Saturday, October 31, 2015

Anger — What is it good for?

Part 1 of 3 by Kevin Rose RPC, RTC

20151031_154409-1_resized“Bitterness is like cancer. It eats upon the host. But anger is like fire. It burns it all clean.” –Maya Angelou

Clients often ask me about anger. It’s a popular topic in therapy: … Read the rest

The post Anger — What is it good for? appeared first on Steadfast Counselling.



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Anger — What is it good for?

Part 1 of 3 by Kevin Rose RPC, RTC

20151031_154409-1_resized"Bitterness is like cancer. It eats upon the host. But anger is like fire. It burns it all clean." –Maya Angelou

Clients often ask me about anger. It's a popular topic in therapy: … Read the rest

The post Anger — What is it good for? appeared first on Steadfast Counselling.



from Steadfast Counselling http://ift.tt/20jmafS

20 Sensory Bags To Make

20 Sensory Bags To Make

Have you tried making your kids sensory bags? They are so much fun! Kids love playing with them and they are easy to make. Plus, there are endless possibilities.

If you're looking for inspiration or a new idea to try, here is a huge list of sensory bags to make.

sensorybags1

20 Sensory Bags To Make

Ocean – This fun sensory bag looks just the deep blue ocean!

Baby Water Blob – Even the little ones can play with this fun sensory bag.

Fall – This is so fun and festive for fall. via Kids Play Box

Halloween – Here are three fun bags for Halloween that your kids will love! via Plain Vanilla Mom

Googley Eyes – Green and gooey, this bag is perfect for Halloween! via Clare's Little Tots

20 Sensory Bags To Make

Watermelon – This squishy bag looks and feels like the inside of a watermelon. What a fun way to play without making a mess! via Fantastic Fun and Learning

Playdough – Flattened playdough and a few shiny pom poms make a fun baby activity. via Simple Fun For Kids

Nature – Use things you find outside on a nature walk to make this fun suncatcher sensory bag. via Hands On As We Grow

Lava Lamp – This is so fun – make your own little lava lamp bag that glows! via Growing A Jeweled Rose

Christmas Tree – Perfect for the holidays, make this Christmas tree sensory bag! via Mom Inspired Life

20 Sensory Bags To Make

Goo Bag – Play with goo without making a huge mess. This bag is so fun for little hands. Hello Bee

Sparkle Snow –  via Glowing A Jeweled Rose

Night Sky – This is beautiful and looks like the night sky. So fun. via Learning And Exploring Through Play

Magnetic Polka Dots – Inspired by the book Press Here, this is onf of my favorite sensory bags ever! via Mama Papa Bubba

Snowflakes – Perfect for winter, this snowflake bag is so much fun. via B-Inspired Mama

20 Sensory Bags To Make

Frozen – This winter sensory bag is perfect for the snowy months. via A Little Pinch of Perfect

Red Apples –  This activiyy goes with the book Ten Red Apples and is fun for little hands. via I Can Teach My Child

Gelatin Squish Bag – This one is edible! via Stay At Home Educator

Learn To Write – For a fun pre-writing activity, make these sensory bags! via Pre-School Play

Grinch – Watch the Grinch Stole Christmas this holiday and then make this fun sesnsory bag! via Growing A Jeweled Rose

The post 20 Sensory Bags To Make appeared first on Kids Activities Blog.



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20 Sensory Bags To Make

20 Sensory Bags To Make

Have you tried making your kids sensory bags? They are so much fun! Kids love playing with them and they are easy to make. Plus, there are endless possibilities.

If you’re looking for inspiration or a new idea to try, here is a huge list of sensory bags to make.

sensorybags1

20 Sensory Bags To Make

Ocean – This fun sensory bag looks just the deep blue ocean!

Baby Water Blob – Even the little ones can play with this fun sensory bag.

Fall – This is so fun and festive for fall. via Kids Play Box

Halloween – Here are three fun bags for Halloween that your kids will love! via Plain Vanilla Mom

Googley Eyes – Green and gooey, this bag is perfect for Halloween! via Clare’s Little Tots

20 Sensory Bags To Make

Watermelon – This squishy bag looks and feels like the inside of a watermelon. What a fun way to play without making a mess! via Fantastic Fun and Learning

Playdough – Flattened playdough and a few shiny pom poms make a fun baby activity. via Simple Fun For Kids

Nature – Use things you find outside on a nature walk to make this fun suncatcher sensory bag. via Hands On As We Grow

Lava Lamp – This is so fun – make your own little lava lamp bag that glows! via Growing A Jeweled Rose

Christmas Tree – Perfect for the holidays, make this Christmas tree sensory bag! via Mom Inspired Life

20 Sensory Bags To Make

Goo Bag – Play with goo without making a huge mess. This bag is so fun for little hands. Hello Bee

Sparkle Snow –  via Glowing A Jeweled Rose

Night Sky – This is beautiful and looks like the night sky. So fun. via Learning And Exploring Through Play

Magnetic Polka Dots – Inspired by the book Press Here, this is onf of my favorite sensory bags ever! via Mama Papa Bubba

Snowflakes – Perfect for winter, this snowflake bag is so much fun. via B-Inspired Mama

20 Sensory Bags To Make

Frozen – This winter sensory bag is perfect for the snowy months. via A Little Pinch of Perfect

Red Apples –  This activiyy goes with the book Ten Red Apples and is fun for little hands. via I Can Teach My Child

Gelatin Squish Bag – This one is edible! via Stay At Home Educator

Learn To Write – For a fun pre-writing activity, make these sensory bags! via Pre-School Play

Grinch – Watch the Grinch Stole Christmas this holiday and then make this fun sesnsory bag! via Growing A Jeweled Rose

The post 20 Sensory Bags To Make appeared first on Kids Activities Blog.



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Bigger is Better – in Cookies

giant cookie recipe

Afterschool cookies are a bit of a tradition around here.  We make a big batch of cookie batter every couple of weeks and scoop out cookies as needed.  It is a great way to welcome kids home, even the neighborhood kids stop by for cookies several days a week!

But, let's make it fun, make Friday's cookie more fun!  Make a cookie into a memory!  Instead of the regular cookies, we made a GIANT cookie recipe – Cause bigger is better!

giant cookie recipe

Levi's Giant Cookie Recipe

  • 4 Cups of Flour
  • 3 Cups of Old Fashioned Oats
  • 1/2 Tablespoon Baking Soda
  • 2 Teaspons of Salt

Mix the dry ingredients together.  In a separate bowl mix the wet ingredients together.

