Substance Use Recovery ↔ relates to ↔ Vision Optical

ce of British Columbia. Idaho's state capital and largest city is Boise. With an area of 83,569 square miles (216,440 km2), Idaho is the 14th-largest state by land area. The state has a population of approximately two million people; it ranks as the 13th-least populous and the seventh-least densely populated of the 50 U.S. states. For thousands of years, and prior to European colonization, Idaho had been inhabited by natives. In the early 19th century, Idaho was considered part of the Oregon Country, an area which was disputed between the U.S. and the British Empire. Idaho officially became a U.S. territory with the signing of the Oregon Treaty of 1846, but a separate Idaho Territory was not organized until 1863, instead being included for periods in Oregon Territory and Washington Territory. The state was eventually admitted to the Union on July 3, 1890, becoming the 43rd state. Forming part of the Pacific Northwest (and the associated Cascadia bioregion), Idaho is divided into several distinct geographic and climatic regions. The state's north, the relatively isolated Idaho Panhandle, is closely linked with Eastern Washington, with which it shares the Pacific Time Zone—the rest of the state uses the Mountain Time Zone. The state's south includes the Snake River Plain (which has most of the population and agricultural land), and the southeast incorporates part of the Great Basin. Idaho is quite mountainous and contains several stretches of the Rocky Mountains. The United States Forest Service holds about 38% of Idaho's land, the highest proportion of any state. Industries significant for the state economy include manufacturing, agriculture, mining, forestry, science and technology, and tourism. Idaho has been a predominantly Republican state since statehood, with the Republican Party dominating in both state and national elections; abortion is severely restricted and the state retains the death penalty, including methods like the firing squad. The state contains the Idaho National Laboratory. Idaho's agricultural sector supplies many products, but the state is best known for its potato crop, which comprises around one-third of the nationwide yield.

Idaho's highest point is Borah Peak, 12,662 ft (3,859 m), in the Lost River Range north of Mackay. Idaho's lowest point, 710 ft (216 m), is in Lewiston, where the Clearwater River joins the Snake River and continues into Washington. The Sawtooth Range is often considered Idaho's most famous mountain range. Other mountain ranges in Idaho include the Bitterroot Range, the White Cloud Mountains, the Lost River Range, the Clearwater Mountains, and the Salmon River Mountains. Salmon-Challis National Forest is located in the east central sections of the state, with Salmon National Forest to the north and Challis National Forest to the south. The forest is in an area known as the Idaho Cobalt Belt, which consists of a 34 miles (55 km) long geological formation of sedimentary rock that contains some of the largest cobalt deposits in the U.S. Idaho has two time zones, with the dividing line approximately midway between Canada and Nevada. Southern Idaho, including the Boise metropolitan area, Idaho Falls, Pocatello, and Twin Falls, are in the Mountain Time Zone. A legislative error (15 U.S.C. ch. 6 §264) theoretically placed this region in the Central Time Zone, but this was corrected with a 2007 amendment.

g methods like the firing squad. The state contains the Idaho National Laboratory. Idaho's agricultural sector supplies many products, but the state is best known for its potato crop, which comprises around one-third of the nationwide yield. Its official state nickname is the "Gem State". Etymology In the early 1860s, when the U.S. Congress was considering organizing a new territory around Pikes Peak in the Rocky Mountains, the name "Idaho" was popular among the Congressional committee, as they believed it to be derived from a Shoshone term meaning "gem of the mountains." Realizing in January 1861 the name was quite possibly a fabrication and not Native American at all, the U.S. Congress ultimately decided to name the area Colorado Territory when it was created. But, by the time this decision was made in February 1861, the town of Idaho Springs, Colorado had already been named after their early frontrunner for a name, Idaho. In 1863, the Territory of Idaho was formed, though “Montana” was nearly its name. More than a decade after the name Idaho was first discussed for the eventual Colorado Territory, George M. Willing, a politician, claimed that he had been inspired by a little girl named Ida and that he coined the name in Washington at the time of the Congressional committee when he had been posing as an elected delegate to Congress. The same year Congress created Colorado Territory, a county called Idaho County was created in eastern Washington Territory. The county was named after a steamship named Idaho, which was launched on the Columbia River in 1860. It is unclear whether the steamship was named before or after the legitimacy of the Native American origins of “Idaho” came into question. Regardless, part of Washington Territory, including Idaho County, was used to create Idaho Territory in 1863. Idaho Territory would later change its boundaries to the area that became the U.S.

ther information networks and exchanges. EHRs may include a range of data, including demographics, medical history, medication and allergies, immunization status, laboratory test results, radiology images, vital signs, personal statistics like age and weight, and billing information. For several decades, EHRs have been touted as key to increasing quality of care. EHR combines all patients' demographics into a large pool, which assists providers in the creation of "new treatments or innovation in healthcare delivery" to improve quality outcomes in healthcare. Combining multiple types of clinical data within electronic health records has enabled clinicians to identify and stratify patients with chronic conditions. EHR systems may also support improvements in quality of care through the use of data and analytics to help prevent hospitalizations among high-risk patients. EHR systems are designed to store data accurately and to capture a patient's state across time. It eliminates the need to track down a patient's previous paper medical records and assists in ensuring data is up-to-date, accurate, and legible. It also allows open communication between the patient and the provider while providing "privacy and security." EHR is cost-efficient, decreases the risk of lost paperwork, and can reduce risk of data replication as there is only one modifiable file, which means the file is more likely up to date. Due to the digital information being searchable and in a single file, EMRs (electronic medical records) are more effective when extracting medical data to examine possible trends and long-term changes in a patient.

Terminology The terms electronic health record (EHR), electronic patient record (EPR), and electronic medical record (EMR) have often been used interchangeably, but "subtle" differences exist. The EHR is a more longitudinal collection of the electronic health information of individual patients or populations. The EMR, in contrast, is the patient record created by providers for specific encounters in hospitals and ambulatory environments and can serve as a data source for an EHR. EMRs are essentially digital versions of the paper documents used in a clinician's office, typically functioning as an internal system within a practice. An EMR includes the medical and treatment history of patients treated by that specific practice. In contrast, a personal health record (PHR) is an electronic application for recording individual medical data that the individual patient controls and may make available to health providers. Comparison with paper-based records While there is ongoing debate regarding the advantages of electronic health records compared with paper records, the research literature presents a more nuanced view of their benefits and limitations. Increasing discontent and burnout among healthcare professionals is well documented as of 2023, with several studies finding that a leading cause of job frustration and increasing stress for most doctors and nurses is the increasing burden of increasingly complex record-keeping, paperwork, and administrative workloads.. Proponents of EHR note that these systems can substantially reduce such burdens, for example cutting time spent on insurance eligibility tasks by more than 80%. But along with increased convenience, transparency, portability, and accessibility, there is also an increased risk that sensitive information may be accessed by unauthorized persons or unscrupulous users (versus paper medical records). This is acknowledged by the increased security requirements for electronic medical records included in the Health Insurance Portability and Accountability Act (HIPAA) and by large-scale breaches in confidential records reported by EMR users. Meanwhile, handwritten paper medical records may be poorly legible, which can contribute to medical errors. Pre-printed forms, standardization of abbreviations, and standards for penmanship were encouraged to improve the reliability of paper medical records. An example of possible medical errors is the administration of medication. Medication is an intervention that can turn a person's status from stable to unstable very quickly. With paper documentation it is very easy to not properly document the administration of medication, the time given, or errors such as giving the "wrong drug, dose, form, or not checking for allergies," and could affect the patient negatively. It has been reported that these errors have been reduced by "55-83%" because records are now online and require specific steps to avoid these errors. Electronic records may help with the standardization of forms, terminology, and data input. Digitization of forms facilitates the collection of data for epidemiology and clinical studies. However, standardization may create challenges for local practice. Overall, those with EMRs that have automated notes and records, order entry, and clinical decision support had fewer complications, lower mortality rates, and lower costs. EMRs can be continuously updated (within certain legal limitations: see below). If the ability to exchange records between different EMR systems were perfected ("interoperability"), it would facilitate the coordination of health care delivery in non-affiliated health care facilities. In addition, data from an electronic system can be used anonymously for statistical reporting in matters such as quality improvement, resource management, and public health communicable disease surveillance.

Comparison with paper-based records While there is ongoing debate regarding the advantages of electronic health records compared with paper records, the research literature presents a more nuanced view of their benefits and limitations. Increasing discontent and burnout among healthcare professionals is well documented as of 2023, with several studies finding that a leading cause of job frustration and increasing stress for most doctors and nurses is the increasing burden of increasingly complex record-keeping, paperwork, and administrative workloads.. Proponents of EHR note that these systems can substantially reduce such burdens, for example cutting time spent on insurance eligibility tasks by more than 80%. But along with increased convenience, transparency, portability, and accessibility, there is also an increased risk that sensitive information may be accessed by unauthorized persons or unscrupulous users (versus paper medical records). This is acknowledged by the increased security requirements for electronic medical records included in the Health Insurance Portability and Accountability Act (HIPAA) and by large-scale breaches in confidential records reported by EMR users. Meanwhile, handwritten paper medical records may be poorly legible, which can contribute to medical errors. Pre-printed forms, standardization of abbreviations, and standards for penmanship were encouraged to improve the reliability of paper medical records. An example of possible medical errors is the administration of medication. Medication is an intervention that can turn a person's status from stable to unstable very quickly. With paper documentation it is very easy to not properly document the administration of medication, the time given, or errors such as giving the "wrong drug, dose, form, or not checking for allergies," and could affect the patient negatively. It has been reported that these errors have been reduced by "55-83%" because records are now online and require specific steps to avoid these errors. Electronic records may help with the standardization of forms, terminology, and data input. Digitization of forms facilitates the collection of data for epidemiology and clinical studies. However, standardization may create challenges for local practice. Overall, those with EMRs that have automated notes and records, order entry, and clinical decision support had fewer complications, lower mortality rates, and lower costs. EMRs can be continuously updated (within certain legal limitations: see below). If the ability to exchange records between different EMR systems were perfected ("interoperability"), it would facilitate the coordination of health care delivery in non-affiliated health care facilities. In addition, data from an electronic system can be used anonymously for statistical reporting in matters such as quality improvement, resource management, and public health communicable disease surveillance.

