA Administrator will determine the final selection and amount of funding for each project after consideration of the findings of the technical evaluation committee. Geographic diversity, diversity of the project type, the amount of local match to be provided, and the applicant's receipt and management of other Federal transit funds may be considered in FTA's award decisions.

Prior fare payment innovation efforts may receive priority consideration. The FTA Administrator will consider the following key DOT objectives. A. Utilizing alternative funding sources and innovative financing models to attract non-Federal sources of investment.

B. Whether the project is located in or supports public transportation service in a qualified opportunity zone designated pursuant to 26.U.S.C. 1400Z-1. And c.

The extent to which the project addresses challenges specific to the provision of rural public transportation. (3) FAPIIS Review Prior to making a grant award, FTA is required to review and consider any information about the applicant that is in the Federal Awardee Performance and Integrity Information System (FAPIIS) accessible through SAM. An applicant may review and comment on information about itself that a Federal awarding agency previously entered. FTA will consider any comments by the applicant, in addition to the other information in FAPIIS, in making a judgment about the applicant's integrity, business ethics, and record of performance under Federal awards when completing the review of risk posed by applicants as described in 2 CFR 200.205 Federal Awarding Agency Review of Risk Posed by Applicants.

F. Federal Award Administration Information (1) Federal Award Notices FTA will announce the final project selections on the FTA website. Project recipients should contact their FTA Regional Office for additional information regarding allocations for Start Printed Page 63657projects. At the time project selections are announced, FTA will extend pre-award authority for the selected projects.

There is no blanket pre-award authority for these projects before announcement. There is no minimum or maximum grant award amount, but FTA intends to fund as many meritorious projects as possible. FTA only will consider proposals from eligible recipients for eligible activities. Due to funding limitations, projects selected for funding may receive less than the amount originally requested.

In those cases, applicants must be able to demonstrate that the proposed projects are still viable and can be completed with the amount awarded. (2) Administrative and National Policy Requirements a. Pre-Award Authority FTA will issue specific guidance to recipients regarding pre-award authority at the time of selection. FTA does not provide pre-award authority for competitive funds until projects are selected, and there are Federal requirements that must be met before costs are incurred.

For more information about FTA's policy on pre-award authority, see the FY 2020 Apportionments Notice published on June 3, 2020, at https://www.govinfo.gov/âcontent/âpkg/âFR-2020-06-03/âpdf/â2020-11946.pdf. b. Grant Requirements Selected applicants will submit a grant application through FTA's electronic grant management system and adhere to the customary FTA grant requirements for research project (insert Circular name). All competitive grants, regardless of award amount, will be subject to the Congressional notification and release process.

FTA emphasizes that third-party procurement applies to all funding awards, as described in FTA Circular 4220.1F, âThird Party Contracting Guidance.â However, FTA may approve applications that include a specifically identified partnering organization(s) (2 CFR 200.302(f)). When included, the application, budget, and budget narrative should provide a clear understanding of how the selection of these organizations is critical for the project and give sufficient detail about the costs involved. C. Planning FTA encourages applicants to engage the appropriate State Departments of Transportation, Regional Transportation Planning Organizations, or Metropolitan Planning Organizations in areas to be served by the project funds available under this program.

D. Standard Assurances The applicant assures that it will comply with all applicable Federal statutes, regulations, executive orders, FTA circulars, and other Federal administrative requirements in carrying out any project supported by the FTA grant. The applicant acknowledges that it is under a continuing obligation to comply with the terms and conditions of the grant agreement issued for its project with FTA. The applicant understands that Federal laws, regulations, policies, and administrative practices might be modified from time to time and may affect the implementation of the project.

The applicant agrees that the most recent Federal requirements will apply to the project unless FTA issues a written determination otherwise. The applicant must submit the Certifications and Assurances before receiving a grant if it does not have current certifications on file. E. Free Speech and Religious Liberty In connection with any program or activity conducted with or benefiting from funds awarded under this notice, recipients of funds must comply with all applicable requirements of Federal law, including, without limitation, the Constitution of the United States.