  • 1 1/3 Cup of Shortening
  • 2/3 Cup of Butter
  • 1/4 Cup of Water
  • 3/4 Cup of White Sugar
  • 1 Cup of Brown Sugar
  • 3 Eggs
  • 1 Tablespoon of Vanilla

Stir the wet ingredients into the dry ingredients.  Add 1-2 Cups of Walnuts (optional) and 1 Bag of Dark Chocolate Chips.

Store in a big air-tight container in the fridge.

cooking cookies in cast iron pans

Bigger cookies are better.

When you are ready to bake your cookies, scoop them out onto a cookie sheet and bake for 10-15 minutes at 350 degrees.

If you want to build memories with your kids and bake a giant cookie, spray a cast iron pan with oil liberally.  Then press scoopfuls of cookie dough onto your pan.

Stick your cast iron pan into your oven at 350 degrees and let it cook for 10 Minutes.  Keep it in the pan until your cookie and the pan have cooled.

cookie wide feature2

It's a GIANT cookie!  Perfect for building memories!

cookie being eatten by kids

In a group it makes sense to cut the cookie into slices.  But half the fun is nibbling from something SO huge!  Your kids will LOVE having a giant cookie.

 

The post Bigger is Better – in Cookies appeared first on Kids Activities Blog.



from Kids Activities Blog http://ift.tt/1M7SHiL

Bigger is Better – in Cookies

giant cookie recipe

Afterschool cookies are a bit of a tradition around here.  We make a big batch of cookie batter every couple of weeks and scoop out cookies as needed.  It is a great way to welcome kids home, even the neighborhood kids stop by for cookies several days a week!

But, let’s make it fun, make Friday’s cookie more fun!  Make a cookie into a memory!  Instead of the regular cookies, we made a GIANT cookie recipe – Cause bigger is better!

giant cookie recipe

Levi’s Giant Cookie Recipe

  • 4 Cups of Flour
  • 3 Cups of Old Fashioned Oats
  • 1/2 Tablespoon Baking Soda
  • 2 Teaspons of Salt

Mix the dry ingredients together.  In a separate bowl mix the wet ingredients together.

  • 1 1/3 Cup of Shortening
  • 2/3 Cup of Butter
  • 1/4 Cup of Water
  • 3/4 Cup of White Sugar
  • 1 Cup of Brown Sugar
  • 3 Eggs
  • 1 Tablespoon of Vanilla

Stir the wet ingredients into the dry ingredients.  Add 1-2 Cups of Walnuts (optional) and 1 Bag of Dark Chocolate Chips.

Store in a big air-tight container in the fridge.

cooking cookies in cast iron pans

Bigger cookies are better.

When you are ready to bake your cookies, scoop them out onto a cookie sheet and bake for 10-15 minutes at 350 degrees.

If you want to build memories with your kids and bake a giant cookie, spray a cast iron pan with oil liberally.  Then press scoopfuls of cookie dough onto your pan.

Stick your cast iron pan into your oven at 350 degrees and let it cook for 10 Minutes.  Keep it in the pan until your cookie and the pan have cooled.

cookie wide feature2

It’s a GIANT cookie!  Perfect for building memories!

cookie being eatten by kids

In a group it makes sense to cut the cookie into slices.  But half the fun is nibbling from something SO huge!  Your kids will LOVE having a giant cookie.

 

The post Bigger is Better – in Cookies appeared first on Kids Activities Blog.



from Kids Activities Blog http://ift.tt/1M7SHiL

14 Ways to Recycle Old Magazines Into New Crafts

14 Ways to Recycle Old Magazines Into New Crafts

If you’re like me, you feel bad throwing away all the magazines you’ve already read. I mean after all, there’s tons of ways to create crafts from magazines. So stop hoarding and start creating!

14 Ways to Recycle Old Magazines Into New Crafts

Cool Crafts From Old Magazines

Looking for some different ideas? Below are ten of our favorite ways to recycle magazine pages into fun craft projects and beautiful pieces of art!

  1. Pretend Cookie Tray
  2. Magazine Strip Art
  3. Fall Magazine Tree
  4. Magazine Wreath
  5. Magazine Collage Ornament
  6. Easy Magazine Flowers
  7. Paper Rosette
  8. Homemade Cards
  9. Cut Out Funny Faces
  10. Paper Dolls

Classic Uses for Recycled Magazines

There are several creative ways to make crafts from old magazines and moms just like you have been crafting with them for many years.

14 Ways to Recycle Old Magazines Into New Crafts

Some of the classics I’ve seen around are:

  1. Collages – Making a collage is a fun way to spark creativity and create a one of a kind keepsake. Give your kids a piece of 8.5″ x 11″ card stock or construction paper and some glue. Ask them to pick a theme for their collage. Using that theme, have them go through stacks of magazines and cut out pictures for their project. For example, if Tom wants his collage to be about dogs, have him find pictures of different dogs, dog food, bowls, a park, fire hydrants, dog houses, etc. They can be as creative or inventive as they like. Once their pictures are cut out, have them glue them all over the construction paper, overlapping if they like.
  2. Decoupage – Pictures cut from magazines are great for decoupage projects. First, to create your own decoupage medium, mix together equal parts of white glue and water. Use a paint brush to combine, adding more glue or water if needed to make it to a milky, paintable solution. Use a paint brush to apply decoupage to empty vegetable cans, pieces of scrap wood, or empty glass jars. Lay your picture on the decoupaged area, then paint a layer of decoupage on top of the picture. Use the paint brush to smooth out the piece and get rid of any bubbles or lines.
  3. Beads – Making magazine beads is lots of fun and they can be very colorful and unique! They are time consuming and best suited for children that are elementary aged and up. You can make beads of all sizes and all you need are strips cut from magazine pages, a dowel or straw to wrap them around and some glue to secure them. Sealer is a good idea to protect your hard work, so instead of glue you can always opt for a decoupage medium such as Mod Podge (affiliate link), which acts as a glue and sealer.
  4. Mosaics – You don’t have to stick with pictures, but pick colors instead. For example, find a picture of grass for “green” and a picture of the sky for “blue”. Cut or tear the sky and grass into smaller pieces to make your own colorful designs. Use these smaller pieces to create fun mosaic designs. You can cut colorful pages into squares or simply tear them into chunks, then glue them into a design on a piece of construction paper. Make a fun sunflower by cutting or tearing up pieces yellow and pasting them onto your paper to create petals. Use brown scraps for the center of the flower and green for the stems and leaves. Be even more thorough and use blue and white to fill in the sky and clouds for the background of your creation.