Medicaid is the largest source of funding for medical and health-related services for people with low income in the United States, providing taxpayer-funded health insurance to 85 million low-income and disabled people as of 2022; in 2019, the program paid for half of all U.S. births. In 2023, the total (federal and state) annual cost of Medicaid was $870 billion, with an average cost per enrollee of $7,600 for 2021. 37% of enrollees were children, but they only accounted for 15% of the spending, ($3,000 per person) while seniors and disabled persons accounted for 21% of enrollees and 52% of spending (more than $18,000 per person). In general, Medicaid recipients must be U.S. citizens or qualified non-citizens, and may include low-income adults, their children, and people with certain disabilities. Medicaid also covers long-term services and supports, including both nursing home care and home- and community-based services, for those with low incomes and minimal assets. Of the 7.7 million Americans who used long-term services and supports in 2020, about 5.6 million were covered by Medicaid. Along with Medicare, Tricare, ChampVA, and CHIP, Medicaid is one of the several Federal Government-sponsored medical insurance programs in the United States. Medicaid covers healthcare costs for people with low incomes; Medicare is a universal program providing health coverage for the elderly; and the CHIP program covers uninsured children in families with incomes that are too high to be covered by Medicaid. Medicaid offers elder care benefits not normally covered by Medicare, including nursing home care and personal care services. There are also dual health plans for people who have both Medicaid and Medicare. Research shows that existence of the Medicaid program improves health outcomes, health insurance coverage, access to health care, and recipients' financial security and provides economic benefits to states and health providers.

2025 Medicaid cuts in the second Trump administration In 2025, Republican Congressional leaders John Thune and Mike Johnson announced goals of cutting 1.5 to 2 trillion dollars of the US federal budget, with President Donald Trump stating that cuts to Medicaid would only include "abuse or waste". The 2025 budget resolution, which was passed by the House of Representatives with only Republicans votes, proposed cutting $880 billion from the Standing Committee for Energy and Commerce, which includes many areas, such as Medicaid and Medicare. On July 4, 2025, President Donald Trump signed the One Big Beautiful Bill Act, intended in part to implement this resolution. The act cut Medicaid in a number of ways: while it did not repeal the ACA's Medicaid expansion, it mandated work requirements for able-bodied Medicaid recipients. It also requires Medicaid recipients above the federal poverty line to pay more fees for coverage; adds new verification requirements; increases the number of times states need to check the eligibility of their Medicaid expansion recipients; prohibits Medicaid from funding nonprofits that provide abortion care; makes it harder for illegal immigrants to use Medicaid; bans pharmacy benefit managers from using spread pricing; and puts limits on so-called "provider taxes" that states impose on healthcare providers to fund their portion of Medicaid spending. The non-partisan Congressional Budget Office (CBO) estimated that it will reduce the number of people on Medicaid by several million.; the CBO estimates that the work requirements in particular will lead 11 million to lose their Medicaid coverage, many of whom already work or qualify for exemptions but will not be able to get through the red tape. The bill prompted claims that undocumented immigrants are on Medicaid. Undocumented immigrants are already ineligible for full Medicaid benefits, and many undocumented immigrants access state-funded health programs rather than federal Medicaid. According to a CBO analysis, the bill's provisions could lead some states to cut back those state-funded health programs, potentially causing an estimated 1.4 million people to lose state-level health coverage, including undocumented immigrants. When commenting on the Trump administration's One Big Beautiful Bill Act and the impact of the Medicaid provisions on the economy, USDA Secretary Brooke Rollins stated that 34 million able-bodied adults on Medicaid should be working.

Arizona: AHCCCS California: Medi-Cal Connecticut: HUSKY D Illinois: HealthChoice Illinois Iowa: Hawk-i Healthy and Well-Kids in Iowa Maine: MaineCare Massachusetts: MassHealth New Jersey: NJ FamilyCare Oregon: Oregon Health Plan Oklahoma: Soonercare Tennessee: TennCare Washington: Washington Apple Health Wisconsin: BadgerCare As of January 2012, Medicaid and/or CHIP funds could be obtained to help pay employer health care premiums in Alabama, Alaska, Arizona, Colorado, Florida, and Georgia. Differences by state While states have significant autonomy in implementing the Medicaid program, their flexibility is bounded by federal requirements designed to ensure a baseline of coverage and access. For example, federal law mandates that certain services, such as inpatient and outpatient hospital services, laboratory and X-ray services, and physician services, must be covered by all state Medicaid programs. Additionally, states must adhere to federal guidelines regarding beneficiary protections and quality standards.

t an intervening health care provider." When rural settings, lack of transport, a lack of mobility, conditions due to outbreaks, epidemics or pandemics, decreased funding, or a lack of staff restrict access to care, telemedicine may bridge the gap and can even improve retention in treatment as well as provide distance-learning; meetings, supervision, and presentations between practitioners; online information and health data management and healthcare system integration.

gration. EHealth encompasses a wide range of applications, including but not limited to the following: Two clinicians discussing a case via video conference; Robotic surgery performed through remote access; Physical therapy conducted using digital monitoring instruments, live feed, and application combinations; Diagnostic tests transferred between facilities for interpretation by a higher specialist; Home monitoring through continuous transmission of patient health data; Online consultations between patients and practitioners; Video remote interpretation services for clinical visits.

Telehealth versus telemedicine Telehealth is sometimes discussed interchangeably with telemedicine, the latter being more common than the former. Telehealth has been described as a disruptive innovation in healthcare because it enables medical services to be delivered remotely using communication technologies. The Health Resources and Services Administration distinguishes telehealth from telemedicine in its scope, defining telemedicine only as describing remote clinical services, such as diagnosis and monitoring, while telehealth includes preventative, promotive, and curative care delivery. This includes the above-mentioned non-clinical applications, like administration and provider education. The United States Department of Health and Human Services states that the term telehealth includes "non-clinical services, such as provider training, administrative meetings, and continuing medical education", and that the term telemedicine means "remote clinical services". The World Health Organization uses telemedicine to describe all aspects of health care including preventive care. The American Telemedicine Association uses the terms telemedicine and telehealth interchangeably, although it acknowledges that telehealth is sometimes used more broadly for remote health not involving active clinical treatments. eHealth is another related term, used particularly in the U.K. and Europe, as an umbrella term that includes telehealth, electronic medical records, and other components of health information technology. Methods and modalities Telehealth requires good Internet access by participants, usually in the form of a strong, reliable broadband connection, and broadband mobile communication technology of at least the fourth generation (4G) or long-term evolution (LTE) standard to overcome issues with video stability and bandwidth restrictions. As broadband infrastructure has improved, telehealth usage has become more widely feasible. Healthcare providers often begin telehealth with a needs assessment which assesses hardships that can be improved by telehealth such as travel time, costs or time off work. Collaborators such as technology companies can ease the transition. Delivery can come within four distinct domains: live video (synchronous), store-and-forward (asynchronous), remote patient monitoring, and mobile health. Audio-based telemedicine, primarily through telephone consultations, has been studied as a tool for managing chronic conditions.

The Food and Drug Administration (FDA) is a federal agency of the United States Department of Health and Human Services (HHS). The FDA is responsible for protecting and promoting public health through the control and supervision of food safety, tobacco products, caffeine products, dietary supplements, prescription and over-the-counter pharmaceutical drugs (medications), vaccines, biopharmaceuticals, blood transfusions, medical devices, electromagnetic radiation emitting devices (ERED), cosmetics, animal foods & feed, and veterinary products. The FDA's primary focus is enforcing the Federal Food, Drug, and Cosmetic Act (FD&C). However, the agency also enforces other laws, notably Section 361 of the Public Health Service Act as well as associated regulations. Much of this regulatory-enforcement work is not directly related to food or drugs but involves other regulated products like lasers, cellular phones, and condoms. In addition, the FDA uses its authority to mitigate diseases in a variety of contexts, from household pets to human sperm for use in assisted reproduction. The FDA is led by the commissioner of food and drugs, who is appointed by the president with the advice and consent of the Senate. The commissioner reports to the secretary of health and human services. Marty Makary is the current commissioner. The FDA's headquarters is located in the White Oak area of Silver Spring, Maryland, occupying the former Naval Ordnance Laboratory. The agency has 223 field offices and 13 laboratories located across the 50 states, the United States Virgin Islands, and Puerto Rico. In 2008, the FDA began to post employees to foreign countries, including China, India, Costa Rica, Chile, Belgium, and the United Kingdom.

White Oak Federal Research Center Since 1990, the FDA has had employees and facilities on 130 acres (53 hectares) of the White Oak Federal Research Center in the White Oak area of Silver Spring, Maryland. In 2001, the General Services Administration (GSA) began new construction on the campus to consolidate the FDA's 25 existing operations in the Washington metropolitan area, its headquarters in Rockville, and several fragmented office buildings. The first building, the Life Sciences Laboratory, was dedicated and opened with 104 employees in December 2003. As of December 2018, the FDA campus has a population of 10,987 employees housed in approximately 3,800,000 square feet (350,000 square metres) of space, divided into ten offices and four laboratory buildings. The campus houses the Office of the Commissioner (OC), the Office of Regulatory Affairs (ORA), the Center for Drug Evaluation and Research (CDER), the Center for Devices and Radiological Health (CDRH), the Center for Biologics Evaluation and Research (CBER) and offices for the Center for Veterinary Medicine (CVM). With the passing of the FDA Reauthorization Act of 2017, the FDA projects a 64% increase in employees to 18,000 over the next 15 years and wants to add approximately 1,600,000 square feet (150,000 square metres) of office and special use space to their existing facilities.

