RAO Bulletin Update for Dember-Lot's of Information

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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.vawatchd og.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/Representat ive 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.defensel ink.mil/news/ Nov2007/d2007112 8ngr.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/Certific ationandComplian c/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.Regulati ons.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.Regulati ons.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-satisfacti on 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
Food and Drug Administration Home Page 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, U.S. Department of Veterans Affairs. 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.retirementlivin g.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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