The post 14 Ways to Recycle Old Magazines Into New Crafts appeared first on Kids Activities Blog.



from Kids Activities Blog http://ift.tt/1v0EVpo

14 Ways to Recycle Old Magazines Into New Crafts

14 Ways to Recycle Old Magazines Into New Crafts

If you're like me, you feel bad throwing away all the magazines you've already read. I mean after all, there's tons of ways to create crafts from magazines. So stop hoarding and start creating!

14 Ways to Recycle Old Magazines Into New Crafts

Cool Crafts From Old Magazines

Looking for some different ideas? Below are ten of our favorite ways to recycle magazine pages into fun craft projects and beautiful pieces of art!

  1. Pretend Cookie Tray
  2. Magazine Strip Art
  3. Fall Magazine Tree
  4. Magazine Wreath
  5. Magazine Collage Ornament
  6. Easy Magazine Flowers
  7. Paper Rosette
  8. Homemade Cards
  9. Cut Out Funny Faces
  10. Paper Dolls

Classic Uses for Recycled Magazines

There are several creative ways to make crafts from old magazines and moms just like you have been crafting with them for many years.

14 Ways to Recycle Old Magazines Into New Crafts

Some of the classics I've seen around are:

  1. Collages – Making a collage is a fun way to spark creativity and create a one of a kind keepsake. Give your kids a piece of 8.5″ x 11″ card stock or construction paper and some glue. Ask them to pick a theme for their collage. Using that theme, have them go through stacks of magazines and cut out pictures for their project. For example, if Tom wants his collage to be about dogs, have him find pictures of different dogs, dog food, bowls, a park, fire hydrants, dog houses, etc. They can be as creative or inventive as they like. Once their pictures are cut out, have them glue them all over the construction paper, overlapping if they like.
  2. Decoupage – Pictures cut from magazines are great for decoupage projects. First, to create your own decoupage medium, mix together equal parts of white glue and water. Use a paint brush to combine, adding more glue or water if needed to make it to a milky, paintable solution. Use a paint brush to apply decoupage to empty vegetable cans, pieces of scrap wood, or empty glass jars. Lay your picture on the decoupaged area, then paint a layer of decoupage on top of the picture. Use the paint brush to smooth out the piece and get rid of any bubbles or lines.
  3. Beads – Making magazine beads is lots of fun and they can be very colorful and unique! They are time consuming and best suited for children that are elementary aged and up. You can make beads of all sizes and all you need are strips cut from magazine pages, a dowel or straw to wrap them around and some glue to secure them. Sealer is a good idea to protect your hard work, so instead of glue you can always opt for a decoupage medium such as Mod Podge (affiliate link), which acts as a glue and sealer.
  4. Mosaics – You don't have to stick with pictures, but pick colors instead. For example, find a picture of grass for "green" and a picture of the sky for "blue". Cut or tear the sky and grass into smaller pieces to make your own colorful designs. Use these smaller pieces to create fun mosaic designs. You can cut colorful pages into squares or simply tear them into chunks, then glue them into a design on a piece of construction paper. Make a fun sunflower by cutting or tearing up pieces yellow and pasting them onto your paper to create petals. Use brown scraps for the center of the flower and green for the stems and leaves. Be even more thorough and use blue and white to fill in the sky and clouds for the background of your creation.

The post 14 Ways to Recycle Old Magazines Into New Crafts appeared first on Kids Activities Blog.



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Friday, October 30, 2015

Genetic Information Safeguards And Wellness Programs; 2016 Marketplace Coverage

Tim-ACA-slide

Implementing Health Reform (October 29 update). On October 30, 2015, the Equal Employment Opportunity Commission (EEOC) released a proposed rule concerning the application of the Genetic Information Nondiscrimination Act (GINA) to employer wellness programs, together with a fact sheet and a series of questions and answers.

Also on October 30 the Assistant Secretary for Planning and Evaluation (ASPE) released a report on Health Plan Choice and Premiums in the 2016 Health Insurance Marketplace. Accompanying the ASPE report, CMS released the public use files on marketplace plans on which the reports are based.

Finally, the Centers for Medicare and Medicaid Services has released the marketplace eligibility notices they are using for 2016.

Applying GINA To Wellness Programs

GINA is a federal law that protects employees from employment discrimination based on their genetic information. It prohibits covered employers (with 15 or more employees) from using genetic information for making employment decisions. It also forbids employers from requesting, requiring, or purchasing genetic information regarding their employees unless one or more of six narrow exceptions applies. It strictly limits the disclosure by employees of genetic information.

Genetic information includes information about the "manifestations of a disease or disorder in family members of an individual." Family members obviously include spouses.

One of the exceptions to GINA's information request prohibition applies when an employee voluntarily accepts health services from the employer, including wellness program services. Employer wellness programs often include not only employers but also their spouses. Current EEOC GINA regulations provide that employees cannot be required to provide genetic information as a condition of receiving incentives from their employer. The question thus arises as when wellness programs may legally offer incentives to obtain current or past health information regarding the spouses of employees. This proposed rule addresses this question.

Wellness programs are currently very popular among employers. According to the recent Kaiser Family Foundation Survey, 72 percent of employers with 5,000 or more employees offer or require employees to complete a health risk assessment while 65 percent have biometric screening programs. When incentives are offered for participation in wellness programs or penalties imposed for nonparticipation, serious issues arise under a number of federal laws, including the Affordable Care Act and the Health Insurance Portability and Affordability Act (HIPAA), which prohibit health status discrimination in the provision of health plan coverage; the Americans with Disabilities Act; and GINA. Wellness program rules under the ACA and HIPPA were published in 2013, while the EEOC proposed rules under the ADA earlier this year.   The proposed GINA rules complete this regulatory effort.

The proposed rule would allow employers to offer limited inducements (financial or in-kind and in the form of rewards or penalties) to obtain information from the spouses of employees covered by the employer's group medical plan regarding the spouses' current or past health status, through a medical questionnaire or examination. Provision of spousal information would be considered "voluntary" even though these inducements were offered. Participation would have to be with written authorization.