Regulations The programs for safety regulation vary widely by the type of product, its potential risks, and the regulatory powers granted to the agency. For example, the FDA regulates almost every facet of prescription drugs, including testing, manufacturing, labeling, advertising, marketing, efficacy, and safety—yet FDA regulation of cosmetics focuses primarily on labeling and safety. The FDA regulates most products with a set of published standards enforced by a modest number of facility inspections. Inspection observations are documented on Form 483. In June 2018, the FDA released a statement regarding new guidelines to help food and drug manufacturers "implement protections against potential attacks on the U.S. food supply". One of the guidelines includes the Intentional Adulteration (IA) rule, which requires strategies and procedures by the food industry to reduce the risk of compromise in facilities and processes that are significantly vulnerable. The FDA also uses tactics of regulatory shaming, mainly through online publication of non-compliance, warning letters, and "shaming lists." Regulation by shaming harnesses firms' sensitivity to reputational damage. For example, in 2018, the agency published an online "black list", in which it named dozens of branded drug companies that are supposedly using unlawful or unethical means to attempt to impede competition from generic drug companies. The FDA frequently works with other federal agencies, including the Department of Agriculture, the Drug Enforcement Administration, Customs and Border Protection, and the Consumer Product Safety Commission.

ern Oregon to Boise, and is the most populated area in Idaho. Historically, the valley had been known as the Lower Snake River Valley or the Boise River Valley. Pete Olesen, president of the valley's association of local Chambers of Commerce, coined the name "Treasure Valley" in 1959 to reflect the treasure chest of resources and opportunities that the region offered. The valley has a very diverse terrain, from sage flatlands, to mesas, agricultural areas, and urbanized areas.

The Treasure Valley is a valley in the western United States, primarily in southwestern Idaho, where the Payette, Boise, Weiser, Malheur, and Owyhee rivers drain into the Snake River. It includes all the lowland areas from Vale in rural eastern Oregon to Boise, and is the most populated area in Idaho. Historically, the valley had been known as the Lower Snake River Valley or the Boise River Valley. Pete Olesen, president of the valley's association of local Chambers of Commerce, coined the name "Treasure Valley" in 1959 to reflect the treasure chest of resources and opportunities that the region offered. The valley has a very diverse terrain, from sage flatlands, to mesas, agricultural areas, and urbanized areas.

eflect the treasure chest of resources and opportunities that the region offered. The valley has a very diverse terrain, from sage flatlands, to mesas, agricultural areas, and urbanized areas. As the Boise Metropolitan Area grows, more and more undeveloped and agricultural land is being urbanized. History Settling the region The tribes that roamed the area, specifically, were the Northern Paiute and Shoshone. In 1834, Thomas McKay built the original Fort Boise, in the area near present-day Parma, which was run for a time by Francois Payette. It later was moved because of flooding troubles and was abandoned in 1854. The Oregon Trail runs through the Treasure Valley. The valley was settled for the most part by ranchers and farmers, initially to supply the gold and silver mining communities in the higher elevations nearby: Idaho City in the Boise Basin and Silver City in the Owyhees. A new Fort Boise was constructed by the U.S. Army in 1863 in present-day Boise, from which the city grew.

ot employees of a covered entity. The act consists of five titles: Title I protects health insurance coverage for workers and their families if they change or lose their jobs. Title II, known as the Administrative Simplification (AS) provisions, requires the establishment of national standards for electronic health care transactions and national identifiers for providers, health insurance plans, and employers. Title III sets guidelines for pre-tax medical spending accounts. Title IV sets guidelines for group health plans. Title V governs company-owned life insurance policies.

Title I: Health Care Access, Portability, and Renewability Title I of HIPAA regulates the availability and breadth of group health plans and certain individual health insurance policies. It amended the Employee Retirement Income Security Act, the Public Health Service Act, and the Internal Revenue Code. Title I also addresses the issue of "job lock," where employees remain in a job to avoid losing health coverage. To combat the job lock issue, the Title protects health insurance coverage for workers and their families if they lose or change their jobs. Title I requires the coverage of and limits restrictions that a group health plan can place on benefits for preexisting conditions. Group health plans may refuse to provide benefits in relation to preexisting conditions for either 12 months following enrollment in the plan or 18 months in the case of late enrollment. Title I allows individuals to reduce the exclusion period by the amount of time they have had "creditable coverage" before enrolling in the plan and after any "significant breaks" in coverage. "Creditable coverage" includes nearly all group and individual health plans, Medicare, and Medicaid. A "significant break" in coverage is defined as any 63-day period without any creditable coverage. Along with an exception, it allows employers to tie premiums or co-payments to tobacco use or body mass index (BMI). Title I mandates that insurance providers issue policies without exclusions to individuals leaving group health plans, provided they have maintained continuous, creditable coverage (see above) exceeding 18 months, and renew individual policies for as long as they are offered or provide alternatives to discontinued plans for as long as the insurer stays in the market without exclusion regardless of health condition. Some health care plans are exempted from Title I requirements, such as long-term health plans and limited-scope plans like dental or vision plans offered separately from the general health plan. However, if such benefits are part of the general health plan, then HIPAA still applies to such benefits. For example, if the new plan offers dental benefits, then creditable continuous coverage under the old health plan must be counted towards any of its exclusion periods for dental benefits. An alternate method of calculating creditable continuous coverage is available to the health plan under Title I. 5 categories of health coverage can be considered separately, including dental and vision coverage. Anything not under those 5 categories must use the general calculation (e.g., the beneficiary may be counted with 18 months of general coverage but only 6 months of dental coverage because the beneficiary did not have a general health plan that covered dental until 6 months prior to the application date). Since limited-coverage plans are exempt from HIPAA requirements, the odd case exists in which the applicant to a general group health plan cannot obtain certificates of creditable continuous coverage for independent limited-scope plans, such as dental, to apply towards exclusion periods of the new plan that does include those coverages. Hidden exclusion periods are invalid under Title I. For example: ‘The accident must have occurred while the beneficiary was covered under this same health insurance contract. Such clauses must not be acted upon by the health plan. Also, they must be re-written to comply with HIPAA. Title II: Preventing Health Care Fraud and Abuse; Administrative Simplification; Medical Liability Reform Title II of HIPAA establishes policies and procedures for maintaining the privacy and the security of individually identifiable health information, outlines numerous offenses relating to health care, and establishes civil and criminal penalties for violations. It also creates several programs to control fraud and abuse within the health care system. The most significant provisions of Title II are the Administrative Simplification rules. Title II requires the Department of Health and Human Services (HHS) to increase the efficiency of the health-care system by creating standards for the use and dissemination of health care information. These rules apply to "covered entities" as defined by HIPAA and the HHS.

Title II of HIPAA establishes policies and procedures for maintaining the privacy and the security of individually identifiable health information, outlines numerous offenses relating to health care, and establishes civil and criminal penalties for violations. It also creates several programs to control fraud and abuse within the health care system. The most significant provisions of Title II are the Administrative Simplification rules. Title II requires the Department of Health and Human Services (HHS) to increase the efficiency of the health-care system by creating standards for the use and dissemination of health care information. These rules apply to "covered entities" as defined by HIPAA and the HHS.

ervices in areas such as funding medical studies. Before the separate federal Department of Education was created in 1979, it was called the Department of Health, Education, and Welfare (HEW). HHS is administered by the secretary of health and human services, who is appointed by the president with the advice and consent of the United States Senate. The United States Public Health Service Commissioned Corps, the uniformed service of the U.S.

es Senate. The United States Public Health Service Commissioned Corps, the uniformed service of the U.S.

Organization The Department of Health and Human Services is led by the United States Secretary of Health and Human Services, a member of the United States Cabinet appointed by the President of the United States with the consent of the United States Senate. The secretary is assisted in managing the department by the Deputy Secretary of Health and Human Services, who is also appointed by the president. The secretary and deputy secretary are further assisted by seven assistant secretaries, who serve as top departmental administrators. The following organizational structure is current as of the beginning of 2025.

