BACK

RAO Bulletin Update
1 December 2007
 
 
THIS BULLETIN CONTAINS THE FOLLOWING ARTICLES
== CA Vet Homeowner ------------------- (Foreclosure Problem)
== VA Retro Pay Project [10] ----------------- (Deadline Missed)
== Wreaths Across America --------------- (National Campaign)
== VA Data Breaches [39] --------------- (Indianapolis Med Ctr)
== VA Data Breaches [40] --------------------- (VA Auditor Theft)
== VA Data Breaches [41] ------------------ (Lawsuit Mediation)
== Legislation of Interest [08] ------ (COLA/ Suicide Measures)
== Legislation of Interest [09] -------------- (NDAA & Medicare)
== CA Chula Vista Vet Home --------- (Construction Concerns)
== Mobilized Reserve 28 NOV 07 -------- (Net Decrease 2022)
== Veteran Charities Review [02] ------------ (VVA Solicitation)
== Social Security Myths] ---------------------------- (Insolvency)
== Nursing Homes [04] ------------------------- (CMS Worst List)
== VA Facility Expansion [11] ------- (Las Vegas Vet Hospital)
== Agent Orange Lawsuits [11] ------- (VA Win-Win Maneuver)
== VA Claim Backlog [13] ------------- (No Improvement FY 07)
== Medicare [05] ---------------------- (Long Term Cost Outlook)
== Vista Business Concerns ------- (Microsoft Image Impacted)
== Tricare Prime [02] --------------------- (New Website Options)
== PTSD [16] ------------------------------ (PTSD & Asthma Link)
== Overseas Holiday Mail [01] ------- (2007 1st Class Deadline)
== Shingles [04] ---------------- (Tricare Vaccination Coverage)
== VA Hospice Care [01] -------------- (Patients Living Longer)
== VA Claim Representation [04] ----------- (Gratis Assistance)
== DFAS 2008 COLA Pmts ------------------- (Pay Adjustments)
== Pennsylvania VSO Support ----------- ($450K State Funding)
== VA Benefits Video -------------------- (Video News Magazine)
== Retirement Tax Considerations [03] ---- (Inheritance/Estate)
== CA/Fed Disabled Benefits (0% SC) -------- (Entitlement List)
== CA/Fed Disabled Benefits (10% SC) ------- (Entitlement List)
== Veteran Legislation Status 29 NOV 07---- (Where We Stand)


Editor’s Note:  I have returned to the United States and can be reached
 at (760) 839-9003 until further notice.


How Much Is A Billion?
---A billion hours ago, humans were making their first tools in the
 Stone Age.
---A billion minutes ago, it was 104 A.D. and the Chinese first
 invented paper.
---A billion seconds ago, it was 1975 and the last American troops had
 pulled out of Vietnam.
---A billion dollars ago, it was only 3 HOURS and 32 MINUTES at the
 rate our government spends money.

 
CA VET HOMEOWNER OPTIONS:  Governor Arnold Schwarzenegger on 29 NOV
 launched a public awareness campaign to educate homeowners about options
 that can help them avoid losing their homes to foreclosure. The message
 he wants to get to California veterans and other homeowners is that
 lenders are willing to work with borrowers on finding a solution.  “Some
 of these homes could have been saved, but right now we are seeing
 homeowners who are afraid to even talk with lenders. In fact, loan officials
 have not been able to reach borrowers in more than half of all
 foreclosures”, he said.  The $1.2 million campaign - funded through existing
 consumer education efforts within the Business, Transportation and
 Housing Agency and the State and Consumer Services Agency - will:
• Inform borrowers about their options.
• Urge borrowers to work with lenders before foreclosure.
• Encourage the use of nonprofit housing counselors.
• Partner with local leaders and trusted organizations, like churches
 and community groups, to spread the message.

To assist California's veterans and active military personnel who are
 at risk of foreclosure, the Governor directed the state’s Department of
 Veterans Affairs to work with his non-traditional mortgage task force
 to address this issue.  The group will explore ways the CalVet Home Loan
 program can provide a fixed rate CalVet loan to active military
 personnel and veterans who qualify and currently have subprime loans. A half
 million Californians have subprime loans that will jump to higher rates
 within the next two years. Seven of the top sixteen metropolitan areas
 with the highest rates of foreclosures in the nation are in
 California, according to the latest data from RealtyTrac. Earlier this month,
 Governor Schwarzenegger announced an agreement with four loan servicers -
 representing 25% of the market - to streamline the loan modification
 process for subprime borrowers living in their home, making timely
 payments and likely to default when their loan jumps to a scheduled higher
 rate. All lenders are asked to subscribe to that agreement, which may be
 found at http://www.corp.ca.gov/notices/subprime.html.  Additional
 resources available for homeowners are:
• The "HOPE Hotline" (1-888-995-HOPE or http://www.995hope.org/), which
 provides free mortgage counseling 24 hours a day, seven days a week.
• A website with helpful information for prospective homebuyers, as
 well as homeowners who are experiencing difficulty in keeping payments
 current: http://www.yourhome.ca.gov/ and the Spanish language version:
 http://www.sucasa.ca.gov/.
[Source:  Imperial Valley News Finance Desk article 29 Nov 07 ++]


VA RETRO PAY PROJECT UPDATE 10:   Many retirees have been frustrated
 for months by a lack of information on the VA Retro Pay program coming
 from the Defense Finance and Accounting Service (DFAS). And for some this
 frustration turned to anger when a 15 NOV self-imposed deadline for
 DFAS was not attained. The deadline was to complete a review of pay
 records for 133,000 disabled retirees, that original pool of retirees
 potentially eligible for retroactive “concurrent receipt” payments was missed
 without explanation. The retro pay program, which so far has paid
 catch-up amounts worth $200 million to disabled retirees, has been marred
 by several missed deadlines and shoddy communication. But those failings
 will be addressed, a senior DFAS official vowed in a 28 NOV interview
 with Military Update. Monies due retirees resulted from a period when
 DFAS and the Department of Veterans Affairs were still debating how to
 implement Combat-Related Special Compensation (CRSC) and Concurrent
 Retirement and Disability Pay (CRDP). The pays were enacted in 2003 and
 2004 to begin to dismantle a ban on concurrent receipt of military
 retirement and VA disability compensation. VA and DFAS still struggle with the
 complexity of the payments, particularly with compensating eligible
 retirees retroactively. Individual retro payments so far have averaged
 about $1,800.

     DFAS and VA officials, when they launched the VA Retro Pay effort
 in SEP 06, said all payments would be made within a year. In August, as
 that year drew to a close, officials said all but 33,000 files had
 been reviewed. DFAS set a new deadline of mid-November to fully pay the
 original pool of eligible retirees, many of whom are owed thousands. DFAS
 officials now acknowledge that they didn’t have a firm grasp on the
 facts when they revised that deadline three months ago.  As of 15 NOV, a
 total of 48,760 files of disabled retirees still needed to have pay
 reviews completed to determine retro pay eligibility. Also, DFAS officials
 say they don’t have enough facts yet to set a new completion of
 payment deadline. Lee Krushinski, the senior executive has been acting
 director of operations for DFAS for three weeks, since replacing Patrick
 Shine who retired 31 OCT.  He said, “We have not met customer expectations.
 I personally find that unacceptable and apologize to all the VA
 Retro-eligible recipients.” Krushinski promises to address VA Retro Pay
 problems. One of his first steps is to improve communication. Letters are
 being sent immediately to all retirees with files being reviewed and to
 46,000 retirees whose files have been reviewed but have no back pay due.
 It is “just unacceptable” that these retirees weren’t informed
 earlier. Communication with our customers was not what I would call adequate,
 at all,” he said.

     The missed deadlines, and the inaccurate statements on progress
 made earlier by DFAS and VA officials, were blamed in part on a
 misunderstanding of data being supplied by Lockheed Martin, the contractor hired
 to review files and calculate payments. The payments reported by
 Lockhead often only partially compensated retirees for total retro pay due.
 For example, some retirees are eligible for both CRSC or CRDP and can
 switch between the programs each year based which will pay more for
 their personal circumstances. A retiree might be due two or three payments.
 DFAS officials had misinterpreted Lockheed’s monthly payment totals to
 mean total retiree pay files reviewed and cleared. This fooled Pat
 Shine before he retired. It also left Thomas J. Pamperin, deputy director
 of the VA compensation and pension service, misinformed. These two
 senior officials routinely briefed the media on progress with the program.
 Krushinski said he too misunderstood the data when briefed on VA Retro
 Pay just a few weeks ago. It was only after he “sat down with everybody
 and really went through the numbers, drilling into them, that I
 definitely saw the problems we have here.” Wrong numbers given “the media,”
 he said, “led many people to believe we were closer to finishing the
 project than we actually were.” Lockheed Martin personnel trained to
 screen retiree pay files have cleared 128,000 payments through 15 NOV. But
 only 84,300 potentially eligible retirees from the original 133,000 pool
 have had pay files reviewed. Lockheed has been told to raise the
 number of full-time personnel hired for the project by 16, to reach 98 in
 December, an official said. Another factor for November’s missed deadline
 was computer software developed to automate retro pay calculations. It
 had an error rate of 17% and had to be scrapped. “We really counted on
 that automation to allow us to get out of manual processing,”
 Krushinski said. DFAS officials couldn’t explain why that information wasn’t
 shared with retirees before now. [Source:  Stars & Stripes 1 Dec 07 Tom
 Philpott article ++]