As required by the wellness program regulations under other laws, the wellness program would have to be reasonably designed to promote health or prevent disease and not be a subterfuge to violate GINA or be highly suspect. To be reasonably designed, a program would have to offer follow-up information and advice in conjunction with health assessments or examinations; not impose overly burdensome time or cost requirements; and not be unreasonably intrusive.

The total inducements offered for participation of an employee and spouse cannot exceed 30 percent of the total annual cost of plan coverage. The maximum inducement that an employer can offer for an employee's provision of information on himself or herself is 30 percent of the cost of sole-employee coverage. The maximum inducement that an employer can offer for spousal provision of information is 30 percent of the cost of family coverage minus 30 percent of the cost of sole-employee coverage. Wellness programs are not limited by these apportionment rules if the program does not involve health information and otherwise complies with federal requirements. The GINA rules do not limit requests for medical information, on a voluntary basis without inducements, from an employee's spouse or children in conjunction with the provision of medical treatments.

An employer's offer of inducements to obtain health status or genetic information on an employee's children (biological or non-biological) is not permitted. Health information on an employee's children is much more likely to reveal prohibited genetic information about the employee than health information about the employee's spouse and is thus more carefully protected. Also inducements cannot be offered in return for spouses providing genetic information other than health status information, including the results of genetic tests and family genetic information.

Employers can ask questions about genetic information, but must clearly state that those questions need not be answered in order to obtain an inducement. Employers cannot use genetic information as the basis for employment decisions. Employers also cannot offer employees an inducement to waive GINA's confidentiality requirements or permit the sale of their genetic information.

The EEOC requests comments on a number of related issues, including:

  • Should inducements be equally available if employee's spouses in lieu of providing medical information provide a doctor's statement that they are under the care of the doctor and all medical risks are being addressed?
  • Should the proposed authorization requirements only apply to wellness programs offering more than de minimis inducements?
  • What safeguards are necessary to avoid wellness programs simply shifting costs to employees or spouses with health conditions?
  • Are additional protections necessary where employers store medical information electronically?
  • Should programs be prohibited from accessing genetic information from other sources such as claims data or medical records?
  • Are GINA regulations necessary to address employer wellness programs offered outside group health insurance plans?

The proposed GINA rules do not limit the protections offered by other federal laws including HIPAA, the ACA, and the ADA. The proposed GINA rules correspond to the other rules and should give employers assurance that compliance with one set of rules will not cause problems with compliance with the others. The proposed rules do raise a serious question, however, as to whether provision of spousal medical information to a wellness program is "voluntary" when employees can be charged thousands of dollars more for their health coverage if they refuse to provide the information.

2016 Marketplace Coverage

The ASPE report supplements the report that ASPE released on October 28. It offers some of the information, but contains more detail on premiums as well as additional information on plan availability.

The ASPE report covers the 38 states participating in the federally facilitated marketplace (FFM) for 2016, although some of the tables exclude Nevada, Oregon, and Hawaii, which did not participate in the FFM for 2014, and others exclude only Hawaii, which only joined for 2016.

The report states that the national average 2015-2016 increase in the second lowest-cost benchmark silver plan was 7.2 percent. The October 28 report had stated that the average 2015-2016 increase in the second lowest cost silver plan premium was 7.5 percent, but the October 30 report notes that advance premium tax credits (APTC) are actually not necessarily based on the premium of the second lowest-cost silver plan, but rather on the portion of the premium of the second lowest-cost silver plan that is available to a particular consumer that covers the essential health benefits (EHB). Some silver plans apparently cover non EHB services such as adult dental, and in some areas the second lowest-cost premium silver plan may not in fact be the benchmark plan.

Nationally, the average monthly premium for the second lowest-cost silver plan for a 27 year-old before tax credits is $240 for 2016, up from $224 in 2015. Average premiums for 2016 for a 27-year old run from $189 in Arizona to $590 in Alaska. Tax credits average $97 a month for a 27-year old with an income of $25,000 and $464 for a family of four with an income of $464, but range from $486 for the 27 year old and $1,820 for the family in Alaska to $46 for the 27-year old and $278 for the family in Arizona.

As of October 19, 2015, when the report was finalized, there were nearly 240 insurers signed up to participate in the marketplace for 2016, with the totals varying from 1 in Wyoming to 17 in Texas and Ohio. (Insurers have state-specific licenses so multiple insurers owned by the same parent company are counted separately if they are licensed in separate states). On average, there are 6 insurers per state and 3 per county for 2016, the same as in 2015.

As of October 19, 40 insurers had joined the marketplaces for 2016 and 35 had left. Since October 19 a number of insurers (mainly the CO-OPs) have exited the marketplace, but new insurers are scheduled to join the marketplace during the 2016 open enrollment period, so participation remains about what it was for 2015.

During 2016, 88 percent of the population will live in a state with a choice of 3 or more insurers, the level that seems to be necessary for vigorous competition. New entrants also increase competition. Previous ASPE analysis showed that in 42 percent of counties with new entrants, the new insurers offered at least one silver plan with a premium below what would have been the second lowest-cost plan of existing insurers. Experience from 2015, however, shows that lower premiums are not necessarily in the best interests of consumers if they are not sufficient to maintain the solvency of insurers.

Consumers will be able to choose from 50 plans on average in 2016, down from 58 in 2015. The number of available plans per county varies from 13 in Alabama to 88 across the state line in Mississippi. While the national average is down an average of 2 plans per insurer, this may simply indicate that insurers are responding to consumer demand and dropping unpopular plans or plans that are nearly identical to other plans. On average, 19 silver plans per county will be available compared to 22 in 2015.

In 2015, nearly half of consumers selected either the lowest-cost (31 percent) or second lowest-cost (17 percent) plan in their metal level. According to the report, 86 percent of current marketplace enrollees can find a lower premium plan in the same metal level by returning the marketplace to shop. The average consumer who bought a silver plan in 2015 and decides to shop for a better deal in 2016 can save $52 per month, $624 per year.

After applying tax credits, 78 percent of current marketplace enrollees can find a plan for $100 or less per month and 72 percent for $75 or less. After applying credits, 63 percent can find a silver plan for $100 or less and 41 percent for $50 or less. After applying tax credits, 57 percent can find a plan for $75 or less and 66 percent for $100 or less without changing metal level. But only 47 percent of 2015 enrollees will be covered for $100 or less and 36 percent for $75 or less if they do not change plans.

