Florida bans Medicaid from covering gender-affirming treatments

https://www.politico.com/news/2022/08/11/florida-finalizes-ban-medicaid-transgender-treatments-00051259

The move by the Florida Agency for Health Care Administration came after the agency published a report claiming there was not enough scientific evidence to prove that the treatments improved health.

Florida Gov. Ron DeSantis speaks at the Conservative Political Action Conference.
 

TALLAHASSEE, Fla. — Florida’s Medicaid regulator has finalized new rules banning health care providers from billing the taxpayer-funded program for gender-affirming medical treatments, a move that comes as the state has sought to block such therapies for young people.

The Florida Agency for Health Care Administration on Thursday added new language to the rules governing the state’s $36.2 billion Medicaid program. The new rules declare that the program does not cover services for treatments such as puberty blockers, hormone therapies or surgical procedures as a treatment for gender dysphoria, which refers to the feelings of discomfort or distress some transgender people experience when their bodies don’t align with their gender.

The updated rule will take effect on Aug. 21.

 
 

The new rule is the latest step by Gov. Ron DeSantis to restrict gender-affirming treatments. Last Friday, Florida’s medical board voted to start the rulemaking process that could lead to the banning of gender-affirming medical treatment for youths. And the Republican Florida governor has become increasing vocal in his objections to such treatments.

The American Academy of Pediatrics and the American Medical Association support gender-affirming care for adults and adolescents. But medical experts said gender-affirming care for children rarely, if ever, includes surgery. Instead, doctors are more likely to recommend counseling, social transitioning and hormone replacement therapy.

A coalition of LGBTQ and health rights groups, including Lambda Legal, Southern Legal Counsel, Florida Health Justice Project, and National Health Law Program, said the rule will leave thousands of transgender Floridians without critical care when they need it most.

“Ignoring thousands of public comments and expert testimony, Florida’s AHCA has finalized a rule that will deny Medicaid coverage for all medically necessary gender-affirming care for both youth and adults,” the coalition statement said. “This discriminatory and medically unsound rule will take effect on August 21, 2022, putting transgender people in jeopardy of losing access to critical gender-affirming health care services.”

The move by Florida’s Agency for Health Care Administration to ban Medicaid from covering such treatments began in April after the agency published a report claiming there was not enough scientific evidence to prove that the treatments improved health. AHCA held a public hearing on the new language in June that attracted more than 150 people on a late Friday afternoon.

 
 

Florida’s Department of Health also accused the U.S. Department of Health and Human Services and the American Academy of Pediatrics of misleading the public into believing the treatments are safe.

The American Academy of Pediatrics, however, has ramped up efforts to protect transgender youths amid an increase in states pushing legislation aimed at preventing minors from accessing gender-affirming care or transgender girls participating in women and girls’ sports.

“It is critically important for every child to have access to quality, comprehensive and evidence-based care — transgender and gender-diverse youth are no exception,” said Lee Savio Beers, American Academy of Pediatrics immediate past president in a statement earlier this year.

To select a class, a minority class for particularly harmful discrimination, is that what the Land of the Free has come to?

Desantis and Floridians have an unhealthy obsession with trans people.

You know what? It’s becoming clear that they have NOTHING to run on.
1) Their idol is a traitor and a criminal who is going down;
2) Most voters (even in deep red Kansas) hate the SCOTUS Dobbs decision and don’t think the 10-year-olds should be forced to give birth;
3) Most voters hate their snearing, cynical mockery of grade school gun violence victims;
4) Ron Johnson openly talking about the R’s sunsetting Medicare and Social Security is going to be about as popular as egg salad that has been sitting in the sun for 3 days;
5) Despite all their bullshit, spin and lies and whining about gas prices, Biden has outperformed all recent presidents on the economic front and job creation, unemployment is at record lows and the Democrats have actually passed a boatload of good legislation (which even some Republicans like Hawley or Sasse admit to being jealous of) and even the gas prices are coming down.

So they are going to run on hatred of transgender people and other minorities because they have nothing else. And they are going to keep getting uglier and nastier as it gets closer to November. Democrats need to stay true to their principles and call out their cruelty, but do not let them change the conversation.