WREATHS ACROSS AMERICA:  The Department of Veterans Affairs' national
 cemeteries will again participate in this year's annual Wreaths Across
 America initiative scheduled to take place at noon on Saturday, 15 DEC
 07.  That date marks the 16th anniversary of Maine wreaths being donated
 to decorate the graves at Arlington National Cemetery and the second
 year of a national campaign, dubbed Wreaths Across America, that will
 bring the same remembrance wreaths to over 230 National and State
 Veterans cemeteries and monuments across the nation. The Worcester Wreath
 Company has donated 5,000 wreaths for placement by volunteers on gravesites
 in Arlington National Cemetery, in a mission to Remember - Honor - and
 Teach the value of freedom in the world today.  Participants include
 veterans groups, companies, school children and individuals. The truck
 carrying the wreaths, flanked by a contingent of Patriot Guard Riders,
 is scheduled to arrive at Arlington National Cemetery at 9:00am.  The
 volunteers will then lay the wreaths, and a ceremony will be held at the
 Tomb of the Unknown Soldiers at noon. This year, all 125 VA national
 cemeteries will participate with wreath-laying ceremonies for six wreaths
 - one for each Service and one for POW/MIAs. The wreaths are made and
 decorated by the employees of Worcester Wreath Company.   Through this
 program, company president Morrill Worcester wanted to recognize
 veterans, active duty military, and their families.   For more information on
 this event, refer to: www.wreaths-across-america.org or
 http://wreaths-across-america.org/civil- air-patrol. html.
[Source: NAUS Weekly Update 20 Nov 07 ++]


VA DATA BREACHES UPDATE 39:   On the evening of 10 NOV thieves stole
 three computers from the offices of the Richard L. Roudebush Veterans
 Affairs Medical Center. The theft was discovered when staff reported to
 work on 12 NOV. It is not known how the thieves gained access to the
 locked offices at this time. The Department of Veterans Affairs Office of
 Inspector General is investigating the theft, in cooperation with local
 and state law enforcement authorities and the FBI.  One computer was
 used as part of a medical device to analyze data. The other two computers
 were used for office purposes. VA IT staff determined the date of the
 theft upon a review of when the computers were disconnected from the
 internal network.  The files of approximately 12 thousand patients could
 be affected. While it is likely that one of the office computers stored
 personally identifiable information of patients, the computers did
 have strong password protection as is the policy of the medical center.
  The Medical Center is in compliance with VA IT Security Policy. Back-up
 files at the medical center will allow VA officials to determine which
 patients_ information was potentially compromised, and VA is notifying
 these patients individually. There is no need for veterans to contact
 the facility on this issue unless otherwise notified.  The Department of
 Veterans Affairs will provide one year of free credit monitoring to
 people whose sensitive personal information may have been stolen in the
 incident. Should additional information become available during the
 investigation, the VA will notify those potentially affected.  Anyone with
 any knowledge of these stolen computers should contact the VA Police at
 317-988-2200.  [Source:  VA Press Release 14 Nov 07 ++]


VA DATA BREACHES UPDATE 40:  A man who purchased $5,600 in jewelry at a
 store in Tustin using three fraudulent credit cards was arrested in
 Los Angeles after a months-long investigation.  The investigation also
 uncovered from his home computer about 1.8 million Social Security
 numbers from the U.S. Department of Veteran Affairs, where he had been
 employed as an auditor. Veterans Affairs’ officials have said only 185,000
 numbers are at risk because many were repeated in the file. Tae Kim, 28,
 was booked at Orange County Jail and is being held in lieu of $1
 million bail after being arrested at a car wash in Koreatown, police said. On
 7 APR, two Asian men identified as Kim and Justin Hong, purchased
 jewelry from Jewelry Exchange at 15732 Tustin Village Way using three
 skimmed cards belong to three different victims. Kim was on formal probation
 and a search was conducted at his Los Angeles residence 14 JUN where a
 computer was taken as evidence. After a search warrant was obtained,
 police found the Social Security numbers hidden in a computer file. Kim
 had worked at the Veteran Affairs office since 2003 when he was a
 student at USC but quit in February of this year when he discovered a
 background check would be conducted. The U.S. Department of Veteran Affairs
 verified that Kim did not have permission to possess the Social Security
 numbers. Officials have notified several victims from Orange County,
 police said. Authorities from the Orange County District Attorney’s
 Office, LAPD and U.S. Marshalls have been attempting to arrest Kim since
 August. Kim is believed to be a member of Koreatown Gangsters, police
 said. He faces eight different charges, including commercial burglary,
 fraudulent use of an access card, identity theft, criminal street gang
 activity and computer access fraud. Justin Hong is in L.A. County Jail
 awaiting trial for a gang related murder. A warrant for his arrest is also
 pending filing with the court. For more information about VA data
 theft refer to
http://www.vawatchdog.org/va%20data%20theft%20news.htm. [Source: The
 Orange County Register Erika M. Torres article 16 Nov 07 ++]


VA DATA BREACHES UPDATE 41:  Lawyers for people who sued the Veterans
 Affairs Department over last year's data breach will begin mediation
 with government attorneys in the weeks ahead and will update the federal
 judge overseeing the case in early 2008. Earlier this month, U.S.
 District Judge James Robertson dismissed several aspects of the case but said
 the handful of plaintiffs sufficiently made the claim that the
 department failed to safeguard their personal information, as required by the
 Privacy Act. The action was brought to the U.S. District Court for the
 District of Columbia as a potential class-action representing each of
 the estimated 26.5 million veterans whose data could have been
 jeopardized in the incident. The FBI eventually recovered the stolen equipment
 and said the files were not accessed. The mediation must be verified by
 the court by 7 DEC, and a status conference will be held after a 60-day
 work period, Robertson said at a 28 NOV hearing. The Justice
 Department, which is representing the VA, previously asked that the case be
 dismissed.

     Federal privacy law requires agencies to establish appropriate
 administrative, technical and physical safeguards to insure the security
 and confidentiality of records to protect against any anticipated
 threats or hazards to their security or integrity. The plaintiffs alleged
 that the VA's failure to enact such protocols "left their personal
 information unprotected [and] caused them to suffer emotional and pecuniary
 harm." If the suit is successful, each veteran impacted would get a
 minimum of $1,000 in damages. The government sought to have the claim
 dismissed on the grounds that the veterans failed to plead intentional or
 willful violations of the act, according to court documents. That would
 require proving that the VA acted with something greater than gross
 negligence. "Clearly, the VA is eager to convince veterans that while
 egregious security breaches occurred, they suffered no harm," plaintiff Tod
 Ensign wrote on his Citizen Solider Web site. "At a minimum, all the
 veteran groups are committed to forcing the VA to adopt reforms that
 ensure this kind of privacy invasion doesn't occur again." American Civil
 Liberties Union Legislative Counsel Tim Sparapani said Robertson's
 decision to allow the lawsuit proceed is a wake-up call to the federal
 government. Safeguard the data you gather on the public and put it in a vault
 with protections like Fort Knox because the private data is like gold
 in identity thieves' hands. [Source: National Journal's Technology
 Daily Andrew Noyes article 29 Nov 07 ++]


LEGISLATION OF INTEREST UPDATE 08:  The President has signed into law
 (P.L. 110-111) the annual COLA adjustment for certain veterans benefits.
 The 2.3% hike is the same as the annual Social Security rate and
 military retired pay. The COLA applies to VA disability compensation
 payments, survivors' dependency and indemnity compensation (DIC), and a
 clothing allowance for certain veterans'.  The change becomes effective on 1
 DEC and will be reflected in checks mailed in early JAN 08. One
 example, the new basic monthly DIC rate for survivors of veterans who died of
 service-related causes after January 1, 1993 will increase to
 approximately $1,091 from $1,067. The President also signed into law a veteran
 suicide prevention measure (P.L. 110-110) that addresses training,
 screening and tracking of veterans at risk for suicide and other mental
 health illnesses. A large new study by Army researchers in the Journal of
 the American Medical Association (November 14, 2007) found significant
 levels of PTSD and other mental health concerns among combat veterans.
 The study concluded that the large clinical burden recently reported
 among veterans presenting to VA facilities seems to exist within months of
 returning home, highlighting the need to enhance military mental
 health care during this period. [Source: MOAA Leg Up 16 Nov 07 ++]


LEGISLATION OF INTEREST UPDATE 09:  The Uniformed Services Disabled
 Retirees  (USDR) organization is requesting veterans “TAKE ACTION” on the
 following:

This Tuesday, 4 DEC the 110th Congress will return to "work" after a
 14-day Thanksgiving vacation during which nothing was accomplished.
 Further, they intend final adjournment of the 1st Session on 21 DEC. That
 leaves 17 calendar days (maybe 15 work days if they work Monday-Saturday)
 for them to enact major money legislation to keep the government
 funded. Some of this important legislation directly affecting the retiree
 community includes:

1. Legislation to again defer the mandatory 10% cuts in Medicare
 reimbursements that will otherwise take effect this 1 JAN 08. Tricare
 reimbursement ratios are directly keyed to Medicare reimbursement ratios, so
 military retirees will take a hit whether or not they have Medicare.
 Many physicians have already stated that they will be unable to accept new
 Medicare patients and others will seek other lines of work.
2. The 2008 National Defense Authorization Act to authorize funding to
 the Department of Defense. This bill presently before a conference
 Committee requires agreement of that committee’s membership on the
 following:
• The Lautenberg amendment to prohibit increases in TRICARE fees for
 FY2008 and to express the sense of the Senate that military service is
 unique and that military members have earned their benefit by virtue of
 their service and sacrifices.
• The Nelson amendment to eliminate the SBP/DIC offset and accelerate
 30-year paid-up Survivor Benefit Plan (SBP) coverage to 1 OCT 07.
The Reid amendment providing full, immediate concurrent receipt to
 disabled retirees deemed “unemployable” by the VA retroactive to 1 JAN 05.
• An amendment by Sen. Lott concerning the Armed Forces Retirement
 Home.  This amendment would prohibit “privatization” of the Home into a
 non-government charitable institution.
• The Chambliss amendment to reduce the Reserve retirement age by three
 months for each 90 days served on active duty since 9/11/01.
• The Lincoln amendment to authorize Guard or reserve members to use
 their mobilization GI Bill benefits up to 10 years after separating from
 the Selected Reserve.

  At least one military department has already initiated planning to go
 to minimum manning by furloughing both civil service and contract
 employees. Certain factions in Congress seek to sabotage the 2008 NDAA by
 including controversial "hate crimes" legislation that has nothing to
 with National Defense. The reasons none of this important legislation has
 been passed boils down to politics where the anti-war faction has tied
 passage of just about all legislation to that issue whether or not
 that legislation has anything to do with the on going hostilities. So,
 beginning this Monday, 3 DEC, let's begin a telephone campaign to support
 passage of this important legislation. Make the phones ring all day,
 everyday. Using the below procedure, use any of the following toll-free
 numbers to call your Senators and Representatives concerning the above
 issues.
          1-800-833-6354 (provided by AMA)
          1-800-846-6225 (provided by AARP)
          1-866-272-6622 (provided by EANGUS)
          1-800-828-0498
          1-866-340-9281
          1-866-220-0044

1. When the Capitol Operator answers, tell her which Senate or House
 office you want.
2. When the office answers, tell the staffer that you are a constituent
 and that you want your Senator/Representative to support and vote for
 the following -

          a. Stop the 10% cuts in Medicare physician reimbursements to
 take effect 1 January 2008.
          b. Pass the 2008 National Defense Authorization Act as a
 "clean bill" without the non-relevant controversial "hate crimes"
 amendment. Support the Troops!

3. Provide additional information requested by the staffer. Generally
 this will be your name and ZIP code.
4. Be polite and courteous, remember the staffer is simply the
 "messenger".
[Source: USDR Action Alert 30 Nov 07 ++]


CALIFORNIA CHULA VISTA VETERAN’ HOME:  Lawmakers on 28 NOV opened a
 series of hearings on some of the problems that have plagued the 400-bed
 Chula Vista Veterans home, pledging to avoid a repeat of those mistakes
 as the state prepares to build several new facilities from Los Angeles
 to Redding by 2010.  “I'm fearful this could happen again,” said
 Assemblywoman Mary Salas, D-Chula Vista.  Salas and other lawmakers grilled
 state Veterans Affairs officials, including the top administrator and
 his aides, for more than three hours over the state's response to shoddy
 construction and the department's policy of dipping into general
 operating funds to cover repairs – a practice that may keep some patients
 from being admitted because of tight budgets. Tom Johnson, secretary of
 the California Department of Veterans Affairs testified that at no time
 was resident care or safety compromised.  Salas, the chairwoman of the
 Assembly Veterans Affairs Committee, said she plans to challenge the
 administration to flesh out more details of what went wrong, to hold
 contractors more accountable and to be more forthcoming on budget
 shortfalls.  “I wasn't satisfied with all the answers they gave, nor was I
 comfortable with all of their solutions,” she said later in an interview. “If
 we can't take care of the three homes we have, we have no business
 opening new ones until we get the systems in place to guarantee the
 operations of the veteran’s homes.”

     The department has asked the governor and lawmakers for $1 million
 in emergency funding immediately and an additional special allocation
 of $2.2 million in 2008-09 to pay for the shower repairs alone. Salas
 says she will support the request to avoid “punishing” current
 residents.  Salas expressed irritation that the state's general fund may have to
 cover costs that could be traced back to construction defects. The
 contractor has since gone out of business and the state is attempting to
 piece together claims against the company.  However, poor record keeping
 and lax oversight on the part of Veterans Affairs and the Department
 of General Services may prevent the state from collecting, legislators
 said.  Some defects also may have gone undetected for several years,
 which inflated maintenance bills, lawmakers charged.
Though he wasn't in charge at the time, Johnson candidly conceded that
 the department supervised the construction poorly, and audits have
 highlighted budget shortcomings. In response, the state has stepped up
 inspections at the current construction sites and two managers will be
 hired to oversee needs before the doors are open, Johnson said.

     “We are doing business differently from when the Chula Vista home
 was constructed,” Johnson said.
There was some sparring. Salas was armed with minutes from a 2001
 meeting that appeared to note maintenance problems then and contradicted
 some of the department's explanations yesterday.  She also pointed out
 that staff members had to forage through many unmarked boxes to examine
 some of the construction records. There was “no rhyme no reason” to the
 filing system, she said.  Lawmakers also are disturbed that state
 officials could not fully explain the status of the contractor's surety, or
 performance, bond designed to ensure quality.  Salas agreed that “the
 quality of care has not suffered” at the homes. However, she is convinced
 the department has had to limit admissions to stay within budget.
 There are 367 residents in the 400-bed home in Chula Vista, according to
 state figures.

     Located on a 30-acre site off Telegraph Canyon Road, adjacent to
 Sharp Chula Vista Medical Center, the Veterans Home of California, Chula
 Vista (VHC-Chula Vista), is the only veterans home located in coastal,
 urban Southern California. With views of the Pacific Ocean and
 downtown San Diego, VHC-Chula Vista’s location provides residents with
 numerous cultural and recreational opportunities. Completed in May 2000,
 VHC-Chula Vista is a long-term care facility providing options for
 Domiciliary - Independent Living, Licensed Residential, and Skilled Nursing
 Care. Employed physicians provide medical care in both the licensed
 outpatient clinic and the inpatient skilled nursing settings. Acute care is
 provided at either the La Jolla U.S. Department of Veterans Affairs
 Medical Center, or at the nearby Sharp Hospital in Chula Vista. Veterans
 desiring to be considered for membership must be residents of California,
 age 62 or older (or younger if disabled), and have served honorably.
 Veterans seeking admission should call 1-888-857-2146 or write to:
 Veterans Home of California, Chula Vista Attn: Admissions,  700 East Naples
 Court Chula Vista, CA 91911. [Source: Copely News Service Michael
 Gardner article 28 Nov 07 ++]


MOBILIZED RESERVE 28 NOV 07:  The Army, Air Force and Marine Corps
 announced the current number of reservists on active duty as of 28 Nov 07
 in support of the partial mobilization. The net collective result is
 2,022 fewer reservists mobilized than last reported in the Bulletin on 7
 NOV 07.  At any given time, services may mobilize some units and
 individuals while demobilizing others, making it possible for these figures to
 either increase or decrease.  The total number currently on active
 duty in support of the partial mobilization of the Army National Guard and
 Army Reserve is 70,859; Navy Reserve, 5,467; Air National Guard and
 Air Force Reserve, 7,243; Marine Corps Reserve, 7,310; and the Coast
 Guard Reserve, 361. This brings the total National Guard and Reserve
 personnel who have been mobilized to 91,240, including both units and
 individual augmentees. A cumulative roster of all National Guard and Reserve
 personnel, who are currently mobilized, can be found at
 http://www.defenselink.mil/news/Nov2007/d20071128ngr.pdf. [Source: DoD
 News Release 28 Nov 07 ++]


VETERAN CHARITIES REVIEW UPDATE 02:  The following was reported by Tom
 Waskovich, former Executive Director of the Special Operations
 Association:  “The last week I have received calls from the VVA soliciting
 money for homeless veterans and also a Navy affiliate wanting money to send
 packages to the troops.  I checked on both and our veterans and the
 public should be aware that after expenses such as mailings rent etc.,
 80% of the money being raised through these solicitations will be going
 to the telemarketer (i.e. if you donate a dollar , only 20 cents go to
 the charity). When anyone is solicited by phone it is recommended that
 they ask what percentage goes to the Charity and what percentage to the
 fundraiser so they can make a conscious decision on where to best place
 their contributions. [Source: twaskovich@hotmail.com Waskovich 28 Nov
 07 msg ++]


SOCIAL SECURITY MYTHS:  Following are five myths about the causes and
 impact of Social Security’s anticipated Insolvency:

1. Social Security isn't a big-deal problem because, absent any change,
 the system will be able to pay 75% of promised benefits in 2041. Even
 those reduced benefits would be larger, in real terms, than what
 current retirees receive:  Those numbers are correct; the implication isn't.
 Social Security represents the only source of income for one-third of
 elderly households and more than half the income for another third. No
 one wants to see those benefits suddenly slashed by a quarter -- least
 of all those who care about preserving what Franklin Roosevelt called
 "some measure of protection . . . against poverty-ridden old age."
Advocating thumb-twiddling as sensible strategy ignores the reality
 that acting sooner spreads the burden of change across more generations,
 allows changes to be phased in gradually and lets future retirees plan
 ahead.