Finally, the report contains a number of tables showing number of insurers and plans and average second lowest-cost plan premiums and average premium tax credit amounts for hypothetical single individuals and families by state and for particular counties.

Along with the ASPE Report, CMS also released the public use files on which it is based. The public use files for 2016 include plan-level data on essential health benefits, coverage limits, and cost sharing; plan level data on maximum out-of-pocket limits, cost sharing, HSA eligibility, formulary ID, and other plan attributes; plan-level data on individual rates; plan-level data on application of rates, such as allowed relationships (spouse, dependents); insurer-level data on service areas; insurer-level data identifying provider network URLs; plan-level data that crosswalks 2016 to 2015 plans; and insurer-level machine-readable plan network and formulary URLs.

2016 Federally Facilitated Marketplace Forms

Finally, 2016 FFM forms and notices are now available, including open enrollment and redetermination notices; eligibility notices; notices requesting additional documentation for citizenship issues and noting the resolution of citizenship issues or the expiration of coverage for failure to resolve these issues; periodic data matching notices sent to individuals enrolled both in marketplace coverage and Medicaid or CHIP; account transfer notices for accounts being transferred between state Medicaid agencies and the marketplace; and the tax form 1095-A cover page.



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Genetic Information Safeguards And Wellness Programs; 2016 Marketplace Coverage

Tim-ACA-slide

Implementing Health Reform (October 29 update). On October 30, 2015, the Equal Employment Opportunity Commission (EEOC) released a proposed rule concerning the application of the Genetic Information Nondiscrimination Act (GINA) to employer wellness programs, together with a fact sheet and a series of questions and answers.

Also on October 30 the Assistant Secretary for Planning and Evaluation (ASPE) released a report on Health Plan Choice and Premiums in the 2016 Health Insurance Marketplace. Accompanying the ASPE report, CMS released the public use files on marketplace plans on which the reports are based.

Finally, the Centers for Medicare and Medicaid Services has released the marketplace eligibility notices they are using for 2016.

Applying GINA To Wellness Programs

GINA is a federal law that protects employees from employment discrimination based on their genetic information. It prohibits covered employers (with 15 or more employees) from using genetic information for making employment decisions. It also forbids employers from requesting, requiring, or purchasing genetic information regarding their employees unless one or more of six narrow exceptions applies. It strictly limits the disclosure by employees of genetic information.

Genetic information includes information about the “manifestations of a disease or disorder in family members of an individual.” Family members obviously include spouses.

One of the exceptions to GINA’s information request prohibition applies when an employee voluntarily accepts health services from the employer, including wellness program services. Employer wellness programs often include not only employers but also their spouses. Current EEOC GINA regulations provide that employees cannot be required to provide genetic information as a condition of receiving incentives from their employer. The question thus arises as when wellness programs may legally offer incentives to obtain current or past health information regarding the spouses of employees. This proposed rule addresses this question.

Wellness programs are currently very popular among employers. According to the recent Kaiser Family Foundation Survey, 72 percent of employers with 5,000 or more employees offer or require employees to complete a health risk assessment while 65 percent have biometric screening programs. When incentives are offered for participation in wellness programs or penalties imposed for nonparticipation, serious issues arise under a number of federal laws, including the Affordable Care Act and the Health Insurance Portability and Affordability Act (HIPAA), which prohibit health status discrimination in the provision of health plan coverage; the Americans with Disabilities Act; and GINA. Wellness program rules under the ACA and HIPPA were published in 2013, while the EEOC proposed rules under the ADA earlier this year.   The proposed GINA rules complete this regulatory effort.

The proposed rule would allow employers to offer limited inducements (financial or in-kind and in the form of rewards or penalties) to obtain information from the spouses of employees covered by the employer’s group medical plan regarding the spouses’ current or past health status, through a medical questionnaire or examination. Provision of spousal information would be considered “voluntary” even though these inducements were offered. Participation would have to be with written authorization.

As required by the wellness program regulations under other laws, the wellness program would have to be reasonably designed to promote health or prevent disease and not be a subterfuge to violate GINA or be highly suspect. To be reasonably designed, a program would have to offer follow-up information and advice in conjunction with health assessments or examinations; not impose overly burdensome time or cost requirements; and not be unreasonably intrusive.

The total inducements offered for participation of an employee and spouse cannot exceed 30 percent of the total annual cost of plan coverage. The maximum inducement that an employer can offer for an employee’s provision of information on himself or herself is 30 percent of the cost of sole-employee coverage. The maximum inducement that an employer can offer for spousal provision of information is 30 percent of the cost of family coverage minus 30 percent of the cost of sole-employee coverage. Wellness programs are not limited by these apportionment rules if the program does not involve health information and otherwise complies with federal requirements. The GINA rules do not limit requests for medical information, on a voluntary basis without inducements, from an employee’s spouse or children in conjunction with the provision of medical treatments.

An employer’s offer of inducements to obtain health status or genetic information on an employee’s children (biological or non-biological) is not permitted. Health information on an employee’s children is much more likely to reveal prohibited genetic information about the employee than health information about the employee’s spouse and is thus more carefully protected. Also inducements cannot be offered in return for spouses providing genetic information other than health status information, including the results of genetic tests and family genetic information.

Employers can ask questions about genetic information, but must clearly state that those questions need not be answered in order to obtain an inducement. Employers cannot use genetic information as the basis for employment decisions. Employers also cannot offer employees an inducement to waive GINA’s confidentiality requirements or permit the sale of their genetic information.

The EEOC requests comments on a number of related issues, including:

  • Should inducements be equally available if employee’s spouses in lieu of providing medical information provide a doctor’s statement that they are under the care of the doctor and all medical risks are being addressed?
  • Should the proposed authorization requirements only apply to wellness programs offering more than de minimis inducements?
  • What safeguards are necessary to avoid wellness programs simply shifting costs to employees or spouses with health conditions?
  • Are additional protections necessary where employers store medical information electronically?
  • Should programs be prohibited from accessing genetic information from other sources such as claims data or medical records?
  • Are GINA regulations necessary to address employer wellness programs offered outside group health insurance plans?

The proposed GINA rules do not limit the protections offered by other federal laws including HIPAA, the ACA, and the ADA. The proposed GINA rules correspond to the other rules and should give employers assurance that compliance with one set of rules will not cause problems with compliance with the others. The proposed rules do raise a serious question, however, as to whether provision of spousal medical information to a wellness program is “voluntary” when employees can be charged thousands of dollars more for their health coverage if they refuse to provide the information.