Statutory, regulatory, and public policy requirements, including without limitation, those protecting free speech, religious liberty, public welfare, the environment, and prohibiting discrimination. The conditions of performance, non-discrimination requirements, and other assurances made applicable to the award of funds in accordance with regulations of the Department of Transportation. And applicable Federal financial assistance and contracting principles promulgated by the Office of Management and Budget. In complying with these requirements, recipients must ensure that no concession agreements are denied or other contracting decisions made on the basis of speech or other activities protected by the First Amendment.

If the Department determines that a recipient has failed to comply with applicable Federal requirements, the Department may terminate the award of funds and disallow previously incurred costs, requiring the recipient to reimburse any expended award funds. (3) Reporting The post-award reporting requirements include submission of the Federal Financial Report (FFR) and Milestone Progress Report in TrAMS. An evaluation of the grant will occur at various points in the demonstration process and at the end of the project. In addition, FTA is responsible for producing an Annual Report to Congress that compiles evaluation of selected projects, including an evaluation of the performance measures identified by the applicants.

All applicants must develop an evaluation plan to measure the success or failure of their projects and describe any plans for broad-based implementation of successful projects. FTA may request data and reports to support the evaluation and Annual Report. A. Independent Evaluation To achieve a comprehensive understanding of the impacts and implications of each proposed hypertension medications Research Demonstration Program, projects funded under this announcement will require the recipient to conduct a third party independent evaluation of their project.

Recipients will be required to contract with a third party independent evaluator to assist in developing an evaluation plan, and collecting, storing and managing data required to fulfill the evaluation requirement. No more than 10 percent of the Federal share of the project may be used to hire the third-party independent evaluator and the inclusion of a third-party independent evaluation should be described in the grant application. If the project duration is more than two years, an interim evaluation report would need to be submitted to FTA, otherwise the evaluation report should be included as part of the final project report. B.

hypertension medications Research Demonstration Grant Program Evaluation Projects funded under this announcement will be required to establish a set of performance metrics set by the third-party independent evaluator and shared with FTA. G. Federal Awarding Agency Contacts Information For questions about applying, please contact Jamel El-Hamri email. Jamel.El-Hamri@dot.gov phone.

202-366-8985. A TDD is available at 1-800-877-8339 (TDDFIRS). To ensure that applicants receive accurate information about eligibility or the program, applicants are encouraged to contact FTA directly with questions, rather than through intermediaries or third parties.Start Printed Page 63658 FTA staff also may conduct briefings on the competitive grants selection and award process upon request. Start Signature K.

Jane Williams, Deputy Administrator. End Signature End Supplemental Information [FR Doc. 2020-22316 Filed 10-7-20. 8:45 am]BILLING CODE 4910-57-P.

GREAT FALLS, check this Mont cost for lasix. Â For months, the jail in central Montanaâs Cascade County was free of the hypertension, which seemed as distant a threat as it did in much of the nationâs rural Mountain West.Then a few people who had the lasix were arrested. By the time Paul Krogue, the jailâs medical director, realized cost for lasix there was a problem, nearly 50 inmates were infected in the jail, where some had been sleeping on mats on an overcrowded floor.

After several weeks, Mr. Krogue got a call that s were spreading to a side of the jail that had been lasix-free.He hung up the phone and put his head in his hands.âI just kind of lost it, like, âMy God, I donât know how much longer I can do this,ââ cost for lasix Mr. Krogue, a nurse practitioner, recalled.

ÂI was just scared that Iâm not going to be able to see it through, that Iâm going to get sick â you just feel so exhausted and itâs just a lot.âThe Mountain West, which for months avoided the worst of the lasix, has rapidly devolved into one of the most alarming hot spots in a country that recorded its eight millionth confirmed case on Thursday, a day when more than 65,000 cases were announced nationwide, the most in a single day since July.Seventeen states, including many in the Mountain West, have added more cases in the past week than any other week of the lasix. And the spread through sparsely populated areas of rural America has created problems in cost for lasix small towns that lack critical resources â including doctors â even in ordinary times.Wyoming, which did not have 1,000 total cases until June, recently added more than 1,000 in a single week. Reports of new s have recently reached record levels in Alaska, Colorado and Idaho.