2.  Social Security isn't a big deal because the shortfall is small
 (less than 2% of taxable payroll), smaller when measured as a share of the
 economy (less than 1%of gross domestic product):  The shortfall is
 small, and it's a lot smaller than the Medicare shortfall. But increasing
 taxes or cutting benefits by an amount equal to 2% of payroll shows
 only what it would take to make Social Security solvent if that change
 were made immediately. Even then, this is only the amount needed to shore
 up the program for the 75-year actuarial period, leaving it suddenly
 strapped for cash at the end of that time. Waiting decades would require
 a much bigger tax bite or benefit cut. Social Security isn't the
 biggest budgetary challenge, but it's the largest single federal program and
 the most easily fixable.

3.  Social Security isn't as big a deal as it was a few years ago
 because the insolvency date has been pushed back, from 2029 (the projection
 in 1996) to 2041 (the projection this year):  The projections have
 improved, but the problem remains. Those who thought Social Security was a
 significant problem in 1996 with insolvency projected in 33 years can't
 cavalierly dismiss the matter today with insolvency projected in 34
 years. The bottom line is that the long-run outlook has remained
 virtually unchanged for the last thirteen years.

4.  Social Security isn't a big deal because the trustees' projections
 are based on unduly pessimistic assumptions, including anticipated
 economic growth that is slower than has been the case for the past several
 decades: The projected slowdown in economic growth is based largely on
 the slower growth of the workforce, which is inevitable unless
 fertility rates or immigration soar beyond all predictions.
 Better-than-expected growth cuts both ways: It increases the amount of payroll taxes
 coming into the system but also the amount of benefits owed. Even if the
 economy were to grow significantly faster than predicted, that growth
 would push insolvency back by only six years. Weighing in the opposite
 direction: The trustees' projections on life expectancy may be too low --
 good news overall, bad for Social Security. Yes, the trustees'
 optimistic scenario shows Social Security solvent for more than 75 years, but
 that is so unlikely (fertility would have to return to pre-1970s levels,
 for one) that Social Security puts the chances at less than 2.5%.
 Furthermore, Social Security's intermediate projections are in line with
 those of other experts. "There is a greater than 99% probability that
 total outlays over 100 years will exceed total revenues," the Congressional
 Budget Office found last year.

5.  Social Security wouldn't be a big deal if politicians would stop
 raiding the trust fund for other purposes, such as financing President
 Bush’s tax cuts: This point conflates the Social Security shortfall with
 the larger question of fiscal discipline: using the trust fund to
 underwrite current spending (especially Bush's unaffordable tax cuts) and
 mask the real deficit. Eventually, the government's borrowing is going to
 have to be repaid, adding budgetary pressure at precisely the wrong
 time -- a strong argument for a more prudent fiscal policy. But Social
 Security would face the same shortfall even if the now-forgotten lockbox
 had not been picked.
[Source:  Washington Post Ruth Marcus article 28 Nov 07 ++]


NURSING HOMES UPDATE 04:  The Luther Home in Marinette and the Willows
 Nursing and Rehabilitation in Sun Prairie are among the "54 worst
 nursing homes in the nation," according to a new study by the U.S. Centers
 of Medicare & Medicaid Services. U.S. Senate Special Committee on Aging
 Chairman Herb Kohl (D-WI) commended the public disclosure of the list
 by the CMS. The facilities named are enrolled in the agency's "Special
 Focus Facility" program, having exhibited a history of providing poor
 care to residents based primarily on the results of federally financed
 state inspections. Kerry Weems, acting administrator for CMS, said the
 list of nursing homes was released in response to a forthcoming nursing
 home bill crafted jointly by Kohl and Sen. Charles Grassley (R-IA).
 Disclosing the program participants, considered to be among the most
 troubled nursing homes in the country, is included in the bill that will be
 introduced in coming weeks. The Nursing Home Transparency and
 Improvement Act of 2007 would allow consumers timely access to accurate
 information on nursing homes - including the results of government inspections,
 the number of staff employed at a home, and information about the
 home's ownership. To view the complete list of the nation's worst nursing
 homes, refer to
 http://www.cms.hhs.gov/CertificationandComplianc/Downloads/SFFList.pdf. 
 [Source:  Small Business Times article 29 Nov 07 ++]


VA FACILITY EXPANSION UPDATE 11:  The Department of Veterans Affairs
 (VA) has awarded contracts for the next two phases of the new medical
 center under construction in North Las Vegas. The Phase II contract, for
 constructing foundations for the medical center and accompanying
 warehouse, was awarded to Whiting-Turner Construction Company, Las Vegas in
 the amount of $9,170,000.  Completion of this phase is scheduled for JUN
 08. VA awarded the Phase III contract in the amount of $47,800,000 to
 Clark Construction Group, LLC of Las Vegas for the design and
 construction of a new 100,000 square foot, 120-bed nursing home care unit which
 will be built adjacent to the future medical center. Completion of Phase
 III construction is scheduled for SEP 09. Phase IV construction on the
 main medical center is scheduled for completion in mid-2011.  In
 Nevada, VA operates two major health care systems -- the VA Sierra Nevada
 Health Care System in Reno and the VA Southern Nevada Healthcare System
 in Las Vegas.  In fiscal year 2007, VA facilities in Nevada treated
 about 40,000 patients, accounting for more than 2,400 inpatient admissions
 and nearly 435,000 outpatient visits.  The current project is a result
 of VA’s Capital Asset Realignment for Enhanced Services (CARES) plan,
 which included the recommendation to construct a new VA medical center
 complex that would include a 90-bed inpatient hospital, 120-bed nursing
 home care unit, and a large outpatient clinic to meet future demand.
  Ground was broken for that facility in OCT 06. Funding necessary to
 support the contracts was authorized and appropriated in FY 2006. [Source:
 VA News Release 28 Nov 07 ++]


AGENT ORANGE LAWSUITS UPDATE 11:  On 19 NOV Acting VA Secretary
 Mansfield approved a notice for publication in the Federal Register to rescind
 provisions of its Adjudication Procedures Manual, M21-1 that were
 found by the U.S. Court of Appeals for Veterans Claims (CAVC) not to have
 been properly rescinded. The notice can be reviewed in the 27 NOV issue
 (Volume 72, Number 227) Page 66218-66219.  The notice in effect says
 that since a 2001 change to the manual’s 1991 provisions has been ruled
 illegal by the CAVC it would be further changed if the VA lost their
 appeal to this ruling.   The provision in question allowed veterans who
 received the Vietnam Service medal and served offshore in Vietnam during
 that war the presumption of exposure to Agent Orange in accordance with
 a 1991 ruling of the Veterans Court.  The VA subsequently changed the
 rules in their M-21 manual in 2002 taking away this right which brought
 on the Haas v. VADC-Nicholson lawsuit which the VA lost and is
 currently appealing.  Now the VA is seeking to correctly alter the M-21
 provisions by giving notice and a time for comment as required when an agency
 makes a “substantive change”.