 

It works… bashing gays, blacks, trans people, immigrants… plays right to their base. Its a party of hate and it drives their people to vote in every election

 

ABC NEWS: Officers barred from guarding Derek Chauvin get $1.5 million in settlement

Officers barred from guarding Derek Chauvin get $1.5 million in settlement
Derek Chauvin was convicted of murder in the death of George Floyd.

Read in ABC News: https://apple.news/Ayt5–LZbTeizVS25qKlw5A

Shared from Apple News

Sent from my iPad,Best wishes and Hugs,
Scottie

CNN: Ukrainian nuclear plant facing “grave hour,” U.N. watchdog says

Ukrainian nuclear plant facing “grave hour,” U.N. watchdog says
The “alarming” situation at a Russian-occupied nuclear power plant in southeastern Ukraine had reached a “grave hour,” the head of the United Nations’ nuclear watchdog said Thursday, as he called for an immediate inspection of the facility by international experts.

Read in CNN: https://apple.news/A-HM0HyQUReWWmG2tgKJWhA

Shared from Apple News

Sent from my iPad,Best wishes and Hugs,
Scottie

Judge: Trump Has Until 3PM Tomorrow To Decide On DOJ’s Motion To Unseal Mar-A-Lago Search Warrant

Raw Story reports:

Federal Magistrate Judge William Matthewman has set an expedited schedule after Attorney General Merrick Garland announced the Department of Justice moved to unseal the Mar-a-Lago search warrant and property receipt. Matthewman instructed DOJ to “immediately serve a copy of its Motion on counsel for former President Donald Trump.”

“On or before 3.:00 p.m. Eastern time on August 12, 2022, the United States shall file a certificate of conferral advising whether President Trump opposes the Government’s motion to unseal,” the Judge explained. However, if Trump moves to oppose the motion it could be weeks for the records are unveiled.

Read the full article.

JCF • an hour ago

Well played, Merrick. Well Fucking Played!!!

Oh, Parker JCF • 37 minutes ago

Trump walked right into this one. Got a rake right in the face.

ohbear1957 • an hour ago

While you’re at it, judge, how about a court order to exhume Ivana?

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Gigi • an hour ago

Why does Trump get to decide whether or not the warrant is unsealed? Release it. We want to know!

Then, LOCK HIM UP!

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Reality.Bites Gigi • an hour ago

He gets to decide whether or not he objects.

JCF Reality.Bites • an hour ago

…and he’s damned if he does, and damned if he doesn’t! 😈

Darreth • an hour ago

It will be weeks. He will delay as long as possible. That way he stays in the news cycles endlessly.

Makoto Darreth • an hour ago

Absolutely. Keeps the grift going, keeps the anger high, keeps the possibility that maybe some of his folks will “take the hint” and proactively “work” for him to distract the news cycle..

The Diabolical Hoodwink • an hour ago

He’ll block it. But then he’ll look even more guilty as hell. But to his base? Doesn’t matter.

Nic Peterson The Diabolical Hoodwink • an hour ago

Trumpanzees won’t care either way. Piss tapes, hookers, rape allegations, child molestation allegations, attempted coup, even espionage and his base will continue to lick his boots.

omi-palone • an hour ago

Let’s talk about Garland’s statement on the Trump search….

Beto O’Rourke Drops F-Bomb On Abbott Supporter Who Laughed At Gun Violence

https://www.huffpost.com/entry/beto-o-rourke-gun-death-heckler_n_62f46d8ce4b0da517ef56f23

We need more younger democratic candidates willing to take the fight to the opposition and fight back hard.     This was a group of Abbott supporters there to heckle and mock O’Rourke.   He did not tolerate them and forcefully put them in their place.    Hugs
 
 
The Democratic candidate for governor had a scathing response to a heckler.
|
 
 

Former Rep. Beto O’Rourke, the Democratic candidate for governor in Texas, didn’t hold back when a heckler laughed as he described the gun used to murder 19 children and two teachers at an elementary school in Uvalde earlier this year.

“It may be funny to you, motherfucker, but it’s not funny to me, OK?” O’Rourke fired back at the laugher, who was standing among a small group of supporters of Republican Gov. Greg Abbott.

See the full exchange from Wednesday evening in Mineral Wells, about 50 miles west of Fort Worth:

O’Rourke, who is polling 5 percentage points behind Abbott, has long made gun control a core issue.

Earlier this year, O’Rourke interrupted a news conference held by Abbott after the Uvalde mass shooting to demand action.