And Montana, where more than half of the stateâs cases have been announced since August, is averaging more than 500 cases per day.In Cascade County, more than 300 inmates and staff members have been infected in a facility meant to hold 365 people, the countyâs first major outbreak in a region where cost for lasix the lasix is suddenly surging.The county seat, Great Falls, is seeing its worst case numbers yet. The local hospital and its 27-bed hypertension medications unit is at capacity. The county health department is racing to hire new contact tracers.

And Mr cost for lasix. Krogue, who also teaches nursing at Montana State Universityâs Great Falls campus, has seen attendance in his classes dwindle as students fall ill or quarantine.âI was just scared that Iâm not going to be able to see it through, that Iâm going to get sick,â said Paul Krogue, the jailâs medical director.Credit...Tailyr Irvine for The New York TimesOne place where the s have spread has been local jails, which are confined, often crowded spaces. Jails are staples of local communities cost for lasix and tend to have people coming and going more quickly than prisons.

Jails can hold everyone from people awaiting criminal trials for months to those picked up for a suspended driverâs license for a few hours. With so many people filtering in and out, jails pose extra risks for the lasixâs spread â not only inside facilities but in potentially feeding outbreaks in the rest of the community.Nationally, jails and prisons have seen disproportionate rates of and death, with a mortality rate twice as high as in the general population and an rate more than four times as high, according to recent data.A New York Times database has tracked clusters of at least 50 hypertension cases in a cost for lasix dozen rural jails in Montana, Idaho, Utah and New Mexico during the lasix. Among them.

The Purgatory Correctional Center in Hurricane, Utah, with 166 s. The jail in Twin Falls, Idaho, with cost for lasix 279. And, in New Mexico, the Cibola County Correctional Center, which has reported 357 cases.In Cascade County, s at the jail make up about a quarter of all known lasix cases in the county.

Health authorities say that the jailâs outbreak, cost for lasix which began in mid-August, was not believed to be the main cause of the communityâs recent surge, but that it had led to some cases. In the past two months, Mr. Krogue said, the jail released 29 people who were considered actively infected.s at the jail make up about a quarter of Cascade Countyâs known lasix cases.Credit...Tailyr Irvine for The New York TimesGreat Falls, home to about 58,000 residents, is in the less mountainous part of Montana, with the Missouri River flowing through and a large oil refinery on its banks.

The Cascade County Detention Center sits along a highway at cost for lasix the edge of town. Drive five miles in any direction and you are surrounded by wide-open plains.Montana requires that masks be worn inside businesses and indoor public spaces, and many people in Great Falls wear them when walking around downtownâs Central Avenue, where shops and cafes are still recovering from shutting down in the spring. Others go without masks, citing the cost for lasix open space and lack of crowds.Bob Kelly, the mayor, said people had not been overly worried about how the jail outbreak might affect the rest of town when it started.âI think that by the very definition of a jail, hopefully, the disease will be incarcerated, as well as the patients,â he said.

ÂIs there concern?. Sure, cost for lasix thereâs concern. But is there overreaction?.

No.âThe mayor of Great Falls said that residents had considered the jailâs outbreak a distant concern at first.Credit...Tailyr Irvine for The New York TimesSome residentsâ nonchalance about the risks of the lasix, said Mr. Krogue, the jailâs medical director, cost for lasix can be traced to a spring and early summer when almost no one in Cascade County knew anyone who had been sickened.âWe benefited from that early on,â he said. ÂBut in some ways, I think it did us a disservice, too, because it also created a certain level of complacency.âThat has quickly shifted now, he said, as cases have spiked.The number of active cases known to county officials on any given day has risen sharply to about 600, according to Trisha Gardner, Cascade Countyâs health officer.

The county has seen 1,261 cases and six deaths during the lasix, cost for lasix a Times database shows. Some of the cases have been tied to the jail outbreak, she said, and others have been connected to bars and restaurants. Even figuring out what has led to some cases has been complex, she said, as residents have been reluctant to cooperate with contact tracers.âOur hospitals are at capacity, our public health system is at capacity,â she said.