2016 Marketplace Coverage

The ASPE report supplements the report that ASPE released on October 28. It offers some of the information, but contains more detail on premiums as well as additional information on plan availability.

The ASPE report covers the 38 states participating in the federally facilitated marketplace (FFM) for 2016, although some of the tables exclude Nevada, Oregon, and Hawaii, which did not participate in the FFM for 2014, and others exclude only Hawaii, which only joined for 2016.

The report states that the national average 2015-2016 increase in the second lowest-cost benchmark silver plan was 7.2 percent. The October 28 report had stated that the average 2015-2016 increase in the second lowest cost silver plan premium was 7.5 percent, but the October 30 report notes that advance premium tax credits (APTC) are actually not necessarily based on the premium of the second lowest-cost silver plan, but rather on the portion of the premium of the second lowest-cost silver plan that is available to a particular consumer that covers the essential health benefits (EHB). Some silver plans apparently cover non EHB services such as adult dental, and in some areas the second lowest-cost premium silver plan may not in fact be the benchmark plan.

Nationally, the average monthly premium for the second lowest-cost silver plan for a 27 year-old before tax credits is $240 for 2016, up from $224 in 2015. Average premiums for 2016 for a 27-year old run from $189 in Arizona to $590 in Alaska. Tax credits average $97 a month for a 27-year old with an income of $25,000 and $464 for a family of four with an income of $464, but range from $486 for the 27 year old and $1,820 for the family in Alaska to $46 for the 27-year old and $278 for the family in Arizona.

As of October 19, 2015, when the report was finalized, there were nearly 240 insurers signed up to participate in the marketplace for 2016, with the totals varying from 1 in Wyoming to 17 in Texas and Ohio. (Insurers have state-specific licenses so multiple insurers owned by the same parent company are counted separately if they are licensed in separate states). On average, there are 6 insurers per state and 3 per county for 2016, the same as in 2015.

As of October 19, 40 insurers had joined the marketplaces for 2016 and 35 had left. Since October 19 a number of insurers (mainly the CO-OPs) have exited the marketplace, but new insurers are scheduled to join the marketplace during the 2016 open enrollment period, so participation remains about what it was for 2015.

During 2016, 88 percent of the population will live in a state with a choice of 3 or more insurers, the level that seems to be necessary for vigorous competition. New entrants also increase competition. Previous ASPE analysis showed that in 42 percent of counties with new entrants, the new insurers offered at least one silver plan with a premium below what would have been the second lowest-cost plan of existing insurers. Experience from 2015, however, shows that lower premiums are not necessarily in the best interests of consumers if they are not sufficient to maintain the solvency of insurers.

Consumers will be able to choose from 50 plans on average in 2016, down from 58 in 2015. The number of available plans per county varies from 13 in Alabama to 88 across the state line in Mississippi. While the national average is down an average of 2 plans per insurer, this may simply indicate that insurers are responding to consumer demand and dropping unpopular plans or plans that are nearly identical to other plans. On average, 19 silver plans per county will be available compared to 22 in 2015.

In 2015, nearly half of consumers selected either the lowest-cost (31 percent) or second lowest-cost (17 percent) plan in their metal level. According to the report, 86 percent of current marketplace enrollees can find a lower premium plan in the same metal level by returning the marketplace to shop. The average consumer who bought a silver plan in 2015 and decides to shop for a better deal in 2016 can save $52 per month, $624 per year.

After applying tax credits, 78 percent of current marketplace enrollees can find a plan for $100 or less per month and 72 percent for $75 or less. After applying credits, 63 percent can find a silver plan for $100 or less and 41 percent for $50 or less. After applying tax credits, 57 percent can find a plan for $75 or less and 66 percent for $100 or less without changing metal level. But only 47 percent of 2015 enrollees will be covered for $100 or less and 36 percent for $75 or less if they do not change plans.

Finally, the report contains a number of tables showing number of insurers and plans and average second lowest-cost plan premiums and average premium tax credit amounts for hypothetical single individuals and families by state and for particular counties.

Along with the ASPE Report, CMS also released the public use files on which it is based. The public use files for 2016 include plan-level data on essential health benefits, coverage limits, and cost sharing; plan level data on maximum out-of-pocket limits, cost sharing, HSA eligibility, formulary ID, and other plan attributes; plan-level data on individual rates; plan-level data on application of rates, such as allowed relationships (spouse, dependents); insurer-level data on service areas; insurer-level data identifying provider network URLs; plan-level data that crosswalks 2016 to 2015 plans; and insurer-level machine-readable plan network and formulary URLs.

2016 Federally Facilitated Marketplace Forms

Finally, 2016 FFM forms and notices are now available, including open enrollment and redetermination notices; eligibility notices; notices requesting additional documentation for citizenship issues and noting the resolution of citizenship issues or the expiration of coverage for failure to resolve these issues; periodic data matching notices sent to individuals enrolled both in marketplace coverage and Medicaid or CHIP; account transfer notices for accounts being transferred between state Medicaid agencies and the marketplace; and the tax form 1095-A cover page.



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35 Ways To Make Fudge

35 Ways To Make Fudge

I love fudge. It is one of my favorite desserts and something we make every year during the holidays. Of course, the traditional chocolate recipe is amazing, but there are SO many more fun ways to make fudge. Here are thirty-five to get you started!

fudgecollage

35 Ways To Make Fudge

One of my most faorite recipes is crockpot fudge – so simple!

Perfect for Halloween, try candy corn fudge. via Totally The Bomb

If you're in a hurry, this 3-minute fudge is ready in no time. via Chocolate Chocolate and More

This butter pecan fudge recipe goes great with Thanksgiving dinner! via Growing Up Gabel

Rainbow chip fudge is so festive and is perfect for a birthday. via Betty Crocker

The ultimate fall recipe is this pumpkin spice fudge. via Ebay

If you love s'mores like I do then try this s'mores fudge. So yummy! via Wine and Glue

Buckeye fudge is the perfect combination of chocolate and peanut butter.

If you love eggnog then you'll love this eggnog fudge! via I Heart Naptime

fudgecollage3If you don't have the patience to make a dessert, just try this easy microwave fudge.