Together with amendments made to it by the Health Care and Education Reconciliation Act of 2010, it represents the U.S. healthcare system's most significant regulatory overhaul and expansion of coverage since the enactment of Medicare and Medicaid in 1965. Most of the act remains in effect. The ACA's major provisions came into force in 2014. By 2016, the uninsured share of the population had roughly halved, with estimates ranging from 20 to 24 million additional people covered. The law also enacted delivery system reforms intended to constrain healthcare costs and improve quality. After it came into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans. The increased coverage was due, roughly equally, to an expansion of Medicaid eligibility and changes to individual insurance markets. Both received new spending, funded by a combination of new taxes and cuts to Medicare provider rates and Medicare Advantage. Several Congressional Budget Office (CBO) reports stated that overall these provisions reduced the budget deficit, that repealing ACA would increase the deficit, and that the law reduced income inequality. The act largely retained the existing structure of Medicare, Medicaid, and the employer market, but individual markets were radically overhauled. Insurers were made to accept all applicants without charging based on pre-existing conditions or demographic status (except age). To combat the resultant adverse selection, the act mandated that individuals buy insurance (or pay a monetary penalty) and that insurers cover a list of "essential health benefits". Young people were allowed to stay on their parents' insurance plans until they were 26 years old. Before and after its enactment the ACA faced strong political opposition, calls for repeal, and legal challenges. In the Sebelius decision, the U.S. Supreme Court ruled that Congress cannot use the Commerce Clause to compel individuals to buy health insurance but upheld the individual mandate by recharacterizing the penalty as a tax. The Court also held that states could opt out of the ACA's Medicaid expansion without losing existing federal Medicaid funding, while otherwise upholding the law. This led Republican-controlled states to not participate in Medicaid expansion. Polls initially found that 43% of Americans wanted to see the law repealed or scaled back and 49% wanted to see it expanded or enacted as is. By 2017, the law had majority support.

o constrain healthcare costs and improve quality. After it came into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans. The increased coverage was due, roughly equally, to an expansion of Medicaid eligibility and changes to individual insurance markets. Both received new spending, funded by a combination of new taxes and cuts to Medicare provider rates and Medicare Advantage. Several Congressional Budget Office (CBO) reports stated that overall these provisions reduced the budget deficit, that repealing ACA would increase the deficit, and that the law reduced income inequality. The act largely retained the existing structure of Medicare, Medicaid, and the employer market, but individual markets were radically overhauled. Insurers were made to accept all applicants without charging based on pre-existing conditions or demographic status (except age). To combat the resultant adverse selection, the act mandated that individuals buy insurance (or pay a monetary penalty) and that insurers cover a list of "essential health benefits". Young people were allowed to stay on their parents' insurance plans until they were 26 years old. Before and after its enactment the ACA faced strong political opposition, calls for repeal, and legal challenges. In the Sebelius decision, the U.S. Supreme Court ruled that Congress cannot use the Commerce Clause to compel individuals to buy health insurance but upheld the individual mandate by recharacterizing the penalty as a tax. The Court also held that states could opt out of the ACA's Medicaid expansion without losing existing federal Medicaid funding, while otherwise upholding the law. This led Republican-controlled states to not participate in Medicaid expansion. Polls initially found that 43% of Americans wanted to see the law repealed or scaled back and 49% wanted to see it expanded or enacted as is. By 2017, the law had majority support.

expansion of Medicaid eligibility and changes to individual insurance markets. Both received new spending, funded by a combination of new taxes and cuts to Medicare provider rates and Medicare Advantage. Several Congressional Budget Office (CBO) reports stated that overall these provisions reduced the budget deficit, that repealing ACA would increase the deficit, and that the law reduced income inequality. The act largely retained the existing structure of Medicare, Medicaid, and the employer market, but individual markets were radically overhauled. Insurers were made to accept all applicants without charging based on pre-existing conditions or demographic status (except age). To combat the resultant adverse selection, the act mandated that individuals buy insurance (or pay a monetary penalty) and that insurers cover a list of "essential health benefits". Young people were allowed to stay on their parents' insurance plans until they were 26 years old. Before and after its enactment the ACA faced strong political opposition, calls for repeal, and legal challenges. In the Sebelius decision, the U.S. Supreme Court ruled that Congress cannot use the Commerce Clause to compel individuals to buy health insurance but upheld the individual mandate by recharacterizing the penalty as a tax. The Court also held that states could opt out of the ACA's Medicaid expansion without losing existing federal Medicaid funding, while otherwise upholding the law. This led Republican-controlled states to not participate in Medicaid expansion. Polls initially found that 43% of Americans wanted to see the law repealed or scaled back and 49% wanted to see it expanded or enacted as is. By 2017, the law had majority support.

The Centers for Medicare & Medicaid Services (CMS) is a federal agency within the United States Department of Health and Human Services (HHS) that administers the Medicare program and works in partnership with state governments to administer Medicaid, the Children's Health Insurance Program (CHIP), and health insurance portability standards. In addition to these programs, CMS has other responsibilities, including the administrative simplification standards from the Health Insurance Portability and Accountability Act of 1996 (HIPAA), quality standards in long-term care facilities (more commonly referred to as nursing homes) through its survey and certification process, clinical laboratory quality standards under the Clinical Laboratory Improvement Amendments, and oversight of HealthCare.gov. CMS was previously known as the Health Care Financing Administration (HCFA) until 2001. CMS actively inspects and reports on every nursing home in the United States.

rtification process, clinical laboratory quality standards under the Clinical Laboratory Improvement Amendments, and oversight of HealthCare.gov. CMS was previously known as the Health Care Financing Administration (HCFA) until 2001. CMS actively inspects and reports on every nursing home in the United States. This includes maintaining the 5-Star Quality Rating System. Organization The agency carries out its responsibilities from its national headquarters located in Woodlawn, Maryland, and its 10 regional offices. It is organized around six centers to support its key functions.

History Originally, the name "Medicare" in the United States referred to a program providing medical care for families of people serving in the military as part of the Dependents' Medical Care Act, which was passed in 1956. President Dwight D. Eisenhower held the first White House Conference on Aging in January 1961, in which creating a health care program for social security beneficiaries was proposed. President Lyndon B. Johnson signed the Social Security Amendments on July 30, 1965, establishing both Medicare and Medicaid. Arthur E. Hess, a deputy commissioner of the Social Security Administration, was named as first director of the Bureau of Health Insurance in 1965, placing him as the first executive in charge of the Medicare program. At the time, the program provided health insurance to 19 million Americans. The Social Security Administration (SSA) became responsible for the administration of Medicare and the Social and Rehabilitation Service (SRS) became responsible for the administration of Medicaid. Both agencies were organized under what was then known as the Department of Health, Education, and Welfare (HEW), in 1965. Since then, HEW, has been reorganized as the Department of Health and Human Services (HHS) in 1980. This consequently brought Medicare and Medicaid under the jurisdiction of the HHS. In March 1977, the Health Care Financing Administration (HCFA) was established under HEW. HCFA became responsible for the coordination of Medicare and Medicaid. The responsibility for enrolling beneficiaries into Medicare and processing premium payments remained with SSA. HCFA was renamed the Centers for Medicare & Medicaid Services on July 1, 2001. This was later codified in law by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. In 2013, a report by the inspector general found that CMS had paid $23 million in benefits to deceased beneficiaries in 2011. In April 2014, CMS released raw claims data from 2012 that gave a look into what types of doctors billed Medicare the most. In January 2018, CMS released guidelines for states to use to require Medicaid beneficiaries to continue receiving coverage. These guidelines came in response to then-President Trump's announcement that he would allow states to impose work requirements in Medicaid. In October, CMS reported a data breach of 75,000 people's personal data due to a hack. In February 2018, CMS removed a notice from its website that informed insurance companies they were not allowed to charge physicians a fee when the companies paid the doctors for their work. This has resulted in doctors being charged up to a 5% fee on their compensation, adding up to billions of dollars annually. In January 2021, CMS passed a rule that would cover "breakthrough technology" for four years after they received FDA approval. In September 2021, CMS submitted a proposal to repeal the rule based on safety concerns. On September 19, 2023, the Subcommittee on Health held a hearing titled "Examining Policies to Improve Seniors’ Access to Innovative Drugs, Medical Devices, and Technology." Dora Hughes, the acting director of the Center for Clinical Standards and Quality at the U.S. Centers for Medicare and Medicaid Services (CMS), defended the proposed Transitional Coverage for Emerging Technologies (TCET) pathway, which aims to restrict coverage for breakthrough medical devices to five reviews a year. Some lawmakers and medtech trade groups called for expanding the pathway to include diagnostics.

Private equity (PE) is stock in a private company that does not offer stock to the general public. Instead, it is offered to specialized investment funds and limited partnerships that take an active role in managing and structuring the companies. In colloquial usage, "private equity" can refer to these investment firms rather than the companies in which they invest. Private-equity capital is invested into a target company either by an investment management company (private equity firm), a venture capital fund, or an angel investor; each category of investor has specific financial goals, management preferences, and investment strategies for profiting from their investments. Private equity can provide working capital to finance a target company's expansion, including the development of new products and services, operational restructuring, management changes, and shifts in ownership and control. As a financial product, a private-equity fund is private capital for financing a long-term investment strategy in an illiquid business enterprise.

Leveraged buyout (LBO) refers to a strategy of making equity investments as part of a transaction in which a company, business unit, or business asset is acquired from the current shareholders typically with the use of financial leverage. The companies involved in these transactions are typically mature and generate operating cash flows. Private-equity firms view target companies as either Platform companies, which have sufficient scale and a successful business model to act as a stand-alone entity, or as add-on / tuck-in / bolt-on acquisitions, which would include companies with insufficient scale or other deficits. Leveraged buyouts involve a financial sponsor agreeing to an acquisition without itself committing all the capital required for the acquisition. To do this, the financial sponsor will raise acquisition debt, which looks to the cash flows of the acquisition target to make interest and principal payments. Acquisition debt in an LBO is often non-recourse to the financial sponsor and has no claim on other investments managed by the financial sponsor. Therefore, an LBO transaction's financial structure is particularly attractive to a fund's limited partners, allowing them the benefits of leverage, but limiting the degree of recourse of that leverage. This kind of financing structure leverage benefits an LBO's financial sponsor in two ways: (1) the investor only needs to provide a fraction of the capital for the acquisition, and (2) the returns to the investor will be enhanced, as long as the return on assets exceeds the cost of the debt. As a percentage of the purchase price for a leverage buyout target, the amount of debt used to finance a transaction varies according to the financial condition and history of the acquisition target, market conditions, the willingness of lenders to extend credit (both to the LBO's financial sponsors and the company to be acquired) and the interest costs and the ability of the company to cover those costs. Historically the debt portion of a LBO will range from 60 to 90% of the purchase price.