ÂItâs not sustainable at cost for lasix this rate.âWhen the outbreak at the jail began, social distancing was impossible, the authorities said. Three inmates shared cells designed for two. At night, men slept on thin blue pads in every available cost for lasix space.

On the floor in the day room, in shower stalls, in stairwells, in hallways outside of cells.Inmates did not receive masks until August, and jail officials said many have refused to wear them.In interviews with more than a dozen inmates and their family members, inmates described the jail during the outbreak as chaotic and unsanitary. They said their pleas for help often went unanswered by nurses and guards.Newly arriving inmates were not always quarantined from one another before their test results were known because of a lack of space, inmates and jail officials said.Owen Hawley, 30, said every inmate in his living area of 38 men had tested positive for the lasix. He said he had been unable to eat for three days, had intensive body aches and suffered from a headache so powerful it felt as if it was âbehind my eyes.ââAfter the fourth day of like, cost for lasix not eating and stuff, I just shut off, you know?.

Â he said.A jail area set aside for quarantining new inmates.Credit...Tailyr Irvine for The New York TimesAt one point, Mr. Hawley said, he and other prisoners protested the way the lasix was being handled by refusing to leave their living areas and by cost for lasix blocking new inmates from entering. Everyone was ultimately tested, Mr.

Hawley said, and cost for lasix each prisoner was given a disposable mask.Sierra Jasmine Wells, 25, another inmate, said women in her dormitory had grown ill, one after the next.âEveryone around me was getting sick and it was tough on me,â she said. ÂBy then, I had already accepted the fact that I was going to get sick.âWhen she became infected, she said, she was given cough syrup and Tylenol.âI kind of was just left alone to deal with it,â she said.Jesse Slaughter, the county sheriff who oversees the jail, said that the jailâs medical staff was doing everything it could, and that he had been seeking health care assistance from other counties. Officials defended their handling of the outbreak, noting that all inmates received standard medications including Tylenol twice a day and were taken to area hospitals when they needed added care.

Seven inmates, as well as some staff members, cost for lasix were hospitalized. No one from the jail has died from the lasix, officials said.Sheriff Jesse Slaughter, who oversees the jail, said he had been seeking health care assistance from other counties.Credit...Tailyr Irvine for The New York TimesMr. Krogue said that since the start cost for lasix of the outbreak he had been working up to 16 hours each day and sleeping in his basement, away from his wife and children.

He remains healthy but says he fears bringing the lasix home. The lasix has slowed some in the jail, and officials have moved some inmates to other facilities, but other prisons and jails in the state are now seeing outbreaks.âYou can start to see what some of these other places experienced much earlier on, and we just didnât have that experience, but itâs certainly happening now,â Mr. Krogue said cost for lasix.

ÂItâs just real in a way that it wasnât.âLucy Tompkins reported from Great Falls, Maura Turcotte from Chicago and Libby Seline from Lincoln, Neb. Reporting was contributed by Izzy ColÃ³n from Columbia, Mo., Brendon Derr from Phoenix, Rebecca Griesbach cost for lasix from Tuscaloosa, Ala., Danya Issawi and Timothy Williams from New York, Ann Hinga Klein from Des Moines, K.B. Mensah from Silver Spring, Md., and Mitch Smith from Chicago.Start Preamble Federal Transit Administration (FTA), DOT.

Notice of cost for lasix funding opportunity. The hypertension Disease 2019 (hypertension medications) public health emergency Start Printed Page 63654has had a significant impact on transit operations. During a series of FTA listening sessions held over the last three months, transit agencies asked FTA to support research to identify solutions to address the operational challenges that they are facing as a result of hypertension medications.

In response, FTA makes cost for lasix available through this Notice of Funding Opportunity (NOFO) funding to support research demonstration grants to public transit agencies to develop, deploy, and demonstrate innovative solutions that improve the operational efficiency of transit agencies, as well as enhance the mobility of transit users affected by the hypertension medications public health emergency. Demonstration grants under this NOFO are authorized under FTA's Public Transportation Innovation Program (49 U.S.C. 5312).