If this white red velvet fudge tastes as good as it looks then it might be the best yet! via The Cafe Sucre Farine

Carmel coffee fudge sounds like the perfect fudge recipe. via Inside Bru Crew Life

Cinnamon roll fudge is definitely on my list of things to make. Doesn't that sound delicious? via Oh Bite It

This easy fudge only requires two ingredients to make. via Living On A Dime

If you're a fan of the candy bar then you'll love butterfinger fudge. via Gal On A Mission

My two favorite things combined in fudge – mint oreo fudge! via Spend With Pennies

Snickerdoodle fudge always reminds me of fall. via I Heart Naptime

Yum! Cookie dough fudge is the best. via Lil' Luna

White chocolate cranberry fudge would be great during the holidays. via Mom On Timeout

Here is another mint fudge recipe! via Grab Your Spork

christmasfudge

White chocolate peppermint fudge is perfect for Christmas! via Love Bakes Good Cakes

Try gingerbread fudge this holiday season! via Sweet 2 Eat Baking

Vanilla bean fudge is easy and tastes so good! via Something Swanky

I will definitely be making cookie cutter fudge this Christmas. via Betty Crocker

My kids would have a blast making this festive candy cane fudge, via Sally's Baking Addiction

This strawberry swirl fudge would be perfect for a girly baby shower or birthday. via Shugary Sweets

Keep it simple with this classic peanut butter fudge – it never disappoints! via Cincy Shopper

My son loves pistachio ice cream so I'm betting he would love this pistachio fudge. via Chocolate Chocolate and More

fudgecollage4

Turtle fudge is carmelly sweet and so good. via Chef In Training

Key lime pie fudge is one of my all time favorites. via Love Bakes Good Cakes

Neopolitan fudge would be great for a birthday treat. via I Am Baker

Banana cream fudge sounds delicious! via Inside Bru Crew Life

Rocky road fudge is full of marshmallows which makes me love it! via Mom On Timeout

My kids would go crazy for cotton candy fudge. via Smart School House

Sounds weird but I'll bet bubblegum fudge is great! via The Domestic Rebel

The post 35 Ways To Make Fudge appeared first on Kids Activities Blog.



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35 Ways To Make Fudge

35 Ways To Make Fudge

I love fudge. It is one of my favorite desserts and something we make every year during the holidays. Of course, the traditional chocolate recipe is amazing, but there are SO many more fun ways to make fudge. Here are thirty-five to get you started!

fudgecollage

35 Ways To Make Fudge

One of my most faorite recipes is crockpot fudge – so simple!

Perfect for Halloween, try candy corn fudge. via Totally The Bomb

If you’re in a hurry, this 3-minute fudge is ready in no time. via Chocolate Chocolate and More

This butter pecan fudge recipe goes great with Thanksgiving dinner! via Growing Up Gabel

Rainbow chip fudge is so festive and is perfect for a birthday. via Betty Crocker

The ultimate fall recipe is this pumpkin spice fudge. via Ebay

If you love s’mores like I do then try this s’mores fudge. So yummy! via Wine and Glue

Buckeye fudge is the perfect combination of chocolate and peanut butter.

If you love eggnog then you’ll love this eggnog fudge! via I Heart Naptime

fudgecollage3If you don’t have the patience to make a dessert, just try this easy microwave fudge.

If this white red velvet fudge tastes as good as it looks then it might be the best yet! via The Cafe Sucre Farine

Carmel coffee fudge sounds like the perfect fudge recipe. via Inside Bru Crew Life

Cinnamon roll fudge is definitely on my list of things to make. Doesn’t that sound delicious? via Oh Bite It

This easy fudge only requires two ingredients to make. via Living On A Dime

If you’re a fan of the candy bar then you’ll love butterfinger fudge. via Gal On A Mission

My two favorite things combined in fudge – mint oreo fudge! via Spend With Pennies

Snickerdoodle fudge always reminds me of fall. via I Heart Naptime

Yum! Cookie dough fudge is the best. via Lil’ Luna

White chocolate cranberry fudge would be great during the holidays. via Mom On Timeout

Here is another mint fudge recipe! via Grab Your Spork

christmasfudge

White chocolate peppermint fudge is perfect for Christmas! via Love Bakes Good Cakes

Try gingerbread fudge this holiday season! via Sweet 2 Eat Baking

Vanilla bean fudge is easy and tastes so good! via Something Swanky

I will definitely be making cookie cutter fudge this Christmas. via Betty Crocker

My kids would have a blast making this festive candy cane fudge, via Sally’s Baking Addiction

This strawberry swirl fudge would be perfect for a girly baby shower or birthday. via Shugary Sweets

Keep it simple with this classic peanut butter fudge – it never disappoints! via Cincy Shopper

My son loves pistachio ice cream so I’m betting he would love this pistachio fudge. via Chocolate Chocolate and More

fudgecollage4

Turtle fudge is carmelly sweet and so good. via Chef In Training

Key lime pie fudge is one of my all time favorites. via Love Bakes Good Cakes

Neopolitan fudge would be great for a birthday treat. via I Am Baker

Banana cream fudge sounds delicious! via Inside Bru Crew Life

Rocky road fudge is full of marshmallows which makes me love it! via Mom On Timeout

My kids would go crazy for cotton candy fudge. via Smart School House

Sounds weird but I’ll bet bubblegum fudge is great! via The Domestic Rebel

The post 35 Ways To Make Fudge appeared first on Kids Activities Blog.



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Epic at West – The Newest Condo Development to Hit Olympic Village

Southeast False Creek, or Olympic Village, is one of the hottest places to live in all of Vancouver for a number of reasons. It is true that part of the attraction lies in its proximity to the Seawall and the Canada Skytrain Line. It is also true, however, that residents rarely have to — or want to — leave the neighborhood, as it has a hip restaurants, popular pubs, an Urban Fair, a liquor store, a community centre, and more right there.

Epic at West is the final installment of Executive Group's very successful 3-phase West collection in Southeast False Creek. And if the history of this project tells us anything, it is that these units will not last long!

The post Epic at West – The Newest Condo Development to Hit Olympic Village appeared first on Vancouver New Condos.



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Epic at West – The Newest Condo Development to Hit Olympic Village

Southeast False Creek, or Olympic Village, is one of the hottest places to live in all of Vancouver for a number of reasons. It is true that part of the attraction lies in its proximity to the Seawall and the Canada Skytrain Line. It is also true, however, that residents rarely have to — or want to — leave the neighborhood, as it has a hip restaurants, popular pubs, an Urban Fair, a liquor store, a community centre, and more right there.