“You’re doing nothing. You’re all doing nothing,” O’Rourke told Abbott and other officials gathered on a stage for the event.

O’Rourke was escorted out.

“This is on you,” he said before leaving. “Until you choose to do something different, this will continue to happen. Somebody needs to stand up for the children of this state or they will continue to be killed just like they were killed in Uvalde yesterday.”

After Wednesday’s event, O’Rourke tweeted:

O’Rourke’s f-bomb got quite the reaction on Twitter:

https://twitter.com/keithboykin/status/1557565658635767809?ref_src=twsrc%5Etfw%7Ctwcamp%5Etweetembed%7Ctwterm%5E1557565658635767809%7Ctwgr%5E46324fc19bd24c32bed72a16b0689cbb02c28299%7Ctwcon%5Es1_c10&ref_url=https%3A%2F%2Fwww.huffpost.com%2Fentry%2Fbeto-o-rourke-gun-death-heckler_n_62f46d8ce4b0da517ef56f23

https://twitter.com/0liviajulianna/status/1557563241987022850?ref_src=twsrc%5Etfw%7Ctwcamp%5Etweetembed%7Ctwterm%5E1557563241987022850%7Ctwgr%5E46324fc19bd24c32bed72a16b0689cbb02c28299%7Ctwcon%5Es1_c10&ref_url=https%3A%2F%2Fwww.huffpost.com%2Fentry%2Fbeto-o-rourke-gun-death-heckler_n_62f46d8ce4b0da517ef56f23

 

Graham Praises MI Library For Banning LGBTQ Books

Only church certified and state approved books will be allowed.   All others will be burned.   No access to other information.   No access to other ideas.    When these groups who are a minority cannot win the people with their ideas, they insist only the information they approve of be allowed.   We have seen the attempts for decades to outlaw science books, biology books, geology books, and all information that disagrees with the Christian bible.    Same with sexual education, it disagrees with the minority religious view so must not be taught.  This is a very dark road we are travelling down; it needs to stop.   Hugs

Posted today to Franklin Graham’s Facebook page:

Parents and concerned citizens in Jamestown, Michigan, decided they weren’t going to stand for the indoctrination of their children at the local public library, and they weren’t going to pay for it with their taxpayer money!

The local library featured sexually explicit LGBT books such as “Gender Queer: A Memoir” in a June Pride display, and the library staff refused to remove them from the library even after meetings with the board.

But the local residents didn’t give up—they mounted a campaign to stop funding the library with taxpayer money, and it worked! I congratulate them for standing firm with their convictions and working hard to bring the needed change.

 

Feds seized documents from Mar-a-Lago in June with grand jury subpoena

https://edition.cnn.com/2022/08/11/politics/mar-a-lago-search-subpoena-latest/index.html

Remember that not only did trump lose his security clearances but Biden removed him from being able to receive or attend security / intelligence briefings or meetings.   Biden cited his erratic behavior.    https://www.thefocus.news/lifestyle/did-trump-lose-his-security-clearance/

An aerial view of President Donald Trump's Mar-a-Lago estate is pictured, Wednesday, August 10, 2022, in Palm Beach, Florida.

 

Staff allegedly took down an Escambia County teacher’s posters of Black heroes. He quit

https://www.pnj.com/story/news/local/escambia-county/2022/08/10/escambia-county-florida-teacher-said-pictures-black-american-leaders-removed-his-class/10276112002/

Do we need anymore proof of the complete racist white privilege Florida maga sponsored by DeathSantis is pushing.    Read to the end to see the attitude of the white woman who told him that Former President Obama was not age appropriate to be posted on a bulletin board in a majority black school.   These people don’t even feel the need to hide it anymore.   We have to stop this spread, remember DeathSantis is the favorite for the republicans in 2024.    Hugs

An Escambia County public school teacher resigned this week over what he characterized as racist behavior by a school district employee.

The teacher, Michael James, emailed a letter to Gov. Ron DeSantis and Escambia County Superintendent Tim Smith in which he wrote that a district employee removed pictures of historic Black American heroes from his classroom walls, citing the images as being “age inappropriate.”

Images that were removed from the bulletin board at O.J. Semmes Elementary School included depictions of Martin Luther King Jr., Harriett Tubman, Colin Powell and George Washington Carver, James said.