Eligible projects will demonstrate innovative solutions to improve the operational efficiencies of transit systems and enhance mobility for their communities in four major areas. (1) Vehicle, facility, equipment and infrastructure cleaning and dis. (2) exposure mitigation measures.

(3) innovative mobility such as contactless payments. And (4) measures that strengthen public confidence in transit services. The total funding available for awards under this NOFO is $10,000,000.

FTA may supplement this amount if additional funding becomes available. Applicants must submit completed proposals for funding opportunity FTA-2020-015-TRI through the GRANTS.GOV âAPPLYâ function by 11:59 p.m. Eastern Time on November 2, 2020.

Start Further Info Please send any questions on this notice to Jamel El-Hamri email. Jamel.El-Hamri@dot.gov phone. 2020-366-8985.

A Telecommunication Device for the Deaf (TDD) is available for individuals who are deaf or hard of hearing at 1-800-877-8339. End Further Info End Preamble Start Supplemental Information Table of Contents A. Program Description B.

Federal Award Information C. Eligibility Information D. Application and Submission Information E.

Application Review Information F. Federal Award Administration Information G. Federal Awarding Agency Contact Information A.

Program Description The Public Transportation hypertension medications Research Demonstration Grant Program is funded through the Public Transportation Innovation Program (49 U.S.C. 5312), with the goal to develop, deploy, and demonstrate innovative solutions that improve the operational efficiency of transit agencies, as well as enhance the mobility of transit users affected by the hypertension medications public health emergency. Eligible projects will propose to develop and deploy innovative solutions in four major areas.

(1) Vehicle, facility, equipment and infrastructure cleaning and dis. (2) exposure mitigation measures. (3) innovative mobility such as contactless payments.

And (4) measures that strengthen public confidence in transit. As required by 49 U.S.C. 5312(e)(4), projects funded under this NOFO must participate in an evaluation by an independent outside entity that will conduct a comprehensive evaluation of the success or failure of the projects funded under this subsection and any plan for broad-based implementation of the innovation promoted by successful projects.

FTA may supplement the total funds available if additional funding becomes available at the time project selections are made. FTA will grant pre-award authority starting on the date of the project award announcement for selected projects and should be completed within 24 months from the date of award. Funds are available only for eligible expenses incurred after the announcement of project selections.

C. Eligibility Information (1) Eligible Applicants Eligible applicants include State and local governmental authorities, direct recipients of Urbanized Area (49 U.S.C. 5307) and Rural Area (49 U.S.C.

5311) formula funds, and Indian tribes. Eligible applicants are limited to FTA grantees or subrecipients who would be the primary beneficiaries of the innovative products and services that are developedâtypically public transit agencies. Except for projects proposed by Indian tribes, proposals for projects in rural (non-urbanized) areas must be submitted as part of a consolidated State proposal.

Eligible subrecipients include public agencies, private nonprofit organizations, and private providers engaged in public transportation. Eligible applicants may submit consolidated proposals for projects. (2) Cost Sharing or Matching The maximum Federal share of project costs is 100 percent.

FTA may give additional consideration to applicants that propose a local share and may view these applicants as more competitive. The applicant must document the source(s) of the local match, if any, in the grant application. For any applicants proposing match, eligible local match sources include the following.

Cash from non-Government sources other than revenues from providing public transportation services. Revenues derived from the sale of advertising and concessions. Revenues generated from value capture financing mechanisms.

Funds from an undistributed cash surplus. Replacement or depreciation cash fund or reserve. New capital.

Or in-kind contributions. (3) Eligible Projects Eligible projects will propose innovative solutions to improve operational efficiencies of transit agencies and enhance the mobility of transit users, through projects that demonstrate innovative solutions for. Vehicle, facility, equipment and infrastructure cleaning and dis.

Exposure mitigation measures such a real-time notification of rail and bus passenger loads. New multi-modal payment innovative mobility systems such as contactless payments. And measures that strengthen public confidence in transit.

Each applicant may only submit one proposal.Start Printed Page 63655 D. Application and Submission Information (1) Address and Form of Application Submission Applications must be submitted through GRANTS.GOV. Applicants can find general information for submitting applications through GRANTS.GOV at www.fta.dot.gov/âhowtoapply, along with specific instructions for the forms and attachments required for submission.