     The VA is in effect trying to wipe out both the 1991, and 2002
 M-21 manual  provisions laying the groundwork for a new provision which
 will allow the VA to continue denying Blue water Navy the
same rights as their fellow veterans who received the Vietnam Service
 medal. And at the same time they say that if they win their appeal to
 the Federal Courts, they will withdraw this change and keep the M-21
 change of 2002 which denies presumption of exposure.  Bottom line either
 way NO COMPENSATION for Blue Water Navy veteran’s Agent Orange related
 disabilities.  Veterans are encouraged to exercise their right to comment
 on the change.  Written comments must be received by VA on or before
 28 JAN 08.
They may be submitted through online at http://www.Regulations.gov; or
 by mail or hand-delivery to the Director, Regulations Management
 (00REG), Department of Veterans Affairs, 810 Vermont Ave., NW. Room 1068,
 Washington, DC 20420; or by fax to (202) 273-9026. Comments should
 indicate that they are submitted in response to ``Rescission of Manual M21-1
 Provisions Related to Exposure to Herbicides Based on Receipt of the
 Vietnam Service Medal.'' Copies of comments received will be available for
 public inspection in the Office of Regulation Policy and Management,
 Room 1063B, between the hours of 08-1630 M-F (except holidays).  To
 review call (202) 273-9515 for an appointment. In addition, during the
 comment period, comments may be viewed online through the Federal Docket
 Management System (FDMS) at http://www.Regulations.gov.  [Source:
 http://www.valaw.org Editor Ray B Davis Jr. 27 Nov 07 ++]


VA CLAIM BACKLOG UPDATE 13:   New records show the Department of
 Veterans Affairs fell further behind this year in its attempts to give
 veterans timely decisions on their disability claims,.  The latest numbers
 are in an annual report the VA prepares for Congress detailing a range of
 short- and long-term goals for its disability, health and other
 benefit programs. Overall, the agency either has fallen behind or has made no
 progress in improving its performance in more than half of what it
 lists as its key goals. In the benefits measure the VA has said is ''most
 critical to veterans'' -- the speed of processing disability claims --
 the agency lost ground for the third year in a row. Moreover, McClatchy
 News Service has found that the VA put a positive spin on many of its
 numbers and in two instances provided Congress with incorrect or
 incomplete figures. The agency said it took an average of 183 days to process
 a claim in fiscal 2007, longer than in any of the five years tracked
 in the report. Processing exceeded its 2007 goal of 160 days and its
 long-term goal of eventually reducing processing time to 125 days.

     Congress and veterans closely watch the time it takes the VA to
 process claims, and the agency has vowed in previous years to pick up the
 pace. When it was asked about its processing speed last year, for
 example, the VA told McClatchy that hiring new workers would help it
 increase production and decrease its backlog of claims in 2007. In fact,
 processing time increased by an average of six days, and the backlog of
 pending claims rose from 377,681 to 391,257, the agency's records show.
 The VA said this week that it was aggressively tackling the issue, hiring
 more than 1,000 workers, boosting overtime and revamping training. The
 agency also said it was receiving more disability claims than it had
 at any time in recent history, and that it had received more than it had
 expected in 2007. Beyond that, the agency said that meeting or
 exceeding its goals wasn't always the best measure of success. ''The VA sets
 goals to measure how we are doing so that we can continuously improve
 performance,'' said Bob Henke, the assistant secretary for management.
 ``We use goals to move and improve performance.'' But for Sen. Patty
 Murray (D-WA) the report is more evidence that the agency hasn't been
 upfront with Congress about its performance or its needs. Murray, a member
 of the Senate Veterans' Affairs Committee said, “It is extremely
 frustrating to hear the song and dance that we are doing better when the
 reality is we are not. I want to say I'm surprised. But I'm not.”

     In many sections of the report, the VA looks past the missed goals
 to put the best face on its efforts.
The VA reports that 95% or more of outpatient visits are scheduled
 within 30 days of patients' desired dates, a fact it's touted to Congress
 repeatedly. The agency's inspector general, however, found this year
 that only 75% of the visits it examined took place within 30 days. The VA
 said it didn't agree with that finding and was examining the issue. The
 VA also claimed that customer-satisfaction ratings by inpatients at VA
 hospitals are 10 points higher than ratings from private-sector
 hospitals. In fact, the number the agency used as a comparison is wrong, and
 as a result the advantage for VA hospitals is half as big as the VA
 claims. The VA said that the mistake was made by a transposition error and
 they will be fixing that as soon as possible. [Source: McClatchy News
 Service Chris Adama article 28 Nov 07 ++]


MEDICARE UPDATE 05:  The increasing cost of health care, driven
 primarily by the cost of emerging medical technologies, is a greater threat to
 the financial sustainability of Medicare than the aging of baby
 boomers, according to a recent Congressional Budget Office (CBO) report. The
 Long-Term Outlook for Health Care Spending, released this month by the
 CBO, projects that medical coverage for a growing aged population will
 account for only 25% of Medicare spending growth through 2030. On the
 other hand, the rapid growth of health care spending, rooted in the
 rising cost of medical technology and increased use of services, will
 account for 75% of Medicare spending increases through 2030, and 90% through
 2082. The CBO predicts that by 2082 spending on Medicare and Medicaid
 alone could account for one-fifth of the nation's gross domestic
 product. The projections, which were 50% higher than those released by the
 Medicare trustees, left federal regulations unchanged to demonstrate the
 long-term fiscal effects of current Medicare and Medicaid policy, which
 the report describes as “unsustainable”. The CBO recommends expanding
 research on cost-effective care and reimbursement methods that provide
 incentives for low-cost interventions and penalize providers who opt
 for high-cost and unnecessary care. According to Peter Orszag, director
 of the CBO, between 5 and 50% of health care spending could be
 eliminated without harming health outcomes, with 30% given as a common estimate.
 In response to the report, Senator Max Baucus (D-MT) and chairman of
 the Finance Committee, vowed to jump-start hearings on health care costs
 and methods to overhauling the health system. He concluded that
 finding ways to make the health care system more efficient and cost-effective
 will reduce costs for all health care users, public and private, and .
 . . will pave the way toward getting Federal spending truly under
 control.  [Source:  Medicare Rights Center Newsletter 27 Nov 07 ++]


VISTA BUSINESS CONCERNS:   Microsoft is struggling with business
 concerns over their Vista operating program. The majority of IT professionals
 worry that migrating to Windows Vista will make their networks less
 stable and more complex, according to a new survey. Ninety percent of 961
 IT professionals surveyed said they have concerns about migrating to
 Vista and more than half said they have no plans to deploy Vista.  "The
 concerns about Vista specified by participants were overwhelmingly
 related to stability. Stability in general was frequently cited, as well as
 compatibility with the business software that would need to run on
 Vista," said Diane Hagglund of King Research, which conducted the survey
 for systems management vendor Kace. The survey, echoing one from
 Forrester last week, shows most IT professionals are worried about Vista and
 that 44% have considered non-Windows operating systems, such as Linux
 and Macintosh, to avoid the Microsoft migration. "Clearly many companies
 are serious about this alternative, with 9% of those saying they have
 considered non-Windows operating systems already in the process of
 switching and a further 25% expecting to switch within the next year," the
 report "Windows Vista Adoption and Alternatives" reads.   Macintosh
 leads the pack of Vista alternatives, with support from 28% of respondents.
 About a quarter said they would opt for Red Hat Linux, with SUSE Linux
 and Ubuntu each garnering 18% of the vote. Another 9% cited other
 Linux operating systems and 4% were unsure.  IT professionals also said
 that virtualization is one of the technologies making a move away from
 Microsoft possible. About two-thirds reported that the use of
 virtualization has made it easier to implement an alternative. Yet heterogeneous
 systems management could be a barrier to going with a provider other than
 Microsoft, the survey found. Respondents reported that challenges
 include the need to manage multiple operating systems (49%) and the need to
 learn a different set of management tools (50%). Sixty percent manage
 their Windows systems with tools that don't support non-Windows
 environments.  "Almost half of all participants (45%) cited challenges with
 system management in non-Windows operating systems as preventing them
 from adopting" alternatives, the report states.  [Source: Federal Report
 11-20-2007 ++]


TRICARE PRIME UPDATE 02:  Tricare Prime and Prime Remote beneficiaries
 in the United States, including Hawaii and Alaska, can manage their
 health care online. Prime and Prime Remote beneficiaries can log on to
 https://www.dmdc.osd.mil/appj/bwe/ to enroll, disenroll, choose primary
 care managers, transfer regions, update personal information, add
 other health-care information and request enrollment cards.  The site also
 allows Standard beneficiaries to update personal information, add other
 health care information and enroll in Prime. The site’s link to the
 Defense Eligibility Enrollment Reporting System allows beneficiaries to
 update their personal information for both Tricare and DEERS at the same
 time.  Retirees can use their Defense Finance and Accounting Service
 “myPay” personal identification number, or family member account PIN.
 Enrollments and PCM changes are pending until approved, and approval may
 take up to six calendar days.  Beneficiaries can log on to the site to
 view the status of their account anytime and can cancel pending
 enrollments and/or PCM changes within 48 hours of initiating the transaction.
 To date, the US Family Health Plan, a Tricare Prime option, is not
 available for enrollment on this Web site.  In addition to the new Web
 service, enrollment forms are still available at
 http://www.tricare.mil/mybenefit/home/overview/Enrollment/WebEnrollment
 to fill out and mail to a Tricare regional office.  Beneficiaries can
 also visit a Tricare Service Center to enroll and get assistance with
 other health-care needs.  [Source: Tricare News Release No. 11-05-07 dtd
 16 Nov 07 ++]


PTSD UPDATE 16:  For the first time, a study has linked asthma with
 post-traumatic stress disorder (PTSD) among adults in the community. The
 study of male twins who were veterans of the Vietnam era suggests that
 the association between asthma and PTSD is not primarily explained by
 common genetic influences. The study included 3,065 male twin pairs, who
 had lived together in childhood, and who had both served on active
 military duty during the Vietnam War. The study found that among all twins,
 those who suffered from the most PTSD symptoms were 2.3 times as
 likely to have asthma compared with those who suffered from the least PTSD
 symptoms. The research was published in the first issue for NOV 07 of
 the American Journal of Respiratory and Critical Care Medicine, published
 by the American Thoracic Society. The study included both monozygotic
 (identical) twins, who share all the same genetic material, and
 dizygotic (fraternal) twins, who share only half of the same genetic material.
  The lead researcher Renee D. Goodwin, Ph.D., M.P.H., Assistant
 Professor of Epidemiology at the Mailman School of Public Health at Columbia
 University in New York City said, “If there had been a strong genetic
 component to the link between asthma and PTSD, the results between these
 two types of twins would have been different, but we did not find
 substantial differences between the two.”