Epic at West is the final installment of Executive Group’s very successful 3-phase West collection in Southeast False Creek. And if the history of this project tells us anything, it is that these units will not last long!

The post Epic at West – The Newest Condo Development to Hit Olympic Village appeared first on Vancouver New Condos.



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902 Davie – Downtown Micro-Condo Living

902 Davie Vancouver New Condos (8) 902 Davie Vancouver New Condos (6) 902 Davie Vancouver New Condos (2)

The price of real estate is a constant topic of conversation in Vancouver and Reliance Properties is set to make a splash by offering a project that will enable many first-time home buyers and would-be investors to get into the downtown market.

The 'Micro-Condos' of 902 Davie offer plans that use space in innovative ways, with murphy beds, desks that turn into dining tables, and other tricks of the trade that have been taken from other markets where 'micro-condos' are already popular for those willing to trade space for the convenience of downtown living.

The post 902 Davie – Downtown Micro-Condo Living appeared first on Vancouver New Condos.



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902 Davie – Downtown Micro-Condo Living

902 Davie Vancouver New Condos (8) 902 Davie Vancouver New Condos (6) 902 Davie Vancouver New Condos (2)

The price of real estate is a constant topic of conversation in Vancouver and Reliance Properties is set to make a splash by offering a project that will enable many first-time home buyers and would-be investors to get into the downtown market.

The ‘Micro-Condos’ of 902 Davie offer plans that use space in innovative ways, with murphy beds, desks that turn into dining tables, and other tricks of the trade that have been taken from other markets where ‘micro-condos’ are already popular for those willing to trade space for the convenience of downtown living.

The post 902 Davie – Downtown Micro-Condo Living appeared first on Vancouver New Condos.



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Seylynn Village – Compass

Seylynn Village is North Vancouver newest community. Over the next 10 years will develop into an electric walkable community close to everything you need.

Compass is the second release of 3 towers to be build by Deanna homes in their Seylynn Village Development, the first "Beacon" is now completed and move in ready, (contact us today for final inventory).

Beacon will be a 28 storey tower featuring Townhomes on the podium, with condos above. The higher floors will have some amazing views of the city, mountains and water.

Some of the best features of Beacon are:

  • Triple Glazed Windows
  • Gourmet Kitchens featuring Quartz Countertops, Grohe Faucets, soft close cabinetry
  • Spa inspired Washrooms
  • Individual bike lockers (that means you don't have to have your bike locked up to another bike!!)
  • Fully equipped bike repair shop
  • Three high-speed elevators
  • Gym
  • Meeting/Entertainment rooms

Also with Compass, Denna Homes will be building their clubhouse called "Denna Club" which will be a 14,000 sq.ft leisure facility with a fully equipped fitness centre, 25 metre pool, spa, yoga room, lounge and hot tub!

For more information on this project, don't hesitate to sign up for more information or Call Anthony Riglietti today at 604-813-4686 to answer any of your questions

The post Seylynn Village – Compass appeared first on Vancouver New Condos.



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Seylynn Village – Compass

Seylynn Village is North Vancouver newest community. Over the next 10 years will develop into an electric walkable community close to everything you need.

Compass is the second release of 3 towers to be build by Deanna homes in their Seylynn Village Development, the first “Beacon” is now completed and move in ready, (contact us today for final inventory).

Beacon will be a 28 storey tower featuring Townhomes on the podium, with condos above. The higher floors will have some amazing views of the city, mountains and water.

Some of the best features of Beacon are:

  • Triple Glazed Windows
  • Gourmet Kitchens featuring Quartz Countertops, Grohe Faucets, soft close cabinetry
  • Spa inspired Washrooms
  • Individual bike lockers (that means you don’t have to have your bike locked up to another bike!!)
  • Fully equipped bike repair shop
  • Three high-speed elevators
  • Gym
  • Meeting/Entertainment rooms

Also with Compass, Denna Homes will be building their clubhouse called “Denna Club” which will be a 14,000 sq.ft leisure facility with a fully equipped fitness centre, 25 metre pool, spa, yoga room, lounge and hot tub!

For more information on this project, don’t hesitate to sign up for more information or Call Anthony Riglietti today at 604-813-4686 to answer any of your questions

The post Seylynn Village – Compass appeared first on Vancouver New Condos.



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{Colorful} Egg & Chalk Paint Recipe

Egg Yolk and Chalk Paint

As a family that does LOTS of kids activities and crafts, we have LOTS of leftover supplies, remnants of previous projects.  After numerous games of sidewalk twister and our giant outdoor game board, it's time.  Today we are cleaning out our sidewalk chalk bucket.

Make Paint with Egg Yolks and Chalk

Chalk + Egg = Paint – the same type of paint that Michelangelo used to paint the Sistine Chapel – my kids are making masterpieces!

Grab the chalk bits and pieces from your bin.  I went through our collection of chalk pastels and added some of the smaller pieces from there as well.  Soak your chalk bits in water.  Be sure to keep the colors separated in the water, or the colors will get "grey".  We used a muffin tin – it was a great place to sort, soak, mix and paint from!  Soak the chalk for 15 minuets or so, or until slightly "mushy". The cheaper "dollar" chalk tends to become a smoother paint consistency – but the colors are not as bright as the name brand chalks. Chalk Pastels make the most brilliant paints!!

Use a hammer and gently pound the chalk until it is a powdery paste. You can also just "mush" the chalk stick if it has soaked long enough – that's my kids favorite way to make chalk paint. We break our chalk up on our patio and just hose it off when we are done. If you do not have access to a patio, you can use a zippered plastic bag to contain the mess and crush wherever.

Egg Yolk and Chalk Paint
Once you have the powdered chalk, add an egg yolk.  This is a DO NOT EAT paint as it contains raw-egg.  Be sure to only use this paint with kids who won't put their hands/brushes in their mouths.  If you are still concerned about the "raw egg" bit – you can flash pasteurize the eggs to bacteria.

Separate the egg yolk from the egg white, and add the yolk to the powder until it is a paint-able consistency.  The egg provides a jewel-like finish when the paint dries.

egg tempera paint recipe - so much fun

We used our paint to create Kandinsky-like circles.  Aren't they just brilliant!  I think this is one of my favorite "big-kid" paint recipes.

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More Kids Painting Activities:

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recipes for play
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*This post was originally featured as a guest post by us on the site, Inner Child Fun.*

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