"Distressed-to-Control" ("Loan-to-Own") investment whereby the investor buys debt securities in hope of acquiring ownership and control of the company's equity after financing the corporate restructuring of the target company; "Special Situations" ("Turnaround") investment wherein the investor buys debt securities and equity investments, to be used as rescue financing that will restore the profitability of the financially-weak target company. Moreover, the private-equity investment strategies of hedge funds also include actively trading the loans held and the bonds issued by the financially-weak target companies. Secondaries Secondary investments refer to investments made in existing private-equity assets. These transactions can involve the sale of private equity fund interests or portfolios of direct investments in privately held companies through the purchase of these investments from existing institutional investors. By its nature, the private-equity asset class is illiquid, intended to be a long-term investment for buy and hold investors. Secondary investments allow institutional investors, particularly those new to the asset class, to invest in private equity from older vintages than would otherwise be available to them. Secondaries also typically experience a different cash flow profile, diminishing the j-curve effect of investing in new private-equity funds. Often investments in secondaries are made through third-party fund vehicle, structured similar to a fund of funds although many large institutional investors have purchased private-equity fund interests through secondary transactions.

pa ( ) is the most populous city in Canyon County, Idaho, United States. The population was 100,200 at the 2020 census. It is Idaho's third-most populous city. Nampa is about 20 miles (32 km) west of Boise along Interstate 84, and 6 miles (9.7 km) west of Meridian. It is the second principal city of the Boise metropolitan area. The name "Nampa" may have come from a Shoshoni word meaning 'moccasin' or 'footprint'. According to toponymist William O. Bright, the name comes from the Shoshoni word /nampai/, meaning "foot".

History Nampa had its beginnings in the early 1880s when the Oregon Short Line Railroad built a line from Granger, Wyoming, to Huntington, Oregon, that passed through Nampa. In Nampa there is a history museum that marks the railroad's significance. More railroad lines sprang up through Nampa, making it an important railroad town. Alexander and Hannah Duffes established one of the town's first homesteads, eventually forming the Nampa Land and Improvement Company with the help of their friend and co-founder, James McGee. Despite the name, many early settlers called the town "New Jerusalem" because of its citizens' strong religious focus. After only a year the town grew from 15 homes to 50. As amenities were added, Nampa continued to grow, and it was incorporated in 1891. Downtown Nampa's street grid is oriented with the railroad tracks, which run northwest–southeast; this was done intentionally by Alexander Duffes to prevent accidents like one that occurred earlier in a town he had platted near Toronto, where a woman and her two children were killed by a train when their buggy wheel got stuck as they crossed the tracks. As the Oregon Short Line railroad originally bypassed Boise, Nampa has the fanciest of many railroad depots built in the area. Nampa gained attention in 1889 due to a purported archaeological discovery known as the Nampa figurine. George Frederick Wright wrote up details that year for the Boston Society of Natural History. The first elementary school was built in the 1890s. Lakeview School was on a hill on 6th Street and 12th Avenue North, with a view of Lake Ethel. Just after the school's centennial celebration, it was condemned as a school and sold to the First Mennonite Church. In 2008 the building was refurbished, and it is now used by the Idaho Arts Charter School. Lake Ethel, an irrigation reservoir, had long been the site of community picnics, and many citizens fished, swam, boated, and even hunted on it and its surrounding property. But the hunting didn't last long, as O. F. Persons, owner of the adjoining homestead, took offense when local hunters started shooting his pet ducks. The city later auctioned off the lake. E. H. Dewey (a former Nampa mayor) was the only bidder. But occasional flooding led to a series of lawsuits from neighbors. Dewey eventually drained Lake Ethel. Not long after, the city council became interested in buying back the Fritz Miller property as well as the Dewey home. Pressure had been building for more than four years. Nampa citizens wanted another park. On August 7, 1924, the city council passed an ordinance to purchase the Miller property and name it Lakeview Park. A bandstand was completed in 1928, and the municipal swimming pool opened on August 13, 1934. It is Nampa's largest park and many community celebrations are held there. Colonel William H. Dewey, a man who made a fortune mining in Silver City, built the Dewey Palace Hotel in 1902 for $250,000. He died in his hotel in 1903, leaving his son $1 million. The hotel survived the great fire of 1909, which burned several blocks of downtown Nampa, but was razed in 1963 after redevelopment plans failed. Relics from the hotel such as the chandelier and the hotel safe can be found at the Canyon County Historical Museum, which is in the old train depot on Front Street and Nampa City Hall. After demolition the location on First Street between 11th and 12th Ave. South was sold to private enterprise, including a bank and tire store, replacing this building with modern structures. A public-use postage stamp sized park was later placed across the street from the old palace property as a collaboration between the Downtown Alliance of Nampa (the local business council) and an Eagle Scout Project for the Boy Scouts of America. The park includes a large mural/wall sculpture of running horses commissioned for the project. A Carnegie library was built downtown in 1908; it burned down after the library moved in 1966. Nampa Public Library was then on the corner of 1st Street and 11th Avenue South in the old bank building. A new library, on 12th Avenue South, opened in 2015. Deer Flat Reservoir, an offstream irrigation storage reservoir, was constructed by the United States Bureau of Reclamation between 1906 and 1911. Known locally as Lake Lowell, it is surrounded by the Deer Flat National Wildlife Refuge, established in 1909 by President Theodore Roosevelt. The refuge is administered by the U.S. Fish and Wildlife Service. Lake Lowell is filled by the concrete New York Canal; the water is diverted from the Boise River a few miles below Lucky Peak Dam. In 1910, the Idaho State School and Hospital was built northwest of Nampa for the state's developmentally challenged population. It opened in 1918. The institution was largely self-sufficient, with a large farm staffed by the residents. The higher-functioning residents also cared for residents who could not care for themselves. The land for the farm was sold and is now golf courses (Centennial and Ridgecrest), and the residents no longer give primary care to other residents. The institution is modernized and remains in operation, though a few of the oldest buildings now house juvenile offenders. Nampa held an annual harvest festival and farmers' market from about 1908, a time of celebration and community fun. From this festival emerged the Snake River Stampede Rodeo in 1937, which continues to this day. It is one of the top 12 rodeos in the pro rodeo circuits. In 1913, a local congregation of the Church of the Nazarene built a small elementary school, which became to Northwest Nazarene College in 1915 and finally Northwest Nazarene University. As of 2025, the university has approximately 1,800 undergraduate and graduate students. Karcher Mall opened in 1965, the first enclosed shopping mall in the Treasure Valley. It was "the place to gather" for several decades until the Boise Towne Square mall was built in Boise in 1988, drawing business away. Karcher Mall was renamed District 208 in 2022. The Idaho Press-Tribune is the local newspaper for the Canyon County area.

Idaho Hispanic Community Center (IH2C) In 2003, the Hispanic Cultural Center of Idaho (HCCI) opened thanks to community support. It has recently transitioned back to the City of Nampa and was renamed the Idaho Hispanic Community Center (IH2C) and is home to the Idaho Hispanic Foundation. It hosts events, classes, and festivals, including Día de los Muertos, Hispanic Heritage Month, and Día Internacional de la Mujer. It serves as a meeting place for associations and groups. Displays of cultural history are available to the public. Nampa Train Depot Museum The Nampa Train Depot Museum is a historical depot with displays and archives of the area's railroad and cultural history. The Canyon County Historical Society saved the depot from demolition in 1972. Annual Festival of the Arts Nampa's Festival of the Arts, which began in 1987, is held in Lakeview Park every year and includes local art, music, dance, and food.

The Boise, Idaho Metropolitan Statistical Area (MSA) (commonly known as the Boise Metropolitan Area or the Treasure Valley) is an area that encompasses Ada, Boise, Canyon, Gem, and Owyhee counties in southwestern Idaho, anchored by the cities of Boise and Nampa. It is the main component of the wider Boise–Mountain Home–Ontario, ID–OR Combined Statistical Area, which adds Elmore and Payette counties in Idaho and Malheur County, Oregon. It is the state's largest officially designated metropolitan area and includes Idaho's three largest cities: Boise, Nampa, and Meridian.

Four-year colleges and universities Northwest Nazarene University (NNU), Nampa, Idaho The College of Idaho (C of I), Caldwell, Idaho University of Idaho (U of I), Boise; Extension Campus Idaho State University (ISU), Meridian, Idaho; Extension Campus Community colleges and trade schools College of Western Idaho, Nampa, Idaho (CWI) Nampa; Main Campus, Aspen Classroom Bldg., Canyon County Extension Boise; Ada County Campus Treasure Valley Community College, Caldwell, Idaho (TVCC) Ontario, Oregon; Main Campus Caldwell, Idaho; Caldwell Campus Northwest Lineman College (NLC), Kuna, Idaho Heavy Equipment Operator School of Idaho, Boise Carrington College, Boise Broadview University, Meridian, Idaho University of Phoenix Meridian; Main Campus Boise Bible College, Boise

tistical Area, which adds Elmore and Payette counties in Idaho and Malheur County, Oregon. It is the state's largest officially designated metropolitan area and includes Idaho's three largest cities: Boise, Nampa, and Meridian. Nearly 40 percent of Idaho's total population lives in the area. As of the 2021 estimate, the Boise–Nampa, Idaho Metropolitan Statistical Area (MSA) had a population of 795,268, while the larger Boise City–Mountain Home–Ontario, ID–OR Combined Statistical Area (CSA) had a population of 850,341. The metro area is currently the third largest in the U.S.