Mail and fax submissions will not be accepted. (2) Content and Form of Application Submission a. Proposal Submission A complete proposal submission consists of at least two forms.

1. The SF-424 Mandatory Form (downloadable from GRANTS.GOV) and 2. The supplemental form for the FY 2020 hypertension medications Demonstration Program (downloadable from GRANTS.GOV), which is available on FTA's website at (placeholder for FTA hypertension medications Demonstration Program).

The application must include responses to all sections of the SF-424 mandatory form and the supplemental form unless a section is indicated as optional. FTA will use the information on the supplemental form to determine applicant and project eligibility for the program and to evaluate the proposal against the selection criteria described in part E of this notice. FTA will accept only one supplemental form per SF-424 submission.

FTA encourages applicants to consider submitting a single supplemental form that includes multiple activities to be evaluated as a consolidated proposal. Applicants may attach additional supporting information to the SF-424 submission, including but not limited to letters of support, project budgets, or excerpts from relevant planning documents. Supporting documentation must be described and referenced by file name in the appropriate response section of the supplemental form, or it may not be reviewed.

Applicants should use both the âCheck Package for Errorsâ and the âValidate Formâ validation buttons on both forms to check all required fields. Applicants should also ensure that the Federal and local amounts specified are consistent. Addressing the deteriorating conditions and disproportionately high fatality rates on our rural transportation infrastructure is of critical interest to the Department, as rural transportation networks face unique challenges in safety, infrastructure condition, and passenger and freight usage.

Consistent with the R.O.U.T.E.S. Initiative, the Department encourages applicants to consider how the project will address the challenges faced by rural areas. B.

Application Content The SF-424 Mandatory Form and the supplemental form will prompt applicants for the required information, including. I. Applicant Name ii.

Project Information (title, executive summary, and type) vi. A detailed description of the need for the project vii. A detailed description of how the project will support the Program objectives viii.

Evidence that the applicant can provide the local cost shares ix. A description of the technical, legal, and financial capacity of the applicant x. A detailed project budget xi.

Details on the local matching funds xii. A detailed project timeline xiii. Whether the project impacts an Opportunity Zone (3) Unique Entity Identifier and System for Award Management (SAM) Each applicant is required to.

These requirements do not apply if the applicant. (1) Is excepted from the requirements under 2 CFR 25.110(b) or (c). Or (2) has an exception approved by FTA under 2 CFR 25.110(d).

FTA may not make an award until the applicant has complied with all applicable unique entity identifier and SAM requirements. If an applicant has not fully complied with the requirements by the time FTA is ready to make an award, FTA may determine that the applicant is not qualified to receive an award and use that determination as a basis for making a Federal award to another applicant. All applicants must provide a unique entity identifier provided by SAM.

Registration in SAM may take as little as 3-5 business days, but there can be unexpected steps or delays. For example, the applicant may need to obtain an Employer Identification Number. FTA recommends allowing ample time, up to several weeks, to complete all steps.

Mail and fax submissions will not be accepted. FTA urges applicants to submit applications at least 72 hours prior to the due date to allow time to correct any problems that may have caused either GRANTS.GOV or FTA systems to reject the submission. Proposals submitted after the deadline will only be considered under extraordinary circumstances not within the applicant's control.

Deadlines will not be extended due to scheduled website maintenance. GRANTS.GOV scheduled maintenance and outage times are announced on the GRANTS.GOV website. Within 48 hours after submitting an electronic application, the applicant should receive two email messages from GRANTS.GOV.

(1) Confirmation of successful transmission to GRANTS.GOV. And (2) confirmation of successful validation by GRANTS.GOV. If the applicant does not receive confirmation of successful validation or receives a notice of failed validation or incomplete materials, the applicant must address the reason for the failed validation, as described in the email notice, and resubmit before the submission deadline.

Registered applicants may still be required to update their registration before submitting an application. Registration in SAM is renewed annually and persons making submissions on behalf of the Authorized Organization Representative (AOR) must be authorized in GRANTS.GOV by the AOR to make submissions. (5) Funding Restrictions Funds may be used for post-award expenditures only.