     Several other studies have found a relationship between asthma and
 other anxiety disorders, Dr. Goodwin noted. This new research also
 confirmed previous findings that linked asthma with a higher risk of
 depression. She said, “No one knows the reason for the association between
 asthma and mental disorders. Asthma could increase the risk of anxiety
 disorders, or anxiety disorders might cause asthma, or there could be
 common risk factors for both asthma and anxiety disorders. Our study
 found the association between asthma and PTSD does not appear to be
 primarily due to a common genetic predisposition.” The researchers found the
 association between asthma and PTSD existed even after they took into
 account factors such as cigarette smoking, obesity and socioeconomic
 status, all of which are associated with both anxiety disorders and asthma.
 It is conceivable that traumatic stress, which has been associated
 with compromised immune functioning, leads to increased vulnerability to
 immune-system-related diseases, including asthma.  Dr. Goodwin and
 colleagues wrote, “Alternatively, it may be that having asthma places adults
 at increased risk for PTSD as it increases the likelihood that they
 will be exposed to a traumatic situation because they have a
 life-threatening chronic medical condition.  The findings suggest that a person
 with asthma who experiences a traumatic event may benefit from seeking
 professional help, because they could be more vulnerable to developing
 post-traumatic stress disorder.” [Source: Vets Voice 16 Nov 07 ++]


OVERSEAS HOLIDAY MAILING UPDATE 01:  According to the Military Postal
 Service Agency (MPSA), holiday letters and cards going first-class to
 military APO/FPO addresses overseas must be sent by Dec. 10 to arrive by
 Dec. 25, 2007. Each country has customs regulations that apply to all
 incoming mail, pertaining to everything from food items to reading
 materials. Military units may also have additional restrictions concerning
 incoming mail imposed by unit commanders relative to size and weight to
 ensure logistics support can handle the heavy mail load. And, all
 packages and mail must now be addressed to individual service members as
 required by U.S. Department of Defense regulations. For more information,
 refer to the MPSA website at http://hqdainet.army.mil/mpsa/. [Source:
 Military.com 26 Nov article ++]


SHINGLES UPDATE 04:  The Tricare website now includes the following in
 their Frequently Asked Questions section:

Does TRICARE pay for the shingles vaccine?  Ans: Yes. As of 19 OCT 07,
 Zostavaxa, the vaccine that helps reduce the risk of getting shingles
 (herpes zoster) is reimbursable under TRICARE.  The Centers for Disease
 Control and Prevention (CDC) recommends a single dose of the vaccine
 for adults age 60 or older regardless of whether they report a prior
 episode of shingles (herpes zoster). For more information on the vaccine,
 refer to FDA’s Questions & Answers on Zostavaxa
 www.fda.gov/Cber/products/zosmer052506qa.htm.  Tricare deuductable and copay will apply as
 follows:

• TRICARE Prime Beneficiary: As long as you get your shingles vaccine
 from your primary care manager you won’t be responsible for a deductible
 or copay.
• TRICARE Standard/Extra Beneficiary: You may get your shingles vaccine
 from any Tricare-authorized provider (network or non-network) who is
 licensed to give the vaccine. Standard/Extra deductibles and cost shares
 apply.
• TRICARE For Life Beneficiary: Medicare covers the shingles vaccine
 under Medicare Part D. If you don’t have Medicare Part D, Tricare will be
 the primary payer for the vaccine. You may get the shingles vaccine
 from any Tricare-authorized provider (network or non-network) who is
 licensed to give the vaccine. Standard/Extra deductibles and cost shares
 apply.
[Source: http://www.tricare.mil/faqs/question.aspx?ID=1741 19 Nov 07
 ++]


VA HOSPICE CARE UPDATE 01:   Hundreds of hospice providers across the
 country are facing the catastrophic financial consequence of what would
 otherwise seem a positive development: their patients are living longer
 than expected. Over the last eight years, the refusal of patients to
 die according to actuarial schedules has led the federal government to
 demand that hospices exceeding reimbursement care limits repay hundreds
 of millions of dollars to Medicare. The charges are assessed
 retrospectively, so in most cases the money has long since been spent on
 salaries, medicine and supplies. After absorbing huge assessments for several
 years, often by borrowing at high rates, a number of hospice providers
 are bracing for a new round that they fear may shut their doors. In the
 early days of the Medicare hospice benefit, which was designed for
 those with less than six months to live, nearly all patients were cancer
 victims, who tended to die relatively quickly and predictably once
 curative efforts were abandoned. But in the last five years, hospice use has
 skyrocketed among patients with less predictable trajectories, like
 those with Alzheimer’s disease and dementia. Those patients now form a
 majority of hospice consumers, and their average stays are far longer — 86
 days for Alzheimer’s patients, for instance, compared with 44 for
 those with lung cancer, according to the Medicare Payment Advisory
 Commission.

     The commission, which analyzes Medicare issues for Congress,
 recently projected that 220 hospices — about one of every 13 providers —
 received 2005 repayment demands totaling $166 million. The National
 Alliance for Hospice Access, a providers’ group that is lobbying for a
 three-year moratorium on the collections, places the numbers at 250 hospices
 and $200 million. Because fewer than a tenth of all hospice providers
 have faced repayment, Medicare officials suggest that management might
 have been an issue. But Lois C. Armstrong, president of the hospice
 access alliance, said that if the cap on Medicare reimbursements was not
 lifted, the availability of care would tighten at a time when demand for
 hospice care was exploding and when new research suggests it saves
 money for the runaway Medicare program. Medicare’s coverage of hospice,
 which began in 1983, has become one of the fastest growing components of
 the government’s fastest growing entitlement. Spending nearly tripled
 from 2000 to 2005, to $8.2 billion, and nearly 40% of Medicare recipients
 now use the service.  To be eligible, patients must be certified by
 two doctors as having six months or less to live, assuming their illness
 runs a normal course. They must agree not to bill Medicare for curative
 procedures related to their diagnosis. Medicare, which pays the vast
 majority of hospice bills, reimburses providers $135 a day for a
 patient’s routine home care. The hospice is then responsible for providing
 nurses, social workers, chaplains, doctors, drugs, supplies and equipment,
 as well as bereavement support to the family.

     Studies have reached various conclusions about whether hospice
 care actually saves money, especially for long-term patients. But a new
 study by Duke University  researchers concluded that it saved Medicare an
 average of $2,300 per beneficiary, calling hospice “a rare situation
 whereby something that improves quality of life also appears to reduce
 costs.” In 1998, Congress removed limits on the number of days that an
 individual could receive Medicare hospice coverage, a move that
 encouraged physicians to refer terminal patients. But lawmakers did not remove
 a cap on the aggregate amount that hospice providers could be
 reimbursed each year, a measure designed to contain the program’s cost. A
 hospice’s total annual reimbursement cannot exceed the product of the number
 of patients it serves and a per-patient allowance set by the government
 each year ($21,410 in 2007). For reasons that are not fully
 understood, problems with the cap have been most prevalent at small, for-profit
 hospices in Southern and Western states like Mississippi, Alabama and
 Oklahoma.  Those programs typically have had higher proportions of
 noncancer patients and, thus, longer lengths of stay. But the Medicare
 advisory commission’s analysis also determined that the average length of
 stay in the cap-busting programs was significantly higher for all types of
 patients, including those with cancer. Herb B. Kuhn, the deputy
 director of the Center for Medicare and Medicaid Services, said that finding
 was attracting attention at the center, which is eager to keep the
 hospice care benefit from morphing into a long-term care entitlement.