The Americans with Disabilities Act of 1990 (ADA) (42 U.S.C. § 12101) is a civil rights law that prohibits discrimination based on disability. It affords similar protections against discrimination to Americans with disabilities as the Civil Rights Act of 1964, which made discrimination based on race, religion, sex, national origin, and other characteristics illegal, and later sexual orientation and gender identity. In addition, unlike the Civil Rights Act, the ADA also requires covered employers to provide reasonable accommodations to employees with disabilities, and imposes accessibility requirements on public accommodations. In 1986, the National Council on Disability had recommended the enactment of an Americans with Disabilities Act and drafted the first version of the bill which was introduced in the House and Senate in 1988. A broad bipartisan coalition of legislators supported the ADA, while the bill was opposed by business interests (who argued the bill imposed costs on business) and conservative evangelicals (who opposed protection for individuals with HIV). The final version of the bill was signed into law on July 26, 1990, by President George H. W. Bush. It was later amended in 2008 and signed by President George W.

h made discrimination based on race, religion, sex, national origin, and other characteristics illegal, and later sexual orientation and gender identity. In addition, unlike the Civil Rights Act, the ADA also requires covered employers to provide reasonable accommodations to employees with disabilities, and imposes accessibility requirements on public accommodations. In 1986, the National Council on Disability had recommended the enactment of an Americans with Disabilities Act and drafted the first version of the bill which was introduced in the House and Senate in 1988. A broad bipartisan coalition of legislators supported the ADA, while the bill was opposed by business interests (who argued the bill imposed costs on business) and conservative evangelicals (who opposed protection for individuals with HIV). The final version of the bill was signed into law on July 26, 1990, by President George H. W. Bush. It was later amended in 2008 and signed by President George W.

actment of an Americans with Disabilities Act and drafted the first version of the bill which was introduced in the House and Senate in 1988. A broad bipartisan coalition of legislators supported the ADA, while the bill was opposed by business interests (who argued the bill imposed costs on business) and conservative evangelicals (who opposed protection for individuals with HIV). The final version of the bill was signed into law on July 26, 1990, by President George H. W. Bush. It was later amended in 2008 and signed by President George W.

Boise (locally also ) is the capital and most populous city in the U.S. state of Idaho. It is the county seat of Ada County. The population of the city was 235,685 at the 2020 census. The Boise metropolitan area, located in the Treasure Valley, includes five counties of Idaho with an estimated population of 846,000, the most populous metropolitan area in Idaho and 95th-most populous in the United States. Located on the Boise River in southwestern Idaho, it is 41 miles (66 km) east of the Oregon border and 110 miles (177 km) north of the Nevada border. Downtown Boise's elevation is 2,704 feet (824 m) above sea level. Boise is home to major employers in the technology, manufacturing, and service sectors, including companies such as Micron Technology and Hewlett-Packard.

an area in Idaho and 95th-most populous in the United States. Located on the Boise River in southwestern Idaho, it is 41 miles (66 km) east of the Oregon border and 110 miles (177 km) north of the Nevada border. Downtown Boise's elevation is 2,704 feet (824 m) above sea level. Boise is home to major employers in the technology, manufacturing, and service sectors, including companies such as Micron Technology and Hewlett-Packard.

...that the military should continue killing Indians 'until the last Indian in the Territories was either on his reservation or enriched the sagebrush with his decaying carcass.' ...if the Indians refused to move there, 'they will be killed or put on the reservation by force, and certainly shot if they don't stay there.' Furthermore, the editor continues, 'The idea that the Indians have any right to the soil is ridiculous. ...They have no more rights to the soil of the Territories of the United States than wolves or coyotes...' This would be our plan of establishing friendship upon an eternal basis with our Indians: Let all the hostile bands of Idaho Territory be called in (they will not be caught in any other manner) to attend a grand treaty; plenty of blankets and nice little trinkets distributed among them; plenty of grub on hand; have a real jolly time with them; then just before the big feast put strychnine in their meat and poison to death the last mother's son of them. At the same time, native warriors around the valley, under the leadership of Howluck also known as "Bigfoot" among white settlers, among others, waged an escalating and intensified guerrilla campaign of harassment of passerby caravans along the Oregon Trail. The United States Army also escalated and intensified "punitive expeditions" against formations of warriors and against civilian communities as well. This marked the start of the "unofficial" Snake War in 1866. This war lasted until 1868, and is statistically the deadliest of the Indian Wars in the West in terms of casualties. In the end, 1,762 men were counted as the casualties of this war from both sides. In 1868, Fort Hall Indian Reservation was established in Southeastern Idaho, about 220 miles upstream, according to the terms of Fort Bridger Treaty. The Boise Valley Shoshone and Bannock Tribes were not party to this treaty. Nevertheless, in April 1869, the United States Military embarked on a campaign of "Removal, rounding up of natives in the region including in and around Boise, and expelling them with cavalry escort to Fort Hall Indian Reservation. This period is known among the Shoshone and Bannock people as Idaho's Trail of Tears. Some of the natives managed to escape, and they ran to either Duck Valley or Fort McDermitt in Nevada. Incorporation and growth Boise's early growth was significantly driven by its role in supplying the nearby gold towns that sprung up in the 1860s northeast and then southwest of the town. Miners sometimes wintered in Boise and a number of early prominent businessmen were miners who settled in town in the years after the gold rush waned. By 1864 substantial agricultural production was underway on easily irrigated lands near the river and three canal companies had been incorporated. Early transportation improvements were largely a result of toll road franchises awarded by the territorial legislature starting in the 1860s. These first ran from Fort Boise to the mining centers in the Boise Basin and east to Rocky Bar and to Rattlesnake Station where they connected to the Oregon Trail. Territorial census records from a special 1864 enumeration list the population of Boise as 1,658, and an act of December 12, 1864, was the first attempt by the Idaho Territorial Legislature to incorporate the city. This was rejected by voters the following March. Two more unsuccessful attempts were made to organize a city administration by election before the 1866 version of the city charter was approved by voters on January 6, 1868. The growing number of homes and businesses, for which owners wanted proper legal title, may have contributed to the eventual success of incorporation. All of these rejected efforts to incorporate the city came after Boise had been controversially made the state capital in 1864 over strong opposition from northern Idaho interests. This decision reflected the rapid shift of population growth from north to south after the discovery of gold in southern Idaho. By 1868 Boise had over 400 permanent buildings with a wide range of commercial services. 1868 also marked the formal beginning of a long advocacy for railroad connections to other Idaho communities and, just as importantly, to other growing cities in the west such as Portland, Oregon. Competing railroad and western state government interests frustrated these efforts for many years. Designed by Alfred B. Mullett, the U.S. Assay Office at 210 Main Street was built in 1871 and today is a National Historic Landmark. It first began accepting gold and silver for purchase on March 2, 1872, largely eliminating the need to transport ore to the mint in San Francisco. A territorial penitentiary, now known as the Old Idaho State Penitentiary, opened the same month several miles east of town. Mining continued to be important to Boise's economic growth and periodic booms contributed to population growth as well, though production of gold and silver probably peaked in the 1860s. 1882's gold and silver production of $3,500,000 declined to $1,488,315 (including lead) by 1899. Boise began to earn its City of Trees nickname in this period with a popular focus on a range of tree planting projects. Thomas J. Davis planted several thousand fruit trees in 1864 and several other early businessmen either founded nurseries or orchards of their own. In the 1870s tree planting began in earnest in downtown Boise led by prominent hotels as well as businessmen and residents. In 1907 Davis donated 43 acres of his orchard property to the city for use as a park in the name of his wife Julia. Commercial agriculture continued to expand, but was slowed by the lack of reliable rail links to regional and national markets and by a lack of large scale irrigation projects, which themselves were often tied to hoped-for railroad projects for financing. A.D. Foote, a successful mining engineer, drew up plans to irrigate up to 500,000 acres immediately south of Boise in 1882, but progress was halting and smaller farms were the norm until after the turn of the century with most located near to the river bottom where soil was productive and irrigation more easily achieved. Fruit orchards proliferated and sugar beets, still an important agricultural industry in Idaho, began to be widely cultivated in the 1890s. Cattle and sheep farming became increasingly important as the century closed. With the exception of dairy, most livestock products were exported from Idaho, unlike other agricultural products which were still largely scaled to support local markets. The timber industry also increasingly thrived in the Boise market in the 1880s and 1890s. Large quantities of timber were exported from elsewhere in Idaho, but a growing Boise supported the expansion of Alexander Rossi's sawmill, first established in 1865. Prominent early Boisean William Ridenbaugh had inherited control of the canal now bearing his name from his uncle William Morris in 1878 and later partnered with Rossi to expand the sawmill capacity under the name Rossi and Ridenbaugh Lumber Company. Their materials supported bridge building and the rapid expansion of Boise in the 1890s. As with many early infrastructure ventures, electrification succeeded only after at least one false start. July 4, 1887, marked the start of electrical transmission from a plant located on the Bench. William Ridenbaugh provided expertise and manpower for the water supply and several months were spent rigging poles and lines from the Bench to the service area across the river. Additional electrical supplies allowed the building of an electric streetcar line in 1891. This ran without interruption until buses replaced the lines in 1927, tracking—and sometimes driving—the development of Boise and nearby communities. This system expanded over several decades, reaching into the North End, South Boise and across the river on Front St. A loop line, completed in 1912, ran as far as Caldwell and Nampa, providing transport throughout the valley. Three early trolley companies merged in 1912 to form the Idaho Traction Company with a depot at 7th and Bannock Streets downtown. Additional services and urban amenities arrived in the 1890s as Boise grew. Exploratory drilling for hot water was successful in 1890 and by the end of the decade many homes along Warm Springs avenue were being heated by this source. A natatorium was built in 1892 close to the source of the hot water near the Idaho State Penitentiary. Churches serving several denominations, a Jewish synagogue, a major hardware store and department store, a Masonic hall, the Columbia Theater, Saint Alphonsus' Hospital, a number of parochial and secular schools, a City Hall and a new Union Pacific passenger station, constructed when service was finally extended to downtown, were all built during the 1890s. Falk's Department Store sponsored a semi-professional baseball team representing Boise from at least 1892 and the city supported other organized sports as they became popular.