Funds under this NOFO cannot be used to reimburse projects for otherwise eligible expenses incurred prior to the date of project award announcements. (6) Other Submission Requirements FTA encourages applicants to identify scaled funding options in case insufficient funding is available to fund a project at the full requested amount. If an applicant indicates that a project is scalable, the applicant must provide an appropriate minimum funding amount that will fund an eligible project that achieves the objectives of the program and meets all relevant program requirements.

The applicant must provide a clear explanation of how a reduced award would affect the project budget and scope. FTA may award a lesser amount whether or not the applicant provides a scalable option. E.

In addition, the Department will review and consider applications for funding pursuant to this Notice in accordance with the President's September 2, 2020 memorandum, entitled Memorandum on Reviewing Funding to State and Local Government Recipients of Federal Funds that Are Permitting Anarchy, Violence, and Destruction in American Cities, consistent with guidance from the Office of Management and Budget and the Attorney General and with all applicable laws. FTA will evaluate proposals submitted according to the following criteria. (a) Project Innovation and Impact.

(b) Project Approach. (c) National Applicability. (d) Commercialization and/or Knowledge Transfer.

And (e) Technical, Legal and Financial Capacity. FTA encourages each applicant to demonstrate how a project supports all criteria with the most relevant information the applicant can provide, regardless of whether such information has been specifically requested or identified in this notice. A.

Project Innovation and Impact i. Effectiveness of the project in achieving and demonstrating the specific objectives of this program. Ii.

Demonstration of benefits in addressing the needs of the transit agency and industry and impacts to infrastructure, equipment, transit workforce, and riders. Iii. Degree of improvement over current and existing technologies, designs, and/or practices applicable to the transit industry.

B. Project Approach i. Quality of the project approach such as existing partnerships, collaboration strategies and level of commitment of the project partners.

Ii. Proposal is realistic in its approach to fulfill the milestones/deliverables, schedule and goals. C.

National Applicability i. Degree to which the project could be replicated by other transit agencies regionally or nationally. Ii.

Ability to evaluate technologies, designs and/or practices in a wide variety of conditions and locales. Iii. Degree to which the technology, designs and/or practices can be replicated by other transportation modes.

D. Commercialization and/or Knowledge Transfer i. Demonstrates a realistic plan for moving the results of the project into the transit marketplace (patents, conferences, articles in trade magazines, webinar, site visits, etc.).

Ii. How the project team plans to work with the industry on improving best practices, guidance and/or standards, if applicable. Iii.

There should be no outstanding legal, technical, or financial issues with the applicant that would make this a high-risk project. (2) Review and Selection Process An FTA technical evaluation committee will evaluate proposals based on the published project evaluation criteria. Members of the technical evaluation committee will rate the applications and may seek clarification about any statement in an application.

The FTA Administrator will determine the final selection and amount of funding for each project after consideration of the findings of the technical evaluation committee. Geographic diversity, diversity of the project type, the amount of local match to be provided, and the applicant's receipt and management of other Federal transit funds may be considered in FTA's award decisions. Prior fare payment innovation efforts may receive priority consideration.

The FTA Administrator will consider the following key DOT objectives. A. Utilizing alternative funding sources and innovative financing models to attract non-Federal sources of investment.

B. Whether the project is located in or supports public transportation service in a qualified opportunity zone designated pursuant to 26.U.S.C. 1400Z-1.

And c. The extent to which the project addresses challenges specific to the provision of rural public transportation. (3) FAPIIS Review Prior to making a grant award, FTA is required to review and consider any information about the applicant that is in the Federal Awardee Performance and Integrity Information System (FAPIIS) accessible through SAM.

An applicant may review and comment on information about itself that a Federal awarding agency previously entered. FTA will consider any comments by the applicant, in addition to the other information in FAPIIS, in making a judgment about the applicant's integrity, business ethics, and record of performance under Federal awards when completing the review of risk posed by applicants as described in 2 CFR 200.205 Federal Awarding Agency Review of Risk Posed by Applicants. F.