     Among the matters meriting review, he said, is whether doctors
 have been premature in certifying patients as terminal. Medicare has
 issued disease-specific guidelines for the certifications, which must be
 made by both a personal physician and the hospice medical director. A
 number of hospice providers said ethical and legal constraints would
 prevent them from discharging patients who outlived their profit potential.
 But some said they sometimes delayed admission for those patients with
 illnesses that might result in longer stays.  Like other providers,
 Richard R. Slager, the chairman and chief executive of VistaCare, which is
 based in Arizona and has programs in 14 states, said his company now
 aimed its marketing at cancer patients. After being hit with $200 million
 in cap charges over four years — the equivalent of a year’s revenues —
 Mr. Slager said he chose to close or sell 16 of 58 hospices.  Some
 providers have survived only by aggressively recruiting new patients,
 using this year’s Medicare reimbursements to pay off last year’s cap
 charges, while stalling for Congressional relief. [Source:  New York Times
 Kevin Sack article 27 Nov 07 ++]


VA CLAIM REPRESENTATION UPDATE 04:  The recent gathering at Sidley
 Austin, a firm with 1,700 lawyers around the globe, is part of a growing
 effort to provide free legal help to thousands of veterans returning from
 Iraq and Afghanistan who are trying to win disability benefits from
 the Department of Veterans Affairs (VA). At the meeting which was covered
 by video to beam the meeting to other big law firms from Boston to
 Seattle lawyers were getting a tutorial in the arcane vagaries of
 veteran’s law. "There are 100,000 veterans seeking benefits, and too many of
 them are waiting too long to get them," says Ron Abrams, who, with Bart
 Stichman, directs the National Veterans Legal Services Program, a
 non-profit group in Washington spearheading the effort. "These lawyers are
 going to treat these veterans the way they would treat their corporate
 clients." The approach marks the first time since the Civil War that
 attorneys have been recruited in large numbers to represent veterans. The
 lawyers hope their legal expertise will speed consideration of claims
 and result in better benefits for veterans, Stichman says. More than 50
 of the largest law firms in the USA and more than 400 attorneys have
 signed up. Stichman and Abrams hope to start assigning veterans to the
 attorneys early next month.

     Amanda Smith, an attorney with the Philadelphia-based firm Morgan
 Lewis, says many of the participating lawyers are Vietnam veterans and
 "are appalled at the circumstances that they find veterans in today."
 Besides the push by big law firms, law schools in states such as the
 Carolinas, Virginia, Delaware, Michigan and Illinois also are offering
 free services to veterans. Craig Kabatchnick, who worked as a VA appellate
 attorney from 1990 until 1995, launched a clinic last January for
 veterans at North Carolina Central University's law school, where he now
 teaches. "We had all kinds of veterans who were very disabled, litigating
 against trained attorneys like myself who were defending the VA,"
 Kabatchnick says. The VA would "win" if the claim was denied, Kabatchnick
 says. "Did we litigate to win? Absolutely. In cases where the veteran
 was representing himself, the VA win ratio was very high." Paul Hutter,
 the VA's general counsel, says its attorneys have an ethical obligation
 to fairly and justly review claims and settle meritorious cases
 quickly. “Our job is to ensure that veterans get the benefits allowed them by
 law," he says in an e-mail. Disability claims have increased from
 578,773 in fiscal 2000 to 838,141 this year, according to VA figures. There
 are about 407,000 pending. The average processing time is 177 days, the
 VA says. Traditionally, veterans have represented themselves or sought
 assistance from a service organization, such as the American Legion or
 the Veterans of Foreign Wars. But many of the caseworkers in those
 groups are overloaded with cases, Stichman says, and sometimes one
 volunteer oversees 1,000 veterans' claims.

     The approach has not led to quick compensation for veterans.
 Evidence supporting a veteran's claim — medical records or letters from
 colleagues — is not always submitted with the original claim. When that
 evidence is added later, it can lead to reversals or requests for
 reconsideration. That can add more than a year to the appeals process, the VA
 says. The Board of Veterans' Appeals either reverses or orders
 reconsideration of decisions made by VA regional offices 56% of the time,
 according to an analysis of VA figures by Stichman's group. Congress has long
 kept attorneys at arm's length from the veterans' disability process.
 Until last June, when federal law changed, paid attorneys could not
 work on cases until after a final decision by the Board of Veterans'
 Appeals. The VA is now considering regulations that would require all
 attorneys to pass a test in order to qualify to handle veterans' claims,
 according to Phil Budahn, a department spokesman.  Service organizations,
 including the Disabled American Veterans and Veterans of Foreign Wars,
 vigorously fought the change in law. They are now pushing to repeal the
 law and support requiring a test, arguing that lawyers could turn what
 is supposed to be a non-adversarial process into a litigious one. "The
 fear was lawyers will dominate, and they'll ruin everything," says
 Thomas Reed, a law professor at Widener University in Wilmington, Del., who
 began offering free legal services to veterans in 1997. Joe Violante,
 national legislative director of the Disabled American Veterans, which
 represents 1.3 million veterans, says trained volunteers from the
 service organizations are far more experienced at representing veterans'
 claims than the newly recruited lawyers.  "If the veteran is under the
 impression that an attorney is going to get their claim through faster,
 there's no proof of that," he says. Ron Flagg, a Sidley attorney involved
 in the pro bono veterans' project, says there are so many claims that
 the system is overwhelmed.  "Lawyers are not the cure to all ills," he
 says. "But this is a problem where lawyers can be helpful." [Source:
 USA TODAY Laura Parker article 27 Nov 07 ++]


DFAS 2008 COLA PAYMENTS:  According to Defense Finance and Accounting
 Service (DFAS) officials based on the increase in the U.S. Consumer
 Price Index, there will be a cost-of-living adjustment increase for retired
 pay and Survivor Benefit Plan annuities effective 1 DEC. The COLA
 increase will be reflected in the 2 JAN 08 payment.  Retirees being paid on
 an account where the retiree first became a member of the uniformed
 services before 8 SEP 80 and retired before 1 JUL 07 will receive a full
 COLA increase of 2.3%. The COLA increase for retirees being paid on an
 account where the retiree first became a member of the uniformed
 services on or after 8 SEP 80 will be as follows:
 
--  2.3% for those retiring before Jan. 1, 2007
--  2.3% for those retiring in the first quarter calendar 2007
--  2.3% for those retiring in the second quarter calendar 2007
--  0.2% for those retiring in the third quarter calendar 2007
-- No increase for those retiring in the fourth quarter calendar 2007
 
Retirees being paid on an account where the retiree first became a
 member of the uniformed services on or after 1 AUG 86 and retired on or
 before 1 JAN 07 but elected to receive a Career Status Bonus at 15 years
 of active service, will receive a COLA increase of 1.3%. Retirees being
 paid on an account where the retiree first became a member of the
 uniformed services on or after 1 AUG 86, retired on or after 1 JAN 07, and
 elected to receive a Career Status Bonus at 15 years of active service
 will receive COLA as follows:
 
--  1.3% for those retiring before 1 JAN 07
--  1.3% for those retiring in the first quarter calendar 2007
--  1.3% for those retiring in the second quarter calendar 2007
-- No increase for those retiring in the third or fourth quarter
 calendar 2007
 [Source: AFRN 21 Nov 07 ++]


PENNSYLVANIA VSO SUPPORT:  According to state Rep. H. William DeWeese
 (D-Waynesburg) Pennsylvania's four veterans' service organizations
 serving the state's 1.1 million veterans be able to provide expanded
 assistance and outreach through Veterans Services Officers (VSOs) under
 legislation that unanimously passed the House of Representatives 20 NOV 07.
  DeWeese noted that during the last few years, the federal government
 has not kept the promise of taking care of veterans. The legislation
 (S.B. 915), which now heads to Gov. Ed Rendell's desk, would provide
 $450,000 in state funding for fiscal year 2006-2007 to the American Legion,
 Pennsylvania Department of Veterans of Foreign Wars, Disabled American
 Veterans and the Pennsylvania Department of American Veterans to
 continue to provide VSO support to veterans who need assistance securing
 Federal Veterans Benefits. VSOs assist veterans and their families in
 obtaining federal veterans' services and benefits (medical, prescription, and
 disability payments, etc.). They do all of the paperwork and help the
 veteran or their family navigate the red tape associated with applying
 for and receiving federal veterans benefits. The funding will be used
 to cover salaries, wages, benefits, training, and equipment associated
 with the hiring and retention of accredited veterans service officers
 and associated support staff. In 2004, the average annual benefit for a
 Pennsylvania veteran without a VSO was $4,612 compared to $11,122 when
 represented by a VSO. Pennsylvania veterans received $1.1 billion in
 federal Veterans Administration compensation and pension benefits during
 fiscal year 2005.  [Source: Herald Standard article 25 Nov 07 ++]


VA BENEFITS VIDEO:  The Department of Veterans Affairs is using a
 monthly half-hour video news magazine to inform military members, veterans
 and their families about the benefits earned through their service. The
 American Veteran tells the stories of veterans who have taken advantage
 of the many benefits and services available to them. The series is
 produced by the VA’s Office of Public Affairs and the VA Learning
 University/Employee Education System. It is broadcast to VA facilities on the
 department’s internal network and around the world on The Pentagon
 Channel and community cable services. The program is available on the VA Web
 site, www.va.gov.  Click on “public affairs” and then “featured
 items.” It can also be viewed on the Web site for The Pentagon Channel at
 www.pentagonchannel.mil. The American Veteran is produced for veterans of
 all eras and includes stories of heroism and sacrifice. The December
 edition includes an interview with a survivor of the Bataan Death March
 in World War II and a profile of a Vietnam veteran who lost a leg in
 combat, but has become an award-winning athlete and singer. [Source: Oted
 16 Nov 07 ++]


RETIREMENT TAX CONSIDERATIONS UPDATE 03: 
Inheritance Tax - An inheritance tax is an assessment made on the
 portion of an estate received by an individual. It differs from an estate
 tax which is a tax levied on an entire estate before it is distributed to
 individuals. It is strictly a state tax. Ten states still collect an
 inheritance tax. They are: Indiana, Iowa, Kansas, Kentucky, Maryland,
 Nebraska, New Jersey, Oregon, Pennsylvania and Tennessee. Connecticut was
 phased out after 2005. In all states, transfers of assets to a spouse
 are exempt from the tax. In some states, transfers to children and
 close relatives are also exempt.