Ada County is located in the southwestern part of Idaho, United States. As of the 2020 census, the county had a population of 494,967, which by 2025 was estimated to have risen to 546,141. Ada County is by far the state's most populous county; it is home to 26.8% of the state's population. The county seat and largest city is Boise, which is also the state capital. Ada County is included in the Boise metropolitan area. The Ada County Highway District has jurisdiction over all the local county and city streets, except for private roads and state roads.

populous county; it is home to 26.8% of the state's population. The county seat and largest city is Boise, which is also the state capital. Ada County is included in the Boise metropolitan area. The Ada County Highway District has jurisdiction over all the local county and city streets, except for private roads and state roads.

ea. The Ada County Highway District has jurisdiction over all the local county and city streets, except for private roads and state roads. In the interior Pacific Northwest east of the Cascade Range, Ada County ranks second in population, behind Spokane County, Washington. History Ada County was created by the Idaho Territory legislature on December 22, 1864, partitioned from Boise County. It is named for Ada Riggs, the daughter of H. C. Riggs, a member of the legislature; he established the county and was a co-founder of Boise.

city in Idaho. As of the 2020 census, Caldwell had a population of 59,996. Caldwell is considered part of the Boise metropolitan area, and is the location of the College of Idaho. The city is located approximately 24 miles (39 km) west of Boise, and approximately 17 miles (27 km) east of the Oregon border. History The present-day location of Caldwell is along a natural passageway to the Inland and Pacific Northwest. Native American tribes from the west coast, north Idaho and as far away as Colorado came to the banks of the Boise River for annual trading fairs, or rendezvous. European and some Hawaiian explorers and traders soon followed the paths left by Native Americans and hopeful emigrants later forged the Oregon Trail and followed those paths to seek a better life in the Oregon Territory. Pioneers of the Trail traveled along the Boise River to Canyon Hill and forded the river close to the Silver Bridge on Plymouth Street. During the Civil War, the discovery of gold in Idaho's mountains brought a variety of new settlers into the area. Many never made it to the mines but settled along the Boise River and run ferries, stage stations, and freighting businesses. These early entrepreneurs created small ranches and farms in the river valleys. Caldwell's inception occurred largely as a result of the construction of the Oregon Short Line Railroad, which connected Wyoming to Oregon through Idaho. Robert E. Strahorn came to the Boise River Valley in 1883 to select a route for the railroad. He rejected the grade into Boise City as too steep and chose a site 30 miles to the west. He drove a stake into an alkali flat of sagebrush and greasewood and the City of Caldwell was platted. Caldwell was named after one of Strahorn's business partners, Alexander Caldwell, a former senator from Kansas. When Caldwell was platted in August 1883, its founder, the Idaho and Oregon Land Improvement Company, started persuading settlers and businessmen to move to the area. Within four months, Caldwell had 600 residents living in 150 dwellings, 40 businesses, a school, a telephone exchange, and two newspapers. On January 15, 1890, the Board of Commissioners of Ada County issued a handwritten order incorporating the City of Caldwell. The College of Idaho was founded in Caldwell in 1891. In 1892, Canyon County was established from a portion of Ada County, and Caldwell was named the county seat. Irrigation canals and waterways were constructed throughout Canyon County, providing the foundation for an agricultural economy. The Oregon Short Line Railroad became part of the larger Union Pacific Railroad network and in 1906 the Caldwell freight and passenger depot was constructed. Caldwell experienced moderate growth as an agricultural processing, commercial retail and educational center during the 20th century. In 2009, the City of Caldwell completed a revitalization project to restore Indian Creek, which runs through downtown Caldwell, but had been used for sewage disposal by local industries and been covered over.

History The present-day location of Caldwell is along a natural passageway to the Inland and Pacific Northwest. Native American tribes from the west coast, north Idaho and as far away as Colorado came to the banks of the Boise River for annual trading fairs, or rendezvous. European and some Hawaiian explorers and traders soon followed the paths left by Native Americans and hopeful emigrants later forged the Oregon Trail and followed those paths to seek a better life in the Oregon Territory. Pioneers of the Trail traveled along the Boise River to Canyon Hill and forded the river close to the Silver Bridge on Plymouth Street. During the Civil War, the discovery of gold in Idaho's mountains brought a variety of new settlers into the area. Many never made it to the mines but settled along the Boise River and run ferries, stage stations, and freighting businesses. These early entrepreneurs created small ranches and farms in the river valleys. Caldwell's inception occurred largely as a result of the construction of the Oregon Short Line Railroad, which connected Wyoming to Oregon through Idaho. Robert E. Strahorn came to the Boise River Valley in 1883 to select a route for the railroad. He rejected the grade into Boise City as too steep and chose a site 30 miles to the west. He drove a stake into an alkali flat of sagebrush and greasewood and the City of Caldwell was platted. Caldwell was named after one of Strahorn's business partners, Alexander Caldwell, a former senator from Kansas. When Caldwell was platted in August 1883, its founder, the Idaho and Oregon Land Improvement Company, started persuading settlers and businessmen to move to the area. Within four months, Caldwell had 600 residents living in 150 dwellings, 40 businesses, a school, a telephone exchange, and two newspapers. On January 15, 1890, the Board of Commissioners of Ada County issued a handwritten order incorporating the City of Caldwell. The College of Idaho was founded in Caldwell in 1891. In 1892, Canyon County was established from a portion of Ada County, and Caldwell was named the county seat. Irrigation canals and waterways were constructed throughout Canyon County, providing the foundation for an agricultural economy. The Oregon Short Line Railroad became part of the larger Union Pacific Railroad network and in 1906 the Caldwell freight and passenger depot was constructed. Caldwell experienced moderate growth as an agricultural processing, commercial retail and educational center during the 20th century. In 2009, the City of Caldwell completed a revitalization project to restore Indian Creek, which runs through downtown Caldwell, but had been used for sewage disposal by local industries and been covered over.

location of the College of Idaho. The city is located approximately 24 miles (39 km) west of Boise, and approximately 17 miles (27 km) east of the Oregon border. History The present-day location of Caldwell is along a natural passageway to the Inland and Pacific Northwest. Native American tribes from the west coast, north Idaho and as far away as Colorado came to the banks of the Boise River for annual trading fairs, or rendezvous. European and some Hawaiian explorers and traders soon followed the paths left by Native Americans and hopeful emigrants later forged the Oregon Trail and followed those paths to seek a better life in the Oregon Territory. Pioneers of the Trail traveled along the Boise River to Canyon Hill and forded the river close to the Silver Bridge on Plymouth Street. During the Civil War, the discovery of gold in Idaho's mountains brought a variety of new settlers into the area. Many never made it to the mines but settled along the Boise River and run ferries, stage stations, and freighting businesses. These early entrepreneurs created small ranches and farms in the river valleys. Caldwell's inception occurred largely as a result of the construction of the Oregon Short Line Railroad, which connected Wyoming to Oregon through Idaho. Robert E. Strahorn came to the Boise River Valley in 1883 to select a route for the railroad. He rejected the grade into Boise City as too steep and chose a site 30 miles to the west. He drove a stake into an alkali flat of sagebrush and greasewood and the City of Caldwell was platted. Caldwell was named after one of Strahorn's business partners, Alexander Caldwell, a former senator from Kansas. When Caldwell was platted in August 1883, its founder, the Idaho and Oregon Land Improvement Company, started persuading settlers and businessmen to move to the area. Within four months, Caldwell had 600 residents living in 150 dwellings, 40 businesses, a school, a telephone exchange, and two newspapers. On January 15, 1890, the Board of Commissioners of Ada County issued a handwritten order incorporating the City of Caldwell. The College of Idaho was founded in Caldwell in 1891. In 1892, Canyon County was established from a portion of Ada County, and Caldwell was named the county seat. Irrigation canals and waterways were constructed throughout Canyon County, providing the foundation for an agricultural economy. The Oregon Short Line Railroad became part of the larger Union Pacific Railroad network and in 1906 the Caldwell freight and passenger depot was constructed. Caldwell experienced moderate growth as an agricultural processing, commercial retail and educational center during the 20th century. In 2009, the City of Caldwell completed a revitalization project to restore Indian Creek, which runs through downtown Caldwell, but had been used for sewage disposal by local industries and been covered over.

105, which by 2025 was estimated to have risen to 275,123, making it the second-most populous county in Idaho. The county seat is Caldwell, and its largest city is Nampa. Canyon County is part of the Boise metropolitan area. History Hudson's Bay Company established Fort Boise in 1834 near what is now Parma, but abandoned it in 1855. Emigrants traveled through Canyon County on the Oregon Trail. Discovery of gold in the Boise Basin in 1862 brought settlement to the region again. The lower Boise River was fully contained within Boise County from 1863 until the formation of Ada County in 1864. Settlement of the lower Boise River west of Boise City was limited prior to the completion of the Oregon Short Line Railroad. Middleton was the first European settlement of Canyon County, starting in 1863. The 1870 Census for Ada County listed 76 residents of the Boise Valley, excluding Boise City and the 1880 Census listed 44 residents at Middleton. The arrival of the railroad at Caldwell led to the establishment of a town there as of August 1883. Businessmen James A. McGee and Alexander Duffes filed the plat for nearby Nampa in 1886. Parma was settled around the same time, with the Old Fort Boise post office being moved to the town's location; it was incorporated in 1904. Ada County established precincts for each of the settlements with a combined 1890 Census population of 2,311. Significant settlement of Greenleaf and Notus started around 1904 with the two settlements listed as precincts at the 1910 census. Notus was incorporated in 1921 while Greenleaf was incorporated prior to 1980. Melba was incorporated in 1912 while Wilder was incorporated in 1919. The City of Star annexed a portion of territory in northeast Canyon County prior to 2007, becoming the county's ninth incorporated city. The majority of Star is located within Ada County. The Idaho Legislature created Canyon County from Ada County in an act approved March 7, 1891, effective at the November 26, 1892, election. Caldwell was established as the county seat. The county originally contained all of Canyon and Payette counties and part of Gem; Gem County formed in 1915 and Payette County in 1917.