Federal Award Administration Information (1) Federal Award Notices FTA will announce the final project selections on the FTA website. Project recipients should contact their FTA Regional Office for additional information regarding allocations for Start Printed Page 63657projects. At the time project selections are announced, FTA will extend pre-award authority for the selected projects.

Due to funding limitations, projects selected for funding may receive less than the amount originally requested. In those cases, applicants must be able to demonstrate that the proposed projects are still viable and can be completed with the amount awarded. (2) Administrative and National Policy Requirements a.

Pre-Award Authority FTA will issue specific guidance to recipients regarding pre-award authority at the time of selection. FTA does not provide pre-award authority for competitive funds until projects are selected, and there are Federal requirements that must be met before costs are incurred. For more information about FTA's policy on pre-award authority, see the FY 2020 Apportionments Notice published on June 3, 2020, at https://www.govinfo.gov/âcontent/âpkg/âFR-2020-06-03/âpdf/â2020-11946.pdf.

b. Grant Requirements Selected applicants will submit a grant application through FTA's electronic grant management system and adhere to the customary FTA grant requirements for research project (insert Circular name). All competitive grants, regardless of award amount, will be subject to the Congressional notification and release process.

Planning FTA encourages applicants to engage the appropriate State Departments of Transportation, Regional Transportation Planning Organizations, or Metropolitan Planning Organizations in areas to be served by the project funds available under this program. D. Standard Assurances The applicant assures that it will comply with all applicable Federal statutes, regulations, executive orders, FTA circulars, and other Federal administrative requirements in carrying out any project supported by the FTA grant.

The applicant acknowledges that it is under a continuing obligation to comply with the terms and conditions of the grant agreement issued for its project with FTA. The applicant understands that Federal laws, regulations, policies, and administrative practices might be modified from time to time and may affect the implementation of the project. The applicant agrees that the most recent Federal requirements will apply to the project unless FTA issues a written determination otherwise.

The applicant must submit the Certifications and Assurances before receiving a grant if it does not have current certifications on file. E. Free Speech and Religious Liberty In connection with any program or activity conducted with or benefiting from funds awarded under this notice, recipients of funds must comply with all applicable requirements of Federal law, including, without limitation, the Constitution of the United States.

In complying with these requirements, recipients must ensure that no concession agreements are denied or other contracting decisions made on the basis of speech or other activities protected by the First Amendment. If the Department determines that a recipient has failed to comply with applicable Federal requirements, the Department may terminate the award of funds and disallow previously incurred costs, requiring the recipient to reimburse any expended award funds. (3) Reporting The post-award reporting requirements include submission of the Federal Financial Report (FFR) and Milestone Progress Report in TrAMS.

An evaluation of the grant will occur at various points in the demonstration process and at the end of the project. In addition, FTA is responsible for producing an Annual Report to Congress that compiles evaluation of selected projects, including an evaluation of the performance measures identified by the applicants. All applicants must develop an evaluation plan to measure the success or failure of their projects and describe any plans for broad-based implementation of successful projects.

FTA may request data and reports to support the evaluation and Annual Report. A. Independent Evaluation To achieve a comprehensive understanding of the impacts and implications of each proposed hypertension medications Research Demonstration Program, projects funded under this announcement will require the recipient to conduct a third party independent evaluation of their project.

B. hypertension medications Research Demonstration Grant Program Evaluation Projects funded under this announcement will be required to establish a set of performance metrics set by the third-party independent evaluator and shared with FTA. G.

Federal Awarding Agency Contacts Information For questions about applying, please contact Jamel El-Hamri email. Jamel.El-Hamri@dot.gov phone. 202-366-8985.

A TDD is available at 1-800-877-8339 (TDDFIRS). To ensure that applicants receive accurate information about eligibility or the program, applicants are encouraged to contact FTA directly with questions, rather than through intermediaries or third parties.Start Printed Page 63658 FTA staff also may conduct briefings on the competitive grants selection and award process upon request. Start Signature K.

Jane Williams, Deputy Administrator. End Signature End Supplemental Information [FR Doc. 2020-22316 Filed 10-7-20.