Michael James
 

“It really floored me,” James told the News Journal. “I’ve been teaching special education for 15 years, and it just really floored me when she did that.”

James chose the board’s theme because the majority of the students and the residents in the neighborhoods that surround O.J. Semmes are Black, and he wanted to motivate his students with inspirational leaders they could easily look up to and see themselves.

James, 61, of Daphne, Alabama, sent his letter to the governor Monday night. He officially resigned from his position as an exceptional student education teacher at O.J. Semmes Elementary School on Tuesday morning.  

His resignation came in the midst of a national teacher shortage, a day before the start of the new school year Wednesday.

 

Doing whatever it takes:Desperate for more teachers Escambia County schools suspends new-hire, tobacco-free policy

Superintendent Smith said teachers are permitted to decorate their classrooms with educational materials and he was unaware of any policies that would prohibit a teacher from displaying pictures of inspirational American heroes on their walls.

Smith said a full investigation of the incident, which he called an “anomaly,” has been launched.

Charlie Crist, who is running for the Democratic nomination for governor to challenge DeSantis in November, blamed the governor’s “culture wars” for politicizing Florida’s public schools.

“This is the sad reality of Ron DeSantis’s Florida — a teacher, in a predominantly Black community, comes into their classroom to see posters of historically Black American heroes, including President Obama, taken down for being ‘inappropriate’,” said Crist in a statement by his campaign.

“DeSantis’s culture wars are infiltrating every corner of our state, and it’s Florida’s students who are paying the price.”

Crist, currently a U.S. congressman from St. Petersburg, is running against Agriculture Commissioner Nikki Fired for the Democratic gubernatorial nomination.

Escambia County Public Schools spokesperson Cody Strother provided the News Journal with an official statement on behalf of the school district.

“Our office was made aware of this employee’s resignation and his stated reasons for resigning very early this morning, Tuesday, Aug. 9, 2022,” the statement read. “Around the same time, we were copied on an email written by this individual and released to the Governor’s Office and various media outlets before we had any opportunity to investigate. We are now in the process of conducting a full investigation. If these allegations are deemed factual, we will certainly take corrective action, as it is our aim that all of our teachers feel valued and supported.”

Controversy:Santa Rosa school board candidate: Doctors who help trans kids ‘should be hanging’ from tree

 

The district has yet to confirm the identity of the district employee who James alleged removed the pictures from his classroom walls, but in his letter James stated the employee worked as a board certified behavior analyst for the school district.

Above the pictures of the Black leaders, a copy of the Pledge of Allegiance was pasted in the bulletin board’s upper right hand corner, James said.

“Am I to believe Escambia County Schools employs those that dislike African Americans and are against swearing allegiance to these United States of America? Is there a dislike in anything that states ‘One Nation Under God’ in it?” James wrote, in his letter to the governor and superintendent.

James said he could not work for a school, or under the umbrella of a school district, that would hire people who would condone such behavior.

“I hate to say this about everybody in the staff or the leadership there, but something is not right,” he said. “Something needs to be changed or fixed.”

James previously taught at schools in Hawaii, Georgia and Alabama. It was going to be his first year teaching in Florida.

In his letter, he explained he recently purchased approximately $58 of school supplies with his own money at the Teacher Store in Pensacola.

“With these school supplies purchased, I spent several hours making a classroom bulletin board located behind my desk,” he wrote.

On Monday, the behavior analyst and another behavior coach entered his classroom to help him set up the room.

“That is kind of unusual, but that’s OK,” James recalled thinking. “They came in, and we started moving tables around and swapping some out, and I had made the bulletin board a couple of days earlier.”

 

As an ESE teacher, James was employed to teach students ranging in age from kindergarteners to fifth-graders. The bulletin board was on the wall directly behind his desk at the front of the class.

It contained about five to seven images of Black historical figures, as well as the Pledge of Allegiance. The individual pictures were about the size of a piece of paper, with short written passages on them explaining the achievements of each person.

“I was sitting down in one of the children’s chairs cutting something out, and I turned around and saw her start taking something off the bulletin board,” James recalled.

When he questioned what the behavioral analyst was doing, “She said something along the lines of it wasn’t age appropriate. Something like that,” James said.