History Hudson's Bay Company established Fort Boise in 1834 near what is now Parma, but abandoned it in 1855. Emigrants traveled through Canyon County on the Oregon Trail. Discovery of gold in the Boise Basin in 1862 brought settlement to the region again. The lower Boise River was fully contained within Boise County from 1863 until the formation of Ada County in 1864. Settlement of the lower Boise River west of Boise City was limited prior to the completion of the Oregon Short Line Railroad. Middleton was the first European settlement of Canyon County, starting in 1863. The 1870 Census for Ada County listed 76 residents of the Boise Valley, excluding Boise City and the 1880 Census listed 44 residents at Middleton. The arrival of the railroad at Caldwell led to the establishment of a town there as of August 1883. Businessmen James A. McGee and Alexander Duffes filed the plat for nearby Nampa in 1886. Parma was settled around the same time, with the Old Fort Boise post office being moved to the town's location; it was incorporated in 1904. Ada County established precincts for each of the settlements with a combined 1890 Census population of 2,311. Significant settlement of Greenleaf and Notus started around 1904 with the two settlements listed as precincts at the 1910 census. Notus was incorporated in 1921 while Greenleaf was incorporated prior to 1980. Melba was incorporated in 1912 while Wilder was incorporated in 1919. The City of Star annexed a portion of territory in northeast Canyon County prior to 2007, becoming the county's ninth incorporated city. The majority of Star is located within Ada County. The Idaho Legislature created Canyon County from Ada County in an act approved March 7, 1891, effective at the November 26, 1892, election. Caldwell was established as the county seat. The county originally contained all of Canyon and Payette counties and part of Gem; Gem County formed in 1915 and Payette County in 1917.

2000 census As of the 2000 census, there were 131,441 people, 45,018 households and 33,943 families living in the county. The population density was 223 people per square mile (86 people/km2). There were 47,965 housing units at an average density of 81 units per square mile (31 units/km2). The racial makeup of the county was 83.10% White, 0.32% Black or African American, 0.85% Native American, 0.80% Asian, 0.13% Pacific Islander, 12.17% from other races, and 2.62% from two or more races. Hispanic or Latino of any race were 18.61% of the population. 15.9% were of German, 12.7% English, 10.3% American and 7.6% Irish ancestry. There were 45,018 households, of which 39.80% had children under the age of 18 living with them, 60.70% were married couples living together, 10.10% had a female householder with no husband present, and 24.60% were non-families. 19.80% of all households were made up of individuals, and 8.40% had someone living alone who was 65 years of age or older. The average household size was 2.85 and the average family size was 3.28. 30.90% of the population were under the age of 18, 10.70% from 18 to 24, 28.30% from 25 to 44, 19.10% from 45 to 64, and 11.00% who were 65 years of age or older. The median age was 30 years. For every 100 females, there were 98.70 males. For every 100 females age 18 and over, there were 96.30 males. The median household income was $35,884 and the median family income was $40,377. Males had a median income of $29,418 compared with $22,044 for females. The per capita income for the county was $15,155. About 8.70% of families and 12.00% of the population were below the poverty line, including 14.50% of those under age 18 and 10.70% of those age 65 or over. Communities Cities Unincorporated communities Bowmont Huston Roswell Sunnyslope Walters Ferry, Idaho Politics Like the majority of Idaho, Canyon County is reliably Republican by comfortable margins. The last time a Democratic candidate carried the county was in 1936 by Franklin D. Roosevelt.

Meridian is a city located in Ada County, Idaho, United States. The population was 117,635 at the 2020 census, making it the second most populous city in the county and Idaho, after Boise, the state capital.

Rail transportation (1908–28) Following the raising of $4,000 to lay the Interurban rail line from Onweiler (Meridian and Ustick Roads), the tracks were completed into the village center. Turning east on Broadway and ending at East Second, the last car would spend the night in Meridian before returning to Boise early the next morning with passengers and freight. The interurban Station and Generator building (west one-third of the old library at Meridian and Idaho Streets) was built in 1912, and the line continued on to Nampa via Meridian. The tracks down Broadway were not used after 1912. The Interurban Company entered into receivership and closed in 1928 after 20 years of providing continuous transportation to neighboring towns. It was Meridian's main connection to the area outside the local community. The Union Pacific Railroad spur opened in 1900 and is currently operated by the Boise Valley Railroad. Many industrial customers continue to ship forest, agricultural, and chemical products along this corridor. Creamery (1929–70) The city's official website describes the history of the Ada County Dairymen's cooperative creamery as follows:The lowest days of the Great Depression brightened for area dairymen when the Ada County Dairymen's cooperative creamery began operation in 1929. It provided milk checks to those who were members of the cooperative, enabling them to pay their taxes and provide food for their families. Other community members hauled milk to the creamery and were employed by the creamery, whose product was Challenge Butter. The creamery ran seven days a week for 40 years. Additions and improvements were made while the plant was in full operation. Later years saw the Wyeth Laboratories affiliate with the creamery to manufacture SMA baby formula.

Creamery (1929–70) The city's official website describes the history of the Ada County Dairymen's cooperative creamery as follows:The lowest days of the Great Depression brightened for area dairymen when the Ada County Dairymen's cooperative creamery began operation in 1929. It provided milk checks to those who were members of the cooperative, enabling them to pay their taxes and provide food for their families. Other community members hauled milk to the creamery and were employed by the creamery, whose product was Challenge Butter. The creamery ran seven days a week for 40 years. Additions and improvements were made while the plant was in full operation. Later years saw the Wyeth Laboratories affiliate with the creamery to manufacture SMA baby formula.

on, is a designation earned by a person to assure qualification to perform a job or task. Not all certifications that use post-nominal letters are an acknowledgement of educational achievement, or an agency appointed to safeguard the public interest. Overview A certification is a third-party attestation of an individual's level of knowledge or proficiency in a certain industry or profession. They are granted by authorities in the field, such as professional societies and colleges, or by private certificate-granting agencies. Most certifications are time-limited; some expire after a period of time (e.g., the lifetime of a product that requires certification for use), while others can be renewed indefinitely as long as certain requirements are met. Renewal usually requires ongoing education to remain up-to-date on advancements in the field, evidenced by earning the specified number of continuing education credits (CECs), or continuing education units (CEUs), from approved professional development courses. Certification is different from occupational licensing. In the United States, licenses are typically issued by state agencies, whereas certifications are usually awarded by professional societies or educational institutes. Obtaining a certificate is voluntary in some fields, but in others, certification from a government-accredited agency may be legally required to perform certain jobs or tasks. In other countries, licenses are typically granted by professional societies or universities and require a certificate after about three to five years and so on thereafter. The assessment process for certification may be more comprehensive than that of licensure, though sometimes the assessment process is very similar or even the same, despite differing in terms of legal status. According to The Guide to National Professional Certification Programs (1997) by Phillip Barnhart, "certifications are portable, since they do not depend on one company's definition of a certain job" and they provide potential employers with "an impartial, third-party endorsement of an individual's professional knowledge and experience". Many certification programs are affiliated with professional associations, trade organizations, or private vendors interested in raising industry standards. Certification programs are often created or endorsed by professional associations, but are typically completely independent from membership organizations.

A certification is a third-party attestation of an individual's level of knowledge or proficiency in a certain industry or profession. They are granted by authorities in the field, such as professional societies and colleges, or by private certificate-granting agencies. Most certifications are time-limited; some expire after a period of time (e.g., the lifetime of a product that requires certification for use), while others can be renewed indefinitely as long as certain requirements are met. Renewal usually requires ongoing education to remain up-to-date on advancements in the field, evidenced by earning the specified number of continuing education credits (CECs), or continuing education units (CEUs), from approved professional development courses. Certification is different from occupational licensing. In the United States, licenses are typically issued by state agencies, whereas certifications are usually awarded by professional societies or educational institutes. Obtaining a certificate is voluntary in some fields, but in others, certification from a government-accredited agency may be legally required to perform certain jobs or tasks. In other countries, licenses are typically granted by professional societies or universities and require a certificate after about three to five years and so on thereafter. The assessment process for certification may be more comprehensive than that of licensure, though sometimes the assessment process is very similar or even the same, despite differing in terms of legal status. According to The Guide to National Professional Certification Programs (1997) by Phillip Barnhart, "certifications are portable, since they do not depend on one company's definition of a certain job" and they provide potential employers with "an impartial, third-party endorsement of an individual's professional knowledge and experience". Many certification programs are affiliated with professional associations, trade organizations, or private vendors interested in raising industry standards. Certification programs are often created or endorsed by professional associations, but are typically completely independent from membership organizations.

Data management Business Intelligence and Data Analyst (BIDA) by Corporate Finance Institute (CFI). Certified Data Management Professional (CDMP) by DAMA International. Dentistry Electronics In the United States, several electronics certifications are provided by the Electronics Technicians Association. Emergency management The Federal Emergency Management Agency's EMI offers credentials and training opportunities for United States citizens.