Estate Tax - The Economic Growth and Tax Relief Reconciliation Act of
 2001 (EGTRRA) phases out the federal estate tax that culminates in full
 repeal in 2010. On a much faster track, the Act repealed over four
 years (2002 thru 2005) the federal estate tax credit to which state estate
 taxes were tied. In most states, estate and inheritance taxes are
 designed in such a way that states faced either a full or partial loss of
 estate tax revenues as this credit was phased out. States could avert
 this loss of revenue by "decoupling." Decoupling means protecting the
 relevant parts of their tax code from the changes in the federal tax code,
 in most cases by remaining linked to federal law as it existed prior to
 the change.  Seventeen states and the District of Columbia have
 retained their estate taxes after the federal changes. Of these, 15 states --
 Illinois, Kansas, Maine, Maryland, Massachusetts, Minnesota, New
 Jersey, New York, North Carolina, Ohio, Oregon, Rhode Island, Vermont,
 Virginia, and Wisconsin -- and the District of Columbia decoupled from the
 federal changes. Two states -- Nebraska and Washington -- retained their
 tax by enacting similar but separate estate taxes. 
- Of these, 12 states acted to decouple from the federal changes.
 Illinois, Maine, Maryland, Massachusetts, New Jersey, Rhode Island, and
 Vermont enacted legislation linking their estate taxes to the federal
 estate tax as in effect before the 2001 tax bill.
- Minnesota, which passes a tax conformity package each year,
 explicitly elected not to change its estate tax to conform to the federal
 changes.
- North Carolina elected to decouple at least through 2005, and
 Wisconsin has decoupled through 2007.
- Nebraska decoupled by creating a separate state estate tax on estates
 that exceed $1 million based on the federal law before the 2001
 changes.
- Washington enacted a separate tax in 2005 with a somewhat different
 rate structure that applies to estates that exceed $2 million after the
 state's original decoupling was nullified in court.
- Five states and the District of Columbia will remain decoupled unless
 they take legislative action. In five states -- Kansas, New York,
 Ohio, Oregon, and Virginia -- and the District of Columbia, estate tax laws
 are written in such a way that the state will not conform to the
 federal changes unless it takes legislative action.
[Source: www.retirementliving.com/RLtaxes.html Jul 07 ++]


CALIFORNIA & FEDERAL DISABLED BENEFITS (0% SC): Veterans who are
 residents of California who are rated 0% overall disabled by the VA as a
 result of a service connected (SC) determination are entitled to the
 following state and federal benefits. This list was last updated OCT 06. For
 residents of other states the federal benefits are the same but the
 state benefits will be in accordance with that state's laws.  To determine
 what they are check the VA website associated with the state in
 question:

1. VA fee basis outpatient medical card for SC condition(s) requiring
 treatment.
2. Enrollment in VA Healthcare Priority Group 5 (no co-payment for
 healthcare; pharmacy co-payments required for NSC medications), or Priority
 Group 7 or 8 (co-payments required for both healthcare and pharmacy),
 depending on veteran’s income and net worth.
3. Eligibility for sensor neural aids—hearing aids, eyeglasses, contact
 lenses—for Purple Heart recipients and former POWs, without regard to
 whether the condition producing need for such is service-connected.
4. Eligibility for VA Nursing Home care for any (NSC) condition,
 provided income and assets are within specified limits.
5. Eligibility for Service-Disabled Veterans’ Insurance (RH).
6. Possible eligibility for special monthly compensation for loss or
 loss of use of a creative organ.
7. Possible eligibility for payment of annual clothing allowance for
 specified SC disorders resulting in need for prosthetic appliance or use
 of a wheelchair, or for certain skin conditions.
8. Possible eligibility for 10-point preference for Federal Civil
 Service employment. (Noncompensable (0%) disability must have been incurred
 in combat or have ascertainable residuals, 38 CFR § 3.357.)
9. Eligibility for 10-point preference for State of California
 employment.
10. Possible eligibility for Home Improvement and Structural Alteration
 (HISA) home modification grant.
11. Eligibility for CAL-VET College Tuition and Fee Waiver for children
 (Plan B).
[Source: CA Dept of VA website Nov 07 ++]


CALIFORNIA & FEDERAL DISABLED BENEFITS (10% SC): Veterans who are
 residents of California who are rated 10% overall disabled by the VA as a
 result of a service connected (SC) determination are entitled to the
 following state and federal benefits. This list was last updated OCT 06.
 For residents of other states the federal benefits are the same but the
 state benefits will be in accordance with that state's laws.  To
 determine what they are check the VA website associated with the state in
 question:

1. VA fee basis outpatient medical card for SC condition(s) requiring
 treatment.
2. Enrollment in VA Healthcare Priority Group 3 or Priority Group 6
 (veterans with multiple 0% conditions receiving compensation at the 10%
 rate, 38 CFR § 3.324). No healthcare co-payments required for either
 group; both groups pay pharmacy co-payments for NSC medications, except for
 former POWs.
3. Eligibility for sensorineural aids—hearing aids, eyeglasses, contact
 lenses—without regard to whether the condition producing need for such
 is service-connected.
4. Eligibility for Service-Disabled Veterans’ Insurance (RH).
5. Possible eligibility for special monthly compensation for loss or
 loss of use of a creative organ.
6. Possible eligibility for payment of annual clothing allowance for
 specified SC disorders resulting in need for prosthetic appliance or use
 of a wheelchair, or for certain skin conditions.
7. Possible eligibility for education or training under VA Vocational
 Rehabilitation (showing of marked employment handicap required).
8. Golden Access Passport for U.S. National Parks.
9. Eligibility for 10-point preference for Federal Civil Service
 employment.
10. Eligibility for 15-point preference for State of California
 employment.
11. Home loan guaranty funding fee exemption.
12. Possible eligibility for Home Improvement and Structural Alteration
 (HISA) home modification grant.
13. Eligibility for CAL-VET College Tuition and Fee Waiver for children
 (Plan B).
14. Possible eligibility for DMV Disabled Person Parking Placard.
15. If a 20-year military retiree, possible eligibility for CRSC.
16. Possible eligibility for the California Disabled Veteran Business
 Enterprise (DVBE) and the Federal Service Disabled Veteran Owned
 Business (SDVOB) programs.
[Source: CA Dept of VA website Nov 07 ++]


VETERAN LEGISLATION STATUS 29 NOV 07:   For a listing of Congressional
 bills of interest to the veteran community that have been introduced in
 the 110th Congress refer to the Bulletin’s House & Senate attachments.
  By clicking on the bill number indicated you can access the actual
 legislative language of the bill and see if your representative has
 signed on as a cosponsor. Support of these bills through cosponsorship by
 other legislators is critical if they are ever going to move through the
 legislative process for a floor vote to become law.  A good indication
 on that likelihood is the number of cosponsors who have signed onto the
 bill. A cosponsor is a member of Congress who has joined one or more
 other members in his/her chamber (i.e. House or Senate) to sponsor a
 bill or amendment. The member who introduces the bill is considered the
 sponsor.  Members subsequently signing on are called cosponsors. Any
 number of members may cosponsor a bill in the House or Senate. At
 http://thomas.loc.gov you can also review a copy of each bill’s
 content, determine its current status, the committee it has been assigned to,
 and if your legislator is a sponsor or cosponsor of it.  To determine
 what bills, amendments your representative has sponsored, cosponsored,
 or dropped sponsorship on refer to
 http://thomas.loc.gov/bss/d110/sponlst.html.  The key to increasing
 cosponsorship on veteran related bills and subsequent passage into law is
 letting our representatives know of veteran’s feelings on issues.  At
 the end of some listed bills is a web link that can be used to do that.
 Otherwise, you can locate on http://thomas.loc.gov who your
 representative is and his/her phone number, mailing address, or email/website to
 communicate with a message or letter of your own making.  [Source: RAO
 Bulletin Attachment 29 Nov 07 ++] 


Lt. James "EMO" Tichacek, USN (Ret)
Director, Retiree Assistance Office, U.S. Embassy Warden & IRS VITA
 Baguio City RP
PSC 517 Box RCB, FPO AP 96517
Tel: (760) 839-9003 when in U.S. & Cell: 0915-361-3503 when in
 Philippines.
Email: raoemo@sbcglobal.net Web:
 http://post_119_gulfport_ms.tripod.com/rao1.html
AL/AMVETS/DAV/FRA/NAUS/NCOA/MOAA/USDR/VFW/VVA/CG33/DD890/AD37 member

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