James does not remember the woman mentioning race while taking down the photos. But he did note that she had also seized a picture of former President Barack Obama that he had placed near his desk because there wasn’t room on the bulletin board.

 

“She picked it up and said, ‘You don’t need to put this up either,'” James recalled. “She said — I can’t remember exactly what she said — but she said, ‘the kid are too young or something like that. It floored me. I thought, ‘This is the first Black president.'”

The behavioral analyst’s general demeanor and attitude made James feel like she had authority at the school, he said.

“I don’t know who guided her or why she took that on her own. I’ve never seen that in 15 years — just completely take down my board — without asking or anything,” he said.

In his brand new work environment, James didn’t know what to say or who to go to in the moment.

 

“I didn’t say anything else. I honestly let it go, but got to thinking about it and got pretty upset,” he said. “I could have just sent it the principal. But things need to get done. A lot of times people can just sweep things under the rug.”

His lack of institutional knowledge at his new job and what he characterized as the “rundown” state of the O. J. Semmes Elementary School building compelled James to go straight to the top with his complaints.

James said the school is in poor shape and he believes that it is treated as a lower priority because many of the students are Black children from low-income families.

“I feel like sometimes they are taken advantage of and no one is speaking for them, and that school — there is no way with the Florida lottery — that it should look like that. I’m wondering what kind of equitable division of money is being done for that school compared to other schools in other wealthier areas of Pensacola or Escambia County,” he said.

Currently, teachers are in demand everywhere, and James is not too worried about finding a new job.

“I’ll be teaching somewhere in a month,” he said. “I have excellent credentials.”

I’m at a loss to understand the mental gymnastics the mind has to go through to think that black American history is age inappropriate, other than it comes from the mind of a racist.

 

You answered your own question. Start with a conclusion, then walk backwards

10). White people are perfect
9). And the black people thanked god whites people were there to rule over them .
.
.
1). Blacks are lesser humans at best.

 

as if they believe that toddlers don’t become black or brown until a certain age …

 

But if you give them hopes, and goals, they get uppity. Best to keep them ground down from the beginning.

 

If you don’t give people hopes and goals, then they don’t get uppity when you try to take them away because they never had them in the first place.

All about whitewashing history to the point that the Nazis are the good guys

 

This will keep his poll numbers up in the panhandle.

Jesus fucking christ, they are on an absolute RAMPAGE to rewrite history and write black folks right out of it. Fucking Orwell’s spinning corpse should be connected to a turbine to solve global energy shortages.

Welcome to the new Klan, same as the Old one.

Keep in mind, if the governor of Florida and his fellow Republicans across the country hadn’t demonized education and black experience to the point where many have criminalized the concept of Critical Race Theory, the racists wouldn’t feel empowered to cancel race in the classroom.

Absolutely no doubt about DeathSantis attacking education in Florida.
The bastard took State Education funds to pay for “private” schools. The KKKrist-O-Fascist population jumped at the opportunity for indoctrination, grooming and kiddie diddling Priests.

Just gonna get worse and worse.
The christians know the Supreme Court has their back.

 

Indeed. Right down to Gorsuch lying about the facts in the cases in order to find for the xtians.

I’m genuinely shocked at this, though perhaps I shouldn’t be. The ridiculous white nationalism / Nazi shit is progressing faster than I had expected.

 

I managed to get most of it outside the car

I am not having a good morning at all.    Thank dogs that love gravy for Ron.  I had to go have my blood drawn and pee in a cup for my labs the doctor wants for my appointments Monday and Tuesday.   My plan was to get up about 6 or 6:30, drink some water and go to the hospital outpatient lab.   

My pain levels were so bad by 4:30 I couldn’t stay in bed.   So I got up.   I had a long time to wait so I had a cup of black coffee, no sweetener.   And a big glass of water.    I took my morning pills.   Had a second coffee and large glass of water.   I had to pee but that was OK as I had to wait a couple hours before the lab opened so I would need to pee again anyway.      

For a while now I have been getting nauseous some mornings.    I have developed a very bad habit years ago of taking all my morning pills all at the same time along with my morning pain pills.     Some of them call for taking with food but I have ignored that for years.   Now with my dieting I am doing it more often, taking them with no food.    That is now upsetting my stomach some mornings.

So one last factor of my bad morning.  Next to the hospital is a school.   Both younger and even younger kids.   In the morning the line of parents trying to get into the school parking lot to drop off kids stretches from the main road in front of the school for blocks blocking the far right lane for at least two stop lights.   This is a three lane road.   It used to be you could stay in the middle lane and after the entrance to the school move into the far right lane to get to the hospital entrance which is a block further down the same main road.   The entrance to hospital is off the side road between the school and the hospital and now they have opened the school parking lot to drop off kids on that road as well.   I did not know this.   I was in the middle lane which was stop and go and wondered why that was happening and seen the far right lane blocked with traffic all the way to the side road entrance and then further into the school parking lot as cars waited to drop kids, move one car forward, wait to drop, move one car forward.    Lucky the side road is two lanes so once on the side road you can get around the line of cars going into the school.   The problem is you must be in that far right lane to make that turn onto the side road.   Below is a snip of the area I am talking about.   The blue line is the far right lane before the school and the turn into the side road, then the hospital.   The line of cars to get into the school started further than I could show on the map.   I was luck to be able to get over into the far right lane right after the middle large entrance to the school, but again the line of stopped cars waiting to drop off their children went along the blue line which was my route.   

cape coral hospital

From there my morning got a lot worse.   It took me nearly 30 minutes to go that short distance as cars would drop kids off, then everyone in line moved up one car, and repeat.  Of course these are younger kids so they don’t get themselves gathered up and out of the cars quickly.  The entire time I was getting sicker and sicker, waves of nausea washing over me.   Every time I moved the car a bit then stopped I was in danger of vomiting.   I just hoped I could get to the hospital parking lot in time.  

I got to the side road and moved out of the line of cars and moved in to the left lane to turn into the hospital and was in real destress, I was going to vomit.   I drove into the parking lot, and as fast as I could I pulled into a space and put the car in park, reached to open the door … and as the door was opening I vomited hard.   While I was able to direct most of it downward to the road the door was not widely open and so I got vomit on the door, the floor door sill, my cane that rests there next to the door, my hand, grossly some on my long hair.    I had to back the car up to be able to step out.   As I got out of the car I managed to move around the door trying to get to the grass next to the sidewalk in front of the car.   I did not get there.   By the first step I was again vomiting.   Lucky no one was walking on the sidewalk or I would have gotten them also.   I went to the hatch and got a towel Ron leaves there and using one of the bottles of water rinsed my hand and dried it.   I wiped my hair.  Wiped my cane.   Lucky my shirt was spared and the hospital still uses masks so my face would be covered.   Then started to wipe down the door and other spots.   The bending down triggered the need to vomit again and I stepped out of the car and soaked the area between my car and the one next to it.    Whoever parks in either spot and has to get out on that side of the car is going to hate / curse me.  

But never fear my day was not over with being shitty.   Just inside the entrance to the hospital is a set of bathrooms.   They are single person use so I waited until the men’s was free.   That is where the shitty part comes in.   A man exited the bathroom and I entered, and the smell hit me.   Good thing that fellow was in a hospital because something vital was dying inside him.  But I washed up as best I could include my cane and handle, while trying not to breathe.   I made sure I was as vomit free as possible and went to the lab check in.    When my turn came I went into the blood draw area, sat down where directed and chatted with the lab person as they got ready to take my blood.   She prepped my right arm, she stuck the needle in, filled the first of five vials, replaced it with the second one.  At this point the blood stopped flowing.   She tried to wiggle the needle, moved it around, twisted it a bit, and if you think I was happy you would be incorrect.  She slowly removed the needle in hope the blood would again flow.    She then tried the other arm.  I don’t know if the first try had made her nervous, but the second try hurt going in and was painful the entire time she was filling the vials.

  Now here is where I start thanking dogs that love gravy for Ron.   On the way home I called him and explained what happened.   He met me when I parked the car, he took all the stuff I had with me into the house and as I was getting out of the car returned with a small wash bucket and cloths.    I went to take them and he refused saying I should go in and rest while he would take care of it all.   He washed the insides of the car and got them all cleaned up, brought in the yucky towel and other stuff I got vomit on, put a new towel in the car.   Then after he got done he came in and got me a little food to settle my stomach.   And that was my morning.    Oh and the blood work coming back in seems good, the A1C is 6.6 down from 7.4 and all the results in so far look better than the results from last time.    Have a great day, I am going to go lay down.   Hugs